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HSP #73 with Jill Kring Carter audio
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VIDEO - Jill Kring Carter - HSP #73
Jill Kring Carter explains why you should acknowledge the little problems at your practice and how to work solve them.
- Phone Jill Kring Carter - 717 951 9313
Howard Farran: It’s an absolute honor here to be in Las Vegas at the Townie meeting 2015 in Bellagio. I’m here with one of my mentors and idols for years and years and years, Jill Kring-Carter, did I get that right?
Jill Kring Carter: Yes you did.
Howard Farran: And I am, I’m very excited to talk to you because most of these dentists… I mean look at it, even at a Townie Meeting or the online Dentaltown. You put on a course on how to do a root canal or how to place an implant and everybody goes. Then you put on class on how to run your business and they don’t want to go. They didn’t go to school eight years to learn how to do paperwork or marketing or payroll or business and the bottom line is when you go to a restaurant a chef wants to cook, a chef wants a new recipe, a chef wants to do a root canal on a bone graft. A chef doesn’t want to learn how manage his Yelp reviews and online marketing. So this is going to be awesome where in business you make some, you sell some, you watch numbers. I want you to talk to these kids about the things they don’t want to talk about which is the business side of necessity. So my first opening question to you Jill is very simple. This is April 17th next month 5000 kids are going to come out of dental school with A’s in physics and calculus and geometry and The Krebs cycle and they are going to know all of this technical stuff and they don’t even know what they don’t know. Tell them what they don’t know. What they didn’t learn in dental school and if they want to be a successful business owner/entrepreneur and pay all those student loans off in 10 years, what do they need to think about? What do they need to work on?
Jill Kring Carter: If it’s not something that comes naturally to them business acumen, maybe they didn’t have a father who was into business for himself or a mother you know for herself. People skills, again if it doesn’t come naturally to you, I do focus on young graduates and students to focus a lot of CE as much on those things as the clinical. You are starting a business, I will say dental business way more often that dental practice. You are in a dental business, you are an entrepreneur. There are so many set ups for disaster that can be avoided by understanding the basics of business and people skills and if you don’t accept the need to embrace those things and continue to learn forever just as you need to clinically and work on building a strong, happy business environment it’s a set up for disaster in every way, shape and form. Clinically, personally at work at home it affects everything in your life. You are taking on the biggest debts of your life, even forget the school loans, buying a practice the biggest risk that you can think of. You need to do everything you can to minimize that risk and your entire future.
Howard Farran: So now what…these kids coming out of school, what…how would they learn? How long have you been in dentistry?
Jill Kring Carter: Well my education in hygiene is from the early 1980’s
Howard Farran: So you are a RDH from?
Jill Kring Crater: My degree, I never took licensed because I actually didn’t want to work in that at that time.
Howard Farran: So you graduated from hygiene school and you’ve done it that way?
Jill Kring Carter: Medical practice. I went into the medical side and made a career for quite some time in health care administration, managed care, software development and sales for practice management. Things like that, I fell back into dentistry through a friendship with Kevin Henry in 2000.
Howard Farran: Kevin Henry who is the…
Jill Kring Carter: He was at the time, I think it was 2000, he was with PennWell. Actually I knew him before I started writing for him but…
Howard Farran: That was when he was in Tulsa, Oklahoma?
Jill Kring-Carter: You know I don’t remember exactly where he was at the time. PennWell in Tulsa, yes and Dental Assistant Magazine and RDH magazine and all of that and somewhere back around 2000 I fell back into dentistry through writing and got to know Kevin and Kevin kindly put me into more writing and more writing then with a partner we developed a website, we’ll call it a Facebook for dentists which failed because someone did see the potential and copied us and then basically shut us down and then Kevin through DentistryIQ tried to build the same kind of thing and since I was completely removed from the effort that I had once been in, I kind of gave him a lot of this is what I learned, do this, don’t do that and whatever and we developed a very good friendship at that point and started doing a lot more dental writing and just I found myself being pulled into practices, help with this, help with that. I was married to a commercial lender who had done a lot of lending with dentists and I got…
Howard Farran: You said was, that means you’re not anymore?
Jill Kring-Carter: No, meaning he’s not doing that anymore. I’m still married to him. 30 years it’s been but at the time, married to a commercial lender who did a lot work with dentists and physicians and sort of tapping my brain more and more for information because I spoke the language and I got and then pulled into that financing and transitions aspect for quite a while. We had a company called The Parker Group, still writing when I could not as much as I should have but…then 2008 happened and financially the world fell apart and we focused a lot of financing on the, what we call the BC customers, those who couldn’t qualify for say BOE lending. We would shop their needs around the country and get them finance and then transition them but we couldn’t get them financed anymore at that point that was just not happening. So I really started to focus more on the writing and just helping practices in whatever way I could through people that I knew.
Howard Farran: And now what’s your website now?
Jill Kring-Carter: Now I’m Practice Prudence.com. It’s a brand new site, please don’t be too harsh.
Howard Farran: And Kevin Henry left dental economics and went to dentistry?
Jill Kring-Carter: Kevin joined Advanstar which is Dental Products Report and he remains a very good friend and I’m forever grateful to him. I just had an article on there, how should I pay my RDH, with all the options to consider and to consider the personalities of the RDH and how to pay them and what is maybe going to be the best combination.
Howard Farran: So let’s talk about that because that is a huge debate.
Jill Kring-Carter: Yes.
Howard Farran: Do you pay you hygienist straight commission or do you pay her hourly? I mean some say well if you pay her hourly…
Jill Kring-Carter: There’s no wrong answer. There’s so many ways to do it, so many ways to incentivize them. There are so many things you have to consider, their personality, their clinical skill level, their eagerness to learn and improve their clinical skill level, are they money driven or not. Some personalities are very happy with I work these days, I get this money and that’s my budget and that’s fine. If I get a 5% raise I’m thrilled. They are not meant for production, maybe a little bit down the road they will be as they improve their clinical skills and their strength and their belief in their own skills. To know that they can do better and make better money on production but they also have to understand perio to do well in production. They have to embrace the perio epidemic that we have in this country, they have to embrace six point perio charting which is very simple and they have to understand the importance of doing that and what that results in and that results in massive production through improved quality of care. So it’s not just more money for the dentist but, it is better care for the patient.
Howard Farran: Yeah the managers, I mean I think the really smart thing you said is, it’s just overly simplistic to think that everything is left, right, up, down yes, no, black, white. They just never want to answer it
Jill Kring Carter: Yeah.
Howard Farran: And you just see that in so many people talking dentistry that this would work in every dental office in the United States. In fact the dumbest name I hate is actually The United States because you know when you go to Europe, you know I was just in Europe in Albania, Coast of Macedonia, nobody would compare that to England. You know no one would compare Denmark to Portugal or Greece to Germany and in the United Stated is really not a country. I mean how do you compare New Orleans to Alaska, or New York City to Kansas City?
Jill Kring Carter: They speak the same language.
Howard Farran: Yeah the United States is really a lot of different countries rolled up into one.
Jill Kring-Carter: Yes.
Howard Farran: Half are urban half are rural and what works in Arlington Texas doesn’t work in Key Biscayne Florida.
Jill Kring-Carter: Very much so.
Howard Farran: And yeah so
Jill Kring-Carter: There are a few little things that work consistently and that is for instance Mark Dilatush will tell you, from MPI that specific methods of advertising, because it’s all about the women that make the decisions, that make the appointments and specific advertising ways tend to work state to state, region to region, country to country even in all five countries that they have so far, it works pretty much the same way but that’s one of those rare things that you can pretty much say this works. There’s just minor tweaks for your state and region, the demographics of they patient that you seek, minor tweaks, but everything else, the possibilities usually have a long list and every one of them is right in the right situation and every one of them is wrong in the wrong situation.
Howard Farran: So Jill when I sit next to people on airplanes and I say okay tell me you’re either a lawyer or physician or dentist and say okay I’m a lawyer, name the first three adjectives to describe a lawyer or whatever. When you talk about lawyers, physicians, dentists not one will ever say humbled, nice, sweet, good listener. It’s usually arrogant, talks down, judgmental you know it just never seems to be good. How do you get this dentist to realize that, I know you’re the doctor and know you think you’re all that but you know what, when the patient calls up they’re talking to the receptionist not you and if they’re no good you’re never going to see this person and when these people leave the hygienist, probably is a big factor on whether they love the office and the dentist.
Jill Kring-Carter: Absolutely.
Howard Farran: So how do you…how can you get that dentist to focus on the team and the staff instead of the mirror?
Jill Kring Carter: I think a lot of times the biggest challenge is getting them to admit the denial. They’re denying that there’s a problem and I think most of that comes from that they don’t really think that they can figure out how to fix it without spending ridiculous amounts of money on a consultant. You may need a consultant, you don’t have to spend ridiculous amounts of money and it’s never as hard as you think. It’s just acknowledging that there’s a problem and if for instance I tell you, you need to listen to some phone calls because your front desk person does have a tendency to be little cold or a little putting off and they won’t listen. Oh she’s fine you know. I’ve never heard a complaint about her. Most people won’t really speak up directly to you unless it’s God awful. Even with a hygienist you know you might have a hygienist who is a little off putting or a little cold or you know that caring feeling and you can lose them through her but if you don’t at least take the suggestion to listen and pay attention you know it’s a lost cause. So that’s the hardest thing, it’s convincing them to do that. How to convince them to do that I don’t know other than just to…honestly it’s just being very honest with them or appealing as often as I can until they finally give in and say okay what do I need to do? And once they get into it they finally realize it’s not nearly as daunting as they thought. It may involve firing staff, it may involve re-training staff, it may involve working on a problem between two staff which men typically don’t want to get into so there’s a different challenge for the male provider than there is for say the female dental provider. The female dentist is usually much more okay what do we need to do? We’re having a problem with the girls here, a lot of times with the female dentists they’re as much the problem because of the feminine psyche and they all want to be girlfriends and the male dentist wants to be the boss and they work for me and they’re going to do what I said to do but, you know out of the whole five operatories you don’t know that they’re doing what you want them to do, you need to pay attention to it and when I bring it to your attention to you need to respond to it.
Howard Farran: So I want you talking about that because I have no credibility in that sport because I’m a male but we do know some facts that boys say 2000 words a day and women say 7000 words, that’s a fact.
Jill Kring-Carter: Absolutely.
Howard Farran: We do know that a boy of any country whether he’s Greenback, Silverback gorilla or a Rhesus monkey, every time a boy monkey or ape talks to one other monkey or ape, a girl will talk to five so I don’t have any credibility on that because I grew up with five sisters and then I had four sons so I have seen both sides of the deal. So talk with some credibility about that because I’ve had a lot of women dentists reach out to me and I don’t know quite what they’re saying. I got out of dental school and I worked for a doctor man and he would do everything this way. I bought the practice from him now, I do it just like Dr. Man did and the girls respond totally different. So I can’t talk about that, could you talk…could you shed any in light on that?
Jill Kring-Carter: It’s hard to know of course without really observing but if I had to generalize, I will say that try as you might, as a female dentist you’re more apt to be a little more lenient and to be a little bit more friendly with the staff versus really it’s one thing to be friendly with them, it’s another thing to be out after hours with them and hanging like girlfriends which is so common. I’m very surprised to see how common that is, it can really backfire on an efficient business when the personalities and the relationships go beyond a business relationship to an extreme. In other words it’s one thing that all the girls in the office hang out. It’s hard when that female dentist starts hanging out with the female staff.
Howard Farran: Is it that they don’t fear?
Jill Kring-Carter: I think it’s a little bit of authority. They lose a little bit of authority with that. I’m not saying you are always going to lose authority. I’ve seen plenty of female dentists out there that it works great, they are friendly outside the office and they have been for years and they have this great team but it’s uncommon- I will say it’s not common. It’s a struggle and when you have for even an instance an issue with one of the female team members they’re going to tend much more quickly to try and pull that female dentist into it because she is female and they get it, they understand and they know that and then that dentist has gotten pulled into that in a way that maybe she shouldn’t have been and now what do I do? Now how do I redefine that line again that these people work for me and while I appreciate them and respect them and want to do all the best for them and want that in return, if you’ve crossed that line into buddy it can get very dicey.
Howard Farran: And it seems like when the dentist crosses the line into buddy it’s usually there’s usually sex involved and then that’s when, when you start sleeping with like a receptionist, then she has the green light to start embezzling because she thinks okay doc, you’re married and your divorce would cost a million so if I start stealing $300, $400 a deposit or take anything home on the cash, you’ll probably never catch me because you’re not focused and if you do, I’ll just say- you know the words singing like a canary? So I mean it’s just so dumb so I would say the number one dilemma with guys is sleeping with the staff and I always think God, out of 3.5 billion women on earth, why the hell? I mean when you were little you wouldn’t pick your mom or your sister, so why the hell would you pick someone you work with and that was my big pet peeve with Bill Clinton. If he wouldn’t had an affair with Madonna I would have said well you’re married to Hilary, I get it you know but the fact that it was an employee at 20 was just like predatory and gross.
Jill Kring-Carter: The thing is, if it’s your front desk person or your hygienist keep in mind too that they suddenly feel like they control everything in your practice because they’ve got you on their side, quietly they think and they’ll somehow make it known, trust me because suddenly they feel that they have powers that they don’t and there becomes the explosion in your business of the personalities, now you’re in trouble.
Howard Farran: So for guys the number mistake would be a relationship with an employee and girls the number one management problem they would have is being after hours, trying to be a girlfriend with the…
Jill Kring-Carter: I think with the girlfriend I’ll agree with you on that, with the guys personally I think the number one problem I see with guys is just as it’s been since the beginning of time, that men don’t understand women and it’s hard enough you’re trying to spend the next 30 to 40 years learning to understand your wife, now you’re got to learn to understand the seven women that work for me? That’s a huge thing, I mean that’s daunting and that’s probably never going to happen completely.
Howard Farran: So there will be two strategies to go. One would be I’m going to try and understand women and manage them. Option number two is I’m going to try and find older female office manager and give her the authority and responsibility to manage them and just stay clinical dentistry.
Jill Kring-Carter: Yeah.
Howard Farran: Which one of those approaches do you recommend?
Jill Kring-Carter: You know I think age has nothing to with it. I think how you treat them constantly, you know providing the education so that any of them can become that office manager that you need. Constantly you know trying to provide the best employment atmosphere you can to maintain the best people you can, to minimize those risks the best that you can. You know you mentioned bringing in an older office manager. I don’t know I’m not so sure that’s always the answer quite frankly too. You’re having sometimes to re-train those people from what they have learned in another practice.
Howard Farran: I’ve never seen a really, get that done 20 to 30 year old office manager. It seems like in every office I can think of that’s doing three to four million dollars a year with a bunch of people, two or three doctors it seems like that lady always older.
Jill Kring-Carter: Unless they hire right. I think we are going to start to see a trend change there though, if you hire right. If you hire that young graduate with a business degree. I mean you’re doing multi millions, she’s got a good opportunity to make a good living with her business degree running your business for you so that young graduate with a business degree has all the potential that you’re thinking of with someone with years of experience and years of experience with a very young dentist can be great but it also involves a lot of re-training. You know breaking bad habits or simply changing philosophical habits. You’re philosophically practicing different in your practice than that dentist you worked for, for 30 years that’s been ingrained in her. She’s got to re-learn
Howard Farran: Let’s go back to that. So in your years of doing this and the fact that 5000 graduates graduate next month, that will be May and they’re coming out. How can they learn to be a better businessman because you’re right, look in my class if your mom stayed home and made cookies like mine did and your dad worked for GM and was putting a hole in the bill, you really didn’t learn for enterprise and I see tremendous advantages that linger on with dentistry. One third of the dentists have a dad or a mom or uncle that was a dentist.
Jill Kring-Carter: Right
Howard Farran: The advantages there linger over forever because they were…they grew up in the stuff. I mean they already knew what a root canal was when they were in 6th grade. So let’s say your dad wasn’t a dentist, your mom stayed home and made cookies and worked for a non-business, the post office, something technical and this kid wants to do dentistry. Jill how do they learn business?
Jill Kring-Carter: First and foremost you have to find yourself a mentor or two or three. In the area you think you wish to practice, which is going to be best not to be the area where you graduated from school because of saturation levels. You better be ready to relocate. Find a mentor. It doesn’t have to be someone in person in your town. It can be online, it can be through Dentaltown, you make relationships on Facebook, you make relationships with people, follow the consultants, follow the Dentaltown posts. You will continue to learn, you have to continue to learn using all the avenues that are out there just as you need to learn clinically from the get go, from the get go until the last day that you practice, but get that mentor in place, you’ve got to find somebody who truly has had a very successful business. Who made his way through some bumpy roads and can really help guide you through some of those things that you’re going to face but if not establish those relationships online because it’s so easy with other dentists, consultants, the advertising agency that are the top ones out there just constantly be following them and learning.
Howard Farran: Are there any books that you recommend or is that kind of an old school format?
Jill Kring-Carter: I think it’s a little bit old school, books certainly sell I’m a little old school that I like getting Dentaltown in print. I like to read a magazine and people like to read books. I think there are certainly some really good books out there especially for the marketing and advertising like the stuff that MPI has put out. I like New Patients Inc. that kind of stuff.
Howard Farran: Mark Dilatush and Howard Horrocks. The other Howie.
Jill Kring-Carter: They’ve really put out some real great stuff. The other Howie and you know I think there’s just key people that you’ve got to learn to follow, you’ve got to follow people like Howard and Mark and Howie and you follow people like Christensen and it has to be engrained as something you do every day and every week and that’s how you’re going to learn because you won’t have time to keep going to school really, not if you’re trying to get your clinical skills up to the point where you can buy a practice or buy into a partnership. You’ve got to get out there and start busting your butt as many days a week as you can. If you have time to take courses go take courses. Take psychology, take sociology, take basic accounting and business courses and stuff like that. Make sure that you have relationships with a good attorney who can…not just a good accountant say of like a Tim Lott, but a good attorney like Jason Woods who can look over things for you with a very scrutinizing eye and find things you’re never going to see. One because you don’t want to see it and two because you don’t know how to see it maybe have those relationships early on too.
Howard Farran: And that goes back to the richest people you will ever meet in your life they are always humble.
Jill Kring-Carter: Yeah.
Howard Farran: And the dentists are like… they’re just so arrogant like they’ll come out and they’ll sign a ten year lease for their building and they will have a real estate attorney look it over and then we’ll sit there and see, like this happened in the Scottsdale last week where his landlord said oh yeah we’re moving you. And he goes what do you mean you’re moving me? He said well in your lease there’s this clause, we can move you anytime if a tenant and all we had to pay is new TI’s and so he goes to the only guy in town, Ryan Isaac who does all this stuff and another friend of mine and he looks at it and says well you know that’s why most people pay someone to look over a lease beforehand but since you’re an arrogant know it all dentist, physician, lawyer you didn’t and the same thing they’ll go buy practices they don’t want to…and I’ll tell you something about consultants too. You can’t say that nobody eats at McDonalds anymore when 40 000 of them are open every damn day. Someone’s eating a McDonalds. You know somebody, when you say no one ever clicks a banner ad, really? Then why do people buy banner ads every single day in the tunes of billions of dollars? Somebody’s got to be clicking these damn banner ads and these consultants in dentistry, dentistry is a very small town, everybody knows everybody in dentistry and if you’ve been in the consulting business for 5, 10, 15, 20, 25 years, somebody is paying you money to keep a staff or whatever and you’ve never got 50 000 bucks to buy a consultant to learn how to get all the systems in place and lower your stress and make a lot of money, but you’ll always find $100 000 to go to rehab for 120 days because you finally drank yourself to death from all your stress and problems. So you’re going to have to learn this stuff the easy way or the hard way.
Jill Kring-Carter: Right and this brings out too another early relationship to develop or at least to start following if they offer seminars or something on practice financing and transition consultants and transition consultants often will stay with you not just through walking you through becoming the new owner and all the things that are going to happen in that situation unless you’re really lucky. You know that guidance all the way through but a lot of them like, they will stick with you for many years forward to help you with that continued growth and to help you know review and oversee and kind of guide and you know now you want to try and incorporate this. You’re transitioning constantly maybe you are going to transition to assistant hygiene or building up your perio or you transitioning from using an assistant to isolite where you’re trying to decide whether or not you want to get loupes for all your hygienists and not just you or do you want the hygienist to buy their own? You’re constantly transitioning in your business and you need to have a relationship with some sort of transitions consultant who understands it from the get go of evaluating that practice that you’re looking at and maybe helping you decide that maybe that’s not the practice you want to buy and helping you find the right one, or yes this is a good deal and let’s just renegotiate the price that they’re asking and boom, the process begins. But those relationships because many of us are out there, we’re writing, we’re putting out CE, we’re doing seminars. You can go to these things and establish these relationships and get a feel for who you think you might like to work with, early on, years before you’re ready to buy a practice and I do emphasize years before you’re ready to buy a practice. So that when you are ready you know who you’re going to call, you know the path that you’re going to take and it’s going to be a lot smoother.
Howard Farran: So now at your website Practice Prudence.com, what are you focusing on?
Jill Kring-Carter: The website I think is for now I think mostly my blog center.
Howard Farran: It’s your blog center.
Jill Kring-Carter: But I also have…and I have a lot in store for it but it’s going to take some time. Right now I have a page called Prudence Preferred and it’s not full yet but it’s just some of my favorite people that I refer to for various things.
Howard Farran: Go through that list who’s on top of your head on that one?
Jill Kring Carter: Mary Beth Bajornas with Dental Support Specialties out in Ohio. She covers the whole nation in Canada with virtual administrative services. Really phenomenal what she does I don’t think I have yet to meet an unhappy person.
Howard Farran: Is she here?
Jill Kring-Carter: She’s not here Mary Beth is afraid of flying.
Howard Farran: Is she?
Jill Kring-Carter: She is yeah we keep begging her we’re going to get her here next year.
Howard Farran: She’s in Ohio?
Jill Kring-Carter: She’s in Ohio.
Howard Farran: And her husband works with her too doesn’t he?
Jill Kring-Carter: He does. He’s a former teacher and he’s basically like her right hand in the business and he’s fabulous. Yeah so she is on there. NPI, Mark and Howie are on there. You know if I can’t assist them with marketing needs that they have or it’s that kind of specific marketing that they need to do, Mark and Howie are just the way to go. My other favorite with the advertising and marketing is Lanmark360 and Mike McCarthy.
Howard Farran: I thought he only did dental companies?
Jill Kring-Carter: Oh no they’re everything healthcare, including dental and he also runs The Dental Geek.com which is a blog spot.
Howard Farran: I thought he just did dental advertising for a like a dental manufacturer?
Jill Kring-Carter: No he’ll do practices too, he will help with practices, big practices but he will…
Howard Farran: Yeah Lanmark360.
Jill Kring-Carter: Yup but he’s also just very involved in dentistry. He and I are actually working on something to do for students as we speak, with the dental school New Jersey. We’re going to try and put on some sort of seminar or webinar of exactly what we’ve been talking about. The business of dentistry, the skills you need to acquire, the relationships you need to acquire and I’m going to be focusing on the most efficient things to keep your practice efficient and building productivity early on that you would invest in that where low cost rather than mostly high cost things. Help you prioritize a list, sort of a bucket list for your business and these are the things that you want first so we’re going to really help with production and help us to get those loans paid down before we start investing in big dollar things that maybe… yes they’re going to help too but there’s easier, simpler, less expensive things to start out with that are no brainers and yet so many practices don’t utilize them. So we’re going to be focusing on that.
Howard Farran: You noticed when she said no brainers she looked right at me. That was the only time she looked at me.
Jill Kring-Carter: Oh the psychology there.
Howard Farran: Who else is on your list?
Jill Kring-Carter: Let’s see who else is on my list? I’m drawing a blank as I sit here trying to picture the list. Mears Financial which is both personal and for your business, they’re located in Pennsylvania but if he can’t help you in your particular state or his staff, they of course have a network of people they can refer you too. Tim Lott will be there with The Dental CPA’s I would put him on there.
Howard Farran: Tim Lott that is an amazing guy and that’s an amazing story.
Jill Kring-Carter: I haven’t added him yet but he’s on my list to add.
Howard Farran: Can I just say one thing about that?
Jill Kring-Carter: Oh please, I love Tim.
Howard Farran: You know in 1900 health care was 1% of the GDP, a century later it was 12%, 2010 it was 15%, 2015 it’s now 17% but a hundred years ago a physician just one guy did head to tail and now it’s 58 specialties with the MD’s and just a little old mouth, just one body part there’s nine specialties. Accounting, when I got out of school 20 years ago every dentist was using an accountant and nobody knew anything about dentistry and when he got off the phone with you he was talking to a dairy farmer, a restaurant owner, anybody and now we finally, finally, finally have some specialized accounting firms where there’s- you can now get a CPA that only does dentistry and we’ve got one association that has 6000 dentists and one has 2000 and I’ve never met a dentist that switched from a CPA that he was the only dentist, to a firm that only does dentistry who within one year- there’s one dental accounting firm called Cain Watters and when they do your yearly deal, if you and your wife don’t come down there and sit through an 8-5 review of it, they fire you as a client.
Jill Kring-Carter: I like them, I do.
Howard Farran: I know because outside of Cain Watters I can’t find a dentist that knows any of his numbers.
Jill Kring-Carter: Well what I like about that aspect to that approach is you know that those accountants are looking at things forensically as well whether you requested it or not, whether they think there’s risk or not. There’s always risk. The longer somebody works for you the more the risk goes up. But those CPA’s, those dental specific CPA’s are bringing a piece of forensic accounting to their work for you.
Howard Farran: Okay I think a lot of the viewers don’t know what forensic accounting means.
Jill Kring-Carter: Think of all the embezzlement stories that we hear about and you don’t hear about most of them but there are way more out there than we ever hear about but you’ve heard about some big ones lately. Almost always it’s the older women that were working in the practice for many years the ones that you trusted the most are the ones you need to worry about.
Howard Farran: So you said you heard about some big one lately what were some big ones?
Jill Kring-Carter: There have been some big ones. Oh gosh now you’re putting me on the spot. If you’ve ever had a moment where you thought oh my gosh maybe I should get a forensic accountant in just to look at things, do it. Your gut is telling you something, do it. Statistically it’s likely it has happened to you in the past or is happening now to some degree. It might be a couple of hundred dollars it might be a few thousand, it might be tens of thousands or hundreds of thousands as they find in some of these cases by the time they’re discovered.
Howard Farran: Hell that happened to me the first year I was out.
Jill Kring-Carter: Did it really?
Howard Farran: Yeah.
Jill Kring-Carter: So you know.
Howard Farran: Yeah I was reconciling my checks and this one check just wouldn’t come back, wouldn’t come back, wouldn’t come back by the time I called in… even back in ‘87 the bank had a picture of who’s cashing it. Finally I call the bank, they go no that was cashed and I said no it wasn’t and they walked over, we’re in the same parking lot and Tracy gave me a picture of my dental assistant cashing a $4000 check because I didn’t have any of the checks locked up. I mean the simple fact that I didn’t have a key on the deal and then I brought it back to her and said what the hell and she just started crying and then ran out of the room.
Jill Kring-Carter: It’s hard, you know a lot of what I do, I focus on respecting those people who work with you so that they will respect you. Trust those people who work with you so that they will trust you but don’t be stupid, if your gut’s telling you to look into something look into it.
Howard Farran: So what do you think of preventing embezzlement? So I think the low hanging fruit is to bust up the job duties. Make it so that if someone’s going to steal from you…like I firmly believe if someone was going to embezzle from me, at this point it’s going to take three people.
Jill Kring-Carter: Good to hear. It should take at least two and don’t make it two people that are buddy-buddy because they’re going to protect each other because they think they can but eventually they’re going to get found out but no, even your trusted, business degreed office practice administrator, make sure there is somebody kind of double checking even what she or he’s doing, always. I’m married to a banker so I think in those terms all the time and it’s real and we’ve only seen it too often in every kind of business but I think in medicine and dentistry you have you so many staff staying after hours, coming in early when you’re not there, but practices that don’t have cameras on site and they know that it’s so easy in a lot of ways to get away with it because the dentist trusts me.
Howard Farran: You know who the biggest embezzlers that I’ve seen in of all 20 years? The doctor’s wife preparing for a divorce, embezzling for divorce, putting the money outside of the United States in Canada or Australia.
Jill Kring-Carter: Under the guidance of her attorney, she is doing exactly a list of things
Howard Farran: So they’ll go to their divorce attorney and they will say well before you file, I mean if you’re paying all the bills and all that, every month that you delay you might be able to put some more money away and by the time the dentist actually figures out what’s going on…I mean some of these women have…it’s crazy, crazy, crazy.
Jill Kring-Carter: Yeah and their doing it under the guidance of their attorney.
Howard Farran: It’s someone you’re sleeping with, whether it’s your wife embezzling with you or the receptionist.
Jill Kring-Carter: Please don’t have anyone you’re sleeping with run your practice. That’s all I’m asking you please, please and it’s common and I understand why we employ our spouses to run our businesses, I do, but I guarantee it’s more hassle than it’s worth. There is so much that can be avoided if you just give her some responsibility or him some responsibility but don’t give them the control, it’s just…
Howard Farran: So now Jill talk about the office manager. Do you think that every dentist should have a practice manager or not?
Jill Kring-Carter: I think it depends on the size of the practice and I think the definition of the term office manager versus practice administrator, okay.
Howard Farran: What’s the difference between an office manager and a practice administrator?
Jill Kring-Crater: If you’re doing multi millions, you get a practice administrator. You’ve got somebody I hope that has a business degree or some kind of true formal education and some good background or some great training who’s really running your business. Making decisions for the business. You’re making the clinical decisions, they’re making the business decisions. A small practice where I think there’s a lot more communication among the whole team about every aspect, I think it’s a bit more of an office manager. A people manager and a basic functions of the business, basic functions of the business manager, but the dentist him- or herself is taking care of all the financial stuff and paying the bills and doing those kinds of things. There’s a difference to me and you see many levels of descriptions of each of those things. Practice administrator versus office manager.
Howard Farran: So what do you think about training? So would you say a big organization, the American Association of Dental Office Management?
Jill Kring-Carter: Oh yeah.
Howard Farran: AADOM.
Jill Kring-Carter: And every state has one.
Howard Farran: Are you a big fan of those?
Jill Kring-Carter: Oh absolutely. It’s a tremendous you know, well of information and contacts and just somebody throws a question out there and someone is oh I had to deal with that, I did this. Great you’ve got a possible solution or a lead to something. It’s a culture and a community that I think is valuable, it’s very valuable and you know some of them are more effective and better with what they do than others, but I think just like a provider you want to be involved in your local regional, local, state, regional and our natural organizations to what ever extent you can. They’re invaluable if you let them be, they’re invaluable to you.
Howard Farran: So every state has a branch of the AADOM?
Jill Kring-Carter: I don’t know if every state does or not, I know many states do and I know actually some of them are being challenged by the AADOM because they want them essentially… I might not be saying this right but they’re wanting them not to be entirely separate and use ODAM, like the North Carolina one for instance NCADOM. I think there’s something on that they’re either being taken on as … I don’t know if it’s becoming subsidiaries or if they’re becoming one and just you know in the state or if they’re truly a separate organization but I know there’s some issues going on with various states that are using that same name.
Howard Farran: Yeah.
Jill Kring Carter: I don’t really understand what the issue is or what’s happening I just know there’s something going on out there. I don’t know if every single state has one. I’m assuming they do.
Howard Farran: I have the same problem myself actually, people using the name Chippendales in different areas when I’m to original Chippendale and it pisses me off. Yeah but I’ve seen those issues but yeah I’m a firm believer that the neuron atomists are saying that when they dissect the brains of hundred ants, a hundred humans, a hundred chimpanzees they don’t see any difference in the brain so when you see someone who…this person is really good in sports and this person is really good in music, they’re not finding neurons and stuff to explain the difference but what the psychologists are finding is, it’s like when you go to symphony and you see some little 18 year old girl just crush the violin for an hour. She played it four hours a day every day since she was five. Do you want to play the violin four hours a day? I don’t. I don’t and the Olympic swimmers I mean you know these are people that swim…you know just one swim, the butterfly, two hours every morning before school, and hour after school, seven days a week their whole life. I don’t want to do it.
Jill Kring-Carter: I would like to say that we are different species. I was a competitive figure skater when I was younger and used to spend four to six hours a day on the ice, five to six days a week. We’re different species I think, it’s not just a different brain.
Howard Farran: But…so the point I’m getting at is that if you don’t want to play the violin, you’re never going to be great at violin so I keep telling these dentists that, you know stay away from doing things you hate for money. If you don’t want to manage your business, get an office manager. Don’t ever pay an employee money who you can’t stand to be with in the same room. Paying people to stay in the room that you hate is…I tell that to staff. Don’t work for a doctor that you hate.
Jill Kring-Carter: You need to like your staff. Yes.
Howard Farran: I mean if you hate your boss, there’s 150 000 dentists in America, find another one because if you’re happy and you’re doing what you like to do and you’re making money, good things are going to happen. So again I want you to focus back, I want you now…a second question I’m going to ask you. I started off with that next month, 5000 kid’s roll out of school so I want to ask you another question. So now here’s some dentists that have been out for 20 years and Jill the bottom line is their practice for the last 10 years has been flat, they’re burnt out, if they won the lottery tomorrow they’ll burn their office down and never go back. What would you tell a dentist who says I’ve got to be a dentist. I’ve got to do this job. I’m burnt out, my office is flat. It hasn’t done anything in a decade Jill. I’m out in the middle of El Paso Texas, what should I do? Burnt out, fried and flat and I’m only 45.
Jill Kring- Carter: You have to take a real honest look at why you’re burnt out and fried. There are so many possible causes for that and if you’re willing to identify them with help and address them it can be turned around. If you once loved something you can love it again. You may need to learn to love it in a new and different way with new technology, new approaches to running a business, new ways of patients financing their care for you. You may need to relearn how to do the business of dentistry which is not as daunting as you think but you just need some guidance and if you can fix- that business is your core because that affects your future, your family at home now and your family in the future and if you don’t fix that and, or leave dentistry and go do something else. Which is I think in some ways you giving up so you’ve left dentistry and you’ve gone to do something else unless you’re just fortunate and you go do something else and you can. You have to be open to identifying probably the long list of problems that have occurred over the years and have multiplied and grown and you know got infected and icky and you’re just pulled further and further away in denial because you don’t think you can fix it. We change that mind set and you can fix it and you can love dentistry again.
Howard Farran: You know one of my favorites is, I got out of school and I’m talking about a lot of guys say that you want to get out of dentistry, let me tell you a lady who got out of dentistry and is one of my idols. So I got out of school in ‘87 and when I got to Phoenix I needed a job as an associate for four months while I’m building my practice and everybody kept saying oh go talk this lady, there was this 85 year old Jewish lady who left Germany because of the Nazis and when she came to America, even though the German dental schools where far better than the American dental schools, the Americans would not honor her degree. You know it’s not like she came from a third world country, she came from Germany. Mercedes Benz, Volvo, Porsche, and they said no, and she said come on, look at the situation and they said no. So she looked at the law and it turned out yeah you can’t practice dentistry but you know what, you can own a dental office.
Jill Kring-Carter: Yeah.
Howard Farran: So this lady had her- she was handcuffed, coughed, she can’t practice dentistry. So she had to just hire a dentist and that was probably the best thing that happened to her because when I met her she was like 87, had like four different offices in north, south, east, west Phoenix, each one was doing a million dollars. She was probably, since she, you know if she would’ve done the dentistry she probably would have retired when she couldn’t see very well, eye hand coordination but just being in the business deal I mean she was 87 and when she put on her lipstick they like went up to her to her zygomatic arch. She was loaded with cash, Mercedes Benz, so you know the bottom line is…and then I always give the example look at Steve Thorn. Steve Thorn, his dad was a dentist and he thought man really eight years of college to be a dentist, wouldn’t it be a shitload easier just to hire a dentist than to be a dentist? So by the time he would’ve got out of dental school, he already had like five offices.
Jill Kring-Carter: Right.
Howard Farran: And so again I remind these dentists that don’t want to learn how to do the business but Rick Workman owns 600 offices and he hasn’t touched a patient in 20 years.
Jill Kring-Carter: Yeah.
Howard Farran: Steve Thorn owns 500 offices and he’s not even a dentist. Rick Kirschner is up to 350 offices and he hasn’t seen a patient in 25 years. So isn’t it funny how…the bottom line is, the more dentistry you do the less money you’ll make because everyone who…Rick Workman’s dentistry’s is only a billionaire and he hadn’t seen a patient so the more you focus on what Jill’s talking about, actually your stress would come down and your income will go up and the more you focus on bone grafting, probably the less money you will make and the more stress you will have.
Jill Kring-Carter: Now you brought up something. You happened to mention associating. You know if you’re really beyond, if you don’t think you want to fix it and learn to love dentistry again. There’s nothing wrong with doing other things. Maybe what you don’t want to be is a business owner. Sell your practice and go associate or bring in another associate in your practice and be the owner and still have that practice ownership and go do something else or go associate. There are options out there that you just have to be honest with yourself and think what do I want to do and people tend to, when they get frustrated and burned up, I just want to get out of this altogether. I don’t want to be in this field at all. Now maybe there’s just another way to be in the field, and I’ve seen dentists in their middle age in their 40’s sell their practice and go associate. Why not? If you, just make sure that practice is on its peak when you’re selling so you can get the most you can for it. Don’t start dwindling down at a young age or even at an older age. Keep those hours going and keep those chairs full. Sell it and get out and go associate, maybe what you really just want to do is practicing dentistry and not have any of the other shit that you have to deal with. Do it, there’s nothing wrong with that. There’s nothing wrong with that.
Howard Farran: The easiest way to lower your overhead 10%, I mean there’s so many dentists who, their overhead has been 70% forever and they can’t get it to 60% or they can’t get it to 50% is, go take your office with your 70% overhead, go sell it to someone and then go get a job with someone because you get 40% of production and you don’t have to do any of the business stuff.
Jill Kring-Carter: And work the hours you want to work, do exactly the kind of work that you want to do. Go practice in that place you always wanted to live. Go do it, there’s nothing wrong with that, but if you want to lean to love it again you can, simply by wanting to you can. You just need to accept help, that’s all.
Howard Farran: Yeah and a lot of people tell me that, a lot of people have told me where I just got this question the other day. One of the consultants is very expensive in Oregon…Bill Blatchford.
Jill Kring-Carter: Well you get what you pay for in some ways, I mean he is expensive but he’s also phenomenal.
Howard Farran: They said well man that’s a lot of expense and I said well, do you think he’d be doing that for 50 years if we wasn’t making it for a profit?
Jill Kring-Carter: Exactly.
Howard Farran: And furthermore I don’t care what you pay that guy, if you made twice that much more money take home next year, wouldn’t that be worth it and again, I know it sounds cheesy but people don’t want to pay that money for a consulting but then they’re stressed out of their mind they’ll kill themselves or drink themselves to rehab when it would have been a hell of a lot easier just to fix your environment.
Jill Kring-Carter: Like everything in the business it’s ROI and yes some of us charge way more than others, some of us do way more than others but when they come with nothing but happy clients and all kinds of success for 40 and some years. They are what they charge and there’s nothing wrong with that but it’s all ROI if you know they’re going to turn you around, you know.
Howard Farran: So Jill how do you know when you’re a consultant and you deal with a 40 year old burned out dentist who is just like God damn I’m so burnt out. How do you separate from, this is a medical disease and you need to go to a doctor and take a Prozac or something like that? I’m being real serious, how do you consultants differentiate… you have medical depression and you should just shoot your assistant and hire an office manager. How you do you separate that?
Jill Kring-Carter: You know I’ve seen some dentists who are truly clinically depressed and maybe it’s because of the state of their business and everything else that is being affected by it, failed marriages, bad children relationships, things like that, or maybe they are just situationally depressed because of what’s happening. They’re not clinically depressed. I’ve seen some dentists where we’ve had to talk them into literally going in and getting help or there was no way they were going to be able to turn it around because they need to function optimally or at least close to optimally. Then sometimes you can identify if they’re going to be honest with you, if they trust you and they’re honest with you. They’re situationally depressed, very common. Okay we’ve admitted that now, now how do we fix that? It’s one or the other.
Howard Farran: There’s some very long threads on Dentaltown and I have been, you know I’ve been on Dentaltown since 1998 and it’s 2015- it’s 17 years. I would say some of the takeaways I’ve learnt on there, because there’s a lot of threads that have thousands of comments. I mean you’ve got a thousand posts on Dentaltown. I’m depressed, I’m burned out and whatever and these guys were talking but following and knowing some of these guys over a decade or two, a lot of the guys that were saying that they were depressed weren’t posting on Dentaltown that they were also drinking themselves blind or addicted to Vicodin or something like that and then I’ve seen like last year in Phoenix three dentists committed suicide. I mean I don’t think I’ve ever had one year in Phoenix where at least one of the dentists didn’t kill themselves so I’ve walked through a lot of that and that seems to be like you would think a third substance abuse, a third financial and a third love relationship you know, they got divorces with their lover or whatever but yeah consulting is tough. I’ve really got to give you guys credit because a lot of dentists don’t know what they don’t know and a lot of times it’s the consultant that goes in there and says you know your problem is your favorite employee causes all your dilemmas. Like your favorite person you cannot live without, has worked for you for 20 years and that’s why no one else has ever stayed with you for two years.
Jill Kring-Carter: Right
Howard Farran: And, whatever, so I’ve only got you down for 10 more minutes. So what are some low hanging fruit, some easy takeaways for a dentist who just wants to bump his practice up a little bit? Maybe 10% more maybe 20% more fun, productivity, net income?
Jill Kring-Carter: The easiest, simplest things to look at is all the simple and inexpensive tools that are not being used nearly as much as I think they should be, lights, loupes and microscopes and Isolite. These are my favorite products.
Howard Farran: Sorry say that again.
Jill Kring-Carter: Light, loupes, microscope…
Howard Farran: Okay lights.
Jill Kring-Carter: They could have like a rolling microscope you know from operatory to operatory.
Howard Farran: Okay, what do you mean lights?
Jill Kring-Carter: Well some loupes come with lights okay, Isolite has this built in so you don’t need a separate light. The microscope has a light. Some people use just the loupes and the overhead light but if you add a light to your loupes, what you see…it’s again the kind of difference in what you see by adding the loupes alone.
Howard Farran: I make them, all my assistants and I just wear loupes.
Jill Kring-Carter: Every clinical person should have them on in my opinion.
Howard Farran: The Isolite is…
Jill Kring-Carter: Some people don’t like wearing them but your efficiency will skyrocket because you get so much more done. You drill a lot less …you will see that you can stop now.
Howard Farran: Isolite is a must because even if, you know I don’t think Isolite should be viewed as well if I have it I don’t need an assistant.
Jill Kring-Carter: No.
Howard Farran: What I like about it is with Isolite, there’s so much light in the mouth, it’s gone from a dark hole to now just glowing, I can see everything but what I like about it is now I don’t need Jenn. It’s not like I’m going to fire Jenn.
Jill Kring-Carter: Right, you can get by without Jenn yeah.
Howard Farran: But she’s writing up the chart, she’s getting all ready, she’s setting up so it’s really, Jenn’s assistant. So now because there’s a lot of paperwork that goes involved with doing a filling or a crown and all that and as opposed to her just standing there the whole time with a suction and aiming a headlight in there. So Isolite is huge. Magnification is huge.
Jill Kring-Carter: Magnification and because of you using those things and you don’t necessarily fire your assistant but the assistant is doing other critical things, doing it better, doing it more consistently. You know your documentation or just all the other things that she needs to do. Maybe now she has time to clean up the op afterwards.
Howard Farran: And the magnification is also very motivational if you leave it on when you go to the bathroom. Oh my God, and you just feel all manly and you come back. So what else?
Jill Kring-Carter: So those are the simple tools that you can bring in that cost very little. I even encourage to, you know I don’t want to think about assistant hygiene because it is expensive if you bring in a whole other staff member, get them their own Isolite and loupes. I encourage the hygienists to own their own loupes, take it with them wherever they go. And then there’s the other side of it is just literally evaluating and perhaps retraining and rebuilding the hygiene department itself to emphasize on the perio epidemic that we have in this country. You know at least 50% of adults have some degree of perio. It’s a fact, the CDC has documented it. If there’s one thing that most dentists are not utilizing enough then it’s that fact and the hygienist sometimes, a little training on that six points you know perio charting and especially having to do with a particular system that you’re using. It’s very simple, it’s very quick. It takes only a few minutes of the whole examination.
Howard Farran: So you know the hygienist who broke the Crest story on the blue bits?
Jill Kring-Carter: Yeah.
Howard Farran: What was her name do you remember?
Jill Kring-Carter: I don’t remember her name, but I do remember that. I was one of those people that was finding little blue bits in my gums. Yeah.
Howard Farran: She was saying that she’s seen a far bigger effect of patients getting treatment if you quit calling it periodontal disease and call it pyorrhea because pyorrhea, you know gonorrhea, diarrhea.
Jill Kring-Carter: Disease.
Howard Farran: People don’t want gonorrhea or pyorrhea a lot more than they don’t want gingivitis.
Jill Kring-Carter: Right.
Howard Farran: And she, her mission now is to bring back the word pyorrhea.
Jill Kring-Carter: Just the word infection you know that if you don’t treat this all these things can happen and will happen, it’s just a matter of time.
Howard Farran: And Rob Marcus points out something with Kick Your Apps.com. You know the whole human body, if I fall down, like you gashed yourself. You ran into the door a couple of months ago.
Jill Kring-Carter: I didn’t run into the door my dog pulled the door.
Howard Farran: Your dog pulled the door, and you had a gash and now it’s completely gone. Everybody falls down, so the human mind is, everything always heals so when you tell somebody well you have gum disease and two cavities a lot of humans think oh well I need to start brushing and flossing better and they think well if I change my behavior and start brushing and flossing better I’ll heal.
Jill Kring-Carter: Right.
Howard Farran: And they don’t realize that…so calling something pyorrhea might be more influential than gum disease than when you tell somebody they have a cavity, you have to remind them this will not heal on its own. This will only get worse. If you don’t fix this, this will definitely turn into a root canal.
Jill Kring-Carter: If you don’t treat it, if you don’t treat this condition, this infectious, possibly shared condition, this is what’s going to happen. And it takes more than three minutes to explain that to a patient, every single visit.
Howard Farran: Are you still going into dentist’s offices consulting?
Jill Kring-Carter: Oh sure.
Howard Farran: And so if some dentist out there…what dentist out there, what problems would this dentist have, I’ve only got you for five more minutes, give your close on what would be the ideal situation dentists listening to you now to call the infamous Jill Kring-Carter and do you actually go in the office or are these phone consultations?
Jill Kring-Carter: I can, I mean…
Howard Farran: Tell them what to do.
Jill Kring-Carter: I’m willing to go anywhere. I think it depends on how much your needs are that I can assess from you over the phone and email and whatever. Certainly a lot can be done virtually, but with you having staff issues on any level there needs to be some coming to the site for that. I need to spend time with them, observe and while I’m there observe everything else in your business that I may pick up on some other things that need to be addressed. I think ideally that is the way to do it, but sometimes people have a distinct thing that they want to address. Say hygiene production, it’s best to that on site, to sit chairside with a slightly longer appointment so we have time to talk with the hygienist and things like between but it doesn’t have to be and it depends again exactly what I’m helping them with. There are a lot of things that I don’t have to be there, I just have to be able to communicate with you.
Howard Farran: So how does this dentist go to the next step I mean would you talk to them?
Jill Kring-Carter: Yeah they just call me or email me at email@example.com, firstname.lastname@example.org or my phone number and just you know make contact.
Howard Farran: What is your phone number is that the same one I just saw on the bathroom wall at Bellagio?
Jill Kring-Carter: Yeah. It’s been ringing off the hook.
Howard Farran: Do you give your cell phone, I mean are you that brave?
Jill Kring-Carter: Sure it’s 717 951 9313. I live in Lancaster Pennsylvania but that doesn’t preclude me from coming anywhere and you can call me any hour of the day. If I’m free I will answer my family knows that too. If it’s ten o’clock at night and my phone rings and I’m not busy I will answer it because you might be in California, it’s seven, you are done and now you can talk to me, that’s cool. I talk to dentists on weekends, I have talked to dentists on Sundays and I’ve talked to dentists when I’m on vacation. So just you know I’m on Facebook, I’m on LinkedIn. I don’t do a lot of LinkedIn but I’m there. I have a website that will soon have…there is a contact form on the website as well so there’s you know just contact me.
Howard Farran: And I can vouch for Jill Kring-Carter for 25 years. She is the bomb and a lady like this doesn’t stay in business for decade after decade if she is not getting the job done and you probably have one of the best reputations I know of in the dental consulting business and I would like to thank you for all you’ve done for Dentaltown. You had a thousands posts on Dentaltown.
Jill Kring-Carter: Yes and there will be more I promise.
Howard Farran: And I have a lot of friends of mine over a lifetime that credit you with getting their head turned on straight
Jill Kring-Carter: I appreciate that.
Howard Farran: I’ve just got one last question. Are there dentists on LinkedIn?
Jill Kring-Carter: Oh there are.
Howard Farran: I hear dentists talk about Facebook and Twitter
Jill Kring-Carter: It’s a weird thing there are a lot dentists on LinkedIn but it really doesn’t serve their purpose unless they’re looking for a job. So I’m sometimes not quite sure why dentists are on LinkedIn other than that it’s just another social platform to be one so hey be there. So I always say that I am on there just in case you are and that’s how you like to contact me but I think it’s more logical that they’re going to either send me a note through Dentaltown, through email direct or through Facebook.
Howard Farran: Okay Jill well thank you for everything that you’ve done for dentistry and Dentaltown and thank you for giving me an hour of your time.
Jill Kring-Carter: Thank you very much.
Howard Farran: Alright thank you very much.