Secure Dental-Amrita Patel: Audio automatically transcribed by Sonix

Secure Dental-Amrita Patel: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Dr. Nazish Jafri:
Hey guys! Welcome back to our Secure Dental Podcast. Again, this is Nashir Jafri. I am the host today for Secure Dental Podcast. I am still a working clinician in my office. Plus, I am a CEO, so I wear different hats. I am a mom of three kids as well. So, hey, you know my days are as busy as you guys, and today is special because our guest is from my own school of NYU College of Dentistry, plus my own class of 2011. Back then, when we were just on the clinic floors, running around, maybe crossed paths in the hallway in the Schwartz building, or maybe on a clinic floors, we didn't know that we're going to meet one day at a podcast at this age. But, you know, since then, Amrita Patel, Dr. Patel has become one of the most influential voices in the next generation of our profession. She is a former ADA Ten Under Ten award winner and a frequent contributor to Dental Economics. She's also a speaker, and she understands the real-world hurdles that young dentists are facing today because she's meeting you guys and a lot of you guys, like on an everyday basis. So, she understands from NYU to the top of the field in Westchester and beyond. Dr. Patel, so good to see you. Thank you

Dr. Amrita Patel:
You too. Thank you for having me.

Dr. Nazish Jafri:
Absolutely. So, we've evolved from that student age where everything was oblivious. The only dream that we had was come out of school and we're going to go change the world. You know, everybody's going to come and hire us. We're going to be this grand dentist in this grand office, and we're going to sell $10,000 treatment our first day. Tell me your experience.

Dr. Amrita Patel:
What you see on dental social media is not reality, and what we thought isn't always reality either. Now, that doesn't mean that this profession is not incredibly fulfilling and will allow you to have the life that you want. But I think what you don't see, what we don't see, is all of the hard work and all of the struggles and all of the failures, no matter what stage of your career that you're in, you don't see that, and many people don't talk about that. And so, I think that there's this sort of sense of it's all going to be great all the time that gets perpetuated. And then when you're working towards something that isn't really true, that's when you start to get burnt out and feel like you're a failure to, which you're not.

Dr. Nazish Jafri:
Yeah. No, nobody is a failure. But I think you're right. You are starting to live somebody else's life because of the social media nowadays. You think it is so much out there that every post that you see, everything that you see is just good stuff, which is really good for everyone. They're posting good things, but the stuff that goes behind the scenes, every single minute, every single minute that they have to put out fires, they have to make these difficult decisions. That is something you don't learn in the school. That is something that you learn on the spot, either on your first day of your job or your first day of your ownership of your practice. It's like a tough situation that you're like, hey, I cannot lead to this person who is doing these $10,000 cases. How do I go to that level?

Dr. Amrita Patel:
And I think the most important thing to remember is that we're all on our own path, right? We all have our own journey. And maybe you get to the point where you're doing those cases, but then it burns you out, and you don't find joy or fulfillment, right? Or maybe you take a whole bunch of training, and you're doing all sorts of advanced procedures, and you're like, you know what? Maybe I don't really want to do this anymore, even though it is bringing those big cases, or it is maybe making you a lot of money, because I think there's so much more to everything that we do than just the dollars and cents. And the more you chase it, the more it runs away from you, right? You have to remember to do good work. Be proud of what you do and sort of trust the process and know that it's going to lead you where you want to go.

Dr. Nazish Jafri:
Yeah, absolutely. And then sometimes, you know, younger graduates, they come out, and then they're in an associate position in an office, and they get into this contract situation. I'm sure you've had a few of those. What have your experiences been like from your class fellows or some of the stories that you've heard? Like, what do you think they should have looked out for before accepting positions?

Dr. Amrita Patel:
I think the number one thing that I see the most that always scares me so much is that people will tell me that they either don't have a contract or that they didn't have the contract reviewed by a professional. Now, a professional is not you or I. We're not attorneys. A professional is not social media like an attorney that specializes in employment law. It's going to cost you a little bit of money. But I will tell you that the majority of people that I speak to, even the ones that come to my lectures, even the ones that are very involved, most of those people either don't have contracts or have not had an attorney review their contract. And that's when you get into trouble. That's when you have issues. Yeah. I've seen some contracts that we've heard like some kind of weird stories that they were bound by maybe restrictive covenant, which was like really, really small, maybe five miles of the radius. Some of them are bound by bonuses. And those ones I think are very, very tough because some of the bonuses are $60,000, $70,000, $80,000 and they hold you by the neck. And if you haven't read those tiny little footprints at the bottom of that 30-page contract or agreement, I think when you don't like the place, it's very hard for them to break it or penalty, and you might have to give back when you haven't even done the production that much. Well, and that is true even with like a draw contract, right? So, if you don't understand the way that that works, you might end up owing the office a lot of money and you brought up the bonuses, the bonus might say in the fine print, if the contract is two years and you leave before the end of the two years, you owe a certain percentage of the bonus back, which, by the way, makes sense, right? That does make sense from a business standpoint. But these are all things that unless you have someone review it, you wouldn't know to look for it. And you brought up the restrictive covenant, you know, five miles in some areas of the country. Okay, fine. Five miles in New York City is all of New York City, right? So, yeah, it's the building that you're in. Exactly. I think exactly the next building. That's about it, right? So, that's why you have to be really careful with that stuff.

Dr. Nazish Jafri:
Yeah. And I think when I do here, the business part of it, I am a business owner. We have multiple offices. We don't have restrictive covenant and we don't hire on bonus structure. Anyways, it's more like value proposition if you're a good fit, but people who want to come and join us and they have to break those contracts. I'm mostly asking them, hey, you know, even though you read it, you knew that you were getting into this. How could you have changed your situation in there if you wanted to outlive it, right? So, sometimes I feel like that in the school, we are like kind of under the wings of the school, under the wings of maybe the faculty. And we don't realize that we need to own our own space, and we need to be the leader of our own space. And sometimes we forget, we think once we get out of this school. When I do go practice, I am going to do this, or when you are an associate, and you don't like that place, you say, once I become an owner, I'm going to change the world, right? Every time you think like the grass is greener on the other side. So, sometimes they don't like the places because they might not be in a leadership position. They're not helping or giving value to the place, right? Because of the mindset. Have you had like that kind of thought before in a different way?

Dr. Amrita Patel:
Yeah, it's a two-way street, right? And it's really easy to say, you know, oh, owners are all out to get associates, right? Or associates don't want to do the work, and they don't understand. But so much of this, I think, comes out at the interview and at the beginning, right? So, associates, if you don't ask these questions right up front, you're not going to get the answers. And then you might have to find out, and you might not like the answers, as you have already signed your contract and you're kind of stuck, right? And owners, you need to also ask these questions and figure out what it is that you're looking for. And is this person really a right fit for you? You know, are you really ready for an associate? How are you going to market this associate? How are you going to schedule this associate? How are you going to support this person? And especially, you know, you and I that hire people that are newer. Are you going to be able to be available to support that person because someone supported you in terms of helping you with mentorship and being there for you when you started, right? So, you have to be able and willing to do that for this person. And so, a lot of the owner associate clashes I see are honestly because of miscommunication and a mismatch of expectations in that way.

Dr. Nazish Jafri:
You're right. Usually, new graduates are looking for some kind of help or mentorship because obviously nowadays, even the final exams or the hands-on is on at our time and your time. We actually had to scout for real patients and sometimes pay them money to be present on that clinical day of our exam. But now I see they do it on "..." so there are no human interactions, and their confidence level is very, very low when they're talking to the patient. So, they're always looking for some kind of mentorship. And I feel like sometimes they're not asking for help to make a class two cavity. They're probably just wanting support to be in and around the building or their area, so they know, okay, I have somebody who knows more than me, can still stay around just like a faculty. I think. That's what the mentorship they're looking for.

Dr. Amrita Patel:
Totally agree. I totally agree with you. And the requirements for dental school graduation have changed so much, especially since COVID, right? I mean, the clinical requirements have dropped significantly. And so, this is one of the reasons that I think, and I still think, you know, I had to do a GDPR because you need one for a New York license, even if you're not doing post-grad residency. I think investing in continuing education is so important. And honestly, one of the questions you should be asking is, hey, if I want to do CE, am I going to be supported in that? Am I allowed to take time off for that, right? As an associate, is there a CE stipend? And then, figuring out, not just throwing money at random CE, but what is it that brings you joy, right? Maybe you don't like doing all on "...", right? Maybe you really like doing cosmetic cases. So, invest in good CE. It's called the practice of dentistry for a reason, right? We're always practicing. We should always be practicing and bettering ourselves. Because when you better yourself, you can contribute more and then better the practice. And then no matter what path you choose in the future, you're just setting yourself up for success.

Dr. Nazish Jafri:
Right? You are practicing every single day. You're a student every single day. Patients teach you, your staff teaches you every single day. Different personalities. They teach you every single day. And I think you're just like a lifelong student. You have to have that mindset too. Can't be just like, okay, I've done this all on X. I am this much, oh, how important person, and nothing can beat it. So, but hey, you know, you're learning from the human component of dentistry that comes every single day with every single patient.

Dr. Amrita Patel:
Exactly.

Dr. Nazish Jafri:
You have a lot of leadership experience, and you've held a lot of leadership roles since the school time I've seen. You were in the committees. You were always out there helping, organizing while you were studying as well. And you were the chair in the NYC as New Dentists Committee as well. So, you've done a lot. And how do you think that helps with communication and the leadership that you have developed? Like, what would you say to a young dentist who looks up to you and says, you know, she can do it because she's good at it? And, you know, I just have to still study. I'm okay here in my room.

Dr. Amrita Patel:
I would say this, and it took me a long time to be able to be comfortable enough to say this. My social media is open. It's not private or locked. And if you go scrolling through it and you look, you know, maybe starting like five, six, seven years ago, when I was very involved in leadership, you'd see someone that outwardly looked like she was traveling all the time, having so much fun. Got to work with a parent, like just kind of like, had it all. And I was miserable. You would have never known it. And I was so miserable. And so, what I would tell you is that just because it looks like I have everything together, right? You, anyone has everything together, you don't know what's going on behind the scenes. Look, I think I'm a pretty good communicator. I have my hard days, right? My team doesn't always 100% understand what I'm saying. There are things that go sideways and wrong as I travel and do everything else I do. That's non-clinical. In dentistry, I still have to manage things with my practices. So, I think you have to understand that no one has it 100% together all the time. And if you're going to be involved in leadership and be involved in your practice, and you're going to be involved in your community, and you're going to be a parent, and you're going to be a spouse, and you're going to be a daughter or a son. Something is going to give, right? This work-life balance, a phrase that we throw around all the time, it's not like an end goal. I think it's very much like a moving target, and you're not always going to have it. You're not always going to have it. You know, I'm sitting in Arizona right now in our house in Arizona. I have to give a lecture tonight here, and then I have to get on a plane tomorrow to go see patients tomorrow afternoon in New York and then work a full day on Saturday. So, because when I'm home, I work six days a week. And these are all the things you don't see. But something is always giving. You just have to be okay with whatever it is that's going to give, because otherwise you'll put yourself in the hospital.

Dr. Nazish Jafri:
Yeah, no, you're so right. You have to make peace with what you're doing. So, as long as you know that one thing is liking and one thing is that you do it effortlessly, but sometimes you have to put the face of doing it effortlessly because it's something that you like and work-life balance. You're right. I have three little kids, and I have all this to manage, and there's no work-life balance. I cannot demand work-life balance, but I show up to my kids every single time they're from home. I show up to my mom as a daughter. I show up to my in-laws as an in-law. I show up to my friends as a friend. I show up to my people as a leader. You know, so you show up to everybody. And sometimes you have to change these emotions right away. I might be mad at my kid because they're not doing math homework, but now I have to help a doctor who's stuck with an extraction. You know, I'm talking to them on the phone. So, the emotions that go across, I don't know how work-life balance can be in that. When an associate asks me what kind of work-life balance does Secure Dental offers, I'm like, I don't know. I don't have any work-life balance. This is how I do it. And you just show up to each situation in a very positive mindset.

Dr. Amrita Patel:
Right? Exactly. And look, it's not always going to be easy, but it's always worth it. That's always worth it. Yep. That's the way I choose to look at it.

Dr. Nazish Jafri:
Yeah. If you're at peace with it and if it makes you happy, you do it. But I would really refrain people from impersonating what they see on social media because sometimes that social media, just like you said, you had your rough days. They don't even know what happened. What's happening every single minute behind those, because those are still pictures. There's a live person behind it that, you know, things are happening. So, when you do look at all these things, be mindful of what they're doing. Take it as positivity.

Dr. Amrita Patel:
Right.

Dr. Nazish Jafri:
Right.

Dr. Amrita Patel:
Yeah, yeah. And find again, find what brings you joy. Because if you're chasing someone else's, then you'll never be happy with yourself.

Dr. Nazish Jafri:
So, Amrita, tell me, when did you think of, I know you worked with your parents. Your dad is a dentist, right? When did you think of owning your own? When did you come out of their way?

Dr. Amrita Patel:
I still do, so now. I'm also married to a dentist. So, these practices that we have are ours. And I think the thing that was attractive about owning multiple practices and expanding our business came from a place of being able to take care of a larger patient population, and I'm sure you can resonate. A lot of people on social media think that just because you buy more practices, your income is going to magically multiply with your practices. And that doesn't happen all the time, right? Like it does not. Sometimes, all you're doing is multiplying your problems depending on how well you have things set up, right? And so, dentistry, I believe, is still one of the best small businesses in healthcare out there, which is why the business part of dentistry is so fulfilling. But so much of that comes from on-the-job learning, right? So, what I would say to someone who's a new doctor or an associate that is unsure about maybe wanting to own one day is learn as much as you can, and sometimes you're going to learn from your office manager, your hygienist, your assistants, the people you work with, figure out, especially in your associateship. What do you like about this? What maybe doesn't fit with the way that you would want your practice to be set up. Take the positives of every situation instead of just looking for the negatives. Because even in the best-run practices, even in the biggest practices, even are the ones that are, you know, have a million followers on social media. Things are always happening that you don't see things. There's always fires that have to be put out.

Dr. Nazish Jafri:
Yeah, we have lunch walkers. You hire somebody in the morning, you work with them at 10 a.m. and 1 a.m. they never come back. And that's the reality. Yeah, that happens almost here and there. And it doesn't mean that you're a bad owner. It's just probably they just never fit in the right placer, and now you're doing an extraction with no assistant.

Dr. Amrita Patel:
Right. And it happens. And I see so many people posting on social media, right? Like, oh, this office was understaffed. And, you know, they promised all these things, and they didn't deliver. And it's like, hold on, wait a second. You don't see everything that goes on on the other side where we're like trying to pull one assistant from one office to make sure that you have an assistant, and changing our schedule around, and then like you don't see all of that. But again, this comes back to what is it that you're looking for out of your position? What is your long-term goal? And dentistry. And I think dentists can be very myopic. I mean that we tend to miss the forest for the trees, right? Because our world is this big. And if you're right, if you're an endodontist like my dad, it's measured in tenths of millimeters. And so, it's really easy to like introvert and not look ahead. So, what I would say is figure out where you want to be and then reverse engineer your life. So, if you know you want to be a practice owner as you're starting out, figure out where geographically you want to be. Start to make connections there. Even if you're not going to be there right away, at least get your name out. Maybe you don't know if you want to be a practice owner. There's lots of different paths in dentistry, right? You can teach. You can work in public health. You can work in policy and legislation. Think forward with what brings you joy, and then go make those connections and work backwards to get there.

Dr. Nazish Jafri:
Yeah. You're right. There's a question I asked my associates when we interviewed them. They would be like asking me if they're interviewing me or my office. And I'm like, okay, go ahead. And then one of the last questions is like, how much money am I going to make here? So, I'm like, okay, that is where I catch them. I'm like, how much money do you want to make? They don't know. And sometimes I'm asking them. Okay, if you don't know how much money you want to make, what are your expenses right now? How much are you paying for your apartment, your car, your clothes? What are your fixed expenses? Sometimes they don't even know. I'm like, okay, this is the homework. Let's go write it down. Come up with that number. Then tell me, how much are your expenses for the year, and now how much you want to make. And then we reverse engineer the whole thing like, okay, drill and fill dentistry is not going to get you there. Prophys is not going to get you there. You have to increase the skill. So, obviously, just like you said, where do you want to be? Where do you want to go? Not that what as an owner, you or me are going to do for them? We can do it. I can get you maybe another implant course. But if you don't have the communications to sell it, it's zero ROI. And that happens in somebody's office, or that happens in your own office. If your thought process is not in the right place, and you don't have a vision of where you're going. Some kids have a vision of doing everything. They want to be like Michael APA. They want to be like Ryan Dunlop. They want to be like everybody else and then do multifamily, but they don't have a path. They don't put themselves outside. Yeah.

Dr. Amrita Patel:
Right. And I think you have to be a little bit fearless. And that's scary, right? And no matter what you're undertaking. But I think the other thing about dentistry that I like so much is that if you ask for the help, you will always get the help. The people that have problems are the ones that think they can go at this alone, and they know everything, and they don't need any help. I don't know everything, right? I'm sure you're always learning, too. We don't know everything. Always. So, being teachable and always approaching situations with curiosity, like you said, how much money am I going to make? Well, how much do you want to make? Like, what are you willing to do and invest in yourself and the practice to get you there? Are you willing to sit with your team, your hygienist assistants, front desk, wherever you're working, and say, okay, great. So, I want to be part of the morning huddle. What are our goals? How are we going to get there? Those are the associates that tell me like, okay, this person is invested not just in like my practice and us doing well, but also in themselves.

Dr. Nazish Jafri:
Yeah. You're right. My first job was actually right out of school was one of the DSOs. My husband stayed there for five years. I stayed there for, I think, 2 or 3 years with them. And just like I said, I thought we were glorified. We would be like, I would have like a humongous case when I started the first day. Well, when I started the first day, I had a new dental assistant. I was all the way in the corner of the DSO, and I had little kids to see, and I would just be complaining. I'd be complaining. I don't get anyone. I'm all the way in the corner this and yada yada yada. They were like all paper charts. And then I was like, you know, this is not helping. I'm just blaming everything on somebody else, and I'm just sitting and not doing anything. Let me figure out my own diagnosis. Let me figure out my own thing. Let me see if with my new dental assistant, I started teaching her a little bit. We had downtime, so we started doing treatment plans with her. And that's how I was like. And that mentality kind of got stuck with me. I was like, if I can't be a leader in my little ok room with my little assistant, one person I can't lead. How am I going to lead anybody else?

Dr. Amrita Patel:
As an associate, you are a leader. You are the leader of the team that you have around you, and you have to have that mentality, if you want to succeed.

Dr. Nazish Jafri:
If you want to succeed, yeah. Otherwise, you'll just be complaining about everyone. And when you become an owner, who are you going to complain to?

Dr. Amrita Patel:
Your spouse, your parents, your friends. That's why. Yeah. Yourself. But what I think the most important thing is just because you see someone active on social media. Just because you see someone has a bunch of practices or is getting on stage in front of people, don't think that we don't have our struggles too.

Dr. Nazish Jafri:
Oh man,

Dr. Amrita Patel:
We all have our struggles, and we all feel burnt out sometimes, and we're all tired. And sometimes we all feel like we are failing a little or failing someone. So, don't aspire to something that's not true.

Dr. Nazish Jafri:
Correct. It's not always handy dandy. You just everybody shows up to their best level and show up to the best level. Whatever happens, show up to the best level. You are the same person at 9:00 in the morning with that cup of coffee. You have to survive the whole day for the 3:30 patient who is going to expect you to be just like the 9:00 patient, right? Same energy, same happiness. No matter how many sinuses you opened up in the mirror, the root canal failed. Whatever happens, somebody is getting a refund. You still have to show up for each of them.

Dr. Amrita Patel:
Exactly, exactly.

Dr. Nazish Jafri:
And I think the mindset.

Dr. Amrita Patel:
Yep. And it's not easy. You need a team.

Dr. Nazish Jafri:
I think you really need a good team. I'm really grateful for the team that we've built. Otherwise, we wouldn't have been where we are. Because if we would have not put in the right people in the right seat and identified their strengths in that seat and put in the wrong person, we would be like totally done. And everybody has flaws. Not that somebody is like a really good person in insurances. Somebody is really good communicator. So, just swap those seats so you have the right person in the right seat. Yeah, identifying people to make a good team also helps. As an associate right there, you're again a leader. Being a business owner, you're again a leader. Yeah. Beyond up rooms. Like I was telling the audience about you, like you have done writing, you've done speaking, you've done social media, for a young dentist who's coming out. I know everybody knows how to do social media, and they post their pictures. What do you think they should focus on when they're building their brand?

Dr. Amrita Patel:
So, I think the thing that comes across is this is your authenticity and your niche. Creating content is like your currency at this point, right? It's you're putting out, this is me, and this is how you know that I'm authentic, and this is how you know that I'm passionate. There's a lot of canned social media out there. And when I say canned, I mean like, it looks like everyone's posting about the same thing, and they're all just copying ideas from each other. The people that I see that are the most successful at doing that, whether it's posting on their practices, social media, or creating a social media like personally, are the ones that say, you know what? Like, these are my frustrations. I bet other people have these frustrations. Let me talk about it. Or these are the cases that I really love doing. And I want to share my result because I think they're really great. And I've invested a lot of time in learning how to do them. And I think that that communicates across more than just like, oh, look at me getting ready, and look at me setting up for my full mouth rehab case, and all this content, you see that just basically looks the same. I think it's important to figure out who you are. Stay true to that and communicate that in a way that makes you relevant and relatable to your audience. Because like I said, I think the biggest mistake that people make is getting kind of intimidated by it. Just start like post your cases, post about what you're doing, or what you're thinking. You never know what's going to resonate with people.

Dr. Nazish Jafri:
You never know. Yeah, there might be some little word or some little thing that you've done that they'll be like, oh yeah, this happens to me too. You're right. We just post mostly like success cases, but there are so many failures that people are asking for questions. And I see sometimes patient doctors are posting some of their troubles or some of their issues on social media forms. And instead of getting like a good answer for what their problem is, they get like blasted with a lot of either negativity, or they downplay it or, you know, so I'm like, oh, I wish, you know, they could have better places to get their answer right away. A genuine answer. This happened. This is the way you can solve it. This was our experience. But no, people love being like keyboard warriors nowadays.

Dr. Amrita Patel:
I know, and that's honestly, I used to post a lot more on some of the forums, and I've switched to Instagram because making the real, shooting the little video, and being like, this is what happened to me. Am I the only one? Am I going crazy? And the responses I get back range from you're crazy to hey, this happens to us. And here's a really good solution for you.

Dr. Nazish Jafri:
Yes, that is what people want to hear because they're trying to figure out an answer that they cannot figure out. They're just posting because of it. Nobody likes to share problems, but they might have a general problem.

Dr. Amrita Patel:
Correct? Yeah. I think the last one, the one that I'm about to post, is about replacement periods for insurances. And you ask me about dental benefits earlier on, right? And it's like the patient's telling you, how come you increase the price of my crown? Well, I didn't increase it. Your insurance has a replacement period, so they don't care if you're in pain. They don't care if it's broken, they don't care. But if it was done within that replacement period, they're not going to cover it. I didn't change anything. It's not my fault.

Dr. Nazish Jafri:
Yeah, yeah. Taking insurance is a toughie. Yeah, very, very tough. Especially those missing tooth claws. I hate those missing tooth claws.

Dr. Amrita Patel:
I know.

Dr. Nazish Jafri:
The tooth might be missing since what time.

Dr. Amrita Patel:
What if it were congenitally missing?

Dr. Nazish Jafri:
Yeah.

Dr. Amrita Patel:
So when insurance makes a payment, they write it off on their books as a loss. And that's what I educate patients about that come to me and say, I just want to do what the insurance covers. And quite honestly, a lot of those patients I don't treat. I don't treat because if I can't feel good about it, and I can't provide comprehensive care, and the patient wants to dictate what it is they want me to do, then maybe I'm not the best fit for them. And learning not to be a hero is one of the most important things of practice management, as I'm sure that you have talked to so many doctors about is not every patient is for you. Not every case is you're supposed to do. And that's okay.

Dr. Nazish Jafri:
Yeah. Learn to say no. It's okay.

Dr. Amrita Patel:
Yeah.

Dr. Nazish Jafri:
Just. And I, like you said, the insurance periods is a problem. If they don't cover a crown, they won't cover a crown. So, just don't do a filling on it. And then now you're stuck. You're not getting paid. The patient is upset. There's a bad Google review. You have to refund that filling, too.

Dr. Amrita Patel:
Exactly. And even more than that, now you're liable.

Dr. Nazish Jafri:
Yes, you're liable too.

Dr. Amrita Patel:
Right. You're not going to be liable if you do a consult and document well and say patient refused my treatment recommendations.

Dr. Amrita Patel:
Yeah.

Dr. Amrita Patel:
You are liable if you document that the best treatment option was a crown or full coverage. And the patient said no. So, you just did a filling. You've just contradicted yourself. That's never hold up in court. Never.

Dr. Nazish Jafri:
Yeah. And they say, oh, because the patient was so nice. So, the patient didn't have the money. But that doesn't hold up anywhere. No. And they come back, and they blame you right away. Maybe the next day they'll come and blame you.

Dr. Amrita Patel:
Correct? Correct. And like I said, there are many, many, many cases that I don't do, many patients that I will not start treatment on if that's the vibe I get, if that's the conversation that I have with them. But this all comes down to asking the right questions, right? Whether you're asking the right questions of your potential employer, whether you're asking the right questions as an owner, and whether you're asking the right questions in conversation with patients. You know, if a patient sits in your chair and says, I want a second opinion because I think I might sue my previous dentist, you better get out of that situation fast. That's not the patient that tells you, oh, you know, I have CareCredit, and I can pay you for whatever you need to do. And you see dollar signs, and you take that case on, right?

Dr. Nazish Jafri:
Yes.

Dr. Amrita Patel:
These are the kinds of things that are very easy to pick up on once you start having conversations with patients and you have to, like you said, learn to say no.

Dr. Nazish Jafri:
You have to learn to say no. You are so right. Especially those ones are coming in with tons of dentures, and now you think you can do it. And no. You don't want to do those dentures. No, we don't even do implant over dentures for them because this is going to go south. They have like a bag of dentures. Every dentist that they went to was bad. They extracted this, they did this, yada yada yada. We're like, yeah, let's send them to somebody else. Yeah. And sometimes patients don't know that they are the problem. Yeah. And sometimes I feel like associates who work with you, they are the problem. They don't know they are the problem because if they're not making the money, the owner doesn't hold the hands to make the money. It's how you communicate with the patient is going to sell the whole thing. And I think we're sellers every single day. We're selling to our kids. We're selling to somebody. We're selling to our patients. You know, we're selling something to somebody every single day. But if you cannot communicate, I think it's very hard for anybody to make money or production coming out of the mindset. For your burnout, what are the few things that you do that you would advise when they're doing, juggling so many things?

Dr. Amrita Patel:
It's a hard one. I am not good at this, and I will say that I'm still a yes person. It's hard for me to say no, especially when it comes to my personal life. But what I have learned to do is to figure out, and it's an ongoing practice. Like, what is causing me to feel burnt out? What do I have to do? Let's list everything I have to do. And it could be personal things, it could be professional things. And then I look at that list,, and I figure out, is there someone or something that could be doing this better than me? And oftentimes, what I realize is when I'm starting to feel really burnt out, it's because I'm taking on tasks that I should have delegated to someone else. Or maybe I, or maybe I did delegate to someone else, and then I decided I can do it better. Because that's another thing that, you know, dentists have problems with. We just think we can do it all. We can do it better, and maybe you can, but you should let someone else try. So, that's kind of an ongoing practice. But it's not easy. It's not easy to show up fully all the time for everyone and everything. And I think aside from that, the thing that I've learned to do is just be okay with it.

Dr. Nazish Jafri:
Make peace with it. I think when you acknowledge it and make peace with it, that's best. What you're saying, like wearing all kinds of hats because you think you can do it. I was in a situation where, like for when we were in our fourth office, we were doing marketing, and digital marketing was starting to come in at that time, and we were kind of understanding it. So, I was trying to get with all these like marketers and all these agencies and doing all that kind of stuff. And I had so much on the plate while I'm being a clinician and household and mom. So, I was dropping calls. I was not going oncall. So, my management fee was rising with them constantly. And they would say, Oh, Dr. Jafri, we need some ad budget for this one. Go ahead. And our fees was getting higher because I wasn't paying attention, because I was everywhere trying to do everything. And then I realized I was like, this is nuts. My marketing budget is going like way overhead and I'm just saying yes to very crazy stuff. And they were milking it. And then I started trying to get somebody to follow up with these things and gave some of my plate away. And then now we have a marketing manager who does this. Oh my goodness, that has changed so much of our marketing. That's one second. It has taken so much burden off me because I don't have to be present for all that. There is an expert who just does this, otherwise. You can't really wear hats all the time. With everything, you have to start a micro. I think dentists have a problem with micromanaging everything but their business, correct? They don't know what KPIs are, though. They have no idea. Nope.

Dr. Amrita Patel:
And if you can't track something, then how do you know if what you're doing is working? And if it's not written, then it's not true, right? It doesn't matter who said it or where it came from. You have to be able to track what you're doing to know that it's working. And that applies whether you have one practice or whether you have 50 practices. You don't think that the large team, you know, you've worked in a DSO. Everything is tracked, everything is tracked. Now, whether you agree with how they do it or not, it doesn't matter. But everything is tracked. And I think that that's one of the biggest mistakes that smaller businesses. You know, these like single offices that these people that own one office that I talk to make is they don't know where their dollars are going and they don't know what to track or how to track it. So, it's great if you have a big marketing budget, but if you're not tracking where the patients are coming from that you're getting, how do you know what your ROI is on that campaign? You don't, right? A lot of doctors say, well, our numbers are rising, so we must be doing something right. How do you know? Maybe it's just that you have a lot of happy patients, and they're telling their friends about you. And maybe that $6,000 a month you're spending on your marketing isn't actually gaining you anything. So, those are a lot of the conversations I have with people.

Dr. Nazish Jafri:
Yeah, that is very, very true. For KPIs in your offices, what KPIs are the key that you see almost like weekly?

Dr. Amrita Patel:
I mean, aside from your very standard patient collection and then obviously your very standard production. I look at our AR reports pretty closely. The other thing that I look at is attrition. I want to know, are we losing patients? Why are we losing patients, and where are they going? And if I start to see that there's a lot of patients that are leaving, and it's not because they're moving, right? That they're getting their records transferred or something's going on, then there's something happening that you need to troubleshoot without getting overly involved in things, right? So, I would say that just as important as new patients is also patient attrition, because you want to make sure that you're taking good care of the patients you have. And the cheapest, easiest referral is a happy patient.

Dr. Nazish Jafri:
Yeah, that's right. Because marketing can bring that many new patients. But if you can't retain them because you have like slow systems or somebody at the front desk is just not nice, or they get a vibe, they're probably just not come back.

Dr. Amrita Patel:
Right, right? And look, again, you're not for everyone. You can do the best job possible. And so, it's important to try to not take this personally all the time. But you need to know where your money is going, and you need to know what's working or not, and how your patients are being taken care of.

Dr. Nazish Jafri:
Yeah, absolutely. What is something that you really look for when you are hiring a marketing person? Like we were talking about ROI. I don't know if a lot of people or young dentists even know what ROI means, but can you explain just a little bit of when you are doing marketing, what are you looking for, and what should they be looking for?

Dr. Amrita Patel:
So, especially with the rise of AI, a lot of the marketing companies out there and a lot of the marketing tools are very AI-based. I would say the very first thing to figure out is where are your patients coming from? Are they largely coming because they're looking you up on your insurance website? Are they coming because their friends are telling them about you? See where your patients are coming from. Become involved in your community. A lot of people don't do that. And I think it's really, really important. Now, whether that is making night guards for a different varsity sports team every season, which are obviously, you know, pretty cost-effective to make. Do that. Are you sponsoring a local sports team? Are you going to the farmer's market? Are you going into some of these smaller towns where these practices are in and physically handing out, like referral cards, or do you have a strong internal referral system? I would start there before I started spending tons of money on outside marketing. Now it's important to have an optimized website, of course, and make sure you're appearing on Google searches. But all of the extraneous marketing campaigns I think are secondary to that.

Dr. Nazish Jafri:
Yeah. To the efforts that you are putting in the market. So, the market, the community knows that you exist, right? And then I think these warmth-building things like going out to daycares, communities, doing mouth guards for free for a team. I mostly like repetition building because they see that, you know, you care about your family or your community, so they will trust you in that. Otherwise, everybody's doing the same kind of dentistry. The guy next door is doing same drill and fill composite. It doesn't really matter to them. They just need to see if they can trust you.

Dr. Amrita Patel:
Exactly.

Dr. Nazish Jafri:
And that's where you have to put yourself out with that warmth, mostly. Yeah. Anything that you want to leave in your experience, in your growth experience, that you think has really stood out, and you would like to share?

Dr. Amrita Patel:
Yes. So, I don't know if you have watched the Stanford commencement speech of 2005 that Steve Jobs gave. Now, obviously, we know that he founded Apple. Then he got fired, and he founded Pixar. And then he came back, and he was a Stanford dropout. So, he gives this speech, and to the graduates, and he says a couple of things, and he tells them that he wants them to remember these as being very transformative in his life. And one of the things that he says is that you have to love what you do. And the next thing he says that I think resonates with me the very most, out of everything I've read or consumed or learned, is that you can't connect the dots looking forward. You can only connect them looking backwards. So, you have to believe in something - your gut karma, destiny, whatever that the dots are going to connect, even if it doesn't make sense right now. So, if you're in a job that you aren't 100% fulfilled in, if you're maybe having, you know, in a tough period in school, which we were all in, right? If you are a practice owner and it's not really going the way that you want it to go, understand. And I think what I gained from, like kind of what he said at this point 21 years ago is that, you know, it's just crazy, right? Like it's not always going to make sense, but it will one day. And the best example I can give you for my personal life is that I met my now husband a couple years ago, and we got married two years ago. And if you had told me that I was going to marry someone from Sioux Falls, South Dakota, I would have told you you were out of your mind. I am like a New York City girl who didn't even know where South Dakota was, right? And the way that life works out, that put me in front of him. I mean, you just never know what's going to happen tomorrow. What's the next step? And even if it really sucks right now, one day you'll turn around and look back and say, it really sucked then. But it got me to where I am now. So, trust in that is what I would say. And the last thing that I would leave kind of anyone that's listening, no matter what point of their career that they're in, is to always and always be teachable. You don't know what you don't know. There's always more to learn. And continuing to consume information and knowledge and better yourself and thereby better your surroundings is probably one of the biggest contributions that you can make to your workplace, to society, to all of it.

Dr. Nazish Jafri:
Absolutely. I think the one thing that I learned in these 21 years was investing in yourself. It has been the best rewarding because before everything was external, the problems were all external. Till I realized, no, the problem was in here. The problem was in the communication. The problem was in the conference. The problem was in the negativity that sometimes you kind of get consumed in. And once you start working on yourself and just silence the noise out, it takes time. It takes patience. It takes a lot of endurance to do that because those noises can consume you. But once you start looking within yourself and you start working within your own mindset to positivity and your goal, you have to set a goal. Sometimes the goals can be have to be a little crazy so you can reach it Midway. I think that is the best ROI that you get out of it in everywhere. As a person, you show up to the family as a person that you show up to as a leader, to your people, your team, your spouse, your kids. And that has helped me as well. A lot of internal thinking, reading, improving on ourselves, communicating, that really helped. Yeah. So, Amrita, thank you so much. I know you have another speech to give. I don't want to tire you up tonight, but you know, I really like that you are just a very genuine, transparent person. What is coming to your mind is you're showing. And that's exactly how you put your stuff out there, too. So, it's very hard to be transparent and show your faults. And I think people learn from that because then they can see that you've grown, and they trust you. So, it's rare to find somebody who can balance the clinical side and the high-level business that you're doing, and now you're also speaking engagement. So, it's very rare to be transparent during these times. For all our listeners, especially our young dentists who are going to be graduating or have graduated just recently, Doctor Patel is a living example of why you want to get involved in the business of dentistry, because it's fulfilling if you do it the right way, if you have positivity, if you have your aims and goals aligned to your goals of what you want to do, it's very fulfilling. And just like how you want to hold your handpiece proudly, you know you want to hold yourself and you want to show up every single day. So, thank you for joining Amrita today. Yeah, I highly appreciate your time today. Thank you so much.

Dr. Amrita Patel:
You're welcome. Thank you.

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