Dentistry Uncensored with Howard Farran
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397 Balance Driven Success with Bonnie Pugh and Laci Phillips : Dentistry Uncensored with Howard Farran

397 Balance Driven Success with Bonnie Pugh and Laci Phillips : Dentistry Uncensored with Howard Farran

5/17/2016 9:39:25 AM   |   Comments: 2   |   Views: 244

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VIDEO - DUwHF #397 - Bonnie Pugh and Laci Phillips


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AUDIO - DUwHF #397 - Bonnie Pugh and Laci Phillips


Bonnie Pugh:

Bonnie, founding partner at Practice Dynamics, blends her love for the dental industry and business to help dental teams across the country reach new heights in their success. She specializes in coaching teams to goal by blending their unique philosophy with proven systems and business practices.

Bonnie has a long record of success in the business of dentistry. Prior to founding Practice Dynamics she was the Product Line Manager for the Dental Division of Carestream Dental. In this role she was responsible for the strategic planning of the dental practice management line of products. This experience gives her a unique understanding of the blend of the business of dentistry, the technology that supports it and the teams that make it happen.

A professed lifetime learner and educator Bonnie recently took on the role of Executive Director of the Academy of Dental Management Consultants. In this role she guides an organization that serves to help dental management consultants throughout the country improve and grow their skills.

Her love for knowledge and personal growth drives her to provide balance driven success through systems, teams and technology for the practices she works with every day.

Laci Phillips:

Laci discovered at an early age her true passion for speaking and entertaining audiences. As a founding partner at Practice Dynamics she combines her knowledge of dentistry with her passion for teams to deliver customized coaching, workshops and speaking events throughout the country.

Laci began her road to coaching as a chairside assistant while going to college to pursue a dream of one day having her own talk show. While working her way to the business side of dentistry, she was fortunate to learn from top industry professionals. The experience gained on this journey gives her unique insight into the technology and business side of dentistry. The excitement of working in high tech offices, as well as, high-end cosmetic practices has instilled in her the passion and the knowledge to coach dental teams on their road to excellence.

Balancing coaching dental teams with her speaking career is a dream come true. Each time she takes the stage her passion for dentistry and the dental team comes to life in her words and the lessons she teaches.

Practice Dynamics specializes in coaching teams to reach their goals through balance driven success using systems, teams and technology.

www.PracticeDynamics.net 

Howard:

It is a huge honor for me to be at Townie Meeting 2016. This is our 14th Annual Townie Meeting, and I have been your biggest fans for a long time, at least 10 or 20 years. I don't recognize you today because you usually have one them big ol' hats on.

 

Laci:

I have no hat on today.

 

Howard:

What do they call those hats those hats from the '20s? What are they called, flappers, flapper hats?

 

Laci:

I wear the big ones that ...

 

Howard:

This lady can rock a hat.

 

Bonnie:

Yes.

 

Howard:

I am old. I am 53. I still love a woman that wears those big hats. You look like you should have been in The Great Gatsby movie.

 

Laci:

I love it, man.

 

Howard:

I think you should have been born in 1920.

 

Laci:

Thanks.

 

Howard:

You were born in the wrong ... Yeah, sorry about that.

 

Laci:

Right now we're going to have to take his phone.

 

Howard:

Basically, I want to start with this. I am going to set you up for all this. You guys heard my lecture this morning. Thanks for coming. That was an honor. That was an honor, to have people like you.

 

Laci:

Absolutely, yes. It was an honor to listen.

 

Howard:

I feel like you're one of my mentors, so it's nice to have a mentor in your crowd. That's an honor, but I want to start with this, and then I'm going to let you guys take it away. It's my perception ... and you may disagree with this 1,000%, and you may agree ... I believe that this dentist doesn't have his house in order, and it's stressful. There is employee dysfunction, there is high overhead, they're not making the money, and they always think the solution is ... You know what the solution is? I am going to leave and fly away to Key Biscayne at the Pankey Institute or Scottsdale and listen to the Scottsdale Center, or I am going to Seattle Kois, or I am going to buy a shiny object like a laser or a CAD cam, or I am going to learn a new procedure like placing an implant, and the reason it's appealing is because they're getting out of Stressville, USA where all their stress is.

 

 

They're going to another city; they're staying in a resort; they're buying a shiny object. They're getting in more debt, they're living in a bubble, and the reason they want to leave their city is what you guys fix. Don't you think they should get their damn house in order before they go buy a $100,000 shiny object or learn how to place an implant in fricking Dominican Republic or Brazil?

 

Bonnie:

Oh, absolutely. The have no idea about the numbers, or they don't want to know. I think some of them don't want to know. I think some of them don't want to know. They're scared of them, but the numbers tell the story. We always say that the numbers start the story. They don't tell the whole story, but we always start with the numbers, looking at their overhead, and they don't want to know. We had a dentist in our class, last week, in Hinman, and we were going over overhead numbers and where they should be and where the healthy places are. His staff ... not his salary, but his staff salary ... was at at 32% of his overhead, and he's arguing with me that that's healthy, but he has continued to give them raises, and nothing has changed. The production hasn't gone up. They want to run away from them. They want anything to distract them from the real story.

 

Howard:

Would you agree ... ? We're going to be holding hands a lot on this show. Would you agree that they don't want to look at the numbers because they're not humble, they want to keep it in the closet? I am supposed to be the doctor; I am supposed to be smart. I know everything, and my ego is so fragile that I don't want to show you that I got an F on my report card.

 

Laci:

I don't think that's it. I don't. I think a lot of them don't understand it. I don't think it's a matter of ego. I don't think it's a matter of I have to keep this secret from my team. You and i have discussed this before, and that's why I have listened to you forever. Dentists typically don't have a business degree, going into dentistry. They want to do the dentistry. You talked about this this morning. You love root canals. You can do a four wisdom tooth extraction in five minutes. You love the dentistry side of it, but you're an anomaly, Howard, because not every dentist understands the business side of it. They don't understand the numbers.

 

 

For example, I have a dentist in Arizona. She texts me and said, "I am paying all these lunches. I am taking these girls out for happy hour. We're discussing ... I am doing this for my team. I doing that for my team. I need a budget," and I said, "Right now where does your team compensation," which is what they get paid ... it's benefits, it's lunches, it's CEs. "Where is that in your overhead?" She texts me back, and she goes, "I don't understand what you're asking me," and I said, "You should be 25%, 27% at the most, in your overhead for your employee compensation. Where are you right now?" She goes, "Yeah, I still don't understand what you're saying." I said, "I am going to send you a spreadsheet, and it's going to be your overhead, and it tells you exactly where you should be with everything. Fill that out, and then let's you and I have a discussion so we can set your monthly budget."

 

 

I don't think it's ego, Howard, I don't. I think it's just not knowing.

 

Bonnie:

Yeah, and maybe a little bit of apathy because they get so much joy out of dentistry that they don't want to spend the time, but if they spend the time, they're all in. We have got clients that, once we teach them how to look and what to look for, it's like ...

 

Laci:

Right.

 

Bonnie:

Infectious. They want more. "Tell me more, tell more." For me, I love business. I grew up on the corporate side of dentistry at Care Street, and I love the business side. That's why I loved the talk this morning. It was all about business, and then you threw football in, and I was hooked. I think they want to learn. They don't know where to start, and I think the teams that we've worked with, once we explain to them the numbers, they feel bad. They're like, "Oh, my God, I didn't know I was taking advantage. How do we fix it?"

 

Howard:

My goal in this is, the reason our podcasts are huge is because they're free, and they're multitasking. They are listening to this while they're driving to work, or they're sitting on a treadmill or whatever, and I want my homies to get it done. They don't know if there is anything wrong. Can you go through the numbers and try to explain them to a person who's salivating because he gets to do a retreat on a molar root canal today with a broken file in MB2, and he knows he's going to get it, and he's all excited. Go through the numbers because ... Can you go through the numbers and paint a picture?

 

Bonnie:

Sure, absolutely.

 

Howard:

What red flags would be an issue?

 

Bonnie:

We usually start with a P&L and looking at the overhead, so we want our offices to at a minimum have their overhead at 65%. We would love it to be smaller. Some of our specialists obviously are smaller, but we love the overhead at 65%, and then that means their compensation is at 35%. We like to get it a little better than that, but then our salary in our teams, we want to see between 25% and 27%. When we talk about those percentages, it's loaded, so it's everything. It's the benefits; it's the tax. That's a loaded number, so everything should be in there, and then you come down and you look at lab costs, but they're all variable because you make more, you spend more, and that's a good thing. What intrigues us is your supplies should be around 4% to 7%, and that is where they always want to look, to save, and they're not going to save in supplies. That's not where to look.

 

 

First, it's looking and making sure that overhead is healthy at 65% and where everything is falling. Do they have a marketing budget in there? Where are the things? Where is their money to spend if we need to? Making sure that they're taking home, and they're building towards what they want in life. Then, from there, taking it and figuring out what we need, what's that band? How many days do we want to work this month? Where, how are we going to divide it up? Because what we want to take off is so that we balance their life once we get the numbers in a healthy place and those levels. Do you want to work four days a week? Do you want to work three days? What do you want? We've got I want to be a $1 million practice.

 

Howard:

Go back to the beginning.

 

Bonnie:

Sure.

 

Howard:

What's the name of your company? What's the website URL?

 

Bonnie:

PracticeDynamics.net.

 

Howard:

PracticeDynamics.net, and you guys are practice management consultants?

 

Bonnie:

Yes.

 

Howard:

If 100 people called you, wanting your services, what is their chief complaint, and is their chief complaint what they're worried about, match up with what they need a fix on? What are people calling you, and what are you doing for them, and how much is that? Who should be calling you? Who's calling you? What's the problem?

 

Bonnie:

Number one for me is profitability.

 

Howard:

Overhead is number one chief complaint?

 

Laci:

That's not why they call.

 

Bonnie:

It's not chief ...

 

Laci:

That's not why they call.

 

Bonnie:

They want growth. They want to make more money.

 

Laci:

They want systems and teams, is why they call: "We don't have systems in place. We don't have a morning huddle. We don't have ah tray set-up. We don't have verbal skills. They want systems, and then they go 'Oh, by the way, my team ... '"

 

Bonnie:

Right. For me, we reversed them, but you're right, team is number two.

 

Laci:

Then Bonnie and I either log in or we get in there, into their system, and we look at their numbers, and we go, "Wait a minute. There is something else going on here," so very seldom do I take the phone calls at least that say, "Laci, my overhead," or "My AR," no. It's systems and teams, and then we take a look at the numbers and say, "This, you need to look at this too" because they wear their production number like a badge of honor.

 

Bonnie:

Right.

 

Laci:

"I am a $1.5 million practice." That's great, but what are you making?

 

Bonnie:

It was exactly what you said this morning. I love the way you said it: "I charge $1,200 for a crown." Why? "I don't know." "How much do you actually write off of that?" "I don't know." You said, "You did a crown today, but how much did you actually make off that crown?" No idea.

 

Howard:

What do you do for them? It's PracticeDynamics.com.

 

Bonnie:

Dot net.

 

Laci:

Net.

 

Howard:

Dot net. PracticeDynamics.net.

 

Bonnie:

Right.

 

Howard:

When you say they call you, what is the number they call you at?

 

Laci:

888-425-3235.

 

Howard:

Say it again.

 

Laci:

425 ...

 

Bonnie:

888.

 

Laci:

Oh, correct. 888-425-3235, and they can ...

 

Howard:

I know a lot of her clients for a lot of years. This is a good smart person here. You have my word on it.

 

Laci:

I listen to Howard.

 

Howard:

Go, again. Give them a couple of scenario, case studies. What is the problem? Why did they call? What did you do; how much did it cost? Because here is what I don't understand. Here is what I think your dilemma is, the price management problem is. All my really rich friends ... and I don't want to say their names and embarrass like Jerome Smith or whatever, and whatever it is now, but we always ... It seems like everyone doing $2 to $4 million a year is always giving consultants $50,000 to come in and fine-tune and take it to the next notch, and they're growing us more and more, but it's always the return on investment. Then all of the people that almost ready to hang themselves on the ceiling fan will go buy a $65,000 laser, but they won't buy a ...

 

 

I guess what I'm saying is, it seems like everybody where you would be God won't buy you, and then everybody that buys you is fine-tuning up a little, and it's still a return on investment, but it seems like the biggest return on investment people never will get a consultant, but they will always buy a shiny object or go to Cancun to learn how to place implants. Do you agree with that, or disagree?

 

Bonnie:

It's hard to say because I'm not the one calling, but, yeah, the ones in my previous life ...

 

Howard:

I guess how much is the average office that's calling you ... ? We know the average office collects $675,000, so what does the average office that calls you? What is the average office collecting?

 

Bonnie:

Net collection, we've got some pretty large offices. We've got a couple that are doing ...

 

Howard:

That's my point.

 

Bonnie:

Exactly.

 

Howard:

I have a lot of big offices. Yeah, because all the big offices like me are the ones using consultants.

 

Bonnie:

Right.

 

Laci:

Right.

 

Bonnie:

Then all the people that would benefit the most, that don't even do $750,000 a year, they are never calling you. Every time I talk to great consultants, they will say, "Actually, I mostly do really big offices." Yeah, that's right. They're really big because they're using consultants.

 

Laci:

Here's the reason why, though, Howard. If you don't know your numbers, and you're not collecting and you're not producing, thinking all of a sudden somebody wants me to invest $40,000 in them? That's overwhelming. For those people who really, truly could use some help, that's overwhelming for them at that point, to think of a $40,000 price tag. That's crazy.

 

Howard:

Yeah, but they're not going to have to write you a check for $40,000.

 

Laci:

No, no.

 

Howard:

What are the terms of it going to be?

 

Laci:

No, no, no, no, and that's what I was going to say. My favorite saying right now is that whole, "How do you eat an elephant?" That's so weird, right? That's such a weird saying, but how do you eat an elephant? One bite at a time. Take baby steps. I'm not saying call us for it, but when you talk to a coach, when you talk to a consultant, ask them if there's something other than that $40,000 price tag, say, "Can we start with a phone call? Can you look at my numbers and say do these look right? Where should I start?" Don't think that you have to buy the whole cow right now. Start small, if that's what it takes, but ask.

 

Bonnie:

Start.

 

Laci:

Yeah, start.

 

Bonnie:

Start.

 

Laci:

Start.

 

Bonnie:

Having the uncomfortable conversation.

 

Laci:

I love it.

 

Bonnie:

Like we were talking about this morning.

 

Laci:

I love it. Most successful people have had an uncomfortable conversation, and they are okay with that. That's leaning into the discomfort. That is asking those uncomfortable conversations, at least start somewhere.

 

Howard:

Go through some case studies. Why are they calling you, and what are you doing for people? What are you seeing out there in the field today?

 

Bonnie:

A lot of team challenges, getting everybody on the same page, the systems, not knowing their overhead, wanting to make more money but not knowing where to start. Looking to cut supplies, and then teaching them that it's okay if the overhead goes up, but something else has to go up. You're going to make less. It's an equation, right? The numbers, they're pretty simple to read, but teaching them that. What's a good client we can go through?

 

Howard:

I want to hear some ... I am going through what I see on Dentaltown like yesterday ...

 

Laci:

Okay.

 

Howard:

Yesterday. This is a very common question on Dentaltown. A dentist is about ready to blow a gasket and cough up a blood clot because his hygienist came in at lunch and said, "I want a raise," and he is sitting there, saying, "My overhead is sky-high, and she wants a raise," and he doesn't want to confront her. He's afraid. "She's my hygienist. I don't want to piss her off. She found me a crown this morning." How do you deal with that pit in your stomach when a hygienist wants a raise, and you figure ... ? How would you specifically answer that?

 

Bonnie:

For us, it's about having the uncomfortable conversation. We believe in sharing numbers with the team, helping them understand, because most ... 95% of the times, when we get to the point where it's not uncomfortable ... and we'll tell them because we will lead them through the team meeting with the numbers, "It's going to get uncomfortable. Read through it, and let us get to the end, and let us share the numbers," and let them understand, and "Then let's work together for a solution." 95% of the time, they're like, "I get it. How do we do this?" Get them engaged, get them accountable. For me, accountability is big.

 

Howard:

What's the highest overhead you've ever had to deal with, and how low did you get it down, and how do you get people to lower their overhead? Explain why offices have high overhead and how you get it down ...

 

Laci:

Absolutely.

 

Howard:

Because they're thinking, "I need to fire all my long-term staff and replace them with the greeters from Wal-Mart." Is that how you bring down staff labor?

 

Bonnie:

Absolutely not.

 

Laci:

No, and, oh, by the way coaching/consulting is not about coming in and firing your team.

 

Bonnie:

No.

 

Laci:

You and I have discussed this before. Consultants have a really bad rap, a bad reputation in dentistry, because you think we're going to walk in, look at your team and say, "You have too many of them. She must go, she must go, she must go." That's not what this is about. This is about becoming more effective and efficient. This is about understanding that dentistry is in fact a small business. It's about learning Business 101 and what it takes, so I love that you, of all people that are standing up in front of these docs and talking about overhead, talking to your team. It's a business.

 

Bonnie:

Right.

 

Laci:

Yes, we're healthcare. Yes, we have tho take into consideration healthcare. Anyway, talk about the [inaudible 16:16] ...

 

Howard:

Your hygienist, one of your staff ...

 

Laci:

Asks for a raise.

 

Howard:

Wants a raise.

 

Laci:

Okay.

 

Howard:

I feel like my overhead is high. I feel like my PPOs, I'm adjusting off big numbers, and I'm having a hard time paying my bills, and she's my right-hand man. She's been my hygienist for seven years.

 

Laci:

Sure.

 

Howard:

What the hell do I do?

 

Bonnie:

You start looking at productivity and profitability. Are the PPOs profitable? Do we need to get out of some of them? Are we being efficient? Are we looking at the emergency patients? Our practices love emergency patients. They're gold mines. Are they producing as much as they can? Usually, they're not. They're not working their systems, so if you raise your production, then your overhead isn't as high a percentage of that overall number. Not working more days, but working more efficiently and more profitably.

 

Howard:

How do they evaluate their PPOs? When I ask them, "How many PPOs do you take, five, eight, 10, 12?" they don't have a fricking clue.

 

Laci:

Right. They don't.

 

Bonnie:

This is Laci so far. Insurance.

 

Laci:

It makes me crazy. It makes me crazy because ...

 

Howard:

Laci, you were crazy before you got into dentistry.

 

Laci:

I was. That's why we love each other.

 

Bonnie:

Yeah.

 

Howard:

Don't blame it on dentistry.

 

Laci:

That's right.

 

Howard:

You and I were born crazy.

 

Laci:

I know, I know, but it makes me crazy because we don't look for adjustments, or we only charge what insurance said we could. No, and I love that you brought that up this morning. No, we charge our fees, and you adjust off what you're not going to collect, and you have to label your adjustments, not just an insurance adjustment. It's got to be Delta, it's got to be MetLife, it's got to be United Premiums Plan, so that at the end of the quarter ...

 

Howard:

Nice.

 

Laci:

... at the end of the year, we can go in and ...

 

Howard:

Nice.

 

Laci:

We can go in, and we can run a report and say, "Okay, these are your top-10 PPOs that you're taking right now. This is how much dentistry you produced. This is how much you collected, and this is how much you actually gave away." Okay? Then we take the smallest insurance company with the fewest patients in your practice, and we start talking about do we really need this because, if you've got 16 PPOs in your practice, but you have absolutely no idea how many patients are actually on those PPOs, or what you're producing and what you're collecting and what you're giving away? Again, it comes down to business. With the hygiene question, she's been valued and we love her, too, but how many open hours does she actually have? How long does it take her to do a [profi 18:41], how many hours or minutes are we scheduling for a profi ...

 

Bonnie:

Are we diagnosing perio?

 

Laci:

Do you have a soft tissue management program? If you look at the statistics alone, you have to have a soft tissue management program in your practice. It's not just, "I've been here for a year. The sun has passed around Uranus. Loved it." The sun has passed around Uranus, so "I should get a dollar more." No, it's how many days are we working, how many profis or how many patients did you actually see, what's our retention. Everybody talks about new patients. They're great, but what about the people who came through the door the first time?

 

Bonnie:

Right.

 

Laci:

Are they coming back a second, a third, a fourth time? Are they compliant? Are you retaining them?

 

Howard:

I want to tell you another thing. Some of the dentists ... I've heard this at a dinner. I've heard this 100 times: "Yeah, you're lucky, Bonnie, because your wife, she's your office manager. My wife is home having five babies. She's having a baby every six months and all this stuff, and I have to do all this myself." Then another guy says, your panacea, maybe he's got an office manager. The dentists listen to all this stuff. He doesn't know how many PPOs he has. He's not going to do all this stuff. He's sitting there listening to us, and he's overwhelmed, saying, "I'm in Parsons, Kansas. There is no smart people in this town. I'm never going to be able to teach my receptionist anything you're saying. I'm not in Chicago or L.A. where I can hire a bunch of smart people. I'm in Parsons, fricking Kansas, and my wife is home having a baby every six weeks. How the hell am I going to get any of this done?"

 

Bonnie:

Coaching, good coaching, working with a consultant.

 

Howard:

Can you teach a girl in Parsons, Kansas how to do all this?

 

Laci:

They're the best person to build a relationship. The person in Kansas is going to build a better relationship, relationship, care, trust, with your patients ...

 

Howard:

Attitude.

 

Laci:

Than the one in Chicago. Not to say that they're not nice in Chicago, but the person in Kansas is going to be, "How was soccer practice? How are your kids? Oh, my gosh, I saw on Facebook that little Johnnie is 13 now. Where do the years go?" That's what women, that's what patients, that's what we want now, in 2016. That's why social media is crazy right now, because it's all about the relationship. Can you teach somebody in Kansas? Absolutely. It's already born and bred into them. You've got to tweak it a little bit.

 

Bonnie:

Exactly.

 

Howard:

How much do you guys cost? What are the terms?

 

Bonnie:

We've got three different offerings, so we've got three different services that we provide. The easiest one to get into is what we call GPS coaching, which is remote coaching, and it is that "We've got your back" thing where we're logging into their systems on a monthly basis, pulling out their KPIs, taking a look at their P&Ls, making sure of their overhead and then coaching calls with them ...

 

Laci:

Weekly.

 

Bonnie:

To get them understanding the numbers and figuring out what goals do we need to set, what are the KPIs we really should be looking at, to get you back ...

 

Howard:

What is KPI?

 

Bonnie:

KPI is key performance indicators.

 

Laci:

Those are your numbers, your production, your collection, what you're hired to ...

 

Bonnie:

Right.

 

Howard:

I know, but they didn't.

 

Laci:

I know, I know, I know.

 

Bonnie:

Your production and then your net production, what are you writing off, your collection and your net collection, what's your bottom line. How long is that money staying on the books? Do you have collection issues? What are your receivables?

 

Howard:

If that's [inaudible 21:59], how much is that a month?

 

Laci:

$895.

 

Howard:

$895, so ...

 

Laci:

That's a little bite of the elephant.

 

Howard:

Less than one PPO crown.

 

Bonnie:

Exactly.

 

Laci:

Right.

 

Howard:

In your experience, what kind of return on investment is that entry level, one crown a month? What is the return on that investment usually for the average doc?

 

Laci:

It's priceless, Howard. It's priceless.

 

Howard:

I know, I know, and I know friends that swear by you.

 

Laci:

Here is my thing.

 

Howard:

Why would they go buy a biolase, a CBCT and a CAD cam, and then fly all the way to the Pankey Institute to learn how to ...

 

Laci:

Because that's what they know.

 

Bonnie:

It's comfort.

 

Laci:

Because that's what they know, and that's their passion. That's what they want to know. How many dentists, honestly, that wake up in the morning and go, "Oh, my God, I can't wait to review my numbers"?

 

Howard:

Can I tell you something that I've noticed, and Ryan knows this. My son is my ...

 

Laci:

We love Ryan. We're going to steal him.

 

Howard:

I've been in Ahwatukee since 1987, and we ate in a lot of restaurants because my ex-wife, if you wanted to hide anything from her, you put it in the oven, so we always had to eat out. Here I am, with an MBA from Arizona State University ...

 

Laci:

That's awesome.

 

Howard:

... I would always say, "Hey, is the manager busy? I don't have a complaint or anything. I want to meet the manager, the owner." The owners would come out, and I would say, "I'm curious. How many people eat here a month? What's your average dinner?" I would ask them any numbers. They wouldn't know any numbers, an they were always out of business in one or two years, and 28 years later, there is only two restaurants that are still there, bringing in $3 million a year, and it's Va Bene and CK's, and 28 years ago, those managers could tell me every one of their numbers. I'm sitting here thinking, okay CK's, it's beers and cheeseburgers and chicken fingers, and obviously no one drove across town to eat their food, but he's in business because he knew his ... so many different businesses, it's always the people that know their numbers that are always in business, and some of the best-tasting food that was ever made in Ahwatukee was gone a year later.

 

Laci:

Even on DentalTown, Howard, I've seen the posts. I am not even kidding you because I follow way too many of the threads. I get 500 posts if I don't look at my email in a day and a half. It's crazy, but even on Dentaltown, it is so divided. You have those dentists who say, "Ask for help, get some help," and then you have those dentists who say, "Why do you need somebody else to tell you this? You should know it. You shouldn't ask. Don't ask for help." It's crazy to me that it's okay to ask somebody how to do an amazing crown or how to do [inaudible 24:48], how to do an implant, how to do better hygiene programs, soft tissue management, but it's not okay to ask somebody for help with your actual business. I don't understand that.

 

Howard:

There is my identical twin brother, or he's the partner ...

 

Laci:

Every time I see him, I want to run up and bump into him and see if I can knock him down, which I think I can.

 

Bonnie:

Good shot, Ryan. Good shot.

 

Laci:

Yeah, yeah.

 

Howard:

It's sad, it's sad because, every year in Phoenix that I have ever lived there, one to three dentists commit suicide, and I have either known them directly, some of them I have had in my front room crying, and some of them, at the very least, I knew them indirectly from one of my very best friends. I would say of that deal, maybe 25% were substance abuse, but 75% were financial abuse, and they kept chasing the ultimate root canal, build-up and crown, but their house was never in order. I want to ask you another question. Here is the flip side to consultants. How do you specifically deal with this that I see it a lot? The problem is, your a dentists, but your lifestyle, it's like you're Mick Jagger in the Rolling Stones.

 

 

How do you go into a house ... not to throw women under a bridge, but his wife is bat shit crazy and will only buy a $5,000 Gucci purse, and she has to drive a Mercedes, even though when he met her, she was a waitress at the Waffle House? What do you do when you go in there and say, "Dude, you're not Mick Jagger. You're a damn dentist. You're not the Rolling Stones." Do you see that very often?

 

Bonnie:

I think that comes out ... Again, start with the numbers. If you look at their overhead and what they're pulling home, they're outliving it, so their debt ratio is unbelievable. It's an uncomfortable conversation, but it's conversations we have to have.

 

Howard:

Is it very common?

 

Laci:

Oh, yeah.

 

Bonnie:

Yeah.

 

Laci:

Do you know how difficult it is when somebody hires you to come in and fix their house and clean their house, and they're the issue?

 

Bonnie:

Right.

 

Laci:

That's a really difficult conversation.

 

Howard:

Say that again? Say it again.

 

Laci:

When somebody hires you ...

 

Howard:

They're the bad guy.

 

Laci:

Yeah.

 

Bonnie:

You're the problem.

 

Howard:

What percent of the time is that the case, though? Seriously. All the time, or all the [inaudible 27:08]?

 

Bonnie:

Out of the clients that are calling us, I would say 30% maybe, but that is the ones that are calling us, they've got some challenges, but at least they're having the conversation. We can help at that point, but I would say the ones that are calling us ...

 

Howard:

There was a dentist in Scottsdale that came to my house in tears, and I said, "Calm down and bring your receipts, and I will go over them." The guy had five cars, and they were like BMW, Range Rover, Mercedes. He didn't have one ... and here I am, I have a 2004 Lexus with 120,000 miles. I am like, "Dude, my car is 12 years old, and you have five cars, and you make payments on each one." That's like ...

 

Laci:

That's that guy that you asked, "You charged $1,200 for the crown. How much did you actually make on that crown?" and he looked at you and said, "I have no idea."

 

Bonnie:

Right. Some of those, when we uncover that, we don't hear from the again sometimes because they're not ready to deal with the problem. "Here's your problem. You're looking at it in the mirror every morning. When you're reading to deal with it, let's deal with it."

 

Howard:

Now I want to turn this conversation completely, so forget everything we said, start all over. What is your name again?

 

Bonnie:

Bonnie.

 

Howard:

Who are you?

 

Laci:

I'm Laci.

 

Howard:

Laci?

 

Laci:

Laci. Nice to meet you, Howard.

 

Howard:

Laci, I graduate from dental school this year. I am going to have $300,000 in debt. If I was your daughter, what advise would you give me?"

 

Laci:

Grow out your hair. Sorry, I couldn't resist.

 

Howard:

Because here's the question you're asked on Dentaltown. "Would it be better financially if I was a specialist?" because you even said that specialists have lower overhead than general dentists. I have heard rural is better than big towns. Is that true? Should I go get a job? What should I do? Because the bottom line is, when I look at the bottom line of the show, if 8,000 people watch this show, probably 10 or 15% are probably going to be juniors and seniors in dental school, and all the rest are going to be without, five years out. I never get a 53-year-old to send me an email, "Howard, Dentaltown, I'm a big fan of your show." It's always "I graduated three days ago." Talk to these kids like it was your own daughter walking out of school at $350,000. You've seen all the come to the fork in the road, "Go this way, not that way." She's $350,000 in debt, she is your own damn daughter, talk to her.

 

Laci:

I'm going to let you go, but, first, I want to say congratulations. You should be so proud of yourself. You've picked an industry that's actually amazing, and there is a ton of resources out there. First and foremost, be super proud of yourself, and then don't hesitate to ask for help.

 

Bonnie:

We're going to talk about one of the clients that we're actually working with, same situation. Let's talk to you, and let's think about your goals, long-term, short-term. Where do you want to be in five years? Where do you want to be in 10 years? What's your niche? What kind of dentistry do you want to do? Then let's set the good standards of spending money and making money and where do we put our team, and how do we fill this three-year/five-year plan. Where is your blue ocean? Where is your strategy? Where do you want to be? We have a dentist we're working with now that is new in the area ...

 

Laci:

Oh, my God, she's amazing.

 

Bonnie:

She went back to her hometown. She's amazing. She's wonderful to have business conversations with. Don't shy away from business. Talk about the hard conversations. She's bringing in 100 new patients a month.

 

Laci:

You know what she did, Howard?

 

Howard:

Is she single?

 

Laci:

No, but I almost said yes.

 

Howard:

See? You thought I was going to get married again.

 

Laci:

You know what she did, though? She researched where she was going to put her practice. It's the smallest ...

 

Howard:

Doesn't every franchise in America do that?

 

Laci:

Franchise, yes, but do we in dental do that?

 

Bonnie:

No.

 

Laci:

She researched. There is not another dental office within a 17-mile radius of where she is. She also went next to a Kroger.

 

Bonnie:

A Kroger.

 

Laci:

Grocery store.

 

Bonnie:

She's awesome.

 

Laci:

She's amazing.

 

Howard:

What state?

 

Bonnie:

Georgia.

 

Laci:

Georgia. She had 131 new patients in the month of March. You know what I mean? She did her research. Sometimes we have to throw things up in the air and see if they stick, but there's a science behind all of this. What's really great about dentists? You guys are scientists anyway. You have that mind, you have that concept for it, so this is scientific as well, putting it all together, and Bonnie is absolutely right. It's not, in the beginning and throughout but in the beginning especially, about setting your numbers in your business, but we need to make sure that you're on track with your personal finances. We need to make sure that you're taking care of yourself as well as the business.

 

Bonnie:

Let's go back. You did say earlier that specialists had lower overhead. Is specialist worth the return on investment? Do you think specialists have an easier gig than a general dentist?

 

Laci:

I think chiro. Not chiro. I'm sorry, ortho. I think ortho is ... I love watching orthodontists. They are rock stars, man. THey've got it going on.

 

Howard:

You know why an orthodontist has got it going on, and why general dentists mess up with so much of their CE? It's, if I say to 100 women, "Would you rather spend $500 on veneers for yourself or braces for your daughter?" biology says braces on your daughter. I've got four boys. I'd give any one of them my liver, my kidney, my anything, and they always are going to courses like Pankey's, Scottsdale, Kois, Speer, they're always learning how to do full-mouth rehabs on 80-year-olds who should be taken to the vet and be put down, and then they wonder why they're not sold. Then I say, "In business line, can you do ortho? Can you do a chrome silver crown?" Because mom will give plasma to fix her baby. She ain't going to give plasma to fix her husband or her 80-year-old dad. The orthodontists are kicking ass because biology says you would do anything for your offspring. You've got two kids, right?

 

Laci:

I do, I do.

 

Howard:

That's why you said you hate me, because your kids didn't turn out as good as my four kids.

 

Laci:

I know. Your four kids are amazing.

 

Howard:

I know, I know.

 

Laci:

Ryan is actually my favorite.

 

Howard:

She said she would throw her two kids way to have my four kids, Ryan.

 

Laci:

I would take Ryan home with me today, and not know [inaudible 33:23].

 

Howard:

Ryan is like, "Please tell me she's a cougar. Please tell me she's a cougar."

 

Laci:

No, the ortho, look at the business model of ortho.

 

Howard:

Let me ask you another question because we get this question a lot. Is it a return on investment to get a residency for a year to go to specialty school? Is that a better ... ? You're a business consultant. Is it a better business thing to become a specialist or set up my own practice?

 

Bonnie:

Yeah, I would have to run the numbers. I honestly don't know the answer to that question. I know once they're out. I can you where their overhead ... and they do make more money, but I don't know cost. They're investing in themselves versus ... but I will absolutely research that.

 

Laci:

Here is what we will do, Howard. If you're a GP, get the specialist in the same building as you.

 

Bonnie:

Right.

 

Laci:

I think that's where we should go with this, is not necessarily large corporate practices, but if you're a GP, get the specialist in the same building with you. Have an orthodontist in there, have an oral surgeon in there. You guys work together. You're partnering. All your patients are right there in one building. You're sharing them. They're not going anywhere else.

 

Howard:

Here's another question specially that they're going to ask. I just got out of dental school. I am $350,000 in debt. I read all the trade journals, and they say I've got to buy a $150,000 CAD cam, a $75,000 biolase, and a $100,000 3-D x-ray machine. I buy three things, and I have doubled my dental school debt. Do I have to buy those three things to be a good dentist?

 

Laci:

No.

 

Bonnie:

Absolutely not. Do you want to ... ?

 

Howard:

Lay it out. You're the only ones saying it. Every marketing dollar in dentistry is you've got to buy these three toys.

 

Laci:

No, no. I don't let you talk. We do this all the time, but ...

 

Bonnie:

She rarely lets me talk.

 

Laci:

... I would rather see you invest in outside companies that can enhance what you're already doing in the beginning than the technology. For example, communications companies that are allowing us to communicate with our patients the way Americans like to be communicated with now. Data mining, so I can pull out of my practice management software all of the patients in the last 12 months that have had some sort of periodontal procedure done in our office. I want to send them a newsletter about periodontal disease. How about a phone system that actually tracks how many times did my business team answer the phone? Did they actually schedule from that? How about social media? Why don't we invest in the things that cost us very little but absolutely enhance the business side of it, and then we build up what we need for the technology aspect of it? Get your dentistry, get your house ...