Ep 128: Upgrading Dental Office Technology with Dr. Eric Tobler

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John Meis (00:02.551)
Welcome to this episode of the Double Your Production Podcast. I'm Dr. John Meis here with my partner, Wendy Briggs. Hey, Wendy.

Wendy Briggs (00:10.411)
Hi, Dr. John.

John Meis (00:12.506)
And we're also with us is Dr. Eric Tobler, long time friend, long time colleague, long time partners at one time. Just an absolutely fantastic guy. Eric, welcome aboard.

Dr. Eric Tobler (00:27.818)
Thank you so much. So fantastic to be here.

John Meis (00:31.338)
Yeah, do you want to tell everybody a little bit about your dental story? You come from a dental family and just how we all got together.

Yeah, yeah, definitely a dental family. So my dad's a dentist. Growing up, he and my mom ran a single practice in Provo, Utah, two operatories, a pretty tight space where the staff lounge was also where we kept records and nitrous and staff lounge and you know, everything just in that little space. And then as my brother and I got into dental school, we decided that we wanted to practice together and so my dad made the incredibly bold and amazing move of building a really big practice for us to be in together. And that's, as I graduated from dental school, obviously building the practice is the easy part. The hard part is running the practice. And so that's when I was first introduced to Dr. John and Wendy. Right out of dental school, I went to a team training Institute mastermind group and felt I really didn't belong in that room.

John Meis (01:25.09)
Yes.

There were so many just really high performing doctors and team members who were speaking another language and talking about things that I really didn't comprehend. And so for me, that mastermind group was so influential and important for me to understand the business of dentistry, the passion behind dentistry and just what it takes to lead people as well. You don't really get much of any of those things in dental school. And so that was really an exciting way for me to start my dental career and like incredibly beyond grateful to both of you for the mentors that you've been to me and friends and colleagues and everything else beyond there. But from the very beginning, the two of you were so influential in really the way that I looked at dentistry.

John Meis (02:23.734)
Well, you certainly belonged in the room. You brought a lot of knowledge, experience, excitement, and passion to the room. And one of the things I've always enjoyed about you that all three of us share is a great curiosity about what's happening in our profession, where are the places that we can improve, what are the new things coming along. And knowing what those are is kind of one thing, but really figuring out, you know, what is really a usable thing that's gonna be sustainably used in our offices versus the gadgets and things that we have in the garage or in the basement of our office. So do you wanna talk a little bit about how you think about that as far as choosing technologies?

Yeah, yeah, I would love to. And maybe just catching up to what we're doing today. So the practice that I was at with my dad and my brother, we grew it really aggressively early on with the help of you and your team and the insights of the other dentists that we learned kind of how to do that. We grew our practice to support all three of us, just one doctor, two doctors, three doctors, then three years. That felt like a really aggressive growth.

John Meis (03:40.854)
Oh, it was.

But it just kind of happened because we were doing the right things and then it continued. And so we added some friends from dental school and then added some practices, just kind of slow and steady growth over the next five or 10 years after that. And eventually then joined Mortenson Dental Partners with our group. And so, today I'm the clinical director for Mortenson Dental Partners. So I get to help integrate technology and have lots of examples of successes and failures in those. I think, you know, thinking back to our practice in Lehi early on, we had one closet specifically that was just like the graveyard of specifically $5,000 inter-oral cameras. Those are one of my favorite things to look at there.

John Meis (04:17.043)
Yes.

I guess.

Yeah, I mean, it just all sorts of things and that's hard enough. I think, you know, there's something nice about the doctor going to the dental conference to learn about the technology, purchasing it, and then bringing it back to the practice. Because at least you have one person that's 100% bought in, or at least they were at one point during the conference, right? If the salesman was really good, or whatever the reason is. At least you have one person in the office who's really bought into it before it ever shows up, right? And that person also has a financial obligation or connection to that technology. And so now, being part of a group, that's not always the case.

John Meis (05:00.842)
Yeah.

You know, so I think that the challenge is making sure that you get the right things in there that are easy on the front end. It's amazing how before you get momentum, like the tiniest little pebble in the road can bring a monster truck to a stop. Once you get going and you're using it as part of your workflow, it's not so hard, but really focusing on, you know, making those workflows easy early on, and that we've kind of thought through all of the challenges, you know, Wi-Fi in the practice is an issue for many technologies we roll out to.

John Meis (05:30.402)
Sure. Yeah. So now you're clinical director for 130, 40-ish, kind of lost track of the number of locations really across the United States in specific markets, but the markets are all around the United States. So that brings a whole other level of challenges. So when you're looking at a technology, you know, what are some of the things that.. There's all kinds of new stuff coming out and you've got a list of things and you have to rank them in priority of impact, of ease, of cost, of all of that. So walk us through kind of your mindset on how you're choosing things to advocate for within your organization.

Yeah. That's a tough one. The motivation for it can come from a various group of spots. Sometimes it's our clinicians asking. In 2022, we added scanners across nearly every practice in the company, and that really came from our doctors asking us for that. We do regular surveys asking them, "Hey, how are things going? What's working well?" One of the questions we specifically ask is, "What technology would you most like to implement in your practice?" And by a great margin, scanners were number one. And so that really, you know, listen to our doctors. Let's give them what they want to provide great care. Number two on that list was CVCT for the technology. And it's been a couple of years since we've done one of those. So I think that now we're also looking at AI. I think that has applications and advantages in a number of different perspectives. And as a clinician, I love it so much. I mentioned my dad earlier. When I first heard about AI, I brought this to him and said, "Hey, what do you think about this? I know you're obviously pretty comfortable with diagnosis. What do you think? Is it great for the young doctors? Would you ever use it?"

Even at his stage in his career, he's like, "Yes, this would be amazing just to validate what I'm doing and, more than that, have a way to communicate it to the patient in a way that's clear, I think is amazing." Some of the new technology in finding and diagnosing or helping to diagnose PARLs is really, really interesting. Those abscesses show up way more consistently than I'm comfortable with, I'll say, in my limited experience with what I've seen with that. So I think that has some opportunity.

John Meis (07:47.478)
Yeah.

Potentially, I think there's a lot of talk about helping to align dentists and payers as well through AI as kind of a somewhat neutral party to help with that. So there's a few different areas that I think that has application. Most recently in our company, we're making a clinical move, but it actually wasn't driven by the clinical team much at all. It was actually really our I team that was driving it, and that is going to cloud-based imaging.

Our doctors have wanted a way to share images more easily, especially CVCTs. We don't have a great way to do that right now within our organization. But, you know, our doctors said that would be nice. It wasn't a top priority for them. But for us as a company, we're using a number of different platforms, so different versions. Those things kind of make it challenging. And then our servers, we were to the point that our servers were at capacity and we were going to make a substantial investment in upgrading those servers or cloud was the alternative. And so that's kind of maybe one of the drivers that you wouldn't expect. You know, it's a it really is a clinical tool, but it's the IT side that's driving that decision.

John Meis (09:20.674)
Sure, yeah. Yeah.

Yeah, Dr. Tobler, you know, you mentioned earlier the buy in with the doctors, you know, when it's a single doctor that owns the practice, the doctor gets excited. Dr. John has long talked about this as the bright shiny object syndrome. You know, they go find the next bright shiny object and they get excited about it. And then they bring it back to the team. And one of the things that we see often is, I guess, a breakdown in communication behind why this is an influential tool or something that's worthy of our time and investment.

Yep.

as well as just a struggle with the actual implementation. Dr. John and I often share screenshots when we lecture and we'll have, one of my favorites when it comes to digital scanning was the hygienist saying, "Is anyone really scanning, taking the time to scan your patients on the hygiene side? We just got our iTero and I already hate the word iTero."

Haha.

So what can you see or can you give anybody, any of our listeners, I guess, insight into how best to message the advent of technology and then maybe some success stories from some of your practices that have implemented it maybe better than the average would or you mentioned failures too. You know, failure, we can learn from failures also. So maybe struggles with implementation is one of the things that we often hear complaints about.

Yeah.

Yeah, it's a challenge. Yeah, you know, talking about the scanners earlier, I was so excited to get the scanners out. For me, that was a really huge, huge deal. And as we were sending out the survey of who wanted it, one of the doctors sent a message back and said, "I'll be getting the scanner, but only so I can sell it on eBay." And it like broke my heart. I was like, "Oh, how could you?" You know, working so hard to try to keep us on the cutting edge of technology and provide great patient care.

That felt like a little bit of a slap in the face. But the great thing is somebody telling you they're not gonna use it is actually a beautiful thing. Because then you know, like, okay, let's have a reasonable conversation about it. You obviously care about your patients and your team and everything. So let's figure out where the roadblock is. Is it a concern about the trait? Where's the concern? Let's work through it. And maybe it's just not a fit, that's okay too.

John Meis (11:19.784)
Yeah.

I think the bigger challenge is the person who doesn't raise their hand and just doesn't use it and it slowly collects dust. I think one of the most important things with implementing technology long term is just having a way to understand how it's being utilized. If you're in a single practice, then you're just looking at it and watching it. But in a bigger group, having some kind of enterprise-level reporting or insights into

John Meis (11:41.579)
Yes.

the technology you've invested in is really, really helpful. Metrics, more and more for all of us, metrics are driving everything we do, and so that's really helpful. But on the individual implementation side, I think the best thing to do is just to find an early adopter, find some folks who are influential in your organization, and well-respected, and excited about the technology. And if you can't find those people, then it's

might not be a good technology. There's a lot of people who are so engaged in what they're doing, they wanna grow their own personal skill sets. They wanna learn what's new and exciting. So you find those people and help really engage them in the process. That's, I think, what I've found most successful. And that's true for the organization as a whole, but also even at the practice level, finding that expert in the practice who has the passion and they can really carry the rest of the team through the bumps in the road.

John Meis (12:36.864)
Right. Yeah. I love it when we have a doctor on board and a team member that's going to champion it. That seems to be the most successful. If it requires a lot of extra effort, time from the doctor themselves, that sometimes stalls out. That's when the doctor has invested in the technology themselves in a group situation where the doctor may have not put a dime in. That test is the doctor willing.

Right.

John Meis (13:32.967)
and then finding a team member who's going to give it a little greater sustainability by championing it.

Early on too I think when you do have those successes early on for us, again, using the example of the scanner, it was really fun for me to get an early report from our major labs on the remake rate, digital versus traditional impressions. And that was a drum that I was banging. To anyone who had listened, I wanted to talk about that because we saw our remake rates drop in half. And so the remake rates were important. But what's more important is...

Yeah.

What does that remake rate mean? It's talking about the quality of the crown. So even if a crown fits, there's good fitting and there's great fitting. And for me, remake rates are really pretty much the only insight we have into that. And so anything we can do to make our dentistry great, let's focus on that. And so that's really, I think, what I try to focus on with the new technologies.

John Meis (14:36.798)
Yeah, that's a great number, having the remake rate. And that means the ones that aren't remade are probably of a higher quality than they were before, right? There's a certain, there's acceptable and there's unacceptable. Yeah, yeah, yeah. What are some of the other technologies that you're looking at right now that are someday going to make it up to the top of your list?

Yeah, I mean, there's some assumption that goes along with that. Yeah.

Oh boy, I mentioned CBCT, that's one that… Boy, I think that combination I was mentioning earlier, the combination of diagnosing abscesses with the help of AI. And then, so I mentioned, you know, I've just started to dive into that and it's surprising and concerning with me of how many of those that AI is finding. And so then when I take the AI diagnosis off, I look at the image again, I'm like, oh,

I don't know, but here's what I do know. I definitely am going to take a CBCT on that patient and find out exactly what's going on. And the part that's concerning is when I've done that up to this point, it's an abscess and I wouldn't have diagnosed it on my own. And I'm a pretty good dentist, I think, but man, it hurts my feelings to see that. And it really, I think, highlights the opportunity that we have in our industry in that area specifically. So I think that combination of AI

John Meis (15:43.159)
Yeah.

and CBC's TEAS together can be a pretty powerful tool going forward.

It's so exciting because now we're avoiding painful situations for patients, infections rarely, but occasionally can be very serious, even life-threatening. We're helping to avoid that. Also, when we're restoring badly damaged teeth, we have a little better understanding about really what the risks are involved with the.

I think, you know, the other thing I...

Awesome.

John Meis (16:36.234)
the tooth, the health of the tooth, the health of the root structure, all of that. I think it's such a great thing for patients.

It absolutely is, Dr. John. And I was going to actually mention that, you know, when you talked about the remake rate and being able to diminish that by 50%, when you talk about being able to identify abscesses early on, you know, let's, let's talk as well about the patient reaction and the elevation of the patient experience just by having the technology. You know, back when we switched from film radiographs to digital radiographs, patients are blown away by the technology. You know, I'm imagining now, you know, with everything else that we bring, I can tell you the first time I saw

Yeah.

my own CBCT, I was like, wow, you know, I've never really been able to look at myself in that way. Look at my own jaw in 3D. It was pretty, pretty killer, right? So I think we often discount that or diminish the power that the technology adds that we bring into the practice. You know, I think we might use them for our own benefit, but I think often there's opportunity for us to really highlight the investment in technology to the patient and help them see how it does enhance their care and their experience. And it was funny, sometimes we'd get comments from patients like, oh my gosh, you guys are so high tech. And I'm like, digital technology, digital radiographs have been around for quite some time. We're really not that high tech, but I didn't say that. I'm like, yep, we are. We invest in the best technology that we can. And I think there's a huge opportunity for us there. And just recognition that it does have an impact on patient experience. Certainly we wanna see a return for the practice, but that's a big one right there.

Yeah, no doubt about it. I think you're exactly right too, Wendy. As a clinician, it's so easy for us to see the technology and think about how it affects us. The CVCT is a great example. It has that such a cool three-dimensional view that you can rotate around and look at it. And I never look at that. I'm like, what's the sagittal view like? What's the axial view? That's all I care about in my Zoom, right? But it is such an amazing tool in the technology, like you said, for our patients, helping them understand the...

John Meis (18:30.2)
Yeah.

The quality of their diagnosis because of the technology that's helping to support it, I think, is a huge thing.

John Meis (18:44.722)
Yeah, awesome. Well, Eric, where's... Yeah, let's hear it. Let's hear it. No, you go, you go.

Another technology I think Dr. John, go ahead. Oh, well, what I was gonna say is I think just all, so much software right now is trying to streamline processes, whether it's kind of tracking our equipment, where it's at, or it's definitely claim submission, so many other things on that side. I feel like technology's helping to streamline a lot of the processes that we use in the practice to support it.

The challenge is just knowing which ones to use. And it seems like companies, as they start to get some momentum, they start to build out. And most companies are kind of butting up against each other, whether it's patient communication or finance. So many of those overlap. And so I think one of the challenges for us in dentistry going forward is consolidating and simplifying the processes that we're using. Because I think any dental practice has got to be in the double, if not triple digits, and the number of softwares that they're utilizing just to run daily operations. There's so many programs that we're using that we don't realize until our internet goes down. Then all of a sudden you realize how much you rely on it for everything you do. Some of us can't even get into the building if the internet's down, right? You can't even open the door. So it's, I think, a great opportunity, but it's also a challenge just how many dashboards do we all have now that we're constantly looking at to...

John Meis (20:00.248)
Yes.

to look at a lot of things going on.

John Meis (20:18.186)
Yeah, one technology expert said the average practice now has 11 logins that they need to function in their practice. And boy, that's a lot. And one of my frustrations with technology has been the thing that you mentioned is that these companies are often going broad, meaning they're adding...

Mmm.

John Meis (20:41.354)
additional features out of their software instead of making their core product really good and make it interface with other software is really well And so that I think that will shake out over time. They'll probably be consolidation and that'll probably shake out. But in the meantime, it's a little frustrating that we've got, you know, three softwares that do the same thing But each of them does something else separate really well. And so now we've got how we've got a bunch

Yeah, I...

Right.

about to overlap. Well, Dr. Tobler, we are so excited.

John Meis (21:10.294)
So Eric, we're so excited that you're gonna be speaking. Go ahead, Wendy.

I'm so excited I'm going to be speaking too. All three of us, we can't wait.

We're saying the exact same thing. That's one thing about running the podcast together is we've done this for so long that we often know where the other one's going, right? I was just going to say that we're so excited about your insights and all of the great ways that you've helped so many of your practices incorporate technology that we invited you to actually share some of your insights with our members and our attendees that are upcoming Champions of Dentistry Summit. That's exactly, I think, what Dr. John was going to say, yes.

John Meis (21:51.502)
It absolutely is. So Eric's going to be talking on leading a team through change and through integration of technology and executing your technology plan and maybe a few tips on how to create a technology capital expenditure plan as to what's coming. Obviously, we do things one at a time and get them in place well before we move to the next, but he's going to be talking about all that as well as sharing some of the- shall we call them land mines that are out there that we want to make sure we try to avoid? And I'm just so excited to hear you speak, Eric. I just recently saw you speak in Las Vegas and I saw you interview Jay Leno and you did a fantastic job with that and that was super fun. So we're really excited to have you on our stage and I'm always excited to be with you.

Thank you.

Well, you guys always put on an amazing summit. I've been to a few of them over the years and there's nothing like it. It's always unexpected. It's always fun, engaging. And I think something really special about the two of you that I really appreciate is it seems like the dentist that you work with, there's a high level of trust and appreciation for just sharing best practices with each other. And I love that and just happy to be a part of it.

John Meis (23:22.014)
Yeah, that's awesome. Well, you can see the show notes for more information about how you can see Dr. Tobler, Wendy and I at the TTI Annual Champions of Dentistry Summit. And that's it for this episode of the W Production Podcast. Thanks everybody for being on board. We'll see you in New Orleans at the summit.

Thanks again, Dr. Tobler.

Thank you.

Ep 128: Upgrading Dental Office Technology with Dr. Eric Tobler

Ep 128: Upgrading Dental Office Technology with Dr. Eric Tobler

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