POS Instructor Dr. Brian Liao does it all. When he's not working in one of his 2 practices on 2 different continents, he's traveling around the world teaching and helping students diagnose thousands of cases (he's the #1 most requested consultant on SmileStream). Get to know Dr. Liao and learn more about his impressive orthodontic journey in this interview.
MILES MCGANN: Hi, my name is Miles McGann. I'm the CEO of Progressive Orthodontics. I'm here today interviewing a very good friend of mine Dr. Brian Liao. Brian was originally from the US has been working and living in Taiwan for the past two or three years...
DR. BRIAN LIAO: Five years now.
MILES: Oh five years now. Has it really been that long? Gosh time flies. So he's had the experience of working in a dental practice both here in America as well as in Taiwan. Brian also teaches all over the world on every continent as well as does a tremendous amount of case diagnosis, so we're going to be talking about a wide variety of topics. I think it should be quite interesting. So welcome, Brian. Thank you for coming out to your hometown since you are from Irvine.
DR. LIAO: Yeah, I actually grew up in Irvine not too far from here. I moved to Irvine when I was 10 so this is like a homecoming for me.
MILES: Nice! So your original practice was out in Arizona, so tell me when you first started your practice up and built the practice to where it was.
DR. LIAO: Well right after I graduated I decided that I wanted to do ortho, and I didn't realize what kind of ortho I wanted to do because I thought about going to an ortho residency program. But at that time right after I graduated I needed to make money because I just got married. I moved to Arizona and started my practice around 2003 or 2004 and I decided that if I have to start making money to raise a family, there's no way I can go into an ortho residency program. At that time I went through all the brochures and I was looking for the longest program available. I didn't want a weekend course because I told myself if you're going to do ortho, you got to do it right. The only brochure that I found that had the two-year program was POS and at that time I was still debating about POS so what I did is I called up the headquarters and I believe Iveta was the one that answered the call and she's like well let me have somebody call you. Within an hour, Dr. Viviano called me and it was so wonderful to hear an instructor calling me. He answered all my questions. The question that really made me decide POS was the one was I asked him if you guys went out of business, if POS goes bankrupt, would I still be able to use any appliances to make it work, he goes of course and we're here to teach you an ortho concept not to sell brackets. To me, that was the selling point.
MILES: That's always been the foundation. Yes, we do have our own system, but our own system is designed to be more efficient, but all of our students can use whatever system they choose and we give you the background to do that. We do teach our own stuff because we think it's the best thing you possibly can make. So one of the interesting parts when you were early in your orthodontic career is that you did a lot of case diagnosis with my father. Tell me about how often you sent your cases to my dad.
DR. LIAO: Pretty much just about all the cases I sent to your dad in the beginning and he was able to help me out a lot. We were always told to find an instructor that you feel comfortable with and just work with them and your dad was one of the instructors I really, really felt comfortable working with and he actually taught me a lot of other stuff through case diagnosis. Yeah and then I still remember the day when I graduated from class, Dr. Dana actually came up to me and asked me to be an instructor and to me that was a great, great honor but I didn't feel like I was ready. So I went through a lot of years with your dad and Dana kind of mentoring me through the program.
MILES: Right, and so you did diagnosis not only during the program but after the program for a number of years. I remember my dad even telling me that you were one of those guys that he was getting cases from and he was looking at them going, he knows how to do this and all he's asking for is a check at the end of the day.
DR. LIAO: But that that's how you learn.
MILES: And you know that was kind of your concept of I'll just keep sending cases, anything that you had the slightest bit of concern about, but you were doing the full workup and my dad would just go I'm just basically going through here and in five minutes I can check it send it back to him.
DR. LIAO: Right, and that's how you learn. To me, that was sort of like an insurance policy so that I don't get myself in trouble.
MILES: I remember that term you gave me was this is my insurance policy because I'm willing to pay a little bit to make sure I never run into a problem.
DR. LIAO: Absolutely, that's the way it works.
MILES: So then when you became an instructor, I will always laugh because I was the one that recruited you to become an instructor, and we had become good friends over the years, and so I was hammering you and you were the most…
DR. LIAO: I don't know if you remember that day when you came to me at the Update, and I believe was it was the 2012 Update. After class you came up to me and said "Brian I want you to teach." I said I'm not ready and you were like you're ready. I said well I want to hear what other instructors say about me before I was ready, so you had to go around asking Dana and all these guys.
MILES: But it took me years to get you to do it because the entire time my dad and Dana everybody else is going look, this guy is good. This guy is ready.
DR. LIAO: I don't know about the good part, but I thought I still needed to work on it.
MILES: And you told me I'm not ready, I'm not ready, I'm not ready. I think it was wasn't until you were done with the instructor class you said, okay maybe I was ready.
DR. LIAO: Well yeah, but I mean in the instructor class I still learned so much from your dad.
MILES: And your case diagnosis, the word methodical kind of jumped out at me because what I tell everybody about you is that everything you approach, you approach in a very methodical way and that goes to your case diagnosis. I mean you do thousands and thousands of case diagnosis per year. How do you approach each one that comes in? Because I know you have your system.
DR. LIAO: The truth is I learned my case diagnosis through your dad. Don told me exactly how he wanted me to do it, and ever since then I've been doing it exactly the way he wants it, and from what I've heard, I rarely have any issues. The students are okay with my diagnosis and that makes me very happy. In every case diagnosis, I tell them exactly what the issues are, and how to approach it, and here's what to expect, and what could happen if the case does not go well.
MILES: So you've learned a systematic approach, so no matter what the case is from the start you're looking at the exact same things every single time, making the same determinations, and that allows you to diagnose thousands and thousands of cases at a very high volume with accuracy.
DR. LIAO: Yes, and to me the most important thing is you have to be there for the students after the case diagnosis is done. So I always tell the doctors, if you ever have questions, please feel free to email me. Sometimes we do have a certain limitation on how many consultations we can do, but if you have a question and you need an answer, I'm always there for you because that's how I was trained.
MILES: And that's how you treat your patients too.
DR. LIAO: Yeah of course.
MILES: A big part of this is a reflection of how you practice in your own practice. Where the patient has to be, you have to take care of them and give them enough information, treat them in a systematic way where they know what's happening, they know what to expect from you and that's how you build practices. Now going back to that concept of building practices, you've now built two of them because when you moved to Taiwan you had to take a year off and get your license. Then you decide to start up another practice in Taiwan, so what did you learn the second time around? Since most guys don't have the opportunity to build a second practice, they build one and they work that one to the end. Starting from scratch after having so much experience with your first practice, what did you see differently?
DR. LIAO: Well the second time I opened a practice I actually had the luxury of having a partner who is a periodontist so this time around I kind of really just focused on want what I wanted to do which is ortho and implants. So for my part I do a lot of full mouth reconstruction where I set up the case orthodontically and I do a lot of implants myself and I have a partner who's a periodontist. So now when I have issues with like soft tissue management he goes in there and helps me out. Now we do have other associates who do a lot of other work for me. So this is kind of a running joke in my office, I haven't done like a filling in the last six to eight months, which is perfectly okay with me. I'm very happy with that. The other day I walked back to my clinic, I had a patient that was waiting for me for two months for a veneer and I'm sitting there sweating because I haven't done a veneer in like over a year. I tried to pass off that patient to my associate but they wouldn't have it because they're like expats from the states so they were like I want you to do it, you're going to do it. I said okay I'll do it but it makes me happy because all I want to do is ortho and implants, which I'm doing a lot.
MILES: And by gaining other skills, I know you worked very hard in ortho and I know you worked very hard to learn implants, it allows you to pick and choose what you want to do.
DR. LIAO: Absolutely, and this is to me the fun part of dentistry because I know I no longer have to sit there and just kind of treat it as a rat race where you just kind of go through the motions every day. I go into clinic right now and I'm very, very happy and I still try to get in about 20 hours a week, which is pretty impressive considering how much I teach.
MILES: Seriously. I don't know how you do it man.
DR. LIAO: You know the practice in Taiwan is a little different because sometimes we go in there from early in the morning and we finish at night. So like the day before I traveled to California I was there at 9:00 in the morning and I finished at 9:00 at night. That's a 12-hour session. I still try to get enough hours in there because I still I have a lot of ortho patients I still got to see.
MILES: Update in Asia, so you're going to be teaching it coming up here in April, tell me how you're approaching that seminar.
DR. LIAO: That seminar is about surgery, so I would like to approach it from the students' point of view of what kind of cases are surgery, what kind of case is not. So to me that is where a lot of the doctors are actually missing out because I'm still getting a lot of case diagnosis with the records where the doctors should be treating it as a surgical case, but they don't know what the limitations are. So what I’d like to do when I go into that class is let them know exactly what the boundaries are. If you're going to cross that boundary you need to know exactly how to manage it. To me, that's a really, really important seminar so I'm hoping that all my Asian students when they see this video they understand that this is a very, very critical seminar for them just to show up.
MILES: Yeah I remember when you first saw the seminar and you said we have make sure this happens in Asia.
DR. LIAO: We have to make sure it works.
MILES: Right, because these students need to see this seminar.
DR. LIAO: Absolutely, that's why we're still trying to bring it back to Asia because I really think the Asian doctors are missing out on this.
MILES: Case finishing, so you also teach Case Finishing, so tell me about how you approach that class.
DR. LIAO: You know, when I go in that class, that class was already written by Dr. Taylor and all I had to do was pretty much follow what he has to do with a little of my flare. When I go in there I usually tell the doctors finishing really starts with alignment because you can't go to finishing unless you have the alignment and the mechanics correct. So when I teach that class, in the first half day I usually go back to the alignment and mechanics stage and tell them exactly what they need to do correctly and after that we go into finishing and then we tell them exactly what to look for in finishing. We do spend a lot of time on wire bending, so sometimes the doctors get a little overwhelmed. I always tell them when I learned wire bending I had to buy like 200 wires and I went back and I just practiced and I practiced I until I had blisters on my hands but that's the only way to make it work.
MILES: And last one Mechanics. Tell me how you approach Mechanics.
DR. LIAO: Well I haven't taught that class yet but I'm looking forward to it because I know Charlie and Shock wrote a really nice class for that I heard very good reviews about it. So when I go in there, what I'm hoping to do is gather a lot of the email questions I've had over the years and I'm going to put it in a PowerPoint and I'm just going to tell them this is what all these doctors had issues with, and this is how I would have approached it. To me, that's actually going to make the classes more interesting because now they see these are real-life questions that other doctors have. If we go in there with that approach, and then we show the cases after that, I think the doctors will appreciate that a lot more.
MILES: Sounds like some exciting classes.
DR. LIAO: I'm hoping it is.
MILES: Thank you so much Brian, it's been a pleasure.