Dentistry Uncensored with Howard Farran
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385 Taking Care of Business with Andre Shirdan : Dentistry Uncensored with Howard Farran

385 Taking Care of Business with Andre Shirdan : Dentistry Uncensored with Howard Farran

5/5/2016 5:57:57 AM   |   Comments: 0   |   Views: 337

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AUDIO - DUwHF #385 - Andre Shirdan


Andre is an author, inspirational/motivational speaker, certified software trainer, CAD/CAM/CBCT training professional and National Speaker. He was the founder of Systems Practice Management, a dental practice management, training and consulting firm. Creator of the CREW team-building and training process, a contributing creator of the companies DentaLife, Dynamic Dental Systems and HMS and co-author of the periodontal protocol Stat-Ck.

Howard Farran:

It is a huge honor for me today to be podcast interviewing one of my idols. I’ve been following you for years. Andre Shirdan. Andre is an author, inspirational/motivational speaker, certified software trainer, CAD/CAM/CBCT trainer, professional and national speaker. He’s been interviewed in RDH Magazine, The Passionate Dentist Podcast, been published in Dentistry Today, The Outlook & Bulletin and has interacted with thousands of dental professionals.

 

 

He was the founder of Systems Practice Management, a dental practice management, training and consulting firm. Creator of the CREW team-building and training process, a contributing creator of the companies DentaLife, Dynamic Dental Systems and HMS, and co-author of the periodontal protocol Stat-Ck. Gosh, where do we even want to begin today? What do you want to talk about today Andre?

 

Andre Shirdan:

Well, one of the things I want to talk about was the Stat-Ck program. A lot of what I do is going around the country, helping offices with implementation of technology. Inevitably, we get to the point where we’re working with hygiene and making hygiene better. It seems to be the weak point of a lot offices. A lot of times, that is really about the periodontal protocols that are in the office. Everybody has a perio protocol. I think I Googled it a few months ago when there were about 509 results when you do perio protocol as a search. Everybody’s got one, but there’s no consistency. That’s what I’ve been working with a lot of offices with Stat-Ck on.

 

Howard Farran:

What is the www on that?

 

Andre Shirdan:

Well, there is www.stat-ck.com. That allows you to get some information about the program, but it’s been published in Dentistry Today. It’s been on bunch of different places. One of the easiest ways to find out about it is shoot me email or hit me up on Facebook, and I can just actually send you the info on the program.

 

Howard Farran:

What is that email?

 

Andre Shirdan:

My email is andresyst@comcast.net.

 

Howard Farran:

Syst as in the beginning of system?

 

Andre Shirdan:

Exactly.

 

Howard Farran:

How come you didn’t just add the EM on that? You just …

 

Andre Shirdan:

I got lazy a year ago. Hey, I see a tail in the background. You’ve got a friend with you.

 

Howard Farran:

My cat. I have two cats and they could never figure out why I’m staring at the computer and not talking. Oh my gosh [crosstalk 00:02:36].

 

Andre Shirdan:

That’s my partner in crime right there. That’s Spaz.

 

Howard Farran:

Spaz? S-P-A-Z?

 

Andre Shirdan:

There you go.

 

Howard Farran:

Right on.

 

Andre Shirdan:

Everything with me is a four-letter word, just like in your world.

 

Howard Farran:

I found out that the only woman that can live with me is a cat.

 

Andre Shirdan:

There you go. Well, he’s a boy. He likes hanging out with me in the office.

 

Howard Farran:

Right on. That’s in Media, Pennsylvania.

 

Andre Shirdan:

Yeah. We’re just south of Philadelphia.

 

Howard Farran:

Okay.

 

Andre Shirdan:

Yeah. We’ve been here for a long time. This is my 27th year in dentistry. I’ve been enjoying what I do. I work with about a small percentage of people, because what I do is really specialized. I go after that small chunk of people, who are just looking to work on the small things that are missing. I’ll give you a perfect example. You talk about the three parts in your book and a lot of business. We talk about people, process and profit. What I work on, it’s the fourth P that nobody ever talks about, which is philosophy.

 

Howard Farran:

Nice.

 

Andre Shirdan:

That’s what I work on-

 

Howard Farran:

You said people, process …

 

Andre Shirdan:

Profit or product. Some people use the word ‘product’ instead of profit. I work with that philosophy end of things. That’s what Stat-Ck does. Instead of concentrating on protocol like, “How am I going to see the patient?” I’m not a clinician, so, “How do I scale? How do is disrupt biofilm?” What I like to work on is, “What’s the philosophy of the office? What defines class one, class two, class three perio?” Stat-Ck actually makes it a lot easier, because we use letter grades. We take those types. What we found is that if we change the language, we can get our patients to accept care better. I go back to four-letter words. I use the word ‘sell’ a lot, but I’m from a sales background. I use the word ‘sell’ to mean ‘Seeking Equal Listening and Learning.’ That to me is a much better process. If we can get on the same page with our language and our listening skills, then we can get patients to move forward with periodontal care a lot easier.

 

Howard Farran:

Sell, S-E-L-L; Seeking Equal …

 

Andre Shirdan:

Listening and Learning.

 

Howard Farran:

Listening and Learning. That’s nice.

 

Andre Shirdan:

Yeah. Again, my background before dentistry was selling really high-end retail clothing. I sold 10,000-dollar ball gowns. I fell into this business, because my brother-in-law was a dentist. The minute I got into dentistry, I’ve never left.

 

Howard Farran:

These are worth $10,000 dresses?

 

Andre Shirdan:

$10,000 dresses. I work for the e-seller on Couture Boutique.

 

Howard Farran:

You should’ve kept all their names and created a do-not-call list for men seeking women.

 

Andre Shirdan:

I agree. I think I paid for a lot of really wealthy men in the world. The way that language works is try to stay as far inside of dentistry as I can and outside of dentistry. I use all the things that I learn outside of dental world in dental world, like that selling technique. When I started, like most front desk people, because I worked at the front desk. Most front desk people were thrown at the front desk and told to learn something. I was given your tapes, the 30-day MBA. I was given a big, giant book on perio disease. I was told, “Hey, just learn this stuff. Suck it in and then you’re going to work at my front desk.”

 

Howard Farran:

You didn’t get to the 30th day. I don’t think anybody on earth got to the 30th day.

 

Andre Shirdan:

Now, I think the VCR broke before I got to the end.

 

Howard Farran:

By the way, I put all those up on iTunes and YouTube for free. It’s a separate channel. Just Doctor’s Farran’s 30-day Dental MBA. A lot of the dental students … It’s amazing. They’re the hottest in Japan and Asia.

 

Andre Shirdan:

It’s phenomenal information. It’s the backbone for what I learned. Your MBA program, I picked up Tom Limoli’s book on periodontal disease and charting and coding. I picked up a bunch of things like that. Actually, one of the first books that I was given was a textbook that my brother-in-law had. The first page, I think, the lining notes had a phrase, and it was something like, “Don’t treat the patient as a whole,” or, “Do treat the patient as whole,” W-H-O-L-E actually, “and knock them out a hole,” H-O-L-E. That was one of the first things I learned. That’s my path down this road.

 

Howard Farran:

Okay. I know my homies. They’re all driving to work right now, and they’re listening to you and they’re saying, “There’s nothing wrong in my perio program.” You only know what you don’t know. Paint a picture, red flag. Try to get into their walnut brain of what could possibly run [inaudible 00:07:36] because they like the hygienist. She sees them on time. They’re busy. What is wrong with her hygienist?

 

Andre Shirdan:

Well, there’s nothing with her hygienist. There’s nothing wrong with her program.

 

Howard Farran:

I mean their hygiene program. Yeah.

 

Andre Shirdan:

What’s wrong is the disconnect between the patient and the clinician. That part of the process where it’s … Okay. I’ll give you an example. You use this really well. Do I have brushing cavities, or do I have flossing cavities? Now, I understand why I have a filling that I need to have done. A patient understands differently than the clinician. The Stat-Ck program, it’s the using class one, class two, type one, type two perio. We use letter grades. Is the periodontal condition asymptomatic; A? Is it bleeding;B? Is there subgingival calculus? That’s C. Is there depth or disease? That’s D. Is it failing? That’s an F.

 

 

If we can talk about that based on quads, the way we’re going to treat them, we can divide the mouth up and say, “Hey, Howard, on the right side, you’re doing really well. You’ve bot B’s in the upper and then B on the lower. Bleeding, we can take care of them. We can work together for that. On the upper left side, there’s a C. We need to get a little more aggressive with that. On the lower, there’s a D and we might need to be a little more aggressive and maybe treat you with some specific anti-infectives or something like that. Once we come up with a language where it’s a commonality, we can have patients accept care better. Like I said, it’s not the perio protocols. It’s not the getting them in, we’ll get them in three months, four months, six months. It’s getting them to accept care.

 

 

That’s where I see the breakdown. That happens across the board with either you have one hygienist who’s into perio, and one hygienist who’s not. We have a doctor who walks in the room and says, “Ah, patient looks great,” but they’re bleeding buckets. That’s what happens with the disconnect. Most people have very good hygienist and very good programs, but then patients don’t accept or somebody at the front desk says, “Well, they don’t cover it, so we’re not going to get it done.” A lot of it is just the disconnect in the listening-

 

Howard Farran:

When they blame it on the third party, it’s amazing when you go to Asia and Africa. I just got back from four countries in Asia and a country in Africa. It’s amazing how poor women come up with the money for Invisalign orthodontics. They got their iPhone and their Invisalign trace in, and they’re supposed to be in a poor country.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

No third party paid for it.

 

Andre Shirdan:

I agree. Yeah, I agree.

 

Howard Farran:

If a human wants anything, I don’t care if it’s drugs or an iPhone, they’re going to get it.

 

Andre Shirdan:

I agree 300%. Again, I worked on an environment where I had customers coming in buying three, 400-dollar shoes at that time or 10,000-dollar ball gowns. These were just wealthy. These were people, who wanted the product and could afford to buy the product. I use the example, there are lots of really nice cars in some really bad neighborhoods. People spend on what they’re going to want to spend on. They also spend for things that they understand. That’s why Invisalign has taken off. So many people understand it.

 

Howard Farran:

That’s true too. I practice across the street from the Guadalupe Renovation. You know an area is poor when there’s $25,000 Catholics living in there and there’s no church for the catholic priest there. It’s just a Catholic nun. You know it’s really poor.

 

Andre Shirdan:

I know.

 

Howard Farran:

There’s not even priest in there. Most of the homes, well not most, but I’d say over half the ones I’ve been into have a dirt floor.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

The son has a 30,000-dollar purple Lowrider parked right in front of it.

 

Andre Shirdan:

I agree.

 

Howard Farran:

He’s sleeping on a dirt floor.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

It’s amazing.

 

Andre Shirdan:

Yeah. One of the things I used in a presentation I do, I do a presentation called, “A Disney Dental,” where I use the example of Disney ever built a dental practice and put it across the street from your practice. Would it scare you to death? Would they start taking your patients? People go to Disney, wind up spending $15 on an ice cream sandwich and don’t blink. You can get that same effect in your practice. I did it in the practice I worked in. We took every single PPO plan. We did all kinds of work. We had patients getting IV sedation. People were getting lots of work done, but they valued it based on the language that we used. That’s been a passion of mine for years.

 

Howard Farran:

It’s always been in the soft skills. What do you think of some of the consultants out there? Tom Orent talks a lot about your patient comes in for cleaning, exam, x-ray on a PPO, whatever, but you can upsell on a fluoride treatment, some of this big change. I’m pretty sure Hartland Dental does. They’re always suggesting … to adult fluorides, I mean.

 

Andre Shirdan:

Sure.

 

Howard Farran:

What do you think about that on? There’s a buzz about that? You agree? Disagree?

 

Andre Shirdan:

I think it’s a great thing. I think a lot of people and a lot of things I have seen recently, people are pushing the envelope with insurance. That’s a little scary, but I value the adult fluoride conversation. I think it just needs to be done in such a way that it fits in with again, philosophy of the practice, major concern. Does it meet the philosophy of the practice? Does the doctor agree? Do all the hygienist on the team ... sorry, on the crew agree? If so, then it should be something that is part of the protocol. It shouldn’t be an add-on that one hygienist does not than the other. If it’s the philosophy of the practice, I’m behind it 300%.

 

Howard Farran:

That’s what said about all the continued education. I’ve been to a gazillion courses. On the right hand of the room, it’s all single dentist that came by themselves.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Then the other side of the room, it’s all dental offices, where for every dentist, there’s the spouse, the hygienist, the receptionist. The whole team learns, and you just go down there and pull everybody’s PNL. The dentist have brought the whole team. They’re making almost twice as much net income as a dentist that always come alone. It’s a team sport, and they don’t get it.

 

Andre Shirdan:

Yeah. It’s interesting. I did a presentation a few weeks ago. I had an entire crew from office come, but the doctor didn’t come. The next week at a long phone conversation with the doctor asking if I could come back in and redo the entire seminar in his office, so that he could hear it. You missed that continuity of care when everybody’s not involved. What did he save? He really didn’t save anything by not being there? He just didn’t want to go that day. When I see an entire crew from a dental office at one of the presentations, they get it. They’re all charged up. They go back Monday morning and they’re ready to put it in place. They all are in the same page. That’s the most important part of what we do.

 

Howard Farran:

Tell everybody what you do. What do you do?

 

Andre Shirdan:

Well, I spend 99% of my time working with Patterson Dental helping them integrate a lot of the technologies in the Intel offices; software, CAD/CAM, digital x-ray. I do a lot of the speaking too. In my endings, on my weekends, I’m out speaking with dental societies, AADOM. I’ve done AADOM a few times. All kinds of dental groups like that, I spend time doing that. I spend a lot of time also coaching in offices.

 

 

I have a lot of doctors who call me. I’m a recovering consultant, if that’s a good way to put it. I’m on step 11 of a 12-step program. I’m no longer a consultant, but I do a lot of coaching. I still have offices that I worked with 20 years ago, who still call me couple times a month and just say, “Hey, I got an idea about this. How can you help me with me this idea?” I love just giving those kinds of phone calls. I spend a lot of time doing that.

 

Howard Farran:

Well, can we talk about things like maximum return investment? What’s got you excited where you see a dentist changes something, get something, does something different? The stock market’s got a lot of air out of the market in the last couple of months. I got MBA, the average recessions about every eight years. Believe it or not, it’s been eight years since the last one. A lot of people are nervous, scared. They think their practice [inaudible 00:16:02]. What do you think can spice up an office as a bottom line?

 

Andre Shirdan:

Well, the number one thing to change in office right now is your hygiene program, the easy one. Any practice management software should be able to generate this report. If they just run a report for the number of exams they did in the last 12 months, so tell me the number of periodic exams, D0120 and-

 

Howard Farran:

D0120.

 

Andre Shirdan:

D0120s and the D0150s. That’s obviously a D0120 and a D0150 for the last 12 months. Run that number. Let’s just say for-

 

Howard Farran:

The D0120 is an exam. D0150 is what?

 

Andre Shirdan:

Is also an exam. The periodic is the 120, and the comprehensive is the 150.

 

Howard Farran:

Okay.

 

Andre Shirdan:

They run two exams. They can tell how many exams they did in the last 12 months.

 

Howard Farran:

Okay.

 

Andre Shirdan:

Then, what they want to do is run the number of adult pro fees they did in the same period; D1110.

 

Howard Farran:

D0110.

 

Andre Shirdan:

No, just D1110.

 

Howard Farran:

D1110. Okay.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

That’s a pro fee.

 

Andre Shirdan:

That’s an adult pro fee. Now, if they divide the number pro fee they did into the number of exams they did, that gives you a percentage of the patients who are having pro fees. If that number, which … I’ve been in probably 5,000 practices in my 27 years. I do that almost every office I go in. Typically, it’s about 85%.

 

Howard Farran:

85% of the people who had an exam had a pro fee?

 

Andre Shirdan:

Yeah. The scary part is the ADA says, “Statistically, 80% of the patients in the US have periodontal disease.” Now, they count gingivitis. Okay, we’ll go with that. The CDC says, “There’s 50% of the patients in America have periodontal disease,” because they don’t count gingivitis.

 

Howard Farran:

ADA says what percent?

 

Andre Shirdan:

80%.

 

Howard Farran:

80%, they count gingivitis. The CDC says, “50%.” The ADA is a trade group for dentist, so that’s why they’re exaggerating 30%.

 

Andre Shirdan:

I agree.

 

Howard Farran:

The CDC saying it’s 50%.

 

Andre Shirdan:

Because they don’t count gingivitis as periodontal disease. If you just look at that number, just so we can appease some people, let’s just say, “It’s 60% of your patients have periodontal disease.” If you want to be nice about it, let’s go with the CDC and say, “50%,” then you’re obviously doing either bloody pro fees, which we see all the time. If you’re sponging up the patient after they’re getting out of the chair, there’s a problem. They’re either doing bloody pro fees or they’re billing incorrectly. There’s one or the other.

 

 

If we can shift some of those patients, even if we say 10% of those patients to perio treatment, for one, you’re doing the right thing clinically, and for two, it’s going to boost the practice from a financial standpoint. There’s got to be a path that goes back to what I said, that fourth P that nobody uses; the philosophy issue. If you start with that philosophy issue, if we’re treating periodontal disease as a practice, then we’re at 50%, 60%, 70% or 80% of our patients being periodontally treatment.

 

Howard Farran:

Of adults?

 

Andre Shirdan:

Of adults. Again, you’re going to have a patient base of seven to 10%, who are either kids or Mrs. Jones, who is the denturist. We take that number out. Definitely, you’re going to see 50% of your patient should be in some continual periodontal care. I usually get that, “Well, our patients won’t accept that.” That goes back to what we’re talking about before. They’re not going to accept it if you’re going to say, “Periodontal therapy is not covered.” Well, it is covered. It may be covered differently, but it is covered in most insurance benefit programs.

 

 

We just have to find a language in order to be able to get that to happen. Like I said, that’s what the Stat-Ck program is. That’s what I keep mentioning crew. That’s what crew is all about, is getting everybody in the same page. For years, people have talked about teamwork and teams. You’re a sports guy. I’m not a sports person. Every time I think about a team, I could think of one person on the team. I’m from Philadelphia. I think about Allen Iverson, but you probably couldn’t mention anybody else who is on that team.

 

 

I use the example when I go in offices about, “If a team hits the lottery, we’re all leaving tomorrow. If you’re a crew, while you’re on the boat, you row.” When you’re off the boat, you could do whatever heck you want. When we’re on the boat, we need to all be rowing at the same pace with the same purpose in mind, with the same stroke, so that we’re all in the same page. That’s where I come from with perio. We all need to be on the same page. That’s why … Yeah. Go head.

 

Howard Farran:

Okay. The average office collects $765,000 a year, and that’s 175. You said seven to 10% are kids or denturist, is that what you said?

 

Andre Shirdan:

Yeah.

 

Howard Farran:

What would the numbers be for that D0120? What would be about the average number of exams and then the number average of pro fees?

 

Andre Shirdan:

Well, if you think about the typical pod office, so you talk about a doctor with two hygienist. That’s a typical pod in my language-

 

Howard Farran:

Is that about the typical office?

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Would you say the average office has two hygienists?

 

Andre Shirdan:

Yeah. If you’re talking about one full, two part-timers, it’s still about the same.

 

Howard Farran:

Okay.

 

Andre Shirdan:

The capacity on office like that is 1,600 patients. If you think about one patient an hour, eight hours a day, 50 weeks a year, that’s 1,600 patients. You’re asking your patients to come in twice a year, so that’s really the capacity of 800 patients per hygienist. Total, 1,600 patients, one doctor. If you think about that number, that’s about right. The key to that is, I look at it like the orange juice growers in Florida. When they squeeze an orange, they don’t just pinch it. They squeeze it and get all the juice out of it, then they grind the rinds up and sell it to somebody who makes orange juice extract.

 

 

Then they sell the seeds to Burpee or whoever. They get every bit of juice they can out of an orange. What we’re doing is we’re squeezing patients. Sorry. I put it that way, but I’m in sales, so that’s way it goes. We’re squeezing the orange, but we’re trenching by going pro fees and not doing adult fluoride, and not really looking at the patient as a whole. We’re just brushing their teeth and sending them on, which is a complete waste of time.

 

Howard Farran:

I think the only mission statement a dentist should ever had, I think every dentist should have this mission statement, “I want to create a dental office and I want my own children and grandchildren, and great grandchildren to go to.”

 

Andre Shirdan:

I agree.

 

Howard Farran:

Do you want your grandchildren drilled, filled and build with inlays, onlays root canals, crowns and implants? Or do you want all that stuff prevented?

 

Andre Shirdan:

Exactly.

 

Howard Farran:

The hygienist and the dentist is 65. They’re not 10% any Dentalist, 75, they’re not 20% of Dentalist. I can count on one hand how many dentists I know that personally got an implant.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Prevention is what makes you get excited, not ripping out all teeth and do a mini adventure.

 

Andre Shirdan:

I agree. I’ll give you a great example of a client, who’s taken that to another level. This is a guy I worked with 20 years ago. His patients were all on a six-week recall. That’s by choice, because what he did is he changed the language of dentistry. He doesn’t do pro fees for his active patients. He allows them to come in and have their teeth polished any time they want. The patients who call up on a Friday or Thursday and say, “Hey, I got a hot date tomorrow. Can I get my teeth polished?” Sure. Come on in. It’s 40 bucks or 50 bucks.

 

 

They pay in cash out of the pocket for something that we understand is just polishing their teeth. These are patients on record. They come in for their normal recall, revisits, but they can come in anytime they want to have their teeth polished. They’ve changed the language of dentistry. They actually think about dentistry more like a preventive measure, and they seek out. It’s amazing just like somebody might have Invisalign or whitening or something like that. They start to look at dentistry differently. They look at the office differently.

 

Howard Farran:

That is really cool. I also love that when you advertise teeth Whitening For Life.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

I love that. You got a patient in there every six months for recall. They pay to have their teeth bleached. The Whitening For Life, is that every time you come in for your cleaning, you get two more tubes of bleach.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Bring your trend, so made sure it fits and it’s all good and everything. Do you like that too?

 

Andre Shirdan:

I love it. It keeps us on top of it, so that when we do see something happening inside of the mouth, we can quickly fix it. We’re not talking about root canal, post or core crown, et cetera. It’s funny. Working in a dental office, at least once a month, we all shut down for a little while, so that we could have our dental work done. I see a lot of offices, who don’t take the time to do that. We just get so busy with what we do that we don’t do what we’re supposed to do.

 

Howard Farran:

Okay. Logistically, she’s driving to work and she’s saying, “Okay. I hear you. Man, I’m to pull up to work in 30 minutes, how do I get this change? How do I get my staff from A to B?”

 

Andre Shirdan:

Okay. Well, first thing, as somebody who teaches on a daily basis with office. One of the things is we have to slow down. I was at a care credit conference a little while back. One of the reps said, “Slow down and see the crowns.” I love that. I should get it on a t-shirt. We need to slow down. Starbucks shut down for a day. They lose $38 million in one day, because they shutdown to train their staff on how to pull an espresso, because they lose their focus. We need to slow down. We need to train our staffs. We need to get on the same page.

 

 

Somebody pulling up to their office, I would tell them, “Okay. If you have this idea, don’t throw it to your front desk person.” Don’t say, “Okay. Admin staff, this is what we’re going to do tomorrow.” Say, “We need to shut down two weeks from now and retool. We need to figure out a way to implement some of these ideas. We need an idea that we can put in a place that will stick.” If you don’t take the time to do it, everybody come in with this great idea that they’re going to do tomorrow. My brother-in-law would come, “Hey, tomorrow, we’re going to start doing Begg technique ortho.” Okay. What is that? Well, I just was at a conference. I’ll give you the paper work and you’ll learn how to do it. Now, we need to shut down and learn how to do it.

 

 

He came back with phase bows after he’d gone to Dawson, and said, “Okay. Tomorrow, I’m going to start doing these things.” You really need to take the time to learn how to do it before you implement it. I say, if you get an idea from this conversation we’re having, talk to your staff. Ask them what the coding’s going to be. Ask them how that’s going to impact some of the things that we do. Pick a timeline to get it implemented, and actually take the time to get it done. You can’t do it tomorrow morning, unless you expect it not to work. That’s the best way to make it fail is to throw it into the office.

 

Howard Farran:

If they email you, you’ll email them the perio plan?

 

Andre Shirdan:

Be glad to. I’ll give them anything they need.

 

Howard Farran:

Damn.

 

Andre Shirdan:

I’ll be glad to spend any time on the phone with them. I spent about 30 to 60,000 miles a year in the car. I’m loving the talk to doctors while I’m driving. It keeps me awake.

 

Howard Farran:

What’s your phone number?

 

Andre Shirdan:

My cell number is 484-437-5562.

 

Howard Farran:

You’re a huge poster. You got 500 posts on DentalTown.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Did you start to thread on that?

 

Andre Shirdan:

On which? On the Stat-Ck program?

 

Howard Farran:

Yeah.

 

Andre Shirdan:

Yeah, I did a while ago. Actually, I put out a challenge to see … Again, with normalizing perio, I’ve been to a bunch of the universities, and actually, was in talks with one of the universities about putting Stat-Ck into place, so that they could have across all of their teaching programs a normal way of diagnosing perio. I challenged DentalTown with this. As a patient, if I walk in and I just have eight teeth, or let’s just say, I have two through nine, one’s impacted. That’s all the teeth I have in my head.

 

Howard Farran:

Watch what I’m going to do. I’m sorry.

 

Andre Shirdan:

Okay.

 

Howard Farran:

I’m going to hit on the app on your column. Anyone have perio case type form? Is that the one? You posted that one too.

 

Andre Shirdan:

That may be. Yeah.

 

Howard Farran:

I’m going to hit ‘comment’ and then I’m going to hit on the app, then I hit ‘camera,’ and then hit ‘take new picture.’ We’ll go like this. Wave. Then I’ll hit ‘use photo.’ If you’re on DentalTown, it should be on today’s active patients.

 

Andre Shirdan:

Okay.

 

Howard Farran:

It’s the topic, “Anyone have perio case type form,” and then the other one said, “Anyone have a nice flowchart for perio protocol,” and then you talked about it then.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

All right. Okay.

 

Andre Shirdan:

It’s interesting. I actually met somebody on DentalTown, Karoline Biami. She’s the RDH down in Florida, who used to be a dentist in Brazil. She’s got a phenomenal perio protocol, flowchart. It works really well. Again, if patients don’t say, “Yes,” who cares if you got a protocol. There’s lot of Rolls-Royces sitting on a lot that people aren’t buying up every other day. There’s got to be a call to action to get them to do it. That’s why the PSR failed. Although it was a great program, not a lot of people bought into it.

 

Howard Farran:

Why do you think it is?

 

Andre Shirdan:

I think it used the language, again, that had nothing to do with patients. It had a lot to do with periodontal diagnosis, but if patients don’t understand it and patients don’t get it, then it’s pointless. We’ve all come back to the office on Monday morning with this great idea, but to actually get it to work, it’s a whole different story. There’s lots of CERECs sitting in somebody’s garage that they couldn’t get it to work, because the staff didn’t buy into it. In my hands, the machine didn’t work.

 

Howard Farran:

I thought that was intriguing. You said you do 99% of your work with Patterson.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

I said, “So then what do you want to talk about?” I just knew it was going to be the CEREC machine.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

You were right to perio.

 

Andre Shirdan:

Well, I love the CEREC machine. Just like you, I was back in the day of the CEREC 2. I remember doing it-

 

Howard Farran:

Dude, I was back to CEREC 1.

 

Andre Shirdan:

It’s making teeth with Legos.

 

Howard Farran:

I had the CEREC one.

 

Andre Shirdan:

Yeah. It was amazing tool for the guys who could do it. Like talking to Sam Puri on a regular basis and seeing what he does with the machine. It’s amazing, but at the same time, there’s a buy in that has to happen. There’s a language that has to happen. It changes the practice.

 

Howard Farran:

The thing people don’t realize about Sam Puri is that number one, he’s tall, dark, handsome, gorgeous, the ultimate people. When he comes into my office to train my staff on CEREC, my assistants are melting.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

That guy could probably sell my assistants to get a full mouth denture.

 

Andre Shirdan:

I agree. He’s probably going to do it for me too.

 

Howard Farran:

He gets an A plus on all the soft skills.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Then someone who doesn’t have the leadership skills, the soft skills, the selling skills, all is going to stop, and just want to buy a shiny object. They’re going to think they’re going to have the same results as Sam Puri. It’s like me buying a piano and expecting the results of Beethoven. You got to learn how to play the piano first. You got to learn how to play the people first.

 

Andre Shirdan:

I agree.

 

Howard Farran:

… the soft skill stuff. You got to get the people on board.

 

Andre Shirdan:

Yeah. It’s funny. I was watching a YouTube video. I was just clicking through some YouTube video. I was listening to some classical music. One of the links was to a concert that Liberace did. To see the way that this guy, not only paid the piano, but played the audience. You’re talking about selling, that is selling. The way he sold himself to the audience is what our doctors need to do in order to be able to get them to accept care.

 

Howard Farran:

My mom’s on Grandma Mary. She thought he was just the greatest entertainer in earth. Liberaci walked out then he’d say, “Do you like my gown? You paid for it. It was 100 gran.” They’d all clapped.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Oh god, he could play the people. He played the people better than the piano.

 

Andre Shirdan:

I agree. Like I said, I look outside of dentistry a lot. I spend a lot of time in high end clothing stores, in evening markets. Everything that I find there, I just used back in the dental office. I was talking to a friend who’s struggling with the idea of having an implant done. He said, “I really don’t want to have to go through all this. Then they told me that the implant wasn’t the crown.” I thought, “You know what? Here’s something that we keep missing. We keep using the language that is within our own field.” An implant as an example, maybe we should stop calling it that. Maybe we should start calling it an artificial root.

 

 

We do artificial limbs, we do replacement knees. Maybe we should stop calling it an implant. Implants imply a little something different that a little further below the neck that we work on typically. If we call it an artificial root that we didn’t put a crown on, I think patients understand that a little bit. They’re accepting a little bit more of the two-part procedure. I think the word, “Periodontal probing,” nobody wants to be probed. What we do is we measure the pocket with a periodontal ruler. If we change the language, we change the acceptance rate. A lot of it has to do with … we’re talking amongst our friends, but we’re using the language that is within our profession. We’ve got to look outside of our profession a lot on that.

 

Howard Farran:

Tell me if this is a minor problem, medium problem, large problem, because you’ve seen so many offices for so many years, you’d been doing this, what, three decades.

 

Andre Shirdan:

Almost, yeah.

 

Howard Farran:

Almost three decades. It seems like the dentist is an introvert, shy engineer, math professor type personality. He or she hires people just like that. It seems like if a hygienist comes in and starts talking and selling or whatever, the dentist clamps down and say, “Hey, you can’t diagnosis this. Why did you tell she had gum disease and needed this? I have to do the exam. Blah, blah.” Do you see hygienist wanting to sell and do all the stuff, and being squashed by the dentist? Is that very common?

 

Andre Shirdan:

Well, again, when I walk into an office and I see that the hygiene crew and the doctor are on different pages, that is a problem. I don’t see that a lot. What I do see is people are selling incorrectly. Let’s put it that way. They’re not looking for that equal listening and learning. What they’re doing is they’re either treatment planning to a point where they’re going back to the engineer field and they’re saying, “Okay. You need a root canal, post and core and crown.” Of course, the patient is going to say, “Can we do the root canal last, and can I get the crown first?”

 

 

They’re giving line items. I am a big car guy, but when I go to the mechanic, I can’t stand when they open the hood and show me what’s the under the hood. I could care less. I love to drive. I don’t want to know what’s under the hood. We go to that place that we’re most comfortable with, with that line item idea. Sometimes, it’s better to have somebody at the front desk, somebody who’s an assistant, who has that language skill, who can do that for the entire office. That was my job when I started. My brother-in-law is the nicest guy in the … or was the nicest guy in the world.

 

 

He was the ultimate dentist. He was the ultimate NCE. He loved what he was doing. As far as language skills, he needed somebody too who could actually clamp down and actually talk to patients at their level. I used to say, “Hey, Mrs. Jones, would you like to have a cap?” He would freak out that I would use that term, but the patients understood it, and my acceptance rate was in the 80%. You’re right, sometimes, we need somebody else to do it, but as far as being on the same page, most of the time they are. Most of the time. yeah.

 

Howard Farran:

How long is the Stat-Ck program?

 

Andre Shirdan:

How long has it been now?

 

Howard Farran:

No. When you emailed it, it is one page, 10 pages?

 

Andre Shirdan:

It’s a one pager. The original Stat-Ck program was a 36-page clinical document. It was actually called, “PQI,” way back then; Periodontal Quality Index. It was a 35-page clinical exam that was done. We got it down to a one pager. You could fit on the back of a deck of cards. That’s how small it is. It’s not a-

 

Howard Farran:

Well, I’m thinking for the homies. Would it be easier if you started a new thread called, “Andre Shirdan Stat-Ck program”?

 

Andre Shirdan:

I could do that. That’s not a problem.

 

Howard Farran:

Then when we put out the podcast, we’ll put a link to it also?

 

Andre Shirdan:

Sure. I could do that.

 

Howard Farran:

They’re driving to work, I don’t know if they’re going to be able to remember. Andre, ANDRE, and then think of system, syst. Andresyst@comcast.net.

 

Andre Shirdan:

Yeah. A lot of the easier way to get to me is Facebook. That seems to be the linchpin for everybody’s communication. If they go to Facebook.com\shirdan. S-H-I-R-D-A-N. It’s other good way to get in touch with me.

 

Howard Farran:

You said that’s Irish for Shirdan?

 

Andre Shirdan:

That is.

 

Howard Farran:

That was Ireland?

 

Andre Shirdan:

Yeah. I do a lot of genealogy research. That’s where it goes back to for Shirdan.

 

Howard Farran:

Are you an Irish whiskey man?

 

Andre Shirdan:

I’m a tequila guy.

 

Howard Farran:

My son turned me onto a new thing, a tequila on a town meeting where you put some plants there. Was that a little plant?

 

Speaker 1:

Some old Japanese flowers.

 

Howard Farran:

Some little Japanese flowers that’s floating in your margarita. You chew it first and then you drink the margarita.

 

Andre Shirdan:

Okay. I’ll hand my glass to you. You can peel out the flower and then I’ll drink the rest of it. How’s that?

 

Howard Farran:

What other things? When you’re talking about normalizing periodontal diagnosis and treatment that you see out in the field that people should think about?

 

Andre Shirdan:

Well, the biggest thing is doing that crew work. It’s actually getting everybody on the same page clinically, getting everybody on the same page financially. I was in an office recently, where the front desk person was actually telling people not to put their entire co-payment on their credit card, because that would be a financial strain for them. Obviously, she wasn’t on the same page financially with the office.

 

 

Getting everybody on the same page is critical for all in all aspects of the practice. Building that philosophy first, knowing where the office stands clinically, where we stand about collections, where we stand on Amalgams versus composites, removals as opposed to fixed. Whatever the philosophies of practices, it needs to be from top down. That’s the big-

 

Howard Farran:

Are you mostly driving around Pennsylvania all day, around Philadelphia? Is that mostly your main focus, the 80-20?

 

Andre Shirdan:

Yeah. That’s my 80-20. The 20%, I’m on the plane. Before 9/11, I was on the plane 200 days a year. Now, I’m in Pennsylvania, New Jersey, Delaware, Maryland. That’s most of my day.

 

Howard Farran:

Doing these three decades and being in all these offices, how do these offices look compared to a decade ago, 20 years ago, 30 years ago? Is dentistry growing in vibrant? Do you see it contracting and shrinking? How do you see it change?

 

Andre Shirdan:

I do see it contracting. I think what’s happening is the cost of goods has gone up, and the value of dentistry to patients has gone down. I think that’s what’s happening. The heyday of my consulting days was pre-9/11, was the heyday of dentistry, then we have of course Leeman day, 2008. That changed a whole lot.

 

 

I think what’s happening now is the docs, who I know, who had thriving practices now are in a situation where dollars are tight. If you had a hygienist 20 years ago, 15 years ago, she’s making big bucks now. That’s cutting into your PPO schedule. When your margin’s 40% and your overhead 60%, you can’t afford to pay a hygienist that and sit around just doing pro fees. You can’t have our pro fee paddles.

 

Howard Farran:

Well, that’s interesting, because you talked earlier about a Starbucks closed down and lose $38 million to train all their employees for a day. What’s very interesting, since 2008, economist have written articles that the three sectors that have not recovered to their pre-9/11 days is dentist, lawyers and lattes.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

We have not gotten back to that level. That was eight years ago.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

That was a long time ago.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

I’m sorry, not 9/11. I said that wrong. Leeman’s day, not 9/11.

 

Andre Shirdan:

Leeman’s day. I don’t think dentistry will come back. I think what’s going to happen is, and you’ve actually mentioned this too. What I see with managed offices … I hate that corporate office thing, corporate dentistry word, but the managed offices, I think that’s going to be a strong driver for what happens in the dental economy. The sole proprietor is going to be stronger based on getting their gain together. Then the small groups are going to be a huge component of what happens in the future. The sole proprietor’s going to be there, but they’ve got to really be on top of their business. They’ve got to start thinking like a business. It has to be a business and not just a practice.

 

Howard Farran:

What percent of these ones that you’re seeing? I’ve signed up for PPOs. How prevalent is it?

 

Andre Shirdan:

Well, the … 8%. It’s pretty high.

 

Howard Farran:

Well, I’m sorry. It cut out.

 

Andre Shirdan:

I think 80% of the offices are PPO providers.

 

Howard Farran:

Yeah.

 

Andre Shirdan:

… in one shape or form.

 

Howard Farran:

Right. Yeah, 80. Yeah. What’s the other 20%?

 

Andre Shirdan:

The other 20% are fee-for-service. Again, I see a lot of specialist, periodontics, oral surgeons. Well, I don’t see a lot of oral surgeons. I’d see PD, ortho. They’re going to take the plans, because that’s where their bread and butter is. The fee-for-service guys are struggling. I have friends who are fee-for-service providers, they’re struggling. I think I get a call a week where it’s, “Andre, when is that time when I need to take a plan?” That was like planting a tree. Actually, that was 20 years ago.

 

Howard Farran:

Twenty years ago, dentistry was margin driven, where you took your cost out of your profit, or I bet your fees and went to the insurance. They only decide what on what percent they’re going to pay. Now, it’s volume driven, where the insurance company say, “You sign this plan. I’ll deliver you a volume of patients, but here’s the fee.” You got to subtract your profit and arrive at a budget. Dentist have not … they have not, back to your philosophy, “People, process, profit/product, philosophy,” they have not changed their business model.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

The older they are, the more they don’t get it. Some of these young kids coming out in a volume-driven dental market, that’s all they’ve known.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

So many dentists, they still have that business model of the days when Delta would pay 80% of whatever you submitted to them.

 

Andre Shirdan:

Yeah. One of the more interesting things in what I get to do, I get to work with offices implementing technology. Most offices are looking for an edge. How do I make this easier, better, faster? They’re not changing the way that they do dentistry. It’s not that software’s going to make it easier, better, faster. It’s process, is going to make it easier, better, faster. How often you getting up out of the chair to go to a closet to pull out something? How many times have you cut back staff in order to make it easier for your payroll, but at the same, now, you’ve got to go get and clean your insurance. I see doctors doing this all the time.

 

Howard Farran:

Andre, what do you think of … I’m always just thinking of my homies, how they’re going to get it in? What do you think if you made an online CE course for the hygiene system? The dentist could just sit there and all she have to do is say, “I just need to close down my office and we’re going to play a computer. Then my hygienist and my assistants, my instructions going to hear from Andre.”

 

Andre Shirdan:

Yeah. Actually, I talked to Harold Goldstein about that. I think we’re going to get that done in the next couple of months. That’s something we’re going to get done.

 

Howard Farran:

It’s so much easier to have a good guy, bad guy and have some bad guy far away that’s going to make us change.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

A dentist come in and say, “I’m going to move your cheese.”

 

Andre Shirdan:

I agree. Like I said, a lot of this is you could have the best perio program in whole world. It all fails if your admin team is not on the same page. A big part of putting a perio program in place is understanding how it’s properly built. That is really important. There’s a lot of things out there on the lecture circuit that aren’t teaching the proper coding, or they’re teaching coding that’s a little on the gray area, but understanding how that all works is important. You have to be all the same page, clinically and financially.

 

Howard Farran:

You don’t have to switch gears, you can stay on perio.

 

Andre Shirdan:

Sure.

 

Howard Farran:

You’re with Patterson. You’re lecturing a lot on technology. Go from the highest return on investment to the least return. What technology are you out there lecturing the study clubs and lectures, and going into office where you see the highest chance where the dentist bought or adapted a technology, they’d be better?

 

Andre Shirdan:

Right now, this would’ve been completely different three months ago, it would CBCT. That’s something that is a game changer right now for a number of different reasons. The biggest reasons is the doctor-

 

Howard Farran:

You’re talking about the GALILEOS?

 

Andre Shirdan:

GALILEOS, any of the [inaudible 00:47:20] systems. If they’re incorporating it into our offices, for one, it’s changing the philosophy of the practice. The doctor’s look in deeper. They’re seeing more. They’re understanding more about what’s going on. They made different treatment decisions. Are we going to retreat this endo? Are we going to let it go and go for an implant? It dramatically changes the way that the office looks at dentistry. As a consultant, I guess I’m legally obligated to use the word, “Paradigm shift.”

 

 

I like the idea that Bill Gates actually uses the term, “Pond.” He says, “You don’t have a paradigm shift. Your pond changes,” which means it gets deeper. It gets wider. Sometimes, we put life in it. Sometimes, we get dried up, but that pond changes on a daily basis. That’s how it has to happen. It has happen organically. It has to really work in such a way that when you bring a product, any product, CAD/CAM, a cone beam, digital, whatever product it is. When you bring it into the office, it needs to change the office organically. It can’t be the shift.

 

 

I see so many offices bring in digital. The first patient that gets in the chair they say, “Oh, Mrs. Smith, we have a new product that we’re going to use on you.” Well, you wouldn’t want to hear that if you went to your cardiologist. It just sounds bad. It should be something that flows with the philosophy of the practice. “We brought a digital in here, because we want to be able to diagnose better. We’re using cone beams, so that we can see a little bit more, and we can treat you better.” It can’t be this paradigm shift, where a door opens up, and all of a sudden, you just throw it in. It has to be organic.

 

 

That’s the game changer right now. CAD/CAM is phenomenal. CAD/CAM’s always been phenomenal, but people didn’t adapt in the way it was. We looked at it as a marketing strategy. Bad idea. We looked at it as different things. CAD/CAM is … it’s making crowns. It’s making inlays, onlays. It has to happen in such a way that it’s patient focused. We’re doing this, because it helps the patients. It’s more conservative restoration. Those are the things that drive those products for.

 

Howard Farran:

A big complaint is with CAD/CAM and I think my best friend sold it best. A lot of those CAD/CAMs, it used to be … You just schedule an hour. You’d numb, press, impress, temp rise, they’d be out and then be back two weeks. We want to do this in office, same day. A lot of times, people like Sameer don’t knock that out in an hour and a half. Out in the trenches, a lot of times, that’s two, three, four, sometimes five hours long.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

Now, one of my friends, he’s just scanning them all. Then modern has this lady come in on Wednesdays and knows them all out.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

He can do a crown every single hour. Numb, prep, temp rise, get them out, and then shoot them in Wednesdays, just know them all out. I think that’s amazing, but you know-

 

Andre Shirdan:

I think that’s a great idea. That’s phenomenal idea.

 

Howard Farran:

Back to that CBCT, the easiest way … Every dentist wants to be quality. They go to Pankey. They go to Kois. They go to Spear. They’re always chasing Frank Spear in the Scottsdale here. Loupes, if you can see two and a half, three times better, magnification. There’s not an orthodontist I’ve ever met that said, “My god, when you look in that clean canal at eight to 12 X, it’s a game changer.” CBCT, I don’t know a single person that got a CBCT that wants to go to 2D pano. I don’t know a single person that can see that wants to be blind. Just seeing is a game changer.

 

 

I’m going to tell you the down side of the CBCT is … I’m in there. I got two associates and I’ve always got friends and now, there seems like there’s a dentist some office every day from somewhere. Every one of those CBCTs will appoint to something and have no idea where we’re getting. It reminds me in the three, the GALILEOS, the space level up there. You see all these images and you’re just like, “What the hell is that?” I swear to God, there are so many times they’re just like … I think that the online training of how to read CBCTs … If I was selling GALILEOS, if I was selling Carestream, if I was selling a CBCT, I’d find some oral radiologist to make a hundred hours of how to read that thing. I see it every week, where three doctors have no idea what that image is. It’s just so much information. It’s mind blowing.

 

Andre Shirdan:

I agree. One of the unique things is working with my … When I started in dentistry, again, when I started, I was in the minority of men working in a dental office who wasn’t a dentist. One of the unique things that happened was every time I would go to a course with my brother-in-law, I get there for registration and they’d say, “Oh, Dr. Shirdan. I guess we’ll sign you up.” I would just go with it and say, “Sure.” Here I am over a cadaver doing laser surgery, had no idea what I’m doing. I took all these courses so I could understand it.

 

 

I see these offices, who … they buy these machines, but they don’t take the CE. They say, “Yeah. We’ll just send that off.” Again, like you said, if you don’t know what you’re looking at, you’re lost. It’s a road map that you can’t read. It’s a road map in French, and you don’t know what you’re talking about. You really need to take the CE, if you can, to get educated on that product. You need to know what’s going on there. Once you do, again, it changes dramatically the way that you treatment plan your patients.

 

Howard Farran:

The gender did change. My president’s a women. Today’s dental officer manager is a man. Two out of four of my assistants are guys. My associate dentist is a female. I think it’s because America lost 50 million manufacturing jobs, and then guys are seeing … They can’t find a construction job, and their wife’s bringing home bank of the dental office. They’re just like, “Why not go into healthcare?”

 

Andre Shirdan:

Yeah. It’s funny, because in my area, there are so many dental schools. I get to hang out at Temple University and University of Penn a lot. Seeing the classes change over the last 20 years, it’s been amazing to see what the classes look.

 

Howard Farran:

What is this? The two dental schools, you said Temple and Penn?

 

Andre Shirdan:

Within an hour of me, I’ve got Temple, Penn. If I go another couple of hours, I can get to Howard. I can get to University of Dental Medicine-

 

Howard Farran:

Howard’s in what …

 

Andre Shirdan:

Howard’s in DC, the DC area.

 

Howard Farran:

Is it in the actual 10 miles of DC area?

 

Andre Shirdan:

I can get to DC in about three hours from my house.

 

Howard Farran:

It’s in DC. Is Georgetown in DC? Is it Maryland.

 

Andre Shirdan:

I don’t know where the dental school is at Georgetown. University of Dental Medicine, New Jersey. If I go five hours, I can get to Tafts. I can go to Pittsburgh, which is five hours.

 

Howard Farran:

I’m going to throw you under a bus. Which one’s better; Temple or Penn?

 

Andre Shirdan:

Let’s do this. My dentist went to Temple. How’s that cropped out?

 

Howard Farran:

All right. You are a politician. You answered that correctly.

 

Andre Shirdan:

There you go.

 

Howard Farran:

What other technologies? You said CBCT. After CBCT, what would it be?

 

Andre Shirdan:

For me, because I train on every single day is the software, practice management software. This is what I find. Practice management software is that iceberg that the Hindenburg hit. You see that little tip that people use, but they don’t ever use what’s under the surface. I have offices that I go into. I show them something that’s blithely obvious in the software that they’ve never ever used. All I get is, “Well, that wasn’t there yesterday.” I have to tease them and say, “Yeah. I brought that along with me. I brought that feature when I came in today.” They don’t utilize the software. They have it, but they don’t utilize it. There are lots of flaws in softwares. All the softwares have it, but-

 

Howard Farran:

What percent of the software, when you run in and run a report about what’s never been ran or used? What percent of the softwares never been used?

 

Andre Shirdan:

80%.

 

Howard Farran:

The difference between dentistry in franchise America, which is the same size healthcare, healthcare is about 17% of the economy, franchise is about 19% of the economy, is they stream it all down to a process that you keep talking about. People, process, profit/product, philosophy. There’s exactly only one way, it hurts trying to [inaudible 00:55:40] check in a patient, only one way at Hilton. What the software company has done, is every time a dentist is setting a software idea for 30 flipping years and said, “Okay, we’ll add that.” You log on to denture. It’s Eagle Soft, [inaudible 00:55:52]. They’re all the same. 47 million things you can do, every consultant says they’ll never use 80%. I told every one of those CEOs myself 20 years ago, 10 years ago, five years ago that I would get what a consultant to say, “Here’s Andre’s way. To check in a patient, you have to do this. To check out a patient, do this. If you don’t do this step, it’s too much.” Get down to a process, so that I can take someone off the street and they can learn it in an hour.

 

Andre Shirdan:

Yeah. The syst after my email address-

 

Howard Farran:

You would think they could just have the existing Eagle soft, where one of the programs could be, “We’re going to get rid of  80% of the stuff you’re not using anyway, and you’re just going to do Andre’s process.” If another consultant came along and said, “No. I want to do it like Sandy Pardue or Sally McKinsey or Linda Miles or whatever.” Then you go into an office and say, “What do you do,” and say, “Well, we have Eagle Soft, but we do it according to AADOM.  We do their process.”

 

Andre Shirdan:

Yeah. I agree. It’s funny, because I train in such a way that I always do it … Like I said, you can do it anyway you want. This is the way I suggest that you do it. I show them one way that I know is the best way to do it. Again, this is my orange analogy. I want to squeeze every bit of juice out of that orange. I want them to use every conceivable thing they can, because again … all. I’ve seen all the practices. I see how they use the software. I see offices, they generate as much paper as they do data stream. They’re using paper everyday where they could be using a computer.

 

Howard Farran:

Andre, the 4,000 pounder in the room, that’s the big, evil monster is corporate. Do you think corporates are making a material impact? If so, what are they doing right? What are they doing wrong? What could we learn from corporate? What is corporate doing wrong?

 

Andre Shirdan:

I think corporates are doing everything right. I have lots of respect for what Rick Workman’s done with Heartland. There are some who do it well, some who don’t do it well. I think what we learned and a lot of the young associates that I get to meet have had it a few years in those corporate environments. They tend to learn good business practices by working with those offices. I think we learn from them the same things we learned if you’re a diner and you work at a McDonald’s for a little while. You learn process. You learn profit margin. You learn those thing that are really important. You also learn, again, philosophy. This is how I want to run my practice, not that I’ve worked in a corporate environment. I think that they raised the water level for everybody. They’re also bringing patient education up. Every time they run an ad on TV, although it doesn’t normalize cost very well for most of the fee-for-service offices, at least that it gets out there. The commercials, they had a clear choices doing for the whole course.

 

Howard Farran:

Oh my god, that is so amazing. They’ll watch 30-minute info marshals and all enforced, then run to your office and tell you all about it.

 

Andre Shirdan:

Thank god for that.

 

Howard Farran:

Yeah.

 

Andre Shirdan:

Thank god for that. I remember the days of patients coming in and saying, “Look at the new veneers that we got at the office down the street, because they’re cosmetic dentist,” and go, “What we do in here, well, nobody ever told me.” Well, I think they’ve actually made the game change. I think they’ve raised the game for everybody.

 

Howard Farran:

You’re talking to a lot of young kids. You’re driving all around several of these states. Is success easier in rural than urban? Or was that really not the issue?

 

Andre Shirdan:

Well, it’s changed dramatically. Philadelphia again, you’ve got all the dental schools. You have tons and tons of dentists. In this area, the city worked for a long time, but rural is the way to go. If I were building a practice, it would definitely be a rural practice. Again, the city is moving out too. If you’re rural today, you might be the city tomorrow.

 

Howard Farran:

The city’s going to move out. The suburb’s about to take a quantum leap, because the problem when humans want to get away from their work and downtown filly is they don’t want to drive. To drive those cars, it’s going to be a game change, because you’re just going to walk out, and then it’s going to be just an enclosed box, and you’re going to have your favorite chair and you big screen TV or your computer on your desk, and you’re just going to get that and start doing your emails or watch a movie, or whatever.

 

 

At that point, it’s no longer going to be a stressful commute. As soon as that is the norm and the technology’s all there, they’re rolling it out, then when mom wants to buy a house out in the country and had 10 acres or whatever, and then she’s looking at that, “But I got a two-hour commute.” She’s like, “You know what? That will be the best two hours,” because when you talk to people that work in office, they’ll all tell you they get so much more done at home, because no one’s interrupting them.

 

Andre Shirdan:

Yeah.

 

Howard Farran:

When you’re just in your little cubicle box being automatically driven to work and nobody’s bothering you, you’re just going to crank out the work. They’ll actually going to love it.

 

Andre Shirdan:

Yeah. You’re seeing it too with the event of the audio book and the podcast. A lot of commuters don’t mind to commute anymore. It’s downtime. For me, distance driving is no big deal to me. I drive three, four hours a day, back and forth to an office, and don’t think twice about it. I think what’s happening is people are getting used to the commute and they’re accepting that. It’s not a big issue anymore. Going to a rural environment for a dental practice, I think that’s where I would go if I were a kid coming out right now, definitely.

 

Howard Farran:

Well, we’re out of time. I got to leave you on the funniest commute story I ever did in my life. I was in this dentist office in New Orleans. I’m pretty sure I got the city that is New Orleans, and they’re on their way home. There’s this long bridge, it’s a really long bridge across swamps or bay or whatever the heck it was, and right before you get on the bridge, there was a drive through liquor store. We’re just driving and we’re talking and everything, he swings to there without even blinking, buy this two big old 40ounce, hugest can of big I’ve ever seen, hands me another one. Just pops that thing and takes back [inaudible 01:02:18].

 

 

I’m looking back to that liquor store. There’s just a line of Coca-Cola. I’m thinking, “Wow. That’s how everybody in Louisiana is dealing with the long commute. They’re just getting a 40-ounce tall boy.” That’ll be better when those guys drive those cars. Hey Andre, seriously dude, thank you so much. You’ve been a tawny since the beginning. Day one, dude. Day one. You have that start date of 06/21/2001, and that’s a default, because when we updated the software, we started ’98, but a lot of the dates just went to that. You got 500 posts. Seriously dude, I love your posts. I’m a big fan of you. Everyone I know that knows you loves you …

 


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