Latest / Becker’s Healthcare Podcast / The Mouth-Body Connection, Patient Trust and the Future of Dental Care with Joe Feldsien

Transcript

The Mouth-Body Connection, Patient Trust and the Future of Dental Care with Joe Feldsien · Becker’s Healthcare Podcast

• 0:02
  - Oral health is finally being recognized as part
• 0:04
  - of Whole Person Care. And at the same
• 0:06
  - time, digital tools and AI are reshaping how
• 0:09
  - practices prevent disease, engage patients, and grow.
• 0:13
  - DSOs are expanding. Independent
• 0:15
  - practices are proving their staying power, and investment
• 0:18
  - is accelerating across the sector.
• 0:20
  - Dental leadership has never been more complicated
• 0:23
  - or more consequential.
• 0:25
  - Becker's fifth annual future of dentistry roundtable brings
• 0:28
  - together more than 250
• 0:29
  - executive level attendees
• 0:31
  - and 90 plus speakers
• 0:33
  - for two days of sessions in Chicago, all
• 0:35
  - built to help leaders benchmark their priorities,
• 0:38
  - stress test their strategies, and walk away with
• 0:40
  - a clearer picture of where this industry is
• 0:43
  - heading and how to position for it. It.
• 0:45
  - Join us September fourteenth and fifteenth in Chicago.
• 0:49
  - Register on our events page at wwwbeckersdental.com
• 0:53
  - by clicking on the events tab in the
• 0:55
  - upper right.
• 0:57
  - Hello, everyone. This is Cameron Cortagiano with the
• 0:59
  - Becker's Dental DSO review podcast.
• 1:02
  - I'm thrilled to be joined today by Joe
• 1:04
  - Feldstein, senior vice president of integrated care at
• 1:07
  - PDS Health. Joe, thanks so much for being
• 1:09
  - here today.
• 1:10
  - My pleasure.
• 1:11
  - Awesome. And just to start us off, can
• 1:13
  - you just introduce yourself,
• 1:15
  - and tell us a little bit about your
• 1:16
  - background, whole organization,
• 1:18
  - all that good stuff?
• 1:19
  - Yeah. So,
• 1:21
  - Joe Felsin,
• 1:22
  - senior vice president of integrated care for PDS.
• 1:26
  - Been with PDS now for, just a little
• 1:28
  - over twenty two years.
• 1:30
  - It's been an amazing journey.
• 1:32
  - I've had
• 1:33
  - the distinct privilege to do a number of
• 1:36
  - roles at PDS. When I first started out
• 1:38
  - in 2004,
• 1:41
  - I was,
• 1:42
  - able to help with, some of the CEREC
• 1:45
  - things that we did early in those days.
• 1:46
  - That was a lot of fun. And then
• 1:49
  - I opened up Arizona for PDS, which is
• 1:51
  - the first,
• 1:52
  - state outside of California,
• 1:55
  - where we opened from scratch basically and helped
• 1:58
  - get that going.
• 1:59
  - I was there till 2010,
• 2:01
  - and then, I came to Irvine
• 2:03
  - and supported,
• 2:05
  - the clinical environment with some recruiting efforts with
• 2:09
  - building out educational
• 2:11
  - capability
• 2:12
  - in Irvine.
• 2:13
  - And then in 2020,
• 2:16
  - I joined the,
• 2:18
  - the IT team. And in those in that
• 2:20
  - role, I was able to help roll out
• 2:22
  - CBCT for the organization.
• 2:25
  - And then
• 2:26
  - about a year and a half after we
• 2:28
  - did that, which happened, to coincide with COVID
• 2:31
  - in 2020, we
• 2:33
  - I joined, became one of the the territory
• 2:36
  - partners
• 2:37
  - at PDS. And then about a year later,
• 2:40
  - as part of that, we acquired
• 2:42
  - some medical practices
• 2:44
  - in Arizona.
• 2:45
  - And so I got to be part of
• 2:46
  - that, and shortly thereafter, I became
• 2:49
  - president of the medical business unit for PDS.
• 2:52
  - And,
• 2:53
  - literally this past March,
• 2:55
  - I handed that over to a gentleman by
• 2:57
  - the name of Brett Bingham,
• 2:59
  - who's got extensive background in the
• 3:02
  - medical space, and he's doing a famous job
• 3:04
  - now of taking that to the next level.
• 3:07
  - And, I moved over to s v SVP
• 3:11
  - of integrated care where I have a host
• 3:13
  - of responsibilities,
• 3:15
  - including marketing
• 3:17
  - and then working with the company as we
• 3:19
  - roll out new initiatives related to the mouth
• 3:21
  - body connection
• 3:23
  - and related to,
• 3:25
  - just that
• 3:26
  - the the whole the whole oral systemic health
• 3:29
  - link. So it's a lot. When I first
• 3:31
  - started, we had 65 offices. Company is doing
• 3:34
  - about a 100,000,000. Today, we have nearly 1,200
• 3:37
  - offices, and, we're gonna be pressing,
• 3:40
  - almost 400 or 4,000,000,000,
• 3:43
  - by the end of the year. So very
• 3:44
  - exciting
• 3:45
  - very exciting to be part of everything that's
• 3:47
  - happened here at PDS.
• 3:50
  - Great. Thanks so much for that. And, I
• 3:51
  - mean, the growth over the last couple of
• 3:53
  - decades, I mean,
• 3:55
  - six 60 practices
• 3:57
  - to to over a thousand is is really
• 3:59
  - incredible.
• 4:00
  - Just to to start us off here, what
• 4:02
  - are some of the biggest issues that you're
• 4:04
  - following in the dental industry this year? I
• 4:06
  - know PDS Health,
• 4:08
  - we talk a lot about that,
• 4:10
  - how you how you, mentioned in your your
• 4:12
  - intro about that,
• 4:14
  - mouth body connection, just integrated care. So just
• 4:17
  - what are some of the biggest issues trends
• 4:19
  - that you're following in dentistry right now?
• 4:22
  - Yeah. You know, biggest issues
• 4:24
  - that I think we find in dentistry
• 4:27
  - is, you know, there's there's tremendous
• 4:30
  - variability
• 4:31
  - in how dentistry is practiced across this country.
• 4:34
  - Even if you were to narrow it down
• 4:36
  - to the DSO space, there's just so much
• 4:39
  - variability
• 4:40
  - and, you know, a lot of different perspectives
• 4:43
  - on what is best for patients.
• 4:46
  - You know, when I was growing up in
• 4:48
  - the dental industry,
• 4:49
  - the whole idea was, you know, the hygienist
• 4:52
  - was central to what was done because the
• 4:54
  - hygienist was good at building relationships,
• 4:57
  - the hygienist would clean teeth, and then ultimately,
• 5:00
  - the hygienist would refer patients to the dentist,
• 5:04
  - for crowns. Crowns and bridges and implants and
• 5:07
  - all sorts of things.
• 5:09
  - And, in some cases, that's still the way
• 5:12
  - it is. It's kind of wait until it
• 5:14
  - breaks and then we'll fix it. You know?
• 5:16
  - And then you've got the other end of
• 5:17
  - the spectrum where dentistry
• 5:20
  - was seen as a as a preventive
• 5:22
  - aspect
• 5:23
  - to overall health, not just oral health. And
• 5:26
  - so when you think about that,
• 5:29
  - now you've got people that are using,
• 5:31
  - salivary diagnostics.
• 5:33
  - They're talking to the patient about the mouth
• 5:35
  - body connection,
• 5:36
  - that the bacteria of the mouth are in
• 5:39
  - fact causing
• 5:40
  - severe damage
• 5:41
  - to the rest of the body and can
• 5:43
  - have big, big implications.
• 5:45
  - And so I think the big thing that
• 5:47
  - we suffer from in the dental space is
• 5:50
  - there's so much variability
• 5:52
  - from one end of that spectrum to the
• 5:54
  - other, you know, and then, if we're if
• 5:56
  - we're transparent, if we're honest about it,
• 5:59
  - you've got, different levels of,
• 6:02
  - you know,
• 6:03
  - character,
• 6:04
  - you might say. Some people
• 6:06
  - may
• 6:07
  - be doing things a certain way that isn't
• 6:10
  - well received, and that can,
• 6:13
  - cast a shadow on all of us. And
• 6:15
  - so one of the issues that we face
• 6:17
  - in dentistry
• 6:18
  - is some people question whether they can trust
• 6:21
  - the dentist.
• 6:22
  - And I think you only have a have
• 6:24
  - to have a few bad actors in order
• 6:26
  - for that to affect us all. And so
• 6:30
  - being very, very good
• 6:32
  - at being able to describe
• 6:34
  - what is truly going on with the patient
• 6:37
  - is absolutely at the center. And then having
• 6:40
  - them walk away with that understanding
• 6:43
  - and completely bought in to the treatment plan
• 6:46
  - going forward is is really, really critical
• 6:49
  - to the credibility
• 6:50
  - of all oral health care providers.
• 6:53
  - Yeah. Absolutely. I think that
• 6:56
  - the the patient provider
• 6:57
  - trust in that that link there is is
• 7:00
  - really just a baseline for everything. If the
• 7:02
  - patient doesn't trust who's
• 7:04
  - working on their teeth and their mouth,
• 7:06
  - you're not gonna get very far with,
• 7:09
  - treatment acceptance
• 7:11
  - or getting the treatment or or anything along
• 7:13
  - those lines. So I think that trust how
• 7:14
  - you're saying it is huge.
• 7:17
  - It's massive.
• 7:19
  - Something that I'm curious to to get your
• 7:21
  - thoughts about are what are some of the
• 7:24
  - things that you're most excited
• 7:26
  - about when it comes to dentistry right now,
• 7:28
  - first off? And then secondly,
• 7:30
  - what are some things that are potentially making
• 7:32
  - you a little nervous?
• 7:34
  - So, yeah, I think that there's no doubt
• 7:37
  - as you look at the studies,
• 7:40
  - as you look at the key influencers out
• 7:42
  - there that the mouth
• 7:44
  - is being brought back into
• 7:46
  - whole body care,
• 7:48
  - and it was separated
• 7:49
  - now over a hundred years ago. But I
• 7:51
  - think little by little, that is coming back.
• 7:54
  - You can see it obviously at PDS with
• 7:56
  - some of our initiatives,
• 7:57
  - but it's well beyond PDS in terms of
• 7:59
  - what goes on there.
• 8:01
  - So,
• 8:02
  - you know, the the one of the big
• 8:04
  - things that I wanna make sure that I
• 8:06
  - state even on this podcast
• 8:09
  - is what is going on with salivary diagnostics.
• 8:11
  - You know, we are able to see now
• 8:14
  - through saliva so much more, which is very
• 8:17
  - significant because what that does is it allows
• 8:20
  - us insights into what's going on in the
• 8:22
  - body. You know? And with those insights, what
• 8:25
  - we can do is we can talk about
• 8:27
  - specific bacteria.
• 8:28
  - And if I can, you know, one of
• 8:31
  - those bacteria,
• 8:33
  - FN is what it's
• 8:34
  - known as,
• 8:35
  - it is having significant impact,
• 8:38
  - on young ladies as it relates to
• 8:42
  - getting pregnant,
• 8:44
  - as it relates to preterm
• 8:46
  - and low birth weight babies.
• 8:49
  - And it also obviously then, sometimes that preterm
• 8:53
  - delivery can result
• 8:55
  - in a in a miscarriage.
• 8:57
  - So there's just so much going on there.
• 8:59
  - We've also seen that FN
• 9:01
  - can is a factor in colon cancer.
• 9:04
  - It's also a factor in breast cancer. And
• 9:07
  - so the bacteria of the mouth can have
• 9:09
  - a significant impact
• 9:11
  - throughout the rest of the body.
• 9:13
  - And so I think from that perspective, that's
• 9:15
  - what's really encouraging to me. The dental profession
• 9:19
  - has never been more relevant to The US
• 9:21
  - health care crisis
• 9:23
  - than it is today, and it will only
• 9:25
  - be more relevant as we go forward.
• 9:28
  - What concerns me the most is the willingness
• 9:31
  - of dentists to grab a hold of what
• 9:34
  - that is and what that means for them.
• 9:36
  - And it's through no fault of their own,
• 9:39
  - but I think by nature, dentists are very
• 9:41
  - conservative
• 9:42
  - and rightfully so, you know, above all else,
• 9:45
  - do no harm. That being the case,
• 9:47
  - with all of the information, with all of
• 9:49
  - the studies that are available,
• 9:52
  - the more dentists can
• 9:54
  - read,
• 9:55
  - understand,
• 9:56
  - get mentorship,
• 9:57
  - and guidance to take hold of what the
• 10:00
  - mouth body connection and the oral systemic health
• 10:02
  - link,
• 10:03
  - the better for the oral care space. As
• 10:06
  - they say, you know, the high tide lifts
• 10:08
  - all boats.
• 10:09
  - And so the more of these clinicians that
• 10:12
  - can step into this, the better for dentistry,
• 10:15
  - the better for DSOs,
• 10:16
  - the better for the independent,
• 10:18
  - unsupported private practices.
• 10:21
  - So that's that's that's how I would answer
• 10:23
  - that question.
• 10:25
  - Yeah. Definitely. How at
• 10:27
  - at PDS Health as a
• 10:29
  - a dental organization,
• 10:31
  - you're taking
• 10:32
  - some of these insights from those diagnostics,
• 10:36
  - that, you know, aren't necessarily
• 10:39
  - dental related and
• 10:41
  - using them to to help patients get better
• 10:44
  - care.
• 10:45
  - Yeah. There's so many different things that we're
• 10:47
  - doing. You know, first of all, I mentioned
• 10:49
  - the the the salivary diagnostics
• 10:52
  - and what we're able to do there to
• 10:54
  - help patients.
• 10:56
  - You know, again, the best example is if
• 10:59
  - a patient in, informs their doctor either through
• 11:02
  - their health history or through the verbal conversation
• 11:05
  - that they are going to be, pregnant or
• 11:09
  - trying to get pregnant, we will encourage, you
• 11:11
  - know, the oral DNA test from Access Genetics.
• 11:15
  - And that works very, very well to help
• 11:17
  - them understand
• 11:18
  - what their level of FN is. And then
• 11:21
  - we can monitor that going forward,
• 11:24
  - throughout the pregnancy to ensure, you know, as
• 11:27
  - minimal
• 11:28
  - issues as possible
• 11:30
  - related to any, again, preterm
• 11:32
  - low birth weight
• 11:34
  - and or, you know, other issues related to
• 11:36
  - that. I think
• 11:38
  - the other thing that is significant, and I'm
• 11:40
  - gonna pivot away from salivary diagnostics
• 11:43
  - into cone beam CTs.
• 11:45
  - So PDS,
• 11:47
  - supported clinicians now are have done
• 11:51
  - so many CBCTs,
• 11:52
  - and they're using it in a diagnostic
• 11:54
  - function. But probably one of the greatest, I
• 11:57
  - would say either secondary or tertiary benefits, and
• 12:00
  - it's hard to say that when when I
• 12:02
  - tell you what I'm about to say,
• 12:04
  - is the ability to identify
• 12:07
  - calcifications
• 12:08
  - in the carotid arteries.
• 12:10
  - We have seen I don't know if countless
• 12:12
  - is the right words, but certainly thousands of
• 12:15
  - patients now who after having a CBCT done
• 12:19
  - in one of our supported practices,
• 12:21
  - the doctor identifies calcification
• 12:24
  - in the carotid artery, and that patient is
• 12:26
  - sent immediately
• 12:28
  - to, their cardiologist
• 12:30
  - and or their primary care
• 12:32
  - for intervention purposes.
• 12:34
  - And,
• 12:35
  - on more than,
• 12:37
  - on on a number of occasions,
• 12:39
  - we've been told you saved this person's life.
• 12:42
  - You saved this person from having a major,
• 12:47
  - traumatic situation related to either cardiovascular
• 12:50
  - or, you know, some of the cerebral health
• 12:53
  - issues
• 12:54
  - that face,
• 12:55
  - you know, stroke victims and things like that.
• 12:57
  - So those are just two examples,
• 13:00
  - that we're doing on a regular basis, and
• 13:02
  - it's just so great,
• 13:04
  - again, to be able to offer those kinds
• 13:06
  - of solutions
• 13:07
  - to our patients, you know. And the more
• 13:10
  - we do it, the greater,
• 13:12
  - the credibility we have and the stronger the
• 13:15
  - demand it is for the services that we
• 13:17
  - offer.
• 13:18
  - Yeah. Thanks for show sharing those those two
• 13:21
  - examples. Really just demonstrates
• 13:23
  - the the impact,
• 13:25
  - in that push for integrated
• 13:28
  - oral health and and overall health.
• 13:31
  - Just to close this out here, I just
• 13:33
  - wanna get your thoughts on
• 13:35
  - you obviously have a lot of experience in
• 13:37
  - health care leadership. What do you think the
• 13:39
  - most effective health care leaders,
• 13:42
  - over the next couple of years will need
• 13:44
  - in order to be successful in their goals?
• 13:48
  - Yeah. Yeah. There's really, if if I had
• 13:50
  - to boil it down, there's there's two things
• 13:52
  - that that I would love to benefit the
• 13:55
  - audience with.
• 13:56
  - Number one, it's the discernment to choose
• 13:59
  - the right things to focus on.
• 14:02
  - And what I mean by that is I'm
• 14:04
  - a big believer in the Pareto principle
• 14:07
  - and or the eighty twenty rule.
• 14:10
  - And, you know, we were just talking a
• 14:11
  - little bit about the trust that is required
• 14:15
  - between dentist and patient
• 14:17
  - in order for the patient to choose to
• 14:19
  - take to do the care that the doctor
• 14:21
  - is diagnosing, and then secondarily,
• 14:23
  - you know, to come back to that doctor
• 14:25
  - for future care.
• 14:27
  - There's really, you know, from that perspective, as
• 14:30
  - you look at the time between the patient
• 14:33
  - calling to make the appointment
• 14:36
  - and choosing to come back, there's really two
• 14:38
  - key
• 14:39
  - pieces to that whole engagement. Number one is
• 14:42
  - when the dentist does the examination
• 14:44
  - and then sits the patient up to explain
• 14:46
  - to them what they've identified
• 14:49
  - and the best way to take care of
• 14:50
  - it. That is
• 14:52
  - that is probably the number one
• 14:55
  - variable
• 14:56
  - in whether a patient is going to trust
• 14:58
  - the dentist or not. It's the ability for
• 15:00
  - that dentist, you know, to articulate what's going
• 15:03
  - on, the consequences
• 15:05
  - related
• 15:06
  - to that disease, you know, and then,
• 15:09
  - listen to the patient for the level of
• 15:10
  - concern that they have and the questions they
• 15:12
  - have. That is so vital.
• 15:15
  - And then the second one is,
• 15:17
  - it's still second, but it's important, and that
• 15:20
  - is when the financial conversation takes place.
• 15:24
  - How the insurance works,
• 15:26
  - what are the the credit
• 15:28
  - solutions available,
• 15:29
  - the cost obviously associated with it, how they
• 15:33
  - work with the insurance.
• 15:34
  - Those two conversations
• 15:36
  - will determine whether the patient starts the care
• 15:39
  - and comes back.
• 15:41
  - And so that would be one example,
• 15:43
  - you know, of the eighty twenty rule that
• 15:45
  - I think is huge.
• 15:47
  - The other the other thing
• 15:49
  - that is fundamental was everybody's getting very excited
• 15:52
  - about AI
• 15:53
  - as they should.
• 15:54
  - AI is bringing capability,
• 15:56
  - and it's it's amazing.
• 15:58
  - I think though people are
• 16:00
  - they're because it's early, they're a little confused
• 16:04
  - by what AI can do and should be
• 16:06
  - doing. The good news is,
• 16:08
  - AI can do a lot a lot of
• 16:11
  - the administrative
• 16:13
  - issues that face us
• 16:15
  - in health care, whether that's at a DSO
• 16:17
  - level or even at a, individual unsupported private
• 16:20
  - practice level. It can help us, you know,
• 16:23
  - with some of the administrative issues, and that's
• 16:25
  - great.
• 16:26
  - And I think many will benefit from that,
• 16:29
  - but many will not benefit from the strategic
• 16:32
  - capabilities
• 16:33
  - that AI offers.
• 16:35
  - And what I would say by that so
• 16:37
  - the second point is
• 16:39
  - structure.
• 16:40
  - The structure that you put into your company,
• 16:43
  - the strategy and structure,
• 16:45
  - when you get that right,
• 16:47
  - what you'll find is that AI can really
• 16:51
  - multiply and accelerate the kind of work that
• 16:53
  - you're doing on scale.
• 16:55
  - If you don't benefit your company
• 16:57
  - with the strategy and structure and then you
• 16:59
  - and then you incorporate AI,
• 17:02
  - you're gonna get a mess. You're gonna get
• 17:04
  - a lot of chaos.
• 17:05
  - So the right strategy, the right structure, and
• 17:08
  - then implement,
• 17:09
  - AI on top of that, now you've really
• 17:12
  - got something that can that can move, can
• 17:14
  - make a difference, and help dentistry as itself
• 17:17
  - advance, and then your company in particular
• 17:20
  - move to the top of the food chain,
• 17:22
  - so to speak.
• 17:24
  - Yeah. Definitely. I think those are some some
• 17:26
  - great pieces
• 17:27
  - of advice.
• 17:28
  - Well, I think I wanna thank you again
• 17:30
  - for joining us today, Joe, and sharing
• 17:33
  - you those
• 17:34
  - valuable ex pieces of expertise and insights and
• 17:37
  - advice.
• 17:38
  - Been a pleasure speaking with you, and I
• 17:39
  - look forward to connecting with you again in
• 17:42
  - the future.
• 17:43
  - Sounds great. Thank you.