Hello. This is Arianna Portallatin with the Becker's
Dental and Dias overview podcast. I'm thrilled to
be joined today by doctor Robert Traeger, a
dentist in JFK Airport in New York City.
Doctor Traeger, thank you so much for being
here today. It's great to have you on
our podcast.
My pleasure.
To start us off, can you introduce yourself
for our listeners and tell us a little
bit about your background?
My name is Robert Traeger, and I'm a
dentist. I've been here
in JFK for about forty years. Before me,
there was always a dental
department here, and it's been basically about sixty
years. I'm originally from the Boston area
and did my,
residency at Lenox Hill Hospital in New York.
Stayed here in all these years. Figured if
they're gonna make it anywhere, it has to
be in New York. So that's where I
still am, but I still root for my
New England
sports teams. But in the meantime,
being in the airport is a fascinating
situation. I'm
situation. I'm physically, as I say, in the
airport. I used to be in the terminals,
and then they tore it down. And I've
been in the Port Authority Administrative
Building now for about twenty five years, and
it's just a fascinating type of dental practice
in the location that no one else in
the country has. And,
it's just something that's really
enlightens what you do because you see people
from all over the world.
These are the patients who work in the
airport because you got 30,000 people work here,
and then you got people from
fly in. So in my case, it's wonderful
for me to learn different languages, not fluently,
obviously, but enough to make the patients happy
and to respect you, and it makes it
for a much easier transition.
Alright. Thank you for that.
First question for you here. What are some
of the biggest issues that you're following in
the dental industry this year?
Oh, I read Becca's,
every day. I read what goes on, and
there's just so much problems out there.
And I am a solo practitioner. There's a
big difference. When I came to Chicago
for the panels, I was the only solo
practitioner. They're basically up against the DSOs.
So my particular case, whether it's me or
a DSO,
the biggest problem that's facing us is the
advent of AI. Is
AI for all of us? In high case,
I don't think so, only because of the
fact that, I've been reading X rays and
practicing as a solo for a number of
years. I have a good business background,
so I'm able to handle all these problems.
Whereas the DSO goes, yes. This is an
excellent
situation for them to use for themselves.
And your other big problems today, basically, are
the dealing with insurance companies. So what's really
interesting is
California,
news governor Newsom just passed a law telling
these insurance companies
that they can't force dentists
to accept their payments
on a credit card machine, and they can't
force you into
assisting and working with other
insurance companies
who go ahead and merge or buy out
another company, enforcing you because you're on the
panel to take them and their fees.
So these are the things basically that I
really see is bothering. Of course, there's always
this problem with the shortage
of good health as far as that goes.
But these problems of running and maintaining an
office
with the bottom line being positive is the
most important thing that I can see today
as far as that goes. The fees and
costs and overhead is going up constantly,
and these are situations that affect everyone in
dentistry and all the health fields.
Yeah. Just a a follow-up question for you
there. Where have you seen the biggest
increase,
as far as cost for running your practice?
Basically,
I'd say your laboratory fees. I forget the
price of gold is $44,000, so all these
precious metals
are costing more. His supplies are costing more.
Basically, they're gonna use excuses tariffs, but I'm
sure there's other factors in raising the cost
of just living today.
A lot of companies
are unionized, so the cost to produce,
products obviously,
are expensive.
Transportation,
everything,
unfortunately, is going up, cost of living. So
that you do find a lot of problems
in maintaining and running a practice.
A lot of the biggest problems is poor
management. That's the problem.
The younger dentists today don't wanna go into
private practice. They have no business background,
and they can't handle it. So what do
they do? They go into a DSO.
Wonderful. They get that paycheck each week. They
have no problems. Problem is, they're gonna stay
there forever. No. But they're not learning business
acumen. So when they get out on their
own, this is what's gonna have a problem
with. And don't you think that DSOs are
having business problems?
It's very difficult for them to run
a business like that because these
speculators out there with, money managers
and putting up money
to buy out these practices, they all think
they're gonna do wonderful. But if you don't
have a business background and you can't manage
it, you don't know how to manage health,
and you don't know where to buy your
supplies or get the best deals,
how to money market and manage your money,
they're gonna fail. I'm looking recently just what
happened. Rite Aid, one of the biggest
drugstore chains pharmacies in the country,
5,000
stores which is closed. They went into chapter
11. I mean, it's amazing, and this is
sometimes it's happened with some of these DSOs.
It's wonderful.
They have the people
put up the money for this,
and yet what happens is you don't have
a good management. No matter how many offices
and clinics you have and the amount of
money that you're gonna save that you take
in, what good does it do if you're
gonna end up losing without having good management
and well trained individuals? And this is what
I see happening today.
Okay. Thank you for sharing more about that.
Next question for you here. What are you
most excited about when it comes to dentistry
right now, and what makes you nervous?
Oh,
excitement
is, for most people, the AI, which obviously,
if you use correctly, can help.
But I because I'm a solo practitioner, and
at my age, I'm still working five days
a week.
And, people don't believe it, but I wouldn't
know what to do if I didn't. So
what I love now is my implant restorative.
See, now I use a three eye Zimmer,
and I use the encode. I just have
to take
picture and scan of a, of a,
implant. So I take an impression. Yeah. To
clean off the top and see the code
numbers. Because all you have to do is
take an impression,
send it to the lab, and there's not
that many here in the New York area
that do it, and they scan it, send
it right to the laboratory
in Florida, and you get back the completed
implant
restorative crown. That's all you have to do
is go in if you use a customer
bump cemented and go ahead or just,
screw in the implant itself. So to me,
in my particular case, this is what I'm
very excited about as far as that goes.
I'm just excited about the fact that I
can manage a dental practice. I've had the
background for over forty years. So this way
here, I can
navigate through all the problems that a lot
of other people have, but dentistry is changing.
There are more and more technologies being
invented and used as far as that goes.
But the biggest things today from most people
is how to navigate with these insurance companies.
They're the ones that are hurting. In fact,
today on your,
podcast or on your daily,
twenty five percent of dentists now,
not accepting insurance, they're leaving it because of
the problems that they have. And it's just
terrible because they don't know how to deal
with these insurance companies. I know how to
deal with it because I've been doing it
for years, and you try to outsmart us.
Trouble is I haven't been around long enough
to outsmart them. So as much as they
try to mess around with me, I go
ahead and beat them at their own game
because I know what to do. And what
I try to do is tell these individuals,
companies, whoever has to deal with them,
they offshore everything to The Philippines
or to Canada or basically, if it's not
The Philippines, it's India or Costa Rica.
Always ask for a US supervisor. Don't let
them try to help you because they don't
know what they're doing, and they're poorly trained
and they'll admit it.
So always ask us to say, basically,
no offense against you, but what I have
to have done has to be
certified and agreed upon by somebody administration. So
please transfer me to a US supervisor,
and believe me, you'll get things done much
faster. But let them know the game that
they're playing, that you're aware of it. And
when they go ahead and try to force
you to take a credit card, where they
take off two and a half percent more,
or they downcode the fees, you just tell
them like I do. I'm in the airport.
There's 30,000 people there, and a number of
these airlines and companies use your insurance. I
will speak to the HR people and tell
them this particular company is not doing a
good service for
their employees, and they're gonna, hopefully, so switch
somebody else. They don't wanna lose
subscribers. Alright? They ain't want that money. But
you gotta let them know that they can't
fool you,
play games because they know most dentists don't
have a business background. So you gotta go
ahead and preempt everything and show them that
you're smarter than them.
Alright.
And last question for you. What will the
most effective health care leaders need to be
successful in the next two to three years?
The health care leaders cannot go ahead and
buy up everything that they see that's available.
When you get too big, too fast, and
you can't manage it, it becomes a tremendous
burden. That's what happened to Rite Aid as
far as that goes. And there are other
DSOs sometimes that are having
money problems as far as that goes. And
these are the things that they could be
be aware of. And, of course, you have
to have the right help, the right type
of individuals who are loyal to you and
wanna stay there and learn. And when you
interview them, you should ask, what do you
plan to do in the next ten years?
What do you look forward into? What what
is your anticipation,
as far as that goes? Because if you're
running a big DSO and you're having
all these patients come in, some have lousy
plans, some have Medicaid, and so forth, you
have to know how to navigate
through the system in order to meet the
bottom line. If you're gonna do fillings
for $25
and another company or contract will pay a
100 like with me, it's just amazing. That's
why I make sure that I see the
the type of patients that I want that
have good plans, and I try to find
out from HR the type of plans they
have
and to know just what the bottom line
is. You just can't take everyone that shows
in the door, so you can brag and
say that you've taken
800,000,
a million dollars. No. You wanna take in
what you feel is the correct fees. And
even with the insurance company, don't be afraid
to
negotiate with them as far as that goes.
Let them know that you're a business person.
You get your paycheck every two weeks, or
I'd like to get mine the same way.
And at the same time, what they have
to learn is how to make sure that
they don't delay payments.
See, the game that they play now is
just like today. We call up the insurance
company, and they're telling us we use dental
exchange. A lot of times, we file electronically.
One of them is one of the deltas
goes ahead and has the nerve. And this
is the manager, and he tells my office
manager, well, we don't accept electronic claims, only
ADA forms. Is it are you sure now?
She says,
well, I wanna prove you wrong. And he
said, what do you mean? Because I have
other claims that you sent me electronically that
you paid on. So I'm proving you wrong.
He got so upset he just hung up
on it. This is they don't like for
you to know more than they do. But
their main goal is to keep the float.
They have all this money in reserve, collecting
interest. Anything they can do to delay payments
to all these big DSOs or any solo
dentist. That's the game that they play. And
when you send in, they'll tell you they
never got the x rays. They never got
the paperwork
as far as that goes. So this is
the scenario
that they use to go ahead
and discredit the work that you do, not
pay you on time,
and go ahead and make it frustrating. In
fact, I think they've caused because I redone
the line. There's a lot of these places
causing fraud in other words. I'm sure
not completely at fault, but I see a
lot of these individuals and companies now where
the dentists are being sued and the companies
because of fraud.
But then again, the honest small
individual wants to be honest, they're forcing them
to find ways possibly commit fraud or do
things they shouldn't do because
of a way they're
disrespecting the profession of dentistry
and down coding and doing everything they can
not to have to lay out money.
Now the loss ratio, a lot of states
are now trying to get loss ratios
instituted
between 8385%,
which is excellent, but you need the cooperation
of politicians
and you need everybody working together. And that's
why the ADA, unfortunately, is losing membership and
all of the dental societies because they're not
getting the support that they really need. People
can
go open up an office and be in
dentistry and don't need the support.
And with bad management, this is what happens.
In fact, the ADA, unfortunately, has lost a
lot of money because of bad management in
certain cases, and this happens in
professional organizations. And people have to be aware
that these things are happening.
And no matter how big a operation you
have or how small it is, you have
to navigate the system, be aware of what's
really happening out there. And that's why, unfortunately,
these younger dentists
who are mostly going into these type of
situations have no idea of background. Once they
leave or if they try to open up
or even have a couple of friends open
up an office, they're not gonna fail, unfortunately,
or they're not gonna have the ability
to go ahead and run it as a
business, which it is. And this is my
problem.
Looking forward to a lot of these individuals
out there. They do not have the background.
Well, that is all I have for you
today, doctor Traeger. Thank you so much for
joining us on our podcast. It's been great,
speaking with you, learning more from you about
your experiences in the industry, and I'm looking
forward to connecting with you again in the
future as well.
Alright. Thank you, and have a good day,
Adrian. It's been a pleasure. And anytime you
need any input, I'm more than happy to
give you my,
input as far as that goes because as
I said, I've been around long enough to
at least have some decent ideas,
at least I hope so, to help people.
Thank you, and have a good day. You
too. Thank you. Bye.