The Mouth Offers Clues to Disorders and Disease; Dentists Could Play Larger Role in Patient Care
By MELINDA BECK

HEALTH JOURNAL DECEMBER 27, 2011 http://online.wsj.com/article/health_journal.html

The eyes may be the window to the soul, but the mouth provides an even better view of the body as a whole.

Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue—sometimes long before a patient knows anything is wrong.

WSJ ‘Personal Journal’ Senior Editor Melinda Beck explains that one’s teeth and gums hold a lot of details about the body’s overall health. Also, don’t be fooled by a bright set of pearly whites. Tom Gannam/AP Images for Crest and Oral-B

There’s also growing evidence that oral health problems, particularly gum disease, can harm a patient’s general health as well, raising the risk of diabetes, heart disease, stroke, pneumonia and pregnancy complications.

“We have lots of data showing a direct correlation between inflammation in the mouth and inflammation in the body,” says Anthony Iacopino, director of the International Centre for Oral-Systemic Health, which opened at the University of Manitoba Faculty of Dentistry in Canada in 2008. Recent studies also show that treating gum disease improves circulation, reduces inflammation and can even reduce the need for insulin in people with diabetes.

Such findings are fueling a push for dentists to play a greater role in patients’ overall health. Some 20 million Americans—including 6% of children and 9% of adults—saw a dentist but not a doctor in 2008, according to a study in the American Journal of Public Health this month.

“It’s an opportunity to tell a patient, ‘You know, I’m concerned. I think you really need to see a primary care provider,’ so you are moving in the direction of better health,” says the study’s lead researcher Shiela Strauss, co-director of statistics and data management for New York University’s Colleges of Nursing and Dentistry.

George Kivowitz, a restorative dentist with offices in Manhattan and Newtown, Pa., says he has spotted seven cases of cancer in 32 years of practice, as well as cases of bulimia, due to the telltale erosion of enamel on the back of the upper front teeth, and methamphetamine addiction. “We call it ‘meth mouth,’ ” he says. “The outer surface of teeth just rot in a way that’s like nothing else.”

Some of the most distinctive problems come from uncontrolled diabetes, Dr. Kivowitz adds. “The gum tissue has a glistening, shiny look where it meets the teeth. It bleeds easily and pulls away from the bone—and it’s all throughout the mouth.”

An estimated six million Americans have diabetes but don’t know it—and several studies suggest that dentists could help alert them. A 2009 study from New York University found that 93% of people who have periodontal disease are at risk for diabetes, according to the criteria established by American Diabetes Association.

It’s not just that the same lifestyle habits contribute to both gum disease and high blood sugar; the two conditions exacerbate each other, experts say. Inflammation from infected gums makes it more difficult for people with diabetes to control their blood-sugar level, and high blood sugar accelerates tooth decay and gum disease, creating more inflammation.

Diabetes also complicates dental-implant surgery, because it interferes with blood vessel formation and bone growth. “When you put a dental implant in, you rely on the healing process to cement it to the jaw, so you get a higher failure rate with diabetes,” says Ed Marcus, a periodontist in Yardley, Pa., who teaches at the University of Pennsylvania and Temple University dental schools.

Dr. Marcus notes that about 50% of periodontal disease is genetic—and even young patients can have significant bone loss if they have an unusually high immune response to a small number of bacteria. Giving such patients a low dose of doxycycline daily can help modify the immune response. “It doesn’t really control the bacteria, but it helps reduce the body’s reaction,” he says.

There’s also growing evidence that the link between periodontal disease and cardiovascular problems isn’t a coincidence either. Inflammation in the gums raises C-reactive protein, thought to be a culprit in heart disease.

“They’ve found oral bacteria in the plaques that block arteries. It’s moved from a casual relationship to a risk factor,” says Mark Wolff, chairman of the Department of Cariology and Comprehensive Care at NYU College of Dentistry.

Bacteria from the mouth can travel through the bloodstream and cause problems elsewhere, which is why people contemplating elective surgery are advised to have any needed dental work performed first.

The American Heart Association no longer recommends that people with mitral valve prolapse (in which heart values close abnormally between beats) routinely take antibiotics before dental procedures, since it’s now believed that oral bacteria enter the bloodstream all the time, from routine washing, brushing and chewing food.

But the American Heart Association, the American Medical Association and the American Orthopedic Association all urge people who have had a full joint replacement to take an antibiotic one hour before any dental visit for the rest of their lives to reduce the risk of post-surgical infections. “I have my guidelines taped to the door in my hygienists’ room,” Dr. Kivowitz says.

Dentists say they also need to stay up to date with all medications, supplements and over-the-counter drugs their patients are taking. Blood thinners can create excess bleeding in the mouth. Bisphosphonates, often prescribed for osteoporosis, can severely weaken jaw bones. Both should be stopped temporarily before oral surgery.

Antihypertensive drugs, calcium-channel blockers and some anti-inflammatory drugs can cause painful ulcerations of the gums. Many medications, from antidepressants to chemotherapy drugs, cause dry mouth, which can cause cavities to skyrocket, since saliva typically acts as a protective coating for teeth. Additional fluoride treatments can help.

Some proactive dentists have glucose monitors for another check on blood-sugar levels if they suspect diabetes. Some also take patients’ blood pressure and hold off on invasive procedures if it’s extremely high.

The Centers for Disease Control and Prevention recommends that dentists offer HIV testing, because some of the first symptoms appear in the mouth, including fungal infections and lesions. Dentists can do the HIV test with a simple mouth swab and get results in 20 minutes.

Breaking the bad news is often more difficult. “I went into oral surgery because I didn’t think I would have to deliver that kind of news to patients,” says Clifford Salm, an oral and maxillofacial surgeon in Manhattan who has found leukemia, lymphoma, AIDS and metastatic breast cancer after performing biopsies on suspicious spots. “It can be a difficult conversation,” he says, “but most patients are very grateful.”

F. Martin Ramin for The Wall Street Journal
Don’t Be Fooled by White, Shiny Teeth

A gleaming, white smile is a sign of a healthy mouth, right? Not necessarily.

“Whiteness and the health of your teeth are totally unrelated,” says Mark Wolff, an associate dean at New York University College of Dentistry.

In fact, many dentists worry that people who whiten their teeth may have a false sense of complacency, since their teeth can still be harboring tooth decay and serious gum disease.

Even people who have no cavities can still have inflamed and infected gums. It could be that their saliva is particularly protective of their tooth enamel, while their brushing and flossing habits, needed to keep gum tissues healthy, could be lax.

“I get these patients in their mid-30s who don’t have cavities, so they haven’t been to a dentist in 10 years. But they have full-blown periodontal disease,” says George Kivowitz, a restorative dentist in Manhattan. “They are losing all the supporting structure, and I have to tell them that these gorgeous teeth will fall out of your head if we don’t turn this around.”

Using whitening products more often than recommended can erode some of the enamel and cause teeth to appear translucent. But whether that actually harms teeth is controversial. “No one has really shown that it’s damaging, but no one knows the long-term results,” says Dr. Marcus, the periodontist in Yardley, Pa.

You can view the full article here http://online.wsj.com/article/health_journal.html and write to Melinda Beck at HealthJournal@wsj.com

You can’t patch a broken crown. You know it. I know it. So why patch a beat-up, broken-down business model? It’s a hand-me-down from the guy or gal before you, and they got it from some geezer with nose hairs in the 1950s. If you think that shabby old business model is going to serve you and your practice well, think again.

Unfortunately, you can’t have a business without a business model. Where does that leave you? Not in an ideal place.

I’m betting that, like most of my clients, your professors at dental school spent a whopping half hour on business and people management. Blink and you’ll miss it—and you probably did.

You were trained as a healthcare clinician. But it didn’t take long in the real world to discover everything your pricey education hadn’t covered. You quickly learned you needed to be an entrepreneur, marketer, sales person, accountant, mediator, boss, mother/father, husband/wife, and Pilates instructor—just to survive.

You were bamboozled. Sure, you don’t need to make rounds or be on call. But you live in a space of uncertainty, worry, and doubt, twenty-four hours a day, seven days a week.

Consequently, you’re tired, run down, spread thin. So one day, you shoot straight with yourself. You were trained to do dentistry, not run a business. You have no business running a practice. Your job is to set up the practice and hire someone who thinks like a businessperson to run the business side.

So you surrender. You realize you can use some expertise and you hire a consultant. You experience a nice increase…but the results fly away with your consultant when they leave. And you don’t even get frequent flyer miles.

What then? What next? What now?

It’s time to start dating a Super Model. A Super Practice Business Model that’s going to revolutionize the way you do business…and the way you live your life.

With a Super Model, you’re doing what you do best: dentistry. You have a business model with controls and return on investment measures at every position on a daily basis. You have an on-site coach—aka office manager/team leader—with an eagle eye, someone who’s managing the business and reporting to you once a week.

The typical advisor tries to patch the bleeding points by putting Band-Aids on the surface. When you date a Super Model, you’re practicing the tenets of “functional healthcare,” a new system where practitioners don’t just throw meds at symptoms; they drill down to the origination of the problem.

At NextLevel Practice, we take the same functional approach to business and team development. For example, why do your team members forget or not always follow through on new tasks? The answer is easier than you’d think: because subconsciously, we all struggle with fear of loss versus the opportunity for gain. Your team members are afraid they’ll lose their jobs if they fail at trying something new. They consciously want to do it, but they’re slaves to the voices in their heads.

Where does that voice originate? The brain. And the brain’s got two functions: reproduce our species, and survive. Survival thinking versus thriving is where we all get stuck if we don’t transform our relationship to that pesky, risk-averse voice.

At NextLevel Practice, we study why things stay stuck. We put Radical Common Sense tools, systems, and structures in place to ensure sustainability. This is all done without the enabling presence of a consultant, which can cripple your practice in the long run. “Teach a man to fish,” goes the Chinese proverb. When you date a Super Model, you’ll be catching fish for the rest of your life.

The old school business model has you micromanaging your team, tight-roping your cash flow, and doing the kind of dentistry you don’t enjoy. With a Super Model, your business runs as smoothly and efficiently as a machine. It’s an asset that works for you, meaning you can finally stop slaving over it.

With a Super Model, your team drives the practice, not you crazy.

With a Super Model, your patients demand treatment and pay for it before they arrive.

With a Super Model, your spouse doesn’t have to be chained to the books because he’s not worried about you paying your bills.

The new Super Model practice shifts molar jockeys into total health dentists, cleaning ladies into pioneers for total wellness, assistants into not just assistants, and front desk people into customer service concierge so good they make the Ritz jealous.

So what are you waiting for? Stop patching your practice. Start dating a Super Model today.

Actually, this is going to hurt. A lot.

It’s called “Facing the truth about your practice.” And the truth hurts.
All too often, the pain the patient feels is minuscule compared with the pain the dentist feels.

Cash flow problems.
An unhappy team.
A revolving door for staff members…and for patients.
Your time wasted micromanaging, instead of being chairside.
Patients who don’t show up, or don’t pay.
A little Novocaine might be looking pretty good right now, Doc.

If you’d like to trade the pain of an unsatisfying practice for the gain of a practice that works — for you, your team members, your patients, and your bottom line — consider this.

You could have a pain-free practice.

With patients who keep their agreements, show up, agree to treatment, and pay on time.
With team members who are happy, motivated, and don’t need you to be standing there reminding them of what they should be doing.

With a constant flow of resumes in your inbox because you’ve got the hottest practice in town.
With you where you belong. Chairside…and smiling all the way to the bank… and your second home.
With your spouse happy, too, out of the office (and no longer overseeing your finances!).

Ready for your practice to go pain-free?
We guarantee that your practice will be pain-free within 90 days. Will there be some dislocations, some discomfort, some bumps along the way? We guarantee that, too. Change can be painful. It’s just like what your patients experience. A little bit of pain…for a whole lot of gain.

We’re the home of the Pain-Free Practice.TM
The truth about where you are now might hurt a lot. But if you face it…the truth can set you free.

If you’re ready to have your practice work for you, if you’re sick and tired of feeling sick and tired, give us a call and experience 5 star service and educational experience like no other.

The national health care debate can not be complete unless we include dental care as part of the discourse. Dental care relates not only to teeth but more importantly to our overall health. Researchers have discovered links between a healthy mouth and prevention of heart disease, diabetes, liver and pancreatic cancer.
And  recently,  The Mayo Clinic–has published an article linking oral health to other diseases like cardiovascular disease, premature births, diabetes, HIV/AIDS, osteoporosis, certain cancers and other conditions. In fact, Dentists often treat problems no one can see and are often asymptomatic until an advanced stage.

The primary function of the mouth is to take in and process food and liquids for a healthy body. With a healthy mouth, we break down our food properly and put less stress on the digestive system.  Our mouths also serve as a conduit for communication and expression. Without a full set of teeth clear communication becomes problematic and difficult and health declines.

On a base level good oral care means successful management and stabilization of the bacteria  that lives in the mouth. Without that, our overall health is threatened. Which makes leaving dental care and coverage out of the healthcare debate, a mistake. One that has been made before and about to be repeated.

Why is that? Dentists themselves are in part to blame. Let’s face it—in our world, dentists do not get the respect and honor they deserve. They’re not perceived to be real doctors. Shows on TV aren’t written about compassionate dentists who diagnose the rarest conditions accurately saving lives not just episodically, but routinely. Perhaps the lack of sex appeal in dentistry is not a surface issue and part of why dental coverage for everyone is an after thought in the national health care conversation.

To reduce this argument to a businesslike bottom line, we aren’t getting remotely serious about healthcare cost-containment until we examine the benefits of dental care for all Americans.

Think about it. Part of the reason the discourse on this issue is at the level it is, is that most of us have had no dental, vision, or mental health coverage for so long, we’ve come not to expect it. Its as if health insurances tops at the neck.Today, you’re lucky if you have medical coverage. But any responsible medical doctor will confirm that having a healthy mouth in general is just as important, if not more important than anything else we can do for our bodies.We have been trained not to ask about dental coverage from our employers,as if it’s a luxury akin to a private jet.Generally the reasons is ‘too expensive’ but what is the expense long-term for not supporting oral health care?Dentists are widely perceived as working with archaic equipment, long needles, and cranky staffs, all of which adds up to pain in your mouth and in your wallet. Dentists need to get the word out that the technology today is radically different from just a few years ago.

If you haven’t been to the dentist in the last five years, first of all, you’re not alone. Most people take better care of their cars than their teeth, which makes no sense, because it’s tough to eat corn with a Honda.

More important, dentists now serve their patients with a stunning range of high-tech, cutting edge technologies that minimize the pain and invasiveness of older dental practices,cutting down the time factor, the pain factor and creating better, healthier results.It’s time for Americans to realize that the dental community exists to serve us, keep our mouths healthy and clean,our bodies disease-free, and our kisses long and lingering.Don’t get me wrong. Like most people who value a great smile, I’d rather be snorkeling in the Caribbean than lying back and getting a root canal. But it’s time we made a societal shift and recognize that dentistry is more than a punch line for a nightclub comic or the negative stereotypes Madison Ave uses over and over.

It’s time we recognize the value that dentists provide, as highly trained healthcare professionals who truly care about their patients. Real doctors who advocate for oral healthcare.The services they offer make a huge difference as we seek to untangle our snarled healthcare delivery system.So let’s give dentists respect they deserve. But let’s also include dentistry in the battle to provide America with fundamental healthcare.You can rinse now.

Help My Practice TV was originally offered as a three-part series giving specific, immediately actionable tips that Dental practices can begin using right now to enhance their practice, their team’s performance, and their financial bottom line. Here for you now, are all three parts together as one complete video.

Success-prone teams are not shrinking and waiting this economic downturn out. They understand that right now it is actually an opportune time to grow their practices. This economy shrank, and in doing so it unveiled many areas of greed and over consumption, but those who understand the shifts in patient buying trends as well as how to organize their team to be on the same page as accountable world-class educators, are winning no matter what the circumstance.

We call this the “future-proof practice.”

You can join the “future-proof revolution” and realize that practice growth, your lifestyle, debt elimination and working on your own terms is not on hold. Join those of your colleagues who are not sitting around on the sidelines simply watching their businesses fall behind, but are suited up and showing up in a whole new way.

We understand these are scary times. Taking the reigns and beginning a move forward isn’t always easy. With our unique areas of expertise we bring understanding with a non-judgmental empathy for those teams who allow us the privilege of supporting their dreams in one of the most intimate places of their lives. We understand there are fundamentals common to all practices and there are unique nuisances that need to be understood, and a customized solution must be crafted that will not upset patients, or the team’s apple cart.  For many practices, keeping the team intact is a primary desire.  Still, occasionally there are times when not everyone in the practice wishes to remain on board. In the event that a team member should decide to opt out and leave,  we will work with you to help you attract a team member who is enthusiastic and desires to be a willing team member without your having to spend extra time with the interview process.

The results your team experiences remains, even after the consultant leaves. The art and science of implementation is spelled out for you. We work efficiently and conveniently in one-on-one connections through the use of our own NextLevel Practice virtual video classroom.

With Gary Kadi’s time-tested NextLevel Practice methodology you and your team will be inspired, challenged, and guided on a weekly basis to go well beyond the success you have already enjoyed throughout your career.

Get started!

To receive more, please call 866.926.0914

After signing up with Next Level in April 2009, we have changed the way we view treating patients.  First of all we have all agreed upon our office’s healthy mouth standard.  We use this for every patient to help to get them healthy.  We recommend treatment and the patient has the power to accept it.  We offer several payment options to help make it more affordable.

We have implemented a new bonus system that rewards those who come to work and work hard.  The bonuses are controlled by that particular staff member.  It is still a work in progress as everything in a dental office is.

We are more committed as a practice to making sure our patients are healthy and happy with their teeth.  We do not treat patients differently in the treatment we recommend based on preconceived notions or past experiences at our office.

We have proudly raised our fees and offer quality dental work.  There is no compromise.  We stand behind our work.  When asked about our fees, we inform the patient about our quality.

Both of the dental hygienists actively help the doctors to diagnose.  They do not diagnose themselves, but they point our any areas that look suspicious or sticky.  They take pictures on every patient to help the patient to see what we see, and discuss treatment that may be recommended.

The dental assistants are the trusted people who answer any questions the patients have and help them to make educated decisions about their mouth.  The treatment coordinator and scheduling coordinator assist with this as well.

Our biggest realization is that we thought we had a case acceptance of 80 percent when we started with Gary.  We now realize that we are only closing about 34 percent with in 30 days, which has given us a very definite goal to strive for.  There was a lot of work being done with no outcome.  Flat out, the patients weren’t coming back after diagnosis.  Something was missing.  The whole team now works together with the same common goal- to get every patient to commit to the treatment they need and deserve.

Dr Melissa Smith, D.D.S.

Thriving Under Any Circumstance

Transforming  Anxiety and Uncertainty into Opportunity

This Summer little league, softball and professional teams take the field playing to win. Batters sit and wait for the “meatball” pitch: the one where you are so locked in, and it comes right in your wheelhouse, that you know without a doubt it will be a home run every time. Then there are pitches that sink, curve, and drop so much that you are lucky to get a piece of the ball. You must adjust. You must know the pitcher and anticipate his/her strategies and strengths. With good understanding of your opposition you can make the necessary modifications.  No matter what is thrown at you, you will do more than miss or foul the ball off: you will get back to hitting home runs.

This is the adjusting that forward thinking practitioners are doing right now. They are not putting their practice and their life on hold and just waiting the storm out. They are taking the biggest gale force economic winds since The Depression, and using them as wind in their sails moving them faster and farther in their personal and professional lives right now.

Working with practices in NY and NJ during the 911 tragedy was great training for me to help successfully maneuver practices through crisis. When we are living in non crisis times running a practice is more like hitting a baseball pitched slower and straighter, like the pitches you see during batting practice. What do we do with the knuckleball we are currently experiencing?

We are beyond recession proofing practices at this stage. We must future proof. With The Future Proof Practice no matter what happens in the economy or any other circumstance, you will be in total control of the things that you can control.

Here are several Focuses of a Future Proof Dental Practice that will give you clear direction, increased certainty,  confidence, and capability in your business and personal life for you, your team, your patients and your family.

1. Focus on what is working versus what is wrong.

I call this the Ding in Your Door Principal. You have this beautiful car (big picture) and you can’t see or experience its beauty because you are myopically focused on a one centimeter dent (problem).  This limited sight view of the big picture prevents you from seeing the myriad of opportunities that abundantly flow through your practice every day.

2. Focus on outcomes versus activity

Most team members are focused on being busy rather than being productive. It is not their fault – it is just the way business in America is set up. We pay the team for their time and they fill it. By now you have noticed we fill time to meet the deadline set, just as you may have noticed that your expenses rise to meet your income. Now you know what happens when you make more money but have the same amount. If 20% of your actions make up 80% of your results then locate where you and your team are successful and do more of these things. More importantly, stop doing things over and over that are not producing results. With regard to your team stop trying to implement laundry lists of job descriptions, and have them focus on what we call DPOs or Daily Primary Outcomes by position. Then reward them daily, by position. (All the details on how to do this are in my book, Million Dollar Dentistry).

3. Focus on what patients want versus what they need

I cannot motivate you. Only you can motivate you. I can speak to what motivates you and then you might take action. The same is true with your patients. Locate what is emotionally relevant to the patient, then show them how your solution enhances their life, and you will have higher patient retention and case acceptance.

4. Focus on your team as an asset versus a cost or liability

You exchange money for time with your team. Your challenge is that you want them to think entrepreneurially like you do, and they do not have the same risk/reward as you do. Transform your biggest expense into a profit center by establishing each position as an interdependent business with return on investment baselines for each. (Details for this concept are found in  Million Dollar Dentistry).

5. Focus on highlighting problems rather than offering just solutions

When was the last time you bought something that you didn’t think you needed, was going to cost you thousands of dollars, would hurt you and take time out of your precious schedule? Right!  Consulting for your practice (well, maybe for some of you). Seriously, this is what we are offering to our patients every day. Remember, we only buy solutions to problems we KNOW we have. The problem here is that most care givers do not want to be bearers of bad news. So here is a way to overcome this challenge. Share this when presenting, “I have some bad news and some good news…..”.

6. Focus on your purpose versus trying to manipulate, persuade and sell

I had a hygienist who said I will never, ever sell anything so do not even ask! I said, “Great, I agree.” The root word of sales means “to assist” and sales has become associated to many negative connotations. Not many care givers like to sell but everyone loves to buy. Working with this sales resistant hygienist I asked her why she became a hygienist.  She said, “because I love to help people be healthy and look and feel their absolute best.”  At that moment, I could see her make the paradigm shift in her relationship to presenting treatment. She got to see that when she comes from a place of purpose, combined with the trust her patients have for her, the results are huge. In her first week with her new eyes she educated four patients who bought the gifts of health, function and beauty that Invisalign offers.

7. Focus on bringing 5 things to completion versus moving 1000 things 5 inches

At any one time there are hundreds of “door dings” in your practice that you can fix. Consider that these nasty distracters of your time and attention, and are symptoms of a deeper root cause. Most people spend their time fixing these challenges on the surface just to have them return when the adhesive on the band aid gets a little wet. Make a list of the “door dings”, and prioritize the top 5 most likely to make the most dramatic direct impact in the most areas. Drill down from “the surface” to find where the distraction originates;  And fix the “bleeding point” at its root using a structured system, accountability, or agreement.

8. Focus on Return On Investment versus the Cost

It is not what you pay for salary, equipment, third party financing, consulting, and merchandise, it is the return you get from your investment. I see this very often with practitioners who do not like spending money on the cost of money when it comes to third party financing. I would rather have the boatload of treatment closed at 91% because you offered a monthly solution rather than 100% of nada. Only 20% of people like to make large purchases in full and 80% like to pay over time. I learned this from the automotive industry, where they do not ask how much you want to pay for your car but how much you want to pay per month and then work the car into the payment.

9. Focus on serving the whole person rather than just fixing hard and soft tissue

In the new economy, it is no longer enough to have an even exchange for products and services, but to offer layers beyond the widget you offer. In dentistry the layers we offer start at the lowest and go to the highest: eliminating pain, fixing problems, oral systemic health, aesthetics, emotional well-being , enhancing your community’s health and well being and giving back on a global scale.

10. Focus on the accountability and systems that support technology versus buying toys

The world has changed and we must change with it. We are on the clock with the amount of time we have left to take advantage of the gift of the downturn when it comes to buying. It is a buyer’s world, and the universe is on sale! Right now is the best time to expand while most are shrinking. The key to expanding with technology is to prepare your team with training, developing the systems, and letting them know “why it is we need it and how it will benefit us.” This is the difference between dust collection and collections from production using the equipment.

11. Focus on thriving versus surviving

When taking the test for their license, motorcyclists are immediately taught not to look at the pavement because they will end up kissing it “someday.”  Race car drivers are taught not to look at the wall because they will smack into it when they go into a turn. This is true in business right now. From CEOs in major companies to dental entrepreneurs everywhere I receive calls asking for help in surviving the current situation. I let them know that I cannot help them survive but if they want to thrive I can assist. In every area of your life the more you focus on something the more you get of the thing you are focusing on. Usually this thing is rooted in some variation of “not enough”. Not enough money, time, love, patients, good team members, collection, production, yada, yada. Currently, the scope of most practitioners’ sightline is minimized. Consider the loupes you look through regarding your business are inside out, just take them off and turn them around.

Baseball and apple pie are strong American traditions. So is the privilege of thriving in our free democracy. Winning in today’s world may be more challenging, because we are playing in unchartered territories. Doing  nothing, delaying, and denying come from the fear of the unknown. It’s just because you temporarily bought into what the media is feeding you. If you take your eyes and ears off the negative news you are seeing and hearing, you can focus on the limitless opportunities that are before you right now. Remember this is only a BAD economy if you do not know what to do with what is happening.  It is the NEW economy for those who are willing to adapt. This is a time not about not enough money but about an exposing and cleansing of all the areas of greed, selfishness, cheating and stealing that were going on. Therefore, those who know how to build trust are those who are thriving. Swing for the fences, you deserve it.

Just by coincidence I happened to be seated next to dental practice management expert Gary Kadi at a recent conference, and we struck up a conversation in between speakers. We realized we had seen each other in the gym that morning getting our 1-hour cardio session in before the conference started.  We talked about how easy weight loss is to figure out, but how difficult it is to do. People always ask if there is a secret to weight loss, but it is just common sense. From this conversation came a discussion about “radical common sense,” which we continue in this interview. Enjoy!

Michael DiTolla: Gary, you and I had a chance to meet each other when we both attended the Milestone Scientific CCLAD (Computer-Controlled Local Anesthetic Delivery) conference in New Orleans and happened to sit next to each other. And the course of conversation became very interesting, in hearing about what you do for dentists, as you started to explain your concept of “radical common sense.” It really struck a chord with me because a lot of times in dentistry, we tend to kind of overcomplicate things, and I like the approach of using radical common sense. Before we move into that, however, why don’t you tell us a little about your background and how you got involved in dentistry.

Gary Kadi: Sure, Mike. My background is in business and team development. I’m not a dentist, though everyone thinks I am. I got involved in dentistry about 15 years ago, when I had two firms: a marketing firm and a management consulting firm. At the marketing firm, we worked to bring people to service professionals like dentists, chiropractors, and other different types of businesses, and I got a great education by interviewing each of those businesses. I probably interviewed more than 1,000 businesses and really learned the intricacies and best practices and found what was really going on behind the scenes so I could market them externally.

I got a lesson on how to structure systems, processes, and things like that in these businesses. Of my clients, many were dentists and I realized that I had an affinity for dentistry and really loved it. I was excited to learn about dentistry and, with my management consulting background, I learned how to get team members to be accountable and follow through on new thoughts, and how to bring in systems that were sustainable, systems that dentists can follow through on because this is usually the biggest challenge in dentistry. But the number one reason I chose dentistry amongst all professions was this question: “When was the last time you bought something that you didn’t think you needed, was going to cost you a thousand dollars, may hurt you and take time out of your day?”

When I saw that question, I thought, “If I can come up with a solution that we can install, implement and customize for general practitioners, then we might have something that can really change the industry.” And really, what we take on is solving that problem. The other piece to this is enhancing the quality of people’s lives. I noticed that the quality of life for practitioners and team members—there was a big gap between what was possible and how dentists and dental teams were living. So, our background is not just building great practices but building great lives. Just as supermarkets created new aisles for “green” products because they didn’t exist before, we use the word “consultant.” But we don’t actually apply that word because it lumps us into a category of business that has done wonderful work, but automatically gives people the perception about the type of work we do—because what we do is a category that didn’t exist before. We actually focus in on business and team development, with our product being the outcome of what a doctor and dental team want, not just in the business sense, but also in the quality of their lives.

That’s a little background about myself. I live in Manhattan with my best friend, Judith, whom I married six years ago, and my son, Rome, who is four and a half years old. We have an office in Scottsdale, Ariz. That’s where part of my team is, and we also have a team in Manhattan. So, that’s a little background about the company and myself.

MD: Let’s go back to something you said because you put it pretty succinctly: as dentists we’re telling people they need something they perceive they don’t need, they probably don’t want, and they probably can’t afford. It’s interesting that you put it in such simple terms because that kind of defines one of the challenges of being a dentist. When I ask dentists why they became dentists, they usually respond, “It’s because I didn’t want to go into sales.” And now all of a sudden we have something for sale that people don’t have a perceived need or want for or don’t think they can afford. That’s an interesting situation to find yourself in, is it not?

G: Yes, exactly. And people don’t buy solutions for problems they don’t think they have. Endodontists didn’t use our company in the past, but they are calling us now because their referral sources are drying up and they don’t know what to do. A lot of general practitioners are doing much more endo now than they did before. But the thing is, when people go to endodontists, they know there’s a problem. It’s symptomatic. There’s pain, and they know something is associated with it, so they want to get it fixed. Problem—solution.

In general dentistry, 90 percent of treatment is not symptomatic. It doesn’t hurt and it doesn’t look bad, so how do you engage the patient? This is the biggest challenge, as you mentioned before, because a lot of health care practitioners are caregivers and don’t like to sell anything, you know? We actually don’t like to force and manipulate sales. The root word for “sales” means to “assist,” not to manipulate or take advantage of, which is what it has become over the years. So, we really understand practitioners. Like, how do you get practitioners who don’t want to sell to speak in a way that engages the patient? That’s the type of methodology we’ve invented so that dentists can engage the patient and convince them accept treatment, versus being manipulative with scripting and the old traditional ways of presenting treatment and selling the patient. We don’t even have our practitioners step into that pool because once you get into that, you can’t get out of it.

MD: Yeah, that makes sense. I can see how that could be a real slippery slope. Well, I mentioned earlier your concept of radical common sense, a term that I love. Explain what you mean by the term radical common sense.

G: It’s a term we coined; we made it up to really speak and embody our philosophy. It was born from my grandfather, who was one of my mentors and heroes in business, and in life. And he one said to me, “Gary, the best educator, the best people who are trained to educate, they take complex things and simplify them.”

For years, the industry of practice management has been about doing more, doing better, and doing different. What happens is that it becomes perceived that one must do even more. What we’ve found is that you can actually peel layers off and not do all these things, and focus only the things that matter and make a difference. If we can drill down and isolate and simplify the whole process of practice management, the business side of dentistry, and the whole component of the people side of dentistry. If we can make it so radical common sense that an eighteen-year-old single mom with no background in business could manage an entire practice—that’s who we want to speak to. A lot of people want to justify their existence by making things complicated. We actually take a counterintuitive approach and believe the gift is in its simplicity. That’s the background of how radical common sense was born.

MD: That’s interesting, and that’s a lot of what I try to do in my educational efforts here at the laboratory. I look at some of the clinical mentors that I’ve had over the years, people whom I really respected. People who either had a real set of hands, real God-given talent, or had a great system that was very complicated to do. I try to look at what they’re doing and find more simple ways to do it, because that’s how I have to do it. I mean, you could come up with the most elaborate management system for a dental office that would result in maximum production and collections. But if it’s too much, I take it the staff will never buy into it.

G: Absolutely. You know, it goes back to what we call “justifying your distance.” When I first got into this field, when I used to be called a consultant, my immediate approach was: “Well, if I’m charging for this, I have to really make myself sound smart and give them a lot of stuff.” Even when I spoke early on, my natural mindset was that I had to come across as incredibly intelligent and knowledgeable—what if they found out that I didn’t know it all?

But to tell you the truth, it came from my low self-esteem. I had very low self-esteem; I wasn’t sure of myself, and that caused the thinking that went into making things complex rather than simple. Some of the tools that we teach doctors in order to build their self-esteem are the same ones that I used on myself. A lot of the tools that we came up with in this radical common sense process, we live ourselves. We live these principles and we practice them on ourselves because we are not immune to what dentists go through. People used to ask, “Well, you’re not a dentist, so what gives you a right to be in a dental practice?” I agreed with that, and so I sat in every chair that was in a dental practice. I didn’t cut or scrape teeth because I didn’t have a license to do that. I’m not the greatest assistant, by the way, so you definitely don’t want me to be an assistant either. But I used to think the front desk looked so easy. One of the chapters in my next book is “Why the Back Hates the Front.” And now I totally understand the reason, because the back looks busy, and they are busy, handling instruments and having their “roller skates on.” Up front, they just look like they are e-mailing their boyfriends. But, let me tell you something. You sit up at the front desk, and the phone rings. You pick it up and the patient starts asking questions you can’t answer. And then the hygienists release three patients on the hour—and it’s chaos. Now, I have so much more compassion and understanding for what it’s like to live in each of those positions. So, we created this radical common sense methodology from a businessperson’s perspective and understanding how to build teams and apply the nomenclature and the science of dentistry to those components.

MD: There’s a culture that seems to exist in organized dentistry that practice management classes aren’t “worthwhile” enough to earn continuing education (CE) credit. Since we have a required amount of hours to take, dentists tend to ignore these business-oriented classes, and it makes it difficult to work on the business of your practice. So, if somebody came in and they were a dentist, I might say, “You’re a dentist, so why should I listen to you about this business topic?” Now, while I wouldn’t listen to you, Gary, about how to prep a crown, I do when it comes to business stuff. I mean, what does being a dentist have to do with running a practice?

G: I agree, and I’d like to give you a distinction here because I think it’s really appropriate. We give our dentists not only what to do, but how to implement these changes. Here’s an example of that. What you’re talking about is what we call a “filter.” A filter is the subconscious and automatic screening process that validates your beliefs or point-of-view. So, in another words, if you have a belief that I should be a dentist to coach you, and that’s your filter, then we’re definitely not going to be doing business together. But if you have a filter called, “I want a business expert, or a keen development expert, or a personal development expert…I want a person who comes from that place, but also understands the clinical side and science and nomenclature of dentistry and has the compassion and understanding to know what it’s like to be a dentist,” then your filter validates that and I become a resource for you. And filters are like loupes—you can either lower your filter and open up some new opportunities or, like inverted loupes, it makes your world smaller because you’re looking to validate your beliefs about something. And our beliefs either allow us to grow or keep us where we are. And this is how we have breakthrough, quantum results—by giving dental teams tools to apply about how they perceive each other and how they perceive patients.

MD: I don’t want to gloss over something you said earlier, because I haven’t heard it mentioned much or seen it mentioned in many articles, but you said that it was one of your personal breakthroughs: the building of self-esteem. It sounds like that’s one of the things you do with dentists that makes a huge difference in their lives. Again, here’s a filter; that’s something you never hear about in dental school or organized dentistry. Talk a little bit about self-esteem and what you see—you’ve worked with a lot of dentists—tell me what you see with the average dentist and their self-esteem, what you’re able to do to help increase that, and the effect that has on their practice and overall happiness with life.

G: Yes, thanks for bringing that up. It’s one of my favorite topics. You know, my whole life, it feels like I’ve lived a double life. On the outer veneer, if you looked at my life, I’ve had it all: I drove a nice car, I had beautiful women, I traveled around the world, and it looked like I had it all handled. But deep down inside, I was really bankrupt and empty. I knew I had to improve this and to examine how I got to such ruin. How can I have what looks so good on the outside work on the inside? Wherever and however you’re operating, it’s coming from a place—we are often trying to get to a place. But one of the things I’ve learned is about coming from a place. So, if you want more love, you come from a place of love. If you want more respect, you come from being respectful. Someday will you become confident—it’s inside you. I know you’ve heard that cliché before, but here’s the tool that we implement to help doctors and treatment coordinators with presenting treatment (this applies everywhere). We call it the “three agreement.” There are agreements that you have with others, agreements that you have with yourself, and agreements that you have with your morals and values.

Agreements with others can be something such as: I agree to be on time and show up for that. That’s where trust is built with others. The self-esteem is really learning how to trust yourself, so if you make an agreement to go to the gym, and you continually don’t go to the gym, then you know that you can’t trust yourself to follow through on things that you say. For me, I’ll give you a personal example, this is where I had my breakthrough: I used to drink. I used to say I wouldn’t have wine when I came home, but I would continually have wine when I came home. Then I would wake up the next morning and beat myself up. I realized at some point that I had to stop this. I was not able to trust myself anywhere else in my life. The minute I stopped drinking, when I said I was going to stop drinking and I actually stopped, all of a sudden my self-esteem started to rise naturally. I came from a place of confidence, knowing that no matter what I would be able to do it. You can count on me and I can count on me. That’s where it comes from—I was able to trust myself.

By the way, the current economic crisis is not about money, it’s about lack of trust. The economy flattened due to lack of trust, and the practices that are future-proofing themselves are the ones that know how to build trust with their team and then translate that trust out into the world. So it starts with trusting yourself first, building your own self-esteem, and then trusting yourself and keeping your agreements with yourself. Then, secondly, building that trust with your dental team. Once you have that created trust with your dental team, you can go out and create trust with your patients and have them trust you on a whole new level. I didn’t trust my team in the beginning. I would micromanage these people—and they are talented, powerful people. I had the most amazing team of people (I’m still in awe of them every day), but I would micromanage them because I didn’t trust myself. Therefore, I didn’t trust them. And the minute I started trusting myself, I started trusting them. Our business is going to quadruple this year because of the transformation that happened in myself and that I’ve given away to my team now, and also putting structure into place—I don’t want to miss that. I now trust myself to know what I need to put in my business, and it’s showing up in the productivity and the awareness out in the dental industry. I’m just so blown away by this one distinction about trusting oneself and building one’s self-esteem.

MD: Wow, that is pretty amazing. Again, that’s not the kind of thing you typically hear in talking to the average practice consultant. And I’m sure there are dentists who hear success stories from other practices of yours, and get all excited about having the practice of their dreams, but there must be some dentists who upon hearing what this entails may not be a good fit for you guys. I would think this isn’t the most comfortable thing for a lot of dentists to hear. Would you say there are some dentists who just want to throw a system or something else at the problem? Because it sounds like, in your system, you’re asking the dentist to make some fundamental personal changes in their lives.

G: Absolutely, this is definitely not for everybody. It can work for anybody, but you have to be ready and willing. If you’re not ready and willing it’s not going to happen. See, what you’re talking about, Mike, is dealing with a symptom. You know, throwing a system at the problem. What’s going to happen is it may sit there for a few weeks, a few months, maybe a few years, but it’ll definitely go out of existence. We are working with two things: are we dealing with the symptoms or the source? When we do a diagnosis, we find out what people are complaining about or where the inefficiency lies. And we drill down to the source point of where it originated. Every upset or inefficiency in a person’s life or practice is in one of two places: either in a broken agreement or a missing agreement.

So when we work with doctors, and teams actually, we’re not interested in doing surface stuff. We’re interested in getting into the root cause of things. And yes, you have to be ready for this, because if you’re not ready, it just doesn’t work. So we actually qualify our clients prior to working with them; they have to meet certain needs and criteria so that the relationship works. We put them through a series of questionnaires. The way we structure our program is to make sure it’s a good fit for the both of us…rather than, if you have a pulse and a certain amount of money we’ll take you as a client.

MD: That makes sense. I think the same is true for dentists who want to take every patient. They operate in the position of being desperate, so when a case comes in where they know they might not be the best person to do it, they’re going to do it anyway because the checkbook balance is a little low. And they end up starting a case they know deep down they probably shouldn’t start. So, are you saying, in addition to the dentist building the self-esteem and all the changes that come, that this also happens for the team members as well?

G: Oh, yeah. Our work not only works for the dentist leader or owner, but it works for the team. And the beauty about this, too—this is where the real value comes in—we believe in our business and we transfer this to dentists. It’s not just good enough to be able to provide the service, but it’s all about having people live a bigger life. You can give your staff a great job where they can generate a great income, but their life becomes further enhanced because of the work they do in the office—and a whole new loyalty that is born. There’s a whole new reciprocity that happens when you care for your team members on that level. Not only do they grow personally inside the practice, but they grow professionally and personally at home as well. I can’t tell you how many times they bring this work home to their family and they say, “You know, it not only works so well here at the office, but it works with my teenage son who I couldn’t get to make his bed and always leaves his socks lying around.” They learn how to manage people, and kids especially love some of these tools that I’m mentioning. So, it’s really wonderful to see the transformation of doctors and teams and families, too. It just really spreads like dropping a pebble in a flat pond of water and seeing it trickle out—it’s really profound.

MD: You know, one of the cultures of dentistry is that clinical quality is kind of the end-all, be-all of what we’re trying to do. That, in order to have the “practice of your dreams,” you need to go out and take more courses, get better clinically and sign up for a couple of institutes. It’s all about chasing the elusive goal of clinical excellence. And while I don’t want to necessarily downplay the need to be clinically acceptable, or better, it doesn’t sound like your plan necessarily has a lot to do with the dentist changing how her or she does things clinically. Am I missing something?

GK: No, not at all. We believe that every successful practice has a stool with three legs. There’s the clinical side, the business side, and the people side. Our expertise lies in the business development and the people development side. That may be developing patients through their compliance and having them follow through on their treatments, or retaining patients and then running the practice like a business. Most people work for their business; what we do is a paradigm shift in which we have the business work for the owner. We only have one bloody slide here, so we really don’t present anything clinically. There are so many clinical experts out there; we really just have our expertise. We only work with general practitioners, and we only work in the area of business and team development.

MD: So, in other words, what I’m hearing is that it is different than just going out and getting more and more training for these clinical things to be able to create the practice. I just think for a lot of dentists, that’s something they feel comfortable improving about themselves—they feel more comfortable taking clinical classes than they do working on their self-esteem. It seems like it always goes back to that because the dentist tends to return to the “what impression material are you using” or “what bur are you using” questions. They think it leads to what’s going on in their practice and I don’t think it is. Are you able to talk specifically about some of the things that you do when you go into the practice and how the process works?

GK: Absolutely, I’d be honored to.

MD: When you go in, does it typically start in the hygiene department or over on the dental side? Or how does it work when you first go into a practice once they’ve decided to go with your program?

GK: We have a four-step process, Mike. The first step is to discover point A, if you will. “What is existing?” So, we find that out in seven primary areas. And that’s in the executive division, which handles management leadership; the administrative division, which is HR facilities and equipment; then we have a division called “generating interests,” and that’s also known as “marketing.” And that’s known on three levels because there are three primary ways to grow your practice: new patients, patient retention, and case acceptance.

Then, the next division is gaining commitment. And, you know, you can interest people in being new patients, but if they are not committed or they don’t register as new patients, it doesn’t work. And if you see someone or you tell somebody they need to come back and they are not retained as patients and they drop out the back door, well, that doesn’t work. And people can be interested in Invisalign^®, but if they don’t say yes it doesn’t convert into revenue. So, that’s the next division. Then we have finance, where it’s money in, money out. We set up the budget and structures, and we make sure doctors are paid first and their retirement’s paid and they pay their debt down.

Next, we have the scheduling for the production division, which is to ensure that we don’t get rollercoaster days and that every body hits their numbers each day and what’s the risk if they don’t. That’s the accountability. Then there’s the quality assurance position to ensure that patients are served beyond expectations; that they want to pay and stay and refer others because you’ve given them such a great value. It goes back to executive administration, generating interest, gaining commitment, your finance department, scheduling for production and quality assurance. We discover what a practice has in those areas and we turn over every rock.

Then we go into step two: co-creating a plan. And what we do is start with the end in mind, and we work with doctors to detach them from their past, so you have your past, present, and future. Most people create their goals from their past: “Oh, I can get a little better this year, let me just increase it 10 percent,” or whatever it might be. We actually have the dentist go through an exercise where they detach from everything. We say, “If you can have it any way you want, say how it is.” And we figure out how much time they want off. Let’s say they want to work three weeks out of the month. Okay, twelve weeks off. Okay, they want to do $2-3 million. So we calculate what they need to do per day, then we design a business and build a bridge backward from where they want to end up. So, we don’t come from their past, we come from their future, which allows us to invent new solutions from that place. What we do is co-create a plan, and it’s basically a step-by-step plan from point A to this future that they’ve created for themselves. Then what we do—and this is a key part Mike, I really want to highlight this—is roll it out to the team. We take responsibility for engaging the team because if the team is not fully on-board and they are not wanting to be fully responsible to drive this thing, we make them part of the solution.

In the interview process, we interview each team member, and they become part of the solution. They are the ones who come up with the idea, and then we get agreement. One of our tools that we mentioned is getting agreement with others. We don’t tell team members what to do. We engage them and show them how they are going to win and become part of the solution. We ask them what they can be accountable for and they tell us; it’s sort of like a trainer for practice. We show up and make sure they are committed to what they said. And that’s how we get sustained implementation that they really want to use, let’s say for a hygienist, an intra-oral camera for every patient every time. We come up with an agreement and show them why and show them how using the camera fits into all the other systems so that they willingly use it. That would be an example of that.

The fourth step in the process is refinement. We would actually refine the process so that when it goes into place, we have a scoreboard for each team member. For instance, let’s say you want to do a million dollars and work 16 days. That means you have to do $5,500 a day. That means the doctor has to do $4,500 and the hygienist needs to do a $1,000. So, we create what is known as the “DPO,” the daily primary outcomes, by position, and each team member has accountability by position that they need to be accountable for. So the coordinator has to schedule $4,500 and a $1,000. The assistant has to drive the doctor’s production to $4,500. The hygienist has to do a $1,000 and then recommend, let’s call it, $9,000 in treatment out of his or her room. If you’re closing 50 percent of that, that’s how you get $4,500 in a doctor’s schedule every day. And so on.

This gives us the ability to isolate where the source points are as to why the practice isn’t performing, so we know where to go to isolate the challenge and then we can course-correct it accordingly. This is how we automate the management of the business of dentistry and the structure that we put in so that it goes back to the original conversation of making it radical common sense, so simplified that you don’t have to think about the zillion moving parts that most people have their attention on, trying to control. We simplify the whole process and just look at seven or eight little areas that make up the whole practice.

MD: So, there’s a chance that you have an employee or two who isn’t really pulling their weight, and may, in fact, have been a significant part of the reason why the practice wasn’t running the way it should. But in the old system, they were able to kind of hide a little bit. With the new system in place, and the accountability placed on everybody, it becomes readily apparent that they might actually leave the practice on their own volition now that there’s a little more being expected of them and things are being measured. Do you find that some team members kind of weed themselves out in an office that gives so much personal accountability to the employees?

GK: Absolutely. When people hear this process and are educated, those who can’t be responsible run for the hills. But it’s very interesting: less staff members leave than you might think. Most team members want to be responsible, but here’s what they don’t want to be: they don’t want to be blamed for not doing something. With all due respect to doctors, they want an outcome. When this system’s in place, people are responsible. And if they can’t hit their number, people actually reach out and go, “Hey, I can’t do this.” And the team rallies around it because I invented a bonus system, because most doctors have a risk/reward. If they don’t hit their numbers, they can’t get paid. But the team doesn’t have that, Mike. Because the way the team is set up is that you are exchanging time for money. “We’ll give you money and you sell time.” Well, time isn’t the reward that the dentist wants. The dentist wants outcome by position. But you’ve got to understand that it’s not set up that way and it’s not rewarded that way. We had to shift the whole context of the relationship of how dental teams go to work in the morning when their feet hit the ground. I’ll find the jewel in the rough team member who is brand new to the industry and produces huge returns on the investment. Or I’ll find someone who’s been in dentistry 150 years, sitting around, who is costing you way more than the others. What this does is really wonderful, because the biggest expense in dentistry is your staff salary. Now, everybody has a return on investment so that you watch your staff salaries. People are so concerned about how much they spend for somebody. We’re more interested in how much they return for you, not how much you spend on that.

MD: I love that approach. Going back, you talked about how you don’t plan from the past, but you plan from the future. I just had an example in my life where I can see how powerful that is, and I told you about this in Florida.

I set a goal for where I wanted my weight to be, and I knew I needed to lose about 45 pounds. I set a goal for where I wanted to be, put it in the computer, and it said that if I wanted to be at this weight by this date, here’s what I have to eat and what exercise I had to do every day. And I did what it said every day. I ate the right amount of calories. I did the right amount of exercise. And I started losing two pounds a week, just like it said I would, and I got confidence from that. It was a great roadmap and I ended up achieving that goal. But it wasn’t even until I met you, when you talked about planning from the future, when I realized how effective that could be as a technique. Had I done what I’ve done in the past—where you’re just going to the gym and not sure if you’re eating the right thing or you’re not sure if you’re exercising enough, and just kind of doing it by the seat of your pants—it would have yielded unsuccessful results. Planning from the future was a concept I was totally unfamiliar with. Now I am a complete believer, just based on my own experience. It might almost seem too good to be true to a dentist as well, if he sets down with these goals and you say, “Okay, let me show you how to get there.” I can see a dentist not even expecting that to happen. Is that correct?

GK: Yes, and it’s crazy. First, I want to congratulate you for creating the body that you deserve. And I want to highlight that keyword here: deserve. I also lost 40 pounds, and I kept it off for six years. And I’ve had a challenge with weight my whole life. You know, I had a breakthrough in really understanding how to keep something consistently off, like weight. It was something I learned and it goes back to working with dentists. It’s something I call your “healthy deserve level.” The title of my latest book is called “Raise Your HDL,” because you can have all your systems and processes and you can know how to lose weight. I know how to lose weight: eat less and go to the gym more. But here’s what stops us, which we blame on procrastination or no time: underneath and subconsciously, we don’t think we deserve a good body. Therefore, we won’t take the actions needed to get a good body. Whether it’s your body, your income, your practice, productivity, your relationships—all of it, is related back to one’s deserve level.

If you want to know what your deserve level is, take a look around your life right now. That’s what you think you deserve. Because in life, you don’t get what you deserve, you get what you think you deserve. I know it sounds so radical common sense, and one of my friends says, “This doesn’t sound too good to be true, but too simple to be true.” It’s awareness; it’s so simple that once you think you deserve it, you’ll create it. So, we talked about qualifying dentists earlier on, and what I sniff out is: Do they think they deserve to get the outcome? Because if they don’t, they are going to kick and scream the whole way. What I learned was that if they don’t think they deserve it, I can’t get them there.

As we speak, today we’re at a practice in northern Virginia. They are doing $3 million a year and they have 7,000 patients. We showed them how this could be an $8.5 million dollar practice. And the beauty is that both practitioners, when they saw that, got a little scared. They said, “Well, that’s just a little overwhelming to us.” But they knew they deserved it and so they’re creating it. It’s happening right now and it’s amazing, and it’s really brilliant to see people get what they want because they now distinguish their future from the past.

MD: The other thing is that dentists might believe that “you simply can’t do $8 million in a dental practice without ripping people off.” To me, it’s not the thinking that they don’t deserve it, but that you’ve got to be doing something wrong to product that much.

GK: You want to notice something there, Mike. People give us reasons that really look real. See, when somebody totally gets it, they deserve it. They don’t put reasons or justifications in the way of it. They say, “How do we do it?” And believe me, when I first had this realization, I didn’t know I was putting justifications in my space just to say why I couldn’t do it. And it’s so real and it’s so subconscious to us that we actually put things in the way of obtaining what we want to have. It’s directly related to what we deserve or not. So, if you don’t think you deserve it, of course you’re going to justify why you can’t have it. You are going to think “that’s stealing” or “guys making $8 million dollars are bad” or “anybody with money is bad.” I had a doctor whose father is a priest; he started out seven years ago doing $50,000. He did $504,000 this past March in the heat of a crazy recession. His dad told him that people with a lot of money are bad. This filter had stopped him—going back to that filter distinction—that filter stopped him from creating his dream.

MD: Yes, but the thing is you never know that you have these filters, right? It’s not like you look down and see a list of your filters. These have been given to you by your parents at such an early age that I would assume many people confuse these filters with who they really are. “If I don’t have this perception of money, or if I don’t believe this, then who am I?” I think we almost get it confused with who we really are.

GK: Yes, that’s absolutely right. I’ll give you an example. Not only have our filters been given to us by our parents and our past, but they have been shaped by our experiences. We work with this dentist up in Michigan. This gentleman didn’t think he deserved to get paid for his treatment. We wanted to see where he got this belief. And he said, you’re not going to believe it, but you helped me to see where this originated from in my world. And it was this: he said, “When I was a child, I went out and shoveled snow at my neighbor’s house, and I shoveled snow there and I came back so excited—I got paid $20 to shovel the snow! And I came back to my mom, and I said, ‘Mom, look what I got! I got $20!’ She says, ‘Where’d you get it from?’ ‘From the neighbor.’ She goes, ‘Take that money back! Give that money back to the neighbor.’” And he was like, “Why?” “No! You take that back!” Anyways, long story short, he goes back to his mom years later and asks her, “Why did you tell me not to accept that $20? Because ever since then I have felt like whenever I do work, I don’t deserve to get paid for it.” She said, “Son, I owed that woman money. I didn’t want you to take it because I owed money to that neighbor.”

MD: Oh, that’s just great. And this becomes one of his core values!

GK: But that’s what happens in our whole life. We have experiences, we make those experiences mean something, and then we pattern our decisions around that for the rest of our lives.

MD: Wow, well there is certainly a reason why humans are more complicated than cats and dogs, huh?

GK: (Laughter) Mike, you’re a hoot! This is wonderful. I really appreciate the opportunity to work with you on this interview; it’s really a joy for me.

^{Gary Kadi is a world authority on dental practice management. To further explore the ideas mentioned in this article or to request his services, visit www.garykadi.com or call 866-926-0914.}

^{Invisalign® is a registered trademark of Align Technology, Inc.}

Imagine a NASCAR race where the winning car ignores the checkered flag and continues to hurdle around the racetrack at 200 miles an hour, even though all the other competitors have packed up their cars and trailers, and helicoptered away from the track to their next destination.  The pit crew members have gone away and the crowd in the stands has driven home.  And yet, here’s this one lone race car, passing turn one, turn two, turn three, turn four, endlessly, until he finally smacks into the wall or runs out of gas.

He won, but he didn’t realize he won.

He didn’t think he won.

Because he didn’t think he deserved to win.

I see so many people in the dental industry who look as though they have it all.  Great practice, celebrity like career, great income, the perfect car, a monster home in THE gated community and the seemingly perfect relationship.  They won the game, but they don’t feel like they’re winning on a day-to-day level.  They live in what I call obligation—they spend their entire day trying to justify their success.  There’s no freedom with that mentality.  They live, and I did too, in a realm of justification, decision, and obligation.  If only they would raise their HDLs, they would be living in a world of peace, freedom, and choice.  These talented overachievers are by and large not strangers to personal and professional development.  They’ve done Tony Robbins.  They’ve watched The Secret.  They’ve read all the books.  And yet, they feel plateaued in life (plateau is just a fancy word for stuck) and they feel like there’s got to be something more out there.

They’re right. And that’s what I call HDL.  They have the toys…but they don’t have the time to play with them.  They’ve got the partner…but don’t have the mental space to really be intimate with them.  They’re so focused on winning the game that they don’t realize they’ve already won!

As a practice development specialist I’m always being challenged by our best clients to take them to the next level.  After 15 years of doing this I often wonder when I will hit my plateau. Just when you think you’re done the next thing shows up!

After mastering the ability to have our clients get their time and money handled, I naively thought that’s all they needed to make the difference for them.  If we got their business handled, their personal finances straightened out, their time management issues dealt with, and helped them hire and retain great teams so that the entire business was producing great results, the dentists wouldn’t have to do these things themselves.  They’d be happier, and so would everyone around them—their team members, their spouses, their children.  Everyone would be holding hands and singing Kumbaya, right?

Wrong.

So I thought, what’s really going on here?  I’m really good at transforming businesses then doubling and tripling gross income.  I’m really good at getting teams to be happy and getting clients to be happy.  But there’s still something missing.  Why can’t I take these hard-working, successful dentists and transform them into happy campers?  Then I realized I was transforming their businesses and their teams, but I wasn’t transforming the dentists’ thinking. I came to realize that how you think dictates how you speak and what you do.  I was all wrapped up in what the dentists were doing.  I wasn’t paying attention to what they were saying, and as a result, I had no idea about what they were thinking.  One day I had the breakthrough awareness that people’s actions—and therefore their results—always march in exact lockstep with their beliefs about what they deserved.

It’s not true that in life, you get what you deserve.

Instead, you get what you think you deserve.

Nothing more, nothing less.

If you truly think you deserve a high income and a large net worth, that’s what you will have.  If you don’t think you deserve those things, you can work just as hard or even ten times harder than the next person, and you’ll still come up short.  This is why I found the seemingly average dentist may have less technology and be clinically inferior than the dentist right next door but makes double and enjoys life more.

The same thing is true with having a healthy, attractive body.  If you think you deserve it, you’ll have it.  If you don’t think you deserve it, you won’t, no matter how many hours you labor in the gym, no matter how carefully you count your calories.  Just ain’t gonna happen.

The same holds true with having a great relationship.  Think you deserve one?  Then you’ll have one.  Think you don’t?  Then you won’t. Having breakthroughs in this area has saved my clients millions in alimony.

The awareness in my thinking was simply this:  We have in life exactly what we think we deserve.

So success doesn’t come from working harder, or working smarter, or working around the clock, or working just four hours a week.  Success comes from thinking that you deserve success.  And that’s when I came up with the concept of the Healthy Deserve Level, and that’s what my latest book is all about.

A Healthy Deserve Level is a state where you think you deserve a nice life, however you define a nice life.  It could be living in a beautiful home in a great neighborhood.  It could be having a great relationship with your spouse and children.  It could be success in the workplace.  It could be a big bank account.  Or it could be all of these things.  We coach dentists to establish a standard they want to create for their patients that we call a “healthy mouth baseline.”  When you go to the doctor for a checkup, you want the doctor to tell you that your body is healthy and strong.  When you go to your finance advisor, you want to hear that your portfolio is healthy!

But we never viewed our lives in terms of a Healthy Deserve Level…until now.  Want a quick barometer of where your Deserve Level is?  Look around your life.  Whatever you have is what you think you’re entitled to.  Nothing more, nothing less.  One of the most exciting movies in recent years is, of course, The Secret.  And the secret of The Secret is the law of attraction—whatever you talk about, you attract.  But to go beyond the secret of The Secret…to the real secret of life…if you don’t allow yourself to deserve something, you’re not going to be able to think about it.  If you don’t think about it, you won’t talk about it.  And if you don’t talk about it, it’s never going to materialize in your life.  That’s because you’ll never take the actions necessary to make it happen.

The law of attraction will not happen if you truly don’t believe you deserve it. If you truly don’t believe you deserve, then it just won’t work

Everybody’s focused on what they’re going to do next.  I want to know what you’re going to think about next, because that tells me what’s going to happen next in your life.

When JFK said that America was going to put a man on the moon by the end of the 1960s, he didn’t know how we were going to do it. The day Kennedy gave that speech, he didn’t know what actions were necessary to take or even if there was a space scientist in the entire United States who knew either.  But JFK, speaking for America, believed that we as a society deserved to put a man on the moon.  JFK believed that our capitalistic, free society was superior to that of the Communist society of the Soviet Union, and that we deserved to win.

And we did.

Roger Bannister was a medical student who ran during his lunch hour and set the goal of breaking the four-minute mile.  Of course, back then, everybody said that a human being couldn’t run a mile in under four minutes.  It was never going to happen.  Bannister proved them wrong.  Why?  Because he took the actions necessary to run a sub-four-minute mile.  Why did he take those actions?  Because he thought that he was capable of running that quickly.  In his mind,  he deserved to run that quickly—and he did.  Roger Bannister had a Healthy Deserve Level when it came to running the four-minute mile.  When you look at the rest of his life, it appears he had that same high HDL across the board.  He was a successful physician in London for decades, and had a successful family life, as well.

You get what you think you deserve, because what you think about dictates what you say and what you do.  If you don’t believe you deserve something, it’s never going to happen.  In fact, you’ll do everything in your power to sabotage the possibility of getting what you want.  It’s perverse, but it’s human nature.

Because it’s been such a blind spot for people, I believe HDL is the critical piece in the discussion about how to get what you want,.  We all want to have great relationships and strong, healthy, attractive bodies, with more money, more time, and more freedom.  I’m no different from anyone else.  But back in the day I had to learn this stuff the hard way, I didn’t think I was entitled to make a lot of money in a short amount of time.  It just wasn’t in my realm of deserve.  So I created my business in such a way that I would have to work hard to justify the income I was earning—until I finally thought I was just going to explode.  Back then, I couldn’t get to where I wanted to go because my configuration and belief about what I deserved was so poor.  I didn’t think I deserved free time, freedom to be with my family, a lot of money in a short amount of time.  I’ve transformed my thinking, and I’ve transformed my Deserve Level to the point where I now have an HDL that allows me to have both money and time.  And I don’t have to choose between work and financial success on the one hand and a successful marriage and family on the other.  If you deserve it, you can have it.  And that’s true whether you’re a dentist or a ditch digger.  It’s that simple.

The key to HDL is that we all want to feel good.  That’s ultimately what we want.  We want to feel good about the money we make.  We want to feel good about the career we build.  We want to feel good about our relationships.  It’s all ultimately about feeling good.  That’s why HDL is critical.  Because, if you feel good about yourself, if you feel that you deserve things, they’ll come to you.  You’re probably thinking this sounds too simple.  But that’s just your ego telling you that you don’t deserve the benefits of what I’m going to share with you!

So why doesn’t everyone have a high HDL?

Maybe you were raised by people who modeled a low HDL for you.  But it’s all too simple to play the blame game.  I’m going to share with you now what I’ve discovered to be the number one reason why people have a low HDL.  And it’s got nothing to do with what happened when they were growing up, if their parents were alcoholics, abusive or Father Knows Best types.  It all comes down to this:  Your ability to make and keep agreements with yourself, others and to your values.  If your ability to do this is high, your HDL will be high.  If you act in a manner not in keeping with your agreements, like having sexual relationships outside of marriage, or cheating in your financial life, you’re going to pay a price for it.  Maybe not in divorce court, and maybe not with the IRS.  But you’ll pay for it in the corner of your mind where your HDL lives.  The great part about this is that if you have broken agreements, you can step up and take responsibility for them and restore your agreements. If you keep breaking your agreements your word will lose all of its power and your deserve level will dramatically suffer.

Low integrity creates a downward spiral in your HDL.  Or to put it more positively, your HDL is directly related to your ability to have impeccable integrity.  Integrity is not about being right or wrong or good or bad. According to Webster, the definition of Integrity is (noun) the possession of firm principles, completeness and wholeness, the state of being sound and undamaged. We all have areas of our personal and professional lives according to this definition of integrity that need attention.

If you want the short course on HDL, just stop doing whatever that thing is that you know is not creating wholeness or completeness.  Only you know for yourself. It is going to take some courage to confront these things but on the other side of it is pure freedom. Your HDL moves in lockstep with your integrity.

Do you owe someone on your team a review that you promised? Have you committed to yourself to go to the gym and have made a perpetual wrong turn into Cold Stone Creamery? Have you been doing wallet biopsies on your patients and not informing them of the disease and infection that resides in their mouth?

You can’t earn your way into a high HDL.  You can’t love your way into a high HDL.  You can’t diet and exercise your way into a high HDL.  That’s like putting icing on cowpie.

The end game is what you do, because that’s what gets you what you want.  But the beginning—the place to put your efforts—is on how you think about what you deserve, because again, that dictates what you declare to the world and what you actually do.  It’s just radical common sense.

HDL is what I call Radical Common Sense.  Life is so brutally simple that we actually have to work hard to make it simple.  So I’m trying help you to cut the curve on this thing.  You don’t have to go to a four-day seminar and party and clap your hands until two in the morning.  You don’t have to do anything—just stay focused on your HDL, and you’ll get it in a second.  Sometimes I ask people how long it took them to quit smoking.  They might say something like, “It took me twenty-five years.”  I say, “No, it only took you a moment to quit smoking, once you chose to do it.”  So it’s all about what choices you’re making in terms of…altogether now…what you think you deserve.

Raise your HDL—you’ve already won, but you didn’t look up to see the checkered flag.  And instead, your life may feel like you’re just spinning around that track and you don’t know what to do next.  Rev your engine, enjoy the journey and acknowledge the wins you receive each day.

GARY KADI, AUTHOR OF MILLION DOLLAR DENTISTRY, TAKES TOP DENTAL TEAMS BEYOND SUCCESS.

You have already won the game. You have done it all. You are a successful DDS with a BMW, have a black AMEX, kids at BYU, MIT and NYU. You are an overachiever with an 8,000 square foot home in the best gated community.

You are a top One-Percenter… and you know there is winning at a higher level. You know there is another hill to climb beyond where you are now.

You’ve achieved more than you or your parents could’ve ever dreamed of.

You should be feeling like you are on cloud nine but you realize something is missing.

Success is not success until it is complete. So many dentists who have practiced for decades and have reached the top one percent category are asking themselves the same question, “Now what?”

All the money you have made has gone toward good causes – back into your practice, your kids, great experiences and some fun toys. Oh yeah, maybe some of the leftovers went into your retirement too.

It is like you have won the game, but you have stopped winning.

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Hey all!

Well, I know some of you have seen me speak live, and I don’t think I’m exaggerating when I say that it is truly an event one should not miss! It’s not only a blast–something I know you’ve never seen before. But, the results teams are getting from simply hearing me speak (and get CE credits at Invisalign events) is in and of itself fairly profound! Here are a brief couple of results that teams are having after my It Takes A Team events around North America:

~Dr. King from Woodbridge, VA went from 3 Invisalign cases in Q3 to 10 cases in Q4 after coming to my event!

~Dr. Thomure in St. Louis, MO had just 6 new Invisalign cases in the first half of 2008 and after the event it went up to 21 cases in the second half of the year!!

Teams are also sending in emails saying how they are so inspired and motivated that they are using my book Million Dollar Dentistry during their morning huddles and that they now see each patient as a “new” patient and it is making a huge difference for their team and practice.

And then there are the teams that have taken the leap and worked closely with me and my team–producing results in their practices, like one that went from doing $50,000 a month, to doing over $5 Million a year! Pretty great, huh?!

So when am I going to be in a city near you? Click here to find out!

Can’t wait to meet you!

Consider that we all have an imaginary container that we built in our minds that limits the capacity of all the things we can have in practice and in life. Let me share with you a great visual for you so you can begin to see it more clearly.
Baby elephants are contained by a stake driven into the ground with a rope attached to one foot. When the baby elephant attempts to get away, that rope stretches and limits how far it can go from that stake. When the elephant grows older, larger and stronger, that same rope is still placed around its foot, however, the stake has been removed and the elephant remains contained and does not run. It doesn’t, because the moment it feels the rope on its foot it stops. It “thinks” it cannot go any further. Consider we, as humans, have a similar mechanism. When we reach a level that we invented in our minds as the limit, from the past, we stop doing the things that will naturally allow us to go to the next level. Consider that our “comfort zone” only allows us to go 20% above or below our imaginary baseline in all areas of life – income, career satisfaction, fun, being connected, success, weight, freedom, etc. Take a look around at the people you associate with. Your income, net worth, interest, and even physical weight is 20% up or down give or take a pound, a dollar or two of theirs.

What do you do, now, knowing that information? Well….take the lid off the container you have self-built around yourself and your future…then see what’s possible and start following your dreams!

I’ll get right to it:
1. Know what kind of game you are playing and if you’re all playing the SAME game.
Get your team on the same page. If the game you were playing was basketball, it wouldn’t work and you wouldn’t win if 3 of your teammates thought the game was tennis, football, and volleyball. Find out where everyone is at and bring everyone up to speed.

2. Move from activity-based thinking to outcome-based thinking.
It’s not “do more” equals “achieve more”. The equation is “do less” equals “achieve more” by taking actions that directly correspond with the outcome you are out to produce. My team and I call this the DPO (Daily Primary Outcome) for each position, team member, and the practice as a whole.

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No…not Master of Business Administration…although it kinda fits. What I’m talking about is Manage By Agreement. It’s a simple fact that most of the time while we are working we are dealing with people’s feelings and emotions about everything. And, these feelings and emotions get pretty intense when it’s about a broken deadline or misunderstanding.

So, my simple to use and ultra-stressfree tip is to only Manage By Agreement. When you are only dealing with what was promised, what was broken–all the FACTS, there isn’t much to get emotional about.

It’s another way to say “integrity”. Doing what you said you would do, by when you said you would do it…

Ahhh…imagine the simplicity of it all!!

Have you ever felt that way? That people were just not listening to you, always cutting you off mid-sentence, and that they even started treating you differently at some point in time? What I’m about to say is really geared towards you, not them, unless “them” are reading this, too. What’s going on is a filter. A filter is a pre-concieved idea or notion about how something is or how a person is or is going to be. Maybe their filter for you is that you’re righteous, that you don’t listen, or that you don’t care.

For example, when my wife was pregnant, every woman I saw was pregnant. It was the filter I had for women at the time. They stood out like a sore thumb. What I’m getting at is that you have a filter for everyone and everything…it’s not bad…we all have filters, but distinguishing your filters will have you able to either keep it or let it go and create a new, empowering one.

Also, guess what, maybe you’ve been wanting more patients, well, from now on all your current patients are new patients! You have had a filter for patients, each and every one of them, and you now have the power and choice to create a filter that maybe has them paying up front, always happy to be there…always on time, even!

Well, keep looking for where you have filters and how altering them will enhance your life and theirs!

When someone asks you, “What’s great in your life?” there is a knee-jerk reaction that happens in our brains that says all the things in our life that are NOT great. Just click on the title of this post (a new window will open from “Box”) press play, and listen–this audio clip is about ANTs and how they affect us in life–from my Boston event! Enjoy!

Clearly these are two very different approaches to how to not only run your practice, but also on how to react in life to any circumstance that heads your way.

It’s rather easy to get bogged down in the swamp of “should haves” and “if onlys” in life. “If only I wouldn’t have bought ‘X’,” or “I should have handled ‘Y’ better,” or “If only I had more time, money, love, etc.” What’s certain in life is that it’s going to keep happening–circumstances, events, emotions, and people…it’s just going to continue on and on. But what you have power over is how you react to life and all that it entails.

Fear-based driven performance will have many in these economic climates scurrying to survive. They will react to situations with anger, frustration, terror, sadness, and resignation that they are doomed to not succeed and live their dreams. This will lead to driving family, employees, and patients away—I know that “away” is not where they want them to go, really—and so do you.

Others, when operating from Confidence-based driven performance, will succeed in any given situation because they know, because of a high deserve level and commitment to success, that life is 10% of what happens, and 90% of how they react to it. These people will see the opportunity in every challenge and they will work as a team, both in the practice and at home, on producing the outcome that they desire most, that benefits all involved.

One isn’t better than the other—that’s simply a matter of opinion…do you want alienation or accomplishment? Sinking or succeeding? Fear or fun?

Your outlook on performance is going to be the key to getting whatever it is that you want in 2009 and on!

You have lots of assets at your fingertips that can really be leveraged right now and position you for profit optimization. One of the assets I’m going to highlight here is to hire, if you don’t currently have one, a dedicated treatment coordinator. This person, your treatment coordinator (tc from here on out), will be a key agent in closing cases and in patients accepting the full treatment presented. The tc’s expertise comes in after the hygienist has educated the patient, the doctor has recommended and requested certain treatment be done to take care of whatever problems the patient may be having or have in the future, and now the patient is in the tc’s dedicated space to have a very important conversation. This conversation the tc has with the patient is to gain agreement on moving forward with the treatment presented and on payment.

The tc is so valuable here…this is where you can drastically reduce broken and cancelled appointments…and even reduce any patient complaints you may have about your work if you have any. The patient will have a full understanding about what will happen in their treatment plan, why it should be done, and they will leave with ease about how it will be paid for…since the tc worked hand in hand in having it be treatment that will work with the patient’s lifestyle! Perhaps the tc assisted them with third-party financing and made it work in a payment scale that is affordable to the patient, or they received payment in full from the patient…either way, the patient is set up, the team is set up, and the doctor is set up…TRIPLE WIN!

A treatment coordinator is a truly valuable and usable asset, right now, that will help you close cases and increase profitability…let me know how it goes and what you think!!

Recession…wow, I thought the only recession I might be hearing about or talking about is my hair-line recession, and to be honest, it’s the only one I’m really all that interested in. However, there is a monetary recession happening these days and how we can deal with that here in the US is by strengthening our Hygiene Department in patient education, basic steps, and processes.

It’s the holiday season and consumer confidence is down. They’re going to buy only one of three things this year versus last year when they bought all three. The three things to focus on have to do with:

1. Having to do with their home.
2. Having to do with their travel.
3. having to do with their personal self.

The one they choose is going to be the one that will make them feel the best in the face of all the negativity, fear, and uncertainty. Let’s educate them and have them choose Invisalign. Paint a picture for them (figuratively–not literally) letting them know how great they’re going to feel about themselves and how they will be able to transform a room with one radiant smile. They won’t know what happened–everything will just look good, feel good, and fresh. This will truly provide something happy and wonderful for them in spite of the hardship that is at hand and will get them in action on creating more happiness and beauty in their life. It all starts with a little patient education on what’s possible…right now, not later.

And in case you were wondering, I have a very full head of hair…

Hello loyal readers!

Well, it’s been a week since Thanksgiving and I’m still feeling the need for a little more pumpkin pie…I hope I’m not the only one! Thanksgiving is a holiday that signifies giving thanks and gratitude. The only downfall in that is that we are dedicating one specific day a year to do this really profound and personal growth exercise of gratitude.

I recently read something that spoke about gratitude. And what it said was, “No matter who you are or where you are, you can change your life with gratitude, but you must feel it with your whole heart and radiate it from every cell. Gratitude is not a mental exercise, and in fact, if you simply use your mind for gratitude it will have little or no power. True gratitude comes from your heart! You must think gratitude through your heart, speak gratitude through your heart, and feel it intensely in your heart.”

If you’re anything like myself, I’ve never thought of gratitude in this way and the bountiful joy that it brings into one’s life. Imagine what it would be like to work with patients and your team this way…and how your family will benefit from this simple, yet not utilized, act.

Here’s my suggestion…treat every day like it’s Thanksgiving…feel gratitude through out your entire being…but maybe without so much pie…it’s up to you.

I am thankful for you and the difference you make in the world!