Latest / The Resting Stitch Face Podcast / Let's GO! w/ Dr. Brendan Gallagher
Transcript
- Erin: Welcome back to another episode of the Resting Stitch Face podcast. I'm your host, Dr. Erin Sheffield with... Sarah Harding: Dr. Sarah Harding. Erin: Welcome back. We are so excited for this guest today. This is Dr. Brendan. He made it. Dr. Brendan Gallagher. Sarah Harding: Hello? He's made it. Brendan: Made it to the resting stitch face. What's going on to everyone? Erin: He needs no introduction. You guys probably already know and love him, but Brendan, can you tell a little more about yourself for those people who may not be familiar with you? Brendan: Of course, of course. And thank you. ⁓ I'm an oral surgeon on Long Island in New York. And I graduated a year ago from residency, went to Stony Brook Dental School, NYU and Bellevue's oral surgery residency, did the four year track, not the six year. And since then, just been working private practice, ⁓ just trying to search for the dream, right? Do a lot of podcasts and a lot of social media, try to mentor, educate, and really kind of teach the public on the a never ending unknown it seems like the public knows about dentistry which is good and bad especially when they think they know more about us about third molars we'll get into that in a second Erin: Yeah, definitely, definitely. Sarah Harding: Yes, for sure. Well, we like what you've been doing and your visibility is strong. And I think that your relatability is really strong too. And it's been fun to watch you grow and see what kind of things you're putting out there. Yeah, yeah, of course, of course. All right, so first question I have, sorry, Erin, I'm gonna cut you off. All right, so Brendan, the first question I have for you, did you get your hospital privileges? Did I miss this? Brendan: Thank you, thanks Dr. Harding Erin: So what's the transition? yeah. Go, Sarah, go. You're good. Sarah Harding: Did it all work out? Brendan: ⁓ great question. Let me check my email. That's a great question. Let's ⁓ Let me just hit refresh, refresh the script. Erin: haha Guys, real time info here. Straight to the source. Sarah Harding: There we go. And I'm telling you this because I just got a nasty gram from the board because I don't have hospital privileges. And they're like, ⁓ by the way, we know we didn't ask you for this in your last update, but it's required. And ⁓ by the way, you'd be well, you do yourself well by figuring that out before we start our audits in June. I'm like, I haven't, what, why? And I'm just so annoyed by it. Brendan: So. It is very annoying. It's super annoying. And while in one way I get it, I understand the policing and everything. I would also like a little bit of the defending of the specialty, defending of the surgeons, not just slapping a, you got to get this by a certain time, figure it out. By the way, when they sent, I'm sorry, when they sent out this email, it's not like you could just walk over to the hospital, hand them your license and stuff and be like, can I get privileges now? Sarah Harding: Yes. Yeah. Thank you. Yeah, I'm like... No. Brendan: Since mid-February I had to redo it again because I lost all the materials from the fall. So mid-February, March, April. This is the end of May now. It's been taking over three months to get these privileges. Literally yesterday they had like their once a month administrative, administrators of the hospital meeting. When I cleared it a month ago, all like the blood work, the physical exam, all my clearance letters that took a month and half to get in. And yesterday was the board meeting and I was like, Hey, so we got it. literally emailed them at noon yesterday and they emailed back and they're like, yeah, we're to send you your, um, your welcome letter tomorrow. It's after 4pm here. They still haven't emailed that. And I need to email that letter to the aid, the American board of oral surgery thing. And then they're finally going to let me know if I passed the board exam. So anyway, um, I wish they would reinforce cause a lot of us have to take free call in the hospitals to have the credentials and privileging and everything. And it's like. We all bills to pay. Some people have massive debt to pay off with loans. How about they think about the surgeons that are in their specialty for once. And ⁓ my God, it's even worse with the ADA as I talk to more and more dentists on the podcast. anyway, I'm sorry to cut you off about that. Sarah Harding: Mm-hmm. Yeah. Yeah. My thought is I'm happy to do free work for patients. I'm not happy to do free work for a hospital. Sorry. Not my jam. And also, you know, when I'm looking into it here, I've got to pay some application fee and some something fee to the hospital so that they can look at my stuff to see if they can put me on their whatever. And I'm like, screw this. Erin: Amen. Amen. Sarah Harding: You know, like what good does that do anybody? And ⁓ by the way, I'm not going to take call for you for free after I've already paid you to look at my application so you can put me on. Yeah. the. Erin: for the privilege of operating for free where you get poked with wires with someone from Hep C, because that's the demographic of people, I don't know. Brendan: And for listeners, you have to pay that application fee every year. At least we do here on Long Island. And it's like 400 bucks. Sure. Okay. It's not $4,000, but after a couple of years, that is $4,000. Sarah Harding: Anyway. Yeah. Yeah. Erin: Ugh. Sarah Harding: Yeah. Yeah. Well, and that's the other thing, right? Because I keep paying the board. So I took, finally took my boards because I gave in and finally did it. And then now I'm just paying every year them all this money, right? And I'm like, what do you do for me? What, like, what, what benefit do I have for this? But I can put it on my business card, you know, my husband's like, well, patients probably like Erin: For sure. Sarah Harding: They probably want to, if they choose between you and somebody that's not board certified, they'll probably choose you. And I'm like, but they don't, but not necessarily, you know? And so it's like, and I'm not any better of a surgeon now than I was 10 years ago before I took my boards, you know? And so it's like, I don't know. Anyway, these are my thoughts. So. Erin: There was an editorial in the journal that was talking about this old tale, did anyone see this? Of a donkey and how this donkey was doing a really great job plowing the fields and the owner realized if he fed the donkey little less he could still continue to plow the fields but he made more money because it cost less and he kept paying less and less and less until the donkey Sarah Harding: I love this. Erin: killed over and died and he'd said something like, basically blaming the donkey. Now I'm forgetting the exact punchline and that just changes the story. But you know, like if he could have just kept going another couple of weeks, he could have got so much more out of him, you know? And so I was like, wow, this is an interesting analogy. But then the poster ended up continuing talking about, so this is our specialty and our specialty is changing completely where, We've got the dental alveolar office, private practice people, and then we've got the people carrying the load doing all the bigger stuff. And so how can we basically, I felt like it was shame people or strong arm them into doing the things so that our specialty stays the same. And my thought was like, you're blaming the donkey. Like, what was the whole point of your story? Because you're acknowledging that it's so hard for us to continue on. Like, yeah. Sarah Harding: Right, right. Erin: doing call for free and all these things where we're not getting compensated and it's really hard to manage. But then you're blaming us for not making it happen. Like what can you do, like you said, to support us, make it easier, advocate for us getting paid or whatever it is so that it's more beneficial for us as desirable. I'm pretty sure if you paid enough, there's a lot of docs that would happily... you know, pay themselves extra to help out. But it's just hard to give that up for nothing. And I was disappointed that that was the way that that article spun it, you know, like, so shame on all of you donkeys for dying. Brendan: Every time. Sarah Harding: Yeah, yeah, yeah. So now you can see how curmigene we are having been out of residency for greater than 10 years. Welcome. Brendan: We're all on the same page here though. It's crazy. It's so insane. ⁓ my goodness. Did you guys see this? This, ⁓ I don't know if it was an article or an ad or some kind of promotion material, but I'm not gonna say their name, but I know an oral surgeon who was sent, I don't know if it was a booklet or like I said, an advertisement or something in the mail and they're hosting a conference for program directors to help with recruitment of new oral surgery applicants. Erin: Welcome. Sarah Harding: That's right. Brendan: And now this kind of goes into an article where like the story of the donkey and stuff, and then they go and blame it on the donkey. Now this is kind of like, no, no, we're not having a problem with recruitment. Everything's fine. Everything's fine. But by the way, we're going to host a conference for all the program directors to learn about recruitment. And now, so I think that's, that's, that's great. Those conferences now, whether it's on recruitment or the whole program experience and yada yada, but like, Erin: Wow. Brendan: So do they have all the answers here? Are they recruiting anyone to join the conference with ideas? they just gonna keep inviting everyone who's, they're kind of, where's the new fresh energy coming in of like, this is what we need. Why don't we try this idea differently? Why don't we try this idea? Like, what's this conference gonna be about? I don't know. I wasn't invited. ⁓ I'm not, I'm like. Erin: old guard. Yeah. If they want to invite us, we can come. We have ideas. But yeah, that's true. mean... Sarah Harding: Yeah, yeah, but they're going to charge us $3,000 to be an attendee where we're probably going to be the ones with all the ideas. And then they're going to, it's just like the hospital, right? Like you can't, you can't have a level one trauma center unless you have an oral surgeon on the books, but you're not going to pay me and you're actually going to charge me. So. Brendan: You Erin: This is something, yeah. Brendan: Yes! Yeah, yeah, how many donkeys can we get to this? This is the donkey conference. Erin: Mm-hmm. Yeah. Sarah Harding: Yeah. Erin: Right, Donkey Kongference! Sarah Harding: The Hucking Kong Friends, Brendan: You Erin: in the Amos powers that be kind of chided me recently for like, Erin, you're like the woman empowerment person and Amos knows all about you and they're not all all happy about it type of thing. Like Sarah Harding: You're like, that's weird. They haven't reached out to ask for how I can help. Erin: Right, you know? And so it's like, well, I feel like they're missing a lot of opportunities. Like, I think so much of the reason we just want to say women want to take the easy route or they want to stay home with their kids so they're not choosing it. And that's part of it. Like you go into dentistry for the lifestyle, most of those people aren't going to be excited about doing the extra work and taking on surgery residency and maybe even the after lifestyle. That is totally fine. That makes sense. Sarah Harding: Mm-hmm. Erin: But I think so much of it has to do with mentorship and visibility. I did a research project in my residency on this and it was amazing to see how much the views of oral surgery shifted from early dental students to graduating dental students in our class at Iowa. Where like they became much more interested in oral surgery when they had exposure to it, but there was so much nervousness about like, I don't know if I can do it. Can I manage a family? Or I hear all these. things about how the men are so mean to you and it's not worth it. And so you hear these, you just get enough of that where for me, I was brave enough to do it because there was one woman there on faculty and when I talked to her, she encouraged me and she had children and she was making it work. And that was so helpful to see. And I could see myself in that where, you know, okay, I like surgery, could I do it? But I'm nervous. That push was... Sarah Harding: Right. It's discouraging. Yeah. Erin: what I needed and if I didn't have her, I wouldn't have chose it. I really don't think I would have. Brendan: Wait, wait, this is such a great, great point. And actually this, want to, I just want to build on this a little bit. Where did you meet this person? Where was she a resident or an attending or where and what year was she, if she was a resident. Okay. Attending older, younger, Erin: She was an attending, so she was actually the program director at the time at the University of Iowa. Brendan: Program director, so that is so empowering. And did you meet her in the dental school? Was it in the hospital? Was it on an externship? Where was this? Sarah Harding: Mm-hmm. Erin: in the dental school because she was teaching like one of our, you know, lower level oral surgery classes. Brendan: Excellent. So this is the perfect point to build. My thing is I can't tell you how many places residency programs I've talked to, I've been at here at in my dental schools home programs associated with LIJ. They don't even have all surgery residents in their dental school for the last couple of years now. Why not? Where they go? What's going on here? Who's building at NYU every year? There's there's only one or two residents at a time at the dental school, just in a two chair clinic. The clinic's much bigger than that, but that's given to the Erin: Yeah, I heard that. Yeah. Yeah. Brendan: Oral Surgery International students, have four chairs. But then on our side, we have two chairs and it's one or two residents at a time. And one of them is always on call, one of is always covering two of the other hospitals at the same time. My point is, all these dental schools are losing the oral surgery residents, the attendings. Everyone's kind of run to the hospital for all these emergencies that we're covering for free, right? Erin: Yeah. Sure. Yep. Brendan: And now the dental students, other ones missing out. They're not meeting the relatable resident or attending or the program director was giving a lecture. They don't have time for lectures, not getting paid for lectures. not getting right. This is what I want to go to that conference for. I want to say you need to reinforce in dental schools. You need to get residents back in the dental school. Maybe they don't want to suck it up. You need to give back and teach dental students what oral surgery residency is about that they can do it, that they can have a family during it, that, you know, the lifestyle is tough. Sarah Harding: Right. Yeah. Erin: Yeah. Sarah Harding: Yeah. Brendan: You have to work hard, but as a team, you will get through it. And all they do is hear from the Perio residents that all week with the gum butchers, with the butchers of the population. But that's what's going on. Sarah Harding: Right. Yeah. Yeah. Yeah. It's so funny. It's the same in my, cause I went to residency. So I did dental school in South Carolina and then residency at Baylor in Dallas. And so in South Carolina, the oral surgery residency was over at the hospital, not far right across the little quad, you know, you could walk through there to get there. And, but they were rarely ever over in the undergrad clinics. Whereas when I went to Baylor, Erin: The cowboys, those crazy cowboys, yeah. Sarah Harding: We were right down the hall. I mean, like from here to the end of my bedroom, essentially, you know? so, and there we were always over, if we didn't have anything on the schedule, we were over in the undergrad clinic helping do stuff, taking teeth out, you just answering questions. And it was so accessible. the, and I will say this, the level of confidence and the level of training of dental students at Baylor and the oral surgery realm was significantly stronger, significant. There were, Brendan: Mm-hmm. Sarah Harding: plenty of dental students that I wouldn't be upset if they were doing bigger cases, you know, that they were doing like full mouth extractions and alveoloplasties, if they were doing tori reductions, if they were doing things like that, because we were there and helping them do them and they were confident and comfortable doing it because we were always around. And so having that exposure is so important. Brendan: Exactly, exactly. And that's my whole point about that. And you just gave a solid example of the differences. And this will help with recruitment because who's actually coming into the oral surgery clinic from the dental student side to learn and assist and engage with the residents, engage with you as an attending, who's not afraid of you to talk and like, hey, how's your day going to the attending? Like literally just something as simple as that. And then vice versa, when they're a resident, the attending could be like, Sarah Harding: Mm-hmm. Brendan: like if they hear something bad about a resident, like, hey, you were one of the most outgoing with good attitude personalities as a dental student. You were in clinic all the time. What happened? now they're going to go home down. Like it's, I think this is really what it comes from. Another thing is idea had is like on externship, spend a little more time with the dental students, ask them a couple of questions, have an exit interview. Like there's so many things that can be done. That's all it is. It's just a little bit of one-on-one time, a little bit of one-on-one contact. Anyway, big, big topic there. Big Kenworth. Erin: the Because ⁓ that was before my, like, I barely missed that. That like a couple years behind. think Sarah and I both probably took like number boards, you know, where we got scores. ⁓ But I am so grateful didn't have to take that test because I think in the day it used to be, you could decide last minute to become an oral surgeon. You could decide ⁓ after doing a year on that you could come back. And now I feel like, Sarah Harding: Yeah. Mm-hmm. Yeah. Erin: It's so prohibitive. If you don't decide early, then you didn't have time to study and take this test and apply like on cycle. I think if it were me as someone already out in practice and feeling like, you know, oral surgery could be great and I was smart and I did well, I'd be like, no way am I studying for a test anymore. I'm done with that. Like, especially when you're not sure, someone like me, I wasn't sure if I was going to get in, you know, like I had the imposter syndrome. And so that was one more level. Sarah Harding: Yeah. Erin: where luckily Sarah and I just took boards and I was gonna study and try to do well on that either way. I think that adds an extra layer of complexity. And not only do I have to ace my grades, but now I have to do this test that's taking away from my ability to do well on my grades, it's crazy. Sarah Harding: Yeah. I feel like aren't dental schools pass fail now too? crazy. Brendan: Some of them are pass fail. A lot of the Ivy League schools are pass fail. ⁓ Some of them are like unranked pass fail. My dental school Stony Brook was, it was not pass fail. It was ABC, but it was unranked. So as far as the CBSE goes, just to answer your question, there's definitely positives and negatives. I really support that exam because of the fact that it's based on step one. And when you're in the hospital setting, I took forever just to learn Epic. Erin: Yeah. Brendan: our dental school didn't have that big, never saw it before. Just that's like the computer system, like where to put in meds, how to write a note, how to sign a note so it's not just pending for two months. Just little things like that. I don't want to learn like pharmacology and the mechanism action because we didn't go over it in depth in our dental school. Whereas I had to learn that in depth, like the secondary complication of taking this could cause kidney failure kind of thing when in the dental school pharmacology class we can learn that. You do. Sarah Harding: Yeah, same. Yeah, but you learn that as you go. You know, I mean, like that's what we did. I learned it as I went and and actually you remember better because you're learning it while you're do you have a specific example of why that is? Brendan: You wanna... Did you guys... Erin: Right? Brendan: That's true. Did you do the six-year or four-year? The four year, okay. I mean, you do learn it as you but ⁓ then I would look, you would look like, you know, not good to some of medical residents. ⁓ Sarah Harding: Four ⁓ Erin: We both did four. I don't know, they're always very impressed with us. But yeah, I mean, that's an advantage going in, but I'm thinking that's taking away from your time to study for your classes and you're trying to get great grades, or then you're also studying for this extra test. And it's one more thing that that's limiting your pool of applicants because not as many people are, if you weren't like gung ho from the very beginning, I'm gonna be an oral surgeon. If you're a woman that's like, wow, I didn't think I wanted to do oral surgery, but now it's... Sarah Harding: They didn't ever, I think they were always really, yeah. I was always told that I was doing great. Erin: year three and a half and I didn't take the test so ⁓ probably not worth it. I feel like that probably happens a lot. Sarah Harding: Yeah. Brendan: That is a great point. Sarah Harding: Because I think a lot of other residencies are going towards those other tests too, right? Like the, was it ortho that made people take the GRE or something? And there was just other ways that they were, and so maybe they just need to make dental students take it. And if you don't want to specialize and you don't care, then you don't study for it. Erin: Yeah. Yeah. Yeah, it's interesting. Brendan: That's another good idea. Sarah Harding: Right? But because if you do that, then it's like, well, now we have this sort of metric and we have this group of people that are interested in specializing. And so we can help them. We can create study groups. We can do all of the things other than just doing it on your own. Because I do feel like it's very, you learned all that stuff because you chose to take the test and then you studied. Whereas Erin and I didn't have to take the test. And so we ended up studying on our own to apply it in real life as opposed to apply it to the test. What's the difference? You know, I don't know. Erin: Yeah. Brendan: That's a point. That's a good point. I don't know. Sarah Harding: Yeah. Erin: a tricky situation when it's hard to measure people. I don't know why I'm suggesting going back to pass-fail boards. I don't know. Sarah Harding: Yeah. Brendan: So, and to your point, to your point, I gotta say, some people who literally like did so well on the CBSE, they could probably write the test, you know, make the test. They don't necessarily make the best residents. so I gotta say, right. Sarah Harding: Mm-hmm. Erin: No, they don't. And that's the thing. ⁓ Sarah Harding: They don't know. Yeah. Yeah. And I say this often, like I had to take boards twice because I got an 85 the first time and I studied my ass off and got a 90 the second time. And I'm just not a good test taker in that way. And, but you're right. I mean, there's people that are just like super knowledge heavy, but they don't have any of the things that it takes to make a good surgeon. Erin: 100%, we've all seen it. We know those people. Brendan: Nope. They're not testing hand skills. They're not. They're not testing hand skills. It kind of comes in handy as a surgeon. Let me tell you. Erin: Or people skills, which also comes in handy. Yeah. mean, like the top, just cause you made it to the top of your class, doesn't necessarily mean you're going to be the best surgeon. And that's also frustrating when like I didn't get in the first time and you know, because I only applied to one place and that's just foolish and probably not how you'd mentor all of your mentees. But you know, it's like sometimes the people that were at the top didn't necessarily do the best as a team member or whatever in the program. It's frustrating. Yeah. That's tough. Sarah Harding: Right. Yeah. Brendan: Yes! Sarah Harding: You Brendan: you Sarah Harding: Yeah. Erin: I'm glad we're all past that. All of you going through it. Bless you. ⁓ Sarah Harding: Yeah, yeah. Yeah, so here's a question for you. Brendan: pass it yeah yeah what's the painting I'm sorry dr. what's the painting behind you I gotta ask. yeah ⁓ wow ⁓ Sarah Harding: Don't you love it? and I am. Brendan: It reminds me of like the Avatar, the blue, you know, Avatar. I like that. Who made that? Sarah Harding: Yeah. Yeah, thanks. I don't know. All of my art is from estate sales and consignment stores and stuff. Erin: Do you want to see the painting behind me? Brendan: Awesome! That's so cool! You got another one? Sarah Harding: Here go. Brendan: ⁓ wow, and I see a little avocado down there. Sarah Harding: Yep. Always with the avocados. That's right. Yeah. That's right. That's right. Got to do it. Yeah. So. No, you could. Brendan: Nice snake plant. Snake plants are one of the top three air filtering plants, by the way. Erin: Yes. So how, oh, go ahead, Sarah, you were next. Are you gonna have a more interesting question or am I? So how has the transition, like give it to us straight up. How has the transition been from residency to the promised land of private practice? Has it been all you were sold and hoped for and you're living the dream or have there been some challenges that have been a little bit of a let down? Like give us. Sarah Harding: No. Erin: Like the full tea here. Brendan: The faulty, I don't know if I can do the faulty just yet, but I. Erin: I mean you have to keep your political, you know, opinions safe or whatever. Yeah, but Brendan: ⁓ this isn't political. This isn't political. I'm starting a new job in July. Erin: No, mean, like political just as far as you know, got to be smart about how you say things sometimes but Brendan: Yeah, did not not political at all. I'm just you know how they say that sometimes your first second jobs aren't your final ones and I very high hopes very hopes. I don't really want to go too far into it. But ⁓ yeah, just wasn't what I thought. And so this year I'm hoping for something closer towards what I thought the dream lifestyles and all. Sarah Harding: Mm-hmm. Erin: Sure. Mmmmm Sarah Harding: Same brother, same. Yep. Same. Well, yeah, I mean, I was in the Navy for 12 years and then I got out about three years ago. And so it's because so when you're in the Navy, you don't get to choose. That's just what you get. Right. And then so getting out after that, like you hear the same things, right? Like it may not be your first job out. It's usually not going to be the where you stay. But you think, well, but I think I know who I am as a surgeon and I think that I know how I'm going to land. And but you don't. Brendan: You choose this year? Erin: It's so tricky. Brendan: Yeah. Yeah. Sarah Harding: You don't know. You don't know. Mm-hmm. Erin: He's such a nice guy or this is gonna be great. Yeah, it's so easy. I always give people my biggest advice when you're looking into a practice and signing a contract, as I always say, give yourself an in and give yourself an out. Because I know some people that just take a job like this is just a filler job and then we'll see and then it works out and they'll love it and they didn't give themselves an option to stay like you have to stay an associate the whole time or whatever, you know, like, so negotiate it as if it's going to turn out great. And then Sarah Harding: Mm-hmm. Yeah. Erin: negotiate it as if it's not because the opposite like it's going to be great and they said it would be fine and so we don't need to worry about what happens and the non-compete will never apply to me and then you get into a position where you're like, oh, oh. Sarah Harding: Yeah. Or you could just be like me and not have a contract. Brendan: Yeah. Ooh, that's scary though, no? It's good if you wanna leave, but then it's bad if you wanna stay and then just... No? Sarah Harding: you know, or even if you want to leave, you know, it's just it is what it is. So there we go. ⁓ You know, you're right Yeah, you're welcome. ⁓ So one that you showed was and I sent Erin this, I was you said something about it was like a count of your day and it was like seventy five surgeries ⁓ and this this and I was like. Erin: life lessons learned here on the Resting Stitch Face podcast. Yes. Sarah Harding: what is he doing? know, he is like his main target audience is these young like dental students or residents. And I'm like, I hope he's telling them that he's just hungry because he's just fresh out and this is not a sustainable life. And this is not how like you're gonna survive burnout. Brendan: Oh yeah, that's a great point. Let's dive right into that. The first thing I would say about like the job starting out or at any point in your life, it's just like a relationship. The red flags that come up from the get go in the beginning that you overlook end up being the red flags that kind of terminates and separate. goes for practices, goes for relationships, it goes for pretty much everything. Unfortunately, that's how it goes. And that was one of the mistakes I made when you hear things to the grapevine or you see things that you don't really like, learn from that and Sarah Harding: Yeah. Brendan: take note, right? These red flags add up. Next thing. ⁓ Yeah, you were talking about that. So I was at a it's very important to know, like the demographics that you're of patients that you're taking care of. And then kind of like the insurance related to to that or whatnot. But essentially, the practices that you're at, ⁓ if they take all insurances, then you're going to be very, very, very busy. And the only way you kind of hit your base salary is by volume. Right. And, you know, that's quantity. versus that, but it doesn't have to do say quality though. It doesn't actually correlate, but the quality of how you're treated by maybe the office manager or the COO or whoever's your boss quote unquote, it may affect the quality of how they talk to you based on your care, right? But then the less insurance is that you take, your schedule is generally maybe a little bit more free and then you don't see as many patients. So that's just kind of to give a very broad scope step back and look at. Sarah Harding: Great. Brendan: what practice types are out there. I think that makes sense. ⁓ That one day, like this was a couple of months ago when I was talking about how many surgeries and patients I'd seen in that day and everything went fine and whatnot. And that was at a point in time where I wasn't taking lunches and I was really trying to grind if you will. And things were going great. Things were going fine. But I was also staying at the office to like an hour to two hours after finishing my notes from the day, getting the medications, calling the patients. Hey, you got your wisdom teeth out today. How are you feeling? Sarah Harding: Yes. Brendan: Like just any questions I can answer for you. Because turns out I was the only associate doing that. But nonetheless, it's not like to toot anyone's horn or something. But like that's the kind of quality care I want to give. And sure, you could grind during the day that will trail into your evening schedule, right? You might finish at five, but you might not finish notes until 630. So anyway, so it's a different quality of life and a lot more than what you see on the screen, you know. Erin: Yep. Sarah Harding: Yeah. And I think that what we're fed is that when you're just starting out, you take these crappier insurances and you do this because that's how you build and that's how you... You're like, no, that's how you burn out is because you're still going to provide the same quality care no matter what the patient's insurance is, right? You're going to do the same exact thing for this patient with this high tier versus this low tier. And you're going to give them all their options just like if they want the Cadillac or the Hyundai. And you know, it is what it is, right? But we were told that we just have to do that and grind. And then you're like, this is awful. I'm not even getting to see my family. This is why I finished residency because I thought that there was a light at the end of the tunnel. But here I am doing the same exact thing. Now I'm getting paid a little bit, but it's not what I was thinking. And now I have a whole bunch of loans to pay off, right? Brendan: Right, right. And you're exhausted at the end of the day and then going into work the next day. That's such a good point. And that's what I initially thought. was like, let's take all insurances in the beginning and then we'll lean down over time. ⁓ That's yeah, I don't know. I don't know. Sarah Harding: Yeah, it's a great way. Mm hmm. Yeah. Erin: And you're used to grinding it out. Like in residency, you're grinding it out, but it's for someone else. And so when you get out and you're grinding out for you, it feels really good. And like, ⁓ if I saw one more patient, I can make this much more money. And I got loans to pay. You're like, there's a lot of pressure and I haven't got my 401k going yet, you know, but it's not sustainable or what's it worth? Like how much money do we need at some point? You know, like we're going to make enough. Is it worth? Sarah Harding: Mm-hmm. Brendan: for you. Yeah. Erin: sacrificing your quality of life. Is that why we did this? To make as much money as possible and be miserable? Or did we do it because hopefully we are building a life that's worth living. Brendan: The thing that you just mentioned too is working for someone else, whether it's the hospital, whether it's DSO or it's for an owner with or without partnership versus working for yourself. Working for yourself, you're going to have to do a little bit more. You're going to have to grind it out in the beginning, gain your network, your referral basis, meet patients, give to the community, what have you, take call. But you you got to work, you got to grind a little bit and work your way up. But it's a totally different thing. If you're grinding and working Erin: Yeah, sure. You Brendan: the company up, the organization up, and there's really no ROI. They're not meeting with you to show you the vision. What's the trajectory in this practice when I go out and meet all these dentists and build a referral for this office that isn't mine? Do you want to have a partnership track here? Are we going to talk about that at any point? Anyway, so a lot of... Sarah Harding: Yes. Right. Right? Yeah. I think. Erin: And I don't find the loyalty kicks in on the other direction in my experience. Like I'm a loyal person and I'm always trying to do the things for the practice or the group or the residency or the university. And then as soon as it doesn't work out for them, they're happy to say like, bye Erin. And you're like, I gave so much. What do you mean? Sarah Harding: Yeah. Yeah. And I find too that the whole, well, you're going to take the lower level insurances because we're going to appease these referrals so that they'll send me better cases because you're taking care of these other patients that they can't find somebody else to take care of. But I don't want to take care of them because like that, that hurts my bottom line. But you doing it, in fact, increases my bottom line, but not your compensation, my compensation. You're like, great. Brendan: Bingo. just, just to piggyback on that, the, is a ⁓ story a friend of a friend ⁓ where working in the same office as a boss and the boss is taking all the higher insurance paying or fee for certain out of network patients. ⁓ And everyone else you're getting the lower end insurance patients. So you're still doing maybe similar, maybe even not the same quality of surgeries, right? Because certain people, when they can't afford those out of pocket things, like an extra implant to make that the perfect hygienic treatment plan. They don't do it because the expenses and whatnot. But the boss is it's a way they so they bring in the referral basis, but they get to pickpocket, they cherry pick out the better cases. ⁓ That's this goes on throughout the United States. Sarah Harding: And that's their prerogative, right? As a business owner, that's your prerogative. And as a practice owner, that's your prerogative. You can do that, but just understand that that is not a good long-term strategy, right? Like if you're trying to build and grow, right? Brendan: You don't have to keep your associates. Erin: And it has to be clear, like if that's your model, then you need to be open about that because your associates not going to be happy if it's not how it's framed. If you come in eyes wide open that that's the model, then that's a whole other deal. Sarah Harding: Mm-hmm. Brendan: Mm hmm. Exactly. Exactly. Something else that was frustrating with so we took on a lot of Medicaid. It was great because I mean, it was a loaded schedule every day is very full, a lot of volume and everything. I got a lot of reps in quote unquote. I got to see and treat a lot of people in the community that would literally try to have like two hours away when we're only one of like three to five offices in the county that take Medicaid. However, on the other end of it, when a patient comes in, it's like the referral says five teeth and it's like, great, hey, we're going to help you out today. Sarah Harding: Yeah, that's fair. Wow. Brendan: No, no, no. I only want this one removed today. This is the only one causing me pain. I can't tell you how many times. ⁓ my God, it breaks my like, I get it. Look, you're in pain over here, but it's like, we're going to do that. And guess what? Look at this. This one's got a worse periapical radiolucency over on this side. I'm going to see you in two months about this one. Sure enough, three months later, they're back. You're right doc. ⁓ But this one now. ⁓ Erin: Hmm Sarah Harding: This is so hard for me. Erin: Yep. Sarah Harding: Yeah. Well, and it's like your informed consent has to go out the roof because then you're like, okay, but you understand this is what was sent to me for me to handle. And I'm even seeing more than what's on the referral. And you're only doing this little bit, but I know that all of this is going to blow up. And I don't want you to come back to me and say, well, why didn't you take care of it? And so you have to document that you have these conversations and that they understand that these other things are big problems and that they have decided not to take care of it today. Erin: My other issue is that the dentists don't put it on the referral. They're like, I saw them for an for emergency, so I'm just going to say that one. And they come in and they've got six different root tips. And I didn't prepare for that appointment because it's a single tooth local. And you're like, ⁓ why isn't this tooth? I didn't prepare getting x-rays ⁓ and it through. ⁓ Sarah Harding: Mm-hmm. Yeah. Well, and then they don't want to pano Erin: I already had my x-rays done, yeah. Brendan: I don't need a panorex. I just I have xrays from the other office. What's it? Well, where are they? Didn't email to you? No, they didn't email it to us. I know that they gave it to you, though. Where is it? Erin: Oh, they get so upset. I said they're going to they said they're going to you don't have it and have a time like I have it and looking at it and they're like freaking out. Brendan: text him right now and get him to send it over? Oh yeah, I got your dentist from from two and a half hours away right on speed dial right here. It's not like they're busy, right? But every day it's an argument. It's they're like, no, it's a Friday. It's a Friday. They come in like this. Well, you know, it wasn't hurting me two weeks ago. And then this happened last night. Anyway, anyway, the joys. Sarah Harding: Yeah, right. Erin: It's a Friday every time. Yeah, sounds like it's the same in California and New York and the Midwest. We've got it covered across the board. People are people, Sarah Harding: Yeah. Brendan, one of the things that we talk about a lot on our podcast is the ⁓ myth of work-life balance ⁓ and how ⁓ do it all without having to really do it all, I guess, or finding what's good for you. ⁓ So we that you ⁓ are engaged getting married. And so as a man, oral surgeon, Brendan: ⁓ we gotta talk about it. Thank you. Sarah Harding: Do you think about, Erin's wanting this tea. Do you think about ⁓ decisions that you make now, like where I'm gonna go practice, how I'm gonna practice, how I'm gonna set up my life? Do you think about that and how that's gonna affect your family planning, for example, or like not necessarily kids right away, but like how is that gonna blend with my wife's schedule? And then if we do wanna have kids, like how will that go? And do you think about that stuff? Brendan: Oh, yeah. Well, how do you know I'm a man? No, I'm kidding. I'm kidding. it's such a good question. Because because obviously we think like I get into discussions on my head on Max face mads. The other week talking about this like I had no idea. Sometimes young women feel feel like they might be a little insecure and or just putting on eyeliner because what if the attending sees calls you out in the middle of the the OR and like you're scrubbing in and it's I some things that I've Erin: What are your pronouns? ⁓ Sarah Harding: Well, I'm in California, so I don't. Yeah. Brendan: never consider because I've never thought about I've never been in that situation. I don't wear eyeliner or mascara, whatever it was that we were talking about. But yes, there are absolutely some considerations because it's like so my fiance is in marketing. She's a marketing strategist, right. And it's predominantly remote over like weeks like this week, she's got to go into the office three times. But as far as like family life is very important to both of us. And we're planning to have kids in the future. And so I need to be there at least, you know, I need to Sarah Harding: right. Brendan: pull my weight, I need to take my fair share. And we started to notice that very early on in residency, right? Not with kids, but like, if I am there, what can I do to take some of the burden off her? I don't cook. She's an outstanding cook. I wash the dishes then, and I tell her like, literally just, you better not touch a dish. I'm gonna get there and clean them tonight. Just save them for me. I'll take them all off the, out of the thing. You know what mean? I think it's having the communication with your partner, having the self-awareness for me to say, I can't cook, I'm not gonna cook. I will burn it before you even consider this again. But I will wash the dishes. I'm fine with doing that. I might take a little longer, whatever. I think self-awareness is to say, look at your strengths, look at your weaknesses, go all in on the strengths to help out, pull your weight. Another thing is, so what happens when your first job or another job doesn't work out and then you need to transfer? Or after your residency, you're looking at jobs and you need to travel and make that? Because there's time in the office, time in the hospital, right? But then there's also commuting time. Erin: you Brendan: and all this stuff just tacks up and say your commute is really far. Say you work nine to five, your commute is out 45 minutes an hour. So now it's not just an eight hour day. Now it's a 10 hour day. When are you going to work out too? And then say you do work out. Well, now you're home for literally what? Like three hours and now you're significant other has been taking care of the kids the whole time or like you have a parent, you know, your kid's grandparent is home taking care of the kids. So look, I, I'm still early on we don't have kids and she's still in the process of like moving in. because we built the house I grew up in, we're, that's why there's, was telling you guys before, there's no furniture in this room anymore because it's, we need to make sure that she feels like it's her home that she's moving into too, right? Which is weird because it's like, now we're taking out all this stuff that might've been purchased five to 10 years ago, it's fairly new, but it's also like, that's my parents' stuff. We need to make it our thing, and I want her to control that as much as she needs to feel a part of the home, and we're growing, we're building. on that. ⁓ So yeah, I know, I feel like I was just all over the place with that, but I absolutely Sarah Harding: my, like, just like you said, my first job out of the Navy was the traffic on the 15. It should take 35 minutes to get there, but it would take me an hour and 15 minutes each way. So I was leaving at 6:15 in the morning, getting home at 6:30 at night, you know, and we had an au pair at the time. And that was helpful because my husband flies internationally and is gone in random days and random times. And, and so. Erin: Hehehehehe Sarah Harding: We needed something. And then when our au pair left, I was like, well, this is ridiculous. Because I wasn't getting to see my kids on those days. And it just was, it's not worth it. know, like, it's not worth it. Brendan: That's crazy. What do do now? What do you have now? Sarah Harding: Yeah. You're looking at it. No, so I'm getting like a mostly right now I'm just doing the podcast. And then I'm building a little mini practice inside of a pediatric practice. It's about still about 30 minutes away because I'm in the sticks. I mean, I live in agricultural area of San Diego and so everything's 30 minutes away. So. Erin: Hehehehehe And maybe she's gonna come locum at my office if the credentialing ever goes through. Brendan: Credentialing? someone say credentialing? We've a good three years before that goes through. Sarah Harding: Yeah, I know. Erin: I know, yeah, we're not holding our breath luckily for our health. Brendan: How far away, like what's the distance between your home and then your practice, if that was to work? Sarah Harding: ⁓ it's a flight. I live in California. She's in Illinois. Erin: ⁓ Brendan: How, like how long, that's a long flight, no? Erin: The problem is you'd probably have to fly to St. Louis and then have to drive a couple hours, so it's not, yeah. Sarah Harding: It would just be for like, like... Yeah, there's a, but there's also like you would do a chunk of four days and then. Brendan: Mm-hmm. Sarah Harding: You know what mean? It wouldn't be like Monday through Friday every week. Brendan: be like twice a month. Erin: Once she's here, the commute would be like one mile. Sarah Harding: Yeah, yes, very different. Yeah. How far is your office or how far like where you live? Because I think of Long Island, Long Island is very different from North to South, right? It's just like San Diego, like super urban in the South and then super rural in the North, right? Brendan: Pretty awesome. Erin: That's the best part of living here. Brendan: More or less different areas too, because the further out east you go, it gets very, very ⁓ rural. then closer to the city, more urban. And then yeah, the north to south. It's cool that you know that. Sarah Harding: Yeah. Okay. It's very much like San Diego. Yeah. Interesting. ⁓ and I'm all the way far north, far far. They call it North County, but we're far North County. Brendan: or you can go to the north or south part of San Diego. And in like, how does that relate to? Um, I don't know how to say this. Uh, I don't know. Like, is it like, you're proud of that or, cause let me give some context on Long Island. There's like. Sarah Harding: ⁓ yeah. I'm not a city dweller. Brendan: Got you got you got you you you got you But there's like a stupid little like north or south thing where it's like, well, I'm from the south. We're tougher. I'm from the north. We have some grass. It's like a stupid little funny thing. I didn't know what he was saying there. Sarah Harding: Yeah. Yeah, yes, it's the same. Yes, it's the same. Erin: So where does Dr. Ellie live? Do you know where she lives? Ellie Rosenfeld? She's a Long Islander. Sarah Harding: Yeah. Brendan: She's in garden city, which is a very, very, very nice, well off part of town in there, but, ⁓ I. Sarah Harding: Is it in the middle north south east west? Brendan: Maybe I would probably put it towards the middle and in Nassau County, I believe so closer towards the city where I am. I don't know where she lives. I don't know what town she's in. Sarah Harding: ⁓ Okay. Okay. Me neither. Yeah. But how far is your commute? Yeah. Yeah. Erin: She was on our podcast the other day, so was like, we're just doing the Long Island shuffle or something here. Brendan: Yeah. Oh, you know, I reached out to her once and I was, Hey, you know, good job. I really like your content and everything. And, I'm not trying to put her on blast and everything, but I just got kind of like, Hey, thanks. Like I followed her and I was like, Hey, you got some great content. I love what you're doing. Very educational. This is when she had like 2000 followers or anything, anything. And it's just like, Oh, thanks. Sarah Harding: Put her on blast. Erin: You Sarah Harding: Yeah, she's a busy gal. Yeah. What's there not to like? Erin: What can I say? She really likes us. Brendan: You Erin: Nice, Sarah's trying to get those sound effects in. Brendan: Where do you have that? Where do you have those sound effects? Where is that? Sarah Harding: They just rolled it out. I'm just like a, I'm like a Riverside junkie now that I've taken over the editing. It's over on the side on media. You're welcome. ⁓ And so what is your commute like? Brendan: That's awesome. That's great. I can't find it. Erin: you Brendan: It was like the distance with no traffic is probably 20 to 25 minutes to the office I was working at for the last year. ⁓ and then they started sending me to other offices a couple of months ago. ⁓ And they were further marginally further. Like one was maybe about the same distance. And then one was another maybe 10, 15 minutes with traffic to play 15 minutes. Hey, full disclosure, though, but I only had my contract, only one office. And I was like, Sarah Harding: Mm-hmm. Brendan: I know if I want to get, but like, I literally said like, Sarah Harding: Do it. want to, cause how do you negotiate that? Because I was just thinking like if that, because if you're just getting out and starting negotiations and that's even a remote possibility, it needs to be in the contract, right? And so like, if like, are you getting mileage based on the commute? Because I think, you know, you're doing them a service by providing care at multiple offices. Erin: you Brendan: So I had several mentors through residency and I was telling them about, it's still private practice. They have several offices and maybe my dream is partnership track. Maybe that's a stall, still a possibility. I was warned by several mentors. were like, okay, but look at how DSOs do it. They want to send you two days a week over here. One day a week over there, two days a week over there, just getting your contract. If you really want to grow and like really get your feet down in one office and build that network around that area. And you wanted that, like, what would I do that? But if you don't really want to be driving around here, over there, covering that, then getting your contract for one. So I did that. I tried to think ahead. But I also said, look, I'm willing to drive all over Long Island for you if I'm on the partnership track. I said that. Like, this was in the conversation multiple times because this is my goal, my vision, like looking down the line. That's so that's it. You want a team player in me show me the ROI and not in like an egotistic, not in an overconfident way. Look, I have so much to learn. I'm still only one year out. This is not like a, you know what I mean? But when we're going to sign something on the contract that we both sign and agree upon. And that was one of a few things actually that started to change over time. But now I'm like literally a couple of weeks before I stopped there. It was like, now I three offices. What is going on here? You know what I mean? Anyway, ⁓ it's just, it's in. Erin: I think sometimes too, you need to know your worth. Like, yeah, you're new and starting out, but there's so much to offer. And sometimes just you being a well-trained warm body is all they really need. And I feel like they like to, I mean, it's really a big liability has taken you on and we're investing so much in you. Like we're losing money. on you. That's like the message you get. And then my first practice, I went in the first year, I made like $1.3 million for the practice straight out the gate. Like, oh, you really good thing you let me come and help you. Sarah Harding: Yeah. Clean up your, clean up the scraps, the trash for you. You're welcome. Yeah. Erin: Right, you know, and I'm not to say that's like this crazy out there number, you know, if you've been out. like you're doing them a favor, but really they obviously want you for a reason, right? And some places are like the associate turn thing, because they know they make money off you. So unless you're really slow, you're probably doing just fine for them. And so, you know, make sure that you go in with some good advisement and know your worth and are willing to negotiate a little bit, especially as women who are bad at that notoriously. Brendan: You ⁓ Sarah Harding: Yeah, that's fair. Brendan: with your mentors. Make sure you get everything in the contract. Make sure you lay everything out and have that conversation with making your attorney make it a battle between the attorneys. Like just say like, look, this is what I was interested in. You know what I mean? Like, but I think communication is gonna is gonna be key. It's you need to have You need to be able to like you got to read or that is that person actually willing to communicate too. You need to communicate but are they willing? I don't know. Erin: Yeah. Yeah, definitely. Sarah Harding: Yeah. Here's another blind spot for you that I just noticed. So when you're saying like, talk to your mentors. And I know in residency that my co-residents who are all dudes had that relationship with our attendings. Mine was very different because what I wanted out of my life was very different from what the guys wanted out of their lives. And so when you say, talk to your mentors, And for us, and Erin, correct me if I'm wrong, I think it's a little bit more difficult to have to find those people and to have those conversations because if you're like, well, I don't want to do that full grind that you guys all want to do. I want to make sure that I have time to go to my kids things if I this, that and the other, right? And so, but I could never imagine having gone with that thought to talk to one of my attendings and actually say that out loud. I never would have done it ever. Yeah. Yeah. Brendan: Ooh, that's a great point. Because they would have looked at you like you had four heads. what would you don't want to? Yeah. Sarah Harding: And so you aren't able to get that advisement. And so that's why we're doing what we're doing here is because like we want to be the ability to be mentors and have that advisement and educate and stuff and people that not every person that finishes an oral surgery residency is doing the exact same thing. Right? Yeah. Yeah. ⁓ Erin: Yeah, of course. Brendan: OMFS? What is it called again? Erin: It's the doctors all in and it's women in oral surgery and dentistry or you know, if you're in medicine you want to come too. But yeah, it's it's I made it for our community because I just saw such a need. You know, there's just such a lack. Brendan: Can you throw all the information on how to get involved with that? do, like just for listeners, because like you said, this is the space for true mentorship to find the people that need exactly what you're giving. Can you just get all the information on the next conference, the last conference, like if you can. Erin: Yeah. Right. Sarah Harding: Yeah. Yeah. Erin: Yeah, definitely. Sarah Harding: we've talked about it on the last episode too. And so we, and we'll continue to plug it. So we talked about it all the time. ⁓ Yeah. Yeah. And so it's, it's ⁓ the it's is the website and we just opened we ⁓ look at ⁓ Erin just up. It's not my thing at all. It's totally Erin. ⁓ And, ⁓ just up the registration for next year. So February 26th through 28th at Miraval in Austin. Erin: You Brendan: Okay, great. just... ...shut off. Erin: I'm glad you're taking ownership, Sarah. means she's all in. Sarah Harding: And so it's like a super duper beautiful place, but also more than that, I think it's like a great community, a great group and everybody leaves feeling a hundred times more empowered and better when after it's over. So that's what I would have to say about that. ⁓ Yeah. So I wanted to ask you, and I think Erin wanted to ask you too. So residency for you. And I'm prefacing this with Erin had a blog in residency and would write some things on it. They got her in trouble. Erin: Thank you, Sarah. Brendan: Yes. Sarah Harding: you were doing this kind of thing in residency, right, with social media. And so you had ⁓ visibility. And as we all know, because program directors are asking themselves how to increase their recruitment, they're not looking outside for any information. How did that go over for you in residency? Brendan: ⁓ Well, let me start by saying I had a program director who understood what social media was, like the, I guess, the power and influence and just exposure in it, which is great. And first and foremost, we protect her residents. If anything came pushed to shove, would just kind of like ruffle the, like calm the waters, if you will. You know, wouldn't want no ripples in the water, which would just blanket everything and help. But everything underneath that blanket, the residents in the program, other attendings in the program, not so hot, not a great experience with making social media content on the case of the day or a kid subway surfing and the train went over the car. And I get on social media and say like, guys, don't subway surf. I'm seeing this in the hospital, just trying to like give basic information. Everyone was talking about subway surfing was a hot thing on TikTok like three years ago. I didn't hear one person say like, probably not a good idea kids. I yeah, it's common sense. But it's also like, this is what's going on right now. How about we get a surgeon on online just to say like, guys, you got to be kidding me. Let's look for something else to do. You know, like try like count jelly beans. don't know. Sarah Harding: Right. Yeah. Yeah. Yeah. Here's what your face will look like afterwards. You know, because you can't get that on the news. Yeah. Brendan: or like that, right? Like, So, ⁓ yeah, ⁓ I don't know when people are obviously not on your side in residency. You can be in a really malignant program. You could be in a really teamwork oriented program. You could have certain residents that are, got your back to the death. There could be certain residents that are just trying to get out as quickly as possible and maybe throw you under the bus so that they shine. ⁓ you guys know, Sarah Harding: ⁓ I wouldn't do that. Yeah. I was just trying to get out of there. had a countdown, a daily countdown. Brendan: You throwing other people under the bus though? No, you weren't. I know you Sarah Harding: No, no, no, none of that. But it was like, many days left? And I knew to the T how many days were left. Erin: Ha ha ha! Brendan: Which is great, right? But then there's also, I don't know, someone trying to burn your building down to make their building seem higher or whatever. So that was my... Sarah Harding: ⁓ yeah. You know, and that was the beautiful thing about being going into the Navy afterwards was that I didn't have any, any reason to shine. I don't, that sounds bad, but because so when, so my residency was typically a six year program and they had a four year spot for military. And so, but my year, the, so I had two guys supposed to finish med school and then come join me. Brendan: What do mean? Sarah Harding: And then, but one of the guys didn't pass step one, I think. And so he got kicked out of the residency. So it was just me and a six year. So that was my running mate. And I thought it was really kind of wonderful because we didn't have, I was going into the military and he was planning to go onto fellowship. And so we had like a great dynamic and we were also able to pull in our juniors and have them taking on a lot more responsibility. Whereas before that, like we were, it was always the chiefs that wanted to operate together, but we made a deal that we would never operate together. I think we did one case together and, we'd always have a junior. And so we really built up our people below us, ⁓ in order to make our program that much stronger, right? Which was really great because I, and I, it wasn't like I was trying to get, you know, everything because I'm not sure if I'll ever get this opportunity again because I was going in the Navy. You know what I mean? And so I knew that there were opportunities that I would have that I wouldn't have if I was going into private practice. And so I thought that was a really special. thing that we had, like a special dynamic that we had because we were able to do that. I don't know. Yeah. Yeah. Brendan: I agree. think it is. That's excellent. But that also came down to you guys. You know what I mean? And if this program did, was there any change in leadership? No, right. Sarah Harding: Oh, I had four program directors in my time there. So yes, lots. Yeah. Yeah. We had the same chairman throughout, but the four different program directors. Yeah. And then we brought in a guy that did like cancer and you know, that brings not just cancer patients, but also cancer into the program. and hold on, hold on. I got it. There it is. Brendan: Wow. ⁓ wow. Wow. Wow. Huh. Cause sometimes you just... Sometimes, sometimes. Sarah Harding: And so, you know, that was a real challenge. That was something that we really had to fight against because that energy into the program was malignant, right? And so we really had to stand firm on what we were planning to do. So, yeah, it good though. Erin: Thank you Sarah Harding: I don't know what got me off on that tangent, but there it is. You're welcome. ⁓ right. Brendan: That's such a good point. Yeah, the leadership leadership trickles down into the program and the residents year to year will their personalities and attitudes may train change drastically and that will affect the culture and environment of the program every day the learning environment as well as the surgical environment how well or how often or how not as often you operate it how well you're taught in the OR if you're doing it for a year, you're going to learn a lot more than just watching it for a year. I ⁓ that's totally get it. Erin: Thank Yep, definitely. Sarah Harding: So how did you decide to start doing all of the social media? You just saw a need for it? Or how did you do it? What was your thought process? Brendan: well, first I got to say you guys are awesome. I feel like we could just chat all day long. I love it. I absolutely love it. So thank you guys for one. And number two, like to answer your question, there's just, there wasn't a lot of information about like surgery, the residency experience, the, the dental school, dental student to resident experience or transition or route. and I mean, that's what social media is. It's really just another space of visibility. And as these algorithms continue to change over time, you will. Sarah Harding: Thanks. Mm-hmm. Brendan: be given from the algorithm what you're searching for. So people, want, they have so many, I get asked the same question every day. Like, is my DAT good enough? Is my GPA, is my ranking good enough for oral surgery? How's my CBSE? Will I get an interview with this? And most of these answers are just like, I don't know the rest of your reputation or like, I mean, normally that would be good, but I don't know what your letters of recommendation like, right? And it's like, but that's more information. like, ⁓ yeah, I didn't think about my letters of recommendation. It's just a... Erin: you Brendan: I think mentorship, think social media is a great platform. It's like pipelines. They allow you to connect with people that are looking for it. And same thing with trolls. If people are looking to troll certain people, that's going to happen too. You just got to have thick skin. I don't know. just, wanted to get out there and, to answer the question through dental school, created, uh, me and my buddy created social media pages, students of dentistry, elite dentists and top dental practices and among a number of others, but like, Sarah Harding: Yeah. Brendan: That was for throughout dental school for three and a half years. We were just featuring other people throughout the country. And I didn't start actually making my own social media content until after I'd matched to all surgery residency. And I was like, look, I just want to help and give back and like make a couple of videos that maybe it brings them insight or it's like it helps someone with an open lock jaw or it it makes someone laugh and chuckle because it's like, I don't know, you won't get sent home in residency unless you have COVID or poop your pants or like people. Sarah Harding: ⁓ well. Mm-hmm. Yeah. Brendan: found that funny and like maybe I look like a douchebag surgeon but in another way it's like guys let's relax let's joke a little bit here right Sarah Harding: Right. But there's so much funny stuff that happens in the resident room and like happens in residency and you just like, I have this treasure trove in my brain of it. And I'm so glad that you're putting some of this stuff out here because it's like, this just so funny, you know? Brendan: Yeah, what was that? Erin: I think it was so brave of you to do it in residency because again, I just think there's so much judgment and there's so much hierarchy. And the thing I kind of landed on because I keep being like, why does it seem so offensive, so threatening to academic people or like the old, I call them the old guard kind of people. Why is it so bothersome? Like my partner told me like, it shouldn't be on social media. It's such a liability. know, like why are they? Sarah Harding: Rain. Erin: so angry, sometimes angry about it. Why are they so unsupportive? And I realized, maybe I'm wrong, tell me what you think. But I think so much comes down to authority had to be given, right? You had to get your authority from jumping through the hoops, progressing year by year through, like suddenly your chief, it's like, I remember one of our chiefs said like, never question me as if like, that's a safe or good thing. Like, okay, you've been here for four years, you... Brendan: Mm-hmm. you Erin: never have to be questioned, but there's a definite hierarchy. And then there's like assistant professor and then there's tenured professor and there's vice chair and there's department head. You know, there's all of these things and you have to collect your ribbons at the AAOMS meeting or whatever before you're allowed to speak. That's been how it's been for decades, right? And now all of sudden some little guy named Brendan can start talking about orthognathic surgery online. and people are paying attention to him and they're asking him questions instead of me and maybe they're even paying him some cash. Like I think you can take the authority for yourself and you don't have to be given it anymore. And I think that's incredibly threatening to just the system, which has been very hierarchical. Brendan: Good point. I agree. think that has a huge thing to do with it, which is frustrating. It's like sometimes things change and it makes it more accessible for people for information, the mentorship and education. it's, it's, there's a lot of bad, but there's a lot of good that comes of it, you know? Sarah Harding: Yeah. Yeah. Erin: Of course. Well, and I think everyone has their unique point of view and the thing that they can uniquely share with the world. like the people who are following you are following you because they like you and the way you present things and it's accessible to them. And maybe they like the more academic person for whatever they have to offer. You know, like I think we live in such this mindset of lack instead of this like light and love and abundance. And there's an abundance. Sarah Harding: Mm-hmm. Abundance, yeah. Erin: of information and welds out there. And if we didn't have to be so threatened and worried about what other people are doing, that would be very helpful in the world. Sarah Harding: I agree. ⁓ Brendan: That's right. Erin: Well, thank you so much for joining us, Brendan. This was so fun. I think it was also... Sarah Harding: Yeah. Brendan: Thank you guys, thanks for having me. Sarah Harding: It's really fun. Yeah, finally. I'm finally excited. I'm excited to finally meet you. It's been too long. Yeah. Erin: I know, right? And I think some of it's like getting just that side of you we don't get to hear and also all of our deep thoughts about how the world works for men in our specialty. That was helpful too. So thank you for sharing and being so open. So can you let our listeners know how we can find you online? Brendan: You too! You too! Sarah Harding: Yeah. Yes. Yeah. Brendan: Sure, ⁓ I mean, so I guess like I'm on Instagram at Dr. Gallagher, same thing, TikTok Dr. Gallagher, LinkedIn, Brendan Gallagher, DDS. ⁓ We also have YouTube shorts that would either be Dr. Gallagher or Dr. Gallagher's podcast, Spotify's Dr. Gallagher's podcast and Dose of Dental podcast. One of them is in food spray. Sarah Harding: We're going to link all of it in the show notes, so be kind. That's me typing it all up. That's right. I'm going to need you to email those to me, Erin: There's gonna be a long list, Sarah. Brendan: hey, it is what it is, you know. Erin: Okay, well definitely check out all the amazing content that Dr. Gallagher is putting out. It is so helpful and insightful and I think you do a great job just being your friendly, authentic self, which is something we really are on board with. Sarah Harding: Yeah. And finding a ton of people in this space that are doing totally different things and introducing it. There's so many things that I had no idea that people were doing that you've introduced to me. And so I super appreciate that. Yeah. Brendan: Thank Erin: Yes, thank you. Brendan: Yeah, Resting Stitch Face. Let's go. Let's go. Erin: Let's go! All right, well thank you for joining us with another episode of the Resting Stitch Face podcast. Please, as always, like, share, and follow, and we'll catch you next time! Sarah Harding: Let's go.