Dr. Shilpi Priyadarshini on Building Clinical Systems That Help Dentists and Patients Win

Speaker A: The decision making fatigue that a dentist experiences in the office seeps down into the daily life, into their personal lives. The best way to make sure that you are not this fatigued is to have clear clinical and operational systems. I want a dentist to be less and, uh, less needed in the office.

Speaker B: Welcome back to the Dental Economist Show. I'm your host, Mike Huffaker. If you're getting value from the show, please subscribe. And even better, leave us a review. It helps us bring more conversations like this one to the people who need them. Uh, today's guest has done something most clinicians don't. She stayed in the chair long enough to learn what great care actually looks like, then moved into leadership to build systems that could deliver it at scale across 40 plus locations. Now she's taken that experience to the DEO where she coaches dental entrepreneurs and develops clinical leaders across the country. Dr. Shilpi Priyadarshini is the Chief Dental Officer at DEO, the Dentist Entrepreneur Organization. Before that, she spent nearly 12 years at Jefferson Dental, most recently as Regional managing director overseeing 130plus providers across 40 locations. She holds a DDS from UCSF and a master's in Health Administration from San Diego State. Dr. Shilpe, welcome to the Dental Economist Show.

Speaker A: Mike, thank you so much. Thank you for an amazing intro. It, it just uplifted my heart and soul.

Speaker B: Absolutely, of course. Well, I've been looking forward to this conversation. You know, uh, you have the clinical credential and M the Ms. Mha, which is a combination that most dental leaders don't have. When you were at UCSF, did you imagine running a region of, uh, 40 locations and ultimately moving into the leadership role that you hold today?

Speaker A: Honest answer, no. I always wanted to, but dental school can be very overwhelming. You're trying to understand how to work with patients, people, the cavities, the different classifications in the mouth. My dental school period was a zip. We learned a lot, we partied a lot. But I am very humbled with the way the universe has spanned out its opportunities for me. But honest answer to your question, at that time, I did not see myself walking on this journey where I could help coach and mentor other people. I was the class president at UCSF for both the years, so I probably had a little bit of some traits lingering around that just bloomed over the years.

Speaker B: Just a slight bit of ambition there,

Speaker A: Just a little bit.

Speaker B: What was your initial impetus for getting the mha? What, what was kind of your thought process for why you wanted to pursue that?

Speaker A: That's a very interesting question. I always felt like I wanted to understand the business of a, uh, healthcare system. My father is a physician. He's a practicing physician. He's a head and neck surgeon at his times. He started to do his residency in ent, which kind of blurred into the areas of the mouth, especially when there was cancerous lesions. So I heard him, I saw him. I, uh, grew up seeing him take care of patients. But he had one single office. There were no fixed times. This was back in India about 35 years earlier. And I was very mesmerized with how things happen on the back end. If we were ever to create a formalized system for him, that was my initial interest in understanding the policies, the administration, what goes behind a, uh, business. I always wanted to become a dentist. There is a process as you come into the country to walk the path of becoming a licensed dentist. But in the meantime, I really took my time to understand and gain this skill set of what's happening in the background of running a successful healthcare organization.

Speaker B: Now, you spent nearly 12 years at Jefferson, and then you, about a year and a half ago, I believe, is that right? Made the move into the do as the chief dental officer. What was the pull? What was the attraction? Was there something that you wanted to do that you couldn't do inside one organization that you were able to do at the deo?

Speaker A: My CEO right now, Emmett Scott, I had the same conversation with him a couple months earlier. What I did in Jefferson is very, very similar to what I do right now. There is just a little change. The folks are different, the systems are different, the states, the countries are different, the people you're dealing with are different. So I felt like when I was in Jefferson, I was able to get a horizontal experience on how to manage a dental office, how to support and grow them. A dental office can never work in silos. They are all interlinked to each other. Even though you have departmental classifications, they are all linked to each other. So in Jefferson, I was able to understand the horizontal aspect of it. Every team, every department. What are the basics needed to keep them running? And then I took my experience and I came to the deo, where I am now able to double click vertically, go down deeper and deeper and deeper on how to develop the clinical systems. I do occasionally help doctors in the other realms of dentistry, but then, um, we have so many amazing coaches who are experienced and experts that now I get to develop my coaching techniques, my mentorship around how to develop doctors into mini leaders in their office.

Speaker B: Yeah, no, that's great. I Definitely want to get into the development and the mentorship, uh, piece in just a second. Before, before we do that, I'm just curious, you know, I've speak to a lot of people on this podcast and just a lot of people in the industry in general, and there seems to be this maybe common thought or prevailing thought that dentistry has a bit of a standard of care problem, um, that it's not necessarily clearly defined, that depending on the practice that you're working that a patient goes into or the providers that they see that, you know, you might get a different level of treatment, different diagnosis, which is also played in, I think, to some of the distrust that sometimes patients or consumers feel towards the dental industry. They'll see one provider and be upset with what they hear and go, well, I'm going to go get a second opinion. And it can vary widely with what the diagnosis and treatment that's recommended is with the next provider that they see. How do you think about standard of care? Is it possible to define it and make it where it's operational and not just aspirational?

Speaker A: So I don't think dentistry has a standard of care issue. I think we are at a lack of systems issue. So when you are in a dental school and you walk out that stage on your day of graduation, you know you're on top of the world. You feel like you own the world. That was me, by the way. You walk with your degree and you are a dentist right now, but the uh, actual learning to dentistry happens with your patients, when you see patients, when you encounter real life. So once you are in your office, there are so many things that shape the way you think, the way you practice for the next years in life. Number one, I think dentistry is a very lonely profession, Mike. A dentist speaks to hundreds of patients, but it is always a service, relation, conversation until and unless you are in a multi provider facility, you are the only dentist. You are handling all the patients, everybody in the office is coming to you, you become the firefighter and in the process you are solving so many other things which is just not dentistry related or dental care related. And there is this loneliness that starts seeping in which solidifies the way you started treatment planning and practicing dentistry in your earlier stages. So if we had a system that allows us or uh, that guides us on what are the things you need to be looking, how are the ways you could diagnose, what is the discipline that we can bring in when we are talking to patients about care? We will eliminate a lot of these issues. If I double Click on your question. There is a difference in standard of care within one organization. You might be looking into three different dentists in the same office, talking differently. And there is a standard of care among different offices once the patient steps out. In this situation, AI X ray analytics has been a huge advantage to get the process at least baseline standardized. Now your doctors are beginning to look at the same things. What you are looking on an X ray and what I am looking on the X ray is the same. And then we take it to the next track as to how are we diagnosing and treating it. But at least we are looking into the same annotations on the X ray.

Speaker B: You mentioned coming out of dental school and feeling on top of the world. And, uh, I've thought about that a bit and I've heard some folks say that coming out of dental school, you're really only equipped to do about 6% of like the total available dental procedures. And then, you know, you end up ideally having some mentorship with wherever you go next. But it still must be like that high must turn into maybe a bit of a low or at least like a significant amount of fear. I could imagine all of a sudden starting to see patients and going, am I actually prepared for this and am I going to do the right thing for the patient? With every desire to do so, but a fear that maybe you're not. How did you overcome that?

Speaker A: When you first started practicing every procedure in dentistry, you need at least 500 to 700 repetitions to build muscle memory. Some of those procedures you get to early on, like say a filling or a crown, these are procedures that you normally do. It's not uncommon that any new patient walks through your door might need a few fillings. And doctors tend to do that more and more and they develop the repetitions for it. But procedures like say an extraction or a, uh, root canal, if you don't do it in the first two years, you never are going to have the courage and energy to do it. So when I started, I was placed in a very high volume practice. But most of Jefferson General's offices are very high volume. They have a loyal, loyal pool of patients. Right. And I was in an office where I saw four generations of the same family.

Speaker B: Oh, wow.

Speaker A: So patients would wait for you, patients trusted you, patients wanted you to take care of them. And that is where I really learned to become a dentist. And it was an organization where mentorship came naturally. Everybody taught, supported and mentored each other. And that is probably the beginning of my journey as being a Mentor. You see one, you learn one, you teach one. And when I started seeing so many mentors, I started learning from them and I started teaching, too.

Speaker B: Uh, you mentioned a few minutes ago the impact that radiographic AI can have on how patients are treated. I saw somewhere that you had seen an increase in case acceptance from 38% to 71% through AI assisted workflows. That's a very significant number. What was breaking down before and what changed?

Speaker A: Mike, are you ready to be talking all night? Because I could be talking on this all night.

Speaker B: Sure. Sure. Let's go. Let's do it.

Speaker A: Okay, so let's role play a little bit. Okay, so you come in and you say, Dr. Shupi, my tooth is hurting. And at that point, I look into your mouth, I take the X rays, and I tell you, Mike, um, I know why your tooth is hurting. You need a root canal. Now your problem was pain. What did I just do? I gave you a new problem for your existing problem. You don't know what's the root canal. You don't know if it's going to hurt you. How much time off do you need to take? How much money is it going to cost you? So we started realizing that diagnosing and treatment planning was an internal situation. Communication, case presentation and building empathetic relationships with patients was the external situation. And together was what decided how good a clinician was. And this is also a part of what I do right now. Customized mentorship plans tailored to the strength of every doctor utilizing radiographic AI. Now, what we were able to do is develop systems for doctors to present the findings in a more quantifiable manner. Before AI, I told you, Mike, you have five cavities and you're like, oh, okay, Now I'm showing you the X ray and I'm telling you, Mike, the red is bad, the green is good. Look at how many greens you have. Great job. I turn off the greens, now we focus on the red. So there was a structure on how the information was delivered to patients. There is an FDA approved system sitting in front of you. So patients had trust on what the doctors are saying. All of a sudden, the computer monitor started becoming the problem lister and the doctor started becoming the solution giver. This was a game changer for me. Um, I coach this all the time. I say that as a clinician. You have to be a liger. Mike, do you know who's a liger?

Speaker B: Is that a lion combined with a tiger? Yes.

Speaker A: Yes.

Speaker B: Oh, yeah, yeah, yeah. Absolutely.

Speaker A: You get an ice cream. Mike, you answered Right. So it's an offspring of a lion and a tiger. It is strength and intuition together. So I tell doctors, you have to be a liger lucid. Be clear in your conversations, in what you're talking to. Patients do all the thinking inside. They do not know that you are confused. You are thinking of a second opinion. You are new on the feed. I intuitive G Gravitas. Your aura should be there before you come into the room and just linger on long after you leave. E. Empathetic. Are you empathetic to your patient's needs to what they're feeling at that time? Uh, what is their emotional status? Can they afford the treatment? Are they nervous? Or are you just being a robot and just repeating everything that you found? And R is resonant. If you can combine these characteristics as a clinician, then you are bridging relationships between every patient and the trust factor increases, which is a direct influence on case acceptance.

Speaker B: Let's play out your role play just a little bit more. So I come in and I'm in pain. And there's option A, which is the dentist tells me that I need a root canal.

Speaker A: Yes.

Speaker B: Now, I'm, um, in pain, I'm scared. And I'm thinking that this is going to cost me a lot and hurt a lot more.

Speaker A: Yes.

Speaker B: So that's the diagnosis. That's what should be the internal piece. What does it sound like to me with this system externally versus the other option, option A? So what would be the better path to put that patient at ease, to help them understand what actually needs to transpire?

Speaker A: So, in my experience, I feel you have a patient's attention for five to 10 minutes at the most. That is when they are alert. Every nerve in their body is alert, waiting to speak to you. If you lose the first 10 minutes of showtime, then they pull out their phone, they're on Instagram, and then you lose the connection. So the first, most important modification in any workflow that I recommend is be prepared before you enter the patient's room. You already have the X rays. Do you have the scan? Nowadays, everybody has a scan on every patient. Do the medical history review, come up with a tentative treatment plan. Now, when I go inside the room, Mike, I say, Mike, hi, I'm Dr. Shilpi. I am so sorry you're hurting. So you know that I know already. And then I immediately say, mike, I think I know what's happening in your mouth, and I already have a solution for it. Let me take a quick look inside the mouth, confirm everything, and I'll Explain you right away. That is when my showtime started. I caught my patient's attention. I made sure that my patient understands. I came prepared. Let us flip the scenario, Mic. I come in, I'm not prepared. I say hello to you, and now I ask you the same questions again, right?

Speaker B: So what's going on?

Speaker A: What's going on? And you're like, okay, I've already explained this. Then I'm clicking on the computer, I am logging on my laptop, I'm clicking stuff. What do you do, Mike? You take your phone out and you log into Instagram, and I have lost my patient. It takes me a few good minutes and some really dramatic tactics to bring you back into that zone of having a conversation with me. So first thing, I come in prepared. As soon as I enter, it is showtime. You are my audience. I jump into what was the problem? I make sure that you are resonating with my diagnosis. This was the pain. This is how it feels. And then we jump into the solution. Even when I am in solution mode, I am not talking about what is a root canal. I am talking about how convenient it is and how I can make it easy for you to get the root kid out. It's going to take me one hour. Mike, you're already here. I have done thousands of this. I'll be there with you. Together, let's take care of this. You're going to go back home and you're going to sleep so much better. A patient mirrors the doctor's confidence always.

Speaker B: I love that. So let me. Let me ask this question. There's a slight change of topic, but I feel like a lot of operators maybe feel this way, but they don't. They don't say it publicly. Is, Is the insurance system actually compatible with delivering the care that you want to deliver, or are we kind of papering over the, uh, a fundamental conflict there?

Speaker A: It is sad, right? It's just seeped into our systems. And when I say that I see so many providers basing their treatment plans on the covered insurance benefits. It is sad, but it's not uncommon. Insurance benefits were introduced in 1954. It was a union wage benefit. It was not a way for them to get health care. And at that time, these benefits were max 2000, $1500. But you could buy a car at $3500 at that time. Now, if you add inflation, the car price is 35,000. But our insurance benefits are still capped 2000 or 1500. So if this has become a soft narrative in the patient, in the doctor's and the clinician's mind. I don't blame them. It is what every patient walks into. But what we need to think about is separate the two things and then merge them. So a, uh, patient's benefits is not related to the most honest, the most comprehensive and preventative treatment plan you can come up with. Step one, let's not marry the two. Let's consider the patient's needs. Connect the mouth to the body. Make a treatment plan which is most preventative, because if you catch the decay right now, you are going to save the patient from a root canal and an extraction down the lane. I call it the delay to damage curve decay. Now may be a curedont or a resin infiltration, bigger filling, you do a composite slightly more root canal or a crown if you continue waiting extraction and implant. So can we come up with the most honest and preventative treatment plan for the patient? Tell the patient, Mike, I'm going to tell you everything that I see in your mouth. Don't be overwhelmed. I will sit down and I will make it all concise and repeat the information again. But I want to educate you. Once part one is done, move to part two. Understand their affordability, understand where they're coming from, and make a plan that can immediately improve their bacterial load and improve their quality of life. But what doctors often do is they jump to part two before doing part one, because there is this assumption that my patient's not going to do braces or clear aligners because they don't have benefits. But do they not deserve knowing what could be done for them?

Speaker B: Do you think it's possible, at, uh, real scale, to move meaningfully towards treatment first rather than benefits first, and what would have to be true for that to work?

Speaker A: I am an ardent soldier in that war. Wake up every morning, I wear my armor, and every doctor and every associate, every hygienist I meet, I say the same thing. And I tell them, borrow my confidence for your skepticism to this tech, this method until you start seeing the wins happening for you and your patients. And then you can return me my confidence at that time. Because you will have enough of your own. With enough coaching, with enough mentorship, with, with enough training on how to do the right things, we might be able to move the needle slightly, but can be completely eliminated. I'm not really confident, Mike. It's very, very deep seated. But there is another fact that I want to share. According to research, less than 3% of the patient population who have insurance have even maxed out their benefits. So we talk about benefits not being the reason or being the reason for patients not getting care. But if you look into research, maybe it's already seeped into us and we are playing victim without anything happening.

Speaker B: Let's, let's talk a little bit more about coaching and mentorship, which I had already in this, in the 20ish minutes that we've been talking. I can get a very good sense of your coaching and mentorship style. And it's very, very approachable and very understandable. You're now coaching dental entrepreneurs at CEO. What is coaching a dentist look like compared to somebody that's, you know, also the business manager?

Speaker A: I have multiple, um, dentist entrepreneurs whom I coach. They are my peers and I share with them strategies that has worked for me and I try to implement systems for them. I'm also the fractional chief dental officer to many organizations where I get to work with a slightly more integrated and penetrated capacity into the organization. If you ask me to summarize what I do, I specialize in creating customized systems and mentorship pathways for your organization. I try to be the TED Lasso of your office coach to the best. So a, um, great, great clinician might not be a great leader. So the first thing I do is I have my systems in place. I do clinical audits to figure out what are we doing well and what are we missing in terms of diagnosing and in terms of delivering care. I just did this audit this morning and we realized that the doctor is amazing in crowns and composites. But there were no implants diagnosed, no bridges diagnosed or, uh, no partial dentures diagnosed. So I went and I did a second deep dive on how many patients in just August were diagnosed with one missing teeth without the wisdoms. And they were 73 patients. So if you take an average of 50 to 60% conversion, 35 of those patients should have received a combination of either an implant or a bridge or a partial. So the first thing that started skimming upwards is the doctor is not confident in diagnosing missing tooth options. But the doctor is really good in composites and crowns. So I gave her amazing kudos. I told her, you're doing so well there, but this is the area of opportunity. That's my clinical audit. I do something called an avatar analysis. I want to coach to their best. I cannot tell you to talk like me. Your secret sauce is your personality. So I try to really understand what works for them, what are the things that is natural to them. And then I do the KPI audit numbers. the end of the day, it's healthcare business. Excellent. Dentistry is always leading to revenue. So is the revenue happening in the right manner? It takes me a good few weeks to completely conduct an audit to this level. And when I have the data, I start planning the mentorship pathway for the doctors and the hygienists. The operators in the office get a sneak peek. They walk alongside, but only for a certain point of time. And then we start digging deeper and deeper into the clinical systems. So very, very briefly, this is what I do. If you are the doctor or the dentist in the office, Mike, and you have five doctors, then I teach you to teach them.

Speaker B: I see. So, look, let me ask a question about the example of the doctor was great with crowns, but is not diagnosing missing teeth options when you share that information, say, hey, you're doing a wonderful job in this element, but there's a gap here. Are you met with, like, reluctance to change, defensiveness, maybe, you know, hurt feelings? How is it typically received and how do you overcome or get through to somebody that is initially adverse to receiving feedback and coaching?

Speaker A: I think, uh, knock on wood, I am getting better at that. As a coach and a mentor, I have to connect with people. I need to make them realize that I'm coming from the same side. So if I was physically with you, Mike, right now, coaching you, I, I wouldn't sit across on the table. I'm going to sit alongside on the table with you. Just a simple body language switch makes the doctor or, uh, the associate feel like this is a person along with me. So my first few sessions is never about what they are not doing. It's about learning more about them, asking them questions, understanding the support that they need, allowing them to really, really trust me. And then when I do dive in, the clinical audit is basically factual data. I'm not coming in and telling Mike, you your numbers are not looking good. You missed this and you missed that. I'm coming in with factual data, letting them know that I have done the same mistakes. Please use me as a launchpad. So doing the avatar analysis helps me understand the doctor. Doing the clinical audit allows me to do a quantitative conversation. I don't even go to numbers. The first few sessions are only about knowing, getting to know each other, and what can you do different with your patients. I met with a lot of resistance initially in my initial days of my career, but I think I'm learning from my own mistakes. Like I said, knock on wood. I haven't had anybody yelling at me for this one whole year. So I am at my happy Place.

Speaker B: Wonderful. So you talk about the systems that you have as a coach. You know, it's the clinical audit, the avatar audit, the number analysis. You mentioned a little bit earlier in the conversation when we were talking about standard of care that you don't think is necessarily a standard of care problem. You think it's a systems problem. What are some of the systems that people are often missing in their own practices?

Speaker A: If we talk about somebody who is. The moment you have another associate or a hygienist reporting to you, you have automatically become the chief dental officer of your organization. You like it, you don't like it. The roles and responsibilities are, uh, you are their supervisor, and you do have something called the moral supervisor liability, where you want to make sure that your doctors and your hygienists are well supported, coated, and the care delivered by them to the patients is of the utmost quality. So that is where the lack of systems happen. They have no way of auditing the work of their doctors and their hygienist. The only thing that is happening generally in the office is numbers. You did $5,000 yesterday, you did $3,000 today. The numbers is in no way an indication of what the doctor could do or what the doctor could not do. Are we auditing and marrying the operational systems in the office to the doctor's strength? For example, Mike, if you are my doctor, I am going to sit down and I'm going to try to understand with you and from you what are the things you like to do and what are the things that's a little tough for you. And then I'm gonna go up to my front office and my schedule builder, and I'm gonna tell them, for Dr. Mike, I need you to build 80% of his schedule with fillings and crowns. What does that do? You have a dopamine release on every successful patient outcome. Your schedules are predictable. And every time there is a dopamine release, what does it do to your confidence?

Speaker B: You want to do it again?

Speaker A: Exactly. What does your assistants look at you? Oh, this is an amazing doctor. Whoever patient we put on his schedule, he is able to complete it. So the first few months, give them what they are good at, coach them to what they are best. Now I have enough dopamine and confidence, I'm going to ask the doctor. Mike, do you want to now move into the next stuff? Shall we start with anterior root canals? Oh, yes, Dr. Shopee, let's do that. There is this process of mentorship that I want to establish in every office which a chief dental Officer might be missing. Are we communicating with them? Do they know that they are going to have regular audits, which is a part of us getting better, not them being in trouble? Has these things been established during the onboarding? Have you sat down and got an alignment with your doctor? If this is. If a patient comes in with sickle cell anemia trait, don't worry, doctor, we should be able to do all regular stuff. But if it is full blown sickle cell anemia, we want to be careful when we do the extractions. Have you had those conversations with the doctors? The next thing I know, your office manager says, Dr. Mike referred this patient. And you're like, how could he refer without talking to me? Did you have the alignment discussion with the doctor before even this situation surfacing out? I feel you can get away with not having good communications with your spouse, but you have to have good communications with your associates. You're spending more time with them.

Speaker B: You were talking about learning from some of your mistakes before. What's, uh, maybe the hardest lesson or just a lesson that you can reflect on, that you've had to learn as a clinician, that you now pass on to younger providers and those that you

Speaker A: coach that mistakes are going to happen. If you do enough dentistry, there will be a complication that does not define us. The first time I had a complication, it was 4th of July weekend in 2014, and I cried myself to bed the entire weekend. But it took me a, uh, good two weeks to regain my confidence and start doing those root canals again. Please don't do that mistake, everybody. When you do enough dentistry, there will be complications. What's important is, did you identify the complication and did you render support that makes us a good clinician. And the second most important thing, do not marry insurance. With the care a patient needs, the moment we marry them together, we are collapsing the entire system of us trying to help a patient. Give the patient the most honest treatment plan that you can come up with. Don't forget to be empathetic and get them to a plan that they can accept and treat themselves. But this, these are two parallel tracks initially that intersect down the lane.

Speaker B: You just made a comment about the doctors that succeed. You kind of referenced it through the lens of the complication experience that you had. What is the gap that you see maybe most often between clinical leaders who thrive and then those that stall or that they, maybe they don't grow?

Speaker A: Anybody who has thrived or has gone up the ladder has just become very, very good at basics. And your basics are Diagnosis. It might sound very simple, but diagnosing every patient appropriately is one of the most difficult things in dentistry. I can close my eyes and do a root canal. I mean, not literally, but you know what I mean? Um, I have developed the muscle memory I see from the eyes of my mind. But treatment planning is a whole different ballgame. Every patient comes to you presenting a unique arrangement given to them by the universe. Everybody up top there has really, really become strong and an expert in the basics of treatment planning and doing all the basic dental procedures and, and then being brave and upgrading their skill set every few years. It could be root canals, it could be extractions, clear aligners, implants, all on X, utilizing the most modern technology out there to bring it into your office. But you cannot have a closed mind. You are in the world of dental practice, and it is a practice for a reason. You're practicing all your life. You're trying to get better. The moment a dentist feels like I know it all, you're looking at stalling your growth.

Speaker B: You think the dentist that thinks that I know it all, or the dentist that is unwilling to pursue growth with adding new procedures. And now, now the root canals or implants, or all the different examples that you just laid out, the ones that are reluctant to do that, these are the ones that are more likely to burn out. Or is burnout something that can happen, uh, across the board to anybody? And how do you think about what really is the root cause for that, uh, challenge that exists in dentistry in a very real way?

Speaker A: Mike, if I haven't spoken about this yet, this is a concept that I believe strongly and I coach everybody. Decision making fatigue. A dentist experiences very high decision making fatigue. For example, Mike, in the course of this podcast, I have turned you into a dentist. So you are Dr. Mike for today. On a Friday afternoon, you have seen about 10 patients and you go home and, and your son says, dad, let's go out. And you're exhausted and you're tired. You're like, ah, uh, buddy, can we do it tomorrow? And he's like, no, please, let's go out and get ice cream. So you do go, but you are not mentally completely available. But if the same thing happens on a Sunday morning, you're going to be like, let's go, let's go to the park, let's go to the zoo. The decision making fatigue that a dentist experiences in the office seeps down into the daily life, into their personal lives. The best way to make sure that you are not this fatigued is to have Clear clinical and operational system systems. I want a dentist to be less and less needed in the office. Don't get me wrong, you cannot eliminate a dentist from a dental office. But I want them to have the operational systems, the technical systems in the office all sorted out in a way where there is a clear chain of command in the office. If something happens, there is a go to person and there is an owner. So that is managing an office. Let's talk about clinical skill set. I don't want to place an implant, that's totally fine. But can I make sure that I'm diagnosing them and maybe having an expert come into the office once every week or building relationships with doctors who could do that. So if you are not delivering the care, but at least you are diagnosing it and you're making sure that option is available for the patients, you are still preventing yourself from experiencing the burnout which can come through because of being stalled because everybody around you is growing and moving. You want to keep up to that pace.

Speaker B: So you've talked about the importance of radiographic AI. There's a lot of talk in dentistry about AI in general. And there's a lot of different technology and noise out there and all sorts of new clinical tools. And there's all these voice tools now, voiceperio and restorative and ambient listening and all these things that can it which all change the workflow within an operatory and the life of a dentist. And maybe some that are for the best and maybe some that become just noise or a distraction. Where are you skeptical? What do you think is overhyped and what are you excited about?

Speaker A: Mike? I'm not at all skeptical. I am passionate and I'm unapologetic about the advantages AI can bring in. However, there is a small call out here. It's not a magic solution. It's a tool. So I hear people. There is a lot of polarized opinions about AI, right? Some feel like it's going to solve everything. Some feel like there's a lot of skepticism around it. Right? So there has to be a balance. I have not seen a single office where AI was the problem. What was the problem was it wasn't properly integrated in the office. So, hey, I got an AI. Okay, you integrated AI into the computer systems. But the walk from integration to implementation is a short one, but an, uh, extremely important one. Just this morning I had a conversation with the doctor who told me, Dr. Shoukhari, my AI has so many false positives, I don't trust them. I'm just gonna unsubscribe. And I'm like, hold on for a second. When you talk about false positives, you are giving the AI the power of diagnosing. That's not their job. We hold the power to diagnose. Let AI bring into surface every deviation in the radiographic radiolucencies. Let me eliminate the clinical and decision making fatigue of squinting and checking if there is a deviation. Let AI bring everything to the surface. I decide, should I treat it or it's just normal? And he's like, oh, now that you say it that way, it makes more sense what the problem is. It is not a magical solution. It is a, ah, tool that needs to be worked upon. Your team needs to understand that they have an assistant for them and not somebody who's going to be fighting against them or increasing their workload. And that's one of the things that I do when I go into the offices to coach them. I create an AI implementation plan, uh, AI implementation workshop for every category of team members in the office. And that has been a game changer. No skepticism from my side. I am very excited. All I request everybody is please understand the process behind it and spend time to really, really implement it in the office.

Speaker B: All, uh, right, Two closing questions for you. Who has had the biggest influence on how you lead and what is something that they taught you that still sticks with you today?

Speaker A: My passion for helping people and me being a clinician to take care of patients is from my father. I have seen him all my life. We come from a society with lot of friends and people just knock at the door sometimes at 2 in the morning and they tell my dad, something is hurting here. And he's like, okay, okay, sit down, let me check your blood pressure. He has never once told us, mike, please don't open the door when I'm taking a nap. He has never told us that. So patients first. I was taught in dental school, but I saw it happening and it became a part of my DNA. And I have so many mentors along the way who taught me what I am today. It's going to be just so hard for me to point out someone, particular person.

Speaker B: That's fantastic. And then last one, if you give a piece of advice to a young dentist that wanted to pursue a path similar to yours, they, they want to go from the chair into clinical leadership. What would that piece of advice be?

Speaker A: Please be humble at all times. It is impossible to think and feel that we know it all. Ask a dentist who has 50 years of experience and they're still gonna say I'm learning. Humility has to become a part of our thought process, our framework. And please be open to doing the right thing for patients at all times. A textbook treatment plan might not be the best treatment plan for a patient. So being open to learning from people who have been there, who have done it, and really keeping your patients as a priority is the only mantra for success.

Speaker B: Dr. Shilpi, it was a real pleasure to have you on today. Thank you so much for joining.

Speaker A: Thank you so much. I enjoyed my time. I can't believe it. It's been an hour already. And thank you for giving me this opportunity to share my thoughts.

Speaker B: The Dental Economist show is brought to you by Planet dds. To find out more about how cloud based dental software by Planet DDS helps unleash dentists and their staff to focus on patient care, visit www.planetdds.com. stay tuned for upcoming episodes by following wherever you listen to podcasts. Thanks for listening.