Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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834 Success Your Way with Corinne Jameson-Kuehl, RDH, BS of Custom Dental Solutions : Dentistry Uncensored with Howard Farran

834 Success Your Way with Corinne Jameson-Kuehl, RDH, BS of Custom Dental Solutions : Dentistry Uncensored with Howard Farran

9/6/2017 10:54:44 AM   |   Comments: 0   |   Views: 380

834 Success Your Way with Corinne Jameson-Kuehl, RDH, BS of Custom Dental Solutions : Dentistry Uncensored with Howard Farran

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834 Success Your Way with Corinne Jameson-Kuehl, RDH, BS of Custom Dental Solutions : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #834 - Corinne Jameson-Kuehl
            


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AUDIO - DUwHF #834 - Corinne Jameson-Kuehl
            


Corinne Jameson-Kuehl, RDH, BS is from Hartland, Wisconsin and has been involved in the dental field for over 20 years. Corinne graduated from Marquette University, the Coulson Institute of Oral Myology and has a certificate from the Human Resources Institute. She is an experienced private practice clinician, practice development administrator and previous dental staffing company founder and owner.

“Corey” owns Custom Dental Solutions, a company that provides business and training solutions to private dental and health care offices. She and her team develop successful protocols and systems to maximize growth and production. The experience of founding and owning a successful dental staff replacement company called “The Dental Connection, Inc.” gives her the background and knowledge in the industry to key into what practices need to ensure quality and excellence with patient and employee care.

Corey has been the recipient of the Sunstar-Butler Award of Distinction, and has been a Colgate Oral Health Advisor. Corey values her family time, but when there is free time, she enjoys writing articles for professional and consumer newsletters and magazines. She also enjoys traveling to conferences to represent forward-thinking companies and networking with her colleagues.

www.customdentalsolutions.com




Howard: It was just a huge honor for me today to be podcast interviewing Corrine Jameson-Kuehl RDH S. The owner of custom Dental Solutions Inc. I'm podcasting here today from Hartland Wisconsin which is between Madison and Milwaukee. She has been involved in the business of dentistry for over twenty years. Corrine graduated from Marquette University the Coulson institute of Oral Biology and has a certificate from the human resource Institute. She's an experienced private practice clinician, practice development administrator and previous dental staffing company founder and owner. Corrine provides practical business development and proven solutions to owners of private practice dental offices the experience of founding and owning a successful dental staff replacement company called the dental connection Inc. gives her the background and knowledge in the industry to key into what practices need to ensure quality and excellence with employment care. She is truly passionate about business owner success. Corrine's professional interests include writing articles and presenting continued education to dental offices across the nation. She is an editorial board member for Pennwell - Pennwell’s the owner of dental economics and RDH (01:22 unclear) Do you know where the name Pennwell comes from?

Corrine: Where?

Howard: That was their first magazine a hundred years ago as Pennsylvania oil wells

Corrine: Ahh okay that's interesting.

Howard: So, it started with pennsylvania oil wells and they added firemen policemen, dentists, hygienists. She's the regional coordinator for the oral cancer foundation and was a 2016 recipient of the sun star Butler award of distinction. Her professional memberships include ABA, ADHA, Seattle study club AADOM, AADH.  It is just a huge honor to have you come on the show today. Thank you so much for joining me today.

Corrine: Thanks Howard I'm excited.

Howard: So, you're from Oakland Wiscon, halfway between Laverne and Shirley and Milwaukee and a cheese head in Madison, so

Corrine: That's right.

Howard: So, do you just eat cheese and drink beer all day?

Corrine: Pretty much, yes we do.

Howard: So, what are you --  what I like that; I love the people from the Midwest the most because I was born in Kansas went to dental school. I went to undergrad at Creighton dental school University of Missouri and it seems like the greatest companies were started,  pizza was started in Wichita so was Godfather's, Walmart were started in Bentonville because those small town country people try to keep customers for life. They develop policies because when you're in LA and New York and Houston and Chicago you could piss off a hundred new patients a month for forty years and still just market for new customers.

Corrine: Right.

Howard:  When you're in Hartland Wisconsin, it doesn't take long before the whole entire town doesn't like you. So, you have to be nicer you have to focus more on keeping customers for life loyalty programs because you don't have a situation where you can just burn and turn people in Los Angeles for your entire life and still have three million people you haven't pissed off yet. So, what are you seeing in the field ? why are people going to customdentalsolutions.com? what problems are you seeing in the field and what problems are you solving for these people?


Corrine: Yeah, we are finding Howard with our clients. People are coming to us because they are transitioned dentists, they're new they've maybe;  they purchased a new practice or they are starting from scratch and they just need some good systems and protocols to be put in place and they want that hands-on approach. They need specialized care in certain ways for instance maybe they we need to set up some different systems to make sure the insurance is being processed through properly or sterilization, everything is set up according to OSHA standards and so forth and so, we're finding that our clients are looking for us because we can provide that customized hand-holding for that process and we're doing a lot of by-scratch practices as well. A new dentists coming out of school and building scratch practices maybe that don't have family history of Dentistry and so they they're not quite sure where to turn we're finding people that are also just maybe looking for something new. They've been in dentistry for a while and they just want another set of eyes to come in and say hey we've worked with consultants before we know you're different from consultants can we just have another set of eyes can you tell us what we're doing it this is okay? Do you have any suggestions for us? Or most of the time it's they just want to bounce their philosophies off of us. I find that most of my doctors, they know what they want in business they just don't know how to get there and so it's just helping them get what's in their gut out and project that forward. Getting their philosophy out to where it needs to be and help them with whatever level of growth that they want to see. So, that's what we're finding in our experiences with who we're working with.

Howard: I found something you said very interesting where when I was little and in school they always said that women got 90% of all the TMJ and the migraines of the headaches, so, all the researchers started going off almost because they estrogen or something a guy doesn't have right?

Corrine: Sure.

Howard:  And then they found out over the years that the epidemiology was the same with boys and girls. It's just that girls are smart enough to ask for instructions and directions when they're lost and they'll go to a doctor when they have migraines and I can still remember one of the biggest blowout arguments I ever saw in my life was my dad wouldn't ask for instructions we were lost in LA looking for Disneyland with six kids in a station wagon and my mom's screaming at him, "Stop, just stop the damn car now!" and men don’t ask for help and you were saying that you were having more that you think on Millennials doing a start-up that more of the business was female dentists because they're just smarter and asking for help. I mean guys think guys really do think that if they are lost in a car that they're a Neanderthal and they're a cro-magnon and obviously homosapien should know where the damn restaurant is. The boys don't ask for help but that's what you're seeing in the field is that more millennial females area asking for consulting help than males?

Corrine: I am. I would say probably ninety percent or even a little higher with who we're working with are female Millennials either from scratch or they've just purchased from a baby boomer dentist with an exit plan and they want to be ensure that from the beginning that they're doing everything possible for dental business success. So, part of it and I don't have any scientific research and I've spoken to many Dental Society meetings particular for female Dental Society meetings and they love to open up for discussion because it's so interesting what they come up with. So many of them say it's because they still feel in today's day and age they still feel a stigma with being a young female dentist maybe that previous owner is a baby boomer male who doesn't really think they know what they're doing. They can't give up control specifically even though that new dentist owner has overpaid for the practice or has given them more than a fair share that person needs to know, Hey, I purchased, I need to step away and I need to let her take over and do it her way I would say a lot of what we do with those transitions. I go ahead and have to go between that previous owner and that new owner and try to bridge that generational concern where hey, dude you just you just walked away from your practice she just purchased it let it go or somehow try to facilitate a kind mentorship. But they want to do it on their own and they do tend to ask for help more easily because they're looking for that family work balance immediately most of them have other things going on in their lives besides dentistry. So, they want the business but there may be juggling family lives or hobbies or other things as well and they just, I think females are just a little more attune to whine at balance in life versus males specifically.

Howard: Well when I sell my practice I'm only selling it to a woman dentist I'd never sell it to a man because I..

Corrine: Really, why is that?

Howard: Because for once in my life I was some woman to write me a check for several million dollars.

Corinne: I guess I see your point that makes sense.

Howard: Any divorced man wants to see that come back the other way someday but I think I think that's awesome. So, what are the issues -- you're doing several different cases, you got the De Novo and then you got the person buying a baby boomer and then you got the baby boomer fixed up. Let's walk through all those three, let's start with Millennials because again, old guys like me the fastest way to learn something is read a textbook. I mean, I could read a textbook on implantology and in the eight hours I read a textbook on implantology I would have ten times more notes than if I went to an implantology lecture at a convention, right?

Corrine: Sure.

Howard: I mean, it's just the bottom line it's just the way it is. So, millennials are podcasters so we're talking to mostly Millennials and maybe some Generation X-ers, in fact email me Howard@dentaltown.com and tell me how old you are because forty-four to sixty I wonder sixty that's a baby boomer your generation Xer between sixty-five and seventy-nine year born in seventy-six the Bicentennial two hundred.

Corrine: That's right, the Bicentennial baby.

Howard: Are you gonna live to the tricentennial? Is that your goal?

Corrine: Sure. Of course, yes.

Howard: To live to 2076 and if you're born after 1980 you're Millennial but dude send me an email at Howard@dentaltown.com and tell me 'cuz I want to verify who I'm really talking to, but let's start with the millennial and.

Corrine: Okay.

Howard: She's working at corporate, she's working as an associate. I want to start there first, are you seeing a lot of boomers like me having very successful long-term associates? or do you see people who have associates having massive turnover associates?

Corrine: Yes, the latter. I do find simply because I've worked within this field for several years of trying to find associate dentists connection.

Howard: You sold the dental connection Inc.?

Corrine: No, I did sell that a few years ago so/

Howard: Is this still in business?

Corrine:  So, it’s been four years now since I sold the dental connection so I did work in that industry four eight years and I found more turnover than stability. There most of the reason was is because our baby boomers they said they wanted to step back, they said they want an associate but then when that associate was provided for them, they made me didn't want to take those extra hours off they weren't quite ready to hand off more responsibilities and the associate then would get frustrated and say, "Gee, I didn't sign up for this, I didn't sign up just to do pedo checks, I didn't sign up to do hygiene checks I want to go make some freakin money here, I want to go do my own thing". So they may last for maybe a couple years or whatever and they decide, "Hey, this looks like a great location and I actually have the capital for whatever reason I'm gonna build my own dental practice". And so, I've been seeing that more and moreover the last couple years actually that those that have that personality in that millennial age range they just go and start their own practice or they have the capital to just purchase an existing owner who's decided just to totally get out of the game but in my experience I don't see a lot of those associate ownerships working on a real long term basis for more than a couple years unfortunately. There's a difference in philosophies, a huge difference in philosophies and goals honestly.

Howard:  I mean in corporate, I mean there are some corporate chains where their average associate doesn't even last year and then when you talk to corporate CEOs it's considered a victory if they say twenty-four months. So, the question is can you build a successful dental office if the average dentist always stays there two years?

Corrine: Well, that's an interesting question. I think if you are looking for a long term associate it boils down to that right personality fit then too. So, I think sometimes the due diligence isn't done necessarily with a personality fit you may take the first person available or this person recommended it because they went to dental school with her dad or his dad or something like that but I think you need to do your due diligence as a baby-boomer dentist to find that right fit if you're looking for somebody who maybe wants to be groomed a little bit and eventually purchase your practice those discussions need to be made immediately. I find that we don't have that communication piece out there in the open I'll walk into a practice sometimes and that associate net owner they've never even talked about if that person wants to ever buy or how long that person wants to stay or what their goals are and so just trying to facilitate those communications so that we're all on the same page to ensure success is really, really valuable because it can happen. But you have to find two people that want the same thing as basic as that sounds and often times that's not the case.

Howard: And then if you've ever watched just more than one episode of Judge Wapner, you start saying all this crap and the first thing he says is, "Can I see your receipt?" and then the idiots saying, "Well, we don't have a receipt" and then you listen these associates and I was like well he said, she said, he said, she said, he said it's like well, where where's the contract? where's the writing? Oh we just talked at lunch of Subway and then three months later we were at McDonald's and then we were at Starbucks and they have nothing in writing and I understand the importance of dating I mean I wouldn't want to walk in there on the first day and then you know and get married. So, I understand I want to get there but how long do you think after this millennial is working with this old baby boomer before they say, "Okay, I like the people, I like the location, I could live here, I could send my kids to school here, I feel good about the whole thing, I want to start getting something in writing". How long should that time period be?

Corrine: In my opinion I think it needs to happen immediately there needs to be parameters immediately where these conversations are visited. First do a three month, a six month, like you would with any standard employee and then after a year the baby boomer can say to the millennial you've worked out well, we've talked we've meshed our philosophies, we want to continue to go in the future. I plan to step out in 2019 like I need those older dentists, I need them to say this is the date because what happens is they give a date verbally and then they're not held accountable for in 2019 rolls around in the associates pissed off because things weren't happening the way that they thought they were going to happen that older dentist feels good maybe went through a divorce so maybe he wants money still or -- life changes happen that's the reality but again we have -- then the contract is broken, the verbal contract is broken. So, I like to see it set up where we have these timelines where we get together we renew philosophies again just like you did with do with any employee you're gonna have a review you're gonna have a philosophy discussion and keep going from there I've seen associates strung along for ten to fifteen years and that's not right, it's not right at all they stop and they go start their own.

Howard: But come on ten to fifteen years at some point you have to realize you're an idiot.

Corrine: But I don't know if you know this Howard but dentists don't move very quickly usually.

Howard: You know why isn't there they're very smart, they're paralysis by analysis and I know that we've had our yearly townie meeting in Vegas for fifteen years and we're moving to Orlando, you know why?

Corrine: Why?

Howard: Well it's a couple of reasons, number one I'm selfish bastard and I have grandchildren now and they want to see the Mickey Mouse and I wanna go drink martinis at the bar and smoke cigars as grandpa.

Corrine: Right.

Howard: But number two is Vegas is - they're about gambling, that's where they make their money and they have a list of all the occupations and dentists and engineers - I think dentists, there's only one occupation that Gamble's less than we do and it's engineers because they're too analytical. A dentist is gonna go lose $2,000 on blackjack there but a bowler will.

Corrine: Exactly:

Howard: Someone going to and when you look at the concerts in Vegas, look at the concerts they have, those

Corrine: Right.

Howard: Those people that like whatever genre you're playing are most likely to leave their entire paycheck in Vegas over the weekend and so we're going to Orlando where that - because we always get we never get any top priority or we're always back burner. Well, maybe we can squeeze you here maybe nobody wants you but we'd rather have a bunch of dentists and hygienists versus nothing but other than nothing the only people we hate more than you are engineers and so their paralysis by analysis but yeah.

Corrine: Yes.

Howard: are you starting to say is that you should have this conversation in three to six months?

Corrine: Absolutely.

Howard: Absolutely and you should know in three months, I mean you wouldn't date young buddy for three months and not have some idea if this is gonna work, the people.

Corrine:  Absolutely.

Howard: Then I want to talk about the other hard thing. So this millennial, here's where I see I'm getting screwed, the Millennial goes and buys this practice and they overpay for it and then when they go in there most people think total labor cost should be between twenty-five to twenty-eight percent. What do you think labor should be between?

Corrine: No, I would agree. I would say twenty-five to thirty percent.

Howard: Okay, I say twenty-five, twenty you say twenty five to thirty.

Corrine: Yes.

Howard: But that's the total cost that's FICA matching four-hundred one k medical that's the entire amount of money it cost me to get you to work for me and they're buying offices that have these thirty, forty year old legacy employees that have been there since Fred Flintstone they've gotta raise every time they're around the Sun and their labors like thirty-eight percent.

Corrine: I know.

Howard: So, do I buy this practice then say, "Hey, Kareem I'd like to buy you lunch of Subway and during your tuna fish and which tell you that instead of getting paid $32 an hour, I'm gonna have to move you that $19". I mean how does that go over that's like bringing a bomb to church.

Corrine: It is, I am so happy you brought this up because this is an issue I'm dealing with pretty much on a daily basis and it is so hard because yes, what happens is the employees oftentimes they'll even hijack the new owner and say, "Well, I haven't had a raise for five years and we're gonna leave if you don't pay me five dollars more an hour", and that new dentist is freaking out because "Oh, I need Sarah who's been here for 38 years", and so, quite honestly part of my job and it's not always the funnest part is to come in and let that doctor know, you don't need Sarah, you really don't, it's okay. You can let her go and let her go find her best fit somewhere else and let's find somebody who is excited about you, your philosophy, your practice and who costs a heck of a lot more into your budget range, in your price range because I don't I think what staff doesn't understand and team members don't understand especially with a new practice owner they've just put every penny they have on the line for this new business, they don't have anything extra they really, really don't and so new team members don't get that they just see moneybags walking through the door and they take advantage and so, my aspect with custom dental solutions - I have a team approach to our to our clients and so my specialty actually is the HR portion and so I do a lot of releases, I talked to the doctors, we kind of have meetings with these different employees and we let them know, "I'm sorry Dr. so-and-so is not your previous owner they can't keep up these benefits, they can't keep up this hourly wage this is what we can offer you, we'd like you to stay" They never do, Howard they always leave and they try to go somewhere else and it's usually pretty ugly process unfortunately but then within a few months when we have that right fit personality wise that right fit financial wise for our doctors their stress level goes way down and they're so happy because it stresses them out. I'm working with a doctor right now who I did a hygiene analysis forum those hygienists hijacked him when he purchased the practice and told them how much they needed to get paid guess how much he gets paid on each hygiene appointment? 16 dollars. After he's paying his hygienists, after he's paid the obviously the operating costs and after the insurance and so forth 16 dollars, I said, " When are you gonna let me let these guys go? $16 per hygiene visit because they've hijacked you?" "Well I don't know Cory I'm gonna have to think about that" "Okay, you think about that as you're not making any money in your business" So, this is something we deal it with on a very regular basis at Custom Dental Solutions is the problem of employees that you've inherited that are costing way too much and quite frankly don't have the skill level either to handle today's modern era within dentistry, many of these practice have to - we're starting from scratch with like digital imaging even getting them up to speed on OSHA or these places look like they're from 1982 and it's a lot of work.

Howard: 1962, I resent that comment.

Corrine: Well then you can keep your country blue wallpaper and you're down the alley.

Howard: I was in college with the glow lights. Another, how would - so, the baby boomers sell in this office and he's got this practice broker and he says okay this thing's worth all this and a bag of chips and they've been at school a year or two. What can they do to bring some transparency because obviously the seller is motivated and the broker gets, if the broker gets paid a percentage would you or they get a percentage of a million dollars or a percentage of $750,000?

Corrine: Exactly.

Howard: So, everybody. So, I look at these dental students and they got a big target on their back. The dental schools hire all these faculty and pay him all this bullshit money so they graduate like a third of a million in debt. So, there's poor bastard has to go payoff for twenty years for what all these inefficient high costs. Many of them just complete bullshit dental schools and then they come out and immediately everybody's trying to sell them a laser and a CADCAM

Corrine: Yes.

Howard: And I mean it's just a just crawling along supporting all these industries and all these dental schools and now that guy that's going to sell them his practice, he's saying that if you think the dental school screwed you, if you think that dental supply out screwed  you, I'm gonna actually screw you to death. How does that millennial get a second opinion or figure out what's - am I paying, overpaying I guarantee you they're never gonna underpaid for breakfast.

Corrine: No.

Howard: I guarantee that's never gonna happen. I've never heard that soon yet i underpaid for a practice.

Corrine: Right. No, I strongly encourage people that are looking at purchasing a practice to get another opinion from either a consultant or someone like us who are in practices every day working through

Howard: What states do you work in?

Corrine: We are all over we're mostly in the Midwest however, we do have clients outside of the Midwest as well. So, it depends on what the need is, we do travel if we need to travel, obviously most of our - not everybody is in Hartland Wisconsin. So, we do travel I have a team of four people at this time and myself included we travel to whatever location we need to, to run reports obviously in today's technological age they can send over reports and things as well but I personally, I want to physically be in that practice I wanna see the workspace of the people that are currently working there I want to have my red flags at rolling.

Howard: Do you go to Canada too?

Corrine: We have not been invited to Canada but we could.

Howard: (25:05 unclear) too?

Corrine: Sure, we should. It'll be fun.

Howard: Some people just won't (25:09 unclear) Some people, they just have their boundaries.

Corrine: I'd go to Canada, I think it'd be great, it'd be fun.

Howard: Well, you should never do dental consulting in a country with their number one pastime is knocking people's teeth out with a hockey puck.

Corrine: I'm pretty close to Canada we know a little bit about hockey and Wisconsin too.

Howard: That is not a very pro dentistry philosophy.

Corrine: Right.

Howard: So, you would recommend that they hire a consultant and the thing I like about that the most is in my 30 years, the people will go buy an office and right now the sweet spot of what I'm seeing most practices that sell are in the 750 range and

Corrine: Yes,I would agree.

Howard: you'd agree to that.

Corrine: Yes.

Howard: So, you gotta spend it has 750 on a practice why don't you spend another 25 to 50 having a dental office consult and hold your hand to manage his 750 thousand dollar practice and I have nothing against chair side milling CBCT lasers and all that as long as you realize they're just toys and I know boys have toys. You can have a boat,  you can have a cabin and you can have a laser but you don't have to have a cabin to have a successful dental office. You don't need a boat and a jet ski to have a millions dollar hygiene department

Corrine: That's right.

Howard: And a number one return on investment I've always seen is a dental office consultant so, you're going to buy a $750,000 office what is your fee for a year-long consulting contract? how does that work?

Corrine: We don't even, yep.  We do it differently, Howard. I think because we're not consultants we definitely - we would - we have training fees where we come in and we train new employees something like this for someone's just looking for another set of eyes, we just charge hourly. So, we charge travel and then we charge hourly and hourly were $165 an hour so we're pretty reasonable as far as we as other costs we do monthly fees and that again we charge traveling and then our monthly fee again customized to what we specifically need to do so it's really inexpensive for doctors that are looking for just another set of eyes. My biggest thing is when someone's purchasing that practice to ask that current owner, do you mind if I have Cory just look at your books? do you mind if I ever go into Dentrix or Eagles often just look at your systems? If they say no they have a problem with it, that's a big red flag run on go away. So many times these younger people purchasing these practices they maybe are using an accountant or an attorney that doesn't have dental knowledge so they may not see that full dental big picture they may see some basics and these all other bank just needs X Y & Z to get this loan push through but I can't tell you how many times I can't - I get in there after the fact and I see so many red flags and say, " Hey,  we could've pushed this purchasing price down 50, 60 grand because of X, Y & Z but because you didn't surround yourself with dental knowledge people, you've just got screwed spending more than you should have because you didn't do your due diligence totally most offices, most previous owners have no problems sharing their information with me I'll sign a confidentiality no big deal. Yes, I agree this is a great purchase this is exactly the amount of active patients that I see and you know kind of going from there but I can also tell you how many holes I'm trying to dig out my clients out of now too that didn't do their due diligence and we're promised 2,800 active new patients and that's truly not the case because nobody bothered to check and just things like this that can be really quick choices before you purchase you can quit go in and take a look and that's something again we just charge hourly for. We don't make people sign these large contracts if somebody wants us for a year, we do that as well those are usually transitions because there's a lot of work to be done and they want HR overhaul they want all kinds of overhauls but I don't want an office to become dependent upon me as a consultant. I want to empower them to find what they want for their business and I want just partner and support them and so help them, you bought this business take ownership of it I just - we just had a new client this week and they said "You know for the first time in three years after talking to you and your team we feel like we actually own our business we're taking our business back". Their employees had hijacked them, they had been working with a consultant just telling them whatever they wanted to hear and they would listen to that person. Well, do what you want it's your business it's your Faustian and that's not a dig on consultants there, we're not for everybody either. There are many places where people need certain types of consultants for certain things in their business in their practice but some people don't need that either they just need to be listened to and told hey why don't you go do this yourself or why don't you change this yourself or maybe I can come in and help you with your office manual or your office policies or let us look at your agent report, let us clean it up for you and get the right person in there to keep down the right track. So, that's kind of what we do with with those transitions and then also just with those new owners. Really giving them the ability to find success their way and what their values are.

Howard: Alright so what's listeners says I want to talk to - you go by Corey or Corrine?

Corrine: Oh, either one is fine.

Howard: What did your mom call you is you pissed off?

Corrine: Corrine Elizabeth.

Howard: Do you prefer email, phone how do they contact you? what? go to the website?

Corrine: Yes sure, they can go to the website and learn more about us they can contact me on my phone two six to eight five three fourteen fourteen. They can find us on Facebook, they can't find us anywhere.

Howard: You got an e-mail?

Corrine: Yeah, e-mail is great probably (31:01 unclear)

Howard: You must go by a Corrie, is that your email? Corey, corey@customdentalsolutions.com.

Corrine: Yes.

Howard: I want to say a couple things on what you just said, they try to do the right thing like when it comes to when they're gonna buy a prac -  they need a lawyer or an accountant so they go ask their pastor a church and he tells them live in their church

Corrine: Yes.

Howard: And he might be a very moral man but you really need to get an accountant and a lawyer who only does dentistry not the guy/

Corrine: Yes absolutely.

Howard: who sits next to you in the Baptist congregation. What is your definition of an active patient?

Corrine: Oh, I like to see 18 to 24 months.

Howard: Well that's a big range.

Corrine: It is.

Howard: So that’s a 25%

Corrine: It depends on what style of practice it is. I think when you have families versus maybe a geriatric population depending on what again they're offering for a sale price. I find that most practices will consider everybody an active patient and then when you really dig an active patient is usually twelve months or less. It depends on what that doctors exit plan is, if if he or she is active up until their exit plan they were gonna have more you know active patients meaning patient contact. Some dentists kind of coast and they just phase out you know they kind of lose their mojo and then they're riding the coast for you know three or four years and then say, "Oh, I'm gonna solve this practice and I have eighteen hundred active patients while you get in there and these are 600 patients that are truly have been seeing within twelve months or twelve, eighteen to twenty-four months. So, it depends on how much contact they've had and what their office is doing, so, every situation I think is a little bit different as far as just a short you know a long version of a short answer there.

Howard: I always switch guys, we talked about the young millennial coming out of school and you give them lots of amazing awesome advice on getting in buying a practice, getting things in writing within three to six months. Now here on dental town when I go to practice. Here's the big middle deal not the Millennials on one end of the old guy selling.

Corrine: Yeah.

Howard: But in the middle it's this, man, I've been practicing in Wichita Kansas for twenty years and I signed up for every PPO known to man, my overhead is off the charts and my office is flat and and it just seems like since 2008, my office is just flat but the only thing going up is my overhead and it seems like every year I just see more people for less money and it's starting to make me get burned out and give up. What do you do for those doctors?

Corrine: Those are the people that I like to go in and I'd like to see.

Howard: Do you see this very often? I mean, do you see that somewhere else?

Corrine: Yes, absolutely.

Howard: Is that a great common scenario?

Corrine: It is and I love it because those people are - it's really hard for them to ask for help so I'm always super appreciative when they finally reach out and they want to move ahead because I know they've thought about it for a long time and they feel hopeless and they feel helpless and so just coming in and feeling the culture and sometimes it's like a bad apple in the bunch maybe it's a real rotten employee who's just really you know made the environment and the team just flat and the goals maybe maybe they've had a consultant in the past or Scripts put in place that aren't being done anymore and just kind of bringing life back into the place sometimes can help or getting rid of somebody who is the bad apple or saying to the doctor, "If you want to grow then why don't you look at some of these management systems or some of these patient experience types of marketing and so forth". So,just try to encourage them to find what they're looking for in that way but just to get help them get their mojo back too because I think no matter what career it is in dentistry of course is our passion but you know after so many years you do get kind of you get a little bored and you wonder where the change needs to be and and you maybe just need a little push in the butt to get going on something and what I find most then more than anything it's somebody or several members of the team that need to be changed.

Howard: I know  so why you..

Corrine: And you guys never want to change them you're too nice.

Howard: Is it because they're too nice or is because at first because - tell me what percent of time is because it's a long legacy employee and so the relationship is moved from my receptionist to my sister and she's my sister and you roll your eyes and yet the first five years or first ten years were great.

Corrine: Yes.

Howard: But then, she got divorced her husband left or whatever the hell now she's just rotten tomatoes. So is that usually the tuxedo boy are they often times just a new young employee whose is off-the-charts crazy.

Corrine: Well you know there's a little bit of both, I tend to find that it's that long-term legacy employee who really sets the tone of the practice and that negativity has grown because they're pissed off at the doctor for whatever reason or they're ticked off because they're maybe they're spend some hire some changes that they don't like or they don't they they're in charge of things that they shouldn't being charge of and they're burnt out there's a whole plethora of different reason.

Howard: And because they don't realize that there is a maximum pay grade.

Corrine: Correct.

Howard: They just they just don't realize that, okay twenty eight percent is the maximum pay grade and they keeps on  but you haven't given me a raise in three years and it's like, dude, our overhead should be sixty-five and it's sixty-nine and your solution is a raise.

Corrine: Correct and instead of looking for a solution to the to the problems and the practice maybe looking at the supply costs, here they're whining a raise but wow your supply costs are twelve percent every month. What are you doing as an employee to keep those supply costs down? maybe that'll be a factor why your doctor can't give you a raise because nobody's controlling the supply costs and they're out of this world or different things like that so just trying to encourage that thought process of "hey, if you don't have employees who aren't always looking out for your best business then go find those employees that will be there". I always tell people you can train you can train dentistry, you can't train enthusiasm, you can't train initiative, you can't train personality traits for somebody who wants your business to grow and succeed and so, I find that as much as my doctors are hesitant to replace team members and I know it's not a popular theory because we you know we want to play to people's strengths and we want to give them opportunities and yes we do to some extent however I find ninety nine percent of the time Howard when I sit down with a doctor before even meeting any of his team and I say,  "Tell me about your employees, what bothers you about them and what do you like?" their first gut instinct is. "Well she's a good hygienist but she doesn't do X, Y and Z and she doesn't do X, Y and Z with this, the patients like her but she doesn't do any continuing education, she doesn't wear loops, she doesn't improve her, whatever I'd buy her a laser if she'd use it but she doesn't want to" "Okay, so what I'm hearing from you is that she doesn't share your philosophy, so why does she work for you?" "Well, she's been here for 28 years and I bought the practice she was with the practice" "Well, great that was very kind of her to help you through the transition but perhaps it's time for her to transition out and for you to find someone who fits your business philosophy better". And then they usually nod and then they don't say anything because they don't want to address it and they know that it's a problem. So, I do find the opposite on too when they finally purposed in their heart to make those changes. I walked into a practice a couple years ago and I said to the doctor after 20 minutes of watching this horribly dysfunctioning team, I said "I will take your contract but I need to fire everybody and surround them with what you need in your goal in your mission he gave me permission to do it and he made the most money he did into that following year because we found him the right people and he was the happiest till then.

Howard: At what percent is that - how many gets fired?

Corrine: I fired everyone but two-and so that would have been eight people they were a team of ten.

Howard: Holy moly, my God.

Corrine:  And you know what? it is bumpy. I'm not gonna lie and say that those are fun times and not that there isn't some negativity and some retaliation but when you get that right connection that right flow of people together you've been practicing for 30 years and you hate what you do because you've surrounded yourself with people who don't care you bring in those right people that do care and dentistry is fun again, it's enjoyable you're making money, you're indifferent time of life or you're paying for your kids college maybe or you're trying to maybe catch up on some retirement you didn't do earlier. It really can be a really awesome experience too and it's not that this is done in an unkind way. In fact, I don't even say fiery and my employees always joke with me because I call it a release it's we're releasing these people to find what's a better fit for them and I always, when I do it for the doctor 'cuz most of the time the doctors don't want to do it themselves, I am hired to do that for them. I'm very, very kind it is accompanied with a letter you've served doctor so-and-so well he or she appreciates X, Y & Z however our philosophies are going in different directions and we need to go in a different way and we trust that you're gonna find the best fit for you and it's not always pleasant, I've been bumped before I've been screamed at before but it is what it is.

Howard: Herb Kelleher the founder of Southwest Airlines now his big match was hire on attitude and train.

Corrine: Absolutely.

Howard: And you're saying you can train the dental skill you can iron out soon but people know to take that a little further you know higher on attitude training for skill but fire on attitude

Corrine: Yes.

Howard: And showing someone else the damn skill

Corrine: That's right.

Howard: And what it is, in my opinion is the hardwired nature of Homo Sapien, you're a social animal and the only way we survive the last two million years was doing whatever the four hundred pound gorilla said and not being confrontational because in the last two million years light like a shark. A shark can be on his own and just swim around eat kill he's a top predator, a bear doesn't need a friend

Corrine: Right.

Howard:  But a sapien, a shark and a bear don't need a friend but a sapien if they would have kicked you out, you would have been eaten by hyenas and lions and tigers. So, they're hardwired program to not have an uncomfortable conversation and I always say the most successful business people in the world are the ones that will have the most uncomfortable conversations and you see it when they go in there and even when I go into a meeting that everybody's like oh how was your game baby how's your kid? How's Taylor and and so they're monkeys, so you know they always want to eat and ask about babies cuz it's about reproducing and offering. So,what I always do is that I say okay and I always clap hand. Okay, okay now let's go to work and then you start with an uncomfortable conversation. Let's look at the numbers, okay why are supplies going up so high? or whatever the issue is but you almost have to break 'em out of translate. Okay, I know we all want to get along no one wants to get eaten by a hyena, no one wants to get dragged off by a bunch of the carnivores but we're all safe for eating, we're safe

Corrine: Right.

Howard: But let's go to work and get some focus because so many of those meetings they all get off-topic and they all got rambled on but no one will adjust and then the dentist also he has that a volcano deal where the assistant comes in five minutes late and they're you know in the middle of the staff huddle and then in three days and he never says anything and then after ten or fifteen times she comes in and then he just starts screaming and yelling or he'll throw an instrument or it's like dude this is not a controlled release of pressure, you just threw an instrument you don't throw an instrument. So, communication is everything.

Corrine: Yes it is and I don't understand too when we see in general business, we do this all the time. General businesses replace people with people or they promote people that have those better abilities and they either release people that are not fitting the mold, in dentistry we just can't do it and I think so much of what it the problem is because we've gotten too personal with our employees in dentistry and I know with our experiences we work with small private practice so unfortunately you are a dental family and we always refer to it as that as well but the doctor then knows more about Maria his dental assistant and yeah, she's a crappy assistant but he knows that Maria is a single mom and he can't let her go because she's the breadwinner for those kids and so, we get to connected when instead of thinking and it's not unkind to think this way Maria is not a good dental assistant she should probably go find a job at a daycare she's better with kids she's great with kids but she can't she can't work our hours because of her kids which again is her choice to do but why do we let her come in late every other day and say that that's okay? In any other world that would not be okay you can't go into your job at the bank and be late you can't go into your job in corporate America and be late you just can't but we do in dentistry all the time and so why can't we think outside that box outside of that, again it's our family of Wow, what would happen if I actually got a dental assistant who was exactly what I wanted and could be here on time number one which sounds pretty basic and could hand me the instruments that I want and could do this Rockstar job? Does it exist? Of course it exists but you won't let Maria go to find out. And that's where again the huddle of of jumping or the hurdle rather of jumping over that and thinking that way from a business standpoint is what our doctors need help with and it's really fun.


Howard: The kids thing is total bullshit like tuck this is Tuesday, tomorrow I leave - my next few lectures are in Sydney Australia and in  Melbourne Australia and every time I get on those airplanes it'll be a sixteen hour flight and I'll say the flight's time. So, where do you live? she's like " LA, Phoenix whatever" I said, "well this is a sixteen hour flight how long's your layover?" "A day" so long story short she won't see her kids for three days but can't find day care to get to work on time but that Friday tenant can find date there for four days?

Corrine: Right.

Howard: So that's a true hassle.

Corrine: Well part of it too Howard, I was a single parent for four years raising a child by myself before I was remarried and so my tolerance level is pretty low because I've been there myself without family help and I was able to work and you know what? my daughter is eleven right now she's probably been in more dental offices than anybody on the planet. I take her with me. I take her with I mean, she still comes along we stopped at an office last week she's like, "What doctor do we have to see?" I have never yet had a dentist care. Again, if you can't make it, make it work get to your job time get to where you need to be get your ducks in a row you're not always going to be in a situation in life where you're gonna have family support or whatever but if you've made a commitment to a work environment you need to commit to that. The whole rest of the team doesn't need to be jeopardized or their work hijacked because you have to leave to get your kid from daycare or your kid is sick again for the nineteenth time. I mean there are some things that are unforeseen I don't mean to sound totally cold but I mean, I can remember taking Brooke to a dental practice and she sit back in the in the you know the lunchroom area and I saw one time she was back there and this dental assistant comes running out the back she had puked in the back and I'm like "whoa, okay I guess this is the last time I bring my kid to work". But you gotta do what you do because you're committed to an employer, you stay there, you work so I just - I see a lot of lack of commitment and a lot of dentists had just accept that and it's not acceptable it really isn't.

Howard: How old's  Brooke?

Corrine: She's 11.

Howard: Well I'll tell you what. I was born and raised with five sisters my little brother wasn't born till I was graduating high school he was a Catholic Vatican roulette birth control form mistake and an accident and I can either stay home with my five sisters and pray rosaries and play Barbie dolls all night or I can go to sonic drive-in work with my dad and I'll tell you what all my happiest best memories of my life were going to work with my dad and it's so when Brooke, when she is my age she will look back traveling with her mom and doing dental deals that's where she'll cut her teeth on life business lessons all that. I want you - okay so right now my homies driving to work eighty five percent of my guys are -  they're commuter, they got an hour commute to work and that's why we do the show an hour and give some red flags on what a toxic employee is. Why do people like a dental consult like you walk in there and spy? How long does it take you to find the toxic cancer?

Corrine: Twenty minutes?

Howard: Okay, so why does this dumb ass works in the sixteen hundred square foot office with five chairs and he can't see it and everybody around him sees it is? Give him some red flags of what a toxic employee is?

Corrine:  Sure, this is awesome because I'm actually working on a CE right now called ten ways your dental team hijacks you and so this is on my brain anyways.

Howard: Is this an article or /

Corrine: No,I'm developing I think we're gonna do it for dentaltown you and I are gonna talk about that.

Howard: In the magazine or online CE?

Corrine: Probably online CE, I think.

Howard: Nice.

Corrine: So, I think. Oh go ahead.

Howard: Yeah I mean, why can you see it in twenty minutes? I mean sometimes I'll go meet a dentist for a lunch and I'm just like sitting there like "Holy shit, what's wrong with that person and then everyone feel, I mean, okay how can you spot it what are some red flags help this guy driving to work understand which one is as cancer and cancer's need to be removed entirely.


Corrine: Well, one of the things that's always interesting to me is my team and myself it's usually me and at least one of the other team members or I'll do it by myself will go into a practice and just kind of hang out for a while and I'm amazed all the time at how open they are with us without knowing us, the things out of their mouths what they say about their boss. I'll ask them, "So, how many of you worked for Dr. Mark?" and they'll let you know or what do you think of his dentistry? what do you think of Dr. Susan's dentistry and I'm amazed at what they tell me. In fact earlier last week I asked a lady at the front and an administrative person I said well how long have you worked here and and she said well about six months and so, what do you enjoy? she goes why don't you just ask me what I don't enjoy? Okay, what do you not enjoy? I don't like getting his coffee, he could get his own damn coffee. Wow that sounds like a real positive person that I want to be around all day. So, I mean it takes two seconds to here really I'm a stranger I'm here to support you in your role I'm here to help your practice and within two seconds you've told me that you are a very negative person. So, how would you hire a negative person if you don't like getting a coffee then how do you talk about his work to the people sitting out in the waiting room? how do you talk on the phone then? Are you negative on the phone because you had to go get his coffee? I think it's pretty easy to - those are red flags to me. It's also red flags to me when somebody cannot say where they work, they're not proud of where they work they won't put it on their LinkedIn, they won't put it on their Facebook, they won't do whatever we just did this exercise with the practice last month where we we looked at all their employees and out of their 13 employees one person had it all over her Facebook that she worked for this office and she is the type of person that you walk in the practice and you she loves eats and drinks that practice she thinks the doctors the best thing since sliced bread she loves everything about it. Those are the people you want on your team that's a "Whoo-hoo flag" this is the person we want so to meet red flags again, they're not telling people where they work, they're grumpy to strangers and then also people that are milking the clocks are red flags to me as well, people that are staying after they think the doctors made of money so they should be able to stay after you know an hour and do their chart notes. No, there's no hour after doing your chart notes one of the things we do is we assess team flow and where there are deficiencies so, people can come in and step in and help. We get super tunnel vision as a team in dentistry where - well, I'm an assistant but I could not go help a hygienist do periodontry, I need to just do this. So, we try to expand that horizon for them and say,  "Hey, instead of milking the clock here why don't you go over there and help this person with periodontry in there. Did you get up and walk around and see if anybody needs help in any of the treatment rooms? So, when they're receptive to those types of trainings those are positive flags too. People that are like, "Oh Corey's here this is horrible" I tend to think that they're either not supportive of the doctor or the team as a whole and I understand because if they've if they've worked with a consultant before or they're concerned like other consultants here to tell me everything I do is wrong I understand that from their perspective too that can be uncomfortable but we are really there to be a support and to maximize their position within the business and so anyone who's not supportive of that to me is a red flag.

Howard: So, there's only really two -  I mean the two greatest people in math for us sir Isaac Newton invented calculus and I was a 1686 and there was a Albert Einstein but an animal behavior anthropology, it was basically Abraham Maslow and who's the guy who wrote the naked ape? Yeah, Justin Morris so, Justin Morris was my first love of anthropology and my second was Abraham Maslow and Abraham Maslow wrote a book called Maslow on management and he said that "You can't be a friend with a fellow homo sapien and you're his boss because you reserve the right to fire him and if you become his friend now he doesn't think you're gonna fire him and how could you be my friend? If Corey was really my buddy, I'm not gonna fire my buddy because that's gonna rock your world and all that. So you get all this dysfunctional behavior

Corrine: Yes.

Howard: So I wanna ask a specific like on Facebook, do you think a dentist should be friends with their staff on Facebook? I mean should I? do you think so?

Corrine: You know what it's hard. It really changed me philosophy because generally I'm a pretty private person however I do think the world has changed with Facebook specifically and I don't think there's anything wrong with a doctor having a Facebook page for employees and team members and so forth their level of comfort though of what they share obviously should be there with the understanding "Hey, I've got employees on here or I have team members on here". I think it's really within your value system, so, if your value system is you're very private you don't want that out there, that's private for you then no, you should not be from employees. My general concept is no. However, with the way the world has changed in the way that business has changed I think social media is a necessary evil we all need to unfortunately be a part of so I don't think it's you know again depending on who the doctor it's really what works for them and what's comfortable for them but definitely having a business page and even if they have their own you know Corrine Jameson Kuehl page and then her clients can be on that. Because I have the same issues too, I have clients and employees that wanna be my Facebook friend and I had to just let that go and be okay with it 'cuz they wanna see pictures of

Howard: (55:59 unclear)

Corrine: Minus personal because they wanna see me as a person. They wanna see pictures of my kid playing volleyball and that's you know what? that's okay. I'm not gonna put it out there every night I'm out to dinner/

Howard: they don't wanna see me they just want to hear me on iTunes they said you don't have the face but you do.

Corrine: But you're a celebrity so, I don't know.

Howard:I will be friends with any of my employees because I want to reserve the right to fire their ass. I mean, even though you've been with me forever and even though deep down in my heart I think is a sister I'll fire my damn sister right and I used to tell my boys every times I told my four boys I'm not your friend, I'm your father I mean, even though you want to go out and get high with them you can't because you're their father.

Corrine: Right, poor Ryan proud of you so much.

Howard: But it is weird but okay now were to switch yours. Let's say the staff is fine everything's (57:00 unclear) but the overhead is high and and they're flat. Do you think it's all that with marketing overheads high and they're flat would you try to get any more new patients and grow it out or would you try to look at expenses and cut them back? What would you say to dentist. I was flat I'm just flat.

Corrine: If the team is awesome and everybody's on the same page and we find that too. We walk in and everybody wants the growth and they want the change they just need another set of eyes so then, they just need training they just need training to kind of maybe overcome some of those old thought processes that maybe got them into a place like, "Hey, just seen another set of eyes saying hey these supply costs are crap let's do some re-negotiations, let's look at some other possibilities or yes, maybe you need to bring in a marketing firm to update your web page or update some of your you know your radiuses of how you want to reach certain patients or potential patients and we have resources that we've give to people that way because we don't deal with any marketing or scripts necessarily too if they want to use something like that. But yeah, that's a good point too there's many teams that are great and they're they're just flat and they need just a nice boost and those are fun those are the fun teams to work with because they are open minded to change and they want to grow the business and they love their doctors and they want to see and we growth.

Howard: And what percent of the offices that call you or that's an arrow versus a toxic environment?

Corrine:  Maybe, probably like one percent. Well I mean, literally one percent most offices call us are in an SOS frame of mind and that's okay we're very much accustomed to dealing with that but then there are some/

Howard: and the SOS frame of mind? what - tell me, so, in SOS frame of mind what percent of - what is the number one reason, let's go through the top five reasons of an SOS? would you say that number one was what? was it the toxic employer is that not the number one?

Corrine: Yes. No,  I would say toxic employees is probably number one they feel - or hijacked employees, hijacked by their employees their new owners they're hijacked by previous employees, that's our number one call and they don't know how to deal with that. How to change systems to their philosophy without offending the entire team or how do they move their their business philosophy forward because they don't have the support of their team, that's number one. Number two would be they've had a turnover and team members in the past and so maybe insurance aging and AR is out of control that's another huge SOS that we get and then number three would probably be they've done, they've had employees leave and they've hired or they need assistance in hiring and they need training so then we would be we would provide training for new at straight -- IV and assistance and so forth to the doctor's philosophy that would be another one then I would say number number four and five for being somebody wants that other set of eyes to look through supply costs look through our OSHA, look through our systems and protocols. What can we do to increase production? what can we do to have better team building? and then that fight would be that percentage of these really awesome doctors and sometimes myself and my team we chuckle when we get these calls and they want us to come in because the doctors are freaking out because they're over ninety is at five thousand dollars like are you kidding me? They're so good they just need encouragement Howard they're doing so awesome but they're, "Well don't know what to do my over ninety's and five grand" "Okay, you mean like literally five grand you're not talking five zero and so, those are fun practices where they just want pep talks they want phone coaching they just want to feel empowered and they just want an oh-ra-ra and those are probably people that aren't listening to podcasts and are trying to get you know more dental information they're working their brains out but they don't know they're doing a good job and they're doing great work and they have a great team and they're really they put in some great protocols and systems they just need encouragement. So, that's kind of where I think we as cause some dental solutions where we fit in the best is really those those kind of dysfunctional situations we really pride ourselves in turning those around and really helping our doctors go to that place that they want to be that makes them feel secure as a business owner and just providing that strength for them and providing resources for them to just really grow and just whatever they need we're there for them that support.

Howard: I want to run the front door problem of the funnel, the funnel from the front door and the funnel going out. The funnel going out is that by the time you get to five thousand charts, four thousand of them are inactive but let's talk about the funnel command. So, we know and what advice could you give us we know that the average Dentist, ten people have to land under dental office website before that shitty website converts one to calling the office. We know that three people had to call the office before that lady upfront named a piece of furniture, the front-desk lady (1:02:23 unclear) to come in.

Corrine: Yes.

Howard: I mean three people have to come in with a cavity for you to convert one to get a drill fill and bill. So, the average dental office in America does 650,000 a year, they take home 180 but to take home that 180 to get that one patient three had to come in, to get three to come in, nine had to call and that means ninety had to land on the damn website.

Corrine: Right.

Howard:  What can they do to fix any of that shit I mean I mean the whole six -fifty is because ninety people landed on the website to get nine to call they get three to come in to get one to get treatment I mean I think it just fix any part of that funnel, they get to have million dollar practice.

Corrine: I know and part of it too since I'm not a marketing person so much Howard, one of my biggest things that  I like to tell my doctors before they start throwing money down at marketing and trying to turn to overcome the odds and the numbers that you're just talking about, romance the people that you have already treat them kindly look at the people that need the work that needs - is there another way you can approach them. Once they're in your chair romance those people and that's where you can really grow however I'm sure the marketing experts would have other -

Howard: No, I don't like - I think getting hooked on marketing you might as well get hooked on beer cigarettes, wine, crystal meth, opioids or whatever the hell

Corrine: That seem more fun.

Howard: Because what you just talked about is why four thousand at it, by time you get to five thousand charge four thousand will come back because when they come in, you didn't romanced them

Corrine: Correct.

Howard: We talked about,  look at their mindset they've had new patient experience. Screw the new patient experience.

Corrine: Right.

Howard: What about the existing patient experience?

Corrine: Absolutely.

Howard: It's so difficult because they want to go to how to eat, they don't want to go get a root canal

Corrine: Right.

Howard: And then so number one I don't want to see you and I'm gonna bump into the receptionist, the hygienist, the assistant so, I don't want to be here yet four people can piss me off to where ill never come back.

Corrine: Right.

Howard:  So, sounds that you were starting to rant about the back door, so these five thousand people showed up why did four thousand never come back and why did a thousand leave that was probably the better question for you? why did a thousand stay and why did four thousand never come back?

Corrine: My reason is because of who the dentist has surrounded themselves with. I think that they don't come back because they were treated rudely by someone in the administrative office they were not felt warm, they did not feel warm fuzzies in any way sometimes we forget and people with personalities like mine we're pretty cut and dry. I need to be reminded of this as well, that people are very fearful of us in dentistry when they walk through the doors we need to do whatever we can to make them feel comfortable or in a personal space we are taking their money. I don't care what we're doing, we're so busy fluttering around the office doing all these different things but maybe you do have to sit out in the reception area and chat with the old grandpa for awhile because that makes them feel comfortable. Who on your team is gonna do that person to do that? You have to have these lovey dovey people to surround yourself with because they may love the doctor but if they don't get the whole team experience they're not coming back. I had a doctor tell me last week that he said, "I found out from for patients they left my practice, they liked me they liked my work but my treatment coordinator wasn't nice to them, they didn't feel she was nice, what should I do? well obviously my responses let her go and find somebody who's gonna be treating your patients nicely. No, there's only four people that actually express it to him, how many people leave without saying anything? that's more the norm people leave without mentioning why they're leaving. So again I think it's surround yourself with the right team and the right mission and those people aren't going anywhere romance the people you have and they're not leaving.

Howard: And you know what? being a dentist for 30 years every single time I've reached in their mouth and said who did this gold crown, you'll have one gold crown your whole mouth, who did it ? they never know I'm like are you kidding me somebody got in your mouth and put a crown and you didn't see him?

Corrine: Yes.

Howard: Did you ever wake up on the sidewalk and see some guy running down the street maybe it was him.

Corrine:  Right.

Howard: And so what I think is, they never remember what you did, they only remember how you made them feel.

Corrine:  That's right.

Howard:  Every time I've had a patient call out all upset "yeah, that feeling you did now the whole area is hurting and it's swollen or whatever" it's usually on the other side of the mouth it's like they remember I was on the upper right and you're pointing at the lower left.

Corrine: Right.

Howard: So you never remember anything technical and what I see the major difference is you know when a dentist gets done doing a root canal or crown or filling or whatever, the unprofitable ones go in the room and shut the door and the profitable ones walk them all the way at the front. I love to go out in the wedding, I love to shake their hands,

Corrine: Yes.

Howard: I play people like you have Brooke who's 11 so ,if you're on the waiting room, I wouldn't go out there and say, "Hi, Corey how are you? I squat down and shake Brooke's out.

Corrine: That's right.

Howard: How are  you doing Brooke? and I know that every Widow who's over eighty phase,  I mean they just die for a hug and every damn widow

Corrine: Right, absolutely.

Howard: whether it's a bear hug, a kiss, how're you doing and it's that soft stuff and my dad always called he always said, "Howie, they don't know or care what dental school you went to you get out there and you act like me running for mayor,you go down there and you you act like that every two years there's an election coming up and they're gonna either/

Corrine: That's right.

Howard: Vote your ass back into the the mayor's office or fire you and get someone else and as long as you're out there.

Corrine: So let me ask you Howard are you calling your patients after those really traumatic experiences - are you personally calling them?

Howard: Absolutely.

Corrine: 'cuz that's a few one.

Howard: Yeah

Corrine: That most doctors and if you're doing that you understand that is like, that's gold standard amazing care when you are calling your patients yourself they don't want to hear from me, they don't want to hear from your assistant, they want to hear from you asking them how they did after that root canal or that you know (1:08:47 unclear) or whatever it is that was a more traumatic experience. So, if you're calling them yourself that's awesome because that's what they wanna hear from you.

Howard: That's what I like the most, that's my second to the favorite when you call and the husband answers and you're asking for the wife they go, "Man, who's this calling?" and I say, "Well, you're not the husband are you?" and they'll say - but the best phone call ever is when their phone starts ringing on the counter and they got a rubber dam on them and they can't answer the phone and I pick up and then I go, "Hello?" and they just freakin' out and they say "who is this?" and I was like "well, who's this?" "Is my wife there?" "Your wife's kind of busy right now, why don't you call back after an hour to talk to your wife" God, I love it. They're literally doing a back bend of the chair trying to get out there. I loved your bath I think the world of you I think people in Madison in Kansas and Louisiana are nailing it better than people from you know Beverly Hills and these big city high-end deals because when I'm out there talking to dentists they say, "Well, I read this article but I mean this guy's from Manhattan and Manhattan really doesn't remind anybody of Kansas and Oklahoma and Alaska."

Corrine: Right.

Howard: And then you talk about these guys and we're talking about their cosmetic practices or the time when the movie stars they did well there ain't no movie stars in Parsons Kansas, okay? Nobody is on the big screen from Parsons Kansas and I love talking to real world in the trenches in a flyover state like Madison because I think even Laverne and Shirley left Wisconsin didn't they?

Corrine: Totally, yeah they worked in a beer bottling Factory in Milwaukee, what a great job!

Howard: with Squiggy?

Corrine: Right with  Squiggy yes.

Howard: But Laverne and Shirley and Squiggy that's real world Americans.

Corrine: And don't forget the fans either.

Howard: The fans.

Corrine: Yes it is and the fans don't forget him. No and that's why even at this point in my business I love still being in our practices I can't just sit at home and manage from afar I need to be with my doctor still and that's that's one thing that that is so enjoyable that I love being a dental entrepreneur is that, I can get out there and see whoever and it's just awesome and yeah you're right, that Midwest route definitely gets us into a lot of places because we're friendly and legitimate that's true for sure.

Howard: So you're driving your work (1:11:18 unclear) ninety percent of all TMJ, TMD orofacial pain specialist will tell you that ninety percent of all their clients are women only because women go get help, the men had the same rate of the disease they just don't get help she started the show an hour and ten minutes ago that the bottom line is women Millennials are calling up and that may gets them to buy a practice better, you don't buy a practice without some armchair psychologist. So, you can call it Corey at two six two eight five three fourteen fourteen that's two six two eight five three fourteen fourteen or email at corey@customdentalsolutions.com because you're not going to solve the toxic staff member and your insurance aging and your turnover and your training and supply and all that bullshit by learning how to do bone grafting or going to or deciding if maybe you're using the wrong dental implant and maybe if you just switch from Straumann to Mehigan or whatever I mean, you always try to - you have a restaurant that's sinking and your best ideas well maybe if we just added pizza it all be okay and if you can't make money on hamburgers, fries and cokes then

Corrine: Amen, that's right.

Howard: add in pizza or bone grafting or a laser or chair side milling, I mean if you can't make money on cleanings exams and extractions and root canals if you can'build a two million dollar practice with that you sure as hell aren't going to build your practice with with sleep apnea.

Corrine: Absolutely, amen.

Howard: On that note I'll give Brooke a big hug and a kiss from uncle Howie and on that note I hope you had a rockin' good day.

Corrine: Yeah, thank you, you too bye Howard.



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