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Hey there, dental professionals and industry enthusiasts.

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Picture this. It's October, and you're in the

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middle of one of the most transformative

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experiences of your career. You're at the Becker's

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Fall Future of Dentistry Roundtable in the vibrant

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city of Chicago, fresh off an incredible 3

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days at the Hyatt Regency. Imagine yourself inspired

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and invigorated

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after attending captivating keynote sessions by none other

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than the legendary boxing world champion and CEO,

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Lila Elite, and the extraordinary

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professional basketball player, Caitlin Clark. See yourself engaged

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in lively discussions,

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exchanging ideas, and collecting a stack of business

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cards from fellow dental experts and potential partners.

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You've networked with over 350

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attendees and learned from more than 80 speakers

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who are at the forefront of dental innovation.

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You sat in on educational sessions exploring topics

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that elevate dental care as a critical element

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of whole person health. You've witnessed firsthand how

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digital technology is revolutionizing

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patient outcomes

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and how both large DSOs and independent practices

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are flourishing. Get ready to transform your career

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and don't miss out on this incredible

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opportunity. The Becker's fall future of dentistry roundtable

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is from October 30th to November 1, 2024.

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Get registered by going to beckersdental.com

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and clicking on the events page.

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Welcome everyone to the Becker's Healthcare podcast series.

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I'm Mariah Muhammad, writer and moderator with Becker's

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Healthcare, and I'm thrilled to have with me

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today Cyrus Lee, CEO and executive dental director

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at Permanente Dental Associates. Cyrus, welcome back to

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the Becker's Healthcare podcast. Very excited to have

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you join us today. To get a start,

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would you mind please introducing yourself and telling

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us a bit about your background?

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Yeah. Hello. I'm Raya. First of all, thank

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you for having me back again today, and

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I'm looking forward to chatting with you,

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and our audience today. So, my name is

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Cyrus Lee, and I'm the chief executive officer

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and executive dental director

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of Permanente Dental Associates. We are the dental

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group for Kaiser Permanente Dental here in the

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Pacific Northwest.

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That's specifically Oregon and Southwest Washington.

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We provide dental services for over 250,000

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Kaiser Permanente

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Dental members

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out of 21 dental offices.

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We are a professional corporation

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with most of our dentist clinicians

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as shareholders

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of our group. So we are

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dentist owned and led.

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We have about a 150

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general dentists, specialists,

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denturists. We have a dental therapist and

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administrative,

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professionals.

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I'm really proud that our group, was just

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accredited again

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by the Accreditation

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Association For Ambulatory Healthcare.

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We've been continuously accredited since,

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1990 and are really proud of that.

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Also this year for the 5th consecutive year,

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we were named number 1,

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in our employee category for Healthiest Employers of

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Oregon

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as well as 5th consecutive year number 1

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for Healthiest

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Employers,

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Washington.

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About a 100 of our dentists are members

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of the National

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Dental Practice Based Research Network.

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This network is a consortium

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of participating practices and dental organizations

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that investigates,

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research questions and shares experiences

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and expertise.

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This nation's network, it's really an effort to

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help, dental professionals directly improve

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the efficiency and effectiveness

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of dental care.

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So essentially, it's it's research done

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about and in the real world of daily

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dental practice. So that's,

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something exciting that a lot of our dentists

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have done. Let's see. I've been a practicing

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dentist for over 20 years. I'm a native

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Oregonian.

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But I did spend several years away during

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my undergraduate college years.

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I graduated dental school at Oregon Health and

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Sciences University, then spent a few years in

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the US Army where I completed an AEGD

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and spent some time overseas.

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Then I returned home and have been with

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Kaiser Permanente Dental since 2006.

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In January 2017,

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I opened up,

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our Cedar Hills Dental Medical Office, which was,

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really a first of its kind,

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fully integrated

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medical

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dental

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office. So there were workflows

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that,

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really traversed,

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our patients between the the dental,

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visit as part of an overall,

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health care touch points. So for example, we

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have nurses dedicated

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to our dental patients to help them close,

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both preventative care

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gaps, like vaccinations,

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as well as disease management care gaps, like,

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blood draws for diabetic patients to monitor their

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a one c levels.

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At the time, we had a physician right

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there on-site, which allowed also those in the

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moment collaboration

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on, patient care. But more importantly, because we

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are in a truly integrated health care delivery

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system,

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it's really in our people's DNA and in

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our culture to take that shared

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dentists here at Kaiser Permanente Dental are truly

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every bit part of our patient's care team

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and there's really no friction at all

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as members of our patient's care team from

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their dentist, hygienist, primary care physician,

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and other specialists in some cases like oncologists,

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all all communicate, with each other as part

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of a true team service to our patients.

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So,

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I spent most of my career in the

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care delivery operations aspect of Kaiser Permanente Dental.

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And then,

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for the past 2 years, I've been in

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this role as executive sales director and, CEO.

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Wonderful. Wonderful. Thank you so much for giving

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us that background, and congratulations

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on your new awards. That's absolutely amazing. And,

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you know, getting those awards must mean that,

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you know, you and the organization will be

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on the top of your game, in dental.

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So I must ask you, what are the

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biggest issues you're following in dental this year?

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Yeah, Brian. There there really are a lot

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of big issues, and I think, we're in

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a very dynamic time in dentistry,

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certainly over the past few years, and,

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and that really hasn't changed in this past

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year, really all of health care. And I

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think those biggest issues, really all contribute and

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are affected by each other. So the ones

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that I'm particularly following is around workforce,

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technology, care advancements,

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practice consolidation.

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So first and foremost, workforce.

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So,

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we all know now that for quite a

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while now, there's there aren't enough dental assistants.

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There aren't enough dental hygienists.

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It remains a big issue for a lot

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of dentists for us as well. It was

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an issue before the pandemic.

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Pandemic made it worse. It remains an issue.

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Maybe it's it's gotten a little bit better

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over the past year, but it's still still

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a big issue.

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And I I foresee it, remaining,

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a big, big challenge. You know, when you

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look at,

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enrollment data prior in dental schools and you're

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looking at,

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those predoctoral dental students and you compare

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those numbers with dental hygiene and dental assistant

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students, the number of dental students has been

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going up. And,

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it's projected to continue going up for for

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another

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few years,

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with the opening of new schools and and

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increased class sizes.

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But meanwhile, the number of, hygiene students and

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the number of dental assistant students has has

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really not,

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been anywhere close to keeping up,

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with the number of of dental students. So

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so I do see this as an issue

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that's,

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really gonna have to be

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resolved,

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in one way or another because you really

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have more dentists, competing for fewer staff,

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which then

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raises the overhead cost of the practices.

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It's your classic,

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supply and demand.

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And so you combine

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that increased overhead cost of running a practice

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or practices

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with reimbursement rates that really aren't keeping up

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with those rising,

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costs. And then the, you know, then the

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financial model, supporting,

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dentistry becomes much more stressed

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than it's ever been,

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which which does have some ramifications.

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Then another workforce issue is around dentists themselves,

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and that's primarily the cost of dental education.

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The amount of debt these graduates are coming

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out with is is really, really incredible.

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So my background, I I did spend, some

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years in the army.

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I got an army scholarship.

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And for me,

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the thought of having,

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barely a 6 figure debt load coming out

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was unfathomable. So that's that's why I looked

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into a military scholarship, which I still think

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is a great way to go. It was

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such a valuable experience both clinically and non

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clinically.

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But these days, you know, I I think

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graduates looking at

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being barely in 6 figures in the debt,

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like, being, like, a 100,000 in debt. That

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that's nothing compared to

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what a lot of these newer dentists are

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facing.

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And so,

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those folks, they're borrowing $500,000

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or more

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for their education. So there's some really big

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implications to having

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that type of debt burden and and the

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financial,

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pressures

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practicing. So,

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so that's the workforce piece.

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Also tracking, I think,

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technology as well as care advancement.

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So,

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technological advancements, they're really rapidly changing the landscape

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of, dental care from, digital scanner scanners and

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3 d printing to advancements

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in artificial intelligence,

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and really staying abreast of these innovations and

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incorporating them effectively into practice is,

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both a really exciting opportunity, and and it

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can be a challenge. Just this, you know,

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past couple of years, we've seen progressive incorporation

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of generative

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AI, artificial intelligence, or augmented intelligence.

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I think we all know,

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now that a couple of initial areas is,

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augmenting a clinician's radiographic exam, but,

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I'm really looking forward to the opportunities of

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of ambient listening technology

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combined with AI to

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describe chart notes, for our clinicians.

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Patient education and communication is another area that

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I could see

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really productive use of this technology.

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And then on the payer side, of course,

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the, utilization

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claims,

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review.

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In terms of care advancement, you know, since

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I'm with Kaiser Permanente, that's all medical dental

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integration is a big one,

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for us.

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You know,

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the valve was separated from the rest of

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the body,

284
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in terms of education

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and and training and, therefore, the entire

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health care infrastructure.

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But that's

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really not how our bodies work, and we've

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known this for

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at least a quarter of a century

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with the 2000 Surgeon General's report on on

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oral health.

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So here at KP Dental, we've been, you

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know, doing things around

295
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putting the the mouth back in the body,

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medical dental integration.

297
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We've been doing things for decades.

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Talked about opening the first,

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truly integrated medical,

300
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dental office and

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team. I think the challenges in health care

302
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are so big that I don't think we

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I I don't think we have any choice

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but to, you know, break down the historical,

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silos. So our approach here, because we have

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an integrated health care system, is to really

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leverage our dental visit as an additional touch

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point,

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in the health care system.

310
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Dental for

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many healthy patients,

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might be their only regular touch point,

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of the health care system. So,

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really, our thought is how can we

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work as an extension

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of primary care and and reach,

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all of the patients that we have that

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shared responsibility

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for. And I think that just, elevates our

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profession as an integrated part of the health

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care team.

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And then the last piece was,

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consolidation and and

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the employment model of dentists as opposed to

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practice owners.

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So

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I think when you look at some of

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those,

329
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dynamics, challenges, and,

330
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issues,

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workforce,

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increased overhead costs,

333
00:12:36,320 --> 00:12:38,480
decline the flat reimbursement and,

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debt burden for for new dentists and

335
00:12:41,919 --> 00:12:42,899
capital investments

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00:12:43,360 --> 00:12:44,899
needed for all this

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awesome clinical technology,

338
00:12:47,544 --> 00:12:49,464
I think it does make it more and

339
00:12:49,464 --> 00:12:50,284
more difficult

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00:12:50,904 --> 00:12:53,964
for individual dentists to operate a practice.

341
00:12:54,584 --> 00:12:56,524
And I think over the past few years,

342
00:12:57,144 --> 00:12:59,225
with the influx of private equity money into

343
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the dental space,

344
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and a number of dentists looking for a

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00:13:03,429 --> 00:13:07,830
practice exit strategy being presented with incredible offers

346
00:13:07,830 --> 00:13:09,850
and and just incredible, valuation.

347
00:13:10,789 --> 00:13:12,410
We've we've seen some shifts,

348
00:13:13,504 --> 00:13:14,004
movement,

349
00:13:14,865 --> 00:13:16,325
towards an employed

350
00:13:17,664 --> 00:13:18,644
model. So

351
00:13:19,024 --> 00:13:21,184
I do think we'll continue to see more

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existing and and more new dentists,

353
00:13:24,785 --> 00:13:26,399
looking at an employed model,

354
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as opposed to a practice ownership model. I

355
00:13:29,360 --> 00:13:31,600
just think there's more interest in income security

356
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in light of of some of those, financial

357
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dynamics

358
00:13:35,680 --> 00:13:36,259
and challenges

359
00:13:37,040 --> 00:13:38,340
being a business owner.

360
00:13:39,004 --> 00:13:40,924
As well as, you know, it might be

361
00:13:40,924 --> 00:13:41,725
appealing to,

362
00:13:42,684 --> 00:13:43,584
have a

363
00:13:44,044 --> 00:13:45,024
a less stressful

364
00:13:45,404 --> 00:13:47,964
work environment and better work life balance and

365
00:13:47,964 --> 00:13:49,105
not having to manage

366
00:13:49,804 --> 00:13:50,464
the business.

367
00:13:51,350 --> 00:13:53,429
So I do think with more dentists seeing,

368
00:13:53,670 --> 00:13:56,230
an employed model as viable and maybe even

369
00:13:56,230 --> 00:13:59,830
attractive, I think the consolidation of practices will

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00:13:59,830 --> 00:14:02,250
likely continue a bit in dentistry. It,

371
00:14:02,629 --> 00:14:04,784
appears to slow down a bit over this

372
00:14:04,784 --> 00:14:06,865
past year, but, I don't think it's,

373
00:14:07,424 --> 00:14:09,365
I don't think it's gonna gonna stop.

374
00:14:10,464 --> 00:14:12,704
Yeah. Yeah. You made some really good points

375
00:14:12,704 --> 00:14:15,105
there. I think workforce specifically is definitely a

376
00:14:15,105 --> 00:14:16,865
trending topic. And I think every time I

377
00:14:16,865 --> 00:14:18,784
kinda talk to the executives, they kinda say

378
00:14:18,784 --> 00:14:20,789
the exact same things about, you know, it's

379
00:14:20,789 --> 00:14:22,309
really causing a lot of stress on a

380
00:14:22,309 --> 00:14:24,089
lot of different areas in the workforce.

381
00:14:25,029 --> 00:14:27,350
Very quickly, Cyrus, if you could give me

382
00:14:27,350 --> 00:14:29,289
a couple points on what do you think

383
00:14:29,350 --> 00:14:31,589
the most effective health care leaders need in

384
00:14:31,589 --> 00:14:32,490
order to be

385
00:14:33,065 --> 00:14:34,585
in the next 2 to 3 years?

386
00:14:34,985 --> 00:14:36,205
What what would you say?

387
00:14:37,384 --> 00:14:38,684
Yeah, Mariah. I think,

388
00:14:39,544 --> 00:14:41,404
you know, just with the with the significant,

389
00:14:42,585 --> 00:14:43,085
shifts

390
00:14:43,785 --> 00:14:45,245
in the in the landscape,

391
00:14:45,879 --> 00:14:47,259
I I do think adaptability

392
00:14:47,639 --> 00:14:48,779
and and innovation

393
00:14:49,720 --> 00:14:52,679
is is really, really important and the ability

394
00:14:52,679 --> 00:14:55,639
to to adjust to new realities and and

395
00:14:55,639 --> 00:14:57,980
the fact that the, the truth of

396
00:14:58,745 --> 00:15:00,684
today may not be the truth of tomorrow.

397
00:15:01,144 --> 00:15:03,164
So, whether that's, technological

398
00:15:04,264 --> 00:15:07,304
advancements, workforce challenges, financial shifts, you name it.

399
00:15:07,304 --> 00:15:09,884
I I also think that, focusing on patients,

400
00:15:10,024 --> 00:15:12,044
continuing to focus on patients is key.

401
00:15:12,750 --> 00:15:14,110
I I always like to think that if

402
00:15:14,110 --> 00:15:15,790
you're doing the right things the right way,

403
00:15:15,790 --> 00:15:18,269
it's it's easier for everything else to fall

404
00:15:18,269 --> 00:15:20,590
into place. But as a leader, I think

405
00:15:20,590 --> 00:15:22,350
at the end of the day, the most

406
00:15:22,350 --> 00:15:23,730
effective health care leaders

407
00:15:24,350 --> 00:15:26,110
are really gonna need to be able to

408
00:15:26,110 --> 00:15:27,250
motivate their people,

409
00:15:27,825 --> 00:15:29,904
because there's only so much an individual leader

410
00:15:29,904 --> 00:15:31,684
can do. It's really about being

411
00:15:32,384 --> 00:15:35,524
that force multiplier and, moving everyone

412
00:15:35,985 --> 00:15:36,884
in an organization

413
00:15:37,745 --> 00:15:40,799
in that same direction to be adaptable and

414
00:15:41,039 --> 00:15:43,139
innovative and focusing on patients.

415
00:15:44,000 --> 00:15:45,519
You know, the old saying many hands make

416
00:15:45,519 --> 00:15:47,919
light work. So so, yeah, I would say

417
00:15:47,919 --> 00:15:49,620
if I had to pick only 1,

418
00:15:50,240 --> 00:15:51,299
I I would say,

419
00:15:52,320 --> 00:15:55,839
being an effective motivator of of people so

420
00:15:55,839 --> 00:15:56,339
that

421
00:15:56,745 --> 00:15:57,245
everyone

422
00:15:57,865 --> 00:15:58,345
can,

423
00:15:58,904 --> 00:15:59,565
be adaptable

424
00:15:59,945 --> 00:16:00,764
and innovative,

425
00:16:01,705 --> 00:16:02,764
focus on patients.

426
00:16:03,384 --> 00:16:06,264
I think that's really the, the single key

427
00:16:06,264 --> 00:16:07,485
for health care leaders,

428
00:16:08,105 --> 00:16:10,345
to be successful in what I think is

429
00:16:10,345 --> 00:16:11,404
a really, really

430
00:16:11,960 --> 00:16:13,420
exciting time for Danesh.

431
00:16:14,440 --> 00:16:16,360
Yeah. Yeah. I completely agree. And thank you

432
00:16:16,360 --> 00:16:17,960
so much for those final thoughts, Cyrus. This

433
00:16:17,960 --> 00:16:20,200
has definitely been an informative discussion. So I

434
00:16:20,200 --> 00:16:21,639
wanna thank you so much for coming on

435
00:16:21,639 --> 00:16:23,559
Becker's HealthCare, and I look forward to connect

436
00:16:23,720 --> 00:16:25,500
connecting with you again soon.

437
00:16:26,851 --> 00:16:28,211
Thank you so much, Mariah. You have a

438
00:16:28,211 --> 00:16:29,671
great day. You too.