Could subbing in multiple offices before starting your own be the key to clarity? In this episode, we're bringing on Dr. Lara Saleh, a seasoned dentist, to reveal some game-changing advice for aspiring practitioners. Lara shares her journey from working in various offices to finally opening her own practice, highlighting the invaluable lessons she learned along the way. She candidly discusses the protocols and strategies that have made her practice thrive, from managing financial challenges to implementing clear emergency protocols. This episode is packed with real-world insights that could make all the difference for anyone dreaming of establishing their own dental hub.
Lara delves into the critical importance of working in multiple dental environments before taking the plunge to start your own practice. Recognizing what works and what doesn’t has helped her shape a practice that not only meets her standards but also ensures patient safety and satisfaction. She pulls back the curtain on the must-have protocols and the potential pitfalls, including which stress-inducing sedation techniques to avoid and why hiring adaptable team members is crucial. With a focus on continual learning and adaptation, Lara's advice is both practical and inspiring for any dentist looking to elevate their career.
What You'll Learn in This Episode:
Tune in now to empower your career with Lara's expert advice!
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You can reach out to Dr. Lara Saleh here:
Website: https://drtoothfairy.com/
Email: lara@drtoothfairy.com
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Michael: Hey, Laura. So talk to us. What's one piece of advice you can give us this Monday morning?
Lara: my one piece of advice for anyone who is thinking about opening their own practice. is if it's possible to do what I did. And I think it's a wonderful start of a career. If you want to do private practice is to take some time off, but not completely off.
You'll be doing subbing or replacing doctors. Either because of an injury, or they go on maternity leave, or for any other reason, they just want to go on vacation, you just cover for them. So I did this exclusively for about 18 months before I opened my own practice, and that really opened my eyes to what I wanted to implement in my office, what were the non negotiable things that I wanted in my office, what I could compromise on, And the definite no no's. And I gained a lot of perspective by knowing what not to do in my office. And actually it set my priority list on what's really important and non negotiable all the way down to what's really a kind of forbidden to be done in my office. And that I do not want to go down that path.
And that was. The best thing that I did throughout my career, because when you work in one office for a long period of time, you're an associate, you get sucked into that office and the policies of that office. I think I covered about, 21 offices in the whole state of Virginia, where I worked, I just got to see so many things that I never thought I would implement in my own office, or I didn't think it would have been, a good idea.
But when I was there and practice in these offices, it turned out to be fantastic ideas that I would have never thought about had I not been in that situation in this office at that time.
Michael: After the 18 months, did you feel ready?
Were you like, okay, this is all I needed. I'm good to go on my own.
Lara: Absolutely. I felt I'm ready to do everything that I needed to do clinically to open a practice. But also there's not a lot of transparency when you're actually visiting an office. There's not like that huge door that they would open for you to look at their finances and to look at billing issues.
So that part, I just had to learn when I opened my own office because you learn it hands on, like the first time I saw an EUB is the first time I learned how to deal with an EUB. I've never seen one before until I opened my own office and that's how I learned it.
Michael: Yeah. Interesting. Okay. And then what were some of the non negotiables or the no nos that you mentioned?
Lara: most of it were protocols. That I did not want to implement those. Emergency protocols. really learned it the hard way in one of the offices you never think that it's going to happen to you, but it might happen to you.
And the worst thing is not to be prepared for it. So even subbing at those offices, I had it in my contract that I had to look at their emergency protocol before actually going into that office and making sure that. Their emergency kit is up to date and well stocked.
Michael: Gotcha. So emergency protocols and you immediately implemented that into your absolutely now.
Lara: Yes.
Michael: Okay. And then what were some things that you watched that you said, I would never want to do this. I thought I did, but I would never want to do this with my team or my practice. Yeah.
Lara: Honestly, oral sedations. my training program was very heavy on oral sedation. some of the practices wanted me to do.
To sedation at a time and then sedation fell out of favor, but some offices still were heavily sedating kids some of the offices would advise you to use their protocol, which might be something that you're not trained to use, like Demerol. I was not trained to use Demerol.
they had good record with Demerol. my stress level was much higher with sedations. And I knew that right there. And then when I wanted to open my own office, keep in mind that I opened my office after 10 years of practicing. So I've had a lot of experience experience and I saw a lot of things and I was okay doing sedation the way I learned how to do it.
But once I started seeing how these sedations are and how little control you have after the sedation for monitoring, I decided that is something that I do not want to do in my office.
Michael: So do you get a lot of parents who ask?
Lara: Actually some parents don't really know the difference between nitrous, mild sedation, moderate and deep sedation.
So there's a lot of people who don't know, so kind educating them. And I do refer some cases to other providers who do them. It's just I learned to be true to my comfort level and to listen to myself. If I'm not 100 percent comfortable with a procedure, I'm not doing it. And I learned that from, age and just stress levels.
I don't want to be stressed for the rest of the day or for two days after my sedation.
Michael: you ever feel Laura, like the ones that you feel super stressed or not comfortable, do you think okay, you know what, I'm gonna get there. I want to get there. I'm going to get some training. Or you're just like, Nope, that's just not how my practice runs.
That's not how we are.
Lara: After 10 years, I kind of learned, what really stresses me out. I just want to avoid it. let's say it's an advancement in pediatric dentistry, I definitely want to learn about it. So if it's something that we were not heavy on in my residency, I would want to learn about it.
But sedation, I had, a lot of training on it. And we were super competent doing sedations. We did this every morning in our residency. So every morning we started with a sedation three days a week. So we're super, super comfortable doing the sedation. It's just my stress level was high after doing them that I decided I do not want this chronic stress, even if it's not super high stress, chronic low stress, I feel is very detrimental for your health, your mental health, your physical health, and for everybody around you.
Michael: Yeah, no, a thousand percent. So then You worked at 21, that's a lot, 21
Lara: Sometimes it was just an afternoon.
So it still counts, but it was just an afternoon. But it was quick in and out. It would be an emergency. They'll call me and can you come in this afternoon and I'll show up for the afternoon.
Michael: Yeah. Interesting. Okay. So the 21 offices that you worked at, which were the things that you saw when it came to systems that they implemented?
Were a good idea or were not a good idea, but it turned out to be fantastic to you in your eyes.
Lara: Some of the systems that I thought were a great idea are system implemented by someone on site. There was that office manager that she ran this office.
lovingly being respectful to everybody and in an emergency situation, you have the team leader, you have everybody knowing their roles, things just fell into place. And the day went by so well. Another thing is an office manager that was super tight with the owner, I feel like everybody liked that nonchalant, but nobody knew what they were doing. So instead of doing your job, a hundred percent, everybody was getting by, by doing 50 percent and people just getting confused, who does what and when should it be done? So I feel like these kind of situation I wanted to avoid.
Michael: All the confusion and everything like that. So be more specific.
Lara: Yeah. having like a role for everybody and a very well defined role. So these are your responsibility. And it's kind of hard sometimes when you're a startup, cause you really don't, know everything.
And then you start making lists. And that's what I did. I started making lists and start as I go adding on to these lists of responsibilities, but it's so well defined that people have their boundaries and also like, this is what's expected of you and.
this is the outcome that I want. So you can do everything that is expected of you, but not have the outcome that you want. That means maybe you didn't give them enough training on it, there's something that needs to be fixed within those boundaries that you've set.
Michael: I like that. So then whenever you're making this list and you add new technology, new practice management software or something. Do you put it on there like, I expect you guys to get it, to know it, or do they sometimes say like, I don't like this practice management software, it's not working with us,
Lara: some people express this pleasure with some things. It's just cause you're adding things on their plate. But I was very clear that I am learning with them. So as I learn more things, they need to keep up with me. And that's how we're a team. If I'm just learning, that means everything is falling on me.
That's not teamwork. So as I learn and every CE that I go, I try to take at least one or two people with me, even though it will not be super beneficial for the dental assistant to come to a trauma. for me, it's just keeping that teamwork. If I learn something, I want them to learn with me.
If I evolve, I want them to evolve with me. And that's how I think the best thing for a team is to evolve together. So we have actually blocked time on our schedule when you're a startup, you have a lot of time, but I do block time for us to go through pediatric dentistry articles and I have also blocked time to go through our software.
everybody needs to know how to schedule an appointment, how to cancel an appointment, how to collect payment. Everyone in the office, no matter what their role is, everybody needs bare minimum. And then with our current software, we have a lot of evolution in it. And requests, so they keep adding stuff to the software and we block time to actually go through every additional feature, whether we use it or not, it's going to be determined later, but we all go through it together.
Michael: I like that. And then the software you guys use is what right now
Lara: is Oryx cloud based.
Michael: Gotcha. Is there a reason why you guys went with cloud based?
Lara: I think this is the future of everything having your software, your radiographs, everything in the palm of your hand, anywhere you go was just a non brainer for us and not having a server and depending on backing up those servers was just I feel like it's a dinosaur age to have anything that is not completely cloud based.
Michael: Okay. I like that. So then any final pieces of advice that you would like to give to our listeners?
Lara: If you're thinking about opening your own practice. Open it with the mindset of the future.
if you're going to hire somebody, hire them thinking that they need to be open to all the newer technologies that you want to implement. Do not hire someone who's so attached to their previous, say software, or do not hire someone who's attached to their previous practices who are not open to learning new things.
Most of my hires have no dental experience. And it worked out great for me.
Michael: Wow. That's fantastic. If anyone had any questions or concerns, where can they reach out to you?
Lara: They can reach out to me at my first name, Laura at Dr. Tooth Fairy, which is the name of my practice. Laura at drtoothfairy. com.
Michael: Nice.
Awesome. Laura, thank you so much for being with us. We appreciate it. And thank you for being with me on this Monday morning episode.
Lara: Thank you for having me.