The “Health-centered” Secret to Loving Your Practice

You're listening to the Phil Klein Dental Podcast According to our guest, Dr. Stephanie Vondrak, when you're a health-centered practice, you need to let the patient know at the very first visit. And she says, a health-centered dentist is not pushy about any treatment, but rather the goal is for the patient to understand what's possible. But the decision is up to them. So what exactly is a health-centered practice? What's the advantage of being one? And how does it grow your practice and really make you love what you do? To tell us more about it is Dr. Stephanie Vondrak, our guest. She owns and operates a private practice in Elkhorn, Nebraska. She has pursued over 600 hours of postdoctorate education in TMD, occlusion, orthodontics, and sleep apnea, including the Panky Institute, the Schuster Center, and the American Academy of Craniofacial Pain. 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Dr. Vondrak, thanks for being on our show. Thank you so much for having me. So we've heard the term health-centered dentistry for quite a while now. It seems kind of like a buzz phrase to some extent. It seems to be related to the mouth-body connection, which has also been a popular phrase in the last three to five years or more. Tell us in your mind what you mean when you say a health -centered practice. Great question. So I am a health-centered dentist, and the way that I define myself in that way, is that every patient that comes to my practice is given the opportunity to become as healthy as they wish to be. And I tell every patient that. And so what I think it really means is that you're focused on each individual and what they're looking for as far as their long -term outcome. Some patients just want to come in for basic recare, and that's all that they really need, you know, a little filling here or there. And that's as healthy as what they're looking for. But other patients come in and want to use us as a resource for all sorts of things. Maybe they want to quit smoking. Maybe they want to learn about diet things that are going on. Maybe they're having airway problems. Maybe they're snoring. There's a thousand different things. So I think being health-centered means having that philosophy where you listen to patients, their individual needs, and then you're here to provide a variety of solutions based on what those individuals really want. For the typical person, that looks at a dentist as someone who fixes teeth, they need to know that that practice they're going to has the ability to address those issues that you just mentioned and fall into the category of health-centered. So I guess the marketing and the word of mouth is critical before you attract those patients, right? Yeah, I would say at this phase of my practice, I have people coming in from word of mouth referral more than anything. right? Because I'll treat someone and I love taking someone from point A to point, you know, S if it needs to be, to wherever it is along that continuum to get them better. And usually people are so excited because they don't even know these things were a possibility that they tell other people about it. But I also have patients occasionally that show up that don't realize that I'm different. And so how you do that new patient exam really sets the tone for what you're able to provide in a health-centered way. So my new patient exam is 90 minutes in the doctor's schedule, no cleaning scheduled that day, and I have a very systematic way of gathering all the information from the patient that I then review and do a 30-minute phone consultation a couple weeks later. And when I do their 30-minute phone consultation, they've already received a review of findings via email kind of outlining their steps, has pictures of their teeth on it from their first visit. So from the get-go, I'm defining myself different. And so if you wanted to become health-centered in your practice, you have to find ways to define yourself differently so the patients can see what that different outcome can be like. Yeah, so that first appointment is very important in defining your practice as health-centered. Absolutely. Because patients don't know what's healthy in their mouth and what's not. You know, they might have a silver filling they don't like, but I can show them an older silver filling that still has perfectly smooth margins, it's no big deal, versus one that's three-fourths of their tooth, that's corrosive, that's rough, that has an open contact, that's just a problem waiting to happen, you know? So I can show patients these things and walk them through the process. And then they can choose for themselves. And I think that that's a really key point here. When you're a health-centered office, you're not pushy about any treatment. The goal is that the patient understands what's possible, but the decision is up to them. And so I think that's very powerful for people to be in a setting where a doctor spends that much time to help them understand their body, and then they get to make the decisions for themselves. How did you open your eyes to becoming a health-centered practice? Because that's typically not the traditional path that a dentist takes when they graduate dental school or graduate school in a specialty program or whatever, or they do a residency. So you kind of transformed your practice with this health-centered philosophy of care, which has been very successful for you. And I want to talk about that, how this has affected your financial outcomes. But what opened your eyes to it and then tell us how it has improved the financial outcomes of your practice as well as your quality of life? Sure. So, you know, right out of dental school, I'm one of these people that loves to learn. You know, I wanted to keep going. And so I started my CE. You know, I graduated in May and my first course I flew to was in... July. And so one of the places that I went that first introduced me to this idea was the Pankey Institute. Then I did some work with a place called the Schuster Center. And I just would piece together all sorts of different people that I was inspired by to kind of fine tune how I was going to do it in my practice. So there's lots of, there's other people besides me doing it this way. But what I really found was that Once I could find something I was so passionate about, which was making sure that the patient ultimately has the choice as to what they want to do, there's so much dentistry that you can provide for people that can help them. And it really did change my practice. I mean, I'm usually booked out six to eight weeks, which is a little longer than I want to be. But it's happened because when you do this and you provide these plans, people might not be ready, but then you save them. And I'll have people call me up. A year later, two years later, hey, Dr. Vondruck, I'm ready to start now. And it's a good thing I detailed that plan because I got to go back and remember exactly what all I told them we would do. But when it's on someone else's timeline, they will treat themselves as it works in their individual lives. And we don't know their individual lives. So all of that's been very financially rewarding because my schedule is very full. But at the same time, it's been so personally rewarding because it's neat to see people truly get better and then maintain that work. One other thing I'll say real quick is that when you're health-centered, you spend a lot of time in that first 90-minute visit helping the patients understand what a healthy mouth looks like from a plaque bacterial standpoint. And it sounds silly. It sounds like something we all do, but we don't all do it. I'll see people come in that have 10 crowns that all have decayed margins. And when I spend time talking to them about really what's happening, you see a huge turnaround in what they do at home. So those home care discussions and really making sure they get it day one will differentiate you and people will really appreciate it. We'll be getting right back to Dr. Vondrak in a second. But first, when it comes to digital workflow equipment, it's important to partner with companies that provide premium products with unparalleled service, all at an affordable price. That's why you should check out Shining 3D Dental. a company that offers a complete and integrated suite of high-quality and easy-to-use digital dental equipment. Their local offices are based in California and Florida, so you get in -time comprehensive support. 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So that 90-minute... initial visit that you have with the patient first time they're coming to your practice I guess you do quite a lot of listening in the beginning or the front end of that visit right you want to be able to absorb as much as you can about the patient to sort everything out as far as what services would be best for them and the priority of delivering those services is that right absolutely yeah there's no actual they do not leave my appointment with a treatment plan They don't leave my appointment with a referral to a specialist unless there's something that I think is going to be an emergent problem. I am just there to learn about them. to listen to their needs. And I'll show them possibilities. When we go through their intro photos, I'll say, see how healthy this tooth looks. Look at this tooth. It doesn't look quite as good, does it? You know, and I do some of that co-diagnosis where I talk them through it. And then I say, these are things that I'm, you know, would like to spend some time looking at. So you're prepared. There's a good chance we're going to talk about the lower right quadrant, or there's a good chance we're going to talk about a sleep study. And then when we meet for the phone consult, it's not like they're blindsided. I've talked them through that. whole appointment. And I've listened to their concerns as we've had this discussion, but no treatment plan is given that first day. I want to really spend time making sure I understand what they want and what's really going to help them. And what happens on the subsequent phone call that you have with them? Sure. I send them a written review. I have everything outlined as far as this is, this is what looks great. These are my concerns. This is where I would start. And we go through, I have their intro photos printed on my review. And then I, sometimes I'll even put pictures of like dentistry that I've done so they can learn like, this is how we'd like it to look. This is how it currently looks. Is this something you're interested in? So they get one email that's my review that has all of that information. They get a second email that's a financial considerations. On there, I give, you know, payment options and what everything costs and all of that. And then at that review, typically people accept treatment. Sometimes they have to wait and think about it, but then I can schedule them from there. And part of being health-centered is how you schedule also. You know, I'm not trying to run as many people as I can in and out of my office. I like to do quadrant dentistry. I like to do as much as I can in one setting so that I can just get everything healthy in a quadrant and then it's done. So I tend to see fewer patients when I'm doing restorative dentistry and do more at one time because I feel like that's a better service to the patient. So after that initial visit, that's 90 minutes, you work it all up. You don't give them a treatment plan, but you do email them that information that you described. When is the phone call with them? After you send them those emails? schedule the call? Oh, sorry. Yes, I email the same day as the phone call, generally. Sometimes the day before if I'm really ahead of the game. But typically, let's say if I had seen you today for a new patient appointment on the 3rd, I'd probably see you back in two weeks. And I tell them, be expecting an email from me the same day as your phone consult. I always do my phone consults at the end of the day so that I'm not going to ever be in a rush to see another patient. So I'll say, I'll email it to you that day. Please just have it up on the screen when we talk. And then I go through it with them. And then that's it. And then they can decide from there. So from the day I see them for the exam, it's usually about two weeks. And they get the email that day, the financials that day. We talk that day. And then we move forward. What you're describing, Dr. Bondrek, is very fascinating. It's certainly different than any experience I've ever had in a dental practice. I usually go in. They do an exam, take some x-rays, and tell me what. if i need something in most cases i don't need anything which is great news once in a while i'll need a filling and they either do it right there or schedule me for the procedure and that's it well it just depends on what you're looking for long term like i said i love comprehensive care and you know i you know some of these patients come in and yes they might need a crown on 14 that we start with or something like that but when you start asking them if they store Do they sleep through the night? Or you start looking at their mouth and you see that they have a really narrow maxilla and there's tons of wear and I know I can do things to change that. Or there's lower anterior crowding. It's really hard chair side to be able to go through all of those different facets of treatment towards a very comprehensive plan. In whatever time you have their chairs, it's just really difficult to do. So when I lay it all out, they may or may not pick all of it. Or they may say, I'm going to do phase one and phase two this year, but I'm interested in Invisalign for next year. Great, you let me know. But you start painting a picture of what health could look like. And, you know, a lot of people in this country are very interested in getting healthier. Yeah, without a doubt. But we, unfortunately, we have declined in America as far as our health. We are. Kind of a sick country overall, unfortunately. Tremendous amount of patients and people are overweight and marginal, diabetic. And so, you know, we're all aware of that. And there's a lot of reasons for that. we need to really improve our health. I know patients are aware of it. It depends where you are geographically, you know, what part of the country, what's part of the demographics you're talking about. But yes, I think we're all... But that's where I get really passionate. We have the chance to do it. Yes, yes. Well, you know, the patient, in the healthcare environment, the dentist is the most frequently visited healthcare provider. And that's why I've done recent podcasts with some really brilliant physicians who specialize in throat cancer. That's going to be released sometime in the future. I don't know what the schedule is. But this Dr. Kamal, K-A-M-A -L, he talks about how important it is to screen for throat cancer, which is very much related to HPV. And there's so many things that the dentist can do to, you know, move towards a more of a health-centered approach. But again, I don't know how much of this stuff is taught in dental school. The dental school curriculum is packed. You know how dental school is. It's almost impossible to add anything new. But you're amazing. I mean, you took a continuing education course. You weren't even out of dental school a year. That's like, wow, that's impressive. And these courses that you're taking are from really super elite groups of mentors, which I think is a really good thing to do, especially when you get out of dental school, just to form your opinions and try. to learn what the opportunities out there as a healthcare provider. But I think it gets you excited, Dr. Vondrak, as a practitioner about your career, right? Being health-centered. Absolutely. It's just such a neat thing to be able to form relationships with these patients. And when you work with them and get them from point A to point whatever, and they've had dental problems their whole life, they're used to going in and always having a problem. Once you get them better, you get to just chat at their re-care visits. I mean... Once I get somebody, they get through their plan, I rarely am doing anything. And if I'm doing it, it's 10 years later, you know, where something weird happens or now one big composite really does need a crown or something like that. But you get away from that dread, quote unquote, of going to the dentist because they're not worried when they come in for an exam because they know what health is. We've established health. They're maintaining health. I'm not going to find anything. You know, it's more of just maintaining what we've done. And one thing that's really powerful for me is that if I start working with a patient, that 90 minute visit, by the time I've talked to them two weeks later, I don't sell electric toothbrushes in my office on purpose because I want to see if they go get one. Interesting. Right. So I go through the whole thing with them. You don't make very much money on that anyway, in my opinion. So, you know, I want to see if they got one. I want to see what they tell me. I ask them, have you made any changes since we last talked? And they can't wait to tell me all the things they've done. And it's interesting because if they haven't made changes or they haven't gotten it done or they're unsure, I'm logging that in the back of my mind. Because the last thing I want to be is an excuse for why something fails. When patients prove to me that they can take good care of their teeth, then I want to do their dental work. If they don't want to take good care of their teeth, someone else can do their dental work. I've got dentists either side of me. you know there's one a couple blocks one way went a couple blocks the other way and i'll tell them that you know what i'm not sure this is going to work like this is i see all this plaque i'm like but i guarantee you that you i can help you get an appointment and if you aren't going to do the work guess what they are so excited to go home and do it you know they've never had anyone say no right so it's interesting It's a great position to be in the way you deal with your patients. And I think you've established your practice as the practice that actually partners with their patients. So their home care compliance is probably way up because they don't want to disappoint you. And like you said, they come in and sometimes you just have a chat on a re-care appointment because they're motivated to do things on their own, partly because they want to be healthy, but partly because they want to... please you as their dental partner in their quest for good dental health. It's not just like you need to do this, you need to buy a brush, you need to do that. It's kind of like you're doing it together. And people sense that. So it's a philosophy that's really working for you. So to wrap up this podcast, and again, Dr. Von Drack, really good stuff you've included in this little short time we have together. How would someone get started if they wanted to implement this philosophy of a health-centered practice in their own practice? Absolutely. I really think that spending time with your team and figuring out how you're going to do that new patient appointment and knowing that you're trying to make a different impact is really important. Obviously, going to courses is fantastic, but to really implement it, you have to kind of look within and say, okay, if I want to do my new patient appointment differently, which changes could I make? I mean, maybe the first step is just making sure you take an interval photo of every tooth and go through that with the patient so they can see what their mouth looks like. Maybe it's picking two or three patients a month and saying, you know what, can we do a follow-up phone consult? And just taking a couple of them that you think are maybe more complicated and work through it in your office versus trying to diagnose chairside. I always think taking small steps towards a big goal will help you get there faster. Yeah, great advice, Dr. Vondrak. We really appreciate your time. We look forward to having you on more podcasts and webinars on Viva Learning. And until next time, have a great evening. Thank you so much. You too. 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