The DOC Podcast DeLuke Orthodontic Coaching, LLC

What a great conversation with an amazing orthodontist and person, Dr. Courtney Lavigne!  We cover everything from her professional journey, to her personal struggles with Upper Airway Resistance Syndrome, to the challenges of balancing a career with the responsibilities of family and motherhood (as she is currently 38 weeks pregnant!).  You’ll hear us discuss:
What led Courtney to sell her successful restorative practice after 10 years and return to school to specialize in orthodontics.The impact that people like Frank Spear, Greg Kinzer, Gary DeWood, and Vince Kokich had on her understanding of interdisciplinary care. Her personal journey with airway issues and orthodontic treatment after having 4 premolars extracted and the anterior teeth retracted as a child, then needing a MARPE to address the underlying transverse deficiency as an adult.What Upper Airway Resistance Syndrome is and how she figured out she had it.Why traditional orthodontic education is not focused on preventative and proactive treatment strategies, especially when it comes to airway compromise and sleep-disordered breathing.If the orthodontic profession risks becoming obsolete by neglecting to embrace the value of early intervention, especially as it pertains to airway and breathing.How Courtney balances being a mom, wife, orthodontist, national lecturer, and business owner.What advice Courtney has for busy moms who are working to achieve a work-life balance between their personal and professional responsibilities.The importance of setting goals and developing a vision for what you want your professional AND personal life to look like.The curse of the Type A achiever.The importance of saying no and setting boundaries.

He’s back!  In September 2023, I had Ty on to talk about CBCT imaging.  Now he has a new role as a practice transition broker with Professional Transition Strategies (PTS) where he assists with pairing doctors with a DSO that best fits their needs and desires.  In this episode, we do a deep dive into all things DSO (OSO, etc.), including:
What PTS is and how they can get the best financial and personal outcome for a provider when looking to sell to a DSO.The value of having a sell-side-only representative when considering selling to a DSO.How to get a free practice valuation from PTS with no strings attached.The number of offers PTS typically gets its clients.The reasons why private equity is so interested in dentistry.The difference between activist groups and aggregation/passivist groups in the corporate dentistry arena.How to use your practice as an investment vehicle.What a recapitalization event is, how often it is anticipated that they will occur, and how they can create generational wealth.The difference between a private equity transaction and a Mercer acquisition (selling off a piece of your practice at a time to a junior doc).The average age of the doctors that PTS represents in the sale of their practices to DSOs. How to determine if a DSO will let you keep your name on the door, keep clinical independence, and maintain control over staffing decisions.The differences between the DSOs of twenty years ago and the DSOs of today.The possibility of an owner doc selling a portion of his/her practice to a DSO and retaining ownership of a certain percentage.How fringe benefits (aka seller discretionary earnings) are handled once you sell to a DSO.The three most important things to consider when doing a deal with a DSO.How working for a DSO can create “organic growth.”How PTS gets paid.LINKS
·         To learn more about Professional Transition Strategies: https://professionaltransition.com/our-team/
·         To get in touch with Ty:  ty@professionaltransition.com; (469)360-1031
·         To contact Ty on LinkedIn: https://www.linkedin.com/in/tyramsey/
·         Link to the first episode with Ty: https://youtu.be/rPQ-P5NDj3g?si=7nFihFRb51Znx6Na·         To learn more about DOC:  www.TheOrthoCoach.com
·         To contact Dr. DeLuke: drmike@theorthocoach.com 

In this episode, I interview Dr. Dan Grob.  Dan has been a practicing orthodontist for 40 years, has been actively involved in academia throughout his career, has published numerous articles, and is the past Editorial Director of OrthoTown magazine.  Dan recently discovered the numerous and amazing benefits of providing more early orthodontic treatment and it has transformed how he approaches patient care.  We discuss:
What it was like purchasing Charlie Tweed’s brother’s practice in AZ.Why Dan didn’t do much early treatment in his first 25 years of practice, and how that changed approximately 15 years ago.How self-ligating appliances have helped improve his clinical efficiency.The importance of starting the patient evaluation by looking at the patient’s face and finishing with the teeth.How being airway-aware can both change lives and grow your practice.The void in our formal orthodontic education system when it comes to early treatment and airway.The reasons why pediatric and general dentists seem to be more cognizant of the benefits of early treatment, especially as it pertains to airway.The state of affairs in higher dental education regarding the disconnect between pediatric and orthodontic departments, and what we can do about it.How doing more Phase I treatment to address the transverse early has simplified Dan’s practice and given him more control over his cases.Why spending a bit more time to treat over two phases is well worthwhile based upon the superior results you can attain.Whether dental crowding is due to large teeth or small jaws.The different techniques that Dan and I use to expand the mandibular arch.How full braces and wires during Phase I can generate amazing expansion and arch development.Dan’s thoughts on lingual frenectomy.The best way to decrease the number of impacted canines you have to manage.The importance of determining the etiology of the transverse deficiency in younger kiddos.What can be done to shift the paradigm of orthodontic treatment towards one that focuses on the value and importance of early treatment.LINKS:
DOC CE Courses on Phase I Treatment: https://theorthocoach.com/ce-courses/

In this episode, I interview Matt Rej, Partner with Merchant Cost Consulting (MCC).  Matt and his colleagues started MCC to help doctors save money on their credit card processing fees.  He and I discuss:
The dirty secrets of the CC processing industry, including how they generate extremely high profits off the backs of dental and medical offices.What is considered a good target percentage of CC processing fees that your practice should be paying.Which CC processing rates can be negotiated and which cannot.What the CC processing industry considers a “stick account” and why you don’t want that to be you.The fact that your PM software company is likely getting kickbacks from the CC processing company, which increases the fees you pay.How to receive a free analysis of your CC processing fees.The difference between the services offered by MCC and standard CC processing companies.Why you may even be eligible for a refund from previous egregious fees.How to save tens of thousands of dollars each year on your CC processing fees without having to change providers/terminals.  How MCC gets paid.The importance of maintaining PCI compliance and how MCC can help do it for you as part of their services.If MCC can work with practices that are part of a DSO/OSO.Real examples of practices that Matt and MCC saved dental practices tens of thousands of dollars by renegotiating their CC fees.LINKS:
-Email Matt: Matt@merchantcostconsulting.com
-Partners Page on MCC website: https://merchantcostconsulting.com/partners/
-Episode with John Vento, CPA, CFP: https://youtu.be/1-EXO-IlQgs?si=2jIspKkZajqJKrXw
-Episode on budgeting: https://youtu.be/d31JwW_Ucmw?si=jQHDaMmUqpKkIJtX

In this episode, I have the pleasure of speaking with a true pioneer in the area of 3D imaging, TMJ, and airway-focused orthodontics, Dr. Bill Harrell.  We discuss:
How his interest in TMJ was shaped by his work with the legendary Dr. Bill Farrar. How his relationship with Dr. David Hatcher, a world expert in craniofacial radiology, got Bill interested in both 3D imaging and airway in the 1990s.What he learned from Dr. Christian Guilleminault that helped change his thinking on pediatric airway and orthodontics.The potential of going into schools and working with nurses to use facial analysis to screen for sleep issues in children.An article by Ketchum in 1912 highlighting the importance of orthodontists recognizing airway issues in young children, referring to their otolaryngological colleagues, and then addressing the aberrant growth and development with arch development. Why we don’t learn more about airway and early treatment in orthodontic residency training.The reason why it is not practical (or ethical) to conduct long-term studies on the treatment of airway compromise.The potential for using rhinomanometry to help diagnose sleep-related breathing disorders and quantify changes achieved during and after orthodontic treatment.How the Salzmann Index is harming the ability of orthodontic residents to treat patients in the early mixed dentition.The importance of using CBCT to look at maxillary and mandibular bone widths.Acoustic pharyngometry and whether or not it can aid in the diagnostic process.The importance of orthodontists working with ENTs to coordinate the care of patients with a restricted airway.The CAST (Children’s Airway Screener Taskforce) Committee of the ADA and how they are developing a screening protocol (CGASP) to improve our ability to detect airway issues as well as determine the impact of interceptive orthodontic treatment on airway patency.Bill’s upcoming textbook titled, “Growing into breathing problems: the quest for collaborative lifetime solutions” and what we can expect from this amazing book, including chapters by:  David Gozal, David McIntosh, Jerry Simmons, Stanley Liu, Audrey Yoon, Steve Carstensen, Dave McCarty, Steve Lamberg, Karen Davidson, Linda Gibson-Young, Duane Grummons, Nicole Goldfarb, Eric Thuler, and many more!LINKS:
-Dr. Jerry Simmons email to inquire about CAST/CGASP: jsimmonsmd@csma.clinic
-Dr. Mike email address:  drmike@theorthocoach.com

In this episode, I speak with an expert in the field of commercial real estate, Mr. Colin Carr.  Colin's firm, CARR, is the nation's leading provider of commercial real estate services for healthcare tenants and buyers.  They are licensed in all 50 states and represent over 5500 clients of all sizes across the US.  We discuss:
The reason why doctors need a tenant broker and how having one can save you hundreds of thousands of dollars over the life of a lease. Why doctors are at a major disadvantage when it comes to identifying, negotiating, and leasing/purchasing office space.A real-life example of how easy it is for a doctor to be taken advantage of by a landlord/seller.The advantages and disadvantages of buying versus leasing office space, and the steps to go through to determine which scenario is best for you.How to find a good tenant representative broker and what questions to ask to determine if they are a true expert in the field.How a good tenant representative broker can save you significant amounts of time and money.The typical stages of a commercial real estate transaction.The biggest difference between commercial and residential real estate.The peace of mind that a tenant representative broker can generate for a doctor.Why it's important to look at multiple properties.If it is more difficult for dentists to obtain financing today.How a tenant broker can help with the procurement of financing.How to manage the emotional side of the transaction and obtain peace of mind that you got the best office space and deal for you.Some of the items that landlords attempt to sneak into a lease that you need to be aware of.The items in a lease are the most frequently and easily negotiated.Why you also need a real estate attorney on your team to review the lease and terms of the agreement.The compensation structure for both the seller and buyer brokers in a commercial real estate deal.LINKS:
CARR website:  www.carr.usDOC website: www.TheOrthoCoach.com