Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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202 The Practice Management Edge with Jennifer de St Georges : Dentistry Uncensored with Howard Farran

202 The Practice Management Edge with Jennifer de St Georges : Dentistry Uncensored with Howard Farran

10/22/2015 2:00:00 AM   |   Comments: 0   |   Views: 765




Some offices "have no idea how to use their system. There's no training!"


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AUDIO - HSP #202 - Jennifer de St Georges



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VIDEO - HSP #202 - Jennifer de St Georges



Practice management software can be a great tool. But most offices never use it correctly. The best practice management is a personal, real, genuine touch.

 

 

Jennifer de St Georges has developed a strong global reputation for providing dentists and their teams bottom line and logical solutions to solving complex dental management issues. 

 

Audiences love her content driven programs delivered in her fast-paced, humorous, and motivating style. Meeting planners appreciate her multiple programs, allowing them to mix, match and customize her programs for their group’s specific needs. This flexibility allows Meetings to book her for multiple days and ongoing return visits.

 

Jenny places special focus on helping dentists and teams raise their level of oral and written communication with patients. Jenny supports all her programs with detailed workbooks. Attendees relish this take-home tool to plan and implement her program solutions. Through her company JdSG International Inc., Jenny provides telephone, webinar and self-paced management support programs.

 

A member of the National Speakers Association since 1983, Jenny is regularly booked by NSA and its affiliate global organizations, to educate career and emerging speakers, on raising their level of speaking careers to the next level. Born and raised in the UK, Jenny has been based in the San Francisco Bay area for many years. To book Jenny to speak, please visit www.jdsg.com, or call 800.393.2207.

 

Some facts about Jenny:

• Jenny has given over 1,000 programs on five continents

• Her expanding international meeting bookings include 8 FDI annual conventions

• Jenny’s been featured at virtually every national, state & regional meeting in US

• Jenny customizes her programs for specialists, study clubs and private sponsors

• Jenny has over 350 published articles and commands a loyal following as an author

 

 

Toll free 800 393 2207

email: info@jdsg.com



Howard: It is such an honor and a privilege today to be actually interviewing my first role model [inaudible 00:00:15] dentist Jennifer de St Georges. You probably don't remember this because you gave a million lectures but it was 1987. I just opened my practice and, I live in Phoenix and 90 miles away is Tyson and all my older friends in the AGD that had their fellow ships and master ships were telling me that, "Man you're a young a kid." If I would have listened to Jenny instead of developing these bad practices and all these bad habits, you need to go there and start on the right foot. I packed up all my stuff. Jane was in the front seat. 

We all drove down there and we sat at the front row and it just seems like yesterday and I swear to God Jane is still with me 20 years later and I still hear her talking to the younger associates and she's setting out her shoulders back and saying, " Jennifer de St Georges told me 30 years ago that blah blah blah blah. " We talked all the way back, 90 minutes, she fired us up and probably over the years we saw you half a dozen more times and thank you so much for that because when we came out of school back in '87 we studied math, algebra and physics and chemistry and all these crap that I've never used. Every single day I never use 80% of all the stuff I ever learned and in the first week I had to make payroll and I was like, "What?" I mean they couldn't even show us a pegboard. We didn't know anything and you gave us focus and you gave us light and you gave us goals and if there is anything I can tell, these podcasts are being devoured the most by kids under 30. 

If you're under 30 you just podcast and if you're 53 like me they don't even know what a podcast is and it's hard to teach them how to to do it and all that stuff. I'm telling you kids you don't want to be a horrible golfer for 10 years and then start taking lessons because it's so hard and I'll give you a classic example. You start not having a payment policy and you do that for a year and then you find out how dumb that was and then you start doing a crackling of what all the patients are going to say. "That's not the way you did it last time." If you're going to do anything smart, it's you take all these information, the first day out of school. You want to take 3-5 hundred hours of CE the first year you get out of school not when you're 60 years old trying to fix up your practice before you sell it when you're 70. I'm rumbling too much Jennifer thank you so much for gracing me today. How are you doing?

Jennifer: I'm doing well. Thank you for you're most gracious remarks and thank you also for the support you've given me over the years. If I could just make one comment about what you said. What you just said, the most important thing you said and we're talking about the kids under 30 and I realized I can't call them the guys because over 50% of them are women. We never have time to go back and redo stuff when we get busy. The time to put the structure in place is when we are not busy because we can never get that time back so you're exactly right, if we start doing something the wrong way like playing golf for 10 years, you have to unlearn the bad stuff before you can replace it with the good stuff, very very stressful. For the young kids listening, what you just said, if they took nothing else away today that is a take away for a new practice or a new dentist.

Howard: I want to ask you first, do you think that there are no schools or any better teaching kids management, marketing today and 2015 graduates than they were in 1987 when I got out.

Jennifer: The answer is no. My former husband graduated from PNS, the last year it was PNS college of physicians and surgeons and he graduated in the class of '67 before it became UOFP which was the class of '68. When Edmond graduated, Howard, the class started with 134 dental students enrolled. Two weeks before graduation they were still kicking the guys out. They graduated 34 of the 135. In order to graduate the patients had to have their bills totally paid up. The way they taught the dentists in the last year of PNS is that the student got the patient to pay them and the student paid the school. 

The students learned very quickly to communicate and to marry the benefits of the dentistry to the course. The patient paid the student, the student went to the school. Three weeks before graduation, the graduating students got a bill. This is how much your patients owe us, you've not collected the money. Not only did they go and get an equipment loan and a loan to live for the next year or whatever. Many of them were financing 60, 70, 80 thousand, whatever it was of past due patient bills so they learnt very quickly on day one there was a business side. I doubt today that's even brought into the equation.

Howard: Talk about what you mean when you say that marketing and management have to work as one.

Jennifer: I devise that term over 30 years ago and it's more appropriate today in my opinion have been, it's ever been in the past. I talk about the marriage of marketing and management. When I came into dentistry with no dental background and started picking up the phone. We had more patients in California than we knew what to do with so through the 70s we ran what I'm going to call is a horrible expression which is a cash practice and that basically is if they had the money we saw them. If they didn't have the money we waited till they had the money. Really, we didn't have to spend a lot of time thinking about marketing. We opened the door, they were in the parking lot waiting for us. 

Today we have 35000 in California and the day of just sitting there and not marketing, those days have gone. The first part of the equation is, we have to market but when I look at the websites today and I look at social media and I look at search engine optimization and I look at some of these reminder services dentists are using to remind them of their appointments and all that stuff. There's not much point investing in that service and that marketing approach if I have an attendant hang on the phone who in two or three sentences cuts them off at the past. I was talking to a dentist the other day and he talked about the very high no show rate he's having on new patient exams. I come from the school that says and I'm on record for saying this forever. 

I believe that a dentist should have 100% show rate on a new patient exam. The patient had a problem or they saw a neighbor had a problem and they didn't want the same problem. Unsolicited they picked up the phone or they booked the appointment on the web depending on the way the office is set up. Why would they not turn up? My sense is that 9 times out of 10 is, it's the way how that initial phone call was handled so when I talk about the marriage of marketing and management, marketing brings them to the front door or brings them to the telephone or brings them to the website and be email but unless you can manage them from a customer service and from a management perspective, the practice will not make it. 

Howard: You know what I think is hilarious, when you're on Dentaltown and you go to the ... we don't market the forms for political, the form on politics or religion is not on today's head topic you have to go to leisure and then you go to politics and then it says do not enter [inaudible 00:08:55] but it's so funny how all these dentists are all anti-government and they just can't find anything right what any political party.

As a consumer when you go around America, the only 2 places with zero customer service is health care and government so for me to see a doctor badmouthing the government, it's like, "Are you kidding me?" Any sector, 7/11 and Circle Kay probably has a nicer friendlier person by in the cash register than any doctor I go to in town. Any doctor you go to in town is like, "Sign here," they don't make eye contact. They treat you like you're almost a wasp or a bee or a cockroach. I go pick up my friends for lunch and their receptionist and I can stand there for 5 minutes before she even acknowledges that I exist. You only see that in health care and government. Do you agree with that or not agree?

Jennifer: If I could sub categorize it a little bit. I like to talk about physicians and dentists because I find the physicians on customer service generalized ration maybe 2 out of 10. I think most dentists try. They may some succeed. I live 5 minutes from Stanford university and Stanford hospital which is in fact one of the top 5 hospitals in the world, excuse me, in the state not the world and I noticed last month they had started TV advertising on the local stations focusing on customer service and listening to patients and I found that interesting that even Stanford with all its millions has finally realized that if bodies stop walking through the door they will not have a business. There's obviously been a complete change in the environment and a focus on that concept.

Howard: It is amazing because we're out here in Phoenix which has the male clinic over in Scottsdale and Kansas center of America is getting a ton of business because they're focusing on all the soft stuff and here's Mayo and all these Stanfords and John Hopkins just think we're the best so you'll come here. It's like wow, not really. If you're better on the soft stuff, if you're better on the greeting, the touchy feeling, all that stuff. They're going to get more patients.

Jennifer: Howard, if I may again separate physicians and dentists. When you have a dental emergency. You don't negotiate with the dentist you need to be seeing. How much of dentistry is emergency being based? The minority not the majority. When you're going to see a physician or a hospital and you're ill or you've broken you're leg or you're having heart attack, this is not selective which in my opinion is why dentists have to be so far superior in their communication skills because they get in the patient by with discretionary income and it's a contest for the patient. Do I go to Hawaii or do I have peril searching and nothing is bleeding but doctor says I need to do it. The mindset, my opinion for physicians and dentists is very different on how they approach the patient.

Howard: What do you think of all these patient appointment reminder services. There's a lot of them out there.

Jennifer: Bottom line, they're driving me crazy. It's been very interesting because in the last few weeks I've actually had to change my dentist after 40 years because Edmond has sold his practice. I've had some medical issues I just need to get tests on and second opinions on. I have been fascinated going into the hospitals, going in to get the blood tests, going in to the different medical and dental offices because I'm wearing the hat as a patient but I'm also wearing the hat with my background and I was in a dental practice recently and I won't say the service that they're using. I got reminded twice the day before. I got reminded twice the day of. The second reminder was when I was already sitting in the office. I had not left the office and got to my car before the service was asking me for a referral to other patients. Nobody seems to customize the verbiage or how these are going out so I could most probably speak for an hour in my opinion let me take Stanford hospital. 

I got a call from Stanford last week. How if this is exactly what they say on their telephone confirmation call. "We're calling to confirm," which by the way is a reconfirm as far as I knew it was confirmed. "We're calling to confirm you're appointment tomorrow at 4.30 with Doctor Smith. If you wish to cancel hit 1, if you plan on attending hit 2 and they wonder why they have no high show rates. It makes no sense. It makes absolutely no sense.

Howard: What would you have recommended they say?

Jennifer: My recommendation today in 2015, Howard, is what it would be from the day I got up on stage and it's this, every patient coming into a dental practice, I don't care if it's a group practice, solo practitioner, they have the exam. They have the consultation. I don't call it a case presentation. I hate that but not in number but not the case, it is a consultation. The consultation has 3 components. The clinical. What was diagnosed? What needs to be done? Options, pros and cons, decisions made, option number one. The second component is money. What's it going to cost? What financial options does the practice offer? Which does the patient accept? The last component which only people who take my programs understand is the third component of the consultation with a new patient has to do with management. Do you confirm? Do you not confirm?. What's your no show policy? Do you take the assignment? Do you not take the assignment? If the patient is a minor, is the bill going to be paid for by dad in Arizona or mum who walks through the door. 

There are 5 or 6 points which need to be covered and if you'd like me to do it I'd be happy to give you the vocal skills. This is what I feel that a staff member, not the dentist, a staff member looks at Mrs New Patient who said yes to the treatment, yes to the money putting it on care credit or wherever it's going. She has no stress on the treatment and the money so I looked at all our patients and I'd say Mrs New Patient sometimes [close 00:16:16] in our practice we don't confirm appointments. That's a statement. Then I always explained to a patient why I have that philosophy because if you don't they're going to say why? Without pausing for breath I say the majority of our patients are prepared to take responsibility for keeping their own appointments and the secret to this is to pause. 

For those of you who've been to any of my programs or listened to them on CDs there is a word that is called pause. It's in capital letters, it's capped, it's underlined and it says pause for 3 to 4 seconds. If the patient is a busy person they say fine, "Hate my appointments being confirmed" but if the patient says, "I need that confirmation service." I sJay, "Wonderful, it is our pleasure to offer you that social service. How would you like it? Texts, phone call, email, fax," whatever and now you're chasing around the 15% who want it and you're not upsetting the 85% who don't want it. 

Howard, I have friends who are busy physicians and busy attorneys. They repeatedly ask their dentists to stop confirming appointments and the dentists have been known to say yes I listened to Jenny and she tells me I should be off but I'm too scared to do it. It's not a staff issue, it's a dentist issue and if you talk to the staff who confirm appointments they will admit it that when they call to say, Hi I'm Jenny, I'm just calling to remind remind you of your appointment with doctor de St George tomorrow." There's a 50% chance the patient is going to say. I'm so glad you called. I've been meaning to call you for the last couple of days. I don't think I'm going to be able to make it. 

If we weren't on the phone they could have kept the appointment because they would have been embarrassed to cancel short notice. I keep saying to these medical people and these dental people, "Can I put something in these systems so I am not confirmed? Your appointment is in my appointment book in red. If I do not turn up, I was killed on the free way driving to you." They have no idea how to use their system. There is no training. I think automation is wonderful but if it is not personalized. I'm just trying to think ... [Badpress 00:19:03] and I went back many years. [badpress 00:19:08] had this ...

Howard: How's he doing?

Jennifer: I haven't talked to him in a long time.

Howard: He's an origan , right?

Jennifer: I don't know.

Howard: [Covales organithing 00:19:16]

Jennifer: I don't know but years ago came out talking about the need to, hi-tech soft touch. That's what he called it. Was the need to customize and personalize technology. It's the same with taking a someone to benefits or sending out statements. There is no customization. There is no acknowledgement on the statement of what the patient told the financial person when they set it up and I think with such lack of individuality, I think that the dentist just loses that edge.

Howard: In 1900 health care was 1% of the GDP by 2000 it was 14% by 2010, by today it's 17 cents of every dollar in health care spent yet when you go to medical they don't teach any business finance and then you go to the state meetings and if you have a meeting on cost, money, finance, scheduling, whatever. A lot of states, almost most states won't accept those as credits. How can you have a ballooning health care course that's literally paralyzing the 20 richest countries in the world, while you still have state dental meetings who don't even want speakers to talk on it and won't even take credit for a practice financed on hours. Does that make any sense to you?

Jennifer: Well, lets see now.

Howard: They got time to teach you algebra, trig and gold foils.

Jennifer: In November of 2012 Damon Adams from Dentistry Today invited me and I was very honored to write for, in my opinion, the guest page in dentistry today. I did the whole 1800 words on the very subject you're talking about. Why is management not in dental schools? Why is it not on the big programs? I'm going to make a comment ...

Howard: Or recognized by any state boards.

Jennifer: Exactly. I'm going to comment now which is not politically correct but I'm going to make it anyway. When I go to many of the state meetings now, I am seeing subjects like myself and Caffie Jameson, what we would normally speak on being taught by a DDS or DND so they can get CE credit. I sat in 3 programs recently. I won't say which state on social media given by dentists who had obviously taken a course on it but I didn't find it practical. I was pleased that it was acknowledged. 

When I started in California, 50% was class one for clinical and 50% if you'd CE could be in practice management which was class 2. Then California took it out completely and now they brought it back as long as the copy is written so that the state perceives there is a benefit to patients. There is nothing in management that is not a benefit to patients and one has even to quibble about it and you're 100% correct so when I talk to the meeting planners they say the guys come in and they want 3 crush days or 2 crush days. They want to get the 55 units in 2 days so they don't have to worry about it. 

Management is not there so now we have clinically brilliant Einsteins being embezzled because embezzlement is even worse than I thought. Don Louis who is the go to guy on embezzlement or a surgeon from [inaudible 00:23:10] Ohio has always shared with me, embezzlement in dentistry is 1 out of 4, vets is 1 out of 2, medical 1 out of 5. From the horror stories I have heard in the last few months, I'm going to say dentists maybe 1 out of 3. We've got beautifully trained dentists who have no idea how to set up systems but more importantly how to monitor.

Howard: Funny that you just said that because today's paper that is the first thing I saw. I don't know if I can find it. Anyway, basically a lady in Texas just got sentenced for 5 years for embezzling 2000 dollars from her dentist in Texas and the dentist in Texas said he had no idea. You just hear this. You can't go a week on social media without some dentist getting [inaudible 00:24:07]. Jenny, I want to ask you a question from 30,000 feet because you and I have been in this sector for decades. When I got out of school 9 out of 10 dentists just started a practice from scratch. Your husband started a practice from scratch. Now that is rare. That is just the out layer. What's changed between us all graduating and running 2000 square feet and getting some plumbing done and starting a scratch practice. Why do you think it's gone from 90% go scratch and now it's fallen down to 10%. What are your thoughts on that?

Jennifer: When Edmond graduated from dental school, 5% went into graduate or into the military, 95% went on their own. The figures I had been looking at for the last few years. You're exactly right have been reversed. 95% go into some sort of relationship. I'm not a dentist. I have no clinical background so I can make the story really personal so I'm not stepping on anybody's toes. Edmond always told me when he graduated there was nothing that could walk the door that he did not feel prepared to handle. The old PNS was down in the mission district which in San Francisco was not a place maybe you'd walk down at night but it meant that the dental IQ was low. The patients who walked in from the streets genuinely brought in every problem you could think of and a whole lot that you hadn't even thought of. Then they moved the school up to Pacific Heights, into the super area and the patients walking in aren't the same kind of patients and now they've moved the school back to the Mission district. Why did they move it in the first place? I don't get it. 

There was a confidence that I saw in Edmond's class and dentists of that era that I'm not sure that I see there now. I'm only quoting Edmond because it's important that my facts be accurate but they also, I can't speak for other people but I think he had to make 26 sets of dentures. When he made a denture the patient could not get it out. He had to teach them how to get it out. The other thing was that no, the management was never involved and when I worked with Jim Pride. I go back many years, went back many years. He is no longer with us.

Howard: I can never figure out that he was a dentist or a winery [inaudible 00:26:57]with him it would be 30 minutes of dentistry and 30 minutes about his vineyard.

Jennifer: He was a dentist but he was so tipped in at UOP. I met him, and I'll tell you the story one day offline but I met him one day and he said come and talk to me. I went and talked to him and he said, I am so passionate that you're passionate. I'm going to give you Monday morning at 8 for the final year. He said nobody will turn up. He said nobody walks into dental school with 8 o'clock on a Monday morning because they've all been out grousing  all weekend. We're lucky if they turn up by 11 but the least I tried. I had the last 3 months of the graduating class. Everybody was there at 8 o'clock in the morning. The other school in San Francisco heard about it. Their dean wouldn't do it. They took money out of their pocket and they asked Jim and I to go on a Wednesday evening and teach them management that they weren't getting in their dental school. Jim and I went in of course and we didn't take any of the money.

There was an acknowledgement then that management was important. However, in fairness to today's dentist, Howard, I've had so many conversations with deans and I'm sure you know what I'm going to say. You say to the dean, why is management not included and this is what they say, we don't have any time in the schedule and the guys don't want it anyway. You go and talk to the students, they're crying out for it. The dental schools in the UK a few years ago took dentistry in the dental schools from 4 years to 5 years so they could teach communication and all that stuff that they couldn't fit in 4 years. That's how important. I also believe that the graduating students must in turn, with a couple of practices to get hands on experience before they go out to the market place and I think the American schools in my opinion should be looking at that kind of format.

Howard: Jenny, you were actually born in London. Were you?

Jennifer: That was in the North of England. I'm from Lancashire where the beetles come from.

Howard: From the beetles, don't you think that dentistry in England has changed more than any other country in our lifetime. Seems like when I got out of school most work for the government NHS and now 30 years later looks like a third of them no longer participate with that.

Jennifer: If you divided England to the south of England, the north of England and Scotland so you've got the bottom half the middle half and the top half. 99% of all dentists in the south of England have gone private.

Howard: 99% ?

Jennifer: Yes, and they've been that way now the only thing that they do which costs them money but that is their commitment is they will take kids till the age of and I want the say it's 16 under the NHS program. They will take the kids because they feel very strongly the kids should not be compromised because of a family financial issue. They will take the kids on the government program and then when they move into their late teens then they become private. There are a few dentists who do National health. When you get to Scotland, Howard, the majority are going to be on the NHS system. I find looking around London ... 

I spoke to the Society of American Trained Dentists. I've got the words wrong. It's about 80 dentists from England who have taken a 2 year course in the states to get their DVS degree or DMD and then go back and practice in the US. When I'm in Paris, you will walk down the shores [inaudible 00:31:11] and you will see and you will see a brass plate with the French qualification and then you will see a DDS or a DMD so they came to the states to get their education and they went back. I would say in Europe there's a bigger gulf then in the states. You see some of the best dentistry in the world and you're going to see some of the worst. I think most probably in the states it's not discussing state by state but the overall it's most probably of a much more even approach.

Howard: What are your thoughts about understanding the UK NHS and how that's more after the last 3 years when you keep seeing newspaper articles even in your state of California where they were complaining that so few dentists participate in their state medicaid program but then the dentists are saying yeah but your fees schedule is only 30% of our usual and customary fees and they're overhead at 65%. The dentists are saying if I participate every dollar I collect on state medicaid, I will lose a dollar. I don't have the dollars to lose. What are your thoughts when you have 65% overhead and state medicaid wants to pay you 30% of your usual and customary fee.

Jennifer: Your timing is just amazing. I was driving in the car just last week and the announcement on the news is that the California medical has just increased the reimbursement to the dentists because they have patients and nobody can find a dentist to work with medical and I would say that states, we might tell the dental societies what to do but it seems to me that each state dental association, I'm sure CDA in California was very instrumental insacremental pointing out the point you've just made is that the dentist today with an overhead of 60, 65% can not afford to lose a 100 dollars an hour seeing a medical patient so they've just increased the fees.

Howard: [inaudible 00:33:22] the dentists be a volunteer when they graduated 300,000 dollars of students loans and then how can I give them state of the art dentistry and lose 100 dollars an hour. It's kind of a fairy tale. I want to ask you another question 30,000 feet, a macroeconomic question. When I got out of school in '87 and saw you, Lazarus out of New Orleans had taken orthodontic centers of America all the way to the New York stock exchange. All the orthodontists were saying it was the end of private service. They would all be working for him. He actually started building his own ortho schools in Colorado and all the orthodontists, the sky was falling and it was game over and there was a dozen companies on that stack and they all imp-lauded. They all fell apart. They were all gone for 10 years now they're all back. Are they back to stay? Are they different? Are they not going away? What do you think of like the Heartland, the Pacific dental cares, the Aspens. I think the last list I saw, there's about 50 corporate chains that are in more than one state.

Jennifer: What did I read? Target? I read this week or last week, Target is going to start going towards that way. I was talking to somebody. It was a confidential conversation so I can't say too much but he was sharing with me the potential business plan of Heartland. It is unbelievable. When the Heartlands of this world started many years ago. I actually called them up because I sort of wanted to get in on the ground floor because I felt and I don't know if this is Heartland but certainly when you and I were talking many years ago, they were business people from Walls street starting these places. 

I was bold enough to call in and say I want to be in on the ground floor so when you create the structure it is practical because my concern Howard is and I don't know how it is now but my concern is they attracted the dentist who doesn't want to worry about the management or the staff and don't lets kid ourselves that's about 98% of dentists. If dentists knew before they went to dental school the crap they have to handle which is non dental in the practice, half of them would not go to dental school. I always felt that these corporations would attract the dentists who wanted to focus on the clinical expertise and not worry about the management so my question is how good is the management? I don't know how good the clinical is, that's not my realm of expertise. I've done some research and I've looked at some structure and it seems to be pretty good but I would always like to think there will always be room for private dentists.

When I attended the meeting the other day to which I was an invited guest, I ran into a gentleman. He remembered me from 35 years ago. He said that money is now on the table from the bank he's with to help the students out of the San Francisco two dental schools begin to start a scratch practice again because most of the guys coming out. Over 250,000 on a school loan and then what are they going to do. Take out 125,000 per treatment room. That's half a million before they've even seen the first patient. They most probably don't have a line of credit. 

I'll tell you a story for those younger dentists who are listening. This is called weep. When Edmond graduated in '67 we went to Crocker bank. The loan officer for dentists was called Mr Moosbrugger. We signed a loan to start 770 square feet with 3 treatment rooms of which we were going to equip 2. We didn't sleep that night because the loan was 25,000 dollars and he looked and said you're not going to make any money so why don't I put in another 10 or 15 thousand in the bank account so you don't have to worry. We had 2 used wedding rings and a used VW. That was our collateral. After 2 months I called him up, I said I need more money to buy equipment. I'm opening the third room for hygiene. That was after 8 weeks, excuse me, after 4 months, 16 weeks. He looked at me and he said that they'd be no dentist in California who've ever gone bankrupt. I doubt you're going to be the first one, good luck.

Those days have gone. If I were to sum up what's going through my head, I've always said that if a dentist wants to move into a practice, whether it's to buy a practice or be an employee to become an [inaudible 00:38:39] down the way or whether to associate for two three years to get the knowledge they need to open their own. Please go into the appointment with the dentist a couple of hrs ahead. Sit at the reception room. Say the traffic was not as bad. Be a fly on the wall. Watch the staff. Listen to the phones. If the verbal skills are not good, "We don't take welfare. Doctor's office. What do you want? No. We don't have time today." He or she can not go in and change it and if they don't change it they're just going to have a bad role model.

I realized that the practice brokers are looking at the equipment and are looking at the AR and they're looking at the goodwill of the practice but they really most probably, I don't know this first hand don't go into the management the way some consultants do. I believe any dentist buying a practice needs to have a management consultant really doing audit on the management not just on the charts but on the philosophy.

Howard: I think it's funny that when you look at a balance sheet only a being conter or accountant could come up with a valuation in practice. They're sitting there giving me the value of a dental chair and you have two practices and one has 5 staff members. They've all been there 20 years and the other one's got 5 staff members that have all been there 2 years or less and this does not show up on the balance sheet. They'll appreciate a stupid dental chair for me. It's just crazy. 

Jenny, I want to talk about the most frustrating thing to me and see if you can address it. All my friends that are my age, 50 to 60, that have million dollar practices and making bank. We all have a long history of bringing in all kind of consultants because we always know we give guys like you a book. By the end of the year we're going to get our book back and some change. You take people like a ... one of the most successful practices I've ever seen has had a consultant every single year for 38 years, a different one, he tries every different one because he sees them as the caffetery. He's never had one that didn't teach him something. 

Everybody that uses consultants like you. We're just fine tuning, inching up going up a stairway for 10, 20, 30, 40 years but the people who you would just be god. The people who need you the most never ask you for help. Why is that in dentistry that the dentist that could just avoid a suicide and the people that would save their family. The one that you would just be a miracle worker on won't call you and then everybody that calls you is already successful and just wants to get even a little better every year. Do you get where I'm going?

Jennifer: Let me just clarify something. I am not a dental consultant. I do not go into practices and consult on site.

Howard: Well you off they say Howard said yeah.

Jennifer: When I had my large corporation, I had a full time consultant who literally went around the country and that's what they did. My passion is creating programs, being on stage, creating audio programs, doing webinars, kicking butt and getting people motivated and getting the verbal skills right and getting them on the right path. I love it and I work with several consultants who are the ones who go in now if I took 100 dentists. They are most probably 10% who will take what they hear in say a Jenni seminar and run with it. There are at least 10% to 15% who will sit in the room and basically say this is crap but I got my CE credit, whatever. The rest in my opinion genuinely want to make the change but one of the issues and I talk about this because I understand it. 

I've always explained to people, I'm a recovering perfectionist. Dentists are perfectionists. Dentists drive their spouses crazy. They drive their staff crazy. They drive their supply detail people crazy because in an effort to make no mistake they keep procrastinating. I talked to a psychologist many years ago and he told me that dentist were the most independent of any profession he had ever worked with. When you have a perfectionist who sets very high standards of themselves never mind what they do of other people. I think it is hard for many perfectionist to ask for help.

Howard: The only person dentists ... I love my profession the most because all my friends ... I've said that I've been in a 100 dentists homes and every one of them has several hundred no fiction books. It's pretty cool when you get a job and everybody there is got 8 years of college, is a big reader and any subject you jump into they're well read. I love my group but the number one profession they remind me of is just a cowboy on his own horse. Does everything by themselves. Won't listen to anybody. Has his own gun.

Jennifer: The psychiatrist told me that as far as he was aware, many dentists could be brilliant brain surgeons. He said these are some of the brightest guys I've ever met but he said if you think they would put up with politics in a hospital for more than 5 minutes. He said they won't do it. He said they want to be king of their own castle or a female, queen of her own castle. They do not want to be bossed around by other people so by the time many of them and you obviously need to ask this over consultants but my perspective by the time they pick up the phone to the consultant they are almost past help. They're just looking for somebody to come in and make it happen for them which is why to be a consultant is most probably to be a therapist first and get into their head and get that sorted out and when the head is sorted out the staff flows but if they're fighting the staff with some hatred, keep the money.

Howard: I always said I would never do an office dental consulting because every time someone paid me to go in there I would just listen to them like are you kidding me and I thought they all needed Doctor Phil not Doctor Farran and I was like if you want to be a dental consultant you should go hang out with Doctor Phil for ten years because once you get their heads to see things in a business side. Success is very counted on your hard word and be the 400 pound gorilla and you've got to delegate. You've got to let your assistants talk. You've got to let your [inaudible 00:45:46] talk. Everything that makes you successful in dentistry is the opposite of how you're hot wired at birth.

Jennifer: That's the secret.

Howard: Name one gorilla in Congo today that's letting all the little gorillas run the tribe. That's just not how it works and you've got literally a million years of evolution beating your chest and keeping everyone suppressed and the dentists that go in there and build a great team. I only got you here for 13 more minutes and I want to right into that hard stuff. Every time I've seen an office go from the bottom stair, up a stair, up two stairs, 3 stairs, it's always getting the staff on board. It's always having a rocking height. The reason your ex-husband was so successful was because he had you at the front desk. 

Talk to these dentists about staff. What's the low hanging fruit on getting a dynamic, wow staff that can talk to the patient on the phone, that talks when they walk in and knows how to communicate and talk about clinical dentistry and money. What's the low hanging fruit. Here's what I see and I'm in a lot of offices just with my buddies and hanging out with friends after a root canal they go back in their office and shut then they get beeped to another room. They go in there and do a [inaudible 00:47:14]. You can be in their office 8 hours in a day and they're either in a mouth or in their room with the doors shut and then all the other staff always says things to me like can you ask this or can you ask him that and I'm like what do you mean can I? Who is your leader? I am his friend who stops in every once in a while. How can you get through. You're talking about 7000 dentists commuting to work. Talk to them about staff.

Jennifer: While I'm known for teaching vocal skills on scheduling and money and all of that, the number one subject that I love talking about is talking to dentists and their spouses about how to hire and maintain quality staff. For those people and of course I didn't know where this interview was going to go so I'm going to pick out certain key things. Number one, a dentist must hire to their limitations not to their strengths. I never talk about weaknesses, I talk about limitation. When you've written a job description, it needs to acknowledge what anyone's limitation is. Many dentists are perfectionists so they tend to gravitate towards perfectionist type staff. Now we've got everybody paralyzed.

Secondly, I have maintained this for years. Hire for the front desk outside dentistry. Hotels, restaurants, coffee shops, airlines, travel agents and retail. I do not need anybody coming into the front office with clinical background. I have a program available that should be put together by a friend of mine that's called, " Welcome to dentistry." They only have to listen to it twice and as long as they know more than the patient. What I want, a mature staff, with verbal skills on how to handle patients. I was in Toronto many years ago and I got on my [soapbox 00:49:28] about this and there was a very elegant dentist and at the end of the day he came to me and he said, Jenny, I listened to what you said so at lunch I went across the street to the Ritz Carlton and I just had the [consiliators 00:49:44] right off the floor. I love [consiliators 00:49:45] they're under paid and they don't know what the word know is. I'm not quite sure about that give me 10 minutes and I'll get the answer. 

I've had dentists call and tell me they've took somebody off first class in American airlines. I've lived on American airlines for over 30 years. I've got over 5 many miles on the American. Never yet had anybody not given me superb class in first class. I want people who can manage and listen to and communicate with patients. We can teach them the difference between removable [inaudible 00:50:19] and a fixed bridge. I was in a pi-do practice many years ago and my late husband was Chinese-American and he was very gregarious but many of the ancients were quite quiet. He was a pi-do dentist, very introverted. Never took his eyes off the carpet, the floor. He surrounded himself with seven introverted ancients. Never got their eyes off the floor and then wondered why nobody wanted to bring the kids in. 

I never ask a dentist to change their personality. This is very important. The people listening understand this. Please don't think that I am asking to change your personality. I'm perhaps asking you to change your management style. If you don't like talking to the patients, find staff who will talk to the patients. I have a dentist that when I did on site consulting in Alaska. It was impossible for him and I always say you never talk money at the chair. Never talk money at the chair two exceptions, emergencies and a change of treatment because with informed consent you can not continue with those two procedures without a financially informed consent. This man could not mention money at the chair so there was an agreement, emergency or a change of treatment. He left, Suzzie came in from the front, sat in his chair, took care of everything. She walked out, he walked in as if nothing had happened. Everybody's needs were met. I didn't force him to discuss money. I said, you don't want to do it, we'll find somebody who does.

The other thing, this is a perfectionist and I see this happening all the time. Dentists get frustrated because they feel they can't delegate because they didn't want 10 years to go and somebody made a mistake so they're not going to do it again. I have actually sent dentists consultant type employees. Employees that could run a 4 million dollar a year company. This marvelous goddess makes a decision without discussing it with doctor. In this particular case I'm thinking of sending re-audit the business cards without asking doctor's permission. He lost it, she walked out. The perfectionist in him finds it hard to delegate. They end up not with executive staff but they end up with more immature staff who will take their crap obviously because the mature staff who in fact would carry the burden for the dentist and be partner can not work in that environment. This is all very generalistic and simplistic but there's a lot of truth in making stereotype comment sometimes.

Howard: I agree. You've given a 1000 programs in 5 continents, I assume one the continents you didn't lecture was Antarctica. What was the other one?

Jennifer: What I'm I missing. Is it the North pole or the South pole? What am I missing?

Howard: North and south America, Africa, Europe, Asia, Australia and Antarctica.

Jennifer: Then maybe I've been on 6.

Howard: That's what I was thinking. You've been on 6, I assumed you didn't lecture any penguins but I couldn't think of a continent that I haven't seen you lesson.

Jennifer: If that was the perfectionist in you picking it up, thank you Howard.

Howard: If someone wants you to speak at their next general meeting, their study club, their whatever, how do they get a hold of you?

Jennifer: Well, I'd love it my 800 number is 800 393 2207 and email honestly my personal email jenny@jdsg those are my initials Jennifer de St Georges jenny@jdsg.com.

Howard: What is that name de St Georges. Is that British?

Jennifer: No, it's actually French. Edmond was from Paris so it's de St George(french accent) so so we say de St George in the US and when I go home to Europe it's de St George( french accent).

Howard: That sounds very romantic like a perfume. Say it one more time.

Jennifer: De St George( french accent )

Howard: I couldn't repeat that if you put it again in my head.

Jennifer: I was talking to my former sister in law this morning actually and her name is, her surname is [foreign language 00:55:16]. It makes me flop.

Howard: You have to admit when you go to all ... I've lectured in 50 countries. When you go to a whole lot of other countries. The language sounds kind of brutal but when you go to Paris you have no idea of what they're saying. It does sound like a Michael Jackson song.

Jennifer: It's like music.

Howard: Yeah. It is music and they absolutely no doubt have the prettiest language. You said Don Louis is the go to man on embezzlement?

Jennifer: Don Louis is the only dentist I believe in the world who is a certified fraud examiner. He's brought out a couple of books. I've not seen it but I understand he, with his forensic accounting company have created a software to detect embezzlement.

Howard: Where's he out of?

Jennifer: He's out of Cleveland, Ohio. 

Howard: Can you introduce us? Can you send him an email and me, howard@dentaltown. I'd love him do a podcast. Also Damon Adams, he's your buddy from Dentistry Today. 

Jennifer: Oh, Yes.

Howard: Tell him I sent them an email that I want to do a podcast with them. I don't know if he saw that and thought well you're in a competing magazine [inaudible 00:56:21]. I'd never think of... The thing I think about other magazines and websites and whatever is the same thing I think about the dentist across the street. We're all on the same team. I tell the dentists across the street we're all buddies. We compete against cars and TVs and trips to Disney land. As far as magazines and websites go I've never met a dentist who only read one magazine. When I was MBE school, I read the Economists, Fortunes, Forbes, Ink. I think hope, growth and abundance, I don't think conspiracy but I would love Damon. I think he's a great guy and I just think that would be phenomenally great.

Jenny, last thing, I'm going to throw you under a bus. You've never given us an online teaching course. We've put up 350 courses and they've passed 550,000 views in 206 countries and I want a course on there not for all the help I do for all the dentists just to raise the status image of Dentaltown to have a course on there from the legend herself. I totally want a course from Jenny. If you ever find it in your heart someday to put a course on there. We will love it and we will tell 300,000 dentists around the world about it.

Jennifer: Your timing is excellent, let's get together because I'm just making some changes in my programs. I would love it Howard, thank you for the honor.

Howard: The last question I got it's worth 15 minutes, I got two minutes. I want to get your final thoughts closed is corporate dentistry going to take over like Wall Greens took over pharmacy or do you think it's just going to be a niche market. Ten, fifteen years from now or I've been here 30 years. 30 years from now do you think most dentists will be employees or do you think it will be a mixture half and half. Will it be urban vs rural. What do you think?

Jennifer: If I was that good of foreseeing things I'd be a multimillionaire on the stock market so I can just give you my personal opinion. I've been looking at the UK. Some years ago, Boots which would be the equivalent of, it was like Sears. No, Boots is like Wall Greens but they tried in England to put these dental centers in some of these large retail and it didn't work. After a period of time it didn't work. Why it didn't work? I don't know. It's a subject we have to address. People like you and I need to address it because we have to be ahead of the curve and I'm not quite sure where it's going.

Howard: I just want you to just my concern. My concern is that things have been going on in the first round that wasn't [inaudible 00:59:12]. They can never keep a doctor. Some of these corporate chains, their average dentist doesn't stay with them for one year. My question to you is can you be a successful dental chain if you can't keep any of your dentists working long enough with you longer than 12 months.

Jennifer: I don't think so. I really don't and we have some chains in California, I can think of one particularly and they don't even put a dentist name anywhere. That's in the paper and there's not a single dentist and I'm thinking if I were a patient I'm not going to a building, I'm going to a person so the answer is I don't think so. When I look at the UK market to be in practice alone is also unusual. It's nothing to walk into a practice and see 17 names on the door and I just always think and I know we're running out of time. I just always think that there's room in the market place for the practice that wants to take [bowteak 01:00:15] approach. Not everybody can do it and that's a conversation between you and I. I could tell you stories about that. If a dentist is committed to quality and wants to back the tide and provide quality service in a place which supposedly can't take it, the chances are they'll be very successful.

Howard: My son Grego always points me to the data of lawyers who started corporations decades before and the corporations grew but they all leveled out, about half the lawyers work in corporates with multiple lawyers and the other half are all individual and he thinks that's a mature market. He takes that assumption and goes to dentistry but we are out of time. We're a minute over time. Again, from the bottom of my heart and Jane and Lorrie and Stacy and Christina and all my staff that idolize you for all the help you put into our practice. 

I was 24 years old and I was running 15 different directions and you gave us order and structure and handouts. I feel like we still have some of your handouts from 1987. You set us straight and Jane and I still think the view was just the one. You were the North star for us and thank you for that and I would love for you to grace our online scene with your name just to build our brand and have the Mercedes Benz herself Jenny St George. If you want to have an outstanding speaker in your meeting and you want those practices to go back home and get more organized and raise your production and net income, call Jenny. Her number was 800 393 220 sub 800 2207 or you can email her jenny@jdsg.com and that stands for Jennifer de [inaudible 01:02:14]. com and I'm telling you she'll be the hit of your meeting I guarantee you. Thank you so much Jenny.

Jennifer: Howard, thank you for everything. Bye.

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