Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1503 Dr. Richard A. Huot, DDS on Managing Your Practice for Long-Term Success : Dentistry Uncensored with Howard Farran

1503 Dr. Richard A. Huot, DDS on Managing Your Practice for Long-Term Success : Dentistry Uncensored with Howard Farran

11/18/2020 4:00:00 AM   |   Comments: 0   |   Views: 152
Dr. Huot was a private practice owner from 1985 to 2008, and still practices clinical dentistry on a per diem basis, working as a clinician/consultant for private and public health concerns. He retired from the USAF Reserve Dental Corps in 2012 after 30 years of military duty. Dr. Huot is a past President of the Maine Dental Association in 1994, and the 2006 President of the Atlantic Coast District Dental Association in Florida. He served on the Florida Dental Association Board of Trustees, and two years as Vice President of the American Dental Association. He currently serves on the ADA Council of Members Insurance and Retirement Plans, and the AGD Legislative and Government Affairs Council.
VIDEO - DUwHF #1503 - Richard Huot

AUDIO - DUwHF #1503 - Richard Huot

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*Please excuse any typos as this was digitally transcribed.

It is just a huge honor for me today to be podcast interviewing Dr Richard a Hewitt DDS he's the founder and CEO of beatside dental consultants ada second vice president FDA board of trustees uh rick Wilford nba cpa cfp love this guy he said about you dr Hewitt’s enthusiasm for the profession clinical expertise and strategic planning perspective are a unique combination to guide any client to a more satisfying and productive practice Richard does practice management consulting from a dentist perspective if there is anybody that has lived management while practicing dentistry it's rick Hewitt starting in his hometown in Maine 32 years ago rick built a practice from scratch and averaged 50 new patients per month after nine years rick sold his practice moved to Vero beach Florida and successfully bought and merged four existing practices into one he produces in the top 20 nationwide on a 150-day work year dentistry is hard work so let rick show you how to work smarter not harder while enjoying one of the most rewarding professions rick's prior experience in managing management consulting makes him an ideal boost to your practice health his program to help your office can be customized to fit your needs and concentrates on financial benchmarks before during and after his initial work with your office dr Hewitt has a very well diversified skill set in a variety of private public and non-profit work settings always look for new fields to explore in healthcare information technology um for his healthcare consulting and you moved from Maine um to Florida so did you just get burned out on lobster you're just like i can't eat one more lobster or was it the weather uh you know it's funny because we were just talking before the show that i i was in uh your deck of the woods for two years in Arizona and 83 through 85. i got used to those long summers he had in Arizona but i missed i missed the four seasons as i thought and then i went back and were you at Williams air force base or Luke i was at Williams on the southeast guide and i was some of your readers some of your viewers would know this but they had just extended the superstition highway out to Williamsfield road when i was there so that just shows you chandler where the base is located was seventeen thousand what's the population now two hundred and seventy thousand demographics matter it certainly does so left i left an area that was booming and i went back to my hometown and Maine’s economy was booming in the mid-80s but it slowed down and the weather got to me and my wife and i decided to go down i-95 1500 miles away live in Florida was it more you or your wife i think weather-wise it was my wife because she was internal next 11 and a half months of the year so i said you know we can always i said i could spend continuing education money and go to every southern course there is for the next 20 25 years or we can just make the move now so we voted on it and uh the move is there yeah and what's weird is now you're in Florida um Maine in the far northwest of the united states is actually just 5 300 kilometers from Africa um morocco whereas Florida’s easternmost point singer island is 6500 kilometers from Africa it's hard to imagine on a three-dimensional globe that Maine is closer to Africa than Florida but it is and the thing that blew my mind i remember the first time i lectured in brazil at the aesthetic at 2000 conference with 4 000 people in attendance that south America is not south of north America you if i go straight down phoenix i go straight down south it's ocean all the way to the south to Antarctica and that south America is way out there east of uh America in the ocean uh so um so now you're further away from Africa um and you were you're the um are you the trustee now or you were the um are you the currently the uh FDA board of trustees so i got off the FDA board of trustees right as i became vice president of the ada but that term finished out last year so those are two past officer positions that i had and you and i are both friends with the um the newly elected president-elect um Caesar sabotage who was my classmate at umkc and he's friends with you down in Florida how is that um being a vice president how cool is it that you know the president-elect Caesar well so i was on the board of the ada with Caesar for two years and i had the pleasure of working with him at the FDA level also but it is amazing how many umkc grads practice in Florida it's quite a big alumni down in this area so you you know there was one of your classmates i actually bought his practice uh in Vero beach many years ago so there's are you talking about joe diciano that's correct oh my god i love joe diciano oh my gosh and that was a neat story he was a um the family had an Italian restaurant he worked at the restaurant for years and he always thought if he had to do it all over again he would have gone to dental school then he realized i think when he was a freshman in my class i think he was already like 40 or something and he saved up his money and everybody in the class just thought it was so cool that this guy had a restaurant for 20 years who always dreamed about being a dentist and and did it i mean uh my gosh well what's he doing now well he when i bought his practice he was moving to the west coast and i lost track of him but he needed to sell his practice enviro and that's part of the part of the things that i like to do is to emphasize you know when i do consulting is is that every dentist has great patients and some dentists you know where the dental field now is more mobile somebody might you know the traditional model that you know of somebody plunks down and stays in that same city for 20 30 years or even more than that but you know with the with the demographics we have with more women in the dental profession you're not going to see that as much in the next 20 years so people people will have you know practices will come up for sale and uh they're great opportunities i uh bought i bought two of them in Maine a lot even after i started from scratch i bought two practices in Maine and then sold that when i left and then when i came down to Vero i actually bought one that was existing and bought three more before i stopped practicing as an owner in 2008 but i can tell you every dentist has great patience and uh if you if you can work it out and you can if you have the the selling dentist work back for you it's even a win-win situation it's good will you know and everybody has everybody likes to hand off their patience to somebody when they leave that they can trust and your patients appreciate that well i want to um since um well first of all joe deciano if you're out there listening my gosh give um uh send me an email Howard um but um since you were just finished your um vice president of the ada since you're a trustee since you know Caesar i want to um uh derail this interview and go right to um one of the biggest threads on dental town is cancel your ada membership the guy starts off uh dental offices should have never been closed down and i totally blame the ada they majorly dropped the ball I’ll never be a member again and he posted that in um 6 8 so uh what is that uh June 8th uh June so July august September October November so in the following five months it's just exploded it's one of the biggest threads on dentistry um my position I’ve always been a member of the ada and the reason I’ve been a member of the ada is because the united states has one million attorneys and they're always trying to negotiate for whoever they're representing and they're representing big insurance companies all all these different sets and someone has to be sitting at that table playing poker uh for me and and that's why i remember there i always seem as they're like my parents uh my parents aren't perfect uh but they're my parents my mom is uh i she's already emailed me and called me three times a day um you know they can be um good bad crazy whatever um but they're still your only parents and um gosh what do you say to these dentists who say that um they're not going to be a member and they would rather just practice alone in their dental office and have nobody sitting especially at the state level like it's not just the american dental association like you're from the Florida dental association what percent of the average working dentist know the issues going on in the Florida legislator that could affect their dental office and they need someone like you and Caesar arguing for your point of view what would you say to those people well you're spot on number one but i'm gonna i'm gonna tell you that i used to watch your podcast and i think you compared the american dental association years ago in the best light that i ever said you compared it to going to church and i thought that is great that is a perfect analogy if you've ever been to church it's like it's you know deep down inside you should do that and it betters you but you know you sort of kind of say i'm not sure if i really want to do that i'm a gentle dentist and i'm a member of the academy of general dentistry and a member of the american dental association not because i do you know i because i'm involved with those organizations i look at it as an insurance policy for the crazy things that happen and believe you hit it right on the nail and you you hit it right on the nail when you're talking about state legislatures they can get a little crazy and they they that is the tripartite of the ada is we're unique in that if you want to if you're an attorney you don't have to belong to the national bar association the state bar association but in the ada it's been held up in court you have to belong to all three and it really what it is is it's just malpractice prevention from legislators that's what it is and both both i think personally as a general dentist i feel i should belong to those two organizations if i were an adonis i would belong to the ada and the american association of endodontics and i think because you know the ada even though it's 80 percent general dentists that there are some things that are unique to specialty groups and you have to look at general dennis as a specialty group and you should belong to both of those organizations now i you know we don't have time in this podcast to prove it but you can save your dues just by some of the programs that are offered and i know you can get other i know you can get deals and i know you have them through your your dental town thing but i'm talking about things like life insurance disability products that you probably don't offer through your membership that that you know is unbelievable they have they have the best rates by far yeah um but what would you um what do you what about the issue though where um closing down where he was saying you know that the issue for him was dental offices should have never been closed down and i totally blame the ada um they you know you can say that but i know these dentists weren't sitting around the table with all the stakeholders i know for a fact i i interviewed um chad the existing president ada and i mean they were they were getting calls from all kinds of big major institutions within the united states and from around the world so um what would you say to this dentist sitting here doing a root canal thinking well if it was me i mean he wasn't talking to all these other uh agencies so i would tell this dennis so in your hometown wherever you practice your intern has closed his office or her office the surgery center closed their office do you honestly believe that we would get any credibility as a health profession if the dentists were still open i it doesn't make any sense and i i chad and i talked before his decision chad is uh obviously a real close friend and was a great president he had to make a tough decision and he called a lot of his you know close friends and said what do you think of my decision and i said chad you had to do it and you're going to either get vilified for it or you're going to get praised and in hindsight when you think about it the original uh closing issue was for only i think three or four weeks now the state legislatures in Florida popped early and allowed dental practices to return but everybody knows that it was a state-by-state issue like i don't know when Arizona dentists were allowed to come back but i do know that the Arizona dental association was right there for them lobbying as far as the safety about coming back so just as fast as we had to close them and sort of kind of go along with the band-aid we were right there to uh ensure that we could practice in a safe manner which we're doing now you've seen the stats less than one percent of dentists have are there's a less than one percent infection rate of dentists and their staffs so it's obvious that we could we handle this and i think we handle it in a great manner the other thing that we found out all along the way while we were closed is hey guess what dentistry is an essential service you need that you know people sit there and grind their teeth worrying about covet all day long guess what they bust cusps they break teeth and something that they've been putting off for years is now coming up to the forefront well put and you're um my gosh you're uh consulting um you know we were closed down for two months and um i was closed down on um st patrick's day to cinco de mayo so the irish shut me down and the mexicans opened me back up uh that's what i think when i'm ordering a drink I’m I’ve switched to all margaritas and uh given up on the jamison because they closed me down but you're you're a dental practice management consultant and we're hearing um you know the ada um first uh vuceck was saying a couple months ago that the industry was down about 30 to about 70 percent his latest numbers are showing that the amount the entire profession of dentistry is down about 38 so that's almost 40. and projecting next year 2021 that'll be down 20 percent you're in Florida um what's it look like on the ground to you and um what would you say to these dentists when they're looking at they're operating in a macro economic environment that's down 38 percent i mean it's a lot nicer to go into a business where you have a a tailwind behind you like you know like like your time at chandler Arizona when you open up in channel and there's 17 000 and now there's 277 000 if you couldn't have found a new patient out of that uh you're you know something's wrong but imagine if you were in a town with 277 000 dentists and 20 years later it's down to 17 000 i i would be telling you that you're in the wrong place to move so what do you tell what first of all what do you see on the ground in Florida as far as busyness levels well from what i'm from my colleagues are telling me and i don't do just Florida practices my colleagues you know they got they they were as busy as they were going nuts when they first opened that but keep in mind that everything was shut down around the march mid-march time frame so if you expect if you extrapolate out for six months now there's your hygiene now it's kind of like when we have hurricanes in Florida our hygiene schedule gets kind of messed up because people have other expenses they lost their roof well guess what they're gonna replace the roof before they come and see you and in this particular in this particular pandemic you have the added part about the medical portion of it and people were a little afraid to come back just to get their teeth clean so i'm sitting around you know in in my community over here and i'm playing tennis with a couple friends of mine and they're they're saying well rick is it's safe to go back to get my teeth clean and i go yeah it's safe yeah i i you know i know the dentist can go back you're going back to and you'll be fine but there was that hesitant hesitant part of patience now the emergency part took care of itself so a lot of dentists were very busy originally just doing emergency care and fixing things but then now projected out i think you're going to see I’ve seen marco's numbers and i agree with them in perception but i also think that it comes from i also think that it's dependent on a state by state basis there aren't let's face it i mean i mean i know you know this from your your client base and and you know your dental town funds there are some states that are doing better than others and one of one of the things that's pretty well uh documented right now is this the states that opened up earlier are doing much better i don't like the state's you know economies i mean Disney is open in Florida but it's not open in California that's going to affect that's going to affect the economy in Anaheim a heck of a lot more than it's going to affect the economy in Orlando i think you can understand that so um Florida is um i mean that's a um that's just a big state i mean uh um Florida has 21 million people the uh Texas has 28 and the largest is California at 39 million which actually doesn't sound like a lot and i lectured in new Delhi and that city has a population of 39 million the city of Delhi has more people than California um Texas so they're 39 Texas 28 Florida is 21 million new york's only 19 million um that's just a huge huge state and it's it's kind of interesting because um Florida is the only state where the more south you go uh the more north it is because you go south everyone's from like where you are up in Maine and then you go north it's really the south it's like Georgia um so do you have you're in Vero beach and um is that sorry to say this but when you live in Arizona i think that it's probably like a bunch of people over 65. is that an old folks community um is that an old folks town or is it a different mix of dentistry than say just a regular you know uh Kansas city Missouri you know just the the full spectrum so the demographics in Florida have changed completely and so has Vero where i live so the the fastest growing demographic in Florida right now is the younger you know age uh 1 to 18. because a lot of families have settled here we've got a tremendous amount of immigration from south America you know in the south Florida area but i'm kind of like about i'm directly across from tampa so i'm mid state if you want to call it that and we get uh we get a high amount of retired people from connecticut new york new jersey just flying out of those those states because of uh the tax situation and because of covet and the new england states also but interestingly enough we're getting we're picking up a lot of people from illinois and we're picking up a lot a lot of people from California not as much as Arizona does but you've been in Arizona long enough to see these waves of californians that move from California to Arizona especially when the the uh the tax situation gets crazy in California and we've we've we're getting over a thousand new people a day in Florida and and it's it is amazing the influx and they're uh you may have heard of this community and just north of Orlando called the villages and it's it's amazing it's a huge retirement area and it's growing in leaps and bounds yeah um top 10 states growing numeric growth we said California was number one population 39 million but they um they don't even make the top 10 for growth they're they're losing population my practice since 1987 10 of all the new patients came from California um and the people in California don't get it like san diego used to be the the international tuna fish capitaling capital of the world they caught all the tuna they processed it they canned it they shipped it around and then the environmentalists came in and said oh it's not you know it's not good and they regulate it and tax it and killed it but here's here's where i draw the line did people in California stop eating tuna fish oh hell no and now that it's done on all these other poor countries do you think they do it environmentally better or environmentally worse and that's what America does they they they regulate you to death until the business dies but they don't change their behavior it's like all these people that um um want me to drive an electric car and then they go out and buy an f-350 you know uh for a hundred thousand dollars but i wanna i don't wanna get into politics sex religion or violence but young dentists have asked me this and i i'm gonna ask you because um you're you should know um you're out there on some type of it's not like an island but it's vera beach but i mean it's what do you even call that it's a barrier the berry island side so you have the intercoastal which runs all the way from key west that runs right up through the chesapeake area in maryland and goes right straight up of the mid-atlantic states so essentially you know you think of north carolina has the barrier side and you know those are the more famous one but we have a basically we're on the uh there's Vero beach and vera beach has a land side and a berry island side i happen to be in on various side but since i do consulting and work from home uh you know i don't really need geographically although my office when i had an office was literally five miles down a1a from from where i live so i had a nice little commute in the morning and it was really relaxing and uh sold my practice and did great however i still have active licenses in four states and i do per diem work if the need uh is is there i have a lot of brokers as as friends who say hey rick i could use you to work uh for this you know dennis that's thinking of selling and just had a you know an injury or something like that and i can do that kind of work and a lot of times when i'm doing that i can actually write an operating plan for them in the air force i used to do operations inspections basically i would go into a base look at how they could improve their productivity and this came in really handy after 9 11. um you know we lost 15 percent of our dental corps they they the officers were relocated to war fighting and so the dentist in the air force had to work a little harder but more importantly they had to work smarter and be more productive and we inspected bases we digitized them we've got them new facilities and uh they're guess what their production increased by 40 percent that's not true well here's here's the politically incorrect question they're asking uh me and that is um i know uh after this last election let me just say one thing that um America is completely divided there's two you know the there's two um different views of moving forward and it's neck and wire so if your team won or lost um you're still right here there's eight billion people stuck on earth you're not getting off um and you know you got to figure out how to work together but another really politically sensitive thing to talk about is global warming and a lot of the young dentists are saying well you know where rick is um is isn't that going to be underwater and they see news reports like your Florida coastal home could lose 15 percent of its value by 2030 due to sea rise and it could lose up to 35 percent its value up to new report if you were a young kid and you just graduated from nova i'm serious you're they're 25 years old and let's say you were selling your practice and everything was right about it and they really wanted to buy there but then they're thinking damn is this is this going to be under water i mean what what would you tell a young kid because they're going to practice from 25 to 65 i mean they're going to be there for 40 years i mean I’ve already been in my office for 32 years um so what would you what would you say to a young 25 year old that was going to buy your practice as you were rowing out to the ocean so my office was about 500 yards from the ocean uh and in 1989 i can tell you the buildings in the same place and the is at the same level it was in 1989 as it is now so anybody that thinks that the water is gonna suddenly rise by two feet because some glacier is melting in the arctic ocean is uh you know it kind of gets spread out on the way down here uh i climate change is uh there's a difference i don't believe in global warming i believe in climate change but i can tell you that there have been no more hurricanes in Florida since we got here than uh what we went through this year now there were a lot of storms this year but very few of them made landfall as hurricanes so i don't i don't want to get in the politics of this too because i think first of all it's what i would consider way above our pay grades when it comes to actual statistics but i really wouldn't worry about setting up a dental practice uh because of climate change in the state of Florida now down south in miami there are areas of the city that they've had to do mitigation as far as the water levels but that's true just about everywhere on the coast uh you know you'd go up to north carolina and you could see that you could go to uh the west coast and see that so i don't think i would concern myself about we're practicing uh there are a couple practices on the barrier side and to tell you the truth most most of the dentists in uh in Vero beach practice on the other side the land side if you want to call it some but nobody's nobody's office is under four feet of water because if the insurance companies knew that there was a high likelihood of that they would have already reflected that i know that's what I’ve been saying the whole time it's like i don't you know i i don't want to get in the politics of it but you know when when bill maher always says you know 98 of all climate change though yeah that's called group think bill did you just learn about group thing i mean you couldn't get a job at the wall street journal if you believed in communist marxism they kind of only hire people they kind of believe in milton friedman so that's what you see in everything you see this group thing thing but wall street my god those people only see dollars and cents and if they really really thought this was an issue do you think they'd be loaning 30-year mortgages to uh dental office and houses on the beach he's got the wall street journal right there okay so i would tell you i would tell your your fans out there these are the two mag these are the two papers you have to read what do you do online or not whatever whatever your purview is i'm sitting here in Florida and it gets thrown in my driveway every morning but i'm gonna tell you this okay usa today very liberal very left-leaning written for an eighth grade education it's got a lot of nice graphs though but that's what your patients you know you can put that one in your reception area the wall street journal is written for about a senior in high school's reading level and it's more conservative and you some of the articles you mentioned are there but this is how you educate yourself this is what they taught you in the military is you do opposition research right you read about one point of view and then you read about another point of view you don't take everything for granted and if you can do that you will have a successful business one way or another now a lot of the education a lot of the media has shifted for our young dentist to their phones so you can do the same thing right you and i know you could i bet you you could call out ten names of of online news sources now that are new and coming up and they're probably most of the younger people are probably looking at stuff like that now but it's always good to have more than one point of view because groupthink like you said is dangerous like the herd yeah i i agree and i loved um calling out opposition research um some dentists actually get mad at me because i'm um interviewing dso captains and those some emails like they're the enemy what are you what are you interviewing them for and it's like what and that that you you're running one office this guy's running 500 you can't learn something from this guy and you would have called it opposition research and I’ve sold every i like dental town online ce that wasn't my idea i lived in phoenix and every time i was driving to the airport i saw a university of phoenix online and it had to go from not one building but two buildings it took nine buildings before my thick skull said i wonder if i should put an online ce course on dental town you know and and now we've had a million views but none of these are my ideas um i i just i just make an art of stealing the best ideas that we've learned through history and that's what i love about dental consultants like you is that um you know this guy is sitting here practicing his office and he can't even figure out his own office and then you've seen gazillion offices for many many uh many many years so um so basically um surviving this uh uh pandemic and uh being a dental consultant um what are the dentists doing that you're working with um what are they doing more of if they're having better numbers and what are the dentists that are still you know down 38 plus what what should they be doing or at least thinking about so do the opposition research for the people that are doing better so intuitively if you have all this ppe that you have to put on right wouldn't it make sense that you need to do more procedures per patient because that way you don't have to change this stuff every every time would it make sense to maybe like allocate your hygiene department to make sure that one dentist checks you know patients and maybe a uh uh one dentist that's working on an implant case or a surgical case shouldn't come out of scrubs it makes sense it's not only is it less costly so what you have to do is i think what we have to do in in dentistry right now is there are some offices and i know you've seen plenty of them that still do this like you know wham bam you know couple fillings and this and that's it i think you have to do some comprehensive treatment planning and it doesn't have to be full mouth cases but if if you're going to do restorative cases the days of doing like one or two restorations or sitting are gone if if this stuff is costing you 20 to 30 dollars every time you've gone up now we're not going to be in covet forever but i think i think now is the time to change and the dentist that i know that are doing really well the ones that are talking to me and saying you know i i know i always should have done this but covet forced me to do this but i see less patience and do more of them at one sitting and by doing that of course that's going to take a lot as you know that's going to take a lot of hands-on verbal skills from front stand you know from front desk staff saying oh mrs jones by the way this disappointment this isn't like your 200 appointment like you're used to this is gonna be a two thousand dollar appointment because we're gonna do this this this and this because dr jones figures out that you probably don't want anybody else you want to get this done in one city and we have the you know of course with payment plans and and you know tools such as care credit and other types of third-party payment plans there's really no reason in this in this universe that you're not doing that it is amazing how many dentists still do the crowd of the month club i mean you know i think you know about that and and uh then the other thing is is from a procedural point of view why is it that one dentist can do a crown prep in five minutes and another dentist takes an hour because they have done studies and showed that the dentist after somebody looked at him a third party looked at him and really couldn't tell the difference on the preps which ones were done in five minutes and which ones were done in an hour so wouldn't it make sense to get a ce course on how to effectively do a crown prep in five minutes or so i'm sure that i mean you've been in a chair practically as long as i have we're the same age group and uh you know you certainly have increased the speed of your crown preps over the years but you may have taken a course on how to do that also or figured it out on your own and in dentistry it's a dead giveaway because every general dentist will tell you well you know that guy is doing a crime for him half hour he's cutting corners and you know burger king has uh you know square uh wendy's has square patties because they don't cut any corners and I’m not cutting any corners I’m gonna I’m gonna spend an hour and a half to do this and I’m like dude how long does it take you to do a molar root canal it's not an hour and a half okay enos hour how long would it take you to pull these four wisdom teeth an hour okay an oral surgeon in 15 minutes every spec oh my god have you ever seen a pediatric dentist what i would rather where if i had to do that case first of all I’d just tear up my license and run to another country but the speed they do it and this i got a friend who's a pediatric dentist and her thumb is the bite block she doesn't even care you can chow down on that thumb and she's going to knock out that chrome silk crown while she's confusing you about Elmo or something and um there's so we already know in dentistry the specialists are much faster so you saying that going slow is because your conscience and you're doing it better and someone else is doing it faster better easier cheaper smaller is um is not a good person there's just no evidence for that and it was Regina her linger uh i got an MBA master’s in business administration she has a doctors in business administration from none other than Harvard which was the first university in the united states so first mover advantage you'll always have the biggest brand name that's why Coca-Cola is still better than Pepsi because it started a decade earlier but um Regina her slinger called it the focus factory and she said if you um study if a surgeon only removes appendix that's all he does he will have significantly higher success rate than some general internist who does five or six different surgeries and all of them take twice as long she says you want to go to someone who only does one thing and they'll do it faster better easier cheaper everything so um i couldn't agree with you more there are orthopedic surgeons in Florida you know in Vero beach to do left knees on a certain day so if you don't think that has something to do with efficiency and i i can tell you right now getting back to your molar root canal story if you're taking an hour and a half for a molar root canal you have two options number one you need to refer out or number two you need to get somebody into your office that does them in a faster faster than that there's just it's just not a really you know it it's a pride thing you know some people think that you have to do everything in general dentistry to succeed i think you and i have reached our comfort zones and we know what we we refer to you know i in the military i used to do a lot of wisdom teeth but my rule was under local anesthetic if i can't just do the set of wisdom teeth in an hour i need to refer this to one of the oral surgeons or somebody that could do it under iv that wants to take a little bit longer it made no sense for me it made no sense for the patient you know you you have to think about patient comfort in this also also when you do root canals if you're not stealing that thing before you leave if you're not either doing the core in the crown on the same appointment you're doing that patient and a tremendous injustice because everybody knows every study i've seen lately says if you don't have a good seal on a root canal you're you're you're you're destined that tooth to to something that it shouldn't be um you um your website is called mil in fact even your email is dr hewitt well I’m sorry is that rude to give out your email address uh yeah if you if you have a question just i mean go to his website it's military dentist uh dentist not with an ass just dentist military dentist one guy and his email is dr hoy it's france hewitt but it's spelled h-u-o-t at um to you know lots of people have been in the military before but they don't they don't name their website military dentists um i i would think that for you to name your um website and your practice uh that you have very positive thoughts about your experience in the military um you wouldn't um and there's a lot of kids listening to you right now that are in dental school that might be thinking about joining uh the military you were in the air force talk about your journey how did a kid eat in lobster in maine end up in the air force and out here at uh williams air force base okay so the one and I’m happy to talk about that and i i really enjoy it thanks for asking the was only for my consultant company my my the name of my practice was beachside dental which is no longer so that but i did have that that website also but that was purchased with the practice when i sold it so the military dentist is basically for my speaking and consulting and i grabbed it because nobody had it and i said well jesus I’m gonna do it and one of the things about the military is so I’m sitting in um I’m sitting december of 1981 in north at northwestern the economy is like in in shattered it's in tatters uh ronald reagan just got in and they just jacked up the interest rates about 18 and a half percent on the prime rate now you and i can remember those days your father was in business in those days and i mean that's loan shark rates you know when you think about it and uh i looked around and said you know i don't think I’m ready to get right out of dental school into private practice i had an idea that i want to go back to maine my uncle was a dentist in my hometown but he wasn't ready to retire and he certainly didn't have enough extra patience for me so i was looking at a scratch practice start in 1982 when i graduated with the interest rate somewhere around 16 and i said you know something i think the air force is looking real good right now it was the best decision i ever made in my life uh you know i went to a small base it's not a small base anymore osan air base in Korea there were six general dentists we were of varying ages and we did all the work that was there anything else we had to refer if we had to refer something you had to go to the army base in Seoul which was an hour away by bus so we got to be really good at doing general dentistry and everything else that goes along with it uh and then after serving for a year in Korea since it was a remote location i wasn't married at the time i was you know considered a remote assignment you got to pick where you wanted to and i looked around the the uh the country and said you know i've never lived in the southwest it's a great opportunity for two years to live let's see what phoenix has got to offer and i think i'll live in this town called mesa and it's not too far from the base so that's where i put my roots down for two years wow um so you know when you um started your lecturing and consulting business and everything um i uh think of you it seemed like you were talking a lot about um asset fraud protection internet social security media security retirement portfolio analysis financial reporting quick and home budget review accounts receivable review collection service accounts payable review quickbooks setup estate review asset insurance protection merger acquisition strategy human resource review performance and salary review processes strategic planning office core values productivity analysis procedure and coding analysis insurance contract analysis internal and external marketing analysis social media life coaching health and fitness analysis equipment purchase analysis supply has your consulting um how much of that is still what you talk about versus pre-pandemically versus post pandemic how much have you had to shift on your um post pandemic i think mostly now uh people are asking a lot of retirement questions i think this for the older days this is really changed their outlook on do i really want to still continue on but i like the merger and acquisitions part i really still like that i still think that there's tremendous opportunities for young dentists who probably have a a better facility and b more modded equipment to absorb an older practice and bring that uh practitioner in you know and and let them practice with them and it would be a symbiotic relationship the other thing i did in my spare time was uh i went through the college of financial planning in denver and i went through the whole cfp program now i actually didn't sit for the uh the task that gives me those letters after but i took i passed all six sections so it made me just enough just dangerous enough to state on my website that i work with any financial professionals because i think it's important for young dentists to get a hold of a good accountant a good financial planner and like like you found out over the years you know there's nothing there's nothing better than starting early on a 401k and just letting uh compound interest do the rest and that's one of the reasons that you know one of the philosophies i have is the dental careers it's a marathon it's not it's not a race it's not a sprint so you got to pace yourself but the easiest way to do it is to make sure that you put away the maximum amount every year in a retirement plan and you shouldn't even look at the stock market right now as a young dentist you should be putting the maximum account as the maximum amount you can and whether it's a 401k whether it's a roth or both you should be putting all that away as best as you can should be paying yourself first in your retirement accounts before you even bring a a dime home well you know um wall street is just it's built on m a in activity and these dental offices i mean uh these dsos i mean i mean gosh they're looking at should i start a de novo office where here's a group practice that has eight locations i mean that's all they do is m a um every i noticed way back in my career it's like everyone so I’d run into some dentist doing like three to four million a year taking out a million and I’m like what the hell how did you do that and he said well you know i set up in this small town and there were five dentists and each time the oldest guy put his office up for sale i didn't want to sell to some young kid like you with a bunch of energy it's like i'll buy out the old man and all moving into mine and he says those old men never they always think they have enough money to retire and an hour after they retire they want a new truck the wife wants a new you know the the grandkids and he goes so then they end up staying on an extra day or two for years after they thought they were going to retire and and they just built i mean they literally owned the town why do you think m a activity uh rules wall street and dentistry doesn't even look at it and you did it when you moved from maine to florida uh you emanated four offices and rolled them into one and um and how does that m a activity looked today post pandemic because when you look at dentaltown it's had free classified ads forever it's the hottest it's one of the hottest sections on the site there's always been about 1 000 dental offices for sale and 4 000 jobs available now there's 2 000 dental offices for sale and only 1 000 jobs available that's why i tell people that a socialist means that you own your means of production and if there's an economic downturn and you're an employee who's just a wage slave and a time wage slave you'll be fired but the guy who owns his own dental office can uh adjust and raise prices if there's inflation but how is the m a activity change post pandemic and why do you think it's so overlooked in dentistry except for the major dsos because because i think the dsos get it and they have the venture capital to do it I’d like to think this is when you when you come up with a selling price and I’m not going to tell you how to do that there's a variety of ways you can get appraisals all that stuff can get done when you come to a final agreement i guarantee you that you can probably pay the nut that monthly payment just on the hygiene of that acquired dinner dental office and if you're doing that the rest is just great and if if you have an an older dentist that says hey rick i want to just work two days a week i don't want to work this four day a week stuff guess who gets to do the other two days of work i mean there's just absolutely no reason why if i were a young dentist that's that's that's really i would be scouring that dental town uh class fights right now and looking at every one of them that's in the area now some dentists are not going to really some dentists might not want to advertise that because they don't want to let the competition know that they're uh you know considering selling but i would challenge that young dentist you take the five oldest dentists in your town you invite them out to dinner one night you pay for it and you say hey listen the reason I’m asking you right now at dinner is I’m gonna be totally honest with you if any of you have any chan any idea of probably slowing down I’d like to have the opportunity to practice with you and just let it go at that and you might even see something that comes out of that because that's what i did i took it was a the the uh this dentist that was uh he was a northwestern grad from 1951 that was practicing in vero he was just going to shut his practice down he had some amazing patience and i i took him out to lunch three or four times the last time i took him out he told me he goes rick you don't have to sell them you don't have to sell me yourself anymore i've decided that I’m going to come I’m going to come in with you because i think my patients will be best off with you now where were his options at the time he could have sold to a dso that probably didn't that may or may not have had you know it wasn't as popular back then but i can tell you that putting it on you know on the market and stuff you probably didn't really have the patience for that so you might you might do these deals and what do you get in these what do you get in these m a's right howard you get equipment you get employees there's a tremendous amount you get a steady patient you're going to spend 65 dollars you know per patient marketing wouldn't you rather spend the money on an established patient versus one that you're trying to track or take away from some other office it makes sense to me and and the thing you know i know i i know that everyone hates it when some old grandpa starts whining about how much better it was yesterday but I’m gonna I’m gonna do it right now um when i got out of school um a dentist you know they owned the land and building and the practice and they would sell the practice and let's just say they sold it for a dollar and it was for a seven year term at 10 interest rate they would carry the paper now i that was much better than going through some third-party bank who doesn't know anybody because back then they were actually worried who he was going to give his patients to it wasn't the dollar amount of the cell it was like is this going to be a good guy he's not going to over treat he's going to warranty his work is he gonna be is he gonna make the community better not some stranger that I’m just gonna take the money and run but when the dentist sold the practice for a dollar the 10 interest rate for seven years made him another dollar so now instead of selling it for one now he is at one dollar again that's like a down payment and then he's got that dollar spread out over seven years again and then at the end of seven years in real estate the only variable in real estate really is uh can you uh um sell it and um here's a person who's practiced here seven years everybody knows the practice and all that kind of stuff so then he wants to buy the landon building but he doesn't have much room to negotiate i mean hell he's got all his equipment there so then he sells it for the final third so doc got three dollars over seven years instead of selling a dollar and run but better yet since you sell the invisible i mean if i go to a circle k and say i want a diet coke or a dr pepper i know the difference between diet coke and dr pepper uh one of them's not a real doctor and uh and but um in dentistry we're selling invisible when i look at rick and you say hey Howie you got four cavities i mean what am i to do yeah i mean i i have to believe you and trust you or not and the number one thing that as is correlated with uh trust is employee turnover and we see this repeatedly I’m out here in Arizona ground zero for doss and every dentist i know that i say well what is it like practicing across street from that big do and i said it's the same thing every day he said patients come in and say every time i go in there it's a different dentist some dentist told me i needed four cavities one of the next time he's not even there and then the new dentist says i only have two and then he did two then i went back and now another dennis says i have four more and you know it's just crazy so by having that seller sell to you um the old man and then he stays under your day week he transfers that trust he's still part of the family you're the new baby in the family and when you're selling the invisible trust is everything do you agree or disagree oh absolutely and actually i did i did a practice like that in in Massachusetts um not naming names he was a very famous sports figure and he wanted to uh he wan and i could visit a good friend of mine and classmate to uh buy his practice and he put it on the market and he wanted this for this and he looked around and i think he was really interested in making sure his patients were were comfortable with uh the new dentist and he wasn't satisfied with the people that were looking at the practice so finally my friend said can you come over and talk to him and just you know tell him what you do and so i went in there and i talked to him and i we reminisced he's about his sport and i said look i said we'll call my friend jay jay is probably the best person you could want for your practice you know he's going to treat your patients for respect he used to cover for you when you were out of town and i said all you have to do now is figure out what the heck the price is and what the terms are and just let it go with that and you go and i says but i tell you you do him a real favor if you'd stick around for six months he didn't need the money he had made his money in professional sports but he stuck around and after i left after that that that consultation that i had he goes i like your friend i trust him he goes let's get this done so sometimes you know for the consulting part it's just a matter of being a third party and that's what i tell people is like you know sometimes you just need somebody else to look at one of the things you probably did very early on in your career is you probably visited a lot of offices because you wanted to see what people did and i call those nuggets and i did the same thing when i was in the military for three years i visited every friend and person that would let me in their office and I’d sit there and take notes because i knew that every dentist had great ideas but if you compile all those ideas you can have a pretty good office going right out of the box these are issues that have been around forever but um they kind of the pandemics kind of drawn them out and one is uh insurance they um they didn't cover the ppe fee and a lot of dennis said damn it that's the last straw I’m dropping that I’m dropping dental insurance uh when you when you hear somebody a dentist say that um what runs through your mind i mean is that a is it a good strategy just to drop all dental insurance is it a pie in the sky i mean um a lot of dentists say they don't participate in any ppos and then they're like dude you're a delta provider and they don't even know that's a i mean when i got out of school i set my fees to delta and they paid a hundred percent of clean exams x-rays 80 of root canals fillings and half on crown and bridge now they send me the fee and i was charged i was sending them the fee for a crown of a thousand in 1987 and now they're telling me they'll agree to 650. so the number one overhead in dentistry today didn't even exist when i got out of school when i got out of school labor was a number one overhead now it's 42 percent coast to coast adjusted production from your fee to the pbo fee then there's labor 25 but what would you say to a kid if he says I’m in miami and I’m just going to drop insurance would you say go for it that's a great strategy or would you say you're out of your mind I’d say i say you're going to need to do some demographic research before you do that because to tell you the truth what you just described is the way i pre i practiced the last uh let's see from 1990 1989 to 2008 i did not practice i uh did not accept insurance assignment so when i sold my practice i had two hundred dollars of accounts receivable do you think that you can reproduce that everywhere in this country absolutely not and i would never cookie cut that kind of program that i did for myself to anybody however i like to i like your delta story because i get this all the time i ask people i says do you participate in any ppos and then they said oh absolutely not and i go you take delta and they say well yeah and i said well you do know that delta is a ppo right i just want to let you know that so not picking on delta it's interesting how a dentist approaches things the insurance part is really difficult to understand all i know is is that if you merge and acquire practices you can become less insurance dependent simply by economics you may you know if you're if you have an ample amount of patient and your and your patient flow is good you may be able to transition to a program like that but to just plop down in any demographic area would you do that in per would you do that in peoria Illinois with uh you know john here being the only insurance provider i don't think so you know you'd have to really watch out before you do that so it takes someone you know it takes some analyzing there's way to do that but what income did you say you would need for the insurance independent what kind of income or household income or no emerges act you know if you did a merger you might be totally independent from insurance if you had enough patience coming in from that merger and you say you know we're not going to do this anymore this is the way it's doing it especially if you acquired a practice that wasn't dealing with insurance so you could say okay from now on we won't do that but that's a tough road to hold and if we did that i would not be you know I’m doing a disservice to your to your audience by thinking this is really easy to do it takes a lot of research and takes a lot of internal when we switched to it not taking insurance assignment it took a lot of staff meetings to get the wording right for our patients and you have to be able to file those insurances immediately which shouldn't be a problem these days you should file those those things should be filed electronically so they get reimbursed immediately the one thing i did find out Howard i think you'll you'll laugh at this is used to take me six weeks to get a check from insurance companies when i became free of that how come they used to get the check to my patient in three weeks that's kind of interesting and that's a classic example of a of a tactic that your local state dental society is arguing with your representatives and um you know and that that's a class example where uh delta uh abuses dentists by if you're not uh in network they'll send the check to your patient and the patient routinely will cash that and spend it i mean the first time i that happened to me the very first time i still remember her name i will say her last name on the deal but her first name is sandy and i'll never forget her and she and and she was so insane that she says well you know i was really broke and i really need the money and you're so sweet Howard i knew you'd understand i thought oh my god now i can what am i supposed to say no no I’m actually a real and i want you to get back um i want to i can't believe we've gone over an hour but I’m going to switch to a totally different subject um when you you know i've been on dental town at least four hours a day every day from 1999 seven days a week till yesterday and if i had to sum up what stresses out my homies it's it's people it's either their patients or their staff i mean they just don't do good with people they're they're introverts they they grew up in a library um they just um it's just not that they're their safe spot and you were a air force united states air force commander 920 aeromedical staging squadron of a 240 member highly deployed squadron assigned to six continents and four areas of responsibility um what did you learn managing 240 people in the united states air force that my homies could learn and take away to managing their five-person team okay so it's a big stretch from going from a dell office to a medical commander but in a way it's the same way i can tell you one thing right now what i would tell your homies is it's not the dental it's the mental so instead of spending 300 on the 14th course on composite bonding in the first 10 years of your career start taking things a little bit off the wall like right brain uh right brain thinking uh positive reinforcement uh that kind of and you're gonna get that some of it is coming into dental continuum but a lot of times state boards don't let you have credit for it and i tell your homies back with it take it for your personal you know benefit go out and get a course you know uh go out and get a any type of course that a lot of other businesses you know call up them call it the local McDonald’s franchise talk to the manager and says when you need motivational or or staff handling uh you know business courses where do you go you know a Disney has Disney down the street here we have a timeshare situation with Disney Disney in Orlando runs a program where they show you how to do how they do the Disney way the Ritz Carlton does the same thing they have programs and that type of customer service experience is what you really need to get across but managing people whether you're managing a military squadron and everybody says well it's really easy to manage a military squadron you're the colonel and they just say yes sir well guess what it doesn't work that way do you ever try to manage 10 physicians all of them highly trained trauma docs or 30 nurses you know i got to tell you something the best thing i ever did my first week in being a military commander was watching the physicians and the nurses go at it and that the first thing that came in my mind is wow dennis thinks they have it bad with dental hygienist you got to see those two groups go at it it is amazing just to sit back it's worth the price of ignition one other thing on the um um the staff problem is uh not only does it stress them out they they they they easy when they ask for a dollar raise um it's just easier to give it to them than think about it and a lot of these guys go to sell their office and they've been giving their staff a dollar raise every time the earth goes around the sun and they they want they you know they're right they don't want staff turnover they want to build long-term relationships that's all true but they're paid their staff labor just keeps drifting up higher and higher and higher and the dsos all decided they're going to start doing de novos because when you they buy your dental office with 30 labor and they got to get it down to 25 it's not going to make anyone happy you know so do you what do you see staff labor at do you see that as a problem in general or what are your what are your thoughts on stuff like because when you go get a job at McDonald’s i mean just good old McDonald’s i mean um McDonald’s is um you know i i grew up with my dad and uh cutting um sonic drive-in and my gosh uh McDonald’s a lot of people don't realize the the uh um accounting but my gosh McDonald’s estimates the average total startup investment ranges from a million to two million dollars with franchises netting an estimated annual profit of roughly 150 000 now a lot of dentists they say god i mean if you bought an office for 750 to a million i mean it's gonna be a million or under a McDonald’s is a million to two million and then if you own a McDonald’s you're gonna net 150. i mean my gosh i mean dentistry is so much better than a McDonald’s but when i go get a job at McDonald’s you know their net sales um say here's estimated breakdown that sells two million seven hundred thousand food costs eight hundred thousand paper hundred thousand so gross profit a million seven crew payroll 540 000 or a half million manager payroll 100 000 payroll taxes 54. but the bottom line is when you go get a job at a crew they say hey howie you're uh you're going to cook french fries and we're going to start you at a minimum wage say it's 15 bucks and the highest range a french fry maker can make is 17. so the range is 15 to 17. so when you get to 17 don't ever be coming back you're asking me for a raise because dude you're a dental assistant the maximum we pay dental assistance is 20 an hour the maximum we pay hygiene is 40 an hour so if you're a dental assistant and want to make 150 000 you need to start thinking about going to dental school or hygiene school or being an office manager or something else but satisfaction equals perception minus expectations and hr your hr design is that it's based on astrology that every time the earth goes around the sun and passes uranus you give them another dollar and then it drifts up to 30 from 25 to 30 percent and then five percent of your office that would have been profit dollars from having capital employed in the dental office is is not to be seen so i mean hr starts with having a formal conversation and they they just don't do it i mean they don't have job descriptions they don't accept payroll ranges how do you how do you how do you get a dentist who again wants to sit in a library and read about gravity and the speed of light um he doesn't want to sit there and he he perceives that i don't want to have a battle with my hygienist about not giving her a dollar I’d rather just quit how how do you change your mindset so i started working with uh hr people I’m glad you mentioned that because i think you have to outsource hr now for for especially small practices and the way you would do it is you need to do it through a consultant like myself or you you would actually hire somebody that would do that kind of work for you and one of the things that we did early on even when i was in Maine is you know with the retirement plan it's so easy now first of all they have safe harbor 401ks where the you know you put a automatically you put an amount for the for the employee then you got to start thinking you got to start thinking in a different manner you got to get get away from that dollar per hour mindset that you just spoke about and you got to get into the nitty-gritties of what do you do well i provide health insurance well how much does that cost this is how much it is per hour this is what it cost me to give you this as a benefit and then you're going to say like the thing i used to do i never did my initial interviews and one of the last things i said before we hired somebody is i just looked at the my potential employee and said look you can go everywhere in town and get more per hour but i guarantee you that not everybody is going to get give you a 401k health insurance and other benefits including a health savings account and i said and if you do then grab that job and if they can if they could still pay you more than then I’m paying you have at it but that's one of the things you have to do today is you have to look at the whole picture and so while you're helping them with their retirement plans you're helping yourself and now it's so easy with 401ks now there's a new law basically where they have to opt out so you immediately put them on that but more importantly you have to show them how much that how much they get one of the things i used to get in the military at the end of the year was this w-2 that had all my benefits on it it showed the social security breakdown it sold the match it showed me the value of a health benefit it showed me the value of everything that the air force provided for me and yeah i knew darn well that i wasn't making as much as that guy in in private practice in chandler but i also knew that i didn't have to pay the what what that dentist was making for health insurance either so you have to get smart about stuff like that and these are the types of things that young dentists really need to latch on early on in their practice life and once you start latching on like that it gets easier and easier as you get to be our age well luckily we're both not nearly as old as caesar sabotage i mean my gosh we're just young spring chickens compared to that guy but hey his name is Richard Hewitt uh his web his consulting website is his emails dr Hewitt h-u-o-t military i mean come on guys uh works faster better easier cheaper smaller rick thank you so much for coming on the show i know uh you did that as a favor uh to me uh and um thank you so much for coming on the show and uh good luck trying to help these dentists all navigate through the pandemic um it's been a pleasure being with you this whole time and hopefully I’ll see you in January in Scottsdale I’m looking forward to it oh my gosh let's do it thank you so much for coming on the show thank you you're great 
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