Dr. Jacobi graduated from the Indiana University School of Dentistry in 1975. After running a successful solo general practice for 36 years, he transitioned to a different type of dentistry. Over the last eight years, he has made 15 trips to areas in the U.S. and 13 countries in Central and South America, the Caribbean, India, Africa and the Philippines. He has traveled with the U. S. Navy, as well as with civilian, university and non-government organizations. In addition, he serves as a mentor to the Pre-Dental Society at the University of Louisville and has taken many students to Remote Area Medical (RAM) clinics in Kentucky, Tennessee and West Virginia, as well as to Louisville Dental Society community clinics.
VIDEO - DUwHF #1238 - Joe Jacobi
AUDIO - DUwHF #1238 - Joe Jacobi
Dr. Jacobi also serves as the volunteer Director of Manufacturing and Technology Development at WaterStep, a Louisville-based nonprofit that responds to critical needs for safe water and infection prevention in developing countries and disaster situations by evaluating and implementing simple solutions and teaching people to use those tools. He has helped build water treatment systems in Central and South America, India, Africa, the Upper Amazon and Puerto Rico. Dr Jacobi lives in Louisville, Kentucky, is a Life Member of the ADA, and is a Fellow of the Academy of General Dentistry and the American College of Dentists.
Howard: So it is an honor to be here with Dr. Joe Jacobi at the Kentucky State Dental meeting the annual meeting in Louisville right by the river. Dr. Joe Jacobi graduated from the Indiana University School of Dentistry in 1975 after running a successful solo practice for 36 years he transitioned to a different type of Dentistry over the last eight years he has made 15 trips to Ares in the US and 13 countries in Central and South America the Caribbean India Africa and the Philippines. He is traveled with the US Navy as well as with civilian University and non-government organization in addition he serves as a mentor to the pre-dental society at the University of Louisville and has taken many students to remote area medical Ram clinics in Kentucky Tennessee and West Virginia as well as the Louisville Dental Society community clinics. Dr. Jacobi also serves as the volunteer director of manufacturing and technology development at water step a Louisville based nonprofit that responds to critical needs for safe water and infection prevention in developing countries and disaster situations by evaluating and implementing simple solutions and teaching people to use these tools. He has helped people build water treatment systems in Central and South America India Africa the upper Amazon in Puerto Rico. Dr. Joe Jacobi lives in Louisville Kentucky is a life member of the ADA is a fellow of the Academy of General Dentistry and the American College of dentists. Joe is an honor for you to come on the show.
Joe: Well thank you Howard.
Howard: Looks like you've gone from private practice to volunteerism.
Joe: That's true
Howard: Tell us about your journey and how that happened.
Joe: It kind of happened because I was very intense on building my private practice and really focused on that for many years I'd been to some of your seminars back in the early years of my practice and really love private practice. After a while I got a little tired of it you might say you know running the office and doing all the the business side of it but I just thought I needed to break and so I took some time I was able to find a buyer for my practice very quickly I was able to sell it took some time off did a little fishing and began to see what I might do for this next part of my life retired sold to practice when I was 60.
Howard: So that was eight years ago, you sold it?
Joe: Yeah
Howard: and six years old and it was here in Louisville?
Joe: It was across the river in southern Indiana.
Howard: Oh so right across the river.
Joe: Right across yeah
Howard: That sounds like a dumb question but I wouldnt know.
Joe: A geography lesson yeah
Howard: So you lived in Louisville the practice in Indiana so you were a Hoosier
Joe: Yeah I grew up I grew up in southern Indiana originally
Howard: and they figured out what a hoosier actually is.
Joe: I moved here with my wife got a house and kept the practice over there
Howard: and so what when you retired how was entering retirement some people think it's gonna be fun and then they get bored or depressed or it's hard on the spouse cuz she was used to you being gone all day and now you're you know in her in her face all day I was the transition from...
Joe: Well it takes an adjustment for sure the the we had been in planning my wife and I we're planners we started out about ten years before I actually made the move of looking at finances seeing what we could do to build the practice to make it more desirable including upgrading equipment decorating the office appropriately keeping things fresh just like you might do a house but your well to sell and get a good price for it you do some things to keep it spruced up and so we incorporated fully computerized office we had digital incorporated digital x-ray added laser we did the moved into the high-tech because the person I was envisioning would be my buyer would be a younger person who would expect to see some of those things in the office that may not be the brand that they would have chosen if they were buying but I've got first-rate stuff that will do the work for them. So I tried to make the practice very desirable and that's we started about 10 years before we end up actually selling because I didn't know exactly when that was going to happen. About five years before we end up selling we spent time in earnest both Kathy and I of really looking at not only what we were doing with the practice or what would we do after we sell the practice so we went to some adult college courses about don't retire we rewind or...
Howard: Don't retire but rewind
Joe: Yeah I can't think of the exact name but it was something along that line of if I was planning to retire somewhere between age 60 and 65 I'm in good health our finances were in order so I expected to be able to do something I haven't learned how to play golf yet and that's still on my list but it keeps getting pushed down I keep finding other things I want to do.
Howard: and that was eight years ago so you're 68 than you look great.
Joe: Thank you thank you
Howard: You look great very great.
Joe: Thank you so we worked really hard the the what turned out five years before we actually retired of really tuning in on finances exploring a little bit what we might do after we sold the practice do I did I want to keep working and somewhere in some capacity we plan to do some traveling which we have of course I want to do some fishing and some other things but I still wanted to be useful I still wanted to be engaged and put in the world I still want to be engaged with people I still liked dentistry and like doing it but I also wanted to do something that gives me a purpose I'm kind of procedure driven I kind of liked them do things and make things which is one reason I became a dentist not a physician. I like to create and help people by making things.
Howard: Surgeons work with their hands what percent of dentists do you think work with their hands and what percent of physicians do you think work with their hands?
Joe: I think dentist by far are from the ones I've met and worked with the the average GP physician I've had the most experience with have a lot in their head but don't have it in the hands.
Howard: Right
Joe: They can diagnose and prescribe ooh wonderful thing medicine that way but when it comes to making stuff not so much.
Howard: and what they don't realize is that AI is coming after them the fastest because if you have a submarine that's underwater for six months with 800 souls on board you couldn't have a physician specializing anything anyway right and AI is coming after health care like like like a rocket but he can't touch dentistry I mean I've been in the countries where an ATM machine you stick in your your medical card and your and your prescription comes out of an ATM machine but you're not gonna get a root canal or a filling or a crown done by AI.
Joe: Dentistry is so procedure oriented it takes a mind and it takes trained hands to make it happen.
Howard: Yeah and I like working with my hands.
Joe: I do too.
Howard: I mean on I think it's very very fun but it seems like you are you've really taken a turn into missionary dentistry?
Joe: Well I kind of backed into that.
Howard: Was there a beep beep beep
Joe: Yeah there kind of was kind of was my wife was vice president of the Community Foundation here in Louisville and so she had contact with many of the nonprofits in the area and I said I'm really interested in selecting a non-profit or interviewing some to see if they have a place that I might fit that that it would appeal to me well she made a few suggestions and I ended up with as you read in the bio a group called water step and water step was a beginning a fairly new nonprofit and we talked about how important water having safe water is to a community and to the health of the population and to me that sounded like health care. Also I grew up in an engineering background of civil engineering and water system sewage treatment plants and things of that nature and so that appealed to me as well and they were starting to make build and those built design and build equipment to treat water so I got involved with them and it so happened that they were requested by the Navy to be an NGO on a humanitarian trip to the Central and South America and of course I ran into the dental department and they said hey you're a dentist why don't you come work with us when you get a chance so that was my initiation into in doing restorative dentistry extraction missionary type Dentistry if you will kind of by the back door with the Navy.
Howard: You know what I always think about missionary dentistry from my perspective is these Americans they think have all these problems and I did my first missionary dental trip back in the day I don't have any problems I mean the stats on this water step.org well first of all I was thinking of if you reduced to eight billion humans 2/3 one has a smartphone one is the cell phone not connected and one doesn't have either and water step.org 748 million humans don't have access pain water 80% of all diseases worldwide are caused by contaminated water and three and a half million people die every year from water related diseases and then she's all the Millennials she just graduated she's all stressed out because she has student loan debt. Would you rather be two hundred eighty seven thousand dollars in student loan debt or drinking dirty water water yeah do you think a lot of people don't realize what's going on out there?
Joe: We don't we don't realize it here I never realized that the scope of it I realize it because having grown up in civil engineering with my father in his business I knew about water contamination sewage contamination how you keep the two separated if you you have to have a certain amount of infrastructure to keep a healthy population and to me that sounds a lot like health care we're trying to keep people healthy.
Howard: Yeah
Joe: People here don't realize if we take water that's safe to drink well looks like air it's here.
Howard: but I mean but I even done there was a city here what was the city here...
Joe: Flint, Michigan
Howard: What do you think of Flint Michigan water compared to water in the developing nation?
Joe: Well Flint Michigan's problem if you remember was because of lead contamination in some of the ways of from the old water system and the lead resolved into the water drinking water supply you could drink that water and have a tree of germ contaminations so it's basically safe to drink. Now if you drink leaded water for a longer periods of time you could see developmental problems especially in younger kids or they absorb the lead more frequently the problem in a large part of the world it's contaminated with feces with animal and human there is no water treatment at all. So for a short period of time if I were in Flint Michigan I wouldn't have any problem drinking the water from the system if I know if I were in a in Tanzania and drink the raw water I would almost guaranteed to be sick within 24 hours.
Howard: Yeah I did volunteer dentistry at an orphanage in Tanzania and I'm really at school I mean number one they were the doctors were telling the kids drink coke because coke was was clean right and other countries like oh no they'll get decay it's like decay and obesity is not the issue its bacterial infection and I also have seen the dentist listening to the American dentist about doing a getting rid of amalgam and they're doing composites in an environment where there's no isolation and it's a complete disaster and developing poor nations need amalgam and they need to drink you know Pepsi if the alternative is a composite that
Joe: that won't hold that
Howard: That won't even hold I mean I I watch dentists in in Africa several different nations where they're doing composites while the patient's rinsing every between every step but anyway so how long so now you've done volunteer dentistry.
Joe: Now I've kind of backed into volunteer dentistry my introduction to it was through water step and working in the water and include me and then I was invited to do des credentialed invited to do dentistry and
Howard: With one for the same company Water Step?
Joe: Well with the with the Navy's Department of Dentistry the dental Department of the Navy.
the dental department has a volunteer Dentistry section?
Howard: Yes oh my wish you and I'm the little town has 54 categories and I'm 50 categories and one of them is humanitarian dentistry and they're always at I wish you would post a link to that see under the humanitarian dentistry
Joe: Yes.
Howard: I wish you would post I mean I never knew the name to talk about the Navy.
Joe: Well the Navy occasionally runs humanitarian missions and they use typically one of the hospital ships the USNS comfort or the USNS Mercy which are big white ships with red crosses on them.
Howard: Oh my god
Joe: One station mercy is on the west coast the comfort sails out of Norfolk Virginia
Howard: USS Mercy and USS comfort?
Joe: USNS comfort NS comfort
Howard: USNS comfort
Joe: Yes and USNS Mercy
Howard: Wow okay
Joe: Now every so often they'll have one or both of those ships out just to as a humanitarian mission to treat to go to various parts of the world like the comfort generally goes to the Americas to the Caribbean South America Central America and it is composed the crew and includes a dental department is composed of military Joint Forces of Allied partner military dental officers civilian doctors and hygienists and three dental students from the University of California at San Diego free Dental Society is where I got hooked up with it. So UCSD PDS is the NGO that is it...
Howard: Do you know the website link for that?
Joe: Right off I don't but I can get that to you.
Howard: Well could you post that on dentaltown under humanitarian?
Joe: Yeah
Howard: There's so many dentists decide they want to get into something like that and I really recommend it don't you think it's kind of like almost like a spiritual retreat?
Joe: Kind of kind of you know we use here dental missions or at least my interpretation I always thought that it had to be kind of Church related and and you know kind of the church lady will fix some teeth but you know here's here's the gospel which is which is fine. I look at it when I hear dental missions is like the Navy SEALs missions special ops mission where the dental special ops team that works to help a task achieve a task and help people and doing so.
Howard: Yeah we under humanitarian dentistry we definitely separated charitable dentistry from mr. Destry because some really want to do a religious mission right and some want to do so with the Navy it's a charitable?
Joe: Yes it's it's it's a secular like there you become as a civilian you are signed the MOU to you will follow the military laws you take your orders from the CEO to a dental department you stand formation with the with the sailors and other doctors that are assigned to the dental department and you receive your assignment when you go to work sometimes you're doing work shipboard and the shipboard clinic other times you're off on land working in one of the land-based clinics and the land-based clinics Howard have dental as we talked about but they also serve medical veterinary and optometry clinics when they do this. So each clinic in country usually sees between six and seven hundred patients a day
Howard: Oh my gosh
Joe: Dental sees typically again several hundred it's one of the biggies all everyday.
Howard: So where have you gone where be done in dentistry?
Joe: I've done dentistry and all the countries in Central America, I've been to several countries in South America I've been to a large number of countries islands in the Caribbean.
Howard: and what I'm what is your experience with this been?
Joe: Well first of all I have found it very rewarding to me especially Howard when you see people that have been lined up for a long period of time with their families and usually whether that's very hot very rainy and they're standing out there having travelled long distance to see you as a dentist a perfect stranger often you can't speak the language but they've come with trust that you can help them with their issues their dental issues.
Howard: and you feel bad because after all day you're trash you got it rest so you're sitting there relaxing having a beer and they're standing in line and it's pouring rain and you know that lady's gonna be there holding that kids...
Joe: She'll be there tomorrow.
Howard: and then and then these dentists are like stressed out because of what it's really like to be human it resets.
Joe: It resets it you're right you have a stress level in the office and we have all done that and where patients have been late and we got this big bill do the end of the month and we've got those stresses that are on top of us and when we're out doing you know a special ops dentistry we're focused more on treatment what can I do to get this person out of pain what can I do that will help them so you're thinking a little more artistically just about what can I do that helped and you will work hard you'll be sweating you'll have bugs bugging you, you have sweat running down your back we were in a big top tent in a clinic in Haiti and the heat index was a hundred thirty the pres med Doc's were worried that everybody was going to get dehydrated and sick but you charge on because you know the people...
Howard: and the Haiti and America in perspective that one year they both had an earthquake of similar size in LA in Haiti and in LA I think six people died in Haiti and what a quarter million people died?
Joe: Yes
Howard: What A tragedy, so when you're in a country like that is it amalgam or composite I mean what is the mostly extraction?
Joe: They usually oftentimes it's relief of pain and or do some basic restorative so you get pretty good at extractions just a lot of times that's what you can offer you do I personally do a lot of amalgam.
Howard: Oh you evil monster
Joe: I know
Howard: I could tell there was something wrong with you doing a filling that last 38 years instead of placing inert plastic the last six and a half in a country. I know I go on this mission I'm like are you kidding me you almost doing a pulp cap if you leave what is he gonna do I mean what do you think last longer?
Joe: Amalgam
Howard: The best you can find on composites is that the average one last six and a half years the routine one you find on amalgams is 14 to 38 years and now you're in Tanzania and you're really gonna do a composite.
Joe: and those numbers are usually taken from dental offices under more ideal provisions when you're in the hill somewhere you're just trying to get something in there and amalgam still the go-to for me.
Howard: Yeah I assume you're talking about Goddard Kansas yeah I yeah I don't care that you want to be a cosmetic dentistry and I have nothing on the composites I just wish the composite manufacturers who put a damn active ingredient in them yeah because there's there's no active ingredient and in inert plastic composite and the next dentist tells me that his composites with his hands they are permanent your you know I've seen insurance claims insurance data of hundred million fillings done so either they're all being done by aliens that aren't from America or they're the ones from your hand it's the same dentist says well I've never had a root canal fail and then there's four thousand endodontists who do six failed retreat no they they average three retreating failed root canal a day. So I showed you how many immigrants move the United States a root canal has done in other countries since none of the Americans have ever had a root canal fail right the four thousand and endodontist retreat three of your failed root canals every day that's four thousand times three that's twelve thousand a day and you've never had a root canal fail and your poster composites are permanent it must be fun to be you.
Joe: Not mine
Howard: Yeah must be fun. So how could one of my homies you get involved in something like this?
Joe: Well you know mission based dentistry we tend to think of it or I used to think of it I had to go to Ecuador I had to go to Haiti I had to go to Tanzania to do it and really what I am going to talk about tomorrow and my CE course the other side of that is you got the home missions you've got around of the Remote Area Medical Ram clinics that are available that you can go to within a couple hours.
Howard: A Ram?
Joe: Remote Area Medical it's Ramusa.org
Howard: Interesting
Joe: and they are here at the exhibit hall.
Howard: and is this a government agency?
Joe: Nope this is a secular NGO.
Howard: and what an NGO?
Joe: I'm sorry NGO is a non-governmental organization that means it's not part of government Red Cross is an NGO it is a non-government organization.
Howard: and how did you get involved with Ramusa.org?
Joe: I happened to look around I heard their name I looked them up went on the website which is very comprehensive about them and I worked with the pre dental students here at the University of Louisville and we trained them as dental assistants in our local free clinics here which is again part of our mission based dentistry and I take six to ten free dental students with me to a Ram site and they work with me and other doctors and other dental students as assistants so they get to see in their pre-dental years what it's like to do clinical dentistry.
Howard: Man those are some neat pictures on the site.
Joe:Yeah they are a great organization.
Howard: So give an example of an American it says over the past 34 years Remote Area Medical is providing free medical dental vision to hundreds of thousands of people so like where have you done this at?
Joe: I've done it primarily in the states of Kentucky, Tennessee and West Virginia regional because I when I'm taking my students I'd like to kind of keep it within a three or four-hour drive so that's been my group. Now this summer are actually my daughter is an optometrist out in Albuquerque and Ram's is going to have a clinic out in Roswell New Mexico.
Howard: No way
Joe: Way
Howard: Next to area 51
Joe: Yeah I guess so.
Howard: So these are they really millions of Americans really go to that or...
Joe: Who knows
Howard: I had a patient come in from the military I said you think well you think a million people are gonna storm area 51 they go no I won't happen they do and they go they wouldn't they won't they can't but anyway so she's going to Roswell.
Joe: Yeah and I think she and I will do the RAM clinic as a daughter daddy thing that a ram clinic.
Howard: So your daughter moved from Louisville
Joe: Yes she finished her optometry training and was in various parts of the country on on her in her fourth year and end up meeting and marrying a marine sergeant major based in Albuquerque and so she has a practice associated with Indian Health there in Albuquerque.
Howard: Wow
Joe: A tribal Medical Center
Howard: I have a friend who had an only daughter she asked dad if he would pay for her senior year of college she could do the remote study in London for this special thing so he said I yeah sure so you wrote the check when I'm there met a guy fell in love never came back now his only two grandchildren from his only daughter are in London but at least Phoenix has a nonstop flight from Phoenix on its nine hours there's worse things than a nine hour non-stop to see your two grandchildren. Well this is really amazing and your American is such a huge country, a lot of people in fact I don't even like I don't even think the term I think the term United States of America makes as much sense as Europe because you don't compare Germany to Finland or Portugal to Greece and you can't compare Anchorage to Manhattan you can't compare Goddard Kansas to Miami and there's areas there's remote areas very poverty in America talk about that to the person who lives in downtown Nashville.
Joe: It's you won't believe it we were I'll just give you an example we were in Knoxville with my students at one of the RAM clinics and when you see a patient comes to you they've been triaged and you try to get to know them and do a little chit chat before you start in their mouth and so we asked this lady nice and slightly older lady we said you know where you from and we expected to hear somewhere in the area like we've been hearing and she said Columbia Missouri now we were in Knoxville Tennessee and if you hooked on the map Columbia Missouri is halfway across the state of Missouri and she was very matter-of-fact about just a sweet lady she said yeah my kids took up a collection and got me a bus ticket so I could come to Knoxville and get my teeth fixed and we go he said yeah and then she said yeah I got off downtown and stayed in a homeless shelter but it started you get too rough and so I walked the five miles out to the clinic sight in the dark and this was wintertime and it gets cold in Knoxville so I could be in line to get it an entry ticket at 5:00 in the morning.
Howard: Wow
Joe: and then she got in to see us.
Howard: You're never ever supposed to talk about politics sex religion violence but there's now that you're retired you're a dentist your retired what does it make you think of the US health care system mean no system is perfect I think everything if you don't think everything can be better faster easier higher quality lower cost then you shouldn't go into business
Joe: Right
Howard: but what does it make you think of it because it seems to be the most controversial part of politics because you're for not just now I mean you go back to when they started to Roosevelt and Roosevelt from Franklin Delano Roosevelt to now politics health care are off the charts I am so what do you think what how does it make you think you were a health care provider in America it's a subject you can't talk about so what are your what this Dentistry uncensored well what does it make you think of them well US health care?
Joe: I think the whole situation is a mess of health care and I'll move dentistry off to the side for the moment my wife for instance just recently retired from the Community Foundation and she was on Cobra for the 18 months and she's too young for Medicare when she's 65 so we have a gap year of about 10 months where we had to really scramble and only had one option to purchase some kind of coverage insurance coverage health insurance for that particular time because of just of regulations and what was available to us in the state at that time, I've also seen how government-run health care works in other countries not terribly impressed they say it's there but what is stated and what actually happens in the field to them to the individual is usually quite another thing that never the promises are never really met or what you think was promised definitely is never meant a lot of deficiencies I don't know where the answers are I'm yeah I'm just the dentist.
Howard: Yeah I want to way on that what are the reasons that people love socialized medicine is because only 1% of a society spends the night in a hospital once a year so if 99% never tasted the restaurant but are glad it's there if they're hungry yeah only 1% was actually there and the only thing I know anything about and medicine is dentistry and when I look at those national programs like in Japan France England they pay $100 for a molar root canal so I've been podcast with dentists from Japan in France and London in Japan France they say well we can do for a hundred hours in Tokyo that's right so because of government socialized medicine they extract the tooth and then place an implant because the implant they can charge you $1,500 and pay their bills in Tokyo where land is a million dollars a square meter and so it's so complicated it's so...
Joe: It is
Howard: It's so it'll probably be a long time before anybody figures it out. So what's next for you?
Joe: Well I planned on doing similar things again a good part of the special ops dentistry if you will is also working in the community the Louisville Dental Society works with several of the community medical facilities around that we come either with our portable van or have set up a clinic a dental clinic within that so...
Howard: So you have a mobile dentistry
Joe: Uses mobile
Howard: and who owns this?
Joe: The Louisville Dental Society
Howard: Owns a mobile clinic?
Joe: Well we lease a metro government has a van that they lease to us.
Howard: Thats leased out for dentistry but you can rent a dental mobile clinic from the government?
Joe: They happen to have one but it's be that is being...
Howard: I hope you make a post on dentaltown about
Joe: Okay
Howard: because there's so many mind-blowing things you're saying with so many links I mean I've never heard of the USNS comfort the USNS Mercy I didn't know you can run a mobile but yes that is just amazing gosh I could talk to you for 40 days and 40 nights last question where does all this purpose passion come from why don't you just watch some baseball games drinking a beer?
Joe: Well I do enjoy the occasional baseball game but bt Howard it's like you it's fine, it's hard for me to sit still and as long as I'm able and capable and I my hands work and my mind works mostly and I can see what I'm doing, I just choose to spend my time in something that's productive something is creative something that helps someone.
Howard: Were you born that way, did your mom or dad make you that way? Do you know where this came from?
Joe: I don't know like the song says maybe I was born this way.
Howard: Well Joe Jacobi thank you so much for all that you have done for dentistry for your community for everything, good luck on your lecture tomorrow and thanks for coming on my show and talking to my homies I thoroughly enjoyed podcasting you and I would love to see your notes posted because I know there's gonna be a lot of people that want to do this.
Joe: Sure thing and Howard I want to thank you for many years ago you inspired me to think of dentistry a little bit different and think of the business of Dentistry and how we needed to do the things we needed to do to make our offices inviting to have the proper staff the proper people there and the proper training and the rest comes with it.
Howard: Great well thank you we should you and I should start a mutual admiration Club we'll be the only two members.
Joe: Good to see you again.
Howard: Good to see you buddy.