Rick Cohen: Congratulations on being a 40 Under 40 nominee and winner. Where is this podcast finding you?
Dr. Michelle Farnoush: Thank you for having me on your podcast, first of all. It was an honor to be selected as a recipient of the Incisal Edges 40 Under 40 Award and even more among the other amazing recipients that are on there. Reading all their stuff, I’m like, “Oh, wow, this is so cool.” Some of them I know. So it was really cool to reconnect and see that. I am currently in Vegas, and that’s where I practice.
Rick Cohen: Oh, very cool.
Dr. Michelle Farnoush: I’m in my living room right now.
Rick Cohen: Bright and early.
Dr. Michelle Farnoush: Yup.
Rick Cohen: Thank you. Thanks for taking the time. Well, that’s news to me that you knew others in the 40 Under 40. Did you know them from dental school or are they also from Las Vegas?
Dr. Michelle Farnoush: Just through continuing education. Like Marina Ambridge of Arizona, I met her at AACD, which I’m really active with, and Diana Tadros, who’s part of Kois, and I’ve met her through friends. It was really nice to see other young females in there too. It was really cool. Marina actually reached out to me first, and she was like, “Hey, you’re out here too!” So, it was cool. It was definitely cool.
Rick Cohen: It’s definitely easy to find females in dentistry. Dentistry is, without question, a profession for females. Not only are over 50% of the graduates female, but everyone else in the office. 95% of them are female. Very much, dentistry has shifted from male to female over the years.
Rick Cohen: How’s Las Vegas these days? Probably had some hiccups during the virus, the worst of the virus. But have you felt that in your practice?
Dr. Michelle Farnoush: Knock on wood. We were closed for a little bit like most people, but we came back pretty strong in May, obviously different, as most experienced in their practice. But we’ve been pretty busy and slammed. Actually, a lot of my colleagues are. I was just talking with one yesterday. She has a start-up, and she’s going into her fourth year now. And she’s been slammed, too. So, it’s good. But definitely, just like everyone across the country, we went through a little bit of a hard time.
Dr. Michelle Farnoush: But it’s funny how, and I’ve heard this time and time again, people said and thought last year would be a terrible year. But between scheduling better and more efficiently, it actually wasn’t that bad, in terms of how we ended the year. It was rocky a little bit in the middle, but toward the end, it just goes to show that with efficient scheduling and things like that, you can actually still make it through the end of the year. I just thought that was really interesting.
Rick Cohen: I’m actually hearing it more and more from dentists. And it’s very interesting to hear it from you. It sounds like you used the downtime to reengineer how you were doing things. You mentioned that you’ve gotten a lot of efficiencies. So, it sounds to me like you were able to do more dentistry or do it more efficiently thanks to some changes you made during the pandemic. Is there anything you can point to?
Dr. Michelle Farnoush: I’m in private practice. I’m in more of a luxury private practice, and it has had that reputation for a long time, 20 years here in town. So, it’s not like we never had the time to spend with patients. I just think how we scheduled was more efficient. We are a fully digital office. We’re a fully CEREC office. I just think we were smarter with how we did things. It’s not like we cut the patient time. Because our reputation is equally important. I just think, the little things we did and the time that we took helped.
Dr. Michelle Farnoush: We had a ton of Zoom meetings, which were fun. We had an array of ages in the office, and so getting everybody on Zoom was super fun. I think we had some training over Zoom. We watched some CEs together over Zoom. We had assignments for our front staff to watch certain things. I think those helped not only in keeping us together, grounded, and come back hitting the ground running but in allowing us to shift our schedule and say, “Okay, let’s do this.”
Dr. Michelle Farnoush: And we had to shift our schedule. We were like, “Okay, we anticipated opening on April 15th, but the governor was a little lax and pushed it back. So, we kind of have to move people.” But they were very flexible. While we were hoping to do things, we would anticipate the next month. So, we would instead do a soft opening to kind of come back. I just think we were better at communicating, I think that was one of the big things, not only between our own team but also with our patients. I think that helped.
Rick Cohen: You know, the shutdown was so scary. It was scary for us. Now, it’s easy to say, “What’s the big deal?” But back then, we didn’t know when things would come back. So, we used that time to reengineer our processes. I think the smartest dentists did exactly the same. We recognized we can’t do dentistry during those months. We recognized that the schedule won’t be quite as full. So, let’s use this time to take a breather, really think about how we’ve been running our practice, and then make things more efficient. It sounds like you did all that, which was smart and great.
Rick Cohen: So, you mentioned it’s a higher-end practice. I’d love to know more about your practice, like where it is and how long you’ve been doing it. You also mentioned you’re fully digital. I’d love to know more.
Dr. Michelle Farnoush: Sure. I’m actually an associate. I market the practice with my boss and colleague, Dr. West. She’s amazing. She’s based in Vegas. I’m in Summerlin, a little bit north. She has been in airway dentistry since 20…10 or 15?
Rick Cohen: Early. Early for airway dentistry.
Dr. Michelle Farnoush: Early adopter. She is LVI-trained. I’ll come into perspective in a minute, but she was an amazing neuromuscular trained doctor. She did, FMR (full-mouth restorations) and got into airway dentistry very early, back when everybody was making fun of airway. Now, she gives lectures in airway. And so, I had the opportunity to join her practice from another private practice. I just needed an opportunity to grow. And that was my opportunity.
Dr. Michelle Farnoush: So, I do pretty much all of the dentistry. And it’s a great fit. We deal with anything, any airway issues. When a patient comes in, they get a full spectrum of a comprehensive exam, including airway analysis. We have a dedicated sleep staff that manages that. We do a really good handoff that way. I do all the dentistry while making sure that we address people’s airway issues as well.
Rick Cohen: Interesting. Some so many people suffer from sleep apnea. I’ve read a statistic, which blew me away. A billion people in the world, they expect, suffer from sleep apnea. Many have no idea that they have it because they’re asleep when the symptoms are happening. I happen to have a close friend who was in denial. He would admit that he was in denial for two years, that he had a real problem. He didn’t go the dentistry route. I think his situation was a little bit too severe. He went with a CPAP, and he cannot stop raving about how his life has been turned around. He was falling asleep while he was driving. It was really scary.
Dr. Michelle Farnoush: Very scary. And more so because there’s a lot of people, depending on their career paths, who can’t have it on their insurance record, which makes it tough to get the care that they need. I’m blessed to be in a practice where I’m able to learn all this stuff. It’s huge for a young dentist.
Dr. Michelle Farnoush: But it’s amazing to know that sometimes they have to pay out of pocket to get the care that they need. And that’s not always on people’s spectrum financially. So, we need to make it possible for them to get that access to that care. It’s such an important part of dentistry. If you’re doing small makeovers or full-mouth restorations, which I’m grateful that I can do in the practice, that you pay attention to those things because you’re resetting everything.
Dr. Michelle Farnoush: So, combining that and making sure that the flow, like the patient’s experience, the patient’s flow, through making sure that their airway issues are addressed, and then coming in for the dental side are really important. We’re all improving on those. Of course, it’s always a work in progress, but it works well. I think people appreciate it. I always say, “It’s fine if you don’t want to go through with it or you’re not ready to do that yet, but realize it’s my job to tell you.” It’s important, as a provider, to be able to do that.
Dr. Michelle Farnoush: We have great, long-standing relationships with physicians in town here, which are important. There are some physicians we get pushback from, but most have pretty much gone on the bandwagon, even with people that are allergic because we can’t prescribe a CPAP, but we can work with patients. And some people are CPAP intolerant. So, what are you going to do there? So, having those options is huge. And we do Vivos as well in the office.
Rick Cohen: Oh, yeah. We’ve just begun learning about Vivos.
Dr. Michelle Farnoush: Oh, it works! If you can do it with kids, you can do it with adults. It takes longer, obviously.
Rick Cohen: What percentage of the cases are you able to fix without a CPAP with Vivos?
Dr. Michelle Farnoush: Oh, that’s a good one. We started incorporating Vivos in the last 18 months, pretty heavily. Most of our cases are still in treatment. But you can see the difference. You can see expansion. You can see teeth moving. You know it’s working. It can work with brackets. One of my very good friends, who’s an ortho, did his own case with brackets. So, you can do brackets with a Vivos appliance. But to answer your question, how many can you fix? That would have to be something I’d get back to you when they’re done. But, it’s working. We evaluate them the whole time. You can see the expansion. You can see it moving.
Rick Cohen: It does take time. The thing about sleep apnea is that the CPAP machine is not for everyone. So, I would imagine that if you can reduce the problem by 70%, that might still be desirable to a CPAP, which might eliminate it. For that reason, Vivos would make a world of difference. I’m very interested in Vivos in general, and I’m excited that you guys are doing it. You’re right, it’s relatively new. In a year or two, I’ll follow up with you and find out how those patients are doing. So, very cool.
Rick Cohen: I’d like to go back to you for a second. I’d love to know how you decided to become a dentist and at what point did you know you’d become a dentist? Did you know in high school? Did you know in grade school? Did you know in college? How did you get to be a dentist?
Dr. Michelle Farnoush: I took a very nontraditional way of getting to dental school. I like sharing that story. I did a YouTube live podcast with a dental shadowers group, which is a cool group because kids can’t go into offices now. So, they’ve taken everything online, which is really cool. I got to talk to a lot of high schoolers and prospective dental students about this. So I say, there’s more than one way to get there. And it’s important to hear the stories from people who have taken a different route. It’s not just high school-undergrad-dental school. I took a huge wide turn to get a school. Great experiences. But no, I didn’t know I always wanted to be a dentist.
Dr. Michelle Farnoush: I knew I wanted certain aspects of it. I knew I wanted to work with my hands. I knew I wanted to foster a really good relationship with patients. I knew I wanted to have that quality control over my own work. Those are skills that can transcend any profession. I knew I want to be in health care, so that limits it a little bit. I actually was studying to go into cardiothoracic surgery. That’s where I wanted to go. I was accepted into med school after taking my MCAT.
Dr. Michelle Farnoush: I was born and raised in Canada. I went to undergrad at McGill University.
Rick Cohen: Good school.
Dr. Michelle Farnoush Yup! And it’s a super fun school.
Dr. Michelle Farnoush I’m a Quebec resident. I was in my third year, going to the fourth year when I took my MCAT, and then I got accepted into medical school, and from some personal and some professional events, I realized that it just wasn’t what I wanted to do. I worked with a cardiothoracic surgeon at a hospital, and just from things that had happened, I was like, “This is not the life I want.” Doing all the schooling, I realized it just wasn’t for me. That was really hard. But it also came as a big blow because I was at the beginning of my fourth year. So, I’ve missed the cycle for dental school. I’ve missed all of that.
Dr. Michelle Farnoush: My sister, who is eight years older than me, was finishing dental school at McGill when I was starting college. I just pivoted. And I was like, “This is just not what I wanted to do.” It wasn’t like I don’t see myself being in surgery and working with patients. It was just not the field for me. And then, my sister asked me to assist in surgery. So, I went into my sister’s surgery, and I was like, “This is the coolest thing ever!” She was doing this cool, perio surgery and some implants. And I was like, “This is so cool!” The transformation, the relationship, the trust, all that stuff that we come and love to know about dentistry, it was just so cool to see that. And I was like, “This is what I want to do.”
Dr. Michelle Farnoush: So, I was a late bloomer. As I said, I missed that cycle. I had to come up with a backup plan. In my resume, you’ll see that I’m very good at backup plans. In Canada, we have certified dental assisting schools. You have to be certified for the profession so you can have expanded functions, like a level two. So, that’s what I did.
Dr. Michelle Farnoush: I went to Windsor, Ontario, which is right across the border from Detroit. I did my CDA, my Certified Dental Assistant Level II program, and then my internship. I was the first student that was doing an internship at the Detroit Children’s Hospital, and they had a cool collaboration program where you work with children who were born with cleft lip and cleft palate. So, you had everything from psychology and speech pathology to family psychology and all these professions that were here to plastic surgeries that were available to kids from the day where they were born up to 21 years old. It was inspiring to see all that. Dentistry is such a big profession.
Dr. Michelle Farnoush: Then, I took my Canadian DATs while I was doing my dental assisting so I could apply to dental schools. I applied to a couple of dental schools. At the same time, I applied for a business degree, a master’s in business at Harvard. I got waitlisted for NYU, but I got into Harvard, and so I decided to go there. I knew I always wanted to have a business degree. Dentistry is a business, at the end of the day. You need to be able to understand that and be able to strategize and pivot and do things like that. Those are important skills to have. So, I went there.
Rick Cohen: So you were waitlisted at Stern Business School…
Dr. Michelle Farnoush: No, I was waitlisted at NYU Dental School.
Rick Cohen: Oh, NYU Dental School. But you got into Harvard Business School.
Dr. Michelle Farnoush: Yeah.
Rick Cohen: Very cool. That’s quite a safety school.
Dr. Michelle Farnoush: Yeah. It’s not so bad.
Rick Cohen: It’s always good to have a backup plan. When Harvard Business School is your backup plan, that’s a good backup plan. Okay, so they welcomed you, and you went. Did you complete your degree?
Dr. Michelle Farnoush: I did. The funny thing is, I reapplied to dental school, and then I had, of course, another backup because that’s just what I do. My husband always says, “You’re like a Canadian contingency plan.” That’s what he tells me. “You always have a Canadian contingency plan.” And so my backup plan was, I applied to the Institute of Human Nutrition. It was a masters of science in human nutrition in Columbia.
Dr. Michelle Farnoush: At that time, schools were starting to not take Canadian DATs. I was calling and saying, “Hey, will you still take it?” And they said, “Oh, we’ll still take it. We’re not sure if we’re not taking it this year or next cycle.” And I was like, “Okay, might as well try.” And by the time everything closed, and I started getting rejection letters, I called and asked why. And they were like, “Oh, we don’t take the Canadian DAT anymore.” I was like, “Thanks for taking my money.” So, I didn’t get in that round, obviously.
Dr. Michelle Farnoush: Then, I went to Colombia and did my master’s in human nutrition there. I did my thesis in early childhood education and worked a lot with the dental faculty in the graduate programs.
Dr. Michelle Farnoush: I met my now-husband, at the time, my boyfriend, at Harvard. I was working as a dental assistant. When I got my dental assistant degree, I got a partial scholarship for a school in Boston in Cambridge. Then, the other half, [00:19:18]I worked with a pedodontist there [3.3s] to make a living and pay for the rest of my school.
Dr. Michelle Farnoush: When I moved to New York, he had moved to Las Vegas. So, we kind of traveled back and forth, and he said, “Why don’t you look at Las Vegas?” So, I asked some faculty at Columbia about Las Vegas and they said, “You know, everyone that applies from there has great experience.” That was what I wanted. That was more important to me, to have the experience that I wanted in dental school.
Dr. Michelle Farnoush: So, I retook my DATs, obviously the American DATs. While I applied that year, I worked at the research lab at the dental school for a year, which was an awesome experience both with students and faculty. Then, I finally got into dental school here at UNLV. And like I said, it was amazing because I get a ton of experience here. Of course, it’s like dental schools, you can get as much or as little as you want, but we don’t have the graduate programs like NYU would. So, all that work comes to us. It was really exciting to form some great relationships there. Then, I just kicked off my continuing education journey from there. So, that’s my long-winded story.
Rick Cohen: It’s such a cool story. I know there happens to be a dentist with a Harvard MBA who’s on our board of directors. You would be the second one that I know who’s a dentist with a Harvard MBA. Obviously, that’s such a useful degree. I wonder if you ever see yourself in 10 years or 15 years in business, not practicing dentistry? Do you see yourself leaving the practice of dentistry for maybe the business of dentistry?
Dr. Michelle Farnoush: That’s so hard. I don’t think so. I love everything about dentistry. I mean, you can say, “Oh, she’s just too young out of school, and she thinks that,” which is fine. But I don’t know. Just right now, no, I don’t see leaving completely. I’ve done lectures at the dental school and taught. That’s an avenue that I want to pursue for sure. But I don’t want to lose that practice and that pulse on the clinical side of things. So, maybe I would go to like a half-half or something.
Rick Cohen: Interesting. We have time for one more question. And here’s what it is. This will cause you to think a little bit. Imagine an imaginary group of 11th graders who have been selected because they raised their hands and they said they had an interest in dentistry. How would you advise them?
Dr. Michelle Farnoush: That’s a great question. I think I would say, “There are many ways to get to your goal, and you need to embrace that path.” I’m proof that you don’t have to go the traditional route, and you need to take advantage of those experiences and set yourself up. We live in a world where social proof is very relevant. And doing other things makes you more well-rounded. You can connect better. You have better experiences. Don’t be afraid of that. It’s okay. You can still get to your goal. I’m still working on my goal.
Dr. Michelle Farnoush: My continuing education path started very early, from doing Kois and doing AAID and doing all these amazing programs. You need to set yourself up from the get-go. So, don’t think that that’s your end game. Enjoy the journey as you go there, and you’ll build your reputation from that. It’s not just about the cookie-cutter way to get there.
Dr. Michelle Farnoush: You just need to really embrace that and embrace those experiences because it makes you, you. And it makes your reputation, and you need to have that regardless of anything. So, just enjoy what you’re doing. Enjoy the journey. I think one of my mentors told me that. Just enjoy because you know, you’d stress out. You’d stress out trying and getting to all these programs. So, chill out, enjoy the journey.
Rick Cohen: It’s true. I’ve known you since only the beginning of this podcast, but you seemed to me like an education junkie. You mentioned Kois, LVI, Harvard Business School, dental school, and undergrad. It sounds to me like you are a lifelong learner, and it doesn’t sound like you’re finished either. So, I would bet that that would be part of your presentation to the 11th graders as well.
Dr. Michelle Farnoush: Definitely. It doesn’t end there. You know that.
Rick Cohen: It never ends. Right. But if you’ve grown to love it, as you seem to have, then you’ll look forward to whatever your next experiences.
Dr. Michelle Farnoush: It’s inspiring. I love going to CEs. You have to plan it strategically, right? It’s not something where you like, “Oh, I’ll sign up for this assignment for this, and I’ll sign up for that.” You don’t want to do that. You want good presenters, high-quality. You want to go where you can see people whom you can really learn from and have takeaways. It’s what you need to be able to continue. It’s lifelong learning. You can’t just stop.
Dr. Michelle Farnoush: It’s inspiring to go to these meetings, and you’re motivated. You’re reenergized. Dentistry can get tough. It is tough. One day, you’re like, “I’m so great at this job.” And then, the next day you’re like, “This is terrible.” It can have those ups and downs, but it’s definitely motivating. And programs like 40 Under 40 remind me you many amazing people are out there. So, it really does energize you.
Rick Cohen: Dr. Farnoush, thank you so much for taking the time off your Saturday morning to spend some time with me to be on this podcast to tell us a little bit about your background and how you got to where you are today. Congratulations once again on being a 40 Under 40 nominee and winner for 2020. It’s been a pleasure meeting you and getting to know you. And I look forward to seeing you at dental events in the future. So, thank you once again.
Dr. Michelle Farnoush: Likewise. Thanks so much, Rick. I appreciate it.
Rick Cohen: You, too. Bye-bye.
Dr. Michelle Farnoush: Bye.