Ep. 53: Building Boca Perio: Dr. John Lindsay’s Story

Part 10:00

This is Beyond the Arches, where full-arch dentistry meets real talk. Let's get into it. Hello and welcome to Beyond the Arches. I'm your host, Dr. Daniel Noorthoek. With us today, we have Erica. Hello, Erica. Hello. And we have a special guest, Dr. John Lindsay. Welcome, Dr. John Lindsay. Hello, folks. How are you today? So far, I'm doing pretty good. So, Dr. Lindsay is our periodontist and was the periodontist, the office that we purchased when we were first starting and we needed a home. So, there are lots of stories that we have.

Isn't that right, Dr. Lindsay? You were homeless. We were homeless. But I've known John for around 10 years now and have had the pleasure of working with him and treating patients and same patient base and then also cohabitating. What do they call it now when two people live together but they're not married? Oh, it's called a dink. It's called a dual. Well, I guess that is that. ▶It would be a couple. Dual income. Well, anyways, we co-resided in the office together, done in one, and Dr. Lindsay, whose practice we changed over to the name Boca Perio.

And so, it was actually an absolute pleasure. But let's kind of, let's start with kind of getting to know you, Dr. Lindsay. I'm just going to call you John from now on. I'll respond to that. So, John, so tell us about sort of your origins and, you know, where did you grow up? Where are you from? That kind of thing, early. Well, one side note, we had met about 10 years earlier. We had practiced together then and you had this glowing opportunity to go back to Jacksonville and, and hit it big. So, and you did. So, I was lucky enough that you decided to move back to our area. And then subsequently, you're back in Jacksonville as well. So, you've made the full circle. All magnet in my life goes right back to Jacksonville. Through your travels, you keep circling around. I actually am a country boy. I'm from the Midwest, from a small rural town and didn't think I'd ever leave Missouri, really. And I went to dental school in Missouri.

▶And ultimately, I did my periodontal training, in Boston. And my wife was from Boca. My father-in-law was the first dentist in Boca. So, we ended up back there. We've been here, gosh, almost 50 years. So, I'm a bit of a pioneer. And we love it here. I love everything about it. The people, the weather, and, and the practice because socioeconomically, it's an excellent place to practice what we do. And so, it's been just a wonderful home for me, my family, professionally, personally.

So, I do it all over again, same way. And, and I am fortunate to have a circle of dentists that refer to me that are really high quality. So, it's really made my professional life exceptional as far as I'm concerned, especially for a foreign boy. You know, it's a big, big change. So, I've enjoyed every part of my professional career here. Yeah, you've, you've done a wonderful job. I would say that probably the testament to that is I'm just purchasing your life in reverse, just one little piece at a time. We purchased the office. There was a boat. He, he owned a boat that was, is my favorite sort of style, brand, everything.

Bought it, reconditioned it. So, I'm just kind of chipping away at you. You stopped short. You've offered, offered my house where I live. So, I think he's moving right into me. He's moving me out to the home, I think. I joined the same country club as him. I'm just chipping away at you. I'm just chipping away at you. I'm just chipping away at you. I'm just chipping away at your life. Yeah. You've made some good choices, and they're easy to follow.

It makes me proud that you, you are following in the same footsteps. I'm trying. You've made some good decisions. I'm trying. Let's go back to you, your education. So, you went to Boston for your perio training. Correct. But before that, you actually had practiced for a little while, I believe, as a general dentist, correct? I did, in Boca. I was going to go directly and my father-in-law had lost his longtime associate and was kind of caught short and wondered if I could come down to spend a year or two till he could find someone to fill in because he knew that was my my aim and it was such a sweet situation maybe my my wife strongly wanted to come back home here to practice which which was good because I wasn't sure how I would like it it's quite a different environment than I grew up in and I adapted pretty quickly it wasn't too difficult and so we've thoroughly enjoyed our years here he made it a wonderful opportunity for me he didn't like doing prosthetics fixed prosthetics and I loved it so he fed me everything he had and his associate had so we had a very nice situation for several years but I always knew that I really wanted to go back into perio and I had a kind of an acceptance waiting for me but at that time we had a one-year-old which it made it pretty oh wow pretty testy to go back moving to Boston with a one-year-old and and you know my wife was kind of in charge of all the home stuff but we love Boston too Boston was a great experience and it was a great program and I really felt like I got the best of it and I told her I because I had applied to Penn and to be into Missouri and I told my wife I said you know if I don't if I don't really get into to be or maybe secondary Penn then I probably won't do it I'll just stay here it was too too nice of a situation to pass up and so she got the mail first when she opened it and she came to me she said okay you got either put up or shut up because you got in so that was the decision and we followed through with it and it was testy my one-year-old we had Monday and Tuesday nights we had late late meetings and so I wouldn't get home till it was kind of her bedtime and she'd get so mad at me she wouldn't talk to me till almost Thursday for being gone for a while and I was like I'm going to go to bed I'm going to go to bed I'm going to go to bed I'm two straight days and nights so it was a family you know stressor for me yeah but the education was great the city was great the experience was was great and a little more expensive than I thought because we were about to run out of money right at the end so it was tight but you know all

Part 26:53

in all I have to say you know coming from a farm town you know life has been better than I ever could have expected I happen to love what I do I still still love it and so I'm going to go to bed that's what keeps me going what was it um that you did love about it the the the time when you joined periodontics didn't have a lot of emphasis on dental implants which is probably the younger generation's biggest hook so what was it about periodontics that you fell in love with back before that really became what it is today with implants uh I hated perio in dental school hated it and our head of the program was horrible it was the most boring horrible specialty I could ever imagine uh the head of the department did a surgery kind of with me and for me on a young young boy who had a lot of hyperplasia and I assisted and it was about two weeks before his prom and that's back when they put dressings on and I was the one that had to take a dressing is basically like silly putty in the mouth it kind of covers the wound and it's it's basically silly putty yeah it's like bubble gum that you put over it and I think it was more for us so so the patient couldn't see it for two weeks I found out because when I took that off and he saw what he started crying I mean he had a date for the prom like two days later and he he looked hideous and I mean that was start of me hating perio but when I when I moved down here when I was working uh I had a mentor uh rosenberg who very very talented individual and he got me really excited about perio pros that combination and that combination is what really attracted me and it was a natural you know especially having it those years as a general dentist I went through all of pinky all of dawson all the you know better actual courses you could take so and they're right here in florida so another another advantage so uh marvin really influenced me and I saw a whole nother world of perio that I didn't realize that was out there but I will tell you that into my first year at bu we had jerry kramer ron nevins you know a really an all-star class and uh I asked ron nevins midway into the first year I said I see the future and I see the future as implants and I'm acutely interested in implants could we incorporate implants into the program and he was always kind of short with these answers he said don't you think you guys should be able to do that should learn perio first which I remember that quote vividly because he was probably one of the premier implant people you know through the perio restorative international programs so we were we did not get much implant training in our program you're right we were kind of the first edge of it so but that was always my main interest in perio really was integrating perio and it became you know really as you said I think a lot of people more think of it as implants than perio at this point yeah and I think that I I was still of the generation if you will that there was still the directors were you should learn perio first before jumping into an implant at that point yeah um but I would say that from what I've observed with the younger generation I feel like that's sort of fading because you have you have directors now that are young enough that they sort of have started in that implant world and that's what got them into it so they more understand why somebody would get in for that reason and I feel like that barrier is kind of gone now now they kind of embrace it of sorts that took a long time to come around but what happened here it was kind of phenomena in this south florida area everywhere else united states uh oral surgeons were primarily doing implants and the more sophisticated we became in the prosthetic side of it it gave us a whole nother treatment planning view and if you were treating the perio it was a natural that you would get involved with the restorative implant side of this as well so it was really a natural and primarily at least it started in this area that periodontists were primarily doing the implants and but again it was just many times we were the first one to see the patient because of the implant and we were the first one to see the periodontal problems so we had first access at it but it really fell into place very nicely and I do think people students going into the specialty now are looking more at the implant side of it than perio I just don't think as much perio is being done especially heroic perio where it's an end stage situation they're probably going to lose their teeth anyway then you have to really look hard at what you're doing for the patient economically physically and then you have to look hard at what you're doing for the patient economically physically and it's really in the in the patient's interest as to how you treat implant the the thing that worries me is and I think we're doing this to ourselves in dentistry is in in the programs they're kind of giving dental students undergrad dental students the feeling that they're pretty well situated to start doing surgeries and implants and when you really know what they do in their training they aren't trained in that and they're not trained in that and they're not trained in that and they're and so I think it's a misnomer to the patient because they really truly don't have surgical training they don't have that background and I think in some cases it it really is critical I don't mind general dentists doing it as long as they have the education you know to toward it so that is a bit of a problem within dentistry I think that we need to address I I would agree and I'll tag on a little bit to that I think that the even in the surgical programs there is enough focus on implants where the fundamentals get left by the wayside the things that you were hammered in and spent many you know a couple years in in residency training learning how to do the fundamental surgical basics I don't see them being trained as much which is a little bit concerning to me from a it doesn't necessarily relate a lot to maybe end result as much but it feels like that really changes the surgical outcome in terms of trauma patient experience um that that a computer and digital x-ray and printed 3d printed guide for implant placement great but there's no replacement as you know there's no replacement for good surgical fundamental technique and i think that that there's a big chasm there that's sort of forming well i think that there is also uh with time and a lot of the a lot of perinatis surgeons out of my era feel the same way i we do guided surgeries we do do them but the truth is you lose all feel tactile sensual you know sense and i really feel so confident in my ability to do this i i hate to do anything where i can't feel it when you're working around the nerve uh they're they're really important anatomical areas and i think that's a really important thing to do and i think that you have to be aware of and if you can't feel it then it's a problem so and i think a lot of times general dentists feel that's their their stick is if they can put it on a program in a computer and have the computer guide them into the right situation that's good but what if there is an error a problem and a lot of times the guides you use can't allow the forms in the back teeth there's not room so you still have to add libs so it's it's really a little bit of a misnomer truthfully i agree couldn't agree more if you want me to do a really bad job placing an implant make me use a guide yeah it really it's it kind of holds you back a little bit and it forces you into certain positions you know don't feel right don't look right and especially at the level you do it well it obstructs it obstructs the view of the surgery you have no view you have no view let's go back to a little bit to when you were in in perio training and you were developing this passion we'll say for implants you know what you have really the basis of your practice really was kind of at least equal implants in perio surgery but pretty primarily implant driven um let's discuss or let's talk about what it was like when you started to do these implants because that was a um that was a world where there wasn't a ton of surgical literature on it and things were being figured out of surgery so it was a world where there wasn't a ton of surgical literature on it um what was that give us a sense of what that was was like in those days how did you learn did you primarily learn from the vendors themselves was it a um a trial and error sounds more extreme than it needs to be but um a little bit of like learning what you trusted in terms of brands and and feeling that out or um was it similar to what it is now where there kind of is a compendium and a and an agreement on what to do and what to do and what to do and what to do and what needs to happen and what doesn't there was almost none in my training program in my graduate program but fortunately uh the atlantic coast has a research center there and a very good friend of mine and a perinatist who went to bu i used to play racquetball with him rich lazera had he was a pioneer in this and friend uh with three eye and um so he was one of the leaders and at that time it's pretty specific to perinatist and he was one of the leaders and he was one of the leaders to take but he offered an extremely good hands-on program where you actually could do the surgery treatment plan him he was there along with several others that oversaw it and uh it was a perfect learning opportunity and we we did a lot of implants and under supervision which i think is important and uh philosophically you know he had a very good command on he actually developed as you know the restorative parts to fit to the implants they didn't have that with nobel when it first came out right so uh he was integral to the development of of implant and restorative implants so i was very fortunate and he pretty much stopped doing perio let's pause there real quick because i don't want to um lose that little moment there when we would start when we started with implants um they you would put the base in the implant and to be able to put anything on top it had to be essentially custom made by the lab to fit on top it was it was a cast metal that was made on top and so what he's talking about is you know we have stock components um that we can fit into the implants that those really didn't exist and so he was what he's describing as sort of the beginning of that yeah he was a pioneer in terms of making that transition to where almost anybody could restore it because they had set parts that you could fit in and a step further where my training helped is he kind of backed out of clinical surgical treatment but he was at it long enough and being ceo of the company when unusual failures would occur uh we had he would send it to me in boca and i did this with dr john courtney a very good restorative dentist in boca and we got their failures and nothing teaches you more than trying to bail out a failing uh failing case of course so we we really really learned a lot through that and um it it's uh

Part 318:59

a lesson we we learned a tremendous amount so uh but that was a real benchmark period when rich rich really went to all the local prasananas in west palm beach and said help me design this and um yeah because three i was based out of palm beach gardens right right and three the other interesting thing is he exactly duplicated the nobel implant and so they were sued big time from germany and they ended up with the nobel implant and so they were sued big time from germany ended up uh it went to a national uh jury trial and rich knowing rich he knew his time was up because there was no i mean he didn't even deny it you know we we absolutely you know figured their their implant and so this so he said we're going to place all that we can because we said so we're going to run for it and keep it going because we know the end will be coming soon well lo and behold he won the lawsuit so that opened the gates for him i mean that really was a and he'll even tell you that was a miracle the fact that he won the lawsuit was a miracle and i mean that was a miracle fact that uh you know international thinking at the time he just didn't think he had a chance but he won that lawsuit and that opened everything you know as far as restorative parts of implants and what he had been doing so it was it was really monumental did it feel as i think back to or if we're looking at a case that has really old implants there's lots of different ideas and designs that you see in those and now you kind of have a little bit more of um set course where you you have parts that fit inside the implant that they're all kind of more kind of getting to a singularity if you will did it feel a little chaotic at the time or was it you know when this was sort of developing did it feel kind of chaotic like this company's trying this and this company's trying this i wish i could have both of these or were you enough sheltered in you with the brands that you were placing sort of singularly focused on that and believing in that did it not feel that way truthfully much less chaotic man because there were much less selections i mean there was only a couple out there now how many how many you know different brands are there last i knew it was six high 600s a little 700 and everyone has their own system their own sizing their own parts and when you go into a system as you know you got to buy into the whole thing you know so you have to have every driver every part every screw so it's a big commitment when you take on a system and you have to have every driver every part every screw so if you're trying to take on five or six systems i mean you have to have a whole warehouse full of you know things to fit them together so it's gotten more complicated really just before you walked in we were discussing that we when we were bringing in a different implant company this year we spent sixty thousand dollars on the boca location and the jacksonville location each so a hundred and twenty thousand in stock so yeah i know about having a stock of stock is expensive for sure and that's not immediate money makers for you either is it sits on the shelf you know it's and if you think about it is a very simple selection what what i do day in and day out and what those are those implants will be used for is very cookie cutter versus what you do with um different locations having to consider the different doctors that are requesting it so in in many ways of anything as the example mine's one of the more simple ones you know even at you've cheated a little bit you cheated the system by simplifying it down but you still have the issue of taking out failing implants and it's you're really good to have the parts where you can you know really uh retract them out rather than cutting them out so but that is the ideal way of when you're involved with implants you you've kept it as simple as it

Part 422:50

can be you know with one system basically one type and um you know that that really does cut through the chase of a lot of problems if you had to give us a couple things if we were making a dr lindsey implant tell me your number one thing that you would want for you to love your own implant in design just what would you be looking for well i i really like the tapered design i think there's a lot of studies that show that it's probably the most secure once it integrates uh so i do like the the tapered design the threading you know you you can't do that with a tapered design you can't do that with a tapered design you know you just kind of get into materials which is probably not you know something we have to get into here but i do think platform switching is the way it is however i have to say of the nobel system that i use i i love their 60 implant which is not platform switching it's a trilob design but that wider platform it really creates less problems when you're putting it into a molar and you're not creating big spaces embrasure spaces where they're getting food caught and we've had very good success with it it i've begged nobel for years to switch that to a some kind of a lock-in design rather or you know the platform switching yeah and they've just refused to do it but i i think that the wider implants for molars make a lot of sense i see a lot of people trying to do four millimeter three and four millimeter implants in molars and it's going to create a long-term maintenance problem so we're going to get back to that in a second so um the taper design is just for an explanation of of the people listening parallel uh you have two different types parallel and taper design and that goes to the screw and the body of the screw a parallel design is basically like everything is equal all the way down with threads on it and the tapered one goes down to more of a point and um also has threads on it and a tapered design is basically the theory behind it is that at the at the at the end of it where it becomes sort of pointy allows for better bone compression and better stability when you place it rather than the parallel design that isn't able to sort of create its own um compression the we're gonna where we get back to um what you were saying about the width of the implants actually no we're going to talk about um platform switching i know we've made a lot of progress on the platform switching but i think it's going to be a lot mentioned it before but it's a platform switching is a concept where essentially where the parts meet the abutment and the implant meet together uh instead of being the abutment being essentially right at the edge where the two parts can wiggle back and forth and create a bacterial pump and create bone moss around the edge a platform switched implant is a smaller abutment or a smaller place and it's going to be a lot of work and it's going to be a lot of work and it's going to be a lot of work and it's going to be a lot of work and it's going to be a lot of work and it's going um that you put the piece in that allows for space and that wiggle and that pump doesn't kill the the bone at the edge um so well with that thought the you're taking that little edge uh away from the bone itself you know when you bring it in you know because naturally a little plaque bacteria things can get caught in it and if it's right out there adjacent to the bone well it'll have an effect on the surrounding bone but when you tuck it in you're kind of of removing that that source from the bone itself so and by anything i've seen or heard i don't think it loosens the connection or you know there's any problems technically of that sort that's what i was going to go with it is uh so you'll use you studied with a prominent um surgeon dr fugazato and dr fugazato has the exact opposite opinion of you last i listened to one of his lectures where i hope you didn't believe him no no okay i don't place don't play single implants anymore there's nothing to believe for me but um he he likes the skinnier ones have you had this conversation with him because i know you trained with him correct yeah we were we were we went through the program together it's a conversation you might have to have well i don't know on on this particular format but uh he is a unique individual oh yeah um i've put a tapered implant into him okay he has one okay and it's named the fugazato implant and uh he's strictly strawman it's a different system but he's been you know very loyal to that system and uh he had to have one he flew down from boston and he had an unusual space it was in a upper left second molar position uh with a sign at prominent sinus of course and this is back probably 15 years ago that i placed it and when i was looking at it he had an unusual anatomy and i said you know i i don't think the standard strawman is gonna gonna work here he said no problem and he pulled out of his pocket a fugazato implant this is true story he was sitting in the chair and uh so i said okay well before he did it i actually called beth uh petruzzelli who was the rep at the time and i said do you have this particular implant and fugazato already told me i guarantee you she won't she said no i've never heard of it they don't have that i said it's funny it's in my hand i'm looking at it right now so he brought his own implant and it was the right fit and he still has it to this day but in part of our discussion uh he it was it was really broken down it was a difficult surgery and we had talked about trying to maintain the area bone and it was hard it kept fracturing and we had really discussed this so in the middle of he wrote a note to me and handed it to me he says buckle bone is good like i said maybe i forgot uh but fortunately it went well it was really the perfect size implant it's still it's still available um and it tapers from like uh it would would be a 3-0 or a 3-2 up to uh about a 5-0 and at that time that was really a new design for for strawman so but that's what he has in his upper left second molar that's funny so um so let's uh let's actually go back in time a little bit and go towards um you graduated from perio school and decided to build your own practice let's talk about the sort of just the uniqueness of the location that you selected in the community that you essentially helped create um which is the practice today well it uh it was uh a two-person practice at the time i joined it uh marvin rosenberg and bob holt uh two excellent periodontists uh marvin had done beyond perio had done two years at nih in just bone grafting research and so he's probably one of the world's leading researchers in bone grafting and he did a monograph on it which was a one of a type monograph that he prepared bob holt my other partner was periodontist trained in alabama and was a phd in microbiology and had you know published quite a bit you know esoterically on microbiota of the paranormal situation so i really joined a great academic practice clinical practice and and marvin also was a pioneer in perio pros you know integrating the two so uh it was a wonderful experience for me we had two actually at the time we had three practices we had a palm beach practice a boynton practice and a boca practice uh i lived in boca and had practiced general dentistry there so i had many many friends in the dental community there so really my main thrust was always there they after a year they had talked me into spending a day a week in west palm just they wanted to have that variation and i did it and i enjoyed west palm pretty area but it you know really i was already busy in boca and that didn't make sense for me to to go up there so and then we added a fourth phil zenzir who was a also a classmate of mine at bu had gotten out of the service a very nice guy and he joined us and for many reasons we had a wonderful practice and after about eight years i realized that they all went back and forth and i didn't and it was as simple as every weekend when they were on call they'd call me if it was a boca call and they want me to go see their patients and you know it was other issues but i just for me it worked better for me to be on my to strike out on my own and uh i'm glad i did it it uh and we parted friends you know it was a it was uh they knew up front what we were doing and as a matter of fact the first year i i said i wanted to go out it wasn't good timing for them and they said can you wait you know maybe a year for different reasons i said sure you know it's not an emergency so then the second year i went back and said okay you know they said you know it's still not great and i said okay you know i can do one more year of this the third year when i went back they even said you know i said no no no no this is the year yeah it's going to have to happen but they appreciated my honesty you know we we dealt with it up front and we remained friends you know after that so uh i have no misgivings about where we started and i particularly enjoyed my own practice i could kind of do it more my way and as you know the more people you get involved it gets difficult to make decisions um i remember one night we had to meet in boynton that was a midway and we had to buy some copiers three hours later we're still talking about copiers i thought then when i drove away no no i'll never spend another evening with you know all my partners i think you i think you told me that story before and i feel like uh after hearing it again you um you really don't like sitting around and talking about copiers i think you you gathered that right i drove that point home didn't i yeah um so let's talk about the the practice as you when you did strike it out on your own um you built basically from scratch it was a not a dental um floor at the time um it was a new building correct right new build out everything tell me how that kind of formulated because it it has become sort of uh one of the prominent dental floors of boca so how how did that come to be and and this was right around 92 93 90 well it was actually probably 88 89 okay and i lived right across the street and watched the building go up and the building was being built by a very good friend of mine tom head uh and once i saw it i was like oh my god i'm gonna have to buy a new building and i saw it and saw the location there was about four or five of us that were wanting to locate together and we're looking for a space and so when i first approached him he talked to the owners he was the builder but uh they really didn't want medical or dental in there the parking demands and you know just the build-out demands you know everything you have to do for a dental office so he said they really prefer not to have well it sat empty for six more months and he came back to me he said are you still interested because i think they've changed their mind so we had a great group a core of guys that were all still in place looking so we worked out a how did this group come together well we were all friends we'd work together they're all guys i had worked a great deal with and and they were my friends you know we we had a lot in common and uh so it it came together beautifully i mean really that floor uh is you know and then we added another uh surgical you know team on that floor too so the whole floor is dental at this point i think at last count it was like 14 dentists or 15 dentists on that floor and it um you know it provides for the patients it was wonderful because we had all worked together before so if a patient was a chair and had emergency or a problem sometimes they just walk it straight down to me to look at or ask me to walk down there and take a look and save the patient a whole nother you know visit so uh it really was a very fortuitous thing for all of us you know really on the floor the floor's turned over now and i think it's a really good thing now i mean we've pretty much you know i think i'm the only original that really is still there and uh but still very dynamic you know all the practices there are thriving everything's and as much as they didn't want us in the building now we're what is that 1990 what 30 40 years later uh we're the only floor that has been stable in the entire building over that period of time i mean all the stockbrokers all the lawyers all that they've come and gone weekly monthly i mean out but our floor has been stable you know since we've been there i think that if they could probably do it all again and go back 30 or 40 years they probably would have um still allowed you to build out that floor but they probably would have put it on the first floor with all of the intense plumbing and leaks that happen out of nowhere but actually there's a bank that took up half that floor so that was what you know what but you're right that would have saved a tremendous amount of time and effort that being on the floor that would have saved a tremendous amount of time the third floor you know what what had to be put up with so um you know it was uh but it was very fortuitous at that time that was considered extreme west boca that we moved from i was on dixie highway so that was a big move out there and uh actually turned out to be perfect because you had a budding community in west boca out to 441 and those people didn't you know for them to drive down to dixie highway that's that's a schlep but now you know we were in the middle of and i think it was just a perfect location for what we were doing so in every way it really was and they kept the building up nicely patients don't feel threatened when they come into that building so uh it really was was very fortuitous that we that we ended up there i'm very proud of uh all my all of our locations but i have always been very proud of that as a perio location and i think that the one of the things that's the coolest about this floor is that it's not um it's not impervious to new technological improvements but it has done a really really good job as a whole and this is independent business owners operating doing um essentially insulating and protecting from going with dentistry's newest fads and latest trends and um but it's done a really good job incorporating technology like we were just discussing um incorporating one of the practices down the hall from you, we were discussing that they have added AI assistance in detecting cavities, et cetera, which is a great ad and doesn't really change the way that that, it will change the way that that practitioner practices, but it doesn't really make a big dent or difference in, doesn't make it skeezy or doesn't cheapen the product that's being offered.

And I think it reinforces too. It reinforces, correct. What he's saying, you know, committing to. So I think it is an adjunct, definitely an adjunct. And if you look at the floor, a lot of the restorative dentists, the prosthodontists, he has scanners in there. The endodontist has a really nice CT scanner. You have a nice CT. Everyone has computers. Everyone's paperless at this point. There's a big- I'm paperless, thanks to you. You're welcome. And Erica. Erica. Erica was one of the chief scanners.

That was a, how long did that job take? ▶That was like a six month of sitting in front of a computer, scanning every, each individual piece of paper into everybody's file. And he still writes on paper. Well, they get rid of it quickly though. Yeah, good. But we all appreciate your efforts though. Absolutely. There's, when you go around and looking at offices to like, you know, shop for them or look to buy them, you see either, there's someone that's really succumbed to a lot of the trends and has sort of gone by the wayside because people can sniff that out, and they have a, you know, backroom full of extra old equipment that they bought and don't use anymore.

Or you see the person that sort of stayed on paper charts and that's the way they're going to do it, there's no screens, et cetera. And there isn't a lot of middle ground.

Part 539:41

And what I think that the practices on your floor have done, and maybe it's a mindset thing that sort of is deep rooted in there, but I think it's done a really good job of not, of really striking a good balance to, you know, accomplish what needs to be accomplished. A patient needs to have good adjuncts for good information and good practitioners and a good direction and pay a fair number for that and not feel like they're being oversold.

And I think that that whole floor is just a goldmine, if you will, in terms of good ethical practice, you know, good amount of technology, but not overdoing it and going super trendy. Yeah, I feel it's a classical, each one is classical in their approach. And I think all are very altruistic in the way that they do approach dentistry. I think they're trying to practice good quality dentistry and fair prices. I do feel very good, and none of us are interrelated.

I mean, we're all independent practices, but, ▶I think that the confidence that we have in each other and, you know, I just feel blessed by some of the specialists on my floor right next to me that they're there. I mean, if I have a problem with a patient in the chair, they're not, you know, they will walk down and take a look, spare that patient, what, how many hours to go, set an appointment, get an appointment, go for a separate appointment.

And I think it saves the patients a lot. So I think it's, it really has maintained good quality, fairness, and I really respect all the guys on my floor. And again, we're all independent. Nobody's, you know, linked together. So it's been a very nice situation to practice under professionally. Absolutely. The, just as an example, I sent one of my closest friends up to the endodontist the other day, and Erica got a letter, a referral letter from him to our practice updating us on, Mm-hmm.

On what happened. And I didn't fill out a referral pad. I didn't do anything, but it was nice to receive the letter, very traditional, get the update. And I'm not, I don't have any future treatment with them necessarily, but it was nice to sort of get that. And that's what you get everywhere across that floor, which has gotta be a nice way to practice, but that's kudos to you to helping establish that, be the way that things go.

▶And that's, it's always been a nice, you know, it's always been a pleasure for that side of it, is having a piece of that is very rewarding for sure. Yeah. That specialty particularly has gone through several transitions. The specialty of endo has been when a general dentist referred a case to you, then your obligation was to do a root canal. Today, it's much more sophisticated than that. If that tooth can't be restorable, you don't put the patients through the aggravation, the cost of a root canal, there's other better ways to do it.

And that's one thing that the endodontist on my floor is extremely honest. And I'd say at least 30% that I send down for opinions on, he'll say he thinks it's in the patient's best interest to not do a root canal. And so that just speaks of him, the quality of, you know, his treatment planning. And that's one reason I totally trust him. I'm very fortunate to have him right there on my floor in my building. And I do totally trust him.

And I know you know him well. Yeah, as fate would have it, I went to dental school with him and he was a really close friend in dental school and completely randomly ended up on the same floor. Crazy. Bananas. Yeah. Real quick, I'm gonna throw some compliments to you. So when I, I won't say that I'm the world's leading expert on a practitioner's quality of care, but what's been awesome is that even from the very beginning, from when I first met you, your, the style of your practice and the way

Part 643:53

that you approach your surgeries, the way that you do your surgeries is very similar in line to the way that I feel is the appropriate way. ▶Whether, again, whether that be right or wrong, doesn't matter. In my worldview, it's always been, wow, he does that as well. I like that. I like that. And so that's been always great to have that relationship, to be able to watch you do surgery, and learn some stuff, but know that it's, when I'm learning it, it's because the comfort with incorporating that into my own side is that your approach is very similar to the way that I like things taken care of, which is a very, you know, comfortable, clean, efficient, and logical way to approach surgery, which has been really fun.

Well, that's a great compliment. I mean, I've watched you do your surgeries in different, different type of surgery, but yet the efficiency of which you can do it. And I think that the, you know, compliment from a fellow colleague is, you know, really it's the highest. I mean, you really appreciate when a patient thanks you, but they're mainly thanking you if you didn't hurt them. But I mean, that comes from, you know, the whole package of, you know, meeting the patient, treating them correctly, you know, trying to treatment plan them correctly, and then actually carry it out.

▶And that's always been foremost in my mind. And I see it with you too, you know, it's a different, little different style, but it's still the ultimate goal is what you're trying to achieve and in the patient's best interest. So you hope everybody's that way. Yeah, it's an honest sort of altruistic approach, relaxed, it's not pressured. But I think that that's sort of the basis of what has always kind of drawn you and I together in our storyline here, you know, of 10 years worth of kind of a little bit back and forth, but it's always been a very straightforward dealing, but I've always come back to it because it's a very comfortable place because it's very similar to the way that I want things to run.

And so it's always been sort of like a feather in my cap for sure. You just outgrew us, that was all. No, no, no. Well, I think that one thing that really worked well was when we were performing the full arches inside of the perio clinic. ▶And inside of your practice, that allowed us some space to really learn from each other and grow where we weren't stepping on each other's feet. And I think it really led to a very like amicable, nice, beautiful relationship from a working side by side standpoint.

I never stepped on your toes and you never really stepped on mine. And I think it really led to a nice, great relationship. It did. Like I said, you outgrew us. Yeah. Well. I didn't have a waiting room big enough. Then we brought somebody in to go ahead and step on your toes. So we have since moved out into our own location. So I don't get to see John as often, but we have added another periodontist. And actually, as you came in, I just was thinking, it's pretty wild that we actually have four periodontists essentially on staff, on the team here, which is pretty wild to think.

You know, it's hard to get one in the room. It is. And have them get along. You know, it's all a test. How have things been going with Dr. Copulis? We're going to bring him in at some point, but. I think he's doing fine. You know, it's a transition for him. ▶And I think he's trying to change a little bit the style of practice that he has, that he's developed over the years. But he's been here in town a long time.

I found he's a very devoutly religious guy.

Part 747:34

He's very, very involved in the Greek church. I mean, very, almost every night he's at the Greek church with some committee or another. He mentioned to me the other day, they meet once a month, with a group that writes to prisoners, particularly people on death row. Wow. And they write, you know, encouraging letters to them about, you know, religion. So, you know, there's really another side to him. But, you know, I think that, I mean, he's well-trained.

He trained at Florida. And he's very up-to-date, you know, on his techniques. And so I think it's been a good combination, you know, that he's brought his practice with him. And I like having him there, because he's there for my overflow, can help me. And so it's worked out very well. You know, we've had a good relationship. ▶It's fascinating, because even though I'm not there every day, since we brought him on in what, it was around July, this last year, since then you can kind of feel the comfort in the production and the numbers.

It's, you know, bringing over his own, you know, stuff and then a little bit of a dip because things are a little uncomfortable and he's not sure how everything works and now it's starting to grow and he's certainly starting to treat your patients a little bit more so um that's been a nice sort of watching that play out has been really nice yeah he's uh you know he's he he's a good treatment planner you know he's a solid solid periodontist and uh he seems to have a good rapport with the patients i mean it's been a transition mainly for him you know to uproot and move into to us but i i think it's complete i think right now he's perfectly happy where he is what he's doing uh and uh he is um he likes to learn you know and a lot of times he'll want to sit in and watch me do some procedures he's not really been doing yet and he's incorporated him that's awesome he's starting to do sinus lifts in a little different manner he's uh watched a few uh subepithelial connective tissue grafts that he's he's still doing classically free gingival grafts and patients pass out when they even hear about that where they strip the palate yeah so he uh you know he's he's watched a few and he's you know he's kind of grown in different ways uh always learning you know he's he's got a lot of little he has this versa drill that he's used he likes uh i do it in a different way same end result but uh so he's you know he's experimenting a lot he's he's got a lot different little instruments that i don't use that i've learned from him so it's it's been mutual well whatever he's learning i can tell you he's learning from the best well that's that's kind we have a good relationship we really do good what um let's move on into personal life just in terms of you know we were just discussing that you're um a recent retiree from golf it may be temporary yeah until i can get over the depression of last week um but you like you enjoy fishing um running every day um tell us a little bit about your your passions and your interests and in your personal life well uh i do like that's one transition it was easy for me i love the outdoors so uh if i'm not running i'm biking uh i've just you know recently taken up pickleball i'm gonna start a new sport uh i'll call the orthopedic surgeon now yeah get a retainer for me uh the actually that's funny because i had a physiatrist come in as a new patient about a year ago fairly young guy but he said that it had been a struggle because he's kind of in a niche period of medicine until pickleball he said pickleball has created his whole practice he said it is amazing how many injuries come from pickleball so uh i have that in the back of my mind be careful i don't want to have to be limping around um love to snow ski snow skiing still still a passion of mine um i have you know i do golf i took out very late in life i swore i would never golf it just didn't have enough exercise benefits for me until all my good friends said if you want to see us on saturday mornings you better start showing up for men's golf so i had to learn amongst my friends who were long-time golfers and they're very kind with me they just said keep this in mind we don't mind if you're bad just don't be slow and so i've learned that i'm never slow i pick up and go on and so they've continued to play with me over the years and so it's been a very slow development yeah you know golf you take two steps forward you take one backwards uh so i think i'll bring it back i just i quit it last week i think i'll probably try it again next week um the uh but i do like my outdoor activities i've been very fortunate at my age to be able to do that and i'm able to you know still do the things that i do and uh that also keeps me mentally where i want to be and so i've stopped doing marathons i haven't done those for a few years and i i do think in retrospect that maybe that kind of breaks you down more than you realize at the time but um but i still enjoy you know five you know five mile runs that type thing the uh and my kids are kind of a reflection of me they're both very athletic very outdoor minded and uh so and we live in a great community you know the community and they're friends we we move there from boca bath which is right across the street from my office i mean i could walk to my office in those days as a matter of fact patients that knew me will ask if i came a little late if i missed that one light between my house and there and so which funny enough copulous lives yeah he lives in the same community so we tease him now you know when he comes in a little bit late you missed that one light yeah um so but the community it really was all of boca bath i bet 30 families moved from boca bath to royal palm wow all within about a year and i was one of the last because i had no motivation i mean i i lived across the street from where i worked everything was nice um but the community in which we live is is great uh my wife my kids everybody enjoys it it's handy we ride a golf cart almost all weekend i never get in my car we just drive the cart and you did a little different you took your boat down to royal palm and then you took the cart so you you took your own route yes absolutely um that's uh that's great so so you also um have a home in uh north carolina and you go back and forth i do we're coming up on when you're about to start to get more and more absent that is that's true we love it there we love it uh i don't like the round trip flights every weekend it really gets old you're a maniac and i just don't know how much longer i can keep that up but once you're there it's worth it i mean we just uh we love everything about it it's a it's a mountain golfing wise it's a mountain course we have some holes you're hitting over waterfalls others you're on the top of water waterfalls hitting down we the uh the stream in north carolina the rain the state of the earth is a state of the earth it's a state of the earth it's a state of the earth state record rainbow trout came out of the stream that runs right along our 17th fairway as a matter of fact when i was first learning golf if i really had a bad day then i kept a fly rod in my golf bag and i just walk off the course and i walk straight into the river and i just go out and fly fish for a while i just forget golf i wouldn't even finish finish the rest of the round um i'm a little better that's why i take the boat to royal palm if i need to i can fish on the way home that's true you get best of both worlds so i i forgot about that uh but do we do enjoy it?

do we we were there kind of spring summer and into the fall and um so we we do enjoy it it's taxing it really is tough you know maintaining both places and uh but you know we enjoy both worlds so um as long as i can handle it i try to keep it going you purchased that right around when we first met right around 2016 2015 somewhere in there when this man bought this house it was i'm gonna try to describe how much pink there was but it's not gonna even do any justice imagine every surface in a home every light fixture every ceiling every wall every carpet every countertop everything every appliance he had pink appliance was it that mauve that mauve color yeah no it was like the 90s hard pink and the husband i i said boy your wife he said what do you mean i he said i like it too come to find out all their homes everything i've always been pink wow the mix master i mean it's it's it's it's it's it's it's it's it's it's it's it's it's it's it's everything was pink and then the final straw after the closing we went to check around we noticed that they even had pink toilet paper in all of the bathrooms toilet paper that's carrying it way way too far and they had a pink chandelier huge pink chandelier over the dining room and he called me before the closing he said you know he was really asking if possibly he could take that pink chandelier if i had plans for it and said my plans are in your hands you can have that pink chandelier it's all yours wow so uh a very good friend of mine carl watson uh came in saw the house with us he's the ex-ceo of rinker up in west palm great guy he walked in and he had to turn he said i had to leave i got nauseous oh he said it it just kind of made him a little sick seeing so much pink everywhere it was the most intense we had to kill all the pink that was that was costly just to get all the pink out of that house i think i was nauseated just looking at the picture i can't believe you remembered that yeah oh it was it was it was it was it was it was it was it was it was it was

Part 857:26

seared in my brain well that's been uh an amazing time talking with you um i'm sure we'll have you on again to to get in deeper as we close um what's uh what's the number one thing that um as you look back on your career what's what's the number one driver of dr lindsey not and i say that because not many people practice as long as you have with a smile on their face voluntarily uh with as many patients as as happy as you have what's what's the thing that gets john out of out of bed what's the what's your number one um you know uh life tip or what what really is is the driver of john lindsey that's the easiest question you've asked me all day the patients i love the patients and can ask my staff they get so upset with me because if i have an hour exam it goes an hour and a half because i start hearing about their family their their and that's what makes it for me uh is uh that intimacy getting to know the people as friends and a lot of my patients have been with me the whole full time and they truly have become friends and when i see them you know i know their ups their downs and um so it really is very very personal to me and so and the staff knows it they fully see it and they quit they quit screaming at me now when i run late because they know i'm doing what makes it worthwhile to me it's not just about the treatment but it really is about the patients and getting to know them personally and uh and many of them been with me for the full years i've been here and um they just refuse to see anybody else they only will see me but and generally it's not for me to see them it's so they can sit and talk to me you know tell me more about their family but that is maybe you should have been a therapist uh maybe i may have may have worked too uh because that is something that always has been part of my personality i just and that was a little problem with my group because we've gotten big we had a management company they wanted to cut down on the amount of time for exams and you know they were showing us you know where that would you know end up the bottom line better and i basically told them then then i would be no good to you because that's absolutely not my driving force my driving force is really the patients and getting to know them and uh and many times we alter a treatment plan because of their health of their economic situation but that's why i like to get to know them you know it's i can make better decision help them make better decisions so that is definitely what gets me out of bed in the morning is looking forward to the patients so that's uh that's a perfect uh summary and definitely is something that you can feel when you when you work and interact with with you john and um you know i think that's a testament to you that you've been able to maintain that for 35 plus years in this area built something very strong um and you know to to wrap it up the it is a complete honor that you would entrust that to us in terms of the next generation and and making the decisions to move on to the next and kudos to you the the last thing i'll say is that um something that has been uh uh really great and i think that's a testament to you that you've been able to maintain that for in acquiring your practice and incorporating it into the fold is that you have done a really really good job rolling with the punches not that we've done anything that's just absolutely crazy but you know we totally took all of your my charts away that took your charts away um we took your name essentially off the door and switched it out for boca perio we um changed the colors out we did a little bit of a revamp but now that was an issue that's right you and i had had a discussion that's true but um but you've done a really good job rolling with the punches and you've come on the podcast now so you know it's there's you've done a really good job not just saying well i'm john and i'm just going to take care of my patients and leave me alone you've you've done a really good job sort of staying up with where we want things to be but doing it in a very graceful uh and understanding way um so that we can sort of get this practice to the next um stage of its life uh and so to credit to you that um you've helped that run very nicely and done it very graciously and and just as we would hope that it would work so we we definitely appreciate that well your part of the transition aided me in that because it really was like no change i mean i really practice exactly the way i've always practiced i have all the same tools same people you know it really has uh it has made it very easy for me like is very minimal transition so i i have to give you credit for setting the environment for me to allow me to talk although i want to talk and do the things i want to do well your your patient um perspective your patient for a sort of perspective your drive being the patients is what we hammer in here that's what we we want we want it to be a patient focused experience rather than a efficiency and a boop boop boop kind of scenario so your practice goals are very in line with our practice goals and so that probably is the thing that kind of is the glue that holds it all together yeah it's a common thread that i think has really helped tremendously i i mean i don't feel that there was a huge transition you know we've lost a few along the way no staff not patients yeah true true um anything else you want to add erica that's all i've got i've definitely i i've actually really enjoyed this podcast i think this might be one of my favorite things to do and i think it's going to be one of my favorite episodes we dr lindsey and i go way back personally as well and i've i've enjoyed my time with you i feel like i've have a lot of takeaways and at first it was very interesting because like you mentioned before it was kind of you're you're the last standing original on that floor in our boca office and i was kind of part of that um generational swap out moment where you could tell that some of the older staff and older team were kind of like seeing what's coming and what's not and and and and and and and and and and and and and and and and and and being a little bit nervous and a little bit anxious for it but you definitely never gave us any pushback so i appreciate the way that we were treated and you're always somebody that you know we'll we'll look up to and we'll find um good morale and it's kind of how like dr dan said we we bring that into our office as well well it's it's really been a pleasure and um i i feel very secure you know where i am and what i'm doing and i think that uh the that you you guys really in the transition made that made that happen because it could have been much rougher it could have been but but wasn't oh it could have been i miss you guys i miss you guys not being there but hey if we're if we're still in a war in a few more months we might be moving in i say i think i probably have i probably learned 80 coming from a no a no dental background myself i probably learned 80 to 90 of my knowledge from dictating your letters that you send out to everybody on the floor everything you can imagine well i thank you for doing that yes that really was helpful yeah yeah yet day in day out she does not beg to go back to dictate i keep looking for it she did that that job opportunity has been open a couple of times can't figure it out we appreciate you coming in doc and uh sharing your career and your personal side uh and your perspective to everything it's always um comes with a really great due um of respect and uh honor to have you here to to give that to us so we appreciate it and we'll see you next time bye-bye and um we look forward to the next time you come on well thanks for giving me the opportunity and thanks for not telling me what to prepare for so that everything here has been ad lib totally so exactly that's how it always is thank you for those of you who wish uh watching or listening we uh appreciate your attention and uh hope to see you soon thank you very much