Northwest Dentistry first crossed paths with Dr. David Klein in 2009, when he won a slew of ribbons at the Star of the North Meeting photo exhibition. The first thing we knew about him was that he was a hellaciously good photographer. The next thing was that he has an affinity for birds. And with the first phone call, we learned there is much more to discover about this man of many skills and interests. Enough, in fact, for two separate articles. But the fact is that the two Davids are not separate, and the photographer informs the dentist as much as the reverse. Herewith the unphotoshopped original, and a true-life adventure along the road less traveled.
NWD: With this much ground to cover, let’s start at the beginning.
Dr. Klein: I was born and grew up in Saint Paul, with a short stint in West Saint Paul, and then I lived in Roseville from mid-junior high through college. I have no experience in dentistry whatsoever in my family! My dad spent his career with 3M, and he encouraged me to pursue chemical engineering, but I wanted dentistry from a fairly early age, perhaps junior high, and that focus stuck. I attended the U of M, graduated with a degree in biology, was an ’86 grad of the School of Dentistry, then stayed for a year’s residency in Advanced Education General Dentistry (AEGD) under Dr. Jim Gambucci, and for nine years following I was adjunct faculty here both in operative and prosthodontics.
I left the University in 1996 when the private practice I had taken over for a retiring dentist got busy. I was away for ten years, but I knew I wanted to return to education in some capacity, and as time passed the idea grew to make a career in academics. In the mid-2000s I contacted a colleague to find out the possibilities, and he mentioned they were looking for someone to work with students to help them capitalize on dental office technologies. The position seemed to fit my c.v. almost exactly: technology background; clinical experience; I had a lot of experience with CAD-CAM dentistry through CEREC (I am a trainer for Patterson); and I had already used a lot of high-tech components. It
felt like coming home.
NWD: Let’s talk about the “you are here” of life now, and teaching at the School of Dentistry.
Dr. Klein: One of the things I do is direct the dental practice management course which is something I enjoy. I have a strong background in clinical private practice/practice ownership and management, which allows me to share a practical experience about the fi rsthand, in-the-trenches, joys and challenges of practice ownership, whether solo, partnership, corporate, or community structure. The course explains ownership structure, management systems that need to be in place, laws/rules/statutes, all constantly changing. I am, as well, involved in the licensure process as faculty liaison with CRDTS (Central Regional Dental Testing Service) and last year, Minnesota approved a non patient-based licensure exam for initial licensure to practice in the state. I’ve found that students appreciate the insights and look to me as a resource for a lot of different information: practice management, technology, patient care, licensure, etc. I get to wear a lot of very interesting hats.
A great advantage in academics is that it is ever-changing. As new opportunities for the School present themselves, the Dean and others will look to individual faculty in terms of their strengths and background and tap them to help promote the education, research and outreach missions of the School. I think the reason I chose to leave full-time practice was (and this may be true for many of us) the degree of sameness to the experience over the years. I like to add to my repertoire and stay open to new challenges.
NWD: Are you still chairside to any degree?
Dr. Klein: In addition to directing the practice management course, I am a group leader in the Department of Primary Care, Division of Comprehensive Care. The School restructured its clinical education program a few years ago and students now learn in the comprehensive care environment of a general dental practice they’ll encounter after graduation. Patients are assigned to one of eight patient care groups. Each group consists of a dental faculty group leader, a patient care coordinator, a staff dental assistant, six dental hygiene students, second-year dental students (during Spring semester), and about 25 third- and fourth-year dental students...about 12 or 13 from each class. In addition, each group includes one or two internationally educated dentists from the school’s Program for Advance Standing Students (PASS). Faculty from the Division of Operative Dentistry and the Division of Dental Hygiene are assigned to groups for each session and oversee and evaluate skill development in their disciplines. Students also have access to faculty from all clinical specialty areas for consults and referrals, and to oversee treatment.
As a group leader, I develop, facilitate, and sign off on the treatment plans that students develop. Group leaders demonstrate techniques, monitor the quality and progress of treatment provided by students, and intervene should a student have any skill or patient management challenges. Sometimes we also function as career counselors...students will seek me out as resource for clinical and academic issues, to schedule cases for review, etc., and you have to be accessible for all of that to be the instructor they need.
These are very self-motivated students. As a generation, they have a different way they like to learn. They are interconnected with one another — they have high expectations of themselves and are sometimes surprised that we ask for even greater effort. They also tend to be very “causal” and volunteeroriented, which is a great fit with their last year of school which is mostly devoted to outreach experiences in community-based clinics serving underserved populations. They find these experiences to be valuable learning opportunities and personally rewarding. But they have their own way of viewing the world, their career path, and have the expectation that the role of faculty is to help them pursue their goals. We are much engaged in structuring courses that reflect the way they learn the best. We are always processing a day’s work.
This is a very exciting time to be at the School of Dentistry, with this forward-thinking dean. Not that we don’t have our challenges, especially budgetary. We are one of the largest providers of dental care for patients on the state’s health plans. That comes with a lot of responsibility, but we are always moving forward to form new partnerships and leverage resources so that we can create better outcomes for our students, patients, and our state. It’s exciting to be a part of that momentum. This year the School received the W.J. Gies Award for Outstanding Vision by an Academic Institution from the American Dental Education Association Gies Foundation. We are being recognized on a national level for a lot of things we’re doing in promoting alternatives to licensure, dental therapy, and the strength of our experience, etc.
NWD: So we have a new kind of student and a new style of teaching. Any pitfalls?
Dr. Klein: Well, I mentioned the financial challenges. We’re also always trying to optimize the faculty-student ratio and continue to look for general practitioner role models. The students fully embrace adjunct faculty as a very important part of their education and develop friendships that go beyond their time here. Finding a community of support might appeal to a seasoned solo practitioner after years in that role. When I was in practice and teaching at the same time, I could bring in a challenging case and have colleagues offer help — it was a resource outside of my practice.
Another challenge is that we’re always trying to broaden our patient base — we welcome referrals and encourage any willing party to consider making the School of Dentistry their dental home to experience affordable quality care. We’re here, too, as a resource to the dental community. Many practitioners refer their patients to the dental school for things like root canals, and we return that patient to his/her own dentist for ongoing care.
NWD: Please tell us more about the success of the outreach programs.
Dr. Klein: Dr. Paul Schulz coordinates our outreach program and students are required to complete 6-8 weeks of service-learning where they treat patients in underserved communities. We currently have eight outreach sites — in Willmar and Hibbing, and at three innercity Minneapolis clinics. Our newest outreach rotation is at the Native American Community Dental Clinic in South Minneapolis. Our students also treat patients aboard a mobile dental unit that travels around the state, in a health center for senior citizens, and we have a program in eastern South Dakota. We’re looking to expand both the amount of time students spend in underserved communities and the partnerships that allow us to create those opportunities. After exposure to these outreach experiences, many of our graduates have sought employment in Greater Minnesota. They connect to the experience we provide, like the community, and want to become a part of that. For new graduates, practice opportunities are easier to find in outstate areas than in the metro. The opportunities are almost limitless, quality of life is excellent, and recent grads who started their own practices outstate are doing exceptionally well.
NWD: And the dental therapist program?
Dr. Klein: Dr. Karl Self directs the new dental therapy program. We’re in our first year and from all that I can see things are going well. We have nine students in the first dental therapy class, and 33 applicants for the 10 positions in the incoming class that will begin this fall. We continue to analyze/study the program itself, its applicants, the graduate we will be producing, and where we would like to see those people positioned in the community. All eyes are on Minnesota in terms of what we are doing in creating a new practitioner in dentistry. We know that we are creating a template for other schools and states.
NWD: What are these students like?
Dr. Klein: I would say they’re bright, with varied backgrounds, and very service oriented. Four of the nine students in our fi rst class are dental assistants, which we feel is excellent experience. Dental therapists in Minnesota will be licensed to perform a limited subset of restorative dentistry, preventive measures, and extractions of primary teeth.
The other students in the class include a former junior scientist in biotech research at the U, a dental lab tech, a lab assistant, a dental hygienist, and a recent college graduate. Eight students are pursuing Master’s degrees. One student is in the bachelor’s degree program. She’s completed her pre-requisite courses and is now taking the 28-month dental therapy program. Our dental therapy students are a very engaging, optimistic group, and they do think of themselves as pioneers.
NWD: What are some of the dynamics of dentists becoming teachers?
Dr. Klein: Dentistry is both an art and a science. In my teaching I always ground a discussion about ‘outcomes’ in a discussion about the reason a procedure should be performed in a certain way, so students don’t see it as an isolated experience. I show the science, the idea behind the demonstration, and share my own personal experience.
Dentistry does not key on a “correct” treatment plan, but instead on the various ways to treat our limited number of diagnoses, and there can be great variation from practitioner to practitioner. I want to make sure I give my students a solid set of experiences to fall back on, to reference as they go into their own practices.
An effective teacher breaks down roadblocks to learning and helps students find and consciously understand their own process of inquiry. And this literally extends into their hands. We relish those “aha” moments, and watching our juniors grow into the confident seniors we see in the clinics. Teachers are always managing this growth along with the
academics. There is no short course to confi dence. And if we are going to develop leaders, we have to start by developing individuals. I tell my classes, “One of my goals beyond this course is to find one of you who will one day replace me!”
NWD: You are a very accomplished photographer, particularly of wildlife, and how all this ties in with the art and practice of dentistry, and of teaching, is pretty interesting. When did you start taking pictures?
Dr. Klein: I started in college. Things really came together about ten years ago, but growing up I was very nature oriented, a bird watcher since about six years old. I loved to camp and travel in the Upper Midwest, and it was natural to bring along a camera. Time for that diminished in school, until in dental school I needed to document cases and send work to the lab. Dentists by their very nature have always been gadget oriented, and we’re now technology driven in our practices. Photography is an easy fit for me. This “passion on the side” turned its focus to birds — coastal, mountain, Rio Grande, Manitoba, Hudson Bay ... The personal satisfaction and reward is something I would recommend to any graduating student — to have something outside of dentistry that gives you balance in your life. Photography takes me away from practice stresses while keeping me engaged in things I love: technology, technique, artistry. There is a very natural extension for me from documenting esthetic cases in my practice to what I do with my photography — the interesting things in the outside world.
As for the birds, they chose me. My wife and I and our two boys (ages 11 and 13) have a Bloomington backyard that backs onto a wild expanse, filled with feeders for all the birds we have around us. But we have more wildlife than that — we have a red fox currently. I have been a member of a Minnesota nature photography club for years. I won some awards and can create something we can enjoy in our home, too. And it is an outlet. Dentistry can become consuming for many of us, and with this I can step back. It is two very different ways of accessing what you love about life.
NWD: Any formal study?
Dr. Klein: I have taken a number of workshops, especially now in the digital age where we have to learn to manage our images. You get immediate feedback and learn as you go. Two or three times a year I will take a personal trip to a new area for birding. I mostly go alone — I’m up before sunrise and back late, so the family says, “Have a good time, Dad!” (The subjects I photograph take a lot of time and patience.) A favorite local place is Woodlake Nature Center in Richfield, so I really don’t have to go far. Talking about urban wildlife, we live across the river from where there was a cougar sighting, but no bears — yet. Although I did startle a sleeping woodchuck under my hose reel — I don’t know who screamed the loudest. Raccoon, deer, coyote, muskrat, geese on parade, turkeys! Out by Bush Lake I had a turkey jump onto the hood of my car in attack, and he stared me down through the windshield. Urban wildlife is going from sophisticated to bold to aggressive. I heard about a group of wild turkeys that disrupted a photo shoot of the graduating class at William Mitchell College of Law. There is a hand-lettered sign down on Lexington Parkway in Saint Paul that says, “Watch for deer and turkeys”! The most bizarre moment with all of this so far has been in my own backyard. I looked outside and thought WHAT is that sitting on the bird feeder? It was a turkey vulture!
I know we have flying squirrels but they're nocturnal, so that's by indirect evidence. And we've had mink, a gray fox, very unusual. They climb trees. Bald eagles and other big raptors over the river are so beautiful.
NWD: Had any adventures?
Dr. Klein: I've run across black bear up north, but as long as you're not wearing that good luck ham around your neck, you'll be fine. No snakes yet, even in the Southwest desert. I once inadvertently started the protective parent of a young sanhill crane and almost ended up with that wicked beak through my driver's side window.
NWD: What would be your toughest shot?
Dr. Klein: A night shot has always intrigued me, maybe that flying squirrel...the challenges of natural lighting.
NWD: Are you tough on yourself?
Dr. Klein: Kind of - it's hard to disconnect that critical eye you were trained with. Because didital is a "laboratory in a box", your dental bent is encouraged.
NWD: How about a dream shot?
Dr. Klein: I would love to see Alaska, and extend my repertoire to bigger, more panoramic shots and more behavior/action shots beyond the small and the static nature shots. They tell a more interesting story. Then, perhaps, the Everglades - Two very different terrains.
NWD: Are you consciously aware of how what you do in your avocation informs your teaching, and vice-versa?
Dr. Klein: If I look at my career and my interests and pursuits, what has always been key to me is to identify what I like to do best, where my passion is, and how that relates to my dentistry and my photography. I see so many crossovers. My discovery about not wishing to stay in solo practice for my entire career led me to explore what else there could be both from me and for me in the profession. I wanted to continue to learn rather than just replicating what I already knew I could do.
To bring the crossovers from photography to dentistry and the unique pieces of my skill sets to a University-based position that could really utilize and tap into a lot of what my career represented was a huge plus in helping me realize there are other options. The key to me is trying to understand who you are and what works best for you, and not to try to fit yourself into something that doesn’t feel like it’s you. This is a profession I love to be a part of, but it was very liberating to find this more non-traditional way to do that. That can be the answer for many of us out there, to think deep and look deep and decide whether “this” is the way you want to relate to the profession best. Look for alternatives and solutions.
This University has been my career home during my time as a student and now during my return as a teacher. To be welcomed by today’s student and this faculty to be recognized for what I can contribute, and to be a part of where this University and this career of dentistry is going is a wonderful process. The key is listening to that voice inside that says, “Follow your passion.” That’s what brought me to where I am today, engaged me in my photography, and keeps me balanced.