Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1310 Private Practice in a Corporate Landscape with Brett Pierce : Dentistry Uncensored with Howard Farran

1310 Private Practice in a Corporate Landscape with Brett Pierce : Dentistry Uncensored with Howard Farran

12/11/2019 6:00:00 AM   |   Comments: 0   |   Views: 220
Stanford University graduate, successful entrepreneur, and former NFL athlete, Brett Pierce, is CEO and co-founder of Elite Dental Alliance. An affiliate of Cain Watters & Associates, ELITE is the nation’s premier membership organization built specifically for the independent dental practice. With over 1,100 member practices across the U.S. and over $1.5 billion in collective annual production, ELITE has created a marketplace of member-exclusive offers from industry-leading vendors. From dental and office supplies, to equipment, to patient financing – and everything in between – the ELITE vendor marketplace is designed to take the guesswork and stress out of running a productive dental practice.

VIDEO - DUwHF #1310 - Brett Pierce

AUDIO - DUwHF #1310 - Brett Pierce

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Howard: It is just a huge honor today to be podcast interviewing Brett Pierce, Stanford University graduates successful entrepreneur and former NFL athlete my gosh is NFL day, he even has his own Wikipedia page Brett Clayton reporters born January 7 81 is a former American football tied into the National Football League for the Baltimore Ravens and Dallas Cowboys he played college football at Stanford is a former American football Titan and the NFL for the Baltimore Ravens and Cowboys he played college at Stanford, he attended Columbia River High School where he recorded nine varsity letters in football he was a two-way player defensive end and tight end he was a two-time Allstate my gosh she just goes on and on and on your professional athlete days are amazing but now he's Brett Pierce's CEO and co-founder of elite Dental Alliance an affiliate Cain Watters and Associates. Elite is the nation's premier membership organization built specifically for the independent dental practice with over 1,100 member practices across the US and over 1.5 billion in collective annual production ELITE has created a marketplace of member exclusive offers from industry-leading vendors from dental office supplies to equipment to patient financing and everything in between the elite vendor marketplace is designed to take the guesswork and stress out of running a productive dental practice. Today we are talking about one of the most popular topics in the dental world the DSO movement it's no secret the dental landscape has become increasingly more corporate over the last couple of decades and this trend isn't expected to slow down any time soon while dsos have annualized growth rates of 13 to 14 percent private practices are shrinking 7% annually according to the Health Resources Institute of the ADA. So Brett why is a DSO movement growing?

Brett: Well Howard, you probably hear this on a daily basis but you know we interview hundreds of doctors we hear all the all the concerns all the questions all the fears there's a lot of reasons that it's growing but it's typically three general categories it's the student trends, what's happening in existing practices and the challenges they're facing in this and the third part is investment options you know what are people gonna do with their money and so students and this is no secret but students are coming out with record high levels of student debt right now so the idea of coming out of college with five hundred thousand dollars in debt and then buying into another practice for seven hundred thousand dollars more isn't always that exciting to to everybody to everybody that coming out of school. There's some there's based on the conversations that have about these doctor there's a training gap sometimes in the schools now where there is just there's even less focus on kind of how to run a business and what opportunities to opportunity to pursue and then this administrative intimidation so when you're coming out of school you're kind of being told that it's really hard to run a business it's really hard to manage all these people it's really hard to do payroll when are you gonna do all these things and then who's got the biggest booth that the dental school trade shows it's the DSOs and they're marketing and they're explaining how they can help them with all of those with all those factors. So that combined with what's happening in the existing practices the challenges that they face in terms of the same the same debt situation the administrative age injuries broker marking some marketing is a big piece of this so we're trying to figure out why is the DSO group why is the DSO Movement why is it growing why is all this happening, well people are marketing to these dentists like never before there's not a day that goes by Howard that I don't have somebody say hey I got this offer from so-and-so what do you think that wasn't the conversation ten years ago that wasn't happening quite as prevalently and the reason that that's happening more and more often is the investment options out there so one of the big one of the big reasons it's happening since all this money is flooding into dentistry and you know this better than anybody Howard there's just so my background I also spend about seven years in private equity and so we used to buy and sell small businesses very similar to the one that dentists now and the investment options are always they always determine what the multiples are going to be for the businesses that you buy so if there are better things for me to do with my money as a private equity firm or as a rich guy or whatever it is I have these other options but right now as volatile as the market is with all the instability with you know this election year and we freaks out about the election year what else could I do with my money that would be better than investing in medicine and in dental of this market it's a little it's still a little bit green I mean is that are you hearing anything different Howard I mean what do you kind of think of those are those kind of broad topics but we hear it every single day here and that's it's just it just kind of happening.

Howard: So do you there I mean my gosh you said so many profound things I don't even know where to start you know there are several contributing factors of DSO movement growth on one hand you have I mean there's so many things...

Brett: You know the most curious thing Howard is even when even five years ago the narrative wasn't the narrative was I have these problems to solve as an independent practitioner how my best going to solve these problems and recently those conversations have turned to I wish I didn't have to solve these problems and as soon as you go down that road it's kind of hard to come back and we used to buy businesses the same way Howard we're divided by businesses we'd say hey you want to sell your business know I love business, business is great and love what I do I love my staff everything is great cool here's the letter we're interested in buying it six months later hey you want to sell your business to us no no everything's great it's awesome you know fast forward eighteen months the secretary quit the warehouse is the warehouse needs repairs it's raining people aren't showing up whatever the case may be hey where's that letter where's that letter I want to talk to this guy maybe I don't want it maybe I don't wanna deal with these problems anymore and so they are being people are being told that they don't want to do these things now but they don't want to solve these problems when in the past they were just trying to figure out the best way to solve them and that's a really critical really critical shift in mindset and I think that's probably happened to that and you at some point Howard I don't know.

Howard: You know you know I I ear both sides of it on the one hand I know there's two dental schools down here on each side of the fence there's A.T. Still in Mesa and there's one in Glendale Midwestern and my god DSO's coming in there with free pizza lunch every every week and if you show up there with a bunch of free pizza and they they talk doom and gloom Howard's old school and when he was little every pharmacist to own their own store now they all go rolled up into Walgreens and and CVS but then I come back and I say okay well these schools have been here a decade and when they come out they they all go jump into a DSO and they're not happy and they don't last a year and a job hop from year to year to year and usually it's about five years they've had five jobs they're so miserable that now they've lost their fear of being a private, own my own office because they're living in hell they're they're no longer afraid of getting ran over by a cement truck so they're like I'm so miserable you can shoot me I'm gonna open up my own dental office because I'm so sick of working for someone else which i think is indicative of any in of any career where you have seven eight nine ten years of college if you want a bunch of people to take orders you need to be a marine corps captain and have a bunch of eighteen year old kids but by the time all those 18 year old Marines have eight years of college each you can't even get them to agree that today is Monday so I am I think there's gonna be I think there's different markets I'm just like there is Chevy Pontiac olds Buick Cadillac the DSO market right now I hear everything from twelve to eighteen percent how big do you think it is now and how big do you think it will get?

Brett: Well it's gonna keep getting it's gonna keep getting larger I mean I think it's I think you're right it's 12 to 18 percent I think that the latest number is about 17 percent is getting it's gonna continue growing and it probably should and a lot of these you know I think just in the past six years they've gotten a lot better in terms of doctor and patient experience I don't think it's these dental factories I think I think the the the popular thought is Oh corporate dentistry it's a bunch of dudes in suits with MBAs telling me how to do this this and this then just looking at a P&L and they'll either fire me or not fire me basing that P&L; in the some degree that is true because you have investors involved but I also think however that the a lot of these DSOs the good ones are still really taking care of their doctors to a certain degree so I'm not an anti DSO I'm not pro DSO so I'm whatever's best for that particular doctor we fit who we help facilitate sales the DSO is all the time we help fight the DSOs all the time we're counting on both sides of the fence but I think it's gonna continue growing and it probably should continue growing Howard because dentals a little bit behind some of the other industries in terms of sophistication I think you probably would agree with that and the DSOs are bringing a lot of sophistication to the dental space in terms of customer experience in terms of Technology in terms of software in terms of tracking and analyzing the practice as a business not just as as as your personal kind of bank account and so I think because of those factors and all the factors we listed before it's not going away but that doesn't mean that's a bad thing necessarily for the independent practices doesn't necessarily mean it's a good thing for the DSOs I mean if these are just businesses these are successful successful businessmen and successful financial guys that are finding good places to invest their money and what better place than dentistry right now.

Howard: Yeah and we could and they can help dentistry we can learn a lot from dentistry they're better on answering their phones you can call Aspen at two o'clock in the morning and a human answers the phone so what how do you think corporate dentistry can help private practice?

Brett: Well kind of some of the things I said so if you are willing to adapt and if you are willing to grow if you're willing to learn and if you're willing to treat your practice like a business in some degree and still take care of the patients you are you're gonna have a leg up on the DSOs and all the independent practice who are who aren't willing to do that so it's kind of natural selection argument a little bit if the DSOs are growing at this rate and they're growing at that rate because of acquisition that means by definition that there's going to be less independent practices in the future because it'll be more DSO practice. If a patient prefers an independent prep probably do if they were if they were asked there's going to be less options for them to choose from and if you are one of those remaining independent dentists that means your market share is going to have the opportunity to even mark that being said you better get your stuff together and understand that this is coming and you can't just put your head in the sand because you have a shingle up on that your dad's had and your granddad's head and your granddad's granddad had that's just not how that's just not how it works anymore because the guy next door is offering free whitening every it takes every insurance you've ever seen and you know they'll get you in the same day and get you out the same day so there's all these different things that you need to pay attention to if you want to compete but if you're willing to compete and if you're willing to continue to focus on that patient experience I think the independent practice the ones that the ones that are willing to do that are gonna absolutely blow it up and I think they're gonna be awesome and I get it I get opportunity to deal with a lot of the highest end dentists and doctors in the country every day and these are the guys who are leading that charge to say hey I'm not just gonna sit here and let this whole thing happen around me and be scared of all these words and you know all these marketing terms and MBAs and whatever else all this stuff is I'm gonna I'm going to take action I'm gonna take the best of both worlds so my whole goal with this business in this in this conversation is these didn't you get me all fired up now Howard see what's going on here, you can have the best of both worlds you can run a business like a DSO can run a business but you can also take care of the patient like the independent like the independent practice is famous for the patient experience is an asset for the independent practice sometimes the DSOs look at it as a liability or an expense and so that's that's kind of the primary difference so if you're willing to change and adapt you know the world is your oyster so to speak if you're the independent practice but if you're not you're gonna go away and that's probably good for dentistry and good for the patients.

Howard: Well the the easiest thing to fight back is I mean the number one complaint here in Phoenix is every time I go there is a different doctor yeah I went in there and the dentist said I had seven cavities and I went back to get the first one done and he no longer even works there and the next guy didn't even know what was going on and he so just the fact that you don't have a different dentist every time the patient walks in you can be a huge facing experience but like Aspen I am you know I lost a great patient Aspen and I tip my hat to Aspen I'm when you come into my office for a denture reline you got to come in the morning you got to drop it off you got to go spend the day without your teeth and then I said it'll happen well Aspen put the lab in the office and you know so now my buddy goes to Aspen and while they're realigning he just sits out there in the waiting room and you know plays on a smartphone and it's like I'm glad Aspen is there for him and I'm glad they did this I have the opportunity to put in a lab same thing when smiles drug came out you know they you know the orthodontist wanted to see them every month for two years and smiles direct club said well we're just gonna do it for 14 months we're gonna give you all the trees today I already know orthodontists that are adapting saying well you know I really don't need to see you every single month why don't I why don't I give you a tray for every two weeks for two months at a time so when you come in I'll give you today's tray and the next three and so they're cutting out appointments and speeding up so I think competition at the end of the day it's always for us and in Phoenix Arizona the metro's 4 million I don't know if it's bigger or smaller than Dallas do you know which?

Brett: I think we got to buy a little bit.

Howard: Are you talking about the Cowboys record or the Arizona Cardinals record

Brett: Both

Howard: and the bottom line is on Sunday I mean if you got any if you fell off your bicycle and broke your leg Danny I'll pick you up they'll take you to the hospital but if you thought off your bike and broke out your front two teeth there's not one dentist in Phoenix Arizona that would be open on a Sunday. I tell people if you're gonna get hurt on the weekend just make sure it's not your teeth so so I think that this competition I mean it is embarrassing as a dentist at eight percent of all the emergency room visits in the United States of America or odontogenic in origin and the reason is, is because at five o'clock there's not a dentist in Dallas and after Thursday at five there's no dentist in Dallas and so when people say well Dennis aren't real doctors well you're absolutely right because a real doctor would be in the hospital 24 hours a day seven days a week in fact I don't know I still can't figure out why a DSO hasn't put a location in every emergency room across the United States because any time I've ever gone to the emergency room since I've been a dentist with four boys how many might I raised four boys and now I have five grandchildren four which are boys so how many times you think I've been to an emergency room you know how many times I stood up here and stood up in their waiting room and said hey how many people are here because of a dental reason and every time it's just like the numbers say it's five to ten percent I'm like well why isn't the number one DSO Net dental emergency center calm and go rent some place that's the emergency room because I would want my grandchildren if they knocked out their two front teeth to be able to go to a dentist at two o'clock in the morning or whatever but and then the other thing is attitude I mean you know that more than anything being the NFL I mean dentists will work at a DSO with this horrible attitude and I'll say you're working for a guy that owns five hundred to a thousand offices please tell me the genius business knowledge you've learned and he hasn't learned anything he just sat there hating it for a year and then other people I know I say well what did you do after you left well after one year working for McDentals I found the best regional manager girl and she's just great and I talked her into leaving with me and we at my own and she brought you know five years of systems from Mcdentals and they're doing you know like two million the third year and I'm like there you go.

Brett: You know that is Howard that's all those things you just mentioned are listening they happen because you're listening to your customers the DSOs and just regular businesses listen to their customers what matters to you what are you well you want weekend you want Fridays you want same-day treatment we're listening to the customers when it's easy and you know very smart educated people which these dentists are it's always been your way that the patient has to adapt to right now the reverse is happening people are seeing I actually like this I'm I I don't want to be at somebody's beck and call I want you to be at my beck and call and I think that transition happened probably 10 years ago in medicine now you know I don't want to talk to you I just want I want you to text me when my appointments happening and I want to come in on Friday or Saturday morning or I want same-day treatment or I want or I want it instead of going to the emergency room and having some guy put some wooden teeth in my mouth I actually want a dentist there they're listening to their customers and that's probably the biggest lesson of all of these things being was willing being willing to adapt to your customers on the sales side and on the patient experience that the patient experience the independent practice can dominate that dominate that all those things you talked about are basically patient experience you if you were to walk into when you're a patient anywhere Howard I mean how would you want to be treated you don't you want to point them whenever you want one we do have the we actually have a lot of dentists that are doing these urgent care centers to Howard I don't know if you've seen many of those like they're turning their practice during the day into an urgent care center at night or they have a kid come in and work there practice same equipment same same lease this producing no revenue at night maybe you get something out of it.

Howard: You know I'm really proud of my dentist because the only because in where I'm in Phoenix the dentist and the chiropractors and the veterinarians they try hard I mean they're really trying too hard but I go into any of my MDS any physician's office this got the glass door you go sign-in she opens the door hands me a deal without making eye contact I'm supposed to sign that you know I'm always gonna wait one hour in the waiting room then when I go in there the doctors not even gonna acknowledge that he's an hour late. I mean the physicians are so bad yes that they make the dent the vets are the best I mean the vets I think the veterinarians I mean my gosh they're just I wouldn't want to be a vet anymore and I want to be a pediatric dentist which are really the veterinarians of Dentistry I don't want to work on people who can't talk or communicate but I'm glad someone does that but you know if they can't keep a doctor for a year you how can we not beat them on the customer experience?

Brett: Yeah you you have to all you got to do is think about how you want to be treated the same exercise that you just went to and all of the same a lot of the things that affect the patient experience don't cost a lot of money answer the phone answer the phone the right way, make eye contact when you come in there open the door say hello how would you want to be treated you're going to buy a Mercedes or going to buy whatever that's that doesn't cost a whole lot of money Howard but how much would it affect your experience at the medical office the only problem is the medical office is a little bit different because you know insurance pays for that's a whole different situation but insurance pays for everything your patients are still paying for most of the work that you do so it's even more important that you treat in the right same with vets same with the vets right. So that patient experience is you know if you get outclassed in marketing if you get outclassed in financial analysis if you get out class and business operations that's one thing you should never get outclassed in terms of patient experience ever there's no excuse for that ever some of these offices still have everybody's gone from 12:00 to 1:00 right somebody needs to be something needs to be there than 12:00 to 1:00.

Howard: Yeah when they're working I mean just basic software on your phone when does this on the phone sir tree I mean we put software on because anybody who delivers your cable for us is for our state it's Cox cable and you're in Texas it's what's it called there?

Brett: Well there's some DirecTV we we just put like tinfoil hats on these Longhorns and they just walk around and we get tv.

Howard: There's a big one out there what's the real big one Texas because they're rolling in here now from Texas?

Brett: A cable company?

Howard: Yeah

Brett: Suddenlink maybe no

Howard: No but anyway you know use for some software on there when is your phone ringing and basically every dental office I've seen is starts they start ringing at 6:30 the morning to about 6:30 night Monday through Thursday it's about 7:00 to noon on Friday it's about 8:00 to 12:00 on Saturday and and then they'll go in there and they don't they don't even sort answer info until 8:00 well they have two girls there why doesn't one girl come early take a lunch early and the other girl come an hour later take a lunch later and stay later and they can just answer more phones but you know I've been going to Dallas well you're in Plano Texas I've been seeing Darrel Cain since in the late 80s that's why it was so sad to see that you were born in 1981 oh my gosh that was that one hurt but I would say I would say that since Darryl Kane started that I don't even know what year he started that but it's been going along for 81-81 he waited till you were born and then as soon as you were born he opened it up and but I think one of the biggest problems the dentist still don't know their numbers I mean it's been 32 years and you ask a dentist well what what is your you know how many incoming phone calls that you have last month I don't know well you just said you did a big marketing campaign to increase your incoming phone traffic 10% I don't know, what is your return on asset for last year you returned equity I don't know what is labor I don't know I mean and then they come out of school 285,000 are student loans they think and I'm going to ask you they think well to be a really good Dennis I need by a CAD CAM or $100,000 CBCT or $100,000 laser they make three decisions they just doubled their student loan debt and then to buy a practice is 750 but what is in no offense to you at all but the NFL players they don't know their numbers either I hear that half of the NFL declares bankruptcy five years out of school so is it just that football players love the game dentists love surgery and neither football players or dentists like to see the math the numbers. I mean do you see any parallels between the NFL and dentists with not knowing their numbers?

Brett: I see what you did there Howard, pretty good. Well I guess there are some there are some parallels the difference is I guess right at a school dentists and Carell huge amount of debt when football players right out of school incur a huge amount of money so you know that is just kind of a contest to see who can piss it away the fastest I think at that point and I think NFL players probably win in the short term so yeah it's knowing the numbers is very very important and unfortunately you know everybody it's really easy to say oh dentists are bad business people tend to serve everybody every likes to say that every likes to lean on that as a crutch well I'm gonna tell you Howard almost all of the smartest brightest most sophisticated minds that I've met in my life are in some way related to the dental profession these these people are brilliant and it's not that they're bad business people necessarily although they can't they can't be good business people it's their the main producer of this business so they're busy you're only making money when your hands are in somebody's mouth right so if my hands aren't in somebody's mouth I'm not making any money therefore I want to have my hands somebody's mouth as off as possible which means I am producing from 8:00 to 5:00 or 6:00 or whatever four or five days a week I probably don't feel like analyzing the numbers or running my payroll reports at six o'clock or 6:30 on Thursday after I've done 15 fillings that day and listen to 16 parents yell at me about the price I get it the constructs the guy who digs the holes doesn't typically run the construction company either on that's the situation that you guys are in so I don't fall for that I don't believe that doctors and dentists can't be good business people I think they can they just need to be able to understand what tools are available to them and they need to understand why how it matters the days of just running your practice based on your bank account and your schedule those days are over it's easy to do you know we see here a lot you know business is up that's great that many accounts better maybe there's some tax implications maybe there aren't that's a whole other conversation but if we can find ways to better understand the business and if we can find ways where it doesn't take away from our time to produce that's that's that's probably my I'm kind of a data guy and so the analytics of the practice kind of like you talked about Howard how can I manage something that I can't measure right it's kind of it's kind of its kind of the old adage and you do need to know your numbers you need to know more than just your new patient numbers more than just your production numbers how about net new patients how many new patients am I getting versus how many am I losing there's a hole in the bucket some more Howard I don't know and so what why are they falling out what's happening is it a scheduling problem is that it's a treatment acceptance problem what's the sales cycle in this practice in this practice you know what are all these things that are happening cuz even the day when I can't say this a lot but it's you know if you're running into if you're the dentist in the dental practice it's your life and it's your practice if you don't care about it and you don't want it you don't care about your financial future that's fine but it's there's some pretty easy things you can do to analyze your numbers and to understand worries you to apply your time what every where you shouldn't. I mean how much time did you spend on that Howard I'm not on those kinds of things?

Howard: It's the priority I mean it's I mean I'm a dentist I would rather pull for wisdom teeth and go golf there's no question questions asked I'd rather retreat a failed root canal with a broken file than do a root canal front tooth just like I'm sure when you played for the Cowboys you didn't want to play the local play no high school football team. I mean I love I love it but I know that everybody that owns a thousand dental offices they're either knotted or they haven't done dentistry for 25 years so if you spend all your time working with your hands then you're not going to spend any time working on the business and you got to work on the business and and you and the other thing you said which I thought was um another problem I'm back when Darrell started Cain Watters is you just said sell dentistry they even tell you that they don't want to sell dentistry they don't tell you they're not as doesn't mean they're very honest just like my my oldest sister is a Catholic nun you know she'll tell you she's not the drinking partying type you know what I mean and she doesn't ever plan on being my dentist friends tell me they don't they don't ever want to sell dentistry they don't want to learn treatment plan presentation they so it's a hard group of people to coach into selling dentistry presenting treatment watching their numbers in fact some people even tell me that it's gross like well I don't want to and in fact there's a big argument this weekend because some guy said well you know I'd rather I'd rather be a dentist this what he said and some socialist communist country because I just want to get paid an X amount and and do the dentistry that on you that I would want to do on myself and I shouldn't have to be bothered with any economies and the other guy says so you're a Karl Marx you're a socialist or a communist but what are you and I'm like no it's just a dentist he just hates business he hates cells he's not interested is that what's fueling the DSOs just so many people with that mindset?

Brett: Yeah there's a lot of it it's kind of like this how can I relieve any of this administrative burden that I have or all these things that make me uncomfortable can someone else please do all these things for me just like you said I want to do dentistry you're really comfortable you're really comfortable doing what you do and you're uncomfortable with some of the other things so how can I get back into my comfort zone which is an easy trap to fall into next thing you know you're an employee if you want to be an employee that's completely fine I don't know that you started your business because you want to because you wanted to be an employee or not but that's that's what's going to happen and honestly these DSOs are great at these administrative at these administrative kind of cocoons that they'll put you in and so if your main complaint about dentistry is the administrative stuff and the numbers and I just want to produce and go home or whatever that's a really good option for you at that point I don't think it makes a whole lot of financial sense sometimes but that's what that's kind of what this in this marriage with with Cane Watters that elite bent Alliance has you know Keene waters is Cane Watters is the best dental financial minds in the country with some of the best dentists in the country also and so you know what nobody is immune to wanting to hide from kind of these numbers and so Cane Watters is gonna help you understand what's happening in your practice help you understand all the different data points that hit your brakes and all the things how they affect what matters most which is your which is your your financial future your retirement or whatever your financial goals are and we can identify Cane Watters can identify problems in the practice that exist the lead in alliance helps solve those problems so okay this is too high this is too low this is off this is your in the your in the top 99 the 99th percentile and overpaying for whatever it is here's the solution here's the solution have you thought about this have you thought about this so we worked really well together so you're gonna come in here and get your financial life looked at every dollar in every dollar out of your personal professional life how does that how does that tie into the efficiencies that we can gain through the elite Alliance program in your practice so the inception of this program was built to support the Cane Watters practice and help them better understand how they can solve some of these some of these problems and and getting people to underscore understanding of your ability to understand these things how are you can you can understand all of these things the problem is most of these dentists only here practice advice from commissioned sales reps and so that may or may not be you know always the best advice it may it may be but there are a few there are a few things that we've kind of noticed over the thousands of practices that we've sat down and talked to about kind of the best ways to to help the independent practice kind of thrive and do some of the things that can help them keep the edge and obviously the first one is patient experience. The patient experience is your moneymaker that is by far the most important thing in each of these independent practices if you don't have that you don't have anything I mean when you when you hear somebody say I love my dentist okay why do you love your dentist I have not heard one person tell me recite to me the degrees that they have on their wall or tell me about any dental any dental technicalities it's because he's nice and the hygienist remembered my son's name or whatever is right those are those are the patient based experiencing the consistency of care try to keep your care as consistent as possible what's the biggest problem with the Aspen or whoever you rent an early hard you're gonna see somebody different every day or every every time you go in and that's kind of that's not a satisfying patient experience and that's an easy thing to solve for with some simple scheduling tools on your side of them then set the office up to make it feel like you'd want it like you'd wanted to feel when you go to when you go to a an orthodontist or if you go to a medical doctor and then follow up the patient experience follow-ups one of the things that I was actually shocked by when I got in dentistry Howard how little follow-up how unsophisticated the follow-up is in terms of treating the patients like customers I know it's probably a bad word to call patients customers but you know you treat them like customers so you follow-up you make sure they're okay you know what else can I do for you yeah this might we have this amount of unscheduled treatment how can we get that on the books this is a I mean call it what you want it's a sales cycle but these people showed up to you because they want your advice and they want your help so give them every opportunity to enlist your services. The second kind of the second biggest thing is marketing so every kid with a laptop is a marketing guru now Howard every kid with every kid with a laptop in a garage and his parents house is a digital marketing company who's going to make a website for you or whatever and they're going to give you all kinds of acronyms and words and SEO and SEM and who knows what and it's not only going to cost you ten thousand dollars a month and it's gonna be the best thing ever because they're doing it down the street and you're gonna get all these flicks and you don't know what any words are and so you sign up that's the number one overspend that we see in our practices is I love the good marketing companies but you got to understand what the heck they're doing for you you know do you want a pretty website just at a pretty website or do you want a pretty website because you want more patience you know what's the goal of all those things what's your online reputation you know what is what are people saying about how are people making decisions now you have a bunch of you have a bunch of grandkids how how old your oldest grandkid Howard?

Howard: They are my gosh sure one two now I got a 1, 1, 2.

Brett: Oh man their young.

Howard: 4 out of 5 are in Beeville Texas

Brett: Oh really

Howard: Yeah and the biggest fight they have a grandpa is being a Houston fan over a Cardinals fan and we just agree to disagree but you know what I like you know but back to family you know what I like the most about Darryl back in the day he started that in 1984 he was so smart he would not take you on as a client if you didn't bring your spouse with you and he knew that the you know you can say a lot of people say divorce is over a third money a third sex a third substance abuse but it's really not either those it's about communicating about you know that the old man thinks it's okay to have the six-pack every night after work or whatever they're not they're not talking about and these dentists them when their spouse is not involved in the office and they hear well I get $1,000 for a crown and then he comes home and he says I did five crowns a day and the spouse saying wow he made five thousand bucks she didn't know that a thousand dollars is the fee but it's a PPO and it's just down to 650 and basically is overhead is 65% and and I really like that but but basically the other thing I liked about Cane Watters is Dallas is a South way to our Southwest airlines flight away and in 1900 health care was 1% of the GDP and there were no specialties one physician delivered your baby and amputated your foot and by 2000 health care was 14% of GDP and there were 58 specialists if you're still using a general accountant from the 1900s who does dentists and farmers and ice cream makers and cattle farm I mean you're crazy you wouldn't if you had if you had your retina detached you wouldn't go to an oral surgeon you'd go to an ophthalmologist who only specialized in retina detachment Cane Watters only does dentist they got you know some 2,000 1,900 dentist clients around the United States they only do dentist and when they're gonna show you the end-of-the-year report you're gonna bring your spouse in there because if you think your student loans are bad my student loan that was an eighty seven thousand dollars my graduated dental school my divorce was 3.8 million cash and I always have to do the I always I haven't memorized the number but I have to do it just to give myself an extra ulcer if you take 3.8 million divided by eighty seven thousand dollars my divorce was forty three times more than the student loan so you should so Darryl hit on the now if you think your student loans and practice purchase was a lot of money wait till you get divorced is my god that is nothing. So I Cane Watters is you have to have at can accountant a CPA who only does dentistry and you say well I can't find one in and I'm in the middle of nowhere Iowa well then you're within a two-hour Southwest Airlines plane flight to Dallas the only thing wrong with Dallas is the obnoxious Cowboys but just don't look in that evil direction but tell me more and then I also like the you guys got that national dental placements founded in 2005 with helping young dentists find established practices and assisting in the transition owner but I want you to talk about you're in charge of the elite dental alliance is a group purchasing organization developed by Cane Watters and associates to give the independent practice a competitive edge against corporate dental operations elite leverages years of industry expertise with the collective volume of its members to negotiate deep discounts on the supplies and services that our members use every day,  is that mostly with Benco does Benco do that for you?

Brett: No no so like our our program is all-encompassing we find solutions and partnerships in that basically affect every line on every line in the P&L; so Benco have big who is our supply partner but we have right now we have over seventy five unique vendor partners that provide corporate level pricing and service and all the different advantages that to the vendor practice that you get with the DSO. So our goal like I said earlier is to give these independent practices the best of both worlds so we want you to be able to run your practice I want you to be able to run everything possible through your dental practice you get all the tax benefit you possibly can be a business owner be in charge all these things but I also want you to be treated like a DSO from these vendor partners I want you to get all the benefits reserved for these huge huge groups where and the pricing is not the same the independent practice does not pay the same price as Aspen does that's just the way it is it's just a simple economies of scale argument so we bring that we bring some of the most sophisticated dental professionals with some of the largest practice in the country we bring them all together and say hey look then vendorX vendor Y vendor Z or we believe in your service we believe in your product we vetted you out we have all these reviews on you each out multiple conversations we've done a full financial analysis of your business and find that make sure you're financially soluble and viable option for us we need you to treat us like a group we need you to give us those same benefits so are all of our arrangements our corporate level arrangements the doctors don't have to do any negotiating there's there's no change basically in the operation of how they've been are treated with their rep so that's anything else but you know that you're gonna get a fair deal and the company is gonna be great and the company's gonna do everything they can to service you because there's 600 other customers of theirs on the back end that we're responsible for so we know that these are the these are the these are the right vendors we love our vendor partners we're very exclusive we don't take every vendor on them on the planet we typically only have one option in each space maybe two because we were able to find the best option you're not gonna come to me and ask me a question and want me to give you fourteen options Howard you're not gonna say hey Bret what should I do here well Howard here's fourteen options you figure it out okay well I didn't really provide a whole lot of service there so what we do is we take a full financial analysis of your practice we look at your spending pad and we look at your general ledger what are you spending who are you spending it with and how much should you be spending. Let us take you through that entire thing it's kinda like a it's kind of like a Costco with a personal shopper so to speak so you know it's a membership organization you have access to all the different things that you need at Costco at pre negotiated rates and you can pick and choose the things that you want you want to buy ours is the same thing but it's a dental marketplace and we're gonna help you shop through the whole to the whole organization make sure that you find exactly what fits for you and if there's something outside of our marketplace that's the best option for you we're still going to connect you to them and because our allegiance Falls with with the doctor first and that's kind of that's kind of I do it. So we were built to solve the problems that Cane Watters uncovers of Cane Watters Like I said they will tell you how you are comparing to other practices they will tell you what you're doing right what you're doing wrong on the financial and tax side we can tell you what you're doing wrong or doing right on the operational and purchasing side and we're gonna lead you through the whole the whole situation with a variety of different treatment plans we have a treatment plan dedicated to patient growth we have a treatment plan dedicated to patient retention we have a treatment plan dedicated to purchasing optimization and overhead we have a variety of different proprietary tools that we use to make sure that you're getting everything that you can out of the membership and that you're getting your practices up be the most profitable that's possible whether you want to just have a better practice or physics or position it to sell so that that's kind of a marriage between Cane Watters and elite and then NDP national dental placement nationally on placements has been a practice transition provider for years kind of private to private sales and recently recently we have gotten into the the DSO space so NDB corporate sales helps facilitate and analyze sales of independent practices to the corporation so what's happening is all of these brokers and all of these DSOs are kind of carpet bombing so to speak our our practices and they're sending them letters hey are you interested in selling your dental practice are you selling your dental practice I think your practice could be worth as much I think your practice could be worth that much I imagine that most of your a lot of your listeners have received letters like that either from a DSO or from a broker these are very different transitions than when you're selling to your son or you're selling to a friend you're selling to a partner and it's it did a it needs a very different type of service and so what Cane Watters does Cane Watters helps you identify is this a good deal for you and your financial plan NDP tells you is this a good deal for you in regards to the marketplace conditions so is it a good deal for you Cane Watters is it a good deal overall that's NDP so we found a way to whether you want to whether you want to just make your practice more efficient and more tax savings make it more profitable find ways to grow that's cane waters and elite you want to make yourself more profitable on all these areas and grow your patients and then do all these different things that's elite and if you're doing all those things again because you want to sell or transition at the end of the day that's NDP so it's this ecosystem Howard of these three businesses kind of working together. There's no downside to making your practice more profitable whether you want to run it forever or sell it it's all upside so you might as well start thinking about that kind of stuff now and if you do want to sell you know you're gonna get it you're gonna get a higher valuation because that because your property is going to be higher because of all the tools that Cane Watters and the elite help you implement into your practice.

Howard: If I ask dentists it's not everyday you get to talk to someone who played in the NFL but when I if you ask a hundred dentists and we pull them all times on dentaltown when you post when you start a thread you can start to poll so a lot of people will say you know well half the dentists say this and half that I always say wow I'd love to see that poll where's the data they never updated it says just some day they just saw if they say it five times it's true but when you polled dentists and you say what stresses you out the most it's always people it's the patient or the staff and so many people are in dentaltown and they're so afraid of their hygienists and they're like my overheads going off the PPOs won't give me a raise my hygienist once a ray they're so afraid and they don't want to confront the patient and I mean I don't want to tell I don't want to tell a nice guy like Brett that he has 12 cavities so I'm just gonna not present it or have the assistant do it they don't communicate but I notice in the NFL you know there's a lot of big egos and those players and a lot of them are on talk radio and you got quarterbacks talking about wide receivers like don't you guys play on the same team do you really think you should need to be on a different podcast you know. So what did it so dentist um there introvert they're shy um what would did what did you learn from the NFL in getting along with players and building a team that you think a dentist should think about yeah and that's the question what are what are in fact you should write an article for dentaltown lessons from the NFL that every dentist should think about.

Brett: I actually have I've kind of started something like that not necessarily for dentists based but you know I got to play for four of probably you know four of I mean it's a pretty high-profile group of coaches so I started but I started in Baltimore with Brian Billick and then I jumped on board with the Cowboys and Bill Parcells was there then I went to Chicago with Lovie Smith and I ended up in Denver with Mike Shanahan those those are four really prominent coaches I think all of them I don't think Lovie won a superbowl I think he might have got the second here or he might have want I don't know certainly what not when I was there but those are four very prominent coaches and they do it they'd all did things very differently they were trying to achieve the same exact goal those four organizations are trying to achieve not just a similar goal the same exact goal they're trying to win the Super Bowl right and they all go about it in different ways and it's all based on the talent that they have around them so Brian Billick was very analytical very much a player's coach we had all these big time players Ray Lewis, Dion Sanders, terrell suggs all these guys on that team he treated out he treated very much like men and you know they'd won the Super Bowl a couple of years before and watching him like take the way the way he the way he managed the team was different than the way Bill Parcells manage his team Bill Parcells team was not quite in the best they hadn't won Super Bowl three years ago they and the ones who role since 1995 I think and had a lot of younger players so he treated them very differently a little more a little more of a disciplinarian but that was based on the staff basically the staff that he had Lovie Smith was like the nicest guy I think I've ever met in my life he never raised his voice in everything he was just a great great man and the players on his team were more mature players and they responded well to that type of leadership and then Mike Shanahan was kind of a mixture of all of them and they were all very successful in what they did in different ways they did it but it it was really interesting for me to see that from a player's perspective and I didn't absorb all of this at the time I'm still too worried about getting my head knocked off and not getting cut and all those things at the time but afterwards I was able to kind of kind of process these things and at the end of the day all this stuff is about leadership and all those guys tried to achieve the same goal by being leaders in a different way based on the personnel that they had and they they did that because they paid attention in the personnel and they cared about them and they understood what mattered to these people and what didn't a lot of times these problems that happen in these dental offices with the staff is because they're not paying attention to the staff or they don't either they might not even talk to them you don't have that opportunity in the NFL to just hide these things and hide from these people they are there are a lot of divas in the NFL there are a lot of divas and dental offices and I'm not just talking about the girls the guys want the doctors are too right you know how do you understand your team how do you change your leadership style based on the experience and the personalities that your that your team has are you paying attention to everybody or are you trying to shove everybody in the same in the same box because you're absolutely right Howard it's like man you know the old adage if it wasn't for the customers the employees and the vendors business is great right everybody you know it's all these it's all these people things and I haven't heard a dentist tell me yet I you know I kind of like dentistry but I got into this because I love administration I have her I haven't heard that yet maybe maybe I'll hear it tomorrow I don't know and so but it's all about is paying attention to the staff and putting the right people in the right places and you know that's kind of a learned skill but at the end of the day it's your life and it's your practice why don't you take ownership over the people and take the ownership over you know how you're how you're assigning tasks and how you're treating them. Now I don't know if I asked you your question there but that was a that was the beginning of that paper that you're kind of talking about is all these people trying to achieve the exact same goal doing it in a different way and they all had success but all the situations were different now you know you can't run your practice one way with every single staff member Howard you know that everybody can respond to things differently the fact the question is do you care about that hurt you just wonder you wanted to fit in or go or go home you know there's kind of there's kind of balance.

Howard: So it really depends on it really so you're saying that these four great men were all trying to get to the exact same exact goal the Super Bowl four different ways so there's a lot of different ways to be a leader and that's you know the leadership aspect I think is is very underutilized.

Brett: and the best businessmen are also the best leaders of their people in a lot of cases successful business people have good teams behind them that they're able to you know pick up the slack or maybe they're better than that.

Howard: So did they handle the Divas differently because when you say there I mean there's a lot of dentists that are divas and you know who they are they're they're always you know you've already seen nine pictures of them blowing a kiss in their own bathroom mirror but when you have an employee it's tough because everybody wants the the customer experience would you've mentioned several times well sometimes after a staff been there 10 20 30 years they're kind of an entitled diva how do you draw the line between how do you handle divas? I am and did they did those guys handle their divas differently?

Brett: Yeah so the football coaches absolutely did so I was in I was in Dallas when Terrell Owens was there right so his locker was actually right next to mine and at any given moment they were you know 50 reporters standing in the standing and then in his locker so I couldn't even I could even get to mine. Bill treated his star players star players I mean he treated guys like that very very differently so he was kind of dismissive of them and so it like publicly but privately privately Bill's very always very respectful to everybody but you know it also there's always a cost-benefit analysis right like you know how good is the player or the employee are they worth are they worth this extra hassle right you know because as soon as you're useful life is over in the NFL as soon as you're not quite as good you know all your jokes not quite as funny anymore you know you're the rich guy that used to have a bunch of friends that has no money now all your jokes point out aren't quite as funny anymore you know but yeah they all treat them very differently and I think the most common like diva situation in dentistry is the people who are very averse to change that have been doing things a certain way for a certain amount of time and they're very averse to change and hey I think we could do this, this could really help change our practice but you know Susie or whomever is is kind of against it and they're going to give me a bunch of trouble and so you always want to ask her so I always tell the doctors ask so this question ask yourself you know if she was he or she wasn't here what I want to do this would I implement this system or what I implement this change and do I think it would help my practice and what's the answer to that, now you got to go back and analyze well how much work is it gonna take for me to coerce the staff into doing these different things and a lot of it was we a lot of the problems have come because the staff doesn't understand the overall goal of why and why these changes being implemented and so if you have if you have a diva who wants to do so that's not one thing a certain way he wants to run his route a certain way but that route doesn't fit him to the route tree and it doesn't help the team get to where they need to go if the diva understands that there's a better opportunity that he's going to change because he understands the overall mission and the overall goal of the team. If the diva doesn't understand that if he's not told anything he just said run your route this way don't run it that way don't be stupid that diva is gonna react badly to that situation because they don't know they don't even know why the hell you wanted to run different route right?

Howard: Yeah

Brett: and conversely if they know the mission and they're told to run the route differently and they don't that's a whole nother problem that's probably that's probably trying to find the expression that's not offensive to somebody that's probably cutting ties I guess you know.

Howard: If you were thinking about um you a lot of times when people go to sell the office they're always thinking um before I saw my office maybe I should upgrade the the pano into a CBCT I should get digital x-rays I should remodel what do you what do you think the older guys like me should be thinking if they want to sell their office and instead of just calling you up and saying hey surprise grandpa's dead and we need to sell his office so and so you know I'm sure when you when the NDP national dental placements gets a call or fax or obituary, that's very different than I want to plan ahead and and then if you were a young dentist the same thing I think if you were opening up a practice again what would you say about these big ticket items when you start an office do you need a CAD CAM a CBCT and a laser and if you're getting ready to sell your practice and transition out in the next five years do you need all those big things you got nineteen hundred clients do the big boys and girls who wear their big panties who take home the 250 350 on up do they know what do they have in common?

Brett: Well they all what they have in common as they do invest in their practice they will always invest in their practice they're investing in themselves first my even coming to Cane Watters and they're certainly looking to invest in their practice and that could mean equipment purchases I have no problem with anybody buying anything related to the practice as long as there's a plan for it as long as we understand what the hell we're doing how is this thing I paid for itself do you want it just because you saw somebody talk about it on stage you don't even know how to use it do you want it because your friend has it and you still don't know how to use it or do you want it because you know what it can lead to this it can lead to this it's gonna help me sell more dentistry and each time I use this each time I scan this patient I'm gonna give this much I'm gonna get this much and we're gonna move on down the road to helping me to helping me produce more dentistry. If that's one of the answers if it's well thought through like that and you understand what exactly that machine is gonna do for you and how you're going to use it I don't care if you're 15 years old or 55 years old it's going to work for you if you're dedicated to it. I will tell you though it's like it's also on the on the back end on the first question you ask about the older guy you're not gonna get your money out of whatever you buy right it's just like it's just like putting new put new a new paint job on your house or putting new blinds in your house before you sell it you're not gonna get you're not gonna get dollar for dollar out of that let 7 come in and kind of help rehash rehash the equipment and if you get a little if it hits you a little bit on the valuation hits a little bit on the valuation but most of the good practices are not afraid to invest in sand certainly in technology and I'm kind of nervous even saying that because there's a lot of irresponsible spending out there if you don't know what it does and you don't know what it costs and you don't know what it's going to what it's going to produce for you every time you use it you probably have you probably need to have some more conversations before you do that and these things sounds simple they sound of bread of course I'm going to know what the hell it does before I buy it but you might be surprised at at you know there's a lot of these pieces of equipment have a lot more functionalities and maybe you might think and I'm a big proponent of a lot of them you know. So when you're thinking about selling a practice on the on the back side even before we get into the numbers and the nuts and bolts of the equipment you got to figure out what the goal is determine the goal of what you want to do so I actually so Christy Radcliffe and I actually head up to NDP corporate sales division too so it's kind of the other hat that I wear around here and a lot of the conversations we have are just basically high-level like what are you trying to accomplish by selling this practice what is it going to do for you is it curbing some fears that you have you want to take some chips off the table do you think dentistry's kind of cease to exist.

Howard: What's the other hat you wear before you just said that real fast?

Brett: Yeah so NDP as a transition service an NDP corporate sales helps helps doctors understand the differences and helps others to analyze their options they have when selling to a non private buyer like a corporate buyer.

Howard: and who do you do that with?

Brett: Christy Radcliffe and myself so Christy Radcliffe runs national dental placements right now and while Charles libretto for years they've been doing private to private sales Christy Ratcliffe and I now help people understand and help trim and help make transitions from independent into the corporate world and so we know a lot of the DSOs that you know they're not all created equal a lot of the ones that we work with we are really really good but really really good companies and they take care of their people but you know we still need to have these conversations because like I said Howard, we get a lot of we have a lot of conversations I got this letter what do I do with it is this letter the DSO or is this letter the broker well I don't know I don't actually know well this broker just wants to sell your sell your practice like a real estate you wants to sell your house you know maybe he can help you sell it maybe he can't maybe when he can help you sell it you know but we need to understand first what is the what is your goal like what matters what matters to you right now why are you selling is it money is it risk is it fear of missing out is it because your friend told you he got seven hundred times for his practice even though that's there's no way he did we can kind of help you walk through all those things and and so you need to have these it does help to have these conversations before like you said grandpa's before grandpa dies and you gotta sell its practice somehow. These transitions are gonna take a few years if you want to do it right just like in real estate if you're never in a hurry to buy and you're never in a hurry to sell you're probably gonna be okay but as soon as one of those things isn't true you have a little bit more risk but help let us help you understand what the risks are and how that lines up with your financial plan how that lines up with your goals not just a simple transaction hey I'm gonna get the most money out of this guy so I'm gonna go here it's much more important than that, sure we'll help you get the most amount of money possible but what does life look like afterwards and what are the things that matter to you is it days of the week that matter is that in health insurance that matters is in money is that you know the name on the building there's all these different things that are happening and a corporate to private sale is a very different animal than a private a private sale you know so all those things you know no matter who you're selling to get that practice as profitable as possible show the world that someone else can work in that practice with you if you got four million dollar practice and you're the only producer in that practice it probably makes sense to show a potential buyer that someone else can work in that practice maybe it's worth maybe it's worth having a conversation they're getting associated in there maybe it's worth understanding you know getting all good for certainly getting all your charts in order making sure your processes are in order how much unscheduled treatment do I have that I can that I can kind of help how much unscheduled treatment do I have that I can cultivate prior to this sale that'll kind of blow by multiple.

Howard: Well you know why I would love to get a Christy Radcliffe CPA CVA you know what I'd like to get on the show because all these dentists have all these insane rule of thumbs well if your product is collects is a million dollars that's what it's worth no what if your practice collects a million dollars and you lose a hundred thousand year and in other offices collects a million and takes home a hundred thousand a year and this one collects a million and they take home four hundred thousand a year. So there's so many rural thumb's tell tell Christy that if she ever wants to come on the show and I get rid of all these rules of thumbs in fact that's what we should call the the show getting rid of all your thumbs.

Brett: That doctor dentist's information highway I don't know where that information comes from sometimes our when the dentists are talking to each other about multiples and finances and things but it's a little bit inconsistent sometimes I think I think it's also kind of dangerous because if you start believing those things that understanding the details you're going to be you could potentially be in an interesting situation so you know we can have those conversations with you Christy and myself we have we have different backgrounds what we kind of complement each other nicely on these conversations understanding what do you want to do you know you're not gonna get some crazy multiple these are very very smart people that are buying your practice they're not going to give a bet they're not going to make a bad deal just because.

Howard: Their not gonna overpay for it that's the bottom line if anybody's gonna overpay for anything it's gonna be a physician a dentist or a lawyer it's not gonna be an MBA or somebody from private equity or somebody with a CPA.

Brett: Not a ridiculous amount you're absolutely right well they will pay if you all you got to do is put yourself in the buyer's shoes so if you've ever bought a practice if you ever entertained bring on associate what are the things that you're worried about that are making you hesitant towards you know buying someone else's practice well if this doctor if I buy this guy's practice now he gets disincentivize and he leaves or doesn't produce the same way or his patients leave or his referral base doesn't like me anymore all these things are things you thinking about all the questions that I get asked all you really need to do is put yourself in the buyer's shoes and the more risk you can mitigate for the buyer the he's gonna give you the more money he's going to pay you. If he's worried that you're going to go away then he'll make you work back for a certain amount of years in a contract and he will pay you more because of it if you want to quit tomorrow you're going to get paid less all those all those different things help me help me as a buyer mitigate my risk when I'm buying your business I'll pay more for it because it's more of a sure thing and a better asset for me to buy.

Howard: So if you go to his website I can't believe we went over an hour if you went over to is a website its and you go to the vendors I mean it's American orthodontics browser care stream cross cross tax dental phone elite dental elite patient financing buy green sky health first coals I mean it's everybody it's phillips staples vitality young innovation zest Benco, Bank of America, ADP, Benco net, bright Eva seed our CED our HR Caesars cedar right up the street here in Tucson yeah in fact Clarion Financial CWA dental enhancements DDS lab dental HQ I mean the list is just it's front office rocks I mean my gosh lighthouse inspired hygiene molar media NDP open dental that's what I use ortho bank, ortho brain, paycheck, practice mojo, prosperident and smile more soPhi I mean basically who you didn't get that beast that'd be easier and you just have a list of sorry we don't got that one.

Brett: Well you'll notice there's only one or two players any in each space this is the and those are brand those are brand names I would put our vendor group up against anybody's in the space DSO non DSO anything these people are dedicated to the independent practice they proved their dedication to the independent practice by getting on board with us understanding our mission and wanting to help the independent practice all those people you mentioned we have predetermined deals with each one of them and they're going to give you that white glove service that we demand from all them and just spectacular I would I trust every single one of them with every one of our doctors and if I don't they're not gonna be on there if they don't pass any single test they don't get on it that's why we only have I mean realistically it's not that many vendors and it's because you know this is a close-knit family our members are part of our family and so our vendors or keeping everybody happy in this sunshine fairy tales in the unicorns Howard.

Howard: and the other thing I'll say is Dallas is it's central I mean if I look back everything I did I mean I have a million miles on two different airline companies I mean living down in the corner in Phoenix or San Diego or Miami or Seattle or Boston is not smart to do what we do I should have lived in Chicago or Dallas and Chicago is miserable and freezing cold and you live in the perfect deal you're a two-hour flight from anyone so again this is all I'm gonna say to you if you don't know your numbers and if you don't have a full-time CPA dedicated to just dentistry you're an amateur and nobody is suggesting that we go back to the 1900s where one universal physician treats the whole body were way beyond that it was long overdue for those guys to die and anytime I meet a dentist who used a CPA that's doing you know restaurants and chefs and farmers and weed farmers they have no idea what's going on. So find yourself a CPA that only does dentists and if you cannot find one you're a two-hour flight from Dallas on Southwest Airlines which has a gazillion hotels and you know it doesn't cost any money and Darryl makes you take your spouse because you know I can't I just laugh when you hear dentists saying that the president I say should reduce welfare or Social Security or cut in title dude you can't even stand up to your wife you can't even ask one person to quit spending money oh but the president you know he's supposed to order a hundred million people to do it you can't even tell Muffy to do it so you know get on the plane bring Muffy and they will sit there for the whole day and when you leave you know your numbers you know what you have to do and again I tell dentists he even said is I mean dentists are the only ones in their town that knows the difference between geometry and trig know that ever seeing cosines and tangents I mean you know what Sir Isaac Newton argued with Einstein about I mean you know where quantum mechanics broke down with relativity this isn't rocket science man if you got an A in trig and and you know who Niels Bohr is you can figure this stuff out you just have to focus on it guys you got to get your numbers down and if you win with your numbers boys can have toys I don't care if you buy a Ferrari a cad/cam a laser I don't really care what you do because you're having fun but when you don't know your numbers and you're getting beat up and you're arguing with your spouse and you're starting to not spit out the Listerine and then swish and swallow you need it's always gonna come down to your numbers it's not your hands it's your numbers and that's really the major difference between the NFL and Dentistry and the NFL if you don't have a set of hands if you're not an athlete you don't even you don't even get in college ball and there are dentists who graduated with no hands but they're such good business people they can still stay in business so and the other thing about the NFL is the average their average career isn't even four years and my god if you can do this for 40 years and you just make a little bit of money and put a little bit away and save consistently for 20 30 40 years oh my god you can get so rich on this.

Brett: You just need a plan Howard, you just need a plan.

Howard: So if my homies need to talk to Brett for a plan how do they contact you?

Brett: Yeah go to the website you can always go to the Cane Watters website as well and we'll get you hooked up with a financial plan an overhead an overhead reduction plan patient growth plan and if you're interested in a transition national dental placement will help you transition as well so it's nice little ecosystem there little suite of services just reach out to us that way and we'll get you squared away with with all three of those.

Howard: and on that note you should you should at least end your in Dallas you should at least end with a Tom Landry quote "Football is an incredible game sometimes it's so incredible it's unbelievable setting your goal is not the main thing it is deciding how you will go about achieving it and staying with that plan" Tom Landry the greatest coach ever a nice little kid the Dallas Cowboys was it was Tom Landry's team he was the greatest loved his hat he said "Leadership as a matter of having people look at you and gain confidence seeing how you react if you're in control they're in control" and that note thank you so much for coming on the show today Brett it was just an honor to podcast you today.

Brett: Awesome thanks Howard

Howard: Alright have a great day

Brett: Go Cowboys 

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