Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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236 Ethical Sales with Ashley Latter : Dentistry Uncensored with Howard Farran

236 Ethical Sales with Ashley Latter : Dentistry Uncensored with Howard Farran

11/23/2015 2:00:00 AM   |   Comments: 3   |   Views: 576

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AUDIO - HSP #236 - Ashley Latter

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VIDEO - HSP #236 - Ashley Latter

•What is Ethical Sales?

•Some of the biggest mistakes Dentists make in their communication 

•My eight step process

•Why dentists find it challenging discussing fees with their patients

•What is important in order to hear a "yes" more often 

•Why technical skills are important, it only accounts for a small percentage in hearing a yes from your patients

•Why everyone in the practice is involved in sales

In 1997, two Dentists took part on Ashley’s Ethical Sales & Communication Programme and since then, over 8500 delegates have now taken this Programme world-wide. This programme is legendary in the U.K. Dental World and is probably the most sought after programme in Dentistry today. Ashley has delivered this programme in 14 different countries, including Estonia, Serbia Canada, five times in the USA.

Apart from the Ethical Sales & Communication Programme, Ashley delivers other programmes including creating a World Class Patient Journey, Creating a High Performance Team, High Impact Presentation Skills Programme and Reception Programme-How to Turn Telephone Enquiries into Appointments. Ashley also works with a very forward group of dentists and Orthodontists on the Serious Players Club, which is an Entrepreneur group

Ashley is the author of Helping patients to say YES, Don’t Wait for the Tooth Fairy-How to Communicate effectively & Create the Perfect Patient Journey & You are Worth it- Communicate your fees with self-confidence & Achieve the income your services deserve He also wrote a chapter in Dental Masters and has written hundreds of articles. In 2014, Ashley got voted number 12 in top 150 most influential people in UK Dentistry and he was the only overseas speaker at the 100th Dutch Dental Conference, which was opened by the King of Holland. 

Ashley has now delivered over 23,000 hours of Business Coaching to the Dental Industry all over the world. Simply he is the best at getting Dentists and their teams to communicate with their patients, which results in a world class patient journey, more patients saying YES to treatment plans and increased profits for the Practices.

Purchase Ashley Latter’s new books “Don’t Wait for the Tooth Fairy” and “You are Worth It" at and get a free copy of his new DVD “How Good Practices Become Extraordinary Practices” (Offer valid from November 23rd to November 29th).

Howard: It is a huge, huge honor for me, to be interviewing the man, Ashley Latter, from That is and we are going to talk today about ethical sales, how to have more patients say yes more often to your treatment plans, so that you can deliver the dentistry that you love to do.

I got to tell you who this man is, because probably about 85% my listeners are in the United States and 15% around the world, but over on across the pond, you are a legend.

In 1997, two dentists took part on Ashley's Ethical Sales and Communication program, and since then, over 8500 delegates have now taken this program worldwide. This program is legendary in the United Kingdom dental world and is probably the most sought after program in dentistry today.

Ashley has delivered this program in 14 different countries, including Estonia, Serbia, Canada and the United States. Apart from the ethical sales and communication program, Ashley delivers other programs, including creating a world class patient journey, creating a high performance team, high impact presentation skills program and reception program, how to turn telephone inquiries into appointments. Ashley also works with the forward group of dentists and orthodontists on the Serious Players Club, which is a entrepreneur group.

He is the author of 'Helping Patients Say Yes', 'Don't Wait For The Tooth Fairy', 'How To Communicate Effectively and Create The Perfect Patient Journey', 'You Are Worth It', 'Communicate Your Fees with Self-confidence and Achieve The Income You Deserve'. He has also written a chapter in 'Dental Masters' and has written hundreds of articles.

In 2014, Ashley got voted #12 in the top 150 most influential people in UK dentistry, and he was the only overseas speaker at the 100th Dutch Dental Conference, which is opened by the King of Holland. Ashley has now delivered over 23,000 hours of business coaching to the dental industry all over the world. Simply put: He is the best at getting dentists and their teams to communicate with their patients, which results in a world class patient journey, more patients saying yes to treatment plans and increased profits to the practice.

Ashley, seriously dude, it is a complete honor that you would spend time with me and my American homies. I am just going to ask you the bottom line. The bottom line. This is what ever dentist says, 'Dude, I didn't go to school for 8 years to sell dentistry. I am not a salesman.' How do you answer that?

Ashley: Yeah, good question. 

It is also a pleasure as well, to be on your show, so thank you for inviting me. 

It is an extremely important question. My view on this is this: Is that the dentists, the doctors they're called in the states, and every single one of your team members, every single day, is communicating and selling ideas. Not just among themselves, but to other patients as well.

Whether that takes part in a treatment plan or not, will probably be, not down to the technical ability of the dentist, but how they communicate what it is that they actually know to the patient.

If you think ... We do the exercise and the courses, but if you write down a list of the qualities of someone who is really successful in dentistry, you will probably find that there will be a lot of things like good communication skills, good listening skills, good empathetic skills, good at building rapport, positive attitude, good discussing fees and all those things, skills and attitudes. 

Then there will be things like product knowledge. Product knowledge is absolutely vital, everyone knows that, but if you can communicate your ideas in a way that excites the patient and in a way that gets them to wanting what it is you are going to offer, the patients won't take up what it is that you are going to offer.

The greatest compliment I get when people come off my course ... I just finished one, I have literally dashed out. I have just done a 2 day, 18 hour program with 31 doctors, but the main benefit they tell me at the end, the main compliment that they give me is 'Why aren't they teaching this at dental school, because I have learned all the technical skills, I learned how to do short term ortho, I know how to place implants, but I have never been able to communicate it in a way that gets the client excited and wants them to take what we have got to offer.' 

You better believe it, dentists are selling their ideas everyday and most of their success will come down to how good they are at communicating the technical knowledge of what they know and what they can deliver. 

Howard: What can a ... When you help a dentist try to go from being a technocrat to ethical sales, how do you do that in your program and is it effective? Are dentists teachable, are they trainable? Can they be like a movie star and play a villain when they are not really a villain?

Ashley: Yeah.

Howard: Can they play a sales guy when they really aren't hardwired?

Ashley: Here are some long winded answers to a brilliant question. Ethical sales is actually ... We teach 8 steps on the program.

The first thing is ... The 31 delegates that have just taken my course, have paid $1600, $1700 each to be there, so they come along with their team members as well, so the first thing is to recognize that they want to improve those skills and that they want to get better at these skills. The fact they come and pay to be there helps.

The second thing that we do is we take them through an 8 step consultation from things like preparing well for the appointment, how to build rapport, how you ask the right quality questions, how to present treatment plans in a way that excites patients, how to talk fees with confidence and achieve the income that your services deserve. 

A lot of dentists seriously undercharge for what they do. They discount prices in their head. We teach them how to gain commitment, we teach them how to overcome price objections and concerns and follow up. We take dentists through an 8 step,but what the thing that is different is this.

That for 18 hours, I am not lecturing, Howard, I am giving them the proven process, I go through one step at a time, then they hear examples, sometimes from me, sometimes from other dentists who have used the techniques and who have success with it. Then we practice with them and I coach them until they get it right.

What makes my programs unique and different is a proper behavior change program, so it is ... The best analogy that I can give you, Howard, is it is a bit like learning how to drive a car. In the UK, you have a session for an hour. The instructor shows you how to drive a car, then you get behind the wheel and then he coaches you to get it right and then eventually you take a driving test and you pass it and hopefully you can drive. That is what my course, that is what we do, we take you through 8 steps and the last thing they do at 5 o'clock, or 6, is through the whole consultation, from start to finish, but they are able to deliver this as if they have been delivering opening lines. They don't need the book, they can just do it automatically.

That is the big difference. Nothing changes, Howard, it is changed behavior, and that is really what we do on the program. That is probably why you mentioned eight and a half thousand have gone through it, we are close to 9 thousand now. At November, was it the third or the fourth today, between now and Christmas, we will have another 350 people go through the course, and that is why it is so successful. That is why it works as well. 

Howard: Would you ever consider coming to the great state of Phoenix, Arizona and giving your two day program?

Ashley: I would. I just got back, actually. I delivered a course two weeks ago in Atlanta, so I was there and I have been twice to Atlanta this year. A couple of times to Dallas, in fact I had a holiday. I went for a week in Florida after, but if we get the numbers, Howard, we get the delegates, I would love to go it.

Howard: Is it a one day course or a two day course?

Ashley: It is a two day 18 hours. We need 18 hours over two days.

Howard: Our magazine goes to 125,000 dentists, so we would fill it up. How many people do you like in that course?

Ashley: I did a course in Chicago, last year. We had about 5,100 and you know what? It was absolutely brilliant. On average, we get anything from about, I would say our low number would be about 20 or about 50, would be an average, or anywhere in between that.

Howard: Do you recommend just the dentist, or does he bring his staff? Or her staff?

Ashley: If you can bring the team members with you then, Howard, things just change in the practice. The thing is, you see, you got to get everyone singing from the same hymn sheet and if you got a sales prevention officer amongst your ranks, they can destroy everything that the dentist or the doctor has done in the surgery.

The more people of the team that you bring on the program, the better of the results that you will get, because you will get a perfect patient journey from the way the telephone is answered at the desk, right through the whole consultation, right through the followup, it works like a dream, so if you get the doctor bringing their team members, it works an absolute dream. It is brilliant.

Howard: I would ...

Ashley: The thing is, Howard, I just had 31 people and I would say 12, 13, of the delegate were team members. The thing that we do, is we find the violets (?), the people who got, who acquire and all of a sudden they blossom and grow and all of a sudden we find rising stars that become treatment coordinators and outstanding team members and that is probably why I love my job so much.

Howard: Do you want us to cap it off at a certain level? Is too many people to ... Is it better for a focus group? What is your ideal max number?

Ashley: I would say 40 is the ideal number, because what I like to try and do ... This is an 18, 20, hour course and I am try and get around and build rapport, and trying to get everyone on the course over the two day, so you get 40, we have an ideal number, then that is a great group, because the other thing about what we do, Howard, is very, very motivational and inspirational.

We take people outside their comfort zones with growing confidence, so the whole thing is very motivational and inspirational as well, so 35 to 40 is an ideal number.

Howard: Do you have any gambling addictions or anything I need to know, because when I have them in Phoenix, I have them at the Talking Sticks Resort and Casino, and I don't want to bring you all the way from the United Kingdom and you stay on the blackjack table all night.

Ashley: No, no, no.

Howard: And can you pull yourself away from the casino long enough to give your course?

Ashley: No, I might ... I should imagine that the only thing you will be able to pull me away is probably by from the swimming pool. I know you have miles better weather than we have in Manchester. We are just about going into winter now, so we won't see the sun now for about six months. (laughs)

Howard: You email me a couple of dates, and I am going to bring you down to Phoenix, Arizona Talking Sticks Casino because everybody I know on your side of the pond thinks you are the man and you are a legend and I would love to bring you down to Phoenix and have you give your two day course. We will cap it at 40, so it will sell out in a day.

Basically, let's start from the beginning here. What is ethical sales?

Ashley: Good question Howard, great question.

Let's, first of all, talk about sales. Sales is not about selling dental treatment to patients that they don't want or need. Ethical selling is actually really doing four things really, really, really well. Let me tell you what those four things are.

The first thing is building relationships with the right type of patient. The key word there are 'building relationships', because if you haven't got really strong rapport with your clients, then there is no trust and not much is going to happen after.

A big part of what we do over the two days, is really how to connect with people and get people to instantly like you and build rapport with all types of characters.

The other key word there, Howard, is 'right'. What you need to accept, and what dentists find a bit challenging is, and I suppose I am a bit like this as well, is most dentists are absolutely passionate about teeth. They go to parties, they look at peoples' teeth and they think '$3000, $4000, $5000, I can change them, take five years off their face, give them massive confidence', but they find it hard is that some people would rather spend $5000 on a tattoo for their backside, or the back. 

The keyword there is 'Right'. It is finding the right type of patient who values what you do, so step one is building rapport with the right type of patient. 

Ethical selling, then, is step two. The biggest mistake dentists make in their communication skills, is that they provide solutions without first, truly, fully finding out what patients wants and needs are, because, in short, they don't ask enough questions. What we teach is, in part two, is how to ask the right type of questions. How to ask the right type of questions in the right order, how to listen empathetically, so that you not only create more opportunities through the dentistry that you love to do, but create amazing rapport with your patients, so we teach them how to ask the right type of questions.

The third part is you then found out some problems or issues that the patients want, or patients need. The third part of ethical selling is this. We will then teach them how to communicate the benefits to the patients, or communicate what you can do in a language that gets the patient excited and that normally leads an emotional level, so we teach dentist how to present treatment plans in a way that gets patients really excited about what you can do and gets them excited onboard. 

Once you have done that, the fourth step, you say to the patient 'Look, Mrs. Patient, here is what your problem was, here is a solution or here is the best solutions for you. What do you think? Is this the sort of thing that you would like to move forward with?' Then you got commitment. Ethical selling is not about hard selling. It is not about selling treatments to patients who don't want or need it, it really is about doing four things really well.

It is connecting with the patient and having an amazing relationship with them. It is asking questions to find out what their problems are, it is solving them in a language that they understand and the fourth part is getting commitment in such a way that the patient turns around and says, 'Howard, this is exactly what I want and you have solved my problem. I would like to move forward and go ahead.' That is really what ethical sales is about.

Howard: Ashley, so many dentists say to themselves 'Ashley, I just can't talk money.' Why do you think dentists find it so difficult to talk money and should the even be talking money? Should someone else be talking the money? Should I tell you that you need a root canal and then Amy comes upfront and tells you how much it costs? Why is money so difficult for a doctor to talk about?

Ashley: It is ... I can basically ...There are two agendas here. Let me talk about it from the UK point of view, and then I will talk about it from the American side.

The first thing is: There weren't taught these skills at dentistry schools. What you were taught at dentistry school was to do dentistry. Nobody teaches you how to communicate or discuss fees. That is number one.

Number two is in the UK, as you may be aware, we have a National Health Service, so the National Health Service still accounts for about 55% to 60% of British dentistry, although it is decreasing every single year. It is getting less and less.

On the National Health Service, a lot of the dentistry is free. All of a sudden you got dentist who is saying free one minute and in the next minute they are saying 3000. It sounds exactly the same word, but there is a massive difference from free to three thousand. That is another reason.

The other thing is that dentists seriously, what I believe, undercharge for what they do. A big problem for a lot of UK dentists, and American dentists, I have done courses in the States four times this year, is they think of a price in their heads.

Say the treatment is $1000, but, for some reason, by the time it comes out of their mouths, it is $850. $150 has gone missing from somewhere, and the patient doesn't even know that a discount has been given. 

That is another thing, another dentist thing, or doctor thing, would have made the treatment cheaper, or [inaudible 00:17:16] knock something off, they are more likely to say yes. That is just not the case and I can prove that on the course.

Should I think doctors should discuss money? Personally, unless they have got an absolutely, outstanding treatment coordinator who can take over and do that, then I think they should. 

I was in the States two weeks a go, I was with a doctor and he brought his two receptionists on the course and here is what the doctor does. The doctor sees the patient, has a consultation, patient says 'What is the price going to be', and the doctor says 'Downstairs, Mary will tell you what it is.' The patient leaves, not knowing what the price is, hasn't a clue as to what the next step is. He goes to the desk, speaks to Mary, Mary says, 'Well your Six Months Smile Treatment, or whatever it is going to be, is $4500.' 

Now, all of a sudden, they patient is going 'Wow, that's expensive'. Mary has got the phone ringing, she has three patients waiting at the desk and she has now got to deal with the client's objection. Mary wasn't even in the surgery, so she hasn't got a clue what is going on. Patient leaves and whole thing is ... The butter has been dropped. 

Ideally, you want the dentist or the doctor to be able to discuss fees in the surgery so the patient knows exactly what is going on, what the fees are and if they are happy to go ahead then you got closure, or you got the commitment step, to move to the next level, all in a very ethical way.

To answer your question, which is a great question, yes, I personally believe that doctors should be able to discuss money, the alternative is, unless there is a brilliant treatment coordinator who is maybe sitting in the room at the same time as the doctor, who can then take the patient to a different room and discuss finance, then that would be acceptable as well.

Howard: Ashley, how do the other non-dentists contribute to success and sales? Do other things contribute to a higher closure rate, like a world class patient journey? Do other things contribute to this?

Ashley: There was a dentist who came on my program and what he did was he researched a patient that he had coming in half past eight the next day. He found out the guy was a professional speaker from an email he got. He watched the YouTube channels, he watched the videos that he produced, and when the patient came in the next day, the first 15 minutes of the conversation was all about him being a professional speaker and how impressed he was with the videos and impressed with the YouTube channels. 45 minutes later, a $12,000 treatment plan was accepted and agreed.

Closing is important, but unless you got the foundations right of the preparation, the building rapport and all of that, you will never get there, so most patients are making their mind up within the first few minutes. How you connect and build that relationship with a patient is absolutely vital.

Howard: What was ... There was a book 'Don't Wait For The Tooth Fairy', right?

Ashley: Yeah.

Howard: What was the essence of the book then? What was the takeaway?

Ashley: The book ... I wrote the book about seven years ago and the book is basically the book of the course, so I go through all the 8 steps from how to take an inquiry on the telephone to how the whole patient journey, the whole consultation right through the close, the followup, and how to ask for a referral. The book is everything that we do on the two day course, so if you were to say 'What is the manual of the course, then 'Don't Wait For The Tooth Fairy' is that manual.

Howard: Where do they buy that? Is it available on Amazon. Com or should they go to Where would you prefer they buy it?

Ashley: It is available on Amazon, or if they come on my website,, you can buy the three books there and if you get the books, you come on my website, I'll sign them and make them special and we will send you some free goodies at the same time as well. We will send you a free DVD and some other bits and pieces that will help you as well.

Howard: What are the three books?

Ashley: The three books we got on the website are: 'Don't Wait For The Tooth Fairy: How To Communicate Effectively And Create The Perfect Patient Journey in Your Dental Practice'. The other book, written about 18 months ago, is called 'You Are Worth It: How To Discuss Your Fees With Confidence and Achieve the Income Your Services Deserve' and that really all about how to discuss money, how to charge right for what you to do and to make sure you don't undercharge. It is how to feel comfortable about how to discuss the fees and the other book there is the 'Dental Masters'.

It is about 12 of us in the United Kingdom, some business coaches, and we all put a couple of chapters in the book together, so it is really about what ... It is like the dental experts, so we got that book there as well, so you can get all three books from my website.

Howard: You know what my fantasy is? You are a legend on the other side of the pond and we put up 350 courses on Dental Town, and they have been viewed over a half a million times. I wish you would do a course where if they signed up for your online ezine course for an hour, part of the fee, they got your three books or whatever, but you are not a townie and you haven't put online zine, I would love to turn 205,000 American dentists onto Ashley Latter. I think you would do so much good for industry and Americans love ... They love to hear something fresh from the other side of the world. 

Ashley: Yeah.

Howard: From England or Australia or Canada. Would you ever consider that? Doing [crosstalk 00:23:07]

Ashley: I would love to do this. We have delivered ... I don't know, in the last three years I have come over to the States about 8, 9, times now and they have been some of the best programs I have delivered and they have been the most receptive as well. I love coming to the States, it is just a real buzz. I know you guys like coming over to the UK, but we just get a buzz coming over to your place as well, so I would love to do ... We can do an hour workshop over on the Skype, we we can do [inaudible 00:23:35] Love to do it, would be more than happy to do it, so we can totally make that happen. 

Howard: Yeah, I would absolutely love that. If someone ... Where would you begin? What is some low hanging fruit necessities when the person is answering the phone? The dentist is back there and they just want to do their root canal, they want to do their crown, what should the dentist be thinking about when somebody is answering the phone. They will hire a receptionist and the dentist will say 'I wonder if she is any good, let's put her up front and we will just start with her answering the phone', as if that is the least important job. 'Instead of sweeping or vacuuming, we will just have her start at the front and just answer phones and hopefully she will work out.'

I think it is very important to answer the phone. What should the dentist be thinking about as far as when somebody is up there answering the phone? That is the first contact with the office.

Ashley: Yeah, I could talk to you about three hours on this, but let me give you the [inaudible 00:24:29] 

First thing you got to do is this ... And if you are doctor just doing one, two things will significantly increase your ... More patients coming through your door.

The first thing you do is this: You got to be record the calls. You got to be seeing what the girls are saying at the desk. I was with a practice, I did some training with them about a month a go, it is a practice on Harley Street. On Harley Street, there is about 150 dental practices. It is the main street in London for health, and I listened to 24, 25, phone calls. You could not make it up how bad it was.

You see, what happens is the receptionist were talking about the treatment and not trying to get the patient through the door. You have to record the calls, you have to be able to see what the receptionist is saying and what they should be saying and what they shouldn't be saying, but if you did this one besides that, if you did this one thing, you will see more patients come through the door. 

You got to answer the telephone to new inquiries away from the desk. It as to be an inquiry room, it has to be in a place where a life changing conversation can take place and that is not at the desk when there are sixteen other things going on at once. That is the main thing that you got to do is record the calls. Obviously, train your receptionists, because they can kill you. They may make or break whether a patient comes through the door or not. They decided the patient comes through the door or not, by the way they deal with the patient on the phone. 

If you nothing else but take the phone away from the desk, particularly to new inquiries, you will see a significant increase, because the bottom line is this: When a receptionist answers the telephone to a new inquiry at the desk, she has got 6 things going on at once, and whatever happens, she can't give that new inquiry, that new patient, a 100% attention because there is too much going on.

We did just that one thing alone, you will see more patients coming through your door.

Howard: What are the technicalities of recording a call? Do you need a special phone? Is there a company that does it in the UK and the United States? Can you talk about the logistics of how you actually record phone calls?

Ashley: Good question. I don't know specifically, but I am certain there are companies in America and in the UK that specialize in this. If you went to your local ... The company you register with your telephone, or the other companies as well. 

The company that we ... We use a company ourselves called It is a UK based company. They might be able to do that. They actually ... Here is another thing as well. Here is another quick tip, because I am big on giving people value at all times, is answer your telephone after work hours. 

Doesn't actually have to be you that answers the phone, you could delegate that to a third party company. If you think about it, Howard, now most people, most clients, are searching the web at nighttime, between 8 and 10 o'clock at night. If your dental practice, or practice, say 'We are open 24 hours, 7 days a week, call us', and then the person rings they don't get an answering machine, they get someone human. Again, you are going to create more opportunities for more patients to come through your door, so get your telephone answered after hours, even if its from a third party company who can just take a name, number and a message. The next day someone can ring that patient back and you will see a significant increase in more patients coming through your door. So there's a couple of quick tips. 

Find a company, there will be local companies in the States. This company that we use here in the UK is called

Howard: How often should the dentists listen to these calls and when he or she listens to the calls, do you listen to them with the person answering or do you do that outside or ... ?

Ashley: It's not easy, it's not easy, but unless you do it together, the receptionist is never going to change what she does. It was a great help for me to listen to 24 telephone calls beforehand. When I delivered the material, I asked permission at the start of the day 'We go through the material, we go through the program, we will coach and we will train you, but at the end of they day we listen to the ones you have done so far before the course.

Now, it was brilliant and they were so open and honest and when they heard them, they realized at the end of the day what was going on and what they weren't or shouldn't have been doing. Yes, you could have a ... It is not easy, particularly for the receptionist as it could be embarrassing for them, but if you get that permission and you explain to them that 'We are only doing this to become better at what we do and we want to train you to become the best at what you do' and that bought into it, then yes, absolutely you ought to enlist into the course together.

Howard: Don't you think, just the psychology of a human, don't you think just the fact that all of your receptionists are being recorded, make them raise their bar?

Ashley: Of course it does. Yeah, especially if they are involved in it. The receptionists are normally the people that are the least trained, as you mentioned before, but they are the most important people within the practice, because they make the appointment, they greet the patients when they walk through the door, and, in oftencase, they are they person at the end of the appointment, the consultation, where they take over, so they are absolutely key to it. You really need to invest and train these people, because if you think about it, every single ... I am looking at the UK here.

If a patient just contacts your practice, the average new patient must be worth at least $3000 to $5000, $7000 dollars on average. They have to be. If they become a member of your practice and stick around for five years, even if they didn't spend any money on dental treatment, they most likely spend $3000, $4000, $5000 with you. 

Howard: What do you think are things that from a patients perspective, make it appear a world class journey? I know that dentists, like myself, is thinking 'My gosh, I found four canals in this patient, not three. This patient must know that I do the best root canals in the world', in reality, the patient does not know what an extra canal is, they don't know what a lateral canal is, they don't know anything about what we are actually doing, what do you think the patient is grading us on? What do you think makes the patient say 'Wow, going to Ashley's office, that was a world class journey'?

Ashley: We have a discussion on part of the of the course. Did that today. What is do is get the practices into teams and I say to them 'Okay, we are going to spend 5-10 minutes on this, but write down everything that your patient can judge when the come into your practice or make contact with you when they come in.'

Between them, we ran them all up in the board and said, 'Look at it. If you think about it, they can judge absolutely everything about your practice, but the one thing they can't judge is the dental treatment they just had. They can't judge that. I can't judge how good my car service is, but what I can judge is did the receptionist smile at me? Did she make me a nice cup of coffee? Is the environment clean? Does it smell nice? Does it look the part? Do all the staff look happy, are they all joking among themselves? Is a great environment, is if fun there? Does it smell nice? Is the journey, the welcome ... Did the dentist or doctor spend a lot of time building great rapport with me? When I went to the toilet, did it look great? The list goes on and on and on. 

All those are things that people can judge and you got to get those right, I often say to them. 'When they leave today, we have practices who make a long list of things that they are going to change. They can judge the pictures on the wall all those sort of things. The problem is sometimes, is that we as ... I got my own training center in Manchester. I've got a couple of tiles that are stained, but live with that, I see that everyday and yet sometimes you need someone to come in and say 'Ashley, you got to go and change those two tiles, they look a bit dirty', but I live with it. I notice it everyday, but yet I don't seem to do anything about it. 

In short, get your whole team together, have a morning huddle and decide and everything, discuss and say 'Okay, what can the patient judge and where do we need to improve what we do, to make it a world class journey?'

You want to get your whole team doing this, because you get little Nancy and Rebecca, they will give you the ideas, I want you get the ideas, then we will run with it and make it happen. If I go in and tell them, they don't want to do anything about it, so you got to get your whole team onboard, but are right. They judge absolutely everything, but they can't judge the dentistry.

Howard: Here is the most important question I have to ask you, because you are an expert in seeing this relationship form the patient perspective and from the dentist perspective. This dental student in America is coming out $350,000 in student loans. They go buy a practice, it is going to be another $400,000 or $500,000. They are told that if they don't buy a $150,000 CAD cam machine to make 1 hour crowns, or a $75,000 laser or a $100,000 3D X Ray machine, that the patient won't think they are high tech and they have to buy another $300,000 worth of equipment to impress the patient. 

Do you think patients are impressed by CAD cam, lasers, 3D X-Ray machines? Is that part of a world class patient experience?

Ashley: (pause)

Howard: Did I just get you into trouble? Was that to controversial of a question?

Ashley: (laughs) I think I need a couple of beers with you at the bar to discuss that one. Do they really care? Have you ever, ever, ever had the conversation ... Have you ever heard conversation where four women are discussing the doctor's suet machine and how good it was? Not really. 

I had a dentist rung me up last night. She was just qualified, she just left university, she has been practicing for a year and she has been told by her boss to 'I've got to do my course', and I spoke to her for about 20 minutes, and rang her up and we discussed it. She has done all the courses, she has done the author courses, she has bought all the kit, and it is still in the bloody box, because she can't communicate effectively and get patients brought into her.

Get that bit right and all of the toys and stuff will follow. If you can't communicate what you do, you will never ever be making CEREC crowns and stuff and I think sometimes ... I will tell you a very, very quick story.

I was speaking at a the British Implant Conference this year and I gave a presentation, this doctor came up to me. He spent 20 minutes telling me all about his issues, about his problems, how he has done the courses, he has bought the kit and how he has only placed about four implants all year, and yet he has had a couple of dozen consultations and he has got the kit and he as got the stuff and now as I am speaking to him, a doctor friend of mine, he has taken the course seven times, he is begging this guy to take my course, he places 500 implants a year, he said 'You won't spend your money better, please do it', my client goes away, this guy is speaking to me and he turns around and says 'Leave it with me, I am going to think about it and I might buy your book'.

He goes to the next table and spends 2,500 pound or nearly $4,000 on more kit. What is he going to do with that kit? What is he going to do with all of those toys? If he can't communicate and get patients on board, they are just going to stay in the box again. Yes, all of these toys help and everything else, but if you can't get your patients buying into what you offer them, then you will never your suet machine, you will never use all of this fancy equipment anyway.

That is my view on it.

Howard: Let me ask you this: You have done this for two decades for some of the most elite dentists in the world, if you took 100 of your most elite dentists that you have known over the years, and 100 of your most non-elite dentists, are the elite dentists more likely to have a Cerec, a laser or a 3D X-Ray machine, or not?

Ashley: Possibly, yes.

Howard: Pardon?

Ashley: Yeah, probably. Yeah, because they have been able to afford to buy it. 

Howard: If they do what you do, the patient will have help, they will have money, they will sell treatment, then they will have money to afford to learn how to place implants or same day crowns?

Ashley: Correct. 

Howard: The horse comes before the cart and you are the horse and the technology is the cart.

Ashley: Correct. I just bought a training center, I bought me own center three years ago. It has taken me three years to kit that whole place out, we just put new flooring, new tables, new videos and everything else. It didn't happen straight away, I had to have people taking on my courses, so all the other kit and all of the other stuff could follow. 

Now it is ready, not we are there, but I could not have done it three years ago without being good at marketing, being good at selling and delivering brilliant courses. Of course it is important to have these technical toys. I am not dismissing it, please don't think it, but sometimes there is no point in buying all of the stuff if you can't use it or the kit, because you can't communicate what you do to clients, convince them to take onboard what you do and that is my view on it. 

Howard: Yeah, I have to agree. I have the $150,000 Cerec, I have the $100,000 CBCT from [inaudible 00:39:01], I have all of those lasers and toys, but I just think that the million dollar practice I know, they are not more ore less likely to have any of that stuff, they get the human, the sells, the communication. The reason they are a million to $4 million dollar a year practice, is they get the people side right, not the technology right side, and there is a gazillion people who buy all the high expensive toys who can't even make the payments on it.

Ashley: Correct, correct.

Howard: The toys aren't going to save you, the people. It is the people, you got to nail the people and that is my number one complaint for me for 20 years. They don't want to talk about the soft stuff, they don't want to talk about that stuff, they want to go right to how to place implants.

Tell about the implant, is that ... You mentioned placing implants, short term ortho, CAD cam, are any of these taking off more or faster on your side of the pond? 

Ashley: Absolutely. Oh, God yes. I know we would say we are a little bit behind you in terms of implants. Implant treatment has absolutely taken off in a big, big, big way. Most definitely.

We have had some of the most top implant specialists in the United Kingdom take my courses and the short term ortho course has really taken off. We have got ... I speak at a number of these courses and there have been one every weekend in the fall. Absolutely taken off. Cosmetic treatment has really taken off in the UK.

Howard: When I got out of school in '87, what percent of the dentistry were done by the NHS versus 28 years later in 2015? What do ... You said that it was 55% of dentistry in the UK was done by the NHS, how much was it when I got out of school in '87?

Ashley: Oh, God. It would have been probably something like 95% to 5% probably. Maybe even more, with the National Health Services.

Howard: What is your prediction 10, 20 years on? Do you think that the NHS will continue to decline, or do you think it is a cycle and it will come back?

Ashley: It is going to decline. The bottom line is we have got the same problems as you got in the United States. We have got financial problems still, we are still in a period of austerity and I think it could be with us for a long time. 

I think the problem with the National Health Service ... It is a brilliant institution, I am a massive fan of it, but it tries to do too much and it can't do everything. What is happening is that the contracts are getting cut and cut and cut and dentists have been asked to do more for less. There is a breaking point and I think what is happening is a lot of dentists are now really getting to the stage where they are really getting fed up now and more and more are going private.

If you were to say ... If I had a magic ball and 'What would it look like in 20 years?' I would say 'That private will significantly increase. I think we will get to the stage where more people are paying on a monthly basis and I think National Health Service ... I think it will still be there, but I definitely think it will be playing a lesser role in the United Kingdom. Definitely.

Howard: Another question I want to ask you: You have lectured in dozens of countries, is the business of dentistry pretty much the same in all countries? I know clinical dentistry, it doesn't matter if the dentist is doing a root canal if Egypt or Jordan or Syria, everybody is chasing the same parameters of quality from the science of it. 

Math is math, it doesn't matter if you are Egyptian or Syrian or Jordan, but what about the business dentistry? Does it vary much, do some countries ... Is there much variances in how the business of dentistry is delivered so you can say 'Okay, these are best practices, these countries do these better, and these countries do these worst'. Are there best practices variances that you see?

Ashley: I think there's variances in the country, depending on which part of the country. If you went to London, I think dentistry in London, where it is obviously a lot more competitive and a lot more cutthroat, will be completely different to how it is done in the north of England, so I think there are variances that way.

What I do find, is even when I come to the states ... And it is interesting, because a lot of English tend to ask me this, or the UK tends to ask me, but the American dentists have exactly the same challenges in they way they communicate to their patients as they do in the UK.

There isn't much difference in that respect in the way they communicate, they all of have the have the same challenges, they call talk too technical, they're all not good at discussing fees, they're all not good at building that relationship, because they weren't taught those skills at dentistry school, so it is pretty much universal right across the world, but I would say in certain parts of each country, I would say the business of dentistry is more prevalent, depending on which parts you visit and which parts of the country. 

Howard: Interesting. Then give a review ... Tell us I am going to bring you to Phoenix, Arizona, I am going to put you in the Talking Stick Casino, you are going to give your two day course. Tell them what that is going to be like for two days. 

Ashley: Well, we are going to ... I am going to present a program to you where we are going to take you through an 8 step approach where we will develop your communication skills and your team's communication skills, so that you can build amazing relationships with your patients, you will be able to ask brilliant questions to create more opportunities for you, both with new and existing patients. You will be able to present it in a way that excites patients, you should be able to discuss fees with more confidence, you should be able to have more patients saying yes in a very, very, very ethical way and you will have these patients going a way handing your referral cards out and they will bring new patients to your door. 

We are going to do that in a very ethical way. We are going to coach you, we are going to change your behavior, we are going to have an absolute lot of fun. One minute you are going to be laughing so much you are going to break your ribs and the next minute you are going to be practicing treatment plans and conversing in a way that you have never conversed before. 

You can expect fun, you can expect to be stretched, you can expect it very motivational, but you can be expecting to have a lot of laughter along the way. That is what you can expect in 18 to 20 hours of working with me.

Howard: That will be a 2 day course?

Ashley: Yeah.

Howard: Do you like Friday, Saturday or Saturday, Sunday? What do you prefer?

Ashley: I don't mind ... If I am coming over to the States, it makes no difference to me. I think a Friday, Saturday works well. I know you guys ...

Howard: Sorry?

Ashley: You honor your Sundays, so ....

Howard: What will the name of this course be? Don't Wait For the Tooth Fairy?

Ashley: It will be the Ethical Sales and Communication course.

Howard: Can we bill it as ... Do you remember the British Music Invasion of the '70s where every single song you heard on the radio all had one thing in common. When I grew up as a kid ... If you were a rocking hot band, it only came from your country. What was in the water back then in the '70s? How did you guys create every rock band that ever ... How did that even happen?

Ashley: Do you know what that is? Do you know what that is Howard? To be honest, I'm biased, I live in Manchester and I think we produce the best rock bands in the world. I think we have done for the last 10, 15 years. Certainly in the United Kingdom.

I think it is so bloody miserable here, so we don't spend a lot of time outside, so I think we got it beat being inside and making music. That is my view on it, especially when you live in Manchester, where it rains for about 260 days a year, so we are pretty good about doing things inside.

Howard: You know what my theory was and when I was walking the streets of London with my boys and we all came to the same conclusion?

My theory is that the British Rock Invasion came because most countries you go to all the people are the same. You go to Japan, they are all Japanese, you go to Poland, they are all Polish. Most countries are all the same, but due to the British Empire, when you walk down London, unlike any other street in the world, I mean every other person is from a different country, you hear different languages and I think it was just all the world had representation in one city, so they had all the flavors in food cooking and music.

Do you think that had any effect on it? The British Empire?

Ashley: Probably. If you go into most UK cities now, it is very multinational and you will see ... It was interesting, I was walking in the park here the other day in Manchester and it was amazing just to see. It must have been about 20, 30, different nationalities walking around in three hours. Possibly, and it is still like that today, so could be part of it, but I just think we are ... I think the British have always been creative people. I think that is what we have always been good at, is creating and leading and innovation.

I think music is definitely a part of that, particularly where I live in Manchester. We have had bands like Geordie Vision and New Order and Oasis, Stone Roses. We have led the world in producing music. The northwest of England has been like that with the Beatles as well.

Howard: Did the Queen ever lift the ban on Oasis playing in London? Wasn't he banned for awhile for major stadiums?

Ashley: I don't know, to be honest. [crosstalk 00:48:32] j

Howard: Yeah, who knows the tabloids, if they are true or not. I want to tell you that I know you are a busy man, I know that you got to run to a soccer game. I definitely want to bring you down to Phoenix, Arizona, we love putting on courses. 

You said limit it to 50? Or 40, did you say? Did you say 40 or 50?

Ashley: We can get 40 to 50. If we get 40, we will have an absolute ball.

Howard: Okay, we will limit that to 40, so you guys listening, you got to ... Better send them now, because it will sell out before I even announce it, but Ashley I called you, you didn't call me. I am a big fan of you, all my friends and back on your side of the pond talk the world of you. You really are a legend. I really hope .... Dentaltown has 205,000 dentists and they posted 4 million times. 

If you put a course of there, it would really turn on a lot of my American homies to all that you know and I want to turn them on to you, because I think they will be happier and healthier if they deal with all these issues ... Get rid of all the big mistakes and communications and discuss fees and I think you are good for dentists, you are good for dentistry and thank you so much for spending an hour with me today.

Ashley: You're welcome. Thanks very much, it has been a privilege. Nice meeting you.

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