IMPORTANT MESSAGE WE INTERRUPT YOUR REGULARLY SCHEDULED PROGRAM FOR AN - Q1 2018 - Google
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WE INTERRUPT YOUR REGULARLY SCHEDULED PROGRAM FOR AN
IMPORTANT MESSAGE
Q1 2018
inside this
edition... Disrupted :
New Rules for a New Type of Customer
By Angela Weber, CMO OrthoSynetics
Page 34
BUSINESS PRACTICE
& DEVELOPMENT TRAVEL & LEISURE CLINICAL CORNER
18 15 37
From the Rear View Mirror Pro Travel Tips High Frequency Vibration Can
BY DR. COURTNEY DUNN BY PROORTHO STAFF Reduce or Eliminate Pain During
Aligner Treatment
30 20 BY DR. JONATHAN L. NICOZISIS
Traveling to the Greek Islands
New Gaidge CEO
BY DR. DANIELA LOEBL
INTERVIEW WITH RYAN MOYNIHAN
OFFICE LOGISTICS
32
34 Traveling to Peru
Disrupted: New Rules for a New BY DR. DAVID WALKER 56
Type of Customer Beyond Reminders:
BY ANGELA WEBER, CMO ORTHOSYNETICS
40 Tapping the Potential of Texting
Traveling to Spain BY DR. KEITH DRESSLER
44 BY DR. DAVID MAJERONI
What Would You Do If an Aligner
Store Opened Down the Street? 46
Traveling to Europe ORTHOPUNDIT.COM
BY DR. JENNIFER EISENHUTH
BY DR. BEN BURRIS & BRIDGET BURRIS
09
MARKETING/ H.R. INSIGHT Don't Piss Momma Off!
SOCIAL MEDIA BY DR. BEN BURRIS
05 28 24
Go High or Go Low - Just Don't Get Utilize Group Interviews To Made to Measure:
Stuck in the Middle Maximize Hiring Success The Dubious Relationship Between
BY DR. LEON KLEMPNER AND AMY EPSTEIN, BY BRIDGET BURRIS Eugenics and Orthodontics
MBA
BY DR. MARC ACKERMAN
ANSWERS FROM THE
52 EDGE 59
5 Keys to Capturing the Fastest The Economy Is Booming – Why
Growing Referral Source 10 Isn’t Your Practice?
BY NICK DUNCAN Interviews with Dr. Jeff Kozlowski
BY DR. BEN BURRIS
& Dr. Andrew Appel
The ideas, views and opinions in each article are the opinion of the named author. They do not necessarily reflect the views of The Progressive Orthodontist, its publisher, or editors. The Progressive Orthodontist® (“Publication”) DOES NOT provide any legal or accounting
advice and the individuals reading this Publication should consult with their own lawyer for legal advice and accountant for accounting advice. The Publication is a general service that provides general information and may contain information of a legal or accounting
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SmileMedia. The publisher assumes no responsibility for return of unsolicited manuscripts, art, photos or other content.
EDITOR’S NOTE
EXECUTIVE EDITOR Change is good as we have often perspective of patients.
& TRAVEL AND said but few orthodontists seem The good news is that there is
LEISURE EDITOR to understand that change is also tremendous opportunity for any
Dr. Ben Burris inevitable. If something is going to orthodontist who is willing to adapt
happen anyway it is far better to to the new reality and deliver what
CLINICAL EDITOR embrace the change and figure out the customer wants on their timeline
Dr. Derek Bock how to make it work for you than to and within their budget. The number
vainly swim against the current in the of people receiving orthodontic
name of quality. treatment will rise at an ever
MARKETING/PATIENT Quality is probably the most misused increasing pace of the next decade -
ACQUISITION EDITOR
and dangerous word in orthodontics the question is who will be rendering
Angela Weber
these days. We orthodontists say the treatment? Orthodontists are
quality when we want to defend what still in the best position to fill that
WOMEN IN we do though we cannot reasonably need but only if we can shed our old,
ORTHODONTICS EDITOR define quality or accurately assess the arbitrary and detrimental beliefs
Dr. Courtney Dunn
lack of quality of those with whom about who we are, what we do and
we disagree. This age old tradition why. This edition of The Progressive
BUSINESS OF
of claiming the quality high ground Orthodontist Magazine is dedicated
ORTHODONTICS EDITOR will likely be the downfall of many an to looking at some of the sources of so
Chris Bentson orthodontist. called disruption that are positioning
A lack of new patients and case themselves to harness patient demand
starts is the bane of the profession and prosper by delivering what
ORTHODONTIC POP now more than ever and this should customers want. Enjoy!
CULTURE EDITOR
be doubly worrisome given the
Dr. Marc Ackerman
strength of the economy, lack of PS In an attempt to disrupt our
unemployment and high consumer normal operating procedure we have
confidence. With all this, dare we ask also included a healthy dose of travel
CLEAR ALIGNER EDITOR the question “Why aren’t more people journalism composed and submitted
Sarah Sharfstein
purchasing orthodontic services from by fellow orthodontists. We hope
orthodontists?” The answers are clear these pieces inspire you to put in the
TRADITIONAL OWNER/ to those who shed their blinders work so you can enjoy the play!
OPERATOR PRACTICE and look at what we do from the
MODEL EDITOR
Dr. Jennifer Eisenhuth
AAO AFFAIRS EDITOR
INTERNATIONAL
Dr. Anil Idiculla & The The Progressive Orthodontist
ORTHODONTICS EDITOR
AAO Committee on magazine and study group are
Dr. Grant Duncan
Communications your educational resources for new
trends, progressive insights and best
practices for building a successful
WEALTH MANAGEMENT WEALTH MANAGEMENT orthodontic practice in 2018 and
AND INVESTMENT EDITOR AND INVESTMENT EDITOR beyond.
Dr. Aly Kanani Dr. John McManaman
PUBLISHER - Amy Bradshaw ADVERTISE WITH US! CHECK US OUT ONLINE
GRAPHIC DESIGNER - Megan Clark info@theproortho.com WWW.THEPROORTHO.COM
Q1 • 2018 | TheProOrtho.com 1
CONTRIBUTORS DR.
JENNIFER
EISENHUTH
DR. BEN BURRIS Jennifer
Eisenhuth
Ben Burris DDS, MS is a
graduated from The DR. MARC board-certified
ACKERMAN orthodontist
Citadel in 1994 with
who began college intending to be a civil
a BS in biology, spent engineer. After her undergraduate studies were
time working in Dr. Marc
complete, she came to her senses, entering
Washington DC after Ackerman dental school at the University of Minnesota
graduation, received a specializes in and upon graduation, began her orthodontic
Rotary International the orthodontic residency at the University of Minnesota,
Ambassadorial treatment earning both a certificate of orthodontics
Scholarship and spent a year in Wellington of children with dentofacial deformity, and a Master’s of Oral Biology. After a failed
NZ at Victoria University, graduated dental intellectual and physical disabilities and sleep associateship, she borrowed $60,000 from a
disordered breathing. He received his DMD friend and started her own practice, paying
school with a DDS from The University of
from the University of Pennsylvania School this friend back within a few months. Since
Tennessee in 2001, and graduated orthodontic then she has started, bought and sold several
residency in 2004 with an MDS from The of Dental medicine in 1998 and his certificate
practices in the Twin Cities metro area and
University of Tennessee. In his short 13 in Orthodontics from the University of will continue to do so as long as the fun
year career Burris' practice grew to over 20 Rochester-Eastman Dental Center in 2000. Dr. remains. Her orthodontic practice won the
locations which he sold in April 2017. After Ackerman later completed his MBA in Executive “Best workplace 2014” by Minnesota Business
the sale Burris is effectively retired and living Leadership at Jacksonville University Davis Monthly Magazine and she was recently
in Orlando, Florida with his wife and two College of Business in 2009. Dr. Ackerman acknowledged by the University of Minnesota
children but he's actively treating thousands is the Director of Orthodontics at Boston as a top entrepreneur.
of cases via teledentistry and building what Children’s Hospital and teaches residents in both
he calls a lifestyle office where he plans to pediatric dentistry and orthodontics for Harvard RYAN MOYNIHAN
offer braces for 3000 dollars and Invisalign for School of Dental Medicine.
2000. Burris (and others) expect his new office Ryan Moynihan
and unheard of price point to revolutionize has a financial/
how orthodontics is delivered and engage a analytical background
significant percentage of the population in DR. LEON beginning his career
orthodontic treatment. Burris founded S4L. at Intel and Ernst &
KLEMPNER
org, TheProOrtho.com, OrthoPundit.com Young. He earned
& AMY his MBA from
among other institutions in orthodontics and
EPSTEIN Georgetown and has
is a driving force for change in the orthodontic
profession. Burris and Dr. Marc Ackerman spent the past 12
recently released a book, Straighter: The Rules Dr. Leon years of his career in the Dental/Orthodontic
of Orthodontics and do a two-day course in Klempner, industry with 3M and Ormco. Most recently
Orlando of the same name. a board- he was VP of Global Marketing (2 years) and
Feel free to connect with Dr Burris so you certified VP of NA Sales (2 1/2 years) for Ormco. He
can get a better understanding of who he is orthodontist was in private practice for over joined Gaidge in August 2017 as CEO.
and what he does. 38 years. He graduated dental school from
Facebook.com/bgburis the University of Maryland and received DR. DAVID WALKER
his certification in Orthodontics from
Dr. David
DR. DAVID MAJERONI Tufts University. Dr. Klempner has lectured
Walker completed
nationally on the subject of social media
undergraduate,
Dr. David Majeroni marketing and clinical orthodontic treatment.
dental and
has a private practice Amy Epstein has over 15 years of
orthodontic degrees
in Alamo CA and multinational marketing and branding
at UNC-Chapel
founder of the experience. She has an MBA in marketing
Hill. He practices
non-profit "It takes from Baruch College and regularly lectures at
in his hometown
a Village" where he the Zicklin School of Business and Long Island
of Morehead City,
provides orthodontic University School of Business on the subject of
NC as a partner in a
treatment to children digital marketing, entrepreneurship and social
group practice. He is married to his college
with a missing or deceased parent. media.
sweetheart, Leeanne, an attorney with UNC
School of Medicine. They have one daughter,
Madeline, age 2.
2 It’s just BUSINESS
DR. JONATHAN NICOZISIS
ANGELA DR. KEITH DRESSLER
WEBER
Dr. Nicozisis is a Faculty
member of Invisalign® Dr. Keith
Angela Weber Dressler is an
is the Chief National Speaker’s
avid entrepreneur
Marketing Officer Bureau and Clinical
who has over 30
for OrthoSynetics Research Networkand
years’ experience
a company has given over 400
which specializes as a practicing
lectures on Invisalign. orthodontist. In
in business
services for the Dr. Nicozisis is also 2000, Dr. Dressler
orthodontic and dental industry. She leads a the founding orthodontist and a scientific co-founded
team of marketing professionals dedicated to advisory OrthoBanc, LLC a
developing and implementing cutting-edge board member of BAS Medical/Corthera cloud-based automated accounts receivable
strategies and solutions for their members. a development stage company founded in platform, that is currently serving over 4000
Angela has over 15 years of experience in
2003 with a mission to develop and market a healthcare providers. Dr. Dressler also co-
the advertising industry with a vast knowledge
novel technology to accelerate and improve founded Elite Physician Services, a national
of current and past trends, philosophies and
strategies for marketing within the healthcare the stability of orthodontic treatments. healthcare patient finance company, which
industry. Angela has a proven track record of Dr. Nicozisis’ master’s research is the basis grew to over 200 million in sales before it
driving new patient volume through innovate for BAS Medical innovative research. In became the Citi Health Card in 2003.
marketing practices.
February 2010, Corthera was acquired by
Angela holds a B.A. in Mass
Communications from Louisiana State Novartis. Dr. Nicozisis has been awarded
University and an M.B.A. from the University membership to the Edward H. Angle Society
BRIDGET
of New Orleans. of Orthodontists. He has co-authored a
textbook chapter on Invisalign with Align’s BURRIS
director of R+D. Since 2010, he is an SAB
NICK DUNCAN member of Propel Orthodontics. Bridget Burris
is no stranger to
Nick Duncan holds DR. DANIELA LOEBL orthodontics. For
degrees in accounting over 11 years she
and finance. After Dr. Daniela Loebl and her husband
is a second-year have grown and run one of the largest groups
starting his career
orthodontic resident of practices in the country. Having extensive
as a CPA in Boston, experience in every position in an orthodontic
he returned to his at the University
office except chair side assisting, Bridget
native Australia to of Colorado. She
knows how to train employees to maximize
form The Invisible received her Bachelor
their efficacy and how to teach the customer
Orthodontist (TIO) with his father Dr. Grant of Science degree service delivery that is so essential in the
Duncan. Over the past 7 years, TIO has built an at the University of modern practice. Bridget also knows how to
international network of more than 100 doctors Michigan in 2012 grow an orthodontic practice from small to
and worked with them to significantly increase and completed her formal dental training at massive in a logical, stepwise manner because
the University of Maryland School of Dentistry she's DONE IT! Multiple times.
their Invisalign cases. Through his leadership
in 2016. She is originally from Miami, Florida Bridget's knowledge and acumen is
at TIO, Nick has developed a diverse set of only surpassed by her incredible ability to
skills encompassing marketing, technology and and enjoys going to the beach, traveling to new
communicate and get others to do the same.
business development. countries with her husband Steven, hiking,
Her unique skill set allows her to enter
and skiing.
an office, identify the problems, prioritize
issues and form a logical implementation
DR. COURTNEY DUNN plan; but, most importantly, she is then
able to communicate the plan to the owner
Dr. Courtney Dunn graduated from the University of Michigan and employees to get consensus and even
Dental and Orthodontic programs in 2001 and 2004. She received enthusiasm for how all parties can get where
the Milo Hellman award for her research and has presented at many they want to be! No one else in the industry
local and national meetings. She is a diplomate of the American has the experience, wisdom or pragmatic,
Board of Orthodontics, holds leadership positions in the Arizona solution based approach that Bridget brings to
your practice. Her results speak for themselves.
Dental Association and is past president of the Arizona State
Orthodontic Association. Dr. Dunn is in private practice with her
husband, Matt, in Phoenix, AZ. She spends most of her free time
being a proud swim mom.
Q1 • 2018 | TheProOrtho.com 3
4 It’s just BUSINESS
MARKETING, SOCIAL MEDIA & EVENTS
Go High or Go Low
Just Don't Get Stuck in the Middle
By Dr. Leon Klempner and Amy Epstein
–––––––––––––––––– As the orthodontic business model
becomes increasingly competitive,
that orthodontists need to carry in order
to remain technologically competitive.
"Break from the pack prospective patients have many lower Orthodontists are definitely feeling the
fee options. Traditional private fee for pressure from every side.
with a marketing service practices are finding themselves Unless you are almost at retirement
squeezed in the middle, steadily losing age, it’s become clear that staying put is
program that market share. Large, corporate, Dental not a realistic option. This is the reality
differentiates your Service Organizations (DSOs) and
insurance companies are pushing down
of the modern orthodontic industry
landscape. You can either remain on the
practice and attracts fees while overhead costs keep going up.
Computer generated tooth straightening
sidelines and hope for a return to the
good old days, or you can do something
more qualified applications in the form of so-called do-it- about it. Today there are two ways to
yourself orthodontics are commoditizing remain profitable as an orthodontist:
patients." services into a point-and-click shopping go the high volume/low fee option or
–––––––––––––––––– experience. Adding to the burden is a
surplus of competition and mounting debt
differentiate your practice enough to show
prospective patients/parents that you
are worth paying the difference. There
are many ways to stand out from your
competition: exceptional patient service,
using the latest technology, expertise with
multidisciplinary clinical cases or cleft
palate management, being the Invisalign
or “speed” practice, just to name a few.
Each of us are really good at something.
But that is not enough, you can’t just walk
the walk, you also have to talk the talk.
The challenge is that to be competitive,
you need to communicate all of this in
a matter of minutes when potential new
patients can shop around with a quick
tap on a mobile screen. Luckily, there are
ways to do it.
With the right mix of social media
marketing, reputation management, and
social advertising, a practice can rise
above the rest. A strategically designed
marketing program will attract patients
who have self-qualified for your services
and are ready to convert. Potential
patients self-qualify when they’ve been
exposed to your practice through a variety
of online touchpoints, are positively
Q1 • 2018 | TheProOrtho.com 5
MARKETING, SOCIAL MEDIA & EVENTS
influenced by their peers (social proof), like a potential new patient/parent and their searches. At the same time, it’s
and feel that your practice stands out your marketing must help solve their important to have a system in place to
from the rest. At this point converting problem quickly and confidently so they offer a sounding board for patients in case
them becomes a much easier task. don’t have to stress about picking the right their experience wasn’t perfect, giving
A report released by Google called orthodontist. Consumers increasingly them a chance to vent before they take to
“Micro-moments” revealed that look to online communities to verify the Internet to air their grievances.
businesses must capture the attention of their decisions with supporting anecdotal Using a reputation management system
potential customers in a matter of minutes evidence, called social proof. like the one we offer to our clients allows
or even seconds. Mobile is changing us to capture patient reviews at the point
the game in online search. The report –––––––––––––––– of service when they have an immediate
instructed businesses to anticipate the
micro-moments for users and commit to
“A report released by visceral reaction to their experience. This
works twofold. It allows orthodontists
being there to help decision making when
those moments occur. Successful private
Google called to capitalize on a positive experience,
posting the reviews to all relevant websites
fee for service practices pay attention and "Micro-moments" and social networks. It also allows a
embrace the pace of today’s busy patient/ practice to vet negative reviews. A
parent by being relevant to their needs revealed that businesses practice can review and address a patient’s
and connect them to the answers they’re concerns before the bad experience is
looking for online. Why? Because more must capture the posted publicly online, where others
than half of smartphone users report
having discovered a new business while
attention of potential might read it and become influenced by it.
In case you needed even more
conducting a search on their mobile
devices.
customers in a matter convincing that online reviews
matter, consider this: a 2016 survey
To do this you must not only of minutes or even by Brightlocal.com found that 91% of
communicate the core qualities of your consumers are actively reading online
practice but also help your current clients seconds.” business reviews, providing a huge
spread the word about their positive ––––––––––––––––– benefit to practices who have a positive
experiences on business review sites like online reputation. People truly trust these
Google, Yelp and Facebook. Patients who A recent survey conducted by reviews. The same survey reported that
have been exposed to your marketing Softwareadvice.com, a medical software 84% of people give as much weight to an
campaign walk in the door convinced company, reported that 77 percent of online review as they do to a personal
your practice is the right one for their respondents said they used online reviews recommendation. This creates a cycle:
family’s future smiles and are willing to as a first step in seeking a doctor. Your the more reviews, the more new patients
pay the difference. future patients are doing market research joining your practice, leading to even
by reading what is being said about you more reviews, and higher search engine
REPUTATION MANAGEMENT: online. Your reputation is arguably your rankings.
JUST A MOMENT TO CONVERT most valuable asset, are you leveraging it That person in the coffee shop just
A few friends meet at a local coffee effectively? clicked on another practice’s website and
shop. The conversation meanders before The web has empowered patients to arranged for a consultation appointment
settling on the subject of orthodontists. At share their experiences and opinion about because of the dozens of positive
this point, everything stops as someone your practice with friends and neighbors comments and 5-star ratings found on
grabs a smartphone and asks Siri, at the push of a button - for better or for Google Reviews, Yelp and Facebook. With
Cortana, or some other type of personal worse. In the above scenario, five-star a good online reputation plan, the next
assistant app to suggest local practices. ratings on Google Reviews alongside your time, the orthodontic office they choose
If your website is properly optimized, business listing with loads of positive will be yours.
Google reveals your business listing comments from current patients praising
among others. That’s great but what your practice provides the tipping point SOCIAL ENGAGEMENT:
compels them to click on your link rather for potential customers researching an FIND NEW PATIENTS WITH
than your competitors? Remember, you orthodontist online. SHARABLE CONTENT
only have a moment to convince them The key to capturing this busy web The Smiths are a young family who
yours is the right choice for their family. traffic is to translate all the good things have been loyal patients of your practice
Attention is a commodity and you need you hear around your office into authentic for years. Their family friends, the
to stand out online. You need to think online reviews for everyone to find in Greens, are looking for an orthodontist.
6 It’s just BUSINESS
MARKETING, SOCIAL MEDIA & EVENTS
The Smith and Green families spend off to a friend who asked where their kids production. Like three legs of a stool,
a lot of time interacting on Facebook, got their braces, it will be too late. Long reputational management, social
commenting on each other’s pictures, before that happens, a potential customer engagement, and Facebook advertising
life events and news. It’s the hub of will find out about your competitor on form a solid digital marketing plan
their social lives. Because they are so Facebook where mutual friends share unmatched in communicating your
close, they also trust each other’s social posts from the office’s page showing off competitive advantages in expertise and
recommendations about local businesses their kid’s satisfying smile after their experience to deliver superior customer
from doctors to preschools. When the braces came off. service.
Smiths needed a dog groomer they asked There are many entry points to your
about the business that the Greens used FACEBOOK ADVERTISING: website and ultimately to a page that
because they saw an Instagram picture EDUCATION TO ATTRACT directs a new client to contact you. No
of the family pet’s latest styling. When PATIENTS matter how they find your practice
the Greens needed braces for their kids Mom and Dad have 7-year-old whether it’s an online search, social media
they saw a contest the Smiths shared twins. Though their dentist hasn’t yet or a digital advertisement, you should
on their Facebook page held by their recommended visiting an orthodontist, be ready to capture attention. Your plan
orthodontist. That post sparked an online while they’re surfing Facebook, they’re has to be quick, unique and effective
chat in the comments section inspiring a presented with an advertisement about at converting browsers into potential
recommendation. the importance of early intervention for patients who clicked on your link from
There’s no doubt that having current a healthy smile. They click and they’re any source. With a thoughtful mix of
patients share your practice’s content with brought to your website to read a blog marketing, you distinguish yourself from
their social media friends adds value. post explaining all the latest technology the average tooth straightener. This will
In a report published by Deloitte, the available in early orthodontics. Though help you rise above the low fee, high
global professional services firm looked they may not be ready to make a call just volume practices that are squeezing you
at how social media influenced decision- yet, you’re now on their radar where you in the middle.
making by consumers. Their study found weren’t before.
that social media was a factor in the Facebook’s powerful advertising Amy Epstein, MBA and Dr. Leon
purchasing decision of almost one in program allows orthodontists to reach Klempner, a retired orthodontist, founded
three U.S. consumers. This is especially patients who are in need of services but People & Practice (www.pplpractice.com)
true for younger demographics with 47 may not yet be aware of your practice. Ad in 2011.
percent of millennials influenced by social targeting can be very specific, reaching
media. a demographic defined by a variety of People & Practice is a full-service digital
Just having a Facebook page for your categories including geography so your marketing consultancy. We position your
business is not enough. Your social ads will be seen by users who live within practice to grow in a new price-competitive
advertising must have that “social” driving distance to your practice. These economy by helping you compete on value,
element to it. Actively engaging with ads direct back to educational content on not fees. Unlike most digital marketing
your patients through social media will your website. As potential patients click companies that measure their success based
reap benefits exponentially if done right. around looking for more information they on just getting your phone to ring, our focus
A Facebook page must not only have can be presented with forms specifically is different. Our goal is based on attracting
a regular stream of updates, it must be designed to capture contact data delivered quality, educated new patients that are
interactive, encouraging current fans to right to your inbox. much more likely to accept your treatment
like and share your post on their own The blog on your website that Mom recommendation, and pay a little extra
pages too. This helps reach their network and Dad spent hours reading, sharing on for a better service. We use digital social
of friends, increasing the number of their own social pages, and emailing to platforms to enable your current patients to
potential new patients who are aware of one another reinforces your expertise. The advertise for you.
your practice. The content needs to be parents feel like they are well informed
personalized, informative, or entertaining and will have already built trust your For more information or a free
to be good enough to share. A contest that practice. marketing analysis, you can contact them
incentivizes patients to like and repost to at 888.866.DOCS, or by email at
their own page in order to have a chance GROW BY PUTTING IT ALL hello@pplpractice.com.
to win is just one of many great examples TOGETHER
of interactive, shareable content. While these strategies can be
By the time your patients get around to used individually, they work best in
handing an old-fashioned business card conjunction to boost your practice’s
Q1 • 2018 | TheProOrtho.com 7
ORTHOPUNDIT.COM 8 It’s just BUSINESS
ORTHOPUNDIT.COM
DON'T PISS MOMMA OFF! By Dr. Ben Burris
When confronted with a kid who My dad, Dr. Skeet Burris, taught me headed kid too and it took me a long time
doesn’t brush or wear elastics, our how to handle this situation not long to realize how smart my momma was
first instinct as orthodontists is to say after I finished residency. I’ve used his and I suffered for it!” Then I stand next
something like, “Susie, why haven’t you technique for my entire career and have to mom and put my arm on her shoulder
been brushing your teeth?!?!” but as soon shared it with thousands of orthodontists and say, “Susie, this is the winning team
as those words escape our lips we know and I hope you’ll find it as useful as I (pointing to mom and me) so you should
what mom will do. Mom will get upset do. Whenever I see that Susie is not go ahead and get on board or get run
and assertively say something like, “Susie brushing properly I say, “Susie, why aren’t over.” Mom smiles and agrees and then
brushes her teeth ten times a day and is you listening to your momma?” Mom’s I can do whatever I want with mom’s
a perfect angel. I watch her brush and I ears perk up, Susie looks confused and blessing. Brushing instruction, remove the
know she is doing what she is supposed I continue, “Susie, I know your momma wires, remove the braces, whatever… and
to. How dare you question that?” tells you every morning and every night mom will be fine with it because I’m not
We are shocked every time this to brush your teeth, why aren’t you doing attacking her or her child.
happens. What is going on here? Why is what she asks?” At this point mom stands
mom getting upset with us for trying to up and walks over to the chair – just in Simple. Effective. I wish all of life were
help her child and avoid cavities? How time to say, “Doc, I don’t know what to do, this easy! When in doubt just remember
dare her question my integrity?!?! I can I tell that child to brush all the time… I “Don’t Piss Momma Off ”.
tell by looking at this child that she is not guess I’ll have to brush them for her if she
brushing properly, much less flossing! I doesn’t straighten up.” And then I say, “I Thanks Dad!
know inflammation when I see it! Geez know what you mean mom. I was a hard
this is so frustrating.
Perhaps it is time to change tactics to
avoid the upsets rather than stubbornly
repeating the same behavior and being
“shocked” when we get a negative
response? What is mom really saying to
you?
“I am a good parent and I do the best
I can and you have no idea what it is like
to try and handle three kids and get them
where they need to be and work and do
everything else. I don’t need you telling
me I’m not a good parent. How dare you
judge me?” is what mom is actually saying
when you accuse Susie of not brushing.
That combined with the lioness protecting
her cub creates angst and sends mom over
the top almost every time. So what can we
do to get the message across and not piss
momma off?
Q1 • 2018 | TheProOrtho.com 9ANSWERS FROM THE EDGE
As we have done for several issues, here again we ask leading orthodontists a few questions
about what they do and what they see coming. We love Answers from the Edge because we
always learn something. Enjoy!
Featuring Dr. Jeff Kozlowski and Dr. Andrew Appel
PROORTHO: WHAT IS YOUR do as a family (or individually with the
Interview with PRIMARY FOCUS FOR 2018? kids). Our biggest summer family hobby
is wake surfing. The kids are incredible
Dr. Jeff Kozlowski KOZLOWSKI: My primary focus surfers. Unfortunately, Amy can’t surf
for 2018 is my family. I know you were because of recent rotator cuff surgery
probably expecting me to say something so she has to be content watching the
about growing my business – but 2018 three of us. Skiing is our winter family
is all about my family. I’ve spent the last hobby even though Jake and I are the
9 years building my practice and we’ve all-day moguls and glades double black
grown to 4 locations, 20 team members diamond skiers and Amy and Amelia
and are producing at a level I never are half-day green/blue good weather
thought possible. I did all this with the skiers who are content to go to lunch or
love and support of my wife and kids – the spa or shopping. Other things I do
and so this next year is devoted primarily with the family include travel, hunting,
to them. My wife Amy and I will celebrate fishing, spearfishing (a combination of
our 20th anniversary on August 1st and hunting and fishing!), boating, crabbing,
we have two kids. Our daughter Amelia is clamming to name a few. How do we find
Dr. Jeff Kozlowski has a unique
a junior in high school and our son Jake time to do all this? Clinical efficiency!!
perspective on the importance of
is in 8th grade. While I’ve always spent Amy works 110 days per year and I work
clinical efficiency in the business of
lots of time with the kids – this year I’m 131. That means we only see patients
orthodontics. With a background in
really focused on enjoying their “young about 1/3 of the year which leaves 2/3
Economics and Finance rather than
adulthood” – especially with our daughter of our time for everything else we do
Biology and Histology, numbers and
who is heading off to college soon. together!
systems prevail over cytokines and
osteoblasts. While his experience
PROORTHO: TELL US ABOUT PROORTHO: WHAT DO YOU SEE
in orthodontics is varied – from
YOUR FAMILY AND ALL THE FUN AS THE GREATEST OPPORTUNITY
managing a four doctor 5 location STUFF YOU GUYS DO. HOW DO YOU AND THE GREATEST THREAT TO
mega practice – to opening a start- ACHIEVE THE GREAT WORK/LIFE ORTHODONTICS?
up – to lecturing around the world BALANCE WE KNOW YOU HAVE?
– the one thing that has always KOZLOWSKI: While I am a very
been constant is the importance of KOZLOWSKI: I guess I already told positive person, I’ll start with the
achieving great clinical results with you about my family! Amy and I met negative first. I know many see direct to
the least amount of effort. in dental school and she is a practicing consumer orthodontics as the greatest
pediatric dentist. We love to cook and threat but I don’t see it completely that
eat and travel together whenever our way. The greatest threat to orthodontics is
schedules allow for it. As for hobbies with continuing to do what the profession has
the family – well, I am the “Hobby Guy” always done. Our profession continues
so I’d love to share some of the things we to sell patients four bicuspid extractions
10 It’s just BUSINESSANSWERS FROM THE EDGE
and headgear, expanders and lip bumpers, and with better customer service. For in not turning patients away from our
bands on posterior teeth, and all of this those of us who are already doing this profession’s traditionally restrictive
taking more than two years of treatment we have continued to see great growth financing models. (Yes I’m an investor in
(the national average is 27 months of in our practices - even in the face of OrthoFi)
treatment). Many orthodontists continue encroachment from PCD’s with short-
to do what they have always done; selling term orthodontics, aligners, and DIY PROORTHO: WHAT ADVICE
patients the old and tired when there are orthodontics. WOULD YOU GIVE YOUNG
so many new and wonderful technologies ORTHODONTISTS AND RESIDENTS?
available. These traditionalists yell and PROORTHO: WHAT
scream that new technologies are not TECHNOLOGIES OR SERVICES ARE KOZLOWSKI: You can be anything
“evidence-based” and they fight against INTERESTING TO YOU LATELY? you want to be in this world if you set
the change. It is for all these reasons that your mind to it! Orthodontics is such a
options like “short-term orthodontics” KOZLOWSKI: There are a number of wonderful and flexible profession. I tell
and direct to consumer aligners are technologies that I have a great interest residents all the time - you can make
growing. It may be what some patients in. First is Passive Self-Ligation. I’ve been your practice life and personal life be
want - but I believe our traditional way of using the Damon System for over 15 years what you want it to be. Want to work
providing orthodontics is driving patients now and I believe it is the key for me to one day a week? Then do it! Set up your
there. Who wouldn’t want to straighten continually create great smiles in less systems to do 3-4 starts per day and do
their smile in 6 months or do aligners time (averaging less than 17 months of that 50 days per year and you will have
from home when the option many in treatment). We’ve also grown in our use an incredible quality of personal life with
our profession provide is four bicuspid of aligners for patients who prefer not to the financial means to enjoy it! Want to
extraction, expanders and headgear for wear braces. Combining Invisalign with work 5 days per week and crush it, then
2-3 years of treatment. our iTero Element scanners has made retire at 45? Then do it! The other thing I
the process of treating with aligners easy tell young orthodontists and residents is
––––––––––––––––––– and streamlined. Aligner therapy is now to never stop learning. Go to meetings;
“These traditionalists a very relevant and important part of our
practice. I’m also a huge fan of CBCT.
listen and learn. Visit offices and see what
others do - adopt what you like and make
yell and scream that I love my two iCAT FLX machines it your own and see what you don’t like
that provide more information for less and don’t repeat it. We can learn from
new technologies are radiation than a traditional pan/ceph. every encounter we have with others in
not “evidence-based” Patients and parents can immediately
see their dental and skeletal issues when
our profession. And finally, I tell people
- if you are not happy with your current
and they fight against viewed in 3D and I believe it helps situation then change it. I was once a
communication and ultimately conversion partner in a large group practice. It was
the change. It is for of patients to get the treatment they a very good practice with good docs and
all these reasons that need and deserve. Finally, I’d be remiss
if I didn’t mention OrthoFi - a company
lots of patients. But after nearly 10 years,
I wasn’t happy. With the support of my
options like “short-term that Jamie Reynolds and I started with incredible wife - I decided to retire from
our CEO, Dave Ternan, over 4 years ago. the group practice and open my own
orthodontics” and direct OrthoFi has been revolutionary in helping office. Starting from scratch 9 years ago
to consumer aligners practices manage the effects of extended
financing that many patients require in
we’ve grown to 4 locations and 20 team
members. I’m happier than I’ve ever
are growing.” order to do business with our offices. We been and making more money than I
built it for ourselves with the help of some ever imagined. If I can reinvent myself
––––––––––––––––––– really smart orthodontists and business - then so can you! And when I’m done
So this leads me to the greatest people from outside the orthodontic with orthodontics someday - I might
opportunity - the profession could profession. I’m really happy that it’s just become an architect or a chef - who
pivot and start providing top quality grown to help over 250 other orthodontic knows?
care in less time with fewer extractions practices realize the growth potential
Q1 • 2018 | TheProOrtho.com 11ANSWERS FROM THE EDGE
PROORTHO: WHAT IS YOUR My dad taught me something early in my
PRIMARY FOCUS FOR 2018? career that I try to always keep in mind:
Interview with ” as practice owners, it's quite easy to never
Dr. Andrew Appel APPEL: My primary focus in 2018 really turn work "off." He always reminds
is diversification. I spent the first few me to try my best to lock the door at the
years of my career "updating" Appel end of the day, and leave the orthodontics
Orthodontics (AO): improving clinical inside for tomorrow!
efficiency and scrutinizing everything
about the customer service experience PROORTHO: WHAT DO YOU SEE
that our patients receive. We have also AS THE GREATEST OPPORTUNITY
managed to start and grow a new practice AND THE GREATEST THREAT TO
branded differently than our own, which ORTHODONTICS?
has been able to help a great number
of families with insurance plans not APPEL: I think the greatest opportunity
historically accepted by AO. In 2018 I is still having the option to practice a
want to continue focusing on building great profession in a manner that is highly
that brand and re-creating the same tailored to your personal desire: associate
high quality, AO experience in this new with an awesome practice or be your own
practice. We are also partnering with boss, open from scratch or buy an existing
another orthodontic group to open a practice, work as much as you see fit for
more boutique style, aligner-only practice, your lifestyle, choose the clinical systems
Philadelphia orthodontist
and I'm sure we will commit much of that work best for you. In orthodontics,
Dr. Andrew Appel was born and
our time in 2018 to getting that off the we have a unique opportunity to choose
raised in Philly and wanted to be an
ground. There are a lot of horses in the our own path and that should never be
orthodontist since he was 7 years
starting gate, as my dad likes to say. taken for granted.
old. In July 2013, he joined his father
As for a threat, there are certain things
as co-owner of Appel Orthodontics,
PROORTHO: TELL US ABOUT putting pressure on the profession
which will celebrate its 40th
YOUR FAMILY AND ALL THE FUN like never before: growth in corporate
anniversary in 2018. He received
STUFF YOU GUYS DO. HOW DO YOU dentistry and direct to consumer aligners,
his undergraduate degree from
ACHIEVE THE GREAT WORK/LIFE to name a couple. That being said, I try
Pennsylvania State University, then BALANCE WE KNOW YOU HAVE? to focus on the notion that traditional
graduated summa cum laude from
orthodontic treatment will persist in
Temple University Kornberg School APPEL: As a practice owner, I am some capacity and with these changes
of Dentistry, where he became a always planning on work-related items. come new opportunities. My dad has
member of Omicron Kappa Upsilon, Most of us tend to be pretty good at that... been at this for nearly 40 years and can
an honor society that recognizes planning for the next big marketing push; recount stories about when he opened his
excellence in dental school graduates. which CE events we will attend; what our practice in 1978 and all of the older docs
He has a certificate in orthodontics scheduling templates are going to look consistently told him that "the golden days
from Tufts University School of like. I basically try to take the exact same of orthodontics are over!" They couldn't
Dental Medicine in Boston. Outside approach when it comes to non-work have been more wrong! We just focus our
of the office, he is the proud parent of related items. Travel and its associated energy on continuing to move forward.
a very handsome long-haired black life experiences have always been pretty
cat named Oliver, enjoys hiking in important to me. My friends and I like PROORTHO: WHAT
America's national parks, and tries to hike in the summer and snowboard TECHNOLOGIES OR SERVICES ARE
to always make the most of Philly's in the winter so like anything else...we INTERESTING TO YOU LATELY?
awesome live music and dining plan for it! It's nothing ground-breaking,
scenes. just keep your work life and personal life APPEL: I suppose this would fall
intertwined enough so that you can see under the tech umbrella...but we spent
the whole picture and plan time for both! a lot of time this year doing a complete
12 It’s just BUSINESSANSWERS FROM THE EDGE
re-development of our website. I think
it's easy to overlook the importance of the
website in the overall scope of a practice's
digital presence because it tends to be
more static than, say, ongoing SEO or
social media posts and ads. For us, we
realized we have put a lot of time and
energy into what's happening under our
roof, but our previous site did a poor job
at conveying that to prospective patients;
instead, it provided the same, boring info
found on most other sites. We partnered
with Clear-PG for our new site, and we
literally have new patients coming in
saying that they saw our site and our
videos. Some have even admitted they
were holding back tears while watching
this new content! We are finally using our
website to show patients what we are all
about in an effective and thoughtful way.
PROORTHO: WHAT ADVICE
WOULD YOU GIVE YOUNG
ORTHODONTISTS AND RESIDENTS?
APPEL: Well, I am a young
orthodontist, so it feels a little funny to
be asked to dish out advice. Two things
that I think could be worth offering are:
First, regardless of what career path
you choose, write down your short and
long-term goals. I have found that I'm
much more effective in getting things
done when I have put them down on
paper. Second, try to enjoy the ride! It's
so easy to get caught up in the process of
starting and/or growing a practice, the
cases that aren't turning out clinically
like you would hope, the pressures being
applied on our profession by those threats
mentioned earlier. We have it so good in
orthodontics...try to never lose sight of
that and have fun along the way!
Q1 • 2018 | TheProOrtho.com 13TRAVEL & LEISURE
INTRODUCING
TRAVEL &
LEISURE
We’ve always been big on travel and leisure at ProOrtho but in
this edition, we decided to get serious about featuring travel pieces
submitted by fellow orthodontists. We hope you enjoy this section
and find inspiration to kick it up a notch in your practice so you can
take the family on an awesome trip. If you have a great trip you’d like
to share then let us know and we will feature it in future issues.
Travel well!
Ben
14 It’s just BUSINESSTRAVEL & LEISURE
PRO TRAVEL TIPS
By ProOrtho Staff
Traveling, especially with family, a great idea. Hand sanitizer is also a process used to be arduous but now it’s
can be stressful. But this is an artificial great thing to carry with you but make easy and you can do it on a layover in
construct in our minds! Relax and sure it’s a small bottle so you can get any major airport. With global entry
remind yourself that it used to take it through security. Make sure your you’ll get TSA pre-check almost every
a lifetime to cross the globe or even Kindle, iPad, phones, etc. are charged time and that’s nice! Be sure to add
the country. Know that if you travel and ready to go. It’s a great idea to your trusted traveler number to your
much at all, delays are inevitable for download shows for everyone – you airline reservation or to your frequent
any number of reasons AND airline can do so on Netflix, Amazon and flier account. Clear is a great service
employees are there to help you. on most premium cable apps like and very reasonable depending on
Getting upset only raises your blood HBOGo. Do not put your medicine in how often you fly and where. When
pressure and reduces the chance that your checked luggage. Birth control approaching the security checkpoint
you’ll get great service. Reduce stress pills and any daily medication are know that you’ll need a boarding
by leaving an hour earlier for the especially important to keep on you in pass for every passenger and an ID
airport than you think you should. case your bag gets lost! for everyone but children if flying
Avoiding upsets and conflict with domestic and a passport for everyone
your family is key to getting your trip Check and see if your local airport if flying international. Have these out
off on the right foot. Once through has a valet service. Many do and this and ready so you don’t delay your
security enjoy the show. Airports are a is a great way to start your trip off fellow passengers.
great place to people watch. Print out stress free. Frequent travelers who are
your itinerary and your tickets before loyal to one airline get premier status General rules for passenger
you leave the house. Most of the time that allows them to use shorter lines screening on US domestic flights.
the app on your phone will work and for check in, check bags for free and Normal screening - you must
it’s rare that the airline will make a get upgrades. Or, of course you can remove your shoes and any coats,
mistake but when either goes wrong purchase premium/first class seats to scarves, hats. You must take your
you’ll be glad you have a hard copy. get these perks instantly. Some credit laptop and tablets out of your carryon
Taking photos of everyone's passports cards also offer priority perks and and place each in a separate bin.
and your credit cards, front and back, even airline status and are well worth Remove everything from your pockets
is a great idea. That way if they are having. Which one depends on what and take off your Bluetooth headset.
lost or stolen you have the info you airline you fly. The points guy is a Don’t take any liquids, gels or aerosols
need to take action. Remember that good source of info. of more than 3 oz and put the ones
airports and airplanes are often cooler you have in a ziplock bag that you
than your home so consider adding If you travel much at all take the remove from your luggage. You don’t
a jacket or scarf to your carry-on is time to get Global Entry certified. The need your ID or boarding pass out so
Q1 • 2018 | TheProOrtho.com 15TRAVEL & LEISURE
put those away. Ideally while standing First class passengers and frequent since these lounges generally offer
in line or before you’ll get most of this fliers with top-tier status get access to food and drinks included in access to
done and be ready to remove shoes airline lounges. These are quite useful the club.
and laptops so you don’t delay your and convenient and it’s a good idea to
fellow passengers. Wearing shoes that search the airports you’ll be traveling Thoughts about boarding the
are easy on off, wearing socks so you through to find out what lounges there plane and general courtesy to fellow
don’t have to go barefoot, avoiding are. Lounge buddy is a great app for passengers while flying:
belts with large metal buckles and that. If you are flying coach and don’t Remember that backpacks stick
generally knowing what is coming and have top airline status don’t worry out behind you so don’t forget that
being prepared will make your day as many credit cards will get you when you try to turn in the aisle and
easier. into various lounges. Priority pass is smack people in the face. If you can't
very useful and comes as a perk with lift your carry on above your head
TSA pre-check - If your boarding several American Express cards. There then check it. Checking baggage is
pass says TSA pre-check you don’t is a priority pass app that is useful. much easier and more courteous than
have to remove your computer or Also, American Express lounges expecting others to do your heavy
toiletries from your bag. You don’t are becoming more numerous and lifting. The space under your seat
have to remove your shoes. The most cardholders get free admission. is your fellow traveler’s foot space.
best bet is to take any jewelry and Finally, you can pay for a day pass and Sometimes passengers want to stuff
everything from your pockets and depending on how long you’ll be stuck their belongings below the seat they
place them in your carry-on baggage. in an airport this might be worthwhile are sitting on. Don’t be that passenger.
Don’t use headrests as handles
- whether walking down the aisle
or getting in or out of your seat,
remember that grabbing a headrest
and using it like a handle disturbs
your fellow passenger. Especially on
overnight or international trips when
they’re trying to sleep. It’s much more
courteous to put your hands on your
armrests to get in and out of your seat
or on the overhead bins when walking
down the aisle. Use of your tray table,
video monitor and seat back pocket
impacts the person in front of you.
Every time you tap the screen, raise
and lower the tray table, or utilize the
seat back pocket you are moving the
seat of the passenger in front of you so
remember to use appropriate force and
limit the number of times you perform
these tasks.
16 It’s just BUSINESSTRAVEL & LEISURE
Infants cry. That’s what they do. to get some rest. Keep this in mind
Understand that the parents are and be sure to carry those noise
likely much more upset about this canceling headsets! Tapping feet to
fact when traveling with an infant the music, playing music on headsets
than you are. A great way to make loudly and excessive fidgeting
the situation better for everyone is impacts your fellow traveler.
to travel prepared with ear plugs,
noise-canceling headphones and On overnight/red-eye flights
a white noise app on your phone and on international flights it’s a
AND be sure to smile at the parents good idea to leave your window
or even offer to lend a hand if it’s shade down. This gives your fellow
obvious they are in need of one. This passengers the best chance to sleep.
is especially nice when a parent is Modern planes regulate light during
traveling alone with one or more the flight to minimize jet lag but one
infants or young children. passenger opening a window will
destroy this attempt to make your
When in coach remember that journey more pleasant. Also on these
there are more arms than armrests. sleep intensive flights, it’s a good idea
In a three-seat arrangement, to keep conversation to a minimum
traditionally the aisle and window as voices carry a great deal when
passengers surrender the middle passengers aren’t moving around or
armrests for the person stuck in talking much.
the middle seat. In a two-seat
configuration, we must share or take Flying commercial means being
turns (usually one person ends up in a closed space with others for an
predominating). The thing to avoid extended period so avoiding heavy
is allowing our elbow to cross over cologne or perfume, foods that are
the armrest and into the ribs of our highly aromatic and anything else
fellow passenger. This is especially that will negatively impact your
common when using a laptop so fellow passengers is always a good
remember to be courteous. If you idea.
need more room, buy a first class
ticket! Parents - especially tall ones - When you arrive at your hotel the
can increase their room in coach by first thing you should do is secure
taking the middle seat and putting your valuables and travel documents
a child on either side. That way in your room safe if you aren’t
you paid for all three seats and can going to keep them on your person.
encroach on them as you like. Leaving these things lying around
your hotel room – even for just a
Conversation is great when few hours – can have catastrophic
it’s mutual but sometimes fellow consequences.
passengers have work to do or want
Q1 • 2018 | TheProOrtho.com 17You can also read
