April 23, 2025 • 20 mins
Nothing throws off your day like a surprise complication. When a surgical or dental emergency hits, how you respond is what matters most. In this episode, Dr. Taher Dhoon joins me to share how we approach emergencies to keep our cool, make smart decisions, and lead our teams.
We dive into emergency protocols, critical mindset shifts, and how to avoid unnecessary risk. Discover new ways to reset in high-stress situations and grow through the tough cases—not just get through them!
Topics discussed in this episode:
- Mastering your mind during emergencies
- The Dunning-Kruger effect in dentistry
- Leveraging mentors and learning opportunities
- Crisis recovery and surgical timeouts
- Knowing when to pass on difficult cases
Explore hands-on training programs and mentorship opportunities at Colorado Surgical Institute: https://www.coloradosurgicalinstitute.com/
You can also contact Chris Richards at (970) 410-6148 or chris@legacydentalinc.com for more information.
Text us your feedback! (please note: we cannot respond through this channel))
Check out www.relevanceonlinemarketing.com if you want to get the same great marketing results as Dr. Etch. Mention DPH and get your first month FREE!
Take Control of Your Practice and Your Life
I help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.
Join the DPH Hero Collective and get the tools, training, and support you need to transform your practice:
- Team and Doctor Training for every aspect of Practice Management
- Comprehensive Training: Boost profit, efficiency, and team engagement.
- Live Q&A Sessions: Get personalized help when you need it most.
- Supportive Community: Connect with practice owners on the same journey.
- Editable Systems & Protocols: Standardize your operations effortlessly.
Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
You are a dentist and , because of that, unexpected
complications and unforeseenemergencies are bound to happen.
The question is, how preparedare you to lead your team
through them?
Today, dr Tahir Dune is backagain and he's sharing more
real-life insights on handlingdental emergencies and how to
navigate the unexpected outcomesof treatment like a pro.
(00:24):
We're talking about surgicaltimeouts.
We're talking mindset shiftsand more ways to stay calm under
pressure.
Plus, you'll get some greattips on preventing complications
and knowing when it's time towalk away from a case.
This is the episode for everysingle person who has ever had
anything unexpected happen, andI know that's all of you.
(00:44):
Let's go.
You are listening to DentalPractice Heroes, where we help
you create and scale your dentalpractice so that you are no
longer tied to the chair.
I'm Dr Paul Etcheson, author oftwo books on dental practice
management, dental coach andowner of a $6 million group
practice in the suburbs ofChicago.
I wanna teach you how to growand systematize your dental
practice so you can spend lesstime practicing and more time
(01:07):
enjoying a life that you love.
Let's get started.
Hello there, and welcome backto the Dental Practice Heroes
podcast.
I am your host, dr Paul Etchison, and so excited to be joined
once again by the ColoradoSurgical Institute, dr Tahir
Dune just a great surgeon, greatperson and just a wealth of
(01:28):
knowledge on business stuff.
So welcome back, tahir.
How are you doing today?
Doing great man.
Doing great man.
The last time you were on, wetalked a lot about some lawsuits
and other stuff, and if youhaven't listened to that
listeners, go back and listen tothat episode.
It was a very interesting oneand it'll make you think about a
few things with the way thatyou document your patients.
But this time we're talkingabout emergencies and when
(01:52):
things happen unexpectedly, andwhat we can do as the leader of
the practice.
So before we get into what todo, I mean talk about what it
looks like when you don't thinkabout these things and you just
show up and something happens.
Speaker 2 (02:05):
Yeah.
So, first and foremost, if youare doing surgical procedures or
quite frankly, I mean like ifyou have kids, kids get hurt all
the time.
If you have anything going onin your world and you actually
go out there and live life, Imean you're going to be faced
with incidences where somethinghappens unexpectedly.
And for a lot of us, we'reprobably the leaders of our
groups.
(02:25):
We're the leaders in ourpractices, but we're the leaders
sometimes out in our friendcircles too, and so people do
look to us for, like, what doyou do?
Because if we've gone throughlike ACLS, training or anything,
they say, hey, everyone has arole, someone has to call out
the shots, everyone has to kindof fall into their role to get
to the other end of thisemergency.
So back in the day, when wewere recording for Colorado
(02:46):
Surgical stuff and I get a callfrom my wife and she's like I
need you to listen right now andI was like holy shit, okay,
she's only done that like twoother times and it wasn't good.
And I hear my six-month-oldhe's three now, but my
six-month-old screaming like ascary, fear-based yell, not like
a normal kid's cry.
She's like Jonathan fell hiseyes bleeding and shut.
(03:08):
He's bleeding out of his ear,he's bleeding out of his nose oh
my God, like.
And he's six months old.
So you know those little rockerthings that they put babies in,
you know, just to kind of likehave them chill.
My brother-in-law was visitingand he's a great guy, but at the
same time he had him up on thecounter and took his eyes off of
him and then my kid bounces andfalls off the counter straight
(03:29):
on his face, and then she'scalling me and I'm in Arizona,
she's in Colorado driving to theER.
This ability to compartmentalizeyour emotions, so what they
teach in like, sometimes, inlike meditation or when you're
physiologically like gettingstressed out, it's breaking
apart what's happening intothree categories.
(03:51):
So it's like okay, well, what'sactually happening?
What physiologically ishappening to me?
Like, my pulse is elevating, myblood pressure is going up, I'm
sweating a little bit, my handis shaking a little bit, and
then what's the story that I'mtelling myself?
Okay, my kid's going to haveneurologic issues.
My hand is shaking a little bit, and then what's the story that
I'm telling myself?
Okay, my kid's going to haveneurologic issues.
My kid's going to be really,really hurt.
Okay, what's the story?
Kids are very plastic, they'revery resilient, they're very
(04:13):
strong, they can bounce backfrom these things.
So okay.
So it's like all these thingsare happening and in the moment,
what do people really need?
They just need you to pave away for them.
They need someone to shine alight and say, hey, here's the
path through this.
And so you got tocompartmentalize this stuff.
So I go inside, I put my wifeon mute, I'm hitting the road
for my two-hour drive in themiddle of the night to get to
(04:35):
the airport, to get to the redeye, to get to Denver, and so I
get to the hospital right whenhe's getting out of the
ophthalmology exam andeverything is great.
You know, like I mean, he'sfine, there's no neurologic
issues.
He broke his orbit in a coupleof places and they're like, okay
, worst case scenario, he mighthave like a cosmetic surgery if
his eyes are different sizeswhen he's done with growth and
development.
(04:55):
And so it was a very scarymoment for the family.
I say kind of easily right now,but it was like very scary
moment for the family when ithappened.
But I take those things, Iremember how I showed up in that
moment and then I take it tolike complications I have in
surgery.
I'm like, dude, I do the samething.
I do the same thing.
Like we come up with a gameplan.
Someone has to assumeleadership, someone has to be
the beta and it's not really abeta but someone has to be that
(05:16):
ancillary player to just, likeyou know, do certain things, and
that's how you get through someof these complex things.
Speaker 1 (05:22):
It's just a very good skill set to have and I'm
thinking of some times wherewe've had some medical
emergencies at my office, whenI've had doctors come get me and
say what do I do?
And I want to be like you're adoctor too, like I don't know
you do it, but it's like theyjust people, just need to be, I
don't need to be told.
But yeah, they need someone tolead, someone to lead, and it's
(05:46):
hard to.
I've gotten myself in a numberof positions with patients and
usually it's difficultextractions for me and just
stuff that I can't get out, andit's like me cutting bone and
then it starts bleeding a wholebunch and I don't like that and
I'm just like, oh God, what'shappening?
Are they going to die?
Like I don't know.
It's just, it's probably megetting inside my head, but I
besides things to my assistantsand I've been not so nice to
people and then you look backand you're like man, I was just,
the emotions just took over andit's like you can't control it.
(06:10):
But it helps to be aware of it,yeah.
Speaker 2 (06:12):
And the more and more you put yourself in these
situations, the more and moreyou get acclimated to it, and
that's one of the reasons why Iwent to a zygomatic implant
training course way before I wasready to play zygos.
But what it did for me is itshowed me some crazy ass shit
that these oral surgeons weredoing.
We're reflecting out to orbit.
You can see the infraorbitalnerve coming out.
(06:33):
You're going all the way backup to the cheekbone.
Massive bleeds were justclamping them and burning them,
closed and huge holes into thesinus, and that was like five
years ago or so.
Now I'm placing zygos andfeeling pretty comfortable about
it.
I came back from the course.
I was like you know what?
This other thing that used tobug me doesn't bother me anymore
because I saw someone just doit to the 10th degree and just
(06:53):
go like ape shit on this thingand they were just keeping their
cool and I got to see how theyhandle that stuff.
So that's.
Another good thing about theselive patient courses is just you
get to see stuff and to putyour mind at ease because you've
seen more complex things thanyou're going to do at home.
There's something called theDunning-Kruger effect.
It's like a just ubiquitoustype of business thing where,
essentially what it is, it's acurve that shows that there's a
(07:15):
point where you think you'rereally, really good.
And this was me too.
I graduated as a cocky dentist.
Oh, me too, I had awesome caseacceptance.
I was crushing it.
I was, like you know, likeslinging bridges and partials
everywhere.
I thought I was the shit.
And then I was having all thesevideo problems and I was having
all these broken, like I washaving inadequate space for the
teeth and the partials.
(07:37):
And so what happens is you hitthis thing where you actually
think you're really really good,but this is actually where
you're the most dangerous,because you've only done enough
cases to have successes, youhaven't been in the game long
enough to have failures and thennavigate through your failures.
So then what happens is you godown and you have all these
complications and then all of asudden you start coming back up
(07:57):
because as you start to manageyour own complications, you
start to get this real worldexperience, like this internal
knowing of what's happeningversus theoretical knowledge.
You have this like experientialknowledge.
Then you start to move into themasterships part of the
Dunning-Kruger effect and really, at the end of the day,
everyone's going to be in theDunning-Kruger.
Everyone is going to have thispoint where you think you're
better than you are.
(08:18):
You get humbled and then youfind your way through it.
It just really depends how longyou stay in.
The hard part of the curve andthat's what good mentors are
there to help you with, andthat's what good programs are
there to help you with is toshorten the learning curve.
For you To start any procedurefor the first time and expect
(08:38):
that you're not going to haveproblems, I think is a fallacy,
unless you're a unicorn and someof you guys exist out there,
it's not me, yeah.
Speaker 1 (08:41):
I mean, I think about when I graduated and I first
learned how to place implantsand I was doing surgery and just
surgical extractions and I feltcomfortable over it.
Man, I thought I was the shit,I was just awesome.
And then now I look at somestuff.
I did those first, like firsttwo years of practice ownership.
Maybe my second, third, fourthyear out.
I'm just like I don't even wantto try that anymore.
(09:03):
And I remember one thing that Iused to do and this would be a
great tip for new dentists Ifyou don't have a mentor to reach
out to is I would just make alittle note in my phone.
I would put the patient's name,the case and if I had an x-ray
or something or whatever I need,I would put that there and I'd
be like oh, I'm going to thisendo course in a few months.
In between, or at lunch, I'mgoing to go up there and I'm
(09:25):
going to show this person allthese cases and I'm not going to
let anything be amisunderstanding and just keep
working on it.
I think that helped me get alot better.
Speaker 2 (09:31):
That's absolutely a pro tip.
A hundred percent, pro tip,100%.
I feel like everyone shouldrewind that and listen to that
again and do that.
I have a lot of attendees thatcome up and do that with me and
we go through all their cases.
We go through all their cases.
It's amazing.
So, yeah, do that, have it forevery procedure mix and if you
come into contact with someonewho's really an expert on that,
(09:51):
definitely reach out to thatperson because you're going to
want to ask those reallyspecific questions to those
doctors.
So I love that idea, man,that's great.
Speaker 1 (10:00):
You know, one thing that I remembered over my career
that I think has also beenhelpful is when you're really
deep into like a surgicalprocedure, like an extraction,
and you're just struggling isjust saying let's take an x-ray
and just get out of that roomand for some reason just
resetting Like have you everfelt like anything like that has
been helpful for you, doing theamount of surgeries you do?
Speaker 2 (10:21):
Yeah, I do the exact same thing.
I don't call it a reset, I callit a surgical timeout.
So you have a couple of options.
If it's not an emergency andyou're just stuck, dude, it's
totally fine.
Leave the room, walk around theblock.
I literally like walk out ofthe office and I'll go get some
(10:43):
sunshine, I'll pour like a cupof coffee.
I have this one lap I do aroundthe entire complex and I come
back in.
It takes about three minutesand I go back in and I tackle it
.
I liked your idea about hey,let's get an x-ray, so like it
keeps the wheels turning alittle bit.
It's not like you know, you'reupset and walking out of the
room.
And I had a mentor say thatback in dental school and I was
like, ah, I don't know whatyou're talking about, old timer.
And then now fast forward acouple of years.
I'm like you know, there's alot of wisdom Dunning-Kruger
effect.
It comes full circle, man.
(11:05):
So at a surgical timeout, let'ssay it's an emergency, right?
So one time I had this likepetite 16-year-old we're doing
wisdom teeth on, my associate'sdoing wisdom teeth, my
associate's doing the sedation.
He calls me and he's like Ican't keep her sedated.
Her numbers are kind of allover the place.
She's kind of freaking out andI'm midway, I'm halfway across
the highway, Can you get me allthe way across?
(11:25):
I'm like all right, cool, I'mthe shit, let's fucking go, type
of thing.
So I get in there and I did notdo my evaluation properly.
I kind of skipped my own steps,I kind of skipped my own
protocols.
Sure, her heart rate was high,but her blood pressure was very
low.
It was an end of the daysedation.
She must have been completelydehydrated and she was like
(11:48):
scared.
And so I was like, okay, I'llpush some meds.
But also, what's happening isI'm running an administrative
day that day.
So I'm in the operatory fixingthis case and helping my doc
with this case, but I'm havingother people come in the room
and ask me questions and so he'susing a different IV setup than
I'm used to.
So the IV port is closer to thearm versus, like the tubing
(12:09):
being really really far away.
So I'm pushing meds and this oneI really hate, you know, and I
wish I had back, but I don't.
So this one I really hate, youknow, and I wish I had back, but
I don't.
So I'm pushing meds andsomeone's talking to me about
some other shit and I'm notpaying attention.
I look down and I administerthree times as much as I should
have, because I just took my eyeoff of it and her blood
pressure was already low.
And so in that moment I knowthe pharmacokinetics of the
medication and I know what it'sgoing to do to her and I know
(12:31):
her numbers and I have an ideaof what's going to happen in the
next 120 seconds.
So in that moment it's like allright, surgical timeout.
Everyone stops, I clear the roomof all non-essential personnel
and I tell everyone what's goingon.
And I get on the phone and Istart to look up the medications
and the reversal agents and Iget to have them grab the bag.
And I have them grab theemergency meds and I'm getting
(12:53):
everything drawn up because Iknow I have two minutes to
really get this going before shestarts bottoming out.
And so at the end of the day itall worked out fine.
I had to sit there for likethree extra hours and just keep
her numbers up because themedication lasted longer than
the reversal agent lasts.
So you feel like you fixedsomeone, but then they start to
desaturate again because youhave to keep administering the
(13:16):
reversal.
But these are the surgicaltimeouts you stop, you get
everyone out of the room andmaybe it's an inventory thing.
So you go through yourinventory, you make sure you
have everything you need,Whatever's happening in that
moment.
You just need to take a breakand gather your thoughts and
solve the problem and knowwhat's going to happen.
And this one I had never beenthrough.
I've never done that before.
(13:36):
I have systems in place whereI'm never going to do it again.
I'm glad it worked out.
Speaker 1 (13:40):
Well, okay, I mean, I think otherwise we probably
wouldn't talk about it.
You know, it reminds me of Iwish I had like a more
life-threatening, relatablestory.
But I was doing a lip flip onone of my hygienists and if we
do upper lip, it's fourdifferent injections and you put
the same amount on one side andjust put it on the other side.
And somebody came and asked mea question when I was doing the
(14:01):
second injection and I wastalking and I pushed the whole
rest of the syringe in one ofthe injection things and then I
looked up like I was gonna getanother syringe.
I'm like, oh crap, I wassupposed to use that for all
four.
And then we went, we're justgoing to balance it out.
It looked horrible.
When she smiled.
It was like it just was toomuch, it was just dead.
It just didn't look right forlike probably a good six weeks
(14:28):
and I felt so bad for her.
But she forgave me and Ilearned something.
So now we do I get two syringes, one for the right and one for
the left, because I don't everwant to do that again.
But it's amazing and my teamknows this too when I'm typing,
don't ask me a question Like Ihate that's like something they
know, but this it's probablysomething I imagine you'd made a
rule, like hey, when I'mpushing sedation do not ask me a
(14:52):
question I don't know.
Speaker 2 (14:53):
I mean, what would you change After that?
It's like hey, not doinganything that's going to cause
harm.
To come back to the two syringething, my mom's a pediatric
oncology nurse, so she's alwaysbeen like sedating children.
I told her about the story andshe got so mad at me.
She was like you need to drawup what you're going to
administer.
Don't draw up more than you'regoing to administer.
Draw up what you're going toadminister.
This is a common problem, yeah,when.
(15:13):
I have a really young patient ora patient who's like, really
like, a higher complexity of asedation.
I only draw up what I'm goingto administer, so God forbid I
make a mistake.
Speaker 1 (15:24):
No-transcript, yeah, that's a good point to make.
Speaker 2 (15:27):
One of the things I found is it's easier to stay out
of trouble than it is to reallyget yourself out of trouble.
So what does that mean?
That means knowing what casesto do and knowing what cases not
to do.
Well, how do you know?
Because in the very beginning,you're so excited that just
someone's willing to pay thatmuch money for this procedure.
You just learned.
You're like okay cool, I wantto get my reps, I.
(15:48):
You just learned, you're likeokay cool, I want to get my reps
.
I want to get good at thisstuff, I want to do this for my
career.
You start saying yes to a lot ofpeople, but also having a good
mentor in your corner where youcan send them the case.
You can send them the medhistory, you can send them the
cosmetic pictures, you can sendthem a video of the CBCT and the
panel and whatever, and theycan look at it and they can say
you know, this is actually apretty hard case.
(16:08):
I think you should maybe passon it because they know where
you're at from a skill levelperspective.
I can't tell you how many timesI've said that to one of our
alumni or anyone from the DSIfamily where it's like, hey,
refer this case.
I think that these are likefive different reasons why you
want to.
And also, on the flip side ofthat, there's so many cases that
(16:29):
dentists will send me where I'mlike, man, you can do this,
like go, go, go, and they'relike they're so afraid to do it
and they're so concerned becausethey just want to do like the
best job they can.
So it's nice to have someone inyour corner who reviews the case
and is like, have no fear, thisone is green light, sprint at
this one type of deal, and youdo that for a lot of your people
(16:50):
that come through CSI, right,yeah, and actually one thing I'm
doing is I'm going around onrandom Fridays and doing
philanthropy surgeries.
So I'm just doing like freesurgeries for different offices
in Colorado, and so thesedentists who like really don't
have surgical practices arestarting to send me their cases.
And I'm getting to thesedialogues more and more and it's
really fun to see the way thatdifferent dentists with
(17:11):
different trainings like acosmetic dentist who does no
surgery, how he conveys themessage to me versus the GP
dentist, versus the orthodentist.
So it's just a fun littlepassion project I'm doing here
for right now I have a lot ofpeople sending me cases and then
it's interesting to see the wayeach different person's mind
kind of puts it together.
Speaker 1 (17:30):
I think about, like every case that I've lost sleep
over.
There was one point during theconsultation where, even if it
was just a glimpse, where it waslike don't do this, don't do
this dumbass, you're not thatgood.
And I'm like yeah, I am, youknow.
And then I was like yeah, yeah,yeah, a hundred percent.
The ego, it's the ego.
It always crosses your mind.
Speaker 2 (17:47):
Yeah, so there was this one article that came out,
but they're actually provingthat there's like a neurologic
connection between the gut andthe brain.
So that's why, when I have thislike gut feeling, it's your
body actually signaling like hey, something is going on.
And then you have the intuitionthat's like in the mind and
then you're like, oh, I havethis, like you know, heart-based
(18:10):
based feeling.
There's different ways yourbody is speaking to you in the
consultation room and if youjust kind of quiet down a little
bit and you just listen to yourown intuition, like you know
what's right and wrong, you knowwhen you're pushing the limits
a little bit, you know when thatpatient's a little freaking
crazy, you know when to pull theripcord on it.
So just trust yourself.
When you feel that way, trustyourself, say no to it.
The money will come later.
Speaker 1 (18:30):
Yeah, so true, I'm about to deliver 10 units next
week and we'll see.
I've had this feeling the wholetime and I got a bad feeling.
I got a bad feeling that keepspushing me along and we're going
to see how it goes.
But yeah, man, so if anyonewants to reach out to you or
check out what Colorado SurgicalInstitute offers, where do they
go?
Speaker 2 (18:47):
If you want to call Chris Richards, it's
970-410-6148.
Or you can email him at chrisat legacydentalinccom.
Or just check out the ColoradoSurgical Institute page or
socials or what have you, orlook me up on Instagram.
We have programs really thatcover everything surgical.
We even have a Brazil programcoming up and we started a
(19:11):
digital workflow program.
That's like really hands on.
So, at the end of the day,anything that really exists
within this educational forum,we're creating content for us.
If you really want to learn it,I have a way for you to learn
it and we're truly here to help.
Speaker 1 (19:25):
Dude, thanks so much for coming on.
Always a pleasure, and we'llget you back on maybe next month
sometime, because every timeyou're here I think you just
give us so many good things.
So thanks so much, de'hare.
Yeah, thank you, brother.
You are a dentist and , because of that, unexpected
complications and unforeseenemergencies are bound to happen.
The question is, how preparedare you to lead your team
through them?
Today, dr Tahir Dune is backagain and he's sharing more
real-life insights on handlingdental emergencies and how to
navigate the unexpected outcomesof treatment like a pro.
(00:24):
We're talking about surgicaltimeouts.
We're talking mindset shiftsand more ways to stay calm under
pressure.
Plus, you'll get some greattips on preventing complications
and knowing when it's time towalk away from a case.
This is the episode for everysingle person who has ever had
anything unexpected happen, andI know that's all of you.
(00:44):
Let's go.
You are listening to DentalPractice Heroes, where we help
you create and scale your dentalpractice so that you are no
longer tied to the chair.
I'm Dr Paul Etcheson, author oftwo books on dental practice
management, dental coach andowner of a $6 million group
practice in the suburbs ofChicago.
I wanna teach you how to growand systematize your dental
practice so you can spend lesstime practicing and more time
(01:07):
enjoying a life that you love.
Let's get started.
Hello there, and welcome backto the Dental Practice Heroes
podcast.
I am your host, dr Paul Etchison, and so excited to be joined
once again by the ColoradoSurgical Institute, dr Tahir
Dune just a great surgeon, greatperson and just a wealth of
(01:28):
knowledge on business stuff.
So welcome back, tahir.
How are you doing today?
Doing great man.
Doing great man.
The last time you were on, wetalked a lot about some lawsuits
and other stuff, and if youhaven't listened to that
listeners, go back and listen tothat episode.
It was a very interesting oneand it'll make you think about a
few things with the way thatyou document your patients.
But this time we're talkingabout emergencies and when
(01:52):
things happen unexpectedly, andwhat we can do as the leader of
the practice.
So before we get into what todo, I mean talk about what it
looks like when you don't thinkabout these things and you just
show up and something happens.
Speaker 2 (02:05):
Yeah.
So, first and foremost, if youare doing surgical procedures or
quite frankly, I mean like ifyou have kids, kids get hurt all
the time.
If you have anything going onin your world and you actually
go out there and live life, Imean you're going to be faced
with incidences where somethinghappens unexpectedly.
And for a lot of us, we'reprobably the leaders of our
groups.
(02:25):
We're the leaders in ourpractices, but we're the leaders
sometimes out in our friendcircles too, and so people do
look to us for, like, what doyou do?
Because if we've gone throughlike ACLS, training or anything,
they say, hey, everyone has arole, someone has to call out
the shots, everyone has to kindof fall into their role to get
to the other end of thisemergency.
So back in the day, when wewere recording for Colorado
(02:46):
Surgical stuff and I get a callfrom my wife and she's like I
need you to listen right now andI was like holy shit, okay,
she's only done that like twoother times and it wasn't good.
And I hear my six-month-oldhe's three now, but my
six-month-old screaming like ascary, fear-based yell, not like
a normal kid's cry.
She's like Jonathan fell hiseyes bleeding and shut.
(03:08):
He's bleeding out of his ear,he's bleeding out of his nose oh
my God, like.
And he's six months old.
So you know those little rockerthings that they put babies in,
you know, just to kind of likehave them chill.
My brother-in-law was visitingand he's a great guy, but at the
same time he had him up on thecounter and took his eyes off of
him and then my kid bounces andfalls off the counter straight
(03:29):
on his face, and then she'scalling me and I'm in Arizona,
she's in Colorado driving to theER.
This ability to compartmentalizeyour emotions, so what they
teach in like, sometimes, inlike meditation or when you're
physiologically like gettingstressed out, it's breaking
apart what's happening intothree categories.
(03:51):
So it's like okay, well, what'sactually happening?
What physiologically ishappening to me?
Like, my pulse is elevating, myblood pressure is going up, I'm
sweating a little bit, my handis shaking a little bit, and
then what's the story that I'mtelling myself?
Okay, my kid's going to haveneurologic issues.
My hand is shaking a little bit, and then what's the story that
I'm telling myself?
Okay, my kid's going to haveneurologic issues.
My kid's going to be really,really hurt.
Okay, what's the story?
Kids are very plastic, they'revery resilient, they're very
(04:13):
strong, they can bounce backfrom these things.
So okay.
So it's like all these thingsare happening and in the moment,
what do people really need?
They just need you to pave away for them.
They need someone to shine alight and say, hey, here's the
path through this.
And so you got tocompartmentalize this stuff.
So I go inside, I put my wifeon mute, I'm hitting the road
for my two-hour drive in themiddle of the night to get to
(04:35):
the airport, to get to the redeye, to get to Denver, and so I
get to the hospital right whenhe's getting out of the
ophthalmology exam andeverything is great.
You know, like I mean, he'sfine, there's no neurologic
issues.
He broke his orbit in a coupleof places and they're like, okay
, worst case scenario, he mighthave like a cosmetic surgery if
his eyes are different sizeswhen he's done with growth and
development.
(04:55):
And so it was a very scarymoment for the family.
I say kind of easily right now,but it was like very scary
moment for the family when ithappened.
But I take those things, Iremember how I showed up in that
moment and then I take it tolike complications I have in
surgery.
I'm like, dude, I do the samething.
I do the same thing.
Like we come up with a gameplan.
Someone has to assumeleadership, someone has to be
the beta and it's not really abeta but someone has to be that
(05:16):
ancillary player to just, likeyou know, do certain things, and
that's how you get through someof these complex things.
Speaker 1 (05:22):
It's just a very good skill set to have and I'm
thinking of some times wherewe've had some medical
emergencies at my office, whenI've had doctors come get me and
say what do I do?
And I want to be like you're adoctor too, like I don't know
you do it, but it's like theyjust people, just need to be, I
don't need to be told.
But yeah, they need someone tolead, someone to lead, and it's
(05:46):
hard to.
I've gotten myself in a numberof positions with patients and
usually it's difficultextractions for me and just
stuff that I can't get out, andit's like me cutting bone and
then it starts bleeding a wholebunch and I don't like that and
I'm just like, oh God, what'shappening?
Are they going to die?
Like I don't know.
It's just, it's probably megetting inside my head, but I
besides things to my assistantsand I've been not so nice to
people and then you look backand you're like man, I was just,
the emotions just took over andit's like you can't control it.
(06:10):
But it helps to be aware of it,yeah.
Speaker 2 (06:12):
And the more and more you put yourself in these
situations, the more and moreyou get acclimated to it, and
that's one of the reasons why Iwent to a zygomatic implant
training course way before I wasready to play zygos.
But what it did for me is itshowed me some crazy ass shit
that these oral surgeons weredoing.
We're reflecting out to orbit.
You can see the infraorbitalnerve coming out.
(06:33):
You're going all the way backup to the cheekbone.
Massive bleeds were justclamping them and burning them,
closed and huge holes into thesinus, and that was like five
years ago or so.
Now I'm placing zygos andfeeling pretty comfortable about
it.
I came back from the course.
I was like you know what?
This other thing that used tobug me doesn't bother me anymore
because I saw someone just doit to the 10th degree and just
(06:53):
go like ape shit on this thingand they were just keeping their
cool and I got to see how theyhandle that stuff.
So that's.
Another good thing about theselive patient courses is just you
get to see stuff and to putyour mind at ease because you've
seen more complex things thanyou're going to do at home.
There's something called theDunning-Kruger effect.
It's like a just ubiquitoustype of business thing where,
essentially what it is, it's acurve that shows that there's a
(07:15):
point where you think you'rereally, really good.
And this was me too.
I graduated as a cocky dentist.
Oh, me too, I had awesome caseacceptance.
I was crushing it.
I was, like you know, likeslinging bridges and partials
everywhere.
I thought I was the shit.
And then I was having all thesevideo problems and I was having
all these broken, like I washaving inadequate space for the
teeth and the partials.
(07:37):
And so what happens is you hitthis thing where you actually
think you're really really good,but this is actually where
you're the most dangerous,because you've only done enough
cases to have successes, youhaven't been in the game long
enough to have failures and thennavigate through your failures.
So then what happens is you godown and you have all these
complications and then all of asudden you start coming back up
(07:57):
because as you start to manageyour own complications, you
start to get this real worldexperience, like this internal
knowing of what's happeningversus theoretical knowledge.
You have this like experientialknowledge.
Then you start to move into themasterships part of the
Dunning-Kruger effect and really, at the end of the day,
everyone's going to be in theDunning-Kruger.
Everyone is going to have thispoint where you think you're
better than you are.
(08:18):
You get humbled and then youfind your way through it.
It just really depends how longyou stay in.
The hard part of the curve andthat's what good mentors are
there to help you with, andthat's what good programs are
there to help you with is toshorten the learning curve.
For you To start any procedurefor the first time and expect
(08:38):
that you're not going to haveproblems, I think is a fallacy,
unless you're a unicorn and someof you guys exist out there,
it's not me, yeah.
Speaker 1 (08:41):
I mean, I think about when I graduated and I first
learned how to place implantsand I was doing surgery and just
surgical extractions and I feltcomfortable over it.
Man, I thought I was the shit,I was just awesome.
And then now I look at somestuff.
I did those first, like firsttwo years of practice ownership.
Maybe my second, third, fourthyear out.
I'm just like I don't even wantto try that anymore.
(09:03):
And I remember one thing that Iused to do and this would be a
great tip for new dentists Ifyou don't have a mentor to reach
out to is I would just make alittle note in my phone.
I would put the patient's name,the case and if I had an x-ray
or something or whatever I need,I would put that there and I'd
be like oh, I'm going to thisendo course in a few months.
In between, or at lunch, I'mgoing to go up there and I'm
(09:25):
going to show this person allthese cases and I'm not going to
let anything be amisunderstanding and just keep
working on it.
I think that helped me get alot better.
Speaker 2 (09:31):
That's absolutely a pro tip.
A hundred percent, pro tip,100%.
I feel like everyone shouldrewind that and listen to that
again and do that.
I have a lot of attendees thatcome up and do that with me and
we go through all their cases.
We go through all their cases.
It's amazing.
So, yeah, do that, have it forevery procedure mix and if you
come into contact with someonewho's really an expert on that,
(09:51):
definitely reach out to thatperson because you're going to
want to ask those reallyspecific questions to those
doctors.
So I love that idea, man,that's great.
Speaker 1 (10:00):
You know, one thing that I remembered over my career
that I think has also beenhelpful is when you're really
deep into like a surgicalprocedure, like an extraction,
and you're just struggling isjust saying let's take an x-ray
and just get out of that roomand for some reason just
resetting Like have you everfelt like anything like that has
been helpful for you, doing theamount of surgeries you do?
Speaker 2 (10:21):
Yeah, I do the exact same thing.
I don't call it a reset, I callit a surgical timeout.
So you have a couple of options.
If it's not an emergency andyou're just stuck, dude, it's
totally fine.
Leave the room, walk around theblock.
I literally like walk out ofthe office and I'll go get some
(10:43):
sunshine, I'll pour like a cupof coffee.
I have this one lap I do aroundthe entire complex and I come
back in.
It takes about three minutesand I go back in and I tackle it
.
I liked your idea about hey,let's get an x-ray, so like it
keeps the wheels turning alittle bit.
It's not like you know, you'reupset and walking out of the
room.
And I had a mentor say thatback in dental school and I was
like, ah, I don't know whatyou're talking about, old timer.
And then now fast forward acouple of years.
I'm like you know, there's alot of wisdom Dunning-Kruger
effect.
It comes full circle, man.
(11:05):
So at a surgical timeout, let'ssay it's an emergency, right?
So one time I had this likepetite 16-year-old we're doing
wisdom teeth on, my associate'sdoing wisdom teeth, my
associate's doing the sedation.
He calls me and he's like Ican't keep her sedated.
Her numbers are kind of allover the place.
She's kind of freaking out andI'm midway, I'm halfway across
the highway, Can you get me allthe way across?
(11:25):
I'm like all right, cool, I'mthe shit, let's fucking go, type
of thing.
So I get in there and I did notdo my evaluation properly.
I kind of skipped my own steps,I kind of skipped my own
protocols.
Sure, her heart rate was high,but her blood pressure was very
low.
It was an end of the daysedation.
She must have been completelydehydrated and she was like
(11:48):
scared.
And so I was like, okay, I'llpush some meds.
But also, what's happening isI'm running an administrative
day that day.
So I'm in the operatory fixingthis case and helping my doc
with this case, but I'm havingother people come in the room
and ask me questions and so he'susing a different IV setup than
I'm used to.
So the IV port is closer to thearm versus, like the tubing
(12:09):
being really really far away.
So I'm pushing meds and this oneI really hate, you know, and I
wish I had back, but I don't.
So this one I really hate, youknow, and I wish I had back, but
I don't.
So I'm pushing meds andsomeone's talking to me about
some other shit and I'm notpaying attention.
I look down and I administerthree times as much as I should
have, because I just took my eyeoff of it and her blood
pressure was already low.
And so in that moment I knowthe pharmacokinetics of the
medication and I know what it'sgoing to do to her and I know
(12:31):
her numbers and I have an ideaof what's going to happen in the
next 120 seconds.
So in that moment it's like allright, surgical timeout.
Everyone stops, I clear the roomof all non-essential personnel
and I tell everyone what's goingon.
And I get on the phone and Istart to look up the medications
and the reversal agents and Iget to have them grab the bag.
And I have them grab theemergency meds and I'm getting
(12:53):
everything drawn up because Iknow I have two minutes to
really get this going before shestarts bottoming out.
And so at the end of the day itall worked out fine.
I had to sit there for likethree extra hours and just keep
her numbers up because themedication lasted longer than
the reversal agent lasts.
So you feel like you fixedsomeone, but then they start to
desaturate again because youhave to keep administering the
(13:16):
reversal.
But these are the surgicaltimeouts you stop, you get
everyone out of the room andmaybe it's an inventory thing.
So you go through yourinventory, you make sure you
have everything you need,Whatever's happening in that
moment.
You just need to take a breakand gather your thoughts and
solve the problem and knowwhat's going to happen.
And this one I had never beenthrough.
I've never done that before.
(13:36):
I have systems in place whereI'm never going to do it again.
I'm glad it worked out.
Speaker 1 (13:40):
Well, okay, I mean, I think otherwise we probably
wouldn't talk about it.
You know, it reminds me of Iwish I had like a more
life-threatening, relatablestory.
But I was doing a lip flip onone of my hygienists and if we
do upper lip, it's fourdifferent injections and you put
the same amount on one side andjust put it on the other side.
And somebody came and asked mea question when I was doing the
(14:01):
second injection and I wastalking and I pushed the whole
rest of the syringe in one ofthe injection things and then I
looked up like I was gonna getanother syringe.
I'm like, oh crap, I wassupposed to use that for all
four.
And then we went, we're justgoing to balance it out.
It looked horrible.
When she smiled.
It was like it just was toomuch, it was just dead.
It just didn't look right forlike probably a good six weeks
(14:28):
and I felt so bad for her.
But she forgave me and Ilearned something.
So now we do I get two syringes, one for the right and one for
the left, because I don't everwant to do that again.
But it's amazing and my teamknows this too when I'm typing,
don't ask me a question Like Ihate that's like something they
know, but this it's probablysomething I imagine you'd made a
rule, like hey, when I'mpushing sedation do not ask me a
(14:52):
question I don't know.
Speaker 2 (14:53):
I mean, what would you change After that?
It's like hey, not doinganything that's going to cause
harm.
To come back to the two syringething, my mom's a pediatric
oncology nurse, so she's alwaysbeen like sedating children.
I told her about the story andshe got so mad at me.
She was like you need to drawup what you're going to
administer.
Don't draw up more than you'regoing to administer.
Draw up what you're going toadminister.
This is a common problem, yeah,when.
(15:13):
I have a really young patient ora patient who's like, really
like, a higher complexity of asedation.
I only draw up what I'm goingto administer, so God forbid I
make a mistake.
Speaker 1 (15:24):
No-transcript, yeah, that's a good point to make.
Speaker 2 (15:27):
One of the things I found is it's easier to stay out
of trouble than it is to reallyget yourself out of trouble.
So what does that mean?
That means knowing what casesto do and knowing what cases not
to do.
Well, how do you know?
Because in the very beginning,you're so excited that just
someone's willing to pay thatmuch money for this procedure.
You just learned.
You're like okay cool, I wantto get my reps, I.
(15:48):
You just learned, you're likeokay cool, I want to get my reps
.
I want to get good at thisstuff, I want to do this for my
career.
You start saying yes to a lot ofpeople, but also having a good
mentor in your corner where youcan send them the case.
You can send them the medhistory, you can send them the
cosmetic pictures, you can sendthem a video of the CBCT and the
panel and whatever, and theycan look at it and they can say
you know, this is actually apretty hard case.
(16:08):
I think you should maybe passon it because they know where
you're at from a skill levelperspective.
I can't tell you how many timesI've said that to one of our
alumni or anyone from the DSIfamily where it's like, hey,
refer this case.
I think that these are likefive different reasons why you
want to.
And also, on the flip side ofthat, there's so many cases that
(16:29):
dentists will send me where I'mlike, man, you can do this,
like go, go, go, and they'relike they're so afraid to do it
and they're so concerned becausethey just want to do like the
best job they can.
So it's nice to have someone inyour corner who reviews the case
and is like, have no fear, thisone is green light, sprint at
this one type of deal, and youdo that for a lot of your people
(16:50):
that come through CSI, right,yeah, and actually one thing I'm
doing is I'm going around onrandom Fridays and doing
philanthropy surgeries.
So I'm just doing like freesurgeries for different offices
in Colorado, and so thesedentists who like really don't
have surgical practices arestarting to send me their cases.
And I'm getting to thesedialogues more and more and it's
really fun to see the way thatdifferent dentists with
(17:11):
different trainings like acosmetic dentist who does no
surgery, how he conveys themessage to me versus the GP
dentist, versus the orthodentist.
So it's just a fun littlepassion project I'm doing here
for right now I have a lot ofpeople sending me cases and then
it's interesting to see the wayeach different person's mind
kind of puts it together.
Speaker 1 (17:30):
I think about, like every case that I've lost sleep
over.
There was one point during theconsultation where, even if it
was just a glimpse, where it waslike don't do this, don't do
this dumbass, you're not thatgood.
And I'm like yeah, I am, youknow.
And then I was like yeah, yeah,yeah, a hundred percent.
The ego, it's the ego.
It always crosses your mind.
Speaker 2 (17:47):
Yeah, so there was this one article that came out,
but they're actually provingthat there's like a neurologic
connection between the gut andthe brain.
So that's why, when I have thislike gut feeling, it's your
body actually signaling like hey, something is going on.
And then you have the intuitionthat's like in the mind and
then you're like, oh, I havethis, like you know, heart-based
(18:10):
based feeling.
There's different ways yourbody is speaking to you in the
consultation room and if youjust kind of quiet down a little
bit and you just listen to yourown intuition, like you know
what's right and wrong, you knowwhen you're pushing the limits
a little bit, you know when thatpatient's a little freaking
crazy, you know when to pull theripcord on it.
So just trust yourself.
When you feel that way, trustyourself, say no to it.
The money will come later.
Speaker 1 (18:30):
Yeah, so true, I'm about to deliver 10 units next
week and we'll see.
I've had this feeling the wholetime and I got a bad feeling.
I got a bad feeling that keepspushing me along and we're going
to see how it goes.
But yeah, man, so if anyonewants to reach out to you or
check out what Colorado SurgicalInstitute offers, where do they
go?
Speaker 2 (18:47):
If you want to call Chris Richards, it's
970-410-6148.
Or you can email him at chrisat legacydentalinccom.
Or just check out the ColoradoSurgical Institute page or
socials or what have you, orlook me up on Instagram.
We have programs really thatcover everything surgical.
We even have a Brazil programcoming up and we started a
(19:11):
digital workflow program.
That's like really hands on.
So, at the end of the day,anything that really exists
within this educational forum,we're creating content for us.
If you really want to learn it,I have a way for you to learn
it and we're truly here to help.
Speaker 1 (19:25):
Dude, thanks so much for coming on.
Always a pleasure, and we'llget you back on maybe next month
sometime, because every timeyou're here I think you just
give us so many good things.
So thanks so much, de'hare.
Yeah, thank you, brother.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!