Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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Dr. Kyle Fagala is the owner and orthodontist at Saddle Creek Orthodontics, with two locations in Germantown and Collierville, Tennessee. Dr. Fagala graduated from The University of Tennessee in May of 2013 with a certificate in orthodontics and a master's degree in Dental Science for his thesis on three-dimensional imaging of the airway. Dr. Fagala is the course director and lecturer of Development of the Occlusion, a class for 1st year dental students at the University of Tennessee Health Science Center. He is also co-founder of the digital marketing agency Neon Canvas, host of the web series The Digital Orthodontist, and Key Opinion Leader for 3M Oral Care and Komet Burs. He loves music, specifically the drums, and spends more time than he should on social media. Dr. Fagala, his wife Anna, and their three children Charlie, Libby, and George live in Germantown and attend Highland Church of Christ.

www.saddlecreekortho.com

www.neoncanvas.com

Howard:  It is just a huge honour today to be Podcast interviewing Kyle Fagala all the way from Germantown Tennessee.  He is the owner and Orthodontist at Saddle Creek Orthodontics with 2 locations in Germantown and Collierville Tennessee.  Doctor Fagala graduated from the University of Tennessee in 2013 with a certificate in Orthodontics and a Master’s Degree in Dental Science for his thesis on three-dimensional imaging of the airway.  Doctor Fagala is a course director and lecturer of development of the occlusion and class for first year dental students of the University of Tennessee Health Science Centre, he is also co-founder of the Digital Marketing Agency Neon Canvas, host of the web series The Digital Orthodontist and key opinion leader for 3M Oral Care and Komet Burs.  He loves music, specifically the drums, and spends more time than he should on social media.  Doctor Fagala and his wife, Anna, and their 3 children, Charlie, Libby and George live in Germantown and attend Highland Church of Christ.  Now you must have had a few jokes on the playground when you were little with the last name Fagala.  How did that play out on the playground?

Kyle: Yeah, the funny thing is I went to a real small, and thanks for having me on the show, Howard.  The funny thing is when you’re a kid, you don’t really know that it’s embarrassing and you slowly sort of put it together.   And I went to a really small private school in Paragould Arkansas, we were like 27 in my graduating class and so, you know, everyone from kindergarten to senior year, basically.  So, I guess I didn’t really get made fun of it as much but then hitting college and then certainly, you know, dental school, it would sort of be, you know, a prevailing thing.  And people, my one liner, people always ask me, you know what is that, you know, what is Fagala?  And I say it’s unfortunate, and so, but I think, like a northern Italian maybe is what I bred, like beech trees are there and it is like the gays EEAs, the Latin, so I’m trying to figure it out but it’s really, it’s just kind of an odd name.  But I’m the only, I think, Doctor Fagala who’s a dentist and Orthodontist so there’s that. 

Howard:  Yeah, well, having a unique name, I had a classmate in dental school named Dave Smith and he used to say to his mom, really, mom, really, my last name is Smith so you had to go with Dave.  And I remember several times at a bar when you hand them the ID, Dave Smith, the bartender was like, okay, I know this is a fake ID.

Kyle: Yeah, that’s why you go with McGovern when you have a fake ID, a McGovern, so anyway, yeah, it’s interesting, there is a reason why I named my practice Saddle Creek Orthodontics and not Fagala Orthodontics, and I go by Doctor Kyle, just to make it easier. 

Howard:  Well, you know, I call this dentistry, oh, yeah, by the way, my fag joke is when I work very hard to get my FAGD, you know, 5-years, 500-hours and I got my FAGD and I put it on my card and I put it everywhere in the dental office, and the first person that ever mentioned was an 80-year old lady, she says, I see that you’re a FAGD, I have a friend who’s a fag, and I thought, really, that was my only feedback from that alphabet, was that she had a friend that was a FAGD.

Kyle: Yeah, internal marketing. 

Howard:  But the unique name is neat, I think the best marketers are the prescription drug medications, they always, the earliest letters are used the most.  So, they always go to the back of the alphabet and find a word with a Z or an X or a V.  Xerox is made that way, they were informed to come up with a word that didn’t exist, you know, then you can get the website, the copyright, and I like the fact that Farran, there is like only 86 Farrans in the whole United States, so it’s very, very unique.  

Kyle: Yeah, nice, nice. 

Howard:  So, this is Dentistry Uncensored, so I like to talk about everything, I don’t want to talk about anything that everyone agrees on.  And you, I want to talk about where the controversy is and you or, you wrote a thesis on three-dimensional imaging of the airway and there’s 2 components to that.  Number 1, let’s just start with three-dimensional imaging, some people are saying, you know, Orthodontics, you can do that with a pan and a SAF all day long with a lot less radiation, and are we using too much radiation on little kids for a 3D which might not really give us that much extra oomph at all.  That is the controversy.  Do you agree that that’s the, first of all, do you agree that that’s a concern for people?

Kyle: Yeah.  Yeah, I think it’s a controversy, I mean, it might surprise you.  I did my thesis on that and I feel like I understand that world pretty well, there’s people who understand it better than I do, for sure.  I actually saw you at the Henry Shaw meeting, there was some guys in that group that really understand 3D a lot better, and airway a lot better than I do.  But I don’t practice with the one, I don’t have one, I think it’s cost prohibitive, I started my practice from scratch and I could not afford $120 000 i-Cat, it’s a great machine.  I do think, for what it’s worth, that it’s a little overkill for most kids, I think that really the thesis that I did which, it’s a thesis, it’s not like its ground-breaking research, but my conclusion was, is that there’s only so much you can tell by taking the volume of an airway, I think there’s a lot more that goes into Apnoea issues or airway issues.  And I think if you talk to anyone who really understands that, and they will kind of give that up, and so, you know, it comes out of the tissues and how tense they are, and a lot of things happen when you are sleeping.  When you are sitting there and you are getting an i-Cat image on a kid, you know, they are sitting up, they are not lying back and there is just a lot.  There are way, there are tons of things.  So I think it is cool, but I think a pan and staff is a lot less on the, you know, the microsieverts levels and, although there’s new machines that, I think the new i-Cat Flx, they say that it’s actually fewer microsieverts than a pan and staff, traditional pan and staff.  And so, I guess it can go either way on that, I think that honestly, the amount of radiation is so little.  I tell people it’s about the same as what you’d get on a weekend sitting inside your home, and yet it’s still, you know, as low as reasonably acceptable.  So I think we need to be seeking, just like everything with dentistry, to do the least damage possible, but I don’t know that it’s the end of the world, and yet I don’t use it.  Was that like, a political answer? I don’t know. 

Howard: Well, I think that, you know, I’m trying to trying to be a leader, and these dentists don’t realise that when they get into a bunch of debt, that that turns into a lot of stress and a lot of overhead, and I applaud, either you are an Orthodontist, and I know self-esteem and knowledge is like, I can practice Ortho without a damn $120 000 x-ray machine, just because you sell big, expensive, shiny object, these dentists, I mean, it’s like, it’s a human phenomenon.  Warren Buffett always says that 95% of the CEO’s in the Fortune 500 go to work every day to learn how to complicate everything more, and spend those proper dollars, instead of giving them to the stockholders, they find ways to blow all the money.  And it says only 5% of the CEO’s actually go to work every day and say, how can we do this faster, cheaper, easier and higher quality?  And it’s got to do all those four things, and dentists always forget the cheaper, and they say, my gosh, I can get into $300 000 more debt if I start scanning my teeth impressions instead of taking an impression material, milling them out chairside and doing it with a 3-dimensional x-ray machine.  Okay, well now you just doubled your student loan debt.

Kyle: Sure, yeah.

Howard: What is wrong with emperor gum and sending it to the lab?

Kyle: I mean, I’m probably closer to that opinion than the opinion that everything has to be digital and high tech, I mean, I have an i-Terror scanner, I’ve got a 3D printer, so we do some of that but, I mean, 3D printers, you’re talking $3500 for a form, too, so that to me is in the realm of reasonable and then for scanning, we doing a lot of Invisalign, we do all of our appliances digitally so it cuts down on a number of appointments.  So, for me it became that breakpoint of, I do think this will provide for us, you know, more productivity and profitability.  But, I think when you first get out you could actually use an analogue machine, x-ray machine, I mean, I don’t know why you couldn’t, you could basically get those for free.  So, it’s the number one thing that I would probably say to graduating dental student, certainly one that opens their own practice is, you don’t need everything to be nice and shiny, you can get old chairs, you can refinish them, you can repaint them.  So, we got used chairs when we opened our office, so we got 7 chairs and they were all used, saved a ton of money, thousands of dollars.  But I would say this of the 3-dimensional stuff, you never know what you don’t know and I would accept there is a lot that I don’t know about what you can do with a comb b, and so with caution I would say I don’t think it’s necessary but I don’t really know.    

Howard:  As far as those claims about all the radiation, remember that pharmaceutical companies usually spend as much on advertising as they do on RND, so a lot of those new drugs and new equipment and all those claims were usually invented in the marketing department.  You know, so you know, if you’re an American, I mean, Americans are the most cynical people, I mean, I’ve been around the world.  There’s no one more cynical than an American because we live here, we know that when that man, whatever that man is saying, he’s just trying to steal your wallet. 

Kyle: Yeah, yeah, sure. 

Howard:  I mean, I mean, let’s do this, in Tennessee, if 100 women went to get their oil changed with a $29-dollar coupon, at 100 times out of 100 a man walks out and says, well, you really need to change your oil filter.  What percent of the woman suspect bullshit?

Kyle: Probably 100% and then probably 93% get it, you know, I mean, so yeah, and yet I feel that I have to guard against that with Orthodontics because every time you get a dad actually coming to a consult which is about 1 in 30, maybe in the Orthodontic world, you always get the question, or at least 95% of the time you get the question, well, is this medically necessary, do we have to do it, because dads are looking for an excuse to not do it.  Whereas moms are like, well, my baby needs this, and its really easy to want to give reasons and create reasons whereby Orthodontics is medically necessary, and the truth is, Orthodontics is typically just a cosmetic benefit, it’s an aesthetic thing, you know, it’s something we do because we’re a first world country and we can afford to do it, and we look better and that brings with it, you know, lots of benefits.  But like, who really needs it, you know, who really has to have it, I guess, so I think when you’ve got 3D technology and you’re looking for a reason to justify the purchase, you might be apt to use it to justify, well, this is going to open the airway and this is going to make the breathing better and things like that.  Again, I’m not an expert on it but I think that’s used more times than not, well, like, you’ve got an overbite, once we correct that it will open the airway and that little side for my thesis, what we found is class 2’s and 1’s were no different on average in terms of volume and area, and area minimum constriction and all these sort of things that you can measure that I see people circle and say, well, look how narrow it is here.  Now clinically is there a difference in sleek study, maybe, but I just, I think it’s really easy to want to justify our tools, why our treatment of choice is necessary.  And I think honesty is something, I wouldn’t say losing it but I think what you’re talking about with marketing people is we allow them to speak for our profession more than we should.  And their job is to sell stuff, so that is their golden God, you know. 

Howard:  Yeah, and big pharm, I mean, drug adds 5.2 billion a year and rising, I mean, during the last year super bowl, I mean, all everybody said was who won the game, I’m not sure but I think I might take this new drug for an irritable bowel syndrome and toe nail fungus. 

Kyle: Toe nail fungus was the worst, yeah.

Howard:  And it’s pretty amazing that 9 out of 10 big pharma companies spend more on marketing than RNB, I mean, that’s, I mean, that’s just crazy.

Kyle: Yeah, yeah, well, it’s crazy and I think the only major dental company that has understood that has been Invisalign and they understood that marketing and idea to the consumer is more powerful than trying to prove something to a dentist.  And so, you might say we’re fickle and hard to come around but consumers will be easier to market to, so then you have them coming in asking for the product and pushing it and you’ve seen what Invisalign stocks done the last few months, I mean, it’s incredible. 

Howard:  Well, I’m very proud of Invisalign because in my 30 years since graduation, you know, most all your major brands were already existing, you know Cras, Colgate, Listerine, that was the new brand built in my life time that is a household name from here to Cambodia to Malaysia to Soweto, the whole planet understands Invisalign.  But before we start talking Invisalign, that course that you’re teaching covers Anthropology, and I see the big thing now, you know, the millennials want to prevent disease.  They’re not hoping for lung cancer, they’re just not going to smoke, they’re not going to eat Twinkies and Cheetos and then hope they don’t get sick, you know, they’re trying to prevent diabetes, not find the better, cheaper, faster insulin dispenser.  And right now, the thing that lots of millennials are reading about is that malocclusion is a very recent phenomenon with the homosapien, and when you go back, I mean, on today flying around the news is that they found 130 000-year-old Neanderthal teeth near Croatia and it had dental work and this is factual evidence that people, Neanderthal, number one, he must have been smarter than we thought.  Because they thought he was less smart because he was extinct by homosapien, my first thought was, does that mean the world’s oldest profession just got dethroned and now dentists have just replaced the ladies of the evenings, the Mary Magdalene’s, I think we’ve just kicked the prostitutes right off the winner’s stage, we’re now the gold medallists of the world’s oldest profession.  But my question is this, how come when they find Neanderthal, cro magnon, peking man, how come when they find all those groups they don’t have these malocclusions?  And now when you go to Phoenix and Memphis, they’re everywhere, why, and I think the next move in Orthodontics isn’t going from 2D to 3D, or all this is going to be starting to say why the sapien, now modern man have all this malocclusion, is it the binky, is it thumb sucking, is it going from throwing your daughter a bone of the master don and she has to chew on it for an hour and a half, now she’s eating apple sauce out of jar of Gerber baby food.  You see it when they just have the mildest difficulty, nursing mom switches to a bottle and a sippy cup, they’re just like this child is going to consume three times as many calories without putting any forces on his face, do you think that’s what it is?

Kyle: Yeah, it’s funny that you brought this up because we talk about it at length and I think it’s one of the more interesting concepts, is that people don’t realise that malocclusion is recently a new thing.  I mean, it’s 100 years plus or minus old and so there’s a few things that we talk about in class, and the one of them is you lose mastication, we have a softer diet now than we’ve ever had, and so they’ve done studies with monkeys where they’ve given them a soft like, fudge like diet versus a harder diet and then compare that to monkeys in the wild.  And as you’d might expect, the ones with the softer diet, they have narrower maxilla’s, you know, their jaws don’t develop as much so when they kill the monkeys, they weigh their mandibles, the maxilla’s, they weigh less.  And so, there’s just less development, as you would assume, I mean, muscles build bones in a sense so the more mastication, the more force required to eat, the more development of the jaws and with that would come the more development of the upper jaw, the more space to fit within the dental orage, and so that makes sense, like we get that.  But what do we eat all the time, what do most kids feast on these days?  It’s McDonalds, it’s Taco Bell, you could almost eat that with a straw and so that would be like the big major change.  The other would be chronic breathing, and so if you’re not breathing through your nasal passage, your upper jaw is not going to develop to the same degree, and so anytime, well, not anytime but most times when you see a kid with bilateral posterior crossbite, narrow, narrow maxilla high bolt, they don’t breathe through their nose.  And so, it can be combined with a lot of things, one of those being we live in cities more now than we do in rural areas and so we’re around each other, and so we’ve sort of traded these diseases a 100 years ago, like polio and yellow fever and things like that, for obesity and for just being surrounded by each other.  More allergies and things like that and so there’s a lot more that can be said by smarter people, but it’s the way that we chose to live.  So, millennials which, I technical am a millennial which came up this week, they’re calling, I think xennials, it’s like generation X to millennials, I think 77 to 83, I’m 84 but I think I’m more, I don’t really feel like a millennial but if one of the things about millennials is trying to, you know, prevent disease by living better, I think I’ll take that, I think that’s good.  I just don’t know how much you can do, are you ever really going to convince families to not eat McDonald's when they have kids.  And are you ever going to convince people to move out of the city and live out in the rural areas, so it’s one of those things where it’s a disease of civilisation and yet we’re not going to give up on civilisation.  So, I don’t know but I think there’s some things, there are smart parents that could probably figure out ways around this, I would say it’s not vaccines, Howard, that’s one thing that I would say.

Howard:  But why do modern people, why does modern man breathe through their mouth more than the cro magnon and Neanderthal?

Kyle: I mean, that would be a question, I mean, it’s sort of all one in the same, I mean, nearer the maxilla I would assume that would cause for more nasal breathing issues, something about low tongue posture and how that’s all interconnected.  So, we see a lot of overbites, I mean, allergies, I mean, these again and I am kind of speaking outside my area of expertise but it would seem the more people you put closer together, the more apt they are to develop allergies and things like that.  We also exercise less, we work less, I’m actually reading a great book, it’s by Ben Says, it’s called the Dentistry American Adult and it talks about how we have institutionalised school to the extent that kids don’t work younger.  And so, mostly agrarian, you know, industry, I think 90% of people were farmers before like 1850 or something.  Kids were working at 7, 8, 9, 10, they weren’t sitting around playing video games, getting fat, and as we get fat it’s harder to breathe through our nose, more mouth breathing, if we’re at McDonalds we’re not working our teeth out, so, and so forth and we’re also keeping our teeth longer.  So, when you find like an old skull, there’s one called like American glory which most occlusions are, you know, concepts are built on.  It’s a perfect occlusion, it has got third molars in, everything fits in, at that time they were going to be eating rougher foods, they weren’t cooking foods through so it was like raw meats and things like that.  You know, I think things were just different, we’re as different as we’ve ever been over the past 100 years, I mean, those changes have been astronomical and I think that’s one of the things that we see. 

Howard:  And you know, our progress is always 2 steps forward, 1 step back, I think it’s funny right now how the biggest success we had for longevity without a doubt the last century was simply vaccines, clean water and toilets and getting clean water in without cholera, getting your waste material out and vaccines, and here we are 17-years into the new century and by this time last century we already would have had the Spanish influenza which killed 50 million people, 5% of the world’s population but now it seems like the anti-vaccination movement is bigger.  I see the vaccination and the water fluoridation movement, I mean, just the 30-years I’ve been here in Phoenix, I mean, every third woman that’s pregnant that you talk to is struggling with what paediatrician to go to because she’s not letting them vaccinate their kid, I mean, she’s concerned about it, you know, so. 

Kyle: Well, that comes back to the idea earlier of honesty, as doctors we have to be honest, we can’t let people, big pharma, people marketing to us set the standard and so you have the vaccine thing started by a quack doctor that writes an article with a sample size of 12 and people, you know, catch onto it.  And even Doctor Sears son, Doctor Sears a real famous medical doctor, his son’s a paediatrician, he has written book about vaccines and, you know, he’s kind of perpetuating this myth that vaccines are an issue and maybe just spread them out or slow them down and things like that.  And it’s just, you know when there’s a community built around when you write books, you get paid you get to speak and there’s an interest, a vested interest to make money off of things that maybe aren’t true, that maybe aren’t supported by research, that’s a slippery slope, that’s dangerous.  So, you know, the vaccine there is a really cool specialness on John Oliver’s show Last Week Tonight last weekend.

Howard:  Oh, we are two peas in a pod, love that show. 

Kyle: Do you watch that show?

Howard:  Yeah, there’s been more measles outbreaks in one Somalian community than all of America for the last year. 

Kyle: Yeah, it’s crazy and it’s sad, I mean, you’ve got people dying.  I mean, they were talking in France, I don’t know what the disease was there, maybe malaria or something but they had stopped you know vaccine rates went down and herd immunity went down and so then there was like 6 people who died I think it went from like 200 infected to like 15000 in a few years so yeah, it’s dangerous.  But the thing is if you want to Google something, if you want to find your truth and your echo chamber, it’s there somewhere.   And it’s kind of scary.

Howard:  So, tell me about your journey, where you were an Orthodontist, you’re successful, you have Saddle Creek Orthodontics in Memphis, by the way, and for my homies, they’re all driving to work right now, so what I do is so that they can find you without stopping and thinking is, I retweet your last Twitter.  So, I have retweeted, they go to @howardfarran and so then I, let me see this profile. 

Kyle: I hope my last tweet was something good, it probably wasn’t. 

Howard:  It was for Memphis braces, so you’re @memphisbraces and I retweeted transformation Tuesday, my kid is going to have an absolutely gorgeous smile now thanks to braces and those adorable dimples, that was an amazing before and after picture, it is beautiful. 

Kyle: Thanks, Howard.

Howard:  Then the last one before that was Neon Canvas and I thought that was interesting, so you have @neoncanvas, a digital marketing boutique and I retweeted your pinned tweet, when we design a website for a client, people say it’s the best Ortho website they have ever seen.  Now is Neon Canvas just digital marketing for just Orthodontists or is that for general dentists, and talk about your journey, how do you go from an Orthodontist who has no time, because he’s raising 3 children, Charlie, Libby and George, and then start a Neon Canvas.  Tell us what that was all about?

Kyle: Well, first off, your video has frozen, so I know, your son told me if there was something like that just to ask you. 

Howard:  Hang on, we’ll call you back right now, just 2 seconds. 

Kyle: Okay, sure.  

Howard:  When Microsoft bought it, so Skype for 8.9 billion, so you just know it will have nothing but bugs, now they just bought LinkedIn, I’m wondering how fast it will take Microsoft to ruin LinkedIn. 

Kyle: It was already ruined so I don’t know, sorry, not a LinkedIn fan.

Howard:  Why aren’t you a LinkedIn fan, what do you not like about it?

Kyle: It just doesn’t fit, I guess, for what I’m doing and what I’m trying to accomplish, it doesn’t make a lot of sense.  I think if I were in the financial world I have a lot of friends that are in real business to business world that makes sense.  But for me, it just, it there is no utility to it, it seems people are …

Howard:  Because you’re saying you’re in the B to C world, you’re trying to use LinkedIn to attract customers to your Ortho office and it’s really more a B to B world?

Kyle: For me, like professional growth and networking is happening better and more interestingly on Facebook.  So, inside groups and closed groups, and I just feel like LinkedIn, to me, feels like My Space felt 8 years ago.  It just feels like it’s time has passed, that is why I was so shocked they bought it, I mean, I understand the value in it and I am just not their target demo.  It’s just one of those sites when I get on I’m like, this stinks, I don’t like any of this, and some people love LinkedIn, so you know, take it for what it’s worth.  I mean, I love Twitter and some people hate Twitter, so.

Howard:  Well, Twitter is good because if you can get to 5 million followers, you can have the White House. 

Kyle: Yeah.

Howard:  I mean, that was a disruptive technology, I mean, I think the funniest thing is that guy Anthony Weiner he’s, if they never had invented Twitter he’d still have a job. 

Kyle: Well, he would’ve found a way to screw it up, I think, you know, Anthony Weiner, he continues to screw it up, you know, even recently they gave him a show, like a rowdy show and he’s sort of building himself back up and he did another thing.  I can’t remember what it was exactly but he’s back on the poo, poo list, he emailed something and. 

Howard:  The think is, the thing about Trump is that instead of, he dominated the middle man, I mean, everybody is making that in economics, I mean, they want to buy straight from the manufacturer to Amazon to your house.  They want to try get rid of the middle man and instead of going through journalists, he just tweets direct and I think it’s funny how he’s going down, he’s going to get impeached, it’s all over and they had 4 elections since the White House and the Republicans are 4 and 0.  And I think a lot, you know, Fred Doyle always says everything is marketing and I think the direct connection to 5 million Twitter followers, and also, what I don’t think about Facebook is, you post something on Facebook, you don’t have no idea who’s going to see it on your feed.  They have all these out rooms to decide what they’re going to push out whereas you send out a tweet on Twitter and I can prove this.  Because think about this, I have 300 000 followers on Facebook.com @howardfarran, and I only have 20 000 followers on Twitter.  And I’ll send out, I’ll make a post on Dental Town and a post on Facebook and a post on Twitter and that Twitter, the feedback is just boom in your face right now.  Where Facebook just kind of slowly dripples across and if you really want any feedback, you have to boost your post and give them a Benjamin.  And even if you give them a Benjamin, you’ll still only get 100 000 tweets, for me to actually get all 300 000 views on a post on Facebook, I have to give them $300 dollars, so that is basically what a $1 dollar per 100 or whatever?      

Kyle: Yeah, something like that.

Howard:  Yeah.

Kyle: Which is still reasonable. 

Howard:  It’s a $1 per thousand.

Kyle: Yeah, I guess I would say this, I love talking politics and Trump and all that and I think the thing that Trump understood, which if you’re out there and you hate Trump or you love Trump, it doesn’t matter, it’s to see success in a digital marketing form that obviously you can put a thumb on and say, okay, Twitter was a big part of why he won.  It’s because he understands authenticity, he is who is he, no matter his lies about who he is but he has a narrative that he sticks to most of the time.  Then he understands mediacy, so if Hillary Clinton sent out a tweet, it probably went through 2 days of focus groups and 30 other people were looking at it and changing it and altering it, whereas Trump’s came off of his toilet or whatever, you know, it comes straight from his fingers.  And I think that there’s one thing that social media has created for us is a value in authenticity and in the moment-ness if that’s a term.  And I think he really captured that, so I think we can apply those things, whether we like him or don’t, I mean, I didn’t vote for the guy but we can take, we can understand things about how we should market from that and that’s why I like Twitter.  There’s no, it is interconnected, you can speak to anybody that you want and it’s almost like cathartic because it’s like having a diary or a journal sort of, and it just happens that other people read it.  I don’t have as many followers as you so maybe someday. 

Howard:  So, you’re using, on your Twitter you’re using @memphisbraces as a B to C play to try to get patients to your Orthodontic office and then you’re using Neon Canvas as a B to B play to try to get, who’s your target market on Neon Canvas, is that dentists or Orthodontists or both?

Kyle: Sort of both, I mean, when we started Neon Canvas, we only started a year ago and, you know, it’s one of those things, I’ve already got 3 practices, I’ve got a family, 3 kids and too much going on but I have always loved digital marketing websites.  When I was 15, I was building websites like, you know, Metallica fan club websites, they weren’t very good. 

Howard:  It should have been Elvis Presley, you’re in Memphis, dude.

Kyle: Well, at the time was in Jones Wood Arkansas, in North East Arkansas, it’s all about the metal and classic rock.

Howard:  God, I love, there’s only three streets of music in America, there’s Bourbon Street in New Orleans, there’s Bill Street in Memphis and then there’s Second Avenue in Nashville.  And I don’t care, a lot of people say, well, I’m not a big country music fan and I’m like, dude, you haven’t been to Second Avenue. That’s the three best streets of music in anywhere that I’ve ever been around the world. 

Kyle:  I agree, yeah, there might be some places in Europe that compete on kind of an interest level, like a street performance but there’s nothing, I mean, Bourbon Street, nothing can beat the craziness of that but I love Bill Street, I love walking and hearing the Blues music and the Broadway is pretty hard to beat, that thing has just gotten crazy.  So, when I go there for meetings, it’s insane.

Howard:  Broadway, you mean in Manhattan?      

Kyle: Broadway in Nashville, Broadway second, you know that street where there’s all those …

Howard:  Oh, Nashville, I was doing second street.

Kyle:  If Broadway runs then it runs into second and it’s all there, and you’ve got these, I’m a musician, I’m a drummer, and the level of the musicianship in Nashville right now is absurd, I’d say it’s the music capital at this point, I mean, LA still and New York but, yeah, the level of musicianship there is unreal. 

Howard:  And the most common remark you’ll hear from the dentists when you’re down there lecturing and they’re from round the country, they’ll say, God, I always said I don’t like country music and this is so, it’s like a total difference experience when it’s live on Second Street.

Kyle: Yeah, sure.

Howard:  It is Second Street or Second Avenue?

Kyle: It’s actually, they call it Broadway, it’s kind of what it’s, I guess …

Howard:  I must have really been drinking too much, I remember it as Second Street.

Kyle: Well, Broadway runs this way and then you’ve got 2nd, 3rd, 4th, 5th and then, you know, Bridgestone Arena, there’s a lot of fun stuff down there.  But you were asking we got off on that.

Howard:  Neon Canvas, is it for dentists or for Orthodontists?

Kyle: Yeah, so we focus, it’s only been around for a year and we’ve been really successful, we have some kind of legacy Memphis clients and so we’ve got the biggest real estate agent in Memphis, and some restaurants and, you know, some other clients like that, most Orthodontists.  We have a couple of dentists, it’s not like it closed to dentistry, it’s just as an Orthodontist that was sort of the unique portion of the business is that we had an Orthodontist doing websites.  And so, I remember what got us on this Metallica building websites, I was the editor of year book and newspaper.  I’ve always loved kind of creating and communicating and publishing things like that and so it just seemed natural.  So, worked with a guy, he helped build my website, did SCO and another company and so we decided to do that, so no, we’re open to anybody, I mean, I think we’re doing really great stuff.  I don’t know what the dental world is like as much as the Ortho world but mostly it was two major companies, and the websites are pretty cookie cutter so we wanted to have things that, you know, were really custom and true to Orthodontics.  You will read some stuff on the Orthodontic website, it’s like who wrote this because it’s not written by an Orthodontist, and so that was sort of my goal.  To just speak as an Orthodontist would in a way that patients would accept and react to.

Howard:  So, were you building these on a word press?

Kyle: Yeah, yeah.  I had a few options, I mean, you can have a proprietary software but WordPress is kind of universal, it’s kind of like, what’s here, what’s to stay there are issues, things like security issues that are long standing.  But if you’re doing it the right way, it’s fine, the nice thing is if you have a company to build your website in WordPpress and you end up falling out with them, you take it anywhere else and they will be able to sustain it for you. 

Howard:  Yeah, and you got to wonder how can you have really good SCO if you’re with a cookie cutter website and there’s 500 dentists.  Like Twitter’s interesting, like you go to Twitter and some mornings you’ll wake up and like 12 different dentists just sent out the exact same Tweet.  

Kyle: Yeah.

Howard:  I mean, and you’re like, so then, you know, that dentist didn’t send that tweet, he didn’t create then and so how could that be good SCO when you got a cookie cutter website and there were 47 identical Facebook posts and Twitter feeds and all that I think in original content on a website.  So, when I grew up, when I got out of school, the hot new thing was the yellow pages and all of us guys that did it were frowned upon because that was just going to ruin the image of dentistry.  Now the big thing is SCO, would, do you think my homies need to think about when they’re doing a website?  And how much do you charge, so tell us those, for instance, and what does Neon Canvas charge if I’m sitting here driving to work and I’m 25 working Harland and I want to start my own DE novo practice, I want to get a website.  What should she know, what can you do for her?

Kyle: Yeah, sure, I mean, if you going to get a custom website where the content is loaded where we come to your office, we do the video and photo, I mean, we really make it a great website, let’s say.  The website is going to be 25 grand, I know that number sounds huge because I think most people think like 5 or 6 or 7000 for a website but the market that we’re in, there’s so much money left on the table when you don’t go for the best and so if you go for a cookie cutter website that has basically underneath the hood, I kind of refer to it like a car.  Like underneath the hood you have the exact same engine as everyone else in your market or you can go with the muscle car that’s got 600 horsepower, like who’s going to win that race ultimately.  And then a part of it is what the car looks like, so it needs to look good, it needs to be, you know, aesthetically pleasing to your target demo and that type of thing, and tell your story, too.  But we usually shoot for a retainer, so it’s one thing to build a website and build it well and if you do that, depending on your market, you can be successful, and if you’re a little bit tech savvy and you’re okay getting on there and doing your own vlogs and editing your own stuff and giving Google what is wants, which is unique, fresh content.  And the best way to do that is in the way of a blog, you would understand that you’ve got content coming out of your ears, man, which is a good thing.  And it builds you, I mean, when you search on the internet, it brings your website up, the best way to do that is really blogging, and most dentists can’t do that, they’re really good at doing dentistry but they not really good at digital marketing.  And so, we usually seek a retainer somewhere in the range of 2 to 4000 a month, and in the first year the package is doing the website and things like that, so we are definitely not cheap.

Howard:  So, it’s 25 grand for the website and then 2 to 4000 a month?

Kyle:  Well, it depends, and so if you’re just getting a website 25 grand, you get a discount if, you know, you kind of commit to a year-long contract with that certain monthly retainer.  We usually bill that in the bat and then in the year that follows and the retainer goes down and the website is not having to be rebuilt.  I guess what I would say what we have found is we sort of entered the market with one sort of idea of what we’d offer, and now we’ve kind of diversified that because not every practice is the same.  It seems like we fit best in a practice where we can be about 3% of, kind of their expenses, and so I think we can kind of fit in there in a comfortable slot.

Howard:  So, just of the website, it would be, 3% of revenue would be on marketing just for the website, does that include SEO or Google ads, I mean, that or just only the engine?

Kyle: So, paying for the Google ads, Facebook ads is going to be extra, and I guess what I’d say is I’m not the guy doing the proposals, so I mean, I know what we’re offering.  But the proposals always come down to, you know, kind of what is going to fit and what they’re after, so we have kind of a typical package of what we know will build practices and what’s been proven in my practice but everyone’s a little bit different.  So, if you’re talking about, really, like a 25-year-old dentist that’s just getting out, we’re probably beyond that, it’s probably more for the practice that’s producing 2, 2.5, you know, million, not necessarily for someone that’s starting right off the bat.  And in that situation, it’s kind of hard to say, the approach I would take there is that you’re small and sort of like Guerrilla warfare, like you can do social media yourself, you understand your story and you can tell it.  You can blog, you’ve got all the time in the world to blog but once doctors get really successful and they’re still trying to grow their practice, they don’t have time to sit and make a blog and optimise things for search engines and things like that, I mean, most of them don’t.  And so that’s why a company like ours is important because we know what it takes, I mean, the thing is, the rules are all known basically in terms of how to get a website up and it’s essentially created content in the form of a blog, share it to social media and get people to click through your website to establish authority for your website.  And then if you can start ranking nationally, so we rank nationally within our website with things like white spot lesions, and you know what not to eat with braces and stuff like that.  So, if someone in China reads my blog on a website and sits there for 4 minutes and it raises the tide of my website so that when someone in Memphis searches for braces, they’re more apt to find me and someone will rank higher.  And that’s the game, you know, the rules are known, it’s just who wants to spend the time to do it and write good stuff, share it to social media and have followers that want to click through it and read the stuff and it takes years to sort of develop that.  There is no shortcut, so if you’re talking about a company sharing, you now canned social media content on someone’s Twitter, nobody wants to read that, no one cares and they will unfollow you if you keep doing it, you know. 

Howard:  So, is this your company, are you the sole owner?

Kyle: I co-own it, I co-founded it, co-own it with a guy named Gavin Rasmussen, so he is the CEO and like I said, he has 10 plus years in digital marketing experience, he used to build websites and I would say he is an SCO expert. 

Howard:  Rasmussen, R-a-s-p-e-n-s-i-n?                                                                

Kyle: No, R-a-s-m-u-s-s-e-n.  Fagal, Rasmussen, strong, very strong. 

Howard:  Rasmaussen?

Kyle: No, R-a-s-m-u-s-s-e-n.

Howard:  Well, you know, the thing is, okay, so let’s look at the $25 000 cost, what would you say the average new patient is worth in Orthodontists, 6500?

Kyle: Well, I mean, that’s what you’re charging them, I’d say average fee probably nationwide is 5600 probably. 

Howard:  Okay, so 5600 for Ortho records, the whole new patient’s average, you’re saying 5600?

Kyle: Yip.

Howard:  And depending on whatever market you’re in, 2500 divided by 5600 would only be 4 and half cases.  The general dentist, no matter what market you’re in, is averaging his new patient is worth the same as an Orthodontist but instead the Orthodontist, but instead the Orthodontist will capture it in 24 months where the dentist will capture it in 60 months, but the real metric is, and that dentists don’t know.  Like they’ll say, I have a website, and I’ll say, how is it?  Oh, it’s great, and I’ll say, well, how many people go to your website, how many of those convert to calling?  They have no idea, so it’s like, okay, so I mean, Elvis Presley knows more about your website than you do and he’s been missing for 30 years.  By the way, do you know that I saw Elvis Presley with my dad and mum at Henry Marina in Woodstock Kansas.

Kyle: I’m jealous.

Howard:  That was a great deal, he was so blotted and limply and he didn’t finish any song without taking a break and taking a drink and patting the sweat of his head, but anyway, so someone else might say, well, I’ve got a website for 5000, well, they can’t tell you if 1000 people went to their website to convert one decal or if it was 100 people for one decal.  And then you say, well, when people call your office, you know, the national data is that between about 3 and a half, we’ll go with, say, 3 people have to call before your receptionist can convert one to put a butt in a chair.  And then you sit there and then you have to, then you get a 100 million cavities diagnosed in America, they only drill, fill and bill 38%.  So you need 1000 people to see your website before a person calls, need 3 people to call before your receptionist, who has no training, converts one in the chair, and we need 3 people in the chair with a cavity before you can convert one to drill, fill and bill.  So if you can just, and so what’s the answer to this?  But, you know, I think I’m going to change my bracket, I think I’ve been using the [unclear 41.13] bracket and I’m going to, you’ll go to the Henry Schein Symposium and I’m thinking about switching to a new, whatever, what do we work on.  So my question is, do you capture these metrics of converse rates on your website?  Have you gone, do you go to the existing website and say, okay, we just went onto your website last 30 days and your conversion rate is 1 out of 100, is it 1 out of 10, is it 1 out 100, is it 1 out 1000, I mean, that, I need a scorecard at the end of the Super Bowl, that’s what I love about the Super Bowl.  I don’t care what you think at home on the audience, I don’t care if they are doing the wave, the referees had decided that that is a touchdown and there are now 6 points on the board, and that is the final score.  These dentists never know their website scoreboard, do you capture any conversion data on that?

Kyle: Yeah, so one thing and it’s actually funny you bring this up, we are working towards kind of revamping our report system and our analytics to be able to just say that, to say, to study in certain offices, how many leads are we creating, how many are actually coming through, how many are actually starting treatment.  So we actually put an estimated RLI on that.  For me, having done this for 4 years, and having really always, my number one referral source has been digital marketing in some form, I had a good sense of how many we’re getting a month, I mean, you got form fills on your website, we have tracking numbers so we can see when people call from the website, you got, you can see which one of those came from Google ads, or one of those came from Organic.  And so we have an analytic sweep that ties all it in together, and you can see all that stuff in one little website.  And so some of them we use for clients, what I have kind of found is you have clients who are analytical, and you have those that are not, and they are more kind of momentum based who are like, well, I know it is working, I know it is there.  And I honestly fall into that category quite more than I should, but I mean, we get a good month on our website, we’ll get 60 form fills, we also have chats, and we’re getting typically in the range of 20 – 25 leads from our little chat applet that hangs out in the little right hand corner.  And so you’re talking conservatively in an Orthodontic office you know, 75/80 just from form fills and chats.  I mean, that’s a lot of potential clients.

Howard: Okay.  Your users now lingo, I got a lot of my homies, I mean, on Twitter, some of these guys are still in dental school.  So you said form fills, right?

Kyle: Yeah. 

Howard: Where you can request an appointment?

Kyle:  Yeah, so request an appointment for us, it’s, schedule a free consultation, that’s kind of the orthodontic thing, I guess. 

Howard: So you call it form fills, is that Tennessee slang?  Is it more like what you would call, would you call it to request for an appointment or a form fill or, what would you, what’s the technical?

Kyle: I just call it a form, I think that is like, you know, Silicon Valley speak, maybe like nerd speak, just, you’ve got a form.  So an information form, and they fill it and then it, ideally it alerts your receptionist, one of your receptionists and they call on that same day to schedule and to bring him in.  And so you have all different types of patients.  Yeah.

Howard: What is your average, if someone takes the time to fill out a form, what’s the chance that your receptionist can get him to walk physically into your office?

Kyle: So I would say, and I don’t have the exact data, and I need to get it together, honestly.  But I would say, from what I gather, it’s probably in the range of someone that goes online and passably decides, sometimes 2 in the morning to either chat us, or to fill out a form, request an appointment.  It’s probably in the range of about 85% that schedule, which is pretty strong.

Howard: And so how does that chat applet work when your office is closed and its 2:00 in the morning?

Kyle: So I use a, it’s a group that’s focused on Orthodontists, there is two main ones, Orthodontic space, the one I use is Ortho chats, it’s actually run by a guy in Kansas city, really great family, mother is an Orthodontist, he works in the office, and they have a time that kind of works in the same central space so they don’t outsource it.  The thing I like is they understand kind of how your office speaks, they’ve got information.  So they speak almost as close as you can get to someone who was actually in your office, and they cover it 21 hours a day.  So I think.

Howard: 21 hours?

Kyle: Yeah, I think they are not covering from like, 2 – 5 in the morning.  Which is going to be lowest, you know, traffic.

Howard: I bet that’s related, too.

Kyle: What’s that?

Howard: I bet you anything he is Irish, and that’s when, they don’t allow them to sell alcohol in Kansas City, probably can’t buy a beer after 2:00 and then they start again at 5:00 in the morning.  So he just said, no, can’t buy.

Kyle: Can’t stay up without Jamison. 

Howard: And then they go home and go to bed.  So he covers it from 2 – 5, Ortho chat, and, or it’s actually Ortho chats.

Kyle: Yeah, Ortho chats.  And, I mean, there’s a service.  I’m sure there’s a dental service, you can even do it yourself with something called Olark, it’s just a chat applet, it’s just a few lines of job script you drop on your website and it, you been on the website where it pops up, you are on Fed-Ex.com and it pops up.  It’s the fact that it’s a real person and it’s not like an automated thing, because those will piss people off, but it’s just another way by which you capture leads.  

Howard:  The other one was Olark, and that’s one where dentists would put in their own messages, you say?

Kyle: Well, you could be the one on the end, so your receptionist ostensibly could be sitting there and have the little chat applet open and then someone chats and they respond.  Couple guys I knew that tried that, they found that the response time was a lot slower than when they outsourced it.  And also, there is a lot of people that chat in from 6 – midnight, you know, the hours you wouldn’t be in there.  And so I think, you know, if I spend, let’s say $600 a month on Ortho chats, you know, on the chat service where they will be monitoring it 21 hours a day, and on the weekends.  For me, again, is you broke down kind of what Orthodontics is worth, if a patient is 5600, you got an average overhead of 50%.  So it works just saying a patient is worth $2500 to you, pay it out over 2 years, it’s working.  If I get one patient, I’ve paid for the fee, you know, I’ve paid the 600 bucks, and I would argue it is a competitive advantage.  And so if in your market you have chat and no one else does, who’s going to win that battle?  You know.

Howard:  So if someone said that you prioritise, let’s do an upside down pyramid.  So the upside down being the most deals.  So when you are building a website, let’s go most important, we’ll do the top 10.  10 being, will 10 be the most important or the least important?  We’ll go with number 1 to 10.

Kyle: Yeah, let’s start it with 1.

Howard:  Yeah.  When 1 – 10, 1 will be the most important and then 10 will be the least important, because I’m wondering, my walnut brain is thinking, request employment in a chat applet, I mean, is that like, the most important?  Least important?  We’re also seeing now dental companies are making us, so you can schedule your appointment yourself online in the middle of the night.  We, open dental is now doing that feature and we had a podcast guy on here, podcast from a, close to you, Louisville.  Get them on the schedule with Keith English, and Keith English, what’s the name of his company?  Oh, Localmed, and I think he has got Localmed on 1400 websites, and the lowest one is scheduling 2 patients a month.  And he has several that are doing, he actually said he has hundreds that are doing, 100 – 300 people a month.  Because there’s $160 in a week, and most dentists are only open 32 hours, so they go to your website at 2:00 in the morning, they just schedule.  So let’s go 1 – 10, what do you think is the most important that should be on that?

Kyle: So I actually have curated for a lecture that I give, the top 5.  So I’ll do those and then we can talk about some other ones inside, because that also makes, I actually. 

Howard:  You negotiate you ask for 10 you counter with 3.

Kyle: Yeah.  I give you 5.

Howard:  You counter with 5.

Kyle: Let’s meet in the middle at 7 and a half. Yeah.  So number 1.

Howard:  Or you could just pretend you’re a politician and just start making shit up.  

Kyle: Yeah, I’ll just start talking about something else.  So, something we all agree on.  But the number 1 most important thing in terms of search engine job optimisation which I think that’s the goal, so the goal is not to have the most beautiful website or to have, you know, your CV be 1000 items long, whatever.  The goal is to get butts in your seats, you know, I mean, it’s to produce.  And so, SEO is going to be the likes of search engine optimisation, you need to be optimised for as many different search terms as you can.  So the number 1 thing is a responsive and user friendly website, and so responsive simply means that it works on all devices.  We have now entered the mobile first era of the internet, and so we, as doctors, we, as people, who have grown up in a desktop first mind set, that’s the mindset we have, and it’s wrong.  So we design websites with the mobile in mind, you got to make a desktop look good and there’s less space with mobile.  You know, it’ll be like telling da Vinci to paint on a canvas that was a lot smaller, it’s not fun, you can’t make it as fun.  And yet that’s the world we are in, so it’s got to be a response, it’s got to work on everything, it’s got to be user friendly, it’s got to be easy to find things.  It needs, as a dentist, we want to complicate things, typically, it needs to be simple.  And so, I like to talk about an avatar client, and so if my avatar client, who is an Orthodontist, is a 28 – 45 year old mom of 2 and a half kids, and you imagine her kind of driving her kids to soccer in a minivan, that’s who I want to make the website for.  And so, what would she respond to?  She would respond to, and I don’t mean to stereotype but that’s the reality in the Orthodontic world, but she’s going to respond to softer things, so less tech, maybe kind of like what an [50.53] looks like, or Lululemon, or something like that.  So, you know, we respond to lasers and technology and stuff like that, but.

Howard:  So number 1 was SEO and responsive user-friendly websites, because now Google has gone to mobile first because now, when I was little was the IBM a main frame, then Microsoft came out with the Microcomputer soft, or Microsoft which we call BC.  And now over 50% of the internet traffic is actually on a smartphone, so Google is going serve up website to look better on your iPhone or and your Samsung than on a desktop.  So that was number 1, right?

Kyle: Yeah.  So, number 2 would be unique engaging and fresh content which is a kind of a fancy way of saying you need to blog.  I guess you could do it in a way of updating pages or adding pages or adding content to pages, but really, the best way to do that is to blog.  And I would say to anyone out there, so this is a dental student and you’re thinking, well, what am I going to blog about, ask patients, you know, survey patients, what is the number one question you have about dentistry.  You know, collect those, you have a list of 20 sit in your car, you know, if you have an iPhone you got the little audio recorder, record yourself talking about that topic for 10-minutes, take that audio, drop it in online, there’s sites that will transcribe that for you really cheap.  Or use Siri if you’re a cheapskate or whatever and you just want to do it that way, so you’ve basically got a blog, so then you go in and you edit.  I mean, it’s not the easiest thing to ever do and so if you’ve got a background in year book and newspaper and maybe you’ve done a blog and you’re looking for something easier, but content creation and people always ask, I’m sure they ask you all the time and I’d like to ask you as well, how do you come up with all this stuff?  It’s really not that hard when you start doing it, you know, it’s really like everything else, it’s, how do you coat 30 crowns in a day, well, I had to do 15 and then I did 20 and then I had 30.  You just got to keep yourself on a schedule, and so the publishing calendar is a good way to do that, you know, just like Elle Magazine would have a publishing calendar, create one for yourself and just make yourself blog a couple of times a month.

Howard:  Well, what you said that is most profound is dentists and patients are usually Mars and Venus, you should blog about what a patient asks, when a patient asks a question and you just found yourself with this spirited rant for 5-minutes, that’s the perfect blog and its tested because you didn’t pull this out of your butt, you were actually asked this by a live customer in your demographic deal.  Just like in my column, I have, I have written a column every year since 1994 and I refuse to schedule a time to do the column because I can’t just sit there and all of a sudden feel a passionate rant.  What I do is some dentist will send me an email and then if I feel something like, oh, my God, like blah, blah, blah, blah.  I type it out and hit reply and cc my editor and it’s like that was an awesome passionate rant, I don’t want to do a column when the cut, so get a discipline way on a notepad or something so when it actually happens you actually capture the question and that’s your blog.  How long should that blog be, what do you think the word count should be?

Kyle:  We usually shoot for 1000 characters plus or minus which is not that much.

Howard:  1000 characters, how long …

Kyle:  Sorry, not 1000 characters, 1000 words, 1000 characters would be really easy, that’s like 6 sentences, 1000 words. 

Howard:  And two monkeys talking, how long is a conversation of 1000 words?

Kyle:  I mean, this past weekend I’ve had a lot of articles lately, 2000-word article, I probably spoke it in, you know, 15-minutes, 20-minutes, I mean, in actually speaking, if you start and stop, I mean, it might even be 2000 words, I bet that’s about 15-minutes, 20-minutes, it’s not that long.  I think the average human speaks 300 words or is, it reads 300 words a minute, I think we speak 300 words, I don’t know but it would not take long that is the short version of it.  I think what kills people when they’re trying to create content is both not making themselves do it, they are not putting themselves out there, they don’t put themselves in the game, and then also what kills them is staring at a blinking cursor on a word document.  I think with the technology that we have now, there’s no reason why you should not speak it and then at least allow that to be your first draft.  And there’s so many services, you know, you could find somebody to help refine if you stink at grammar in English or whatever else, but you’re good talking, have somebody do that for you.

Howard:  I just learned yesterday, the difference between t-h-e-i-r and t-h-e-r-e, I had no idea. 

Kyle:  Yeah, so I’m also an English teacher so I’ve got that down.  But it paralyses you when you’re like an intense grammarian, it kills you, so sometimes it helps to be a quick start and just kind of like, go for it, you know.

Howard:  Yeah, so then what is number 3?

Kyle:  Number 3 is keyword optimisation, so that would be like kind of what you think of, like historically as SEO Search Engine Optimisation.  And back in the day Google was not smart and its algorithm was not smart, and so you could just stuff into the hidden part of the page, this page is about dentistry and crowns and implants and all these sorts of things.  So, when you search, then it would ping with those things, well, that’s a long-gone thing, and yet still the words that are on your website need to talk about the things you’re hoping to sell.  And so, when you’re blogging, you know, some of our most successful blogs have been like, we will do a shopping guide at Christmas for minthians, like that is going to do really well on social media because everybody wants to know about that, it has zero to do with Orthodontics but you better believe that I find a way to talk about the fact that we’re an Orthodontic office that provides braces and Invisalign and so on and so forth, and underneath the surface, what is called like alt text, like under photos it’s going to have some of those things buried in there.  But the blogs are really going to help build your business in the way of when people search for braces or Orthodontics or Orthodontists or Invisalign, it’s going to be talking about those same topics.  And optimising those keywords when you talk about them.  And so, you know, every blog that we try and put out for a client is going to talk about the geography that they’re in, you know, the 3 to 8 major cities that is surrounding them, you know, it’s going to talk about their name and it’s going to talk about the services that they provide.  So, you’re just optimising those keywords and it shows up on your website 50 times, and Google reads those websites and one website has it once and one has it 50 times, you they going to rank higher, you know.

Howard:  And there is a lot of thinking about the name, I mean, what do you think of the name of your website, like you are Saddle Creek Ortho, which I think is amazing because for SOE, I assume Saddle Creek is a suburb of Memphis, it’s a city?

Kyle:  Yeah, it’s really, there are shops in Saddle Creek, there is no such thing as creek, there is no creek named Saddle, but we just thought it was a nice name, it helped the, you know, people in the area knew where we would be.  It’s also kind of an upscale shopping centre so it kind of sort of, like if you want to hang out with people who are well known and have a good reputation.  So, we’ve kind of built it with our name, we also couldn’t be Fagala Orthodontics for reasons we’ve already discussed, so we like the name and now we’ve put a second location and area that is not Saddle Creek and that’s okay because our name is kind of beyond that, we have grown beyond that. 

Howard:  This is very politically incorrect but this is dentistry uncensored, but I see so many people that use their last name and, I mean, they’re Persian, they’re Farcie, they’re from India, they’re from Vietnam, Thailand, it’s like, dude, I think one rule is if you say the name I should be able to spell it.  When you say Saddle Creek, I’m thinking S-a-d-d-l-e C-r-e-e-k.  Like your partners name, when you said Alex Rasmussen, I had to spell it 3 times R-a-s-m-u-s-s-e-n, I wrote it down, so we had to go over the spelling 3 times, and these guys are going with that as their name because they got it from their Mama and their Daddy and they love their Mama and their Daddy but, dang, it’s not very good marketing.  

Kyle:  Sure, so here’s a very good way of putting that, if you asked 100 patients in my practice where they go, they don’t know how to say Saddle Creek Orthodontics, if you ask 100 of them who I was or what my name was I would like to think they know my name but there’s a good chance they wouldn’t.  Or they would call Fagala some, you know, variation, there’s probably 18 different variations and actually it is funny, you look at the search for Doctor Fagala and there’s like 15 different spellings, you know, because they don’t know how to spell it.  So, I think this idea that it has to be named after you like, so it’s got to be Doctor Jones Cosmetic Dentistry, family dentistry, whatever, like the old kind of peri dime, it needs a shift and so you need to create a unique and creative brand and you can’t do that around a name, especially if it’s Jones, or in this sense you don’t want to name it something where people can’t spell it and can’t find it.  And so, you know, you can talk the book position and kind of classic it marketing book and you need to be able to position in the mind the consumer, something that’s unique and associated well in their minds.  So, if you’re the 19th Memphis, you know, cosmetic dentist, they’re not going to be able to find you.  And so, you need a position unique, kind of, look at Xerox, hard word to spell but it’s positioned uniquely. 

Howard:  So, why did you go with go with Saddle Creek, why didn’t you go LBGD Creek by Doctor Fagala?

Kyle:   It would have been mistaken. 

Howard:  It would have been mistaken.  So, you agree with the name thing, like I had a really good friend he was from Iran, his name was Sena Seriya, I said, dude, go with Steve, just go with Doctor Steve, you don’t spend 30-years teaching everyone how to spell Sena Seriya.  

Kyle: Yeah, I don’t care, I’m Doctor Kyle and I think they know who I am but really, at the end of the day, I want them to know Saddle Creek Orthodontics.  Because when they’re going to tell a friend like, you know, maybe they say Doctor Kyle, he’s awesome, that’s great but I want them to understand the culture of Saddle Creek Orthodontics, it’s just a more marketable thing so.

Howard:  Hang on a second, my dental assistant is not very excited that I’m over here Podcasting.  It’s my dental assistant of 30-years, it’s like having a wife, when your dental assistant has worked for you for 30-years.  

Jen:  Hey, Doc.

Howard:  Hey, Jen, so what’s going on, the person who loves my show the most is seriously only me, everybody else is only listening to it because they’d rather listen to us than talk radio. 

Kyle: Yeah, they do.

Howard:  I think the political scene has done the biggest boom for Podcasts because these dentists say, I can’t listen about Trump and Russia and Hilary and Putin an hour or two from work each day, I’d go insane, I’d rather listen to, you know, horses burp, you know.  So that’s what all Podcasts are exploiting and the price of radio stations, go call a radio station broker, I mean, there are radio stations they can’t give away.  Because of Podcasting which is user generated content as opposed to the other.   Okay, so we were on, number 3 was keyword optimisation and then number 4 and 5, what were 4 and 5?

Kyle: 4 and 5, 4 has quality back links, 5 is page load speed, so quality backlinks would just mean that if, and you would understand this again if somebody has authority, like let’s say forbes.com or Washington Post or something decides to post an article of yours and then link back to your website, it tells Google, oh, you’ve got friends in high places and so it helps rank your website up.  Those are the harder things to do, so you need to PRR and if you’re going to go for these sorts of things, but the more that you write, the more that you lecture, the more that you publish, the more opportunities you’re going to get to that sort of thing. The last one is page load speed, and that simply means that we’re, our attention span continues to shrink and shrink and shrink, I think our attention span is less than that of a cricket now or something, I just made that up now but it needs to load quick. Then another thing is like little things, like if you open up your phone, you’re in bad internet area, it loads kind of halfway, it’ll show you what’s called a skeleton screen and so there’s little ways to trick people into staying around, and so if it loads really slow because you got some big photo or thing that has to load first, you’re kind of dead in the water because people are going to give up and they’re going to bounce elsewhere which tells Google there’s something wrong with your website.  

Howard:  Yeah, and everybody listening to this should know, just think of your own behaviour if you’re on Facebook or Twitter and you see a link and you hit it, I mean, how long are you going to wait for that damn thing to load?

Kyle:  Not very long. 

Howard:  I mean, what do you think the average wait before that click ends?

Kyle: It depends but it’s obviously directly proportionate to age, so, or maybe that is inversely proportionate but I think the younger we are and the more we’ve grown up with the internet, and it’s just slowed down now.  I mean, even YouTube, like a 5 second ad, I’m like, nah, I’m not waiting, it’s like, you know, I’m impatient when it comes to the internet and so if your website still runs like, ah, I’ll go somewhere else, you know. 

Howard:  Okay, so I want to tell you what my favourites are in a website but I don’t have data on this because I’m not in that space. 

Kyle: Yeah, there’s a lot more that can be said but yeah.

Howard:  I don’t like to see a picture of a dentist, I love it, I just love it, like even on your website, you know, you have YouTube videos.  And you know, when you see a website that says Doctor Faran and there’s a mugshot as opposed a video saying, hey, thanks for coming to our website.  I want to see the human and so many of those dentists even like, I look at a lot of the local websites like friends I know, I’m like, dude, that’s the worst picture of you and it doesn’t capture your insane dry humour, you’re funnier than shit, why don’t you put a 1-minute, how long’s that YouTube video you have?

Kyle:  How long should the video itself be, or how long should it be on there?

Howard:  On the website, like how, I think if I was going to say I needed a doctor for something, I’d rather meet the doctor in video, I mean, I think it’s obvious that we’ve gone from text print to video.  So, do you think that website should have a YouTube video of anybody that has their hands in your mouth?

Kyle:  Well, here’s what I would say, there’s a lot, if a picture is worth 1000 words, a video is worth like a million.  So yeah, video is key, it’s the next level and if you can do that on social media you can be super successful.  And when we’re designing a website, so the website is up, it is 4-years old and so the new one will probably come out in a couple of months.  It’s going to be awesome, we’re going to lead with a video, kind of B roll video in the background, that would be the first thing ‘cause it tells a way more diverse story than even, you know, a series of 5 photos possibly could.  And you’ve got to remember like what does something that is interested in trending their smile or in the dental realm, like they want implants or their teeth have had work.  They want to see themselves on a website, they don’t want to see you, they don’t really care what you look like and they don’t want you to be so professional that you seem boring.  That’s the whole going back to the Trump thing, its authenticity is really big and so they would rather you have a quirky sense of humour, there is a guy out of Washington named Cole Johnson, he’s an Orthodontist and he has the quirkiest sense of humour and I guarantee that for every 10 people that read his posts, 1 or 2 are offended but the 8 love him.  And so that is the one thing that we are so afraid to offend that 1 out of a 100 that we don’t appeal to anyone, you know, we just seem very cookie cutter and we have our white coat on and that sort of thing and so, yeah, I mean, we just need to push beyond what our understanding of dentistry would be.  So, if you’re really into music, like make your website about that and I can guarantee those other people will be attracted to that and they’ll think you’re a real person.  So, video you talk about YouTube, yeah, you show videos but you need to do them well and I think like, probably the ideal link of like a, here’s what our practice is about video is probably about 2 and a half to 3-minutes at the most.  And sometimes you would like load one of 17-minutes long and if somebody sees that they’re not watching that, you know, they going to flip through that, if it’s 2 and a half minutes people will watch and there’s data behind all of that but, yeah, you need to keep it short yet to the point and the hope is they going to watch it.  They may just watch the first 30 seconds but they should be able to get what you’re about and kind of what your culture is about.

Howard:  Yeah, they should watch that Howard Stern movie, what was it called, Private Parts?

Kyle:  Private Part, yeah.

Howard:  And everybody, they do that to every doctor in the world, like there’ll be a complaint and so they’d fire him and he’s like screw you.  He would just get a buzz in and he went around, went around for years and years and years before finally some guy said, well, let’s say half of New York City hates him.  The other half is 12.5 million people, they love him and, yeah, I think it’s authentic, I’ve spent my entire life not giving a shit about surveys.  Because I’m standing there lecturing and 90% of the class is busting out laughing, staying all day and at the end you’ll always know there’s some dweeb, idiot from the association, you know, that go, Mrs Johnston walked out because you said fart 14 times.  I’m like, well, does Mrs Johnston not fart?  I mean, if this was Hollywood, it’s PG 13, there was no nudity, you know, I didn’t drop the F Bomb, I mean …

Kyle:  Brief nudity. 

Howard:  Brief nudity and, yeah, so I’ve never cared and I thought it was a badge of honour that half of the places I’ve ever lectured in 25-years said we will never have you back, that’s freaking awesome, man.  That’s awesome, now they just going to have to travel to see me because I was standing at the front of the room and they were laughing their ass off.  And they focused on the one person that didn’t like a fart joke.

Kyle:  I love fart jokes, so you can tell, you weren’t telling enough fart jokes in my mind.  I think that there’s a book called raving fans that like everyone’s read.  And it talks about department stores where 100 people come and shop and 1 person steals, and so then they put up the sign to punish the 99 that says only 5 items or less and what they do effectively is they sell fewer items because they’re limiting the average consumer.  You see in an Apple Store, like the products are right there, like there’s no doubt that they lose products, that products get shoplifted all of the time and yet they sell more products because of the immediacy and kind of the product is right there, you can pick it up and take it out.  So, they get and they factor that into their profit loss statement, they know they’re going to get shoplifted but they know they are also going to sell more.  So, dentists, as dentists we’re very cautious, we went down a path in life where we were rewarded by careful and long term thinking, we went through 4-years of college, we went through 4-years of dental school, some of us went to 3-years of speciality or whatever.  But we have to be, we have to kind of throw caution to the wind a little bit when it comes to social media and our websites.  We’re always worst-case scenario thinkers and it gets in our way.

Howard:  So, when you talk about when wide base storytelling, is that for your website, is that for your blog, wide base storytelling starting with why, Golden Circle, how, how, what.  Dell versus Apple, we all need to change our outlook on how we practice dentistry, is that in your blogs?

Kyle:  I just think that’s in general, I think that’s in the way that you operate, and honestly, it’s funny like this, feeds right into this conversation about your website is, is that the short version is if you’ve not listened to Simons X Ted talk, it’s like 15-minutes and he talks about his book, start with Why.  It’s a great book, the Ted talk is probably even better, especially if you have a short attention span but he talks about how Dell and Apple, in the late nineties Dell was about the what and how of computers, so they were about, you know, a computer with the biggest hard drive, the fastest processor speed at the best price.  Whereas Apple was about the why, the belief system, they were about challenging the status quo, about thinking differently and everything that emanated out from that and what happened was, is that Dell, when they released an MP3 player, it did not sell because Dell is a computer company.  When Apple released an MP3 player, it sold off the shelves because they’re more than that, and they’re almost sort of like a religion and they understand their why and people believe in it and they ascribe to it, and so every little thing they come out with, people stand in line to get, and Dell is barely afloat because they’re a computer company.  And we, as dentists, we go to work, I think, and we design our websites, I think with the how and the what of dentistry considered.  And so, what’s the what, well, as an Orthodontist I straighten the teeth of adults and children, how do I do it, well, I use braces, I use Invisalign.  Why do I do it is a more compelling marketing concept, so why I do it is to make my patients lives better, to give them self-esteem, to make them smile more, to allow them to enjoy life more.  And if I can build my marketing around a why based concept of the story telling, rather than a what or a how based concept of storytelling, it’s going to do better in the market. So, I see so many posts on social media, like, here’s Johnny, he just got his braces off, doesn’t he look great, it’s like, I guess it’s just so boarding.  It would be a lot better to tell something about who Johnny is and lead with that instead of the how and the what and the how and the what is important, if the Apple computer sucked, nobody would buy it.  It wouldn’t matter what they are about or what they believe or what their mission statement is, but it turns out their product is good and it matches their why.  So, if you have not read that, I mean, it will change your entire outlook on how you do things, and the last thing that I would say is that a hygienist, if she goes to work and she’s only focused mentally on the what and how of what she does, well, I got to use this cava Tron to scrape this crud off this tooth, it’s not going to be a fun way of living.  If she instead goes with the why in her mind of I’m going to make this patients life better, I’m going to, you know, if you’re a religious person, I’m going to mission to them or I’m, you know, I’m going to try and be positive and help this person, I want this to be the best part of their day, at the same time I’m cleaning their teeth.  I mean, it’s a more powerful way of viewing life and it’s just a little twist, so the golden circle is the ideas of the why on the inside, you start at the core of something and you move outward, but as dentists, we typically start on the outside on the what and we, maybe we never even make it to the why.  So, a lot more that can be said, a lot more that Simon Senec has indicated on and I would really recommend start with why as a book.

Howard:  Nice, I love that talk, and are you okay, I’ve gone way over with you?

Kyle:  I’m fine, I’ve got nothing to do, nothing to do.

Howard:  Okay.  You also talk about helpful digital tools, you talk about Slack, G Suite, Blinklist, Glass Pass, what’s all that?

Kyle:  Yeah, so I don’t get paid by any of these companies but I just feel like there’s a lot of digital tools that, you know, we all have Facebook, we all have Gmail, well, the majority of us, I would say.  But there’s a lot of really good digital tools that we maybe don’t know about, slack is the perfect way to communicate with your team, so both at Neon Canvas and Saddle Creek Orthodontics, we have slack.  It’s basically like an amalgam of chat and email and text messaging but the beating of it when you’re managing a team is I can have channel for clinical, I can have a channel for reception or marketing or I can private message 1 person, 2 people and it’s all archived, too.  And if you have to let someone go, they can be pushed out of the channel really easily and it’s more professional than group texting or having a Facebook group, and if somebody doesn’t want to be on Facebook and it’s like, okay, forget it, we’re going to use slack.  And the sign of a good product is, is that Microsoft has copied it, so Microsoft has and will do it worse, but Microsoft has Microsoft teams which is the same idea.  G Suite is just, it used to be called Google Apps and it is just basically that your business should be running its email and sharing drive space through G Suite, so it’s $5 dollars per user.  Go ahead.

Howard:  Okay, G Suite is G is for Google. 

Kyle: Yeah, it’s just Google, it used to be Google apps and it’s basically a combination of all their free things, so sort of like Google Drive which is an amazing product, it’s like Dropbox but you can get unlimited space if you’re paying and if you’re a business owner.  Also, Google docs, I don’t know if you use Google docs but it’s incredible, it’s way better than word and even Google sheets.  And so, these are collaborative things that you can share and they’re always backed up on the cloud and it’s very cheap.  So, if you’re starting a business, G Suite is the way to go, you can actually get a hip on compliant, it is kind of beyond the scope of this but you can do hip on complaint through G Suite.  What is the other one, blink list, if you like to read, I love to read, audible is great, I think audiobooks are a whole other way of thinking about reading, you know where you’re in dental school and you in college and you have to read biology books, you don’t want to read for leisure, most people don’t, unfortunately.  But audible is great, 15 bucks a month you can get a book, books are somewhere between 12 and 19 dollars if you listen to it two times faster, if you want to do that while you’re working out listen to a book.  There is just so many ideas that are out there and it’s a shame to adopt this idea that once you graduate dental school, that you’re done learning.  It’s actually when learning should begin and I know that would be one of your big, I know I am preaching the choir here, but ,and blink list summarises books, so blink list is kind of like cliff notes but in an audible format and so you can listen to a book in 15-minutes.  So, it summarises each chapter and it speaks it to you and it’s like 60 bucks a year, so it’s awesome.  So, if you want to try it. 

Howard:  How do I get them to cover my book on dentistry or uncomplicated business? 

Kyle: Yeah, you can request, what you should do is you can request a book on blink list and you can have users request it for them to do it, I don’t know if they would or not.  But they’ve got a pretty good library.

Howard:  It’s been selling really well on Amazon, it’s been, it’s got like 55 views.

Kyle:  We have short attention spans and there is no reason to not read, and the average audio book takes 7, 8, 9 hours and you can be through, you know, 30 blink lists in that amount of time, it’s not going to be the same experience but you can get some good ideas.  And we’ve all read 200-page books where you get to the end and you’re like, I could have read that in 15-minutes, you know, so blink lists are good for that.

Howard:  That’s why I like dental town online, see, because what viewers don’t know is that behind the scenes these doctors will send in a 3-hour video but if you take out the family vacation, the jokes, the this, the that, the that, the next thing you know it’s 1 hour and 12-minutes of content.  It’s editing out all the uhms, ah’s, the technical difficulty, the slide projector.

Kyle:  Sure, sure, yeah.  Yeah, the last one there is Lastpass, there is also one called one password, I don’t know if you use this or not.  But it’s just a password vault and so you only have to remember one password and the place where we have reached now is that your passwords, you will go onto a website and then they’ve changed the rules and it’s like, well, your password is not long enough or it doesn’t have this capital letter of this number of this figure, you’ve got to change it.  So, in my mind, I know like 18 passwords and it’s terrible, so last pass it’ll keep up with all your passwords and you only have to remember that one password, so that is the last password you have to remember and that’s huge.  There is no excuse for not knowing your password because it’s stored in that vault, so I would start that now because when you start a business, your number of passwords and accounts is going to go through the roof. 

Howard:  Yeah, mine is, my password is always just password because whenever it asks for your password, I just type in password.  That’s how I remember my password.

Kyle:  I don’t know if you watch Silicon Valley, do you watch that show?

Howard:  No. 

Kyle:  No, well, there’s a guy on there, he’s kind of a dull, his name is Bighead and his user name was password and his password was password so there you go.  

Howard:  His password was fast word?

Kyle:  No, his username was password and his password so. 

Howard:  Seriously, I just want to tell you, man, this was awesome and I think you’re awesome and I think my homies had a great time listening, too.

Kyle:  They do.

Howard:  I just want to thank you so much for coming on this show today and talking about, sorry I kept you 20-minutes longer than you committed to.

Kyle:  It’s okay.

Howard:  You’re awesome, man, and yeah, thank you so much, every morning come back and update us on more of what’s changed and all that stuff and let me know.  I could listen to you for 40-days and 40-nights.

Kyle:  Thanks, man, yeah, anytime, I love speaking, I love talking, I could argue politics another hour if you want after this has turned off, so we can do that.

Howard:  Well, you know the reason why I don’t and that because, you know the reason and I am always telling my boys that, you know, if you follow that stuff for 3-hours a day from the age of 25 to 45, you’ll have nothing to show for it.  But if you spend that 3-hours a day going back and getting your MBA online or getting a part time job, anything, it’s the most, it’s amazing how many people spend so much time keeping up on something that they have zero impact to change.  It will never make then to be able to afford a cup of coffee, I mean, it would just like, I mean, they might as well just have been standing outside in their backyard watching paint dry on their house.  

Kyle:  Yeah, I totally agree.  I mean, there are things that I spend time on like fantasy football, I know it’s a total waste of time and we need some of those things. There is a really cool thing called the Eisenhower box, President Eisenhower came up with it that, there are things that are urgent, not urgent.  Important, not important, and we spend most of our time, unfortunately, on things that are not important and are not urgent watching that.

Howard:  Well, here is the difference between fantasy football and Fox News, when you’re doing fantasy football you’re having fun and the people around you are having fun.  When you’re on the political deal your voice is elevated, you’re stressed, you’re talking like a loud monkey and the people around you are like, chill, dude, you know, I don’t want to go to a bar and talk about something that is going to make everybody get mad and animated and crazy.

Kyle:  Sure.

Howard:  I love the NFL because it’s the perfect mix of I’m really into it but I know it’s entertainment, I mean, obviously whoever wins or loses the game, nothing happens to the city, it’s not like some kids going to miss a meal if they don’t win.  But you know, it’s entertainment, it’s the same thing with charity, when I do dentistry, you need a filling, you give me 250 I do the filling.  If you don’t pay, it’s pay to play and if you don’t have the money then I get to decide right then am I up for charity.  Like I always am for an extraction because, I mean, I would rather pull your tooth, I’d rather pay you 10 bucks, I would pay you 20 bucks to pull your 4 wisdom teeth ,I really would, I mean, that’s my golf, I mean, it’s 5-minutes, it’s totally fun.  But when they fail a wisdom tooth FA then I decide right then, well, you know what, you’re on hard luck, you know, I’m just going to do it for free.  But I know it’s charity and I know that the NFL is entertainment but I think a lot of people don’t realise that all that political bullshit is just entertainment.  Because there’s nothing they’re going to do to change the course of Putin, North Korea, the election, and no matter who you vote for, I mean, I voted since I was 18 and my first vote was for Ronald Reagan 1980 and no matter who you vote for, they’re a lying, cheating Politician and they’re going to let you down.  So, go work on something that you can change in your home and your business, not in DC and China, and Russia and that stuff because it’s just, you don’t realise that it’s just entertainment and it’s really stressing you out and you’re not fun to be around when you’re on that shit.

Kyle:  Yeah, I totally agree, and also, we need to create more rather than consume and we’re in a society that is all about consuming, and we’re not building anything, we’re not doing anything and if things are not important or not urgent, they have no relevance in 5-minutes, much less 5 or 10 or 15 years.  So, it’s the things that are important but not urgent, those are the things we need to be spending time on, things that build a legacy, things that make a difference, so there you go.

Howard:  And if you’re an environmentalist and every kid comes born with what, 9000 metric tons of carbon, so recycling your dixie cup is not the answer, it’s just having one less kid.  On that note, I’ll let you go. 

Kyle:  Thanks, buddy, appreciate you, thanks.