"Demanding Our Place in the Healthcare Delivery System" with Dr. Brett Kessler, ADA President-Elect

🎉 We're back! Season 5 of Kinda Different is here!  And who better to kick us off than the President-Elect of the American Dental Association, Dr. Brett Kessler. Listen in to their wide-ranging conversation to get Dr. Kessler's perspective on where the ADA is focused in the coming year (and years) - and how you can help shape the journey!

Listen on Apple/Spotify, or watch or read below:

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You can get in touch with Dr. Kessler here:Email: kesslerb@ada.org

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Transcript:

What's up, everyone? Welcome back, not just to a new episode of Kinda Different, but a new season of Kinda Different. This is season five, which is crazy.
Back when I started this podcast, it was like, hey, I just don't want to write blogs and stare at my computer anymore. I want to talk with people. And here we are five seasons later with some amazing guests.
And absolutely this season is gonna be no exception. And we are kicking it off today with someone super special. Before I introduce him, let me tell you who I am.
I'm Dr. Matt Allen, the CEO and co-founder of DifferentKind. And as always, your host for Kinda Different. And I am thrilled today to have somebody that I've known for a really long time, Dr. Brett Kessler, who was actually a dental school teacher of mine back when I was at CU Dental.
He was there and helping me learn how to be a dentist back when I was the baby dentist. Now he is obviously still a dentist, but he is also and probably known to you, you know, as the president-elect of the ADA. So a really important role and something that I'm super excited for him to chat with us about today in terms of where he sees dentistry going and how the ADA is going to be involved in some of that and how he's going to be involved in leading that.
So Brett, thank you so much for taking the time to join us today on this season premiere of Season 5 of Kinda Different. Tell us a little bit more about yourself and then we'll dive into some questions.
Hey, Matt. Great to be here. It's awesome that this is your fifth year of podcasting.
That's quite a feat. Most people do it five or six times and they fizzle out, but you're the Energizer Bunny. I love it.
We keep pushing it. I love that. Thank you for the intro and thanks for inviting me.
I taught Matt when he was a freshman and a dental student in D1. I was his morphology and occlusion instructor. It's amazing how our paths have taken us to just wild places that are in dentistry and surrounding dentistry and pushing the profession forward.
It's really cool.
It's been a long time since then, right? Who would have guessed back then that we would both be here today, right?
No doubt. So anyway, I'm a general dentist. I live here in Denver, Colorado.
I had my own private practice for about 15 years in the northeast part of Denver. I sold it in 2018 with the intent of that was a year I was going to be going to be a board of trustees for the American Dental Association. And I work with a friend of mine, another former student of mine, in the south part of Denver.
And I don't work clinically all that much right now because of my role as president-elect. And in fact, I am working tomorrow. It's been about a month since I have spun the handpiece.
Please say a prayer for my patients. But I truly value, I love being a dentist and I value the work that we do and the impact we can make on our patients. And all the years I've been practicing, I'm 29 years now.
The best, most special thing about it all is the relationships that we have. And I hold that to be sacred. So, yeah.
Awesome, man. Well, certainly let's dive in. I think you're gonna have a really interesting perspective.
And certainly the reason we've been doing this show for five years is I think that there is a really important message of being human in this place and how do we do that well and how do we connect with people and build those relationships like you just mentioned. So I'm really excited to get your take on some of the things that we talk about here. So let's start with innovation.
Obviously, I'm guessing you have a lot planned for the coming year and you're a full presidency in the ADA. Tell us what you're most excited about to be working on now and kind of continue to work on in the coming year. Like, what's the thing that you're just like, man, if I can do this, that's going to have a really big impact.
Yeah, so that's a great question. There's so many things that we're involved in right now, and the ADA is morphing day by day. We are changing.
And I feel that the ADA is the biggest lever in driving the profession forward. And I'm a very forward thinking leader. And I want to make dentistry the best it can possibly be, not only for today, but for 20 years from now.
And to do that, we need to have a future focused mindset with things. And one of the things I'm working on, and this is something that's been on everybody's, every practicing dentist's mind, every hour of every day they practice, is the dental benefit world. And, you know, in the private dental benefit world, it's just not working anymore for the practicing dentists.
You know, we haven't really gotten any traction. You know, we've done some things legislatively all around the country, including national, but, you know, it's still, you know, we look at our workforce issues right now. It's really hard to hire people, but I really think that's due to the fact that, you know, the free market is starting to play out in supply and demand.
Let's look at hygiene, for example. You know, there are not enough hygienists in the market right now, and therefore, they're driving up their salary. You know, just, but in a pure supply and demand, we'd be able to, you know, afford to do that.
But we've got an artificial ceiling based on the reimbursements we get from the dental benefit plan. So we're looking to, you know, I'm not saying blow it up, but, you know, let's look at it from a different paradigm. You know, oral health is health.
There's no question about that. I did a general practice residency after dental school, and I'll never forget, I was taking some teeth out on a patient who had bacterial endocarditis. One of the teeth had, when I took it out, a bunch of pus came out with it.
My attending quickly said, you know, culture that. And so I did, and it was the exact same bacteria that was around the vegetation on the heart valve. And that, to me, that day solidified oral health as health, and I practiced that way my entire career.
And if oral health truly is health, we know, you know, there's so much research. It's compelling, it's robust, that if we can improve the oral health, the status of the oral health, it will improve the status of the overall health of our patients. And so the benefit model that we have, let's look at, if I had degenerative joint disease in my hip, if, it doesn't matter if I'm male, female, young, old, rich, poor, black, white, in shape, out of shape, I can get a titanium post placed right here in my hip.
But I can't get a titanium post placed here in my mouth. And we've accepted that for all these years. And, you know, I'm not accepting that anymore.
Why is medicine allowed to offer the absolute finest care they have to their patients, no matter what their demographic is, yet we're not allowed to do the same? I'm not saying walking is more or less important than chewing, but it's not more or less important than chewing. And so it's time for us to do that.
And if we translated our dental benefit model to the medical model, if I had degenerative joint disease, we'd give you crutches, because that's what a flipper is. It's a crutch. It has no functionality whatsoever.
It gets you around. And so we've accepted that. So it's time for us to change.
And start demanding our place in the healthcare delivery system. And so we got all sorts of things going on there. This past year, we, the ADA and the Forsyth Institute merged.
And the Forsyth Institute is one of the world's premier oral health research facilities. And combining our two brands has made us truly a, given us this true opportunity to change things. And our goal at Forsyth is to take research from the bench to the chair side as quickly as possible, according to the standards for those things.
And so we are pushing the envelope. And there was an article in the USA Today or Yahoo News. It was a bunch of places a couple of weeks ago about a Forsyth company that, you know, was a total robotic dental experience where a robot delivered a crown.
No human interaction except for the patient, you know. And it, you know, that is the future. OK, I'm not saying, you know, that's going to happen tomorrow, but 10, 20 years from now, we're going to be able to utilize technology such as that, and it's going to be a regular part of our practice.
You know, I mentioned I practiced 29 years. When I first started practicing, there was no digital radiographs. There was no intraoral cameras.
And, you know, now we can't live without them. And so, you know, the practice of dentistry 20 years from now will be much different than the practice of dentistry is today. And we've got a chance to write that narrative.
And we're fully in on that.
I love it. You mentioned, you know, this idea of how that impacts the patient, right? In terms of, you know, hey, if it were, you know, I love the analogy of, you know, if the medical model were applied to dentistry, those patients would be walking around on crutches.
What role do you see patients as having in that as well? because I think obviously, like, the ADA is having a big role, not you're having a big role and kind of advocating for that and saying, hey, this is not working for people. How are patients involved in that as well?
because I think more and more in any of these big systemic changes, we've seen increasing patient voice and increasing, like, hey, this isn't working for me either, right? As a patient, how do you see patients involved in some of the innovation? It could be what you're talking about here in terms of dental benefit changes, but also just patients in general, how can they be best involved in innovation from your perspective?
There is a political aspect to health care, and the practice of dentistry could change with one swoop of the pen. It could happen locally in our state of Colorado, or it could happen nationally in Washington, DC. And the best way for things to progress is from the patient side.
Consumer advocate groups are the ones that will drive this forward while we direct the narrative on what's possible. because they don't know what's possible. They just know, I mean, I practice mostly fee-for-service most of my career.
So patients would actually pay money out of their pocket to have the dentistry done. No insurance and conferences whatsoever. So with that, but everyone had insurance though, but yet they still paid out of pocket.
But everyone complained about this model sucks. Dental insurance doesn't do anything. And we can create a critical mass narrative to change that.
And we need to do that to solidify our role in the healthcare delivery system. because oral health is health. And so we will be utilizing consumer advocate groups, demographic advocate groups to do that.
So that's pretty exciting.
That's a really interesting metaphor, I think, there, in terms of almost kind of talking about like the dentist is the guide, right? because yeah, we know, hey, this is possible and here's what could happen, right? But then you need the voices to come in and actually provide.
You know, that's how I kind of like that analogy of kind of guide and, you know, traveler on the road, right, if you will. So that's really...
And it is a bipartisan issue, but different, you know, the Democrats and the Republicans will have different strategies and make that happen. And so we have strategies in place on both sides, depending on especially what happens this November in our election.
So for sure, interesting time for you, right? Healthcare is political and certainly we're in a very interesting political time right now. And so that's how your presidency looks.
You're not quite sure, right? You're at this interesting time, so.
But I think if we, at the ADA, if we focus on the profession and focus on the best delivery, the best possible care to our patients, dentistry can't lose, okay? Another thing that has to happen is, my parents' generation, the baby boomers, have a ton of dentistry in their mouth to maintain. And most of our practice profit centers are based in that realm.
Okay, my generation has much less dentistry in my mouth. Your generation has much less dentistry in your mouth. And so, while I'm not saying Carey's management isn't going to be necessary, but the volume of Carey's management is going to be much, much less in 20 years.
And so, we, you know, our payment model right now is we must spin our drill or scrape teeth in order to get paid. And we have to shift our, and I hate to be so simplistic about that, but, you know, but we need to shift our business model from a surgical-based model to a management of chronic disease-based model, like internal medicine, preventative things. You know, we, and we need to get paid for the conversations we have with our patients and, you know, be paid for the ability to do genetic testing, bacterial testing, A1C testing, vaccines, SDF.
You know, these are the kind of things that 20 years from now will be the mainstay in our practices. There will always be a need for caries management, always be a need for periodontal management. Absolutely, but not to the level that we're at right now.
Yeah. Awesome, man. Well, I'm sure some of this will come back around as we talk about making, you know, dental care more human.
But I want to dive in, you know, into your story for a minute here. And obviously, you have a very beautiful story and have told it in lots of different ways. And if you're not familiar with Brett's story, I would encourage you to go check out, you know, a number of the podcasts that you've been on that are out there.
YouTube videos, you know, you have a very compelling narrative to your life and the things that you've learned and been able to, you know, kind of teach back, I would say, to the profession very well. So given that narrative, though, you know, but you've done a lot in your life, right? Like, you're also not defined by any one of those things.
What is the thing that, like, when you look at what you've done over the course of your life, right? Like, and you're about to become, you know, the ADA president, right? You're the president-elect.
What are you most proud of? Like, what are you most proud of that you're just like, man, this, I never would have imagined that this would have, you know, happened to me or-
Yeah. Thank you, Matt. So for those that don't know my story, I'm a recovering drug addict and alcoholic.
And I got sober in 1998, and I got sober through the Michigan Dental Association Wellbeing Program. I made a call to them. They directed me to help, and I attribute that phone call to the beginning of my recovery.
And also, I attribute that phone call to ultimately what saved my life, because I was not going down a good path, and I'm sure I would be dead by now if I was still on that path. But getting sober, I had to do a lot of personal work to manage my disease of addiction. And that personal work also gave me an inspiration to live my best life possible.
And every day, I try and do that. And so what am I most proud of is that sobriety date, October 21st, 1998. And because without that, I have nothing.
And so it gave me the, because I should be dead. I feel that way. I'm on bonus time.
So anything I do, if I screw up, whatever, I could be dead. I should be dead. And so it's like I live maximally every day.
So that I created a dental practice from scratch. That was fee for service that focused on the relationship with the patient. You know, I got into leadership just because I was pretty outspoken about my recovery.
And but they saw other leadership skills and attributes in me that were pretty darn good. And they encouraged me to, my mentors encouraged me to nurture those and go for things. And I can make a real impact on the world if I continue along these paths.
And so I'm grateful for all the mentors along the way that saw things in me that I didn't see in myself. And I really believe anything is possible. And it came from the genesis date of October 21st, 1998.
I've done a thousand things that I'm most proud of. I've done a thousand things that I'm not so proud of since then. That's part of my humanness, you know.
But it gave me, honestly, it gave me a real empathy for how I care for my patients. And, you know, I can blow up the model of what's possible. Well, if you're going to start a practice, you better be on all these plans and you better get as, you know, 90 patients a month and, you know, and I didn't do that.
And everyone told me I was crazy. It's not a good neighborhood back when I started my practice in this part of Denver. You know, and, you know, I think if you have a solid vision for what you want to do and a real diligence and dedication to that vision, anything can happen.
And I broke the model of doing that because I did have a practice that was fully free for service. And, you know, when they said I couldn't, I could.
And it was all great at that point.
Yeah, exactly.
You're about to meet a gajillion dentists, right, over the course of the next year and certainly in your role. And I'm guessing you've met a gajillion dentists already over the last year in your role. What, you know, like I think a lot of us, when we think about, you know, the kind of leadership roles in these organizations, it's like, hey, what are you going to do for me, right?
Like, even in our current political environment, you know, it's like, well, what is this person going to do for me? Are they going to lower my taxes? Are they going to, you know, whatever it is, right?
And that's great. Like, it's important to think of what our leaders are going to accomplish, right, on behalf of the people who elected them. Yes, of course.
But also, I think, like, we want to know who our leaders are. So, you know, help us understand, like, what are, like, you know, a couple of values that, like, hey, this is who Brett is. This is, like, the things that I hold most dear.
And regardless of whether or not I'm accomplishing that thing that I said I would do or didn't do, or whatever, this is who I'm always gonna be. Like, share with us some of those values so that we can, you know, kind of understand who you are more as a person.
Okay, great question. Haven't been asked that in a long time. That's a good one.
Back when I first got sober in my first year of sobriety, I read a book by Stephen Covey called Seven Habits of Highly Effective People. And, you know, and I was trying to reinvent myself as a new person at the time, but really I was trying to find myself and reinvent myself as a sober person. And so there are exercises in that book about, you know, developing or identifying what your core values are and identifying a vision and a mission statement.
And, you know, so my core values, the first one is courage. because I can say, you know, people could say, well, honesty is my core core value. But if you don't have the courage to act honestly, it's not a core value.
So courage is most important. Family is the second on my list. Integrity, you know, do the right thing.
Humanity. And I look at that as what can I contribute to the world? And so those are my core values.
And then I try and those are and I look at core values. So on my desk at the ADA building, I have a little compass that someone gifted to me. And that compass is a reminder of my core values, that they are my moral compass.
And, you know, and when you're traveling, you know, the ship or the plane isn't going to go straight all the time. And same thing with our path in life. It's not going to go straight all the time.
And but I identify those and I'm reminded of those always. And so when I do start to veer away, I have to get back on course. And I really do my best to live intentionally along those lines.
I love that, man. And certainly, yeah, that analogy, right, I think I'll talk about that often, you know, with friends and whatnot, where especially in relationships, right? Like, we all make mistakes and relationships are messy, right?
But, you know, that's what counseling is for, and that's what therapy is for. Like, all those good things of, they just kind of help us bring us back to, you know, True North, right? And, you know, if we only come back to that compass, you know, once every 10 years, like, you can get pretty far off course, and it could be impossible to get back to where you started, right?
But you're consistently coming back to that kind of True North. And so I love that analogy and just that reminder of, hey, this is a daily journey to come back to True North and, you know, choose those things today that are most important to us.
Yeah. And from that book, you know, Seven Habits of Highly Effective People. You know, we all want to be highly effective, you know, so I don't have to reinvent the wheel.
I could do what other people have done successfully. And that's how I model things. And, you know, I'm blazing trails that I never thought I would blaze.
But I don't have to reinvent the wheel on how to travel that way. And so, you know, that books like that are so important. And anyone who's wondering or they're a little lost right now, pick up that book and then don't just read it, but do what it says and you got nothing to lose.
If you're floundering now, you know, try something new. Might just work.
100%. I love that. Okay.
Well, let's talk about making dental care more human in our final section here. And I love the transition that you just mentioned in terms of, you know, this kind of core value of humanity, meaning like, hey, we want to like produce good in the world and, you know, see thriving. And, you know, I actually think this is a really interesting question.
I think you have a really interesting, probably, you know, perspective to share on this given your role. What is dentistry's role in producing social good? Like what, like, how do we do that?
And what, like, what is our role there? I think sometimes dentists, you know, kind of pigeonhole themselves, right? Like, or people pigeonhole dentists and being like, you're just a dentist, right?
And you're like, no, oral health is health. But then sometimes dentists pigeonhole themselves by being like, I don't want a part of any of this legislation that, like, you know, would include me in health care, because it's like we're dentistry and we're different, you know, and you're like, we can't have it both ways. So I don't know, just give me your perspective here.
Like, what is dentistry's role in producing the social bit and the humanity that you just kind of mentioned?
I absolutely love the relationships I've had with my patients and the impact I've made on their lives. So whether that be removing infection or inflammation out of their mouths, whether it's restoring their ability to function. Okay, there's no way you can get good nutrition without a functioning set of teeth or restoring their smile.
Okay, especially in the recovery world. You know, I treated a lot of people who are in recovery from substance abuse issues and a lot of them had pretty damaged teeth and although they were sober, the scars of their addiction were still on their face. And so I had the ability to change their lives by just restoring their smile, their ability to face the world.
And so dentistry has a big impact. But then the research kind of correlates all these other things. The level of inflammation in your mouth can lead to, if it's really high, it could lead to an uncontrolled diabetic issue and that will shorten your life.
Okay, dentists get to screen for sleep apnea. Okay, an airway issue will take 11 years off someone's life. So, I mean, it's an integrated part of health.
You know, when you look at delivery of dentistry in the future, look at AI. Okay, we're going back to humanity here and I'm going to bring in AI. Of course.
Okay, and so what if, you know, right now AI is really, really moving in the, you know, let's read, you know, diagnose radiographs better, okay? But what if we can produce an AI system that turns out to be the most kick-ass personal assistant that you can ever imagine? You know, as I'm walking into my patient room, I've got an air phone and the AI system is telling me, Mrs. Jones saw you six months ago.
You did two fillings on them. One of the fillings was sensitive. She came in twice for an adjustment and we haven't heard from her since, so make sure you ask her about that.
Mrs. Jones and her three kids went to Disney World over Christmas and, you know, see how that's going. And so, you walk in and I write all these things in my chart for review, but I have to go find my chart and find my notes. And so, it's instantly going in there.
And as I'm having a conversation with this patient, AI is recording the conversation for the next chart note and allowing me to focus wholly and be present fully with this person I'm with. And I can tell you that burnout in dentistry is a big deal. A lot of that is just the paperwork and administrative burden that we have to deal with.
We just want to be with our patients to do the best darn job we can possibly do to improve their lives. That's what we do. And so, we can use technology to do that.
And that's, I know it kinda went on a tangent, but... I love it.
It's great. It's great, man. Well, I just saw it yesterday.
I mean, we both live in Colorado. I just saw that Kaiser here in Colorado just signed a deal with The Bridge, which is a startup that does no taking, but actually gives it to the doctors, but also back to the patients. And it helps do that in their language, and understand all the things, the technical words that might be said or whatever.
So 100 percent, my vision, as we've started DifferentKind is like, hey, yes, we're going to use technology. We should. But it's always with the end goal of not technology for technology's sake.
I think it's always the end goal of like technology serving as the platform.
To improve the humanity.
To improve the humanity, exactly.
Yeah. And look at us, like 20, 25 years ago, when you were back in school, I mean, we would never be doing this on computer. It wasn't even part, it wasn't even in the schools yet.
You still had the big textbooks and things. I mean, it's just like the technology has brought us together in a meaningful way to have these meaningful conversations. And whoever's listening out there in podcast world now has heard something they would not have heard, if not for the improvement of technology.
There you go. Well, I got one more question for you. We named our company DifferentKind for a reason, for a couple of reasons.
Number one, we saw a lot of dentists out there saying like, we're a different kind of dentist. And you're like, what does that mean? I think we can actually produce that different kind of dentistry if we can help people achieve what we want them to do with our data.
But secondly, it was like this idea of kindness, right? And so my question for you, just as we close up here, is how are you making dentistry different? And how are you making it kinder?
You know, the way I practiced was different. Less than 5% of the practicing dentists practice the way that I did with the fee-for-service model. But every practitioner brings their own view of the world and philosophy of how they want to treat their patients and their practice philosophies and stuff like that.
It's very unique to them. And, you know, I think I pretty much described my practice philosophy as, you know, patients were the center of our universe. And, you know, and I developed a team that would, you know, that supported that as well.
And they were really integrated and invested in, you know, that this is not just a set of teeth in my office. This is a whole person who happens to have teeth or not have teeth that wants teeth. And we treat them as such.
I'm in a higher-paced office now with, like I said, one of my former dental students, Ryan Mickel, down in, you know, Centennial and Landmark area. And, you know, and it's a higher-paced practice. We are on some PPOs and, you know, people ask me, well, you, your fee-for-service, you can spend all that time with your patients and stuff like that.
Like, no, anyone could do that, you know. Every hygiene check, if you want to really get to know your patients, you know, you can sit them up if you're meeting them for the first time, look them right in the eye like we are right now, and ask them, hey, what are your goals for your teeth? And they'll be like, what do you mean?
I just want them clean. No, I mean, what are your goals? Like 10 years from now, do you still want to have your teeth?
You want a better smile? You want them whiter? You know, those kind of things.
And a lot of people will say they'll start listing off things they want to do. How important is that to you? And, you know, and the hygienist is saying, come on, we got to go, we got to go.
And I'll tell the patient, you know, I have to see another patient right now. Can I reappoint you where we can have a deeper conversation about what your goals are and to see if I can help you achieve those? And, you know, why are we not doing that as a regular part of our business?
You know, because that turned from maybe, well, I saw a little, you know, by doing the hygiene check, just looking at the teeth and not looking at the patient, you know, you may see a little margin that's opening up on a filling. You may do the filling or it couldn't, or in what I just described in that scenario, it might turn into a full aesthetic case. You know, if you take the time to do that, invest in the relationship, invest in, you know, really getting to know your patients.
It's an amazing career. I've had an amazing career as a result. And I want everyone to have an amazing career with whatever that looks like.
And that's why I'm in the role I'm in.
That's awesome, man. Well, I'm excited for you to, you know, knowing you and knowing, you know, just having been adjacent to you in lots of ways, you know, here in Colorado over the past number of years, I'm super excited for what you're going to accomplish and what that's going to mean for the profession. So grateful to you as well for leading that charge because I know it is not, you know, sit back on the couch and take it easy.
You're going to be busy. You're going to have a lot of people who are, you know, frustrated and it's just part of the role, right? Of, you know, I was just at a DSO meeting and Linda Edgar was there, the current ADA president, and there were some unhappy people, right?
And, you know, she was, it was tough. And so I know that it's hard to stand in that space and be an advocate in the way that you're going to be. So just grateful to you.
Thank you so much. If people do want to reach out to you, if they want to get in touch with you, you know, how do they do that? You know, what's the best way to talk to Brett if they want to?
Sure. So my personal email is bikodds.gmail.com, or my ADA email is kesslerb, k-e-s-s-l-e-r-b at ada.org. It's the best way to get me.
Perfect. Well, thank you so much, Brett. I really appreciate you taking time to kick us off here on season 5 of Kinda Different.
I know we could have much deeper conversations and maybe we will, maybe we'll just bring you back and have like a full other conversation about some of this other stuff. I got like plenty more questions, but I really appreciate you taking time today, man, and excited for what you're going to accomplish over the next year.
Great. Great seeing you. Thank you for inviting me and look forward to walking this path together this next year and a half.
Right on, man. Right on.
Awesome. Thanks.

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