Born in Maryland, Chris became fascinated by dentistry at an early age when he lost #8 in a family touch football game. After graduating from dental school, purchasing his own practice, and subsequently selling that practice and most of his belongings, Chris followed a calling to serve as a dental missionary in Cameroon, Africa for 5 years. It was on this mission where Chris learned the true value of providing legendary patient care, and the necessity to provide that care very well, and very fast. Chris often had patients lined up around the block for treatment, and if he could not serve them that day, they would have to walk miles back home, and return again the next day in hopes of being served. This approach of very well, very fast patient centered dental practice has proven to be a great differentiator for the company.
VIDEO - DUwHF #1198 - Chris Neibauer
AUDIO - DUwHF #1198 - Chris Neibauer
Years after returning from Africa, Chris founded Neibauer Dental Care. Growing from 1 to 26 scratch practices from 2005 to 2011. The offices were located in Virginia and Maryland – and grew exponentially during the recession of 2007. In 2011 Chris sold these practices and eventually moved to live in Park City, UT where the winters are full of powder skiing and the summers are humidity free. Now he is on a mission in Utah to grow a dental corporation focused on delivering legendary patient care. The new corporation is Abundant Dental Care, and is 50 employees strong & growing.
Transcript:
It's just a huge honor for me today to be podcast interviewing Dr. Chris Neibauer, DDS, FAGD, who was born in Maryland. Chris became fascinated by dentistry at an early age when he lost #8 and a family touch football game. After graduating from dental school, purchasing his own practice, and subsequently selling that practice and most of his belongings, Chris followed a calling to serve as a dental missionary in Cameroon, Africa, for five years. It was on this mission where Chris learned the true value of providing legendary patient care and the necessity to provide that care very well and very fast. Chris often had Patients lined up around the block for treatment, and if he could not serve them that day, they would have to walk miles back home and return the next day in hopes of being served.
This approach to very well, very fast patient-centered dental care practice has proven to be a great differentiator for his company. Years after returning from Africa, Chris founded Neibauer Dental Care, growing from 1 to 26 scratch practices from 2005 to 2011 with $60 million dollars in revenue. The offices were in Virginia and Maryland, and grew exponentially during the recession of 2007. In 2011, Chris sold these practices and eventually moved. to Park City Utah where the winners are full of powder or skiing and the summers are humidity-free now he is a professional dental practitioner to which he says this is amazing the customer service is smooth, any kind of formal Lay-on routine is?? does it
the legendary patient care. Chris it is just an honor to have you on this show how are you doing today? I'm doing well thank you Howard how are you? I'm doing great man it's a beautiful Monday morning in Phoenix you're about what is it Phoenix to Salt Lake what is that a 12-hour straight north drive? I believe yeah. I think the most beautiful drive in the world is from Arizona around the Grand Canyon to Salt Lake and all the way up to Canada, I mean it's a thousand miles of just unbelievable nature. Well, I've never done that have you? Oh yes, and down here in Phoenix it's about 10% Canadian so a lot of the snowbirds when they come down from Canada they make that drive and they always, every year, they drive it, they make the drive longer and longer and longer instead of trying to hurry up and get home they just really enjoy that drive.
Reading your bio it's almost like science fiction to grow from 2005-2009, it's like a 2011 six years growing 26 scratch practices, how does one even do that? Well, you know, I'll tell you a little bit of my story so you understand it. I practiced as a missionary dentist for those five years and then I came back in 1987 and I still practice as a missionary business guy which means you don't have any money, Mrs. Jones; your husband's laid off, don't worry about it, get paid me five dollars a month. So all of a sudden I'm doing a little bit of a business guy business guy business guy, and all of a sudden it's 1995, I can't pay myself because of my poor financial arrangements and no business acumen.
So, the next ten years, I went on a tear of continuing education study underneath every dental management guru I can find, charged up the credit cards; and from that ten years of intensive study, the foundation we just went from one office to another office, and what keyed it off was being a missionary. Where I ran four chairs with one assistant and learned how to do dentistry very well, very fast. Flash forward 2004, Waldorf, Maryland I'm in one office, and we did $4.3 million and 15,000 square feet. So being a missionary set that up, so once I set that up, then the dentist wanted to know how I did it; and all of a sudden, we had plenty of dentists to interview, and the rest of us is history.
And then what was your exit strategy in 2012? 2011 who do you sell 26 offices to? Well I never really had an exit strategy I never thought I would sell but Heartland approached me about a year and a half before then about 2010 I said not yet and then they made me an offer that I couldn't refuse in 2011. And now you're you retired back to Utah were you born in Utah or how did you get from Maryland to Utah? By the way I don't believe in Utah. I don't believe in retirement, I mean, retirement but anyhow, you know, I went to Park City because this is where I want to live in this country. I live at 7,000 feet; it got moose, bobcats, and deer in my front yard.
I don't have to put flea dip on the dogs; there are no termites; low humidity summers; beautiful skiing. I came here because this is where I want to live. So you know, for six seven years, I did some investments. There's some real estate and all that kind of stuff, but I figured out my great love is helping young dental professionals master their skills faster, but it took me 20-25 years. My mission is to help them to get in five to seven years. Well, we had a dental student who just graduated last week on the show last week, Brian Jankowski, and he's on his way from Mesa, Arizona, to Utah to join your team. Yeah, that kid, I believe, is gonna be a superstar really quick.
You know, dentists usually don't have superstar mentality in my opinion, studying their traits and their cultures. But there are some born naturals, and I believe he's gonna be a rainmaker serving patients really well quickly. Yeah, I agree so you sold that to Heartland and now you're starting the abundant dental care. How old is your abundant dental care now? I mean, I know you're already up to 50 employees. How far along are you now? We're about three and a half years old. Three employees, the three employees, three years in a little bit more started from scratch, scratch the first time and now by dental care are still practicing. Get out of the chair in 2005 when I grew and worked on the business instead of being practicing this time it was totally scratch.
I knew nobody in Utah, I just loved to go somewhere where it's the most difficult place to get something going and show that it can be done, and so it's taken a while to get going but we're hitting about. We did five and a half last year; we're starting to what I call is hit our inflection point where we're going to start taking off. I'm already looking at some major acquisitions; we're negotiating right now, and you're going to see Neibauer on the horizon again in dental corporations the next five, five, seven years. I'm the kind of guy who does his own thing and nobody knows about. So will you are you planning on the same extra strategy with Pat Bauer and Rick Workman a part of Heartland when when after abundant dental care is created?
I'm not thinking of anything like that I'm thinking of billion dollars baby. A billion dollars? A billion dollar corporation next 15 20 years. And so to be a billion dollar corporation how many how many offices and dentists what does that look like to you? 200 offices 200 offices of 2 million apiece with 20% profit that throws off 80 million dollars in revenue. If you get 12 and a half all of a sudden you got a billion dollar valuation okay so two times two times 20% you got 80 million thrown off you get 12 and a half EBITDA you got a billion dollar corporation so that that's the who knows what's going to be 200 or 400 but that just gives you an idea how it could be done.
Okay say that say that again so 200 offices doing 2 million per year doing 20% profit Throws off 80 million dollars. Yeah. 20% profit or EBITDA earnings before interest taxes depreciation amortization at that level you get a multiple probably like 12 and a half and also you got you got the big B. Warren Buffett doesn't like the word EBITDA what what do you think of Warren Buffett's quotes on EBITDA? You know Warren Buffett is far smarter than I am because he's worth 67 billion so maybe I need to study some more what Warren Buffett thinks. I doubt it. EBITDA is just a quick calculation that you know to find out what the enterprise could be worth.
Warren Buffett is well known for disliking EBITDA E-B-I-T-D-A earnings before interest taxes depreciation amortization multiples to value of business financial formula he is um let me see if I can uh why does Warren Buffett dislike EBITDA? EBITDA stands for earning earnings before interest taxes depreciation amortization is one of many indicators. EBITDA is one of many indicators of a company's financial performance; however, it excludes depreciation amortization on the basis they are not cash items. Depreciation and amortization are also a measure what the country is spending or needs. So, so you know, I guess uh Warren Buffett says: 'It amazes me how widespread the use of EBITDA has become. People try to dress up financial statements with it.
We won't buy into companies where somebody's talking about EBITDA if you look at all companies and split them into companies that use EBITDA as a metric, and those that don't; I suspect you'll find a lot more fraud in the former group.' At companies like Walmart, GE, and Microsoft, they never use EBITDA on their annual report. But the reason I'm focusing on EBITDA is the fact that it's an interesting phenomenon where if you sell one office to a DSO, you might get a multiple of four, but you sell a hundred offices, you might get a multiple of like 12. Why so? It's just more proof of concept. Um. One office might have some variables that might not be scalable, but by the time you got 10 or 20 or 200, it looks like it's very the business model is correct?
Yes and usually when you buy one or two offices it's somewhere between 0.6 to 0.8 of their annual previous annual revenue, so that's the guy you don't get into multiples until you get multiple offices, usually. Okay, so what what will your business model be? You know everybody wants to be unique, everybody wants to have a unique selling proposition. What will be unique about Abundant Dental Care's business model? I thought you would never ask. We're going to do a lot of BS to get to the main thing, Howard, where do we go? Okay, so change as far as the business side and then we're going to go what I call the spiritual side, and don't get worried about spiritual; it doesn't mean dog, but only means serving others, don't go get worried about it only means serving others better.
So let's go to the usual thing open seven days a week how soon can you get here? We take your insurance we say yes see the the patient those kind of things sense of urgency we'll get you in we'll get you in now over expanded hours of work, open up seven days a week. We don't wait because teeth do not have a schedule and so I believe the corporation that does that will always have a differentiator in the marketplace doing what the customer wants instead of what the doctor wants or the doctor's want your schedule – however people want to serve others, but that's what I learned as being a missionary. When you're a missionary, I was making far less than when I was a regular dentist, but I was there for service to others.
So as it gives you a mission. It gives you intensity and a focus to serve all the human being and just that patients understand that and feel that and so that's the great differentiator marketplace along with Part B. That was Part A. Part B is dental students are coming out of dental school, five hundred thousand dollars in debt, three or four hundred thousand dollars in debt. They've done two or three root canals, they've done a few crowns; they really haven't society has failed them in education. What a patient wants when you when they sit in the chair, they want some doctors to do a thousand root canals. That's what they want. So we have what I call about elevating dental professionals to mastery.
We have a system in our corporation where the dental student comes out and says you're a class one dentist, you can do single canals, you can do a few crowns, you can do some fillings, and then we'll require them to get a continue education. The classic way to do it is just get your F.A.G.D., M.A.G.D. Get your five hundred thousand hours in, and we have hands-on training with our dentists, just like I did many dentists at Knife-Eye Dental Care. And obviously from those numbers it worked. From Knife-Eye Dental Care it worked, and so we're having young professionals like Brian that you mentioned who want to learn very fast get to become actual masters. L.D. Pankey says that only two percent of dentists become master dentists.
So our game is to take dental students who really weren't taught very well according to what a public would want, a patient would want, and get them to mastery, get them to the level they can take out 90 percent of teeth. They can do 80 percent of root canal molar root canals. They can do root canal core crown in an hour and a half on a molar. They can prep 14 teeth and get an impression and make it temporary in two, two, and a half hours. The kind of things that are done very well and very fast that they are not held accountable. So the doctors that hire with us, they buy into; they love feedback; they love accountability because we cannot see ourselves as other people see us, and when other people give us spontaneous feedback then we know that we're on the pathway to serving others better as a master dentist.
So much, so much of what you say is so confirmable. I mean, when you look at dental associate dentists associate turnover, it's a plague. I mean not just for DSOs but for private practice. And a lot of these DSOs, their average associate dentist only stays a year. But the ones that stay the longest are actually at Heartland, which is two years, and that's what the dentists say that they stay there so long because they were taking advantage of all the continued education and learning how to place implants or Invisalign, whatever their dreams are there, they're learning that, so they're. And that's what every young dentist who we just had you know, dental school, all the dental schools just graduated last week, and when they're coming out, they keep looking myopically at associations, just based On how much money they're gonna make or what percent they're gonna make, when they really should be looking at what are they gonna learn in that time period that they're that they're employed.
What they should really be looking at and I agree 100% is let's get back to the old missionaries of February. Forever let's get back to serving another human being our mother brother and father and sister every human being that sits in our chair let's get into service of patients and just not my I want I want four day work week I want this much vacation I you got to give me this much to eat you know when you have when your purpose and of course Buddha says your purpose is to find your purpose and so you're really understanding that I'm really not a I'm really a missionary heart still. You know this is a mission for me to help young dentists to get it faster to serve more patients better.
So where does that come from in your life journey where does this sense of purpose and treating your fellow man and going to Africa for five years where does that come from? Well it started from originally it started from I was raised a strict Seventh-day Adventist and so the mission trip was serving a Seventh-day Adventist Church. I have, in my opinion, far since left that behind and got out of got out of the religious dogma and sin and guilt and all those kinds of things, and understand a new and like an eclectic philosophy, and of course when I call that and I have these words trademarked, unconditional responsibility, and Carol Dweck, Stanford psychologist, says that the number one success principle of all successful people is they take full responsibility.
So the term unconditional no effects affects my responsibility. So you've been around the block, I've heard you through decades, I love what you your service to Dentaltown, and helping dentists get better. We all have various callings to do things in different ways and so obviously you've been on the mission by what you do. You call it spiritual whatever but how are you been on the mission? I'm on a mission on a different level. Or a different way doesn't matter as long as we're helping dentists to serve better and we can exponentiate our influence on serving our patients better. So unconditional responsibility you know you've been around the block with dentists too many patients too many dentists they're not insurance is bad blah blah blah blah blah.
Well unconditional responsibility says whatever I have in my life I have a truck. Well, those are profound thoughts. I want to go right into it. I want to make one comment first before we go into that. Your dentists are contracted to a minimum of 70 plus hours of continuing education, this far exceeds the industry requirement of 30 hours every two years and you guys do it all in the name of providing world-class care for your patients. I have always told these kids on the show that in the 32 years I've observed, I've been serving this profession, the dentists who did a hundred hours a year and got their F.A.G.D. in five years and kept doing another hundred hours a year and got their M.A.G.D. for six years; they're all successful by almost any way you measure success.
They're happy, they have purpose, they do quality work, they like dentistry. I just there's something about a human picking up advice and knowledge from their colleagues at the rate of you say seventy, the A.G.D. says, you know it's just that; that is so profound, I mean that just, just do it if you're not taking seventy to a hundred hours of C.E. a year, you're still many. But I want to go back to what you were saying about a Buddha says your purpose is to find your purpose. I've also noticed your you said you're open seven days a week, there's only three publicly traded dental offices on earth today, two are in Australia, one's in Singapore and they all have the same business model where they're open seven to seven.
7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. 7 days a week. Now I believe you're open 7 a.m. to 7 p.m. Monday through Thursday, 8 to 2 on Saturday, what what are your hours on Sunday? Okay, 7 to 7 Monday through Friday and 8 to 2 but we're getting ready to expand it now we're getting more dentists on board so right now it's 8 to 2 on Saturday, Sunday's 12 to 4. So right now on wait on Saturday it's what? 8 to 2. And then Sunday is what, 12 to 4?
What I don't understand is that every dentist listening to you right now has a loved one or themselves or their family that had to go to the hospital emergency room in the middle of the night from having a baby to having a heart attack. Why do you think dentists have never been aware that there's 8 billion humans on the surface and a lot of them are having discomfort? I mean, eight and a half percent of emergency room visits are odontogenic in origin, and they don't even want to acknowledge it. They love living in the box of work-life balance instead of the true the truth which I believe is work-life integration. Work-life integration. So work-life balance is I became a dentist so I can work four days a week and the patient I can avoid the phone calls and they can stay in and paint or whatever go to the emergency room till Monday.
Work-life integration. How it does you. You can do it. So for years when I made my big turn around at 45 years old when I couldn't pay myself till 55 when I started that dental corporation I always answered the phone 24 7 and if I got a phone call at 7 p.m. Saturday night I put the wife the two kids the wife swiped the credit card the kids set off the trays and I took care of the emergency. We worked together as a family, and do you think that was better modeling the behavior for the young children. By the way. my son he'd probably be embarrassed if I told this but he
made a million dollars in his single horse dental practice himself on his w-2 form last year and he's got his MAGD it's just too simple Howard just to think differently and outside the box is that this is my box I don't answer the phone I'm here to serve I'm here to serve every nation kindred and strong and every human being if there's one thing the five years of missionary life taught me is service comes first and everything else comes your way in fact there's a great book out there that I just love I don't know if you ever heard of it it actually changed my life more than any other book besides the bible and it's called a course in miracles a course in miracles I would love for you to grab that book and read if you've never heard of it and who wrote this book uh it was visions to uh I believe some uh big university psychologist you'll have to read it uh it's really quite interesting
story it took me a year to read it first time I didn't understand it it took me four years through to uh probably I'll start understanding and I study every day but what's really interesting about this book and it's not dogma it's Not any uh woo, it's just, it actually teaches you to have no fear in your life. You see, unconditional responsibility teaches you if you have an accident, you attracted that accident. In fact, this is really hard for people to believe, but once you understand it, you can be sick-free. Your mind is all powerful. You are a piece of God. Greater things than these you do. And if you have that belief, you don't have to get sick. You don't have to get in accidents.
You don't have to attract those; you track those by your fear. In fact, that good book written 2,000 years ago says, 'Lo the very thing I feared came upon me.' Quite enlightening, indeed. and so when you live that life so free you attract really great things remember unconditional responsibility says whatever you have in your life you attract by the person you become because and if you don't like what's in your checkbook balance if you don't like the relationship if you don't like the car you drive you change and this is just a result you know basically uh me reading two thousand books over the last twenty years and I'm not going to say twenty years or plus and picking the nuggets that work for me and applying picking the nuggets you know you go to you go to a dental CE you sit there all day long they could have gave you the the nuggets in the half an hour be a nugget uh grabber Howard that's what I teach young folks be a nugget things that work for you and apply them to the workplace in your life so it's a course in miracles by um
it's been seven days a week and when everybody said Manhattan didn't need another endodontist guess who has the largest entity on in practice in Manhattan belly musicket I mean just a complete genius role model of mine so so how do so how do you get these how do you get these kids to come out and say I'm not working on my religious observes day and and then and then set up a a business model where they They have to go to the emergency room because there's 168 hours in a week and the dentists in Phoenix are only open Monday through Thursday. Well, the beauty of it is you got to find people with that are willing to serve others. Is is a religion more important than serving humanity?
Is a religion more important than serving humanity? Isn't the basis of all religions is to help humanity have a better life? And so, yes, we, you know, in this model, we're trying to we're working on being transformational, not transactional. You see, when you're transactional, you pay so much and you work so many hours. And so as we attract more philosophies, you know, you'll have we have people already that want to work weekends. You know, their work week is going to be Thursday, night, Friday, night, Saturday and Sunday. And they got three days off every week. So when you have many multiple dentists in a corporation, it's it works towards the other good. So none of our dentists have to work more than 35 hours or 40 hours a week.
Nobody has to be able to work, but the hours are covered. If you can just think differently or outside the box, you can you can you can serve more patients better. Yeah. When you were talking about purpose, my oldest sister is a Catholic teaching nun or a Catholic nun, and she's read every major religion and it's original. And she says that the only thing in common of every major religion is serve other people like you want to be treated. The Golden Rule, she says, is the only thing that shows up in every religious work, unlike the name of a person, place, city, or town. But it's amazing how hard it is. The these dental graduates, they come out and they they complain that they're three hundred thousand dollars in debt and they want you to throw them a pity party.
And then when you say, well, why don't you work evenings till seven and Saturdays and Sundays? And they're like, well, why don't you work Saturdays and Sundays? And they're like, I'm not that desperate. And you're saying basically it's a it's an attitude that they don't they're not feeling the purpose. Yeah, we're not that we can't hire everybody. You know, we lose tons of candidates because they only work there in the box. They won't think outside the box. But the ones that really are attracted to dentistry and there's a lot of good folks in every generation. And there are folks that became a dentist that want to serve other human beings. And they. They can be inspired if they're not a natural, naturally inspired to serve others better.
And, you know, the first step in getting is giving. A first step in getting is giving. And so when you give you of yourself more than your preconceived ideas to serve another human being, then that's another method of how money just flies into your pocket. It just flies in your pocket instead of trying to live in, you know, that. Blue ocean book and trying to live in the red ocean where everybody's competing in the same hours and the same thing. And so live in the blue ocean where the road is wide open on that road to the extra mile. So the next thing that is so controversial is takes insurance. I mean, there is. I mean, there's Medicaid that most dentists don't take. There's PPOs. We've seen the disappearance of indemnity.
What's your views on insurance? I love insurance. I am so happy that they have insurance because that just means more people will come. But we do do PPOs. We do a lot of free dentistry. We do, and you know, we use that free dentistry, by the way, when we're taking dentists from class one to class two, class three. We start doing free or full mouth reconstruction on free dentistry. So we actually have like a business residency here. Yeah. You know, doing root canals and things. So there's a lot of workarounds instead of doing Medicaid or whatever it is. But we do take PPOs and I have a great positive attitude about PPOs because they come in. And, yes, most patients are what we call the 'crown of the year club.' They'll do one crown or two crowns a year because that's all insurance will cover.
But if you have more people in the chair, you have a more better chance. As LDP Panky said in Dawson's book, the ability to take a patient to comprehensive care, taken from emergency to comprehensive care. So we work a lot on that dirty word in dentistry called sales. The ability to help people to get the work done they need to get done, but they don't want to get done, the ability to help a human being get the work done they need to get done, but they don't want to get done. You know how you can go to any dental office in this country, pull out the charts and you'll see $1 million, $5 million, $10 million of dentistry that needs to be done that was presented that wasn't done.
So back in my history, just to give you this little thought, I really started studying sales really hard from 2000 to 2005. Probably read a couple hundred sales books and applied it to dentistry. And I was working on LBI graduate, took all their courses back then. And so I was working on getting a lot of. And so, what I learned about big cases is most people can't afford it. And so I'm talking about $5,000 and above. And I was closing about 10% of $5,000 above. In three or four years of intensive studying, reading about sales, all of a sudden I was closing 30%. I increased by 300%. But still, of course, seven out of 10 people can't afford that kind of dentistry. They really can't. And it's OK.
We have other methods with associates to take care of them. But you see, by just outstudying, out hustling, working on emotional intelligence, communication, verbal skills, body language, spending thousands of hours of reading books after books after books to help serve another human being, get the work done that they don't want to get done, but they need to get done. That's what we call about service. Working endlessly to get and help. And it's important to see that they are worthy of every good thing. And they are worthy of taking care of their oral health, which is the gateway to overall health. So what was your quote on selling? Selling is the availability to what? What did you say exactly? To help people to get the work done, the work done, that they need to get done, but they don't want to get done.
That's Dentistry 101. All day long. Nobody wants to be a dentist. Nobody wants to sit in a chair. And so that's why we strive to teach our doctors very well, very fast. Get it done well. That's what I learned being a missionary. And get them out of the chair. We don't have the right to steal somebody's time from them. Nobody has a right, according to Napoleon Hill, to steal anybody's time. And when we make them wait, we're stealing their time. When we have three or four patients in three or four chairs, we're stealing time from them. Because we can only. We can only sit down and work on one patient at one time. Now done. Now done. Now done.
And so there's so much philosophy that it whirls itself into unconditional responsibility, serving patients better, so give it of yourself before you're expecting something in return. You know, as we interview these associates, Howard, what happens? What are my hours? I can't work four days. How many new patients? How many new patients are you going to give me? What's the equipment? Ad nauseum. If I get an interviewee that says, 'I don't care about that stuff, just let me show you what I can do,' that's a Brian Janowski, that's a winner. They're like one out of 100 interviews. We have to transform the mentality of society to serve another human being. And that's how everybody wins. That's how we develop abundance. The abundant life. There isn't so much pie that we all have to grab after it.
There's more pie for more people, and that's the beauty of growing and exponentiating a dental corporation. I'm telling you, 68 years old, I'm so damn young I can't understand it. That is amazing. I want to go back on the detail on, You take PPO dental insurance, you do free charity dentistry, but what were your views on Medicaid? We don't take it. But why though? I don't know. There's a couple of reasons. It's government control, so this is government control. There's stories out there where a front desk person just made a mistake, and they got huge fines from fraud. It's too risky, in my opinion. It's too risky. People aren't held accountable; it's giving them the freedom. Giving people for free, they're not going to hold accountable. They don't show up 50% of the time.
How can you do a business model when people don't show up 50% of the time, when it's free? I haven't been able to get it to work, but we'll serve human beings. We'll serve human beings. Yeah. What you said is such a structural obviousness, it reminds me of gun control. I don't want everyone to talk about religion, politics, sex, and violence, but you can argue facts, but you can't argue how people feel, and with gun control, the reason so many people have guns is because of who they actually fear. It's the government, and you just said it in another deal, Medicaid. You mess up with a private insurance company, you have a civil issue, but when you mess up with Medicaid, they're heavy-handed. People go to jail.
We've had people on this show that went to jail for years for Medicaid errors. I know a personal dentist that left the country and now practices in Mexico because his receptionist was screwing everything up, and he realized he was probably going to sit the rest of his life in a cage. So, if the government wants to do it, they're going to do it. Once there are people to be less violent, they have to be less heavy-handed on the people. There's a big pushback on that, but yeah, and then the other thing with Medicaid that you said is so profound is that when everything's free, they don't show up over half the visits, and the reason Medicare is so insanely over expensive is because the patient doesn't have a copayment.
They don't even know how much their knee replacement costs because it's inconceivable to some people that think economics does not exist, that if the patient had a 5% copayment or just a 10% copayment across the board, the utilization of healthcare would be so much more efficient and competitive, and prices would come down, volume would go up. It's just amazing how so many people don't do so many obvious things. So when you started out closing 10% of dental cases, $5,000 or more, and then you went to 10%, and then you were able to raise that to 10%, what were the key takeaways in a three-fold increase of closing big cases? Yeah, it was 10% to 30%. We set up a whole system.
We have set up a system called the high-needs patient protocol that we have in our corporation where we have it's think of the Rockettes and Radio City Music Hall where they're always kicking in, yeah, at the same time. And so we have a whole system from the time the phone call to how the patient identifies themselves as a high-needs patient. And so how a patient identifies himself as a high-needs patient is when they call in, they don't say I need a cleaning, I need a checkup. They said, 'I've broken all my teeth, I'm just getting so tired of this.' My daughter's getting married in a few months, I gotta have a good smile. They say something different. I think I'm ready for dentures, my teeth are hurting and they're getting loose.
They have become the typical 45- to 85-year-olds where they've had MOD, JFK amalgams in their mouth for decades and they're cracking, they're falling apart. They get to a point where they have to make a decision; I'm going to go all out and do a big case. They don't know what to do. They don't know what that means. I'm going to get an engine job instead of an oil change and spend a lot of money either getting implants put in the dentures or getting fixed what they got. And you have to recognize what's in their dental history when they have that crisis and they say certain things. And you know as a missionary, you probably heard this: it's out there that if people take care of their dental health, they're going to live 10 years longer.
And so we got to be focused on helping people. I'm going to be focused on helping people have a better life as they get older. You know the baby boomers, they get almost anything they want. I don't know how many trillions of dollars the 66-year-olds and above have, but they will look good, eat well; they want something that doesn't come in and out, works good. And by the way, that was just my treatment plan, Howard, in my last few years. You know, I want to give you something that looks good, works good, and doesn't come in and out. I'm not going to talk about an MOA number two and number five has all that stuff. I'm just going to get to, you know, genius is just making things simple and your confidence in front of the patient.
So you said you want the dentistry to look good and what? Looks good, works good, and doesn't come in and out. There's my whole $10,000 seminar on treatment planning. Not quite that simple, but you know that's what they want, that's what everybody wants. So a lot of the- A lot of these, a lot of dentists think that the secret sauce of their business model is in their technology. What do you think? I mean, technology can make you do dentistry faster, easier, higher quality, lower cost, but it's also very expensive. What cutting-edge technology do you believe in? Okay, so I believe in everything dentistry's got, you know, from 3D, I love dentistry, I love going to shows and passing out my credit card so I can learn more stuff.
And all that kind of stuff. And then they usually, the people behind me, cancel my credit cards because I spent so much. I just love dentistry. But here it is, here it is, this is what's missing, key point. How much do you love that human being in front of you? It's not about transactional, it's not about all the dental gizmos, see dentists just believe, I've become the best dentist in the world, and they'll come to me and do whatever I tell them. They're only going to come to you if you love them. And you can call it like, or they know that you love that human being in that dental chair as much as it is your mother, brother, father, or sister.
In fact, the master, a couple thousand years ago, written about 2,000 years ago, was talking to a bunch of people, they call it the multitude. And he said, he was helping them have a better life, but when he was talking to them, the greatest business book of all time, in my opinion. And somebody came in the side door, Howard, and they said, don't you know your mother and brother and father are waiting outside here? And the master said, behold, my mother and brother, you see, work-life integration. And there is no work-life here and there. Everybody's my mother and brother. And when you really truly have that in your heart and your soul. Yeah. Oh, it oozes and the treatment plans fall.
That is so difficult to get people to grasp that concept, but I'm a living embodiment of the results I have in my life by that philosophy. But specifically, is your abundant dental care going to have CAD, CAM, CBCT, lasers, all this expensive stuff or digital scanning or does any of that expensive technology, um, something that you'll be investing in or do you not find it necessary? Absolutely. We have 3D, uh, digital scanning. We tried, uh, with, with C-RAC and it didn't quite work out, uh, but we're constantly on the horizon studying, uh, on very fortunately I'm financially independent, obviously when I sold to Heartland, I don't have to do this another day of my life, but I have to do this every day of my life. Obviously, because I'm on a mission.
Yeah. And so, yes, well, we have the latest and greatest, I am a dentist, I love dentistry; we will have what it takes, I, we have, you know, we could say Gordon Christensen-approved materials, we don't have the cheapest composite, uh, you know, we have good stuff here. So yours, but to be specific, you're saying CAD, CAM didn't work out well for you, did it? Also not work out well for Heartland, I mean they have a larger sample size of 900 offices. I don't know; I don't know. I think they don't let each. What I remember, they let each [doctor] decide what they want in their office; I'm not really sure. But it didn't work out for you and you won't be doing CAD, CAM.
We had trouble with the crowns breaking and then not getting the marginal integrity at the level of excellence in my opinion. So no, no on CAD, CAM, what about digital scanning? We're looking into it right now. My son uses it. But you, uh, you don't. He uses impression materials. So, um, no, no other major high-tech materials? So, um, is it a high-tech thing that's a part of your business model, I mean it, would you say technology is a big part of your business model or not or more of a psychological mindset? I have to say neither. You know, we do have 3D imaging, we, you know, what do you call those things? Cone beams. Yes. Because we went excellence in root canal. So I think every root canal needs to be cone-beamed.
That's, that's what we hold ourselves, you know, we do tons of implants and, uh, cone, cone beams. Uh, I believe that's the state of the art now. I believe you're going to open yourself up to lawsuits if you don't have a cone beam. So yes, our office has cone beam, uh, digital impressions. I've been studying and looking at it for, for years now. And so for those of dentists that really are very well-versed fast, it's faster to do a, uh, uh, an impression sometimes. Well, I believe it's about to get there. I'm looking at it. I believe it's about to get there. Okay. Um, so you like 3D, uh, CBCT, um, imaging cone beams for, um, endo and implants. Um, yeah, we have, we have electric hand pieces. Oh, really?
Electric hand pieces. Talk about that. As opposed to air. I mean, is it all set up electric only or do you still have, uh, the compressors? What's that? We got both. Okay. Well, electric hand pieces, you know, fits into how to do a four minute crown prep, which I teach our dentist, uh, how to do that really quick in any dentist without doing crown preps in about four minutes. And I'm talking about a crown prep, you will get an A on dental school. And so, uh, electric hand pieces have torque. And so they slice through the DEJ like butter. And you know, back in dental school years ago, and this is 1976, so I've been a dentist 43 years now. Okay. I got done dental school early and, and studying underneath, uh, a prosthodontist the last six months.
And all I did is crown bridge last six months. And he said, one of the widest words I ever heard was Chris, let's get the damn and them off the tooth and quit thinking around. So I came with a system with electric hand pieces. Since it has torque, you could, you can eat, eat, eat, eat, eat, eat, and, uh, follow a system. And of course in business. We all know, uh, when something isn't working well, it's because the system is, is wrong. Most of the time, people are you generally good. If you give them a system and haven't done the system when they refuse to do the system or best practice, you have a problem, but a crown prep, just like a system and you do a system, you'll get a final result.
You'll look up and all of a sudden, lo and behold, I have a really damn good-looking crown prep that, and our definition of a crown prep is readable margins. So enough reduction and the crown will stay on for 20 years. That's our simple definition. Yeah. Um, and it's also interesting how, um, when you, um, you know, going around the world, it's so, uh, interesting because you get to see a larger sample size of what, what people are doing and electric hand pieces, um, by Cavo or huge in Germany, Austria, um, Lichtenstein. Why do you think, uh, and Scandinavian why do you think, um, do you, what, what type of electric hand piece do you use? Do you use Cavo? Cavo, I believe. Yeah.
So, so why do you, why do you, why are you so aware of that and the Germans so aware of that, but not the Americans? Mainly because I went to LVI. I went through LVI in like 1995 to 2002 and took all the courses and they, uh, they, they taught me electric hand pieces and, you know, in other words, I dropped 150, 200,000 at LVI. Uh, I, I self educated when I didn't have the money discharge of the credit cards, by the way. Uh, you should self educate no matter what, uh, achieved success. But, uh, you know, Bill Dickerson, electric hand piece, all of a sudden zoom, zoom, zoom, you know, the key there is speed very well, very fast.
And so if you're prepping a full arch of 14 teeth, Howard, the goal is to get it all done. Prep. Impression. Temporary. Body registration in less than two hours or less. In other words, so you do not have to numb the patient again. Patients don't be re-numbed. If you can do it very well, well, let's quit, you know, like the average dentist out there, three, six, eight hours of patients in the chair being tortured and being numbed over and over and over again. We talked about, uh, we're still on technology. We talked about, um, uh, CAD CAM didn't work out for you. Um, you do like 3D CBCT imaging for root canals and implants, electric hand pieces, uh, to prep a tooth in four minutes.
Any other technology standouts in your business model that a young child should focus on? Sales. Nothing happens until you sell. You know, yes, you got to do dentistry. That's 50% of it. In fact, a lot of business books say that the scale in whatever you're doing, uh, being a lawyer was only really 20%. The rest is, is, uh, motivating patients. To do motivating clients, motivating, uh, employees, anybody to what they naturally don't want to think they were due because, uh, forgive us a Howard, but we're all trained to be middle-class educational system is made to make us middle-class; it's not to think beyond middle-class thinking it's actually made makes us to be like slaves to middle-class values. You know, we, um, humans. Humans tell themselves stories, um, and to justify their, their actions.
But, um, my gosh, we're dentists, and our homies hate selling, and, um, they say they just don't like it. But in reality, if I have four children that turned into five grandchildren, if I pass on and my grandchildren go to you as a dentist, and they each have a cavity, and you can't convince them to get out their debit card and pay for it. Um. Then I think you're not a very good dentist, but the dentist thinks she's a good dentist because she got her F-A-G-D or M-A-G-D, and she doesn't realize, um, uh, when you don't do the dentistry, you're not a very good dentist. I mean, I mean, and then they talk about dental materials by Gordon Christian, the God of dentistry who goes to your town every year, Park City, Utah, I've seen him up there several times.
And he talks about all these, um, um, the pros and cons of all these different dental materials. But I just want to stand up and scream. Well. Well, you talk about the, how good these materials are on the two out of three cavities that are never even prepped. I mean, I'd rather my grandchildren just had the, the tooth decay removed and they packed it with ice cream and butter than um than just leaving with a whole wad of microbiology pathology. So how do you get them to focus on the necessity of treatment plan presentation and selling? Well. Well, it's very simple. As we say in business, we manage them up or manage them out. So a culture win.
And so how we went from one to 26 and went from $4 million to $60 million in 60 years is we created a culture and a culture in business, see culture and business. Now you're getting into an inspirational culture as compared to a transactional culture. And that's how you really achieve great things in this world. And so the culture is, uh, we have to serve. We serve another human being by helping them to see that they have to get the work done. And as more hours as you spend, here's the quote: what people consider the cruel part. I consider it the joy. The cruelty is we go to dental school, we become the dentist and we take continuing education courses that are all out there that say, 'uh', this is how you work two at two days a week.
And instead of having a big picture of serving a human beings better, that you have to study 10, 20, 30,000 hours in helping people to get the work done, they need to get done, but they don't want to get done. You got to get those skills in order to, and when you get those skills, unconditional responsibility says you always will be a tremendous success. There's nothing holding you back; it is not the insurance, nor is it the government. It's not the dental industry. It's not whether you use this composite or that composite. It's how you help human beings to realize that they need to get this work done. So, what is the missionary? You know, the mission thought is I'm here to serve and whatever it takes, whatever I have to learn, I will learn it.
Howard, did you know, you probably don't know, but for most of the last four decades, I get up at 3am every day. I go to bed at 7 or 8. I go to bed at 9. I get eight hours of sleep. I exercise an hour a day. I'm on a mission. I read two hours every morning because I have so much more to learn today. There's so much I don't know. And I'm going to learn until the day I die and serve until the day I die, in order for all the human beings to have another life. Ray Dalio. Have you ever heard of Ray Dalio? Absolutely. I listened to him an hour yesterday, you know, and in his book Principles, right in his first paragraph.
He says, 'we're worth $18 billion.' So anybody who's worth more than me, I know they know a hell of a lot more than I need to know. And I need to learn from it. But anyhow, he says, 'I'm nothing but a dumb shit who doesn't know much in accordance with what I need to know.' Well, I, you know, that's a humble guy. So it, it boils down and we're getting to about an hour right now, but you know what? It really boils down to a lot of things we talked about today, in my opinion, Howard. What's that? Ego. Ego. And A Course in Miracles will teach you how to be egoless. An egoless person, you know, you know, an egoless person because they're just reading all the time. They're studying.
You don't have to tell them to get their FHED or MAGD. They're already doing it. They're already learning. They will find the pathway to, uh, to, uh, service to another human being. And, uh, maybe if they hear it for the first time. They will, they will figure it out. But the biggest deal in life is constant and endless learning. And that's how you, that's the pathway to abundance life. And that's how you will be 17 in your mind, regardless of where, whatever the hell this looks like right now. Ray Dalio, Bridgewater CEO and founder, one of the 100 wealthiest persons on earth, uses nearly constant feedback. Most meetings are recorded and made available to everyone at the firm. And I think, um, I've always observed that besides, um, a hundred hours of C.E.A.
year, hanging out with the right people, getting the right attitude, um, is the use of dental consultants. I mean, uh, the average dental office collects about $780. If they use dental consultants, it's more like $1.2 million. It's about a $100,000 difference in net income between dentists who have used an office consultant versus those that don't. Um, but I, I think it's just part of, they, they don't even want feedback on themselves. I mean, eight years of college, after you took a chemistry exam with 40 questions, uh, you hoped you missed less than four. Um, but when it comes to practice management, it's like, they don't even want, I think they're too embarrassed from their ego to have someone come in and realize this place is unorganized.
And, um, you know, so how, how do you create a culture where humans, a social animal, um, is open to feedback? I mean, that, that, that's a rare behavior for a sapien. You know, they got to want it. They got to want to grow when, you know, that's the process of our interviewing, uh, back to Carol Dweck. She says there's closed-minded people and open-minded people, and we're always looking for open-minded people. Closed-minded people, uh, are closed-minded. They want to hear a majority of dentists, uh, we have a, a communication style test. We, we actually. We can figure out, uh, uh, the various personality. Most dentists are very high patient conformity. They love roles, uh, like roles, then, uh, typically in the dental world, uh, uh, uh, I don't know if it's majority, but, uh, a good amount love to point out the failures of other dentists when they've done the same thing themselves.
We all screwed up. If we, you hadn't practiced dentistry, you hadn't screwed up. And so, you know, I love going to courses where they show their mistakes. I don't want to see all the good stuff. I want to learn from mistakes. I want to learn how to, you know, they hit it underneath the tree and still get on the green into, uh, uh, you know, that's all about learning, you know, doing it, uh, being open. So it's ego working on your ego and become an ego list. That's what Ray Dalio says, how he got the 14 billion. And you mentioned about accountability, uh, you know, accountability, they have accountability now. And I haven't gone so far as to take meetings, uh, but I'm thinking about it because if Ray Dalio does it and got the $14 billion, well, maybe I want to do it.
What do you think? Um, HR, HR, uh, we'll just human interaction in general. I mean, it's, it's the greatest part of life and it's the most difficult part of life. Whether you're dealing with a family, friends, coworkers, patients, people are so complicated. Um, giving up on employees is the easy way out. You said, 'manage your employees up or out', um, you know, everyone says 'support your people until you don't'. What HR advice would you give to the young graduates? We just had a graduating class come out, uh, last weekend. What, what, how could these introverts who only remind me of a scientist in a library, how would you recommend they get trained better in the understanding of people for HR purposes? Well, read books. Read books. You know, self-education will make you a fortune.
Formal education will make you a living. So the formal education, yeah, they can make two, $300,000 and not do too, too, too much, but self-education will make your living. So number one is you got to read the books. You got to read hundreds of books. You got to read thousands of books. If there's one thing that wealthy people have in common, they have a library in their house. They run tons and tons of books. And so they know what they don't know. They just have to read them. But we direct them to these books. We hold them accountable to read books; we had if they don't read books, it's fine. We understand you're not part of our culture. You're not happy here. Go and find somewhere you're going to be happy.
You see, you can't, uh, there's an old study about, uh, years ago about, uh, a college in Ohio where they had, you know, uh, coed dorms and beer parties and all that kind of stuff. That's what the college kids want. And enrollment kept on declining and declining and declining. And then they raised the standards. No more coeds. You know, study hall time. They raised the standards. So guess what? There's the, the, uh, enrollment skyrocketed. People wanted it in. If you want a better life, raise your standards, raise your standards. And so people got to want the better life. They got to give up middle class thinking. The way they've been trained. They got to be able to live a better life. They got to be able to be happy and want to be hungry.
Now I can, I can guarantee you, I don't have to keep teaching people hungry, but I'm telling you, I'm starving to death today. What about you, Howard? Howard. I love that. I love your quote, uh, um, that Jim Runkle, formal education will make you a living. Self-education will make you a fortune. Um, it is so, but I, but again, a lot of that, their mind has to be ready, um, because they, they don't want to consult and they don't want to tell anybody what they're doing in their practice because, uh, their ego. Uh, they're, they're embarrassed by it. And there's something about humble people and I always found it so bizarre that humble people are always, um, not sure they know everything and learning more.
And then the least educated people, they're just absolutely convinced they know everything. So on society, the people who know nothing are the most vocal and the people who know everything are the least, um, at least vocal. So bad information will travel the world 10 times before. And educated person will even start, uh, to address how insane it is. Um, I want to, I can't believe we went over an hour and I, I, I can't let you go until you at least dress unconditional responsibility. Um, w w where, where does that come from? And you mentioned that Jim Rome quote, uh, uh, forgive me for the mention. That was his quote, but you know, Jim, uh, Rome, uh, Tony Robbins studied him and he had nothing.
Uh, I studied, read everything and it's leading back by every, uh, motivational guy out there. I've read their books many times and underline them over and over and over again. Uh, but one thing about Jim Rohn is it all starts with philosophy. When you listen to Jim Rohn, it all starts with personal philosophies, he called it. And so it was that course that we all avoided in college, you know, and, and studied the previous tests so we can still get an A on it. Okay. Instead of going and understanding that philosophy is where it starts. And you know, my philosophy is very basically unconditional responsibility is after I have, you know, I had the Quran, I have, uh, the writings of LGY, I have Marietta Baker. I have, uh, the Book of Mormon.
Uh, I have Confucius. I read all those things and I'm reading it constantly. But one central thing comes out. Okay. And that is, as we already mentioned, is serving another human being. That's our purpose. We have just decided to remake dentistry as we serve human beings. We use dentists. We have decided, you know, you can be a carpenter, you can be a plumber or whatever, but we just have decided to serve others. So the basic unconditional responsibility is no blame. Don't make excuses. Just what can I do? What can I learn? What solution can I come up with? I'll try this. I make a mistake, I'll just correct the mistake. I'll pivot quickly because it didn't make it. Uh, there are no effects in this world that can affect my responsibility.
And once we understand that, deceive yourself no longer, as it says in the Course in Miracles, that you are helpless in the fact that what happens to you, anything that you have in your life, you have attracted by the person become, become a different person and a whole new world opens up for you. Believe that you are a part of God and greater things than these you shall do. You are creator. Every human being is a creation. Every human being sits in your chairs and your mother, brother, father or sister, treat them just like that and love them within seconds, a millisecond, just like that. You can choose to do that. And, um, you briefly touched on something in the very beginning that you went to Utah, which is, um, very, very competitive.
Yeah. Um, so my question to you, to these, uh, graduates that walked out of dental school, does, do demographics matter? Well, uh, I'm going to prove that it doesn't. I love running uphill with the wind in my face and the rain pouring into my eyes. I don't want to talk, but of course, the common thinking is it does matter. I understand. But, but is it affecting you? I mean, are you? Are you going to, um, go more rural than urban or are you going to, when you open up these 200, I mean, what's really neat is, is you have a very defined goal, um, and your defined goal was 200 offices doing $2 million per year each, um, with a 20% profit margin. Um, how will that goal, um, be realized in demographics?
Are you going to put all 200 offices in, uh, Salt Lake city? No, right now we're looking at about, probably about 12 to 15 here. And then we'll go to Colorado, New Mexico, Texas is our thing, Arizona is our thinking. So you're, so you're going to come down to, um, you're going to come down to Arizona? Yeah. I'm going to open one right next door to you, you. Well, I would love it. Um, I, uh, love the, love the dentist in my neighborhood that I do. I love it. And, and, and back, back to that, the, um, you know, they always say when you see, you're, you know, exaggerated profits that usually, um, capitalists have conspired with the government to restrict competition until they have a cartel.
Arizona was the first state that just accepted, uh, signed a law that they will accept anyone's professional license. You can move here from any state with a dental degree and be a dentist in Arizona. Do you think, what, what does your macroeconomic mind think that impact will be on Arizona? Well, you know, uh, that's way above my pay grade. Howard said it really well, but I love it though. It is called the United States of America, last time I checked. So you get a dental license, it should be for the whole country in my opinion. Wow. Um, um, yeah, it's, uh, competition is so amazing because, you know, is economics a joke to you? I mean, everything they've ever learned in economics is competition is, uh, is, is huge.
And then everybody decides that when they open it up, it's a joke. They open up their business that they want competition for everyone else in the world's richest country on earth, but not for themselves. And uh, and dentistry has to have more competition when there's not even enough competition to make them open, uh, 24 hours a day, like a, like a, um, um, or at least 12 hours a day, seven days a week so that a person with a broken tooth or an injury or trauma can be seen right away. But, uh, my gosh. Go ahead. By the way, Howard, have you read the book, Relentless? No. Relentless? I don't know. Relentless. Who, who was that? It talks about coolers and closers and cleaners, but, uh, uh, you might look at that book really quick.
It's written by the, uh, uh, physical or the trainer of, uh, Kobe Bryant, Michael Jordan, those kinds of things. But it has a lot of business analogies, but, uh, when you're a cleaner, basically you don't worry about the competition. The competition worries about you. So obviously what you just stated was. I never worried about you. I don't worry about the competition. I don't know anybody. I'm always working on our game. I'm always working on our game and that's what I did in our dental care. And they, uh, you know, I got reports that, that back in those days, Dennis will worry when we put in an office next to him because we're open all those hours. I don't know. I'm worried about the competition. I only work on how to serve another human being better.
And so you're right when you get an organization that makes numbers. And by the way, when I came to Waldorf, Maryland in 1987. I didn't know. They told me, 'Don't come here, Chris, there's too many dentists.' And I blew it up. I blew it up because of my philosophy right there in, uh, in the wrong side of the tracks in the Washington DC area. Well, it's always about, you know, worried about, don't worry about all the things, worry about serving another human being better. Yes. Um, profound words. Um, it was, uh, an honor that you came on the show today to talk to my homies. Um, I, uh, you shared so many great pearls and wisdom. I can't wait till you get down, uh, to Arizona and the next time you're in town, uh, you, me and Brian Jankowski, uh, we've got to go eat a fat greasy cheeseburger. Oh, I'm a keto man. So yeah, I eat that greasy, uh, I just don't eat all those sweets.