Rafting with Max

My Son Max (20)

I went rafting down the Animas River with my son Max this past Sunday. This summer, he is a raft guide in Durango, CO. I drove out for the weekend to see him. We did a few hikes, but my hope was for him to take me down the river - Just the two of us. I got my wish!

As with anything in nature, there is a certain amount of danger involved whitewater rafting. Even though it isn't a particularly dangerous river, as a guide, he is responsible for the safety of everyone in the boat. Also, I am sure he wants everyone to have a fun experience.

He made it very clear prior to getting on the raft that he is the guide, I am the passenger. He told me he will give me instructions on when/how to paddle, and he will pick the routes through the varying flows.

I used to do a lot of canoeing on lakes when I was young. The goal was to go straight and fast. I found out river rafting is much different. He kept telling me to let the river take us down, I don't need to constantly paddle. Every time we hit a section of rapids, he would say things to me like, "get ready, it's going to be tricky here.' This was usually followed by "2 forward strokes", or "1 reverse stroke," or "Stoke Hard!"

At first it would drive me crazy because I wanted go straight and I thought constant paddling was helping. I wanted to insert my "control." He said, "Dad, I got this - just paddle when I tell you and we will have a great run!"

It turned out to be a new opportunity to practice step three from my recovery program.

Step 3- Made a decision to turn our will and our lives over to the care of God as we understood him.

I turned it over to him as he took control of the boat. Every time he said "Forward 1 stroke" I paddled one stroke. He was eyeing the best routes, taking us through the most exciting rapids and eddies. We slid perfectly between the rocks. It was a rush letting him lead us. He is truly a master of this river.

During the slower sections, we would relax as the current kept us moving downstream. He shared about how much he loves the river and living in Durango. This kid used to be lost. Today, he was in his element with a clear direction of his life. And because I am sober, I get to witness it.

He told me the final section was his favorite. It is more remote and it presents better opportunities to see wildlife. It was a wide section of the river with a lot of rocks.

A great blue heron was perched on one of the rocks. Max told me to watch the bird. It was looking for food down flow of the rock it was perched on. As we got closer to him, I could see him looking for fish. He turned to look at us, and effortlessly flew to the next rock down the river to repeat his quest. We watched him do this 5 or 6 times.

On the final rock, he took off and skimmed along the surface of the water. He dove down. When he came up, he had a fish in his mouth and landed ahead of us on another rock perch. We watched him shake the fish around and swallow down his long neck. While I am sure the people fly fishing nearby were upset at the missed opportunity, we watched with awe.

Not my picture, but you get the idea...

Soon after we came to the take out area where we had parked our car. As we pulled the raft out of the river and loaded it onto the roof of our car, I expressed how much fun this adventure was for me. His smile beamed the expression of pure joy. I'm sure he thought it was going to be just another trip down the river for him. It was an experience we both will treasure.

I wasn't expecting to practice step 3 today. I find when I integrate the steps into my daily life, my days are amazing. I'm sure glad I did, this day was amazing!

#theadventurecontinues #anythingispossible #sober

Ironman Tulsa 2021

 There's nothing like crossing the finish line at an Ironman. Being unable to carry on a conversation during the 2.4 mile swim or the 112 mile bike, you spend a lot of time in your head. If your head space isn't right, it could turn into a long day.

For me, Ironman Tulsa was a constant battle in between my ears as I moved along in the race. There were times sublime when I shed tears of gratitude recognizing all the gifts in my life. This was balanced against dark times where I had to get into a meditative focus to just move forward one more step, one more aid station, and even one more mile.

Looking forward at the beginning of the run, I couldn't fathom running a full marathon. But I could run 1 mile. So I did. Then I ran another. Then another. Along the run, I probably wasn't the most talkative at this race as I was suffering and needed to focus A LOT!

Thank you to all the fellow runners out there who lifted me up, ran with me and encouraged me to join them in conversation. Thank you to the amazing crowd that lined the course all day cheering us on. Thank you to the amazing volunteers that made sure that my every need was met throughout the day.

So as the run portion brought us back into town, the energy shifted and became palpable. A magnetic pull to the finish. The density of the crowd started to increase. The words of encouragement shifted to sentiments of

congratulations

for your accomplishment. The decibels increased.

The final right turn, a blinding light smacked my face. Hundreds lined the barriers. Dozens of high fives with the spectators- especially the kids whose focused mission that day was to not miss a single runner.

I heard the legendary Voice of Ironman, Mike Riley ahead. My smile grew, my skin started to get goosebumps. I entered the finishers chute and ran towards him as he announced, "Number 594 from Denver, Colorado, Brett Kessler- YOU ARE AN IRONMAN!!!!" He had his fist out and we exchanged one final fist bump.

When I saw the fist bump picture, I thought of one thing, Michelangelo's "The Creation of Adam". First, I thought it was a hilarious comparison. Then, as I thought about it, there's some deeper meaning there.

My interpretation of the painting is that God is reaching with a sense of determination to touch a non-chalant Adam- a metaphor of human ego edging out the spirit. I'm not a very religious person, but I do believe in a higher power and strive to get my inspiration from that source. Often, I become non-chalant towards my higher power and my ego runs the show.

Not today, and especially, not at this moment. I strongly felt the gifts of his presence in my life as I reached for one of my heroes in the Ironman world. A moment I'll never forget.

Pushing myself through challenges such as the Ironman never fails as an opportunity to explore myself at a deeper level. There's still lots to explore! Thanks for joining along for the adventure.

#theadventurecontinues #anythingispossible #sober #ADAtrustee #UltrAspire #inspiredbyathletes #inknburnambassador #ironmantulsa

The Most Influential Person in the History of Dentistry - was not a dentist!

I found out about this in the most surprising way.  I was reading the book The Power of Habit, by Charles Duhigg and I was introduced to Claude Hopkins.  He is considered the most influential man in dentistry.  Ironically, he was a marketer, not a dentist.  He was considered one of the most influential marketing experts of his time as well.

How was he the most influential person in the history of dentistry?  His marketing campaign helped to create the habit of daily toothbrushing.

In the early 1900's, tooth decay was rampant in America.  It was so bad that it had become an issue of national security.  There were so many WWI recruits with oral infections that they were hampered in pain and could not perform on the battlefield.

Claude Hopkins was approached by an old friend about a new dentifrice (toothpaste) called Pepsodent.  At the time, tooth powders were peddled door to door by traveling salesmen.  Hopkins quickly declined the offer to promote this toothpaste.  It was a losing battle as less than 7% of the population in the United States had an actual toothbrush in their medicine cabinets.

It was not part of our daily routine at the time.  Why would people use toothpaste, if they didn't even use a toothbrush?

The Pepsodent people, quite confident in their product, were persistent with Hopkins and eventually he agreed to take on the marketing campaign.

As Hopkins dove into the (boring) dental scientific literature of the time, he stumbled upon a description of the "mucinous plaque" that forms on teeth.  This film, he found out was the root of all dental troubles.  This is where the bacteria was that caused the tooth decay and gum disease.

Ironically, it was easily removed through normal toothbrushing without the use of any toothpaste. He ignored this fact and exploited the horrible "film" that destroyed teeth and ruined smiles.

Figure 1 - Pepsodent ad from 1929 describing the call to action 

Actual Pepsodent Advertisements

His marketing campaign was brilliant.  He created a cue, "Rub your tongue across your teeth and you will feel this film."  He then went on to say that this film must be removed each day.

He also appealed to the self esteem of the population - He implied that having a nice smile is a crucial part in being beautiful and attractive.

By creating a daily cue (rub tongue across teeth), encouraging repetition (the film must be removed daily) and establishing a reward (beautiful smile) - he helped create a national habit of daily oral hygiene using toothbrushes and pepsodent.

Through this marketing campaign, the people in the US that had toothbrushes and actually used them soared to 65% within 10 years.

If he was still alive, I wonder how he could create an ad campaign for flossing everyday too.

The dental profession hasn't figured out how to appeal to the emotions around flossing.  We all know the logic behind it, but to create this habit, we need to appeal to the emotional side of the communities that we serve.

On a side note, I just have to say:

clean teeth do not decay.....

Another side note that I learned at TEDMED last spring:

 More people in the world have smart phones than have toothbrushes......

Hmmmm.....


If you like this blog post, I would love to hear about it.  Please comment or share it on Facebook, LinkedIn, Twitter, etc.  

Thanks for reading!

Dirty 30 race report

Well I have another ultramarathon under my belt.  As usual, it not only challenged me physically, but emotionally and spiritually too.

The Dirty 30  - a 50K in Golden Gate Canyon, CO.  It was actually 32 miles but I guess that doesn't make for a good name....

Gary and I pre-race

Start line

I sent my running partners Gary and John an email back in January telling them I was thinking about doing this race - any interest?  John didn't - he was done doing long races (I should probably follow his lead at some point!).  Gary liked the idea and the challenge.  We have adventured together for several years (Gary 20+, John 10+).  I don't ever look at the race details, just the pictures from the course.  Gary immediately looked at the race details and came up with a plan - we would have to run 19 minute miles, plan our nutrition and we will make the cut-offs.

We went to Golden Gate Canyon several times to recon the course.  It was usually snowy and cold.  We both got busy with life and didn't train or recon to the level that we should have.

This race was a bitch. No if's and's or but's.  It was a bitch!  It was one of the most challenging days I can remember.

For training, I did several mountain runs, however none more than 15 miles. I raced some snowshoe races this winter but they were only 10K.  The bottom line....I was under-prepared.

We decided to opt for the early start as we were going to need the extra time.  There were 50 +/- of us that opted to suffer more than the rest of the crowd.  The weather forecast looked favorable for a great race (low of 40, high 65, no rain).  The sun was just starting to rise, the nervous energy was palpable.  Most of the early starters were first time ultra competitors.  The race director, Megan, called them SISU's.

From the website, "Sisu is a Finnish word that cannot be properly translated into the English language, but is loosely defined as stoic determination, bravery, guts, resilience, perseverance and hardiness, expressing the historic self-identified Finnish National Character.  Sisu is about taking action against the odds and displaying courage and resoluteness in the face of adversity. Deciding on a course of action and then sticking to that decision against repeated failures is Sisu."

I admit, I was a little jealous of the attention that was bestowed upon the newbies.  I knew I was going to suffer today.  The question, "Would I be able to overcome the challenges ahead (and display the qualities of Sisu)?" loomed large.

Go!

I started out in 4th place (for about 100 yards - lol).  Over the course of the day, all but a few would pass me en route to the finish (500+).  For me, this was not a race against the other racers, this was a race against the trail, the conditions, the clock and most importantly, my brain.  My goal was to finish before the course closed.

My race strategy was to power hike all of the uphills, try to run the flats and downhills.  Drink water every 10 minutes or so, try to eat every 30 minutes.  I had a smorgasbord of food in my pack.  I try to eat real food early to keep my stomach happy. Then later, gels, bars, anything that I can tolerate. Over the years, I learned to have a good nutrition plan but be flexible as I never know how my body will respond on any given day.

I also used hiking poles.  They help me with the uphills and more importantly take 20-30% of the weight on the downhills creating less jarring to my knees and hips.  It engages my core and helps with balance - especially in the technical portions.  I did a lot of training at Orange Theory Fitness the past 1.5 years.  This has taught me focus (on the dreaded treadmill and rower), has given me some serious core strength, raised my aerobic capacity and anaerobic threshold.

Back to the race....

The word that best describes the first half of race for me - HUBRIS - I was full of it.  I kept thinking that this is going to be easier than other races/events that I have done - Grand Canyon, Leadville Marathon, Skyline to the Sea, Snowshoe marathons, etc.  Time goals started to creep into my head. "If I can do Leadville Marathon in under 7 hours, this should be easy!"

We were flowing through some nice non-technical singletrack. There were some climbs but nothing too difficult.   I always go out too fast, I always go out to fast, I always go out too fast.  Maybe one day, I will figure this out.  Gary was hanging back. He is much more disciplined than I.  I would get to the aid stations first and regroup while he steady paces his way in.  Today, I didn't realize that he was struggling with cramping and calf pain.

At around mile 9 the trail turned into a crazy technical rock skree field (elevation ~9500').  No running here.  I wondered if there was going to be a lot more of this.  It was totally un-runnable - up or down. The trail started to humble me.  The terrain reminded me of the top sections of Mt. Grey's and Torrey's.  I have climbed several 14-ers and it has proved to be great training for this - both mentally and physically. I was extremely glad for the hiking poles here! We then descended into aid station 2.

We left aid station 2, 40 minutes ahead of schedule still feeling pretty good.  12 miles done - 1/3 of the way there.  The trail out of aid 2 started to climb.  It was steep and long.  The negative thoughts started creeping in.  I ate some food but my stomach wasn't feeling that great.  I was forcing food and drink down. It was almost 5 miles to the next aid station.  It was 5 miles to the next bathroom.  It became clear that I would need it.  There was a sign that said 1 in 100 ultra runners poop their pants.  I was determined not to be that one....Though at times, it was getting close!

The trail descended for 2 miles with a 1000 foot elevation loss into aid station 3.  When the trail goes downhill, I think that I am the king of the world.  The trail flows and time flies. The hubris crept back in.

Aid 3 is 17.4 miles in.  WELL over half way!  There was a volunteer with a sign that that made me laugh so hard, I had to take a picture with her.

I paid a visit to the outhouse to drop some weight.  Now all was well in my world.  Lower bowels were empty and I still had a spring in my step.  I had a drop bag to replenish my food.  I changed socks, wet my head and I was ready to tackle the second half of the race.  Unfortunately Gary dropped at this point. He was cramping really bad.  He didn't think he would make it to the cut off in time to continue on in his current physical state. He called it a good training day and dropped out. There were a lot of people dropping at this point.  Seeds were planted in my brain, though I didn't know it at the time.

The temperature was much hotter than the forecasted 60 degrees - I cursed at the weather man for giving me unrealistic expectations.  It was probably 80 degrees in the sun.  I exited aid station 3 to a grinding 2.5 mile (1200') climb.  I was starting to cramp.  I took several breaks along the way.  The flats and downhills now became shuffles instead of runs.  I was breaking down.  This section was 8 miles to the next aid station.  It was very technical.  I was alone for most of it.  There were a half dozen or so of us suffering, passing, resting, leapfrogging each other.  I felt my attitude plummeting faster than I could run downhill.

I got it into my mind that I would drop at the next aid station as I thought I would only have 50 minutes to make the cut-off from aid 4 to Windy Peak. - the last obstacle of the race.  I thought that distance was 5 miles.  I was now shuffe-walking - visualize Marty Feldman's Igor in "Young Frankenstien" (walk this way).  That was my running gate.

I arrived at Aid 4 (mile 25) and accepted my fate.  My hubris had turned to humiliation. I was defeated. I rationalized that 8 hours, 25 miles was still a good day. It had been a long time since I didn't finish a race - maybe I was due?  My cramping was fierce at this point. I was quite dehydrated.  I sat down in the shade.  I told them I didn't think I would make the 5 miles in 50 minutes.  They immediately started questioning my logic.  It was only 1 mile to the 3:00 cut off.  I had plenty of time.  Fuck, Fuck Fuck! I guess I didn't really have an excuse anymore.

This aid station was probably the best aid station in the history of aid stations.  I ate fresh fried pirogies, boiled sweet and white potatoes dipped in salt, avocados, chips, watermelon and popsicles. Yes - Pirogies and Popsicles how much better could life be!?!  I must have sat and ate for 15 minutes straight.  I accepted that I couldn't use the "I'm too slow excuse" and I was resigned to gut out the remainder of the race.  I refilled my water bladder and set out to finish.   I also took a lifeshotz vitamin boost.  It couldn't have come at a better time. I knew my wife Gina would be proud! I felt awesome!

The rest and food really energized me. My "Igor" gallop turned again into good running form and I was going as fast as I had a the beginning of the race.  I was back in the flow.  Again, I was pretty much alone as almost everyone in the race has passed me by now.... I knew that this rejuvenation wouldn't be long lived, but I would ride it out as long as I can.  I was at the cut off in 8 minutes as it was all downhill.

I turned into a steep downhill single track in the woods. there were several familiar faces coming up looking really tired.  Ominous warning.  I am cruising along and I start to feel something dripping down the back of my legs.  I thought, "Is it water or blood?" Thankfully it was water.  I must not have secured shut my water pouch.  I pulled it out of the pack and there were several hole in it.  Fuck, Fuck, FUCK!   How does this happen?  And what timing!!

 A random hiker offered to lend me her bladder, I politely declined.  The lowest holes were about 2" from the bottom of the bladder.  I could keep about 16 oz of water in the bladder.  I knew that wouldn't last long.  I still had 8 miles, and the hardest part of the course was looming large ahead of me.

The climb to Windy Peak was 2.5 miles and 1200'.  Alone, it wouldn't have been too difficult.  It was now mile 26, exposed in the hot sun and 8.5 hours of running thus far.  I was still able to run the flats and the short downhills.  The uphills started to become more technical and steep.  I was able to maintain with several breaks.  My legs were starting to cramp again.  I took some salt tablets and took a big pull from my water hose.  About 5 minutes later, the cramping got real.  I felt like I was on the edge of full tonic-clonic seizure.  I drank the remainder of my water.  I thought I was close to the top, but I was very wrong.  I took it easy, modified my gait to minimize the cramping.  I was in trouble.  I sat along the side of the trail and massaged my calves and thighs to to try to flush out some of the lactic acid.

I started asking other runners for water.  I had salt deposits all over my clothes, face and hat.  I was pale and my heart rate wouldn't come down.  The other runners let me take pulls off their water hoses.  One trail angel named Charles had a spare bottle in his pack that he gave to me.  This guy saved my race (and most likely, my life!)  I drank a good bit of it quickly, took more salt pills and marched forward.  I summited about 20 minutes later.  I took a picture at the top.  Sat down for a few minutes and drank the remainder of my water.

Top of Windy Peak Mile 28 - Cue the butterfly!

I heard the volunteers talking about me that I was out of water, not looking so good.  There was some chatter on their walkie talkies about sweeping the course.  However, the only way to safety would be to finish.  I needed to go about a mile downhill to get some more water.  I better get moving.  I didn't want to DNF at this point!

I was back to my "Igor shuffle".  All downhill from here (except for the uphills...).  I started to reflect on my life.  My mom is not doing well with her health and her situation weighed heavy on my at this section.  The emotions were strong at this point.  I decided to turn on some music.  Foo Fighters - "Times like These" started playing.  Couldn't have been more appropriate.

About half way down, four high school boys were coming up the trail  They asked me if I saw a guy with a white hat on.  They were bringing up water for him.  I wished it was for me, but I knew I could get water fairly soon and didn't want to take it away from someone who "really" needed it.  I told them somewhat sarcastically that there were hundreds of runners with white hats.  I had a tan hat on.  They kept going up, I kept going down.

I come up to aid 5.  One of the volunteers asked me if I got the water that they sent up for me?  Fuck, Fuck, FUCK!!!  I told her that I didn't think it was for me as the boys specifically said a guy in a white hat.  We both had a laugh.  I sat and drank water and tailwind electrolyte replacement.  2.6 miles to go.  I got up and headed for some more downhill.

I could hear the cheering at the finish line but I couldn't see it.  The last mile seemed like it took forever.  There was a prize for "last ass off the pass".  I was thinking that I had a good shot a winning some money.  I slowed my pace a bit to come in 5 minutes before the official cut off.  Turns out there were a handful of people still behind me.  No prize....

I finished with some people at the finish line but not the crowd I felt I deserved - lol.  Gary was there to support.  He guided me towards the food and we exchanged stories from the battles that were fought today.  Lot's of emotions.  As we were talking, I realized that I had to really had to dig deep to finish.  I was in awe that I finished.  It was a definite character builder!

Thank you Megan and all the volunteers on the course.  There were supporters dressed as clowns, sunflowers, I think I saw cookie monster, and a sadistic sexy police woman in fishnet stockings (she sent the water for me). The aid stations were well stocked with great food, supportive volunteers and great energy.  The views form the trail were absolutely spectacular and the pictures on the website don't do it justice.  A great time was had by all!

http://dirty30.org/golden-gate/course-info/

At the finish.  Full of salt!

I have to thank all those that support me along the way.  Especially my wife Gina, my kids and all my family and friends near and far.  I thought of so many of you on my run while in solitude for almost 11 hours today.  I feel blessed to have the life I have and the people in it.  Gary - always my partner in these crazy adventures.  You will get it next time. And John, you would have loved this race.

 My favorite quote from a sign today:

I am definitely a "special kind of idiot!"

I Try Not to Get Political - But....

"I Have a Dream" - the MLK Step at the Lincoln Memorial at sunrise

Once again, I was honored to have been chosen as part of a delegation to represent Colorado dentists and attend the Washington Leadership Conference put on by the American Dental Association. It is an opportunity for leaders in dentistry to meet with our national legislators to educate and advocate best practices and trends that we are seeing.  In a time of such flux with the delivery of healthcare, we offer perspective that hopefully will help shape health care and ensure that we can best serve our communities.

It was an interesting social and political time in the area.  A man named Freddie Gray was killed while in police custody shortly after being arrested.  Sadly, a much too common occurrence not just limited to Baltimore, but across the nation. The protests began peacefully but soon turned violent.

I was Baltimore to attend the Orioles game on Saturday evening. There was a palpable energy inside and around the stadium due to a strong police presence. At the game’s conclusion, the fans were not allowed to leave for their own safety until the riots had calmed.  

As time marched on, the riots continued. Buildings were damaged and looting ensued.  People were injured.  The National Guard was called in, and a curfew was instituted. CNN and Fox News were having a paparazzi feeding frenzy with a countdown to the mandated curfew. There were several more arrests and a public outcry….The entire situation was sad to witness.

Order was not restored quickly.  It wasn’t safe to be in the area.  The following day the Orioles game was cancelled.  Oddly, the next day’s game was played to an empty stadium.  Never before has a Major League baseball game been played in an empty stadium.

Pictures from the game which no one watched

Back in DC,  we dentists were meeting with our legislators.  Several of our legislators mentioned that they were invited to various “State”events (dinners, lunches, etc) with the President, who was hosting the Japanese Prime Minister. 

The Japanese Prime Minister (Shinzo Abe) must have been wondering about how this "free speech thingy" (1st Amendment) is working for us….I am sure that President Obama was thinking the same thing.  At a press conference to introduce the PM, POTUS took a few minutes to address the rioting. 

He recognized first that the rioters who were committing unlawful acts were not helping the situation.  They were no better than criminals and thugs taking advantage of an opportunity to be destructive. 

He then balanced his displeasure at the fact that some police officers/departments are not doing what is mandated that they do -"to protect and to serve”.  They too needed to reform and be held accountable.  

He continued to address the core issue with some of the most profound and inspiring words I ever heard him say.

"Without making any excuses for criminal activities that take place in these communities, what we also know is that if you have impoverished communities that have been stripped away of opportunity, where children are born into abject poverty, they’ve got parents often because of substance abuse problems or incarceration or lack of education themselves can’t do right by their kids, if it’s more likely that those kids end up in jail or dead that they go to college, in communities where there are no fathers who can provide guidance to the young men, communities where there’s no investment and manufacturing’s been stripped away and drugs have flooded the communitiy and the drug industry ends up being the primary employer for a whole lot of folks… In those environments, if we think that we’re just gonna send the police to do the dirty work of containing the problems that arise there without as a nation asking what we can do to change those communities, to help lift up those communities and give those kids opportunities, then we’re not going to solve this problem.

America, the land of opportunity - has no opportunities to thrive for some people. 

Without opportunity, there is no hope to dream. Frustration ensues and more riots are going to occur. 

We must return to our roots- the ideals that serve as our country’s foundation - life, liberty and the pursuit of happiness.  

We need to take back our freedom.

We must accept that to right the ship, there are no simple answers.

We all are going to need to sacrifice for the betterment of the whole.

The finger pointing needs to end now.  

We need to work together to figure out solutions that spur opportunities for everyone to contribute. Americans have always had the creativity combined with the spirit to make this happen.  

We need real solutions, not more riots…

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

Who is John Galt? How Corporate Dental Offices are Disrupting the Status Quo.

Who is John Galt?

Disruptors in Dentistry

By Brett Kessler, D.D.S., CDA President

"I started my life with a single absolute
That the world was mine to shape in the image of my highest values
And never to be given up to a lesser standard, no matter how long or hard the struggle" Ayn Rand, Atlas Shrugged

Disruptors are innovators.  They are businesses that shift a mindset of how consumers think, purchase, etc. – thereby challenging established businesses.

Harvard Business School professor and disruption guru Clayton Christensen says that a disruptor displaces an existing market, industry, or technology, and produces something new and more efficient and worthwhile. It is both destructive and creative.

Some examples of disruptors are companies like Apple, Netflix, Amazon, and Uber.

I identify Apple not for the computers that it builds, but for another niche that it took over – music and listening device sales.  iPods, iPhones and iTunes have changed how we buy and listen to music. There are hardly any CD stores remaining other than those that sell used discs.  When I grew up, I would buy records.  The cover art would attract me to give new bands a listen.  I judged the band by entire albums that it recorded.  Today, we buy songs, not albums. They are instantly downloaded onto our computers.  No waiting in lines; no browsing through tedious shelves of records/CD’s.

We create playlists with the drag of a mouse.  We use auto shuffle and the “genius” feature to create our own personal radio stations. They connect to our cars, our phones, our tablets and all are stored on our computers.  CD players are becoming a thing of the past.  Music is stored on hard drives, flash drives, iPods, etc.

Netflix took how we rent movies to a new level.  For a low monthly fee, we can have unlimited movies shipped to our house – hassle free – or immediately available to view on our computer or smart TV’s through an internet connection.  Blockbuster used to charge late fees, “you-didn’t-rewind-the-VHS” fees, etc.  I dreaded having to pay this fine. The buying experience was a hassle and expensive.  Netflix is easy, customized to my preferences and instant. Are there even any Blockbuster stores left?

Amazon capitalized on the fact that a book is still readable after it had been read, music is still listenable after it had been listened to, and anything should be able to be purchased on the internet easily!  They created a personalized buying experience based on your browsing and buying habits.  It greatly affected the big chain bookstores like Borders or Barnes & Noble.  It also helps you find the lowest price for a commodity and they deliver it right to your door.  If it wasn’t exactly what you were looking for, ship it back.  Hassle-free!

Lastly, Uber is putting a huge dent in the taxi business. With Uber, you can press a button on your phone app and a nice clean car will be at your location within 15 minutes. Taxi’s get to you when they get to you and the entire cab experience pretty much stinks!

All of these disruptors have innovated, streamlined and penetrated market share. They have challenged and even ruined wildly successful businesses, while reinventing the delivery of these services.  They have changed the consumer’s mindset and changed the paradigm on how these services should be purchased, used and consumed.  The consumer experience is exactly the way the consumer prefers.  We (the consumers) wouldn’t have it any other way.

Another commonality of these disruptors is that they didn’t just enter the marketplace and were welcomed with opened arms.  The status quo or “established” business model was not happy and tried to stop them.

In reality, the status quo was asleep at the wheel. They were lazy and arrogant. They felt they were too big to fail. Those established business models that survived disruption evolved their business models to better serve their consumers.

The question, “Who is John Galt?” comes to mind from Ayn Rand’s book “Atlas Shrugged.” John Galt represents creativeness and innovation.  In the book, the status quo was constantly putting up barriers to protect its own interests in how things always have been done.

The status quo must constantly channel its inner John Galt if it wishes to remain relevant to the people it serves.

There are disruptors popping up in every niche of business, and dentistry is definitely not immune. 

Large Group Practices, better known as Dental Support Organizations, are delivering dental services cheaper, quicker and more efficient than the typical private practice. A Dental Support Organization takes care of all of the business aspects for the dentist – the billing, HR, marketing, equipment, materials, etc. 

They are aggressively growing around the country.  They are aggressively hiring new dentists.  They are aggressively advertising their services.  They have created a niche for themselves and continue to attract patients.  Some may say that they haven’t perfected the consistent customer experience yet, but at some point, this too will change.

As in private practice there are good practitioners and those who could use a little nudge to “up their game.”  The reality with the Dental Support Organizations is that they are being judged by the lowest common denominator.  For every bad patient experience, the entire organization’s reputation takes a hit. If these companies are going to take their disruption to the next level, they need to shore up some of the weaker links in their organizations.  Trust me; they are aggressively evolving their internal practices to do just this. 

I recently attended a forum on Dental Support Organizations. DSO’s are growing 15-20% per year with over 7000 dentists employed, it was illustrated that the trend in healthcare is moving toward consolidation.  Consolidation breeds efficiency, in theory.  If you look around, there are very few privately owned pharmacies; there are very few private physician offices.  They have all been engulfed by corporate entities that manage the business side of the practices. Has it improved healthcare? I’ll leave that for the reader to decide. 

Many of us in private practice (the status quo) are complaining.  Of course, it’s only natural.  The realities are, however, if the private practitioners aren’t evolving their games, they will soon be wondering where their patients have gone. Maybe some of us already are!

Graduating dental students are being hired in droves by these practices.  I asked a recent graduate who was working for a Dental Support Organization what his favorite part was about working in this environment?  He answered that he has mentorship and professional networking instantly available to him.  He admitted he gives up some of his autonomy, but implied that no job is 100% perfect.  I would agree with that statement in private practice too.  There are parts of my day that I don’t look forward to doing (usually administrative) as well. 

Most of these dentists are not joining organized dentistry.  Why?  The most common response: they are made to feel “less than” for working for those companies. 

This must stop.  We (organized dentistry) are being judged by this fact, just as some may be judging those who work for entities different than private practice. The Colorado Dental Association is charged with advancing oral health in our state.  The DSO’s in Colorado are helping us achieve this.  They are just doing it differently than the “status quo”.

We need to be much better at welcoming our colleagues.  They are working the best that they can with the opportunities that are presented to them.  I always remind young dentists to keep the patient’s best interest as their main focus.  We have a must maintain our code of ethics as a profession.

The Association of Dental Support Organizations (www.theadso.org) has emerged to help set standards for it’s members and is looking to ensure that ethical practices are in place.

Evolution is the survival of the fittest.  Those who can adapt and create change will evolve into the new paradigm, and address the needs and desires of the consumers.

The status quo does not exist indefinitely.  It will constantly be challenged.

“Who is John Galt?”

Disclaimer: I am not passing judgment on these disruptors mentioned in this article.  I am justsharing my observations and thoughts.  I may or may not subscribe philosophically with various paradigm shifts occurring in the dental marketplace.  Each serves a niche that is attractive to various people.  That is why they are growing/gaining the market share and shifting the perceptions of the consumers. When I mention “organized dentistry” I mean ADA, state associations and its components.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK

TEDMED 2014

For the second year in a row, I attended the TEDMED conference.  TEDMED is a corner of the infinite TED universe specifically focused on innovation in health care. 

Innovation is much too small of a word to describe what TEDMED is.

They try to introduce it on their website (www.tedmed.com): "TEDMED is a global community dedicated to unlocking imagination in service of health and medicine. Our goal is to seed the innovations of today, making possible the breakthroughs of tomorrow...for a healthier, more vibrant humanity." 

But even this is incomplete.  One must experience it to understand.

To attend, one must go through an application process.  TEDMED is always searching for the proper mix of delegates that will be allow for stimulating networking and friendships to be made.  This year the event was hosted in two cities, Washington D.C. and San Francisco.  I chose the latter.

There were 80 presenters, 2000+ delegates, 80 start up companies from various sectors of health.  This year's theme was "Unlocking Imagination".

240 page conference program

The presentations were thought provoking and expertly delivered in the classic TED style.  If you have ever seen a TED "talk", you know where I am coming from.

They shared how they were improving the design of hospitals to improve both the health of the patients and the communities they serve by leaving no footprint.  One was looking at diseases in different ways - for example, What role does childhood trauma play in all future diseases?

They challenged our paradigms at every turn. For example, legalization and government compensation for the harvesting of organs to reduce black market activity while saving lives.

They inspired us with virtual reality games to reduce pain in patients.  They gave us a glimpse of a new plastic that amorphically changes shape via electric manipulation to be used in cardiac catheterization.

One speaker was collecting voice samples to "donate" to people (kids and adults) who cannot talk - thereby giving them a voice and a personality.

Several bioethicists asked an uncomfortable audience on how messages to the public about drug use should be altered drastically.  One asked, should doctors be totally transparent? While another shared courageously about physician assisted death or discussed the ethics of genome mapping to tell our future propensity to disease.

My favorite speaker was Abraham Vergehese.  He is the author of several books including NY Times bestseller "Cutting For Stone".  I had the opportunity to meet him afterwards and have him sign a book that I read in 1999 titled, "The Tennis Partner".  I told him how important that book was to me and charged me with the impetus to live each day to the fullest.

After sharing life stories for a bit, he signed my book with the last line from the narrative, "...Get the ball back over the net just one more time."  (never give up!).  He gave me a hug and told me that I made his day (how cool!?!?!?!).  http://abrahamverghese.com/

Abraham Verghese and I at TEDMED 2014

     

The "convention floor" is known as the hive.  The hive is always buzzing with activities.  The start up companies are all there on display with things to play with.  Of course, I had to go to the obligatory brainwave activity detector to verify that the old neurons are still sparking once in while.  And, like last year, contrary to most people's opinion, I do indeed have a brain that is functional....I will leave it at that.

Verifying that I do indeed have a brain.

The hive is where it all happened.  The space was designed very deliberately to maximize our experiences. There were several areas for lounging, networking, working, watching presentations, eating, etc.  There were speaker meet-ups where you can have very in depth conversations with the speaker and other curious fellow delegates.

Another area was called the campfire where they served gourmet smores and had a vast array of topics to talk about about current and future trends in health care.

The attendees were medical students, PhD. students, biomedical engineers, heads of various prominent medical school departments, angel investors, artists, employees of tech, medical devices and marketing firms.  I was "wowed"by practically everyone I met. I was humbled my the creativity and intelligence of my fellow delegates.  I was inspired for their zest and zeal to change the world from their specific niche.  I met people from all over the world - US, Israel, Canada, UK, Australia, South America, Hong Kong, etc.

I WAS THE ONLY DENTIST.....too bad....I would encourage some of my fellow colleagues, (especially the thought leaders) to consider coming in the future.  I wasn't lonely, but I was the only dentist!

The over arching theme:  No matter what new technology is becoming available to better treat the patient's physical maladies, nothing can help a patient's psyche more than a healthcare professional (Physician, Nurse, Dentist, etc) that genuinely cares and connects with his/her patients on a human level.

Thanks to all the TEDMED-er's involved in putting on such an amazing experience and allowing me to attend once again!

Peace.

If you like this blog post, I would love to hear about it.  Please comment or share it on Google+, Facebook, Linked in, Twitter, etc.  If you are looking for a dentist in the Denver area, we are always looking for new patients.  Please visit our website http://www.tcdodenver.com/ or like our facebook page,  https://www.facebook.com/TCDOdenver.  Or you can contact us  the old fashion way - call us at 303-321-4445.

Thanks for reading!  BK