Very Clinical: The Kevin Fryer Origin Story

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[00:01:30] Welcome to the Very Clinical Podcast, brought to you by Zerk Dental Products. In about the time it takes to do an MO on three, we will entertain and enlighten you with tips and tricks for regular daily dentistry. Here's Kevin and Zach. Clinical Hacks listeners, welcome back to another episode of The Clinical Hacks. And it is me going solo today. I don't have a Mac. Oh, wait. No, I do. I have an interview.

[00:01:58] So you don't have to listen to me drone on for 30 minutes. We are actually going to treat one of our hosts as a interview guest today. So with me, I have Dr. Kevin Fryer out of Cleveland. Very happy to be part of the show here, Zach. Yeah. I'm so glad that you had me on. Yeah. Welcome to the show. I don't know if you've ever listened before, but we talk about clinical topics. I've heard of your show and basically some mediocre reviews.

[00:02:26] So I'm trying to up your ratings here today. Well, thank you. We are a three-star show, but we are working our way up. So thanks for joining us and bringing us into the big time here. So Kevin, we are going to put you in the hot seat today. Treat you like one of our interviewees. So let's hear the... We've heard it a little bit before, but let's hear it again. Let's hear the Kevin backstory. How did you get interested in dentistry? Where'd you go to dental school?

[00:02:55] Where did your adventure begin? All right. Well, as far as getting interested in dentistry, I actually had a traumatic injury when I was eight years old. I fell off my bike and busted off my front two teeth and spent a lot of time at the dentist office as a young kid and had endos and a bunch of bonding and all that sort of stuff.

[00:03:21] And instead of being afraid of the dentist or typical human reaction, I thought everything was really cool there. And part of it was, it seemed like the pediatric dentist at that time had a really nice relationship with my dad. Like they would joke around and talk about stuff. And I just thought, well, this guy is a cool guy. This looks like a cool job. This might be something I'd like to do. So that's what started my interest in it.

[00:03:51] I went to, my dad was a mechanical engineer, sort of a executive at General Motors. I think he wanted me to be an engineer also. I didn't have much interest in that. However, I did go to Purdue undergrad, which is a big engineering school. And I think my dad secretly thought I would switch to engineering, but I was a chemistry major undergrad, really pre-med.

[00:04:20] Got accepted to dental school at Ohio State, the Ohio State University. Sorry. Where did you shift from pre-med over to dental? When did that? I think it was always dental, but at Purdue, they really didn't have a pre-dental program. They just had a pre-med program. Right on. So I took the DAT, jumped through all the hoops and all that sort of stuff. I only applied to Ohio State and North Carolina. Didn't get into North Carolina.

[00:04:47] I could have maybe been a colleague of Zach's or Max at that time, but I would have been way older. Anyway, went to Ohio State, four years there. Did a GPR at St. Luke's in Cleveland here, and then worked in a Medicaid office for two years and then started my own practice. So you graduated in 89? Is that right? 1989, yes. 1989. That was a good year.

[00:05:18] You did a Medicaid and GPR. That took up the first two or three years? Two and a half years, three years. Yeah. Okay. And then you started your own, did a scratch start or you bought? It was a scratch start. Yeah. Scratch start. And are you still in that location? No. So that location, I had a partner at the time. It was a scratch start with both of us. And then we outgrew that facility.

[00:05:47] So I moved from that original office to another part of the same building. So we were adjacent to each other for probably another 10 years or so. And then in 2014, I moved about four or five miles away to where we are now. Okay. Okay. So you've had a couple moves and a couple shifts over the years then. Yes.

[00:06:14] Tell us about what kind of dentistry you were doing. I know we know what you're doing now because you post a lot in the Clitoclax Facebook page. We know you're doing ortho and sleep and implants and all that. But it sounds to me from talking to you off camera like that a lot of that's less than five years of your practice. So you have a lot of practice like before that. What was your dentistry like for the first 25 years?

[00:06:39] So the interesting thing is in 1989, you know, no one was doing or very few people were doing posterior composites. So I started off with a lot of amalgams, you know, regular ass dentist stuff. Yeah. Amalgams, crowns, gold crowns, partials, dentures, extractions. Um, so we did, you know, really basic general dentistry for a long time. Yep.

[00:07:07] And, uh, uh, that was at the Medicaid office. I learned how to extract teeth there for sure. And, um, we, uh, then in my own practice, you know, we did a lot of, uh, of the same thing, a lot of general dentistry, a lot of, uh, crowns, fillings, root canals, partials, you've always been into endo. Um, yeah.

[00:07:37] So the endo thing, um, I did a lot of, um, non molars. Okay, sure. Yeah. At the beginning, the molars were very intimidating. I had a side gig at, uh, a place called American dental centers, which is like a, a DSO around here. That's really sort of local to Cleveland. Sure. Um, and so I kind of maybe branched out a little bit there. Um, that's code for experimenting a little bit.

[00:08:07] Sure. And started to do more molar endo, but I really wasn't comfortable with it till I took, uh, some continued, continuing education and, uh, started to do more and more of it. And I felt like that was also around the time that I, um, started really being on dentaltown and seeing that people were doing these like endo buildup crowns in the same visit. And I was not doing that.

[00:08:34] And then I saw how that could be profitable and help my patients out. So, um, I learned molar endo fairly quickly to, to be able to do that. Would you say dental town was kind of your first leap from like, um, maybe your dental school training type of, uh, work to maybe the, like the next phase of, of your dental career? Absolutely. Absolutely.

[00:09:00] I got exposed to a lot of different, um, people and thoughts and opinions and techniques that, you know, if you're just in your own office pre or early internet, pre internet, you didn't have much interaction with people. And you were just doing what you knew in your own space. Sure.

[00:09:25] Um, you know, uh, I think I've talked about before, at least joked around with you guys about getting the crown and bridge update from Strup and devouring that, like, you know, it was candy and seeing that there was, that was out there. Um, so that was an influence on me too. Not that I, I don't think I really practice in that manner, but it, it showed me that there was something else out there that, you know, maybe I wasn't doing. Were you a CRA subscriber at any point?

[00:09:55] Did you ever see? I got it for like a year or two. Okay. Yeah. And then. Passed. Okay. Yeah. Right on. So you did the regular ass dentist thing for, for 25 years and you're, you're in, you're like dug into your career. What, what sparked this like next gen here? Yeah. So I do want to say one other thing at that. So at that time, you know, my son was born in 94. Yep.

[00:10:24] And so that was really, as I look back, that was really my focus. I wanted to be a good dad and I wanted to spend as much time with him as possible. So do doing a lot of the CE and trips and all that stuff just didn't seem as important as coaching little league and, you know, going skiing with him and that sort of thing. Okay.

[00:10:52] So I kind of early on didn't do as much CE or expand my career as much because I was doing a lot of stuff with him. And then he grew up as kids do, went to college and things started to change for me.

[00:11:11] So I guess where, where does this like a journey from, you know, a very general dentist-y type practice to having some more advanced things? Where does it begin? Where does it happen? Tell me, tell me the evolution. So I took Rick DePaul's Power Prox course. Okay. Yep. Rick's a friend of mine. We went out to lunch one time.

[00:11:39] He had seen one of my patients and really transformed her smile. And I'd heard about six month braces and probably had the same thoughts that everyone else had about, you know, moving teeth too fast. All these, you know, things that are myths. Because I just didn't understand. And Rick said something to me that he says in all his courses, but I still remember the words coming out of his mouth. I'm just doing veneers with people's own teeth. I'm just rearranging the teeth into a better position.

[00:12:07] And then we either do some edge bonding or whitening. And we're doing that in place of veneers. And my head just went, oh, that's amazing. Because during that time, if you remember, people were mowing down teeth to put veneers on. And although I did maybe one or two cases like that, I wasn't particularly comfortable doing that. Yeah, you're right. Nineties, that was the golden age of the deep pre-venure. Right.

[00:12:35] So I took his class. And really, that started to open my mind and eyes up to cosmetics in general, photography, certainly orthodontics. But being able to do cosmetic ortho and giving people a smile that they wanted without mowing down their teeth is really what I learned from that.

[00:13:01] And because Rick's a friend, I could text him right now and he can give me advice or walk me through a case. So I had a good resource in my back pocket to do some of these or start doing some of these ortho cases. That's a good mentor to have. Right. Exactly.

[00:13:25] So also, during that period of time or before that, I was a CEREC owner since 2008 with the Red Cam. So you got in pretty early. Yeah. Red Cam. I only had the Red Cam for a short period of time. And then they made an offer on the Blue Cam that was no payments for a year. So I jumped that was, you know, to suck you in. And I jumped on that and had the Blue Cam for quite a long time.

[00:13:54] And so I became very familiar with CEREC for making crowns and, you know, became very comfortable doing that. But that's all I was doing with it. And I realized there was a lot more that I could do with the CEREC technology if I only had training to do that. Hey, it's Kate, the assistant. And it's time to get very clinical in this episode's Very Clinical Corner. Are you ready, Dr. Mead? I'm ready.

[00:14:22] Dr. Mead, do you ever feel bad about turning patients away who need a quick procedure just because your schedule's packed and won't allow it? This happens all the time. It often comes down to the room turnover and the sterilization time. I used to beg our schedulers for an extra 10 minutes per appointment just to be able to help keep up in central sterilization. And the front desk team, they weren't thrilled about it, especially with patients waiting and not to mention the daily production goals that they were expected to meet. Yeah, it sounds familiar. My team does their best, but it's tough.

[00:14:52] It's not easy to work all this stuff in. It makes you wonder, like, how much potential revenue is lost because of those missing minutes that are wasted doing sterilization processing? When you think about it, it's probably an awful lot. And the good news is there are ways to reclaim that time. Instead of wasting precious minutes sorting instruments, individually pouching them, and then loading the autoclave, try using cassettes and pouching those instrument cassettes in complete sets.

[00:15:17] That can free up enough time for an extra composite, an orthodontic scan, or even a set of sealants. Wow, that is huge. Listeners, if you're ready to add more procedures to your day, check out the show notes to learn how to elevate your workflows. So, I was looking for some CE. This was 2016. And I came across 3D Dentist, you know, T-Bone's facility.

[00:15:46] And I saw that there was something called a 3D integration course, which teaches you how to design guides for implants and restore implant crowns with your CEREC.

[00:16:05] I was more interested in restoring the implant crowns with the CEREC because that's a huge money saver, you know, what the lab bill is on an implant crown. Very high. Yep. But to be able to do that on my CEREC, I was very interested in that. However, I didn't have an Omnicam. I just had a Bluecam. I didn't have a Conebeam. And I emailed T-Bone. I said, should I even take this course? And he said, sure, go ahead and do it.

[00:16:34] So, which in retrospect, I probably had no business being there. It was the day after Trump was elected. I remember that vividly because I drove to Raleigh and there was very interesting radio on that day. Yeah. And it was just a weird time, you know, the day after the election. And I sat in the class.

[00:17:03] T-Bone started his thing. And, you know, you guys know T-Bone. He's very opinionated, very boisterous, very... It's a wild ride with one of those classes. In the first five or 10 minutes, I felt completely lost. I had no idea what he was talking about. And I almost got up and left. That's how lost I felt.

[00:17:31] But I sat there and I looked around at everyone else. I'm like, well, everyone else is getting this. And I either, you know, at that point, it was three years ago. So, I was 53, 52, 53. And I looked around and I thought, well, everyone else is getting this. If I don't sit here and do this now, I'm going to just let this profession pass me by. It was your get busy living or get busy dying moment? Is that what you mean? Right.

[00:17:59] I mean, it really was a defining moment there. I can vividly picture myself in that room. So, I took copious notes. I asked a lot of questions. And I did the best I could to follow along with the exercises that are part of that class. Okay. The problem is I came home and I still had blue cam and I didn't have a cone beam.

[00:18:27] But I had a demo for an Omnicam come in soon after that. And we ended up trading in the blue cam for the Omnicam. So, what that allowed me to do was make implant crowns on my CEREC fairly easily. So, because I was introduced to 3D dentists, I, you know, was following them pretty closely.

[00:18:53] I had heard T-Bone talk about, you know, don't do fillings and crowns in your practice, which, you know, when you first hear that, you think, well, that's crazy talk. But you realize what he means by that after you've listened. Yep. And I also heard him many times talk about, you know, advancing from general dentistry to emotional dentistry, which means, you know, implants, ortho, and sleep apnea. I was already doing a bunch of ortho.

[00:19:21] So, I had that, you know, box checked. I wasn't doing implants yet, but I decided let's find out more about sleep apnea. So, I took their Sleep 101 course with Erin Elliott. And I met Erin for the first time. And we hit it off pretty well. I mean, I really consider her a good friend. She's a good friend with Missy. Yep. And, you know, we learned a lot in that course.

[00:19:48] I would say at that point in time, we didn't do a great job of implementing it once I got back to the office. That would take a year or two to really get that ball rolling. But at least we were attuned to what sleep apnea in the general practice can do for you and do for your patients. Sure.

[00:20:12] So, then last year, I, you know, I had basically I was bored. You know, I've done a lot of fillings, done a lot of crowns, done a lot of root canals. And I was just getting a little bit bored. And I had already been introduced to all this implant stuff through T-Bone's place. So, I had a master plan in 2018 to start implementing implants in our practice.

[00:20:43] That was going to take several steps, though. I needed to get a cone beam first. So... Yep. More money, more... Yeah. So, and I also had to get some more implant training. Sure. I had some implant training in the past that was, you know, mainly didactic stuff. It wasn't really on live patients or anything like that. And that's not enough. It just isn't.

[00:21:09] So, in 2018, we decided to purchase the cone beam. Because of schedules and vacations and all that sort of stuff, that wasn't going to be delivered till August of 2018. Okay. So, that was delivered.

[00:21:28] And then I investigated Justin Moody's implant pathways and decided to take their fast track program in November of 2018. So, pretty much a year ago. Okay. So, at that course, of course, you learn a lot about placing implants. Sure. You place very many yourself. Yep.

[00:21:57] In the clinical days. So, you know, I felt really comfortable with that. I retook the 3D integration course at 3D Dentist to refresh myself of the stuff that I learned in 2016 that I felt lost at. And after that, you know, basically that course was a refresher at that point. Everything made a lot more sense to me then. And then we started fabricating guides and placing implants, you know, hit the ground running

[00:22:25] in late 2018 till present day. The other thing I want to say, though, is that when I first went to T-Bone's place and I saw what he was doing and I really heard the message of sleep, ortho, and implants, and really getting your team involved with all that. Because I can't make that happen on my own. It's really all those things are team-centric, particularly ortho. Yeah.

[00:22:56] It was stuff that Missy and I were trying to do and were actually succeeding on a small level. But I always looked at T-Bone's office and the way he runs his practice as proof of concept that we could do something bigger. And so implementing those three disciplines into the practice, I could see that that was a possibility.

[00:23:25] I could see that I had team members in place to be champions of these things because, again, you can't do this on your own. I have someone who coordinates all my Invisalign and ortho cases. I have someone that coordinates all my sleep stuff. I have someone that coordinates all my implant stuff. Three separate team members in the practice. And they're responsible for that. And I'm just sort of overseeing that.

[00:23:55] Now, the ortho and the sleep, I have very little involvement in those things except for diagnosing. The actual heavy lifting, I don't do nearly any of it, which is great. Yep. The implants, of course, I've got to place those. That's how that goes. There's no implant placement? Is that... No, I can't have the F to do that. Yet. Yet. Yeah. That's frowned upon. Yeah.

[00:24:24] But all of the other stuff that leads up to it, the fabrication of the guides, the ordering of implants and all the other minutiae that goes along with it, that's all delegated out. And so, utilizing a lot of the stuff that Missy trains other people to do and seeing how that all can be integrated together.

[00:24:53] You know, we really have strong team members that can do all the heavy lifting for us. And that's what's made it a lot easier. All right. So, Kevin, let me play the devil's advocate or just ask you some weird questions. Like, okay, you were at year 25. Yep. I assume your practice had been doing reasonably well. You know, why didn't you, when you were at that meeting, just say, all right, hey, you know what? Let's coast it on out. You know, like what... Why?

[00:25:23] Why did you make the leap as opposed to just, you know, taking the path of least resistance? Yeah, I think part of it was ego. That I didn't want to, you know, unfortunately or fortunately, a lot of things that I've done in my life is because people told me I couldn't do it. And I needed to prove them wrong. In this case, no one was saying I couldn't do it except for myself, probably. And I wanted to prove myself wrong that I could do it. Cool.

[00:25:50] So, I think that's the biggest part of it. Also, I saw the need, you know, there's a lot of missing teeth in all of our practices. There's a lot of people, you extract a lot of teeth that can be replaced. Taking that leap from sending them out to the specialist, your patients don't really want to do that. They want to stay with you.

[00:26:13] And so, the case acceptance with implants in particular has been, you know, higher than I thought it would have been. And the reason for that is they don't have to go anywhere else. And they also see how we're using the technology. And I think it's a very powerful thing for them to see right in front of their eyes. How we're able to make guides that can make the implant placement more precise.

[00:26:42] So, obviously, it was a big investment for you to go from what you're doing to where you're at. Are you seeing either or both of a financial return or maybe like an emotional return? You talked about being bored. Does this stuff make you like going into the office more on the day-to-day? Yeah. So, the best days are when I don't have implants on the schedule.

[00:27:12] So, last week we had two patients both needed two implants. So, four implants were placed last week. Those days were awesome. You know, it's just a lot of fun. So, emotionally, I love those days. Okay. Because I feel like we're, you know, really doing something that benefits the patient. We're doing something that's a little bit more out of my comfort zone, although I'm getting more comfortable every day with it.

[00:27:42] And I enjoy doing those procedures. Also, they're very, very profitable. And that's a big part of it. So, I forgot the first part of the question. Oh, I was asking you, you know, like, if you were starting to see a financial return. Oh, yeah. You were kind of asking, you were answering that saying you're getting the acceptance. So, it's not like you bought the stuff and are waiting for people to, you know, say yes to it. It's happening. Yeah.

[00:28:09] So, we've, in a year's time from 2018, August 2018 to August 2019, we've placed 32 implants. So, at about $3,200, you know, for the implant and the implant crown, you know, that's over 100, slightly over $100,000 of production. How many did you do the previous year? Three. Before you did the office. So, you did pull off the infamous 10X. I 10X'd my implants in one year. Nice.

[00:28:37] So, obviously, there's investment in the cone beam. You know, I look at that as a payment. You know, we're, the return on investment from the cone beam is, you know, it's inconsequential at this point. Because the cone beam also allows us to make the OptiSleep appliance for our sleep apnea patients, too. So, it's got a dual purpose. Plus, you know, it functions as a Panarex machine, too. All right. So, let's get in the time machine here, Kevin.

[00:29:07] And, yeah, go back here. And you're going to, you're going to, you know, you're going to tell, you know, I haven't, let's say I want to be Kevin Fryer. Yeah. First, you've got to grow some hair. Well, yes. No question about that. That'd be a great start. Where would you, if you're going to do it over again? How would you get from just, you know, the basic general stuff like I'm at to you? How would you do it now? Like, how would you do it differently?

[00:29:35] I would definitely do it sort of in the order that I did it. Because I think Rick DePaul's Power Procs course opened my eyes to things beyond ortho. Okay. And a lot, and maybe it was just me. Maybe I didn't have enough cosmetic training or whatever, but I started to see things a lot differently than I ever saw before. So, I would do that first, even if you're not going to do ortho. Just take it.

[00:30:02] It opens up your mind to things that you may not be seeing. And I can't, I can't emphasize that enough. So, I definitely would have done that a long time ago, you know, prior to, I would have done that. And when he first started, you know, giving the courses, if he didn't practice three miles from my original office, it was a lot easier to refer to him at that point. Sure. But, yeah, I would take that right away.

[00:30:31] Rick and I are good friends. And, you know, he's really helped me out with a lot of stuff. I would also... So, you could get ortho education to start off with before you even touched the other things. Yes. What's next? I would definitely get some implant training, either with 3D dentists or with implant pathways. 3D dentists is having their implant continuum, which they're starting, you know, in March. You know, you're going to learn a lot there.

[00:30:57] Justin Moody and implant pathways has been a great benefit to my practice. You're going to learn a lot there, too. There's a lot of good implant training out there.

[00:31:07] But if you think about it, if I did 32 implants last year, essentially in a year's time, and I'm 56, if I was 36 or 30 or whatever, that's a lot of production that you could have produced that, frankly, I'm, you know, I'm near the end of the road here. Sure.

[00:31:31] So, that investment that you might make now as a younger person is going to pay off way more than it ever will for me. What equipment is vital? You mentioned the cone beam, and I would say most people would agree that if you want to get into implants, that that's an important part of things. Because you're obviously a big into your CEREC.

[00:31:53] Is that a required part of the sleep and ortho and implant process? It's not a requirement for any of it. It just makes it a whole lot easier, and it allows you to keep some things in-house. So, the CEREC allows me to design and make guides that can be done a number of different ways. The cone beam is essential.

[00:32:22] It really is. To be able to see things in three dimensions, you really shouldn't be doing implants without that. You can do sleep without a cone beam. It just allows us to make a proprietary sleep appliance, OptiSleep, which I think is really the most comfortable and the best appliance out there when your patient qualifies for it. Sure. And that's a whole other issue. That's a whole other podcast. Yeah.

[00:32:49] Another number of teeth available and all that sort of stuff. But literally, to make an OptiSleep, you scan the patient on the CEREC. You scan them in the cone beam. You hit a button, and somebody in Germany starts making it for you. It's nearly brainless, but not really. There's some thought that goes into it. And so, none of those things are required.

[00:33:16] They just make it easier for me and my patients. Right on. Well, I think we're just about up against it, Kevin. But thank you for giving us the backstory. I feel like we're all more knowledgeable in the Kevin Fryer experience now. So, that's cool. It's neat to see you, the way you've kind of transformed your career in these last few years. In the waning days. Awesome. I took a right turn. But, you know, I really thank you for allowing me to be on your podcast.

[00:33:45] Oh, yes. I'm an avid listener. I think you guys are awesome. I like that. I like the guy with the southern accent, too. I don't know where he is tonight, but you guys are so cool. Oh, you know. Anyway, well, please come on back sometime. I will. We'd love to have you again. I think it'd be great. Thanks for having me. All right. Well, I hope everyone had a great Thanksgiving. And for Kevin Fryer and Zach Miners, this is The Clinical Hacks. We'll see you next time. See ya.