Transcription:
Transitioning from Private Practice to Academia

Bill Klaproth (host): This is an AAOMS On-the-Go podcast. I'm Bill Klaproth. And with me is AAOMS president, Dr. Paul J. Schwartz, who is here to discuss transitioning from private practice to academia. Dr. Schwartz, great to see you. Thanks for being here.

Paul J. Schwartz: Thanks, Bill. I'm really happy to be here and share the story we have about transitioning from private practice to academia.

Bill Klaproth (host): Yeah. We're interested to hear this. And again, thank you so much for being here. So, let me ask you this right off the top. What inspired you to consider leaving private practice for an academic position?

Paul J. Schwartz: So historically, I've always somewhat been drawn to education and yet enjoyed actually my time as a resident. And maybe that's not a common experience for many of us going through it. But as I had gone through my residencies, I always valued that time of being able to do anything I wanted to do under the ease and protection of having an attending there. So, I always enjoyed that kind of educational environment. I did do an additional residency. I started out as an anesthesiology critical care medicine and then transitioned into their OMS program. And because of that, I gained some different types of skillsets. And because of that, I've been always been asked to share that knowledge base mostly with the Oral and maxillofacial surgery community. So, we do it a lot of CE, both locally and somewhat nationally lecturing and that type of thing.

And just a taste of that, I think, drawed me and connected me to the educational component. So, I kind of always enjoyed that, but I had to make a living, I thought. And I wanted to be in private practice and provide for my family, so I went the more traditional route. But there was always in the background, that calling to go back and do something more educationally-based.

Bill Klaproth (host): Yeah. I was just going to ask you, was that always in the back of your mind, "Someday, I'd like to get back to academia"?

Paul Schwartz: I matured in my career. The later years, it became more of a calling. Initially, it was like all in for my private practice and developing that, growing that and making a successful practice. And then even within that, we started to develop doing teaching two things. One was a basic life support, which we provided the training. For our local dental referrals, we'd bring them into our offices or we'd go to their offices and do CPR training. And I always got a kick out of that, teaching their staffs, and they kind of always enjoyed that. So, that was a little bit of educational component.

And then in the state of Maryland, where I practice, we developed an ACLS program because everybody has to be ACLS-certified every two years. So, we set up a program where we did the courses a couple of times a year. And we tailor the ACLS program to oromaxillofacial surgeries with vignettes and scenarios appropriate to the office. And our OMS local docs really enjoyed that. So, that was kind of the other taste I had of education. So every time, I walked out, I said, "That was fun. I enjoy doing that." That's almost as much fun as surgery. So, I think that's how that evolved.

Bill Klaproth (host): So, what set this in motion? It's one thing to think, "Yeah. Someday. I'd like to get back to this." There's got to be a point where something shifts or happens. What happened that kind of made this path possible?

Paul J. Schwartz: So interestingly, what I think goes through a lot of our minds as we get later in our career, I was kind of at the 28, 29, 30-year mark and thinking, "Well, this is good. But what else is there in life to do? And are there any other boxes to check?" At that time, I was approached by my alma mater, University of Pittsburgh, to come back to do some teaching there, that they were in need of a full-time faculty there. And my wife and I are both actually from Pittsburgh. So my wife never really forgave me for leaving Pittsburgh. So when she heard of this opportunity to give back, she was very enthusiastic about asking me to pursue that.

Bill Klaproth (host): And that helps.

Paul J. Schwartz: Yes, that's the personal side of it, but that's very powerful in my decision to move back there. And it was, it was a great opportunity. I really enjoyed the faculty there. They're really good group of people, great institution and kind of a corny thing, but a good way to give back, you know, after a career is to go back and do something like that.

Bill Klaproth (host): Yeah. That's a great thought. I don't think corny at all. I think that's nice that you're able to do that and it's bringing you joy as well as satisfaction to the evolution of your career as well. So, that's really good. So, what was your greatest and/or unexpected challenge during the transition?

Paul J. Schwartz: So, the hard part is transitioning. This is a giant step to blow up 30 years of doing what you do every day and taking a leap of faith and doing something completely different. We had built a really successful life in Maryland and had a lot of friends and great practice, good colleagues. They're excellent surgeons. I was working with in my practice. So, that was hard to kind of leave that. And we had four kids and they had all grew up there and did different things. But at that time, they'd all have been a little bit older. They were either in college or grad school or working. So, that was another good time.

The challenge, I think, was just leaving a home that we were in for 32 years, I think, at that point. And then, moving back to a city that we used to know, which looked very different from what it does now. Those kinds of things, like it was other personal kind of things.

Our practice, it was a challenge just because it was such a different type of practice. And I think all of us in private practice have a vision for what those guys on academia do and what that looks like, but it didn't look like that when I got there. So, it was a little bit different. But it was all good. It was a great transition and I think a good decision.

Bill Klaproth (host): Yeah. Well, it certainly sounds like it. So, you said things were different when you got there, certainly about the town. It wasn't quite maybe what you thought it would be. What surprised you the most then after joining a university academic practice?

Paul J. Schwartz: The concept of academia for me was always from what I remember from days gone by, you know, the guys, the docs. And we had a pretty diverse faculty, even back then. But they would sit back in their office and smoke cigarettes and drink coffee. And then, the residents would run around and do all the cases and watch us. When I returned to Pitt, it was not that way at all. You were like responsible for many, many things. Academia had changed. The challenges to the faculty have changed and matured probably in a very good way. So, we were responsible from day one for our multiple clinics and different parts of the school. And I'm employed by the dental school, so I have the responsibility for training both dental students and residents and comfortable working with residents. I'd done that at MedStar Washington Hospital Center, where I was a senior attending for many years and loved working with those residents. And then, came to Pitt and working with the residents in both dental anesthesiology and Oral and maxillofacial surgery. You know, they're really good, well-trained people, a blast to work with. And then, the dental students side of it, which was you could get really different levels of enthusiasm and knowledge. So, that was a little bit of a challenge.

And then, time-wise was really clinical. We were short-staffed at Pitt. So, we had a staff basically working five days a week and full-time in clinics. But then, I was also asked to do the didactic education for both DA residents and general anesthesia residents and the OMS residence and the dental students. So, I had to start writing lectures. And for me to write a one-hour lecture, it took like 20 hours. So, that was a transition just to get me up to speed with those types of things. But I guess, to answer your question, I think the biggest challenge was to fulfill my clinical obligations and the teaching obligations.

Bill Klaproth (host): Yeah. A little different doing what you're doing and now you're having to come up with course content and lectures for multiple dental school classes and things like that. So, you have had an interesting career. Obviously, one foot in private practice and now one foot in academia. What kind of perspective has that brought you to the forefront for both as an OMS and now as AAOMS president and being in academia?

Paul J. Schwartz: So, getting back into academia was a truly eye-opening experience. And it really brought the basis of why it's so important to have Oral and maxillofacial surgeons and dental schools, especially as well as the residency programs. What I found was an entire generation of dental students who really did not appreciate what Oral and maxillofacial surgeons do. Both from the aspect of dentoalveolar surgeon, just the bread and butter things that we do, to implantology. In the skull, many different entities, we're actually doing surgery and implantology. And what we as private practitioners would hope to see is that when dental students come out of school, they understand who does what as far as the specialties and know that Oral and maxillofacial surgery does implants and dentoalveolar surgery best, and that referral should go to them. But there really wasn't that appreciation in the dental schools. Probably better than most, but what I learned from talking to other faculty was some dental schools actually don't even have full-time OMS teaching in their OMS departments and especially in implantology.

Bill Klaproth (host): That's very interesting to hear you say that there's an entire generation of dental students who do not understand the critical importance of an OMS. Why do you think that is?

Paul J. Schwartz: Again, I just don't think they have that contact. Many of these new dental schools are opening without a full-time OMS on staff. There were I think now 11 specialties of dentistry within the ADA-approved dental specialties. Most dental schools may have like four or five of those, you know, to their credit, has everyone. Or I think we're the only dental school in the country that has every specialty under one roof. But not having a full-time oral surgeon or to having that interaction with them in the clinics where they're learning how to do routine dentoalveolar surgery. If someone else besides an OMS is teaching them, I think that's really a detriment to our specialty.

Bill Klaproth (host): Yeah. That absolutely makes sense. So for someone who is considering the jump from private practice to academia such as you have done, what advice would you give to a colleague in potentially making this transition?

Paul J. Schwartz: I would definitely recommend it. It's kind of reinvigorating to get through 30 some years of doing this. And being able to start over, it's a gift and opportunity to be able to do something like that. It's got its own challenges, but it's very rewarding. And I think just watching, working with residents, I think all of us know who have had the opportunity to do that, that's always fun to do, to watching them mature and having that intimate contact with them day to day and watching how things go from July 1 to when they graduate. That's really kind of a fun transition. And that kind of is also true of dental students too, as we're watching them from going from a D1 first year dental student to be able to graduate, and just watching that maturation, it's such a blast.

Bill Klaproth (host): Yeah, absolutely. So, it sounds like it's just been really rewarding for you. You use the words gift and rewarding opportunity. It really has been a good move for you.

Paul J. Schwartz: Absolutely. And I've been fortunate to have a really good group of people. Our Dean, BJ Castello, and Dr. Cunningham, Larry Cunningham, who was our chair of our department; and on the anesthesia side, Dr. Joe Giovannitti, great people, great role models, excellent mentors. And I think that's the other important factor, is that academia is very different than private practice. And to get to know somebody there that can show you the ropes is very valuable.

Bill Klaproth (host): Yeah. Any additional thoughts as we wrap up, Dr. Schwartz, about making this transition?

Paul J. Schwartz: I think a lot of us think about it and maybe there's not the inertia to push through and do it, so I would recommend doing it. I think it's a great time to transition. You know, if you get to the point where you feel that you've done what you want to do and you're accomplished in your private practice and you're looking for what's next in life, I think that's really a good opportunity for you.

Bill Klaproth (host): Yeah. It's a good message. Go for it, basically. Go for it and do it. Well, thank you so much for your time. It's been great talking with you and learning about your transition.

Paul J. Schwartz: Thanks, Bill. It's been fun.

Bill Klaproth (host): Absolutely. That is AAOMS president, Dr. Paul Schwartz. And for more information and the full podcast library, please visit AAOMS.org. That's A-A-O-M-S.org. And if you enjoyed this podcast, please share it on your social media and make sure you subscribe, so you don't miss an episode. Thanks for listening.

Paul J. Schwartz: Thank you.