Expanding Your Dental Practice: Bloody Tooth Guy’s Insights





By Lexi Marino July 24, 2020

Rolando Mia, from Zyris, hosts a video series focused on the latest news, topics, and conversations happening in dentistry featuring dentists across the nation. We’ve kicked off Season 2, with the primary focus being, “What’s Working and What’s Not”, where we’ll debunk myths by assessing trial and error since the start of Covid-19 in dentistry. In this episode, we interviewed Dr. Jason Auerbach, Oral and Maxillofacial Surgeon and creator of popular Instagram account, Bloody Tooth Guy. The purpose of this discussion was to understand what has worked, since the re-opening during the Covid-19 pandemic, for his practice and has ultimately allowed opportunity for expansion.  

Watch this video to learn the following:

  • Researching specific products for infection control – what works, what doesn’t
  • Building an all-star team during a pandemic
  • Expanding your business or becoming a part of a chain of practices
  • Negative pressure rooms, is this necessary?

 

Transcription

Rolando Mia:

Dr. Auerbach, how are you? Good day, everybody and welcome to Dental Voice, Season 2 with Zyris. My name is Rolando Mia. When you look at Dental Voice, the purpose of this show is to get feedback from clinicians, understand their experiences, and get advice from them. In this season, what we’re trying to figure out is how to separate reality from fiction. Today, we have Dr. Jason Auerbach, who is also known as, “Bloody Tooth Guy”. Today, I want to spend some time with Dr. Auerbach to understand your experience and all that.

First of all, thank you so much for joining – really appreciate it. It’s great to see you.

Dr. Jason Auerbach:

It’s great to see you too. Thanks for having me.

Experience: How BTG Became an Oral and Maxillofacial Surgeon

Rolando Mia:

I’d like to start by just understanding your experience and how you ended up becoming an oral and maxillofacial surgeon.

Dr. Jason Auerbach:

So, for me, oral maxillofacial surgery was something that I fortunately happened upon. I didn’t go to dental school thinking I was going to become an oral maxillofacial surgeon. I went to dental school thinking I was going to go into cosmetic dentistry, work and live in New York city, and have this great existence. And it bit me, it bit me probably second year of dental school. I found myself in the oral surgery clinic and realized that I had an aptitude for it. I quickly developed a passion for it and never looked back.

Rolando Mia:

So, you are in dental school, you end up coming into this and you’re like, “Holy cow!”

What was it that bit you? I’m curious.

Dr. Jason Auerbach:

I mean, it’s difficult to put my finger on it. It was it was something that was entirely different than anything I had experienced within dental school. Up until that point, I felt a lot of minutia. There was a lot that I wasn’t really too keen on. However, when I went down to the oral clinic, it was all about using your brain and your hands – figuring things out. It was just a different level of care, a different level of “clinicianship”, if that’s even a word. That’s basically how I felt about it. I thought it was great in every way, and I’m not really being very specific about it, but it was clearly special, clearly different, and I’m so fortunate to have found it.

Rolando Mia:

It’s incredible. When I look at the videos that you’re posting, the detail, I can see how exquisite everything is, it’s amazing. Was that something that in the back of your head wanted to do, or was it something that you kind of stumbled on and just all of a sudden decided to do?

Dentistry and Social Media

Dr. Jason Auerbach:

It’s interesting. When you look at Instagram, there’s so much video and so much emphasis on the story rather than on the feed. When Instagram started and when I started on Instagram, there were no videos. It was all still photos. For me, it was simply photos of bloody teeth at the time. Then as Instagram evolved, so too did my account and I was fortunate to kind of be ahead of the curve relative to other oral surgery and dental Instagram accounts. From that point on, it was really just seeing where things went, experimenting, what works, and what doesn’t work. So, no, I didn’t plan on it when I started. I didn’t know I’d be filming surgery now. That’s basically all I do.

Rolando Mia:

That’s so cool. In addition to the kind of things that you’re doing, the procedures and the depth that you get into, they are absolutely incredible. So, you clearly have a passion for it. Have you had like medical or dental in your background or is that something that you pursued? How, how did you end up being a dentist?

Dr. Jason Auerbach:

I was always entrepreneurial, and I really didn’t know how I was going to make the life that I wanted to live ultimately. I have a very close friend who was my college roommate who introduced himself to me on day one of undergrad. His father was an orthodontist. I had some really positive experiences with dentists when I was younger, and I really didn’t have a lot of guidance as far as what I was going to do and because I didn’t have a lot of guidance, I kind of figured out my own way.

My inspiration came from certain people that I met, those dentists and my friend’s father, and found myself in dental school. I worked as a dental assistant for a prosthodontist while I was in dental school and totally thought I was going to do cosmetic dentistry. Then, I came across an oral surgeon who I thought was crazy to do the extra years but thank God I met that guy and the rest is history.

Rolando Mia:

You love it and you’re not looking back.

Dr. Jason Auerbach:

Not at all, not yet. I’ve been doing it a long time. There’s, there’s no looking back now, you know,

Experiencing the Pandemic From a Multi-practice Perspective

Rolando Mia:

You founded and started reverse Riverside Oral Surgery, and now you have four offices.

So, in this whole experience and the pandemic that we’re dealing with, how does that hit you and what’s the experience that you and your colleagues/team are dealing with so far?

Dr. Jason Auerbach:

It was really tough for me emotionally. I started my practice from zero and I have multiple people who are with me from those first days from pre-Riverside Oral Surgery. I built it into a team, and we have built it into something that has been pretty special and having to furlough people in the early moments of this, not really knowing what was going to happen. This took a lot of people by surprise. I was very fortunate due to my presence on Instagram to have to have had a little insight, a little bit of like a heads up from some of my colleagues who were going through it a few weeks before we were, especially in Italy and Spain. So, because of those friends, I was able to kind of get ahead of it.

I knew what we needed to do as far as PPE and as far as protocols. I anticipated what was going to happen in terms of shutdowns. Then as we emerged from just emergent care to urgent care to elective care, now, fortunately, we have all the procedures and protocols in place. We have amazing technology. We have the right people, people came back and thankfully New Jersey is still in a good situation, relatively speaking. So, as long as we can stay here and even if we don’t, you know, we’ll be ready to do what we need to do.

Rolando Mia:

Wow. It’s amazing when you think about this pandemic and how it completely shut down businesses, we’re talking globally, there’s so much information. We’re hearing so many things from so many different places. How do you kind of filter what’s just pure speculation or what’s real?

Dr. Jason Auerbach:

So, I try not to watch the news and I try to listen to experts. I mean, science is science and it is evolving, of course, but if you look at the human experience – we’re all sharing the same experience. So, what’s going to happen in Beijing four months after we have a reopening it’s likely to happen here later on. I mean, we’re human and probably to a greater degree. Right? Unfortunately, we see what’s going on in Florida. We see things kind of rolling back in California. For us to think, just because we’re like Jersey proud that we’re not going to have the similar experience – that’s crazy. So, I think ultimately, we have to be prepared for what is likely to occur.

I try to use my brain. I’m a pretty practical guy and I try not to let my emotions get the best of me. I will say they did definitely earlier in all of this. But now, it’s just a matter of like being prepared, doing what you have to do, understanding what’s likely to occur and being able to pivot. We’re a large practice now, but where we’re really nimble and we’re able to be nimble because our team and the people that we surround ourselves with think progressively. And they’re like, “Okay, where are we going to go?” I mean, we are already thinking about what’s to come.

Rolando Mia:

That’s cool. Thank you for that. It’s quite amazing that you were able to kind of get feedback and advice from some of your colleagues or some of the friends internationally. It sounds like you kind of got a heads up before any of this happened.

Dr. Jason Auerbach:

Right? I was talking to people; I did a livestream with an oral surgeon from Italy. They were in the thick of it and we were not quite yet. I was looking to give her an opportunity to speak and she did, and it was unbelievably insightful. I’m very happy that we did that. Then subsequently, we took that perspective. We were able to help our referral network which in my businesses is everything – being able to be the voice and kind of guide people, whether it was about the actual virus or the financial side of things, or different protocols that we had to put into place. For example, like where to get face shields, where to get sneeze guards, or these acrylic screens that we have in front of the reception area.

You know, it’s funny, as it relates to that I have acquired a few. Most of these offices, we’re like a little bit antiquated. So, we all did an open floor plan, open reception area. Everyone is spread out. Now, as I look to build these next two offices out, I feel like we have to go back to a time where there is that divider, some sort of transparency literally, but also a blockade. So, I’m trying to figure that part of it out right now, too.

Inspiring a Team During a Pandemic

Rolando Mia:

Wow. We’ve been hearing from quite a few folks that some of the teams are having an apprehension coming back because of the potential for infection. You mentioned earlier, your team wasn’t that way. How did that happen? How were you able to accomplish that with them?

Dr. Jason Auerbach:

Well, I don’t know that they weren’t that way. Some people had apprehension, totally justifiably, and I think some people are still apprehensive. I was doing everything I could do to protect the people who worked for me. Right? That was the paramount thing. That was the number one thing. I was driving here and driving there trying to procure whatever I needed to do andI was doing what I thought was the right thing to do and my partner as well. People who work for us know that. So, they trust us, and they trust that we’re putting their best interests ahead of everything. We’re working side by side with them. They are everything – without them here, we are zero. So, I think that there’s got to be a trust level there. However, I think apprehension is real.

I think, especially the team members who have elderly parents that they care for or young children, or they themselves are a little bit older or medically compromised. We’re seeing now that it’s really not just you know, just older people who are getting sick, but many people, unfortunately. The fact is as long as you do what’s right, I mean, when we were allowed to see emergencies, we were seeing only emergencies. We were not trying to like trying to do more to get a little bit more. We were really following the guidelines that were set forth by the Department of Health, CDC recommendations, and American Association of Oral Maxillofacial Surgeons. They were great. Governor Murphy has been good, it’s interesting. He’s been good. I’ve been very happy. We’re just doing everything we can.

Rolando Mia:

No, I love that. What’s really cool is the sentiment, and tell me if I got, you were very direct with your team. You respected the apprehension that people had and didn’t try to say Covid-19’s not a big deal. I think that that goes a long way in establishing trust, establishing a connection and I think that’s pretty cool. It sounds like you have a really strong connection with your entire team.

Dr. Jason Auerbach:

Yeah. It becomes more difficult to have those personal relationships with everybody, but you know, how do we accomplish trust? I mean, trust takes time. You just got to build trust over time. There’s no shortcut to it. You can’t buy it or force it upon anyone. Build trust over experiences where people know they can trust you only after they see that they can trust you. So, I value the people who work for me, I expect a lot. I’m not like, all peace and love, but you know, I expect a great deal. I’m a crazy perfectionist, but I think the people that work for me know that they’re going to get love and support from me and I’m going to expect from them greatness – that’s what it is.

How Do You Choose What You Post on Social Media?

Rolando Mia:

Yeah. That’s awesome. All you ask is for them to deliver on their commitments, it sounds like. I love this perfectionist piece because in watching the videos that you post and I also like the fact that some of them, you have the little disclaimer basically saying, “Hey, this could potentially be a little disturbing. So, for those of you who are not clinicians don’t click on this because it’s going to be gnarly.” Do you just videotape, do you do every one of the cases that you have? How do you pick, which ones do you post?

Dr. Jason Auerbach:

You know, I actually video very few of the cases that I do. So, it used to be that I would have my office manager who started out as an assistant then became a receptionist. Now they are my office manager in the office that I practice out of. I used to have her do a lot of the recording and then I actually have undergraduate student right now who would direct message me out of nowhere and was like, “I live in this town that happens to be close to my office and I will come and I will work for you”, and I was like, “Yes.” So, she she’s there now, she’s recording, and she’s great.

However, not every patient wants to be recorded. Not every case is that interesting. I mean, much of what I do is kind of like the same thing. Right? I do a lot of wisdom teeth, dental implants, extraction, bone graft, and pathology – the gamut of contemporary oral surgery, private practice, kind of oral surgery. I don’t do much by way of hospital work anymore, but my recording is done by an awesome undergraduate student who just wants to be an oral surgeon, which is great.

Rolando Mia:

So cool. So, getting going a little deeper here. Everyone is talking about aerosols, so this virus and how it’s beyond bloodborne. What are your thoughts on that? How do you minimize and how do you manage that during the course of your procedures?

Dr. Jason Auerbach:

So that’s totally fair. Each room is outfitted with you know, air purification system, hyper HEPA filtration. The baseline is high airflow turnover. Then we have these extra oral aerosol suction units that we use and turn on, which creates the appropriate suction to that area outside of the patient almost to the above their head. So, any aerosolized virus actually is to a certain degree suction. I know that that does a fair amount. It does a good job. I see it. I can see the aerosol, the fluid going up and into it. Science-wise, I don’t know, honestly, how effective that is. You know, there’s a lot in terms of foggers there is, there is a UV light in the research, that type of stuff that’s being done all over the place.

I think the jury’s still out on what the best way to control that is. There are tons of great products out there and protocols and systems, but I do think that we will learn over time, how, how to best handle it. The way I see this is, you know, what HIV AIDS, hepatitis C did for bloodborne pathogens, universal precautions in the 80’s, this will do for airborne protocols. I mean, Tuberculosis was a real thing 50 years ago and this Covid-19 positive, it will be less of an issue, but we have to treat everybody like they are Covid-19 positive.

Making Decisions on Purchasing New Technology for Infection Control

Rolando Mia:

Wow. So, in regard to all this technology that you’re using, how do you and your team make the decision to purchase it? You’ve mentioned multiple things that you’re doing. How do you make those decisions? What advice would you give other people who are sitting back and trying to wait to see which one works? How do you go through validate with that?

Dr. Jason Auerbach:

Well, I think the first thing is to really tighten up your procedures and your protocols as it relates to sanitation and all of that. I think that’s the number one thing. When you go by the book and you do what you’re supposed to do dental offices are very clean places, right? I mean, you’re cleaning the countertops, you’re cleaning the chairs, you got all the wraps on the headlights, on the handpieces. Everything is clean, appropriately disinfected, and sanitized. So, as long as you’re really kind of doing those things that you should have been doing all along for the most part you’re okay. Right? All the surfaces really should be cleaned.

How do we handle the aerosol? I think aerosol control, like what you guys have in terms of intra-oral stuff.

Also, extra oral suction, air filtration, I think there is potentially a role to play in terms of turning the air over, you know, air quality type of stuff. I was thinking a lot about negative pressure rooms when this started – I don’t know. I understand that a lot more now and I just think, I don’t know if this is the right answer. It’s certainly expensive and cumbersome. It’s probably unrealistic to expect most dental offices to convert to that.

However, I think that there are smart engineers out there who are designing HVA system, HPAC systems, whether it’s with UV filtration or whatever that will be. If you look at it now, I don’t want to like jinx us as a profession, but we haven’t really seen a large-scale dental office exposure issues. Right? Even in states like Texas or Georgia, that really haven’t really kind of shut down in any appreciable way. There’s really not like a whole office turns paused. Maybe it’s not a maybe, maybe it’s because we’re doing a good job.

Rolando Mia:

Well, when you look at dentistry, dentistry has always been very focused on infection control and all that type of stuff. Plus, you get to choose which patients you treat. If a patient is exhibiting symptoms, he would say, “Hey, come back and 14 days.” So, I think that’s so cool from a practice perspective. We’ve heard there are some practices that are struggling, and you mentioned that you’re looking at potentially expanding. Are you seeing that? Does that make it easier to help out some of these other practices or even bring them in to the fold for Riverside oral?

Building A Larger Practice

Dr. Jason Auerbach:

Yeah. I have had some trouble with the current situation, and everyone has had trouble with the current situation, but it’s much more difficult to manage it. I think when resources are scarce, or your connections aren’t there. I’ll just be frank about it, if you’re not really a high priority practice for dental distribution company or whatever, it’s difficult. It’s very difficult to manage that kind of stuff. So being a part of something that’s bigger and has more ability to handle the things that come our way on a larger scale, I think is helpful. I think guys who were at the end of their career for many reasons, want to become part of something bigger, an exit strategy, legacy planning and things like that.

Rolando Mia:

The sentiment and the support are there, I think that’s really important because it maintains the integrity of the patient base. The treatment is there, plus you’re right with the resources that you have, your ability to weather the storm is bigger.

What advice would you give other clinicians in regard to how to keep going right now?

Dr. Jason Auerbach:

You want to differentiate yourself as somebody who is proactive and who’s paying attention to what’s going on out there. I think you have to stockpile to some degree, not taking anything away from health care workers in the frontline, that’s wrong, but I do think you have to think about your practice and what you need over the course of the coming months. Not just from a PPE perspective, but a cashflow perspective as well. Maybe you would keep “X” in the bank on a typical month. Now, you have to really think. If things shut down again and you need to pay your rent and pay your team for two months or however long it’s going to be, you have to be prepared for that.

So, distribution of profits is a different topic – not everybody deals with that the way that we do, but that that’s a real thing. We have to think about keeping more money in the business and keeping everything kind of ready to go. We just have to be able to handle things that come our way. The only way to do that is to be prepared, you know?

Rolando Mia:

Yeah. I love the advice. That’s great. Final thing. If you were to send a message out to patients or your patients, what’s the message that you’d like to get out to them?

Dr. Jason Auerbach:

I appreciate that. we are all about patient safety. So, I founded my practice in 2007, with this concept of creating the optimal patient experience. We live it every day. I think the optimal patient experience has changed from this boutique service-oriented concept, which is still at the baseline of everything we do to highly focused on infection control procedures and safety measures. So, patients have always had a choice. I think a generation before us did the practitioner’s warrant. Some were aware of that, or maybe they didn’t have to be so aware of that, but now patients have choice. I think there’s an opportunity to differentiate yourself in terms of what you’re doing for your patients – we lead. So Riverside Oral Surgery, in my opinion, I don’t know why you’d go anywhere else.

Rolando Mia:

Wow. That’s awesome. People don’t care how much you know until they know how much you care. I love the passion that you have in the way you attack things in with regard to the kinds of things that you’re presenting – Bloody Tooth Guy, who would have thought. I think it’s fantastic.

I’m thrilled that you were willing to spend some time with us. You’ve had a long day, so I don’t want to keep you much longer, but I do want to thank you for taking the time, sharing your thoughts, and being who you are. There’s a genuineness to the things that you do and maybe it’s cause you’re from the East Coast and yyou just say how it is. I like it.

Dr. Jason Auerbach:

Keep it real, always keep it real. But I appreciate what you’re saying – I really do. Thank you.

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