#AskT-Bone – Ep40 – Collaboration between Specialists and General Dentists


Hello and welcome back for another episode of #AskT-Bone on the T-bone Speaks Podcast!

Today I have an absolutely wonderful question, something I’m going to enjoy talking about. It’s a passion area of mine, dealing with the Gentle Dentist specialist relationship.

But before we get into that I really want to ask again ,I’m going to keep asking, so you might as well do this for me. I need you to leave a review for me on iTunes and I need you to guys to submit questions by visiting www.tbonespeaks.com

I don’t try to sell you guys stuff, I want you to come to my workshops but I’m not forcing you to, I’m not constantly promoting these things. I am providing a wonderfully free resource, I’m open and honest. All I ask in return is that you engage in to the podcast by leaving a review on iTunes and then also by submitting questions by visiting www.tbonespeaks.com


So today’s question is from Russell, it says:

T-bone as an oral surgeon I’m always working to improve my relationships with the referring dentists. When I ask the dentists of my community, I feel that they are hesitant for whatever reason to give me a straight answer. I appreciate the honesty in your podcast so I thought I would ask you my question. What are the three top characteristics requirements you look for in a specialist, specifically an oral surgeon.

Thanks in advance for your comments



Russell, thank you for this great question and thank you for being a specialist that actually seems to care about developing a good relationship. So, I do want to take a few minutes and talk about that, but first I’ll tell you why you don’t feel that people are giving you a straight answer. Honestly, they’re not giving you a straight answer not because they are afraid to, they just don’t know. They don’t know what is possible in a good symbiotic specialist general dentist relationship. Because quite honestly 95% of us have never experienced that. We have experienced relationships whether it’s the fault of the GP -and all honestly I lay most of the blame on the GP, personally- or the fault of the specialist. We simply don’t demand a better relationship, we don’t ask for a better relationship and we don’t do what it takes to create a better relationship. And, again it goes both ways.

And too often specialist have view themselves as higher level than general dentist -and I guess maybe have more training, that doesn’t mean you are smarter than me- and that they are above general dentist and that they know better and that general dentist often invade their territory and do things that they shouldn’t be doing. And I would agree and disagree with that I think there are some General Dentist that shouldn’t be doing things, but I would say that a lot of General Dentists are capable of doing it, they learn to do it and they are often afraid because of the backlash from specialist. So, I would encourage General Dentists to start demanding more, to ask more, to experience more and I think that is why they are not able to give you a straight answer.


Now if I would to answer that, what three characteristics I would look for?

I would look for a specialist that is collaborative on my cases for good patient outcomes,

I would look for a specialist that is technologically at the same level that I am,

And number three I would look for a specialist that helps me grow my practice.


So let’s talk about being collaborative:

So, to me and maybe that’s just me, but as a specialist I would demand this as well, if I was specialist I would demand this or do the things that it takes to get this, and that is: I like to collaborate on my patients care, nothing drives me more crazy than when I send a patient over somewhere and they come back with the work done, and maybe honestly I look it again where did I miscommunicated on that, but it’s not that I don’t want them to get the work done, I just want to make sure that what they’re doing falls into my plan. So, I don’t want them to come back with tissue grafting when I am going to do ortho next. I don’t want them to come back with implants when I am going to do something else first or whatever it may be. Maybe I am moving the teeth around, maybe we got something else that needs to be done. Maybe I don’t want that tooth taken out quite yet, I need to hold it for a second, even though I know it’s loose or whatever it may be. You know those kind of things. So, I think being able to collaborate on patient care is really helpful to make sure that before you do things -especially in complex cases certainly, or even semi-complex cases that everybody is involved in that- I like to work with a specialist who views me as a colleague in that collaboration, not telling me what to do but taking my input and putting their input there. Again, I don’t want to dictate what’s going on, I want to collaborate what’s going on. So when I say “hey I want to, you know this is what I want to do” I want them to say “that makes sense but here is the challenge with that this would make it easier…” And I think what happens when you create a collaboration, at least what I’ve seen in my relationship with my surgeon is, he’s become an unbelievably better restorative dentist, not that he’s doing restorations but is becoming a better restorative dentist in the sense that he can plan, he can see things better, he understands the restorative aspect of things and how his work affects the restorative outcomes that the General Dentist needs.

So I would say that collaboration is important.


Now on terms of technology, I expect a specialist and oral surgeon specifically in your case, to have the technology I have. I would say that to me a good specialist must have 3D imaging, and why do they must have? I don’t need them to have 3D imaging because my patients already have 3D images that I am sending to you, but if you don’t have 3D imaging I know that you probably don’t know how to really read it very well, or how to utilize it very well or you are not going to utilize it because you are not used to using it. So, for me having a specialist that utilizes at the minimum 3D technology, I love when I work with my periodontist who is really good about this. I work with specialist who take photographs and send me those photographs so now I have it as part of my Case File. I have it also for when I want to do blogs about my patients and things like that, or I want to write articles. So I love having photographs of their work. And also tells me that when I work with a specialist who is technologically using photographs, that tells me that they care about, they are taking great pride in the work, in the documenting the work, and that they are working at a level where they are critiquing their work and evaluating how they can get better. Also on the technology-end, I don’t have time for lunches, I don’t have time for dinners, I don’t have time for a phone call to be quite honest with you, for collaboration. I need it work with a specialist that is going to use Skype or Google hangouts or Apple Facetime or WebEx or some way that we can collaborate at convenient times that don’t require to be physically face-to-face. I just want of the time for it. I like to work with specialist along those lines who can send me those photographs or video or something along those lines of the patients so that I can view it in a time that’s convenient for me. I like to wake up at 4 o’clock in the morning to start doing my emails and work on things and I don’t want to call my specialist at 4 o’clock in the morning but I’d love to get my information from them, so I can review it at my time. Along that line, there is a periodontist that I don’t longer work with, that literally doesn’t use email. And so, if someone is not using email I can’t communicate with them. I’m not picking up the phone in the middle of my busy day, or in the middle of your busy day and trying to talk to each other. We are all in a hurry, no one’s ever listening. Emails allow us to communicate, allow us to communicate with photographs, allow us to communicate with video, allow us to communicate in a written word.

So you know, those things are unbelievably important to me.


Now, when it comes to practice growth, what do I mean by work with the specialist is going to help me grow?

I think Specialists should hold study clubs or some type of growth meetings, not once in awhile but on a regular basis where they bring in other speakers, they don’t just talk about implants of soft tissue grafting or just talk about how to recognize what you should revert, that’s not what it’s about, it’s about somebody that’s going to help me grow that’s going to leverage, you know putting ten or fifteen or Twenty of us together allowing us to pay money or whether they sponsored on their own to bring in the education or outside education experts that is going to allow me to grow my practice.

So that’s one thing.

Also I want to work with a specialist who is comfortable with me watching them do surgeries so I can learn how to do surgery myself. Maybe I will learn to do things and not referred to you, maybe I will learn to do things and decide I don’t want to do that. But what I know is that the more I know the better diagnose. The more I know how it is done and what to expect, the better my patients are prepared. The more I know and what to expect and how much it cost, the more I can get my patients prepared or what to expect in your office. So those are the things to me from a growth perspective that I’m looking for. I think unbelievably our profession has gone to a us versus them mentality and I need to be a we mentality because we is all about the patient, and when we work together our patient wins and each of our practices win. And honestly here is what I would say to any specialist that may be listening to this and I would encourage you to share this particular podcast to your specialist by clicking the share button. You know the days of simple extractions as a specialist, the days of “simple implant specialist” the days of the Simple Orthodontic, Adult Orthodontic Specialists are going away. General Dentist are being forced and wanting, and technology is making it easier for us to participate in some of those procedures. The Specialist that will Thrive and continue to do well and will build burgeoning practices and great relationships and do more complex Dentistry, Specialist will be those who engage with the General Dentist.


To my General Dentist listeners: Ask more.

But don’t ask more of somebody if you can’t give more from yourself. If you are stupid and don’t know things, don’t expect somebody to spoon-feed you. Go learn, get out there. Get out there and learn, be proactive don’t just bitch and moan that all there is nothing here. Go to a specialist and say hey I would love for you to do this, if you do this I would participate. And then when you specialist takes the time to do this participate even if it’s a topic you don’t like or that you already know. Go, because listen, here’s what happens: If I did something and only three or four or five people showed up I wouldn’t do it again. It wouldn’t be worth my time and effort in doing it. But if I did something and I saw people show up, then you should do it. Is just like at my golf club. When our golf club was first starting out I encouraged my friends: Hey they are doing an event and I know it’s dumb, I know we don’t like it but we have got to go. Because if we don’t go they will stop doing these events. So when your specialist does something you should pick up the phone and say hey I’m sorry I can’t make this one but I want you to know I’m in, I will support you in the future, so that they know what to expect.


So it’s a two-way street, when we all get together everybody wins.

So I encourage us to get together and Russell thank you so much for asking that question.

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