#56: Dr. Daniel German (orthobrain)

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Dr. Daniel German (Orthobrain) [00:00:00]: If I can help lead the transformation of the way orthodontics is delivered so that anybody who wants it has access to it because we've lowered the cost Land we've increased the accessibility to it at a great level, then I know that we're allowing people to be able to have more control of their lives to be able to elevate themselves and be able to get get to the point where where they have the same opportunities.

Jeffrey Stern [00:00:27]: Let's discover the Cleveland entrepreneurial ecosystem. We are telling the stories of its entrepreneurs and those supporting them. Welcome to The Lay of the Land podcast where we are exploring what people are building Cleveland Land am your host, Jeffrey Stern. And today, I have the pleasure of speaking with doctor Dan German. Doctor Dan German is is a man who loves smiles, all kinds of smiles, so much so that he's devoted a lifetime to bringing more of them to the World. Land this may sound tongue in cheek, but you will find through this conversation that Dan's enthusiasm for his work is infectious and genuine. 30 plus years ago, doctor German started an orthodontic practice that became one of the largest privately held practices is in the entire country where he has cared for over 30,000 patients. Through this, he became an orthodontic pioneer in the field, and today he is well known throughout the dental world for educating thousands of professionals.

Jeffrey Stern [00:01:35]: In 2016, Doctor. German transitioned from his practice to found OrthoBrain. And OrthoBrain has effectively transformed the delivery of orthodontics, Solving the global orthodontics skill shortage with proprietary technology that puts a virtual orthodontist Chairside with every single dentist. Now, dental practices from around the globe have access to doctor German's predictable and proven systems And to the orthodontic experience that enables them to create successful orthodontic outcomes for their patients at scale. Doctor German has served as faculty in orthodontics at The Ohio State University College of Dentistry, where he trained post doctoral residence and was an attending clinical doctor, and for the past 25 years, he has traveled the world as a keynote speaker teaching orthodontics and business optimization to specialists and general practitioners alike, which includes teaching tours in Australia, New Zealand, Africa, and throughout the USA. Recently, he was a full day keynote speaker at the Global Orthodontic Program at the Greater New York Dental Meeting, Where 53,000 people attended the conference. And in 2014, doctor German received what he considers the crown jewel of his career, The Distinguished Alumni Award from the University of Louisville Orthodontic Department, which is only the 2nd time The award has ever been bestowed. Throughout doctor German's career, all of his energy has consistently been focused Stern giving people the confidence they need to achieve more and making more smiles happen, dentists' smiles as well as patient smiles.

Jeffrey Stern [00:03:17]: And I can tell you that Dan had made me smile more than a few times throughout this conversation, which I very much it. I would love to start with with your professional journey. It's it's, like, very clear to me already how How much passion you have for the work that you do, and I'd love to hear the story of what what brought you to the world of of orthodontics and and How that's evolved through your own practice, to teaching, to Entreprenuership. Tell us about it.

Dr. Daniel German (Orthobrain) [00:03:59]: Well, I ended up in dentistry primarily because of Coach Woody Hayes at The Ohio State University. You may wonder, What does Coach Hayes have to do with me becoming a dentist? It goes back to the fact that he never recruited me to play football at Ohio State. And once I didn't get the invitation to play football at Ohio State, That blew the entire plan to play football for the Cleveland Browns, and therefore I had to find some way to be able to earn a living and support a family when I became a grown up. So I quickly pivoted to doing what many parents of my era back in the 70s, parents at least in my community Land, I'd say folks that were immigrants or first, 2nd generation immigrants really wanted their kids to be doctors, lawyers, accountants, some sort of professional in order to ensure that you'd have a respectable way to learn to earn a living. I felt that there was a lot of push towards becoming some sort of doctor, and I really like the idea of dentistry. Dentistry gave me that opportunity to be active all day, to use my hands, take a little bit of that, call it that desire to have a physicality to what I was gonna do. In other words, I wasn't gonna be an athlete, Jeffrey, but could I use my Land, could I use the eye hand skills that I had, that fine motor skill Land my desire to always be in motion, to move all Lay? I couldn't imagine sitting at a desk. And so I endeavored to pursue a career in dentistry.

Dr. Daniel German (Orthobrain) [00:05:34]: Regrettably, I didn't have great credentials. I was really focused on sports as a youth Land managed to find a way to get into dental school. It's kind of a cute story how I feel that I got into dental school. Sure. But, but I got in there. You seem a little interested in this story.

Jeffrey Stern [00:05:50]: It's a little bit Yes, please.

Dr. Daniel German (Orthobrain) [00:05:52]: The Prudential were a little bit on the weak side coming out of high school, and had some success in college. I ran out of money, Jeffrey, and so I applied to dental school after 2 years of college, and so I hadn't really completed all the coursework Land I didn't, to have all the skills to take the dental aptitude Stern, and score really high on it. But I went in for the dental school interviews, and I remember this fella, a dentist who had been in the Lay, and he looks at me and he's reading my application Land he says, You know, I'm looking at this and it says that you're the state weightlifting champion from high school. He says, You don't look very strong. I said, Well, I'm strong, it's genetic, I'm sorry I put it on there. He says, No, but you really don't look strong. He says, How could you be a weightlifting champion? I said, It's genetic. My father was an athlete, my grandfather was probably very strong.

Dr. Daniel German (Orthobrain) [00:06:42]: We're just strong people. It's nothing, Let's move on! He says, You know, I'm just not buying it. He says, How strong are you? He says, Did you know how to arm wrestle? I said, Yeah, I could arm wrestle. He said, How good are you? I said, Nobody ever beat me. He says, You don't look that strong. He said, I was in the Lay! Land when I was in the Navy there were 1800 guys on the ship, Guess who the arm wrestling champ was? I said, Probably you? He said, Yeah! He says, You want to arm wrestle? I said, Sure! And so I arm wrestled this dentist who was probably in his 40s, I thought he was a dinosaur at that point, but he was probably in his 40s, a little bit of white hair, and we arm wrestled, and when I beat him you said, Wow, there's no exaggeration, you weren't hyperbolic on your application. For some reason, I claim that that's one of the reasons that I got into dentistry, and when I got into dentistry, Jeffrey, it was really frustrating. I found it Extremely difficult, and I never was happy with the work that I did, so I thought, wow, if I specialize, I could be really good in one thing.

Dr. Daniel German (Orthobrain) [00:07:43]: Land I could do orthodontics because orthodontics is different than dentistry. You know, you can only keep a drill on a tooth for so long Land then there's no more tooth, you just ground the whole thing away. You know, and to be perfect was too hard, and I thought with orthodontics I could just work it until I was really giving people a perfect outcome. So I applied to orthodontic residency and I of the idea of being a doctor and taking care of patients that didn't have any disease. There's no illness, nobody's sick, nobody has an section, they come to you because they want to come to you. So I found it very appealing. So that's really how I ended up in orthodontics Land I had a really simple goal at the The, all I wanted to do was be the best in the world at it, and so I know you can see In the video, but all those books at the top, those are orthodontic journals going back to the 1930s. So, I bought all of the orthodontic journals that were ever printed, I read them all, and my mission was to become the best.

Dr. Daniel German (Orthobrain) [00:08:37]: I think when you become a doctor, particularly a procedure oriented doctor, you develop a huge dose of humility and realize Not only aren't you the best, but you're probably never going to be the best. It's like the tagline that Lexus used to have, The passionate pursuit of perfection. I Came The orthodontist Land I was thrilled with it. It was one of the most gratifying things I could imagine doing to be able to touch lives in such a positive way. You get to touch lives because of the smile and the confidence that you gave people, or that I was able to give people, but also in the way that you care for people. You know, there's care in terms of the medical treatment, but then there's the The, how do you treat your team, how do you treat your patients, How do you treat all the people that you come in contact with every day? And I found that incredibly powerful, and from there I had abundant success, and I became Probably one of the largest practitioners, I was told I was the largest private practitioner in the country. I'm sure I wasn't, but it was of that magnitude, and so I quickly began being invited to give seminars. Even when I was in my late 20s I was already a speaker on the The, Land then I got hired by 3M to help be an advocate and help them develop programs, and became attached to a mutual friend of ours, Doctor.

Dr. Daniel German (Orthobrain) [00:09:55]: Marc Lemshin, who had an amazing product that he developed in software and orthodontic imagery, and fully immersed in our profession. I lived and breathed it while I was raising a family, and what caused me to to pivot and really change my focus was becoming a patient. I became a patient in my mid thirties. My opinion is that if you want to be any form of doctor, you should have to be a patient first, and then you learn how to listen. And therein is The, probably the genesis, the foundation of what eventually became OrthoBrain. It was becoming a patient and experiencing the healthcare system from a patient standpoint and realizing how much work needed to be done in order to fix or help fix a system that is is suboptimal is probably a kind way to frame

Jeffrey Stern [00:10:52]: it. What what were some of the problems that You saw as a patient that you did not pick up on in your time practicing.

Dr. Daniel German (Orthobrain) [00:11:02]: So, let's start with access to care. Think about this, Jeffrey, I treated probably 30,000 patients in my career, and I practice in a great city called Dayton, Ohio. I knew all the different types of doctors, I had every kind of possible connection you could possibly have, and when I became a patient in my mid 30s, I realized how difficult it was to get access to care, to see specialists, to get in there and see the biggest specialists. So if you need somebody is at the very top of their game, because you have a serious medical problem, it's hard to get an appointment. To this day it's hard. It's just as hard now as it was back then, and we live in this probably, I would say The we're in about the best place you could possibly live here in Cleveland, Ohio If you need healthcare with all the great facilities that we have between Cleveland Clinic, Metro, Case Western Reserve, Brilliant doctors and funding for technology. It's fantastic what we have here, but it's inadequate. So it's hard for me to get appointments.

Dr. Daniel German (Orthobrain) [00:12:07]: And when I did get the appointments, if I was outside of the realm of The world of people who knew me, and I was a patient, even though I was called doctor, I felt like a hunk of meat being passed around, that people would take hold of my arm and start doing things to me, and I said, Wait, Who are you, Land what are you doing? Yeah, so some of the basic courtesies were absent. So as I became a patient I decided that Whenever I was an educator, I was gonna help inspire people to care for each person as the precious creature that they are. That every person should be treated with the utmost dignity whether they can pay, they can't pay, whoever they are, that everybody is precious and should be treated as so. So I started to weave that into all of my education Land that became my passion. Transform the way healthcare is delivered in the sense way we interact with each other. Land that was the beginning of my whole idea to transform the way healthcare is delivered, and that was in in the mid nineties. The the access to healthcare problem was in front of me in the late seventies When I needed to use the free clinic in Cleveland for medical care, I didn't have money Land I didn't have insurance back in the seventies. I was a teenager living in East Cleveland, and when I was sick I didn't have anywhere to go, so I went to the free medical clinic.

Dr. Daniel German (Orthobrain) [00:13:28]: Land at that point I decided that I was going to do something in my career to improve access to care, and then I realized it was the way we deliver it in terms of the human interaction. And then you get to the digital revolution. Land with The digital revolution, I was able to leverage everything being digital to be able to Cleveland my knowledge, to be able to care for people outside of my office. Right? So prior to any form of telemedicine, you had a doctor who could see 1 patient. You could see 1 patient at a time. When you become an educator, you can judge The doctors to do the same, but you're still really, really limited. What would happen when I'd go out on those speaking gigs is that orthodontists and general dentists would send me x rays and molds of teeth and say, Hey, what do I do? I'm stuck with this patient, and so I could give these advisory services, but it was all analog. You can't really scale that.

Dr. Daniel German (Orthobrain) [00:14:27]: Here comes the digital revolution, and everything is on the computer, and all of a sudden The light turned on, and in 2016 Stern realized, Lay, I can transform the way healthcare is delivered. I can take my knowledge, the knowledge of a specialist, and I can share that with any dental provider on the Land, anywhere, and they can deliver the care. So if you look at orthodontists, you apparently had the benefit of orthodontics, you've got an amazing smile, And you probably noticed that your orthodontist was more of a conductor than a craftsman. That the orthodontist, The reason I had such a large practice is because it was intuitive to me on how to operationalize my business in order to be able to care for more people. So we were able to take the least costly person who could do the job properly to do each portion of the orthodontics. And that happens in medicine to some Stern, you know, It'd be scary if the brain surgeon had to try and start your IV or draw blood. There's somebody who knows how to do that better than the doctor. I used that kind of mindset for every aspect of my practice.

Dr. Daniel German (Orthobrain) [00:15:42]: And so eventually, Jeffrey, I became a conductor of a symphony of consistency, of excellence and profitability. And I realized that with the digital revolution, I could provide that same sort of know how to dentists anywhere on the planet. And that's how we're going to transform healthcare. So if you say, What's the big idea? Big idea is I want to transform the way healthcare is delivered. I'm an expert in dentistry and orthodontics, so I'm doing it in that model first, but if you want to know what the future holds, I would love to be able to do that in rheumatology, endocrinology. Think of all the different ologies that are out there where we could take a really knowledgeable practitioner, and have them describe and coach The Practitioners that are general practitioners or mid level providers on how to deliver the care.

Jeffrey Stern [00:16:36]: Yeah. Yeah. So I think I I think it might be a good place to just kind of outline what OrthoBrain is, and then we can get a little bit into How it works Land some of the other factors of play here. But, I have many questions for you.

Dr. Daniel German (Orthobrain) [00:16:54]: I have a different way of looking at OrthoBrain. I believe that OrthoBrain is a group of extremely committed and talented people that have embraced this dream of mine, converted it into a vision, and now are putting their hearts and souls into transforming the way we're delivering orthodontic care. That's what Ortho Brain is, it's not the answer that I think you typically would get. We're, what we do is we solve the lack of orthodontic skills on a global level so that orthodontics becomes of, and it's all done using proprietary software that we wrote. So we connect Dental providers with OrthoBrain, and at OrthoBrain, we have a whole team of experts that are orthodontists, The technicians who know how to do the actual clinical work, experts on business optimization, how to schedule, how to offer financing, how to have talk tracks between the hygienist and the patient to make them aware, education, we're turnkey. Anything that the dentist needs, they're gonna get from us. If they Lay, We want to do orthodontics, terrific! We can give you the education, the support, the instruments, the supplies, everything comes in a box Land, you own us once you hire us until you have raving fans for patients. So it is it is a there's a software platform, so yes, we're a technology company that has a human interface in it, at at least for now.

Jeffrey Stern [00:18:30]: And and just some context here, how much of Orthodontics today is delivered through orthodontists versus general practitioners, the The dentists. And as you've Come to to market, if you will, with this vision for increasing access to care by by kind of leveraging technology to to make orthodontics More accessible to general practitioners and dentists. How has that kind of worked in in real life? What has been The kind of reception to it from from the the industry.

Dr. Daniel German (Orthobrain) [00:19:06]: Yeah. It's a it's a great question. Keep in mind that Probably close to 70% of the population would benefit from orthodontics. There's seven point 3,000,000,000 people on the Land, not that we can count all of them living in some of the really big countries, but 7 a half 1000000000 people, More than half of them would benefit from orthodontics. Now, don't fall out of your chair, but less less than 1 1 thousandth of a percent were treated last year. Even if I'm off by a factor of 10 or a100, there's probably close to a 1000000000 people that would benefit from our treatment, and they don't, they can't get the care. There are probably 8,000 practicing orthodontists in the United States, and we have the greatest number of them per capita. 8,000, maybe 10,000 if you count guys like me who aren't even seeing any patients, right? And so the need is gigantic! And the impact on patients it's hard to measure.

Dr. Daniel German (Orthobrain) [00:20:08]: When I first went into orthodontics, it was elective Land it was because people had money and and they want it to look good. It was aesthetic. The medical research has come out and found that your peers rate you is less intelligent, a weaker leader, less trustworthy, less likely to be successful if your smile is screwed up. Totally unfair. This is in the medical literature. So the importance of this is so big that we have to do it. And because the opportunity is so big, Wall Street figured it out. And so Wall Street is now in the game as well, trying to get it out.

Dr. Daniel German (Orthobrain) [00:20:49]: So what's the reception? The reception from patients has been phenomenal. So for the Thousands of patients that we've cared for, there are a lot of raving fans. In terms of the general dentists who use us, It's probably the most profitable thing they do in their practice, it's one of the most highly leveraged things they can do in their practice, and it's one of those things that really builds their practice because patients, whoever calls a dentist says, Hey, I was thinking maybe I'd like a root canal, or maybe Maybe it's like a wisdom tooth pulled. No, they want their teeth to be whiter, brighter, and straighter. So now you're offering something that patients want, and so it really helps the dentist out in terms of their ability to pay back their student Land. General dentists love it. Orthodontists come in 3 different forms. Either they love the idea and they're opportunistic and they want to invest, or they want to work with us because they'd like to improve their revenue while they're on their balcony in Naples, right, or pay back their student loans while kids are asleep, and then you have those who are territorial Land they just have an immediate guttural reaction that is extremely militant against anybody doing orthodontics other than a specialist.

Dr. Daniel German (Orthobrain) [00:22:12]: And for them, thank God, nobody has really given me a hard time about it. I think the beauty is that I've been in our profession as a contributor to orthodontics at the conferences, publishing the articles, supporting all the universities. You know, I'm as straight laced looking, mainstream Extreme orthodontists, as you could imagine, in terms of appearances and what I've always been willing to do for the The, so I think I got a pretty good pass from a lot of people where they said, well, maybe I'm up to something that's good. And so we're creating another channel, another method for orthodontists to be able to practice other than having a bricks and mortar office. So for many of them, they're really enthused about what we're doing. So there's no shortage of orthodontists to help us out. There are plenty of them that wanna do the work, and it's having a big impact on the accessibility. So now we have a lot more orthodontics being done by general practitioners now than we had in the past, going back to your original question.

Dr. Daniel German (Orthobrain) [00:23:14]: Worldwide, I believe that more orthodontics is performed by general dentists than by orthodontists, and I was surprised to find that, but there are countries that have very few orthodontists, if any, where they don't have an orthodontic residency program to train them. So An example might be a country like Land, where treatment is in great demand, but only Maybe 10% of all the providers are orthodontists. 90% is done by by general practitioners. You have countries that that really just don't have access to the specialist. Land even in this great state of Ohio, we don't have enough Mostly orthodontists live in metropolitan areas. If you graduate at the top of your class in high school, then in dental school, then you go to orthodontic residency, and now you're 30 years old and you're ready to go practice, you're going to want to go to an amazing place like Cleveland or some other metropolitan area that has all the cultural advantages. And it's very difficult to get specialists across all of medicine and dentistry. All forms of medicine have the same problem.

Dr. Daniel German (Orthobrain) [00:24:22]: Sanford, 65% of all the counties in the United States do not have an orthodontist, and I would dare say that it's the same thing if you try Land find a urologist, a neurologist, They're not in most of the counties in the United States. Most of those specialties have about the same number of specialists as orthodontists, so it's a huge need.

Jeffrey Stern [00:24:40]: When you think about Land of the grander vision and ambition you have to to expand access globally, Where is OrthoBrain right now in that trajectory? How have you Land of focused where Land the The kinds of practitioners you're able to offer these services to, and and how you get to the global increased access that you're you're working towards.

Dr. Daniel German (Orthobrain) [00:25:05]: Yeah, the pandemic changed the world, and it changed our plan. Our plan was, let's start with individual dentists, call it a doc in a box. A dentist that has a couple of hygienists, and maybe 5 employees, and they work 4 days a week in a small office. And then from there expand to more of a group practice where maybe there's 2 or 3 doctors, and maybe then where they have multiple locations, 2 or 3 locations. So then get to something that's a little more regional. Without saying any names, you could think of some, maybe you've seen an advertisement where they have 10 offices across the city of Cleveland, and then we were gonna grow into the more enterprise. What happened was during COVID, when everything was shut down in dentistry, as you remember, all the dental offices were closed across the country. All of The sudden, the CEOs that are running the big companies, the big enterprise versions, and the vendors who sell into The, had time to strategic plan and think.

Dr. Daniel German (Orthobrain) [00:25:59]: And so all of a sudden I get a call from, from somebody in Cleveland. In a heavy accent. Doctor. Gervin, I have 2 questions. 1, Land you scale your business? I said, Yes, I can. He said, 2, can you care for each patient for this many dollars? I said, Hold on, let me ask the finance committee. Finance committee said yes, we can do that. He says great, we're gonna meet on Tuesday with my leadership team, and we're gonna make a partnership.

Dr. Daniel German (Orthobrain) [00:26:27]: All of a sudden I have a partnership within a few weeks, in April of The pandemic when it first started, right after we shut down. In 2020, I've got a publicly traded company, the best known company in the world for dental implants is now getting into the orthodontic business, and they make an exclusive for us to be their treatment planning service for North America, for the US, and for Canada. Pow! What does that do? That opens the door not only to Canada, but it gives us a credential. Now all of a sudden we've been vetted by a huge, reputable company, and it opened the door. So then we got some other The, and next thing you know, we're jumping over just the individual dentist, and we're going to a larger scale. So where we are right now is we have an agreement with an aligner company, they're the 2nd largest aligner company in the world, so Invisalign is the big whale in the industry, Land second, is a company, they don't do any business in North America, but they're the biggest in Asia, the Asian Pacific market. They're publicly traded, and we have an agreement with them to be their exclusive provider in Australia. And from Australia The want to go to New Cleveland, and eventually, you know, we'll see where it goes.

Dr. Daniel German (Orthobrain) [00:27:44]: They have big Land, and they're Land amazing company. So all of a sudden, we're overseas. It happened like that. It came into our laps. It just ended up me answering a call, and that led to The bigger relationships. So we have a relationship, Jeffrey, with The largest privately held dental distributor in the US, and we have an agreement with the 2nd largest aligner company, We have an agreement with Straumann, the big implant company, and their aligner is called ClearCorrect. Land we have what we call an enterprise dental organization. So think of think of a dental roll up where a company starts to acquire dental offices, and We're working with The that has about 70 or 80 offices and they're rapidly growing.

Dr. Daniel German (Orthobrain) [00:28:33]: It's a huge part of our industry, it's part of the sea change in dentistry or the roll ups. So we're working with those Land I would call that a medium sized, small to medium sized dental service organization or enterprise. We've got our eyes the biggest in the business. You've probably heard of some of those companies like Aspen Dental Land Hartman Dental, Pacific Dental, or they may have a 1,000 dentists working under their umbrella. So that's how we get big Land that's where we are is is we are already international.

Jeffrey Stern [00:29:07]: Yeah. That's that's incredible. I want to Land of pull on a a few threads there And and actually revisit the Conductor analogy and kind of practice how this works Land really kind of Understand what is actually happening, because I I think what what resonated in what you were talking about is orthodontics Land and dentistry is, as As I've always understood, it is kind of inherently limited by a person delivering the service because they have to interact with with your mouth. And so I'd like to understand and go a little deeper on the role of technology, like what is actually happening in In teledentistry, and how you have kind of thought about The.

Dr. Daniel German (Orthobrain) [00:29:49]: Yeah. It's a great question, and you're a terrific listener to pull that out. So think of it like this, teledentistry, telemedicine is typically where you have a patient interacting with a doctor. It's much more efficient because you don't have to drive to the office, you don't have to park your car, you don't have to sit in a waiting room, right? You're right here, so it's efficient for the doctor, it's more efficient for the patient, but you're still limited to 1 patient at a time. Think of our model as 1 orthodontist in a bricks and mortar setting Land care for about 300 patients in a year. New new patients, 300 new sets of patients come in for braces or aligners. In our model, the leverage is 25 times, so I personally feel that I could Stern 7,500 patients a year as 1 orthodontist, helping other doctors. And we're not live, The isn't There isn't a live interaction like we're doing most of the time, most of it's a digital communication.

Dr. Daniel German (Orthobrain) [00:30:52]: So what happens in the field is that the dentist office makes pictures, x-ray, and a 3 d replica of the teeth. There's something called an intraoral scanner, I call it a magic Land, you wave it over the teeth, Now you have a 3 d replica, it truly is almost magic. So we have that in front of us with a prescription Land our experts can look at it Land in a few minutes The orthodontist knows exactly what to do. Click of the fingers, the orthodontist looks at it, This is what we've done, I've done it 30,000 times, the young ones have done it enough times that they can tell right away exactly what's needed, and we send the dentist whether or not it's appropriate to treat that patient or they should refer it, refer the patient, what the diagnosis is, what are the problems, What's the prognosis, meaning is this gonna be successful? Frame the expectations so that the patient knows what to expect, the dentist team knows what to expect, and the dentist knows what to expect. So everybody has reasonable understanding of what the outcome could be, and then we give them step by step instructions. And all of it is operationalized, Jeffrey, so there's only so many different things that go on in Orthodontics, there's so many, there's only so many configurations of crooked teeth and bad bites, and so we're able to have report writers that are operationalized, so that we can have our team provide that sort of deliverable to the dentist so it's sent over on a dashboard. There's a dentist dashboard and a Northeast dashboard. On the dentist dashboard, they can see the deliverable, The diagnosis, the treatment plan, the outlook, and all the step by step instructions, and associated with that are all the collateral materials you would need to give a patient.

Dr. Daniel German (Orthobrain) [00:32:38]: So if you wanna give a patient take home instructions, click here, and we give them a personalized video on their patient reviewing the x rays and the photos so that they understand can exactly what's going on with their patient Land they can learn orthodontics if they so choose. So there's the doctor interface, the doctor needs to Stern, say 3 to 10 minutes creating The of these videos. And from that video, we can have technicians and using our operationalized systems and some AI in order to generate the report. When the dentist needs support, Think of an instant message or a text message of of communication that goes between the different platforms so that we have a team of folks that can read it and triage it so that we have different levels of support in order to answer the questions, and most of the questions are pretty similar. It. It's pretty hard to come up with something that's novel where we haven't answered it, so we have videos that I've made and that the team has made in order to answer the questions that come across. That's basically how it works. There's a file exchange in terms of imagery, and then we share the knowledge with them.

Dr. Daniel German (Orthobrain) [00:33:54]: In terms of AI Land where we are with it, we clearly have some of the foundational aspects of it, and we have some intellectual property that's pending, that's been submitted where much more of it can be, I'll say automated, and I believe it will continue to get better. Right? You're probably aware that x rays can be read better by computers than they can by radiologists. I'm sorry, radiologists, but those are the facts. And a lot of the different features that we're looking at can be done with this AI. And so I believe that where we are is a stepping stone to getting to a point where the AI really leads the charge. You know, think of all the things that you do with your iPhone, Most of of, or any of your smartphones, most of them don't have anything to do with talking to anybody. They're in there. There's no doubt that something in your hand will be able to provide all of the three d information needed for a doctor to do a diagnosis of your orthodontic condition, and do the measurements, the planning, sew it all together, and be able to deliver it with just a tiny fraction of human interface.

Dr. Daniel German (Orthobrain) [00:35:07]: That's where I think we're headed. That's Land of a future look into the orthodontic aspect.

Jeffrey Stern [00:35:13]: That's one of the things I wanted to ask you about, Land of Convergence of technology and magic, but, you know, where where what is your vision for the future of orthodontics? How does OrthoBrain fit into it? And, you know, what is ultimately the the kind of impact that you hope to have and contribute to the market Land of looking back?

Dr. Daniel German (Orthobrain) [00:35:35]: I think there's 2 aspects of my contribution. The of them is to be the visionary and the leader of OrthoBrain to be able to see into the future, which is in part what I've described, and that the impact that we have on people from the company by bringing access is allowing people to get out of wherever they are if they want to improve themselves Land they're in need of the orthodontics. This is shocking, Jeffrey, but I read a stat that 60% of the kids in the city of Detroit, 60% of the kids didn't even see a dentist in a calendar year, let alone get the opportunity for orthodontics. So if you have kids who are in, we'll call it underserved communities, right here in our urban centers, you don't have to go You don't have to go into Northeast Ohio, you don't have to go to Hillsborough to find a need, you can have it right here under our noses, right where you're working, people that live in the cities, are in great need of of. And for them to get out, it's not just, yes, they need education, They need mentors, they need all kinds of things, but the initial impression you have of somebody when you first meet them is what they look like. And it's sad, it's totally unfair, but that's the reality. If I can help lead the transformation of the way orthodontics is delivered so that anybody who wants it has access to it, because we've lowered the cost and we've increased the accessibility to it at a great level, then I know that we're allowing people to be able to have more control of their lives, to be able to elevate themselves, and be able to get get to the point where where they have the same opportunities that many of us have that are that are listening. That's one side of of, and then if you take that and you grow it and say, wow, what if you could do that in medicine in general? What if you could take, take the brilliant minds at the Cleveland Clinic, at at Metro, take those Brilliant minds, think of the biggest specialists you can think of.

Dr. Daniel German (Orthobrain) [00:37:37]: You know, right now, there's members of my family going through healthcare. I'm telling you personally, with all the connections, I have to wait 3 months to see the specialist who's expert in my area. I met the specialist, I said, You know what, you're giving me an hour right now, you only need about 3 to 5 minutes of information about me. You could have told my family practitioner what to do, or the nurse practitioner at one of those, I dare say minute clinic or urgent care, whatever the modality is, all they had to do was send you my physical findings, You tell them what blood test to do, and then you would say what prescription I need. Instead I have to wait 3 months Land you have to spend an hour with me? And then order the The? And then I've gotta wait another 3 months to see you. The system is broken, you could take your brain Land for that 3 month backlog you have Doctor. Rheumatologist, you could probably take care of that whole backlog in about a week, and then never have it again. So if I can get to that point, when I Check out, Jeffrey, I wanna know that I did that I had some contribution to transforming healthcare.

Dr. Daniel German (Orthobrain) [00:38:36]: I'm a doctor, and I'm embarrassed to say that we're not able to reach people Land we're not affordable, and We Lay make it a whole lot better. The technology is there, we just haven't used it. So that's one side. The other side is me personally. What's my role? And I see my role at this point in my life is I am here to inspire anybody that I meet to become the very best they could ever be, way more than they ever imagined they could be. And The when I do that The know Land can Tense that I'm doing it with humility, I'm doing it with compassion, and I'm doing it with of, that I am there to help people be better than they could ever be. And so when I have people that have worked with me on my team in the past, when they transition out of a company because There's nothing left for them to do at my company, they've of, and they're on to something else. Either they took coursework, and they went somewhere else, or they took a big position.

Dr. Daniel German (Orthobrain) [00:39:34]: God willing, somebody's going to take my place and do a better job than me as the CEO, that's my job. I want to sit back Land I want to watch others succeed. What can I do to make others What can I do to make others excel? And I know that that's, it's not a borrowed theme. I happen to be big, big reader, and try to learn from everybody and everywhere I can, and I'm about 3 quarters of the way through the book of You can't hurt me, I think is the name of it, of the Navy Seal, where no matter what The imposed on him, he always found a way to do it and do more than he thought he could do. And I think we can do that in our careers, our professional lives, and I want to help people do that. That's my personal mission. And then I think you have the company vision as the the 2 elements.

Jeffrey Stern [00:40:23]: Before we had of turned on the mic, you were talking about this tension when you were when you were starting OrthoBrain The you've always kind of been an ideas Person, you had these ideas like entrepreneurial inclinations, even getting into some software development, and at the same time, practicing In the craft, in in offering orthodontics, where it's the proverbial golden goose, as you mentioned. How did you make that initial jump to entrepreneurship from from practicing?

Dr. Daniel German (Orthobrain) [00:40:55]: I would say that one of the things it's a great question. I wouldn't discount the idea of being an entrepreneur, of being a business person, a creative business person, as a doctor. I think that that was really it. Look, I had my own little business when I was a teenager. I had a DS German cleaning company, I cleaned houses and had engaged local kids to work for me when I was 12 or 13 for a house flipper. Land so I always had a job, I always created my own little businesses. But I believe that orthodontics gave me that ability to express that creativity, and I think that's what made our practice grow. Things that I brought to the table that were pretty novel in orthodontics, and they were radical at the time, really helped our practice grow without me doing I didn't do advertising, you know, that was not how I grew it.

Dr. Daniel German (Orthobrain) [00:41:46]: The practice got big, I didn't even think I had my name on pencils to give away, so it wasn't advertising. So we had that, but I'll tell you one thing that I haven't done very well, and that is I'm not a multitasker. Right? So I'm really focused on what I'm doing right now. I've dropped everything I do except, you know, my family raising my kids. I still have 3 teenagers at home, and Adults, my adult kids I interact with on almost a daily basis. I have a big part in their lives. So it's really my family, my business, and my faith. I had to drop everything else I do at The time.

Dr. Daniel German (Orthobrain) [00:42:22]: I was a trustee of 7 different organizations, and I can't multitask like that. To build a company like this it requires total focus, so I sold my practice. And I sold my orthodontic practice when it was at its peak Land everything was perfect. I sold it because I really didn't think that I would be giving Ortho Brain every opportunity to succeed unless I gave it all of my attention. And finding other people that can support me is really the key element. So if you take a look at a jumpstart, a bounce, all these angels, Vistage, I'm a member or a Of, and finding people that are great connectors. I mean, the way we got connected through Lee Zappas, That's how it's happening. I have found that Cleveland has an abundant number of incredibly generous and successful people whose mission it is to help others.

Dr. Daniel German (Orthobrain) [00:43:21]: The I can't see any reason why they'd be doing it. It's that they found success in what they were doing, and now they wanna find others and help push them, and I'm very receptive. I wanna hear from all of them, and I and I believe that's a critical part to becoming, successful in in in business. And and so I think that's helped me quite a bit.

Jeffrey Stern [00:43:41]: What what have been the The biggest challenges are things that you felt unprepared for as you have gone through this Ortho Brain journey so far.

Dr. Daniel German (Orthobrain) [00:43:52]: Yeah, I'd say that the biggest challenge is really a personal The, and that is The if you take somebody like me, I need somebody to be by my side Land be my blinders. So that I don't go chasing every idea that I have, because they come all the time. There's hardly a day where there isn't something. Land it's just the way the brain is wired, and It's a blessing because some of those ideas are worth gold, and then others are giant distractors. And you just, I need that sort of help. My father, whose memory is a blessing, once he was gone, He was a person who really put those blinders on me and helped me keep focused, to my detriment, because I think in some regards maybe I could have had a really good software company That might have been a lot better than orthodontics, but he was right because I took care of the Golden Goose and the Golden Goose opened the door for me able to fund our Stern up. You know? So I I did the initial seed money for our company because of the success I had economically with it. So I'd say focus.

Dr. Daniel German (Orthobrain) [00:45:00]: Focus is The biggest challenge for me, is is making sure that I don't get off track. So we've got a team, and I do need that sort of regrouping, staying centered, hearing from my Vistage group, hearing from, from, the Lay people in my company, and then the voice of reason, of course, is is my wife, Terry. So I have a lot of people that are looking after me to make sure that I stay on task. I believe that I can outwork just about anybody, and I have, but I'm, I need a lot of help along the way to make sure that I stay intact and The assist me. It does take I can't do it alone.

Jeffrey Stern [00:45:41]: No. It's interesting to me how I think you've identified focus as both your biggest challenge and also maybe your biggest strength.

Dr. Daniel German (Orthobrain) [00:45:50]: Yeah, and I think it's like that with a lot of attributes for many of us. Whatever your greatest strength is, it's probably gonna be your greatest liability. It can get you into trouble just as quickly as it can make you successful. So ambition is great, but it can get you into trouble if you don't control it, right? And The ego was one that was a challenge I think for me The my thirties Land forties, where I actually stopped Teaching on the commercial level Land stopped, I stopped going on the big stage for about 5 or 6 years, and it was really an ego check. I just felt like my ego was out of control because people thought if you're up there on the microphone and there's a 1000 people there, you're the man, and they don't even know who you are. I thought it was unhealthy, so I stepped away for it, and it took a few years before I finally fired my ego. Now nobody laughs at me more than I do.

Jeffrey Stern [00:46:43]: It's important to laugh at yourself. But one of the characteristics I actually wanted to ask you about was competitiveness because It sounds like, you know, growing up from football to arm wrestling to being the best in the world at orthodontics To building this business, it's been kind of a a contributing factor. And I wanted to get your perspective on How you think about competitiveness Land if it is important?

Dr. Daniel German (Orthobrain) [00:47:11]: For me, it is it is it is the it behind my success. If I wasn't competitive because people think that I'm I'll just tell you, they think I'm really smart and they really think The name of the company, I'm Ortho Brain. I look like I'm smart. You look at the bow tie, right? I've read a Lay, and it's competitive because I want to know everything. I don't want anybody to know any more than I do, so I'm going to sit here and I'm going to read, and I have a chart in my house that keeps track of all the books I read Land how much I study every day, and every morning when I get up I'm gonna learn for at least an hour. That's it, that's my deal. I'm gonna work out for this long, I'm gonna study. The competitive, I can't get rid of of, I was able to fire my ego Land I really feel that I fired it.

Dr. Daniel German (Orthobrain) [00:47:54]: But Jeffrey, I cannot get rid of that competitive, I just screwed it up again. I was out visiting dentists, I gave a speaking gig in another city, and one of the dentists had a gym in his office, a big full commercial gym to work out for his building. And so I couldn't help myself, I'm with The of my business development people, and I look at the guy who's all muscular, and I look at him, I Lay, Hey, looks like you guys work out a lot here. He says, Oh yeah, we work out all the time. I said, Hey, what's the record? What's most number of dips anybody's done in your gym! The says, Why do you ask? I said, I think I want to break it. He says, What? I'm dressed just like The! Full suit, bow The! Unreal. Land so there's a video of me, this is a month ago, jumping on the dipping bars, doing dips until I had the gym record at, you know, as an old timer, I just can't get rid of it. I still, a year ago, I was racing kids on the high school track to see who could run 100 meters faster, and I don't know what it is.

Dr. Daniel German (Orthobrain) [00:48:51]: It's just it's locked in. My father had it. He was a very competitive athlete, and for him it helped him. It opened a lot of doors for him as an athlete. You know, you hear about Michael Jordan competitiveness. My father really had that level in sports, and I'm not the athlete that he was, but it's just it's part of the wiring, and it really frustrates me that I can't get rid of it. I can't just it's so hard to back down. It isn't ego, it's just it's the challenge.

Dr. Daniel German (Orthobrain) [00:49:19]: Can you do it? So, so I've done it with running races, and I still do it to this day in the gym, and and now I guess I'm doing it in business. I wanna, Look, I want to build this company that changes the world, and I want to have success that people never dreamed was possible for for a dental company to for how can a dentist change the way healthcare is delivered? Let's do it.

Jeffrey Stern [00:49:45]: Let's do it. That's awesome. When you reflect on the journey so far, what has surprised you the most about it?

Dr. Daniel German (Orthobrain) [00:49:53]: What surprised me the most is how supportive people are in our startup community, and in our business community, how many resources there are to be able to help us. It was a warm surprise. I always thought of businesses being cutthroat, and that everybody's out to get everybody Land you can't trust everybody, anybody. And I haven't found that to be the case at all. I've, even some of the business vendors that we do work with and said, look, I was a dentist. You know, give me coaching. Tell me what I can do. Yesterday I spoke with a really prominent person, probably one of the most prominent people in Cleveland in the business community, and when we were finished The said, you please tell me how I can do a better job next time? And she says, Absolutely! Land gave me like 6 points on how to do a better presentation next time.

Dr. Daniel German (Orthobrain) [00:50:45]: People are very generous here, and I don't know if it's across the country, if it's a mindset in our world of in the startup and business world or if it's Cleveland. But whatever it is, it's incredibly heartwarming. That's been my biggest surprise, all the resources that are out The. And for those who are interested in doing it, reach out. You've got Jumpstart, Bounce, Ohio, by all means, these these folks are there to support us.

Jeffrey Stern [00:51:12]: Yeah. No. I I have found everyone to be very accessible here and and very supportive in a way that I don't think Is the expectation, and it's just it's just there. It really is quite quite something else.

Dr. Daniel German (Orthobrain) [00:51:25]: Yeah. I mean, think of a you've got a knucklehead dentist in Cleveland, and I reach out to Stan and Alex in California The, right, you interviewed them.

Jeffrey Stern [00:51:34]: Yeah. Yeah.

Dr. Daniel German (Orthobrain) [00:51:35]: They were they it took almost nothing. I mean, I sent them a note, they scheduled immediately, I had both of them on, and there's just so many generous people from this area that are willing to help. I'm really grateful for all that and hope to be able to do the same down the road when I've got some time to help some others.

Jeffrey Stern [00:51:53]: One of the things that we kind of always do at the the end of the show Is, circled back here to Cleveland. And it's for your, not necessarily favorite thing in Cleveland, but for something that Other people may not know about. So with that, I will ask for your hidden gems in Cleveland.

Dr. Daniel German (Orthobrain) [00:52:14]: I do have something. The hidden gem is The total shock, and it's repetitive. I know I'm redundant. It's the people. I would have never guessed that Cleveland was such a warm place and friendly. But I think when you're talking about gems, you're not talking about the people, you're talking about a thing or a place. And I have one! Despite the fact that I work most of the time, You know I like to run, and my favorite place to run is from my home in Beechwood. I like to run through the Beechwood Park, through all the beautiful homes in Shaker Heights, and then I end up at the Horseshoe Lay, which may become the dome, stream without the lakes because of the broken dams, but I go down there and it's spectacular.

Dr. Daniel German (Orthobrain) [00:52:55]: If you haven't been to the Shaker Lakes, Take a look, and if your eyes are open, you will see that there are bald eagles down there. There are actually bald eagles that you'll see. Land now here's the secret. I only tell this Now that we've spent an hour together, you're now my friend, and I only share this with my good friends, all right? If you're going down North Park and you're heading west, right before you get to Roxborough School, the road widens, and it's as if the city Many years ago knew that I was going to want to park my car there where the road widens Land there's a very safe place to park your car on the side of North Park Road right before you get to Roxboro. After you park your car, you walk across North Park. You're gonna see a little trail off to your left, about 15 feet to your left, there's a little entrance into the The, and if you walk through that entrance and you start to head west, which is to your right, it's the only way you can go, Land eventually you'll see very quickly you'll hear the water of the stream, and it's way down in a gully. And if you follow those trails, all of a sudden they start to go down the hill. And you enter this gully, and you're down at the stream as you're heading towards The hill that descends into the city of Cleveland as you get closer towards that water treatment plant, you don't ever get there because there's a crossroad, but you can go about a mile and a half and you're down in the gully by the stream, nobody's ever there.

Dr. Daniel German (Orthobrain) [00:54:24]: I've seen 1 person in all the times I've gone down there, and so I only take my closest peeps down The, and we walk, and you're in a different world. If you're there on an early morning of a Sunday morning when there's very little traffic. You don't hear the traffic because you're down deep, and you're surrounded by the cliffs of the rocks Land It's spectacular beauty. You would have no idea that you were in such an urban environment with, so much commotion going around and around you. It's so peaceful Land there are areas where the water's running through the rocks. You're not gonna take a canoe through there, but you get all the sound. You get the sound, you get the smell, you get the visual, and you can walk it. That's my secret, and that's my go to place, and very few people must know about it because they're never down there, and if they knew about it they'd be there with their cameras.

Jeffrey Stern [00:55:18]: Wow. So

Dr. Daniel German (Orthobrain) [00:55:19]: there you have it.

Jeffrey Stern [00:55:20]: It is a privilege that that you shared this with me, a true honor. The it sounds magical down there.

Dr. Daniel German (Orthobrain) [00:55:26]: Yeah, it is.

Jeffrey Stern [00:55:27]: It is. Wow. Well, it will keep it on the down low with our dozens of listeners here who have stuck stuck with us to the end. They get a little treat. Well, Dan, thank you so much for for sharing your story. It's, it's incredible, and And I really appreciate you taking the time and coming on.

Dr. Daniel German (Orthobrain) [00:55:47]: It's been a pleasure, and I really admire Land am envious of all that you've accomplished in such a short period of time, Land, really grateful that you're doing what you're doing and giving exposure to all of us who are interested in learning about the ecosystem in Cleveland and all the opportunities out there Land the magnificent personalities that are there. It's really been helpful as a newcomer to Cleveland Land So I appreciate all that that you've done and and for sharing your story with me and also with your listeners.

Jeffrey Stern [00:56:17]: Oh, well, thank you, Dan. I appreciate that. If folks have anything they would like to follow-up with you about, what is the best way for them to do so?

Dr. Daniel German (Orthobrain) [00:56:26]: The best way is to send an email. This is easy. Smileorthobrain.com.

Jeffrey Stern [00:56:34]: I love that.

Dr. Daniel German (Orthobrain) [00:56:34]: And then it's there, I have a number of people that read all the messages that come in there, and there's no risk of me, mistakenly swiping it away by accident on my, on my phone. So smile at orthobrain.com, and and that's the best way to reach us.

Jeffrey Stern [00:56:49]: Perfect. With a smile. Well, thank you again, Dan.

Dr. Daniel German (Orthobrain) [00:56:53]: It's been a pleasure.

Jeffrey Stern [00:56:55]: That's all for this week. Thank you for listening. We'd love to hear your thoughts on today's show. So if you have any feedback, please send over an email to Jeffrey or find us on Twitter at podlay of the land or at Stern, j e f e. If you or someone you know would make a good guest for our show, please reach out as well Land let us No. And if you enjoy the podcast, please subscribe and leave a review on iTunes or on your preferred podcast player. Your support goes a long way to help us Spread the word Land continue to bring the Cleveland founders and builders we love having on the show. We'll be back here next week at the same time to map more of the land.