Before founding McCall Dentures, Dr Ryan McCall was a typical Midwestern boy from Effingham, IL, a small town with a population of 12,000. Growing up in close proximity to a farm, he was sure about two things: he didn’t want to live in close proximity to a farm forever and he wanted to own a red Subaru Outback! After graduating from dental school, Dr. McCall opened his first office in the super dank city of Fort Collins, CO. His initial marketing tactic was a $15 hand painted sign in the front yard. Fifteen months later, he opened another office and then foolishly spent a full year flying from Indianapolis, IN to Denver, CO running both offices. He knew there had to be a better way for himself and future dentists. 2 years later, McCall Dentures was born and the persona of 2 Chairz took flight. Today, Dr. McCall continues to be involved with the company as Executive Chairman. He is always finding ways to encourage and support others, from making charitable donations to offering leadership advice. Beyond spending time with his wife Meredith and their four children, his two favorite past times are playing video games and posting excessively on Instagram.Yes, he eventually did get that red Outback!
AUDIO-DUwHF #1093 Ryan McCall
VIDEO-DUwHF #1093 Ryan McCall
Howard: How lucky am i today to get Ryan McCall to come back for seconds on another Dentistry Uncensored podcast.
Ryan: Hey thank you Howard.
Howard: Thanks so much, you are a legend I mean you are when it comes to removables dentures marketing Instagram I mean how many posts do you have on Dentaltown?
Ryan: Oh I don't know I guess 40 some thousand.
Howard: You have 10,000 more then me and I am two decades older than you. When I started Dentaltown you would have been in high school.
Ryan: I guess I was.
Howard: So let's start talking about the reason you're at my house is because there is a huge seminar Avadent.
Ryan: Yeah they're the gold sponsor but it's the digital denture conference.
Howard: The digital denture conference.
Ryan: Yes so IDDT I think it is the lab group and yeah they're gold sponsor and 650 people this weekend at the Sheraton downtown so.
Howard: Oh it's at the Sheraton downtown?
Howard: So did you meet any interesting crack dealers?
Ryan: Oh it's like scary down there isnt it.
Howard: I gave a whole lecture on why it's scary downtown.
Ryan: Oh really
Howard: Well it's really neat Ryan because I gave my first lecture you know I grew up in Wichita Kansas went to Creighton Omaha dental school Kansas City move down to Phoenix which is really just a Florida of the west coast and my first lecture was in New York and I didnt realize someday I'd see fifty countries.
Howard: and everything makes sense when you see all the countries and what's wrong with All American downtown's is you subsidize the gasoline over in the cars so they don't even realize. What it is is the rest of the world that has all the amazing downtown's when you go by it down on the gas inside that gas is all your roads bridges repairs maintenance everything so they may be like eight dollars in gas they because they dollars they buy little four cylinders and they'll live downtown because they're like okay me and the wife are from the suburb you spend 10,000 a year on gas let's get rid of that. So Americans don't realize that all the roads and bridges is paid out in general taxation so everybody drove out into the suburbs so the worst downtowns in the 20 richest countries in the world are only in America and it's only because of the gas tax I've heard it from several PhD economists and if you are it's so funny cuz if he took that away and made the gas go to $8 a gallon, how many politicians would get run out of town?
Ryan: All of them.
Howard: It's just crazy thing but I love Phoenix but the downtown is challenging.
Ryan: I was in Scottsdale last night and that's very nice so it's a it's a really affluent area I think yeah it's pretty.
Howard: Yeah so this digital dental conference you know when they came out with the first cars I mean you know it was when GM came you know the Chevy went after the Model T but then they had fight grace once the Pontiac was hundred orders more because the wheels came off and then the Buick was no the Olds they also those under a spark plug from Delco from I think your state Indian.
Ryan: Oh is it was it from Indiana sounds familiar maybe South Bend.
Howard: and then $100 more the buick had a roof and then the most expensive car is Cadillac and then had Motorola's new radio at home but now all those things are your cheapest cars. So where is digital dentistry right now I mean is it the Mercedes Benz bleeding-edge my god that's a lot of money in 12 people in Scottsdale can afford it or is this something that you're bringing to your in Indiana?
Ryan: We're in Indiana.
Howard: Middle class, red state.
Ryan: Yep so all new.
Howard: Digital dentistry is it bleeding edge leading edge or are you investing in it?
Ryan: It's getting there so it's all so new and they're a couple different you know schools of thought you've got additive manufacturing and subtractive manufacturing so they have milling and 3d printing so they're kind of the competing forces right now.
Howard: So additive is 3D printing?
Ryan: Yep and then milling would be the subtractive and those are the two big schools right now and a lot of companies are really fighting for market space so it's also new the technology is almost there but I think the materials are still kind of catching up especially on the printing side so it's bleeding edge right now I think you can do high-end and low-end so. The milling you know taken away with you know burrs and cutting down pucks and things like that for dentures that's going to be more of your Mercedes and your BMWs and then the printing is going to be more of the Camry and you know like a Hyundai or something like that.
Howard: So additive 3D printing will be the low cost?
Ryan: Right now but I think long-term 3d printing is probably gonna take over more so I'd say maybe 12, 24 months or so.
Howard: In just a year or two?
Howard: It'll take over the low-end the value end?
Ryan: I think so right there'll be a place for both of them.
Howard: but and why do you like 3d additive printing better than subtracting milling?
Ryan: It's gonna be cheaper I think they'll be a place for both of them you know with the subtractive especially some of the nicer mills there's more translucency and the teeth look nicer. So I was actually mean I met with a group last night called digital dental in Scottsdale have you heard of them so they were awesome it's a small company and they're actually milling the teeth and then printing the base and then combining the two so I think you'll be able to do a tiered system and use all three you know you'll be able to print mill and then print and mill together so that's pretty cool dentures are cool now.
Howard: So there's 650 people at this conference
Howard: What does peter griffin always say on family guy really grinds my gears...
Ryan: You know what grinds my gears.
Howard: You know what grinds my gears is the weird infatuation with the richest 1% of America you know of the dental market and then no one even cares about you know the bottom one-third of the people and every conventions got all these speakers on all on four at 25,000.
Howard: but you're thinking of all I'm not and all I know there's a hundred Americans all on none for every one that's got 50,000 for all on four ture or false?
Ryan: True probably even more.
Ryan: That's crazy
Howard: I mean I live in Phoenix this is like saying we almost embarrassed Florida I mean there's just there's probably several hundred people that need denture so why... do you agree with that?
Ryan: I think so I mean I do a lot of implants but most of our stuff is removable and you know just locators and things like that I wish every patient could afford $50,000 but it's just not realistic you know and that's what everyone loves they love all on fours and you know they want to do fixed attachable but it's a lot of work and it's a lot of steps and I would rather do a full mouth extraction.
Howard: and then it gets crazier because you know no one can afford a in the 20 richest countries I mean I think a clear choice last year did have 18,000 arches.
Howard: Well in a population of 324 million people 18 thousand isn't even in the rounding error Plano so but when you go to the other 200 countries you know just all of Africa South America I mean all on none really could be it could be a lifesaver. When you think of a I'll never forget one of the most impactful cosmetic cases I've ever seen in my life where the girl just lost it was in Tanzania and he made her a flipper for removing number eight really and you could just tell this girl just came alive I mean she lost that one too it was just you know she was probably 12.
Ryan: That's so cool.
Howard: Probably just the worst thing I've probably like ten times worse than a guy who loses all his hair going bald and then I came back and I asked every single dentists I mean removal I said I know those online CE courses they're all free in those companies and I said they a CAD CAM course you know an all on four they wouldn't even watch it but I said they need a flipper course because cosmetic dentistry in for most people is removable.
Ryan: Yeah so it's been amazing I mean it's made such a big difference in Indiana for our patients so I'm just kind of sticking in my niche.
Howard: So talk about your journey.
Ryan: It's been crazy so when the magazine came out was it last month with the cover thank you that was so nice this has been wild we're growing so fast now I'm just kind of trying to get out and recruit doctors and you know get people interested in dentures and our marketing has been really solid actually to join McCall Dentures we're the best.
Howard: What are you recruiting for?
Ryan: Doctors that like doing dentures and you know take care of their patients because my model is a little bit different you know we've got the two chairs in a central lab and you know it's a low-cost kind of office.
Howard: (inaudible 9:08)
Ryan: Like the wrapper and my wife the other night was like you're not a rapper so she's the brains but yeah we do high quality dentures and I've been working with a lot of different companies on some of this new technology so I'm just trying to keep up and I had to stop advertising actually so because there's just such a need in Indiana and it's all word of mouth now.
Howard: So how big, how much bigger could you get before you have to start working in North Carolina, South Carolina?
Ryan: We talked about that on our last podcast and you had mentioned you know doing like 10 or 11 offices in Indiana and then branching out but I'm actually getting patients that are driving from all over like Nashville Chicago some lady drove up from Orlando a few weeks ago like 17 hours to see us. So I think if I can if I could get more doctors we could have a hundred offices it's just a matter of getting dentists that actually like doing dentures and feel comfortable doing them.
Howard: Well I'm convinced that that's just attitude.
Howard: I tell my boys all the time because sometimes they'll say I don't know what i'm passionate about I would say okay look at your two uncles they have a construction company, your dad's a dentist, my dad flipped hamburgers.
Howard: We were all massively passionate I mean someone's got to be a plumber in their people and I always saw the story was I lived across the river in the sky for 15 years like 87 to 2005 and he maybe as a gasket company and when he was talking about gaskets I mean he could just sell like he was actually in love with gaskets and I mean he could talk about gaskets until 3:00 in the morning and when I first met him you know one of the five sisters playing Barbie dolls I really didn't even know what a gasket was and then you find out that some guy eats lives and breathes gaskets 24 hours a day seven days his whole career well that's not because of the gasket that was all him. So when you say you don't like dentures well then you're right you just send your like dentures and you can say that you love dentures in one second and wife is just attitude.
Ryan: It is you know and it's my passion like I'm really passionate about what we're doing and helping patients and taking care of our people so like I'm trying to get out there and just speak in lecture and it's been awesome dentaltown has help out a great deal so thank you.
Howard: Oh no thank you you made your own luck, you have some of the most passionate followers i've ever seen.
Ryan: Howard goldstein told me I need to you know stop posting so much but he's funny
Howard: Did he really say that?
Ryan: He does a good job
Howard: Yeah I mean just this week and this random dentist Sam Dominic whos been on the show called and said Ryan McCall is coming into town on Friday and a couple different people were all excited that celebrity Ryan was coming in.
Ryan: No nothing like that.
Howard: It is like that, I think it's like that because not only is it you and your personality and your your charisma and charm and all that stuff but you are the poster child for something that's kind of like the cousin that you hide the shed.
Howard: I'll never forget my first lecture is Irwin Becker talking about how there were A patients B patient C patience D&F and you don't want to get all these and he was describing the A patients on and on BCDF. My whole family tree was a third C a third D a third F. My favorite patients this day of my office is that lady in the the electric wheelchair who's out there wrong with auction tooth holding onto her cigarettes because they're they're just people yeah they're just people i love them to death and something is wrong if everybody I mean everybody needs a doctor, everybody needs a dentist they don't need judgmental. I mean if they need a morals lecture they may go somewhere else and go to church.
Ryan: Yeah definitely
Howard: but when you're meth-head your lady was an auction tooth smoking at the front door not knowing you can smell it in the lab, she needs a dentist too.
Ryan: Absolutely and that's a big part of my lecture to now as patient management and communication and things like that because we've had to let a few doctors go just because they didn't really jive with our philosophy on patient care. So I was in Albuquerque like two months ago and I was speaking and I just got up there and like I didn't really lose it but I got really passionate about what I speaking about and I was talking about how dentist or a major part of my problem and that we need to treat denture patients differently and take care of them and you know look at their best interest in mind and that was like when I really got in my groove and that's kind of what I'm probably best at speaking about.
Howard: Well get passionate about it now I mean it really is like you know they and what's even well let's just talk about business.
Howard: You and I both make a lot of money and we I mean I would rather own McDonalds then the owner chris.
Howard: but every dentist was on was frozen and they say you know they just say something crazy things like like they'll really love Mrs. Jones who brushes and flosses every morning every night he's never missed an appointment and every time she comes in she gets a pro fee you know they probably lost $20 everything you seen this lady for 20 years.
Howard: and the name comes one of my people you know some drunk Irish guy with bombed out teeth and that's the biggest case and their the most judgmental towards them.
RYan: I know and it breaks my heart so I was at Midwestern university earlier today and I met with a bunch of students that were doing dentures and just kind of worked with them on some communication stuff and it was really fun so that's what I enjoy and I was after townie I actually went out to San Francisco and met with that carbon 3d the company the / 3d printing company and we printed like 60 dentures in a day.
Howard: Can you find me that website.
Ryan: It's called carbon 3d they're amazing man I think they're gonna be the printing company that kind of you know takes over and
Howard: What percent of them are dental?
Ryan: So they have like three different sections they're actually printing shoes for Adidas right now so like the mid soles and then dentistry is their second one and then I think they're trying to work with some car companies too but they're just innovating like crazy.
Howard: One word?
Howard: You know what Adidas stand for?
Ryan: No what is it?
Howard: All day long I dream about soccer.
Ryan: I thought it was all day long I dream about sex?
Howard: Yeah that's what all the kids think and his brother was Puma and they had a feud going oh yeah I think they ever saw it because it was two brothers who grew up in a shoe family and one who's going to do Puma and Adidas and I don't think they ever yeah I've ever got along after that but uh okay so.
Ryan: It's pretty remarkable it's cool stuff
Howard: Do you know any of them, this is what is on Linkedin
Ryan: Yep I know a handful of them I can show you something to dental ones so I know I've met James and then Brian Gainey's their dental guy you should have one of them
Howard: How how do you spell Brian Gainey.
Ryan: I think that's a G.
Howard: All right is he a dentist?
Ryan: No he's the director of the dental side I think.
Howard: So their printing shoes.
Ryan: and then they're just getting into dentures and that's gonna be huge so I thought I really like what they're doing.
Howard: and you gotta think about this these are the smartest guys in Silicon Valley the smartest I mean you know I can't tell you how many on Wall Street boyz I've talked to me about it Invisalign yeah and I just love the way their mindset you always want to take the call because you would want to hear what they know I mean I've been a dentist 31 years I don't know what they you know they're the first person and they look at the demand they can't believe how many I mean when I was little was just the crookedest girl who could never get married got braces.
Ryan: Is that right.
Howard: Yeah the Catholic family seven kids old Melissa looks like she beat corn on the cob we're gonna come up with this big money and we're gonna fix Melissa but the boys and everyone else are you here right now it's like with small family it's all the kids you know though yeah but then they're back in their 30s or 40s dropping 6500 on invisalign cuz his teeth and then they get then every time you get divorced at forty and sixty their back. I mean so braces the demand for braces...
Ryan: Oh sure
Howard: Just keeps going up and up and up.
Ryan: and we'll print the clear aligners too so that probably won't be a big you know market for us but I think they're gonna do a lot of that also what do you think about align the company that's a good stock.
Howard: Well Align owns Invisalign and they own iTero scanner and now they're going in next to Apple Genius Bar is about 17% of Smiles direct Club.
Ryan: Oh really
Howard: So they're they're totally bypassing the orthodontists and the dentist's and they're going straight to these really high-end malls where they'll just get someone who's that into really selling makeup and you know the the women that work the makeup counters who can stand on tile and high heels all day and motivate Mrs. frumpy you know to buy lipstick and makeup - up and then they prepare this care they scanner they Center on a final down to Costa Rica they send a trays to the patient's house it's gonna be very very disruptive. So then I podcasted probably probably 50 orthodontist I say well this is make you upset and I absolutely I said so are you gonna quit using Invisalign oh no it's the best trays.
Howard: So they're like no like if they they tell me on the podcast if they go to a cheaper lower cost tray their treatment tends to be longer the finishings gonna be tougher then because there's been a lot of R&D; in the polymer of the trencher and the tray materials like that's the first thing you said about additives materials are 12 to 24 months you know there's gonna be a lot of gains and better additive materials but these are when I say they're they're in love with those trays.
Howard: The material of the tray when they use substitutes and I like it.
Ryan: It's just not as strong?
Howard: Just the way they work.
Ryan: Pretty much everything
Howard: Yeah and then they put a lot of money into researching those.
Ryan: Oh I bet
Howard: You and I should go to Costa Rica that's where it's all taken place
Ryan: I would love that.
Howard: Glidewell's got a place down there.
Ryan: They do?
Howard: and we should go down there and hang out at Glidewell and Invisalign
Ryan: I would love that.
Howard: We should go hang out at Glidewell and the bar and would have so much to talk about we both have four kids.
Howard: and Ryan's jealous because mine have all left home and his are 8,6,4,2.
Ryan: Yes we're in the throes of it it's not thank god I've got an amazing wife she she runs the show and takes care of it all so I've been blessed there.
Howard: We had 4 boys in 60 months, what's yours start to finish?
Ryan: So four years forty eight months yeah it's crazy.
Howard: Oh yeah
Ryan: I win, I beat ya.
Howard: It was like a decade of no sleep.
Ryan: Yes someone's always screaming and like someone's always mad they're always fighting.
Howard: and no matter where you put them bed, you could fly them to LA and put them down to bed and wake up in the morning and they'd be in there.
Ryan: Every morning the two year old man who's kicking you in the face yeah so it could be worse I can't complain.
Howard: Hardest job you'll ever love and yeah that's a great thing and that's what's really neat about me is with now that my four boys have turned into five grandbabies. Eric's made four Ryans made one and you start looking these dental models you start realizing okay I'm gonna die and what kind of dental office am I going to leave behind and you start to get so protective because you're like you start realizing well when I hear these young dentist telling me they're working from some DSO or they have some office manager who's not a dentist not ideal right 35% of the patients are perio and they should be do these perio chips and they're like you're not a dentist and then I look at the greatest companies like Honda and Ford where the head founder was an engineer and from top to bottom it was about making a quality front in this site I certainly these laws differently now because they got I mean I don't even think a non dentist to own an office.
Ryan? Really yeah
Howard: because I don't want Taylor going in there with some MBA guy from ASU saying that she's gonna have pareo chips place in their gums what shouldn't the dentists are on dentaltown saying no I don't recommend that. You know what I mean?
Ryan: Oh for sure I mean it's corporate America you know yeah that's a bit different so some I think it's like any business here some really good ones and there's some really not so good ones.
Howard: and everything's a trade-off.
Howard: It's not right or wrong or left or right, it's gotta be faster, easier, lower cost but yeah I look at it differently because you know in a dental office it's one thing to manage in an office when you're alive and you live 3.0 miles from it.
Howard: I want Taylor to go to that dental office when I'm dead.
Ryan: Yeah you want her to have a lifetime dentist.
Howard:Yeah that's a whole different beast managing from the grave that if you think you know all the great comers like Ray Kroc is dead 38,000 McDonald's gonna today and maybe 2 lb patty sausage cheese. Sam Walton his wife Helen who also had four kids it took them like 15 years to open up like 12 stores.
Howard: Now he's dead they would have 40 a month that's crazy that's managing from the grave.
Ryan: That's amazing genius
Howard: and well what I like about that thing is you're gonna the sweet spot of going bankrupt is between two and four offices because it'd be something really ambitious guy near you and they'll be crushed yeah so then he just wants another location and he you know he gets another location but his team can kind of do their office and do this from the side but then the the drive so let's put up a third one hmm and somewhere between three and four the rope snaps and that's the critical mass of you know and when you're talking about those other locations and I remember I was born in Wichita Kansas and the governor of Kansas for 25 years told Southwest Airlines they pay they buy a 50 million dollar 737 Boeing if they would come there and Herb Kelleher say we're not ready I have to grow my management. One plane turned into two turns into 4 turns into 8 turns into 16 and he took his whole life just to cover our America and 30 years ago all the Wall Street boys said he should have used any ad should go by they've no order for a thousand Southwest Airlines and put him in every city in the mayors of a lot of these small states like Kansas and Oklahoma in narco or they will even buy either plane and stuck to his guns he said...
Ryan: That's smart
Howard: I could only grow my management team and he said the limiting resource was the growth of his team not a stupid Boeing plane.
Howard: and that's why I see on these dentists go bankrupt number one I have some dental school and some kid I said what's your goal and he said someday I would have four offices.
Howard: I said you should want to grow earnings every year want to make more net income so if you grow your earnings from 1 million and two million at one store what do I mean I know they obviously do four million in ones store. So why do you want four offices of a pain in the ass each did a million when you have one that did four but I mean I respected his ambition his youth but he's plant grow earnings not locations locations in the metric you don't say well look at Vietnam McDonald's and Burger King and KFC. Burger King and Mcdonalds still haven't gone over 15 locations because when they went to Vietnam the first thing you learned is okay you really crush in China because what did you know that China is not Vietnam do you know that this is 90 million Vietnamese people and it's very different than the billion 300 million Chinese and they had to revamp their menus and I mean it wasn't people are saying that we taste good and so they so there they said you know the fact that we were so dumb that we came here and so we want to have a hundred locations in seven years you know we were idiots in Vietnam and we you know.
Ryan: They were smart enough to stop the like that's yeah we're trying to scale appropriately cuz I don't want to get you know too big too fast and have it all just fall apart so we're taking our time and I've got some really good advisers that are helping me out so I'm doing it the right way.
Ryan: Yeah it's cool so I can't complain.
Howard: I'll never forget what the founder of Pizza Hut use to tell me, Dan Carney about real estate and the Sam Walton wanted to own all his land in buildings and Pizza Hut didn't. The Sam Walton deal I mean you can't say that Sam Walton was wrong and you sure as hell can't say that Dan Carney the founder of PIzza Hut and his wife Beverly were wrong but Dan used to always say and his brother for a Fred Carney say well I'm either that's $100,000 I'd rather rent a space nice take that money and open up to pizza I'm growing my pizza business yeah so when you start doing your business plan I mean the use of capital. Do you want the land of the building well the control part of you wants to control and own the land and the building but as far as use of capital then having that debt on your balance sheet.
Ryan: So you think it's a bad idea?
Ryan: I do too.
Howard: Yeah its a bad idea especially as Amazon is slaughtering all the retail stores. If you were a UFO when you flew over Phoenix 340 million people you would think the number one hottest store was space available.
Howard: Yeah think because every time Amazon grows by a billion dollars I mean if they can be put in a box and shipped to your house sure retail is dead.
Ryan: Yeah that's true.
Howard: You need a game you know you got a gonna paint your fingernails mani-pedi clean your teeth massage cook make a sandwich if you don't need a monkey to sell this you don't need a monkey to sell this.
Ryan: No the Internet has changed everything.
Howard: You know my I couldn't believe my shaver died though and I'm sitting in two seconds I'm on Amazon and then the next day and I'm so dumb I'm looking out the window thinking live here alone good why is there a package outside my front door, it came so fast site we'd forgotten no I know yeah so oh I don't need to go to Target to buy a Norelco shaver
Ryan: Sure. How do you I have to ask you how do you post so much online like on social media oh yeah I'm impressed like I post a ton but you are the King?
Howard: You know it's two things, I can't repose what people send to me.
Howard: So when you got people feeding you stuff from dentaltown, Facebook, Twitter, Linkedin and you look at it and then you giggle and then I do it all from my deal that's why when everyone says to me yeah but I don't know how to type where I'm like come on Dean I'm 56 I should get an A plus plus extra that I even made the post. Yeah so I just have some digital friends and I just love it and the other thing is she's like I used to really hate commercials like when watching a football game tonight's a football game tonight is it Vikings one one and one?
Ryan: I think so vs. 3 and 0 and I know
Howard: Who are they playin?
Ryan: Not sure we've been so busy with the kids.
Howard: but now when it's a commercial I don't even care because I just love my phone you know and I'm on dentaltown.
Ryan: That's awesome
Howard: Yeah but so you feel like you got good advisors?
Ryan: Yeah really good and the social media has been huge so I started helping some other dentists do that also and I think that I probably you know kind of a second career for me at some point you know do some consulting on the social media and help other Doc's with that so.
Howard: Well let's talk about that because you again not blowing air up your skirt I don't know anybody who rules Instagram more in dentistry yeah I mean you come in here you're amazing on all these but Instagram your the king aren't you?
Ryan: yeah I guess for dentures yeah I've got a lot of content.
Howard: Who else would be number 2.
Ryan: Probably denture Queen who you're gonna interview coming up.
Howard: Denture Queen.
Ryan: Yeah she's great so she's all digital she's like a hundred percent digital and loves digital dentures like there's probably only one other person in the world that's his passionate about dentures as I am and it's her so I think you will...
Howard: Now is the Valerie Cooper?
Ryan: Thats Valerie
Howard: Oh okay and you call her denture queen?
Ryan: That's her name on Instagram is denture queen. She's gonna wear like some crazy like space suit for her lecture tomorrow so she's out there but she's amazing.
Howard: And where is she?
Ryan: She's in Dayton Ohio I think it is.
Howard: Another flyover state
Ryan: I know man and when I got started you know we've got such a big social media audience and a big presence not very many people wanted answered my questions you know cuz I will probably do some lab work too for other docs and she answered everything and like totally helped me out and like offered to rent two chairs in her office to me so like she's remarkable and she was so wonderful to help me so
Howard: She thinks in hope, growth and abundance, she doesn't think in fear and scarcity.
Ryan: Yeah definitely and she's a prosthodontist too so I mean her markets a little bit different than mine and we do a lot of volume but she's been so helpful so you'll enjoy working with talking with her next week.
Howard: So she's a prosthodontist doing high-end digital.
Howard: and your a hoosier and the value...
Ryan: We do high-end too so I can do low end and high end I'd say the majority of my cases it's kind of like tires you know so we'll get the high end but I'd say the majority go for the mid-level and those are all you know press packs.
Howard: So how many options do you give them?
Ryan: Just three
Howard: and there's enough research on that you could do a 40 hour ted talk on that with you when you give a monkey a choice and you say here is well one of the options is no so you don't you don't do that but if you say well we have two options a high and a low then they're thinking about that and a lot of times it gets very stressful for them but when you do the higher than the low they make a decision.
Howard: Yeah they know I'm not gonna go low I mean you know.
Ryan: I don't want that.
Howard: You're not from Clearwater.
Ryan: Right, so it's nice to provide options cuz you know we don't really look at their budget we're just like what type of budget do you have let's work with that even our economy dentures or great dentures.
Howard: and what are your three prices?
Ryan: It's like three ninety-nine and then we usually charge...
Howard: Arch or full mouth?
Ryan: Per arch
Ryan: and that lets me compete with some of the bigger chains but I think we we provide a nicer denture I really do just based on materials and things like that and then our mid levels like fifteen sixteen hundred per arch and then premiums around two thousand or so and I'll get a lot of dentists that...
Howard: So 400 is the low?
Howard: But 1500's the middle?
Howard: and 2000 is the high end?
Howard: I would have guessed...
Ryan: What would you do
Howard: Well the middle is too close to the high.
Ryan: Is it too close?
Howard: Well I mean I would think so but its working though?
Ryan: Yeah it works really well but I've kind of played around with it over the years and you know we'll change the price.
Howard: So how many of those if you did a hundred well we'll keep going. How much would it be on locator in the middle?
Ryan: Then well usually charge anywhere from 2,500 to 3,000.
Howard: Per implant?
Ryan: With the implants. I'm more affordable on the implants I'm closer to like a thousand or so just for the implant and then the attachment we charge a little more for those.
Howard: and are you placing the implants?
Ryan: I place some but I'm so busy doing all the removable that I really needed to find an oral surgeon that can come in and just place implants.
Howard: That's another interesting thing when you lecture around the world when you're in that country you drink the kool-aid.
Howard: So you don't really know what's right but I am The Australian's they do one in the middle.
Howard: and they're like well it's just perfect the way it rotates one in the middle you can everybody is you guys all just put two.
Howard: and now you've made a force vector
Howard: and then I and then when that's not going right then you want four but man they swear by one right in the middle.
Ryan: In Australia?
Ryan: I'll try it.
Howard: In New Zealand too.
Ryan: Okay what type of implants do they use?
Howard: I think their all over the board.
Ryan: Yeah, what do you think about the ceramic implants are you a fan?
Howard: Well I think I'm again the trio so well so what's the trade-off yeah and I have talked to several dentists on this show and an in person and on dentaltown where a lot of people there's something about that titanium that's not as inert as we think it is and there's a lot of people who believe that when you when at 60 months when 20% have peri implantitis that's huge.
Howard: At 9 to 14 years it's 40% and that type and it's not even titanium anyway there's other stuff in there mean it's not a hundred percent right titanium it's an alloy and there's something about that and then and then so you look at that periodontist there's a lot of people to think now you know they had peri-implantitis I removed them I placed some ceramic and it's gone and then you look at the variety of 8 million humans I noticed my 30 years back when porcelain to gold and silver is expensive the low-cost white crown or tooth colored Brown was porcelain to non-precious. They're good and you could do to anybody color you can do it out here on Hispanic American Indian and African American but if they were northern European like Irish English scandinavian it would tattoo and then we immediately added to the health history if you weren't costume jewelry will it tattoo and people who look like me and you the girl say yeah I'll get a green line well you had a fight with that pfm on there you'll get tattoo on there. So it was something you know I'm not sure exactly what it was Gordon used to say that he thought that those people had more ascetic skin okay and the pH was pulling the base metal out but if they were fair-skinned Northern European they knew they needed gold so we're playing millennium so on these these implants I mean I think it's bizarre to think that 8 billion humans stuck on the surface of a rock no wood all react to the same implant the same but I think that there's gonna be obviously there's some biological home care issues but when you have periodontist saying look this says perfect home their health its himself there's his wife right home care is not the issue and there's peri implantitis and then the last straw that I look at that is you know what humans say and how they spend their money are not correlated and go back 20 years ago all the fertilizer but they're always doing surveys they always have fight people come in and evaluate a product but after they did this for 10 20 years they realized it didn't predict anything because the social group if we all sit around you here give me a hundred dollars and you say how what do you think about these glasses the whole I know they might something else and so I look at the money when humans spend money that's when it's clear and every major implant company has bought the ceramic implant look at all of them have and the biggest implant coming in the world Zimmer who makes spine hips knees awesome has already told Wall Street they want to sell out their dental implant division.
Howard: and this is it's a different beast it's not a fully buried in the vanity therefore a knee and there's something going on.
Ryan: So just to competitive or?
Howard: Well I mean it could be too competitive it could be that the peri-implantitis is an issue could be it's just a whole different beast how many point Dennis got spun off in the first place sure eighteen unders.
Ryan: I think they're like what 200 implant companies now or something crazy like that.
Howard: There is 400 just think it over just in Italy
Ryan: Just in Italy what that's crazy.
Howard: Well they had a big on its if it's made out of fiberglass second dentist right David saw me in Taiwan okay they just happened when titanium turned off in Europe and it was all in Italy really so every titanium company in the world was in driving distance of Rome and so yeah they have 400 implant companies.
Ryan: That's insane that's what I was like...
Howard: So yeah I think the random ones I think they're gonna get bigger but the trade-off is you know having all those pieces and screw down an offer now you have a big bulky glass ceramic they're gonna make it in one piece.
Howard: and then when you put it in its yeah
Ryan: It's a lot
Ryan: That's why I like dentures I mean there's only a handful of like really big denture companies so it's been kind of nice.
Howard: I want to talk about something else that I don't think people realize about dentures. So thirty years ago I decided to me it might diplomat the International Congress on the college and I joined the missions institute I got my fellowship the mission institute so back then I was looking for going to do a lot of it I didn't want no fee on your watch and so cases would come in and I I tell Graham I said by the way you know I just got my fellowship and Bubba and I just I'll do this case for free and she'd say well I don't have any problem I don't want to have a surgery I could eat Apple I can eat anything I want I could not believe how many dentists not having a denture it'd be like a wooden leg you're never gettin it's never gonna be just right you know it's it's it's really an impairment sure and then I was watching these 79 year old senior citizens by my office wouldn't even take it for free said I don't have any problems with my denture. I think there's a big misconception about how many people are actually just happy with their denture.
Ryan: Oh I think it's like less than 25 percent or something crazy probably even less than that.
Howard: One in four how many people are wearing a denture in the United States?
Ryan: Oh probably 36 40 million
Howard: Okay so that's 40 million and only one in four love them.
Howard: That means 10 million Americans.
Ryan: Oh it's a huge market.
Howard: I mean Ryan I give you names and phone numbers of old farts that live between here and through miles my office that have a denture and have no problems they just love it.
Ryan: Oh really
Howard: Yeah one of them one of them is my golfing buddy he got it when he was 16.
Howard: He just doesn't have a problem.
Ryan: Everyone's different and then you get those little old ladies that absolutely just despise them and you will do like two remakes and they're still not happy it's a lot of patient management that's the key with dentures I think so even with those new technology it's awesome and I think it's wonderful but it's still the same patients and I think you know patient management is gonna be key no matter what so that's a big focus for me.
Howard: So how many appointments for your dentures?
Ryan: Right now it's for but with some of these new technologies.
Howard: Walk me through those four appointments.
Ryan: So we'll just do impressions you know alginates or we'll do a custom tray and use a PBS and then we do wax room still and then we do a wax try ins
Howard: You'll use alginates or PBS?
Ryan: and yes that depends on the case they're a couple of nice alginates I'll use that we can just do.
Howard: What are your nice ones?
Ryan: We do Ivoclar makes a good one, Acudent's really good and I'll just use that typically. Accudent XD that's good.
Howard: They also make really nice high end denture teeth.
Ryan: Yeah so we use a lot of their materials and it's all really solid.
Howard: So are your denture teeth are they all resin, any porcelain and ceramic?
Ryan: No so I'll use porcelain of people request them and they've had them before and we'll use some of the composite teeth too especially on our hybrids and implant dentures and things like that but yeah we'll do a wax rim still and then we'll do a wax try in for every case even for our economy dentures so that kind of separates us a little bit more to because you know takes more time and then if we need to I'll use a PBS and take a wash and the base plate and that keeps us from using a custom tray so that works really well and then yeah and then delivery after that but with the new technology especially with some of the printing and milling and things we'll be able to go from impression to delivery so just two appointments and that's gonna be a game changer once we really get it dialed in.
Howard: Two appointments separated by how much time?
Ryan: Less than a week you can do it same day if you need to so 7 to 10 days probably.
Howard: So right now you would have to take the oral scan and send it to a lab?
Ryan: We have our own lab so yeah we'll just do it in the lab but right now you still need to scan the wax rims and do a vestibular scan if you can and a lot of people are still doing cone beams with that so I mean it's still a lot of work but eventually it may be a few years but at some point and be able just to scan intraorally and go straight to the process and finish so.
Howard: You know it was Warren Buffett always for gosh was is it going on 50 years since he started.
Ryan: How old is he now like 83?
Howard: 83 or something.
Ryan: He still speaks though he goes that conference and answer his questions.
Howard: Every day he eats breakfast at McDonald's.
Ryan: Does he really?
Howard: Every day
Ryan: He's still healthy. Who's the other guys at charlie is the other one Charlie...
Howard: Charlie Munger
Ryan: Yeah how old is he?
Howard: 90 something
Ryan: He's like 90 something right
Ryan: He gets up there and answers all the questions too and yeah remarkable.
Howard: Yeah it was actually my most embarrassing thought was was Warren in 1980 he came in spoke he was good friends with the business guy Creighton I forgot again he wasn't a little Italian guy with long white hair oh my god he could teach his good and his buddy Warren came over and we listened to them and we was 10 points to writer with all the speech and I was it was 1980 I was 18 I was all excited about nifty 50 and xeroxing and all these companies and then to the nifty 50 and I asked them you know which which nifty 50 you'll understand because if you can't write if you can't take out a 5x7 recipe card with a number 2 pencil and sharpen your pencil because if you can't explain to me what you do on one side of a recipe card I'm not gonna buy your sock this guy is dumber than dirt and he and he is not interested in Xerox and Kodak and all the high tech companies and if I just would have dropped out in college and took that semesters tuition and he gave it to Berkshire Hathaway there were none had a job at McDonald's I'd be a gazillionaire right now I mean that's what he always says he says that 95 percent of CEOs go to work every day trying to make everything slower more complicated more expensive and they spend all the profit on all this stuff so I know I just know when Warren would see a technology like that here's some poor dumb bastard dentist that's taking how to make an adventure trade doing the wax rams deliver net making this nice nest egg and he's gonna take all that profit and by computers and adding machine he's gonna have eighty percent of all the profit dollars and his only conversation I don't know how many companies he owns here's your profit you know you need to send it to Omaha and if if you think going to work every day is how am I gonna spend all that profit and I mean dentistry is hard and so many these people so many people at thirty forty fifty they're still and using other people's money there's no got mortgage on their house their cars finally paid off so that you'll get another one now they got five years payments more and then they want to buy you know you know a CAD CAM a laser in your 401k right how much cash do that and then the truly wealthy is if your debt free and you get your on $50,000 your interest your that's your earn but your burns only forty right do the wealthiest son of a gun in town.
Ryan: You bet
Howard: and then you you meet dentists every day there are 50 60 I mean I'm at 61 just bought his dream house it's on the 30-year mortgage
Ryan: At 61
Howard: it's a big and I'm like okay so you're gonna drill fill and bill till your 90?
Ryan: Yeah that's hard.
Howard: He didn't want to hear that right he just wants to show the house insight is like that's so it is so it's something that it just is what it is so if Warren said 95% of the fortune 500 CEO well you didn't say for 500 he said CEO the publicly traded so probably the Russell 2000 so 95% of those boys are doing this what percent of our homies are doing it.
Ryan: Yeah that's true dentists love technology though don't they they do but I've been kind of hesitant to get into the digital stuff just because we have so many offices and we do such large volume I didn't really need to change anything and I kind of thought some of this was really kind of a solution for a problem that didn't really exist until I started seeing some of the 3d printing and I think that's gonna be the future so we'll do both will mill and print but luckily I've been working with enough companies now that we bought up a lot of brand equity and some of the really good ones have valued that so it's been very helpful so.
Howard: So 100 years ago Motorola radio and you had to have a cadillac to get that now it's so fast easier higher quality lower cost every car has a radio.
Howard: So the question is when does it go from bleeding edge to leading edge to the early adopter when will it make one will have the material and be better faster?
Ryan: It'll be a while I mean it's bleeding edge right now to be honest with you on the denture side it's been around forever for crown and bridge you know it reminds me a lot of early CEREC because I worked with one of the first ones.
Howard: but I call bs on that because when everyone talks about same day dentistry, Phoenix's its 3.8 million people I mean it's like one spend a decade someone says same day it's usually how much is it, are you gonna hurt me.
Howard: It's not I don't care about the cost in the shot it's the same day.
Ryan: It's the best material yeah have you ever had a patient ask for that?
Ryan: Yeah give me the best material
Howard: Have you?
Ryan: Well maybe one or two, my mom, my grandpa yeah
Howard: So it's like when people start people always want to tell you what they want to hear and they want to say what they're passionate about they want to tell you what they believe in and I just I just don't see I just saw so many offices with same-day dentistry spend a whole lot of money and then they go to a lot of courses sure then every time you turn around they're flying their staff to some resort and it's like really because.
Ryan: It's crazy
Howard: I mean I got a $17 impregum impression and I sent it to a guy up the street van Hoek he makes me a white crown for $100 yep and he's made and he is the same year so 31 years I mean how many has he made 10,000
Howard: 10,000 20,000 three and then they're saying oh well you need a $17,000 true definition scanner and the software maintenance is 200 a month 2400 a year.
Ryan: It adds up.
Howard: If I took just oh the software I mean I froze up on the software agree with 2,400 divided by seventeen dollars that's a hundred and forty one impressions yeah.
Ryan: That's a lot of crowns
Howard: and then then they're saying well down that sub call HIPAA needs to be on the cloud and I was like man what was wrong with the triple tray of Impergum I mean I can't even switch to BPS.
Ryan: Oh really
Howard: Well yeah I remember I think oh I my first crack was on Fred Flintstone and if it's always worked for
Howard: 31 years why do I need to change.
Ryan: That's my concern as some of this technology I think eventually it may end up going to China - to be honest with you because I think a lot of that CAD CAM crown and bridge stuff that's where it ended up you know so some of the big labs will end up just outsourcing it at some point if they aren't already.
Howard: Well I have a totally awesome view to that.
Ryan: Really let me hear it.
Howard: Okay so when I went to China okay so when anything was labor-intensive obviously you want to go to her labor cost are low, you want to go to you know that they're working 40 hours a week in America and 48 hours a week in Korea and 56 in China and you know so labor intensive stuff all went to Asia and then the CAD CAM Jim at Glidewell said it the most succinct I think I'm very much your four times at the Chicago midwinter took him they always have a dental lab meeting
Ryan: Lab day or whatever
Howard: Yeah L&T dental magazine puts it on.
Ryan: It's in Illinois
Howard: Yeah and he said you know when you started Glidewell he'd hire you had this extensive library at VCR training and all these tapes she says it would take me in a year to get you to be able to poor up the model trim the dye wax it up Casta stack porcelain contacts he says i would have to invest in you for a year and you get to five crowns a day he says that's why I grew Glidewell he said now I'll buy a CAD CAM I'll hire you on the street and in one week I can train you to mill 50 a day so then when you go to those big labs and I mean I was there I got pictures of them so email me at Howard@dentaltown.com and I'll email you pictures of these UPS trucks.
Ryan: Oh cool.
Howard: and so in the early days it was all these labs that you hear about and they were collecting the cell something secretly clandestinely overnighting it you know Hong Kong driving an agenda and doing it 10 years later that train had reversed.
Howard: Those guys were collecting all those impressions from labs all over Asia in the Middle East or whatever and they were sending them to some of the biggest no labs which I can...
Ryan: In the states? Wow
Howard: say that I could say but I don't know it might make people upset.
Ryan: That's fascinating
Howard: Yeah so it just comes down to well here's the best side you're from Indiana I'm from Kansas would you rather have a bunch of really low cost immigrants plowing those fields by hand and rakes and hoes or would you rather have one guy on a John Deere?
Ryan: John Deere all day now I've got a John Deere to family we just got a tractor okay my wife wanted to she grew up in st. Louis my wife and she has wanted this John Deere tractor so badly for ever.
Howard: You've got a good wife if she wants a John Deere tractor. How many women want a John Deere tractor?
Ryan: I'll send you a picture she's out there mowing and I'm like you've mowed last week you know it rained and stuff but like it's been such a good investment.
Howard: and the next will be drones, driverless John Deeres.
Ryan: Yeah that's true
Howard: but back to the deal I mean if you you know China has got realize just being the lowest cost isn't a strategy I mean China okay like I asked you so China is the second biggest country in the world has large population what's your favorite brand from China?
Howard: Nike is an American company.
Ryan: I don't even know
Howard: I mean Korea has LT Hyundai samsung yeah Japan has Toyota Lexus. Name one brand from China.
Ryan: I'm trying to think.
Howard: There isn't one.
Ryan: No your right. Why is that?
Howard: because they're still just trying to be the lowest cost making all the little parts and pieces like dude the money is in owning the Iphone not making it. I thought you know making some little resistor and they count someone for 50 cents an hour and so big they need to be so and so the deal is so again I'll just say that if you think the whole economy is going to end up in the lowest cost Trina hmm well I think I could see that first in farming I think people start getting rid of all their tractors yep and hiring it's like immigrants for ten dollars now and giving him a rake in a hole that's a good analogy yeah it was mine it was the most romantic thing that I went my idol was Milton Friedman and I'm a libertarian just I mean you'd probably need to aim a gun at me before I started disbelieving Milton Friedman.
Howard: and so John who was John Deere well I can't remember John Deere I think was caterpillar so they call him that because the Prime Minister of India banned all of their stuff because he rightfully was thinking if I had all these unemployed people I don't wanted to have tractors what kind of jobs sure so they said no down there and he walked around so I'm always unemployment and all these people you know they don't need a tractor and they don't need these jackhammers also. He said well if that's your strategy let's take away their shovels and give them spoons and that's what thumped them upside the head it's like well if I took away all their shovels and gave them spoons and sewer line wouldn't be built sure in five years and Milton said I assure you you want to raise their productivity and one guy can buy a John Deere tractor and then cut this sewer line in a day you know one a thousand men out there with a butter knife that's two minutes at the job.
Ryan: That's geanous.
Howard: So this technology so I think
Ryan: So you think it'll come back to the states then?
Howard: Oh it is
Ryan: Nice I should probably set up a lab then.
Howard: It's coming back in the states huge because again well I'll give you an example just a local lab here Vanhook. I mean they they have kids in there that can make 50 crowns a day.
Howard: Now when you and I were little how long would it take you to make 50 PFOS pourn up in stone trim in the dive dressing it up casting putting it back painting the porcelain on.
Howard: Oh right if you did five a day you would have gone home and passed out.
Howard: and now you got kids jamming on their iPhone making 50.
Ryan: Crazy, that's why we're investing pretty heavily in all this because I think eventually I don't know if there'll be lab technicians around you know I think there's what two schools now and we'll see especially with removable it's so hard to find good technicians so this will help our technicians you know be more productive and produce more dentures.
Howard: Well the technician thing is dentistry is one of their worst ideas so, they close down all the lab schools and the dental schools yeah then they don't always take you school sure so now we have an overabundance of hygienists but what would happen if they made the same decision with hygiene that they said with technicians?
Ryan: Would be good for dentures.
Howard: Yeah and so there's that private public relationships a lot of our hardcore political conservatives on dentaltown who think the government can do nothing right yeah well I'm telling ya that we need those the richest countries in the world to govern and the private sector work together really good and if all the dental schools didn't graduate any orthodontist, hygienist you know it's not good for anybody and they made this brilliant genius decision to close down all they're dental labs and one of the reasons China was doing so well is because when you go to Hong Kong any lecture at their only dental school like the freshman dental class was like 50 but the freshmen crown and bridge lab was like a hundred fifty.
Howard: and I said that why is that because really these labs are all popping up and these you know the countries in like Germany where they're paying 250 for a crown they sent here just for 50 I mean they're making bank and so we calculated a huge demand for lab techs.
Howard: So we immediately scale or lab tech deal I said can you send this letter to the all the deans in the United States cuz they they they still don't get it.
Ryan: They don't there's a lot of dental schools that are popping up too.
Howard: and another horrible thing in education is you know we want them to go to these big universities and get lawyers and dentists and physicians but then the guy that's a plumber can't hire a plumb tech and then half these kids in high school are never gonna be mathematicians they're never going to use algebra and trig and if you go to countries like Germany they start weeding these kids out of like middle school grammars ability it just says I hate math it's not gonna be an engineering but I'm gonna do it what do you anything yeah I'd like to be an electrician or a plumber or construction or whatever and train them second that and so in America and you got a big economy but what the guy who comes out to fix your toilet and even last year I think you came out and fix it in Germany it would last.
Ryan: Germans love engineering
Ryan: My neighbors are German so they're pretty cool.
Howard: You know it's the largest ethnic group in the United States.
Howard: It's German then African then hispanic and Irish.
Howard: Well it was all those religious like Martin Luther. So as all these groups these Protestants protesting the Catholic Church the Lutheran the Mennonites the Amish you know anybody who had a beef with the Catholic Church and wanted their own place left Europe who came here and the biggest I mean Martin Luther was a Catholic priest sure and when he hung up his thesis he was they want to be killing him.
Ryan: Nailed it to the door right?
Howard: Yeah and then they and then a nun hid him in a wine barrel and pretended she was taking a delivery to England because the church of England didn't like the Pope either, so yeah you had a lot of German protesters against the Catholic Church and it was the biggest wave.
Ryan: That's crazy
Howard: and that's why us Irish were the most hated I mean historically speaking they were the most hated of all the immigrants you know why, because all these religious groups came and every Protestant which is half the person in the world are Protestant about a billion the other half are catholic and then finally the Irish dice war comes during the potato famine 1841 they bring with them their Catholic Church and they started building these Catholic Church and that's what everybody ran for and it was the worst rub of any immigrant crew and my great-grandmother who lived to be about my THC designs Help Wanted need not apply of Irish and so what they did is they all change their Irish name line from McFerrin to Farran and they go and neighbor to like Ohio made all the way Kansas and they told everyone they were German firstly yeah so it was her name they would give her to the Mc and they would they would lie into the and call German Scottish English just don't be that's crazy and but then it was hard to disguise and what's the first thing they would do... build a Catholic church.
Ryan: There are a lot of German denture companies actually so like Germany Austria Switzerland that's like the hotbed of dentures for some reason so I've been working with MERS dental quite a bit and I really like the stuff they're doing they do some really nice high-end interment aerials and they really care about you know the product so it's been kind of cool to work with them.
Howard: I mean Germany is like sixty percent of European exports I mean
Ryan: Oh really cuz like DENTSPLY Sirona they're German too right?
Howard: Yeah and a lot of people say well they're not in Germany they're in Austria. Austria is kind of like their tax even thing like the the biggest company in Japan in dentistry GC moved their headquarters was in switzerland but you notice the company to move their tax attorneys move
Ryan: To California?
Howard: Well to Austria or Switzerland.
Ryan: Oh sure oh is that why they're all there?
Ryan: I see that makes sense then Liechtenstein places like now I get it.
Howard: Yeah their tax savingings.
Howard: and that's why Apple got busted for what 15 billion and a five billion from the EU because they gave Apple this this big old tax break and because like that it's not even legal for the EU chart.
Ryan: That's crazy did you see I'm the Instagram guys step down this week so what do you think about that?
Howard: I think that cereal well it is the same thing why dentists have a different associate job every year.
Howard: The people that go to college for 9 years don't want to be your employee and they on to the serial entrepreneur that takes a startup to Instagram it sells for a billion and now I'm your employee right and Marks telling me no or I have to do they're not manageable people and that's what you know if you want to manage a million people start a Walmart or a military but if you get a million attorneys dentists physicians or Silicon Valley people that's type to take orders and that's why lawyers the only way they could do it is make you partner it's okay I'll come here you can work on my denture do needed up in a bit of you hustle and you're bringing clients and you're posting case on Instagram you're growing the business then I'll make you partner and when I may be partner then you would stay but now we got these DSOs were there their endgame is always be my employee til the end of time and again you know that works at a place like Walmart where most of your employees you just have high school but it doesn't work in lawyers physicians and I can't tell you how many my physician friends, the ones that own their own building their family practice ophthalmologist dermatologists all look like dentistry they own their own building their own place autonomous they're really happy to work in the hospital and have a chief of staff yeah and it's like every dental school what is what is the number one complaint of all faculty to every dental school American?
Howard: Bureaucracy and politics.
Ryan: Yeah but that makes sense like it's kind of a sad cycle isn't it?
Howard: Yeah if you're really smart ambitious and have a lot of college you just not that guy that's going to put your
Ryan: That makes sense.
Howard: head down and take orders.
Ryan: What do you think that turnover for associates is like for some of those DSO s like what percentage?
Howard: I would say that one to two years is the average but I don't want to say that about DSO's because the evidence is just as strong on the private sector too.
Ryan: Yeah that's true.
Howard: So you know when I meet a dentist who's been out of school for five years they've usually had five different associate jobs.
Ryan: Is that right?
Howard: Yeah and then when they're working for like me or a friend you know they'll tell me everything that's wrong with this guy's office.
Ryan: The associate says that?
Howard: Yeah, it's just a mindset. So any last... I can't believe you stayed with me for an hour while you were at this big convention.
Ryan: I can't come to Phoenix and not come see you
Howard: and you're gonna see another friend of the shows Sam...
Ryan: Yeah we'll see him and I saw Tom from dentaltown and like now that I'm traveling around and lecturing I'm trying to hook up with all the Townies that kind of helped me when I first started and just kind of hang out with them and say thank you so it's been fun.
Howard: and when you lecture overseas
Howard: Do not let them put you up in a hotel.
Ryan: Oh really why?
Howard: because it'll cost them a lot of money in that you're an American so they'll g o to the nicest hotel like if you go to Warsaw the nicest hotel is the Holiday Inn and if you go to Albania it's the holiday in there true but these are resort Holiday Inn's.
Howard: but looking back the last 30 years I'll never forget when I was staying in Warsaw Poland I never opened up a Polish refrigerator before it did not look like any refrigerant and we're open to the United States and just seeing when you're in Vietnam and Cambodia and all these countries I enjoyed living and another family's house.
Howard: more than any part of the whole deal that's cool oh it's so cool and talking to their kids and hearing the the stereotypes and I remember getting into a huge fight argument way too much beer and all that was in I was in San Paulo and this guy introduces his son to me and says he is so smart he's gonna be a dentist just like his dad maintain his daughter says she is so beautiful she's gonna marry a dentist like her dad whoa time out but it was the coolest part.
Ryan: Thats awesome
Howard: Yeah I mean and every single feels like I'm not into like architecture like for the sake of architecture sure but every house in the world has a window and a toilet yeah drawer and they all made them slightly different and from a window to a toilet I mean I remember I mean I remember in Austria I mean the first time I took his shower I said okay I don't know I'm not the sharpest tool in the shed I can figure out this shower, there was like fine knobs like levers and I'm standing in this Austria house thinking I mean it looks like it was made for NASA it's just like that flying you know like I'm a dentist I took math I'm gonna figure out it took me 15 minutes to find out I mean it was it was just crazy but that's the fun stuff.
Ryan: That's cool I'm gonna do that because I mean like I'm passionate about what we're doing and that love dentures and just spreading that and I'm gonna go out and do it all over that's my plan so.
Howard: Yeah and you'll you'll make closer friends and the most mind-blowing stuff is seeing how they live inside their house.
Ryan: That's cool man I'm gonna do that.
Howard: and I shouldn't say this I know I shouldn't say I'm so stupid.
Ryan: Go for it
Howard: Should I say it?
Ryan: You're Howard Farran man.
Howard: They just know I'm socially all right you go to these Islamic countries and everyone outside all proper women sorry all shy humble you walk through that door all that comes off the Rolling Stones the liquor the cooking the music inside that house you thought you're in studio 54 in Manhattan.
Howard: and then outside you thought what you
Ryan: This is different world
Howard: of these countries and then and then I would say okay well so you obviously don't agree with your grandpa and they're like we'll do you. I mean then they talk about all of our eight-year-old crazy conservatives and so it's really interesting because when I'm in dental school I have the most faith in the dental profession because I man those are the people that he replaced me and they're just awesome yeah and then when you go to those other countries I don't care how bad the relations are between the presidents and deals the people are just so cool.
Ryan: That's awesome nice I can't wait to see it man I'm so excited.
Howard: Thanks for coming by and sharing your amazing wisdom.
Ryan: Thank You Howard amazing thanks for everything man Digital dentures hopefully I think they're gonna do the conference on the East Coast next year but if it's back in Phoenix I'll call you you should come down and hang out the podcast with everyone there so that'd be cool so digital dentures they're coming let's do it yes sir thanks brother.
Howard: Thank you
Ryan: Appreciate it.