Latest / Becker’s Healthcare Podcast / 57 Years of Dentistry Lessons: Building a Patient-Centered Practice in a Changing Industry with Dr. Robert Trager

Transcript

57 Years of Dentistry Lessons: Building a Patient-Centered Practice in a Changing Industry with Dr. Robert Trager · 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
  - Hi, everyone. This is Ariana Portolatin with the
• 0:59
  - Becker's Dental and DSO review podcast.
• 1:02
  - I'm thrilled to be joined today by doctor
• 1:03
  - Robert Traeger who owns a dental practice at
• 1:05
  - JFK Airport in New York City. Doctor Traeger,
• 1:08
  - thank you so much for being here today.
• 1:09
  - It's a pleasure to have you on our
• 1:10
  - podcast again.
• 1:12
  - It's my pleasure to always help and work
• 1:14
  - with you and give input.
• 1:16
  - Yes. Of course.
• 1:17
  - To start us off, I'd love to have
• 1:19
  - you introduce yourself for our listeners and tell
• 1:21
  - us a little bit about your background as
• 1:23
  - well.
• 1:24
  - Okay.
• 1:25
  - I haven't practiced
• 1:27
  - when you say at that's really in the
• 1:29
  - airport.
• 1:30
  - There's a big difference,
• 1:32
  - in Kennedy. I've been here since 1985.
• 1:36
  - Was originally what they call the International Arrivals
• 1:39
  - Building till they tore that down and made
• 1:41
  - Terminal 4. So I've been in the Administrative
• 1:44
  - Building, which is about a half a mile
• 1:46
  - from most of the terminals.
• 1:48
  - And as I said, I've been there for
• 1:50
  - quite a while.
• 1:52
  - 95%
• 1:53
  - of the patients that I see actually work
• 1:55
  - at the airport. You have 30,000
• 1:57
  - people work here at the airport.
• 1:59
  - So that they're basically the patients. I do
• 2:02
  - have some from the outside who followed me
• 2:04
  - because I did have an office in LaGuardia
• 2:06
  - Airport for years until
• 2:08
  - they tore everything down and did construction. And
• 2:10
  - my original office
• 2:12
  - was in Jamaica, which a medical doctor bought
• 2:14
  - the building out and basically told me to
• 2:17
  - move. That's why, thank god, I had the
• 2:19
  - two other offices at the airports.
• 2:22
  - And as I said, it's fascinating
• 2:24
  - being in an airport because you feel like
• 2:26
  - you're in Europe or Asia. You're in a
• 2:28
  - multicultural
• 2:30
  - situation where your patients
• 2:32
  - come from all over the world, speak different
• 2:34
  - languages.
• 2:35
  - And I try to learn some of the
• 2:37
  - languages, at least dental wise, to greet them
• 2:39
  - and say hello to them, learn about their
• 2:42
  - culture, their foods, their background. And even though
• 2:45
  - 30,000 people, you're like family. Everybody
• 2:47
  - knows you because I go to a lot
• 2:49
  - of the meetings, and I,
• 2:51
  - help with the health fairs and do what
• 2:53
  - I can. So to me, it's an exciting
• 2:55
  - type of practice, especially when you travel.
• 2:58
  - Your patients will give you upgrades, and you
• 3:00
  - get a lot of free trips. So it's
• 3:02
  - been a fascinating ride over the years, and,
• 3:04
  - hopefully, so I can continue.
• 3:07
  - Alright. Well, such a exciting career that you've
• 3:09
  - had. Thank you for sharing that.
• 3:11
  - What are some of the biggest issues that
• 3:13
  - you're following in the dental industry currently?
• 3:15
  - Well, basically,
• 3:17
  - I see and I read from Becca's, and
• 3:19
  - you guys are fantastic when it comes to
• 3:21
  - issues.
• 3:21
  - I see some of the issues that basically
• 3:23
  - really with the insurance companies.
• 3:26
  - The insurance companies
• 3:28
  - take on risk, and what they wanna do
• 3:31
  - is lessen the risk at our expense to
• 3:34
  - dentists. So they're constantly changing the rules of
• 3:37
  - the game to their
• 3:39
  - freedom and their access,
• 3:41
  - the the lower fees
• 3:42
  - to go ahead and,
• 3:45
  - sublease some of the programs,
• 3:46
  - and they do everything they can to make
• 3:48
  - it difficult
• 3:50
  - for you, the provider,
• 3:51
  - to get a reimbursement
• 3:53
  - that's fair and equitable.
• 3:55
  - And as I said, you got to know
• 3:57
  - how to play the game, and I've been
• 3:59
  - around long enough. So if they're gonna beat
• 4:01
  - me, I know how to beat them, and
• 4:03
  - it's worked out good. And a lot of
• 4:05
  - times, I will call them directly,
• 4:07
  - and I will speak to the supervisors. In
• 4:09
  - most cases, they offshore everything. They always ask
• 4:13
  - for US agent, and I find a supervisor,
• 4:16
  - and I can get all my problems solved
• 4:18
  - pretty quickly.
• 4:19
  - But the fact is you get them know
• 4:21
  - how to maneuver
• 4:22
  - and regulate the systems in order to get
• 4:25
  - things done today. And, basically,
• 4:28
  - it's really the insurance company if you have
• 4:30
  - that type of practice,
• 4:32
  - which I do at the airport because they
• 4:33
  - all have excellent insurances and excellent reimbursements,
• 4:37
  - but you still know how to know how
• 4:38
  - to navigate the system, pick and choose which
• 4:41
  - companies are best, which plans are best. So
• 4:43
  - this is basically what I have the my
• 4:45
  - biggest problem with.
• 4:47
  - Okay.
• 4:48
  - What are you most excited about when it
• 4:50
  - comes to dentistry at the moment? And
• 4:53
  - Well, the thing is you see, you read
• 4:54
  - everything about AI,
• 4:56
  - and then you have photogrammetry
• 4:58
  - now where you can take a picture
• 5:00
  - if you're doing implants via cell phone, and
• 5:02
  - it can go right to finish
• 5:04
  - with your implant
• 5:06
  - and so forth. So you have
• 5:08
  - a lot of new innovations,
• 5:10
  - and it's exciting. But the thing is I'm
• 5:12
  - old school. I've been in practice fifty seven
• 5:14
  - years as a solo practitioner.
• 5:16
  - So as much as they excite me, I
• 5:18
  - can say get along without it, meaning it's
• 5:21
  - good. If I was extremely that busy and
• 5:24
  - I needed them, is a crutch fine? But
• 5:27
  - I'd rather spend more time with my patients,
• 5:29
  - hand on, getting to know them, and they
• 5:31
  - appreciate the fact that you spend the time
• 5:33
  - with them, ask them questions,
• 5:35
  - and you're actually physically working on them and
• 5:38
  - not using a lot of these innovations, which
• 5:40
  - are great, which are shortcuts.
• 5:42
  - But to me,
• 5:43
  - what's exciting is that, yes, I can understand
• 5:46
  - the system, but I can also understand the
• 5:48
  - fact what the patients need. Caring, concern,
• 5:51
  - comfort, convenience.
• 5:53
  - This is what they really want. You go
• 5:55
  - to the medical doctors today, and I have
• 5:57
  - enough from my age,
• 5:59
  - is to get to speak to their
• 6:01
  - dental
• 6:03
  - assistants more, the, nurse practitioner, the physician assistant.
• 6:07
  - You don't get to really
• 6:09
  - speak to the provider like you do in
• 6:11
  - dentistry. This is what I want to continue
• 6:14
  - doing.
• 6:15
  - Having the patients feel that we care about
• 6:17
  - them, come to the office, and getting to
• 6:19
  - know us. And that's what is, to me,
• 6:21
  - is the most exciting,
• 6:22
  - continuing
• 6:24
  - the way I did for years even though
• 6:26
  - it may be ultra conservative, but it works
• 6:28
  - out in the long run.
• 6:30
  - Okay.
• 6:31
  - What will the most effective health care leaders
• 6:34
  - need to be successful in the next two
• 6:35
  - to three years?
• 6:37
  - This is the biggest problem happening.
• 6:40
  - As you see and I read from them
• 6:42
  - just today, you have an article on
• 6:44
  - one eight hundred dentists cybersecurity.
• 6:47
  - A lot of these big institutions are having
• 6:49
  - problems with cybersecurity.
• 6:51
  - The bigger you get, the more problems you
• 6:53
  - have. And this is what is happening with
• 6:56
  - a lot of these individual DSOs and big
• 6:59
  - institutions.
• 7:00
  - You You really gotta be careful today is
• 7:02
  - how you run and do your practice. A
• 7:04
  - lot of them, unfortunately,
• 7:06
  - they take on too many patients, any insurance
• 7:09
  - you want just to show that they have
• 7:11
  - large reimbursements
• 7:13
  - and what is the bottom line. Everyone wants
• 7:15
  - to know, what are your gross? What are
• 7:16
  - your gross? When you have these large institutions
• 7:19
  - and remember, you have a lot
• 7:22
  - of equity
• 7:24
  - provided to these companies. Just now that
• 7:26
  - peak to dental in Colorado,
• 7:29
  - they've got a loan.
• 7:30
  - $170,000,000
• 7:32
  - to buy at more offices. The bigger you
• 7:34
  - get, the more problems you have. And what
• 7:36
  - these providers must realize,
• 7:39
  - you have to to multitask and hire that
• 7:41
  - type of individuals
• 7:43
  - that are gonna stay with you,
• 7:45
  - treat them well, pay them well, but let
• 7:47
  - them do
• 7:48
  - multitasking
• 7:49
  - because the more people you hire, the more
• 7:51
  - problems you have. And this is what a
• 7:53
  - lot of them don't realize.
• 7:55
  - Staffing is important.
• 7:57
  - And at the same time,
• 7:59
  - you have to realize what is the future
• 8:01
  - gonna hold. To me,
• 8:03
  - as far as I'm concerned, is convenience.
• 8:05
  - Today, I urge
• 8:07
  - practitioners
• 8:08
  - to open an office. You don't need a
• 8:10
  - as I said years ago,
• 8:12
  - a strip mall or maybe
• 8:15
  - an office
• 8:16
  - on a mall or not on a mall,
• 8:18
  - but a a strip
• 8:20
  - where there's other is is the thing is,
• 8:23
  - to me, you go where the patients are.
• 8:26
  - Go into the work environment. Open in these
• 8:28
  - little areas that they have,
• 8:32
  - individual businesses
• 8:34
  - in areas that you can have some future
• 8:37
  - because it's true.
• 8:39
  - You never know what's gonna happen depending on
• 8:41
  - the neighborhood. But if you open an office
• 8:44
  - or offices
• 8:45
  - in areas where there's light industries, we have
• 8:48
  - multi
• 8:49
  - types of,
• 8:51
  - individual businesses that all have good insurances.
• 8:54
  - These are the things that you must do
• 8:56
  - today. A lot of these places have filled
• 8:58
  - up and they're filled up with what? Not
• 9:01
  - quality patients. It's the type of patients who
• 9:03
  - have terrible plans,
• 9:04
  - Medicaid, which I don't do. And these are
• 9:07
  - the things you're gonna have to look at
• 9:09
  - to survive. And at the same time, I
• 9:11
  - believe there's gonna be consolidation because the bigger
• 9:14
  - you get, the more problems you get. And
• 9:16
  - then, eventually, you have to consolidate. And don't
• 9:19
  - forget, you have to have a return
• 9:21
  - of investment from all this huge money is
• 9:24
  - being invested in these DSOs and other businesses.
• 9:27
  - You gotta basically have some type of bottom
• 9:30
  - line that can show that you're
• 9:32
  - worth it and you're working and
• 9:35
  - running a business. See, it's a business, and
• 9:37
  - this is what most dentists don't understand.
• 9:39
  - Running an office, whether it's a small one
• 9:41
  - or whether it's a business, you're gonna have
• 9:43
  - the right type of management.
• 9:44
  - You gotta know which dental plans to take
• 9:46
  - on, which type of laboratory to use, which
• 9:49
  - type of health
• 9:50
  - professionals to hire,
• 9:52
  - and it has to be done in a
• 9:54
  - way that you're not gonna lose money. Why
• 9:56
  - go ahead and take on dental plans to
• 9:58
  - pay you
• 10:00
  - $50 when another plan will pay you 75
• 10:03
  - or a 100? The fact is is you
• 10:05
  - gotta use business
• 10:07
  - convenience
• 10:08
  - and intuition
• 10:10
  - to analyze whatever you're doing, the patients you
• 10:13
  - treat, the insurance plans you use, and even,
• 10:18
  - ordering products from the right particular companies. It's
• 10:21
  - a huge business,
• 10:22
  - and today,
• 10:24
  - big business won't succeed if you don't have
• 10:26
  - the right type of management. And this is
• 10:28
  - what a lot of the people in the
• 10:30
  - industry have to look at. What is gonna
• 10:32
  - look like two or three years, even more
• 10:35
  - than that down the road? And then I
• 10:36
  - tell individuals
• 10:38
  - who have practices,
• 10:39
  - what do you think it's gonna look like
• 10:41
  - five or ten years? Is the area gonna
• 10:43
  - gentrify? The business is gonna lose?
• 10:45
  - The people gonna pass on? Who's gonna replace
• 10:48
  - them? And this is what we have to
• 10:50
  - realize as to what's happening in our profession.
• 10:52
  - Yes. There is a need for us. Always
• 10:55
  - is gonna be a need, the dentistry and
• 10:57
  - the solo practitioner.
• 10:58
  - But as far as the big institutions go,
• 11:01
  - they have to really watch how they run
• 11:03
  - their business. Otherwise, they won't succeed.
• 11:06
  - Such great advice for me. Thank you so
• 11:08
  - much.
• 11:09
  - That's all I have for you today, doctor
• 11:10
  - Trager. Thank you so much for joining us.
• 11:12
  - Been a pleasure speaking with you, and looking
• 11:13
  - forward to connecting with you again in the
• 11:14
  - future. Alright. Thank you very much. It's always
• 11:17
  - a pleasure to be able to give some
• 11:18
  - advice and input whether it's right or wrong
• 11:21
  - or whatever it can help. If some people
• 11:24
  - appreciate it, then fine. They can always contact
• 11:26
  - me, and I'll do my best to try
• 11:28
  - to provide them whatever information I've,
• 11:31
  - occurred and resulted in over the fifty seven
• 11:34
  - years of practice. Thank you very much, and
• 11:36
  - have a good day.