Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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149 Behaviors Drive Results with Mark Murphy : Dentistry Uncensored with Howard Farran

149 Behaviors Drive Results with Mark Murphy : Dentistry Uncensored with Howard Farran

9/15/2015 12:00:00 PM   |   Comments: 0   |   Views: 569

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AUDIO - HSP #149 - Mark Murphy

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VIDEO - HSP #149 - Mark Murphy

Mark Murphy, DDS specifically addresses Practice management software--that it only shows results; it doesn't drive them. Learn to take advantage of today's dental climate!


Mark is the Principal of Funktional Tracker and Lead Faculty for Clinical Education at Microdental . He also serves on the Adjunct Faculty at the University of Detroit Mercy and the Pankey Institute where he also served on the Board of Directors. He practices general dentistry on a limited basis in Rochester, Michigan and lectures internationally on Leadership, Practice Management, Communication, Case Acceptance, Planning, Occlusion and TMD. He is an informative and entertaining speaker, blending a stand-up style of humor and anecdotes with current evidence based research that you can take home and use in your practice right away.

Howard: It is a huge honor today to be interviewing Mark Murphy. You're really a legend in my mind. I mean, you really are. You have a legacy of teaching practice management, of the Pankey Institute. I don't think you get any more legendary than that. I spent five weeks of my life down there with [Irwin Becker 00:00:27]. You also were with [Mercer, 00:00:30] that was with [Imtiaz Manji 00:00:31]. That was a huge, huge and still is. He went on I think to Scottsdale Center. 

Mark: He did.

Howard: That was with Mercer at one time, or then they spun off, or something. I mean, out of two million dentists on earth, you have taught at two of the largest, most prestigious, legendary institutes ever on practice management. Kudos to you, buddy. I mean, you're crushing it. 

Mark: Well, thanks Howard. I've been very fortunate in that I've been at the right place at the right time, maybe picked up the opportunity when presented to me. Both those organizations are very open in letting me come in, and giving me an opportunity to grow, and be able to do some of the things that maybe some of them I didn't even know I was capable of doing. It's really a fun run. Both those institutes, especially Pankey, but both of those places have been really good to me. 

Howard: We also have something else in common. Not only are we both male dentists in America, a name like Murphy, I know you're Irish. I had my family tree done because we're in Arizona. It's a lot of Mormons down here and they are really big into genealogy. I don't know if any of these listeners know that, but if you go to any Mormon temple, they do genealogy. 

Mark: I didn't know that.

Howard: I went down to Mesa, started working with seventy-five year old lady. She's volunteering down there and she did my whole family tree. It was amazing. Two parents, four grandparents, eight great-grandparents and still, one hundred percent Irish. 

Mark: That's awesome.

Howard: Why should someone listen to an Irish [mick 00:02:00] named Murphy? Because of Murphy's Law. 

Mark: Well Murphy's Law means, if something can go wrong, it probably will. And, isn't that the way life is? Well Howard, I think they should listen to somebody like me, especially when they think about Murphy's Law, because I've probably made most of the mistakes that they're going to make. I've been around a lot of people who have made other mistakes. I think I've learned a lot. And, if I've learned one thing for sure, it's that I'd like to not keep making the same mistakes over and over again, and calling it experience. I'd like to make new mistakes. 

When people can listen to other people, people listening to you about how to get a MBA, people listening to me about practice management, or [Dag Schwarte 00:02:39] about financial management and stuff. They can avoid some of those pitfalls and mistakes. Dentistry is hard enough. Dentistry is way hard enough.

Howard: Let me start with this question, because I got out in eighty-seven, and I'm fifty-two. You got out in eighty-two, so what are you? Fifty? 

Mark: Fifty-nine tomorrow. 

Howard: Fifty-nine. Well happy birthday, buddy. 

Mark: Thank you.

Howard: You're looking damn good. You look younger than I am. Everyone would think I was your older brother. 

Mark: It's the hair. It's the hair, Howard. 

Howard: We've been around the block a long time. We're doing about seven thousand listens per show. Lot of these kids are right out of school. The young ones are really devouring podcasts, more-so than older people. 

I want you to address their Murphy's Law. Their Murphy's Law is like, "you two older guys, you graduated in the glory days of dentistry. The golden years. We graduated with two hundred and fifty thousand dollars in student loans. There's a corporate dental office on every corner. It's not like it used to be in the good old days." 

What would you say to that kid whose been out of school five years, has two hundred and fifty thousand dollars in student loans, and is practicing across the street from a corporate dental office? 

Mark: Fair question, and a good perspective for us to start with. I think there's an important differentiation between what I kind of want to say, and what I'd actually say. What I'd want to say is, "every generation thinks they've got it tougher than the previous generation." I'd want to give them some historical perspective on our parents, who walked both ways uphill in the snow, four miles to and from school. Told us how tough they had it, how easy we had it, and we told our kids the same thing, and they're going to tell their kids the same thing. 

So, the first thing I'd say that I wouldn't actually say, but I'd be thinking, is "there's this historical perspective that the golden age of dentistry was, and we're living in something that's not. I think that's a bunch of crap. I think it's probably the best time you could ever be a dentist today. Better opportunities than we had when we got out of school." But, that's perspective. I probably wouldn't embrace that in the first part of the conversation with them even though they're going to listen to this in the podcast. 

Instead I'd say, "I feel your pain." Because not only are they graduating with two hundred and seventy-three thousand dollars in 2013, two hundred and seventy-three thousand dollars in debt, not only is there a corporate dental office opening on every corner, but the demand, the patient demand, the US consensus patient demand, consumer price, is declining. Flat at best. The supply of dentists is up. The net operating income of the dentist is down over fifteen percent in the last ten years. Reimbursements are sucking the hind part of the animal. It's horrible. So, we're in this big mess. 

You could look at that and say, "that's a perfect storm." You could say, "it's a horrible time to be a dentist." Or, you could say, like a sailor says, "when the winds change, I can set my sails differently." With those kind of head winds coming at you, probably the worst thing to do is to embrace that language. 

The worst thing to do is fall into that trap of what all that negativity is and say that "there's no hope, and there's no opportunity." 

Instead, I would say, "that polarization for that segment of dentistry would make it easier for anyone if they wanted to, to practice however they wanted. To practice free of dentistry without insurance reimbursement as their main income stream. Without participating in every PPO, and usual customer unreasonable re-adjustment fee that came along. It'd be the best time ever to be fee for service, insurance independent dentist, if that's what they chose to do." I'd never say to somebody, "that's what they should do." 

I'd say, "what do you want to do? What's your dream? What's your vision?" And, if that's their vision, hell, you can get there. It's easier now than it probably would have been ten, or fifteen, or twenty years ago. 

Howard: We do have a great perspective being our age, because you hear all these people talking about how bad the economy is. It's like, how would you like to practice during the civil war when eight hundred thousand Americans were killed? Everything was made of wood, and they fought with fire and burned down entire cities. Then to have World War One at the same time as the flu epidemic. The flu epidemic alone dropped five percent of the planet. That was happening during World War One, and then World War Two. I mean, really unique perspective. 

I get a lot of perspective from reading hundred year old dental books and from lecturing in fifty countries around the world. It's funny how a country, when you're inside a country, you think everybody's drinking the same Kool-Aid, then you go to another country. So, I want to ask this. When you go to Brazil, or Latin America, you go to Africa, you go to Asia, there's no dental insurance. 

Mark: Right. New Zealand. Take a country where it's not a third world country, but it's a first world country like ours. New Zealand: no dental insurance. 

Howard: Yeah. Why do almost all American dentists believe you have to take insurance? Because, are you saying that you don't have to? Is that what you're saying? 

Mark: Absolutely. 

Howard: Okay, so why does everyone in the United States believe that a human would never go to the dentist to fix their teeth without dental insurance? When there's no insurance in China, India, or Brazil? 

Mark: But the dentistry's a little bit different there, too. So, the first part, when you said, "would I say that you don't have to take insurance?" I'd say, "yes, but that's not a change you'd make willy-nilly. There'd be a process for doing that. It would take time. You'd evolve from insurance dependency to insurance independency. It might take two, three, four, five years, but you can do it; and you can't do everywhere, but you could do it almost everywhere." 

When I say that, most of us fell into this trap about taking insurance because, Howard, when I graduated from dental school in 1981, crown fees were three, three hundred and fifty bucks. Insurance covered twelve or fifteen hundred dollars. You could walk into a patient and say, "you need this, this, this, and this." 

They could say "all those crowns?" 


"Does my insurance cover?"

And you say, "hell yes." And then half the dentists in Michigan would waive the co-pay as well, which was ten percent, because Ford, GM, and Chrysler all had very robust dental plans. People were over-billing, taking ninety percent of the fee, and they were discounting their services. But remember, at three hundred bucks a crown, you could do four, five or six crowns in a patient. Pretty successful dental treatment back then, in 1981, two, three, four, five.

Well, then as you know, fees might have gone up. Costs might have gone up. Demand might have gone up. But, insurance coverage didn't change. If we'd indexed it for inflation from when it was first invented in 1954 to today, we might have nine or ten thousand dollars worth of coverage. But, it still covers twelve or fifteen hundred bucks. So today when you say to a patient, "you need this, this, this, this and this." 

They say, "does my insurance cover it?" 

You say, "no. Not even the first crown. It covers part of the first crown." It'll cover a crown and two cleanings a year. It's not insurance. Insurance is when the third party takes a risk for catastrophic loss, and there's nothing catastrophic about twelve hundred bucks. To the average person. To some people, on very limited income, twelve hundred bucks could be a catastrophe, but to most of us, it's not. People have money for what they want.

So, we feel like we have to take insurance because, sorry Howard but I'm going to point the finger at you and me, we, and the dentists of our generation, taught our patients to think that way. Now you fast forward to today. You get thirty years, forty years down the road, insurance covers the same, and we, and our patients, are living in the same paradigm about insurance and how it's responsible for our health, and it's just not working anymore. 

The good news, though, is if we taught them to think that way, we can teach them to think a different way. We have that freedom. 

Howard: Do you think that England, the United Kingdom, is just ahead of it's time? When I got out of school, England had fourteen thousand dentists and they all participated with the NHS; and now, I've been out of school twenty-eight years, and now five thousand of their fourteen thousand have said, "I'm done. I'm going," like you say-

Mark: They're going private.

Howard: "I'm going private." I think what dental insurance has done. Let me ask you this question. My thought is, if you make bottled water, and you make this bottled water, and you sell it for one dollar, and you net a dime. Let's say the dime is like the cap. Well, if you want to make another dime, because you need money for family, life, whatever. The hardest thing to do is make a whole 'nother bottled water, sell it and collect the money, to make your 'nother dime. The easiest way to make another dime, is to raise that first bottled water from a dollar to a dollar ten. Now you've made twenty cents, and that's the easiest way. 

Don't you think these PPOs and what they've done, is they've taken that dime away? I mean, if they keep lowering the fee to where you're basically doing free dentistry? 

Mark: Let me take your bottled water story the other way. If you're selling bottled water and you happen to make thirty cents every time you sell a bottle of water, and you say, "this is wonderful." 

Along comes a PPO and says, "if you don't sell the bottled water for fifteen cents less, give me a fifteen percent discount, then all your patients are going to go buy a bottle of water somewhere else." So you lower your fee to now eighty-five cents, and now you only make fifteen cents on that bottle of water. You have to sell twice as many bottles of water as you did in the initial example. 

In the dental practice, we'd have to do twice as many crowns, twice as many fillings, twice as many cleanings, twice as many everything. What we've seen is that fee-shift in business, they call it the average sale price. You've got a business degree, ASP, the average sale price, is declining. Which means we either increase the number of activities we have and sell the more, or we create efficiencies, or we go off-shore for our laboratory work, or we use our gloves three times and our suction tips twice, and the bur fifteen times. We find some other cost-advantage to take expense out, and that's not in the best interest of the patients, usually. That's a tough way to try and make a buck: cut your way to prosperity. 

Howard: The industry that reminds me the most of dentistry in America is actually the cattle industry. Not one Fortune 500 company owns one percent of the cattle market because so many cattle people sell their cattle at a loss; because they're a dentist, an accountant, and they don't understand their cost enough. They're selling meat at a loss; and the Fortune 500 can't go into a business where your competitors are willing to sell at a loss. 

I look at dentistry, and this is leading up to your Funktional tracker, and we can talk about that because, I think the single largest crime in dentistry today is the fact that their practice management system has no accounting software in there. If their staff was clocking in off the management information system, and you're paying all your bills on the practice management information system. The computer knew that you took half an hour to do this procedure at a hundred bucks, and your cost was a hundred bucks, and you signed up for a PPO. They're going to pay you ninety dollars for that procedure. 

Then, everybody out of the data is saying, "hey Mark, you signed up with this, you'll lose ten dollars every time you do this procedure," then all the dentists will say no. But, none of the dentists know their cost. So the problem with PPO is that so many dentists are participating, running them at a loss, and not even knowing they're taking profits from pay for service cash patients, subsidizing all this garbage they're doing at a loss. It just makes the industry so much sicker and less healthy. 

I was wondering, you're big into this Funktional Tracker, what does Funktional Tracker do and what market failure for existing Henry Shine's Dentrix, Patterson's EagleSoft, Carestream's SoftDent. What is Funktional Tracker doing that these companies are not doing? 

Mark: The point that you've made is awesome, because when we don't know what our real cost structure is. We don't know the cost of goods. We don't know our SG&A is, we start to look at our structure and we say, "well, if I just do a few more of these, or if I pay my team a little bit less, or if I lower my lab bill, I can still eek out a living." But, what's been happening the last ten years, so this is not something we're talking about theoretically. There's been a decline, the ADA's data shows there's been a decline of over fifteen percent over the last ten years of what dentists made on an annual basis when you adjust those all for the same years, value in terms of inflation. So, we're making less, and less, and less money every year, doing more, and more work, because there's no accounting software that really gives you that capability. 

I would add, the average dentist, we just aren't trained to understand that kind of thinking. We're trained to work in this four inch sphere, this little monson radius sphere, where this is our happy place. When we go outside there, and we have to manage people, or think about business, and think about features, advantages, benefits, and how we sell things, we just go, "no, I don't want to do that. I want to just fix stuff." The problem we have is, if we're terrible at the business, if we're terrible at management and leadership, we still make a hundred and sixty, eighty, two hundred thousand dollars a year is the average income for a dentist. A hundred and eighty seven thousand and change, the last recorded number from the ADA. We make almost two bills if we're terrible at it, but we might be fifty or hundred thousand dollars on the table. 

Without that accounting software, we have trouble managing that. That would require a great deal of education for the dentist to be able to sort through that information, and think that through. What we could do, quite simply, is if we could identify some behaviors and track those behaviors that impact those results better, we might be able to change the numbers, even without some sophisticated understanding of business. 

Let me explain. Dentrix, Eaglesoft, all the softwares out there do a great job of recording what happened yesterday, and telling you what the opportunities were, telling you what the opportunities could be in the future, telling you how much money you made, how many new patients you saw, slicing and dicing your data, production per hour, great. But, they're all rearview mirror opportunities for you to look at your practice. If we know that certain behaviors impact those results, we should track those behaviors, and that's what Funktional Tracker does. That's what we should all be doing. It's not about my software, it's about just, even a paper and a pencil, tracking the behaviors that we agreed to. 

So, if the team says, 'we should use the intraoral camera more,' why? Because if you use the intraoral camera more, more patients say yes to treatment recommendations, and more of your hygiene patients show up for their next re-care visit. We should be tracking not just how many patients are up for their re-care visit, and what our dollar revenue is. We should be tracking how many times per day we use the intraoral camera. That becomes the critical metric. 

The solution to the problem is to say, identify the right behaviors: using the intraoral camera, celebrating things with people, asking for a referral, making the next hygiene visit, making the restorative visit, making the first hygiene visit for a new patient when they come in. What are the behaviors that we can identify that impact the results that we want to change? Because, we've got plenty of software that slices and dices the results. We need something that drives behaviors. 

I mean, I wear a FitBit. I wear a FitBit because it's going to help me measure, monitor, and manage how many calories I eat, how much exercise I do, why? Because I want to lose those last ten or fifteen pounds. I want to get healthy, stay healthy, and look as young as you do, Howard. 

Howard: What I do is I hire my personal trainer to wear that FitBit. 

Mark: And you look great on paper! 

Howard: Tell me, of Dentrix, Eaglesoft, and SoftDent, which one's Moe, Larry and Curly? 

Mark: They all do a great job. I couldn't beat up on any one of them. They all do a great job, but they only do a great job on telling you what happened yesterday or today in your practice. They don't tell you anything about what behaviors are necessary to drive those results. 

Howard: So how long is this been out? How do dentists get it? What do you track in? What's the results? Tell us how's it working. 

Mark: Well, thank you, but, I'd like to stay at a global level. I don't want this to turn into an infomercial about Funktional Tracker. But,, it's but it's 'functional' with a 'K,' because we like to be a little bit fun and funky. So Funktional Tracker with a K, dot com, is a website where people can go and look at this stuff. I want to say this again, it's not about my software. 

It's about, if you took your day sheet, and you walked into your operatory and you said, "patient number 1 from a hygienist come in, did they make a six month recall appointment?" Yes, put a check-mark. "Patient number two came in, did they make a six month re-care appointment?" Yes, they did. "Patient number 3?" No. You could track what percentage of the time your hygiene patients were leaving with their next appointment. The average practice is around seventy percent. Best in class is around ninety-four, ninety-five percent. 

The difference between seventy and ninety-five percent, that twenty points on just a one hygienist practice, whose maybe working thirty hours a week and seeing ten patients a day, so maybe they're seeing forty patients a week. A twenty percent delta in that number from seventy to ninety percent is eight more patients or one full day of hygiene. With one more full day of hygiene in your schedule, six months down the road, because you're starting to track that behavior. Whether you do it manually, if that's a pain in the butt, you know, you can buy the software on a monthly subscription basis, but the idea is to track that behavior. 

If you track that behavior, and impact that result, guess what? That practice is busier six months down the road. For every dollar of hygiene that they get in revenue, they get another two or three dollars in restorative out of that hygiene revenue. It's really not about measuring the revenue. It's about saying, "how many patients have healthier mouths? How much more of the dentistry that I like to do, do I get to do? And then, oh by the way, that will also drive revenue." 

So, Funktional Tracker has had great success, but so to could you with a pencil and paper if you had the time, the effort, the energy, and wanted to track that stuff. It's about tracking, not about just how you track. 

Howard: Well, would it be giving away the farm for you if you went over what you're tracking? Or, what the eighty-twenty rule? What the most functional, behavioral things to track are? 

Mark: No, I mean, I would list them as probably in the hygiene arena, the simple most important thing to track is next hygiene opportunity. When a patient's in, did your hygienist make their next re-care appointment? If they did, count that for you. If they didn't, count that against. That should be ninety-plus percent. If the average practice is seventy, there's a twenty percent opportunity to improve in the average practice, and we've seen them as low as fifty, fifty-five. 

I would also have the hygienist using an intraoral camera more. Lots of practices have an intraoral camera. I was once doing a lecture for Mercer, and I asked "how many of you have an intraoral camera in your office?" Just about all the hands in the room went up. I said, "keep your hands up, keep your hands up. If you use it at least once a day, keep your hands up. If not, put it down." I didn't count, but I bet seventy-five to eighty percent of the hands disappeared. If you use the intraoral camera more, and you show a patient crummy gums, they're more likely to come back for their next six month appointment. That means less time, effort, and energy, trying to fill your schedule. Less time, effort, and energy, calling patients, reminding patients, and everything else. 

In the clinical area, I would say that the greatest opportunity is to track your case acceptance. Case acceptance is usually at or below fifty percent in the average practice. If we start to track acceptance, and then we change our behaviors and create a more curiosity-inducing, a more co-discovery type of new patient experience and exam, if we use the intraoral camera more, those two behaviors, we'll find more of those patients who will say 'yes.' And a ten percent change in case acceptance can be a hundred, hundred and fifty thousand dollars a year. That's a big delta. 

On the administrative side in the practice, I would have my admin team celebrating things with patients when they came in. Being very social. If they knew that Howard had been lecturing in London, England, and when you came back in for your next cleaning visit, I say, "so Howard, I understand you were in London, how was it?" And I'd listen to you tell me about your trip, and you'd feel good about telling me, I'd feel good about hearing. I'd celebrate something with you that I knew about you personally. We know that that helps improve patient acceptance, patient retention, and case acceptance all across the board in a practice. I'd work on next hygiene visit, I'd use the intraoral camera more, and I'd celebrate things with people. If I didn't have enough new patients, I'd ask for more new patients, and I'd track how often I did that. 

Howard: I want to go back to intraoral camera. I always think it's ironic how a dental office, their number one largest expense by far is labor. Twenty-five, twenty-eight percent.

Mark: Worse than twenty-eight percent, it's probably north of thirty, but... 

Howard: Yeah, so thirty percent labor. Then, if the average dentist overhead is sixty-five percent, that means the dentist, that's a human, that's labor, that's thirty-five percent. Thirty percent for labor, say twenty five, and thirty five for the dentist. That's fifty-five cents of every dollar goes to the human beings, which is the same average for the S&P 500, fifty-five percent goes to people, whether it be payroll or profits. Then next, lab, eight to ten percent. And, they've always got money for payroll the first and fifteenth. They've never got any money go smarter or faster. What we did in our office, we have an intraoral camera in all eight operatories, and they're turned on in the morning. 

In most offices you go to, the dentist is trying to save a buck, and when he wants to use the intraoral camera, he's got to go to the assistant, "would you go in the room for me," 

Mark: You gotta go unplug it from here, and plug it over here. 

Howard: You're stepping over pennies. You're just wasting so much money because you are going to have your whole office share an intraoral camera. 

But, I want to go back to case acceptance, because that's pretty confusing. Some people say they have a hundred percent case acceptance rate, but they don't present anything. Other people might present Invisalign ten times a week, and at five thousand each, I mean, if they got half of those, they'd be leaving fifty thousand dollars out on the table. That dings their case acceptance. 

Some people like Bill [Blatsford, 00:23:58] is he seventy? Seventy years old? 

Mark: Older than we are.

Howard: Yeah. You know what he does? He does a push up for every year he's alive, every year on his birthday, and puts it youtube, and I can't do fifty-two. 

Mark: I'll do sixty of them tomorrow without any problem. 

Howard: Can you really do sixty? 

Mark: Oh yeah.

Howard: Oh my god. I think he says for every dollar you produce, you got to present three. He's saying his deal is, if you want to do a million dollars, you got to present three million. Talk a little bit more about case acceptance. Then I want you to talk about the other thing about case acceptance. Why do ninety-five percent of the country's ten thousand orthodontists have a treatment plan presenter present the ortho treatment? Ninety five percent do. In dentistry, ninety-five percent do not. 

I want you to come back to case acceptance. You're a Pankey dude. You're a Mercer dude. You guys know how to present big term plans. I bet you of our seven thousand listeners, if five thousand of them have never done a single ten thousand dollar case. 

Mark: Maybe. 

Howard: So can you talk about that for a little while? 

Mark: Yeah, let me go in reverse order. So first let me say, why does an orthodontist have, let's say a non-dentist, an excellent communicator, somebody who's comfortable with numbers and math, somebody who's comfortable with finding an acceptable way of paying for it, having treatment options, why do they have somebody present that instead of the dentist? The simple answer to that one is because we generally, there's exceptions, we generally suck at doing that. 

So if we're terrible at it, and we don't train somebody, or pay somebody, or incentivize somebody to do that, and we do the presenting of that. Whatever we have as an acceptance rate, and I assume it's going to be lower than it could have been, because we're not good communicators, we have trouble looking somebody in the eye and saying it's ten, or fifteen, or twenty thousand dollars. Now, is this true of everybody? Of course not. We're talking about the Bell Curve, we've got the middle of the Bell Curve. They have a tough time presenting that. They can't even look somebody in the eye. They, "the treatment's going to be," and they're afraid to say those numbers. 

They're also afraid that the patient's going to ask that question back that cripples everybody as a dentist. "Will my insurance cover that?" And they don't have an answer, and we need to have answers for that. The reason orthodontists do it, is because orthodontists, we're always going to be presenting a five, six, eight, ten thousand dollar treatment plan. They know that their life blood is going to be the success of those presentations being accepted. 

They are willing to invest in the people and the training to have somebody who is a more competent, let me say, treatment coordinator, salesman, whatever we might want to call them. A closer, to be able to present that in a way that more of the patients, more of the patients and their parents, will say yes. We're not willing to make that investment. 

Now, why can one person have a treatment acceptance rate that they think is a hundred percent; and somebody else, like Bill [Blatsford, 00:27:00] would suggest that if we want to have a million dollars in treatment acceptance, we have to present three million so that we get a two to one ratio. That we get a thirty-three percent case acceptance. That's a pretty wide range. 

Well, if I never present more than twelve or fifteen hundred dollars, I could grunt my way through that case presentation. "(Grunts) crown." 

And you'd say, "does my insurance cover that?" 

You go, "(grunts) uh huh." 

And you'd go, "let's go." Right? 

I don't have to have any kind of interpersonal communication skills. So if I'm a dentist, I don't use my neocortex. I use my, 'I want you to like me mammalian brain,' I use my 'I don't want to feel the pain of rejection' reptilian brain, and 'I want to pay my bills' reptilian brain. I use my inner brains and I say, "what's the least painful? What's the least emotionally costly path of resistance?" It's to ask you to do something that someone else will pay for. So that's where I go, and then I have a hundred percent. Why? Because I never present more than what insurance will cover. 

Once I start going past, and I don't know what the number is, it's going to be different for everybody: three, four, five, eight, ten thousand dollars. But, probably three or four thousand dollars. Now it really requires me creating a value proposition in your mind for what we're going to do. It requires me to help you understand what the role of insurance is and isn't. It requires me to help you make different choices about what you want, even though I know that this is something that you need, because you want other things. 

We spend more money in this country today on alcohol, tobacco, and gambling than we do on dental care. We almost spend as much celebrating Halloween and Thanksgiving as we do on dental care. We spend ninety-one billion, and dentistry is a hundred and ten billion dollar industry. So, people have money for what they want. My goal is to tell you what you need, it's to get you to want it. If I'm not a good communicator, Bill [Blatsford's 00:28:52] right. I'm probably going to have to present three dollars to get one dollar back. 

I either default to the painless environment and say, "I'm never going to present more than insurance covers," or I go over to this spectrum and I say, "at this end, I'm going to present a whole bunch, and I'm going to take my piece of it, but I'll have to be a three-to-one, two-to-one kind of ratio." 

Or, maybe you spend more time honing your communication skills. Honing your conversation and your scripts around insurance. You create more curiosity and co-discovery in the new patient exam. How are the kind of things we learned down in Pankey. If you do that, and you invest at the front end of that more, not every, more of those patients will come to understand the role of insurance. They'll come to understand what their needs are. Maybe they'll come to understand and want what we know they have to have done. By them owning their problem, really good patient education. If we do that, more of them will say yes. Not all of them, but more of them. 

That's a harder track for a dentist to take. "Why don't I just present more?" Or, "why don't I present less, where they'll always say yes." Those are paths of least resistance. 

Howard: Are you for treatment plan coordinator, or against, or does it depend on the dentist? The bottom line is, we all got into dental school for one reason: we got A's in calculus, geometry, physics, chemistry, bio-chemistry. We didn't get accepted to dental school the same reason you get accepted to a broker at Merrill Lynch, because you're tall, dark and handsome and know how to talk to people. 

Mark: Right. Yup.

Howard: Can this physics major, calculous, Krebs cycle geek be taught to do this, or do you think it's a lot easier to do like the orthodontists do and just say 'hey, find a treatment plan coordinator.' 

Mark: Bell Curve answer? Hire somebody to do it. Some people may want to learn those skills and become better at that. And honestly, if they do, they'll probably be better at just about every other aspect of running their business. They'll be better at communicating with people. They'll be better leaders. They'll be better managers. They'll understand business better. I would argue because of the size of our business, the revenue stake that we have, our cost of overhead, our cost of doing business, it's probably worth the average dentist taking a shot at trying to acquire those skills. 

Now, if they keep running into a brick wall all the time, then I think they've got to let go and think about hiring somebody else. But, see the average orthodontic practice has a higher revenue run rate and lower overhead, and they've got a little bit more free capital to hire another employee to do something like that, and compensate them fairly. 

We're a little tighter on that. If you're using your sixty-five percent for example, which I think would be great for today, but sixty-five, seventy percent overhead, you're adding a layer of a person to do your job as a dentist that you're unable to do. You got to pay them fairly. You're probably looking, and in a seven hundred thousand dollar practice, or an eight hundred thousand dollar practice, you might be looking at another three, five, eight or ten points to hire that person. Well, if you're doing an orthodontist practice, doing a couple million dollars in revenue, it's a little easier story. 

So, I'm in favor of both, depending on what you can and can't do as an individual. 

Howard: I know two ladies my age, well not my age, but, maybe ten years, five years younger, who both went and got a job at a dental office doing five hundred thousand. Both started presenting the treatment, they both went to a million five, they are both getting paid about fifteen dollars and hour, and asked for twenty dollars an hour raise, and the dentist said no. Found another office hiring, gave a two weeks' notice and went there, the office that was doing five hundred thousand went to a million five, they left, it went back down to five hundred thousand. And, where they're at now, went from five hundred thousand to a million and a half, and one of them had to do it again, and went to a third office, and that one went back down to five hundred. I mean, can you imagine a lady comes into your office, bumps you up a million dollars, and you can't bump her from fifteen dollars an hour to twenty? These are two of the craziest examples I've ever seen on treatment plan. 

Mark: Yeah. 

Howard: I'm trying to get them to do an online training course on treatment plan, and something. So, if you're a dentist listening to this, and they want to know more, how would you take them to the next level? They're driving to work right now, the average commute is about an hour, that's why these podcasts are an hour. We're halfway through this. Where do you want to go next? You want to tell them how to do this? You want to tell them, what would their next step be? 

Mark: You mean telling the dentist how to do it? 

Howard: Yeah.

Mark: Well, I think-

Howard: Or, do you recommend the person listening on their way to work now go there and start looking for a treatment plan coordinator? 

Mark: I would again, probably take a shot at developing my own skills first. Then, if I was unable to do that, running into a brick wall, I would hire somebody to do it and have to bite that bullet. 

Howard: I think what you said why they should learn how to do it themselves, because becoming a successful sales person, you're going to become successful all around your life. 

Mark: Absolutely. 

Howard: One of the biggest maxims I believe, of successful people, is, how many uncomfortable conversations are you willing to talk about? I mean, these people will tell you things about their own kids. I'll say, "well, when you told your kid, what did they say?"

"Oh, you know. I don't want to, I'm afraid to tell my kid that," and they're telling you what they want to say to the hygienist. "Well, you know, I don't want to confront her." 

These people are always telling me these conversations, and I'm always like, "you shouldn't be having this conversation with me, because you're venting, it'll make you feel better. You need to go back and have an uncomfortable conversation with your hygienist." They won't talk about their spouse spending too much money. 

Humans are pack animals, so they don't like to have uncomfortable conversations. That's what sales is. Sales is being able to say, "Mark, look, you know you got insurance, but dude, you know to do this right, this is going to be a very comprehensive case, and this is going to cost you ten grand." That's why I think they should develop it themselves, it'll help in every aspect of their life. 

Mark: Absolutely, and you know Howard, the challenge inside the dentist is not 'go out and learn the skills.' The challenge inside the average dentist is to accept the fact that we'd rather talk about molar endo, than talk about interpersonal communicating. 

The first step in recognizing that we need to grow into an area is recognizing the deficiency we have in that area, and the need that we have in that area. That's a huge challenge, because that requires a big paradigm shift. The reason that molar endo, and stuff like that, are the number one threads on Dental Town is because that's our four inch monson radius sphere. That's our comfort zone. That's what we want to talk about. That's what we want to think about. That's what we were trained to do. That's what we're good at. 

We weren't selected, you said it, we weren't selected to go to dental school because we were good interpersonal communicators, good providers, good healers, good nurturers. We didn't have a list of characteristics that they look for. They said, "let me test you for the characteristics of somebody who would get through this program in four years and pass the boards." That's an introvert, who's very analytic and very technical in terms of their work. Not strong in interpersonal communications. Doesn't have great leadership and management skills. 

Are there exceptions? Of course. But we're talking about the Bell Curve all the time, so if there's somebody out there listening and wants to get pissed off because I said that about them as a dentist, it's a Bell Curve. We get both ends; but the average dentist is not only not trained, they're not selected for, and then they're not prepared to accept in themselves that they need help in that arena, and then to pay for it. Yet, they'll pay for a class on molar endo. A class on occlusion. 

I mean, look at the continuing education. There's one, and now I'm going to plug Pankey a second where I teach, but, I mean [Spirit 00:36:31] does a great job, [Kois 00:36:31] does a great job, [Dawson, 00:36:32] [LVI, 00:36:34] all those places, they do a great job in technical education. It's harder to find a place, Pankey, where there's a stronger component on the behavioral, the philosophical side, the softer sides of dentistry. It's harder to find that. Why? Because that's not they want. 

If I was opening a commercial enterprise, and I wanted to sell continuing education, I would sell as much technical education as people would buy because that's what they want. And I would sell the hell out of it, and I wouldn't discount it. I'd bundle it, and I'd make a bunch of money. 

But, if you said, "give me what I need." 

I'd say, "you need to learn how to hug somebody. You need to learn how to reward somebody. You need to learn how to communicate well. You need to know how to stand up for what's right in the face of adversity and resistance," and that's harder to do, and that's harder to teach. 

If I'm a dentist, I don't want to learn how to do that stuff. I just want to work here. I just want to fix this stuff. 

Howard: You'll go into dental offices, and everybody I know in consulting says the same thing. When you go into a million dollar office where the doctor's netting three, four, five, I mean, you can sense it in one second. I mean, you go to other doctors' appointments and the doctor's running thirty minutes late, and there's just people vividly upset. 

You go into our office, and we know the doctor's going to be late, and it's just a natural behavior for the office manager and reception to get up there, stand up, walk around, go out there, hold your hand. "Mark, I'm so sorry. Doctor Farran's running late, he had-" and then explain the whole thing, and the patient's like-

Then when you talk to them about stuff like that, they go, "oh, that's all the soft stuff. That's all the bullshit. You know, I want to know on a CEREC machine, you have this setting on this, or do you have the setting-" I mean, in fact what do you address that? 

These kids are coming out at two hundred and fifty thousand dollar student loans, and they're all freaked out because now they got to double down and pay a hundred and fifty thousand for a CAD/CAM, a hundred thousand dollars for a CVCT, a seventy-five thousand dollars for a bio-lase. They're like, they're going to double their dental school debt on three toys. So what would you say to that dentist? Do they need to double their dental school debt to go to the next level on three toys? 

Mark: Well, I certainly don't think so. 

Howard: You certainly know so. I mean, how many dentists you know, have multi-million dollar practices that don't have any three of those devices. 

Mark: Plenty. 

Howard: Plenty! Yeah. And, they'll get those three devices, and they don't have the skill set to get to a million dollar practice anyway. 

Mark: That's right. We look for the quick answer. We look for the easy solution. When a very slick salesman, which we're not, comes in and tells us that this CEREC, this CVCT, that these things are the answer to our problems, they're going to make all our concerns go away. We want to buy into that hope, because they're good sales people, and it's cool-looking equipment. It's snazzy, and we like that kind of stuff. That's our comfort zone again. 

I'm sure there's a lot of people out there with CEREC machines sitting in the corner, barely using them. That don't have that opportunity to really grow their practice with them. 

Now, you take that practice where somebody's running behind, somebody's stressed, but has a good team with all those soft skills. If you can teach those same soft skills to the dentist, if you could teach the dentist good communication skills, if you could teach the dentist to be like the rest of their team that's around them, that dentist could take his number from whatever it is, to whatever he wants it to be, and work as many or as few hours as he wants. We can carve our own path in dentistry. You don't have to [slice 00:40:04] into this insurance crap. 

Howard: So Mark, now this little girl is thirty years old. She's two-thirds of the way to work. She's only got twenty minutes left. Specifically, she says, "okay, I agree Mark, I want to go to the next level." What specifically should she do? Should she start with the Funktional Tracker? Should she start with the Pankey Institute? Should she go to By the way, can she email you? 

A lot of them, every dentist always thinks their problem is unique. They say "Mark, you don't understand. I'm in this town, and it's only five thousand, and the main factory shut down, you don't get it, because you're not from around here." So, can that person ask you a specific question? 

Mark: Absolutely.

Howard: And how do they contact you? 

Mark: Funktional with a 'K.' So M-A-R-K-M-U-R-P-H-Y, Mark Murphy, at Funktional Tracker dot com. 

Howard: Okay, so what would her next steps be? She says, "okay, I want to go to this next level." Specifically, what should she do, and in what order? 

Mark: Here's the challenge. What everybody wants right now when they ask that question, is they want the action item answer. They want it to be something fuzzy and sexy, and something they can get their hands around. They want it be a big hairy, audacious answer to their problems. The first thing they should do-

Howard: And it has to be shiny with lights on it. 

Mark: Absolutely, and a squirrel! Absolutely. What they really need to do is go sit by a beach, sit by a campfire, sit with someone they care about, and talk about what their vision is for how they want to practice dentistry. Because until we get clear on how we really want to do this stuff we call dentistry, it's really hard for us to design a path on how to get there. You know, Yogi Bear said, "if you don't know where you're going, you might end up somewhere else." I love that. 

So, if you don't know where you're going, how the heck can you ask questions? You say, "Howard, should I buy the cone beam or should I send my patients out to cone beam?" 

You say, "I don't know. Tell me about your practice. Tell me about your vision." 

"Should I go with the digital radiography? Should I start making bite splints and [centric relations 00:42:02]? Should I go to [LVI, 00:42:03] where they teach neuromuscular? Should I go to Pankey where they teach [CR? 00:42:05]" 

"I don't know. Tell me about your vision." 

Well, until I know what your vision is, it's really hard for me to help you make decisions about which path you want to take. So, first I would vision for who I wanted to be, how I wanted to practice, how I saw my patient population, how I saw my team. I'd have to let myself go far enough out, three, five, seven years to think: not tomorrow, not in six months, because then there's the possibility of getting there that prevents you from thinking clearly. 

You have to be able to say, "in five years, I'd like to be..." 

And, maybe somebody said, "in five years, I'd like to be practicing independent of insurance. I'd like to have patients who are responsible for themselves and their mouths. I'd have a team that was self-starting and took care of things. I'd like to have better communication skills. I'd like to have really good case acceptance. I'd like to work four days a week, six or seven hours a day." Paint that picture as clearly as you can. 

Once you have that vision, then I would say, "go get the skill sets that you need to acquire that vision as a reality. Those skill sets might be clinical. Maybe you're living in a triple [trade 00:43:05] world, doing one tooth at a time, and you want to do more comprehensive care. Then you'll need some skills, so you might need some clinical skills. You have to add into your toolbox. You might need some communication skills. You might need some behavioral skills. You might need some leadership skills, some management skills, business skills. Go get that stuff. Once you get that stuff on the shelf: clinical skills, behavioral skills, communication skills, then start to deliver. 

Now, this is the hard part, because you're probably going to deliver a higher quality patient experience without really getting paid for it. Because you're still living in this PPO, usual, customary, reasonable world. You're still in this insurance entitlement, and you're starting to deliver more. But here's the good part. Now I'd work on something like tracking behaviors, whether it was Funktional Tracker or your own mechanism, I would start to track the behaviors. Grow my practice. Get busy. I would really work hard to deliver a higher value proposition to my patients. Both in terms of quality of the clinical work, and the behavioral experiences they have in the practice.

Now, after I've done that for a while, I would spend some time telling those patients about the great experience they're having. Reminding those patients that what they're getting here, they didn't get at their previous dentist. What they're getting here, they're not going to get somewhere else. That my filling, my crown, is better. Patients don't always know that difference. 

But, if we point out that we've spent some time carving some anatomy into that composite restoration. If we spend some time explaining to them that we're going to make an exquisite provisional restoration today, and we'll have you back in four or five weeks after that tissue's healed, because if we try to take an impression today, we won't know exactly what the margin is. We'll have a more predictable result by treating your tissues this way. That makes sense to patients. 

And if they say, 'gosh, I remember my previous dentist just injecting, trying to get an impression, and cussing and swearing, taking three or four of them, because he had to get it off to the lab and get it back in two weeks. No one ever said to me, we can let those tissues heal first.' 

So if we can create a differentiating experience and share that value proposition with the patients, I've gone and put good stuff on the shelf. I have this vision. I do some better stuff. I deliver to the patients. I tell them about it. Now, I'm prepared to risk leaving my relationship with insurance." 

So, if that's somebody's vision, then they can create a pathway that's three, or four, or five years long of delivering the kind of dentistry they want, in the kind of environment that they want. Maybe not for full compensation initially. And, then they're willing to risk the loss of a few of those patients, and it probably won't be as many as you'd like or as many as you'd worry about, if you do it the right way. 

I would suggest you don't leave all at once. You leave the worst plans first, and you leave the less worst plans second and third. Then, maybe write a letter to those patients explain to them what's happening. Then, you have them come in for six months and then have a one-on-one conversation with each and every person that's going to be affected by that decision. I would have a slow and careful progressive way of moving towards my dream. 

But, it starts with vision. It starts with vision and to put the stuff on the shelf. You have to grow a little bit and deliver some great stuff. Then, you got to tell people you deliver it, so they understand the value proposition. Then, you can start to risk leaving some of those insurance reimbursements. 

Howard: Now, specifically, would you recommend that they sign up for the Funktional Tracker and go to Pankey? 

Mark: My knee-jerk answer is probably yes. But, I can't really say that to somebody because it depends. If your vision is, or your desire is, "I just want to learn really good clinical dentistry," then I don't know that Pankey's the right place for everybody. Pankey's going to burden you down with some communication skills, and behavioral, and help you develop a philosophy. They're going to spend some time helping you vision how you want to practice. Talk to you about your core values, and your patients. They're going to talk about fluffy stuff. 

If you go, "I just want clinical dentistry." There might be better places out there for you. 

Howard: Is it still like when I went there, where it's a week continued at a time? 

Mark: Yes.

Howard: I went there five times for a week. 

Mark: Yup. 

Howard: By the way, what was the hotel across the street from Pankey on the beach? 

Mark: Oh, the Sonesta? 

Howard: Sonesta. Oh my god, my kids love that place. 

Mark: Beautiful. 

Howard: So would you recommend just going down to week one at the Pankey and giving it a shot? How much is week one? How often do they teach that? Specifics about that? 

Mark: Yeah, I think Pankey offers E1, and I teach in all the 1s and all the 3s. I think they offer E1 six or seven times a year. Have about sixteen students in a class. I think it's around four grand, can't quote me on that. Then we've got condominiums that they can stay in because we're non-profit, they're a lot cheaper than staying in the local hotels. 

The experience that you want is primarily about understanding occlusion, understanding the new patient examination, how to create some of this curiosity co-discovery. Then you start on a journey about self discovery, and looking at Dr. Pankey's crosses, I'm sure you recall: knowing yourself, knowing your patient, knowing your work, applying your knowledge. Then, you'll have rewards in the center of that balanced construct that you have that will be both spiritual and financial. Monetary and behavior, because it's not just enough to make good money. You've got to feel good about it in your heart. It's not just enough to get warm fuzzies, you need to make a couple of bucks because you've got to pay your bills. That's what E1 is all about, and I think that is a great place for most people to start. 

Now, then you'll go through two and you'll learn more about occlusion, and TMD, and splint therapy. In three, you'll do aesthetics, and four you'll do post [area 00:48:16] reconstruction and implants. There's a layering to the learning. But, throughout that, there's a thread of behavioral practice management, financial management. 

So, is Pankey right for everybody? No, but it's right for a lot of the young generation. Pankey's doing better today than they were before. They've still got a lot of competition out there. Back when you and I were going out there, there was Pankey, there was Dawson, there wasn't much else. 

Now, there's ten or fifteen good places to get an education. I mean, good places, and I've been to a bunch of them. I've been to [Superior 00:48:44]. I've been to Dawson. I've been to Cois. I've been to LVI. I've done a lot of different stuff, and Pankey's got some uniqueness to it. As a non-profit, it's got some uniqueness to it. It has a commercial free, unbiased kind of approach. The Funktional Tracker- 

Howard: I want to add, before you go to Funktional Tracker-

Mark: Sure. 

Howard: Specifically, do you think for week one, I mean there's two experiences you can have. You can go for, take your family, stay at the Sonesta, do Pankey eight to five. Or, do you recommend they go solo-

Mark: Solo.

Howard: -and stay in the dorms where you have three or four people, and make it a personal, private solo journey instead of chasing your kids on the beach. 

Mark: This one, I would not say it depends. This one I would say, solo. You go solo. 

Howard: For all continuums, or most specifically for one, or what are you thinking? 

Mark: I would say for all of the continuums, you want to plan on going solo. If you want to have your family down and have them come at the end, or go there at the beginning and maybe overlap a day with you. But, your time, from eight to five in the classroom, doesn't end there. Usually you break for dinner, then there's an evening session. Or, everyone's getting together in the condos and they're meeting. In that after hours learning, the after hour experience, is so much a part of how you grow and what you do, and what you learn at Pankey, that I would try and not to compromise that by having outside interests. 

We had our wives come down when we were at four, we had the wives come down and join us like on Thursday. We finished up on Friday, and then we did something on the weekend. The three of us got together with our wives, so three couples, and we had a nice weekend and everything together. That's a great way to do it. But, I would probably not try to bring a family down during it. 

Howard: How much is the Funktional Tracker, and is this something you download online? Or, is this something that's all in the cloud? 

Mark: It's cloud, yeah. 

Howard: So it's all cloud based? How does this work? 

Mark: It's all cloud based. 

Howard: How much is it, and how does it work? 

Mark: It's three hundred and ninety five dollars a month is the full manufacturer suggested retail price. There's of course, a million different ways to get to that. But it's an online cloud-based behavioral tracking mechanism, because change is hard. Our reptilian brains and our mammalian brains want to take over, and you've got to figure out a way to get the neocortex in charge. It's sort of like a FitBit for dental practice. It's sort of like My Fitness Pal for a dental practice. We've had tremendous results and tremendous growth with those, as well as we have with our consulting clients. But we've had a lot of fun with those trackers really producing some results. 

Howard: Okay, what percent of the offices are paperless charts, all digital? What percent of dental offices would you say are digital x-ray, paperless? 

Mark: Maybe twenty-five. 

Howard: Twenty-five percent? 

Mark: Maybe twenty-five percent are all digital. Maybe forty-five, fifty, have digital radiography, something like that. Maybe sixty percent today. 

Howard: But I'm trying to... This person driving is still trying to picture this. Is this something that in a paperless office, it'd be on the hygienist's monitor? It'd be on everybody's monitors? So the hygienist's would track her day, or is this something that the office manager does? Or, just something the dentist does? 

Mark: Good question. You'd want to have a computer or a terminal in the back. You'd want to have a computer or terminal at the admin site. Each hygienist would want to have their own terminal. If you didn't have a terminal in all those locations, they could use an iPhone, they could use a Droid, they could use an iPad. They could use anything that got them on the internet. That office would just have to have internet access.

Then, the way it works out is, we ask them a bunch of questions, they answer those. There's an algorithm that suggests what the best opportunities are in their practice. Once those opportunities are displayed to them, they approve of those tracker selections, and each team member gets four trackers that their team is doing to improve their success, lower their stress, make more money. We really just want to take the stress out of managing a dental practice, as much as we can with this kind of virtual coaching. 

I like to tell people, "Howard, it's like having a coach or a consultant for a fraction of the price. You get the full monty, like Mark Murphy's coming into your practice for two or three days. Or, Kathy Jamison, or Kurk [Barren 00:52:46]. No. You don't get that same experience. But, for a fraction of the cost, you know, if it's three hundred and ninety five bucks, or four or five thousand dollars a year, and if you grow ten or fifteen percent, that's a pretty good investment. That's a pretty good return on your investment. 

Howard: So how long has this been out, and have you Funktional Tracked your own success with dentists using this? What is your own Funktional Tracking success with this program? How long as it been out and what kind of success are you seeing with dental offices? 

Mark: We launched right at the turn of the year with a full beta test. So in January of 2015, we went live with a group of dental practices. We had some practices on alpha test before that. Some of the practices get a little bit of coaching on top of this. If we clump them all together, because the end isn't large in the beginning, we've got an eighteen percent average growth of the practice. The worst practice we had grew about two hundred and eighty dollars per day. That's about forty-five or fifty thousand dollars on an annual basis for a less than five thousand dollar investment. Well worth their time, effort, energy and money. 

Howard: Do they have to sign a year long commitment, or is this a monthly, automatic credit card thing? Or, how does this work? 

Mark: No. Great question. We will ding their credit card on a monthly basis. They can prepay for the year and get a little extra month at the end of the year, so they get thirteen months for the price of twelve. We'll do that, because we don't have to do all the billing. 

But no, you don't like what you're getting, you don't like what you're working fire me as fast as you fire anybody else. Just like if you're firing the guy that cuts your lawn or the person that cuts your hair. You speak with your credit card, so to speak. 

Howard: What if I don't hire anyone to cut my hair? 

Mark: Well, you're as lucky as I am. 

Howard: I'm as lucky as... So you're having good success with this, then? 

Mark: Yeah, we have been. We've got some strategic alliance partnerships with some groups, so that's an advantage for them as well. It's really been a fun tracker. We're just getting into the full launch of it now, so it's kind of fun. We're waiting for that overwhelming number of sign-ups and subscriptions to come about. We think we've got a very formidable project and we think we've got a very formidable way of helping people reduce their stress in their practice, manage their team, make a few bit more bucks and have more patients have healthier mouths without spending a ton of money. 

Howard: Do you think this might be a new online CE course for you, where you kind of explain it to where some people could see all the bells and whistles, say "I'll do it myself." 

Or, other people, it'd kind of be marketing where they'd say, "god, I want to do it." I mean, do you think that would be an online CE course? 

Mark: Well, I'd love it to be an online CE course. I mean I'd love to do that, and do it for you on Dental Town of course, because you guys have such a... And I've done some of those before. 

Howard: What is the name of your course right now is? 

Mark: It's measuring, the course we have is-

Howard: Measuring the right stuff. Key practice and right indicators. 

Mark: Yeah, and what that-

Howard: When did that course go live? 

Mark: I think just about a month ago, maybe six weeks ago it went live. That was from the townie meeting in April. 

Howard: Does that kind of explain what you're doing? 

Mark: I would say yes it does. It certainly, and it'll even say during that lecture, I'll say to people, "it's not about how you track. Our software does a really nice job of that. It's fairly inexpensive. But it's about that you track. It's more important that you track, and whether you do it with paper and pencil, or you do it with a spreadsheet in Excel, or whether you do it with my software, it's about tracking behaviors. 

Yeah, I got a cool little software. It's fun to use. You know, there's avatars and badges, so people have fun with it like they do with some of the other online stuff. It's not quite as fun as Candy Crush, but it's pretty cool. But the idea being, it's about tracking. I want to make tracking easy. I want to make a software. I want to make it cloud-based. But, it's about tracking. That's what's so critical." 

Howard: A lot of the science says if a person just starts to weigh themselves everyday, they'll start losing weight. If they just start to pay attention to overhead. Or, like if you go into a dental office and just get the whole team to realize what they have to do to break even, you'll stop having days where you lose money. Just because, the whole team realizes, "well god, we have to do thirty-eight hundred just to pay all the bills." It totally changes their behavior to work in an emergency, or fill that cancellation or what have you. 

Mark: Let me tell you a story about that that fits perfectly, because what gets measured, gets done. There's no question about it. This is true. If you take a practice, and you say to them, "so how many, what percentage of your patients do you think is leaving with the next appointment?" They're going to tell you whatever their number is, and most people will grossly over-estimate. 

So immediately I tell them, "well, whatever you think it is. It's probably less. So let's do this: go back to your practice, take out a sheet of paper, draw a line down the middle, and put a tick mark for every time somebody came in for a hygiene appointment on the left side, and when they have a six month re-care appointment, put a tick mark on the right. Do it until you get a hundred appointments from the last month here on the left. Add up the right hand side. Tell me what your percentage is, and it's going to be, the average practice is around seventy percent. Whatever that number is, just tell your team that you measured it. Tell your team that you're going to measure it again in one month. Don't do anything else." 

You and I know the number will go up. Just as soon as everybody knows we're being measured on a certain behavior with no coaching, none of my videos, none of my articles, none of that stuff, with nothing. But, just knowing you're going to have to get on that scale again like you said in the next month, you'll eat better. Or in this case, as a hygienist, I'll make more of my next hygiene appointments. So without any coaching, without any special trackers, that number will get better, just because they know I'm going to measure it. That's how powerful measurement is. 

Howard: Now, we never got to Mercer. Are you still with Mercer? 

Mark: No. You know, Mercer doesn't really exist anymore. Mercer as an investment company still exists. The investment capital company that bought them divested themselves of the consulting side and picked it up, primarily I think for the transitions: buying and selling dental practices. I think for the most part, they've allowed the rest of that company to become very, very quiet. The only thing you see over at Patterson that's a remnant of Mercer seems to be their transition sign. Which, they've got some really good people there, they do a really nice job. 

Then, on the investment side, Mercer still does a very nice job in terms of handling dentist retirement and assets. I think they manage about five billion dollars, with a 'B.' Five billion dollars worth of dentist retirement assets, and they do a great job. 

Howard: In all your years there, we've only got two minutes, anything you picked up on? Transition or retirement needs? 

Mark: Yeah, transition, I think, if you're young enough, I'd sell half my practice, grow it some more, sell another half again, maybe grow it some more. I'd sell it at halves, put that money in the bank, and save it. From a consulting standpoint, they were at one point, the largest consulting company in the country for dentists; and they did a very nice job. They had a software that was called On Track. They did a nice job of tracking some behaviors, and I think that was, if you will, the thought process is any time we can start to track behaviors, we can start to impact results in a more profound way. 

Unfortunately, with them not being around anymore, we kind of lose that kind of initiative. So, what we've tried to do is create a software that, it's far easier to use. It's got gamification in it so it's fun to use. Hence the name "Funktional," instead of with a 'C,' with a 'K.' So it's a little fun and funky. I think it's about making sure we identify and drive the right behaviors so that we can get the right kind of results. 

Howard: So they can log in to Dental Town, and see your course on that. That was a two hour course, wasn't it? 

Mark: Yeah. I think it was. 

Howard: Yeah, that was an outstanding course. So that was a two hour course there. We are out of time. It's been one hour. We're over the hour. Hey Mark, seriously dude, I just want to say that you've been a role-model and an idol of mine during my entire career. Seriously, I mean you really have. Like I said, you've been at Mercer, and Pankey. You're always an innovator. I hope everyone, if they log on to www.Funktional with an F-U-N-K, let's get funky, T-I-O-N-A-L tracker dot com, is there some type of demo or something? 

Mark: Yeah, there's a video on there that shows you how the software works, how it's gamified, how it changes behaviors, tracks the behaviors. Then, if they've got some interest in that, then they can go ahead and sign up. If it's a townie, we'll do something nice for them, how's that? 

Howard: Is that video on your website? Is that on a YouTube video? Is that a YouTube video? 

Mark: It is not a YouTube video. We store those on Vemio, on a private Vemio account. 

Howard: Okay. 

Mark: But we certainly could. I certainly would put it on YouTube if somebody wanted to watch it. 

Howard: Yeah, well again, I just want to say thank you so much for all that you've done for dentistry. Thank you so much for all you've done for Dental Town. Big fan of your posts on Dental Town. I hope everybody that's driving to work thinking, "I need to do something. I need to get to the next level." 

Mark: Howard, I've got to say back to you, thank you for all the innovation you've provided us in dentistry with a venue like Dental Town. To have the foresight and the energy to do something like that, because there still is nothing quite like that anywhere in dentistry, or in any of the other professions that allow this kind of community to have the kind of involvement they do and make a difference. 

Oh yeah, things get goofy on there sometime, but isn't that fun? They get goofy. They get serious. There's all kinds of great conversations that you'll have those threads there. 

Howard: So I'll give you the goofiest conversation on there right now is that the biggest exploding thread I've seen in my whole life, was on Cecil the Lion. Oh my gosh. 

Mark: I can imagine! 

Howard: Oh my gosh. That's the wildest thread I've ever seen. Because, you think about those emotional conversations is, everybody there has got their dentist. They've all got eight years of college. That's what I like the most about dental town is that you think you know it all. I don't care if it's on anything, and the dentists, they always show you something you've never thought about for once. Last question, I can't resist. 

Mark: Sure.

Howard: Last question, I can't resist. This is the overtime question.

Mark: Bonus question.

Howard: The bonus question. A lot of young kids are thinking, "neuromuscular, CR? Do I have to learn them both to see what's right?" What would your answer be? It's a young kid, and they don't want to go down a path five miles to circle around and come back and go down another path. So, neuromuscular or CR? Am I going to get you in trouble? 

Mark: If I could only give you a one word answer, I'd say CR because ninety-five percent of the world walks, talks, and breathes that way. But, there's probably some value in every occlusal school of thought we have, including not just neuromuscular and centric relation, but mathology, and bio-aesthetics. All those have merit, but if I just had to give you a quick answer, I'd say, I'd have to lean in CR. 

Howard: And I would have to say, I know we both have our fellowship in the academies. I would have to say that, if you went and learned how to do all orthodontics from A to Z, and never did a single ortho case, you'd be a much better dentist. It's all cross training. It's all cross training. 

Mark: Yeah.

Howard: You come out of school, and your toolbox has a hammer and a screwdriver, and every time you go to the course, you just keep getting more and more tools. Right now, at twenty eight years of practicing, it's so fun to walk into a room and look at a mouth and think, "I could fix this eight different ways." You know what I mean? It's all good. 

Mark: Absolutely right.

Howard: But again Mark, thank you so much for all you do for dentistry. 

Mark: Hey, and from the Motor City, peace out. 

Howard: Okay, bye-bye. 

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