"Sharing the Load, Finding Your Own Path, and Everyone Knows Everything" with Dr. Joshua Bronner

🌷 Like a beautiful spring tulip, Episode 8 of Season 2 of Kinda Different has bloomed

!In this episode, Matt chats with Dr. Joshua Bronner, director of clinical compliance at Select Dental Management. They discuss how compliance impacts patient experience, including involving the whole team in compliance work and ensuring that everyone in the office is fully aware of the entire patient journey.  

Check out the entire episode on Apple Podcasts or Spotify, or watch and listen below. A lightly edited transcript appears below as well.

You can find Josh and Select Dental Management at the following places:
LinkedIn: https://www.linkedin.com/in/joshua-br...
‍Website: https://selectdentalmanagement.com/

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Transcript

Matt Allen:
What's up everyone. Welcome back to another episode of Kinda Different, a podcast where we talk about innovation and dentistry. We connect with some absolutely amazing guests and today is no exception there. And we talk about how we can all together make dental care more human. I'm Matt Allen, CEO and co-founder of DifferentKind and your host. And today we are super excited to dive into a topic that I don't think most people think about when the idea of making dental care or making healthcare more human comes up. But I think it's really important. And so Dr. Josh Bronner is with us today, the Director of Clinical Compliance at Select Dental Management. And he's gonna share with us some things on compliance and what that looks like from a clinical perspective and how that can actually really impact the patient experience and what that means for how we can make dental care more human together and why. that can also be innovative, which I think, you know, some people might think that's a box checking exercise, but Josh is gonna tell us how we can actually really innovate in that space. And so, Josh, thank you so much for taking the time to join us today. I would love to just start with you introducing yourself and telling our listeners a little bit about you.

Joshua Bronner:
Sure, Matt, thanks so much for having me. Great to be here. Let's see, where to start. I've been practicing for about eight years now. Graduated from NYU, did a general practice residency with Northwell Health out on Long Island. Ran around a couple of offices, you know, in the city, Brooklyn and Long Island, and it was... Definitely a grind and certainly overworked myself. And an opportunity came up to get in with a new group where lots of clinical stuff was in alignment, lots of ethical stuff was in alignment. So we rolled the dice, moved up to Saratoga Springs to select dental management's first office and things got going really well from the start. And about a year later, COVID hit, obviously. And things were kind of uncertain. There were big expectations for me to be a traditional operations leader. And to be honest, that wasn't going super well for me. A lot of what was expected from me I was learning at the time weren't my strong points.

Joshua Bronner:
However, I fell on the clinical team that was responsible for coming up with our COVID guidelines and helping out our other offices. So in doing so, I dove head first into OSHA and infection control related stuff. And those things were not super high up on the C-Suite's goals from the start. And I... you know, was happy to come up with a couple of ideas and say, you know, I'd be happy to kind of get into this and help out our offices and see what we could do. And my sort of goals for that were really to kind of set out and add some cultural and support aspects to compliance, which is generally a massive heavy load, usually on one person that also is involved in direct patient care. So we came up with a couple of different just ways to better support and reduce that load. We have a safety officer program going, so we have one in every office. Majority are hygienists and assistants. So for me, my role fell more into support and being able to work with You know, usually the more motivated people in that office that also care very much about keeping things safe So it's been going really well and we've come up with a number of different ways to help everybody out.

Matt Allen:
That's awesome. I mean, obviously, yeah, that kind of, your story comes into COVID and everything changes, right? And all of a sudden, I think for everyone, right? Like stuff that we hadn't necessarily put at the top of the list of like, hey, here's ways that we can be innovative in compliance and in following those guidelines and making sure everyone is safe and making sure that quality is still met, right? Um, everyone all of a sudden had to like really put that at the forefront. And so it sounds like for you, uh, you know, you were really able to, to lead out in a team-based way, which is so valuable, right? So that it's not simply falling on one person or not simply just being forgotten. Um, so you talk about this idea of kind of being team-based in this. And certainly I think that's, that's very innovative. Um, how do you, what is, what is the cadence of that? Like give me, give us some insight into. You know what that looks like in terms of leading that team and sharing, you know, so once you get this, you know, the, the structure set up, um, walk us through just a little bit of the day to day there to kind of help us understand, you know, what the communication looks like, what the oversight looks like. How do you, you know, if problems comes up, how are you then managing that as a team?

Joshua Bronner:
So I am also in the chair taking care of patients Monday to Thursday. I work with our hygiene leaders and our procurement managers who are immensely helpful in supporting the compliance program as well. So for a day to day, there's lots of emails that I'm attending to throughout the day in between patients and helping out in a timely manner when I can. We've had quarterly safety officer meetings. I've lectured on proper record keeping and documentation that's needed in the office. We did a lecture on sterilization protocols and best practices. Most recently we did one on dental unit water lines since that has been making the rounds in the news and the CDC put out an advisory on that just a few short months ago. And we hope to grow our safety officer program into a regional thing and elevate some of those that have been really involved and motivated to make sure their neighboring offices are also getting the support that they need.

Matt Allen:
I love that, man. That's so great. I so believe that this can and should be team-based care and the fact that you could kind of identify that and structure that in a way that feels like, hey, we can all take responsibility for this. It's not any one person's job, it's everyone's job almost, right? Makes such a difference, which I absolutely love. As you think about that kind of idea of team-based care and having... that be everyone's job. One of the things I think would be interesting to kind of hear from you is, you know, we all see these spots in dentistry and you made a change there that I think has been for the benefit of your organization. It really sounds like if you could wake up tomorrow and transform one thing for the entire profession, like what would that be? What would it look like for you to say, cool, we did this in our organization. Like, here's one thing that I think we could do as a profession that would really make a big difference.

Joshua Bronner:
Just to get rid of some of the stigmas, there are three letters out there that sort of scare people, D-S-O. I would say that those vary just as much as any other general dentist can vary from another dentist. And it's all about being a part of a group that has aligned philosophies and really do care about taking care of patients properly and supporting their team members. From a provider standpoint, I would say I wish this was a field that no one has ever heard a bad story about because there are a lot of stigmas out there. I don't even think I've said the word root canal to a patient for a while. It's nerve treatment. Outside of that, I wish it was also a field where insurance companies didn't exist yet, and I hope if we had to do it again, dentists wouldn't make the same mistake twice, or at least it would be set up in a more, a way that could really get patients the care that they need.

Matt Allen:
Yeah, totally. Well, I mean, so, so much there to, to unpack, uh, in terms of, yeah, I mean, especially, right, like that idea of, we, we wish we had never heard, you know, a bad story of someone having a bad experience, especially as it relates to compliance, right? Cause that feels like one of those things where certain things, you know, are exist in scales of gray and certainly compliance and safety like exists generally in like scales of black and white where, you know, you can't. can't kind of do it, right? You really have to do it all the way. In the interest of time, we'll give you the opportunity at the end to let people get in touch with you and hear those stories at a deeper level. But would love to just kind of dive into you, because I think your background is super interesting and you have some really cool stories that I would love to have our listeners hear. But we'll have to see a little bit more about you. So tell us something that's important to you, but people maybe even within your organization, within your office, maybe might not even know about, would love to just hear something that's important to you.

Joshua Bronner:
Let's see, a lot really. It might sound lame, but just being nice to people is something that really makes me feel good. And I think it's one of life's greatest and sort of easiest joys in or out of the chair. Obviously in the chair, it's a total must. We are in the customer service based industry. The majority of bad reviews out there. about dentists are probably related to poor bedside manner, lack of communication, things like that. For the bulk of the work that gets done, it's not really about the quality of work. It's more about obviously being pain-free, but just being genuine so that your patients feel comfortable with you. I always, when I insert a crown, I always like to say, let's just say, Mary. I really like the margins on this crown. Like, what do you think of the margins on this crown? And she'll just look up at me and be like, you're a nice guy, doc. Like, margins, I don't know. My uncle is a dentist. He has been a big source of inspiration for me to go into dentistry. He was the first of a long line of plumbers to enter the field. He taught me a lot. of prosthetic stuff. He was very good at that. He also taught me more importantly, the ethics of dentistry and really putting the patients first. You know, just things like don't ever even look to see if a patient has insurance until you're done treatment planning.

Joshua Bronner:
Just little tips like that that kind of stick with me and has led me, I like to think, to be a better clinician. I never had a super high level of confidence growing up. I was a late academic bloomer. When it took me a little bit to get into dental school, I was at a school six years before I got into dental school. I did some plumbing with my dad. I did a master's and did some research in cancer genetics, but I did want to be a dentist. I wanted to use my hands. and relate with other people as much as I could. So I was always like, six years out, I'm like already the old guy in my dental school class. And for a long time growing up, I led myself sort of blindly to others that I thought maybe knew my path better than me. But I'm at a point where I'm pretty confident to stand behind myself and know the direction that I want to take. And I have built a nice little network of support that I can seek out whenever I need it.

Matt Allen:
I love that man. Well, you mentioned that too, as you were talking about ops kind of, and it was like, hey, people are pushing me into this. And you're talking so much about finding your own path, finding the strengths that you are. For everyone, that path is different, right? But that self-awareness piece is so important to kind of know, hey, my job is not to be what anyone else expects me to be. My job is to be the best version of myself that I can be. And I absolutely, sounds like you're really finding that and continuing to find that and have found that, which is awesome. Tell us about, you mentioned your uncle, kind of being an influence on you. Tell us about one of your most formative experiences as a patient. I would love to hear something around that would be great.

Joshua Bronner:
So my uncle's dental office was downstairs from my father's plumbing office in Brooklyn. And I remember it was the first time I needed, you know, several fillings done. I think I was a teenager, maybe 14 or 15 at the time. And as soon as I saw that needle, I jumped out of the chair, tried to run out of the building. At the same time, my father was coming downstairs to say hi and, you know, he grabbed me and put me back in his chair. And I said, all right, like if we got to do it, we got to do it. I said, give me that big mirror over there. And I want to see everything that, you know, that my uncle's going to do. And it wasn't, you know, long before I was telling him, you missed the spot over there. And he said, you should be a dentist. And that was sort of like how it first kind of, kind of got in my head. Wasn't that bad. He was pretty, pretty painless.

Matt Allen:
That's awesome, man. I love that story. It's so, yeah, so much greatness there. That's great, I love it. Cool, well, let's talk a little bit about making dental care kind. Let's talk about making dental care more human, making it different. Tell us a little bit how you see your current role in doing those things, making dental care different, making dental care kind, making it more human. Give us some insight into how you currently are approaching those questions.

Joshua Bronner:
You know, so communication comes in lots of different forms. You know, you could be the best speaker in the world, but you know, pictures are worth a thousand words. I'm less of an inventor than I am an enhancer, I like to think. You know, I tell our team all the time, we don't have to be better than other offices, but we do have to be a little bit different. I like to think I provide, you know, a good general dental experience, but I do want... I never want to do anything on a patient that they don't know why we're doing it and what their benefit is going to be for them or the risks of them not taking care of it. So intraoral cameras and photography, they're not just for my records and for my growth. It's for them to see exactly what goes on. So when I'm going into a class two and I'm like, oh, there it is, I'm like, stop for a second, take a picture, and I'll look down at the patient and say, you want to see what a cavity looks like. And more often than not, it's either a hard yes or a hard no, but it's always engaging.

Joshua Bronner:
And the patients I think, whether they don't want to see it or they do, it lets them know that we're human and we're dealing with each other and there's no hidden agendas or anything like that. And the other thing that goes along with communication is, to be there for your patients when you're not in the office because a lot of things come up and different offices have different emergency policies and ways of getting in touch with the patients or their doctors rather. So I utilize a program. There are several out there, but I've only experienced one. It's called Ape Dental.

Joshua Bronner:
And it's basically at the end of the next day after care.

Joshua Bronner:
It gives me an opportunity to reach out to those patients with a different set of templates just to make sure they're doing okay, if they had any questions, if they're feeling things that are a little off to them. And it has been super powerful. I think it's a great way to drive the relationship and patient retention and keep them with you.

Matt Allen:
That's amazing, man. Well, certainly like what we see in our data, right? That's definitely one of the biggest pieces where patients have frustrations around their experiences in the after visit management, right? You might do everything perfectly in the office, but they might have a question or something might be a little bit wrong. And if it's hard to get in touch with you or if they don't know, if they don't know where to go, right? That's such an important piece of not just providing care in the office or trying to make sure that they're gonna come for their appointment. We communicate with them a lot before, right? But oftentimes I think there's a gap there and certainly we're seeing that. And obviously you've identified that in your own practice as well and are really working to close that gap for patients.

Joshua Bronner:
That technology has made it very simple in that communication. Like it's not a real heavy lift for me. I actually enjoy patients always, add a little bit of personal touch to it. Sometimes I have to remember what they said because then they call me out when they come back in the office, they say, was that really you doc? So we do and that's been great. There have been offices where I tried to. you know, make the patient care calls, you know, at the end of the day and I'm exhausted and they don't pick up because they're having dinner. But this has been, you know, everyone's on their devices. So it's made that a lot better.

Matt Allen:
Yeah, that's awesome. And I love it using technology, right, to make that on camera. And I think, you know, that's, that's certainly, we can do that, right? We can make it more efficient, more elegant, if you will, doesn't necessarily just have to look at efficiency. But it sounds like you're using that solution to make it more efficient. Yeah, love it. When you think about patient experience in general, as a clinician, and as a, you know, compliance leader, what's one factor that you think is important, but overlooked, that might be helpful for for patients and clinicians and staff alike.

Joshua Bronner:
Again, as I mentioned, you know, being different. I think that it would be different if, you know, you gave, even if it's just, you know, for the patients on their way back to the chair for the first time, you give them a quick tour and, you know, you show them how you're, you know, performing these infection control tasks and, you know, provide a way for them to feel comfortable that they're The instruments that you're using are properly sterilized. So I think that's just another way to enhance the patient experience and get them more in tune with what you're doing in the office.

Matt Allen:
Yeah, totally. Right. I mean, it's such a, it's such a big thing, right? It's like, I felt safe with the care that I received. And if you're taking a proactive approach to that, instead of a reactive approach, that can be really calming for a lot of patients, right? To know, Hey, I felt like they dealt with stuff that I wasn't even thinking about yet, but I know is, and it was important. So yeah, that's awesome. I love it. Awesome. Well, one last question for you. I always love to have people, you know, think about themselves as a patient, because we all are patients, right. And in various ways, whether we, and see our doctor or going to see a dentist or whatever it is. So when you think about yourself as a patient, what's one thing that a care team does with you that helps you build trust and say, hey, yeah, I trust this person, right? Would love to hear your answer there.

Joshua Bronner:
So definitely not a good look for an office is, patient finishes their visit, you're like, okay, go up to the front, sign out, take care of your bill. And they're walking around the office lost, they don't know where they're going. And they ask another team member a question and team member has no idea why this patient's in the office or anything like that. Just shows a lack, a total disconnect amongst your team. So the orthodontist office that I refer to pretty frequently, I was actually a patient in during COVID, good time for that racist. And when I went through their program in their office, I was really blown away that almost instantaneously, everybody knew, all of their team members knew what the next step was, where I was going, what I was doing. And I spoke to the doctor that runs that office there. I'm like, I got to figure out, how do you guys do this? So we put a couple of things into play. Some offices use headpieces and earphones and things like that. But just we use the morning huddle to get everybody on the same page and run through some of the patients and what they're here for. Let's see, on top of that, we use instant messaging services, so that also it reduces traffic. You don't want the patient to know why or how everybody knows what's going on. You just want them to know that everybody knows what's going on and you're in the right place.

Matt Allen:
Man, that's, I mean, so valuable, right? In terms of making sure everyone's on the same page at the beginning of the day, obviously, but then staying in touch, right? Because things change, things happen, you know? And yeah, that's the second time that someone to me recently has mentioned the idea of like getting lost in an office, which I think, you know, we just take for granted of, oh, everyone is gonna know where to go and everyone's, you know, and I think especially for new patients, right? That can be really confusing. And it can feel really disorienting. Like I'm walking into someone else's room and I, you know, that's, that's so, uh, I think overlooked, uh, in so many ways, but, but super important. So I love that. I love that you saw that personally and then said, Hey, this is amazing. I'm going to find ways to bring this back to our organization. So it was the best patient experience I've ever had as a patient.

Matt Allen:
Well, and that's where we should learn, right? Like, hey, we want more stories like this and less stories like the ones that we see in the news sometimes that are really negative, right? So I absolutely love it. And I appreciate that from you. Um, awesome, man. Well, in the interest of time, like I said, we could, we have, I have tons of more questions we could ask, but, um, want to always try to keep this on like commute level listening, right? So yeah. Um, if people want to get in touch with you, learn more about you, hear more about select on management, whatever it might be, talk about compliance. How do they get in touch with you or learn more about you and your work and your organization? Whatever you want to share, feel free to let us know.

Joshua Bronner:
Sure, they can reach out, I am on LinkedIn. And in addition, they could just email me, it's my full name, Joshua Bronner, DDSNYC at gmail.com.

Matt Allen:
Awesome, man. Well, I appreciate you so leading in this space. Certainly it is not, like I said, something where I think most people when they think about innovation and making dental care more human are saying, Hey, we have to make sure that we shine a light into some of these dark areas around compliance or, you know, clean out the corners. Right. And it's so, so very valuable, so very important and should be front of mind for all of us. And I love the ways that you're doing that in your organization. So thank you so much for sharing with our listeners, for taking the time to join us. It's been a great conversation and we really appreciate it having you.

Joshua Bronner:
Thanks so much, Matt. Really appreciate it.

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