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VIDEO - DUwHF #920 - Timothy Quirt
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AUDIO - DUwHF #920 - Timothy Quirt
Dr. Tim Quirt studied at the top of his class from high school through Dental School, graduating with honors along the way. He is currently working on his MBA.
He has since grown several successful businesses;
- As Regional Director created ways to increase Same office growth in his regions over 5%.
- Multi doctor and location dental service organization before affiliating with Heartland Dental. 12 locations spanning the states of Wisconsin to New Mexico with combined revenues of 25 million plus.
- Multi site Dental assisting school company that serves as a stepping stone for many people to enter the health care field.
- Was a partner in a dental lab for many years providing high quality lab products to group practices.
- Served on the board of a large finance company offering investment options to dental and medical patients.
- Consulted with many dental offices over the years to help with operations and a focused effort to increase patient/business results.
Dr. Quirt is known for:
- Vision
- Executive Level experience
- Company Strategy
- Scalable solutions
- Passion
Currently as a clinical director and regional director of operations for Heartland dental he has led many initiatives to strengthen the support provided to dentists across the country. His passion for patient care and healthcare entrepreneurship has helped his teams create a successful practice and life.
www.quirtdentistry.com
Howard: It is just a huge honor for me today to be podcast interviewing a mentor of mine, an idol of mine, Timothy Quirt, DDS. He studied at the top of his class from high school through dental school, graduated with honors along the way. He's currently working on his MBA. He has since grown several successful businesses; as regional director created ways to increase same office growth in his region to over 5%; multi-doctor in location Dental Service Organization before filling with Heartland Dental, he had twelve locations spanning the states of Wisconsin to New Mexico with combined revenues of $25 million; multi-site dental assisting school company that serves as a stepping stone for many people to enter the healthcare field; was a partner in a dental lab for many years providing high quality lab products to group practices, served on the board of a large finance company offering investment options to dental and medical patients; consulted with many dental offices over the years with operations and a focused effort to increase patient business results. Dr. Quirt is known for vision, executive level experience, company strategy, scalable solutions, passion, currently as a clinical director and regional director of operations for Heartland Dental. He has led many initiatives to strengthen the support provided to dentists across the country. His passion for patient care and healthcare entrepreneurship has helped his team create a successful practice in life.
My God, you've done more by age 36 than most dentists do if they live to be as old as Paul Keyes, who just died. Remember the Keyes Technique? He just died this year at ninety-nine years old. My God, you just hit the ground running. How are you doing today?
Timothy: I'm doing terrific. Thanks for having me on. I took this off from you, remember a long time ago? You used to say, "I don't golf, because what I like doing is business." That's the same way with me. I just worked all the time. I still don't understand when they say, "You are a workaholic" or things like that. What if you enjoy doing some of this stuff? I don't see it as a negative. I have you to thank, because what was it Howard? I want to say it's twelve, fourteen years ago, something like that. I e-mailed you and I said, "Hey, I'm a student and I don't have enough money to get your MBA tapes. Do you have any discounts for students?" And you said, "You know what? I'm going to just send them to you." And you sent them to me, the VHS tapes.
Howard: And now you probably couldn't find a VHS machine in all of Wausau, Wisconsin. What would you do if you had to find a VHS machine today?
Timothy: Oh my God! We'd have to go to an antique store.
Howard: That is so cool. I always could spot the people that were going to make it, because they were hustling in dental school. I can tell you how many dentists. There's two dental schools in Phoenix, one's in Glendale Midwestern, one's in Ottawa. And sometimes I'll come by their office and they'll say, "You think I'll be successful?" I say: "Dude, I've been doing this for thirty years. Just the fact that you had enough initiative to drive over here and walk through the front door and shake my hand and press the flesh, every kid that's ever done it, crushed it." Have you ever met an Eagle Scout in your entire life that turned out to be a complete loser? Just the fact that you became an Eagle Scout, whatever you end up doing, you're going to crush it. And in fact, some of the car insurance companies even give you discounts on your auto insurance if you're an Eagle Scout, just because they have numerical less claims with them. So, what are you doing now? So, you started a dental office, built it to twelve and then sold it to Heartland?
Timothy: That's correct, I affiliated in 2012, actually. My father is a dentist, my brother is a dentist and I went in and started. We did a Kushner style partnership right off the bat. So, the day I graduated from dental school, I was a partner in his practice. And we doubled that practice and we grew and grew, then I started just running the business side. My father said: "You know what, I don't like this business side stuff. You run it." And so, we affiliated with practices, we merged practices, we started practices. I'll be honest with you, because some people think, "Well, maybe he was doing it for financial reasons." Truthfully, I always thought it was an insurance policy. I felt if I had more practices that I would be safer, if one industry collapsed or something along those lines and we didn't have enough patients. So, really, it made me feel great. And banks at that point in time were, that was pre-2008, they were willing to lend money left and right. So, we just took advantage of it and just grew it.
Howard: It seems like they're still loaning money left and right. If I were to go sell a house in Phoenix and it was 25,000 square feet with a nine-car garage, it's an illiquid asset, and you might not ever sell it. But if you are selling a three bedroom, two bath house in Phoenix, Arizona, you list it, you'll get offers that day and you'll flip in a week. In dentistry that sweet spot, three bedroom, two bath house is about a $750,000 office. I'm just not hearing anyone denied for that loan at Bank of America.
Timothy: I'm not either. And I think you even mentioned it years ago. It's just one of the lowest default businesses.
Howard: They have 99.6% pay it off, 0.4% default and they all have one thing in common - they had their license taken away. So, it's either for drinking, something happened with their license. And usually, that's a moral hazard. So, if you don't get your license taken away, dentistry isn't competitive. Compare that to restaurants. What percent of restaurants go bankrupt within two years? 80%.
Timothy: I believe it. That's unbelievable.
Howard: When a dentist tells me, "Times are tough", I'm like: "Dude, does your profession have a 80% two years bankruptcy? You don't even know what competition is."
Timothy: Do you feel that you're still telling people, "Hey, you got to have great hours. Are you open Friday?" And they say no. "Are you open early?" No. Do you still feel like you're saying that to people? Because ten years ago you said: "Hey, there is no reason for you not to." That's all.
Howard: Well, you know, dentistry is so different than medicine, because if you get out of med school and you're in Arizona, you might get a job at St. Luke's and they'll say: "OK, Tim, you're going to work Mondays and Thursdays, a 24 hour shift each day, you're going to show up Monday at 8:00 o'clock and get off at 8:00 o'clock the next morning, you'll come back Thursday and do it again. So, that's forty-eight hours on a salary for forty." And the physicians are like: "Thank you so much for the job." And then you hire an associate out of these two dental schools in Phoenix. And you say, "Hey, two nights a week, can you stay till 7:00?" "What? I can't stay till 7:00, I'm married, I have a child, I can't stay till 7:00." "Well, how about one Saturday a month from 8:00 to noon?" "Oh, no, my kid's in Little League and I'm his coach." Dentistry, I mean, my God! When a dentist tells you that they have banker's hours, I say, "Dude, have you been to a bank in the last 10 years?" They're open 6:00 in the morning till 7:00 at night or open Sundays. There's even some 24-hours banks around here. Is that a competitive advantage with Heartland, hours?
Timothy: Yeah, I think so. I think a lot of our doctors are very... One of the things we like to say is that everybody is open, positive and flexible. Pat Bauer, who is the CEO of the company, essentially just boils it down to - you've got to be nice to work with Heartland. I do think we're open, positive and flexible on hours and being open on Saturdays sometimes in certain offices. So, yeah, I agree about that.
Howard: You know what? I've had Rick Workman on the show, it was one of the most viewed podcasts I ever did. I'd like to follow you with Pat Bauer, I'm a big Pat Bauer fan. How long has he been in the company?
Timothy: I want to say it's been twenty years, right around there. And I'm telling you from inside the bubble, Pat and Rick, they are just geniuses when it comes to running dental practices and helping dentists and supporting them.
Howard: Will you e-mail me, howard@dentaltown.com and CC patbauer@heartland and my son Ryan. I'd love to get them on the show. You guys are number one in most location, number one in revenue, but what I'm most proud of Heartland is, you're actually number one in lowest turnover time of dental associates. Some of these corporate clinics, their average dentist doesn't even stay a year and you guys retain your young dentist longer than anyone else. Do you agree with that or disagree with that?
Timothy: No, I totally agree with that and I'll tell you the reason. One is Dr. Workman, it's Dr. Run and really, this is no joke, the primary premise of what we do is sit down the doctor and say, "Hey, what do you want? We're here to serve you, we are here to support you. What would you like?" And really, our goal during the year is just supporting their goals. I haven't been in other DSOs, but that's what I love most about Heartland. We're really all about the doctor.
Howard: What I'm hearing back from the street and Dentaltown is when I say... And by the way, when we talk about employee associate turnover with corporate dentistry, I want to be absolutely clear, there was this article in Businessweek, Facebook, Google, Uber, eBay, their average programmer millennial stays with them only two years. And Google is supposed to be a fun place to work with foosball and pool tables and bean bag chairs. They can only keep their millennials two years about on average and most associates in private practice, they have the same turnover rate. So, I actually think that you have a lower turnover rate for millennials than Facebook, Google, eBay, Uber, Apple, all these great places. And when I actually get to meet one of these kids one-on-one, who's been with you three years, four years, they tell me it's because they came out of school, they never placed an implant, they never learned all these other things and they say, "If I stay with Heartland, I'll place fifty implants, I'll get my FAGD, I'll learn sleep apnea." I think you're keeping them because the same reason dental school kept them for years. They think, "If I get a job with you, I'm going to learn a lot of advanced dental procedures." Do you agree with what I just said or not really?
Timothy: Absolutely and I'll tell you one of the secrets here, I don't know if a lot of people know about this, but we've got a program that Dr. Workman came up with and Pat Bauer put together. And this is unbelievable, you're going to love this. It's called DMP, Doctor Mastery Program, and what the whole premise of it is, is that it's opposite of dental school. We have to pay tons of money now to young millennials to go to dental school. Well, Heartland's saying, "You get your FAGD when you work with Heartland. So, in a five year time frame, if you get your FAGD, if you're an amazing doctor, if you do free dentistry for your community, we'll have an office goal, if you do some of these parameters, guess what? We'll give you up to $250,000."
Howard: My gosh! That means in five years, $250,000, you'd be able to almost pay off one fourth of your divorce.
Timothy: We're hoping that part wouldn't happen, but we certainly had in mind that... Any of that education, you're just going to see things differently, you're going to treat patients differently, you're going to treat your team differently.
Howard: If they stay there twenty years, will you pay the entire divorce settlement?
Timothy: Well, we'll try to figure that out, maybe, I'll just say maybe. But that's why I say education, Howard, you're saying that and you're right, one of the things that we get highly ranked on is our education and our mentoring. We've got some amazing doctors and some great teachers and that's what we're here to do and that's why they stay.
Howard: Tell me the top three things they would spend their 250 on. What would it be? If I join you and I stay five years, is that 250 going to pay towards my continued education to learn implantology? Are those line-items adding up or are you paying for the implant training, this continued education?
Timothy: All that is paid through your office, but no, that 250 is yours. It's just a bonus, you can use it towards... Again, we were thinking some of the student loans, a down payment on a house, whatever you want to do.
Howard: Down payment on a house? That's the problem with dentists, $250,000 should pay for the whole damn house. I'm serious. Dentist don't have an earnings problem, they have a spending problem. The reason they come out with $350,000 of student loans is because during spring break they were getting in airplanes and flying to Florida and going on cruises. They graduated with a nice car and they don't go buy a normal house under 250, they go buy a $600,000 one. They live like rock stars.
Timothy: Let me just say this Howard. This is another interesting thing, one of the requirements of being a Doctor Mastery Program doctor is, every year and it can be whoever you want, you have to sit down with a financial planner. So, we thought that that would be an interesting little tidbit. Did you see the Dave Ramsey video where somebody called in and they had tons of student debt and he just freaked out about how much the dental school debt was? We actually invited him, he's going to be speaking to us at our winter conference this year for any DMP doctor, so we're going to have Dave Ramsey there. So, that's cool.
Howard: Gosh, darn, score me a podcast with him when you're there.
Timothy: Alright, I'll do my best.
Howard: I'll fly down there to podcast him, I'll film it, ask him if we can film it.
Timothy: You want to sign up on our DMP, Howard?
Howard: Oh my gosh, I'm too old. I think you have an age limit. I'm fifty-five, you'll probably going to take me there, you put down a year or two.
Timothy: You're still young.
Howard: So, tell me what is the business model today at Heartland? Is it more a roll-out or roll-up? And to define that to the listeners, a roll-up is when you go get a line of credit for a million dollars and you go buy a practice collecting a million dollars and you're just rolling up these different offices. A roll-out is what you think about like a McDonald's, where you go out and buy the land and you put up your cookie cutter building and put McDonald's on it and you build it from scratch. Is Heartland more a roll-up play today or is it more a roll-out, building new, "de novo" offices from scratch?
Timothy: That's an interesting question, because I don't know if anybody in the DSO world really has the formula on that. I'm going to just say that it's about fifty-fifty. And one way to look at it is, it's nice to create these beautiful "de novo" offices in areas that you know are going to be successful, but it's also nice to bring in offices that just have great people. We love having happy, open, positive and flexible people who work with us and because we're growing so fast, a lot of those people, like in my office, one of the reasons I affiliated was, some of them now are regional managers and doing things like that. That's really exciting, because they can now move up and obviously make more money and have a lot of success in their career that we wouldn't have been able to do.
Howard: To me it seemed like Heartland started out like Walmart. Sam Walton was in thirty states before he went to a big city. He was scared to death of Dallas and Little Rock, because they had these stores that you might have heard of, like Sears and Gibson's and TG&Y. In fact, he was so scared, he actually went and talked to the owner, Mr. J.C. Penney. He actually went to Chicago to talk to Sears and he said, "I'm going to put a store here, is there any chance that you're going to put a store here?" And they would laugh, they're like, "Dude, there's only five thousand people in the town, of course we're not putting a store there. Those people should only buy through the Sears catalog." But then later, when he really knew what he was doing, then he went into the major cities and crushed them. I thought Rick Workman definitely started like Sam Walton, going into the rural areas that everybody was not participating in. Is it a more rural play today in 2017 or has it switched to an urban play?
Timothy: You know what, a great question, I think we are more urban than we were before. But I got to tell you, there's just so much opportunity to run with that we have and the support that we can offer throughout the whole country, there's just so many. What is it, Howard, about a hundred thousand practices out there? And even though we're the largest, we're only at 800, I think I found out today, we're at 800.
Howard: So, you don't even have 1% of the market yet.
Timothy: Not yet, but we'll get there.
Howard: Let's go in the last five years, what percent of your offices... You said it's fifty-fifty "de novo"/roll-up? What percent of your offices were urban versus rural in the last five years?
Timothy: I would say it's about 70/30, 70% more urban and 30% more rural or outside of a larger city.
Howard: Because I remember, I flew out to Effingham twenty years ago, when this thing was starting, you remember that?
Timothy: I remember that, you had a group of townies there and I remember following it, you guys took pictures and I talked to a lot of them to see what their opinions were. I remember that.
Howard: And also Eaglesoft was in the same town. It's amazing, that little town of Effingham, out in the middle of nowhere, had Patterson Dental and the founder of that later went on to become the CEO of Patterson.
Timothy: Yeah, that's right.
Howard: What was his name, Scott?
Timothy: I can't remember.
Howard: It was amazing that Eaglesoft and Heartland came out of... It's amazing, that town only has ten thousand people.
Timothy: Yeah, that's correct.
Howard: Ten thousand people started two of the largest dental companies in the world. That's just bizarre. If there's an older guy listening to you right now and he says, "You know what? I'm burned out, I'm fried, I'm tired of running the business. I just want to come in and do the dentistry." Who is your perfect client? What should he do? What's the chance if he contacted you, you'd buy him, how does that all work?
Timothy: Well, I get a lot of e-mails and calls all the time about this, so, I always encourage people to do that if they want, but I would say that we look for an office that has around five ops and does about, like you said earlier, about 750,000. One thing that I always like to clarify with people is, if the doctor is looking for an exit strategy, we certainly don't want that doctor to leave. You can stay and work and we'll support you and we'll do whatever we need to do. But if they say, "I've got five, ten years left", we love doing that type of affiliation and really, the only rule is you just got to be open, positive and flexible.
Howard: Open, positive and flexible about everything, marriage, kids, choose your battle. I've got four kids, I've got fifty employees. Choose your battles, be flexible, lower your expectations and you should wake up every morning and lower your expectations even further until you feel like you're at the zoo talking to a giraffe and that's how you become happy. Because you have no expectations from a giraffe or an ostrich or your goldfish, but you have all these expectations on your staff and your mom and your sisters and your kids.
Timothy: That's one thing I like to tell people too and I think you'll like this - be great to your team. The old-fashioned leadership style of "you're just going to do what I tell you", that's not the way to run things anymore. And just be a really good leader, take care of your team, pay them well, have fun, because if we're going to be doing this fort thirty, forty years, might as well be doing it and having fun. That's the way I look at it
Howard: And I can tell you young kids that are in dental school or just starting that, when you're... My dental office turned thirty years old yesterday, September 21st, thirty years old, that any time someone works with you for five years, ten years, twenty years, thirty years, they become just like, you think of them just like your sister or your brother.
Timothy: Yeah, you get very close.
Howard: You can't work with someone twenty to thirty years and not have the same feelings and protectiveness. Are you buying just businesses or you're buying the real estate, too? A lot of these dentists have two things to sell. They've got a dental practice and they own the land and building.
Timothy: Yeah, right now we're doing both. We're buying both and if you want to keep building, we can do that too. We'll buy the real estate off of you and support you and do what we need to do to help you.
Howard: I think that the greatest thing about Heartland for the old guys is, if you have a dental office that's about 750,000, five ops, you buy that, but you bought so many of my friend's dental offices that were between the two and four million dollar range. There is not a kid in America coming out of school with $350,000 backing at financing for two to four million dollar dental offices and they're just huge illiquid assets. In fact, I know dental offices that Rick Workman was the only single person that made an offer.
Timothy: You know what's interesting, Howard? A very similar thing happened in what we were doing when we affiliated with Heartland, because my father was going to retire at some point, he was sixty-six and where the heck was my brother and I going to go to give him cash for something that large? And number two, I like to emphasizes this, his health was great. About a year into it his hands started to shake. This wasn't like a tremor, he had literally had to retire. And what we have done? It's kind of an ironic story that we spoke to them, they talked to us and we affiliated.
Howard: There's a lot of wannabes, a lot of wannabe entrepreneurs or entrepreneurs that are sitting here and they're an associate now and one day they won't be like you, they won't have twelve offices. What did you learn on your journey before affiliating with Heartland as you went from being a baby dentist to having twelve officers, doing twenty-five million a year? What lessons along that road did you learn?
Timothy: Well, I'll tell you right now, it's hard. I didn't get married until quite a bit later in my life. I now have three kids under five, which I know you know how it is, three boys, you know exactly how it is.
Howard: Nice! You'd have one more to keep up with Howey. You do one more - four.
Timothy: Gosh, I don't know and I hope my wife doesn't listen to this. There are so many successes, but I'll tell you right now the list of failures and what's cool about Dentaltown is, you guys helped me so much. You guys just spilled stuff down, I took it and just borrowed it and used in my own office and I said, "Hey, if Howard's doing it, like the warranties on crowns, let's do it!" So, I didn't really sit down and analyze those things too much, I'm just like, "If that's successful, I'm going to do it." I think some people analyze so damn much that they don't implement stuff, instead of saying, "Hey, if it's successful in another person's office and I believe in it, I'll do it!" So, that's one of the successes, but one of the failures I would say is, I wish I would have taken even more courses online. The CE courses you guys have in Dentaltown... If you are sitting in your office and maybe you have somebody that dropped out or you have a couple of hours or something, put up a CE and learn some new stuff and really build yourself. Sometimes I don't understand, I'll see some younger doctors, they'll be on espn.com or things like that. Just get on Dentaltown, the CE is cheap and you know how much you'll learn in such a short period of time? So, that was one of my successes, I went to a lot of courses, you gave me the MBA tapes. I went and saw Kois for a discount, I begged Bruce Baird to go down there, I watched Bob Westermann. So, I would suggest, if anybody is listening, young doctors, just keep learning, keep that intensity.
Howard: Dentists are so often paralysis by analysis. They want to study something until they drop dead and die. I graduated May 11 at twenty-four, turned twenty-five on August 29, I had my office on September 11, which was yesterday thirty years ago, and I know people who are still thinking about it four years later. There's no good time to start an office and there's no good time to have a family. I had four boys in sixty months, I swear to God, I didn't sleep for a decade. Somebody would wake me up. I had four boys and two of them would wake me up in the middle of the night and that always had to be two hours apart. The only noise I hated the most was when I'm right there sleeping and heard the vomit noise, because that means you got to get everyone out of the bed, strip the bed, all that.
You buy "Pathways of the Pulp" by Stephen Cohen and it's $200 and there's nothing of endodontics left to study. You could learn that for $200. But they got to fly clear across the country in an airplane, the flight alone costs more than the book, the course costs several thousand dollars and then they come back with two pages of notes. If you would have stayed home with that textbook, if you read "Pathways of the Pulp" by Stephen Cohen... Another one I just read was "Implant complications". I don't know how you read "Pathways of the Pulp" by Stephen Cohen saying, "I need more knowledge on endo." And then, the second cheapest online CE... These courses on Dentaltown are $18. That's not even cab fare to the airport, but millennials seem to always figure out a way to spend several thousand gazillion dollars on how to learn something and I still think that the fastest, best, easiest, cheapest way to learn anything is walk across the street to your specialist, find a mentor and say, "Mr. periodontist, I'd like to learn implants and I don't work Wednesday afternoons, Friday I get off at 12:00, I only work every other Saturday." And if that guy thinks in fear and scarcity, it's good to know that, because now you just cross his name off your life and then go to the next periodontist and he'll say, "Come on in!" Next thing you know you have a friend, you have a mentor, you have someone to go to the bar with and watch the football game and have a beer, but while talking about implants. And that's why I didn't like golf, because if I went to the bar with those dentists, they'd watch football and talk dentistry, but when you go golf with four dentists, you're not allowed to talk dentistry or your spouses. It's like some weird religion thing. They just don't want to talk business on a golf course or talk dentistry on a golf course. But the same guy you go on a four hour bicycle ride with and he'll talk dentistry the whole four hour bike ride. So, find a mentor. And also, when you place an implant that goes south, where was that lecture that was two thousand miles away in the big city? Don't you want a periodontist or an oral surgeon in your same ZIP code to say, "Don't worry about it, just send them over to me. Let me look at it." You need someone to bail you out and then that lifts your self-esteem, because now you can take more risk, because you know someone's got a safety net underneath you.
Timothy: Absolutely. Amen on all of that. That's something at Heartland, we line everybody up with a mentor they can call and everybody's nice and we have an all doctor e-mail. We get questions all the time and you'll get a response immediately. So, that's cool and I agree. If you're out there and you're on your own, go find some mentors and get in there and learn.
Howard: Another thing I think, you got that all e-mail group, are you aware on Dentaltown they have private groups?
Timothy: I am aware of that, yes.
Howard: I think Heartland should start a private group on there, because you have your own server for all your dentists where you're preaching to the choir. I know you don't want to have an open format to talk about some things that are private or whatever, but I think you should start a Heartland group for people who are curious and join that group, because then they'll go in there and they're like, "I don't like corporate dentistry" and all they want to do is go in there and have a political axe to grind. Whoever starts the group can accept or un-accept anybody on the group. So, you have the whole five hundred thousand lines of code for Dentaltown the five programmers have written from 1998 to 2017, for free. But there's a lot of people on there, on Dentaltown, that don't know how to connect with you guys or don't know hot to get in that club, but I think a private group would probably be the strongest recruiting thing.
Timothy: I think it's a terrific idea. I really do.
Howard: When a dentist sells his practice to Heartland, what do you take over for him? Do I just now go there hours, I mean, how does that work?
Timothy: Well, this sounds kind of simplistic, but we sit down and we say, "Hey, what are the reasons that you want to come join us? And whatever those reasons are, those are the first things we'll try to help you with." We just had an affiliation, just recently, and he said, "I want to schedule a little bit differently, I feel like I'm running ragged and I need an exit strategy." So, that's all we did. We don't go in there and change a whole bunch of things or suggest a bunch of things. First off, you're the clinical leader, we don't do any of that. You just continue to practice any way you want. If there's a difference in maybe how to schedule and you're like, "Hey, I hate my schedule", we'll show you some different ways to schedule. So, in reality, we really are just geared towards what does the doctor want and if you want something we have a system for it and we have other offices you can talk to. Everything is open book with Heartland, which I love. So, there's no flop, there's nothing. You can look up any practice and say, "They're actually walking the talk." So, that's what we do with affiliations. Not too complicated, but we've got an answer usually for everything.
Howard: What if they say to you, "The reason I want to sell my practice is it's been flat for ten years, I don't know how to build it, I need more new patients, I want to grow this business." Do you usually have resources and secret sauces in marketing bumping up their new patient flow, which equals cash flow.
Timothy: Yes. And we've got a lot of stuff I can't talk about either, but yes, we have some secret sauce that will help just about anybody and that's what's fun. And if we don't have any answer, guess what, we have a network of people, just great people that will figure things out.
Howard: Well, just tell me your secret sauce right now and I won't tell anyone.
Timothy: All right. So, it's just between you and I. One of them is..
Howard: A lot of them want to sell because their overhead is too high. What do you do when someone comes up to you and says, "My overhead's out of control. This practice is thirty years old. Every time the Earth went around the Sun, I gave Betty Sue a dollar raise, my labor's out of whack, my growth is flat, I'm not getting new patients, my labor is off the charts." Do you do fixer-ups? Do you buy dental offices that have kind of ran ashore? They've been flat for a decade, their overhead's too high and this guy is basically selling it because he's giving up on, "I don't know how to fix it, I don't know how to run it, I'd rather have a parent, a big brother. Is it fixable?" Or do you look at somebody's office and say, "This is an un-fixable mess. You should shut it down and go to veterinary school."
Timothy: Well, yes, we'll help doctors with that, especially if they ask for that. They'd say, "I've done everything I possibly can." I don't think there's any secret out there, but we have just absolutely amazing prices on a lot of stuff. I mean, our economies of scale are amazing. Right off the bat, we can help people lower their overhead overnight.
Howard: I noticed that you used to buy all your supplies from Shine, but you switched to Patterson and that was the connection we talked about earlier, where Eaglesoft started in Effingham, he went on to become the CEO, then he moved back to Effingham and the next thing you know, Heartland got the Patterson account. Is Patterson kind of shifting their strategy? Because I remember a CEO, long way back in the day, whose name I won't mention, was lecturing out here. I was lecturing on the same day, it was like thirty, twenty-five, thirty CEOs of the biggest corporatives. They have a think tank that meets twice, three, four times a year. A lot of times they have it in Scottsdale, I was up there and the Patterson guys said, "Look, we don't want to be the lowest price. We're value added, we won't offer these services. If you want just the lowest price, go to Shine. But now it looks like Patterson's changed their strategy. Now they're getting religion on price. Is that true or false?
Timothy: I think that's true. I also think the people that are a lot smarter than I am know the trajectory of what we're going to be doing in dentistry in terms of the growth of DSOs. So, I think there's an encouragement from those smart people to invest yourselves in these groups as they're growing, because your business will increase.
Howard: OK, I want to ask you some very technical questions. You and Rick Workman are two of the smartest businessmen who happen to just be dentists. I want to go through the highest line-item veto. You have a sample size of eight hundred offices. So, let's go through the most expensive. Is chairside milling a good return on investment? You're talking about $150,000 and a lot of dentists are saying: "Is that the secret sauce? Should I invest $150,000 in chairside milling?" Of your nine hundred offices, the ones that have chairside milling, are they better, faster, higher quality, lower profit, more profitable? Is it a good decision?
Timothy: I'm probably going to get flamed for this, but no, it's not a good idea.
Howard: You aren't the first on Dentistry Uncensored. And why do you think that is?
Timothy: Well, here's the big reason. I can't give specific numbers, but I would say all your costs involved, including blocks and things like that, I'm fairly certain we could get a lower price than even that, in terms of you milling it, we can get a lower price. You wouldn't be saving anything by doing it, but on the flip side, yes, if you have a population of people or you're marketing towards Same Day Crowns, let's say, I could see that. But no, I wouldn't say that it's a good idea.
Howard: So, usually chairside milling is not a good idea?
Timothy: Agreed.
Howard: I want you to repeat that three times. You're saying you're worried about getting flamed. How would you like to work on my team? My team get so mad at me all the time, they say, "Howard, why did you say that? That guy is a major advertiser." And I say, "Because I am editorial, I'm content, we have nothing to do with advertising." Most of the dental magazines, a company will come to you with an article and say, "Publish this article and we'll buy a full page out of your magazine." They sell content. We don't do that. I am the biggest jerk to my advertisers. So, I'm keeping it real and it costs me money. I can't tell you how much money my mouth has cost. One company stopped advertising with me for five years and my team said that we lost a million dollars. "You want to say it again." And I said, "Hell yeah, I'll say it again, because I believe it. I'm going to say you it, you can't buy me."
Howard: So, let's keep going. Out of your sample size of eight hundred, how many of them have own a chairside milling machine and now it's a coat rack? What percent of your chairside milling machines are coat racks?
Timothy: [00:39:19] I would think Pat Bauer would even say to that. I would say a majority, I don't know a percent, but a majority of those that have it, probably don't use it anymore, it's a coat rack. And then there's a small sliver that actually can make it work. I've seen it work in maybe smaller offices, four ops, things like that, but not in offices that have a little bit more volume.
Howard: Here's where I see it working. My best friend from dental school, and I have like at least twenty best friends from dental school, but one of my best friends from dental school is Craig Steichen in Albuquerque, New Mexico. That CEREC machine, he thinks it's the coolest damn thing in the world. He runs twenty red lights on the way to work. He loves it. And he's a tech guy. So, I say this, I don't care what it is, dentistry can lead to... I mean, you're doing the same procedure over and over and over for a decade after decade. Lots of people in dentistry end up in burnout. If buying anything, getting into sleep apnea, placing implants or chairside milling, if buying a laser makes you run a red light going to work, you can't afford not to have that laser. If you think that lasers are the coolest flipping thing since they discovered Pluto, buy it! But if you think you're buying it to fix your business, no.
It's like with my boys, if I put them in the bathtub and there are no toys, they'd be out of there in like a minute. That's like putting four cats in a bathtub. But if I threw in boats and all these toys, they'd stay in the bathtub, I couldn't get them out of the bathtub. Same thing in the sandbox. You put them in the sandbox and they leave, but you put a bunch of Tonka trucks, then they'll stay there and play all day.
Timothy: Well, let me throw this out, Howard. Let me just say this. I will say this, though. We are getting very heavy in the scanners.
Howard: That was my next question, scanners.
Timothy: We love them and we're seeing humongous success with using a thing like an iTero, we just bought another hundred iTeros.
Howard: Why is chairside scanning gooddone? Why do you like it?
Timothy: Well, obviously, the speed is amazing. It's a lot easier. We do quite a bit of Invisalign at our offices. We really believe strongly in Invisalign. Nowadays you scan it and you can show them before and after in about thirty seconds and you get the crowns back a lot quicker and you can use any material that you want. So, if you really want a strong zirconia, you can go for it. That's probably going to center for five hours. You can get that back in a week and patients are happy.
Howard: So, did Invisalign buy iTero?
Timothy: That I'm unaware of.
Howard: What was the scanner that Invisalign bought?
Timothy: I'm really not certain of that.
Howard: Scanner Invisalign bought? Ryan, can you Google that for me? They bought a scanner, Align Technology, to acquire intra-oral scanning leader, Cadent for 190 million dollars. So, Align Technology in 2011 announced it has signed definitive agreeing to acquire privately held Cadent Holdings, a leading provider of 3D digital scanning solution in orthodontics. But you're saying that you prefer... Ryan, Google who owns iTero. I think it's just iTero out of Pennsylvania. You're saying you use the iTero scanner for Invisalign, even though Invisalign has their own scanner, Cadent. So, my question is why did you guys like iTero? As opposed to 3M has True Def. What's the one in Copenhagen? 3Shape. So, why did you buy iTero?
Timothy: Well, I'd have to talk to one of my fellow clinical directors, but I believe just easy use, the new system is small, probably a good price that we can buy them for, but I'm sure we're open to a lot of... I don't think we're locked into something. We certainly will go with whatever our doctors want and what we think is going to be successful.
Howard: The one thing I've noticed is that, like say you meet a kid who's like dabbling in implants and he's trying to get implants, he might have different CBCTs or different this, but it seems like the hard core specialist, the people who are really hardcore, seems like they always have iTero.
Timothy: It's interesting, I didn't know that.
Howard: The ones that are meant towards the mine are far more likely to buy the iTero. What I like about the scanner, and you don't even understand this, because you're too young at thirty-six, but when you're fifty-five, you can see. I have the biggest iPhone and with readers I still don't even know when I'm texting my son a typo, but when you scan that prep and you're 55, you had 3.8 InSolution and you see that prep forty times, you become a better dentist. I go to endo, when I am already done cleaning, shaping, right before I fill, I pull out a microscope, I look down the canals at 8X and I'm amazed at the crap I see I left in the walls. My big shout to dentists, dentists say, "Oh, I know loupes, Howard. The dental schools today, they made you wear loupes in class." OK, dummy, then why why is your hygienist not wearing loupes, why is your dental assistant not wearing loupes? Anybody who has wet hands in a dental office should see better with magnification and endodontists should get a scope and the scanning, I like the scanning part of that, but I just don't like then you turning into a lab tech and milling and staining and glazing the crown, because there's some guy up the street from you that's made ten thousand crowns in his life and now you buy this machine and you have your assistant do it and she's never made a crown.
Timothy: Well, that's one hundred percent it. I think I learned this from you, Howard, because it's just the power of delegating, for example, your temporaries. My assistant can make amazing temporaries and she can actually do a hell of a lot better job than I can. So, why am I not delegating to her for something like that? So, just like the lab tech, they know how to do it, they're gorgeous.
Howard: But I have to argue with that, I disagree with the assistant on the temporary, you know why?
Timothy: Why?
Howard: Because when you numb, prep and impress the tooth and then have your assistant make the temporary, you might get back a reduction coping, the lab might get the impression and I'll see the margin. What I found out is that, if I numb, prep, impress the tooth, and than have the assistant do the temporary, it's faster if I numb, prep, then I make a temporary, because with my assistant I can make a temporary in like three minutes, but the first round of the temporary, you got 3.8 loupes and you're doing a margin, then you realize, "I don't have a margin." So, you have to go back there and smooth out your margin or make it more detailed. So, then you start on impression number two. So, now I learned a lot about my margin from the temporary, then I adjust the occlusion on the temporary and I go through the temporary. Well, now I just avoided a reduction coping and I need more reduction and there's a plunger cost for reduction. Now I'm on temporary three, I picked up the impression, I got the occlusion, I worked out so many things with my prep, then I take it off, then I take the impression, go do a hygiene check, come back, look at the impression with my 3.8 loupes, then see the temporary. That start to finish I can do in thirty minutes. But if I did that thirty minute deal and then told the assistant to make the temporary, she needs a whole another thirty minutes. So, when dentists have their assistants make the temporaries, they're blocking an hour to an hour and a half for the crown and they're getting back, re-impress and reduction copings and all of this bullshit. And when you say, "I'm going to numb, I'm going to stay in the room, take the shade. When the timer goes four minutes, I'm going to pack the cord 0.1, push the gums down and out, so I don't have to deal with bleeding." It's only thirty minutes doctor time. So, she needs a little extra time to set for you to see the patient and then dismiss the patient, clean up the room. I see hour block crowns with only thirty minutes of doctor time, if the doctor and the sister make the temporary, with no reduction copings, no re-impresses. And then, if you do it the other way, they're blocking an hour and a half time.
Timothy: Well, I totally understand what you're saying, but two things. One is, you're going to think I'm crazy, but I wear 8.0 loupes.
Howard: Holy moley!
Timothy: And I suggest to other people that do a lot of dentistry that, if they can get up to six, six as it is, it's amazing what you could see with six. So, I wear eights and then guess what. If you have a scanner like we do here, you scan it and then you know. You can see my margin and do I have my occlusal reduction, because it'll tell you right on there.
Howard: The scan tells you if you have your occlusal reduction?
Timothy: Yeah.
Howard: I didn't know anybody had a 8.0. What loupes are you wearing?
Timothy: Designs for Vision.
Howard: Designs for Vision, my gosh! Designs for Vision has a 8.0, wow! And iTero scanner tells you if you have the reduction or not?
Timothy: You take the upper lower and then you can take a bite and it will tell you right on there if you have enough. So, if your system scans the opposing arch, gets the bite and you go ahead and prep and you scan it real quick, you can say: "Hey, can I see the margin on the big screen?" And you're right, that's one of the things we see. Remake rates go down when you have a scanner. So, the quality of our work is getting better and better, which we just absolutely love because really, it's for our patients.
Howard: My labs tell me on this podcast that the average dentist has a 6% remake and when they switch to scanning, it drops to 1.
Timothy: That's awesome.
Howard: And I think that five out of six is simply because of the magnification, they can't see their damn prep. I'll tell you why, I've never scanned a prep where I wasn't embarrassed and had to jump back in and get out a soft wax disc or smooth something up. You see it and you know what the assistants thinking, they're thinking, "Stevie Wonder could have done better than that." And you're like, "OK, what about Ray Charles, am I better than a dead man? Or am I equal to just a blind man?" So, you wear 8.0?
Timothy: Yes, sir!
Howard: Do they weigh like forty-eight pounds on your head?
Timothy: They're about seventy-five pounds.
Howard: That is amazing! So, keep going down with these high-tech decisions, because, while I'm going down this road, is they already came out of school at $350,000, they bought a $750,000 office, she's twenty-eight years old, she's a million dollars in debt. So, she's sweating bullets on this high-priced purchase. You talked about chairside milling, you talked about scanners. What other high-tech things can you opine on? Lasers.
Timothy: Laser, yeah, and we encourage lasers. If a doctor wants lasers, we have an amazing course on lasers and then the states that hygienists can use lasers for disinfection purposes, we utilize that. But I would say, and Howard, you know this, ten-fifteen years ago they were huge. If you went to any convention, they had a huge block there. So, it's interesting how things kind of ebb and flow. I use a laser. So, I would say it's is a decent purchase, especially if the hygienist can use it.
Howard: What lasers are you talking about?
Timothy: I use the Millennium one, I do some of Lanap.
Howard: You do the Lanap?.
Timothy: Yes, sir!
Howard: And what was the other brand you said, I forgot. Oh, Designs for Vision was your loupes, Designs for Vision. So, talk about that, because that's a huge investment. I think a Millennium laser and training and to do Lanap, isn't that like 135,000?
Timothy: Yeah, it's a very expensive endeavor and the reason why this is is, my father and I took the course together. My father had a Masters In perio. So, a long time ago we decided and they gave us a good deal together. It was kind of a father-son thing. So, would I suggest it to other people? Probably not right now, just because of the price.
Howard: Of your eight hundred locations, how many of them have the Millennium and do the Lanap procedure and does it work for them?
Timothy: I don't know if there's a huge population of them, but the ones that I do talk to, Bruce Baird is one of our fellow doctors who does it quite often. We're seeing good results, yes.
Howard: So you like them, it was worth it for you?
Timothy: Yeah, absolutely.
Howard: Big shout out, who's the periodontist in my backyard? Allen Honigman did a podcast and I love Allen so much, because when he started, he was the first guy in Phoenix. We're talking twenty years ago. People were talking behind his back, "He's crazy, that doesn't work, what's wrong with him?" And now twenty years later, every single periodontist who I heard trash talking him about that twenty years ago, now they all own one. Allen, that man, what a pioneer. Because one way you can prove you are a pioneer in dentistry is you have at least twenty-five errors in your back. And if you don't have any errors in your back, don't tell me you're a pioneer. When I got here, thirty years ago, the guys that were pioneering implants and doing subperiosteals, Ramus frames, blades, the first time they had a major case fail, the board took their license away. I can give you the name of a dentist who had a house as big as yours and mine, who then moved to a trailer. And now all those procedures are standard operating procedure. And I think it was very, very sad. So, I'm trying to tell millennials, it's very common for a Homosapien to be gossip and judgmental and all that and don't throw rocks, because the guy you're throwing a rock at today, twenty years from now might be the (inaudible). Even Keyes who died this year, remember the Keyes technique with the microscope? And he died this year at age ninety-nine. People thought he was bat shit crazy insane and now every periodontist says he was one of the smartest guys that ever came into dentistry.
Timothy: I don't know if Dr. Workman said this, but it reminds me of a story he tells everybody and I'll just say it real quick. In the eighties they thought he was crazy when he wanted to perio probe his patients.
Howard: I remember in dental school going to my grandma's funeral in Parsons, Kansas and I was so excited, because I found out at the funeral, there was a dentist there. So, I start talking to him and the first thing I said to him, I said, "So, do you see a lot of periodontal disease in Parsons? They should study the water here, there's something in the water, because you don't see periodontal disease in Parsons. And the only thing these people all have in common is they drink the same water. And I think something in it, it's hard water, it might be calcium, might be phosphorus, but you won't see periodontal disease in Parsons, Kansas." So, I went back and told my instructor that. He was about to fell out of his chair, because I was young, dumb student, I don't think I'd even probed anybody at that point. He edumacated me that that was just an old guy that didn't keep up with the times.
Timothy: Can I just say this, Howard, real quick? I think you'll agree with me on this and I just want to emphasize this, especially for the younger doctors. Get really good at bread and butter dentistry. I've got to tell you, that's what I do most of the time. You're good at root canals, so you can do a root canal build-up crown. Root canal build-up crown is still one of my favorite procedures. It's great for the patients and just get really good and you can be super successful. Remember Dr. Westermann? He didn't do anything outside of bread and butter and that man could run laps around me, even to this day.
Howard: Nice! There's two loupes for this, there's Designs for Vision and what's the other one?
Timothy: I think Orascoptic.
Howard: Orascoptic, that's the other one. So, why did you go with Design for Vision instead of Orascoptic?
Timothy: Well, it was through you guys. All my townie friends back in the day said, "Hey, they have great customer service." And I went with them and I just stuck with them, because they do, they have amazing customer service. If I, and I've done this where you drop it or you crack it, they'll send you a replacement one real quick, while they fix it. Because I can't practice without those on.
Howard: I actually have two of them, two pairs, because I didn't realize what was going on when one day I dropped it and it fogged and I couldn't see. And then I sat down without my 3.8s on and I immediately got scared. I'm not seeing good enough to do this and then you think mainly, your first brain thought is. Do what others do onto you. Would you want you working on your own mouth right now? And I said, "Jane, I'm sorry, but I've got to cancel the rest of my my day." So, she said: "Awesome!" Opened up a bottom drawer, whipped out a beer right then. So, that's amazing. More line-item vetos on big cost? CBCT, 3D CAT scans, you got eight hundred locations. When do you buy or not buy, upgrade your 2D pano to a 3D CBCT.
Timothy: Well, first off, I can't speak about numbers, but we get really good rates on getting a cone beam. I have a cone beam and I would say the suggestion that we have is, if you are in an area where you have other practices that can utilize it, if we have densely populated Heartland practices, it's a good idea to have a cone beam in one of them. And nowadays, even with endo, it's great for endo, to try to find additional canals. So, I think you'll see it more and more, but right now I would say, if you have like a "hub and spoke" type of situation like we did, because we had six practices around one practice, that's why we bought one.
Howard: So, how many of your locations have a CBCT?
Timothy: Gosh, I don't even know, to be honest with you.
Howard: What other high-tech decisions purchase items? We've talked chairside milling, we've talked scanners, lasers CBCTs, what other high-tech?
Timothy: Well, I don't think this is high-tech, but we're real big into the WayOne gold endos. Just a terrific system. I love endo, for all of us who have gotten into it, it's just a great system. We get into it that quite a bit.
Howard: Is WayOne endo, is that Tulsa Dental Products?
Timothy: Yes.
Howard: Ryan, any lack on getting to the founder of Tulsa Dental Products, Ben Johnson? We've got that video from Brad Gettleman. Did you see the podcast I did with the endodontist, Brad Gettleman?
Timothy: I did not, no.
Howard: Ryan, can you splice out the end of that video and post that under endo separately? So, my buddy Brad Gettleman, who I went to UMKC with, class '87. He wrote chapter eight in the number one selling endodontic book of all time, "Pathways of the Pulp" by Stephen Cohen. And we both are friends with Ben Johnson who founded Tulsa Dental Products. Ben bought the oldest video of a root canal ever found. It's like a hundred year old video of a guy. If you watch my podcast interview with Brad Gettleman on YouTube, you won't see this obviously on iTunes, but if you go to Facebook, Howard Farann or Dentaltown on YouTube, Ben gave us permission to use that. What was so amazing, it was just amazing watching someone do a root canal a hundred years ago and how much of it didn't change, because he was talking about the rubber dam and isolation and cleaning and. When you want to be successful in endo, it's what you take out of the tooth, but dentists always want to talk about how they obturate the tooth and it's not the obturation technique, it's the cleaning and shaping, it's the finding all the canals. But you guys like WayOne, which is owned by Tulsa Dental Products, which was bought by Dentsply, who then got married and merged with Dentsply Sirona. So, that's a mouthful.
Timothy: Dentsply Sirona, you're absolutely right.
Howard: What other things are you passionate about? What are you most passionate about now?
Timothy:This might sound a little cliche, but it's something you told me a long time ago, it's something that Mike Melker's told me, is paying it forward and I've been incredibly blessed in my life already. Right now, truthfully, I spend a lot of my time helping other dentists. I still practice and try new things, but I help quite a few practices in Wisconsin, Iowa, Illinois, Minnesota. That's kind of a little territory that I drive around and talk to people. So, that is what I enjoy doing. Obviously, I have a family now, so that keeps you busy too, but I just love this stuff, Howard, and I learned that love for the game of business really from you.
Howard: You're just too damn kind. I can't believe how long... Oh my God, we went over. It was supposed to be an hour, we're already over. I've just got one overtime final question. In Dentaltown it's the baby boomers, the sixty thousand people who downloaded the app were mostly born after 1980. I keep asking my guests and I'm going to ask again, shoot me an email to howard@dentaltown.com, tell me who you are, what do you think of the show, any questions, guests you want. Most of my guests are all requested. The big reason I contact people is because people are requesting me. No one pays to go on the show, I haven't paid anybody to be on the show. But I'm shocked at how many... All millennials! Only like once a month does some old guy, old like my age, some fifty-five guy will say, "I'm as old as you." But what shocks me the most is how many d1, d2, d3, d4, it's like 25% of the e-mails I'm getting are still in dental school and the other 75%, all but one a month, are under thirty. What advice would you give a kid coming out of school? They graduated from school, they're $350,000 in debt and they're scared shitless. What advice would you give these kids?
Timothy: Well, first off, I think you need to continue to have the passion that you had in dental school in terms of learning. And fail forward. Get a mentor and go in there and help people. For example, if you're not good at endo or you want to try some new endo, sit down with a patient that can't afford things and wants the tooth extracted and just do the procedure on that patient. Tell them, "Hey, I'm going to be trying a new technique out." Worst case scenario, you have to take the tooth out and that's what they wanted anyway. So, just get in there and help patients. I would also say that, you already said it with the mentoring, there's going to be a segment of the population obviously that can own their own practice and wants to and is going to gun for that and they're entrepreneurs and that's awesome. But then there's going to be a segment of the population that needs help and that's really what a DSO, Dental Service Organization, is. We really have filled the niche. Right. It's a niche that's been sitting there of people that want additional support and that's what we do. So, if somebody is like that and wants to, "Hey, I want to get my FAGD and I just want to work on dentistry and not worry about the counting or the legal and all that stuff", that's really what we're here for. I'm never going to say, "Hey, we're going to take over the world, we are going to do all that stuff." No, we're here for that segment of the dental population that wants to be just a dentist. And really, just a dentist is hard enough. But just to help and that's what we're here for.
Howard: Can I ask you one more or you've got to run?
Timothy: Yeah. I've got all day.
Howard: One more overtime question. The specific question they're asking routinely is, "I got out of school and I feel gypped, because I'm $350,000 in student loans, I didn't place one implant, I didn't do one Invisalign class, I've never used silver diamine fluoride." You talk about Kois, Pankey, CEDR, all these courses, but they don't have the money to take all this stuff. As far as return on investment, would you push them towards placing implants first, sleep apnea, Invisalign, occlusion, there's so much. It's going to take them five years to get their FAGD and learn all this stuff. So, what would you push them towards first?
Timothy: I'm going to say two things. One is, from a technical aspect, you have to get good at endo. I would say endo and Invisalign are the first things, but you have to be good at endo. And then I'm going to go in a little different direction, because as much clinical stuff that I took, which was a ton, I took a lot of practice management and leadership courses. You have to be a good leader, you have to learn how to talk to patients. You've got to use terms that they understand. You're doing a great job, you got through dental school, you talk to all your instructors like a dentist. When you talk to people, talk to them in the terms that they understand. And also don't talk yourself out of everything. I think you said this, Howard, a long time ago, which is - you're getting ready to buy a car and you say, "How much is it?" And then the person takes you inside, shows you the engine and shows you the muffler. No. They want to know how to fit in their budget, they want it. So, don't sit there and tell them what type of ceramic it is or that you're using the noble metal, all that stuff. Just go ahead and just get to the point. It's broken, we need to get a crown on those.
Howard: Your dental students are younger than my four boys. The reason you say you don't want to do more endo and you hate endos because you're not good at it. When you do something and it beats the crap out of you, of course you don't like it. You don't see me picking a fight with Mike Tyson. But if you take a bunch of courses and master it, you're going to fall in love with everything you master and you're going to hate everything that beats the crap out of you. And I completely agree. Everyone's going to say, Hyndman and Pankey in all the big dental meetings are going to say, "Oh, you need to learn All on 4 and sleep apnea and all that stuff." Dude, it's applying demand. Half the people, they go to the dentist, they have a toothache and need a root canal. How many people ever called your office and said, "I have an emergency, I need to come in today for sleep apnea?"
Timothy: You're absolutely right. You got to remember too, when you're marketing for a practice and you've got a baseline of patients, some of them will bubble up. You'll bubble up to an implant or bubble up to... In order to really get that, if you want to do Invisalign, you got to start target marketing for some of those people out there, which you can get quite a few in your own practice. But rehab, let's just say somebody does a big course or wants rehab, you'll get some from your baseline patients, you might get one that bubbles up every six months, but you really got to go after that part of your pyramid with some type of targeted marketing. So, I want to suggest that. Too many times we go to a course, we come back, we don't do anything. And that always bugs me.
Howard: You won't tell me your secret sauce and I respect that, but so many advertising gurus in dentistry say, "Go out there and advertise it, you've got Same Day dentistry, so buy $150,000 chairside milling. I'll tell you what's real in the street is, I have an emergency. I broke my tooth, can I get in today and you can't get him in today, because you don't have an extra operatory or two, or they're afraid of the dentist or they're afraid of the cost. If I was going to do a marketing campaign, it'd be not Same Day dentistry in the middle of their crown, I can get you in today. That's what I call my dental office Today’s Dental and I don't tell people of thirty years: "By the way, you don't need an appointment to go to an emergency room in the hospital. If some day your denture breaks in half or your tooth falls off and you have en emergency, you don't have to call the hospital. Just come on down, we have an emergency room." No one schedules, it's an emergency room. I have more people that are afraid of fear and more people afraid of cost. I tell the dentists, "You need a chairside personality. Don't be condescending, be nice to people, make them feel good. If I had to teach you to learn one thing, learn how to give a painless shot. At least every day someone should say to you: "Damn, I didn't even feel that." Then I say: "Dude, then you got to get back to work and tell everybody I gave you a shot, because half of America won't go to the dentist because they're afraid of that shot. Even though they arm is sleeved with a tattoo, they don't want a shot in their mouth."" And then the other thing is, it's not the cost of dentistry, it's the financing. Start telling all your patients that they can get everything done for $99 a week. Don't tell them, "I need $5,000 right now." Figure out a way to spread that $5,000 over $99 a week for a year.
But hey, Tim, I know you're the busiest man in dentistry, you work for the biggest corporate dental chain. I hope you deliver Pat Bauer. I think he'd be an amazing podcast, too. Thank you, Tim, so much. You have two thousand post on Dentaltown, you've showed so much with the dental community. Thank you so much for all that you've done for dentistry, thank you so much for all that you've done for Dentaltown and thank you so much for coming on the show today.
Timothy: I appreciate you saying thank you to me, but really, Howard, I've got to thank you. I appreciate it.
Howard: Final question. You and I both had 23andMe done. Since your dad and brother are dentists, did 23andMe find some dental recessive gene floating around where now your three boys, are they infected with the gene?
Timothy: I believe the recessivist to be a mortician, so I think that that might explain it.
Howard: All right. Have a rocking good day!