This week Russell talks with Dr. Graham Dersley out of Maryland.  Graham went to Colombia Dental School for undergrad and then did his Prosth speciality at Maryland.  We talk about Graham's journey from associate to buying an existing office to two scractch starts.  Graham has a love of full arch fixed implants and talks about how he incorporates certain new tech into his office but not everything.  We also talk about how his offices have made the switch from a more hygiene model to a problem focused model in marketing especially in a landscape where hygienists are harder to hire.