Very Clinical: Don't Care More Than the Patient with Dr. Randy Houska

[00:00:01] This is a production of the Very Dental Podcast Network.

[00:00:16] Welcome to the Very Clinical Podcast. In about the time it takes to do an MO on three, we will entertain and amaze you with tips and tricks on regular daily dentistry. Here's Kevin and Zach.

[00:00:29] What is up, Very Clinical listeners? Welcome back to yet another episode of the podcast. This is Zach Miners coming to you from Kansas City, Missouri. With me as always, my trustee co-host, Dr. Kevin Harefriar.

[00:00:42] Kevin, what's cracking in Cleveland?

[00:00:44] I'm a little stimulated right now.

[00:00:46] Are you?

[00:00:47] Yeah.

[00:00:47] Wow.

[00:00:48] I'm a little excited.

[00:00:50] Okay.

[00:00:51] Wow.

[00:00:51] Just because of our sexy guest.

[00:00:54] Wow.

[00:00:54] Our sexy guest, Dr. Randy Houska, all the way from South Dakota.

[00:00:59] What's up, Randy?

[00:01:00] Hey, gentlemen.

[00:01:01] How are we doing?

[00:01:02] So, Randy knows that Missy's cousins are total fans.

[00:01:08] And if they knew, they live like right over, wait, right over there.

[00:01:12] Oh, really?

[00:01:13] Yep.

[00:01:13] I was talking to Papa Randy right now.

[00:01:15] They would be busted on the door.

[00:01:17] Ah, they'd be underwhelmed for sure.

[00:01:19] Yeah.

[00:01:20] You know, they're awesome.

[00:01:25] Randy, you like to go to a certain motorcycle event every year.

[00:01:30] Do you not?

[00:01:31] So being a South Dakota boy and being a Harley guy, I've been to Sturgis many times.

[00:01:36] How many times do you think you've been?

[00:01:38] What's that?

[00:01:39] How many times do you think you've been?

[00:01:43] Oh, probably at least a dozen, I suppose.

[00:01:48] I didn't really go until after I got into my forties.

[00:01:52] So don't go every year, but quite often.

[00:01:56] I'm going to assume, you know, I think we all three know what Sturgis is all about.

[00:02:01] But could you explain if, you know, you didn't know what Sturgis was to the average Joe listener?

[00:02:08] Tell us what this event is all about.

[00:02:13] First of all, I'll tell you what people think Sturgis is.

[00:02:17] Yeah.

[00:02:17] Okay.

[00:02:18] People think Sturgis is a crazy, drunken brawl with street fights and bar fights and arrests.

[00:02:26] And that happens.

[00:02:27] Okay.

[00:02:28] So part of that is true.

[00:02:29] So it is.

[00:02:32] But it is, it is really softened over the years.

[00:02:36] Certainly like in the seventies, the Hells Angels would come in and they would take over the city park and town.

[00:02:40] And, you know, ambulances wouldn't go in there, stuff like that.

[00:02:46] But now it's, you know, it's the main thing it is, is crowded, but it's just fun.

[00:02:55] It's there's no, no conflict.

[00:02:58] There's always idiots when you get half a million people around, but you know, that it's just people having a good old time and everyone helps everybody.

[00:03:05] There's, it's just fun, good concerts, great concerts.

[00:03:10] Um, you meet people, you, you travel around the black Hills.

[00:03:15] Um, you know, it's just a good time.

[00:03:18] The people say, Oh, I'd be scared to go.

[00:03:20] There's, there's nothing to be scared of.

[00:03:22] And people think, well, you can't have a, um, a Japanese motorcycle or whatever.

[00:03:27] It's gotta be a Harley.

[00:03:28] People just do not care.

[00:03:30] Um, they don't even know a couple of times.

[00:03:34] We didn't even take a motorcycle.

[00:03:35] Um, we just take a side by side, um, like a Polaris range or something.

[00:03:40] Um, it's not my favorite time to ride a motorcycle in the black Hills because there's so many people and, uh, it's just waiting in line, waiting in line.

[00:03:51] And a lot of people maybe aren't that experienced.

[00:03:55] So that's just a little more dangerous than other times of the year.

[00:04:00] And since we're here, you know, I can ride there anytime I want.

[00:04:04] So.

[00:04:04] Right.

[00:04:05] So I would be accepted if I rode my Vespa.

[00:04:09] Absolutely.

[00:04:11] You know, you really have a Vespa.

[00:04:13] I do.

[00:04:14] Oh, okay.

[00:04:15] Right on.

[00:04:16] Okay.

[00:04:16] As, as long as the lines are in as busy as the traffic is, sometimes that's as fast as you can go.

[00:04:23] Right.

[00:04:24] Right.

[00:04:25] Right.

[00:04:26] Right.

[00:04:34] What's your, uh, what's your favorite, uh, Sturgis story that you could tell on a podcast?

[00:04:41] Well, there's a lot of Sturgis stories.

[00:04:43] The concerts have been awesome.

[00:04:45] Uh, I saw Steven Taylor, Aerosmith, so I'm fall off the stage and break his shoulder.

[00:04:50] Um, Oh, nice.

[00:04:52] We met Peewee Herman.

[00:04:54] Uh, Oh, that's that's, he's a big fan.

[00:04:57] Kevin's a big fan.

[00:04:58] He's a big fan.

[00:04:59] We're both big fans.

[00:04:59] We're both big fans.

[00:05:01] Before he died.

[00:05:02] Before he died.

[00:05:03] But yeah, obviously before he died.

[00:05:04] But yeah, he was there, which was just an odd, odd one.

[00:05:08] But, uh, I, I guess I would have to say my favorite story would probably be in 2009 when I got married out there.

[00:05:15] I better, I better put that one at the top of the list.

[00:05:17] Oh, wow.

[00:05:18] Yeah.

[00:05:19] Love story.

[00:05:20] And then Toby, basically Toby Keith sang at our wedding reception with 50,000 of our friends.

[00:05:26] Holy cow.

[00:05:27] That's amazing.

[00:05:29] Yeah.

[00:05:29] Big concerts.

[00:05:30] Big concerts.

[00:05:31] Wow.

[00:05:31] Uh, we got Kid Rock and Jelly Roll and, uh, Travis Tritt, uh, Theory of a Dead Man, Aaron, Aaron, Aaron, Aaron, somebody or other, Aaron Lewis.

[00:05:43] Yeah.

[00:05:44] So yeah, a lot of good concerts.

[00:05:46] Kid Rock puts on a good show.

[00:05:47] I gotta be honest.

[00:05:48] He's crazy.

[00:05:49] I've seen him a couple times.

[00:05:50] He puts on a, he's, yes, so have I.

[00:05:51] So have I.

[00:05:52] Uh, how long have you been biking for?

[00:05:55] Uh, well, theoretically, I guess I got my first motorcycle when I was about six.

[00:06:00] Oh, okay.

[00:06:01] Wow.

[00:06:01] All right.

[00:06:03] Took a little reprieve from a dental school to about age 40, but then got back in.

[00:06:09] Nice.

[00:06:09] Nice.

[00:06:11] All right.

[00:06:12] Uh, Randy, we're continuing our change your mind series.

[00:06:15] So we're asking this week, what are one or two things you've changed your mind about in terms of the business of dentistry over the, over the years of your career?

[00:06:29] So, and in my mind, this is business related, I guess, but, uh, basically that I am no longer more concerned with my patient's mouth than that patient is.

[00:06:43] You know, that's hard to do.

[00:06:45] That's, that's hard to pull off.

[00:06:46] And I, it is a business move.

[00:06:49] Yes.

[00:06:49] Because in the beginning, you know, you're thinking, oh, everybody's got to have perfect.

[00:06:53] We got to push you, push you, push you.

[00:06:54] And I've got to get you to fix every this, that, and this, that.

[00:06:58] And now, uh, I give them the opportunity to have that if they wish.

[00:07:02] Of course.

[00:07:03] I provide, uh, provide them the chance to say yes or no, but if they say no, I'm going to go, okay, well, if you change your mind, I'm in, you know, but, uh, it's, that's too stressful.

[00:07:16] You know, to, you have to care take.

[00:07:19] I mean, you have to take care of your patients, but I don't think I have to be their caretaker per se.

[00:07:27] I think that's a great way to put it.

[00:07:28] Zach and I have talked behind the scenes a lot about this.

[00:07:32] And I think that there is a mix between being empathetic provider and this all being a transaction.

[00:07:42] Like one of them is too extreme.

[00:07:45] And the other one, you're going to drive yourself crazy.

[00:07:49] Um, because of the stress of trying to care take everyone, as you said.

[00:07:54] And you know, I'll go ahead.

[00:07:57] No, you go ahead, Randy.

[00:07:59] Well, you know, I see a lot of patients and they come in and might be a new patient and they've got something bothering them.

[00:08:08] But they got a lot of things going on.

[00:08:10] Sure.

[00:08:10] And you know, I always just, I mean, if I can do it that day, I'll get whatever's bothering them fixed.

[00:08:15] You know?

[00:08:16] Yep.

[00:08:16] So often I hear that, you know, maybe a patient had this broken tooth, but he had some other this and that.

[00:08:23] And, uh, you know, well, they wouldn't fix anything until they went through the thorough treatment plan, signed the forms, got the financing to get everything done.

[00:08:33] And I'm, you know what?

[00:08:34] I, I'm more than likely if they come in and they need a tooth out, I can have that tooth out within 10 minutes.

[00:08:41] Tell them you got a lot of other stuff going on.

[00:08:44] We need to get together and we'll talk about all that.

[00:08:49] Well, yeah, I think that's a great, you know, Randy, you and I are a lot alike.

[00:08:53] Cause you know, that's exactly what I do too.

[00:08:56] Except the hair thing.

[00:08:57] Yeah.

[00:08:58] And you know, you're way more handsome than I am, but obviously the, the, um, I think as you were talking, I was thinking just, I know we're going to talk about deeper things on the next podcast, but I think being.

[00:09:12] Being open minded, like there is no dogma in this profession.

[00:09:17] There is no one way to do everything.

[00:09:21] And there's a lot of gurus out there and a lot of lectures that we've all heard that, you know, try to pigeonhole things into one box and people just don't work like that.

[00:09:32] Someone calls me and they're in pain.

[00:09:34] I want to take care of that.

[00:09:36] And then we can move down the road and, and invite them to come back for more comprehensive treatment.

[00:09:41] And I just, that's the way it works best in our practice.

[00:09:45] I agree.

[00:09:46] I have seen, uh, my dad over the years get so disappointed when someone like didn't follow through some, like when they were making a decision or, or like, you know, to get a tooth out or to not treat something.

[00:10:04] And he was like, God, why would they not do something about that?

[00:10:08] It's going to be such a huge problem.

[00:10:09] And I saw the burden of that.

[00:10:11] And I was like, I don't want that.

[00:10:13] Why, why would I put that on myself?

[00:10:15] You know, but I did for a while, but I, I quit doing that too.

[00:10:18] Partly from listening to Kevin, partly just from my own sanity's sake.

[00:10:21] It's like these, it's just a tooth.

[00:10:24] It's not even mine.

[00:10:25] You know?

[00:10:26] Yeah.

[00:10:27] Back in the middle early days or middle late days, like halfway through that we had a friend in the office, not my tooth, not my problem.

[00:10:34] And you know, it just allowed us to, you know, you didn't want to proceed.

[00:10:39] That's fine.

[00:10:40] You know, just move on to the next person.

[00:10:41] It's just not that important to some people.

[00:10:43] Yeah.

[00:10:44] No, it's fine.

[00:10:45] You know?

[00:10:46] And I definitely think one of the, the very best services that you can offer is to be able to slick a tooth out in five minutes.

[00:10:55] Mm-hmm.

[00:10:56] You know?

[00:10:57] Yeah.

[00:10:57] Cause that's the answer so many times.

[00:11:00] And that's what gets them out of pain.

[00:11:03] It's what makes them appreciate, you know, he didn't dink around.

[00:11:07] I had a bad problem.

[00:11:08] He got it out and I was on my way.

[00:11:10] I'll go back and I'll tell people.

[00:11:12] Yeah.

[00:11:13] I agree with that.

[00:11:14] 100%.

[00:11:14] As long as, I mean, it can't be your own, it can't be your only weapon.

[00:11:17] You got to know some other stuff.

[00:11:19] Right.

[00:11:19] Sure.

[00:11:20] Having that in your, in your portfolio is, is paramount to dentistry, I think.

[00:11:28] Totally agree.

[00:11:29] Have you been taking out teeth from, from day one after, as soon as you got out of school,

[00:11:33] or is that something you had to bone up on and do a little extra treatment on or not treatment,

[00:11:38] um, training on?

[00:11:39] Um, you know what?

[00:11:41] I think I just, so when I got out of school, I bought a practice within nine days and I was working.

[00:11:49] And solo basically.

[00:11:51] Um, I may, there was another dentist in the office, but he offered really no knowledge,

[00:11:56] no help.

[00:11:58] I am.

[00:11:58] I am.

[00:11:59] I am.

[00:12:00] I am.

[00:12:02] I am.

[00:12:02] I am.

[00:12:06] I am.

[00:12:07] I am.

[00:12:09] I am.

[00:12:11] I am.

[00:12:17] I am.

[00:12:35] I am.

[00:12:38] I am.

[00:12:39] Yeah.

[00:12:41] I am.

[00:13:08] Yeah.

[00:13:09] Yeah.

[00:13:09] I think we're young and you have a heart, but it just, um, I couldn't say that it was one thing

[00:13:17] that pushed me to not my tooth, not my problem. But I think part of it was like, we've alluded to

[00:13:25] carrying the burden of all of these people. It's just, it's impossible. It's not healthy. And,

[00:13:33] um, you know, I also think I have a fairly libertarian viewpoint, you know, as long as

[00:13:40] you're not, as long as it's not going to hurt someone, I don't, I mean, I can't care that much.

[00:13:45] I have given you the option. I have the skill to take care of your problem. If you don't want to do

[00:13:50] it, fine. I just, I can't. It's not life threatening in general. In general. Sometimes it is. And

[00:13:57] things can be, but those experiences in my residency, but that rarely happens in private

[00:14:04] practice. Yeah. And I'm talking about, you know, if someone you take out a premolar cause it needs

[00:14:10] a root canal, but they can't, or don't want a root canal. Okay. Well, it's not the end of the world.

[00:14:16] If you lose a tooth, you know, technically you don't need teeth to survive. I mean, no, also true,

[00:14:23] true, but, uh, it's, we have to put it to the importance of what it is. Don't, uh, make like

[00:14:32] it's brain surgery, you know, but it's important. And to some person, it's way more important than it

[00:14:40] is to the next. I think also a part of this is we spent so much time in school to learn this specific

[00:14:47] skill that, you know, separates from us from the rest of humanity. We have this special skill and

[00:14:53] you're trying to run a business. And I think at a certain point, um, very early on money's

[00:15:02] important. So when someone says, no, it feels like it's coming right out of your pocket or are you

[00:15:06] going to be able to make payroll and all that kind of stuff? But once your own confidence grows and

[00:15:12] you really don't need that, um, to pay payroll or at all, um, it's just, it's easy to just

[00:15:21] move on to the next person. I don't take it personally or very rarely do I take it personally anymore.

[00:15:28] So that you brought up a good point, Kevin, is that easier for us to sit around and say,

[00:15:32] because I think I can, I think I can speak freely that, you know, all three of us being probably

[00:15:38] aren't, you know, saddled by the burden of very many practice or personal or, uh, student loan types

[00:15:45] of things too. Is that, is that a lot tougher for the, the, the newer grad who's got a massive nut and

[00:15:52] he needs some yeses in his life? I think it's a potential issue for sure. Definitely. I think so.

[00:16:00] And it's something that concerns me. We've talked about that behind the scenes.

[00:16:05] We have. If you have this giant student loan, then you know, you can't get, you, you can't take

[00:16:12] the nose, start to trade on you a little bit. I don't wonder if on some level of patients can

[00:16:18] almost smell that. Yeah. Uh, because it's almost the, I don't give a crap attitude almost sells better

[00:16:25] than, than, than, you know, than the overly concerned. I like, I'm really concerned, you know,

[00:16:30] I really think this would benefit, you know, that kind of stuff, you know, before I could go full

[00:16:36] time with my own practice, I was working somewhere else. And when I interviewed for that job, I didn't

[00:16:42] really want it. And they like hired me on the spot. I acted like I didn't want it. I'm like, wow,

[00:16:46] this is the trick. You don't want it. Yeah. I, I agree that. I mean, if you just say, here's what you

[00:16:54] can do, here's what I can do. You know, if you want to do it, I'll do it. If not, let me know if

[00:17:01] I can later on. Yeah. Like I said to someone today in hygiene, we'll be here when you're ready. We'll

[00:17:06] be here. Yep. Sure. Exactly. Yep. All right. Excellent. That I like that one. I do hope I will

[00:17:15] be there. Yeah. I think he said God willing or something like that. We'll be here.

[00:17:22] All right. I liked that one, Randy. Thank you. Thank you, Kevin. Any, uh, any extra notes on,

[00:17:28] on that particular topic or did you think we fleshed it out? Uh, I think I'm riding my Vespa all the way

[00:17:34] to surges this summer. There you go. What is the, what is the top speed on a Vespa? Uh, the top speed

[00:17:41] I've gone on mine is around 55, 57. That's Oh, I didn't know they went that fast. It started to get a

[00:17:48] little squirrely and, uh, a little death wobble in that wheel. Yes. I backed off a little bit. Yes.

[00:17:55] But I, I, I did get it up to, I think 57, but it was, it was not stable when I wasn't,

[00:18:02] when I was in high school, I got up to 120 miles an hour on a blacktop road with no helmet or no

[00:18:08] nothing. Not a smoke. Nicely done. Kevin, do you, do you try this to the office? I'm fascinated by this.

[00:18:15] I'll send you some video. Yeah. All right. I, I, I will, I will say I used to ride it a lot to the

[00:18:21] office, but things have changed a little bit in terms of what our schedule is. And what I mean by

[00:18:27] that is, you know, Missy's work somewhere else now. Okay. Got it. I have to carry things to the

[00:18:33] office sometimes that I can't carry on my Vespa. You need a sidecar. They make a sidecar for a Vespa.

[00:18:38] Get the sidecar. I'll drive Harry, the dog. Uh, I, I figured you were going to say you just didn't want

[00:18:45] No, my hair gets very messed up when I ride the Vespa. I, I wrote it last, um, uh, two weeks ago,

[00:18:53] Wednesday, and I hadn't wrote it for a while. And we have some new employees. Everyone was like

[00:18:58] all over it. I was like the star of the day. People wanted to ride it. Awesome.

[00:19:02] Um, it was pretty awesome. Yeah. That's right. We ride them. That's right. Indeed. Indeed. All right. Uh,

[00:19:08] thank you guys for listening. If you want to, if you have any questions or want to talk about this

[00:19:14] more, check out the very clinical Facebook page. Randy's there. He's in there if you want to

[00:19:19] chat him up. So, uh, anyway, we appreciate you there and we will see you next Tuesday.

[00:19:25] See you. All right.