For Rhonda Mullins, "It's all about the Why!". The concept of Why can help you create and retain value!
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Rhonda Mullins and Kim Pinzini of www.DentrepreneurSolutions.com discuss what value you might be letting slip through your fingers. Learn how to keep it and create amazing strategies!
Rhonda brings years of expertise and the endorsement of satisfied clients and strategic accomplishments to her position as CEO and Managing Partner of Dentrepreneur Solutions, an Atlanta based design consulting firm for Dental Entrepreneurs. As an “Innovative Creative Consultant” in business enterprise and care driven clinical outcome, she delivers! Her contribution to Solo, Multi and Large Group practices nationally has been and continues to be a passion with GREAT persistence in impact and innovative solutions for this industry and it’s providers. She has cultivated a “Design Thinking” approach to close the gap between Research Evidence-Based Dentistry and Optimum Patient Care Delivery through a Care Driven® focus that allows any business model to succeed and be sustainable in the shifting landscape of this industry.
Howard: It is a huge honor for me to be interviewing seriously one of my idols and role models and legends in practice management consulting for … I’ve known you for, what, 25, 28 years? Rhonda Mullins is a dental consultant in Atlanta. She’s worked with very, very high-end people. You don’t probably want me to tell their names because of … John Kois or anything like that. She is your who’s who consultant in dentistry, very high end, a lot of elite AACD members, speakers at the Hinman meeting. You have an interesting story, Rhonda. She was actually consulting in your office, small town Tennessee.
Howard: She came in there and you thought, what could this woman from Atlanta teach me?
Howard: When it was all done and said, you actually now work with her, years later. You're originally from Knoxville, Tennessee, home of one of the idols in dentistry, John McSpadden. I don't know if you guys are old enough to remember the McSpadden history because a lot of our podcast people are young kids. The whole space of engine-driven Ni-Ti really started with John McSpadden because of a necessity. He’s a huge man. My hand could about fit in his palm and he couldn’t hold those files in the back of his mouth.
There he was in Knoxville, Tennessee, total mathematician. He can walk up to the board … One of the things he explains to me, he starts his lecture with how dumb barbells are because they go from 5 pounds to 10 pounds to 15 pounds, and 5 to 10 is 100% jump. That’s what we do with endo files. The first file to the second file is twice as big. He’s like, “They should each go up an increment.” He’s explaining this geometry on a chalkboard to about 20 dentists in his home and we’re just leaning to each other like, you know, you most need LSD to figure out what the hell he’s talking about. One of the smartest men. Great to know a hygienist from Knoxville, Tennessee.
Howard: Rhonda, thanks for coming and hearing your thoughts. Let’s start with this. You know I had been in this industry for three decades. Three decades ago when I got out of school, Orthodontic Centers of America was on the New York Stock Exchange. All the orthodontists said they were all going to be working for the chain, the man, and then that whole thing exploded, disappeared, gone. Ten years, there’s nothing and now they’re back. Are they back for good? What do you think about where dentistry is from when you got into it 30 years ago?
Rhonda: I started out as a dental lab tech. I was Pankey and Dawson-trained. I was a lab owner by the time I was 25. I had four technicians, did my thing. I used to host a lot of educational platforms when blade implants came to the table, just the whole mecca of how the industry has changed. From there, I went into consulting, speaking, practice management, then I went into brokering on a national level with a big company out of Atlanta, and then I carved up my own space. I thought, you know, how do you serve this customer in such a way that it’s not just about success but about significance? What sets that entrepreneurial mind and that person apart from the pack? I had this journey of the last 20 years on my own.
Three years ago, because of the industry shift and the landscape shift of corporate which is coming around for the umpteenth time but it’s very successful. It’s making a huge headway and they are their own type. There is an audience for that service, but I have chosen to take the dental entrepreneur that really has elevated themselves from a clinical standpoint and said, “Okay. So how can you serve that customer without compromising or doing volume?”
I created Dentrepreneur Solutions, which is a strategy company, very innovative ideas, creative ideas for doctors, almost like you, Howard. It’s like, what can I bring different to the industry that’s going to influence the next generation, that’s going to keep some integrity of what we’re about, how we got this far and develop that? I have Kim who’s my hygiene consultant. I have two other administrative consultants that work with me.
Our approach is very comprehensive. I look at their aptitude clinically and I even completed, two years ago, the Kois curriculum as a technician, all nine modules so it allows me to identify with that type of delivery of care and better assist the entrepreneur and the clinician, depending on what level and platform they want to grow to. It’s been very exciting. I’ve never done anything like anybody else so why start now? It’s all really about how you can impact somebody else and serve somebody else in a greater capacity.
That’s really my mantra. I wrote my vision at 25 years old. The theme was to serve others. I think I’ve done it fairly well. I love what I do. I love this industry.
The entrepreneurial mindset today is that there’s a blue ocean. There’s the solo dentist. There’s the emerging large group and then there’s the DSO’s corporate. I believe the blue ocean, the opportunity, innovative, creative space is that solo dentist that loves what they do but they want to do it on a greater level. The emerging large group doesn’t necessarily mean as multiple locations. It can be under one roof.
I’ve had eight dentists in one facility, 18 treatment rooms. I merged two of their offices into one. We built a brand-new facility. That’s the kind of area that this particular practice needed to serve and they’re doing it very well. First four months, that case study, there was an increase of 29% net. Basically, it’s efficiency; it’s effectiveness. These dentists, male and female, that really want to engage in a greater level. They don’t just want to be the victims and/or the reaction to what the industry is doing. They want to be proactive.
I created this model. I love it. We’re all over the country. We have the opportunity to share what we’ve known and how we know it. Because I brokered and I was that part of developing what we in the industry at the time called transition management, so you prep the office for transition. The transition takes place, the acquisition itself, and then you're in there after the acquisition to basically bridge the new ownership in there. That was groundbreaking. That was in 1990 when I was with the largest brokerage firm in the country.
Howard: [AFTA 00:07:15] which stands for [Alan F. Thornberg 00:07:17].
Rhonda: Yes. I learned a lot from that gentleman, I have to say.
Howard: That would be an interesting podcast. Everyone knows AFTA but they don't know it stands for Alan F. Thornberg.
Rhonda: He is really like the godfather of transition.
Howard: [crosstalk 00:07:32] started the endo file.
Rhonda: Absolutely. We’re talking about forerunners here. That’s basically it. Give back. Learn what you know. Really, the way acquisitions … I just experienced an event in New York for one day. It was strictly the top 30 DSOs in the country. A law firm out of Boston hosts this every year. Mergers and acquisitions are still going to be the running horse in the race. There’s a lot of big people that are in this space but there’s room for many more if dentists choose to put on that hat and be that entrepreneurial dentist.
Howard: I want to stop and ask you about mergers and acquisitions. If you follow the Fortune 500, there are always mergers and acquisitions. When I look at some of the biggest practices that are a million, two million, three million, four million, it seems like if someone is retiring or dies within five miles of their office, they’re always buying practices in mergers and acquisitions.
Maybe I’m wrong in this. It seems like 99% of the mergers and acquisitions in dentistry go to 1%, and the other 99% never see it as a strategy. You’ll go in there and say, okay, there are eight dentists in this building and the guy six doors down is for sale and he’s 72 and he’s blind. Why are you not buying that practice? Why are you going to have some strange kid from another county come in and set up? Talk about mergers and acquisitions. Is that a viable strategy?
Rhonda: It’s interesting. Mr. Fontana who started Aspen Dental, is currently CEO, he did a survey of the audience the day we were all at that event. Denovo, which is a startup, they only do Denovo. That’s all they do. They don’t do any mergers and acquisitions, but yet the audience poll showed that 71% of future conglomerates and emerging large group strategists will be acquiring offices still. I think that’s the threatening part of the solo dentist in the industry. It’s like, are we going to be eaten up really? Not necessarily. There’s parts of this country … I have to say this boldly. That a solo dentist is very successful. They serve that community. They serve their people and they are very, very welcomed. That’s apart from the big corporate.
I think when a dentist is in that category that you just mentioned, right now, the thought is, why don’t we merge him in here? Why don’t we ask her or him to join us and/or acquire those patients, to serve those patients? Young dentists … I had a graduate from University of Kentucky. He said, “I want to start a multi-location model right out of dental school. My brother is in financial so we think we can do this.” I said, “What part of the country would you like to do it?”
That’s key. I think like real estate, location, location, location. They’re really looking at what’s available. I do that for clients that want to acquire offices. You have to know not just the business. You always shared … I was reading franchise manuals when I was in high school to learn the business part. That’s the part that I believe sets me apart, is that I have the opportunity to coach and to really facilitate those deals because of the knowledge and the background. They don’t need a broker to talk to them. They don’t need another consultant. I’m able to look at the big picture and say, “Here is what’s good. Here is what’s questionable and here is what you need to consider if you're going to consider this.” That’s the investment, but how are you going to retire the debt? It’s easy to buy something, but what’s the plan of action to move forward?
A lot of the 500 offices … There are 500 emerging large groups in this country as of last week at that seminar that I went to.
Howard: Five hundred emerging large groups? What would be the definition of an emerging large group?
Rhonda: Dentist-owned, self-funded, partnerships of dentists. They have not gone to the private equity investors to have them be a part of it. The ADSO, which I’m sure you're familiar with, has opened up that part of their organization to embrace these emerging entrepreneurs and saying, here’s what’s ahead in the industry. You're the up and coming … That’s the blue ocean. It can be very profitable. It can be very manageable. What I’ve experienced is not just location management but revenue management. If you have one to five offices, you can handle that with a management consultant. You don’t need to bring on a COO or any big payroll or anything like that. You just have to know the model. You have to know your plan if you're going to engage in that level.
Howard: Can I have the … say my reflections. One of the most exciting things about being half a century old is you’re not seeing any pitches for the same time. I have some players that are on the Arizona Diamondbacks. One of them hit one of the greatest runs when they were in the World Series. I said, “What are you thinking about that pitch?” He goes, “Dude. I’ve been looking at pitches since I was five years old. I can tell in a split second what this pitch and where it’s going to be.” When you're 53 years old, you're same old, same old.
Again, I’ll start off with where I started. I came out of school, LSU out of New Orleans has got the Orthodontic Centers of America. There’s a half dozen on NASDAQ. They all crumble. Ten years are gone. Now venture capital … The people are back. Here’s my red flags. The first red flag that the cookie was crumbling is none of those corporations could keep any other doctors. The minute … When you work for Orthodontic Centers of America, they said you had to work here this long and on that day at 12:00 you can walk. They all walked then they ran. I see the same thing. Some of these corporate chains … and if you mention my name, they’ll sue you. They can’t even keep their average doctor for one year. That’s red flag number one.
Red flag number two, what you taught me about 25 years ago and I still see, is capacity. If a hygienist works 40 hours a week, even though we’ve never found one that works 40 hours a week.
Howard: We’re okay. Let’s just say there are four of them; they each work one day. A 40-hour-a-week hygienist, 50 weeks a year is 2,000 hours a year. She can see 1,000 people twice a year. I’ve been out here 28 years. It seems like this dentist … No one changes their capacity. This dentist comes out and he has just one hygienist two days a week. Thirty years later, he has a hygienist two days a week. This one over here had a fulltime hygienist; 30 years later, fulltime hygienist. This one over here built up a two-hygiene practice; 30 years later, it’s still two hygienists. This one over here built up three; 30 years later, still three.
You build this capacity so every month for every time you shove a new patient in the front door, someone falls off the back door. Let’s say dental Walley World sets up across the street. I don’t give a shit. Every new patient that walks in there, an old one is going to walk right out the back door. Nobody has been able to keep a patient happy. Dentistry hurts. It can look funny. There’s insurance. I did the dentistry but you didn’t like my receptionist. You didn’t like me but you love my assist … It’s so damn complicated. I’ve never seen anybody anywhere keep all their patients. If you’ve got 25 new patients a month, every three months, you add another fulltime hygienist. Name someone who’s my age that’s got 10 hygienists servicing all the people in that?
Howard: Nobody. I don’t care who you are. You're not going to keep any of your patients. Any time a new one walks in the front door, someone else is going out the back door. If you would slow down on the CAD/CAM and the occlusion and the lasers and focus on the soft side, how do you get a hygienist like you that can talk? How do you get an office manager or business consultant that actually know … Whenever you talk about that to them, oh, is this going to be like some bullshit soft stuff, touchy feely lecture? I want to know how to bone graft. I want a bone graft. What file do you use?
Every question they ask … They go to Gordon Christensen like he’s god. This is the composite where it’s 15 microns a year. Who gives a shit? That’s not your problem. Your fillings aren’t wearing down. He’ll say, “Well, if you tinplate gold, the tin oxide will bond the platinum. I don’t give a shit. My gold fillings aren’t falling out. Tell me this. Why did your last 10 families leave? I don't know, but I have tin plate on my gold onlays.
Rhonda: That’s where the rubber meets the road. It’s value proposition. It’s sort of like the minute you get a patient is the first day you begin to lose them. Think about it.
Howard: Whenever you restore their tooth, it’s a controlled failure.
Rhonda: It’s the first day you begin to lose them. You have to say, okay, what is it that’s going to be … How can we focus on generating value instead of … Well, basically positioning ourselves with value instead of generating income. Generating the income is the outcome of the people relationship part. Whether it’s touchy …
Howard: Generating the income is the outcome of what?
Rhonda: Of the value part.
Kim: The relationship.
Rhonda: You have to create the value, rendering the value versus generating the outcome. That’s where we all get confused. We’re a healthcare provider arena. We’re in this industry. It’s going to hell in a handbasket healthcare. It’s scary what’s coming down all around us. The beauty of dentistry is …
Howard: When you make a statement like that, what’s scaring you about healthcare?
Rhonda: The overall home medical dental, the whole big picture.
Howard: The whole big picture is I want to smoke, drink, be fat, and then when I get cancer, I want my neighbor’s taxes to pay for my treatment at the Mayo Clinic. I want to spend no time taking care of myself. I want to eat Twinkies and cigarettes. When I die, all the rich people should get me an MRI at Mayo. The rest of civilization, you're either going to have efficient dictators like you see in China and Singapore, which I think are the two best fastest growing societies, or you're going to have all this bullshit democracy where everybody shows up and says, “I don’t want to pay any taxes and I want the best for free.” To blame that on Obama or Romney or a politician or whatever, I blame it on the American people in every democracy. No one wants to work. No one wants to pay taxes, but goddamn they want a free Mercedes-Benz when they want a car.
Rhonda: That’s the part that …
Howard: They deserve it because they were born.
Rhonda: It’s educational to look at a business like a business, whether you want to say dentistry is a business or not. Everything is a business. No matter what we do. Right now in healthcare, education and knowledge are two parallel arenas that we are trying to digest, which is huge.
Howard: What are the arenas?
Rhonda: Education and knowledge which is technology basically. The CEO of Cleveland Clinic, he says it very well. He says that we’re trying to digest that. We’re trying to digest HR, and that’s something dentistry has never really developed the skillsets. I have to say that that’s something that we really dial in on. Hygienist, administrative assistants, it’s like don’t complain if you don’t develop the skillset of your people.
Howard: You're the neutral one here. Who’s crazier, the dentist or the hygienist? Who is it?
Rhonda: I’m neutral.
Kim: I’ll say the hygienist.
Howard: HR will always be impossible because when you got 7 billion talking monkeys trapped on a flying rock around the sun once a year, I don’t care if we’re talking about religion, politics, your family, your office. Talking monkeys are crazy. That’s all we are. We’re all a bunch of talking moneys.
Rhonda: We are.
Howard: We have to play nice.
Rhonda: That’s true.
Howard: I had a lady spend two hours on the phone with my office manager, arguing about the fee, the insurance, everything. When she found out basically she was going to have to give us a dollar, she hang up and wrote us a negative Yelp review.
Kim: Of course.
Howard: I spent two hours … I paid someone two hours on the phone, and what is my reward? A negative Yelp review.
Rhonda: You know what that tells me? That was not a customer of yours.
Howard: Yeah. Go tell Yelp that.
Rhonda: You can’t remove it either.
Howard: The other thing with HR, I remember this. There’s not a single team that ever won the Super Bowl that next year won it again because they average about 25% turnover from injuries and all that stuff. You have 25% turnover in a Super Bowl team and you might not even make the playoffs.
Rhonda: The average retention of HR in dentistry is only 24 to 36 months today. That’s it. You can expect there’s going to be a shifting and changing. Really …
Howard: Let me ask you a question where if I asked it, it would be sexist and so I don’t want to go there. It’s all at you. Some people say that when all the dental graduates were men and they all had stay at home wives … At the end of World War II, the average woman had 5.1 children. Now 27% of women don’t even have one child. Now we’ve gone from dental school. It’s all men who had a wife making five babies, to now half the class is women. A lot of people say that what’s driving corporate is a lot of these women just want a job because they’ve got a husband who has a job and they got kids.
The other thing driving corporate is … What drove it in medicine is when they started coming out with million-dollar MRI machines. You can’t have one doctor buy a million-dollar MRI. That it’s the CBCT and the CEREC CAD/CAM and the laser. It’s all the high-tech stuff which is driving corporate because if you're going to buy $150,000 CAD/CAM from Sirona Dental Supply, you're going to have to split it with two people or three or four. I’m asking. Do you think changing from all men to half women creates a foundation for corporate because there’s now more people who just want a job or do you think that’s not true at all?
Rhonda: I think all meaningful change comes from within, within an individual, an industry, a corporation, organization. This is just the way life is. I believe that the mixture is going to be very positive. Women are 55% of the graduating classes now. We’re at 55% the most.
Howard: Would they more likely be an employer, an owner or do you think …
Rhonda: Let me say there’s a small segment that are very innovative and creative, and they are serving as entrepreneurs, large groups, multi-locations. I met a woman last year in New York from Texas. She has a huge group practice. I think there are five locations. She’s serving that population because there’s such a need. I believe that companies like Aspen, who are giving women an opportunity to have quality of life as well as a career, in launching their Lead Like a Girl segment and putting them in offices and giving them that opportunity, mentoring them, coaching them, that they’re cultivating that.
Howard: There’s a program called Lead Like a Girl?
Rhonda: Uh-huh (affirmative).
Howard: Who runs that?
Rhonda: They launched it last year and they felt like it’s an opportunity for new grads to come.
Howard: Who’s in charge of that program? Is it a girl or is it a guy?
Rhonda: I don't know, Howard. I really don't know.
Howard: It reminds of the ADA convention. They always have the annual young dental convention where the youngest speaker is wearing a denture and a toupee and has gray hair. Can’t one of the young dental speakers at least be under 60 and not have a partial … I just assume that … Knowing dentistry. Aspen Dental, the director of the women league program is a man.
Kim: Is an old man.
Rhonda: Generationally, if you had a daughter, your daughter more than likely might have wanted to go become a dentist and so now here she is following your footsteps, and yet she’s saying, “Dad, I still want to get married. I still want to have children, but I’m brilliant. I still want to serve like you’ve served in this capacity. I still want to go and do mission work, whatever it is.” Looking at that quality of life and balance, a lot of husbands and wives are dentists where they split their time. I have a lot of two females that do one day overlap that share everything in their practices as far as partners. They’re sharp. Women are sharp. I think they’re a complement to the industry, first of all. The diversity is huge. I think that it serves a population that had a need. A lot of patients want to see a woman.
Howard: You know what I am? You know what I actually think on the … I think whenever I see an article written on the changing face of dentistry from all men to all women, I think that is a rounding error. I think the much bigger issue is the intellectual people I think are seeing that there’s four different ways people think. The senior citizens think very different than the baby-boomers, than the millennials, the generation line. I don’t think you should divide dentistry on gender. I think you should divide … There are some generation gaps between how a young dentist is working for a baby-boomer. A lot of the baby-boomers are saying the same things because the baby-boomers …
People like me, I’ve worked 12 hours a day, 7 days a week since I was 10. If you want a day off, the first thing I think is are you just lazy or … I’m thinking, were you born lazy? What made you lazy? I think people that are under 30 look at me and say, it ain’t worth it. You see it in Japan where these kids are watching their parents say, man, he worked his butt off to get into the best high school then the best college then he got a job at Honda and he worked 12-hour days, 7 days a week and then he died of a heart attack at 60. Their kids are like, you can have Honda. I don’t want it. That’s not my life.
I think my four boys, they even tell me all the time, “Dad, have you ever thought about just like taking the day off? We could go camping.” I’m like, “Camping? How could I do email in a tent? I can’t. How would you do your email at a tent?” You know what I mean?
Rhonda: You know, Howard, I’ve had some life experiences. I think life experiences really shape us. I married my husband 16 years ago and I’ve been widowed 7 years. He died a very young man. He had leukemia. He died at 57. I remember thinking, he’s so young. He had been in our industry, served in a lot of capacities. I thought, okay, he worked so hard all the time. He gave, but was he really fulfilled and now this is what’s been handed to him?
When you have that experience, you think, okay, time is very valuable. When it comes down to life, period, it’s like, who loves you and who do you love? If it’s people in your industry, your family, your children, it’s all about making that contribution so there’s value. Then, hopefully, they pick the baton up and they make a greater contribution. That’s what it really is about. When you say my father was Italian, I know how to work. Trust me. It was like either you worked or you're dead, because I’ll kill you if you don’t get in here and do it.
Howard: When I was a child, the only time I ever saw my dad and all my memories of my dad was when I went to his restaurant. He was there when I woke up. He was there when I went to sleep. I didn’t know anything was wrong with that because … I thought I was the luckiest guy in the world because when I got to visit my dad, I got to eat hamburgers, cheeseburgers, chili dogs, French fries, malt shakes. I take my friends. They all thought they won the lottery. I was the most popular kid in St. Patrick’s Elementary School because if I was your friend, you got free cheeseburgers and chocolate shakes. I only know my dad [crosstalk 00:28:29].
Rhonda: Mine too.
Howard: I don’t ever remember throwing a football or a baseball or going to a park or anything. We just worked.
Rhonda: If you can change anything in your life, what would you change?
Howard: Mine would be Ryan, my son, Ryan. I’d switch him out.
Rhonda: He’s adorable.
Kim: He is adorable.
Howard: Luckily, my four boys all had a good look at mother.
Rhonda: That’s okay.
Howard: That was their salvation.
Rhonda: That’s a compliment, Ryan. I look at dentistry like that. I always say to my clients, “Dentistry is what you do. It’s not who you are.” The fact that you have this passion and this drive to develop something, the why is always the driver. Why do you want to develop a practice that’s bigger than you? Why do you want to give other dentists an opportunity? Most of them love to mentor. They love to teach. They love to care for their patients. That’s all about the heart. That’s all about this is why I wanted to go to school. You have that trait too. You go to Honduras. You serve in a greater capacity many times throughout the year. You influence your children. You take them. I think that’s what it’s all about. You never know what that influence is going to do to another human being.
Howard: I go to foreign countries to work on poor people, but the most important program is every year at February is Children’s Dental Health Month where you go into the second grade classes and teach them how to brush and floss. I think that’s the most important because when you're in there and you're lecturing to second graders, you know somewhere in there is your next wife and you're just trying to find her.
Rhonda: It may be a dentist. She just may be a dentist.
Howard: What are you two doing now? Tell them what your website is and what you two are doing now. You're talking to about 7,000 dentists. Most of them are individual. It’s all a multitasking behavior. They’re all listening to you on their iPhone, Bluetooth to their car. Tell them your name, your website and what you and your hygienist friend …
Howard: … Kim actually do. Kim lives in … Scottsdale is on up the street from me. You also are licensed in …
Kim: In California.
Howard: … San Diego, California, right?
Kim: Yes. In the summers, I get out of the heat.
Howard: Because your husband has a business there?
Kim: He has a business there.
Howard: Ryan and I, we all said last week … Me and all the boys, we all went to San Diego for the weekend. We got to figure out how to live in Phoenix in the winter …
Kim: That’s how you do it.
Howard: … and in San Diego in the summer.
Kim: You can work for me, Howard.
Howard: I’m asking you now on live TV. Can me and my four boys move in with you in San Diego?
Kim: Well, our house in San Diego is quite small. You're more than welcome to move in. I don’t know there’ll be room for all of us and my dog.
Howard: Can we bring our two cats?
Kim: I have a dog which she may get along with your cats. I don't know.
Howard: What’s your website and what do you do?
Rhonda: The website is DentrepreneurSolutions.
Howard: I love that name, Dentrepreneur.
Rhonda: Dentrepreneur Solutions. We’re platformed …
Howard: What is it called? What is that, a portmanteau? What is it when you take two words?
Kim: Come on, Ryan.
Howard: It’s like a portmanteau when you have …
Rhonda: Combination words.
Rhonda: Dentrepreneur Solutions.
Howard: Dentrepreneur. Spell it.
Rhonda: D-E-N-T-R-E-P-R-E-N-E-U-R. It’s entrepreneur with a D in front of it.
Howard: Absolutely. Entrepreneur with a D in front. I love it. If I went to that website, what do you two do?
Rhonda: My team, we approach it in a team concept, every practice that calls us. Not everybody is my customer. I usually attract the dentists that has a huge conflict. I’m definitely a solution for that. [crosstalk 00:32:18] probably one in California.
Howard: What is the conflict usually? HR?
Rhonda: No. Well, it’s usually between two dentists. Maybe it wasn’t structure correctly in the beginning. Maybe there was no structure at all.
Howard: The partnership?
Rhonda: Uh-huh (affirmative). There’s no clarity of roles. There’s no clarity of best practice standards, patient care delivery. They’re not on the same page with even the types of dentistry they’re delivering.
Howard: One wants to buy a CAD/CAM. The other one doesn’t. One wants a CBCT. What I understand is this. You get married to a woman. You have great sex and children and cats and half the time that fails. Then, they go marry another male dentist and they have no prenuptial agreement and they don’t have any of the social glues that we’ll sleep together. We have babies. We celebrate all that. You have no social glues holding you together. Who would marry a male dentist? If I had a group practice …
Kim: Not me.
Howard: … which I do, I own 100% of it and everyone is an employee. I’m not going to marry anyone unless they’re really hot or rich.
Rhonda: Right. Partnerships really don’t work in this world. In dentistry, partnerships very rarely work. It’s a huge challenge. That’s what we look at first. We look at the doctors and the relationship. If one doctor, great. I work with a lot of solo offices. I have a solo practice. She has been a client of mine for 30 years. I took her from day one, 250,000 a year. We migrated the way she wanted to migrate the plan and the model that she wanted. She’s ready to retire. She loves the way she practices. When she’s done, she’ll leave. That really works for most people. She was married to a dentist, an orthodontist but they never practiced together. They had two separate entities.
Kim: She’s an awesome dentist, by the way. I work for her.
Rhonda: Yeah, she is. What we do is we are a platform that lets people get things done. I look at things from four perspective: clinical, aptitude, managerial challenges, financial outcome and transition strategies, if any. Transition doesn’t mean you're going to buy something and merge it in. Transition is here’s where we’re at. I get people from point A to point B ASAP. That’s why all my case studies are four months. What’s the impact? We pay for ourselves in four months. That is measurable because after that, you’ve created a sustainable model.
Howard: Here’s what you're fighting though. All my friends who do one, two, three, four million a year and take home half a million a year, they all use consultants and they all, in their brain, in my brain, we know if I give you a dollar, January 1. By December 31st, I’m going to get it back and then some more. We use them and you just nudge us up even a little better, better, better. Some of the greatest friends I’ve ever known like Jerome Smith, he’ll have a consultant every year. Then, the other guys who just would just … You could help my practice a little. You could double half the practices in America in four months and they’ll never give you a dime for a consultant.
What I’m saying along the way is that everybody that desperately needs a dental consultant will never get one and all the people who use dental consultants just use it just to round it up just a little higher and higher and higher. Do you believe that or do you see that?
Rhonda: I believe that because of their mindset, those dentists that make those decisions want to control how they do incremental increases, thinking that they have to compromise something to do that, but you don’t. This is about efficiency, effectiveness and really fine-tuning and reinvesting in your own business. This is not an investment in a consultant.
Howard: Here’s what I believe is the counterintuitive. So much of success is counterintuitive. Here’s what I believe the counterintuitive of success and that most consultants don’t get. Most consultants believe in dentistry that if I go on there and show you what I’m going to do on my website or make an online CE course, and I tell you everything I’m going to do, then you're not going to want me. You're not going to buy me. You're going to do it yourself. It’s exactly the opposite. The dentists says, “I’m not going to bring her in here because I don't know what she’s going to do. What if she’s going to tell me I have to be a cosmetic dentist and drop all my PPO? I don't know what she’s going to do so I’m not going to have her.”
Then, I’d go tell a consultant, “You should do an online CE. You should do your whole program.” Then every one of them, “Well, if I do that, they’re not going to want me.” No. A dentist goes into a restaurant. They want to know, is this a hamburger or a pizza or a taco? Once you say what it is, he doesn’t want to go in the kitchen and make it. The dentist that buys consultants like me is basically I want to know what the recipe is. I want to know what the menu is and then I want to pay to have you implement it because if you can come down here to my 55 employees and get her done. I’m paying to get it implemented.
Rhonda: Yes, you are.
Howard: I want to know exactly what you're doing. All the consultants in the industry, when I’m out with a dentist that say, “Okay, Charlie. Here’s a big name brand consultant. What would they do if they come to your office?” I don't know. Hey, what about this one? I don't know. They don’t buy. If someone gets on there and gets transparent, builds online CE models and they say, “This is exactly how I think, exactly what I do” …
Rhonda: Then, they don’t.
Howard: The dentist say, “Well, I want to order that.”
Rhonda: Dentists need that clarity. The average dentist, the …
Howard: That’s why I’m trying to get clarity out of you. Tell them what you would do. If they hired you, what would it cost? What do you do?
Kim: She asked for their vision most of the time. I think that’s what they … She wants to know what they want and then she’d …
Rhonda: Yeah. I don’t do cookie-cutter management. It really is personalized to that doctor’s vision, philosophy, what they love to do, Howard.
Howard: What did you say the four areas were?
Rhonda: Clinical aptitude, managerial style, financial outcome and transition strategies. That’s it. You have to look at these four things. Also, the other components … This is overview. The other four modules between best practice standards that everybody wants to establish and/or has, and patient care delivery. There are four areas that are vital key components: culture, people, process and supporting technology. Those four components transform every business setting and especially in dentistry.
Howard: Go over that. Just take the mic away and go over that because what I really want at the end of the day is I want to help them get her done. I want my dentists … I want to get her done. They got your name, Dentrepreneur website. Go over these so that somebody driving to work right now might sit there and think, yeah, you're right. I need to do this.
Rhonda: All right. If you have a vision, you're an entrepreneur, you're a solo dentist, whether you own 5 offices or 50 offices. Your thought process is the same: The outcome of what that patient receives. That’s first and foremost because that’s really the heart of why a dentist became a dentist. The fact that they have gifting to be a businessman or a woman and to lead in a greater capacity is fabulous. That really dictates the model that they want to design.
You have to look at the people. You have … A top performance team, and we evaluate that, are people, the right person doing the right job for the right amount of money. What we do in dentistry, most leaders, is that we think that if someone is expensive that they’re qualified to do the job, which that is not true. We throw money at whatever element, administrative, assistant, hygiene, whatever, and they still can’t bring home the bacon because there’s a compromise. You have to take the leadership and the mindset and the vision and say, “Okay. You're going to create a culture that’s nurturing, that’s positive, very much like Starbucks.” Hello. That’s what they’re all about.
Howard: How can you have a positive culture in a dental office when the dentist’s wife doesn’t want to work in there? She doesn’t want to be the office manager, and the male dentist says, “No, you're going to be the office manager because obviously, when you married me, you married me because you were going to be my office manager.” She doesn’t want to be there and she’s got her kids in daycare and she’s not happy and she’s pissed off. All the stats say she doesn’t like her job. She hates her job. Talk to that guy.
Rhonda: That guy basically is not going to get real big, and he’s a controller or she is. I have husbands who work at the front desk of the dentists or the practitioners.
Kim: The female, the wife.
Rhonda: It could work either way. Their vision is minimal.
Howard: What is the red flag that your spouse, whether it’s a man or a woman, should not be in the office?
Kim: They should not be in the office, period.
Rhonda: It’s a barrier.
Howard: I think rule number one is do you want to work here? If it’s a woman, it almost always tells me, hell, no, I don’t want to work here. I got three kids. Why do I want to be in a dental office?
Rhonda: That’s it. Why would you come in to an environment and create a toxicity of sort between the husband and wife and expect a different outcome from the culture of the employees? You set the tone. That’s the responsibility you have. You have to reinforce the vision so the culture reflects what it’s supposed to be and where you want to go.
Howard: How is this dentist going to be a leader if the only way you get into dental school is you got to get A’s in calculus and trig and physics and algebra and we sat in the library? Every single night at Creighton University … This is what I heard every single night. “The library will be closing in five minutes.” The natural selection is let’s get a bunch of freaks. I never had one date in undergrad or the first three years of dental school. I got accepted a year early. You know you're a loser when you get accepted to dental school a year early. No date. No car. You get this natural selection of math, physics, science freaks, and then someone comes along like you, all touchy feely, saying, “You’ve got to be a leader and you got to have this positive culture. You got to attract and retain all these people.” He just wants to go in his private office and shut the door and do a physics problem.
Rhonda: If that’s the person, then they must be surrounded with people that complement what they want to do. You have to form what that is. That means your team has to compensate for your shortcomings.
Howard: Would you say then you have to have an office manager that complements you?
Howard: They all tell me … This is what they say to me. “I don’t believe in office managers.” Do you believe in gravity?
Rhonda: They’re a manager and a clinician. They’re not a leader and they’re not an entrepreneur. Everybody is a leader. It all depends on the capacity in which they choose to lead. You can’t make people wrong because that is their capacity. That’s their limitation. What you do is you create a culture that supports that and still allows them to flourish because that’s where they want to operate. You don’t make them wrong. You nurture what they are able to digest. That’s the bottom line.
Howard: You're good. I love that.
Rhonda: That’s what you do.
Howard: Yeah, that’s good.
Rhonda: The industry is so busy telling us, other consultants, and I won’t name names, that if you …
Howard: This is dentistry uncensored.
Rhonda: If you don’t do this, if you don’t join a group practice, you will not have a place to practice. That’s not true. It’s not true. You look at what people are serving our industry and patients and you say, “You know what? You can have whatever you want. We just need to design it so it really complements you and it serves those patients that you are going to serve.” I don’t cookie-cutter. I sit down and say, “Tell me what you think you want to do. Tell me what you love.”
Howard: I’m a new client.
Rhonda: I’m working with you.
Howard: I call you up.
Rhonda: You're a real project, let me just tell you. You are a huge project, Howard.
Howard: I’m a retired friend and I’d get out of the Betty Ford Center on Tuesday. My practice has been shut down for four months.
Kim: Where do we go from here?
Rhonda: Howard, I had one of those. Not you but I had one.
Howard: It’s actually 18% of dentists during their career.
Rhonda: I know.
Howard: We need to do some podcast on because we’ve done too many on the implants and too many on so many things. Eighteen out of 100 dentists will go to rehab for the length of time in their career. We need to do more of that. Back to this deal. Would you first start about culture, people, process, technology or would you go over clinical, names, finance, transition management? Where would you start?
Rhonda: I do a three-day assessment. That’s the first thing I do. I don’t …
Howard: You come down there for three days.
Rhonda: I live with them for three days.
Howard: In their house too?
Rhonda: In the practice. Not in the house, no, but in the practice. In those three days before I even get there, I’ve done a complete financial assessment to look at where they’re at, what the shortcomings are, what their outcome has been, manage just numbers. I got a picture. When I go on site, now I live with you. I’m in your culture. I’m dealing with your people. I’m looking at your clinical delivery, your aptitude. How many rooms are you managing? What is the operational part of it?
Howard: These guys who are listening, they’re all … My whole motto was when I saw the internet, I was tired of being alone. If I ever had a problem and I called anybody that love me, my mom would say a prayer. My dad would offer mass. We went to mass every day. If I said anything to my mom, she’d say a rosary. My dad would say, “I’ll say a novena.” I just wanted to talk to a dentist. They’re all alone. This guy is listening. You said you look at their numbers. Describe the average financial scenario of someone calling you. What is the average size of the practice?
Rhonda: A solo dentist is doing about 1.2 million which is the average for five treatment rooms and should be. It doesn’t matter …
Howard: These are bigger practices because the average practice only does half a million. The average person calling you is twice the average.
Rhonda: Uh-huh (affirmative). They’re seasoned.
Howard: That was my point earlier. Who’s your average incoming call? Oh, 1.2 million. That was my point. All the people listening doing half a million, they should have called any consultant five years ago. That was the point I made earlier. Everybody who’s already crushing it like me and Jerome Smith are the ones using consultants every year. Then, everyone who desperately needs it will never make the phone call.
Rhonda: You're the right consultant. I had a doctor say, “How do I know which consultant really is going to be a fit for me?” He just finished a whole program with another one. I said, “Here’s what I know. Every consultant will make an impact on you and they’ll nurture you to the next level. It’s like a coach. When they become ineffective and they can’t take you beyond where they have taken you, it’s time to change game. It’s time to get somebody that’s (a) okay, I’ve been with the sparrows and now I need to make a hole only because the capacity … [audio glitch 00:48:18] Here’s my customer. When they say new dentist or 1 to 15 years out, it’s usually around 10, 12, 15 years I get the call. Okay, I’ve paid off my debt. I’ve paid off my school loan. Now I need to make money. Now I need to say …
Howard: Don’t you think it’s funny? They always … Everyone, all they complain about is how much student loan in debt. I’ve got 250,000 in student loans. You're like, “Dude, your first divorce will cost a million.” Can you …
Rhonda: I hope they’re not …
Howard: Your student loan debt to divorce debt. Can you give them some ratio of numbers of how much …
Rhonda: Volume and number, the gross number is not really real because …
Howard: The gross number of the student loan or the practice?
Rhonda: The practice. It’s not real because by the time they look at their write-offs and all the other stuff, they don’t even analyze it correctly. When I go in, I already have a picture of here’s what you need to know and understand.
Howard: If someone calls you up, they’re going to go to entrepreneur with a D.
Howard: What’s your number?
Rhonda: (770) 841-5721.
Howard: I saw that number in a circled area in the bathroom.
Howard: I swear to god.
Kim: For a good time.
Rhonda: I doubt that, Howard.
Howard: They call you up. How much is this to get … Are you going to come in or …
Rhonda: No. I personally go.
Howard: You personally go.
Rhonda: I personally go and it’s all onsite. I can do a virtual assessment.
Howard: These are different packages?
Rhonda: Uh-huh (affirmative). The virtual assessment is me logging in, extracting data, doing everything except visiting you. If I go onsite, it’s double. It’s 7,500 for virtual and it’s 15,000 for me to be there for three days. Out of the 15, I guarantee them a return of 30 in my three days. Treatment presentation, close the cracks on collection. I already have a plan when I walk in there. My objective is always not to be a liability but an asset. Then, I’m able to present with them, especially with my hygiene consultant, my hygiene analysis of the department, is here’s what you're missing. Here’s what you could develop just through your hygiene.
Howard: These guys are already doing a 1.2 million.
Rhonda: Yeah, about average.
Howard: They’re calling you. Here’s my point. Dentistry is such a small industry. You can’t be a consultant in it for 5, 10, 20, 30 years and nobody is happy with your services. The only reason these people stay in business is because of the same reason people come into your office when you broke a tooth and you fix with a crown. If you didn’t help any patients, you wouldn’t be in business. The people calling her already did 1.2. They’re giving her 15,000 and you're guaranteeing they’ll make 30 back. That’s what all the millionaires say. That’s what we all know. What we know is that staff are complicated and all humans are complicated. All humans are basically crazy. At 53 years old, I finally realized that I’m actually the only normal person on earth.
Rhonda: Wow. I’m so glad I came to see you.
Howard: You want my autograph? Since everybody is crazy, myself included, a consultant … When someone comes 100 miles away from home with a plan and a brief case who’s paying attention to practice, they just take notes. Don’t you think you can get them to listen to you in a plan far more than the existing dentist that’s been in there? If you're asking them to change …
Rhonda: Yeah. I always say to them, “Okay. If you were Disney World and you were Six Flags, what’s going to dictate what park you go to?” What is it about your office, you, your team, your location that’s going to have your customers say I want to go there? What is it about … Brand awareness is different than branding insistence. That’s something in marketing and in cultivating what sets you apart. Your distinction as a dentist is huge. It’s absolutely huge and it needs to be mirrored by everybody that’s in there.
Howard: Explain brand awareness and branding insistence.
Rhonda: Brand awareness is Nike. Brand insistence is just do it. Just do it. Just do it. That’s very important for a dentist. Everybody wants to learn cosmetic dentistry. They want to do this. They want to do that. Dentists have a way of tracking with other dentists, like old George is doing it down the street or Mary Ann has come into this office and she does it this way. I always say, “Tell me what you love to do. Tell me what you think your best asset it as a dentist, as a leader, as a provider. Tell me.”
Howard: You talk about clinical and then what was this, management?
Rhonda: Uh-huh (affirmative).
Howard: Let’s talk about clinical.
Rhonda: Clinical aptitude.
Howard: Can a dentist be successful who only does hygiene, restorative fillings and crowns?
Howard: They can be a million-dollar practice and not do molar endo or place implants?
Howard: What percent of the dentists would you say, calling you that have a million-dollar practice and are financially doing real well, never do place implants, do ortho, molar? They basically just do restorative dentistry.
Rhonda: Seventy-five percent.
Howard: There seems to be this big industry perception that if you're not going to buy $100,000 CBCT and $150,000 … How many of these million-dollar practices did not buy $150,000 CAD/CAM?
Rhonda: Almost all the ones I work with.
Howard: I know. The biggest stressful question these kids out of schools. I have $250,000 in debt and now you're telling me to buy $150,000 CEREC CAD/CAM. I don't know of a single guy collecting a million, taking home 400,000, has one. You think you have to have this magic bullet for 100,000.
Rhonda: You're better apt to go in … When I utilize Kim, I bring her in, and I allow them to see the value of education and awareness of their health. Take responsibility for your health.
Howard: Of the dentist’s health?
Kim: No, a patient’s health.
Rhonda: The patient. Through hygiene is where you're going to really connect with that patient.
Howard: I want to ask you another specific. What percent of the time … We see this phenomenon in the United States where 117 metros have about 60% of the dentists and the 19,022 towns in the rural have about 40%. You see things like I’m Hartland who was … They were just going to towns of 2,000, 3,000 and never had it. Walmart was in 30 states before it went into a major metro. How many times do you go in there and you're like, dude, there’s a dentist for every 300 people. You need to move. How big of a demographics or can you usually go in there and work no matter what the demographics is existing? Do you ever get there and say you need to move?
Rhonda: It’s funny. South Georgia. I did an incubation of a mastermind group. Two years ago, I was checking things out. How could I better serve these gentlemen and women who want to lead, who want to have small offices? South Georgia had this gentleman contact me. He came. He said, “I’m looking for an associate.” He was in the middle of nowhere. I said, “Really?” He says, “Yes.” I said, “Well, there’s not many grads coming out of MCG coming back into your area.”
Howard: What’s MCG?
Rhonda: I’m sorry. Medical College of Georgia. That’s the dental school in Georgia. I said, “I think your best associate may be another dentist closest to you that may want to merge with you and collaborate with you, especially if he’s younger.” He was probably in his late 60s. A lot of these areas, Howard, they just die off. There is no young dentist coming to these areas. Everybody wants to be in the metro areas where the competition is off the chain and it’s very hard to buy a practice and make it successful the second time, but the third time, it’s almost impossible. Wouldn’t you say?
Howard: Yeah. It’s always really tough because I saw in Kansas City where all these kids came from small farm towns in Kansas, Missouri, North and South Dakota and you come to Kansas City and it’s got the Royals and the Chiefs and the Plaza and all these fine restaurants and shopping. You can’t leave that and go back to Salina. All the money is made in Salina, but here’s the rub.
Most of the dentists are in the suburb and they have an hour commute to downtown, and most of them in the suburb, if they had an hour commute out of town, they would be driving to a town of 2,500 with no dentist. That’s what the demographics people … That’s what the corporate … That’s what they’re all finding. Everyone listening to my podcast is driving from lower dentists per 1,000 to more dentists per 1,000 and they turn around and make that same commute on the other way out of town. It’ll just be amazing.
In fact, there was this one guy, a very good friend of mine, who actually bought $100,000 plane and he actually lived right up the street where there’s a housing addition that has a runway. What’s that called, Ryan, the housing addition up the street and built a runway in Chandler, Arizona?
Ryan: I don't know.
Howard: He would just get up every morning and he would just ride in his driveway, just roll out his plane and fly two hours.
Rhonda: That’s the creative part. That’s the creative mind.
Howard: [crosstalk 00:58:10] crushed it.
Rhonda: That’s the creative mind that you say, what do we do? I say I design dreams for dentists that really want to do something different. That’s the bottom line. I promise a return. I even started an inner circle, all access, so a dentist can be a part for a whole year, $1,200 a month, beyond personal calls. I help develop their vision, their platforms they want, coach them, group calls, and an annual event, destination event and bring in guest entrepreneurs from every aspect of life.
I had a billionaire be my mentor for six years, Dr. Nido Qubein, who started out as a consultant speaker. He leveraged his success. Now serves on the board of BB&T, La-Z-Boy. He chairs Great Harvest Bread Company. He currently is the president of High Point University. He took that university from a failing institution, in eight months raised $48 million, leveraged it into one of the top 30 private colleges in this country according to Forbes in less than 10 years.
Howard: That is amazing.
Rhonda: When you have people like that influencing you, the responsibility is to then take that and influence in your sphere of influence, which for me, it’s dentists.
Howard: You're saying clinical … That’s not the issue. If you want to refer endo and not do implants, that’s not the issue.
Howard: What is it when you're going over clinical? What is the issue for these four things?
Rhonda: You look at what their clinical limitation is and what they’ve studied and what they like to do. A lot of doctors, they’re CE nuts. They have gone to these courses, whether it’s Pankey, Dawson, Kois, Spears, whatever it is, and they’ve never integrated and penetrated the soul of their practice with that mindset. Do you understand that? They spent hundreds of thousands of dollars and they keep it right here and their team never really understands the value.
Howard: You know the only thing I remember from Kois, who’s a good friend of yours, he’s 100% Greek. He just sprays everything with Windex.
Howard: Didn’t you see the movie, My Big Fat Greek Wedding? Remember grandpa sprayed everything …
Rhonda: That’s what I refer. Management, is there an infrastructure? Are you flying by the seat of your pants? Are you personally managing or have you created self-led individuals that really bring the bacon to the table for you and informed you?
Howard: Here’s your deal. All social animals, all apes, monkeys, dogs, cats, they all have the 400-pound gorilla and we all have to work together as a team. What got us here was we worked together as a team. The 400-pound gorilla wants to control the whole tribe and he won’t delegate anything. You say, okay, you're going nowhere. You won’t let your hygienist read an x-ray because she’s diagnosing even though no hygienist has ever gone to jail ever since the beginning, since Jesus, from diagnosing. You won’t let the assistants talk. You won’t show any of the numbers. There’s no transparency. After every patient, you walk back in the room and you close your door. How do you … The guy is a freak. How do you get a control …
Rhonda: It could be a guy or a girl leaving. Okay.
Howard: An ape is hardwired at birth to control and she’s the 400-pound gorilla. Now you're telling her that she should only weigh 200 and make her receptionist weigh 300 and let her hygienist talk to patients and let her assistant talk to the Cheyenne rep and … How do you … I guess my point is this. If I was going to trade jobs with you and I was going to go from clinical dentistry to consulting, I’d go hire Dr. Phil.
Rhonda: I’m sort of a Dr. Phil.
Howard: If someone wanted me to consult in the office, I would first send in a psychologist and a therapist because I think when they would figure out their issues and just become normal, if they just became normal and delegate and happy culture and no dysfunction and …
Rhonda: It is about the brain. I have a little bit of experience in that. I feel that’s part of my gifting, is that the frontal lobe is where we want to be, but the back part of our brain is where our fear lives. When we’re fearful of letting go, we’re fearful because we (a) don’t believe that we have the right people in the right place to let go with. The model in which we are operating in is an old mindset. If you can’t shift your brain into, okay, I want to be creative and innovative, I want to find the right people that can opt in to what I believe, and how am I going to train them up? There’s a great book that’s called Tribal Leadership. I created a whole program on how to put this mindset in a dental practice.
Howard: I’m going to ask you. When you go into an office, what percent of the time do they have the right people and then they just need to be developed versus what percent of the time do you walk in there and say those three monkeys got to go?
Rhonda: I would say change upon me entering that culture, maybe like 60% we need to change. Here’s what I’ve discovered, Howard.
Howard: You're changing one …
Rhonda: One or two.
Howard: Six in 10 times, somebody has got to go.
Rhonda: One or two.
Howard: Why does the dentist not see that?
Rhonda: Fear that change is going to disrupt and they don’t like disruption. I always say people either have … They’re willing to learn and they haven’t been trained or they’re not willing to change. Here’s Dr. Nido Qubein’s famous … Rhonda, either the people change or you change the people. That’s the bottom line. That is management across the board.
Howard: I already know what they’re all yelling in their car while you're saying that. They say, “Oh, Howard. You live in Phoenix with 3.9 million people and you're talking to Rhonda and she’s in Atlanta with 3 million people. I’m in bumble butt Parsons, Kansas, population of 4,000 bucks and my assistant only has one eye but she’s the only one that had an eye.”
Rhonda: She has the right attitude.
Howard: What do you say to the people in small rural America? Can you find the best people?
Rhonda: You know what I’ve done? I have served rural Tennessee since 1990. I’ve served rural Georgia numerous times, northeast, rural area in Connecticut. If you have the right person with the right attitude and a lot of baking background individuals are fabulous in dental offices. I’ve trained them on dentistry. Dentistry is redundant. If they know managerial, they’re great administrative. If they’re technically gifted, they’re great assistants. That’s my take on it. I’ve taken people with no background and trained them up. They’ve been the best employees in those small areas.
Howard: I agree. I think the best people for business is the bookkeepers and they’re all asking for 25% less than anybody who works in dentistry at any position and the bank tellers. The two best employees I ever got was the lady doing my deposit at Chase and a bookkeeper. Because you can take a bookkeeper and teach them dentistry in a few months, but there’s a lot of people in dentistry that could never learn how to balance their check register.
They’ve been working at this desk for five years on dentistry and you say, “Run me this financial report. You’ve been sitting at that desk for five years. Run that report.” They go, “Oh, well, he never showed me how to do that.” Well, who showed you how to run your iPhone? You just gave a shit enough to figure out how it all works. When he’s paying you money and you're sitting on the desk for five years, you never had any gumption to go figure out anything and then you blame the doctor didn’t train you or take you to a staff to train you, but all this stuff you figure out.
Rhonda: That’s the biggest thing. If you're in a tribe, you have a responsibility with other people in the tribe. If you're a level 5, you have a responsibility to nurture those people up to your level so everybody is on the same platform to serve in a greater capacity with a greater momentum. When that happens, the dentist is leading from the bottom of the pack and they love it. They absolutely love it. You can serve more people and you can make a bigger impact.
The hygienists are a key element to that. That’s why I brought Kim in. After 25 years of knowing her, trained her in a huge capacity beyond what she brought to the table which was fabulous as far as perio care and really said, you know what? What would you do beyond the norm? The norm was educate, educate, educate, and then bring in another enhancement. That’s what I love. This laser service that she teaches in and trains in, Texas just adopted it. That is huge in our country. I think that that’s another way of providing care.
Howard: You're talking about the laser. You're talking about the PerioLase?
Kim: It’s a diode laser. There are several different diode lasers, and I started using 06 in perio treatment. I was a little iffy because I had worked for a periodontist for seven years so I wasn’t … I was like, oh. There’s still a lot of that laser stuff. We don’t know if it works. Does it work? Whatever. Personally, I see a huge difference in my patients when I use the laser. I truly believe in the laser. I truly believe that’s another service that a hygienist can use to get their patients healthy again.
I find that I go in a lot of offices and hygienists, all they’re doing is prophy all day long. I’m sure you’ve heard that and you see that, prophy, prophy, prophy. I go in and first patient I see, I need to do perio on. I go tell the doctor and the doctor is like, “Oh, it’s okay. Just do a prophy.” I see that all the time. For me, that’s what got me so excited and involved. I thought, somebody needs to go in here and actually talk to these hygienists so that they are better educating their patients because our overall health now, diabetes, high blood pressure, all that stuff is so important.
When you get to the patient that way, when I look in their chart, I’m like, “How’s your HbA1c level? Have you had that checked?” If they’re diabetic, and they can tell me. If you do perio treatment on these patients and take care of them, I think if you educate them through that way, they’re more apt to listen and accept treatment because so many patients don’t want to hear that they’ve got gum disease and you need to treat it. I’ve talked to patients. When I finish educating them, they’re like, “No one has ever told me that before.” They’ve been seeing the same hygienist. They’ve been at the same dentist for 20 years, and I don’t understand that. I don’t understand when a patient looks at me and says, “Nobody has ever told me that before. Let’s do this. Let’s get this done.” To me, that makes my day.
Rhonda: Teaching people how to communicate and deliver bad news well is a really effective leader.
Howard: Excuse me. You have an interproximal lesion on the distal surface number 3 causing irreversible pulpitis. We need to do endodontic therapy, a post buildup and a full covered restoration. Do you have any questions?
Rhonda: What did you just say?
Kim: Here’s the thing.
Howard: When that patient said that no one has ever told her she has gum disease, they told her every time. They told her in Latin and Greek. You have periodontal disease. You have a bleeding gum.
Kim: When I worked for the periodontist which was years ago, we had a phase contrast microscope. One of the things that we did …
Howard: That is so cool.
Kim: We would go in a pocket. We’d take the plaque. We’d put it on a microscope slide. I would put it on that microscope. It will come up on a TV screen and those patients would be like, oh my, gosh.
Howard: Why did that go away in dentistry?
Kim: It was the best motivational tool … I tell patients that. They go, “What?”
Howard: Omer Reed and Perry Radcliffe, remember those two? They showed me that 30 years ago and they would show that and the patients … Because what … From the mouth 30 feet down out the back door anus is 12,000 different species of bacteria, fungi and viruses. You go to the San Diego Zoo and there are 4,600 species there. Inside our mouth and inside that gut biome is 12,000 species.
Kim: There’s that disconnect.
Rhonda: That is the news to me.
Howard: When Omer Reed and Perry Radcliffe would do that and put those bugs on the deal and they would show that … Humans are visual animals. Birds are audio. Apes are visual. When those patients would see that, they were just like, wow. They were selling RetarDEX, chlorine dioxide, which was another type. What was the other one, the multilevel marketing?
Howard: Oxyfresh. Omer Reed and Perry Radcliffe, they could sell anything to anybody because they were just so gifted with communication. That phase microscope, I thought 1,000 times …
Kim: It’s awesome.
Howard: Why doesn’t that come back to dentistry? Why doesn’t somebody make a low-cost microscope because when … Here’s the bottom line. Those bugs, when a baby is born and it has no teeth, there’s no environment for an anaerobic bacteria to live. It’s not until a tooth pops through with some tissue laying over it that those bugs, those anaerobics can live. What’s so funny is … Look at these books here. These are 100-year old dental books. When you read 100-year-old dental books by guys … These are $10,000 books by G.V. Black and these guys. A hundred years ago, they were noticing that if you would go to a person and you would pull all their teeth, they would massively get better. Their jaundice would go away. The color of their eyes would come back. Their health would be restored.
There was a movement a century ago that if I really want to do you good, I need to get all your teeth out and get rid of all that pyorrhea and infection, that sea of infection. Here is it 100 years later and you're trying to talk about the oral health connection, and people are talking like it’s some new thing that the mouth might be connected to your liver and Alzheimer’s. Every three months, they discover a new species of bacteria just in dental decay. Not the mouth. Just in the cavity. Every single disease they’re looking at … Not every single disease. Every single organ has at least one disease where they’re finding anaerobic bacteria in there, and the only place they find anaerobic bacteria is when a tooth pops through the mouth, and you don’t have that … Look at gum disease. You pull all the teeth and the gums heal up in 24 hours. Everything we’re talking about …
Kim: It’s old.
Howard: It was 100 years ago.
Rhonda: We’re talking about the care of an individual. Why would we not want to operationally have everything in place to serve them so their fear and their comfort and their trust level was huge to serve them in that capacity and ultimately staying in business so that we can continue to serve them? That’s what we do, to wrap it all together.
Kim: I very seldom have a patient … This is a patient that I’m working as a temporary hygienist in. They’ve never seen me before and they’re wondering where Ashley is because Ashley is so fabulous and they want only Ashley to clean their teeth. When I got with them and most of the time, they’re like, “Are you going to be here when I get back?” They’ll say if I recommend a perio treatment, I almost always have someone compliant with whatever I’ve … Not diagnosed but did a treatment plan for or whatever. It’s the way you speak
Rhonda: It’s the way you speak.
Howard: Can I say my thoughts on the laser parts?
Kim: Yeah, sure. I get a lot of different …
Howard: I think you can’t be dentist-focused. I say, “Are you focused on the patient or the dentist?” They say, “I’m totally focused on the patient.” What are your hours? Monday through Thursday, 8:00 to 4:00. Are you just not right in the head or did you have a head injury or did you drop acid before I asked you that question? They’re crazy. The deal, you need to be patient-focused, not dentist-focused. I don’t care what the dentist thinks, if he thinks that film x-ray is better than digital x-ray. The fact that on digital x-ray I can blow it up on an 8x10 sheet of paper and give it to the patient is why we’re going digital x-ray. I don’t want to hear about the argument of film because I personally preferred film on a view box a lot better. I think it was a lot clearer, a lot better. I loved it, but I even gave it up for the patient.
If a laser makes grandpa’s eyes get big and makes him get focused on his teeth and makes him start brushing, flossing and coming in, whatever makes you motivated. It’s like cardiologists, cardiovascular surgeons. Whatever is going to make you quit smoking, lost weight and start running in 5k, I’m all into it. I don’t care what that takes. Doing it with a laser … I got podiatrist friends who say, “If I got to do foot surgery, I can take a 15-blade and make that split in a second. Pull out my hand piece and knock that corn off in a minute so it’ll be done.” No one wants that. I advertise laser. Now they’re dinking around for 15 minutes with a stupid laser, trying to make this hamburger cut. It takes me three times longer, in fact half the time I just cheat her. Is she’s put out asleep, I don’t even get the laser out. I just slice it open, do it.
If having a laser [crosstalk 01:16:11] makes grandma get her foot fixed then a laser is what a doctor needs to get because grandma couldn’t walk on her foot and it took a laser to get her to come in there and submit to having it done.
Rhonda: If they want to be able to serve in a capacity that really gets the outcome, and I always say, “That’s all well and good but you got to start with you. You got to start with how you think, how you operate, how you communicate.” I do onsite coaching. I literally send the doctor in or the hygienist in, listen to how they present treatment and/or educate, pull them out and say, “Okay. Now I want you to go back in there and I want you to say it this way.” Then, they go back in and they say it my way. Then, they come back out and I say, “Okay. That’s pretty good. When you go back in again, here’s what you're going to say.” It’s behavioral. We learn by experience, 80% retention by direct purposeful experiences.
Howard: I’ve never met an Olympic athlete get a gold medal without a coach. I never met anybody who’s good at anything without a coach. All I’m saying is that the dentists that are humble and realize the consultant’s return investment, they can bring in someone like yourself and can be humble enough to listen. Everyone else wants to think, I’m perfect. I know everything. It’s the humble ones that say, “Hey, Rhonda. If I give you a buck, do you think you can come down here and make me two?” They’re coachable. I would say 28 years of watching dentists, the ones who got the furthest are the ones that are most humble, which means they listen to their staff. It means they listen to their patients. It means they listen to consultants. I’ve always had consultants.
Jan, my assistant in 20 years has cheated on me more times than my ex-wife. My team, we run a democracy. When we vote, there are five people. If three people say we’re going that way and Tuesday going that way, it doesn’t matter that on my fifth vote I own the company. I run a democracy because I think to myself, if I can’t convince four other women that have been with me 20, 30 years, then I need to go back and work on my arguments. I need to go back and work on my thinking. I need to give it more time.
Rhonda: That’s what I really pride myself on. If I meet with someone and they’re not ready for my level of participation, I’ll give them strategy and I’ll direct them to where they’re at to be able to do what they need to do. In that way, you're still serving them in preparation for a greater level.
Howard: In your career, how many times did they tell you their situation and you just took them to a vet and had them put down?
Rhonda: Never. There’s always hope, Howard. There’s always hope.
Howard: Oh my, god. Spoken like a true woman from the south.
Rhonda: Thank you. I’m not from the south. I’m from Pittsburgh really.
Howard: You're from Pittsburgh? I always thought you were from …
Rhonda: No. That’s just where I fly in and out of. [crosstalk 01:18:55] of course. Yes.
Howard: Rhonda, thank you for coming by and spending an hour and a half with me today. Kim Pinzini.
Howard: The name tortellini was already taken or …
Kim: I don't know.
Howard: It’s your husband’s Italian name.
Kim: I’m a southern Italian.
Howard: A southern Italian? Ladies, thank you so much for coming by and sharing what you know. Hopefully, some of those listeners out there will sit there and be humble and get help and say, I trust that if I give these guys a buck, I’ll make two back. They will. I’ve been a big fan of yours for literally three decades. Thank you for all that you do for dentistry.
Rhonda: Thank you.
Kim: Thank you, Howard. Thank you.
Howard: Nice to see you again.