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Welcome back to Not Alone with Melissa Sue Methman.
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Today's guest is Dr.
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Amrita Patel.
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Now, she is a dentist, an author, a speaker, and has been on the council for the ADA and many other councils as well.
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Now, here, what we're gonna touch base on is it's gonna be real, raw, and the truth.
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We're gonna touch base on insurance, mental health, purpose, living a life of fulfillment, and so much more.
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So I'm gonna give the floor here, Dr.
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Patel.
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Thank you.
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Thank you for coming today.
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Yeah, I'm really excited this all worked out time-wise.
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Yes, I know, I know.
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I had it on my calendar that you'd be in town because you live in New York.
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Sioux Falls for now, but New York soon.
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Okay, New York soon.
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And I know I think we got connected just through a mutual friend.
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And so I'm just really curious.
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I really, you know, would love to hear kind of your story, your background, and so yeah, the book can share.
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And I grew up in dentistry.
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My father's a dentist as well.
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He's an endodontist, and I went to dental school and I did a residency in New York and went right into practice with him.
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We built a group of family-owned group practices in Metro New York City.
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So if you're familiar with New York, it's about 30 miles straight north.
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Obviously biased.
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I think it's the best city in the world.
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Um, but I was very involved with uh volunteer leadership within organized dentistry.
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And in that capacity, I chaired the new dentist committee for the New York State Dental Association.
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Uh, got put in front of a lot of rooms of uh new dentists, dental students, residents, which is a pretty vulnerable population, I'd say, that sometimes gets very overlooked when it comes to support and education because you kind of leave the environment of dental school and then kind of get thrust into the world.
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Yeah, I feel they're really not prepared at all.
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You know, at all for the what's the reality, right?
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Yeah, no, I wasn't, and I was in dentistry.
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And so, you know, when my kind of term concluded um doing that, what I realized is that I had this platform in the non-clinical part of my career, which was educating, writing, speaking.
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And so that's really taken off over the last few years.
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I think I've already taken 130 flights this year.
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Wow.
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I know I did 150 last year, and I promised myself not doing that again.
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And here we are.
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But so that's that's kind of me in a nutshell.
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You know, you mentioned New York and South Dakota.
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We talked a little bit about that.
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Um, I was sent to the South Dakota Dental Association a few years ago to do some programming.
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They sent their state's president-elect to pick all the speakers up at the airport, and we got married last January.
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Oh, that's so I have a kind of nerdy dental association love story.
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Um, so my husband is also a dentist, and so I'm kind of like immersed in all of it.
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But, you know, the the profession has given my family and I so much, and I recognize that there was this demographic that felt like it wasn't getting the support that it needed and decided to take some responsibility for it.
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Wow, I love that because I feel the same way about the dental community, and that's why I'm using my voice and try it is a wonderful profession that provides for your family, but also there is some awareness, right?
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That we need to bring to the dentist.
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So I, and especially dental student.
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So, what did you feel that you're teaching dental students that are coming right out of school and the reality?
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Because I know we had associates right out of school, and a lot of them thought, oh great, I'm gonna make this much right out of school, but they don't realize that it takes a while for us to get money from the insurance and get paid.
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So oftentimes my husband would loan them money before until they get onto their feet, you know, and start seeing a paycheck.
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So I think that's not really, you know, taught in dental school the reality.
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Dental school is full of dentistry, right?
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And so there's not that much time in the curriculum left to teach all of that.
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And there are some schools that have been kind of trying to integrate it into the curriculum, but it's there's so many requirements, there's so much that you have to get through that most students are coming out five, six, seven hundred thousand dollars of debt and no real education on how to service that, right?
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And you talked about the cycle of getting paid, you know, the RCM, the when you send a claim, it's not instantaneous, right?
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And if the insurance never pays and the office never pays, you don't get paid.
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Right.
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Which are important questions and things that should be taught and that we should be asking, but no one's really talking about it.
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I love that you bring that up because I know, you know, I could see once I sold the practice, seeing all the numbers, there was so much money that we we never got back, right?
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Because there's a limit amount of time.
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Yep, your timely filing limit.
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Yes.
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So it I think that people don't understand that about insurance.
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I'd love for you to just kind of discuss that the insurance for patients, and also, you know what's frustrating with me with insurance as a dental hygienist is that oftentimes I can't we can't treat the patient, the root cause because it's so based on their insurance thing.
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Well, I'm only gonna follow what my insurance can cover.
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And that's so sad to me, you know.
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I, you know, coming from Canada, I'm not saying that the way they do medical is any better because there's waitlists and all that, but it was more preventative.
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Whereas when I moved here stateside, everything, everyone depends on what the insurance covers.
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And you know, I I remember sitting, there was this wonderful sweet vet in my chair, and they're like, Oh, well, he's not covered for this, not covered for that.
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And I'm like, Oh, he needs an exam, he needs this.
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I mean, he, but they're like, no, the insurance doesn't cover it.
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I'm like, oh my gosh, you know, it it's kind of that you can't get treated, right?
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You know, and I think it's this myth, like you said, that insurance covers everything.
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And so for the viewers, I tell patients that dental insurance is a coupon from the 1970s.
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What do I mean?
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Well, where did it come from?
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It was created by large corporations in the 1970s as an incentive to attract workers.
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Well, what was the average annual maximum in the 1970s?
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$1,000.
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What's the average annual maximum today, right?
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It hasn't changed.
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But what I've really realized is that patients that are purchasing these plans, whether it's from a broker or as part of their orientation at a new job, they're not being explained what they're buying.
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So when they go in and they say, Oh, I have this new job, and you know, I didn't wear my retainers and I really want adult orthodontics.
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And the person in HR says, Well, this plan is the most expensive, it's gonna take the most money out of your paycheck, but it has adult orthodontic coverage.
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What they don't tell them is that adult in insurance world means 18, 21, 26, and then they come to you and now you're the bad guy because your insurance doesn't cover that.
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So it's a complete lack of education, sort of on both sides, but also an understanding that when you get someone that says, I just want to do what the insurance covers, to be able to explain that anytime an insurance pays out, they write it off as a loss.
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It flips that script, right?
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Because at the end of the day, it's about the investment in the oral health that they're gonna make with you.
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Right, so true.
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And seeing it the big picture over time, right?
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So, do you find a lot of practices?
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Because I know for us in Wasilla, Alaska, so many dentists were not seeing either Medicaid, Medicare patients any longer because they were just not almost not making any money, you know, and or oftentimes we get no shows from from them a lot of times.
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And but we accepted them.
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So, do you find that there's a different service that dentists can utilize instead um in-house to make it a little bit better for patients?
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Great question.
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And it's one of the things that I speak on.
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Your in-house membership plans, I think, are so valuable.
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Whether you are looking to transition out of network, um, whether you're purchasing a practice that's not maybe a network, or you've realized that it's you just can't sort of take the best care of patients in the way you want by staying with certain plans, having a good in-house membership plan, I think, is really key.
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And the thing that we realized when we implemented ours, and this is interesting, is take your average patient that you see twice a year for hygiene, x-rays exams once a year, uh, or exams twice a year, x-rays once a year, maybe your doctor is doing a filling or two a year.
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If you look at what's really being taken out of their paycheck versus what they would have paid the office had they been enrolled in a membership plan, sometimes it's a wash.
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And sometimes they're actually getting more money taken out.
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Because what's interesting is as much as everyone is so afraid of maxing out, the data shows that it's really only like 3% of people nationally that max out.
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Most people aren't using the full extent of their benefits.
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Yes.
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Yeah, that's so true.
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Actually, we would notice that, you know, December would get so busy.
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I remember because they're like, oh my gosh, I didn't use everything until the the year rolls over.
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Yeah.
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But they can't get in because we're busy.
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And most of the time, yeah, they don't utilize everything.
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Right.
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Yeah.
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And so that was kind of an interesting experiment where I asked some of the patients that I was very close with or that had been with the practices for a long time, you know, hey, do you feel comfortable sharing this with me?
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And we realized that that was actually one of the ways that we the reasons rather that we designed our membership plan is because it was more cost effective for them to do that.
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And then they didn't have to wait for a pre-auth or a denial or chasing down for a balance.
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It was just care when they needed it, which is really what we wanted.
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Which is almost like a a win for the patient, win for the dentist as well.
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So they don't have to wait to hear back from the insurance and get paid for the the work that they provided.
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And you know, you're you're in dental as a hygienist, you know, your afternoon wipes out, that stinks.
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But now you've got people that are enrolled in a plan that they have paid for.
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Chances are if they've paid for something, there's a Yes, they show up.
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Exactly.
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There's a way less chance that they're gonna pay.
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And how many times if it's paid, like for example, you give something free for someone, like a service.
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They might, for example, personal training.
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You're like, well, it's free, right?
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Sometimes it might be like, Well, I'm too tired, I'm not gonna go.
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Right.
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But if you're paying high dollar,$100 for that personal training, you're gonna show up.
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Yep.
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Right?
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Yep.
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So oftentimes I see that as well because we'd had a lot of no-shows when it was free coverage.
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Yep.
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They would have no shows.
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Yep.
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And but if you're paying for it, so I I like that.
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You know, I hope that more people kind of understand that.
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Yeah, and also because I've always felt that for our front office because you know, people come angry, they have to explain their insurance and they didn't realize what was going on.
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So here I feel with this podcast, we can bring education for the patient side and dentists that are probably starting their new practice, which route to go, right, you know, to start off and thinking about these options.
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Yeah, and again, that I love data, and the data also shows that not everyone is fee for service.
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And if you read dental social media, it'll have you thinking that the only path forward, the only path to be able to be successful but also take the best care of your patients is to be completely out of network.
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And the data doesn't support that.
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Most doctors are networked with at least three PPO insurance plans.
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I see.
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Yeah.
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And now where else, where else are you helping now dentists?
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Yeah.
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So, you know, so much of the other programming I do is for uh new doctors that either are looking to buy practice, um, brand new practice owners is another kind of subset that I really enjoy interacting with.
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And then there are teams, right?
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Because listen, I'm only as valuable as my team, um, you know, kind of the team surrounding me.
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I can't do what I do without the people around me.
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And one of the big questions that we get asked is, well, I've never been a leader before.
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What does that mean?
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You know, I have to set my own policies.
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How do I make sure that what I want to get done is actually gonna happen?
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And talking about what communication is, kind of integrating that into the culture.
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But again, this isn't anything that's really taught anywhere.
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Um, and I think the other thing that really comes up repeatedly is everyone's have everyone has their own struggles.
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You know, social media is a highlight reel of everyone's life.
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You know, I have a very public, uh, open Instagram.
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It used to be private.
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And if you go and scroll back a couple years, you know, 2017, 18, 19, you'd see a girl that was traveling the world and involved in all sorts of leadership positions.
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And I was miserable, Melissa.
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I was miserable and unhappy with myself and felt felt unfulfilled and couldn't figure out what was wrong with me.
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Yeah, like why were you not feeling all fulfilled?
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Even though you were traveling the world, you know, and working with my father and building a business.
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And, you know, I think it was this sense of, you know, and I am the the child of immigrants, my parents are from India, you know, I wasn't married, I didn't have children.
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And so inevitably, when we would be at a dental meeting and everyone was like, Well, how's your how's your kid?
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How's the spouse?
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I would be like staring at my shoes, hoping that they didn't ask me.
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And so then I wore really nice shoes.
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So hopefully the question would be, where'd you get the shoes from?
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That was the distraction technique.
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Oh wow, okay.
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And so much of that is societal pressure, you know, it's what you see.
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But again, not you don't know what's going on in people's lives, right?
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And it took making peace with, you know what, I've worked really hard on my journey.
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I am where I am, I'm gonna trust the plan.
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And walking that path with peace, and literally three days after I made that decision, I met my now husband.
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Wow.
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It was eerie.
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Wow.
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Eerie.
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So once you made peace with it and allowed yourself to be like, no, I I like this path.
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I don't have to be like what the what the, you know, most people say, okay, yeah, you you do your career, you have kids, you have get married, you know.
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But you're like, no, I don't have to follow this, you know.
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No, no.
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And it's hard, I think, when you're being bombarded left, right, and center with those highlight reels.
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And I think especially in the post-pandemic world, it's all become so front and center, right?
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And you compare yourself, right?
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Totally.
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And now everyone's lives fully are online, edited and filtered and perfect.
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And so it becomes even more of a burden.
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And so, you know, so many of the doctors that I talk to, so many of the people that are starting this journey, that's what they come to me with.
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But, you know, I'm not doing enough, or I don't feel like I'm enough, or why can't I this, or why can't I that?
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And a lot of it is like, okay, you need to sit with yourself and decide what you want your life to look like.
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Because as you know, dentists are myopic.
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We miss the forest for the trees all the time, right?
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Like trees and trees and trees, right?
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So we are that's kind of just who we are.
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And so I think it's hard and scary to sit with yourself and think about, you know what, maybe I don't want to be a practice owner.
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Maybe I want to move somewhere that's new, right?
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Maybe I want to go back home.
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Maybe I don't want to be a dentist, maybe I don't want to be a dentist anymore.
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Which is so scary for so many.
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Yeah, you know, maybe I want to explore what else I can do with my degree other than just being a practice owner.
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Because just because you own a practice that doesn't automatically make you successful, right?
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Or or validate you.
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And that piece is is hard.
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And as people that are myopic and often very type A and used to being in control, sitting and letting your control go and letting your guard down with your thoughts is scary.
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It is so scary.
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So scary.
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I always say that.
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I said, spend time because I have a practice in the morning of meditation.
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I need at least an hour before I'm with my family.
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You know, just in stillness in my peace, in my breath work, in my prayer practice, whatever that is.
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So, what does that look like for you when you say it sit in stillness for you?
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Yeah, you know, I think personally for me, my brain is always going at 100 miles a minute.
00:15:13.279 --> 00:15:16.320
And so it is very helpful to get it on paper.
00:15:16.480 --> 00:15:18.080
You know, what's concerning me?
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What is on my plate for today that I think is going to be a challenge?
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What do I need help with?
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Which was hard.
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Because I can do everything, right?
00:15:25.519 --> 00:15:26.000
You can't.
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What do I need help with?
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And a practice that's really helped me is when I start to feel very overwhelmed.
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I take an 8 by 11 sheet of paper and fold it in half the long way.
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On the left hand side, I write down everything that I'm doing right now that's making me feel that way.
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And on the right hand side, I put down everyone or everything that could be doing it better than me.
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And I oftentimes find out that I've taken on things that have been delegated to other people that I'm not making sure are doing it, or maybe things that could be a priority, but not right now, like important, but don't doesn't need to be handled right now, you know.
00:15:59.440 --> 00:16:02.399
And it helps me to organize my thoughts and my life in that way.
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But it's an exercise that I, I mean, do weekly, sometimes daily, and it really helps.
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I can see that.
00:16:08.399 --> 00:16:11.519
I always tell people writing it down, but you're right, prioritizing, right?
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Yeah.