← Becker’s Healthcare Podcast
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- [00:00]
A
Hello, this is Ariana Portolattan with the beckers Dental and DSO Review podcast. I'm thrilled to be joined today by Dr. Krista Kappas, a private practice dentist in California. Dr. Kappas, thank you so much for being here today. It's great to meet with you.
- [00:13]
B
Thanks for having me.
- [00:14]
A
Yes, definitely. To start us off, our listeners, can you introduce yourself and tell us a little bit about your background?
- [00:20]
B
Yeah, I. Well, you've got my name now. Yes. I went to University of Michigan for dental school and practiced at a community clinic. And then I actually worked for a DSO for about five years after that, which was great experience. And my husband and I decided we were kind of sick of the Michigan winters and moved out to Northern California and purchased our own practice. We've been here for five years in wine country, which has been lovely, but definitely a change up from the DSL life to owning a private practice.
- [00:54]
A
Yeah, yeah, definitely. For our first question here, what are some of the biggest issues that you're following in the dental industry right now?
- [01:02]
B
I mean, I think it goes without saying on, you know, a lot of the Beckers titles and just dentistry in general, we're having a huge issue with staffing shortages. I mean, I know we're. Right now we participate with Delta Dental and we're one of the few offices in our area, so we're slammed. But getting good hygienists has been certainly an issue for us.
- [01:27]
A
Yeah, yeah, definitely. How was your experience with staffing shortages when you were working at the DSO in Michigan versus in private practice now in California?
- [01:37]
B
It was different, But I think 2020 certainly seemed to change everything. So we, we ended up moving here in 2020. And I think that was kind of the big shift to a lot of things that it really, you know, hiring a hygienist back in Michigan at that time, you'd put out an ad, you get five, five to six applicants. Several of them would be great. You'd have a hard time kind of deciding who it was going to be. Now it's, I think we had an add out for, you know, a month and a half. And with our Delta fees, I mean, we're basically paying everybody to get cleanings at this point with what we're paying our hygienists. And it's, you know, we're getting people fresh out of school asking $75 an hour. And we're fortunate. We did find some really good hygienists. We burned it. Good reputation name in our area. So we've been able to find and recruit some other experienced hygienists. But it's definitely not been easy to find.
- [02:33]
A
Yeah, I know. And this is something that I've spoken with a lot of practice owners about, too. Just the cost of hiring a hygienist with the salaries that they're asking for. How have you seen those increase since 2020?
- [02:46]
B
So I think when we purchased our office, the average hourly pay for a hygienist was 55 an hour. Now we're. We're at about 80, probably on average. And then with that, we do a bonus system too. So it ends up being, you know, five to six hundred bucks a month extra bonus on top of that. And our delta fees were literally for a cleaning, getting reimbursed less than that. But it's just kind of, you know, that it's. It's however you want to play the game. You know, we're swamped, we're busy. We're got bodies coming and going. So I think we'd rather practice that way. But it's definitely, you know, it's a challenge.
- [03:25]
A
Yeah. Is that bonus, Is that something that you found to be helpful for recruiting staff?
- [03:30]
B
Definitely, and I think it's been really good just for a morale booster, too. Basically, what we do is anything we do a percentage of treatment planned and accepted. And then also they have a daily goal. Anything they get over that goal, they get a percentage of that as well.
- [03:47]
A
Nice. Okay, next question here. What are you most excited about when it comes to dentistry right now? And is there anything that makes you nervous about the industry?
- [03:56]
B
Yeah, excited. There's so much cool technology that's coming out right now. I mean, right now we have. We're a big CEREC office. We love our CERECs. I think that makes participating with insurance doable. We've been working with Pearl AI, which has been huge for patient education. You pull up their X rays, they've got everything highlighted and what potentially could need fillings done, scaling, root cleaning, things like that. It's just really great for patient education. And it's great, too. There's sometimes that you might miss something. So it's. It's helpful for our hygienists to have that pulled up. They've already had a chance to kind of go through things with the patients before we step in the room, so we just have to confirm with them. I think AI is just going to keep getting better and better. I think scheduling is going to get better. You look at where we've come with ChatGPT and things like that. Over the years, I think we'll probably get some more automated online scheduling that just works more efficiently. And with, I mean, I'm a millennial, I think the up and coming generations, nobody wants to call, nobody wants to talk to somebody. It's just, you want to go on your phone and you want to get whatever you need scheduled. You want to pay your bill online, and you want to just get that done at that moment. If it's 11pm at night, you want to just get that scheduled. So I think that's all really coming and developing. I think 3D printing is also. I mean, we have Cerec. It's great, but it's not for everybody. We have a Sprint Ray that costs. You know, the setup for a Sprint Ray is about, I mean, maybe a tenth of it. So I think as that becomes more readily available, I mean, 3D printing a crown versus milling a crown, you don't have any over mill, under mill. Prepping is a lot easier. So I think that's going to keep getting better and better as materials change, too. Great.
- [05:44]
A
Was there anything that makes you nervous about the industry, too?
- [05:47]
B
There's a lot of things that make me nervous. It's interesting. I had a patient the other day who was in. He had a Crown done in 2001. He had his World War II hat on and everything. And he's been joking with me about, oh, well, I bet this crown costs 10 times as much as my crown got done in 2001. Well, let's check, because you've been coming to this practice for that long. Let me pull it up. You know what? Ironically, you're paying $20 less than you paid in 2001. How's that for inflation for you? But it's just, it paints such an interesting picture of where the dental field is going. I mean, every cost has gone up astronomically for us. Staffing costs, all of our dental supply costs, your rent, your. Everything has gone up. But I do think there needs to be a massive change in insurance for us to be able to provide high quality dental. I mean, you look at. We do still participate with Delta Dental, which is a nonprofit business, but you look at them, they had a 9.9 billion Delta Dental of California, $9.9 billion revenue last year. And they've got their costs, obviously, in providing the dental care and things like that. But it's just kind of interesting to look at in any other field how much prices have gone up and ours have really stayed stagnant or even gone down over the last couple of years. So I think that's certainly scary. You know, how are you going to continue to be able to pay and maintain staffing if you're not getting reimbursed what you need to get reimbursed to make that. So that's certainly scary. And like we talked about, staffing costs in general I think is going to be a little bit of a challenge keeping people around. You look at, I think that's been the talk amongst dentists for the last several years. And you read an article, I think I pulled one article up recently that was Dental Hygiene magazine and their solution to it was, well, dental hygienists don't want to stay around, they don't want to work right now. It's negative workplace culture, there's insufficient pay, they're feeling overworked. I think there's only so much you can do with that. We're already paying our hygienist to be there. We're bonusing them, we're giving them an hour for every procedure. There's only so much that you can really do before. That's not really the issue.
- [08:09]
A
Yeah, yeah, definitely. What changes could be made to sort of help the staffing challenges right now.
- [08:16]
B
I just think there needs to be a lot of reform in general. So I think looking at insurance, it's basically been, you know, I think I was looking back at this, you know, in the early, you know, like in the 60s, insurance was truly just. You'd go to the dentist, they would reimburse and it's just shifted and shifted and shifted to where now it's, you know, we're having to send preliminary X rays, post op X rays. We're getting everything pre authorized before we do treatment. We have a whole separate department just for dealing with insurance. We have different companies that we work with for insurance. And it's just gotten so complicated. Insurance maximums haven't changed. So I definitely think there needs to be some sort of insurance reform where, all right, we look at what the profitability they're actually making. I mean, of that 9.9 billion in revenue from Delta, they did donate $100 million. You know, I don't know what their exact profitability is. The CEO made over $30 million last year, which, it's a huge company. I mean a $9.9 billion company should be compensated fairly. But I think there's, we need to take a closer look at that. And maybe there's, I don't know what the changes are going to be, but it's not going in the right direction for dentists to be able to function. I think staffing wise, you look at dental hygiene education, there really hasn't been an increase in dental hygiene programs over the last 20 years. I think it's interesting, in the state of California, you can have an expanded functions dental assistant who can place fillings, they can use high speed handpieces, they can use low speed handpieces, they can put fillings in, but they can't scale teeth. They can use an ultrasonic cleaner if they're removing ortho cement, but they can't scale teeth. So I do think maybe some sort of a shift hygienists were there to originally help release the burden on dentists. But maybe there's a change of. We've got an expanded functions assistant who can do simple cleanings, maybe not scaling, root planning, things like that, kid profanes, cleanings, things like that. But I do think we need to have just generally dental education reform, insurance reform. And with that, I mean, I look at dental education, you know, you're graduating from school with $600,000 in debt. Who's going to be able to go into the workforce the way that it's going and make $100,000 a year and make that make sense?
- [10:48]
A
Yeah, yeah, definitely. A lot of interesting points that you've made there. Our last question here, what will the most effective healthcare leaders need to be successful in the next two to three years?
- [11:00]
B
I think we just need to roll with the changes because I think a lot has changed. Everything that I've talked about today, we're getting some really cool products with AI that will make us more efficient, make things more cost effective. And I think just being willing to adapt and get educated to use these things and be willing to change is going to be really crucial to being successful in the future.
- [11:24]
A
Okay, well, that is all I have for you today. Dr. Capis, thank you so much for joining us. Been a pleasure speaking with you and looking forward to connecting with you again in the future. Thank you so much.
- [11:33]
B
Thank you.