Howard: It's just a huge honor for me today to be podcast interviewing Dimitri Edelchik and Alex Nudel I’ll start with Dimitri he's on the left he's the one that has hair on his head he's not the beautiful bald one Dimitri Edelchik is the director of partner marketing for revenue well and is the past director marketing for plan mecca revenue well helps dentists and practices create closer more connected relationships for their patients and their communities Dimitri is a marketing executive with 12 years of dental industry experience would focus on dental technology like hardware and software and has worked directly with dental practices and dealer channels to help drive technology solutions to advanced patient care he is a profit focused business development leader with over 20 years of experience with a proven ability to grow market share penetrate adjacent markets and drive new product development within start-up and established industrial medical and dental markets he is highly skilled at developing sells channels and key accounts uses a diagnostic approach to problem solving that assesses clients with interdepartmental needs succinctly and inspires teams to produce solutions collaboratively his specialties are everything you're doing in your den office the bulb beauty to the right is Alex Nudel founder of Revenue well how cool is that has more than 20 years of experience as a recognized dental industry speaker practice grow specialist successful practice owner and digital entrepreneur as a dental practice owner he realized the need for an easy way to handle the routine communications associated with attracting new patients increasing production and creating a wow experience for his patients he founded revenue well to meet those needs freeing the doctor and staff to focus on what they do best serving the patient revenue well helps dentists practices create closer more connected relationships with their patients and their communities founded in 2010 revenue well is a fast growing software company that as a single goal helped dental practices succeed their practice marketing Suites automates common patient communication processes from recall and reactivation efforts to social media post and post-operative instruction it also gives Dentist the tools to attract retain and maximize the lifetime value of the patients so Alex I'm you owned a dental office now are you a dentists or you'd live in a state that that's legal or tell us about that.
Alex: Well my ex-wife is a dentist sorry my wife is a dentist.
Howard: Oh my god ah you've fallen for it twice huh.
Alex: I sucked in both times yes and I have a 20 year old daughter who was super excited to take her dat on June 27.
Howard: Nice congratulations so you were very very much so you were married to a dentist in Florida yes.
Alex: So I'm married to a dentist in Florida now as well there are two Doctor Nudels.
Howard: So so tell us about your journey you're married to a dentist who owned their own practice.
Alex: Yes so ultimately my journey became and started in about 1995 when she was working for a very popular dentist in New York in Brooklyn New York and helped with the marketing I come from an automobile business where I did quite a bit of marketing for car dealerships and so helping her market for new patients for a large practice in Brooklyn then she gets accepted into Nova Southeastern University first charter year here in Florida we move down to Florida we got married here and in 1998 my daughter was the first child born into the first charter year school dental school so it was very excited about that I sold a business to Intel that has the a chip technology that you have probably in your iphone and found out that she was going to graduate and start her own practice from scratch right away I said great I’ll meet you at dinner and she asked me to help her she was going to build out a very small practice with just a couple of chairs it wasn't about money for her when we found out that there's more to it I spoke to my Patterson rep at that time and she said we're making a major mistake let's build something with more chairs we don't have to plug them all now and so the first year that we opened our practice was in 2001 and we collected a million dollars.
Howard: Nice well now these dentists um after were so many hats it's so hard to learn root canals fillings and crowns but then you got to be a leader in HR and marketing and accounting and and I think the advantage of these dsos is they got by managing several offices they get a bunch of full-time employees that don't have to work in the business of making dentistry happen they they get to work on the business so do you think revenue well is helping them work on the business.
Alex: So I hear two things new dentists coming out struggling and dsos figuring out what to do with the new dentists and everything else so I’ll start from the first thing so yes new dentists are coming out with very minimal experience of what it takes to run the practice they have minimal experience clinical but they also have less experience and running practices there's a reason why dental schools don't teach business during their clinical years is because there's just not enough time they want to focus on what's going on clinically which I’ve gone through I’ve spent a lot of time I'm clinically savvy I understand that there's a lot to it and learning the additional services like endo special prosto sleep apnea and all of that it's typically not their main goal they want to get out and start somewhere so originally dr. Nudel went into residency and has worked for one year at coes dental prior to opening up a practice so really understand what's going on in the DSO world Dmitry's going to talk about that world in just a little bit but revenue well entered that space aggressively knowing that it's growing and have dso specific platform that we have created that works in a much more interesting way than anybody else that has gone into the DSO space.
Howard: And what percent of your businesses dental as opposed to other verticals.
Alex: A hundred percent of our business is dental.
Howard: Wow what is amazing I mean gosh just on you're a huge company and and you're that huge just in dentistry.
Alex: Yes well we realized that the TAM is different than what everybody thinks about the total addressable market is not a hundred and eighty thousand practices is the ten billion dollars that they spend annually in marketing.
Howard: You're saying you're saying dentists in the United States spend ten billion annually on marketing right about there yes Wow how did you get that number.
Alex: We get that number from ADA we get that number from many different sources but that's approximately what a dental practice well typical dental practice spending on what stage it is we'll spend between five to ten percent marketing for new patients they have major attrition issues that they're dealing with so that's our numbers recently that we looked into the total addressable number and it's about ten billion dollars in marketing for anything new patient cases or whatever it is that they're spending on the platforms and everything that is in the office.
Howard: You know when when you have a marketing campaign you know it's got to come back down to zero space and zero time get a common denominator what do you think them. They dentist can never tell me the average marketing cost to acquire a new patient and then they can never tell me the value of that patient you know or even let alone the lifetime value they said what do you think uh what do you think the average dentist is paying to acquire a new patient today and what do you think the average lifetime value of a patient is in a dental practice and how long do you think they stay.
Alex: What we're seeing is that the average new patients will cost approximately two hundred and fifty dollars for a single owner operator and we're seeing DSO spend between seven and eight hundred dollars to acquire new patient.
Howard: And do you think that's a good investment when a DSO spends seven to eight hundred dollars on a new patient.
Alex: The numbers are very different in the DSO world versus the regular world I believe yes I think that is sustainable for them because the numbers work really simple about a thousand dollars for a new patient the first year if you get them correctly and lifetime value of a patient is huge because I will say it's between what everybody says it's about thirty-five thousand dollars today so if you look at a dsothat is spending seven hundred bucks to acquire a big lifetime value like that it works numbers wise I'm not exactly sure if it's something that I would do because I really separate marketing into two different categories I look at external marketing and internal marketing completely different.
Howard: So do me get this right the average new patient American cost 250 dsos are probably spending 750 the average new patient is worth a thousand the first year and thirty-five thousand dollars over the lifetime value.
Alex: Yes now empty as Manjhi will say it's fifty thousand dollars and I’ve heard as low as 25 I'm somewhere in the middle work I think within a lifetime of a patient if you consider the referrals that you will get from them family members or even in just one case today it's not uncommon to get a $50,000 case to do up and lower all on four on a 55 year old male or female so they're spending the money for sure.
Howard: So I'm not to get sidetracked but you said um you've you internal marketing and external marketing separately my homies listen this show I mean they're 25% are still in school and the rest are young explain the difference between internal marketing and external marketing to him and why do you view it differently.
Alex: Well external marketing you have some logistics and demographics you go through and most of the people will go out for just new patience very rarely if you take the 8020 rule only 20% of the professionals will actually market for implant cases sleep cases Invisalign or anything else like that most of the new most of the practices are just looking for new patients they're very unpredictable statistically you will only keep 41% of your new patients that come through the door because of the way that you get them typically on a heavy discount or you're in network with insurance companies hoping that they will drive business to you when it comes to internal marketing where revenue well shines is we have approximately 60 million patients under management inside revenue well so with all the doctors that we have we're watching patterns what we figured out a long time ago is their artificial intelligence and the artificial intelligence is when you have digital charts whether it's clinical charts pareo charts and with that revenue well can read teeth numbers we can repair your pockets we can read dental codes so we can look at a chart and divide it into two categories that it is for instance in a chart you either have things that are existing and though crowns bridges implants or you have proposed services we recognize the services that are existing we leave the patient alone with that but when we market we can actually attract a certain type of patient for instance if I'm a dentist as wants to do more implants and I could go and run a campaign in my database to look for patients that have missing teeth or to look for patients that have been proposed or as I called prescribe to treatment for restoration by an implant that makes a world of a difference externally there nothing that you can stress out internally you can put a lot of stress on your database and this is why most of the other companies that are out there don't campaign a lot or the people that have them don't campaign a lot is because they've stressed out their database they now look like use car salespeople they only talk about certain things to everybody versus hey Demetri you need implant doctor said it's good for you here's some patient education video here's some information that only pertains to you so we've been lucky to be able to push out a campaign to the right patient with the right message at the right time to bring them back into the practice so when we look at our own database we take the patients and we separate them into two categories you either have an appointment or you don't and we're dental practices are really super awesome at is dealing with patients that have appointments and revenue well is extremely awesome in dealing with patients that do not.
Howard: Nice oh you said your own natural intelligence aslha is creating artificial intelligence that looks at 60 million patients how many dental offices is revenue well in these days.
Alex: So I don't want to say a particular number because we have a lot of partners and we have a lot of people watcher and I will say it's above 7,000.
Howard: So revenue well is installed in 7,000 dental offices so you are able to machine learn 60 million patients Oh correct.
Alex: So we we capture proposed treatments and we capture walk-out statements and a walkout statement I don't know what software using is a receipt of services that have been rendered with the codes and the procedures and so we see what it has been proposed what has been walked out what still needs to be completed.
Howard: Wow that is amazing um yes that date I mean they you can learn so much from looking at all that kind of data so on so what so let's slow down for the kids that are in dental school what are you what do you actually do what wood is reven L what is their marketing platform how much is it cost go go into the specifics of what dentists are paying for is it just is there one plan is there multiple plans is it one price for all dental offices or go through the this is dentistry and sensor go through the dirty details.
Alex: So the dirty details are very clean we have something that is called the revenue l core and the core is our system and the price for revenue L core is only 339 that's will include 339.
Howard: A month?
Alex: 339 a month without a contract no installation fees is included we do a lot of webinars we're holding our customers hands the only thing that we do not do is we don't coach and we don't consult.
Howard: Okay and and when they're signing up for 339 a month why are they doing that what what services are they mainly like if I go to McDonald’s it's a Big Mac fried a coke what are they buying at revenue what's your Big Mac for any coke.
Alex: Okay so we have three parts that we sell that is really driving all the business one of the buckets is the new patient acquisition bucket we are helping dentists with new patients and acquisition by setting them up on social media putting widgets onto their website providing an additional microsite that helps them get found online we have integration with Facebook and Twitter we have a great place on Google local page that describes your business where revenue well is seen now online we are seen as patients connect 365 revenue well is a name for our customers but patients never see it.
Alex: Patient facing is patient connect 365 so if you google a guy I like Raleigh Dental Arts this guy t-bonz hunag well you ever heard.
Howard: I love that guy why only two dental partners I ever had in dentistry I never I never did partnerships and and and our partnership was over a phone call with no contracts.
Howard: So love him your that's amazing man.
Alex: Raleigh Dental Arts is one of the most difficult offices to be successful in for a company like myself because the team is exceptional they have everything figured out and we still do a million dollars of business in the last three years with them and so when you google Raleigh Dental Arts of course t-bone spends quite a bit of money to stay on top because he wants to be in the on top in a very competitive market so on the right hand side on Google patient connect 365 and Facebook is there with reviews and everything about his business because of the microsite that we provided and because of the app that we put onto his Facebook that displays reviews including Google reviews.
Howard: He has 176 Google reviews averaging a 4.9 is is t-bone number one I mean how could you be better than that.
Alex: He is not number one he wants to believe his number one.
Howard: I don't believe it either.
Alex: You know but where he is good it's not about getting Google reviews is getting the right Google reviews and if you read his reviews people are writing articles and statements it's not like t-bones cool they're actually addressed and certain members and it's not about the most amount of reviews anymore as a matter of fact there's only a certain amount of reviews that people will read and people that are in the review business will continuously ask the same people on Google to give you reviews unfortunately on Google you can only have one per customer so if you have a great review here's a tip stop asking them for additional ones because it only goes downhill from there and that's why she's got a certain amount that he concentrates and those he gots recently because he started concentrating and course revenue well has a review platform that will help him drive customers to Google and directly to Google and basically you get what you get and don't get upset we don't gate anything anymore we used to be able to say hey if it's eight or above let's send them to Google we're just going straight to Google but if you also notice his website is high up as well because we have a testimonial tool that puts real Google reviews on there and if you also notice if you googled Raleigh Dental Arts on the right you have his Google Local page and towards you know towards the bottom of it it says patient connect 365 and if you click on patient Connect 365 there will be a micro site that he's got his videos on that we highly encourage people to use youtube in all of their communications and we can talk about that as well as highlight his staff because a lot of people know his staff know his team and may be looking for them and just great way to get an additional way to get found online most of the doctors are looking for one way to be found online in the top ten and see one has three to four to five and most of them are revenue well.
Howard: So does revenue well owned patient connect 365.
Howard: Okay so that's yours and that is that because why?.
Alex: Well because revenue well is not a great way to get in front of your patients so when we would ask him to leave a review on revenue Well and I was like that that would not be right we're patient connect just says exactly what it is is that you're connected with your patients 365 and that is a better way cleaner way to be in front of your patient facing them.
Howard: So why would why would a dentist want to instead of driving traffic to their dental office website have an another option right underneath the the dental office website with a patient he sixty patient connect 365.
Alex: So what we're trying to do is fill up the page with additional content.
Alex: That we have an ability to control and showcase what we want to showcase there so not every Google review not every review that we get is just what we want to showcase goes over there and all the content we control and it's very easy for Google to search that and make them up first then actual websites because we don't control what our customers do with their websites so as you know you can have a really beautiful website set up for twenty thirty thousand or not and so dentists typically don't spend that kind of money and their website is a brochure of their services versus a marketing machine and we prefer to be a marketing machine.
Howard: Okay so um that is really an amazing strategy I mean comprehended before so when I Google Rally Dental Arts versus t-bones website rallied in a large calm next it at Raleigh Dental Arts on patient connect 365 then it's his face book page then it's also reviews I mean the whole the he's controlled the whole first page of the search.
Alex: Right and you will not see a whole bunch of ads there as well typically there would be three or four ads of local dentists that may possibly have bigger practices and more money which is almost impossible but they can't compete because she owns that page at least the top three to five reviews or anything that you cannot and if you go into his website you can see the testimonials and right away we'll see google reviews that are living right there.
Howard: Wow that is on so I'm not to digress because we were on the arm you said there was on three things yeah that revenue well does but but back to his first page Yelp is on there what are your thoughts on Yelp.
Alex: Fantastic it works in some states better than others we loved them I have zero issues with them I do not concentrate on them we concentrate on stuff that we can control cannot control yelp.
Howard: But it's succinctly do you think a dentist should join Yelp and pay them money for a management fee or just stay out of it and let y'all be Yelp and stay out of it or do you think they should because it doesn't Yelp sell services to dental offices.
Alex: It does so my answer and that is again if you're in San Francisco yes if you're New York yes if you're in Miami absolutely not Yelp has zero influence here.
Howard: What about Phoenix I'm so I'm a selfish bastard I wanna know about my today's dental what would you so Phoenix.
Alex: I'm not very sure about that market but I will try it the only problem with Yelp is that no matter how much money you give them you cannot control it and if you have three or four patients that same day give you reviews on Yelp and they're not big Yelpers they will not show up and so I want consistency and I want to make sure that whatever I'm using in my office that I can consistently do to improve my visibility and control my visibility and so if Yelp is Yelp and they do whatever it is that they want to do that's fine they're not expensive if you have additional money for external marketing I would give it a try for sure so yes I would put all my eggs into that.
Howard: Okay so you got three parts part one new patient acquisition bucket what's part two and three.
Alex: Part two is patient retention and part three is treatment acceptance.
Howard: Wow okay that's a that's enough to talk for about forty days and forty nights so uh patient retention okay the the dark the the dark side of marketing in dentistry is that you always need a dentist who went to a town at ten thousand at age twenty-five he's practiced there from 25 to 65 you say hey buddy what do you mean he says I need new patients I'm like dude you've gone through everyone in the county three times to me it seems like the more new patients you get the less problems internally you have to fix and if you fixed everything internally you wouldn't need so many new patients almost like new patient can be a drug too not fix all their problems but what do you think the average patient retention rate is well.
Alex: We know exactly so if you look at a practice between zero to five years their retention is approximately 70% so they will see 70% of their active patient base and active patient base in my eyes are patients that have been in the practice within 18 months not patients that are marked active in the practice management software.
Alex: So I like to add a little algorithm to my numbers because I feel that not everybody does a good job with their practice management software.
Howard: And when you say algorithm you're trying to make a mathematical prediction from their past behavior trying to predict their future behavior.
Alex: Yes so what I'm saying is that she is very simple stuff when you look at a practice management software there are active patients that are inside that pack this management software they might have not been in for four or five years they might have not been in for three or in sonam's by me saying I’ll put an algorithm on it I’ll say I’ll consider active patients that have been in the practice for 18 months so I’ll put a little shape to it instead of just looking blindly at a number that says here's how many active patients are marked in the practice management system I will say patients that actually been to the practice and had something done in the last 18 months that I will consider active patients Dmitry what do you think on that.
Dimitri: Well I think being absolutely correct but again I think one of the things we talked about a little bit earlier is marketing and patient retention and all this Howard: You mentioned let's get new patients but then you look at your own database and you realize you have all this patients but at some point we're given a treatment plan but actually never reached out and never completed the treatment plan and I think that's what revenue all stops in.
Alex: So we're gonna talk about that in bucket number three Dmitry when it comes to treatment he says so if you have a practice that it's five years and above those numbers go down so if you ask a hundred dentist ninety percent of them will say that they're in the top ten percent if you are if you ask a hundred office managers they will tell you that 80% of their patients actually have a future appointment and is active and that is simply not true so when we look at active patients the more patients you have and the longer you have been in business the larger the problem actually becomes the more stuff you throw against the ceiling the more the less things thick so if you look at a patient retention if in the practice that's five years and above that is trying to grow is going to be in the 60 percentile versus seventy percent which is really tough because if you're a million-dollar practice your sun starting in the rear that's why you're chasing those new patients all the time to make up for it versus going into the into your database and figuring out how to get those reactivated versus getting new patients.
Howard: Why do you think most patients leave when you don't retain someone and they leave what do you think it is mostly.
Alex: A million different reasons first of all I will say it depends on how you got them if you are in office that is advertising $59 special exam x-rays and pro fee and the next time the person of the friend does calls and says hey we want to schedule you left without a future appointment the question will become how much and then we'll tell them two hundred and twenty dollars the patient will say I’ll wait that could be one of the reasons second reason means it could be that not everybody is really big on scheduling future appointments so right now what we're seeing is about 50% of the patients are being put on to schedules now there are practices that there are 80% 90% scheduled the problem with that is they have a high no-show rate so you've got to be really careful on how you schedule your future appointments but when it comes to reactivation it's a completely different animal all together when you look at hygiene in general there's two different types there's healthy mouth patients that are supposed to be in every six month and there are every six months and there are periodontal disease patients and I think that a lot of practices do not know how to deal with those periodontal disease patients and do not mark them correctly in the practice management software and do not explain the why why do these patients need to actually get onto the schedule though for future appointments they lose track of them that's one of the reasons and then you know we talk about Millennials right they have a phobia of commitment to begin with so because they have this big phobia they're not scheduling and you're doing a big job chasing them the retention is a very big problem in today's market especially for a DSO.
Howard: And what is the what do you think the average patient not coming back is because of a transient society that we have well versus before there were interstates and.
Alex: So we don't know how to deal with patients anymore we've tried everything in the whole entire world we're listening to way too many people there's way too many groups and we get confused there's two types of patients in your practice right either have an appointment or they don't take those patients with appointments they either have insurance or they don't we do not talk about the same things like we used to and so Chuck Lakeland wrote a book called making money is killing your business and he's a hundred percent correct that we don't do the same things that we used to do on our climb up with our practice so we don't always explain the why they need to come back why they need to be seen every 3-4 months versus six months for healthy mouth patients and because of that we're just scattered and we don't proactively reach out to those patients and we have major problems keeping them on the books.
Howard: Okay so part one was new patient part two was patient retention and part three is treatment plan acceptance rate what do you think of the average treatment plan acceptance rate is for the United States.
Alex: Well the United States I want to say I’ll given numbers that we haven't been side revenue well 50%.
Howard: Huh that that's um what I was lecturing down in Florida it was to a dental insurance corporation I mean I Association so I got a look at all their data they would they wouldn't let me publish it or have it they they really hide their cards on their own data but they were saying it was about a third but you think it's not but they're just dealing with insurance patients but you think the average dental office insurance and cashes is it's half if I tell two different people they'd see the filling one will do it yes and so 80% of the revenue well customers are a little bit higher end dentist they have technology cad/cam they have your CBCT's they're doing more services than the general dentists there's a lot of sleep apnea going on and everything else and so the Dmitri and I talk about this all the time that if you're a million-dollar practice you propose two million dollars to get there.
Howard: Say that again if you're a million-dollar practice it takes two million what.
Alex: You have proposed two million dollars altogether.
Alex: So and we talked about the cracks in every dental office and so instead of going after the patients that know you love you and you just haven't convinced them enough you weren't a good enough salesperson or you're chasing the DSO model to where you're this amazing dentist that refuses to speak to the patient and go take him through the full thing even including numbers right because when if you're a DSO so you're trying to achieve that dentists far away brand new dentist just keep them away from the patients never show them without a mask and will do all the work the front desk will go over the treatment will go over the numbers will schedule them will tell the dentists what to do in the world today a room Gargan unfamiliar I don't know if you know him and we she's one of my mentors Kevon is one of my mentors as well I have the indian mentors so you're better off proposed in your own treatment and going through your own stuff because if there's anything that needs to be changed at least you know where to go you're proposing somebody $35 thousand dollar treatment on the first day that they came to your practice they don't know anything about you you might have not set up everything correctly you said hey you have a laundry list of what's going on give it to Betty Betty has no idea how she's going to make her next month payments under two hundred ninety nine dollar car and meanwhile she's got asked for the patient to give you thirty five thousand dollars the patient says you know what I'm not really sure but I'd like to start on the right hand side Betty says no it's either all or nothing if you're the dentist you'll be more than happy to start on the right side and so you have no way of doing that so a whole bunch of treatment does not get accepted because it gets handed off to somebody that hasn't been trained and then it is up to revenue well in our case to go after it so we have two different modules to be able to go out after that business one of them is an actual treatment plan follow-up module where you can set up a cadence and you can say anything you want and that includes procedures and teeth numbers and codes and it includes patient education videos from Casey to be able to continue what's going on in the practice so I’ve never been to your practice but Kathy Breaudeaux says hello.
Howard: Oh Kathy oh I love her is she in South Dakota.
Alex: She is so she's a great friend of mine then we have very similar philosophy on how things work and so if a patient says no to treatment a dental office rarely would make a phone call and if they will it's only on top cases and when they make a phone call they have really nothing to show and when they have nothing to show to visual people how are you going to get your case done so I’ve never been to your practice but I'm sure you have a monitor in front of your patients right.
Alex: Where you might show a digital x-ray ensure all camera.
Howard: Kathy designed that for my office she's a very smart lady oh yeah she's she's a genius and she did that for me 20 years ago and but I want to interject one thing real quick because when he said presented 30 five thousand dream plans half my homies you just lost tonight what is he talking about he's in rich Miami I'm in porcelain in Kansas hey according to Kelly Blue Book value USA Today and Anthony Pratt at the Pope director of forecasting the average American will buy 13 new cars before they're 76 years old with the mean and median average price at 33, 560 so everyone and so then I go look at my homies and 95% of their practice or a whole career without even doing one of these $33,000 cases because they think nobody has the money but all their patients will buy 13 cars and then by age 74 20% of Americans don't even have a single tooth and it's that the dentists are thinking with their brakes on and they even are the first to tell you man I hate sales I hate presenting treatment I didn't go to school eight years to sell something is Alex: A Salesman.
Alex: Alex: Is a Salesman absolutely and Alex: Is a Salesman that has the most successful customers and Alex: Also knows that in order to be successful you have to ask for it and if you don't ask for it you will never get it and if you prequalify your customer that is the number one mistake you will ever make in the whole entire world because when I go out looking for a car I will first stop by at Walmart and I will buy myself Asst champion $22 sweatsuit and $7 sneakers and I will walk in and I will walk out with a $35,000 car maybe not a $35,000 car but I will walk out with the $300 payment and that $35,000 whole restoration that will change their lives is only six hundred bucks a month they just don't know how to present it they don't teach their staff who presented and they will never get attitude they don't ask but you have to make sure that you're able to deliver it you can't just come out of school and say I'm going to do full mouth reconstruction because that's going to be the worst case in the world for you because you need to know what not to do as much as you need to know what to do and over the years the beauty of what you know of our dental office there's no one to walk away from a case to walk away from a customer or a patient that just came in and says hey my mouth is messed up because my previous dentist made it this way and I'm gonna be suing that guy or that gal for doing that and all I want to do is ask if it's okay for me to get all the treatment presentations that were planned for them so yes you don't have to be the best dentist in the world you don't need $35,000 cases to be successful as a matter of fact all you need is five grands a day four days a week to have a million-dollar practice it's just that simple what revenue well will allow you to do is make sure that you are doing patient care as well and if you propose a treatment to a patient and you never follow up that means you don't care about them and that's the biggest problem that we always have and today if you go to court for some reason and you never followed up on your patients and you never made a phone call or you never send an email or you never educate to them and you never show that you're concerned that is going to be an issue as well so we help the dentist make sure that if you proposed an endo tooth number two and the patient doesn't do it and the treatment plan follow-up goes out by email that is a record showing it's a better record than making the phone call because 90% of the people that make phone calls do not go into the notes and mark down that hey I called Betty we spoke about this she told me no for now and I have time scheduled in the next two weeks to follow up with her that's rarely happens so revenue well helps them as well as custom campaigns custom campaigns are huge and so Dmitri give me an idea of what custom campaigns can do for a DSO versus the standard practice and talk about DSO for a second for us.
Dimitri: So of course DSOs are growing and there's a great study done by Morgan Steelman talks about the conversion rate so in last year almost 10% of dentist said they're actually looking to join DSO for various reason for ideas also used with high reimbursement they certainly they pay a lot higher to the starting to do to the students and what the young graduates are coming out but more importantly it gives you cadence for communications it's a great way to keep track oh so it's a great try to keep up our allies they actually see how many patients come in we get an email every sprays their ham make an appointment come in and we actually track the treatment plan cost so we can show what the ROI so it's extremely important number to.
Alex: What is the average ROI on a revenue well customer.
Dimitri: The the average ROI is 20x so we increase production between seventy eighty thousand dollars per year per practice which is pretty significant so we're talking 20x return which is.
Alex: How did you get that number?.
Dimitri: That while that number based what it cost - what it cost you to have Revenue Well on monthly basis versus the production increase and that's what we get to that number but I want that something else is a lot of times and when I was on the hardware side what the dentists do when they're buying it technologists spend hundred thousand dollars and the next question is hey how do i market that what I do with it so another great way is actually produce new treatment one options a new technology it's a great to reach out to the patient say come on in now have an orthodontist I'm doing end of the Amoy implantology and have technology to match that so this kind of connectivity between patients whether you a DSO whether your logical practice with a sole practitioner it's extremely effective way which gives you discipline and more importantly gives you a connectivity with a patient and it actually tracks your ROI now one of the things we've talked about a little bit earlier how much dollars dentists spend and attract any patients but if you actually ask them a question how many patients you attracted I think most of will really struggle to tell you that right and this is where we come in and we do it so well in extremely disciplined way allowing them to stay connected.
Alex: And oh.
Alex: Go ahead good what you've been doing over a thousand of these podcasts where dentists look back as an ROI when they're doing a marketing campaign externally.
Howard: Well it's tough to say as you know a dentist because there's two hundred eleven thousand Americans who have an active license today there's 150 thousand general dentists thirty thousand specialists that are working 32 hours a week or more and like say some of them are straight out of school you know they just graduated from dental kindergarten and summer season but the one thing I do know and it's very obvious and I hope you kids are listening is that I love you for the fact that you just want to learn how to do surgery all day long better faster easier root canals fillings crowns I get all that and that's why I love you but do you notice when when you say to Marco Luque check you know what does the average dentist collect each year he'll say 788 but if you ask a dental consultant they'll say a million - you already said the average revenue well person you know has bigger numbers higher cells and net income and if I was telling you you're talking about technology I mean the best return on investment is business go back get your MBA get a dental consultant but they always want to buy a gosh-darn CBCT a CAD cam a laser I mean if you go to a dental convention when they're looking at lasers they actually start drooling on the laser and they get saliva all over it and then then I’ll say that person hey what was your last year you know how many how many new patient calls did you get in the first quarter this year versus last year I don't know how many people have to call your office before one converts I don't know how many of you Atlanta and they don't know any of their numbers so I don't have to motivate anyone to want to go see Gordon Christian my god they think he's Yoda they go drive all the way to Provo I’ve been up there 12 times I mean you know you don't to motivate a dentist to watch a 40 hour seminar on bonding ages but you really got a it's tough to get him to go from being doctor never hate selling to transformer into dr. ABC always be closing I mean it's a totally different mindset in the mindsets of the people that went into dentistry and medicine and they didn't have that mindset that the kids did the way in the business school I agree with you.
Alex: They also don't hire for that and then when you're taking your average person in dentistry that's really all they care about is their own personal time hey I'm gonna go work for somebody that has open business hours now retail hours business hours Monday through Thursday where I get three days off and then all of a sudden they're trying to incentivize me to sell more stuff and so this is why revenue well does so awesome is because we can have the office manager launch a campaign see here's the major problem most of the companies that are out there you can send one campaign a month otherwise you'll look like that the used car sales person but because we're going after centers and codes and certain procedures we can do 20 a day without reaching the same person twice that means that I could go out to sleep apnea patients by using the sleep apnea code I could say anybody who would be sixty ten for implants so the system will make things easier for the dentist and will actually go after only what you need many people are telling me our hygiene are soft and we look into their practice management software we run a report on how many root planing and scaling they have completed and we run a report on how many of those patients are on Perea maintenance and there's a major discrepancy there all should be on Perea maintenance so inside revenue well you can say anybody that went through 4341 the route planning and scaling but it's not on pair your maintenance let's teach them and so we have a very strong youtube integration with every campaign you can record a little video explaining to why hey we're reaching out to you because we're concerned that you haven't schedule your next appointment we're concerned you didn't come in for a follow-up we're doing things like post up instructions to where when somebody walks out a an extraction we do a post up instruction for the extraction but next week we're asking hey you should we probably spoke to you about implants and you should have an appointment but if you don't it's important you make one and this is why and so we've given them all kinds of different teleprompting programs to use to record beautiful videos so their patients can under and they're building the youtube channels out better and it's a money-making machine to machine Howard: 'S we're used to ten bucks into revenue well you'll get 200 bucks back so it's one of those things too we have happy customers more than 99% of the customers stay with us without a contract.
Howard: Wow and that's another red flag I mean um you know yeah yeah in dental school you meet the love of your life and you want to start living together and all that stuff but then then out of nowhere comes I need a contract I need an absolute signed contract and if you break this it'll be a billion dollars I mean I mean you got to have a prenuptial agreement and when you hire these dental consultants and they say well here's a contract you you have to keep me for at least a year it's like well your patient does that to keep you for a year your staff can walk out on the job if they don't like you I mean it's just such a red flag to me when they when companies want a contract and talk about that.
Alex: Here so we have over 300 affiliates fortune management is one of our affiliates for instance and we have a lot of single coaches and consultants when you look at external marketing and when you look at a coach or a consultant you have to give it enough time Moscow was not built in a day this is our very funny Russian joke right but the fact that the matter is you have to address many different things in your practice and it's all about your capacity to be able to scale and so if you hire somebody that has a great plan for you and there's going to be training you have to start with the team you got to get the team on board otherwise things don't happen so I am a fan of signing those one-year contracts with an opt-out option to where if they totally don't produce but I have zero issues with that where I have a problem is a company like ourselves coming and saying hey you sign a contract with us although we have more and more customers that are actually asking us to sign a contract with them because they want us to secure our pricing they want to make sure that we don't modify some of the things because besides revenue well-core were also have a great partnership with Jive so we have tremendous voice-over-ip product with telephones we also have we also have patient Connect 365 TV so while we help you control what's inside your waiting room you know because we used to walk into practices and I travel 200 days a year I’ve been into over a thousand practices Co traveling with reps whether it's Patterson and you see whatever our partners are and you see the news on and it's grim so they switch to common garden and now you're instead of fighting the news you're fighting the kitchen upgrade which is the same amount of money as your teeth or your fighting you know Mario Batali on food and garden you want to travel to Tuscany to drink wine over there so revenue well has a great program for it's called patient connect TV for the inside office we have messenger which allows you to do a two-way communication even if a patient is not in your practice management software so where if you're marketing your patients could already do double two-way texting with you we have these tools that we're trying to help our customers be as successful as they want and we do have a small percentage of customers that use some basic functions of ours just because they're super high-end you know.
Dimitri: I just want I just want to add something you know we just did a quick study with revenue Well our customers we take a look at 4,000 offices and as soon as those offices implemented revenue well guess what they got on the average seventy six more equivalents for a month with revenue well I said this correctly.
Howard: 76 existing customers.
Howard: So the average company that signs up with revenue well see seventy six more existing patients per month.
Dimitri: No sees more appointments per month could you would exist in patient base on any average they see increasing appointments made by seventy six on the average and as this is a study done by us so we'll look don't work there's there's a there's a great video I’ll share with you it's called the ROI of revenue well some of the takeaways is that 76 more appointments for a month we're seeing on the average by these practices could utilize revenue.
Howard: All okay so they go to your website revenuewell.com is that I see resources is that on your website under articles ebooks infographics miscellaneous webinars any of that right.
Dimitri: That's correct.
Alex: We include that so we run a webinar series called practice perfect where we take some of the biggest names you know and you've interviewed a whole bunch of them and we paint put these top coaches and consultants for tips and tricks and see what to do we also have a webinar series that I'm doing that is called par patient analysis reports where we're looking at different parts of your analysis in the practice showing you how to better engage your patients and we also are doing a whole bunch of new customer webinars we're trying to help our community just do more with their existing patients and separate themselves from everybody else that is in the market.
Howard: Wow okay um so you I want to say something though I'm you mentioned I I mean you have so much data I'm well it looks which completely away from the dentist provider and go over to the third of a billion Americans what would do they want because the reason mass cuz they come out of school they've barely learned how to do a few fillings and crowns and root canals and they don't know should I learned to place implants first like t-bone should I learn how to do Invisalign should I learn to sleep apneas should I get a CAD cam how would you pray on your understanding of the American market what do you think has the highest ROI CAD cam lasers what what where where would you start for the young kid.
Alex: Alright so I have to tell you that in our practice we we started doing CAD cam in 2003 and the reason why we did it is we have a high-end patient base and a low-end patient base and with the promise of being able to do dentistry in a single visit for two or three that helped us as a case acceptance tool there's less of a learning curve today I think that is a great marketing tool that if you have two thousand patients that are active and you just got a new tool it's helping you do quite a bit of patient reactivation with it just by being able to go and say hey we got this amazing new piece of technology that is helping us to do single visit dentistry we know you're super busy we also know you have three crowns that need to be done that could be done all in one visit please schedule your appointment today that's one thing we know that services initially as a patient people want to go to the same place they don't want to be shuffled around to go to specialists unless they have to and so if I was a new dentist and the new dentist within five years I would absolutely try to start every year to learn something new that's how you grow a practice and so implants according to noble byuk there's 42 million teeth get extracted every year only two and a half million gets restored.
Howard: Is that for the United States or the world?.
Alex: It is in the United States..
Howard: 42 million teeth get extracted each year in the United States.
Alex: Yup and only two and a half gets restored t-bone says - so here's the major window of opportunity take a look in what you have in your practice management system and go after that I have people with holes in their head I'm gonna go and learn how to place implants and what I will learn when I do learn to place implants is exactly what not to do maybe I’ll start with some you know posterior maybe I’ll start with some interior or some basic things but I will have healthier patients throughout the time and so if you're a dentist that is doing dentures you can run a campaign that we deliver dentures this year but we just started fixing them two implants very profitable and instead of here's the whole thing Howard: It takes an hour to do an mo GBL composite from the time you start and inside the patient you'll get 200 bucks takes an hour to do and then lay on lay on the crown you'll get 1,200 bucks takes an hour to put in four implants and you get six thousand bucks so just figure it out right it takes an hour to prep somebody to do a clear aligner ortho case which may or may not be profitable but that's where you got a look at what do I want to do and what do I have can I say the word balls to do.
Howard: Can you say it?.
Alex: There's a lot of that this yes these females females today have a lot more balls and do things much faster better more gently than any man that I see and these female dentists are learning things faster and I see them consistently so implant seminar I see all those people that go through there and when you talk to them they say it's the best thing that they've ever done in their whole entire life but yes you have to invest into learning how to do it you know and how to diagnose it you need a restorative kids you need a surgical kit you and not what the salespeople tell you a hundred percent more than what you think this is going to take in the beginning you need to be able to shut down your office and go somewhere to learn about these things so everybody immediately I would go for ortho I would go for implants I would go for that right away and make a plan a five-year plan which a lot of dentists don't have business plans as it is.
Howard: You know what the end you've heard of them affordable dental affordable dental care services out of New York who has power I mean how many locations you think they have well over a hundred you know they know you know what their core marketing was to from the beginning to this day when they go into a market they just do this simple advertising of a $99 extraction because who do you know that needs a tooth extracted that doesn't have a train wreck of a mouth eating pareo and cavities and root thousand crowns and implants and they're like God we would we would pull a tooth for free to meet that patient as opposed I said you got me as a new patient you know how I am at a cavity in thirty years.
Alex: But then you have 80% of the dentists to be woken rude oh well I don't want to lose money when the first time when a patient comes because I have to do this and it cost me thirty dollars to set up a room they just don't know and I agree with you 100% that's the clear path get them into the door the problem is they don't understand what it takes to market and the first thing of marketing is making sure that the person that answers the phone can convert.
Howard: Right right.
Alex: Bring them in.
Howard: It's just a whole new culture so how would you how would you train never doctor never do it to start and turn into dr. ABC always be closing.
Alex: Or ABS always be selling so there's a building there's a building in San Francisco it's 450 Center a place right 100 dentist separate none.
Howard: A 168 dental offices and seven labs I’ve been there so many times.
Alex: So I walk that with a good friend of mine that is a rep from Patterson dental and I go up and down and here's what you get on the 21st floor and on the 23rd floor everything goes on that's one two second floor the guy upstairs and downstairs is a stupid moron doesn't know how to do business and shouldn't be here at all the 21st floor they do three million dollars the 23rd they do two and a half and the guy that says everybody's stupid can hardly break 700,000 in the same building it's mindset mindset mindset so yes if you're dr. Apple and Rosenthal in New York or your doctor ABC in Kansas you still have to sell if not cases sell yourself you know who the best salespeople in the world are Howard: Who cardiologist.
Howard: Yes you don't know you're gonna die.
Alex: Yeah well that's what they make you believe and they'll also tell you that hey there's a 40% chance you will survive you never say anything to them but when your dentist says you need a freaking you know a cavity filled then it's gonna be a hundred and twenty dollar copay somebody will turn around and say well I’ll think about it because we propose services because we're preventative on teeth that do not hurt they're not they're not swollen they're not bleeding and they're not infected yet and that's what we're trying to stop we need to learn to sell and the office the team needs to be able to say that dr. Howard Farran is the best doctor in the whole entire world you're with him he's got you exactly where you need to be the only thing you have to do is say yes to everything that he proposes to you because he's got your best interest in mind and that's the bottom line when your office team members can say that about you everything else becomes easier.
Howard: Okay well I want it this is dentistry unsensored so I like to ask the tough questions and we are I can't believe we're well over the hours so we've got to wrap this up quick because they're that sir commute to work that's the always house but everybody in Wall Street you mentioned Morgan Stanley they whatever they analyze the company they always want to analyze their competitors so who's the competitor in your space I'm assuming it's a lighthouse 360 legwork practice mojo solution reach which is formally smile reminder what would you say to a kid listening the same well what's different than you and all the others what is your selling proposition.
Alex: Our unique selling proposition is we know digital charts we know your patients we know how to deal with the patient's that say no we can get your cases we can get your patients to come in for crown and bridge work instead of just showing up and not knowing what they're there for and what they're going to do we are offering a full service without a contract and like I said 99% of the people stay with us and the reason is is they're profitable so it's not let's confirm appointments anymore which we do it's about being able to welcome a new patient into the practice what we found out is we have the digital forms if a new patient fills out the digital forms 99% chance they're going to come into the practice we reduce no-shows we help the practice do what they do best see the patients with appointment and we continuously keep on driving the patients back we can separate the healthy mouth patients from the diseased patients and I think that anybody that ever starts with us and leaves well 80% of them come back so I don't want to say anything negative about anybody else but if you're gonna spend the money spend it on something that is going to make you money save your time make you efficient make you productive raise your hourly wages by using revenue well put the right patients into the seats and you will be happy everybody else is just playing the me to game we refuse to do that.
Dimitri: And I just want to add that we have absolute phenomenal customer success team which writes unbelievable support and that's also extremely critical when you want to serve as your customer base is have extremely strong customer service.
Howard: And last question you guys are both Russia did you did you meet in Russia or was it a Russian community or.
Alex: Oh yeah Howard I know every single Russian there's no question about that by the way the you know Mike Jones in Arizona.
Alex: The other one the other one so here's what we do we hire the best people that we can for our customers and for our patients some of them happen to be Russian I mean it was a big score to be able to take Dmitri from plan Mecca and put him to work for a serious company.
Howard: That is amazing I love Russia unless you're in St. Petersburg and that was the time of my life but my god they were they were first in space first woman in space first dog in space landed a first droid in space man they just have an intense scientific education and their their community but hey I wish I you guys would I mean if I Google revenue well which I just did on dental town I mean it's literally I mean my gosh how many pages I mean it's a it's it's five pages of threads asking about revenue well I wish it'd really be an honor of you guys huh went in there as the founder and CEOsand and answered some of their questions I think it'd be amazing I will absolutely do that and I'm with Demetri in charge it's going to be a lot of fun matter of fact Howard: You know I won some of the competitions I’ve been through seven or eight County meetings and you might remember me dressed up as a chef at the Bellagio and with Patterson dental we love it and we're definitely looking to come back and I I'm a big fan we have a lot of Sandy Pardeaux by the way says hello then we have a lot of big fans internally we listen to yourself all the time.
Howard: Well I am I have a picture of you in your contact that I saved at County meeting with this big belt on and everything you should make that your avatar picture it is so dang cute but hey seriously man I want to thank you guys for all that you do for dentistry the only reason that shows the success is cuz really smart creative geniuses like you come in and share their knowledge I want to thank you so much to both of you for coming on the show today.
Alex: Thank you Howard: .
Alex: Alright we get another chance with you get down to the Nitty Gritty stuff yeah you know what you gotta do you ought to make an online CE course on dental town I mean god we put up 401 our courses they've been viewed a million times and where you're talking about you know marketing patient retention treatment plan acceptance rate you know just real nuts and bolts because like say this is a May 6 and about another couple of weeks another 6,000 dentists are gonna graduate they don't they don't even know the vocabulary they don't even know the language and they got a master this stuff and don't but uh thank you so much for coming on the show today.
Alex: Thank you.