Very Clinical: 12 Crowns and $350K in Debt? Inside Modern Dental Education

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[00:00:55] Welcome to the Very Clinical Podcast. In about the time it takes to do an M.O. on three, we will entertain and amaze you with tips and tricks on regular daily dentistry. Here's Kevin and Zach. What is up, Very Clinical listeners? And welcome back to another episode of the Very Clinical Podcast. I'm Zach Miners coming to you from Kansas City, Mo. With me as always, my trusted co-host, Dr. Kevin Hare Fryer. Kevin, what's up? How's it going, Zach?

[00:01:22] Good. It's summer in the city. I love this time of year. Big fan. I love the summer. I love it. I love when it's late and the sun is still out. I'm a huge fan of that. Huge fan of that. Huge fan of vacation. The lake's warming up. And I love that stuff. So all good in the summer. As promised from last week's episode, we brought back Dr. Melinda Meredith. Melinda, what's up? Hello. Melinda, you haven't moved away from Zach yet?

[00:01:53] After this podcast comes out, I think the for sale sign's coming out. Oh, I'm not buying a house at this market. No way. All right. I guess you're stuck there. That's it. That is it. So speaking of neighbors, as we discovered on our last podcast, Zach and Melinda are neighbors. We are. And I'm sure that Zach is a wonderful neighbor and I don't want to create any animosity between these two fine fellow dentists and humans.

[00:02:21] But I'm sure you've had some bad neighbors in the past. So let's talk about bad neighbor stories. Okay. Who wants to go first? If not, I will go first. I got this. I will jump in. So not in the current neighborhood I'm in, because actually I genuinely enjoy the vast majority of our neighbors in the little community that we're in right now. But where I moved from previously, next door to me was a hoarder.

[00:02:52] And the backyard, I kid you not, this, you know, the backyard had vehicles with like, you know, the tires all blown out, that kind of thing. It had, you know, jet skis that were just, I mean, it was seriously packed out and it actually made it difficult to sell the house. Some people took one look outside and they're like, I'm not living next to these people. You open, open the garage and there's not like a square inch of anywhere to put in it.

[00:03:21] I mean, it was, uh, these people were the worst and they came into the office once and did not pay their bill, you know, on top of that. So that's always fun. That's always, uh, I should have sold some junk to pay your bill. Oh God. None of this stuff was worth anything. They, they just, they couldn't say no to anything.

[00:03:40] Even when I was cleaning out my house to move, I said a few things on the, like, you know, at the bottom of the driveway, free take me, you know, I figured out they grabbed every single one of those things as if like, you know, Hey, this might be worth three bucks or something like that is. So the hoarders, I hated those people and they sucked. So that was my bad neighbor story. All right. Melinda, you're up. Uh, I have a really sad one. We moved here.

[00:04:08] I think like for a safety issue, our old neighbor was a paranoid, schizophrenic young guy and it was really sad. And we really wanted to kind of stick it out. I think most often those people are not a harm, but we had little kids and our daughter's the same age as his daughter who we obviously hadn't seen. So, I mean, I was never going to move from that house and I'm really glad we did because this neighborhood is super fun and there's a ton of kids in the neighborhood, but it was pretty scary. I mean, it'd be funny if there wasn't a serious mental issue. Like, you know, he thought he was in the CIA.

[00:04:38] He thought, um, he talked about me and a porn star and thought I was a porn star. I don't know if we're allowed to talk about this. Then he compared me unfavorably. Please keep going. Zach talks about porn stars all the time. Yeah. Okay. I mean, it's very dental, but then he compared me unfavorably to the porn star. Oh. Yikes. Anyway, we moved. Okay. I'm glad we moved. This neighborhood's great. All right, Kevin, what do you got?

[00:05:07] I feel like you got something brewing in the tank there. Well, I mean, I've lived here for 11 or 12 years and our neighbor over there, I barely talked to. He's an ex-lawyer and he's just a really odd guy. So there are two stories.

[00:05:28] One, I think two years ago, maybe two or three years ago, we were planting some bushes on that side, basically to make a natural fence so we don't have to see them. And the wife was out. And the wife was out and she said, and she was also doing some gardening. And she said something like, it's so nice to talk to you. How long have you guys lived here? Like a year or two?

[00:05:58] And we've lived here for nine years. And this is the most you've ever spoken to us. Oh, my God. So that was kind of awful. But the other story is that we were on vacation and we have a dog watcher and our dogs were in the habit previously of running into the neighbor's yard and running back right away, like this loop that they would make.

[00:06:21] And so our neighbor waited, the lawyer neighbor waited till we were gone so he could sort of scream and intimidate our dog watcher, who's a young woman, which was really awful. So she texted us about it. I'm like, don't worry about it. I'll take care of it. And the next day I was home, our oldest dog, Ringo, went into his yard and he comes flying over yelling at me.

[00:06:47] And meanwhile, Ringo's barking at him, like, you know, trying to protect me because that's what dogs do. And so this guy's a lawyer and he's used to, you know, like intimidating people or whatever. And he's saying, you got to keep your dog out of my yard, blah, blah, blah, blah, blah. And I was like, I just stopped him. And I said, has my dog ever hurt you? He's like, no. And I go, OK, I'll try to keep him out of your yard. But, you know, sometimes it's going to happen. That's just what dogs do. Sorry.

[00:07:16] And he totally backed down. And, you know, but I don't think I've said two words to him since that day. And I probably never will. My dad has a lawyer. My dad has a lawyer neighbor that he has the same all kinds of like. These little mental battles with it's just a turf war thing. Yeah. The lawyer has to win, you know? Yeah. Like he's got some weird. He's marked the property line. Yeah. Very distinctly. Like, you know.

[00:07:47] And, you know, even, I mean, it's just, he'll like measure how close your cars are parked in the street from his property. Just bizarre. Sad that you have so little respect for your own personal time as to do that kind of stuff. You know? That's a good way to put it. And the thing is, you know, Ringo's a border collie. So he actually walks right down the property line. And he'll purposely walk a little bit over it because he wants to push the envelope a little bit. But. That's funny. Like, it's, no one ever taught him where the line was.

[00:08:17] He just knows. Yeah. It's really weird. Huh. Anyway. That's funny. Oddballs. Well. Neighbors. I wish I had a hoarder. Yeah, hoarder sounded good, Ryan. I guess so. The hoarder sounds better than the skits of running. That's for sure. All right. So back into dental education. If you missed last week's show, Melinda works at UMKC Dental School. She teaches operative dentistry and works on the clinic floor.

[00:08:46] And so what we talked about last week was just what it's like to be a dentist that works in education. And this week we're going to kind of talk about like the state of where dental education is, where things have changed if you're not a recent grad and kind of what's happened since the, you know, COVID apocalypse. Or as Kevin says, the Kobe apocalypse. Everything bad happened after Kobe died. So. It's not wrong. Go back in time. Look at the day Kobe died. The Kobe died.

[00:09:16] As a Kansas City person, there's only, I have only one corollary to that. And that is the Super Bowl. We won our first Super Bowl in 50 years the next week. So I'd like to say it's like right after that. That is like. I think it was the chief Super Bowl clause. Because that's my take. But anyway, you're right about that. Wait, wait. Which happened first? The Super Bowl or Kobe died? Kobe died before the Super Bowl. Because Kobe died right after Voices of Dentistry. And then. And I was going to the Super Bowl the very next week. So. Yep. After that. That's right. That's right. That's right. Yep. So anyway. Did you have to go to that one?

[00:09:45] I did. Oh, man. It was a super duper experience. That sounds awesome. I've talked about it on other shows. Okay. I'm super, super braggy about it. So. I would be. That's really cool. It was. It was very, very cool. Okay. So. Belinda. What has. What is going on with dental education these days? Like what's. What's changed since the. Since Kobe died. That's very broad. We kind of. When we were talking before. We talked about boards changing. There are.

[00:10:15] As a result of the pandemic. They are. Type and not based now. So I think that's a good place to start. That's a pretty huge thing. And I know. I feel like some of us are kind of like. Well, we had to suffer. Through patient boards. So others should have to too. But what. Cruel and unusual punishment. For the patients involved there. I mean. I don't know if when you all were in school. There was always talk of. The state dental boards. Trying to get rid of patient. Of live patient boards. And I kept hoping. It would be done by the time I graduated. And it took a global pandemic.

[00:10:45] To actually. Make it happen. So. It was a pretty crappy experience. Relying on those people to come. Yes. Yeah. And qualify. At the glitch booth. Yeah. Yeah. Sometimes you had to pay them. Stuff like that. They're there sometimes. Eight hours in a row. They were there for a very long time. Rough on everybody involved. So. And. I get it. Not at all. Standardized. To everyone. Yeah. Especially the perio part. I believe. And I mean. I think we also. Okay. Let's.

[00:11:15] Let's talk about that. Like. So. When I was in school. I. I remember. It was. Class two amalgam. Class three composite. Gold crown on a typodont. And then it's quadrant scaling and root planning. What. And that was. Whatever the. Midwest regional board. Or whatever they called. Called that. Credits. Credits. Yeah. And it switched to REB. My year. Western regional. Okay. What do you. What do they do now? What is on the board? So it was REB. Up until this year. When ADEX took over.

[00:11:44] And I think ADEX is almost every state now. Which. Okay. I like that you don't have a different board for every state. Because. That's nice. Dentistry is not like law. It's the same. Yeah. So. I get your jurisprudence is different. But. The. This was our first year doing. ADEX. I really liked the western regional. So that's what we had the first time with the typodonts. We were able to purchase the. There are teeth with. You know. Simulated carries in them. They're a lot harder than natural teeth.

[00:12:14] We bought diamond bars for the students to use for the first time on the boards. But now we're on to ADEX. You can't buy the simulated teeth. We buy a simulated tooth. But it's different. A huge percentage of our students had pulp exposures. On their simulated teeth. Yeah. Which is. I think. Quite a bit more difficult than. You know. The. The lesion that's just into the denton. That we all. Sure. For hours. Sure. It is funny in the springtime.

[00:12:44] Students aren't saying. Hey. Will you look at this x-ray. Will you look at this x-ray. So. Mm. Definitely different. You don't have to. Have all that panic. Um. And it is more standardized. I really think. If we're going to do it on typodons though. Cut an ideal class two prep. Or an ideal class three prep. That tells you a lot more than. You know. Identifying carries. Because you're not identifying carries. You're identifying. Something somebody made in a lab. That's. Okay. Really. I mean. You remember.

[00:13:14] Maybe you don't remember cutting on plastic teeth. It's terrible. It's not easy. It's not easy. I think it's much harder than cutting on enamel. Because burrs are made for enamel. Not plastic teeth. So that's the part. I don't like about it. I also think. There's a perio section. And it's on a typodont. So. That's bizarre. So what. What are you. What are you doing? Are you. Is there fake tartar on these. Fake cactus. Yes. So you have to buy. You have to buy the typodont. I think the entire exam costs $3,500. So that also.

[00:13:44] Seems like an ethical issue. And I think you get. That is three times. That's what it was in the. Yeah. And you don't have to pay your patient. But it's still. It's. Okay. When you're chosen that much. Oh. Wow. So is it. Is it still. So it's quadruple. Class two. And then. Is there a crown. I think you have to do a class two. And a class three. It can do. Okay. Composite or amalgam. And there's an endo portion. Oh yeah. That's right. I forgot about the endo. That was also a fake tooth though too.

[00:14:14] So. Yes. Yes. And that one. It doesn't bother me as much. Because you're seeing if you can. Instrument. Right. Sure. I don't know. Instead of. Simulating carries. Okay. And I think it's unreasonable to. Do a root canal on a live patient. For aborting. Sure. Sure. It was always. It's not okay with me. I don't remember if there is a fixed. Portion. Okay. Sorry about that. There's no crown. Crown. No. No. I think there is. But I'm not positive. That was a pain too. Because you had to. You had to. Commission a lab.

[00:14:44] To build your crown. Like essentially overnight. Oh. I didn't know. You didn't have to do that. Oh no. I had to cut my gold crown. Type it on. I underprepped. So my lab built in a reduction coping. From a plastic tooth. And then. Pop that. Pop that baby on. Yeah. That's nice. The whole thing. But I. We had to find the lab. And we like. Had to beg them. And overpay them. To. You know. Cast it. Do a gold inlay. Oof. Okay. Live patient one? And cast it.

[00:15:14] I had to wax it. And cast it. On the patient. Live. Whoa. Wow. Well that's a skill. That's really cool to say you have. I wish. Yeah. I was not working out for you right now. Do you know how many times I've used that? In the past 34 years? It's still pretty cool. Once? Never. Never. Oh they're so beautiful when you see them in your office though. Yeah. But I mean. Casting them myself. Oh. No. You're right. That part sucks. For sure. And that left by the time I was in school. And we're not that different Ryan. Sure.

[00:15:44] When we graduated. So I wonder. Yeah. I wonder when that stopped at UMKC. Yeah. I don't know. I've heard some dental schools. I don't know. I don't want to get in trouble. But I don't think Marquette's even teaching dentures now. For example. Like at all. Oh. Complete. I think dentures in that state or something. I don't. I don't know. Okay. I don't know either. Okay. Well we had to do a denture setup. We had to do dentures. Oh for your boards? Are you talking about. In the board. Yeah. Oh my. No way. Which was ridiculous. Wait a minute.

[00:16:15] What was on your board? You had to cast an inlay. Set up a denture. This sounds like a month. No. No you did that. I mean it was over two days. But. Holy. We had to do a class two. Wait a minute. We had to do a class two inlay. Yeah. We had to set down your teeth. We had to do the perio. And I think there was an amalgam too or something. This is like. Yeah. You had to walk uphill both ways. Yeah. It's true. Many. Many.

[00:16:45] Many. Many years ago. That's wild. Huh. Well and. But here's. I will say even talking about this. I've got a pit in my stomach. I was going to say. Is your anxieties or blood pressure up? Because I think mine. My watch. Just talking about. In general. I'm stressed out. Yeah. So stressful. I did not like that. So it did take off a huge part of the unknown stress for the students. That's good. But to be catty. Several students complained. That we had all of ours. In three days in a row. How it was in the past.

[00:17:14] You'd have like Friday. Saturday. Yeah. Sunday. Half day. Yes. And some schools allowed you to take. Say. Perio and endo. In the fall. And then. Operative. Oh. Fixed in the spring. And they were complaining that they didn't get to do that. It's like. Oh my. Hold on. Hold on. Back in my day. They need. Yeah. They need to listen to this show. Listen to what Kevin had to do. Holy cow. You'll never believe. Wow. Yeah. Like pick your battles guys. Sure. Okay. They speak their mind.

[00:17:45] Crazy Dental already has some of the lowest prices on dental supplies anywhere. But you know what's even crazier? Free shipping. Head over to crazydentalprices.com. Load up your cart. And use coupon code veryship. That's veryship for free shipping on every single order. Plus. Every time you use that code. Crazy Dental kicks back support to the Very Dental Podcast Network. Save money. Get free shipping. And support the show. Use code veryship today. All right. Let's talk about the written boards. Why did those become pass fail?

[00:18:14] Oh. Yeah. And it's integrated. Why did that happen? That was the litmus test for who went to specialty school. And who didn't. Like it was your score on that. On part one and part two boards. Like why did those. What happened there? Why did. And now. How did. How do they determine who goes to specialty school now. Without the. Is it just a. A lot of classes are becoming pass fail. Instead of ABC. Yeah. So that's always the issue is. With.

[00:18:44] Hey. That's always the issue with. Going to pass fail. Is. How do we get into specialty schools? It's. It's. It's definitely something that's being. Considered. So now it's just who they like the best. You know. It's. I'm sure it's rec letters. Yeah. Yeah. Looks. Um. Yeah. It's definitely. You bring up a good point. And you're not the only one who has. And also. You know that there's only one boards. Exam now. One. What? Oh. There's no part one and part two. Right. It's integrated now. Um.

[00:19:14] So that is a little bit. Less expensive. You take one test that I think. Six hundred fifty dollars. Instead of two tests that are each five hundred dollars. When do you take it? Then. Is it not between second and third year anymore? Is. I believe it is after third year. The summer after third year. Yes. And you have to go to a testing center. Like. We took our DATs at the testing center. I'm not sure. What. Oh. I didn't have to take the DAT Melinda. Six years. Because you got. The great father did. Yes. Okay.

[00:19:45] I didn't. I didn't take that. I'm better than that. So. Well. And I'm on the integrated boards test construction committee too. With ADA. Which is really cool. If either of you were ever interested in. In doing the test construction. You kind of. I know for you. Taking a day off work. Is a lot different. For me. Taking a day off work. I. And that doesn't. That's not included in my. Vacation time. Time to take that time off. But I always learn a ton. And you kind of get to see how the sausage is made. Doing that as well. And you know.

[00:20:13] They kind of sell you on their philosophy of it. And. The philosophy of it's great. It's. How many dentists. You know. Talk to their patients about the Krebs cycle. Right. It's more. Sure. You need to know how to integrate that information. Into your treatment. And there are still quite a few. Part one type questions. And I think. The first class that did it. I believe was. This. This year that just graduated. The class of 2023. 2023. So they. Recent grads might have something to say about that. Those.

[00:20:41] Those kids that graduated in like. You know. 21. Even last year. And or 20 for that matter. Like. What. What was there like. So. What was that year like. Go ahead Kevin. You don't bust in. Zach. I have a. I have a real concern about. That. Group of. Graduates. Yeah. And Melinda was right in the thick of it. So. You know. I just don't. I don't know how. I mean. I was barely confident.

[00:21:12] Right. At that. At that stage. Same. But without the reps. I don't know. So. Melinda. You're in the thick of it. Tell Zach and I. What you. Yeah. Well. What happened. Your experience. Those. Those. Those kids. In that. Those. Couple years. Yeah. The class of 2020. You know. We left in March. And I never see. Saw those guys again. And some of them were great. A lot of them were heading to. GPRs and AEGDs. No worries about them. Okay. Good. Um. Woo.

[00:21:40] I just pray that they. Go to continuing education. Every single month. And take really good notes. You know. Yeah. Because I'm in the same boat. I needed those last few. Months when I kind of knew. What I was doing finally. Um. And then. The year after that. I feel like all dental schools. Just like everyone else. I'm sure you and your offices. You were just trying to struggle. To see what you could do. To stay afloat. Right. Yep. So. Our school. Um. Combined. And had third years. And fourth years. Working together. As a couple. So. Okay.

[00:22:10] You don't learn the same. When you're assisting. But it is much better. Than nothing. Sure. And we. We had to be at half capacity. For. I can't even remember. How long anymore. And it was an interesting dynamic. We were forced to be at half. Capacity. You know. You know. These orders coming from main campus. And then. In the same. Sentence. Oh. Your production's way. Way down. You need to. Yeah. Use your production. I mean. I can't imagine being the clinic dean. And. Yeah. Not. Using inappropriate language. In front of. These guys.

[00:22:40] And I know they've got. Bottom lines. And they don't know how things. Work. In our. You know. Because you're running a clinic. Sure. A bunch of people. So it was paired then. Um. Then we paired them for a shorter amount of time. But we're still kind of rebuilding those patients. Because we were closed until. From March until June. I do think all of us had it better. Than. Schools like in California. And on the coast. Oh. Sure. In the Midwest. You know. We kind of. Brushed. COVID under the rug. Quite a bit. Yeah. Than other schools.

[00:23:10] So we were able to. It's sort of rebound better. But yeah. There were all these methods. Classes all went online. I wouldn't learn anything. From listening to biochemistry lectures online. You just don't have to be engaged. And I think we're going to see the results of that. For a long time. So even our students. Our students now. Who are entering the clinic. They had a lot of online classes. I believe. But I mean for the next. At least four years. Those students will have had.

[00:23:39] Only online classes. In undergrad. Before they got to dental school. Yeah. It's a whole. Generation of. Yes. Mixed up. Education. And. You know. So I think it's a dual edged sword. In a way. Like we talked about YouTube. On the last podcast. And you know. If you are of the. If you're self-motivated. You could learn a lot of stuff.

[00:24:09] You could learn a lot of stuff. By viewing it. But then there's the doing it. That's. You need those reps. You know. Yes. Under your belt. To get good. Yeah. It's like a musical instrument. Or something. You have to. You have to do it. That's the best analogy. So. Yeah. So. Let's. Let's talk about reps. Because. You know. Just from. Interactions. You know. I've. I've had with. You know. Younger practitioners. It sounds like. Reps have just continued to fall.

[00:24:39] Yeah. You know. Over time. I know my. Like. My dad was like. He thought it was crazy. How few crowns I did. You know. Compared to. Like. What he did. And if I compare notes. With like. Someone like Kevin. Like. Well. He did way more extractions. Way more. And it seems like. Those. Reps keep going. Down. I mean. Like. What are the. How many crowns do you have to do to graduate? Or endos. Or what's. What's. What are some of the. Like. Current standards. We're at 12 crowns right now. And hopefully. That's so little. It's. It's very little.

[00:25:08] And it was fewer during. COVID. Oh. And you had to observe as well. UMKC still has quite a bit more than neighboring schools. From. Students. You're telling me you can get out with like. Half that many crowns. Like. From what I understand. And this is hearsay from students who've gone on to AEGDs. With students from other. Schools. I believe. I won't say names. But yeah. I think. That our numbers are still quite a bit. Higher. Which yeah. When the number's 12. How.

[00:25:36] How is that higher. Than the other schools. But. What we do a lot more of is computer stuff. You know. Documentation. Legal stuff. And I think about that a lot. When. When we're saying like. These guys. I had to do 50 crowns. And they're only doing 12. It's like. I bet they'd rather do 50 crowns. Than. Deal with our. Lab over and over again. And have to write it in Axiom. The. Least. Logical. Computer system. On the planet. So. What is that? What is Axiom? We have Axiom. Is what took over our previous computer system. CMS.

[00:26:08] Okay. Are you talking about this? How you take notes and chart. And stuff like that. Is that. Yeah. Okay. All right. Yeah. Okay. So 12 crowns. How many extractions did or did he get out of the door? I think 50. Okay. That hasn't changed much. That's a lot. Yeah. That has. That hasn't changed. But I had. And I think it depends on where your school is too. You know. If you're at University of Iowa. When. Everybody's going to that dental school. Because they want to support the Hawkeyes. You've got a very different clientele. And. Sure. Yeah. I'm very. Yeah. I'm very. I'm very.

[00:26:50] I'm very. And graph. Component live clinical patients. And. You know. We have to either. Unlearn bad habits. Or completely learn. How to do extractions properly. And. We have to do that. Like that. To. You know. To fulfill the. The needs of the patients that we're seeing. In the. In the free clinic there in Raleigh. So. Or in Durham. Sure. So. Anyway. I.

[00:27:21] That's a tough. That's a tough one. Yeah. All right. Go ahead. Go ahead. I do think there's a lot. Less faculty. Than when we were in school. Oh really? Oh the numbers are down. Okay. I didn't know that. Yeah. It's. Yeah. It sure feels down. I think that's a budgeting issue. Hopefully it's getting back up. But. You kind of mentioned. When did you stop doing clinical. Because I do feel like when we were in school. There were faculty members who taught the classes. And you'd see them maybe a couple times a week on the floor. Maybe. And I don't know if that's how it was at the.

[00:27:50] Ohio State. But. It's very much. Everyone on the clinic floor. Is. Not everyone. But most of us are teaching a class now. And doing the clinic. And you don't have. You don't have time the semester before. To get ready for your class. You have some. You have some preparation time. The semester of. But. A little late then. It is definitely. You're spread a little more thin. Interesting. Interesting. I have the resources. I feel like. We used to have that whole BMS. Biomedical.

[00:28:20] Or BMC. Biomedical communications. That could support us with our lab manuals. So now it's me and my husband. When I. He's really good with computers. So when I. I'm having a tantrum. He'll come save my bacon sometimes. And we've got. We've got a good person. We don't. We just don't have. We don't have the teams that we used to have. As the support. So. Okay. So. There's less faculty. But the price of the education. Keeps going up. And which. And then we got segues into what.

[00:28:50] One of the things that Kevin wanted you to touch on. The loans. Like. What's. What's going on there? Where's the. Where's the disconnect between less faculty. When. When. When the prices just keep. Rising up. And what are. What are kids in for these days? So from. This is a little political. But my understanding of it. Please fact check me. But. From what we've heard from our chancellor. You used to get quite a bit of funding from the state. Since we are a state school. And that funding has. Crashed. The chancellor gave some statistic that.

[00:29:20] At the rate that. Funding for public education is being cut. UMKC will get no dollars. And I believe the year was 2026. You know. I mean. It was. Oh man. That'll be your free note. Yeah. And again. A fact check. So. Yeah. You know. Like the school is. There is a grant for that. But. Half of it has to be from private donors. For the new school building. Right. So I think that's why. There used to be a lot more support from. From tax dollars from the state.

[00:29:50] And that is no longer. There. Is my understanding of it. And I believe our current governor. Is a big fan of supporting schools. In like Joplin. And Springfield. And Cape Girardeau. From what I've seen in the news. So just not. Yeah. Not real supportive of St. Louis and Kansas City. Academics. Okay. So that's my take on that. Yeah. But I. Don't you think that the student loan. Is a big fan issue though. Those. That's like. You know. Like robbery. In a way. In terms of. There being a middleman.

[00:30:20] Like. We've talked about this before. On the podcast. But. You know. If I. If I owe Zach something. Then I just pay him directly. But if you get in. You didn't pay. I didn't get the money. I would have paid. Okay. But if someone gets in the middle of that. Then you have this triangulated relationship. And there is no direct relationship. Between those three parties. So that encourages that third party to. Or it encourages actually the university.

[00:30:49] To raise the tuition. Because they're not actually getting it from the student. They're getting it from the student loan. Well. I think that's kind of. Was the ethical dilemma with like the GI bill. Right. Colleges raise their prices. Kind of along that. Yes. Yeah. Quite possibly. Also. My perception. Because my. My son went to the Ohio State University. For his undergrad. And my perception was that. You know. Undergrad wasn't that expensive. In my. My opinion.

[00:31:19] Compared to inflation. But. There was non-stop construction. At the Ohio State University. All five and a half years. He was there. Yeah. And. I. My perception is that. That's happened at every major university. Because they're. They're so flush with cash. They have to. To do something. They got to spend it. Huh. Huh. Yeah. Huh. I don't. That's just my observation. I feel like the undergrads get a little bit more of that too. Because you've got the sports fans and the diehard alumni. Especially.

[00:31:48] Yeah. Like the Ohio State. I would think. Yeah. Because they're alumni. Yeah. But I have some friends who work. With like big donors at Mizzou. And it's a very different. World than UMKC. Sure. I bet. I bet. University. A different animal. What's a. What's a. What's this year's grad. What's the. What's the average nut that they've. They've got a crack. I think 350. And we're probably. We're one of the most affordable. Yeah. That's more. Cost of living too. I was going to say. That doesn't include.

[00:32:19] That includes. So that would be the loans they take out. Yeah. Okay. Yeah. Okay. But I think. But let's. Look at 50 a year about. What. Let's tie this together though. $350,000. And you've done 12 crowns. And then you have to go out. And make a living. And. Yeah. Again. I will. I will say this again. I was barely competent. Yeah. I didn't know what I was doing for. You probably did three times that many crowns.

[00:32:48] Right. You know. I think I did 30. That's. Well almost. Okay. I carry a one. You know. It's all good. Yeah. I like that. So. You know. New York State no longer does the boards. They just require a GPR. An AGD. And I'm sure the quality. Yeah. That is different. But. I like that. I like that too. Additional training. I like that too. Or if there was some sort of. I'm just throwing this out there. Some sort of partnership with private practice. Where you. You. I don't know. You had a mentor. Yeah.

[00:33:18] Yeah. Or. And that's feeding. I don't know. When you've got all those. Loans. Also. I don't know if you knew this. My. Interest was deferred. And my interest was. You know. Less than. I. I consolidated at less than 3%. Their interest. Before all the pandemic. Situation. They got it. Day one. So they're paying 7% interest. From the first day. Yeah. In the school. Isn't that crazy? So I'm also. Juice is running. Yeah. Yeah. If you have a. You know.

[00:33:48] If you have a 30 year mortgage. Whatever. You feel like you're paying that forever. Or whatever. I think that. Some of these people are just going to have. A payment. For their whole career. Yeah. Yeah. More or less. I think. Generationally. You always hear about. Like my dad bought a house for $20,000. Right. And he made this much. And I think that. Yeah. Yeah. I think we. I scooted in there. Got. Got at the very tail end of being able to. Have it all. I also think about. When I was 22.

[00:34:18] Hopefully you all were savvier than me. A hundred thousand dollars. Two hundred thousand dollars. What's the difference? You know. These are both. Unfathomable numbers to me. Just give me the loan. I'm going to be. It was meaning. It was meaningless. To me. At $30,000. Or $33,000. That's what I owed. That money was. Yes. Oh man. That was meaning. Meaningless to me. It still was a lot of money. In 1989. But. Yes.

[00:34:47] My 22 year old brain. Was like. Whatever. I'll make it back. Sure. It's just not a number. That. That makes sense to me. So. And I. I don't. I never had a loan before. Like I didn't have a car note. Or anything at that point. So. What did I know? Yeah. An education is worth it. I mean. Definitely. When we were growing up. Pay for that education. It's. It's going to be worth it. That's what Dave Ramsey came along. But I mean. I feel like it's getting. I feel like it's. The number. Is getting to the point though. Where you've got to pay it.

[00:35:16] You've got to pay attention to it. Right. I mean like. It's a big point. Yeah. I mean that's. You know. That's a lot. The thing is different about dental though. You can get an art history degree with no. I mean. You learn a lot from that. But there's no marketable skill with that. And I think there's really value. But you can get an art history degree. And also owe $350,000. I can't imagine doing that. But this is. There's no question that dental has it still. You know. It's still a good investment. But it would sure be nice if that good investment included.

[00:35:45] Walking out and feeling confident at doing at a minimum. Class all your operative. And at least single crowns. Without having to feel like you're struggling. One of the. Kevin and I are on a. On a few. You know. Message board types of things. And the recurring joke is always that if you hire a new grad. You know. You're in to replace like a third of their class twos. At the. You know. At about the two year mark. Because it's. Yeah. So that seems to be the sticking point. Melinda. Teach those class twos really well.

[00:36:14] Teach them really well. Teach them to bond. Be hard on those people. That's a hard thing about. Really doing right. You're only in clinic two years. Almost nothing can last two years. You don't see your own stuff fail. Yeah. Yeah. That's a whole. That's a whole other conversation. Because you're right. Like. I don't feel like you know what's going on. With that. Until about year seven. You know. I mean. Shoot. You barely practice long enough. To start seeing everything go downhill. You know. When you lose your money. Because you have to replace it for free too. Oh sure. That's the learning opportunity. That is where the real learning happens. Because.

[00:36:44] Yeah. Yeah. Yeah. Yeah. That's the school of hard knocks. Yeah. The worst. That is when you learn to get better. Okay. Melinda. Final thoughts on dental education. Before we. You know. Wrap this up. Yeah. It's a tough one. I think it's still a great career to get into. The. The cost. Literally and figuratively. Is very steep. So. You're right. It's a. It's a. It's a tougher decision to make. But it's a great profession. What do you. What do you have to say. What's. What's. What's. What's your take on dental school.

[00:37:15] Uh. You know. I. I don't. Want to denigrate. My dental school experience. Because it's allowed me to have this great career. And meet. Find people like you too. But. You know. There's. There is. There is a tipping point somewhere. And I think we've. Tipped past that. Unfortunately. It. It's getting there. That's for sure. I don't know. I don't know. I don't know what to think. I haven't done the analysis on it. But like the. When I. The. Cost to.

[00:37:45] Number of reps ratio. Eesh. Wish it was better. When did that send. Take that back to the. The dean. They need more reps. Also. Would that. You know. Provide some more production. For the school. Maybe they could use that. To subsidize the cost. We need the patients. Oh. You're hurting for patients. Gathering the patients. Has to be more difficult. Than we would imagine. Are you coming in for three hours? I couldn't be a patient. Right. At the dental school. So. I don't know. If we could get everybody assistant. Get them to. Half their time. Yeah. We got it.

[00:38:14] Now we need the money for assistance. And I think that's going to up our production. Is this still one. Two patients a day? Yeah. One in the morning. Okay. Yeah. That's tough. Linda. Thank you. Thanks for taking an hour. Linda. To join us. Thank you very much. Thank you guys. This is fun. So. Yeah. Anyway. All right. If you have not joined the Very Clinical Facebook page. And Melinda. You should join the Very Clinical Facebook page. We will let you in. No. You don't have to pay. For a fee. Yeah. You have to pay $350,000.

[00:38:45] The bargain. It's a bargain. Just like dental school. So. Anyway. If you haven't joined. Please join. Thank you for listening. And we will catch you next Tuesday. See ya.