About Gary Wald
Gary’s career includes stints with major advertising agencies (Ogilvy & Mather, Grey), consulting firms (Luminant) and Fortune 500 marketers (NBC, GTE/Verizon, Medtronic). He is adept at launching and building new brands and new companies. His expertise includes growing revenues and profits, customer acquisition, business development initiatives, and strategic alliance partnerships.
Prior to becoming the CEO of The TeleDentists, he was a co-founder and EVP of Teladoc Health where he helped build that company into a leading telemedicine services provider.
Gary earned an MBA in Marketing from Northwestern University.
About Dr. Maria Kunstadter
Dr. Kunstadter graduated from U.M.K.C Dental School. While there, she co-founded the U.M.K.C Dental Outreach Program. The program has taken students, faculty and alumni to third world countries to provide dental care for 25 years. Dr. Kunstadter has led and participated in over 24 medical mission trips worldwide since 1982.
Dr. Kunstadter has been in private practice of dentistry for over 30 years. In 2001, she co-founded The Smile Salon, the Midwest’s first Dental Spa. In 2004, she was designated an “Innovator “by the Invisalign Corporation. In 2008, she achieved the designation of Elite Preferred Provider with Invisalign, which is awarded to only 1% of Invisalign providers in the world. Dr. Kunstadter was the first woman dentist to be awarded this honor. She is an international speaker with Invisalign and continued to receive Elite Status during her tenure at the Smile Salon.
In 2013, Dr. Kunstadter was appointed the Dental Director of The PAINS Alliance of Kansas City, an organization developed to address chronic pain nationwide.
She is the co-founder of The TeleDentists, the first Teledental platform to provide dental consultation services to the healthcare industry.
About The TeleDentist
The TeleDentists is pioneering tele-dentistry with an easily accessible solution to urgent oral and dental problems 24/7/365. A proprietary, national network of Board Licensed dentists use secure online video consults to connect with patients’ smart phones, laptops or tablets. They diagnose problems, start remediation and, when needed, arrange next business day appointments with a conveniently located dentist. The service is available to hospitals, urgent care facilities, retail clinics, self-insured corporations, senior-living centers, universities and telemedicine service providers. Visit www.theteledentists.com
U.S. Domestic Medical Travel (USDMT):In your own words, tell us about The TeleDentists model and how it’s changing the way patients receive dental care.
Dr. Maria Kunstadter (MK): I am a dentist and have been for a long time.
The idea for developing The TeleDentists arose in 2013 when I was in Washington, DC attending a pain organization meeting. The FDA was just beginning to crack down on narcotics.
All the medical people in the room kept referring to the number of people that were going to hospital emergency rooms (ERs) for toothaches. That was the craziest thing I’d ever heard of because there were no dentists in ERs. They are extraordinarily expensive, the wait time is ridiculous and there are no dental specialists in the ERs so no treatment is rendered.
So, together with several smart people who were into telehealth, we determined the need for a “virtual dentist” in the ER.
In my practice, pharmacists say all the time that people walk up to them and say,” My tooth is killing me! What should I do?” The pharmacist advises them to go see a dentist.
But in the real world, going to see a dentist is complicated. It could take up to six weeks to get an appointment as a new patient. That simply won’t work because the patient is practically dying right now from tooth pain.
Unfortunately, when somebody calls and says they are in pain, the dental office will immediately ask, “What type of insurance do you have? Can you pay cash?” If the patient can answer affirmatively, the dentist will respond, “How soon can you get to the office? “
USDMT: How is your model addressing this problem?
MK: Our proprietary, national network of Board Licensed dentists use secure online video consults to connect with patients’ smart phones, laptops or tablets. They diagnose problems, start remediation and, when needed, arrange next business day appointments with a conveniently located dentist.
Within 24 hours the patient is in a dental chair and getting treatment.
USDMT: If someone has dental insurance, can they still talk to a TeleDentist?
Billions of dollars of dental insurance go unused because people are afraid of two things at the dentist: how much is it going to hurt and how much is it going to cost.
With dental insurance there’s usually a copay, for some portion of the bill — usually paid out of pocket. People still fear that the visit is going to cost them thousands of dollars and they don’t even use their dental insurance.
That’s one of the educational components of this model. We talk to the patients and discuss their options, including associated costs.
We can get them to see a provider in their dental network or to providers that are screened by insurance companies. This “gets them over the hump” if they were reticent about going to the dentist.
Our role is to get them to the right place and get them taken care of.
USDMT: What is the market need that you are answering?
Gary Wald (GW):First of all, the data shows that 2.1 million people went to an ER or urgent care clinic in 2015. CMS did a study in which they concluded that for every one patient who goes to the ER with a toothache, there are probably three more who suffer but don’t go.
There’s six-seven million people annually who have this urgent oral pain need and need to get some type of care. Part of that is triggered by the average person in this country who hasn’t been to a dentist in three years. It’s inevitable that these kinds of problems are going to arise.
As Maria said, even though those who have dental insurance don’t go the dentist because they don’t think they need it and can wait and put it off, etc. When these unexpected problems arise, they don’t know where to turn.
We want to become the place that people turn to.
We provide oral care and at the same time we also provide a lot of information about the importance of oral health to overall well-being.
In the long term, what we are integrating oral health into the overall well-being of the patient and stressing the importance of having a regular dental home.
MK: This is a perfect time to discuss the primary care component.
The Academy of Pediatrics and the American Academy of Family Practitioners recommends that oral health be part of primary care visits. During the three years that people don’t go to the dentist, they still visit their primary care provider more than once during that timeframe. But the issue remains that primary care physicians do not want to perform oral health exams.
Therefore, we have a component of our package that answers this challenge, and we’ve digitized the exam to reside on a tablet or a computer.
Here’s the scenario: If a patient is sitting in the exam room waiting for the doctor to come in, they can go through the oral health component. We provide all the training, describe what can be done and billed by the primary care provider, and actually get patients into a dental home.
USDMT: We see that you recently announced a partnership with Call A Doctor Plus. Tell us a little bit about that.
GW:As the co-founder of Teladoc back in 2004, we started telemedicine with PCP’s. Over the years, the telemedicine companies have added specialists to their service offering.
It started with tele-radiology with radiologists working remotely. This evolved into teledermatology, which became a big business. Doctors are able to look at skin abnormalities and make a diagnosis.
Behavioral health soon followed the path to telemedicine as a way for psychologists and psychiatrists to consult with patients using telephone or video consults. Interestingly, research shows that behavioral health patients are much more comfortable talking on the phone than sitting on a couch in a doctor’s office.
Today, wellness care is a component of telemedicine and there will likely be more aspects of healthcare taking this route.
What we have said to the market is that we are a natural extension of specialists that should be added to the repertoire of virtual care companies.
Because it could be done, because there is a need and because this is the future of digital communication, we are a natural fit for virtual care.
We announced a partnership with Call It Doctor Plus, a bundler of benefits that markets and sells to companies with 200 – 300 employees, most of whom have high deductible health plans. One of the products they sell is Teladoc and they’ve now added a TeleDentist benefit as another product in the bundle.
USDMT: Do you have any competitors?
MK: We are the only company that is performing virtual care consultations on a national level. We have a dentist in every state providing that service 24 hours a day. We are the first and we obviously won’t be the last.
If you Google the term teledentistry, you will find companies organized with dentists who will send their hygienists out to see patients.
There are only six states that allow hygienists to utilize a remote computer that can take an X-ray. So, if that patient needs to come in and see the dentist, they are free to do so. If the patient is fine and doesn’t need to come in, the hygienist can do the cleaning.
USDMT: What is the role of hospitals and urgent care centers to leverage this service?
GW: We license our cloud-based service to hospitals and urgent care clinics with the idea that if a patient is going to come into that facility, it is not cost efficient to have ER doc deal with this Level One problem.
The hospital loses a lot of money doing so. The more cost-effective way is for the hospital to install our cloud-based services on a computer in its ER department and let our on-call dentist treat that patient. The same holds true for urgent care centers.
In other kinds of facility-based locations — like a college or university with a medical center — but there’s usually no dental services available. We are a natural fit for these sites.
At a senior living center where the doctor visits periodically with elderly patients, there is nobody addressing the dental problems. WE are again, a good fit for this environment.
At the on-site and near-site clinics of self-insured corporations, again there are no dental services.
For all of these facilities, we are an ideal solution to provide dental care.
We do not sell directly to the consumer. But through middlemen, brokers and insurance companies, we reach consumers, save them money and deliver value to the payer.
MK: With regard to medical travel, and for those members that might be enrolled with a telehealth company, we expect to have an international platform.
If you’re outside the US, wouldn’t it be nice to have access to a TeleDentist who could offer you advice?
USDMT: Just to clarify, if I was overseas and I needed an antibiotic, would I be able to call The TeleDentists for that?
MK: Yes, you could go online and do that while oversees and then walk into a pharmacy and pick up the prescription. And you could be getting valuable advice for accessing care out of the country.
You will get advice on the right medication to take – over-the-counter or Rx.
USDMT: Is there anything else that you want to add?
GW: I think it’s important that hospitals and urgent care facilities really understand how we add value.
We’ve seen some numbers that suggest the hospitals spends $450 in triaging a patient when they come into the ER — that’s all patients, not just people with toothaches. But that’s such a horrible waste of money. If someone has a dental problem, our service is a fraction of the cost.
I guess the other thing to mention is we are currently US only but we are beginning to have inquiries from countries outside the US seeking access to our service. We invite those countries to contact us.
USDMT: That’s awesome and would definitely be an interesting expansion — and we’d love to speak with you again when that happens.