Jarod Johnson 0:07
Welcome to the Sprig Podcast, your source for the most relevant topics in pediatric dentistry. I’m your host, Dr. Jarod Johnson. Today on our show, we have Dr. Sarah Khan. And we are going to be going through her journey over the past few years going through dental school and residency. And if you haven’t heard her story that is wonderful and exciting. And she’s got some great experience in the public health sector, as well as leadership through the American Dental Association, and the American Academy of Pediatric Dentistry. And she just completed her residency and is working in private practice. And during these past year, a year and a half with COVID, it’s going to be an interesting story to hear what she has to say about the challenges that residents have faced and how it’s looked to, you know, coming out into the private practice world from residency so welcome on the show here today. Dr. Sarah.
Sarah Khan 1:07
Hi, good afternoon, or good morning, wherever you are. So, so exciting to be here. And thank you so much for that great introduction. And I’m very excited for our chat today.
Jarod Johnson 1:20
So, can we start off, what got you interested in in dentistry, you did a BS in biology, and you graduated with honors and what made you want to become a dentist?
Sarah Khan 1:32
Absolutely. So, I have a very personal experience with my own dentist, I was born missing my number 10. And I was in ortho for you know, a very long time trying to maintain that space. And I always felt that at a young age, I couldn’t smile as much, and my smile didn’t match my personality. And through a lot of ortho treatment and through implants, I was able to receive an implant and get that space closed. And I think that boosts my confidence and self-esteem. And I wanted to be able to do that for others. I love that dentistry, marries perfectly science, but also technology and also public health and the ability that you have as a dentist to make a great impact on somebody’s life.
Jarod Johnson 2:22
And you’d mentioned public health. That is something that I think fits really, really well with our mission as pediatric dentists. If you look at pediatric dentists, most of us do treat underserved people, populations on Medicaid, maybe some at risk populations. You also have a Master’s in Public Health did that come before or after dental school?
Sarah Khan 2:43
So, it came in when it happened during dental school, which was, to be honest, very crazy. I applied for the dual degree program after my first year of dental school and I was lucky enough to be accepted. And I also received the scholarship. So, in the morning hours, I was doing my dental school classes and then two or three days a week, from 5:30 to 8:30, I would have my public health classes, it was definitely very stressful. And I had to learn how to manage my time wisely. But it allowed me to switch the hats I was wearing and step outside the dental school bubble that we have where we’re so focused on perfecting that distal margin of a crown prep or you know, dentures or all those things and kind of look at health from a larger macro perspective and understand the reasons why certain populations and certain people are kind of more prone to having dental disease and have more trouble in terms of advocating for their own oral health and receiving the proper oral health.
Jarod Johnson 3:51
I think that’s really important that we realize that with everything that’s you know, going on with diversity, equity and inclusion in this time, I know there’s some challenges we have here with health equity in Iowa. And we have one group of kids on a chip program where they’ve reimbursement is what Delta Dental pays us and the Medicaid kids are that get support from the federal government or lower fee schedule. So, there’s a lot of avenues in public health. What’s the biggest thing you’ve taken from your Master’s in Public Health into the Pediatric Dentistry world?
Sarah Khan 4:28
Sure. I think that often times we see that going to the dentist is the first step but so many things have to happen before that. It’s kind of like an entire community involvement. Not only do kids have to be advocated for at school in terms of, you know, the snacks they receive. What types of emphasis they have from their parents and their teachers but also the pediatrician and other interdisciplinary health care professionals have kind of all coming together to view the child as a whole. Not just when the child comes to a dentist, eventually when they do, sometimes it’s too late. And now they have 20/20 of their primary teeth that have decay. But what happened before that? So, I think we need to work not only as dentists but as healthcare professionals to try to really emphasize the AAPD standard of getting kids into the dentist at the age of one and emphasizing good home care habits. Because a lot of good dentistry and a lifetime of health happens at home. Less so what we do. We’re kind of there just to be their cheerleaders and fix problems as they arise and provide anticipatory guidance for things going forward.
Jarod Johnson 5:49
Yeah, absolutely agree. And it’s great, because if you can see that kid early, then we can catch something when it is small. And maybe we can do, you know, a smart restoration, or a Hall crown or see the kid more frequently, every three months for fluoride. And we can really champion that kid, like you said, be their cheerleader to get them to the point where they can have that, you know, restored with something that might be more appropriate than I normally do if they were able to cooperate and avoid sedation. And I know there’s been a, you know, a lot of, you know, press about sedation and dentistry, I think we get a tough rap on it, because we’re so good at using local anesthesia. But those are some great points to be interdisciplinary. I know that’s one of your other passions. Maybe we can talk about that another time. On from your dental school and public health, you decided to go into a GPR. Can you touch on that experience a little bit, because I think that’s a great, great way to get experienced, I know New York, where you are, requires that — also is a great lead in to get some more experience for sedation and things you might be doing special needs for pediatric dental field.
Sarah Khan 6:59
So, my GPR was, you know, kind of crucial for my career going forward. I, like you mentioned, I do think interdisciplinary care is very important. All too often, dentists are viewed as separate from the other health care professionals, my husband’s a physician. So, I’ve always wanted to find the role of a dentist in a hospital and through a GPR that was realized, especially in the emergency room, in terms of trauma, and you know, dental alveolar infections. The physicians, they’re great at what they know, but they really don’t know anything about the mouth. So I thought that was a really unique opportunity and a niche that dentists conserve as far as taking care of those patients providing treatment for those emergencies. And not only that, in my GPR, we had a lot of patients that were undergoing complex cardiovascular surgeries, as well as chemotherapy treatments. So, they always required clearance from the dentist, I really don’t like that word “clearance” because we’re not really clearing them, we’re just making sure that you know, nothing’s going on their mouth that would provide any type of complications or difficulty to their, you know, health going forward. And when I was providing those clearances, from our perspective, I would always try to emphasize to the patient that once they’ve recovered from their procedure or their you know, surgery or medicine regiment that they definitely come back and find the dental home, because making sure that the mouth is healthy, not only the teeth, but you know, the periodontal health, they’ll definitely, you know, ensure them for good health going forward with all the research that’s coming out with the relation of oral health and overall health.
Jarod Johnson 8:45
It’s funny that you feel the same way about clearance. It’s, I was on I remember, in residency, I was on the phone with one of the anesthesiologists, I was gonna do one of the cases for the next day. And he finally said the only person that can clear person for general anesthesia is the person giving the anesthesia, so I got a chuckle out of that. But that’s why I don’t ask physicians for clearance anymore for our GA cases, I asked for their recommendations.
Sarah Khan 9:13
Right. And how we can help optimize the patient. I think it’s just, I think changing the verbiage when we communicate with our other healthcare professional colleagues, will allow them to understand that dentistry is not just the mouth and just the teeth, it’s kind of all connects and all like a patient that has healthy smile and healthy oral health they can. Their PO intake is better. They can eat, they can smile, they can function. They’re not, they have increased quality of life. So, everything really connects and that’s something I’m very passionate about. And I think for pediatrics, it’s so relevant because kids change every day. And there’s so many milestones that pediatricians are tracking as dentists we see those as well. So, I think it’s gonna be, I see the future for the collaboration with pediatric dentists and pediatricians to be very bright.
Jarod Johnson 10:09
Yeah, I think we all have those patients that the parents, you go to do the case on general anesthesia, and they come back and they tell you that the kids a different kid, they’re eating everything, they just change their behavior, their attitude. And it is true. I mean, these kids do experience discomfort, but they’re just so used to it that they don’t know what normal feels like. And it’s just, that’s probably for me one of the most rewarding feelings is when you can have a parent come back and say that their kid has improved and you hear that story, it just makes you feel so good.
Sarah Khan
Oh, absolutely.
Jarod Johnson
After, did you go straight into residency for pediatric residency after your GPR?
Sarah Khan 10:51
No, I did not. So, I finished my GPR in 2017. And then I worked in private practice, for two years before I started my pediatric dentistry, residency. And in private practice, you know, I’ve always had an interest in pediatrics, but I was of the mindset that, you know, I could be a general dentist and see kids too. I had a great, robust, pediatric dentistry education in dental school, as well as my GPR. So, I did feel comfortable, but I found my knowledge based on lacking and I felt that I couldn’t provide for my patients as much as I wanted to. So that’s why I decided to apply for pediatric dentistry. And it just so happened that the practice that I was working in Philadelphia, the dentist that was treating the pediatric patients, was leaving for another position. So, I kind of took over his position and was able to see pediatric patients only for the second year of my private practice experience. And it was great, but I realized I knew I needed to know so much more. And even now, after finishing residency, I still need to know so much more. I feel like every time I see patients, and I encounter something I make, like a mental note to look something up or discuss it with one of my co-residents or discuss it with one of my mentors, and I feel like you just always have to learn because there’s always new things to learn, so we can do better for our patients.
Jarod Johnson 12:23
Absolutely. I think, you know, residency is just the start. And I’m about I don’t know, six years out now, and I’m still learning stuff every day. And it’s exciting. It’s, there’s new stuff coming out all the time. There’s also things that are obscure that you don’t see all the time that you forget about, and it’s just a wonderful profession, and every day is different. And the kids say different things every day, and it’s just a wonderful profession to keep learning in. And I’m excited to keep moving forward with whatever route we go and how things are gonna change over the next few years. You had the chance to also serve in some organized dentistry, which I think is really awesome. It’s something that I think is very beneficial. And I would encourage anyone that is interested in the AAPD is always looking for people to come into a leadership role, but you served on the resident committee. And that’s a huge role to steer the future for, you know, recruitment retention, and also what are the needs that residents have? And how can we address things like student debt and all those things that go along with coming out of residency and finding the practice or public health clinic to work at? Or, you know, what a DSO. So, can you explain a little bit about your experience on that resident committee over the time you were with AAPD?
Sarah Khan 13:48
Absolutely. So, I’m actually one of the senior members of the resident committee, it’s usually a two-to-three-year involvement. And the great thing about the resident committee is that when they select the members, they do a very good job to choose residents from diverse locations around the United States. So, every residency, depending on the state you’re in, and you know, the socio-economic conditions of the population there, it’s a little bit different, but we all have very similar needs. So, by working with, you know, the resident committee throughout the country, we’re able to kind of focus in on the way that AAPD can provide to the residents and we work on — we focus on writing the Pediatric Dentistry Today or Times the magazine that comes out so we write articles for that. And what’s something that’s new that’s we’ve been working on is that we’re working with the American Academy of Pediatrics, their corresponding trainee chapter to, kind of create collaboration and see what type of resources we can create, from both sides to kind of help in the development of our Education and how patient care is approached.
Jarod Johnson 15:03
I think that would be given our discussion today and hugely beneficial to kind of help us bridge the gap and start, where we’re in the mode where we’re learning and be able to get people to connect in that manner. You also did something, I think it’s really, really cool that you were in the ADA Institute for Diversity and Leadership. That’s a pretty big deal.
Sarah Khan 15:26
That changed my life. Like I can’t, I can’t say enough good things about that. That program, I applied and by some miracle or something, I was accepted. And I was actually one of the last classes to have the in-person meetings because the class after me actually, a lot of the meetings were virtual. So, the ADA does a really good job in creating a very robust curriculum for leaders. We not only participate in monthly seminars regarding various leadership, problems and techniques, but we also focus on a particular topic or something that we were passionate about. And then through that project, we get to implement the things that we learned. And that’s been really great. My project that actually did was very similar to my work in the resident committee. I found that when I was in dental school, I was heavily involved in ASDA, the American Student Dental Association, and I was involved in, you know, organized dentistry when I was working in Philadelphia, but I felt that in my GPR, there was a gap. I felt like, as a resident, I was kind of lost, and I didn’t know what type of resources the ADA could provide for me. So, I focused on seeing what the ADA has existing and what kind of things they can do going forward as, as in regards to improving the resources that are available to residents.
Jarod Johnson 17:05
What were some of those things that just came top of mind that were some resources that you thought would be beneficial?
Sarah Khan 17:11
Definitely job searching. I think there’s a lot of misinformation almost about how to search for a job, what the right type of job is. We all go into dental school saying that, okay, we’ll come out in four years and be a dentist, but nobody really talks about what it means to apply for a license, apply for a job, sign a contract, what’s a W-2 versus a 1099? All those questions and those resources exist, I think they’re just not readily available, or people don’t know where to look or what questions to ask. So that was one of the top concerns I found when I did a survey for the for the residents.
Jarod Johnson 17:55
Yes, definitely. That’s just the tip of the iceberg. I think, look, and it can be confusing, because you really don’t know what you don’t know. And if you’re signed up as a 1099, and you’re not paying your own taxes, you could end up in a little bit of a hole at the end of the year. There are some advantages to it. But that’s something that definitely you they don’t teach you in residency unless you’ve got a faculty that’s coming in and talking about reviewing contracts with you. So that’s wonderful that you could get that information out there. I want to move into your last I guess, two years, prior to the residency here, I know that you had your husband’s a doctor, and yes, you guys had to go different places. How? How did that work out? I know, I had some co residents in my class in the class below me that had spouses that were in another location, I think it’s very common. How did you guys manage that stressful time?
Sarah Khan 18:51
You know, it’s, we managed it. And now that we’re living together, I still kind of don’t know how we did it. Going into long distance, neither one of us or anybody expected a global pandemic. And that definitely threw a wrench in the works because we were both working at hospitals, and each state had separate and distinct COVID regulations. So, there was a period earlier in 2020, where we didn’t see each other for eight or nine weeks, which, which is a lot but we made the most of it. And now that we’re living together, I think we appreciate each other a lot more. Thank God for FaceTime, we would spend a lot of time on FaceTime, coordinating things and just keeping each other company while not actually being physically in the same place. I think one of the most frustrating things was the double chores. When I would go to Maryland to visit my husband, you know, we would spend the weekend hanging out and we would cook or go grocery shopping or do laundry and then you know, I would go back to Brooklyn on Monday, early, early Monday morning, and then I would come back. And we had done the chores in one place. But now I had my own cooking to do my own laundry to do, so that redundancy got very frustrating very quickly, but it’s definitely a blessing. And we’re so happy to be living together and kind of getting used to combining the two households that were just separated temporarily.
Jarod Johnson 20:24
I think in your article for Shift, you mentioned that you guys would cook together over zoom, or, Facetime?
Sarah Khan 20:31
Yeah, we would, we would try to cook the same thing. But we have a little bit different palates. So, we would, you know, cook together, fold laundry together, try to do similar chores at the same time. So it created that illusion and that perception that, that we were together. And it was the small things, actually, my Co-Chief, she was also in a long distance relationship. And like you mentioned before, it’s pretty common in the, in the medical profession, but both of us knew that continuing our professional or career goals was important and that it was temporary, and that our relationship would always be there. And we made it a priority to prioritize each other and realize that compromise was needed some days would be very difficult. And they were, especially with, especially with the pandemic, but I think we came out of it stronger than we were beforehand.
Jarod Johnson 21:29
So, you mentioned your co-resident had a similar situation, how did you manage with your co-residents and keeping things to be positive and productive learning environment and, you know, just being a team player.
Sarah Khan 21:43
Absolutely. So I have, I have five co residents, they were all girls, which everybody was pretty worried about just having a group of girls together. But those girls, you know, I think we all elevated one another and brought each other up to go through residency. Residency in and of itself is very stressful, let alone residency during a pandemic where things changed daily, if not hourly, and I think the thing that we emphasize was to always look out for one another. During the pandemic, we were a little short staffed in terms of our assitants, and I never had to ask twice for one of my co-residents to help me if I had a patient there and one of my co residents patients wasn’t there, you know, I would always have help in terms of setting up or helping to manage the patient. So, I just, what I advise to the new first year is when I was chief resident is that just to keep your eyes and ears always open even like when you’re writing your notes. Just try to have an idea of what’s happening in the clinic if you hear you know co-resident struggling or you hear the difficult patient just you know, get up and help. And I feel like through the willingness to help others you end up learning a lot. I learned a lot from just watching my co-residents and seeing how they manage patients seeing how they gave local or spoke to parents and kids like some of the colloquialisms some of my co-residents have I’ve now adopted because I just like the way it sounds and I think learning from your co-residents is probably one of the most valuable things in residency aside from obviously learning from the didactic material and your attendings.
Jarod Johnson 23:25
One of the things I did was I found that the one of the second years as the first year to kind of be my mentor, I know they set us up but everyone’s got different personalities. And sometimes the setup isn’t the best. But yeah, the setup was great. And I learned a lot we still talk almost every week and he owns his own private practice too. And we go through the same things and we can bounce things off. So I think those relationships that you build during residency with your co-residents are really important. And I think like you hit on being a team player and being able to come up and pick up and help out when you need to and realize something that you might need to do to get out the door can wait so you can help someone else. So that I think that just absolutely is the truth. And I think you hit the nail on the head when you said you’ll learn a lot more.
Sarah Khan 24:15
Sorry, the nature of helping is contagious. I feel like if other people see you doing it, they’re more willing to do it. And I think it’s it’s a great way to make your residency a lot of fun. I’ve really, I really missed the group a lot because working in private practice is very different. Sometimes I’m the only doctor in the office and I definitely miss having the great group with me every day at work.
Jarod Johnson 24:41
Yes, some days you’re when you’re out you’re on your own and that’s why you got to do all those difficult things in residency so that you are prepared to do them on your own. Were there any other routines like as far as exercise or you know, just taking some time for yourself, taking breaks that during residency that helped you kind of relax and cope with the stress.
Sarah Khan 25:01
Yeah, absolutely. So, when the weather was good, I would actually walk to the hospital and walk to our clinic, it was about a mile and a half. And it was through Brooklyn. So, it was definitely, it was definitely fun and got me moving. But one of the things that I really did to relax and one of my hobbies is I love jigsaw puzzles. And especially during the pandemic, I did jigsaw puzzles before the pandemic made them cool. Just have to put that out there. But I found the mindfulness of working on a jigsaw puzzle to be very peaceful, and it helped me really get on centered. I think all dentists love working with their hands, and my hobbies are all involved working on my hands. So, in addition to jigsaw puzzles, I love doing embroidery and I love painting actually on my iPad and just like, small things where I can create some kind of have that, that instant gratification that dentistry also gets us when we do our procedures.
Jarod Johnson 25:59
Yeah, I think it’s important, I’ve realized that over the, I guess, the past year and a half that it’s important to have something outside of dentistry that you enjoy doing. I love grilling, I got a new mini pizza oven, I love doing that. It’s like, there’s just so many things that you know, I enjoy about that, that just takes your mind off of being in the office, you know, patients dealing with the stress of an upset parent, or you know, an issue with staff, it just takes your mind off of it. And you can kind of get away and it sounds like you were able to do that quite a bit with your walks and things like that. Coming down here to your graduation. How did it look with COVID and looking for a job post residency? I know you’ve been out before. So maybe you had some connections there. But what was that like? Because that’s, that was a big worry, when everyone was shut down that these all the residents wouldn’t able be able to find a placement, how are you and your co-residents doing?
Sarah Khan 26:55
Everybody’s doing very well, almost everybody is in a job. The two ladies in my program that are not in jobs, that’s because they’re new moms. So, they’re taking care of their kids and spending some time with their new babies, which is also very, very important. And it was different finding a job because it was, you weren’t as easily able to visit the practices and see the thing. So, a lot of the interviews and searching I did was online. But the community of dentists and being involved in organized dentistry definitely aided in that. I had never lived in Maryland before my husband’s here. But I did know some people that knew some people in Maryland. So that was a great way to kind of start the conversation. And then from there, there was some video interviews. And once the video interviews went, well, I visited the practice. And you know, I signed a contract. I actually did that pretty early on back in February, because I wanted time at the end of my program to focus on my research and my board. So I’m super excited that that went well. And from what I’ve been hearing talking to my co-residents and other graduating pediatric dentists, I know I think everybody is well placed despite the worries that we all had.
Jarod Johnson 28:15
That’s wonderful to hear. I think another point you just made is finding out that early when you’re crunching down at the end of residency, and you’re trying to get ready for that written board exam. And also, you’re finishing up your research if you have to. That is nice to have that out of the way, so kudos to you for looking out for that. What types of practices did you look at joining? Did you look at solo practice, you know, taking over solo practice a large group practice or a dental service organization? What types did you get gravitated to?
Sarah Khan 28:47
So, I was really looking into all types of practices. But what was important for me was kind of the ethos of the practice, I want to practice that focused on, you know, providing good care to the patients and becoming a part of their family. And I like the idea of a practice that kind of grows up with the children and parents bring multiple generations like not parents were multiple, there’s like multiple generations of patients in that practice and patients look forward to coming to that practice. The environment is fun, it’s collaborative. Not only is there focus on the dentistry itself, but you know, establishing good habits for the children identifying, you know, other components of the child such as looking for sleep apnea issues or tongue tie issues and kind of combining a little bit of everything. So, it becomes a true dental home.
Jarod Johnson 29:46
And when you were looking at all those practices, I know the type was more important, but were there any resources that you found helpful? I know you mentioned organized dentistry. I know the ADA has Adapt out there which is more centered for general practitioners, but it will probably be coming up with, you know, profiles for pediatric dentists and specialists here in the near future. And then the AAPD, I think has some listings on their website, the Career Center, too, did you what resources were available to you?
Sarah Khan 30:14
So I looked at the AAPD Career Center that was very helpful, as well as just googling different things like Monster and Indeed. A lot of people tend to shy away from those types of things. And at least my philosophy is, the job you apply for is not necessarily going to be the job you take, I feel like it’s almost better sometimes to know what you don’t want as opposed to what you want. And that helps you make an informed decision. I remember very specifically, when I was applying for a GPR job, one of the practices I applied for, it was great on paper. I was like, this is a beautiful office. So like, technologically up to date. And then literally the first question that practice owner asked me, he was like, “How long does it take you to do #15 endo?”. And like, I was in the middle of my GPR. And I was like, “three hours”, which is, I was honest, I’m not gonna I’m not gonna lie. And he was like, “three hours?!” because “I want somebody to be able to endo in 45 minutes”. And that blew my mind. And like, the conversation did proceed beyond that. But I knew that that’s not the type of practice I wanted to focus to work in or to be with that type of person, because that was against my philosophy in terms of how I wanted to approach dentistry.
Jarod Johnson 31:39
Yeah, there certainly are people that can do 45 minutes #15. But I think most of them are probably endodontists. Or have a lot of experience with the second maxillary molar endo. So that brings me to my last question here, how do you feel like your residency prepared you to be in the position you are? I know, that’s what a lot of fear I had when I came out. I was like, Oh, I don’t know everything. But did you feel like you knew enough? Is there something which you wish you would have got more of? How do you feel today practicing? I know your experience is wonderful with organized dentistry in the GPR and your residency. So what things are residents should they know coming out that they’re going to be prepared to go and see their patients?
Sarah Khan 32:29
Sure. I think residency is a great time to ask a lot of questions. I realized this after I graduated residency that never again, maybe not never again, you’ll likely never be in a situation where you’re surrounded by so many other pediatric dentists, between your co-residents and your attendings. There’s so much opportunities for picking one another’s brains. And I think that was the greatest thing I took from residency I think that was the greatest thing that prepared me for the real world is the ability to ask other people questions and work on problem solving together. Residency was very busy and some days crazy. And I think being in residency taught me a lot about how to problem solve. Sometimes, when a patient’s behavior was really bad, and you just needed to, to do something, I think it taught me to be a little bit more fearless and understand that you have the support there. And as long as your intentions are right, and you do the best for your patient that you’ll be able to do well, one thing that I wish I had more experience in is just having more time for OR cases. And that wasn’t anything specific for my residency just because of COVID a lot of elective surgeries were canceled. And unfortunately, dental oral rehabilitation falls into that elective category. Whereas for a lot of our patients, it wasn’t elective, it like really needed to be done. And those four or five months were the OR was closed, I definitely missed having more opportunities to treat patients under GA because I feel like that’s a great opportunity just to work on your speed and clinical skills without really worrying about behavior management.
Jarod Johnson 34:26
Absolutely. So, it’s been a pleasure having you on the podcast today. I’m excited to hopefully have you back. I want to do I do want to bring you back to talk about interdisciplinary care. And I think there’s, you mentioned a lot of things that you already like tongue tie, sleep apnea. There’s just so many things I remember I’ve referred a kid who had, like a Brodsky four tonsils out. I wasn’t going to sedate my office to the ENT. He said they didn’t need to come out and then two years later, he ended up taking them out. So I think there’s a lot of things that we can definitely help. Not tell them what needs to be done, but kind of just start that conversation with our medical providers. So I really appreciate you bringing that part into it. And I’ve really enjoyed hearing your experience and that you’re you are successful and a lot of the fears that maybe some of our first year residents, or second year residents have that were first years last year have, they can come out and be confident to knock it out of the park when they graduate. Thanks again.
Sarah Khan
Of course, thank you so much for having me.
35:33
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