Dr. Amanda Wilson, a native of San Francisco, obtained her dental education from UCSF Dental School and her Masters of Dental Science and Orthodontics Certification at the University of Connecticut. She practiced clinically ten years in the San Francisco Bay Area and during that time completed thousands of orthodontic cases, both fixed and removable.
VIDEO - DUwHF #1127 - Amanda Wilson
AUDIO - DUwHF #1127 - Amanda Wilson
Following her calling to teach and mentor, she eventually transitioned into corporate dentistry and has worked the last six years as a Dental Director and Consultant to both national and international orthodontic companies and DSOs. In 2016, recognizing the lack of orthodontic coaching services that cater directly to General Dentists, she became passionate about filling this space and founded her own orthodontic management and coaching company, StraightSmile Solutions®. StraightSmile Solutions® offers both virtual and direct, coaching to General Dentists and their teams through a HIPPA-compliant communication platform. Designed to deliver convenience and excellent orthodontic outcomes to clients, she hope to make a positive change in the dental industry.
Howard: It is just a huge honor for me today to be podcast interviewing Dr. Amanda Wilson a native of San Francisco, obtained her dental education from UCSF dental school and her master's of dental science and orthodontic certification at the University of Connecticut. I always say Connecticut but I can only spell it grammar so if I wrote out connect I cut so I still pronounce the University of Connecticut. She practiced clinical ten years of the San Francisco Bay Area and during that time completed thousands of orthodontic cases both fixed and removable following her calling to teach and mentor she eventually transitioned into corporate dentistry and has worked the last six years as a dental director and consultant to both national and international orthodontic companies and DSO's. In 2016 recognizing the lack of orthodontic coaching services that cater directly to general dentists she became passionate about filling the space and founded her own orthodontic management and coaching company StraightSmile Solutions®. StraightSmile Solutions® offers both virtual and direct coaching to general dentists of their teams through a HIPAA compliant communication platform designed to deliver convenience and excellent orthodontic outcomes to clients. She hopes to make a positive change the dental industry. I called her she did not call me and thank you so much for coming on the show today
Amanda: Sure, thanks for the great introduction.
Howard: I look at the nine specialties of Dentistry recognized by the ADA when I got out in 87, 31 years ago and you know most of the specialties don't have a lot of turned upside down things. I mean what are the pediatric dentists about the only thing they are arguing over is a silver diamond fluoride. You look at endo I mean how much could you argue about one file system versus another file system but man you're an orthodontist and if there was one specialty that's been turned completely upside down with a direct-to-consumer aligner movement. I mean you got Invisalign opening up their own stores, Smile Direct Club, Candid, Smile Love, OrthoLee. What is it where or how do you see that I mean you're looking at this from thirty thousand feet up in the air how do you see this this direct-to-consumer aligner moment
Amanda: For sure, that's a great question and it's kind of a loaded question because no matter how I answer it I'm gonna get a couple hate emails. So yeah I'm kinda at the center of it, I did help to initially launch Smile Direct Club, I was their first dental director. Love me or hate me for that but you know what it was gonna happen anyways anytime there's something that is just so easy and possibly productive the venture capitalists are gonna find it and you know what we were all doing this anyways every single orthodontist was already doing that in their office. I don't know about even if you were doing it, but we know we have these patients and they go off to college and and they'd say it's mail me my aligners and I'll just take a couple of texts and I'll check in with you and you know what gosh darn it the cases worked fine. So if you get a great treatment plan that works for that kind of movement and if you have a great patient and you combine it together it's totally doable and you know it caught on with the venture capitalist it caught on throughout globally and dentists are now doing it to within their own offices and finding ways to use tella dentistry to kind of streamline their practice and you know I think it's great for consumer access to care to
Howard: Well so when you were their first dental director was that back when they were in Michigan or after they had moved to Nashville, Tennessee?
Amanda: All the above, so yeah I started with them in 2014
Howard: So you were 2014 in Michigan and then moved to Nashville Tennessee?
Amanda: I got to work remotely I was really blessed
Howard: I love Nashville, Tennessee. I mean that second Avenue Street is amazing
Amanda: I couldn't complain yeah
Howard: So let's start with the movement, do you agree with these numbers? I hear I read macroeconomic data, this is only five percent of Americans get orthodontics is that what you hear? I mean there's 325 million people, only 5%...
Amanda: No,I mean maybe if you include every single American and including everyone up to 1895, that's possible but it's changing. I mean the average you know under 18 I'd say more of the majority is having some type orthodontics, whether it be aligners or braces and now I mean there's just so much low-hanging fruit out there. I tell my dentists, look you don't even have to compete with any of this direct consumer aligners, there's low-hanging fruit everywhere you look because if you focus on what the patient actually wants and that's really how these direct consumer companies are flourishing because they're listening to the patient. What do you want to fix, not what do I want you to fix. You don't have to fix bites, we can just you know close that little gap or straighten those bottom teeth sure yes we'll do that for you.
Howard: Well then they just want whiter brighter sexier teeth I mean look at Americans a third of them or almost as fat as I am and my gosh seriously, they obviously don't have a problem chewing. I mean I had I had uncle's when I got out of dental school my uncles, this is 30 years ago their past that had zero teeth and could eat anything their is and and as far as I remember seeing on cases when I got a score there was no it's gonna pull four bicuspids because it was the only way they could treat the midline and then I said that to the orthodontist whose wife was sitting at their reception deal, I said okay well your wife? Where's your midline and he didn't know. I said you're gonna pull four bicuspids to fix a midline when you don't even know where your own wifes midline but you guys reproduce and have offspring. I mean her midline was close enough to pop out a few kids. So you're saying a lot of them don't want don't have problems chewing, bites, midlines, they just want that straighter.
Amanda: Not at all but holy cow you just touched on a whole nother subject which is a subject that four by extraction cases. That's a whole nother huge subject. So many general dentists are getting frustrated with their orthodontists who are pulling out teeth on their patients and now they're starting to be some researchers coming out about airway and the interactions between having four bicuspids pulled. So I mean you touched a whole nother huge hot-button subject in art though.
Howard: Yeah I mean and it's moderation from A to Z I mean when I got out of school I mean there were there orthodontist who three out of four case said bicuspid extraction. Now it seems like thirty years later those guys that we're doing that are down to about one in four. I know there's some extremists who say it should never be done ever and I don't think on a planet with seven and a half billion people you could ever say never but so Invisalign used to own part of Smiles Direct Club I think they bought like nineteen percent and then I guess that's been divested or whatever but if you were talking to a Wall Street analyst would you say these guys got some good business models Invisalign opening up their own stores?
Amanda: I think everyone in that direction, I don't think you can go wrong with any of these business models. Like I said there's just tons of low-hanging fruit it doesn't matter whether you're focusing on removables, patient centered ortho, just you know just antier lineman or if you're focusing on you know airway, you're focusing on like what Invisalign is now they're really focusing on little kids. They're focusing on phase one that's a whole nother group of low-hanging fruit that the direct consumer aligner companies are not touching at all yet. I mean maybe it's just too risky but Invisalign sure as heck is. So you know they're treating kids as young as five now with the liners and you know my daughter she's nine, she's in aligners and you know Clear Corrects I'm using them for her system but it's fantastic for phase one and that's you know if you're not looking at phase one in your patients you really should be.
Howard: So, you just funny because thirty-one years ago there was a turf. I remember not a lot of the orthodontists didn't like a couple of they're really successful pediatric dentists because they were doing phase one and now 31 years later I can't tell you how many business models I see where a pediatric dentist is practicing with an orthodontist.
Amanda: Yeah it's a great hear right there for sure and I helped a lot of times I come into offices and I help these two get along you know, figuring out where the line is, who gets what you know whose territory is who's but really there's just so much blending of the territory that you know anyone can do this. It's not rocket science, it really isn't. Ortho really I think is one of the easiest specialties. I mean don't get me wrong there's really challenging stuff in ortho but it's just a really small piece of that pie and a good 70 to 80 percent of it can be done by any specialty.
Howard: Well I can't wait to get the hay bale on this one. Out of the nine specialties orthodontics is the easiest one but to be fair I mean they're not giving shots, they don't use scalpels or not sutures and our dry sockets, they're not putting people to sleep, they don't have to bill an anesthesiologist. Yeah I would imagine if I was gonna slow down I would want to do white fillings, bleaching, bonding and ortho not bone grafts and sinus lifts and Ludwig's that and failing root canal you know. I mean the blood and guts you know I've always thought their were, I always thought you could split the dentist in half, half of them like me just love blood and guts and the other half didn't really care for that and like to do more pretty soft bleaching, bonding, veneers,orthodontics things like that but I mean. So I gotta be straight with you this is Dentistry Uncensored so Dr. Amanda wilson my first question to you is I'm in Phoenix Arizona I got two dental schools in my back here I got A.T. Still's in Mesa, one Midwestern, they cost $100,000 a year these kids come out $400,000 in debt and guess how many ortho cases they've done?
Howard: Zero, I did 15 canals of endo when I was at UMKC and I talked to a guy that I did one root canal on an extracted tooth but he got to assist, some root canals. I might you didn't you you paid him 400 grand and you didn't do a root canal. So Amanda most the kids listening to this are young 25% of everybody that emails me Howard@dentaltown.com or leaves a comment in the YouTube section, they're still in dental school a quarter the rest are all under 30 their kids, so she's she's driving to work right now and she said Amanda I paid four hundred thousand dollars, I don't even know how to do an Invisalign case I don't know what a clear aligner is. How would she start, how would she start a journey if she wants to be like you and she grows up?
Amanda: That's awesome well you know there's so many different ways to do it and I do think Invisalign is an amazing product. I think if you're gonna do it you need to be all in because they're lab fees are very high and it's getting hard now to charge that $5,000 a case in order to build a medior overhead of it's basically what 1825 plus retention fees. So I mean that's a really slim margin that you're making on those cases and even now that they're launching their Invisalign franchises, Invisalign stores they're fixing those prices at $2499 to $3499 for the doctors that opt in to that. That's a really slim margin, so you have to get smart and you're gonna have to do volume basically or you're gonna have to get creative and think about ways to use off-label, different label aligner system and there's no less than probably twenty to thirty in the US alone. This is not direct-to-consumer this is ones that work with doctors to white label your aligner systems. I like to call it quote "your own brand aligners" but you can white label it if you do it in your own office and you're not reselling it to any other office you do not need a five ten you do not need a QMS and if you don't know what these are these are just different types of FDA approvals that you need. If you're only doing it to your own existing patients you can do this today if you want to and in theory you can turn on these aligners in less than a day. In the morning they can come in and scan in the afternoon you can go ahead and give them out so it's pretty amazing aligners in a day.
Howard: So you know Invisalign is owned by Align Technology and they also own the iTero eye scanner and then they had some legal issues with the guys out of 3Shape and shape is in Denmark, Copenhagen which I had the honour of visiting thats lovely place but I mean going into the scanners are you preferring an open-source scanner or use a course or scanner talk about what scanners. Which one do you recommend?
Amanda: Open source 100% open source. Listen I'm not directly affiliated with any scanning company or any 3d printing company or anything I like to go and play with everything, touch everything, try everything and I realized that they're always upgrading software and everyone's getting newer and sleeker and faster but right now I'm still a huge fan of 3Shape. I think their team is really nice I always like to root for the underdog because they did kinda get slapped in the face by a lion and but they're truly awesome team you know and their scanner if you're a general dentist I still have to strongly suggest that you get that scanner because it is by far the best if you're gonna do implants, crowns, bridges, surgical guides ,anything else that you want to use it for. I mean you can completely create an impression list practice and you can you know just spin those this what do you call it, mailing times, the turn around times it's gonna be so fast on your cases. So yeah I mean I would go 3Stripe. Their's ways to get around Invisaligns little rolls on them, so if you want to know ways to get around it let me know.
Howard: So 3Shape is open source, I actually believe there's some kids that don't even know the difference in open source and closed source but like right now what practice manager software do you to use?
Amanda: I'm fully a consultant right now so, I mean before I've worked with doctors that are using Dentrix they're using Open Dental, all the sorts of ortho ones
Howard: I was on Softden for 30 years and switched Open Dental just because every time I podcast some high-tech guy they say well open dental is open I can program seamlessly straight into the system and then just everybody is working with Open Dental so just happens and so open source because if it's not open source then you have to buy everything from, okay can you give an example of a closed system scanner?
Amanda: Closed system scanner, well I mean obviously Invisilgin, the iTero is a closed system scanner and I believe some of the other ones maybe my guess would be a closest to Sirona,yeah so it's quite a few. So yeah most of my doctors are using 3Shape care stream and some use iTero.
Howard: Yeah and talk about your website where I found you. My homies were telling me bunch people told me to get it hold you. Your website is www.straightsmilessolution.com What are you actually doing?
Amanda: I do it pretty much anything you want me to do if it's in the world of ortho. So most of my workflow is coming in to dentists offices some of them orthodontists, some of them general dentists or pediatric dentists and we come out and we just helped basically look for opportunities. It could be opportunities in airway, it could be opportunities in phase one, it could be opportunities for aligner,s Invisalign, generic aligners, clear correct. I have no particular you know affiliation with any product out there, I'll use whatever you want to use or I can suggest whatever it be the lowest cost lab solution for that case, and we just look through their cases and support them to make sure they have awesome outcomes. A lot of people have cases in progress they could be Invisalign they could be clear correct and they're stuck, you know they're really really stuck and I realize that this line has their assist tool where they will connect you with that doctor but most of us you're paying per case and the turn on time is kind of slow. So it's great to have just be you know connected to an orthodontist and get that turnaround time you know less than a day less than 24 hours on all your cases getting feedback helping you out of some pickles that you might be in with some existing cases even it can be it can be braces, it doesn't really matter I help with anything.
Howard: So you said it's beginning of the show that you know that we were doing mail-order ortho back in the day when some one kid went away to college you need the mail them the aligners who you said you know, if you got a great treatment plan and a great patient there was no problem but you know the great treatment plan, they they keep so much ortho education out of the dental schools. I mean it's really weird and it's really weird it especially is when you're talking to a dental student because if any dental student goes to an endodontist says well you help me with molar root canal, they they try to tell you everything they know. If you can't pull out a tooth the oral surgeon tries to show you everything they know and then you go to an orthodontist and at least half the orthodontist say well if you want to learn orthodontist you need to go to orthodontic school. It's really a closed, I mean do you agree with that? Did I pull that out of thin air or is that true?
Amanda: Yeah I do and I don't, you know a lot of orthodontists so I've actually partnered with a lot of orthodontist because the general dentist I work with end up, it's so funny like people automatically see one at my workflow and they go oh she hates orthodontist so she's taking business away she's ruining our profession. That's not the truth at all I love, love my colleagues and as a matter of fact the general dentists and pediatric dentists that I work with they refer even more cases then they were overdoing because they're looking at every single case you know their their laser focus is this an ortho case now, is this an ortho case later. Let me put it in a bucket you know maybe it'll be in two years. They literally are handing these cases out to the orthodontist see right and left you know the more challenging cases because they're seeing those impacted canines early before you have to pull teeth you know they're seeing that growth issues that are happening early and they're realizing; oh yes this has a class-3 tendency I don't want to touch this I'm gonna go ahead and pass this over to the orthodontist but you know for sure. I mean that's not the case at all we can give you so many more cases we just need to educate our general dentists as to what cases maybe they want to try some easy ones, but they'll give the rest to you just work with them.
Howard: Where would you recommend she's listening now she's driving to work she's an associate somewhere and where would she what would be the fastest easiest way to learn orthodontics. I mean it would it be online, is it a seminar where do you what do you say to the person who says look man I graduated from dental school and they, I mean a lot of these schools are so bizarre that their whole ortho education is like craniofacial growth and development and these weird diseases.
Amanda: Their trying to scare you off, their trying to have you not do it.
Howard: Four years later it's like well can I just do it Invisalign case you know I learned all this craniofacial development stuff for 400 grand how am I gonna pay it? So where would you recommend she start; walk her up that stairway...
Amanda: absolutely I mean look , I'm not gonna say that my program is the best in the world. I really believe in you know learning by doing. So my doctors we go ahead we start looking at some of your cases. We'll jump into your open dental, we'll jump into your Dentrix, we'll do some screen graphs and see what our opportunities are. We're gonna punt some cases over to ortho but we're gonna start finding some easy opportunities. That maybe Invisalign it may be Clear Correct, it may be you want to try in-direct bonding. Their is a lot of in direct bonding systems out there some are branded some you can do yourself really cheap. If you're gonna do braces, traditional braces you've got to get the brackets on perfect. If you get the brackets on perfect and you pick a great case this is a slam-dunk you just put up work your way through the wires and you're done. So first there's so many literally turnkey options that you can do for ortho that it won't you won't stress or sweat at all but you have to know how to look at the cases and their's no way you're gonna have the experience initially to be able to avoid the ticking time bombs and there's some ticking time bombs that are hiding in cases. They may look easy but they're gonna implode on you if you pick the wrong one. So that's really where I think I'm the value-add but you know if you want a program where you sit down and you're actually like learning the movements and learning to take wires and bend wires and all that their's plenty programs out there for you to, that's not me. I'm all about easy, quick, comfortable, safe, but if you want those I can send you to those too.
Howard: and so that's at your website www.straightsmilesolutions.com So you have videos on, Do you have online CE courses?
Amanda: I haven't done that but I should through you, but I correct I have like a couple hundred YouTube videos just going over it, some of its patient focus you know. I have a big Facebook site where patients are able to get on with doctors and talk about you know their ortho, they're worth the questions directly from doctors, patients love it because their really is nothing else out there where they can honestly ask a question and get feedback but from that you know I've created a lot of patient focus videos just to educate patients and a lot of times I end up playing matchmaker. You know like I get patients that are like hey I'm really looking for accelerated ortho I really want Exceladent and I want Invisalign together can you find me a doctor in Sacramento who will do this and I do like if i know you i'll go ahead and give you a call be like hey you know can i give this patient your address your your contact information because they want to go to someone like you and I end up playing matchmaker it's free you know but um why not you know what is your you jump there.
Howard: What is your youtube channel where you have hundreds of videos?
Amanda: It's Straight Smile Solutions is the handle
Howard: Okay it's called straight smile solutions, okay very good and so I go to Straight Smile Solutions I go into YouTube you want to know the secret of exploding your YouTube video? This one's on dental monitoring systems with Straight Smile Solutions that's the first one that came up. You know what you do on Dentaltown, go-to orthodontics and when you make a post when you go to your YouTube video if you click share it has a link but the next button over is embed and it has the code and then on Dentaltown there's a YouTube button on a post you click that you drop the YouTube now the video is playing there and then those people jump right to your YouTube channel and subscribe. So it's kind of like posting on Dentaltown as a marketing for your YouTube channel. Yeah and if you already made over and another great thing to do an online CE course and then they'll get to meet you and fall in love with you then they'll subscribe to your face position what's your facebook group called?
Amanda: My Facebook I have a Straight Smile's group that's for doctors who are looking for support and then we also have one called it's called oh goodness patient focus, doctor moderated orthodontics group or something like that I'm kind of maybe butchering that but it'll probably come up when it comes up and we have about, just started a few months ago we have a ton of patients on there and it's really active we have a lot of doctors that are on there posting. It's really exciting to see what's out there and the patients are so happy about it.
Howard: It's really a revolution I mean if you would have told me when i when i walked at dental school, we thought we were so lucky because they were putting computers in for the next class and we were high-fiving each other that we got out of school and back then they were telling everybody that if you didn't learn how to program in Fortran and cobalt that someday you would be you know a Neanderthal and we're like man I'm so glad I didn't have to learn Fortran and COBOL and learn these damn computer stuff and if you told me that someday I'd have a phone in my pocket they had a computer and a compass in a calculator and an email I mean it's just many times are going so fast and but one thing about the orthos know the full the five rules of economics on a business plan are you doing it faster easier hiring quality lower in costs and making it smaller and more miniature and and the one thing the orthodontists have not wanted to budge on in the thirty years I've been in dentistry is the price. they want to do more cases they want to market more they want to have all the bells and whistles they want to go to oral scanners instead of it all today, they want to do every single thing on earth except lower their price and he wants
Amanda: They have to lower their price now, I mean there's no option not to maybe in a few markets you can get away with it. I mean shoot I used to charge seven back in goodness when was the last, Invisalign back in the Bay Area I was charging easily seven grand for an Invisalign case back in the mid 2000s before the tech bust and I mean now a lot of people, good orthos charging $3500. Look it's Winky Smiles, to get some of these business models out. There's some really innovative business models that are out there. I'm not involved in them but I think it's cool and you know what patients are getting some really good care.
Howard: So how do you think these venture capitalists and companies are squeezing the cost at, I mean obviously the oral scanner was, there making all all 24 trays at once. So you don't to come back. If you if you were coaching an orthodontist or a general dentist, how would you squeeze cost out of orthodontics so that you can lower the price to sell more?
Amanda: I'm excited to answer this question. So number one of course is going to be used the lowest cost lab solution that's out there that may be 3d printing in your own office. It's super easy now to do the 3d printing. I think the designs a little more tricky that might take some training but there's definitely some great options like Sure Smile or Full Contour, where you can go ahead and have somebody do the design for you for I think about ninety nine to one hundred and forty nine dollars. Well they'll just do it and you can export these STL files and go ahead and spit them out either in your own lab, you know and then just all you're gonna do is have an assistant just thermoform, vacumform and trim that's pretty easy. You could have a highschool student do that, bag them. Patients really don't care if it's branded but the majority of patients couldn't care less honestly if it's a branded aligner system or not. They just want to have something that's gonna work and there's a lot of patients that are out there where have you said hey look I can give you this branded aligner system or say five hundred dollars and you can have you know this white label aligner systems, generic they're like yeah I'm using generic toilet paper anyway so what's the difference. If it works the same for my case I'm up for that you know I don't want to eat for all this marketing. So yeah lab solution should be number one number two is gonna be...
Howard: Let's say a lab solution, you gave you recommended SureSmile. That's a SureSmile 360 owned by Dentsply and that's like all the treatment planning, software, appliance, fabrication, support service you need to give each patient smile they want. You like that one?
Amanda: I like it because it's web-based, I mean I think it's great you can either do it yourself or I believe you can pay them a fee to have you do it. FullContour's another one, they're based in Phoenix actually near you it's another one.
Howard: FullContour lab
Amanda: The design only, so they don't actually like make anything they just do the design and then they'll export it to any lab of your choice and if you don't, or your own lab within your own office.
Howard: So continue about squeezing cost out. So you said you know you started out earlier saying you know Invisalign. I mean that's a lab bill of $1825 plus retention.
Amanda: $1825 plus retention. Yeah unless you have volume discount, now Invisalign always thinks I pick on them, I don't, I do but only because you know you can you can be very successful having an Invisalign only practice if you can get that 38% lab discount that I think that's fantastic if you can go diamond plus I'm all for it and I helped a lot of practices to do that, so that's cool that's what you want to do then do it but if you want to start save even more and maybe have a good, better, best option.Then that could be part of your model and then the rest could be exporting to some local labs using something like SureSmile or FullContour or Blue Sky Bio, any of those things that are out there. There's tons of options but beyond that the other thing you have to do is you have to save your chair time. Your chair time has a value your own chair time as a doctor has a value, your chair time for your staff has a value. There's no reason these patients should be coming in every 4 to 6 weeks for an aligner or even even or braces visit there's no reason for this you can trim this and be more efficient with a lot of the options that are out there like for example dental monitoring system. So it's great my doctors save so much money paying that $9 a month but yet saving say 40, 50 percent on overhead, it's a no-brainer for me.
Howard: and what was that website?
Amanda: That would be dental monitoring system, DM it's a Paris based company.
Howard: and you recommend them?
Amanda: 100%, I'm gonna go to their, they have a summit in March, in Las Vegas. So if anyone's coming I'm going because I want to learn and I hear they're releasing some new products but my doctors that use this they never go back because they're like, okay get over the $9 per month and yes the base level but per patient. If you can eliminate, I mean look what the direct consumer aligner companies are doing they're finding good patients and they're eliminating as much as possible of thoughts in office visit you can do the same thing you know. You can monitor your patient aligner visits or aligner cases or even in direct bonding cases it doesn't matter what you're using but for the most part functional appliances even airway appliances there's no reason when they come in if you picked your case right and you did your treatment plan right and the patient's a good patient. I realize there's a lot of variables in there but if everything's going well there's no reason these patients often need to come in as frequently as you haven't come in that's like one of the biggest, I guess barriers to orthodontics what patients hate about the traditional orthodontic experience is having to come in for no reason you know.
Howard: Right, so what do you think is the advantages dental monitoring? What are they actually doing; they're monitoring the patient digitally tell us that. you call this tele-dentistry?
Amanda: I guess I would, they're collecting AI so they have a huge AI already established from all the cases they've done the only for braces, functional appliances and aligners. Far as I know they don't work with the direct-to-consumer aligner companies they're working directly with dentists as far as I know. So there's no reason to not like them you know some people I think they automatically assume that their direct consumer and they're not. So they're coming into your office they're helping you set this up so that your patients can check in anywhere and they put these little retractors on that have some special position points so that way they can collect the data and the AI and they'll actually send you an alert if an aligner isn't tracking or if you have braces and send you an alert that bracket is broken or that a gum is puffy. The computer can read these things and send the doctor and alert, the doctor logs into a HIPAA compliant dashboard and they can go ahead and check into the case and communicate with the patient. You can even set up for aligners say Invisalign or correct your own brand of aligners you can even set up the parameters so that the patient doesn't even advance to the next aligner until you check and make sure it's tracking and you're happy with the the result and the outcome so far and if you do that your case will never go to a track off track if you do that there's no reason you should even be doing revisions or refinements everything should just go straight through and then you'll be done.
Howard: Wow that is, it's just amazing how fast this is all going. It's just dental monitoring, Wow.So have you gotten to the headquarters in Paris?
Amanda: No, I wish, I haven't been to paris in 20 years but I'm hopping.
Howard: 3Shape is in Copenhagen,Denmark and what were the other ones you were talking about what's the one in Helsinki,Finland, E4D. Who owns E4D? Plan Mecca but I have my theory about Scandinavia when you go there you go to Denmark, Copenhagen, see 3Shape you go to helsinki, Finland and see Plan Mecca. They have like four hours of sunlight a day and it's like
Amanda: That's only in the winter
Howard: I know but yeah
Amanda: The summer is the other way around
Howard: but it's a long winter and those guys will tell you it's so cold and dark and miserable that's the way to get through it is just love your work and work ten hours a day six days a week and they go man I come in the winter and I do six ten-hour days a week. I'm talking about dentists and companies and then when the Sun comes up and when everybody wants to visit Denmark and there's nobody there you can't get a restaurant I felt because everybody went to the Mediterranean and is out sunbathing for two months. So it's a really hard if you want to see it working in action you got to see it at its worst and then if you want to see it at its best all the people are gone but I love this play but but Paris France they have some amazing dental companies.
Amanda: Amazing so does Germany, yeah for sure I actually used to live in Germany for a year and a half so I loved it.
Howard: Was that military?
Amanda: No, my grandfather is Austrian so it was my major actually and my undergrad was German. I just think I just want the party so it was a great year and a half and then I went to go to school after that and buckle down.
Howard: Well my favorite dental convention period is always the IDF meeting in Cologne they only have it every other year it's the only dental meeting you ever go to in the world that has a hundred thousand dentists there from every corner. Every time you're talking to some dentists you don't know if they're gonna say they're from Cambodia or Bolivia or I mean just the whole world descends on there.So my gosh this is amazing, I really wish you would do an online CE course or some
Amanda: 100% I will
Howard: It's just too much information to go from I'm 25 I got $400,000 in debt, I got a dental degree and where do I go from here. Now are you what percent do you think the market is right now in America of clear aligners versus brackets I mean you keep hearing, I mean our brackets dying?
Amanda: In some parts of the country and I'm gonna make an reference daughter who's wearing clear aligners and she's in fourth grade but her entire class I came in I'm looking around and I seek I didn't see clear aligners across the room I can tell if it's Invisalign, Clear Correct, your own brand. I can just tell by the shape the trim and every single kid in that class has clear aligners there's no braces anywhere to be found so I'm not even asked her I said would you want braces oh no way I never wear braces. So you know I think it's bicoastal for the most part you know San Diego. San Francisco. New York. A lot of the kids are getting clear options and there's so many options out there you know, you can come you can combine functional appliances with clear aligners and start these cases young and correct the bite and then just use the clear aligners just to fine-tune it. You know there's just no reason that you have to be doing these you know a headgear and these kind of fixed piston herbst or anything. This is torture devices it really is so you know you got to think outside the box and listen to what the kids want and kids are on YouTube now they're on Instagram they're on snapchat they know what their friends are having and they want what their friends have. So might as well figure out a way to offer it.
Howard: So not that you're giving investing advice but which if you had to I mean Smile Direct Club is talking about doing an IPO, Invisalign has publicly traded they the CEO that's been on Kramer and you see them on different talk shows. Do you, which one of these companies do you think will the next 10 years will really dominate and really grow and dominate their market places?
Amanda: Yikes, I'm a little nervous about that question because I do have some non-disclosure agreements and I don't want to get anyone after me but listen anything clear I think is great that's what I've got to say so I would definitely look more towards clear and less towards brackets and wire so that would be my suggestion
HOward: So if she was 25 when she just graduated would you even even recommend that she goes through training to learn how to place bands and spacers and brackets or would you say...
Amanda: No bands and spacers, no I think everyone should learn the basics of indirect bonding because first of all you get in a pickle with the case you could always throw some brackets and wires on and if you understand how teeth move with brackets and wires 100% you can understand how the teeth move with aligners, it's just way easier.
Howard: So no more bands, so you're saying...
Amanda: No no no never
Howard: Bands are dead?
Amanda: That's just like bacteremia, no way.
Howard: Wow and by the way I got a hammer down, you said get in a pickle. Now I'm from Kansas I only heard that in Kansas, Nebraska, Missouri. I've never heard that pickle outside of
Amanda: I lived in Missouri, remember we talked about that so I've lived in a lot of places. I've kind of picked up the lingo everywhere.
Howard: Yeah that got in a pickle came from your Missouri days
Amanda: Yeah for sure, my family is from the deep south so there are alot of those in there somewhere.
Howard: Well just imagine when I got out of school the big hot thing was you know it's going from amalgam gold fillings to composite and the operative department just thought the composites were junk and hated them and the new cosmetic was a pfm and now I'm seeing these things of the pfm I'm seeing extinction of the amalgam in the twenty developed nations and now you're saying that banded molars on ortho is just done...
Amanda: Done, no reason. Hey I've got a DO on number thirteen in me it's my only fill, my husband did it. It was his first composite he did in dental school. He was a second year and it's it's well over twenty years he's an awesome job he's a great dentist but there's nothing wrong with this progress when done right is great
Howard: So did you guys meet in dental school?
Amanda: We did yeah his last name is Wong, my last name is Wilson. It was me and all the Win's, Wong's, Yang's. I'm sitting you know UCSF is notorious for having a very Pacific based of demographics so yeah it was pretty much me.
Howard: So you were Wilson and your hubby was Wong.
Amanda: Yes that's correct, me and all the Wong's.
Howard: Well you know I already switched gears completely cuz that's actually the most important thing, I read lot of interesting research that highly educated people in the same fields have the lowest divorce rate like if you're a lawyer marrying a lawyer or a dentist marrying a dentist.
Amanda: Really, that;'s awesome news.
Howard: One study I posted this on Dentaltown, I've got a thread called brain food but it was shown that when dentists and lawyers and physicians marry each other the lowest divorce rates like 13% and basically what they were saying. I did a couple podcasts on it because that was marriage counselors. They say well you got so much in common I mean you're both dentists. I mean instead of you know you got kids in common. It's just it's a serious deal but any advice you would give to two lovebirds listing this in dental school?
Amanda: This is my favorite question of the day well first of all my husband's gonna flip out, he was the one texting me. If he even knows I'm talking to you because he's such a fan so he's not gonna believe it, we're gonna have to publish it to let him see it but ya no, I mean you know you develop so much trust with what you go through in dental school. I mean there's a lot that you go through and you develop so much trust in such a deep connection with that group of people. So if you can get through dental school you can get through anything in life. So we're very blessed, we have two great kids. You know I don't think either want to be dentists but you know it's really just a blessing and it's fun.
Howard: Well you say they don't wanna be dentists.They say that in 20 years one-third of the jobs in America will be in industries that have not been invented yet, so I mean going through four-year school really is funny because look at war buddies. All my buddies who did a year in Vietnam with some other guy the guy might be living in a whole nother state on the other side but when they meet back up, they're like love brothers you know just because they went through hell together for a year. So the rest of their life they're buddies no questions asked.
Amanda: Our class is like that too and I think so much of our classroom they have 72 people they coupled up like crazy. It's really great when we have our reunions it's really fun.
Howard: Yeah that is great, so do you have any rules like do not talk dentistry when you get home or is dentistry an open subject?
Amanda: I just told him don't talk dentistry right now cuz I'm talking to Howard and he was like what you're talking to Howard but we try not to text each other during the day about dentistry but that's pretty much the only rule so but you know inadvertently he's sending me pictures of this great implant place he loves implants so you know it's really fun to see what he does and to encouraged him.
Howard: So but back to the fastest, easiest, cheapest way to learn ortho. Who do you recommend their?
Amanda: Well that would be me Howard;
Howard: So you would recommend that they go to your site and well tell them how that works, so they go to www.straightsmilesolutions.com and she's 25, she doesn't know ortho. Tell me how it works? What does it cost? How does this work?
Amanda: So my goal is to honesty the lowest price option out there because I want that twenty five-year-old not to be stressing out you know about having a few cases and not having it break the bank. A lot of other systems that are out there they're gonna charge you per case whereas I have as low as a fee of $499 a month for unlimited cases one doctor one office and I don't care if they're Invisalign, clear correct your own brand of aligners, Six Months Smiles. You name it any brand out there of any kind of work though I'll support you with. I don't care if they're new in you know in progress you're stuck on them pickle cases will help you through every single case. I have a lot of doctors that are doing a great job you know like they've gone from doing two cases a month to doing thirty cases a month, all just having having someone there all the time to help them out. You know they never get stuck, that's my goal but yeah I offer every doctor really and I know this is a huge offer a huge give but any doctor can schedule an acquaintance with me. Their's no cost just to chat, we'll just talk about how their cases are going, what their questions are, about the different lab options out there how we can possibly get them started and you know I may not be the solution. I may send you to you know progressive orthodontics and there's so many different options that are out there that maybe are better for you and if that's not me I'm totally fine with that I'll send you where you want to go.
Howard: They're gonna pay $499 a month, they're gonna get on the low-end intro starter deal. The girl, she doesn't know ortho and she's gonna get an open-source scanner, 3Shape right and then any other software that she would need on their computer?
Amanda: You don't have to have the scanner to get started you can do it with impressions. So there's no reason you need to invest in anything all you need to do is have basically a phone or a computer and we'll find a way to to start finding hipaa-compliant ways to review your cases and supporting your cases so yeah that's all you need.
Howard: What would it and who is the average person calling you? Are they young, old ,are they rural, urban?
Amanda: I have everything. I got some guy in Greece talking to me tomorrow, I've had people in Hong Kong, Australia all over the US rural, urban, DSOs, you know high-end practices, you name it. I mean people are afraid to admit that they need help but okay I went to school for three extra years and I've done thousands of cases of course I can help you and you know what if I decided to go back and be a general dentist I would need help with my endo. I would need help with my OS, I would need help with my period. I mean I'm gonna need help too so you know we want you to have a really private way that you can get the help that you need you know and get it as fast as you can sometimes you know immediately when the patients in the chair
Howard: You know the the the one thing I think all the governments haven't figured out yet is that the internet killed nationalism. I mean I've lectured in so many countries where you can tell that these people in Cambodia or Indonesia or Thailand or in South Africa have more friends and family and connection in Tanzania than they do in their own. You know it's just that they're almost lining up more as dentist, two million dentists around the world and they're almost referring more to I'm a dentist and I have my board certification and they and the implantology as opposed to talking about that they're Cambodian you know I mean.
Amanda: Yeah we're all connected. It's such a great connection, I meet so many great doctors all over the world and I just love it and this time I go to a meeting hey if anyone's gonna be at Chicago midwinter. I'll be there I don't have a booth I'm just gonna be kind of walking around but contact me, email me, we'll meet up we'll have coffee we'll talk.
Howard: She'll be the Hawaiian dressed in shorts frozen to death out in front of the hotel.
Amanda: I don't even have a jacket, I lost it somewhere after connecticut. I don't know where it is I'm refusing to buy one so yeah you'll see me.
Howard: Every jacket and coat I own is because I left Phoenix it was in the winter and it was 80 degrees, I forgot I landed someplace since it's 30 degrees and snowing and I'm at the airport trying to buy the thickest jacket they have but one thing I will tell you about around the world is that there's a lot of crazy insurance schemes. In America they're more nonprofit like Delta or they might be for-profit you know but in a lot of governments like Japan, France, London. They have the government dental system and it's so regulated and the price or so. Like in Japan in Japan, Tokyo, and London the government only gives you $100 for a molar root canal and you're not allowed to charge more. So then you go to those states well what all the dentists do well I to do a root canal like an American would do would cost them six seven eight hundred dollars so they but implants and ortho aren't covered so they'll just extract the tooth and place the implant where they can charge 1,500 for the implant. So when I see that around the world I get very nervous about socialized medicine because I only know dentistry really really well I don't know cardiovascular surgery or oncology or any of that stuff but where the government has really tried to help the people with socialized dentistry it's a disaster. I mean it is just horrible and then when I go to any of those countries the dentist will tell me well I can't make a living on cleanings exams and fillings so the government only lets me charge $12 for a filling and $4; but if I just do one Invisalign case a week or the other half of the dentists are in implants. They're either one of the other into the white soft bleaching bonding veneers clear liners are there in the blood and guts implants, canal's, extractions and dentures and they say if I just place one implant a week for my regular fee I mean I'm in Cambodia that that's a thousand dollars a week 50 weeks a year I'm a very successful dentist if I can just take just this minute this Medicaid socialized insurance mass where somebody has controlled the price and then I get to use that base to discover and find and present an ortho case and pretty much everywhere I go and that's where I always come with that metric where I don't really see anybody being successful as far as doing a treatment that's good and profitable unless they're doing at least one a week.
Amanda: Yeah the first couple are gonna be and they're gonna be challenging. You're gonna miss a big learning curve so you can't give up and so many people start ortho and then they give up. So I want you guys to go back find those cases and we'll learn from them and then we'll go find more you know.
Howard: Yeah and and the other thing that I've noticed that as you get from the richer countries to the more underdeveloped countries the women spend two to three or four times as much on personal beauty ,makeup, eyeliner. I mean I was in Shenzhen in China and this guy was showing me that the women spend 40 percent of their income on what we would call health and beauty,hair makeup.
Amanda: Yeah I don't doubt that. I have a sister-in law who lives in Shanghai, she's like amazing the amount of stuff she spends, you know of how she looks but that's just how it is.
Howard: Yeah, so I see the next 20 years whether they're you know Straumann is publicly traded they're the number one implant they sell the most implants. Invisalign, Smiles Direct Club, I think they have so much upward market. When I was interviewing the CEO of straumann he was telling me that that you know 20 countries place more implants per a thousand people than America and he was just saying and Wall Street's look at his stock saying gosh if the United States would just place the same number of implants for a person as they do in Korea or Germany. So I think it's gonna start rapidly being socially unacceptable to be a girl walking around with a Gucci purse missing up a tooth, a molar and whiter brighter straighter sexier teeth is gonna just become every all seven and a half billion humans are gonna want it.
Amanda: It is, it's totally for sure.
Howard: Now are you seeing, what are other signs successful people do. I want you to address this, it's a concern of mine. You go back to 1900 there were no specialties and health care was not very good there's only one percent economy a hundred years under 2000 it was 14% of GDP and the MDS had 58 messages we had nine and so what I see a dentist say well I would have learned how to do clear aligners, place implants, sinus lifts, bone grafts, molar root canal, pediatric dentistry, silver diamine fluoride and I start looking at this saying well historically that's not the way the trend has been going the trend has been going that as this tree breaks out you need to focus on one tree do you think someone. Who would be a candidate to add ortho is that someone who doesn't add implants or are you seeing clients that are being the super dentists that do it all what's the Senate model
Amanda: Ortho goes hand-in-hand with implants 100%. if you're gonna drop an implant or thinking about dropping implant you better have those roots parallel you know and if even if you're gonna do a bridge you want to have the you know the draw really really good so any type of chronic bridge you're doing or implants and you know you want the arches to be widened. I think ortho goes together with any high productive procedure.
Howard: Wow and then talk a little bit more if someone's listening this and they're a pediatric dentist as opposed to an orthodontist like you. What is the pediatric dentist angle from what you've learned over the years?
Amanda: For sure I mean I think originally pediatric dentists were focused on just kind of drill and fill you know baby root canals, preventive but now most pediatric dentists are easily doing phase one treatment you know. Some of their face lens a little rudimentary, it's just expansion but now they're really looking into doing growth and development and there's a lot of really cool night time only appliances out there. A lot of new appliances on the market. I'm still learning about some of them out there, a lot of expensive appliances on the market out there the people are using but for sure I mean it is totally possible to do some types of intervention appliances just at night when the kid is young and have this child's actually never even need braces or aligners so it's pretty amazing how these things work out there.
Howard: and you talk a little bit about teledentistry. I mean this is getting bigger and bigger and bigger where do you see teledentistry headed?
Amanda: Teledentistry is gonna, it's here to stay so and I mean it's no different than any other telemedicine I mean nowadays I can get on and talk to my my pediatrician online and get a prescription I don't even have to go in you know using some of their portals that they're using they don't want you to have to come in and use up there to their chair time and their office time. so for basic check-ins and easy procedures there's no reason you shouldn't be able to use tellen dentistry to eliminate chair time. Hey that eliminates overhead you don't need to run so many chairs, you maybe don't even need such a huge office. You know with and that's for new doctors who are graduating, I think everyone's like oh I gotta get this big office, no you really don't and I think a lot of times if you're creative and you're using teledentistry it's very possible to share an office with somebody else or go in on off hours and use their office. So a lot of different ways to eliminate you know if you already have $400,000 in debt and you're a new grad don't buy the you know don't buy the hype you don't have to buy a huge office talk to me first, I can give you ideas on maybe how you can find ways to be productive without huge overhead.
Howard: Do they need a CBCT? Is CBCT becoming the standard of care in orthodontics?
Amanda: Yes and no, I know for some type of cases yes, I mean for sure for impacted canine cases for surgical cases for cases that might involve tad's but most of those are. Those are ones that are going to the orthodontist. So prefer ones that general dentists are doing, a pediatric dentists are doing I don't think so unless this is an airway case if it's an airway case then maybe if you're billing medical insurance then probably.
Howard: Wow and what do you think is harder ortho or swimming?
Amanda: Oh wait how did you bring up swimming or you knew that I was both in USA Swimming?
Howard: Yeah because um when I turned 50 my new year's resolution I did the Ironman every year three years in a row its bike ,swim right and they told you from day one they said looks like running I mean you put one foot in front there's not a lot of technique bicycling I mean come on you put your feet in the pedals you around but they but it was Michael do Tola who's been on the show and he told me said dude never swim without an instructor because it's so hard, it's like gymnastics or it's so skilled and what I was amazing is I actually didn't like swimming the most because when you're running you can be thinking about anything when you're biking you can be talking to the guy next ya and then gosh when you're swimming it's like you gotta I remember like 25 things that all the time and and the resistance of water.
Amanda: Oh yeah I'm an official for USA swimming, I just got my national level so I go in and I officiate meets, stroke and turn so yes challenging. I love it though.
Howard: So that's that's my question what do you think is harder to intellectually understand orthodontics or swimming?
Amanda: Swimming for me, I'm always learning I actually have my book here I'm always reading the rules it's very challenging I love it you know but if you can do swimming you can do anything for sure and my kids are big swimmers so it's absolutely amazing it's a great community as well.
Howard: Yeah it is, it's a really great community and I their's a lot of dentists that are in the pool in the mornings swimming laps.
Amanda: Tons of dentists
Howard: Tons of dentists oh my gosh so I can't believe I already had you on for an hour is there anything I didn't talk about that you wish I would have talked about
Amanda: Not really I think you touched on just about everything. I just really want to encourage anyone if they, don't worry about finances please just call me. If you're stuck, you have questions, you can message me. Find me on Facebook, on LinkedIn for sure I'm super active. I want you to feel comfortable just asking questions and getting those questions answered no cost no charge just ask. You know and I definitely would love to write some articles for you and do a CE on Dentaltown, that sounds like a great idea.
Howard: Yeah it's great marketing because the one thing we have is distribution. I mean you know we mail our magazines a 125,000 but then it digitally goes on it's emailed all over the world and like I say on your YouTube channel, your YouTube the best way to explode your YouTube channel you start posting the videos in dental town and then it's your actual YouTube so they click to it they go to youtube and then if they like what they see they subscribe and my job is to try to introduce mega stars like you to my homies. No you are,you absolutely are, I mean what you've done, I mean gosh, your resume. I mean 99% of all the kids are listening this right now we're never gonna have your resume and it's just amazing. Thank you so much for coming on but you gotta explain those, are those all surfboards behind you?
Amands: These are surfboards. You know in Hawaii we have very small houses so we're right near the beach. These are my husband's and my kids, I'm not a great surfer but yeah this is my office/surf room.
Howard: and give us a and give us an update on the volcano it's been erupting it's been using for what 2 or 3 months
Amanda: It's Pretty much dead know it's my kind of dormant so we can go back and visit. It's a really cool place to visit if you've never been to Hilo side you should definitely come check out that volcano, it's very neat.
Howard: Yeah I've been to Hawaii so many times, so many I and Maui is not to be rude, Maui is my favorite, Hawaii's my second favorite. The reason I'm not a big fan of Honolulu's because it's kind of really close to San Francisco or San Diego whereas Maui and the Big Island is something you never saw in Kansas.
Amanda: Kauai for me is my favorite.
Howard: Yeah I mean when you're in Kauai or near in Maui or you're on the big guy in Hawaii you are not in Kansas anymore I mean it is so damn cool but I imagine if you want to do all the shopping and eating and restaurants and all that Oahu is where you want to be. How did the ADA meeting go was that a big success going there?
Amanda: Actually it wasn't not for ADA, they didn't do anything wrong but we had that big strike going on with Marriott SPG so it really kind of disrupted a lot of people's vacation and I felt terrible you know for the visitors. So that's really not who we are but that's just how it was. They just didn't sign up.
Howard: I wonder about the booth people because if you go to like Chicago midwinter and all the dentists know that it's minus 12 outside they all stay in the convention and they all go around the booths but if you say it's 70 degrees outside and you should be golfing then everybody leaves the lecture hall and just runs for their cars so
Amanda: I always know it's done, everything's done by 2/3. So yeah it's a really short exhibit time.
Howard: Also I just gotta have one point of view there's two when people go whale watching in Hawaii the winter whales are twice as big as the I mean the whales you see at Christmas and holidays those are just little sperm whales right the big blue whale,
Amanda: We have the humpback whales now, yeah their here.
Howard: but the big blue whales come in this summer
Amanda: I don't know, I only know about the humpback whales. Sperm whales and humpback whales and then yeah I think there are harder to see those but yeah if you've never been whale watching she's definitely come check it out it's amazing.
Howard: Right yeah and I my gosh I love Hawaii. Is it that much more expensive to live there do a lot of people say?
Amanda: Yes, I travel all the time, I travel just to buy back to school clothes I mean one trip I go to Trader Joe's buy clothes for them it's much more expensive we buy everything from Amazon but yeah for sure. I mean you live very simply here.
Howard: and last question and I'll let you go because you're on double overtime. Do demographics matter if someone is some little girls listen to you right now and she's thinking you know I'm an A.T. Still, I'm in Phoenix. I mean Phoenix dumps out couple hundred every does that matter the demographics matter or would you talk about demographic can you be successful?
Amanda: It doesn't matter at all, don't judge a book by it's cover I've helped doctors go into Medicaid practices before and get successful because you know don't judge a book just because they don't maybe have insurance for ortho, it doesn't mean they're if you can great come up with great financing that they're not gonna find way to build to make it happen so if I always recommend giving every single patient all their options don't just think they want the Kia treatment plan they everyone should get the Porsche treatment plan and then you can have good, better, best but that frustrates me when people just assume that people don't have the finances for things because you'd be surprised at what people want what they can make happen when they want something.
Howard: I know so don't diagnose the pocket book, that's excellent advice. These people find a way to buy an f-150 pickup truck and they're making payments for four five six years they say well my insurance doesn't cover it and they're holding $1,000 iPhone in their hand and the reason they're not accepting it because you don't go for you didn't present it you didn't make it more in the need.
Amanda: Yeah I mean explain the need so and you know everyone should have the best and if they can't then at least you can always document that you gave them the best options and then you can come up with something in the middle and all that will work for their budget but yeah sure.
Howard: You're an orthodontist you know I own two magazines websites, would you be writing an orthodontist for Orthotown for the orthodontist and then something separate for the general dentist in Dentaltown?
Amanda: Orthodontists don't care for me so I'm pretty much ostracized from that group, so that's we'll just make assumption so no I think I'd write for Dentaltown.
Howard: but if you want to but it's my job I mean that's why I'm Dentistry Uncensored. I don't do this podcast so to make a friend I mean I'm trying to help you and if you don't like what I'm saying, I mean two plus two equals four I'm sorry that you want it to be three or five or seven, I don't talk what it should have could have this is what it is and you know economics doesn't care if you believe in it or not. I mean you know economics is gonna work and go forward long after you're gone but hey thank you so much Amanda for coming on the show.