A Conversation with Dr. John Kois
This month, the founder of the Kois Center shares some of his insights on where the profession is, where it’s going, and how private continuing education programs can contribute.
INSIDE DENTISTRY (ID): How did your experience in dental school have a lasting impact on your career as a practitioner—on your philosophy as a teacher?
JOHN KOIS (JK): I am a graduate of the University of Pennsylvania School of Dental Medicine, and I completed my Periodontal-Prosthodontic training at the University of Washington. Both schools offered fantastic opportunities for me and were very progressive with their curriculum. The educational experience was wonderful, and I remain very grateful for the way it has framed my career. Even though I do not use many of the procedures I was taught, I learned to be a more critical decision maker. The most important contributions came from being exposed to gifted, passionate teachers who were my mentors. Dr. Ralph Yuodelis, Dr. D. Walter Cohen, and Dr. Morton Amsterdam were among the most influential.
ID: Tell us when and why you founded the Kois Center.
JK: The Kois Center was founded in 1995, based on the need for a comprehensive approach for continuing education. The goal was to create a graduate program for practicing dentists that was cohesive rather than a combination of different courses. The core courses were designed to create improved critical decision making (treatment planning), understanding function, and dentofacial evaluation. The implementation courses focus on periodontics, biomechanics, and implants have seen the most change driven by science and technology.
Many other courses are able to provide great information but that is not the same as education or teaching. Education is designed to create a more significant impact by transforming the student through a platform of understanding and commitment.
The ultimate purpose of the Kois Center is to create world-class performers. The individual practitioner in turn derives more confidence, gains improved clinical performance, understands the financial accountability of dental procedures, and has more satisfaction from the practice of dentistry. This is not possible without receiving feedback on results, which is demanding and it is not always much fun. It isn’t work or play but something entirely different. It is what Geoff Colvin describes in his book as “Deliberate Practice.”
ID: What are the key components of a postgraduate institute that dentists should look for when researching various facilities and/or programs?
JK: I think it is critical to avoid significant conflict of interest concerns. It is important to have a “safe” environment where practitioners can discuss failures and their problems. Another critical piece is the opportunities available for continuous growth. We have an annual symposium which addresses the new science that has been published only in the last year. This is the evidence-based platform that modifies existing systems leading to best practice parameters. We also have mentors that work closely with students inside and outside the classroom. They have become a critical support network to answer questions, provide follow-up information, and help with implementation struggles in private practice. The mentors and clinical instructors are an integral part of the infrastructure that enable us to be more like what Seth Godin refers to as a “tribe.”
ID: How has your vision for the institute grown or changed over the years?
JK: The outcome is more than I ever dreamed of because it is now being driven by the students themselves. Their feedback has helped to develop reputable methodology (checklist), accountability coaching, an execution system, and community learning to share and reinforce best practices and accelerate learning. It is so exciting to see the dentists’ confidence and capability increase; that is the priceless component. In addition, my son Dean is a prosthodontist and my daughter-in-law, Tara, is a general dentist. The opportunities we have practicing together add even more depth and credibility to the Teaching Center. I can understand the struggles of younger practitioners in today’s challenging times and benchmark the improvements from our systems.
ID: What are the obvious (and perhaps the not so obvious) differences between a university dental school environment and a private institute environment such as yours?
JK: My current faculty position at the University of Washington does not involve any administrative responsibilities; therefore, my comments would be speculative at best. I view the role of a dental school as creating core competencies, but they are still entry-level skills. Therefore, our major differences are because we are inherently very different. I see my role as creating continuous improvement for dentists already in practice. This environment is changing so fast, it is harder for dental schools to keep up.
ID: With so many changes in technology coming to every aspect of dentistry, what in your opinion are the most impactful for practitioners as well as for patients in terms of providing better treatment options and more predictable outcomes?
JK: In many respects the changes in technology represent “disruptive innovation” that may not always be better. It depends, of course, on how we frame the concept of better. When technology can help create more predictable outcomes, more cost effectively, then dental healthcare becomes more affordable and we can help more patients. Everyone wins in this scenario.
The real problem is that the changes are happening so quickly and we have fewer expert clinicians to learn from. This is why we incorporated our own research center without any commercial support and depend more heavily on a precalibrated user group. The real challenge here is continuing to grow our understanding because information is traveling at the speed of thought and it is not all correct. Our own Research Center, under the direction of Dr. Yada Chaiyabutr, has added another unique component. Her background has enabled us to provide targeted research that directly impacts daily practice. In addition, the Research Center does not have commercial financial support, which makes it much easier to avoid any conflict of interest and publish in refereed journals.
ID: Which technologies have had the biggest impact on your institution in terms of how and what you teach?
JK: Technologies that provide better diagnostic metrics provide the biggest impact with what I teach. This will reduce the emotionally or empirically driven decisions. For example, scanning technology can provide a comparative evaluation of tooth wear from one appointment to another. Explaining to a patient they have lost 29% of their tooth structure will provide more meaningful communication than just telling them their teeth are “wearing down.” Telling them that their teeth changed 3% in 1 year will be more influential than saying their teeth look a little shorter. It is often our lack of clear, objective data that allows one dentist to determine treatment needs that another dentist would judge to be inappropriate. All of our clinical decisions must begin by determining each patient’s risk for future disease, even before they have expressed it. This paradigm shift is based on the need for a wellness evaluation, not a reparative model. The technologies that have the biggest impact are those that lead to “precision medicine” that will create a more predictable dental healthcare model.
ID: Tell us about the typical dentist-student at the Kois Center. What do you think they have in common? What do they leave there with that they didn’t have coming in? Who is an ideal candidate for the center?
JK: That is easy. They really care about their patients and want to be proud of the treatment. In a nutshell, it is about caring, commitment to excellence, pride, making a living, and making a difference for humanity.