Starfish and Ripples - Musings from Guatemala dental mission trip

Recently, my wife, Dr. Gina Kessler and 15 other colleagues from Dentistry Making a Difference went to Guatemala for a dental mission trip.  We have always wanted to do something along these lines.  The opportunity presented itself so we decided to go for it.  Here are some of my musings. 

March 7, 2018 - I am in San Pedro, Guatemala on a dental mission trip with my wife, staff and several colleagues.  We are seeing people who are in extreme poverty with huge dental needs.  My comfort zone is being stretched in huge ways as I am not in my "cushy urban" office anymore.  We are in a 5 chair clinic that opened recently through the Spear “Open Wide Foundation”. 

One patient I will never forget.  Her name is Araceli. She is a beautiful 5 year old girl, dressed in a pink jacket and a traditional style dress. I haven’t treated a child this age since dental school.  I don’t know who is more nervous - her or me.

Araceli (5 y.o) looking into the clinic

In the morning, she had been outside watching us do our work from a window outside the clinic.  Her turn was in the afternoon.  She came in terrified and reserved - probably frozen by fear.  I had a translator help with the communication. I looked in her mouth and my heart sank. She had dental needs in every tooth due to rampant decay. I consulted with the staff dentist at the clinic hoping that she would say refer her to a pediatric dentist - this kid needs to go to the OR for her treatment.  There were none to be seen. The staff dentist and I consulted, it was decided to take out her five front teeth (c-g).  This was just scratching the surface of her dental needs.   

I gave her injections and pulled her teeth.  

She screamed, I cried. I fought through my own emotions and got to work as quickly as I could.  She screamed some more, I cried some more. 

When it was over she calmed down and gave me a hug, thanked me for helping her. I am not really sure if I helped her.  She is a kid that, if she was in the states, she would be brought to the operating room for her treatment. My mind was racing with questions probing the unknown.   Did I really help her?  Did I traumatize her?  How will she get the help she needs?  How will her dentition turn out?  How will her psyche be affected?  I took out 5 infected front teeth. Will her adult smile reflect the beauty of this girl as she grows into adulthood.  If her teeth are this infected, how is her overall health?

Gina, Araceli and me after her treatment.

There is so much dental disease here. There are not enough dentists in the world to fix all the decay here.  How can I possibly be making a difference?

Starfish story link - 

https://www.youtube.com/watch?v=Z-aVMdJ3Aok

I have come to the conclusion that I made a difference for Araceli. I may not have been able to address all the needs in this town.  But I made a difference for her.  Our team of 5 dentists and 12 assistants/hygienists made a difference for the 100 or so patients that were seen in our clinic these past 5 days.  

Hopefully she will start to brush, floss and change her diet. I am not sure if there is clean water where she lives.  She probably doesn’t even have running water let alone indoor plumbing in in her house.  I tried to explain Araceli’s dire need for more dental work to a lady that said she was her grandmother. (She also said she was the grandmother to the several other kids that were there that day).  I am not sure if she understood - I didn’t speak Spanish, she didn’t speak English.  My recommendations were translated to her, but was it heard? 

Guatemala has what is considered extreme poverty.  The average income for a family is $300/month.  Over 25% of the population is considered illiterate.  School is mandated for 6 years, but the average is a little over 4.  There just aren’t resources for them - especially in the rural areas.  

I know that there are similar situations happening in our communities back in the states as well.  I feel that for most though, they have a chance. There is infrastructure to provide opportunities to get help.  I also know there is not enough.  

The dental future for Araceli and her family may have changed trajectory based on this experience.  I hope so. I also hope that her experience in our clinic will ripple out in ways that she will be able to contribute to the world in her own unique way. Who knows, she may become a staff dentist at a similar clinic in her community.  

We never know who we impact or how we affect someone - be it our patients, friends, colleagues, acquaintances, etc.   It could be that we get someone out of pain, fix their smile, remove infection.  It may be that a conversation that we have with our patients every single day finally sticks with someone.   We never know when someone hears something that catalyzes a much needed change in their life.  All we can do is keep doing the best we can - sharing our unique skillset to those in need.  I have had many patients come back for their six month cleaning and check up and tell me how our conversations changed the trajectory of their lives.  I feel that a smile is a window to the soul and we do everything we can to help our patient’s soul shine through. A smile can change a person’s life.  

I have come to the conclusion that we made a difference today for Araceli.  We barely scratched the surface, but we made a difference for her.  

I hope that the difference we made for her (and our patients back at home) ripples out into the world to create more positive difference.  

Starfish and ripples. 

BK

I Try Not to Get Political - But....

"I Have a Dream" - the MLK Step at the Lincoln Memorial at sunrise

Once again, I was honored to have been chosen as part of a delegation to represent Colorado dentists and attend the Washington Leadership Conference put on by the American Dental Association. It is an opportunity for leaders in dentistry to meet with our national legislators to educate and advocate best practices and trends that we are seeing.  In a time of such flux with the delivery of healthcare, we offer perspective that hopefully will help shape health care and ensure that we can best serve our communities.

It was an interesting social and political time in the area.  A man named Freddie Gray was killed while in police custody shortly after being arrested.  Sadly, a much too common occurrence not just limited to Baltimore, but across the nation. The protests began peacefully but soon turned violent.

I was Baltimore to attend the Orioles game on Saturday evening. There was a palpable energy inside and around the stadium due to a strong police presence. At the game’s conclusion, the fans were not allowed to leave for their own safety until the riots had calmed.  

As time marched on, the riots continued. Buildings were damaged and looting ensued.  People were injured.  The National Guard was called in, and a curfew was instituted. CNN and Fox News were having a paparazzi feeding frenzy with a countdown to the mandated curfew. There were several more arrests and a public outcry….The entire situation was sad to witness.

Order was not restored quickly.  It wasn’t safe to be in the area.  The following day the Orioles game was cancelled.  Oddly, the next day’s game was played to an empty stadium.  Never before has a Major League baseball game been played in an empty stadium.

Pictures from the game which no one watched

Back in DC,  we dentists were meeting with our legislators.  Several of our legislators mentioned that they were invited to various “State”events (dinners, lunches, etc) with the President, who was hosting the Japanese Prime Minister. 

The Japanese Prime Minister (Shinzo Abe) must have been wondering about how the free speech thingy (1st Amendment) is working for us….I am sure that President Obama was thinking the same thing.  At a press conference to introduce the PM, POTUS took a few minutes to address the rioting. 

He recognized first that the rioters who were committing unlawful acts were not helping the situation.  They were no better than criminals and thugs taking advantage of an opportunity to be destructive. 

He then balanced his displeasure at the fact that some police officers/departments are not doing what is mandated that they do -"to protect and to serve”.  They too needed to reform and be held accountable.  

He continued to address the core issue with some of the most profound and inspiring words I ever heard him say.

"Without making any excuses for criminal activities that take place in these communities, what we also know is that if you have impoverished communities that have been stripped away of opportunity, where children are born into abject poverty, they’ve got parents often because of substance abuse problems or incarceration or lack of education themselves can’t do right by their kids, if it’s more likely that those kids end up in jail or dead that they go to college, in communities where there are no fathers who can provide guidance to the young men, communities where there’s no investment and manufacturing’s been stripped away and drugs have flooded the communitiy and the drug industry ends up being the primary employer for a whole lot of folks… In those environments, if we think that we’re just gonna send the police to do the dirty work of containing the problems that arise there without as a nation asking what we can do to change those communities, to help lift up those communities and give those kids opportunities, then we’re not going to solve this problem.

America, the land of opportunity - has no opportunities to thrive. 

Without opportunity, there is no hope to dream. Frustration ensues and more riots are going to occur. 

We must return to our roots- the ideals that serve as our country’s foundation - life, liberty and the pursuit of happiness.  

We need to take back our freedom.

We must accept that to right the ship, there are no simple answers.

We all are going to need to sacrifice for the betterment of the whole.

The finger pointing needs to end now.  

We need to work together to figure out solutions that spur opportunities for everyone to contribute. Americans have always had the creativity combined with the spirit to make this happen.  

We real solutions, not more riots…

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Inalienable Rights

The Statue of Liberty stands proudly in New York Harbor. It stands as the universal symbol of freedom and democracy. This symbol stands for what makes our country great.

I love the practice of dentistry. I love the freedom that it offers us.

We have the freedom to cooperatively treat our patients, helping them achieve their goals in a predictable and satisfying manner. Patients are free to choose to go to any dentist they like. Dentists are free to choose to treat anyone they like and do any procedures that they like and vice- versa. As a result of these freedoms, we are an example of a free-market healthcare system that works.

Our professional autonomy (freedom), however, isn’t free. Eleanor Roosevelt said, “Freedom makes a huge requirement of every human being. With freedom comes responsibility.” The values of the profession must be actively upheld by us — the practicing dentists. If we are not diligent and stand for what is best for our patients, our profession will no longer be autonomous.

Author Peter Drucker said in the ’70s, “Those that are content to rise with the rising tide will also fall with it.” And when it falls, if we did nothing to better and preserve our work, we have no right to complain. In other words, if we are passively riding the waves, we will have no choice but to accept our fate when the wave crashes.

We are responsible to serve the needs of our communities. We have an obligation to stand up for the individuality of our practice philosophies. Our uniqueness is what makes our practices special and attractive to our patients. We cannot let outside entities influence our standards, our ethics and our decisions. We do what is best for our patients because it is in their best interest.

This past year, Colorado has introduced an adult Medicaid benefit to our state. They have allocated over $100 million to provide these services to those who are eligible. It is estimated that over 300,000 adults are now eligible for this benefit. The CDA worked closely with legislators and the governor’s office to create this benefit. As dentists, we directly witness the impact that dentistry has on those who need it.

We improve oral and overall health, we restore function, and we provide smiles.

We continue to fight hard to shape the benefits and make sure that our communities have access to our finest care. Our communities need Medic- aid providers to serve this need. We understand that the system is a work in progress, and are working daily on your behalf to address concerns to help the system run much smoother in coming weeks and months.

At the same time, we have the responsibility to provide care to Medicaid patients. Currently, there is extensive discussion among policy- makers and the public regarding gaps in Colorado’s dental health. If we are to make the case to the public that qualified dentists are the answer to access concerns, then it is incumbent on our profession to step up to the plate.

The fate of our profession is in our hands. “With freedom comes responsibility.”

Author Jim Collins wrote, “No matter how much the world changes, people still have a fundamental need for guiding values and sense of purpose that give their life and work meaning. They have a fundamental need for connection to other people, sharing with them the common bond of beliefs and aspirations. They have a desperate need for a guiding philosophy. More than any time in the past, people will demand operating autonomy - freedom plus responsibility - and will simultaneously demand that the organizations of which they are a part of stand for something.” We take this statement seriously.

What does the Colorado Dental Association stand for? The CDA is advancing oral healthcare to our communities — in the best way possible. It is here to support its members so we can provide the best, most appropriate dentistry to our patients.

Recently, the Colorado Dental Political Action Committee (CODPAC) met with 40 state legislators and candidates individually. It was an extensive task that involved hundreds of volunteer hours and immense coordination. The purpose of this endeavor was to further our relationships with key influencers, educate the legislators on our issues, and then strategize our legislative agenda.

We sent them information about key legislative priorities and our objective to make it as easy as possible for dentists to deliver the best possible care to our communities. We dialogued about possible solutions regarding these subjects: increasing Medicaid reimbursements, improving student loan forgiveness programs, dental insurance reform and preventing the introduction of a new mid- level dental provider in our state.

The legislators seemed genuinely impressed with our ideas, our passion and our mission.

The hard work that we have been doing over the past several years resulted in several congratulatory statements of support by the legislators. Respect for our profession has greatly improved. Today legislators look at us as experts to help guide and shape policy around oral health and oral health care delivery. But if we don’t fulfill our obligations, our influence will be gone.

Thank you to our CODPAC colleagues representing us. Thank you to our members for contributing to CODPAC and the American Dental Political Action Committee (ADPAC). These dollars are the best investment that you can make to preserve the freedom that we have. Please tell your communities how important it is to get involved either with monetary or voluntary contributions. Remember, we all must do our part in giving to the profession.

On the west coast there is a proposal to build another statue. This one is being called the statue of responsibility (http://statueofresponsibility.com).

It will symbolize this notion that freedom isn’t free. We are responsible for setting the standard and delivering the finest oral healthcare in this state. We take this seriously and by our actions, we will continue to enjoy our freedoms.

If you would like to make a donation to CODPAC/ADPAC please contact the CDA at info@cdaonline.org or 303-740- 6900 or 800-343-3010.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Advocacy in Dentistry - ADA Storms Capitol Hill - Washington, DC

United States Capitol at Sunrise

I was honored to be part of a delegation that went to Washington DC to provide dental care advocacy on behalf of the Colorado Dental Association and the American Dental Association.  We had a chance to meet with most of our Colorado legislators in person and if they were unable to meet with us personally, they had their health care staff expert meet with us.

This year we had three issues to bring forth.  The first was a reform on student loans hoping to get a reduction in interest and an increased tax deduction.  This is for everyone with student loans, not just dentists.  An interesting stat - Americans collectively owe $1.1 trillion dollars in student loans, much of it subsidized by the government.  It is quickly approaching the amount of money that we owe China ($1.4 trillion).   Congressman Paul Gozar, DDS (R-AZ) calls this a bandaid, a good start - but not a comprehensive solution.  The cost to go to college/graduate school must evolve as it is unsustainable.  Dentistry is the costliest of the professions to train and it is not unheard of for a dental student to finish with a $500,000 student loan debt.  This is a 30 year mortgage, not a student loan.

The second issue we discussed was an ask for grant money to help start initiatives that will serve those in need.  These grants will help states with initiatives such as "Give Kids a Smile", "Missions of Mercy" and community coordinators that will help people find a dentist via emergency room referrals, nursing homes, schools, etc.  The legislators asked where is the money going to come from.  We call this designated grant money an investment, not a cost.

For example, in Colorado - we have an event called Colorado Mission of Mercy (COMOM). COMOM is a 2 day event where dental professionals set up a temporary dental clinic in a big way.  Over a thousand patients are treated for free over the course of the event.  All of us bring our own dental tools and supplies and treat what is needed.  The cost to put on a COMOM is $160,000.  The amount of dentistry given to the community over a $1,000,000. This is money that won't have to come from government benefits such as medicaid.  The next COMOM is in October in Henderson, CO.

The third issue was a letter initiated by Rep. Paul Gosar, DDS (R-AZ) that we want our legislators to join in and sign.  This letter asked the Center for Medicaid and Medicare services to improve the fairness and transparency of Medicaid recovery auditors and their review process.  We believe that audits of medicaid providers should be done to catch providers trying to beat the system, but not on those that are doing their best to serve those in the community in need.

Currently, in some states, the process is "guilty until proven innocent" with very little opportunity for the provider to have any recourse to defend him/herself. It is difficult for dentists to want to join up to become medicaid providers when these type of audits are in place.

We also had a variety of speakers give us the current state of the political climate in Washington.  There is less than 40 legislative days left in session and due to stalemate political party posturing, they predict that very little legislation of any significance will get done.  Sad that this is the case.....

One of the best speakers was Rep. Peter Roskam (R-IL).  He was preaching to the choir when he said that the Affordable Care Act cannot put a price tag on caring for our patients.  He predicts that the "commoditization of health care" is going to drive down the opportunity for us to truly care about our patients.  I am doing everything in my practice to not let this happen.  I hope my colleagues will too.

A big revelation was how important our political action committees (PAC's) are.  Both ADPAC (national) and CODPAC (Colorado) raise funds to advocate to keep dentistry a profession of relevance.  This year alone, these PAC's have allowed us to spend time with our legislators to explain our needs so we can provide the best dentistry and services to our communities that we serve.

Is Dentistry a Commodity?

From 1991 - 1995, I went to dental school to learn my craft.  I found out that early on, that the scientific based classes came very easy for me as I was a biomedical engineer prior to dental school.  What didn't come so easy, was the artistic training that was required to be a dentist.  We had to learn how to create teeth out of wax, plastic, amalgam, composite, gold, porcelain, etc.

Looking back to grade school, I was the kid that got sent to the principle's office from art class for being disruptive.  I would do anything to not do art.  I was quickly slapped with reality when I struggled in these early training exercises in dental school.  I had no artistic skills!

I struggled so much that I was required to go to what I call "wax camp" during the summer after the first year of dental school. (Does the movie"The Breakfast Club" comes to mind?)

The other "campers" and I huddled around bunsen burners flames and honed our skills with one-on-one instruction from some very talented instructors.  One day, I don't know when or why, the switch flipped and my right brain connected with my left brain and I was able to wax up teeth at a proficiently high level.  As time went on, I became better and better at it.   In fact, I taught this very same class at University of Colorado School of Dental Medicine for 7 years.

So back to the question, is dentistry a commodity?

Dentistry is an imperfect blend of art and science.  It is not mass produced on a conveyer belt in a factory.  It is provided uniquely and personally to our patients.

A mentor and master of dentistry, L.D. Pankey once said, "I've never had a tooth walk into my office. It was always attached to someone.  Get to know that person, and I may get the opportunity to treat that person's teeth."  Words which I live by in my practice philosophy.  We treat people holistically - mind, body, spirit. You are not a set of teeth, you are a "whole" person.

So is dentistry a commodity?

Can a person go to a dentist and say that he needs a size 12 upper molar and the dentist picks one off the shelf and glues it in?  NO

Can a person go to a shoe store and ask the salesman to fit him in a size 12 shoe? YES

Can that person buy a size 12 shoe for $30, and a size 12 shoe for $300?  YES

Is that shoe store being chastised by community organizations for "gouging" its clients?  NO 

Why then do dentists get chastised by insurance companies for charging a fair price for their services provided uniquely to an individual?  Usually people (insurance agents) placing unfair judgements on things they have no experience with.

If a dentist charges more for a service than a patient values, the patient will not buy that service. Simple economics - supply and demand.

If a person sees a value in either price point for the shoe, he/she will buy that shoe.

The same thing goes in dentistry.  There are different levels of service and challenges in treating patients.  A more difficult procedure may cost more as the dentist to takes more time, care, judgement and skill to perform that procedure to the level of care that the patient expects.

And any patient has the right to put value on things important to them.

Most third party entities (insurance companies, government agencies, etc.) have been masterful at creating a "dentistry is a commodity" mindset to the consumers.

I am emphatically saying that it is not a commodity.  Dentistry is a blend of art and science executed with proper judgement and skill that only comes from our highly specialized training and experience.

There may come a day that one can choose a size 12 upper molar off the shelf -

Then again, there may not...

All this could be a moot point as clean teeth do not decay - AND - 95% of dental problems are preventable!

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

25 Things About Me

As my 46th birthday approaches, I decided to take a different approach to my usual rants here on my blog.

This was a facebook thing several years ago.  I retrieved my list from 2008 and updated it. It was a good reflection exercise for me.


Here are 25 things about me in no particular order -

1. I used to alter my mind with substances but found that it didn’t agree with my present or future plans…

2. I am inspired by positive changes in people, places and things...

3. Someone from my high school told me once that I when I grow up, I wouldn’t listen to heavy metal anymore….”F@%k -you old friend, I still do!”

4. My kids are exactly like my wife and I, and it is scary! We are raising our children Jewish…however, sometimes Sunday school interferes with our ski weekends and my mountain running “problem”…Sorry Rabbi Mo!

5. I love to run, bike, triathlon, snowshoe etc.… my favorite running partners over the years have been Gina, my Dad, my brothers and sisters, Gary Benson, Charlie Perez, Maggie Close, Liza Gualandi, John Stevens, Conrad LaPorte, Steven Griffith, Dave Lindeman, Brian Reick, all my Team-in-Training groups, my dog Kida and now Crosby.  Thinking back, Gary Benson has been sharing adventures with me for close to 25 years.

6. I love to run/play in the mountains. In fact, last fall I ran the Grand Canyon, South Rim to North Rim and back to the South Rim in less than 18 hours.  Other notable athletic accomplishments – Leadville 50 mile mountain bike race, mountain biked from Telluride to Moab, multiple marathons, trail marathons, and snowshoe marathons. (yes you read that right SNOWSHOE marathons)

Which segues nicely into….

7. My life is an adventure, just ask anyone!

8. I am a deeply spiritual person. I try to improve my faith every day. Sometimes I falter and my intentions don't align with my actions. I am human and there are lessons to be learned everyday….There is spirituality in imperfection.

9. I am excited to see so many friends that are on similar paths as I. I am proud to walk this path with all of you! You give me strength and hope when I cannot see it for myself.

10. I have an awesome dental practice, and an amazing team of people that I work with. (employees, patients, consultants, referring doctors, specialists, etc). I am proud of the lives that we impact through our dentistry. . I love being a dentist. I believe that the smile is the window to the soul. I do everything that I can to help my patients’ soul shine through.

11. Progressive music genre: “Complicated music for complicated people” – I think that Geoff Tate of Queensryche was speaking to me when he said that!

12. I would play guitar for a living if I thought it would support my lifestyle.

13. Two friends (Mike Ford and Pat Gibbons) died recently from complications of the flu.  Their lives were cut short, but their impact on the world was huge and their spirits carry on in so many lives that they touched.

14. My wife is a saint to put up with me on a daily basis!

15. I am glad to have reconnected with so many friends from the past on social media.  I am so happy for all of you who choose to share about your lives.  I hope to reconnect in person with you in our various travels.

16. The economy may not have a bright immediate future. However, our attitudes do, if we choose accordingly.

17. In October, 2007, I testified before the United States Congress on behalf of the American Dental Association. I was to explain to them about the ravages of methamphetamines on oral health. My true message was that there is a solution to the disease of addiction. Treatment works. Sometimes it may take a few times but it is the best solution going. And, it saves lives!

18. I am about to become the President of the Colorado Dental Association – I am nervous, excited, and amazed that any group of people would choose me to lead an organization.   I hope to leave the organization better than when I took it over.  I work with an amazing board and CDA staff that keep this train rolling in the right direction!

19. The best thing about being a father is that I get to live my childhood again through them. I am blessed to have a loving family to share their experience on how to do this thing! It is easy to father a child, it is an accomplishment to be a father.

20. Religious people are afraid to go to hell in the afterlife. Spiritual people have been to hell (here on earth) and don’t want to go back!

21. I have had many mentors in my life to which I am most grateful. They saw things in me that I couldn’t see in myself and then encouraged me to grow those gifts.  I try to pay it forward by mentoring others. Thanks to all of you, especially mom and dad....

22. My wife thinks that social media is weird but she is starting to warm up.

23. My dream house is in the mountains near a rolling, open meadow strewn with wildflowers and a stream running through it.

24. I played basketball in high school.  As a rebellious teenager, I began to hate it at the time. Looking back regretfully, I could have played at a higher level if I put the effort in.  Basketball has so many life lessons in it.  I took my son Max to the Coach K basketball camp two of the past three years.  Last spring, I reached out to my old basketball coach from high school (Ken Sartini). Over dinner we caught up on what had been going on in our lives the past 20 plus years.  I thanked him for being a great teacher and mentor to me.  I still talk to him often, what a gift!

25. One more….Chicago Cub’s, next year is now! Come on already!

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Who is John Galt? - Disruptors in Dentisty

Disruptors are innovators.  They are businesses that shift a mindset of how consumers think, purchase, etc.  thereby challenging established businesses.

Harvard Business School professor and disruption guru Clayton Christensen says that a disruptor displaces an existing market, industry, or technology and produces something new and more efficient and worthwhile. It is both destructive and creative.

Some examples of disruptors are companies like Apple, Netflix, Amazon, and Uber

I identify Apple - not for the computers that it builds, but another niche that it took over – music and listening device sales.  iPods, iPhones and iTunes has changed how we buy and listen to music.  There are hardly any CD stores anymore other than those that sell used ones.  When I grew up, I would buy records.  The cover art would attract me to give new bands a listen.  I judged the band by entire albums that it recorded.  Today, we buy songs, not albums. They are instantly downloaded onto our computers.  No waiting in lines, no browsing through tedious shelves of records/cd’s.

 We create playlists with the drag of the mouse.  We use auto shuffle and the “genius” feature to create our own personal radio stations.  They connect to our cars, our phones, our tablets and all are stored on our computers.  CD players are becoming a thing of the past.  Music is stored on hard drives, jump drives, iPods, etc;

Netflix took how we rent movies to a new level.  For a low monthly fee we can have unlimited movies shipped to our house  - hassle free; or immediately available to  view on our computer or smart TV’s through an internet connection.  Blockbuster used to charge late fees, “you didn’t rewind the VHS” fees, etc.  I dreaded having to to pay this fine.  The buying experience was a hassle and expensive.  Netflix is easy, customized to my preferences and instant. Are there even any Blockbuster stores left?

Amazon capitalized on the fact that a book is still readable after it had been read, music is still listenable after it had been listened to, and anything should be able to be purchased on the internet easily!  They created a personalized buying experience based on your browsing and buying habits.  It greatly affected the big chain bookstores like Border’s or Barnes&Noble.  It also helps you find the lowest price for a boxed item and they deliver it right to your door.  If it wasn’t exactly what you were looking for, ship it back.  Hassle-free!

Lastly  -Uber is putting a huge dent in the taxi business.  With Uber, you can press a button on your phone app and a nice clean car will be at your location within 15 minutes. Yellow Cab gets to you when it gets to you and the entire cab experience pretty much stinks!

All of these disruptors have innovated, streamlined and penetrated market share, challenged, and even ruined wildly successful businesses while reinventing the delivery of these services.  They have changed the consumer’s mindset and changed the paradigm on how these services should be purchased, used and consumed.  The consumer experience is exactly the way the consumer prefers.  We (the consumers) wouldn’t have it any other way.

Another commonality of these disruptors is that they didn’t just enter the marketplace and were welcomed with opened arms.  The status quo or “established” business model was not happy and tried to stop them. 

In reality, the status quo was asleep at the wheel.  They were lazy, and arrogant.   They felt they were too big to fail. Those established business models that survived disruption evolved their business models to better serve their consumers.

The question “Who is John Galt?” comes to mind from Ayn Rand’s book Atlas Shrugged! John Galt represents creativeness and innovation.  The status quo must constantly channel it's inner John Galt if it wishes to remain relevant to the people it serves.

There are disruptors popping up in every niche and dentistry is definitely not immune.  They are here and they are aggressively working to innovate and change the status quo. 

Disruptor #1 - Large Group Practices are delivering dental services cheaper, quicker and more efficient than the typical private practice.  They are aggressively growing around the country.  They are aggressively hiring up new dentists.  They are aggressively advertising their services.  They have created a niche for themselves and continue to attract patients.  They haven’t perfected the consistent customer experience yet, but at some point that they will figure it out. 

There are some really lousy dentists that practice in this setting.  There are also really good dentists in this arena too.  To be fair - There are also some really lousy dentists in private practice settings.   There are also some really good dentists in this arena too.

The unfortunate reality with the large group practices is that they are being judged by the lowest common denominator.  For every bad patient experience, the entire organization’s reputation takes a hit. If these companies are going to take their disruption to the next level, they need to shore up some of the bad players in their organizations.  They need to do this from within.

A dental organization in the Pacific Northwest is self-regulating through a peer review process similar to the one used in organized dentistry.  I commend them for taking the initiative to self-regulate and get rid of the bad apples from their branches.   

Disruptor #2 – Dental Insurance has been a driving factor in changing consumer perception with respect to the dentist.  There is a mindset that if one doesn’t have insurance they can’t go to the dentist. 

Dentistry is equal parts art and science.  The product that we deliver is a unique service and experience every single time.  The dental insurance industry has been really good at “commoditizing” these services. They view all fillings, crowns, and other procedures as commodities.  They don't take into account level of the level of difficulty it took to achieve a positive result.  Dentists must impart the value of their services to their patients and that dental insurance is a nice benefit but it the cure all to their dental health.

On the flip side - Dental insurance does help with the basic preventative services - cleanings, check ups, xrays etc.  And many people go to the dentist because of the benefits that they receive.  

Disruptor #3 – New Technology is continually changing how we practice.  Film based x-rays are as antique as the horseless carriage.  CAD/CAM, digital impressions, articulations, etc are going to make dentistry more efficient and even more predictable.

Disruptor #4 – This past year, Metropolitan Denver Dental Society (MDDS) built the first and only dental learning center operated and run by and component of organized dentistry.  The new facility has 4 fully operating dental operatories that are being used for hands on learning opportunities.  They have functioning lab benches, auditorium and video streaming from the operatories into the various remote video-viewing stations.

The Metropolitan Denver Dental Society is dedicated to supporting its members, promoting the highest ethical practice of dentistry; providing continuing professional education, including a premier annual dental convention; and oral health education to the public.  This learning center, The Mountain West Dental Institute, will help them fulfill their mission.  Many dental associations around the country are very interested to see how this works.  Some people say they took a big risk....that is what disruptors do.

The Colorado Dental Association recently hosted a presentation in which approximately 100 dentists showed up in person and an equal number viewed the presentation remotely via live streaming technology.  This new use of technology will allow dentists from around the state/country meet, learn, network and communicate.

America is the land of opportunity.  Anything is possible with creativity, hard work, perseverance and a little bit of luck.  Every business must constantly raise the bar if it is to remain relevant and vital.  The business models must evolve to stave off the disruptors and to keep the consumers interested in their product or service.

Evolution is the survival of the fittest.  Those that can adapt and create change will evolve into the new paradigm and address the needs and desires of its consumers.

The status quo does not exist indefinitely.  It will constantly be challenged. 

“Who is John Galt?”

Disclaimer –I am not passing judgment on these disruptors.  I am just sharing my observation and thoughts.  I may or may not subscribe philosophically with various paradigm shifts.  Each serves a niche that is attractive to various people.  That is why they are growing/gaining the market share and shifting the perceptions of the consumers.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Life's Platitudes

“Life’s” Platitudes

Don't you hate those wise, thought provoking quotes? I usually do too, but in recent events, a few of these rang true for me.  This blog entry is dedicated to my friend Mike.

Platitude #1 - Life is Short….

My friend Mike passed away a few weeks ago.  He died of complications of the flu.  This aggressive strain quickly moved into pneumonia, which led to acute respiratory distress. This forced the doctors to insert a breathing tube to help him get oxygen into his blood stream and he was placed into a medical coma.  After ten days, his heart went into full cardiac arrest and he was unable to be revived. He was 49 years old. 

“Crazy,” I thought. “Healthy people don’t die of the flu!  How could this happen?  Why!?!?!”

The night before he died I gave a presentation on leadership.  This talk was to alumni of a drug and alcohol treatment center.  I spoke about concepts that I am passionate about help me to live my life with some level of significance.  The concepts include: Love my family and friends unconditionally; help others; live courageously, humbly and with integrity. I do a lot of prayer and meditation - especially when I exercise.  And my mindset is usually pretty good. Sometimes I'm better at it than others.  But for the most part, these daily affirmations really help me stay focus so I can be effective.

I knew my friend was in a coma but I didn’t think he was going to die.  I shared my worries with the audience, “You never know when your time will be up.  Better live every day to the fullest extent without regret.”  I know - platitudes....But they aren't relevant, until something like this happens.  

I proceeded to tell the group that my friend was in the hospital and his circumstances were grim.

He died too soon for my liking.   It is human nature to ask why did this happen.  With any of life’s challenges, there is a lesson. (another platitude...)

After a lot of praying, meditating and consulting with friends, I have learned that life is short - get my affairs in order, love my family, friends and work, live each day to the fullest.  

Platitude #2 - Life’s a Bitch….

Initially I was sad.  He isn’t here anymore.  He was a friend that, although I didn’t see him that often, when we got together we could talk heart to heart. 

He had a great dental practice. He was universally loved.  He really knew me, I really knew him – so I thought. 

A few days after he passed, I went to his office to help finish some work on a few of his patients that needed follow up care.  After spending time with his office staff about the tragedy, I was given a glimpse into his life over the past few months.  He had been struggling.  My interpretation was that he was lonely, he was stuck in a rut – possibly even depressed.  His practice was struggling financially.  He might have been struggling financially as well. 

Even under this stress, he still marched forward -helping friends, patients, etc.  Maybe he helped so he wouldn’t have to face his challenges.  Perhaps he was stuck and the only way he knew how to get out of his rut was to help others. 

On his desk was a photograph of Mike, myself and another mutual friend.  The picture was at his open house for his business.  The office space was unique, bold and comfortable.  At the time the picture was taken, life for him was so full of possibilities. 

What changed?   What happened?  Why didn’t he ask for help?  Any of his friends would have dropped whatever they were doing to help.  All he had to do was ask.

Lesson – Outside appearances are not always reflective of what is going on in the inside.  Ask for help when struggling.

Platitude #3 - Life is Beautiful…..

I received many phone calls from disbelieving friends and colleagues. I recited the facts of the situation that I knew.  I gave out the info on his funeral. 

At his funeral, hundreds of people showed up. It was a beautiful celebration.  Friends and family from different parts of his life all shared stories.  We laughed, we cried, we consoled each other.

I shared a story on how I met him.

He was an alcoholic.  Almost 11 years ago, I organized an intervention to help him get his life turned around.  At the time, he didn’t want my help.  He was obstinate, stubborn and arrogant. He was in denial and he thought he could beat the problem on his own. 

I too am a recovering alcoholic.  My trajectory turned around in 1998 when life got really bad.  For whatever reason,  I was graced with the willingness to do whatever it took to treat my problem.  A responsibility that helps me maintain my recovery is to share my story. Another key component of my recovery is helping other lost souls like my friend.

A few days after the intervention, he surrendered his will and reluctantly went to treatment for his problem.  He returned a few months later a changed man.  I had been involved in many of these interventions.  When they return from treatment, some want to thank me and some want to hit me.

Fortunately, he thanked me.  In fact, he credits me for saving his life.  I never felt comfortable with that fact.  I was just giving to him what was freely given to me - The gift of hope.  Someone was there for me when I was ready. I owed it to that person (and myself) to pay it forward.

This is why we had such a unique friendship.  We both had suffered greatly and we had overcome our struggles.

As I got over the anger of his death, I entered into the mindset of gratitude.  I am grateful that we had marched together in recovery for almost 11 years of our lives.

I recall a personal story from the book “Alcoholics Anonymous”.  The story tells of a lady’s personal struggles and how she overcame her struggles while building a new life.  The end of the story says, “In exchange for a bottle and a hangover, I have been given the Keys to the Kingdom.”

My friend and I both have been given the “Keys to the Kingdom." 

When I first met my friend, he was close to death from alcohol poisoning.  Jaundice overtook his body as his liver was failing.  After treatment, Grace offered him a second chance at life.  He took advantage of this opportunity and made a life for himself filled with significant relationships and events.  He helped hundreds of other people in the same manner that he claims I helped him. 

He struggled too – but that is life.  I still feel cheated that he was taken away from this world way too soon.  It was his time to turn in his set of “Keys”.

I don’t think he would have traded his life for anything.  Neither would I....

Lesson learned – You never know who is listening, what they hear that touched them with significance, or when they hear it  - so share my experience with the world. 

Be grateful for what I have. 

Find a lesson in every challenge that life throws at me.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can do it the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

“Team of Rivals” - Reflections from my trip to Washington D.C. May 13-15, 2013

The Colorado Delegation in front of the Capitol

I am currently reading the book “Team of Rivals: The Political Genius of Abraham Lincoln, by Doris Kearns Goodwin.  The movie “Lincoln” was based, in part, on this book – although the movie only depicted a small segment of the story.

When “Lincoln” hit the theaters, I was enthralled by it.   I knew how it would end – happily, the slaves would be freed and tragically, he ultimately would meet his demise from an assassin’s bullet. 

The story illustrated his focus on doing what was right in his heart.  He faced tremendous challenges within himself, his wife/family and his political advisors.  Not to mention, the social norm at the time (slavery), the soldiers that were fighting in the Union Blues and the forgiveness that he exhibited toward the Confederates.  Lincoln, filled with guilt over the realities of war, always considered the southern states his countrymen and reinstated them to full citizenship upon the ending of the war. 

Lincoln was torn every minute of every day.  I could imagine the questions that he would be asking himself – “Am I doing the right thing?  Is it worth the war and all of its casualties? Why do the people I am leading, continue to follow?  Is all of this worth the personal sacrifice to me and my family?”  And the most important question,  “Why me? Couldn’t Seward or Chase be in charge?”

There was so much history in the movie that I was unaware if, I went and saw the movie again – and ultimately bought the book.  The book tells the back-story of how Lincoln arrived at becoming the leader that he was. 

 “Team of Rival’s” – Lincoln took his biggest political rivals – people he ran against for President and lesser political positions - and made them his cabinet.  He made them his closest, most trusted advisors.

This is the political equivalent of President Obama asking John McCain or Mitt Romney to fill the same roles. 

I have been in Washington DC this past week as part of a delegation of the Colorado Dental Association and the American Dental Association to try to improve the delivery of dental care to our communities.  During our time here we heard many politicians and pundits describing for us the current state of politics and the political process. 

As you already know, the climate isn’t pretty.  The government is spending much more than it has and nothing is getting done.  There is party posturing and political stalemates on every front. 

Our delegation met with all of our legislators or legislative staff.  We are looking to reform dental insurance - to break up the monopoly that they have.  With a monopoly, there is no competition.  With no competition, there is no innovation in the plans and the insured don’t always get the best benefits at the best price. 

A new medical device task is being implemented soon.  But there is no definition of what constitutes a “medical device”.  We asked to repeal the tax.  If they aren’t going to repeal the tax, at least define what is to be taxed.  As of now, no one has any idea!

I didn’t get a feeling like we were making an impression on any front.  I hope we planted a seed of change that we can nurture over time into definitive action.

Back to Abe Lincoln…As we were meeting with our legislators, searching for inspiration I began to think, what would a leader like Lincoln do in today’s Washington?

I would think he/she would act courageously, inspire us as a country and bring us together by forgiving the past to move us forward. 

I would hope that he/she would say, “We as a country are in trouble. If we continue along the path we are on, the country and all of it’s people will not be free.  Unfortunately, there is no easy solution.  Everyone must be willing to sacrifice and compromise your beliefs so we can once again be the country that we once were. We must not live in the past and pass along the blame that it was the democrats or republicans fault.  It does no good.  We must move forward with a unified vision of a thriving future -an America that courageously stands on the principles upon which it was founded.  We must change or suffer our demise.”

The only way to do this is for our president to look back in our history and create a “Team of Rivals”.  Get the political fighting done behind closed doors, come out with a unified front and unite us, inspire us and let’s move forward before it is too late.