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08 Jun 2017

By Stars Of Dentistry


"All roads eventually lead to Kois". An interview with Dr John Kois

John Kois is a big name in dentistry and delegates in their droves travel to Seattle, USA to learn from him. 


John C. Kois - Color Photo.jpg


Dr John Kois is one of the most sought after speakers in the world of dentistry today. He is an acknowledged occlusion expert, a gifted teacher and one of few truly inspirational dental thinkers. The list of students at his impressive learning facility read like a who’s who of dentistry in the USA. It seems Dr Kois is considered to be one of the best; as one delegate told me, ‘All roads eventually lead to Kois’. 

The complete cycle of courses offers what Dr Kois calls ‘a postgraduate programme for practising dentists,’ which might translate as, ‘an MSc for those of us who still have businesses to run’. Consequently, his methods are simple and understandable and really can be applied in day-to-day practice.

Despite his pre-eminent position in USA, Dr Kois remains relatively unknown here in the UK, so I caught up with him during a trip to Seattle late last year.


I suppose we should get one thing straight from the start. How do you pronounce your surname?

Kois, as in boys.


I understand you are from New York originally. What brought you across to Seattle?

I worked in the air force for a number of years. I had a general practice residency, after which I wanted to do a perio/prostho postgraduate programme. At the time there weren’t that many of them in the country, but there was one in Washington State. I had graduated from the University of Pennsylvania and I wanted to go to a different school.


You are famous for your systematic approach to dentistry. Do you have a systematic approach for everything in your life?

Yes, even going to the airport for trips. I park my car on the sixth floor so I always know where it is when I come back. It’s impossible to keep track without a system. I also have great support staff. Without delegation it’s impossible to keep up with the things I’m involved with in addition to the teaching centre; for example we have recently established our own research laboratory here at the centre. I have standardised in an attempt to stay organised because I’m always travelling.


Can you give us an idea of your schedule?

Typically at the teaching centre I do 40 courses a year and they’re three days each. I do another 40 or 50 courses on the road and I practise 60 days a year. That doesn’t leave a whole lot of time for much else when you add in travel time.


What kind of hours do you keep? 

I get up at 4.30am, I arrive at the office by 5.30am and I work until about 5pm usually. I don’t typically work in the evenings, or at least I try not to. 


You have been working in this profession for 30 years. What is significant for dentistry right now?

Every dentist is exposed to all the latest information, but we really struggle to apply this information in our daily practice lives. It can be difficult and costly to update our practices constantly to accommodate all these new ideas and we also need to make a living. We are in healthcare but we are also in business; we have to be fiscally responsible for how the care is delivered. We have to make sure that certain things happen, while working with a corporate bias.


Do you think there’s going to be a future for individual practitioners implementing new ideas, or will corporates run the show?

I think there is an incredible future for dentistry but I do see two tiers. I see basic care delivery, which for the most part will be government or corporate sponsored centres, like NHS or managed care in the USA, but I also think practices that differentiate themselves from this basic approach are going to be in a whole different position. I think many patients do want quality care; they want people (not organisations) to take care of them and understand their needs. Unfortunately too many dentists want to provide this type of practice, but they’re not willing to do what’s necessary to differentiate themselves; they may do it in mind but not in spirit.


How could dentists differentiate their practices? What would you suggest?

Too many dentists wrongly assume that the patients value their service and care, but in reality most patients look at what we do as a commodity. Many patients feel one gold crown is the same as the next, an implant is an implant, a veneer is a veneer and so on, and as dentistry becomes more of a commodity, patients just shop on price alone. I think the key is to change the culture of your patients. Patients need to understand its not just like for like, furthermore, it’s not just a service either because they have to respect our judgement. People pay me for my judgement, not what I do.


If you had the opportunity, would you go back to full-time practice?

I actually love practice. I really enjoy the patients that I have the opportunity to treat. I still have enough of what I do to maintain my interest. I’m very fortunate to be able to do the things that I was trained to do and even though I have a smaller practice now, I still get enough of the more comprehensive things to do because what I don’t have for the most part is healthy patients. Every patient that I treat requires a lab fee, and some aspect of interdisciplinary care.


You obviously enjoy being a dentist, but is there anything else you would like to have done?

I had two other career options. One was teaching (I wanted to be a school teacher) and I also wanted to go into IT. I worked for IBM; that’s how I supported myself through college 35 years ago. However, through the centre, I’ve now been able to blend both with what I do as a dentist.


What is the most satisfying aspect of what you do?

I think there are many aspects of being a dentist that I love, but above all I love being able to enhance people’s lives; not just for my patients, but also the dentists that come to the centre. I’m grateful for the all opportunities dentistry has provided me with. I’m grateful for the freedom it’s provided me in life choices.


Do you see a downside to a career in dentistry?

I don’t really believe there is one. I think many people in our profession are very committed; that’s part of being a professional, but this does make it difficult to achieve a work life balance. I don’t blame this on dentistry specifically; we as people are at fault. There are ways to achieve that balance but it’s not easy.


Who’s inspired you in your career? 

Firstly, Morton Amsterdam and Dewalter Cohen; both have been to the centre here. I was very grateful that they travelled across the country to see the centre and sit in the back of the room. But there have been many other influential people in my life as far as dental professionals go; Lloyd Miller in Boston Massachusetts, Ralph Udelis, the director of my postgraduate programme, and of course, Peter Dawson – and you certainly know who he is, even in the UK!


What do you see as the single biggest problem facing the profession? 

I think dentists are regularly placed in a very difficult position; they recommend things that are in the patients’ best interests, but the patients believe they are being sold to. Unfortunately we get misunderstood a lot and certainly that’s a frustration we all face.


Can you give an example?

A patient presents with a stainless steel crown. It’s not giving the patient any problems, but it doesn’t fit very well. However, it’s been there for 25 years and the patient resists having the treatment that we believe would be in their best interests long-term. 


Would you say the price is a factor? 

Price is always an issue for some people, yet it’s absolutely not an issue for others. I think it’s person dependent.


What would you do if you won the lottery?

I would still practise dentistry but nowhere near the pace that I’m practising at the moment. I think I would probably do everything a little bit less and spend more time boating. (If you do come to Seattle, you will discover John owns a very impressive boat. The delegates and their families are always invited aboard for an evening social cruise on Lake Union and Lake Washington. Its one of the highlights of the course.)


It’s a very impressive vessel, but if the growth of the centre continues, I think you’re going to need a bigger boat…

I have no desire to make the centre any larger. Most courses are transactional and we’re trying to be transformational. I know that’s somewhat of a cliché, but we’re actually trying to make that happen here and I don’t believe it’s possible with a bigger group. This is why we have our mentors in the room; we are trying to create more intimacy, with smaller groups within the group. 


You could obviously generate more revenue for the centre if you expanded the numbers on each course. There is a waiting list and each course could be sold more than twice over.

Of course once you limit the size of the room you limit the income potential, but I am comfortable with that. Our business strategy allows for this, but like anything else, you have to remain competitive, and teaching is no different. There are others in this business with external financial support, capable of building elaborate teaching facilities, bringing in elaborate technology and so on, but I’m not convinced the facilities are what really matters.

It’s just like general practice. Patients might come for the wonderful facilities the first time, but you must deliver. Delegates don’t come back for the luxurious facilities; they come back for the person, just like your patients do. It’s my belief that if I can help my delegates understand how to create more growth in their own practices, that’s what they will come back for. The wonderful building is just the icing on the cake.


There is now an established network of instructors and mentors who have graduated from the centre who work with you. Are you pleased with what the Kois Center has become?

I spent the early years trying to build up the education side of things; this was before the centre had any type of business concept. We now have a solid business strategy for the centre so we can actually afford to deliver unbiased information. The centre is self-financing now and we’ve struck a balance; altering this balance would damage the core values that this particular teaching centre is known for. Everything feeds back to integrity. In every business there’s always a level that we reach without diluting the integrity; you just have to find out what that level is for you.


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