Chuck Cohen: I’m Chuck Cohen of Benco Dental. I’m here today with Dr. Shalom Fialkoff, who is in Paradise Valley, Arizona, and is a member of our latest class of 40 under 40. Shalom.
Dr. Shalom Fialkoff: Thank you. Very nice to be here.
Chuck Cohen: Very nice to have you here. So talk a bit of, if you would, your somewhat unusual path to dentistry in a suburb of Phoenix, Arizona–where you grew up, how you made your way through dental school, and some of the experiences you’ve had along the way.
Dr. Shalom Fialkoff: So I grew up on the East Coast, in New York, New Jersey, and about 20 years ago, my family moved to Israel. I did not follow them, but I traveled there for a bit. I ended up traveling around for a little while.
I got some work experience. I met my wife. We ended up getting married, and then real life started. We moved to New Jersey, where I attended Rutgers for undergrad. I finished the degree in about two and a half years. And then, I applied to dental school also at Rutgers.
About halfway through dental school, I kind of got a little taken with dentistry, and I wanted to set the field on a larger scale than just on a one-on-one level, treating patients and such. I realized that there’s a difference between what you can do as an individual and what you can do if you have a business background or have a legislative package with an organization or a policy background.
So, I was looking for what I wanted to do, for what I thought would be the next step. I was going to apply for MBA programs, and then I decided that I would much rather do something that was healthcare-oriented.
I was looking for programs in public health, and I ended up getting accepted to a program at Columbia, which I was fortunate enough to be able to do in the evenings. So, I would go to dental school in the mornings and afternoons. And then, on the evenings, I would drive over the bridge into New York, and I finished up a degree there in about a little bit less than two years.
Chuck Cohen: That’s fabulous. So, how did you end up in Arizona?
Dr. Shalom Fialkoff: So, my wife and I got married prior to either of us starting college. And when I got accepted to dental school, we figured that the number of loans and the amount of debt we were about to enter into would be such an astronomical figure. What’s the difference if she started school now?
When I started dental school, she started undergrad, and then she graduated about the same time I was graduating. She applied to veterinary schools. She got accepted to Phoenix. And then we moved out here about six or seven years ago. And we’ve been so unbelievably happy out here.
Chuck Cohen: Fabulous. Talk a bit about what you learned in the Masters of Public Health program that you talked about. You’ve spoken a little bit before about dentistry as a career and dentistry as an industry. Talk about that and what you learned along the way.
Dr. Shalom Fialkoff: Yeah. So, the public health background is a fascinating degree and industry because healthcare affects not only the one-on-one clinical decision-making, how you have to decide on the treatment of each individual patient, whether it’s an outpatient facility, a surgical facility, or an inpatient facility. But there’s a whole infrastructure behind us that has an equal, if not more important, part of how dentistry or healthcare is delivered.
There are components that are administrative, such as running a hospital and group dynamics. There’s epidemiology to understand how the disease has progressed. There is health economics because the vast majority of what we do is economics-based at the end of the day. There are components in consulting and components in designing the system itself. There are international relationships that you can build.
There are policy agendas that we don’t even begin to understand how it affects. And if we look at even what’s going on with the ADA in 2020, the amount of legislation they had to pass and lobby and affect was tremendous. And if you didn’t have that kind of background, you wouldn’t be able to address any of the challenges that came up on a planned basis and also on a pandemic basis.
Chuck Cohen: It’s fascinating. I noticed in your profile that you’ve become very involved in the State Dental Association and on the legislative side as well in Arizona. Talk a bit of, if you would, that experience. And what have you learned from doing that?
Dr. Shalom Fialkoff: Yeah, I got lucky. I happened to have fallen into it. When I first moved to Arizona, I didn’t know anybody out here. To meet people, I just started looking for dental groups, dental study clubs, dental organizations. I joined the American Dental Association and the Arizona Dental Association. I joined some local dental fraternities like Alpha Omega.
And I started just finding dentists and cold-calling them. I would email them or call their offices and say, “Hey, I’m new in Arizona. Would it be OK if I stopped by your office after work one day just to learn more about the dental landscape?” And I would do that.
After a couple of times, I met this dentist. I stopped by his office a couple of times, and we just started talking. His office was on the way home for me. After some time, he invited me to join the Council of Governmental Affairs of the Dental Association, and, not knowing anything about local politics, I agreed to join.
And it’s just been an eye-opening experience. You get to see dentistry, and you see the business or the legislative side of things on a different scale. We sit down once a month now. It’ll resume, but we used to get together once a month. We just hash out what kind of agenda the dental association wants to address in Arizona–everything from Medicaid reimbursement to [00:05:41]legislative health. [0.9s]
Health insurance transparency is an agenda or an initiative that we’re trying to pass. We’re trying to get pregnant women to have to get Medicaid coverage for that.
So, there are many different elements, many different relationship building, and many different ways even to craft legislation. It’s been a great experience, and I’m still learning.
Chuck Cohen: Well, here at Benco, we encourage every dentist to join the ADA and get involved. There’s no substitute for organized dentistry. I think most people don’t realize how very successful the lobbying efforts of the ADA are. And one of the reasons is because most dentists–I think it’s 65 to 70 percent of dentists–are actually members of the ADA and engaged. So, we can’t overstate enough the importance of getting involved in the dental association.
Dr. Shalom Fialkoff: Yeah, it’s powerful when a lobbyist can approach a congressman or senator and say, “We represent 70 percent of all the dentists that are in the United States.” It’s much more powerful than, say, the American Medical Association, where I think the statistic is something like 30 percent.
I joke with patients right now, telling them that politics is a very complicated field, and I got into dentistry because, if there’s a problem, I can solve it in politics. Who knows?
Chuck Cohen: It’s true. Talk a little bit about some of the obstacles that you’ve encountered in your career, from where you started as a dentist to where you are today. What have been the hardest things to overcome?
Dr. Shalom Fialkoff: I feel tremendously lucky in the sense that there’s a lot of hard work and planning that you need to get into dental school, pass dental school, and find a successful job. And at the end of the day, you work hard. And we tend to think that that we’re great at what we do. But there’s a large element of just pure luck. And so, I feel very lucky in the position that I am in life right now.
I’m a member of the Council of Governmental Affairs in Arizona. I feel like the dentist that I’ve met here. I took a job when I first moved out to Arizona in a dental office, and there were some very ethically questionable offices that were fired. I was always very clear about where my line is–what I want to do and what I don’t want to do. I wasn’t afraid to stick up for myself when I needed to.
After about a year, I recognized that the organization that I was a part of was not the one that I wanted to make a long-term commitment to. And so, I started looking to purchase a dental office, which is a natural transition to what many dentists do.
I went through the traditional route. I contacted my local brokers, and I contacted the dental association; I even contacted my local Benco rep, who, by the way, might be the nicest person I know: Tim Schwartz.
Chuck Cohen: Tim Schwartz is awesome. We loved him. Thank you.
Dr. Shalom Fialkoff: Every time I see him, he gets a bigger and bigger smile on his face. And I don’t know where he gets it from, but he’s absolutely amazing.
So, I contacted people, wanted to find out what the next step could be. Maybe they know a dentist who might be looking to hire somebody or looking to sell an office. After a while, I recognized that I needed to go to a different route than most people do.
Most people are looking for the brokers and just contacting whatever was posted online. But I was trying to figure out if I can use my Benco rep or my SHINE rep, or even just continue with my cold calling, and I would just find out if I can speak to somebody. And then one person lets the next person go up to the office that I’m in. And it’s just been a wonderful experience.
I took over an office, the first office in 2016, from a dentist who started the practice. His name’s David Liebowitz. He started the practice in the 1980s. He’s just been a tremendous dentist, and he’s had a practice here for almost 40 years. And not everybody who has an office in 40 years is also a clinician of the same caliber that he is. And so, being able to find the office and convincing him that he was actually ready to sell when he wasn’t ready to sell and having him stay working with me for about four or five years. I’ve just been so fortunate to be in that kind of situation.
Some of the challenges that I think we, as younger dentists, need to overcome are camaraderie, student debt–I think student debt is a huge issue– and the advancement of clinical skills. I think those are some of the most important things that we need to address.
Chuck Cohen: I thought it was great of you to tell your story. A couple of things that stood out to me are the importance of mentors. It sounds to me like you got very fortunate in getting some good mentors when you got to Arizona and also getting in the right situation from a practice perspective. Right? I mean, that was key to getting to where you are today.
Dr. Shalom Fialkoff: Yeah. Before I purchased this office, I was very close, unfortunately, to other offices, and one of them, I kind of realized very late in the situation, very late in the negotiations, that it wasn’t the right fit for me.
Going through the whole process, you get hung up on the fact that you think, “This is what I want. I need to be an owner. I need to be under my umbrella. I need to have complete autonomy.” And you can find yourself in a situation that you didn’t mean to be in.
The most dangerous part about having a business deal, sometimes, is that it actually works out. You could be somewhere and not recognize that it is the wrong place for four years, and, all of a sudden, you just wasted four years of your life.
So, to be in a situation I’m in right now, I feel very fortunate. It allows me to do what I want when I want, allows me to focus on the things that are important to me, both clinically and personally.
Now, if your next question is how do you find the right mentors? I don’t know. Some of it is luck. Some of it is making an effort to go above and beyond what other people are doing. The dental association here does have mentorship available. If you’re interested in becoming a mentor or being a mentee, you can contact them, and they can try to hook you up with people.
But you have to get involved. You have to put yourself out there. You have to go to [00:12:03]local CE. [0.1s] You have to meet people. You have to talk and demonstrate. If you don’t talk, shop. You’re never going to get better at what you’re doing.
Chuck Cohen: No question. Well, it starts with knowing you need a mentor. My experience is that there are two kinds of people out there: the people who recognize that they really can benefit from a mentor and people who don’t quite recognize that. The people who recognize the benefit of a mentor usually have no trouble finding the right mentor. That’s not the issue.
The issue is getting over the hump of, you know, “I could use help. I can learn from someone else.” Not everyone has that insight at an early age. Those who do, I think, tend to go farther. And kudos to you for getting there quickly.
Dr. Shalom Fialkoff: I appreciate that. Thank you.
Chuck Cohen: Thank you. So what advice would you give to a dentist a generation younger than you who says, “I’d like to be 40 under 40. I’d like to have a successful practice. By the time I’m 40, I’d like to own my own practice.” What advice would you give to that dentist who is maybe just a few years out of dental school?
Dr. Shalom Fialkoff: Oh, how to become a 40 under 40? I have no idea. It’s a black box. Yeah, I think Tim first mentioned it to me and encouraged me to apply. And so I filled out an application, and then somebody contacted me. It was a little bit of a mystery how.
I’m reading through the bios of the 40 under 40, and it seems that everybody is incredibly impressive and inspiring. To be included in that list is kind of humbling.
The advice that I give to people who want to be a business owner, I tell people that there’s a very clear line. We’re both a clinician, and many of us are business owners as well. There’s a clear line because, at one point, you’re wearing a hat that you’re the business owner, and, on the other hand, you’re wearing a hat that you’re a clinician. And those two have to never, ever get crossed.
You have to make sure that you’re focusing on the business when you’re focusing on the business. You have to figure out what the best thing to do in terms of hiring and firing and setting up HR policies, and which technology you want to invest in, which dental lab, and how to negotiate with your vendors, and equipment that you want to purchase, and just how you want to get your systems and your processes in place.
And then you have to become a clinician, and you have to make sure that you’re an excellent clinician. The way to do that is by knowing yourself, knowing what you want to work on, what you want to refer to, or aligning yourself with good organizations.
Chuck Cohen: There’s a lot of stuff there to unpack. I like that you talked about the dentist as the CEO and the dentist as a clinician. They are two different roles, and I love the idea that you can never stop learning.
Too many dentists, I think, feel like their learning kind of stops at dental school or not long after. And I agree with you, you’ve got to keep working on your skills all the time. You’ve got to be excited to do that. And you’ve got to keep investing the time and energy in it.
The most successful dentists, the ones who were the happiest in my experience, are the ones who pull that off very well. So, kudos to you. I agree with you. That’s been my experience as well.
Dr. Shalom Fialkoff: I appreciate that.
Chuck Cohen: Any time. Well, thank you very much for being with us today, Dr. Shalom Fialkoff. I appreciate your time very much, and I appreciate your sharing your wisdom with us today.
Dr. Shalom Fialkoff: Thank you. Very nice to be here. Thanks. Nice meeting you.
Chuck Cohen: Nice to meet you too, even if it’s virtually. Congratulations on your 40 under 40. You very much earned it and deserved it. And we’re glad to have you on the list.
Dr. Shalom Fialkoff: Thank you.