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Howard:
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It is just a huge honor to be sitting in my home on a Saturday night, having Demetrios Brooks stop by. Thank you so much for stopping by.
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He was down here Thursday speaking at the very prestigious Paradise Valley City Club. It's very hard to get a speaking gig there. Then the next day, we bumped into each other at, what was the. It was ...
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Demetrios:
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It was at the Summit Convention.
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Howard:
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Who's the guy at the Summit?
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Demetrios:
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It's Doctor Cooper.
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Howard:
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Yeah. Mark Cooper.
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Demetrios:
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Mark Cooper.
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Howard:
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See I never can remember Mark Coopers name because the first 30 years I know him, I only knew him as the Swammi, and everybody called him a Swammi, I didn't even know he had another name. Now, we podcast him, Mark Cooper.
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So let me read your bio.
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Demetrios earned his Undergraduate Degree from the University of Louisiana at Lafayette. So you went to school there and for Business Management further pursued his Masters in Business Administration with a concentration in Human Resource Management from Strayer University. During his tenure at Strayer University, he was nominated as the head of the Student Advisory Board from the faculty and staff from the graduate and undergraduate chapter.
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He has received his Society for Human Resource Management Certified Professional Certification. Known for his professionalism, he is eager to build long term relationships and create client oriented solutions. Demetrios is always seeking to find a win-win situation.
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Demetrios is a Dental Business Management Systems Consultant that assists Dentists in developing their practice and improving their bottom line.
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He works directly with some of the largest banks in the nation that control over 3.7 billion dollars in Dental Practice assets and expansion funding.
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IN 2014 Demetrios became a Chief Operating Officer of G-Max Dental Services Network. He works directly with group practices, solo practitioners, M.S.O.s and D.S.O.s. Since then, they have placed over 127 different companies and over 9,000 keywords on the first page of Google.
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G-Max is also a Google certified ad-words partner. G-Max is also known as Google Max Marketing, has an A plus rating with the B.B.B. since 2012. Demetrios believes that one of the paradigm shifts in Dentistry is having a turn-key Dental Assisting Program that operates inside the practice during non-clinical hours.
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He works with practices across the nation in providing the opportunity for Doctors to make a positive difference in communities and creating passive income while still providing quality care.
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Thanks so much for coming over.
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Demetrios:
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Thank you.
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Howard:
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So you live in, your headquartered out of Dallas Texas.
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Demetrios:
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Out of Dallas yes.
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Howard:
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But your favorite team is still the Arizona Cardinals.
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Demetrios:
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It is the Cowboys I have to say.
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Howard:
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End of Podcast. End of Podcast.
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So you were speaking at one of the oldest study clubs Paradise Valley. What were you talking about Thursday night? What were you passionate about at the study club?
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Demetrios:
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What we normally do, is we do lunch and learns. We show them how they can actually increase production with dealing with implants, dealing with ortho, how to do Dental Assistant School within their practice after hours.
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So we went over strategies on what different locations do. Exactly what the process is, so they can learn how to create so passive income for their location.
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Howard:
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What was the website?
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Demetrios:
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The website is www.yourdentalassistantschool.com
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Howard:
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I love the definition of entrepreneur. An entrepreneur is someone who can make money while they're sleeping. You know dentistry is all hands on surgery. So, if you're pushing a lawnmower, if you're a welder, a plumber, a dentist, a surgeon. If you can only make money working with your hands, there's no scale. It's hard to be an entrepreneur.
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Would you agree with that or disagree with that?
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Demetrios:
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Well, I agree because your limited on what you can do because you only have so many hands. So if you have 2 hands, you can only do that. So the ultimate goal for an entrepreneur, I believe is to have the leverage to have somebody else, that you show, shadow underneath you, and as they grow, then you'll have somebody doing the work for you and you'll reap the benefits.
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Howard:
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I've for doing this 30 years. I've had lots of friends that just lost, like vision in one eye. Where they had an eye problem, a trauma, a surgery., but you're one injury away from not being a surgeon. Dentistry is all surgery, whereas physicians, 80% of them never cut on anybody.
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Yeah, dentistry is very, very tied to your health. You lose your health, you lose your wealth in dentistry.
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Demetrios:
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Absolutely
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Howard:
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So, what were you talking about mostly? Were you talking about the implants, the ortho, or the dental assisting school?
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Demetrios:
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We're talking about all 3. SO, we like to make sure we cover all 3 grounds. The biggest factor is, if you're able to increase gross production substantially, over 400%, what would you do. So that was one of the questions that we asked. It's about growth. What would you do. You're going to get staff, you're going to get more locations, you're going to expand. So, we had a great conversation on what to do, and we were just sharing ideas on how to increase cash flow.
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Howard:
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You're working with group practices, solo practitioners, M.S.O.s, D.S.O. What are they interested in?
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Demetrios:
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The biggest thing that I've noticed recently that they're interested in, is just the common frustration of having the extra help that you need. SO, when you centralize whatever you need in your practice or if you have multiple practices. Having something to have an actually systematic approach, it's the biggest key factor, making sure you have a process, and everything in place, so whenever you grow to that next level, it will be a lot smoother transition.
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Howard:
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When you talk about that you work with some of the largest banks that control over 3.7 billion dollars in dental practices. Are those mostly solo practitioners, where one dentist buys a practice and runs their practice, or more corporate, D.S.O.s, multiple location group practices.
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Demetrios:
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Mainly group practices, and you can also have solo as well. So that's the escelon. So you can start if you're a solo practitioner and you're just getting out of school and need help with funding. WE have something to where we can actually show the new associates that are coming out, what to do business wise. What to do as a clinician, and exactly all the steps that you need to grow. So that's what we do to start off.
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Howard:
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What website is that for you?
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Demetrios:
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I'm sorry.
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Howard:
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What website would that young Dental Graduate go to, to contact you and learn more about that?
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Demetrios:
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Gmaxseo.com
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So, what that does, is it allows them to see how you can actually grow your practice, so we go into to information. One of the most important factors that we have noticed, but actually having the right type of marketing that's needed in order to grow your practice.
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It's really important to understand those different steps, that's needed to grow.
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Howard:
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So how long have you been in the dental space in Dallas would you say?
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Demetrios:
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In focusing on the dental space, has been around 2012, is when I actually started focusing on the dental space. I did do a lot of business consulting work. I learned a corporate America area, on how to build a structure, deal with the profit and loss reports. WE sat down and went over the financials. So, that aspect, I was able to bring into the dental space around.
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So, around 2012, 2013, I started primarily focusing on that area.
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Howard:
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So, you've been in the Dallas area concentrating just on dentistry since 2012. How much has it gone corporate since the old model of individual solo practitioner, and where do you think that trend will be in like 10 years, 20 years? Do you think it's rapidly changing towards corporate?
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Demetrios:
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Well, not always just a rapid change, just a gradual. I believe there's a gradual change towards some of the corporate locations. It just depends on the practitioner. Some practitioners are just anti-corporate, so they prefer not to have that type of surrounding. Some are just want to have group practices and they want to still have that private freedom. It just depends on what the clinician is looking for. That's the biggest key factor.
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Howard:
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We keep hearing that the millennials are different, but I think every generation since the beginning of time, thinks their children and the next generation, is different or not as good, or whatever. Then it turns out by the time they're all grandparents, they're all the same. I think we all turn into our Dad's is what I'm saying. I don't know, it's just hard to think that someone went to school 8 years to be an employee.
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I mean when they were little and wanted to be a Dentist, the dentist that they were modeling after, was a solo practitioner. It just doesn't make sense that, I'm little, I go to the dentist, they're all solo practitioners. I get out of dental school, and say, no, I want to join a big corporate.
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DO you think a lot of that joining corporate is because back in the day there was hardly any student loan debt, and now they're walking out of there a third, or half a million in debt?
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Demetrios:
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I think the shift is, as in using multiple sources to get to the end result. For example, if you had somebody that's going to have to get 100 million dollars in order to get multiple practices. If you have just one person paying that dollar amount, it's astronomical, but if you have 10, 12,30, 40 people that divide it evenly, that's where you start getting the group power. It kind of reminds me of more of like a Costco, or a Sams Club, where you have those type of membership discounts. So as protecting the bottom line, that's why some actually leaning towards it in a way.
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Howard:
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When you say, you're talking about dental assisting school, ortho, and dental implants, I notice one thing they all have in common is, those are fees not set by insurance companies. Insurance companies set the fees on cleaning, exams, xray, fillings. You sign up for this plan, you can only charge this much, and it seems like a lot of people are getting into implants and braces or dental assisting school because the fees aren't set, so they can have a healthier margin.
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Demetrios:
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Correct.
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Howard:
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Lets go through those. What do you like about dental implants? Then we'll do ortho then we'll do dental assisting school. What do you like about those?
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Demetrios:
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Well the biggest thing about implants, is knowing that somebody has the ability to have replacement if they're missing any type of tooth. They have a replacement that has actually a sound foundation, so as they do implants, it makes the client feel a lot better because whether you can choose from dentures or you can choose implants. One, just depends on the preference but a lot of times, its just a durability of implants. In practice and production lines, its astronomical what a practice can bring just doing implants. That's why implant ology has been very popular, and that's why all of your general practices are doing more because it actually helps increase production.
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Howard:
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Same reasons with ortho?
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Demetrios:
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Ortho is for me ... I believe for ortho is more about the longevity of the client. So if you can have somebody when they're 4, 5, 6 or 7 years old, you're creating, you have a family member that say for example has a son that goes there, they have a sister, if they have a brother, if they have an aunt, uncle, or anybody that goes with them, you can actually treat their whole family. So ortho is a great way to increase production by treating the whole family because normally they are there for a child and so that's why ortho has been very lucrative for a lot of the practices.
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Howard:
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What would someone expect from a dental assisting school?
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Demetrios:
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[inaudible 00:12:19] they'll actually do it for example in the evening time or on the weekend. So they'll allow the doctor to stay, they can be at home, they can do whatever they need to do, and still generate cash flow while the location is closed. THat's why that's very interesting for some of the docs that we work with.
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Howard:
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[inaudible 00:12:38] it would be Your Dental Assistant School, yourdentalassistantschool.com. What are they going to find at Your Dental Assistant?
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Demetrios:
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What they are going to find is basically how it works. Just an example of what you can do. What your options are. A little bit about myself. A little bit about what we do, and show you how you can actually do it. THere's different ways that you can do it in different states. So as we work in all 50 states, we customize anything that we need towards each specific state. SO they'll actually get a handful of value from our customer service. THey'll actually get a chance to see our FAQs, a lot of the questions that get answered, and we just want to be very transparent. We want to be very transparent for all of our future clients.
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Howard:
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How much does this cost for a dentist? How does he get involved? Tell us the finance of it.
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Demetrios:
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Well, the finance of it depends on the state. There's certain states that cost more than others, so it's kind of hard to say what is the actual cost of it for a specific state. I know as of right now, for you ... anything other than New York and California, you're looking at about thirty three five, and that allows them to ...
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Howard:
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3,350?
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Demetrios:
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33,500.
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Howard:
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Okay, 33 thousand 500 hundred.
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Demetrios:
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Correct.
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Howard:
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Other than New York or California?
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Demetrios:
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Other than New York and California.
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Howard:
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It's more expensive there?
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Demetrios:
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Correct.
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Howard:
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Are they buying a franchise for a zip code, a city, a county?
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Demetrios:
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No.
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Howard:
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Is it franchise?
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Demetrios:
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Its not a franchise. It's actually similar to a franchise model without the franchise fees. The biggest thing about it is actually a turn-key system. Some situations you actually have it to where you just get a curriculum, and you do your own thing. We want to make sure you get everything you need. Make sure you get a website. Make sure that you get the whole package. Make sure you get all of your clinical supplies, your instructional supplies and we market for the students. We do all the enrollments. Each location has a dedicated phone number so you will actually not even get a call to your practice. So you can focus on the patients. When they do that, we help enroll all the students. Answer their questions. So it's fully turn-key to where they virtually don't even know it's really there, but receive income from it.
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Howard:
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How does a dentist attract people in the area to ... How does he find people who want to be a dental assistant? I assume that's all google ad words?
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Demetrios:
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Google ad words are very popular, that's one of our key elements and what our strength is. Also too, as you have clients that come in, a lot of times they might ask about being a dental assistant, and ask questions about it and so as in your own market, you can actually drum up some students as well.
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Howard:
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How many states are you in? Is it going well? Do dentists like it?
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Demetrios:
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It's going very well. We work in all 50 states. There's no regulations to where we go and we're actually going to be growing in Canada as well. So, that's going to be added to ...
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Howard:
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Well actually you're a football player, and in Canada they play hockey and there are no teeth.
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Demetrios:
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So that's the best place for implants
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Howard:
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Yeah you've got to go up there to put implants on.
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I've noticed also in the 30 years that I've been a dentist that 30 years ago, all of the assistants were girls, but with the loss of 15 million manufacturing jobs, 2 of my assistants are boys, my office manager is male. When I looked at the Bureau Land, B.L.S data, men are trending up rapidly in the health care. Hospitals, dentist, nursing homes. Are you seeing that trend with dental assisting too, more males entering the profession?
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Demetrios:
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Yes there has been more than before. There has been. I guess its just one of those trends to where they're very curious about the medical industry. Certain people when they get out of school, they don't want to be a waiter, they don't want to be a waitress. THey'd rather get into an environment that's more friendly, more patient friendly and so that's been a pretty big trend.
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Howard:
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Almost all the ones I know in Arizona, they're like, my Dad and brothers work outside in the summer in Arizona and it's 118 degrees, and they just to come inside is huge for half the year. Do you also do [inaudible 00:17:09] with consulting?
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Demetrios:
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Correct.
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Howard:
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What problems are you seeing in the field, and what solutions are you giving people that are, how are you helping people in dentistry?
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Demetrios:
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The biggest, one of the top issues is not patients, it's surprising, it's more of employees. That's been the common theme, turn-over, whether you have a disgruntle employee. How do you deal with time clock issues? How to deal with just the operational side. How to keep that part organized? How do you communicate everything from your culture to your mission, to your staff, and have them embedded in their culture as well. THat's been the biggest challenge that I've noticed so far.
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Howard:
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Yeah, if I line up a hundred dentists and say what keeps you up at night? They never say, root canals, fillings and crowns. They say my assisting is fighting with the hygienist. My overhead is going up. My staff all wants a raise. It's usually always H.R. or paying the bills. It's kind of like marriage. They say a third of marriage divorces are over money.
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Demetrios:
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I think that's really good because, my M.B.A. is Human Resource Management and that's what really, that's the reason why I like working with the different doctors. I like to share ideas on what they can do to grow, be more effective. How to make a more positive environment for your staff. You actually have to sell to them to make them know how much you really care, because if you're genuine about what you do, you'll be surprised how many practitioners that have staff that sticks 10, 20, 30 years with them because they are genuine from the very beginning, and they're open.
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That really makes a big ordeal when you're working as a team. Any idea is an idea and there's really no such thing as a bad idea but just having ideas from different people it will help you grow better because I know, you probably know quite a bit and I know I don't know much but it's good to have different ideas. That's what really, really makes a practice grow.
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Howard:
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I think a lot of dentist create an environment where the staff are fearful to share their idea. The office doesn't like change. They don't like new ideas. I think the thing you have to do is make them feel safe to communicate and share ideas and the dentist doesn't have to do it.
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That's the other thing I always tell dentists, when they're comparing working at 3 different places, they always come back with the money, the pay, the hourly. Is it salary? Is it hourly? Do I pay the liability, do you pay the light bill, whatever. I always say to them, forget all of that, go in there and figure out the staff turn-over. If the average employee here is 12 years, this is 6 years, this is 2 years. Run from the 2 and run to the 12.
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One of the biggest problems in dentist is ... you have an M.B.A., you have a concentration in Human Resources. It seems like everything the physician and dentist learned, didn't prepare them for the outside world. They got A's in Calculus, Geometry and Physics and then they graduate and they never use those ever again, the rest of their life. They never care about the crab cycle or any or that stuff. Then they go out there and they have to do H.R. and they have to be a leader. We just had 6,000 kids graduate from 56 dental schools last week. How does a 24 year old kid become a leader?
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Demetrios:
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Well, leadership is, some have leadership skills. There are some, but it can actually be developed. If you work on yourself, and work on going to those type of classes, read those type of books. If you have an exponential learning curve, or are eager to learn that part, that's where your sources come from. A lot of reading, a lot of workshops. I wish they had more of those in school itself, but the reality is, you don't just put a D.B.S. or D.M.B on the door and people just come in and that's one factor of getting patients.
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The next factor is dealing with your staff. If you're not experienced in that, go to someone that's a specialist in that area. Lean on them. Have them on payroll. Have them start it so you won't have that hurtle because the biggest issue is trying to save, you're trying to save cash flow. If you try to do it yourself, it is cheaper, but you have more headache, more turmoil that you deal with because you are just not experienced in that area.
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Its good to go with an expert that you know that could help. Somebody you can put on retainer. Somebody you can ask questions with, or do it your self. So it just depends on the person's preference.
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Howard:
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I think the biggest problem with turnover in dentistry, is that when you go buy a bottle water or glass of grape juice, or an iPhone or cup of coffee at Starbucks, you know what you're getting. When I walk into your oil changing facility and I came in for the oil change, you said, you need to flush your transmission fluid or air filter. I don't know if that's true. When you walk into my office and I say you have 4 cavities and they're 250 each, that's a thousand bucks, and I don't feel any pain. I ave to trust you, and if every time I come in here it's a different assistant, it's a different hygienist, it just destroys trust.
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When you're selling the invisible, I think long term staff is key.
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Demetrios:
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It is key. Also, in addition to long term staff being a key, is how to keep your staff engaged. How to keep them engaged and how to actually delegate duties to the staff and hold them accountable. When you actually get those 2 key factors down, it makes it a lot easier. One of the paradigms is, you can tell someone what to do, but sometimes you don't want to follow up and see if they did it because you don't want to be the bad boss or the bad guy, but sometimes you just have to address situations like they are, and that's a big key factor for some of the new docs coming out of school.
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Howard:
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I love this chart. I forgot who did it, I'm sorry. I love it, on delegating. "If it's important and urgent do it now. If its not important but urgent, delegate. If it's important and not urgent, plan it (take time to plan it). If it's not important and not urgent, then drop it." So not important, not urgent, don't even do it. If it's not important, but urgent, delegate it. I think that, back to dental assisting school, I think if all you did was suction spit all day long, 40 hours a week, 20-30-40 years, that we be boring and burn out. I think many assistants could be, can take over [inaudible 00:24:01] and supplies. They can be your marketing coordinator with whoever you're marketing. There's so many tasks that they can do.
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Demetrios:
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I believe that's true because they're more than just one. They can have their back office. You can have, anybody can do back office, and over time it's one of those things, of are you willing to grow. I've seen more of a trend of more of a hybrid, more of your front office assistants that are coming along because you like them to work the back office correctly but in the front are they doing check in check out patients correctly. Do they know how to do some effective treatment plans. Having the hybrid is really important, because you might have an office manager that, their son or daughter is sick and they can't make it in that day, so who's going to actually take over and help if you don't have anybody else.
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I think being more diverse, only than being a back office, that's really what a lot of the assistants I believe really just need to look into as they grow and be more marketable for any type of practice they work for.
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Howard:
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Do you see on yourdnetalassistantschool.com has this been something for dentists having their assistant do this, or their assistant kind of wanting to be an entrepreneur so the assistant started doing this?
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Demetrios:
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Well, it came originally from the frustration of quality dental assistant. That's where it originated. The dental assistant can riot and that's what we want. It really bring s a growth path because, if you have an assistant that's been doing the same thing over and over, this gives them the opportunity to teach others in an actually type situation. So it seems like it's a slight promotion because they really feel the importance of teaching others but when they do it, they can have extra income for themselves as well. Extra hours because there are certain locations that are looking for extra hours. If you have somebody that you really like that works well, but you just can't give them enough hours, this is a great opportunity for them to actually teach other assistants.
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Howard:
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So how long is dental assisting school? How many hours and months is it usually?
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Demetrios:
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It's 12 week course.
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Howard:
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12 weeks, so 3 months.
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Demetrios:
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3 months, and it's eleven hours a week.
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Howard:
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So 12 weeks, eleven hours a week.
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Demetrios:
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So in that process, you have, fifty percent is going to be your lecture time in the morning, and then your second half is going to be your hands on. The second half honestly, we've been hearing, that the hands on piece has been the most effective part. When they do that, they go over the material, then they apply it. So, people can read a book about riding a bike, but if you don't get on a bike, you'll never know.
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Howard:
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So do they do the hands on during your regular clinical hours so they can be assisting the dentist that's there? Is that where the hands on is?
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Demetrios:
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We initial it's going to be in the laboratory on the dexter. They use a manican with a [inaudible 00:27:05] and also on each other. Just to get the basics down, that's the first initial training process for them. As they get a little better, then they can shadow and do some extern and work inside a practice as well.
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Howard:
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So what does a dental assistant student usually pay for the 12 week course, 11 hours a week for 12 weeks?
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Demetrios:
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It varies depending on the state and the city. So, you're looking between 3,000 to up to around 4-5,000 dollar range. Between 3,000-5,000 dollars.
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Howard:
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Three to five thousand.
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Demetrios:
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Correct.
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Howard:
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A lot of the dental assisting schools out here, a lot of them are 12-19 thousand. Have you seen that?
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Demetrios:
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I have.
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Howard:
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In fact, not only am I saddened to see what some of my new homies are coming out of dental school, I meet some that are half a million dollars in debt. I met one guy who was half a million, and he married a girl half a million, 2 young 24 year olds, one million dollars in debt for two pieces of loan. I've had dental assistants apply at my office before that had twenty-one thousand dollars in student loans just to come out of dental school, and I'm like, that is a big nut to crack and those girls might be 18, 19 years old. It's like you're 18 years old and you're 21 thousand dollars in debt. So this is a faster, easier, more affordable.
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Demetrios:
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Correct. Not only is it more affordable, it's that the application, actually doing the hands on has been the biggest compliment from our students. They really love it We have some students that actually came from the 13, 14 thousand dollar classes, and came to our classes to get hands on.
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Howard:
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Now are you ... is this one associated with ... we're here in Phoenix. There's a woman dentist in Phoenix who owns a dental office in Phoenix or Scottsdale. Is she in this too? Do you know who I'm talking about?
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Demetrios:
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I'm not really sure.
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Howard:
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Maybe it's a different school.
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Demetrios:
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Maybe a different school, because they do have that.
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Howard:
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That guy we met at the convention. The father and son, he had a little son there. I thought I was his mom.
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What other advice would you give the graduating class of 2017 who, a lot of them think that they graduated from doctor school and they're all that now and they don't realize they just walked out of kindergarten class, and the only thing dental school did, is give them a license to start, and they're just now walking across the street for the first time. What advice would you give them coming out of school, this 6,000 students last week?
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Demetrios:
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Number one, be very open to learn. Be very humble and realize that it's not as easy as it's perceived to be, and it's going to be tuff and you're going to really just start from round one. You really are. Not only as in being a doctor, btu on the business side, because that's the biggest key factor, to learn as much as you can about business. Learn as much as you can about all those aspects, and whatever your weak point is, have someone that can help you with that guided. Having an associate that's a veteran, that's willing to come help the students that come out. Find you somebody that's just more seasoned than you are. Find those resources. That's the most important part is trying to find the resources. Network with your current class. See who has a family of dentists. Just get to know as many people as possible, and go with open ears. That's the biggest key advice, I believe, is to have open ears.
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Howard:
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Yeah, a lot of those dentists will ... you're from Dallas, I'm from Phoenix ...They might come to the valley here and say, wow, the valley has 3800 dentists. Yeah it has 3800 dentists Monday through Thursday. You don't have 800 dentists on Friday, and you have zero dentists on Sunday. I mean you have 3.8 million people and the thing. My advice to the millennials is, so many of them come out and they have 350,000 dollars in student loans, within a year or two they buy a house, and it's bigger than their parents. ON a square foot basis, usually it's bigger than their parents and their grandparents combined, and they work Monday through Thursday 8-5. I'm like, did your mom and dad and grandparents every have a 3 day weekend in they're like.
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When I see those kids that come out and they're humble like you said but they're hungry. When I see the kids come out and they say, well I'm working 3 days a week here and 4 days a week here. I'm working 7 days a week, or I'm working 50-60 hours a week. That shows they're hungry. That shows the work ethic. And if they're humble and they're hungry, and they've got a work ethic, I think dentistry is very good. I mean I've seen people in some of the markets where they should never graduate a dentist for twenty years. Like San Francisco, they'll sit there and say "are you kidding me! Every dentist in San Francisco is closed at 5." I basically stay open until 10Pm and Saturday and Sunday I may get five emergencies a day because everyone in this profession thinks they're entitled to Monday through Thursday until 5. So I love the humble part but I like the hungry part.
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Demetrios:
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The hungry will get you a long way. I remember listening to, I don't remember the person's name it was a while back, and they said you can have all the intelligence in the world but if you don't have that grit that stick to-it-ive-ness to do what you have to do to grow business, now you're almost into a world of sales. You really are because you have to sell your staff to let them know you care. You have to sell to your patients to have them trust you. So now they're exposed to a whole nother realm of, I didn't know I had to do this. I don't want to be sale-sy, I don't want to do that, but you have to, and that's what it leads to.
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SO getting that type of guidance is really a key factor to know that you have to know what's best for the patient, but you have to be profitable as well.
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Howard:
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It's a weird culture in dentistry. If you refer to a new patient, as a customer, they think you're from Pluto. If you go out there and say I'm going to have a seminar and teach you how to sell dentistry, everybody is like, gross. Why do you think the culture of dentistry is that you're a new patient, you're not a customer, and this is what you need because I'm the doctor and you're not, and you need this, and you need to sign her. IN fact, they don't even measure their convergence. They don't know how many people, new potential customers have to call, before they can convert one to come in. They don't know how many customers are presented treatment to convert one to drill, fill and bill.
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Why do you think that's so gross and profane in dentistry, but every other business knows, that's survival.
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Demetrios:
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I think it just comes to a core root of understanding how the fundamentals of business works. It's a metrics. You have to have a metrics to quantify exactly what you do. So if you have that ratio knowing for how many patients had called, to how many set up appointments. How many appointments to how many full treatment plans. How many patients actually accept the treatment plans. It starts from the very beginning of answering the phone. If your staff is properly trained on how to answer the phone correctly and how to actually stage the patients to where you have the treatments. Then you know how long the treatments take.
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You don't want to have 4 or 5 patients in one operatory and have one doc try to see all of them. No, you want to know, this procedure normally takes an hour and a half, two hours and knowing those strategies to get patients. But, if you get the patients, are you going to have them convert to a long time, or are they just going to get your special, the $99 cleaning, or whatever it may be. SO, the biggest thing for the docs, is what are you going to do to bring value? How are you going to bring value and be genuine about helping your clients. That's what it really boils down to.
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Howard:
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I think it's funny, cause I think whoever answers the phone, is in sales and marketing. "Thank you for calling Today's Dental, how can I help you?" You ask the dentist, what is that position. They name her after a piece of furniture. Oh, she's front desk. Her career is named after a piece of furniture. I say, she doesn't look like a piece of furniture, she looks like she's answering phones. That's telemarketing, incoming calls. If they walked out and didn't schedule for their cleaning, now its telemarketing outbound calls. That lady is on the telephone, marketing, incoming, out coming, and they go, that's gross, she's a piece of furniture. SHe's a front desk. It's a tough culture to bring ... look at dentistry. It's one of the only business in the world where every single practice management system isn't even hooked up to an accounting system.
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Could you imagine running a hospital with no accounting.
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Demetrios:
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That would be ... I couldn't imagine.
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Howard:
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Oracle, Larry Eleson is the third richest guy in the world. Could you imagine going to Larry and saying, we just don't understand why any of your products are hooked up to accounting. He's probably look at you like, what are you smoking? There's only 2 industries who don't know any accounting metrics. The Department of Motor Vehicles, and your local dentist office.
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Demetrios:
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Those are the only two.
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Howard:
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Government and Healthcare. You only find those no metrics in healthcare and government. You'll never find it in restaurants, automotive, engineering, solar. When you go into a versicle, and the softwares not hooked up to accounting, you're, welcome to government, welcome to healthcare. The 2 most mismanaged industries around the world. I hope this next generation of kids that just walked out, I hope 30 years down the road and they go from kids to grandkids, I hope they understand the business of dentistry.
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Demetrios:
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I believe that as in parents, and as in if you have people that you're showing the ropes of life. I think learning that while you're younger really does make a big difference when you become your solo practitioner, or when you become, you want to grow to group practices I think that knowledge when you're younger really does help out and just talking about it so you have an idea. You don't have to know exactly everything to do, but just know how business works, know that you have to. Because if you think about it, if I told you to go to the store and get some stuff. You go in your car. You go in the parking lot, and you're like, what store, what stuff. That's how it is in the dental market because you don't know.
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But, if I told you to go to the store, go to Safeway, go down Isle 14, at the very bottom left-hand side, that's where whatever item is. That's how you have to see a practice. I was told, if you don't know how much your practice is making per hour, you're really not going to have a successful practice. SO that's one of the key factors. If you're going to have a metrics, just learn that you have to do it. In order to be successful, you have to gauge. There's no way, or everybody would go bankrupt.
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Howard:
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You know another weird tab ut is, you know how the President of the United States makes, your Congressman, your Senator. We're sitting here right now during the NBA finals, you know how much every one of those players makes, but the dentist doesn't want to be transparent with those numbers to his staff, and I say why. If I give them the brand, the labor, and all this other stuff, they might find out how much I make. So why is it okay to know how much every CEO of the S&P 500. Their salary is public knowledge.
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Why do you think that dentists don't want to be transparent wit their accounting to their team.
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Demetrios:
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Well, some people are just more personal. They don't want to expose any type of personal financial information because it feels confidential. I feel my income is confidential to myself but in the overall run, they have to know how much collections. They have to know production and honestly a lot of the staff doesn't try to calculate how much you make. You'd be surprised. They don't really care. They just want to know, what's my goal? What do I need to do? When I get here how am I going to achieve it?
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So if you create the culture of how to be transparent. Don't look at it as how much I make, look at is as, how much is the practice doing, what are the collections, what is the production. When you do it that way and don't get emotionally involved, then the whole staff is on board with you. I haven't had one time where any type of front office or back office ask, why does the doctor make that much. Nobody. Because, they just want to know where the practice stands. They really don't know what s going to you. They don't, unless you expose the lease, and electricity, all the extra bills and expenses.
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Then if someone really wants to dig in to it then they can, but honestly they really don't. They just want to know, what are our goals? How do you see us in the future. How can we get a bonus. You can use that as your benefit. So being transp[aren't is not as bad as it appears to be.
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Howard:
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I've had assistants go to hygiene school over the last 30 years. I've had 2 dental assistants Kelly Bradley and Elaine Goocho go to dental school. If they look at your deal and they say, wow, why does a hygienist make more than an assistant, go to hygiene school. When I went to dental school, there was no guy at the front of the gate that let me in and kept all of my homies out.
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There's 56 dental schools. They accept 6,000 people a year. If 6,000 people can get in dental school, you can.
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The other red flag that dental school deans need to know is two thirds of the dentists go to the 147 metros, the urban, the cities, Dallas, Phoenix, L.A. and only one third go to the other half of America who live in 19,000 small towns. For the first half of my career, they thought if you increase the number of dental schools and class size, you'll push them out further. It absolutely didn't happen. What they understand now is, if I pick a guy from downtown Dallas, he's going to stay in downtown Dallas. But if I pick him from a small town like Childers Texas, he's more likely to go back to Childers. SO the dental schools are realizing that and if you want dentists to go to the rural, you gatta get that little boy or girl that came from the town of 5,000, cause someone who grew up, who likes the plaza, likes the cowboys and all that stuff. They don't want to go live with 5,000. SO you've gatta be born there.
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Every time I see a dentist crushing it the first year or 2 out of school, they're always about 2 hours away from major airports. SO if you were born and raised in Dallas, I would go to Dallas Fort Worth. Do they have just one airport in Dallas. There's 2 in Houston one in Dallas?
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Demetrios:
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THere's 2 in Dallas.
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Howard:
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Oh there's Love and D.F.W. You've gatta be 2 hours away from that airport. It's supply and demand. There's so many damn dentists in Dallas. You go 2 hours away. I was talking to a kid last night in Iowa, went to an, oh my god. He went to a town where the city was 2,000 but the count was 6,000. No dentist. He won't have to take Delta, Medicaid, Medicare. He can charge whatever he wanted for his bottle water, cup of coffee, iPhone. I mean those guys just crush it.
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Then the other thing. One thing I've noticed, a huge variable. If your mom stayed home and made cookies and your dad was an employee, they didn't learn any business sitting around the table. But the kids whose mom owned a restaurant, or their mom was a dentist or a dairy farmer, it doesn't matter, if your mom and dad owned the business you don't realize how many times when you were eating dinner, or breakfast or lunch, or =driving to church, they're all talking about all these things you need to know, marketing, customers, H.R., upset customers, staff. I mean, and by the time they walk out of dental school. They've never had an M.B.A. like you do, but its all back here in the noodle cause they lived through it for 25 years. They lived through a quarter century of small business school.
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I think those dental school deans need to just pick kids from small towns and try to pick the kids that have some family experience in free enterprise. THat's why I think about 1/3 of the class has a dentist in the family. Whether its mom, dad, uncle, cousin. It's not so much the dental knowledge they learned, in root canals, fillings and crown. It was actually the fact they understood it as a business. They had a building. They had staff, they had working hours. They understood the business of dentistry. I think that has far more to do with their success.
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Demetrios:
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I think that would really help out with those who really know the business side, their success is from the root. Those who don't, they have to do a lot of catching up. THat's what the biggest trend for some of the locations that don't succeed is. You want to grow but you don't want to learn anything new. So there's no way you can grow unless you learn something new. So just get out of your head that you can just do whatever you want and you're going to get production. No, you have to actually change. And, if you do change, you'll adapt. But if you never change, there's no growth.
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Howard:
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You and I each got our M.B.A.. I got out of school in '87 and by 1998, I saw corporate, I saw getting more serious. So I enrolled, I'm only 10 minutes away from Arizona State University. They had a Monday and Wednesday night program from 6-10, year round for 2 years. It was 3 trimesters, 2 classes a trimester. So, 2, 4, 6. Twelve class. It was the coolest thing I ever did in my life. What would you say to a dentist if the dentist said to you, Demetrios, I'm not good in business, I'm not that good at all. My parents were both employees, I'm just not good at it. What would you say if she said, do you think I should go to night school or the executive weekend Saturday, every Saturday for 2 years and get an M.B.A.
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Demetrios:
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It depends on your goal. Some locations would rather just have, I would rather delegate it and have somebody do it for me. It depends on their mentality. Some are just burnt out of school. I've been going to school this long, I don't want to do anything else. I don't want any other acronyms behind my name, I just don't want to do that. I do encourage take some type of business courses, even if it's a night class, even if it's online or something. You can get an M.B.A., M.B.A. goes a very long way. What I've learned from that, you learn your core competencies of business. You learn how the structures work, the different business models. How to do analytics. I do several case studies and you would imagine how these case studies work and when you get out of a business course or human resource course. Whatever course it may be, you've learned so much, you have a better grasp.
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So when you do that, you have some type of knowledge. But if you don't, then you're going to keep asking someone else for help. So, I would suggest, an M.B.A. is a great thing to have. It is. I'm so thankful for it and I learned so much, but you don't have to have one to be successful.
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Howard:
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No you don't, you legate.
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Demetrios:
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Delegate.
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Howard:
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The other thing that was great, since I went back. I forgot how old I was, I graduated in '87, 1998, I was born in 1962, so I was 36 years old. SO that 200 people in the class, almost all of them just graduated from A.S.U. undergrad you know, an hour ago. How old were you when you got out of college? 22? So they were all 22 years old, and I was 36, and every time they put you in groups. They say, alright, everybody breaks up into groups like 5. So you'd be in 4 and now you gatta pick a company. Say your studying marketing or managerial economics or macro economics. They say, okay, you're going to pick a company, heres the problem, you're going to work on that for 2 weeks and then the projects due.
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They'd say, [inaudible 00:49:07], and I'd say, please do my dental office. Please do today's dental. They're like, alright. So, I'd be trucking down 4 young hungry kids in M.B.A school, opening up my whole office to them. If its accounting, heres all the books. If it was ... it was so fun to have these fresh, eager, students who, wanting to get an A on the paper. Wanting that special insight, digging through my office every damn trimester, 6 different times, a group of kids were turning my dental office upside down. Trying to make it faster, easier, better. It was the most fun I ever had in my life.
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You know when dental schools over, I kissed the ground and almost cried. Thank God it was over. I felt like I was just coming home from war. When M.B.A. school was over, I'll never forget, I drove home, and it was slow, and it was somber, and I thought, God, I'll never see those 200 kids again. Now some of them became patients and all that. I though to myself, Ill never see those 200 again, it was so fun. Any business that was in the news, any business, you get to class, and two 2 hours classes, [inaudible 00:50:25] first thing you start off is just a group discussion on who was ever on CNN that day.
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Demetrios:
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That's good. I really like that type of environment because the only way to learn is if you have participation, if you ask engaging questions, talk about real life stuff. That's the key factor, real life stuff, not just what's in the books. What's going on in real life, and then maybe it will stick more. I know when you do that, you learn more than if you're just to look at it in the book. That makes a key difference.
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Howard:
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When I'm on Dental Town, and I'm reading about H.R., which is what you concentrate in H.R., one of the biggest fears is they want to sit down and talk to their hygienist or staff member about what's bothering them, but they just cannot do it. They're afraid. They'll even tell you on Dental Town, I wish I could just go up to her and tell her, blah, blah blah. But then did you tell her? No. They'll even say, chicken, fear, afraid. How do you coach someone to have an open, uncomfortable honest confrontational discussion? For instance, I'll give you a specific. The hygienist wants a raise because of course the earth is going around the sun. Her raise is raised on astrological charts and the dentists sitting there saying, my overhead is going up every year. The insurance fees are going down, my overhead's too high, I can barely pay my bills. I can barely pay my bills, and she wants more money, and then you say ... how do you coach or teach someone to have an uncomfortable conversation?
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Demetrios:
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Number one, the biggest thing that I always go over is set an initial goal. Make sure you set an initial goal from the very beginning so they'll know, and you can have a metrics to track. So, if you have a hygienist, the standard is 30-33 percent of production. So you can have a production goal for her. SO, it takes away that subjective feel of if I say something to them,is it really going to hurt their feeling, but no, the production is supposed to be this amount and based off of the numbers. Based off the actual metrics. That takes away that ease of actually approaching somebody cause you're looking on an objective stand point versus a subjective. That is the biggest, the absolute biggest factor, even when you have an assistant, even when you have an associate. You have to go over those numbers. Those are the numbers that are used to gauge, so you can say, based off of these numbers, this is the results of why you don't have a raise. Based off of this, now it takes away that stress in saying, it's you, you're just the person that's not giving them a raise, they blame you. It's your fault.
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No, based off of this, you're supposed to get this much of production, so looking at this, what do you think will be the best plan and so have themselves evaluate themselves. That's another big key factor. Evaluate themselves, ask them. What do you think you need to improve and what do you think went well. Those 2 key factors, number one, have an objective versus a subjective goal evaluation. Number 2, have themselves evaluate themselves. You'll be surprised what some of the employees say about themselves. You'll learn a lot.
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Howard:
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This point in my life, I've lived over half a century, 55 years, I still think the most mismanaged sectors are healthcare and government. Another one is entitlement. When you're working construction, when you're working plumbing. When you come out to a house to install an air conditioner. You just work until that job is done. Every industry, they miss lunch, stay late, come early. SO many times I'm in a dental office and they're talking about high overhead. The eleven o'clock cancel, from 11-12, while they all sit there. Someone calls up, and they don't even think, well 12-1 is my entitled lunch. The 11:00 doesn't show, someone calls in at 11:30 and says, I can be there at noon. Oh sorry, that's our lunch time. Its like, why cannot you eat now and then do that. Same thing at the end of the day. They don't even know their break even point for the day. Let's say it 4000 dollars and they're at 4300 and the 4 o'clock cancels and they're 200 short of paying their bills. Then someone calls up with a broke tooth and they say, well, I can be there in 15 minutes. Oh, I'm sorry, we close a 5. You close at 5.
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I mean, I love dentist, I love my homies but I don't even think they know how entitled and lazy they are. I mean hopefully you had part-time jobs growing up in high school and college. I have never seen, except for government agency, like the Department of Motor Vehicles and a dental office. Look at our peers in hospitals, when they hire young physicians out of school, they say, hey Demetrios, you're going to do a 24 hour shift Monday at 8am til 8am the next day, and Thursday at 8am til 8am the next day. You'll say, thanks for the job, that's awesome.
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You hire a dentist. Um Tuesdays and Thursdays it says I'm leaving at 5, we want you to stay til 7. What? I have to work every 4th Saturday. I have to work one Saturday a month from 8 til noon. Dude if you broke your leg on Christmas, every hospital in Dallas and Phoenix is fully staffed. If there was a storm and the electric lines went down, they'd be up there in cherry pickers while its snowing and raining, and still has lightening.
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It's so hard to look at dentists, they'll come to you and they'll say, it's so tough because I went through a divorce. I'm putting 2 of my kids through college, and I'm just not making enough money. It's like, dude you don't work Friday, Saturday, or Sunday. Has it ever dawned on you that maybe you should just work. It's almost like they call you up and say, how do you make a lot of money just going there 8-5, and always get a lunch 12-1 and always leave at 5, and how do I make twice as much money.
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It doesn't even dawn on them that maybe you should work your ass off for a few years.
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Demetrios:
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It's just like working out at the gym. Think about it. If you're going to do bench press for example, and you're going to warm up. You do a set of ten to warm up. You cannot do just 2 reps, put up the bench press and say, I'm done, I cannot grow muscle, because I'm not actually putting in the work. SO, putting in the work, I think is the most important part when you first start. I really strongly believe that it's the desire. You can have the knowledge, you can have the skills, but the desire's not there because you have this disillusionment, this is how dentistry is supposed to be. Then you get there and the frustration is not like you thought it was, and how it was portrayed. Now you're just in a whirlwind, because you're just frustrated with everything that's going on, and so you want to get out of the environment as soon as you can. SO I think, probably because the norm is to do the 8-5, and there's a lot of locations that do emergencies and stay late, and are open Saturday, those are very successful location.
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So, for those who are actually considering doing only 8-5, you might want to consider adding the extra 2 hours, 2 days a week. You'd be surprised. A lot of people work 8-5, and so if you're closed when they get off, who gets the opportunity? SO it depends on what opportunity. So it depends on what opportunity [inaudible 00:58:09]. You can even have an associate dentist work for you on those days that you don't want to work late, because you can do that. Or you can have somebody else fill-in, you can do temp service. It all depends on that persons desire. It can be done. There's very successful practices that are open 7am-7pm, and their ultimate goal is to grow to multiple practices, and they'll work hard for it. But you have to find out what is your main why. Why are you really doing this and what is your goal. If you have no goal, you're really just goin around with your blinders on.
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Howard:
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It's embarrassing to be a dentist to know that 8 percent of Americas emergency room visits, are a toothache because it's after 5 o'clock. It's on the weekends. I mean 8 percent of people who got to the emergency have a tooth ache. You would think that they would either ... why can they fix a broken leg and do a biopsy and remove a tumor out of my brain. If I was going to start a D.S.M.O, it would be, I wouldn't be renting in Wal Mart. I'd be renting in emergency rooms. This year alone, I took referral pads and I've gone to every emergency room in a 15 minute drive. I do that always with the pharmacists. I sometimes take them to lunch or dinner. I mean you shouldn't believe how many people walk up to a pharmacist and say, what would you take for a tooth ache? Would you rub Ambasol on it or would you take Buffrin or Excedrin or what is best for a toothache? And Brad will say, actually, it's right across the street, that Today's Dental, go see Howard Farran. Blah blah.
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Yeah, if I was a kid. If you didn't want to live 2 hours away, lets say for some darn reason you want to live right smack down town Dallas so you can stare at the obnoxious Cowboys home. Is that the most obnoxious team in football? The Dallas Cowboys.
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Demetrios:
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No doubt.
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Howard:
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They've got to be the least humble.
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Demetrios:
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I love the game. Either if they win or not, I just love the sport.
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Howard:
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Oh I do to. You guys have a rocking hot quarter back this year.
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Demetrios:
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Yes.
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Howard:
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My gosh. Who would have thought. Troy Aikman got injured and his back up was twice as good.
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Demetrios:
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And take them to the playoffs. It just happens. Its just one of those things. You might have one of those diamond players that every now and then, they just give you a star. It's been a pretty good transition. It's going to go okay. We just have to stay humble. Just like in dentistry. Just stay humble and know that the most important part is earning.
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Howard:
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Well, you've had a very long 23 days. You lectured at Paradise Valley [inaudible 01:01:08]. Talk about working hard after 3 long exhausting days. It's dark outside. Its night time. It's Saturday night what did he do on the way home? Stops by some short fat bald guys house and ,talk about a work ethic. It's late on a Saturday night. Thanks for stopping by.
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Demetrios:
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Thank you.
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