Reclaiming Agency: Leadership, Coaching, and the Power of Choosing with Dr. Etienne Lacrampe

You're listening to One Sharp Sword, cutting through to what matters most with Outfluencer Dr. Wayne Pernell.

Welcome to One Sharp Sword, cutting through to what matters most. I'm Dr. P, Dr. Wayne Pernell, your host, guide, and coach on this journey. My guest today is a— well, he's pretty special to me. We're joined by Dr. Étienne Lacrampe, a board-certified periodontist. Yes, a doc who specializes in gum disease, regenerative procedures, and dental implants, essentially rebuilding the foundation that keeps your teeth and your health intact. Dr. Lacrampe is a diplomate of the American Board of Periodontology and is known for integrating advanced technologies like laser-based procedures and 3D imaging, making treatment more precise and far less invasive than people expect. He's just— here's just one of the things I appreciate about him. He's genuinely curious. He's committed to learning, growing, and elevating the field. He's the founder of professional study clubs that bring clinicians together to improve care. and he continues to deepen his own expertise, especially around the connection between oral health and systemic health. And I'll add this: we've known each other for over a decade. He's been both a consulting client and a coaching client of mine, and I've seen firsthand his commitment to both professional excellence and personal growth. Etienne, Welcome to One Sharp Sword.

Thank you.

You're welcome.

How do I, uh, how do I talk after that? I have to deflate my head a little bit, you know.

It's great. Like, it's so good to be able to, to have watched your— watched your growth and been a part of that journey with you over the past decade. Here's, uh, I want to kick this off with a question that I don't think I actually know the answer to, and that is, I do know that your father sort of had his own path as, uh, as a dentist and periodontist. Did you, as part of your path, at what point did you consciously choose, yes, I'm doing it, I'm going into dentistry, yes, I'm going to be a periodontist?

So actually, my dad's a GP, like—

oh, he's a general practitioner.

Yeah. Um, who ended up with two sons who are periodontists, but go figure. Um, and actually, it's funny you bring up journey. I, I was gonna work with my dad. I was going to be a general dentist. I'm, I'm very close to my father, still am. He's still alive and well. Um, but I suddenly realized I needed to do my own thing in my third year of dental school. I just, I I love him. I just didn't want to follow exactly what he was doing, and I kind of blazed my own trail. And I thought rebuilding it, as you said it so eloquently, rebuilding the, the oral structure seemed like a cool idea. And I started doing periodontics and got booked on it.

It's amazing because it's a specialty. It's— I mean, you could just, just quote unquote just be a dentist, uh, which is which is pretty special in itself. It's interesting. On this podcast, I talk with leaders from across verticals, you know, fintech and, and retail and, you know, big organizations, technology, healthcare, all this stuff. And, and you've just been so special to me. I want to, I want to make sure that we had a chance to talk. Because you are a leader, uh, of people and in the community. And so I just— it's, it's really great. And that's— I'm just backing up a little to say you've taken this path in dentistry, and then you spent how many years doing a specialty?

Uh, 3 more.

Yeah, yeah. So that's That's dedication.

Did you— I like to know a lot about a little. That works better for my brain, to know a very narrow topic and know it profoundly, as opposed to knowing a little about a lot. And it— I like to go a little deeper under the surface in learning it.

And so figuratively and literally, yeah, figuratively and literally both.

Exactly, right?

I think that's great, right? So you You like— this came to you as a— you know, when you go through dental school, you go through undergrad like everybody goes through college if they go to college, and then you knew from the outset you wanted to go into dentistry.

Yes.

And at some point it's like, you know what, I am going to specialize, and it wasn't in I'm just— I'm clarifying. It wasn't in, uh, pushing away from your dad. It was actually in drawing you towards something that you found really interesting.

Yeah, and it— and it took the courage in a small sense to say, I'm not my father. I love my father, he's a great man, he's worth emulating, but I'm my own person. Yeah, and that helped me sort of establish that.

So Uh, what about, what about gums, right? It's like, and I'm asking questions that I think most people would never ask their, their healthcare provider. It's like, what about gums, you know? I know, right? It's like, what?

I always say, I've done this 23 years, it's hard to, it's hard to ask a question I probably haven't heard to some degree. Um, I have heard why gums. Um, it's because it's, it's the gateway to the body. There are only a couple places where something hard sticks through something soft to keep, keep it clean, and that's fingernails going through the cuticles and teeth through the gums. And that's the one interface where all the bacteria that are in an area can get easy access into the rest of the body. So it's so essential that that be healthy and that that be and that be clean and that not be permeable for bacteria and inflammation and things like that. So it's such an important thing for people's overall health and well-being, which I hope is the reason people that go into healthcare go into healthcare.

Yeah.

And it's also a really fine technical skill. I like to keep busy with my hands. And actually, I haven't told you this, Wayne. I just found out a couple of years ago that as a child, I was diagnosed with ADHD.

You?

Yeah, I know. That's what my wife said. My mom, it's a whole story. My mom withheld it from me because she didn't want to give me labels. But my son, my oldest son, actually got diagnosed with it. And I told her that and she said, "Oh, yeah, you got diagnosed at 12 too." Like, thanks, Mom. But what I found with that is if you can find something that interests you to lock into, it's a superpower.

It's a total superpower.

That's what it is for me.

Yeah, yeah. Most people think that ADHD is about, oh, squirrel and squirrel and squirrel, right? It's more, yes, there are distractions, and when you find the thing that you lock into, the superpower is the hyperfocus. And you know what, if I, if I needed oral surgery, I would want somebody who was hyperfocused in that space.

Well, that, that's where you helped me a lot because at times I would hyperfocus on, not on my work, but on extraneous details or little stressors. And you sort of got me to like, no, this will be okay, this will be okay. We— this is not— the house is not on fire. Let's move away from that and focus back on what you're good at. And yeah, I've, through training, a large part through you, I've learned to kind of say it's okay. I just need to— these are the things I need to work on. My son, by the way, who has ADHD, his thing is guitar. He's an amazing guitar player.

Oh, amazing. That's wonderful.

And that's what he— he wants to be the next Eddie Van Halen. That's what he keeps doing, and he plays kind of like Van Halen. Um, and that's for the last year plus, that's his thing. So it's kind of cool to watch, and you're, you know, you're being a father and a grandfather, watching your children find a passion and something they love is really cool.

It really is. And, and Yeah, just to, uh, to be able to focus what had been termed a deficit into a superpower. It's amazing. It's really great. Let me bring you back to the, to the mouth for a minute. The, the connection between systemic health and oral health, you talked about it a little. What do you think most people miss in concept when you, when you think about overall health and, um, and the entry through the mouth?

I think they don't realize the cause and effect, that by negating one part of the, of maintaining their body— and a lot of these people, they'll come in, they go to the gym, they try to eat correctly, they do all these things But they're like, I don't really, I don't floss. I love that one. I don't floss. It's like, well, you don't floss yet. You're choosing not to floss. You have fingers, you have the ability to do it. It's not like there's a mental block or, you know, like Pavlov's dog or something where, you know, you're going to have some sort of pain stimulus if you floss. You're just choosing not to. And it's a habit. And some people, I guess, are proud of it. But these same people that will do other things to benefit their health will negate that. It's like, well, but that's, that's as important as going to the gym. That's as important as eating correctly and sleeping well and limiting your intake of caffeine and alcohol and all those other things that we need to do.

Yeah, I flossed once, therefore I'm healthy.

I went to the gym once and therefore, right, I ran 1 mile, I'm good.

Yeah, exactly. So, uh, yeah, yeah, it's, it's interesting that I think most people don't know how much bacteria is in their mouth and how much doesn't— just a great podcast topic— but how much really doesn't come out when you floss, when you brush, just brushing alone.

No, and it's—

and, and the disease is Unfortunately, why people see you is that there are enough people that miss it that, uh, well, and some of it is, and there's also genetic component, getting a little bit older.

1 in 2 Americans over the age of 50 has some degree of gum disease. 1 in 2.

So that's 50%.

Yeah. If any, if, if any of, if all people were cognizant of that and all dentists were cognizant of that, I would be booked out for 10 years.

Oh, amazing.

I'm booked out about a week, by the way, but which is fine, but, but I don't want to be booked out 10 years. But you get the point, like, it is so prevalent out there. It's one of the things you talk about leadership. I think what the way I see things a little differently is a lot of other specialists, they view other specialists as their competitors. I don't. I view ignorance as my competitor. And discretionary spending that other people take up. So I've had people say, well, I don't want to fix my mouth, I want to redo my bathroom. That's my competitor. It's not the periodontist across the street. By the way, there are 4 that I could throw rocks at their offices. That's how densely populated Walnut Creek is.

Wow.

I mean, so, and we're all doing fine. So it's not each other that's the issue, it's the lack of education in the general population and in the general dentists that keep us from getting work.

So let's, let's stick with disease for a second and then we'll move to how you use technology. A lot of people don't know, I'll just throw it out there. A lot of people don't know the link between oral health and heart health. Can you talk about that a little bit? And then one more question to add to it. What shows up in the mouth before it shows up anywhere else?

That's a good question. So to your first point, to heart health, and I'll add another one too that just came out recently. I don't know if you've heard this one, but I, I'll talk about this one briefly and then get back to heart. The blood-brain barrier, we used to think it was impermeable. That's why it's called a barrier, that things that were in the bloodstream could not get into the brain very easily. Well, what they're finding now in autopsy, Wayne, is they're finding about 30 to 40%, depending on the study, of Alzheimer's patients have oral pathogens in their brain.

Wow.

So what we're finding, what the, the causation there, or the expectation is, is that when we have unresolved inflammation in the mouth and that's crossing the blood-brain barrier, it's causing inflammation in the hippocampus, which is what causes Alzheimer's, and, and so forth and so on. It's not a direct thing. Hey, if your gums are bleeding when you're, when you're brushing, you're gonna going to die of dementia or die of heart disease. No, but there's a strong link with heart disease. The idea is, is that if you have inflammation in one part of the body, it sort of primes the pump for it in other parts of the body. And so if you're noticing when you're brushing and flossing that your gums are bleeding routinely, well, all that— there are more bacteria in your mouth than there are people on the planet, right? It's billions. And so if that's permeable like that, if it's bleeding, when you're flossing routinely, all the bacteria that's in your mouth can now travel in the bloodstream. They don't even have to sneak through. They're just getting their mainlining in, and they can start to colonize other places in the body and ramp up inflammation elsewhere. And heart disease is inflammation. Diabetes is inflammation. Alzheimer's is inflammation.

Arthritis.

Arthritis is inflammation.

Is that linked to oral health?

So RA, rheumatoid arthritis, yes. Osteo, I don't think so. From what I've read. Okay, I think that's between gum disease and RA.

Yeah, that's, that's so great. I mean, terrible news and great to know that— take care of your mouth, right? It's like, keep it clean in there.

It's pretty easy to do. I mean, in the early stages. Once it gets advanced, then you need professional help. But toothbrush and floss, your dentist gives it to you for free. And it's pretty cheap on Amazon. So, it's not like this is— you can't make an economic argument. You can't really make a skill argument unless you have decreased dexterity or something. And even then, you could use a Waterpik or something like that. It's effort. It's giving a darn.

That's the skill, isn't it?

Yeah.

Give a darn. That's awesome. That would be the habit. Like, if if people wanted to create a habit that made a difference in their overall health, flossing would be the first one to, to create, right?

Well, it's a lot easier than doing deadlifts. I mean, it's, it's change one thing, right? I mean, that really is the thing. What I tell my patients that don't currently floss is I always say to them, look, I don't expect— just like if you're not running, I don't expect you Like, I like to run. I can run a 5K or 10K very easily. I don't expect somebody that doesn't run routinely to be able to run a 5K if they haven't gotten off the couch in years. So, you don't start trying to run a 5K. You start, you know, going for a walk and just getting your heart rate up. And you just keep progressing that, the distance and the time and so forth. And the same thing with flossing. Look, if you're not currently flossing, I don't expect you to magically convert and start flossing. Twice a day. It's, hey, do it once a week, and then the next week do it twice a week, and then just sort of gradually build up to it. And you know the research on this, how many times it takes to make something a habit, right? I forget, so I won't make up the numbers, but I know that there is a study that, that says that.

Yeah, the, the early studies were basically 3 weeks, 21 days to create a habit, and 90 days to, to lock it in. Um, you know, and once it's a habit, then you'll do things like have floss at your desk, in, right, just right there.

Remind me to not touch your desk next time I see you.

It's—

hey, I'm teasing. I'm glad you do it.

Yep, it's great, it's great. So, you know, one of the things that, that, uh, that I teach when, when people are learning new habits is about linking behavior that already exists. And it's like, oh, I forget to floss. Well, what if you put the floss right next to your toothbrush or right next to— like, if you brought it out, you don't have to open the cabinet. So with any habit, you know, whether that's going to the gym, it's like, why don't you put your clothes out the night before instead of making that a whole process in the morning? Um, if you're looking at changing your diet, look at creating the list before you go to the store or having the food out for yourself so that when you go to snack, you have a very particular thing. I'm actually pointing to an area on my desk where I have like banana and clementines and that kind of stuff. So it's like, have it available to you.

Kind of weird. If it's there, you might do it.

Yeah, that's the point. That's the point.

Take away the barrier.

Yeah, exactly. Exactly. Talk a little bit about how you use lasers these days to kind of— that obviates the need for, for cutting and for stitching sometimes, right?

Yeah. I mean, this was, this was groundbreaking when it, when it came out about 20 years ago. I'm kind of a later adapter of technology. I like to make sure it works before I jump in. And it's a total paradigm shift, and, and you have to be ready to make a paradigm shift. And I started talking to enough friends that, that were doing this and they were getting great results using a laser instead of incisions, stitches, blades. And I started doing it about 5 years ago. It, it has changed my practice. It's changed my view on what it is to treat gum disease. You want to regenerate, not resect. And, and that's what lasers do. Lasers allow you to get deep into inflammation. It targets it selectively because of the wavelength of the laser. It that energy is selectively absorbed by the bad stuff, by the inflamed tissue, by the darkly pigmented bacteria. So we're able to remove them while not harming the healthy tissue. That's what I explain to my patients. When you do an incision, you're cutting through good and bad tissue. That all has to heal. If you can just target the bad, you know, the infected tissue, the inflammation, then you don't have to touch the, the healthy tissue. And that's a lot less trauma, a lot less healing. The body can get a better result. And a lot less discomfort afterwards.

That's so great. That's exciting, actually. It is, because, you know, it takes the fear away as well. When you— it's like, well, we're going to cut here is really scary. Oh, we're going to use this laser for a pinpointed treatment of just the, the, the affected area. Fantastic.

Yeah.

So great. And so great. Where are you seeing dentistry going? Like, so you said this came about 10 or 15 years ago, and yeah, um, that was new then, and it's still relatively new. There aren't a lot of people that have— I mean, maybe what, half of specialists have adopted it?

Well, I don't even know if it's that high. It may be more like a third. Yeah. Yeah, um, you know, it's interesting. There's— when I go to dental meetings, there's a lot of talk of AI in dentistry, um, but a lot of that is almost more like Star Trek watching. I think we're just making stuff up. I know some dentists are using it, but more in a front office capacity. They'll have a virtual reception person in, in lieu of a— like my practice, we, we now have— I have a great office manager, Liz, but I have two other reception people. And, um, you know, you could maybe replace one of them with AI if it, if it were reliable. I still like interpersonal service, and my patients do too. And so I think it's nice to be greeted by a smile as opposed to press 1 for English, press 2 for, you know, Klingon, plus press 3 for whatever. Um, yeah, but, uh, I, I mean, obviously we're in a digital world now I think most people now when they go to the dentist, they're not getting that goop in their mouth anymore. They're getting scanned with a digital scanner. Uh, right to my left here, I have a 3D scanner that I use on every patient for implants. Uh, that gives me a three-dimensional viewing of the jaw. Patients love it because they see their whole skull like Skeletor, and they can see where everything is. And it, like you said, it really enables us to focus on where disease is. Fix that and not have to— it's more conservative. That— it's ironic, this technology and, and new modalities are actually more conservative in that they allow us to really zero in on what the problem is, as opposed to just nuking everything and hoping you get what, what the problem is.

I think that's amazing. So is that— do you think that's where most people fear dentistry? Do— I mean, are you seeing more and more that people are coming to you and going, "Oof, I'm glad it's you," or are you still seeing people who are, um, saying the, the happy phrase, "Oh, I hate the dentist"?

Yeah, nice to meet you too. Um, that's the first thing they say to me, you know, "I hate being here." My line is always, well, I don't, but so maybe you'll leave and you'll be happy to be here too. Um, but the, uh, no, it's funny.

Where do you think the fear comes from?

I think Hollywood doesn't help, but I think a lot of it is because Hollywood's really great at portraying us as bumbling mean idiots, like, uh, you know, The Little Shop of Horrors. But I do think a lot of it, it's generational. I'm seeing in people who are, let's say, boomers, you see it a lot more in people who are 55, 60 or older, right? Let's say 60 or older because they had that childhood dentist, shut up, don't complain, no Novocaine for you. And some of the stories they tell are pretty amazing. Like, oh yeah, that guy held me down while he extracted a tooth. And I think to myself, wow, That doesn't seem very effective or kind. Um, yeah, so people who are like— I'm almost 50— people my age, I see it less because they've grown up with more compassionate dentists that had technology.

Yeah.

And yet I still have patients in their 20s and 30s that you would think would have never had those sort of experiences that have anxiety. So I think a lot of the anxiety— I always say to, to myself 'Cause I have dogs. If you take a dog and put a dog on its back, even though you're its owner and it trusts you completely, the dog will try to right itself. And humans are no different. And so we really have people as dentists in a vulnerable position. We barely know them. We work this far from their face and we lean them back in a chair on their back. And so I think a lot of the anxiety that people feel is being helpless and feeling like they're not in control.

It's a really great observation. It's— there is this vulnerability, and it's almost a demand for instant vulnerability. Come in, let's get you seated, let's rock you back, let's throw a bib on you, let's—

yeah, stick a bunch of sharp stuff in your mouth, a light on, right? Right.

Yeah. Um, Oh, that's so interesting. How do you, uh, how do you get people to trust you?

I think actually the most easy way to do it is to directly acknowledge the anxiety and, and that I see it and that I understand it, and that— and I let them know they're in control in a sense, in that they can say— they can tap out and say uncle, you know. I tell people when I numb them, I'm going to give it time, I'm going to let the, the anesthetic work I'm gonna come back in a couple minutes and check on you. I'm gonna put pressure to make sure you don't feel it. If at any point you feel anything, you tell me, I stop, no questions asked. That's awesome.

Let's, let's talk about leadership for a second or more. Um, you've put together study clubs, uh, over the years, a few, and you've pulled people together. What do you think? These are professional people you've pulled together, and they've been doing their craft for a while. What do you think they miss about Mastery?

You know, I don't know if it's they miss about Mastery. I think when a well-done study club— and actually, it's funny, I'm just now— I didn't even tell you this— I'm just now transitioning my study club away from Spear, from a corporate to private. I'm going to do it myself. Because I've gotten tired of the format that Spear did. But I like my club. I like, like, and I was starting to lose interest in the club. I was starting to get lower referrals because I think I was disengaging from it. And now I feel engaged again because now it's my, again, agency. It's now my thing that I'm going to do. But what I found is that what people, what dentists want from a study club participating in is they want camaraderie and they want collaboration. They want to— because it's a very siloed industry. A lot of us, we're seeing more and more group practices in what we call DSOs, dental service organizations. Basically private equity money. It's buying up practices. But as opposed to like my wife who's in medicine, almost all of them are in group practices. And so they have that collaboration, that sense of they could talk to a colleague right there next to them, or they feel like they're all in it together. Dentistry, we're often lone wolves, we're often alone.

Yeah, yeah, this is interesting. Um, what do you— so I mean, the good news is you're pulling together your own study club. Do you bring topics that are interesting to you, and what do you feel like you're still learning, you know, 20-plus years into this career path.

Well, that's the cool thing about being in a study club is I get to, I kind of, I'll talk about a couple things that interest me, but most of it is actually the way I envision this club. I'm still working out the details actually. It's to say it's like, it's not even half baked, Wayne. I'm still making the batter. I'm like, I'm measuring flour at this point, but I know I want to do it. And I'm, I felt better than I have in a while about it. Just, I just decided that this week, actually, so I'm glad you brought that up. Um, but, uh, you know, a lot of it is letting them lead and kind of seeing where it— I also coach my son's basketball team, and when I coach the middle schoolers, what I've learned is you kind of have to let them— not let them lead, but let them kind of take it where it needs to go, right? What they need to work on, what they want out of it. You can't, you You can't push an agenda. And if I can't push an agenda on 14-year-olds, I, I sure as heck can't push one on 50-year-old Dennis. And so you kind of learn what the club wants by paying attention and, and sort of discuss that. And then from that, other generative discussions come up.

I think that's kind of a life lesson as well. You kind of begin to explore and you're called one way or the other, and You know, that's not a bad avenue to, to pursue. I like this. Awesome. It's great. What, um, I'm, I'm just thinking about whether I should ask you about hard procedures in your practice, or I, I ask you whatever you like, Wayne. I think what I want to do is is talk to you about, um, being a practice owner makes you an entrepreneur.

Okay.

And I think that this is something that a lot of people don't recognize in, in terms of, yeah, here's a solo business owner And what have been some of the biggest lessons that you've learned in running your practice? Because it is a business and you do have team members that work for you, and you do have a reputation, a very good one, reputation in the community. And right, so what do you think, like, what, what is it to be an entrepreneur? What have been some of the bigger lessons for you?

Good question. I've kind of learned it's taken me a lot of gray hair, which I now have a lot of, but that's okay. I like it. It's taken me a while to learn that how exactly the phrase "the customer is always right," what it means. It's not that the customer is always right in the right, wrong, black and white sense. It's that you have to listen to the customer.

That's so powerful.

And when you're a specialist, you have two customers. You have the patient, and actually even more important, especially if it's a, a very productive, good one, is the relationship with the referring dentist. And you have to make sure that both of those are respected at all times.

That's great.

That's the hard part. The patient's actually easy. The referral is much harder because the patient's in front of you. You feel empathy. You're working with them. You're there to cure their, their ailment. But working with the referring dentist and getting on the same page and collaborating, that can be harder sometimes.

I think I just want to highlight something that you just sort of tossed out there, and that is, you know, you're working with a patient, you feel empathy. And I think that that's missed by patients really quite often, that, you know, as a patient come on in, sit down, here's a bib, rock you back. But as the, as the treatment provider, you are human and you do care. And it's more about the overall human in front of you than the great technique you're about to do, right? And the— right, the great treatment. It's, here's this human who happens to have emotions and such. So I just wanted to call that out, that it's like, you're, you know, the— as a, as a specialist, you are human. You are doing human-to-human work, and it matters.

Yeah, my dad used to always tell me that. I used to say, you know, remember that the teeth have feelings. It's not the teeth that do, it's the person they're attached to.

Yeah.

And you can't just you know, look at the tooth. You have to look at the overall picture and understand the psychology.

Yeah.

What's the motivator of the patient? Are they looking to get healthy? Are they looking to have a nicer looking smile? You know, sort of let them tell that to you in their own words and then get them to that point.

Yeah, I love that.

Love that.

Um, all right, think back. Let's go, let's put you in the Wayback Machine. Do you remember when you and I first started working together?

Yes.

And so a couple of questions: what do you remember struggling with, and how did, how did we get you past that?

Sure. Well, the number one thing that you helped me with, I think, was It was, it came from the organization you work with, but you really implemented it well for me. So, and that's the first step is the unkillable leader, right? The idea that when you implement change, and we implemented a lot of change, the number one change that I still do this day, 10 years later, and has revolutionized the way I practice is I was tired of doing surgery in the afternoon. And I remember you, and I told you that you just looked at me like, Well, then why the eff are you doing surgery in the afternoon? And I said, well, you know, the staff and the patients. And you said, well, whose name is on the door?

Exactly. Whose practice is it? Right.

And it's like, well, just mine. Yeah. Okay. Um, so we, we changed that, you and I, and, and we implemented it. And at first I got a lot of resistance from my current office— my, at that time, current office manager, not the one I currently have.

Yes.

And, uh, Yeah, and what— but like, what the patients are going to want that. And, and you said something along the lines of, well, the patients are going to want a pony too, but we're not giving them ponies. This is, this is when it gets done because this is the most effective treatment time for you. Dr. LeCrampe is the most fresh. Everything will go much better. Yeah, so forth and so on, right? And so, uh, it ended up that we, we reorganized the schedule. And to this day, actually, occasionally I'll have an emergency or something where I'll take out a broken tooth in the afternoon, but I am not doing big procedures in the afternoon for 10+ years, and it feels great.

I will tell you that if I were, you know, if I were coming to you as a patient, I would not want to show up in the afternoon knowing that you're tired and wrung out. And okay, you'll you will begrudgingly show up to do surgery. It's like, right, I want, I want my specialist at his, his or her peak. Like, I want—

absolutely.

Yeah. So when you're like, I just don't want to do this anymore, it's like, okay.

So you really taught me to sort of reclaim my space and reclaim my time. And, and I've extended that further even past our time working together. I now go every, uh, you know, speaking of health, I intermittently fast every day. And I found that that's more effective. It keeps my energy up. And I go for a walk at lunch every day. That time is, is not viable. You cannot take that away from me. And patients aren't allowed to be put there unless it's someone in pain or a dire emergency. And I go for a walk in the neighborhood here, right? Put my little headphones in, listen to some yacht rock and have a nice relaxing walk. And I feel better when I come back. I'm ready to take on the afternoon.

Yeah, it's so good. It's, um, there's so many lessons in here, and I'm so glad you're saying all of this because I'm so proud. Uh, you should be.

You did good work.

The, the idea is that each of us is accountable to ourselves for our schedule, that even if you work for an organization, you're pretty much responsible for what you allow on your calendar. I'm pointing to my blank screen over here. Which I shut off because it has my calendar. Um, you're responsible for what you put there and when you put it there, and you know when you're at your best. And it's really— I think that that's a, a huge thing for anybody. I'm reiterating it at the end because, uh, the— for our listeners and our viewers, it's really important. Take control of your calendar.

100%.

Yeah, that's how you—

that's how you can't show up for others if you're not yourself organized and ready to go to give it 100%.

That's so good, right?

I mean, so you, you otherwise, you're, you're sort of part of you's here and part of you's there, and you need to be present.

Yeah, so good. And then, um, and then there's a practice with the calendar where you look at what's coming up both tomorrow as well as 2 and 3 days out. Do you still do that?

Uh, no, not really. I kind of— I mean, I know what's there, but I don't— I remember asking my dad that. I said, you know, when did you stop looking at the schedule? He goes, ah, 5 years in. I just— I figure I can handle anything that shows up when I walk in. I mean, you know, I make sure that I— we do a huddle in the morning, we make sure that we're prepared. If I have a big case where certain supplies need to be ordered, I speak with Sandy, my assistant who does ordering, and I make sure that she's got it all. But that's the other thing I've learned about leadership too, is that when you delegate, it's so powerful because—

True, true. Good. Well said.

I don't micromanage. My team knows what I want and how they get there, short of breaking the law, is irrelevant to me. They want to do it their way. That's okay. So I don't— when— if I ask Sandy to order things, I don't sit— I don't ask her 16 times, did you order it? I don't stand over while she gets it. I don't look at the prices she finds. I just trust her to do it, and by God, she does a great job doing it and has for years.

That's huge. The, uh, the trust as a leader that you put into your team is huge, and that's how you gain loyalty. Your team members have been with you for What, 8 years plus, right?

Some of them, yeah. I had a little turnover because of moving and geography and that sort of stuff, but, you know, people moving for jobs, retirements.

Yeah, yeah.

But I, I like consistency. I like having a stable team. Patients like it. They like seeing the same people. We did hire a new front desk, but that was a, that was a new hire, an additional hire, not replacing someone.

That's so great.

Yeah, that brings a new vibe and energy too.

And, uh, because there's a culture already established, when you hire somebody new, they come into that culture and, and sort of keep pace with the way things are.

Yeah.

As well as bringing a fresh perspective, which in itself changes the culture ever so slightly.

Well, for example, Liz is so organized, my office manager. She gives an offer letter. I had never done that before. And it says, it lists on there, this will be the salary, this will be the expectations, this is who you can speak to, you know, Dr. Lacrampe and I welcome you. And then we now even have a welcome letter that, that everybody else sort of can sign and whatnot to welcoming to the team. And it's because it introduces the culture, right? This is, if I want to sum up the culture, in one sentence, I'd say it's, we take our job seriously, we don't take ourselves too seriously.

That's so great. That's—

we like to have fun too.

I'm fond of saying that about the work I do. Exactly right.

Yeah, the work, the work is important, but that doesn't mean you have to be a pompous ass. And you're definitely not one, and neither am I, right?

Like, right, exactly.

Yeah, exactly. You got a lightsaber behind you, for God's sake.

I do. And Oswald and Dumbo and— yes, a wizard and Yes, and penguins on my shirt and all those things.

Uh, I feel very plain next to you. I just have a— I have some bobbleheads, you know.

That's good.

Bobblehead, bobblehead, model cars. I'm a big car guy, so yeah, it's awesome.

You know, something on your wall might be good, but you—

well, you know, I, I used to have this— yes, and I used to have this giant bookshelf that I just changed out a couple weeks ago, so I went from a tall to a below.

Very good.

So yeah, which was nice because I— one of my hygienists pointed out, she said, Dr. LeCrampe, that bookshelf looks like it's going to fall on you. And I, I looked, it was kind of leaning. I just had this vision of, of a headline in the newspaper like, local periodontist crushed by bookshelf, and thought maybe I'll get something different.

That's a bad headline. And yeah, and you know, being in the San Francisco Bay Area, earthquakes are a thing, so it can happen. Yes. Um, I'm going to put you in the Wayback Machine one more time. So you talked about the work we did in our consulting. The work I did with you in coaching was slightly different, and I don't remember— I don't know, I don't know if you remember, um, how we started or if you could just speak to what had the biggest impact on you. What had a really big impact on you when we, when we did that work?

You know, I think it was more the interpersonal relationships that mattered to me that you helped with, um, mainly my wife and my, my sons. Um, I remember my Lucien, my older one, he's, he could be a little difficult at times. He's a lot like me, actually. He looks like me, he acts— it's kind of funny, people say he's a clone of me, which actually I get tired of because he's his own person.

Yes.

And people always said that about me and my dad. And, and again, I'm very close to my father, but I'm not him, and I, I don't want to be him. I'm me, and he doesn't want me to be him. Uh, but that's a natural comparison that, that people make. So I guess what I'm trying to say is I would at times get in loggerheads with him when he was younger And you would kind of help me get unstuck and understand that I'm dealing with a not fully formed human being. And my wife, who's a pediatrician, would tell me this, but it just wasn't the same coming from my wife as it was coming from you.

You need an outside perspective sometimes, I think.

Exactly, exactly. That's from a trusted person, but someone outside. Yeah, the family dynamic.

Yeah.

And so that helped in just kind of understanding that, and then being intentional in my time with my, with my wife and my kids. And that really helped me restore balance, so I wasn't always thinking about the practice. I would work hard while I was at work, and then I'd come home, and largely I'd be— I'd leave Dr. LeCrampe at 1844 San Miguel and become Etienne when I walked into my house in Orinda, which is, you know, 15 minutes away. So That part was huge.

It is. I think that is huge. I think your, your ability to, uh, to recognize it and your willingness to step into a greater presence— it's like, it's— yes, it's one thing to be very present and very focused with your patients, and what's interesting is that a lot of successful people I work with, um, and I'm working with one now who's in tech, and he's so on the go that he— I had to remind him that going off and slaying the dragon for the sake of the family still takes him away from the family. And they don't know that he's— they don't know his— they know his intention, but they don't know how connected he is unless he can show up and be so present when he's present. And that made a huge difference. That was— that's— it's really great. I think being deliberately present is a, is a huge thing.

So that's so true because you're right. I, I think one of the things that entrepreneurial, traditionally alpha males do is we assume that everyone's right behind us, like, on the charge. And that we assume that we communicate because we communicate directly. We assume that we communicate clearly, and those two aren't always linked. And so there are times where I've thought my wife and kids understood something. Well, I said it and it was interpreted completely differently. And so I've learned that you have to be intentional about what you're saying, what you're doing, where you're showing up. Don't assume that old thing that makes an ass out of you and me, right?

Right.

And I was guilty of doing that with people I cared a lot about.

You know, at least you said it, because there are a lot of, a lot of highly, highly successful people that I work with that are, well, I thought it, and they never actually said it, but I thought it, so they should know, right? It's like, yeah. So for someone who is successful, right, and, and they know or they feel drawn for toward this other level uh, for themselves. Because you knew there was more for you. You knew that, like, there were great pieces in your life, and, um, everything from, you know, the practice to the family to even some of the amazing things that you've kind of given to yourself as outside presence, almost. Um, there's this ache for more, and to to get clarity around that was a, was a big deal for you. So for, for other people who have this sense of, yeah, I'm successful, but I know there's more, what would you say? What would you tell them?

There's so much more than you know. You don't even know what you don't know. For, for more— I mean, literally, I've learned literally anything is possible. And you're capable of so much more than you think you are. And it's only your imagination, or lack thereof, that holds you back. It was like this— it was like the study club. I kept, my God, I really hate this thing. And then I just thought to myself, why the eff am I doing it this way? I could just do it myself. Like, and so there's— sometimes it just takes a moment to kind of get unstuck, or, you know, you need mentors, you need coaches. The analogy I always use is that, you know, I'm a big basketball fan. Uh, Steph Curry is the greatest shooter of all time, and Steph Curry has a shooting coach. And I have buddies of mine in dentistry, they do not understand why when I produce what I produce and I have the reputation and all that stuff, why I still want more. And it's not greed, it's not more money, it's I know I can do more.

You can have a greater impact by doing more. You have a greater—

right, exactly. One of the things I've done now, I'm actually a board chair of my kids' independent school.

Amazing.

The last year, and that, that's been rewarding because I'm helping shape the school. We're building a new school actually, and that's— I'm leading the capital campaign to do that. And so you find things to put your energy into, and it doesn't have to be dentistry if you're a dentist. But there's just— it feels better when you're doing something, at least to me.

Yeah, to contribute meaningfully. I mean, that's living in purpose. That's what it's about. That's so great. It's so great. Well, it's been an amazing, you know, decade and a half or more to have known you and worked with you and all those happy things. It's been great to have you here. Is there anything that I didn't ask you that you thought we'd get to that you want to share?

Not really. I just— I'm grateful for, for you. I'm grateful for our work together. I'm grateful for our friendship. Uh, the world needs more people like you and needs more leadership. So that's, that's, you know, if people could see the way to be better, I think they would take it. I really do.

I would like to believe that, and I, I believe that. I do believe that, that, you know, people get stuck in the safe way of being, which is what they were taught, or right, what they learned generally, generationally, right? But you, you take on certain ways of being in your early childhood, and it's just that's before you have a broad world perspective.

Absolutely.

And then you get into the world and you carry that with you. And to be able to break that wide open and go, you get to own your life, you get to create the life you want at any moment. Call this baseline and start from now. The world needs you to step into your purpose.

People would probably call— because I know your personal story too— people would probably call both you and I later bloomers. But I don't look at it that way. I think it's that we realize something that a lot of people don't realize, that they live in a cage and the door is open. Yeah, they could get out. We got out.

Yeah, it's true.

You know, there's part of the cage that still tries to pull me back, and I— the demons never fully go away, um, in some ways. But you do realize that you are in control of your life and you have agency.

Yeah, you get to— yeah, choices, right? When you realize that you get to make choices, the world opens up even bigger.

It does. Another lesson from my mom and dad— I hated this when I was a teenager— but they used to say, by not making a choice, you're making a choice. And when I was 14, that really pissed me off, but they were right. And I see a lot of people doing that. They just, they live in apathy or just fear. And it's not apathy so much as fear. And they, they're paralyzed and they just stay in this state. And it's like, but so, but you are making a choice. You're choosing to stay that way.

Exactly.

You just don't realize it. You think by, well, I just won't change anything, I'll, I'll be fine. It's like, but, but you're not. You're, you're choosing.

Exactly. Exactly. So, right. So get somebody with an outside perspective. Get somebody who can recognize that you have— when you talk about agency, recognize that that's— that agency is about choice. Um, one of the things that I talk about is awareness leads to choice, and choice leads to greater awareness. It's an upward expanding spiral that expands your life so significantly. Yeah, it's great. It's really great.

Yeah, you realize just how much more there is, and it's sort of that paradox, right, of the more you know, the more you realize how little you know.

Isn't that great? All right, well, with that, we draw our, our episode to a close. Thank you. It's been a very quick hour, you know. It's— it went, it went really fast for me.

Uh, cool.

My guest today, Dr. Étienne Lacrampe, and I really appreciate you taking time to, to be here with me today.

My pleasure, Wayne. Thank you. Yay!

This is One Sharp Sword, cutting through to what matters most. I'm your host, Dr. P, Dr. Wayne Pernell, and we will see you here next week. Please like and share these episodes, and until next time, keep making your magic.

Thanks for listening to One Sharp Sword, cutting through to what matters most with Outfluencer, Dr. Wayne Pernell. For more information, please go to onesharpsword.com.