Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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810 Insurance and Office Managers with Teresa Duncan of Odyssey Management, Inc. : Dentistry Uncensored with Howard Farran

810 Insurance and Office Managers with Teresa Duncan of Odyssey Management, Inc. : Dentistry Uncensored with Howard Farran

8/15/2017 2:41:50 PM   |   Comments: 0   |   Views: 310

810 Insurance and Office Managers with Teresa Duncan of Odyssey Management, Inc. : Dentistry Uncensored with Howard Farran

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810 Insurance and Office Managers with Teresa Duncan of Odyssey Management, Inc. : Dentistry Uncensored with Howard Farran

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Teresa Duncan received her Master of Science degree in Health Care Management from Marymount University and has worked in healthcare for over 20 years.  Her company Odyssey Management offers online courses and training materials for insurance coordinators and managers. She’s worked at every position in the dental office that didn’t require a license – from taking out the trash to answering the phones on the front line to managing the whole operation.

You can find her giving insurance and management courses at meetings like CDA, Yankee and Rocky Mountain. She’s plugged in with office managers and insurance coordinators across the country who depend on her for regular updates on PPOs and claim management.

She’s been named one of the Top 25 Women in Dentistry by Dental Products Report (in 2015) and is in that big issue of Dentistry Today under Leaders in Dental Consulting.  She just put out a great book for teams who have to deal with insurance – which is almost all of my peeps – called “Moving Your Patients To Yes: Easy Insurance Conversations.”

Howard: It is just a huge honor for me today to be podcast interviewing a mentor of mine for decades, Teresa Duncan of Odyssey Management Inc. She received her Masters of Science Degree in Healthcare Management from Marymount University and has worked in Healthcare for over 20 years. Her company, Odyssey Management offers online courses and training materials for interns, coordinators, and managers. She’s worked in every position in the dental office that didn’t require a license—from taking out the trash, to answering the phones on the front line, to managing the whole operation. You can find her giving insurance and management courses at meetings like CDA, Yankee, and Rocky Mountain. She’s flood-in with office managers and intern coordinators across the country who depend on her for regular updates on PPOs and claim management. She’s been named one of the top 25 Women in Dentistry by Dental Products Report in 2015 and is in that big issue of Dentistry Day under Leaders and Dental Consulting. She just put out a great book for teams to deal with insurance which is almost all of my peeps called, “Moving your Patients to YES! Easy Insurance Conversations.” Teresa, I’ve been a fan of yours for 20 years. Thank you so much for coming on this show.

Teresa: It’s my pleasure. Thanks for having me and Ryan too.

Howard: Oh, Ryan. So, yeah—you got a boy and Ryan, when Ryan graduated from college, I said, “What will you do, Ryan?” He said, “Well, Dad, your show really sucks so I’m going to come” He says, “It really needs some help” So he says, “I’m going to move back at home with you for a while to get your show to where it needs to be.”You know, when you ask people what percent take PPOs, well, 95% of them take Delta and isn’t Delta PPO?

Teresa: It is a PPO and it’s the big gorilla in the room, everybody is taking Delta. And they’re hating it—

Howard: What percent do you think take Delta?

Teresa: I’d say you’re about right with the 95%. Some form of Delta, like the Premiere or the PPO, and you know, we’ve got people that are hanging on the Premiere thinking it’s going to be around forever and I just don’t see that happening. So I think that’s a great, I would say definitely over 90% of the market. I don’t have numbers on that

Howard: Well, if you look at Delta’s if you go to any other... well, it’s kind of a bad rep to say Delta because there’s just about 19 different Deltas, right?

Theresa: Yeah

Howard: So, there’s Delta of Arizona, there’s Delta California, but if you go to their websites, the first thing they do is they brag on their market share. I mean they’ll  say, “Buy our insurance because its number is always over 95, 96, 97, some say it’s 98. So, would you call Delta Premiere a PPO?

Teresa: Yeah, sure because they ask you to reduce your rates in exchange for basically them trying to fill your chairs or filling your chairs. So, yeah, I do. I would consider it PPO.

Howard: So basically, an insurance, a PPO, is a volume discount. So basically, I can sell you a tonking toy truck for 10 bucks, but if Walmart says, “We want to buy a hundred of them, we’re not paying 10 bucks, we’re only going to pay 8 bucks.” So, I’ve always thought Insurance, at the end of the day, was just a volume discount. And I always thought it was interesting how dentists won’t blink at reducing their fees 40% to sign up for a PPO and then when you say, “Well, hey you know, half of America doesn’t have dental insurance. Why don’t you spend 5% collected on advertising for the half of America without dental insurance?” And they go, “Nah, I don’t want to do that. I don’t want to spend 5% getting someone without insurance. I’d just drop my price 40%.” You see that?

Teresa: You know what’s funny about that is that it’s all about like they’re worried that they’re not going to have a tangible result from spending five or eight percent on your marketing, they are thinking, “If I spend this amount then I must get this in hand.” And they’re not going to get that. Now, your prior analogy where you said, you know, “If Walmart gets the price down to $8 a price or $8 a piece for a hundred sales.” So the argument there is that you would have a hundred sales, but that’s not guaranteed being on the PPO plan, you’re basically just hoping that people walk in the door and dentists are reducing their fees by 30, 40% and there’s no guarantee that those patients are still going to come in the door and see you. So, like you said, they’re not spending money on marketing, they cry about it, but then, 40% of a write-off is not that big of a deal to them, they don’t even negotiate their fees a lot of times which is a little frustrating for me. So, I would love to see them at least try to negotiate, just give it a little bit of an effort.

Howard: So, what is the best place for them to buy your book, Moving your Patients to YES! Easy Insurance Conversations? Will that be on your website, Odyssey Management?

Teresa: Yes,

Howard: And where did you come up with the name Odyssey? I know you’re named Teresa Duncan is because your father owned Dunkin’ Donuts, where did you get Odyssey Management?

Teresa: So, Odyssey Management. I double majored in college, I was pre-med and then classics, philosophy and religion and I really liked the Odyssey. That was one of my favorite books to translate, and to analyze and so, to me, Odyssey is being on a journey and that was where I started. I thought, you know what, this is perfect for what I’m doing because, you know, when you start out being a speaker-consultant, you don’t know if anybody’s going to come listen to you, you just kind of hope. So, it was a real journey for me, getting out of private practice.

Howard: So, there’s a book called, “The Odyssey”?

Teresa: Yes. Homer.

Howard: Oh, When was that written?

Teresa: Oh my God. That’s ancient Greek times.

Howard: Wow. And you’re a big fan of Homer and his book, The Odyssey?

Teresa: The whole idea of ancient civilizations is amazing to me. You have all these civilizations that managed to come up with math, the basics of math, language and philosophy, and here we are sitting around with smartphones, we can’t come up with very much that’s original anymore because they did it all back then. That’s amazing to me, and the old—

Howard: And every civilization had a religion too, I thought that was very interesting.

Teresa: Yeah

Howard: You’re a religion major, does that mean you’re a hippie or you’re religious?

Teresa: Neither, more like, just seriously curious. That’s pretty much me, but I did five years of Latin, and so when you’re a Latin, you take a lot of Latin class so you just kind of end up taking a lot of Greek History classes, Art History, and that was kind of my fun stuff because my mom had it set that I was going to med school, so that was a great disappointment to her that I ended up not going to medical school. So, we were talking earlier, I am half Asian, so when you got an Asian mom and you tell her you can’t go to medical school or you don’t want to, there’s fireworks.

Howard: That’s funny, but yeah. So, Latin, pretty much lifted everything from the Greeks before them.

Teresa: Yeah. The Greeks, they are the OGs. They are the original everything. I should make more time and go back to that kind of stuff because I used to just sit around and read all of the plays and the dramas, that’s fun stuff to me, but I haven’t gotten back to it recently, I’m too busy doing this stuff, Dentistry.

Howard: Well, this is a very big pain for Dentistry, so basically, in a nutshell, my dental office just turned 30 years and when I graduated in ’87, Delta paid me a thousand for a crown and a thousand for a molar root canal. Now, 30 years later, I get a $600 for a crown, $600 for a root canal, yet every time the earth went around the sun, my staff all wanted a dollar raise and inflation lifted the cost of all my electrical, my goods, and my supplies. So, you’re supposed to do everything better, faster, easier, higher quality, lower cost, and this insurance is huge because when they drop your revenue 40%. Imagine if American Airlines United said, “You know what, Southwest Airlines is number one, they have 27% of the market, we’re going to reduce all of our fees to beat Southwest Airlines.” Well, they’d be bankrupt in 90 days because the only secret to lower prices is lower cost. These dentists signed up for these PPOs, but they sure as hell didn’t lower their overhead 40%.

Teresa: No. And overhead, you know, gets away from an office. That means the doctor can’t control the staff and all that kind of stuff, so the conundrum is, we have really good long term employees, but they are legacy employees who cost us more so it’s hard to get around, so we’re not reaching the point yet where we have unions and legacy cost but that’s a pretty decent analogy, it’s really hard for us to control our operating costs. Dentists aren’t necessarily good at that, they’re just not. They don’t take any classes on that or anything, so this whole insurance thing is supply and demand, there’s too many dentists the networks don’t even need us that much. So, imagine losing 30 to 40% without even planning on it. So, maybe you think you’re going to get off of PPO when you go through the motions, but what happens if you get a letter and the PPO saying, “By the way, you’re off of our network, we don’t need you anymore.” That’s what I’m hearing a lot of. So, I don’t know if many of dentists out there are ready to just lose 20 to 30% of their patients or to have that conversation.

Howard: And then these dentists will go by a practice, they’ll get out of school and then go by a practice; labor should be 20% max, that’s max. You got 25 to 20 but that’s like the matching that’s health insurance, 401K, total max and they’re buying these offices that are 38% labor and then you buy this office and I can’t go to you and say, “Well, Teresa, I know you’ve been with me 30 years and I give you a dollar raise every time the earth turn around the sun, but right now you’re making a $32 an hour as my... and I got to reduce that to a 16.” And if you say yes, now you come to work passive-aggressive. My CEO friends that own DSOs, they say they would just rather start a Renovo because going into an office, buying it, the only way they can fix labor is to fire all the legacy employees because they entered dentistry when crowns are a thousand and root canals are a thousand and now those are both $600 and they still misdeal that, well, I’m an expensive dentistry and, I’m a baller, and this is the kind of money I’m making and they’re like— I mean, most hygienist will make $40 an hour and they’re doing a PPO cleaning. That’s only $40 an hour, $40.

Teresa: Yeah, and they’re not talking treatment either. There are a lot of really good hygienists out there, but what I’ve noticed is that when you have that culture of having to be fast, efficient, let’s turn them over, you’re not going to attract the kind of people who need to talk about treatment, who want to talk about treatment. So, yeah, I think we are in a really difficult place today with insurance. One thing that I will tell you that I see, I’d love to hear your thoughts on this, I think the hardest part of being a business center is not the dentistry, honestly, it’s not the insurance, I think it’s always the people, it always comes back to the people. When you start out as an associate, you know a lot of your homies on Dental Town, they’ll start out as an associate and then plan to open their own office, what I tell them is, “Don’t pay attention to what the doctor is doing in the operatory or what the PPO plans are doing, pay attention to the leadership. If it’s good leadership, you emulate that, if it’s bad leadership, you know what the heck not to do when you get out there. It’s the people skills that are going to really crash and burn an office over the long run, I think.

Howard: Yeah, I also think it’s funny to have this, “Life is an attitude, gratitude determines your altitude.” And they’ll be saying, “Ugh, I hate that I’m working in corporate, I can’t wait to get on my own.” And then I’ll ask them like, five simple business questions. “You fool, you work for a company that manages 500 offices, do you think maybe somewhere in that corporation maybe somebody knows a little bit more than you?” Think of all you could learn, I mean, hell, you could just steal all their documents and put your name on them. I mean, God, all the business that you could learn in a company that has 50-500 offices.

Teresa: You know, I’m curious, Howard because I knew you are lecturing in dental schools and you get asked to go in and lecture dental schools, and I’ve done a small amount of those, I don’t understand why they’re not calling us to talk more and more about that in the dental schools. I mean, the reason I hear is that the D3’s and D4’s are just too busy, they don’t want to hear about the business, but I think that that’s just the wrong way to go. Do you see that changing in academia or no?

Howard: You’re not ready to learn, your mind is not ready to learn until you’re ready. I mean, I remember with all four of my boys, before they turned 16, they got their driver’s license and they were a passenger, so when they’re driving, they’re texting, they’re talking to me whatever, but as soon as you put them in the car seat, they’re like, “Where is it? Where is it?” “Dude, I’ve driven here a hundred times.” They weren’t paying attention.

Teresa: I just had this conversation

Howard: So, when you’re in dental school, you just want to graduate, and then when you graduate, then they just think they want a job. And the problem with their job is the fact that if your dad paid for dental school and you get married and have no kids and you have no debt, and you have no kids, and you and your wife from dental school each get a job at corporate and you’re making a buck fifty, hell, you’re making $300,000, you have no overhead, you have no debt, you’re a baller. But if you sit there and you come out of dental school $350,000 in debt because your daddy wasn’t a rich dentist  to pay for it or you got married in dental school and had a kid, and now you’re $500,000 in debt, or you went to two years afterwards and became a periodontist, BS orthodontist, whatever, and they’re coming out now $600,000 debt, you could never pay that off getting a job as an associate. You used too much of other people’s money and now you can’t even buy a practice for 750, you need to go buy a $1 million practice that has $80,000 a month in cash flow to pay that back in 10 years. So, a lot of them, they don’t realize that if you use other people’s money past a certain red line in the sand, you’re going to have to own your own business.

Teresa: Yeah, and there’s not a lot of those million dollar practices that aren’t being snapped up by the larger corporations anyways or the DSO’s themselves, so it’s hard to compete in that market just building out, doing the Renovo is great, but then you got to find a place that has cheap construction, that has a multitude of clients or patients, I call them clients but patients. I think it’s very difficult nowadays to be a business owner more so than it was when you were starting out, I mean, I’ve been in it 20 years. I started out with my dentist; a lot of the business decisions he has to make now are way more complicated than he ever did way back then.

Howard: Well, I would say that’s true in where half of America lives, in the urban 119 largest city metropolitans, but I’ve seen some dentists where their mom came from Asia. Your mom came from Vietnam, their mom came from Brazil, or their mom or dad emigrated from another country and then they graduate from dental school in downtown UMKC and I say, “Well, your mom came from India, why don’t you go two hours away from town and I just found a little county of 6,000 people in the county and it has a little city of 1,200 and there’s no dentist there. And every time a dentist goes there, no insurance, no PPOs, they set up their thousand for a root canal, thousand for a crown, they’ll do a million dollars and take home $350,000 a year.” And these millenials just say, “No.”

Teresa: They don’t want to live there.

Howard: Now, I’m going to live in downtown Kansas City.

Teresa: So, I was just in Vegas and they were saying there are so many offices opening up in Vegas that there’s waiting list now for the contractors because there’s no good contractors. That was another thing I thought was interesting. People have left Vegas and now you have a waiting list for contractors to even build out the practices, but they’re still flocking there. So, you’re right. You go a couple thousand miles out, you’d have the world, but everybody wants to live near the city, you know, airport. I get it, I get it.

Howard: Well, the rule of thumb is, if you want to find a dental office that doesn’t take insurance, so to say, I mean, you call most dentals, “How much is a crown? A thousand?” And I say, “Why do you say that? Because 95% of the crowns you’re doing are on a PPO fee and your adjusted production was down to $600.” Then I’d say, “What percent of your practice you want to build?” Now, “I want to build the cash.” Well, if you want to build the cash, why do you give them a 40% penalty? So, you tell everybody that you charge a thousand for a crown, but then when they come in and bring in their insurance, you just stopped at $600 but that 50% of America without dental insurance, all they hear is a thousand for a crown, so they hang out, they call the extra thousand, thousand, thousand, thousand… So, if your cash price is only being realized by 5% of the market, why is that 40% higher than all of your fees? But the only people I know that have the cash price are doing a thousand for a crown, a thousand for a root canal or $1,250 for a crown and $1,250 for a root canal, they’re all same things, they’re in a town of under 5,000, 2 hours away from a major airport. And though work four 10-hour days and they’ll pay off all their student loans in a year or two, and then they’ll just commute in for the weekends.

Teresa: I’ll never forget this couple that came to see me at Starla, Nork (0:17:57 unclear), they were adorable. It’s a husband and wife, she’s the dentist, he’s managing the practice and they were telling me that they are the only two employees of this office. It’s just them and they live in a similar situation, they’re outside the skirts of Minneapolis, they have a very busy robust practice, they only work as many days as they want, they have low overhead because they bought an old building, renovated it themselves. Low overhead, it’s just the two of them—they answer the phone, they return phone calls, but they don’t need to answer it live all of the time, they submit their own claims everything, and this is what cracked me up instead of the morning huddle, they told me they have a morning cuddle.

Howard: Oh my God! So, that’s a man and wife?

Teresa: It was a man and wife and I said—

Howard: Do you remember their names? I so want to podcast them.

Teresa: Like 3 or 4 years ago. If they’re listening, contact Howard. They were so adorable. But you know, I said, “Do you want to grow? What do you want to do?” And they said, they were just taking my class to make sure they were doing things right with insurance, and they said, “We’re happy. If we want to close the office and go, you know, camping,” they can. They want to spend time with their kids, they make sure they block it out on their schedule, like that. They were so simplistic that it was really jarring for me to hear that because, you don’t hear that. You hear grow, grow, grow, more operatories, more offices, more space, and here’s these people that are, you could see them that they were just happy.

Howard: We were talking earlier about legacy, where the problem is, lot of these dentists if you go look at the economics of their business, all they are is job providers. That’s all they do. I mean, they were born with the sole mission to do almost free dentistry and create jobs, and that comes from back when these insurance companies were paying bank thousand per crown, a thousand per root canal. Now that the fees have come down to where they’re at, that’s why I love lecturing around the world, I mean, I’m in 5 continents, I was in 5 continents last year,  these countries have been through this deal and what they end up coming back to is that this high production facility of running three chairs with all these assistants and all these interns nonstop, it just does not work and then you find the most profitable dentists going back to that one chair, no employees, one dentist, I’ve seen this sometimes in Singapore where maybe the mom is the assistant and then works the phone and the phone is her iPhone and they go back to where they say, “Okay, we’re only going to gross $400 this year but I’m going to take home $300.”

Teresa: Yeah. How did you like lecturing in Singapore? Because I did that a couple of years ago and it was so hot, so hot, that’s all I remember really, just so hot.

Howard: I always know where I’m at by looking at the satellite antennas because, you know, when you go out to like, Moscow and Warsaw and Quebec, they’re almost at a right angle on the roof because they’re all going to the equator. But when you go to Singapore, they’re all facing straight up. I mean, Singapore is like 1 degree south of the equator, so every satellite is straight up. So what do you think the pain points are for insurance?

Teresa: I think no one’s confident in what they’re talking about, I mean, that’s a lot of the reason why we are at the book. I’ve got a lot of people that take my class and they’re saying, “I can’t give patients a really good estimate on how much is owed because the insurance company keeps changing what is going on with their benefits.” And it’s not like they’re changing it to be super malicious, the changes are regular and are rules, but when you got an office who’s got steady flow of patients, they don’t have the time to sit on the phone and call and get benefits all the time but that’s what we end up having to do. So, if I go in, I’d say it’s going to be 80%, your portion is going to be 20%, I have to be pretty confident than that and my patients are going to smell that and then we get the bad review. So, I just get a lot of people who don’t feel comfortable talking to patients about their insurance because they’re not sure they’re correct all of the time. And you know, they’re changing the plan structure, they’re changing networks, doctors are finding out they are on networks before, you know, they even get notifications in the mail that they even get something, patients are telling them which network they’re on. That’s what’s funny, you know, and I don’t know if that’s happened to any of your, actually, probably not to you, I’m sure that the people on DentalTown, you know, they only got a call that patients will swear up and down that you’re on their plan, you’re going to check the plan and sure enough your name is on there. So, you got people who just don’t know for sure what they’re talking about and they know it and the patients smell that a mile away, and so as a result, you’re having a hard time closing treatment. I’m reading the forums, I lurk on your forums, I definitely see that they’ll tell the patients something and B comes back looking completely different.

Howard: So, it seems like when I find an office that’s dotting the I’s, crossing the T’s they actually call another human for every single time. What do you recommend? Do you recommend that for your high volume practice, you need a full time person that needs to sit there and dial insurance companies and talk to humans, or have you found third party companies that do these as better and cheaper and faster?

Teresa: You know what, there’s a couple of companies who are doing that right now, outsource, they’re the ones who can sit on the phone all day and talk. It’s getting better and better, I think that there’s still a wide market if anybody is out there thinking about, you know, “I want to stay in dentistry, but I want to start a business.” That’s a wide open market right now; we got a couple companies doing it well. But I know some that are doing it that they have a waiting list and that’s fantastic—

Howard: To get on?

Teresa: To get to be a client. Yes, so that they can come up—

Howard: Can you give us the names of those companies?

Teresa: Mary Beth is very busy. Mary Beth Bajornas, she’s got dental support specialties and from what I’m hearing, you know, she does a really good job.

Howard: She’s in Cleveland, right back at the Rock n’ Roll Hall of fame.

Teresa: Yeah, and there’s another lady that I work with, Insurance Billing Outsourcing. Her name is Leslie Icenogle and she’s the same way, she’s getting seriously busy. So, I think there’s a lot going on.

Howard: What is Mary Beth Bajornas’ website?

Teresa: It’s Dental Support Specialties, that’s the name of the company. And then Leslie Icenogle is at

Howard: See my thumbs are too fat for iPhone, that’s my problem. I need to lose weight if it comes out of my thumbs. How do you spell Leslie’s last name?

Teresa: I-C-E-N-O-G-L-E,, I think.

Howard: So, you recommend these two companies?

Teresa: Yeah, and you know what, I make the point of knowing that they have anywhere from $500 to $2,000 a month depending on your volume, other than that, I don’t know the specifics. But, here’s my thing. You know, I managed offices for a while and I’ve had great staff, medium staff, awful staff. When you’re outsourcing something like this where they’re just on the phone all day, it’s somebody who’s taking up space, taking up your phone, I’d rather just give it to somebody else and it’s one less person I have to deal with too. From a manager point of view, that’s one less personality in the office. So, if I were going to outsource anything, I definitely outsource that. You know, but the other thing too, Howard is that we have a whole generation of doctors who have managers who run everything and the person who ends up taking over the insurance is the manager just because she’s usually the one who’s got her hands on everything, and it is turning into a full time job. Then they find out that the managerial staff is kind of gone by the wayside because this person’s spending a hundred percent of their time on insurance, so, I’m really out there trying to say, “Look, if you want to really get a hold of insurance in your office, you need a full time person that’s going to be taking a look at this or else you’re really losing money.”

Howard: In MBA school they ask you a very simple question. Can you add value to this? Like, I have Dental Town magazine and so, the company that prints it, I don’t buy a printer because the printing thing I can’t add value to the printing, but the guy that does the printing of my magazine, he runs it 24 hours a day, 7 days a week. The printer costs about $5 million and when they turn it on, they never shut it off, and then after about 3 years, they throw it away. So, the question is when you call and verify the insurance, well, there’s no customer service magic, there’s no new patient experience. I mean, that’s an algebraic equation, what you’re saying is, you can’t really add value to that.

Teresa: No, and you know, I got offices, doctors are fighting with me too sometimes. After class, they come up and say, “You know, you’re telling me to spend more money to participate with insurance.” My push back to them is, “Look at your best person who’s doing insurance, the smartest person is doing all of your insurance, just take a look at her and see what she’s doing all day. She’s constantly running behind because she’s always on hold with some insurance company which means she’s not talking to your patients, which means she’s not working on improving the reports. She’s just on the phone waiting to hear 80%, 70%, 60%, so, if you want to keep paying somebody to do that, great, but I’m telling you there’s a better way.” That’s my push back. Traditionally, there’s been in dentistry, a resistance to outsourcing, that’s pretty resistant. I think we’re at a tipping point now where people are realizing it doesn’t always have to be the staff that’s upfront that we can see every day. It can be other things, like the appointment reminders, the electronic claims, all of that can be outsourced and the marketing can be outsourced, it doesn’t have to be your person upfront who’s trying to do 500 different things and poor office managers. I talk to a lot of them across the country and they just don’t have time, they’re expected to do pretty much everything, they’re the “girl Friday” or the “man Friday” and that’s all they do is kind of put out fires.

Howard: Wow. So, your two were, Leslie Icenogle—

Teresa: Icenogle.

Howard: What is it?

Teresa: Icenogle, Like she’ll say, “I snuggle, you snuggle” is what she used to say.

Howard: Is she from Iceland?

Teresa: I have no idea. She’s blonde, so maybe.

Howard: She’s Icelandic and her website is then there’s the most talented, beautiful, Mary Beth Bajornas— how do you pronounce her name?

Teresa: Bajornas, I think.

Howard:  Patterson had me lecture at the Rock n’ Roll Hall of Fame a couple of months ago which is so damn cool. I didn’t realize the vice flying in there, I was telling the lady sitting next to me that’s what I was coming down to do and she says, “Look at the building, look at, it’s shaped like the old phonograph.” Have you noticed that?

Teresa: Yeah, I did notice that. Yeah.

Howard: I had no idea like what was that record label that Elvis Presley was on when we’re little with the dog and the phonograph? And you take these escalators up and on the very top of the room is just this little rock n’ roll place where they performed and it was just so damn cool.

Teresa: Did you see the wall? Did you see the Pink Floyd at the wall? I thought that was pretty cool. I was walking into it and when I looked up I realized, “Holy crap! This is the wall!” It just kind of look like an exhibit and that was awesome. So, it took me back a little bit.

Howard: And then the best thing about it is when it’s over, as we’re leaving, there was these two old ladies that drove like from several hours, they wanted to go to Rock n’ Roll Hall of Fame, they had no idea. They thought it was a museum, they had no idea it was so expensive again, so, me and my base tennis buddy, we gave them all of our dental identity and told them to go in there and tell them that they were dentists, so they walked in and used our name tags and I got them into Rock n’ Roll Hall of fame for free. So, that was even more important.So, if they go to, they can buy your book there, order your new book now, $20 plus shipping and handling. I love your book, now let’s go through some of the book. So, how can dental insurance coordinators move their clients to yes? Let me rephrase with this; So, we know that basically, the funnel to get into your office. We know the average general dentist is doing $650,000 a year and they’re taking home (0:30:36 unclear), specialists are doing a million a year and they’re taking home $320,000. Those are facts. But to do that $650,000 10 people have to land on your shitty website which has no Youtube video or anything. To convert one to call, three people have to call before your receptionist named after a piece of furniture, your front desk girl with no training can compel one to come in, and we need three people to come in with a cavity before your crappy treatment plan presentation can get one to convert to getting a drill, fill, and bill. And that’s how you get to $650,000. So, to get one filling you three people, to get three people you need nine calls, and to get nine calls you need 90 people to land on your shitty website. So, my question is; in the conversion when they call, it seems like, if I call you and I say, “Hello Teresa, I’d like to see the dentist, I broke my tooth.” Instead of you just going right for- get this butt in the chair, “Well, when would you like to come in? Can you come down right now because we have extra chairs, we’re not waiting around for a chair that’s not our chug point.” But it seems like so many receptionists go to, “Well, what insurance do you take?”

Teresa: Yeah, it’s the first thing they ask for. Its compulsory—

Howard: I know and they blow the conversion. You’re supposed to get their ass in a chair, and then a lot of times, when they get in the chair, in our chair and they find out, “Well, we don’t take your insurance or this or that.” The convenience factor, they got a credit card, they bought an iPhone, and they called their house in Disneyland and then they went out to eat sushi last night, they’re here, they like you, their new patient experience is great. You know what to be able to be awesome is just for you to do it now, right now here’s the credit card. So, I want you to talk about how much insurance questions should you be asking when your conversion rate on a phone call is less than 1 in 3?

Teresa: You know, the insurance has to be asked, you have to ask about it because we don’t want to upset the patient when they come in because they’ll feel like you were trying to pull one over on them but that’s not the last thing you should be asking for. So, say you called me and you have an emergency, you broke your tooth and I’ll say, “I’m so glad you called right now because I have an opening and I’d be happy to see you, could you come in today at four o’ clock?” You convert them, you get them in like you said, and then you’ll say, “I need some information from you though, can I get some pieces of information before you come in?” And then at the very end of that, you find out what’s wrong; the tooth, their name, where they found you, all that stuff. At the end is you say, “Will you be using any insurance benefits at your visit?” And it’s not what insurance do you take or not one insurance do you have or type of insurance, some of these people at the front, it’s like they’re going down a list and they just need to get through the list; name, date of birth, address, insurance, do you know where in network, do you know where other network, do you know your benefits? It’s so robotics sometimes, that’s another thing I love to see outsources, listening to the call recordings. Doctors really should be listening to these call recordings and seeing what’s being said out there. I did this for so many years and I would slip, I mean, if you were listening to me, I could be on 9 times out of 10 but that one time, it’s a disaster. Everybody has their off days. So, as far as getting the patient in the door, I want to ask them what benefits will you be using today and then they’ll tell me and then I’ll say, “Okay, I’m really familiar with that plan or I’m not familiar with that plan, how about I get your information and I find out about it and I have it ready for you when you come in?” And if I find out that it’s a loopy plan and we’re not going to be covered, we’re out of network, I’m going to let the patient know there’s an extra expense, it’s going to be out of network, it’s going to be out of pocket, we’d still love to see you and want to take care of you today. So, I believe we need to be honest with our patients but so fast are we getting to that insurance point that, we tend to talk about it first and we should be talking about it last, is my point. And I think about it too when I call my medical doctor for an appointment. I’ve been going to her for 6, 7 years, they still ask me every time I call, what’s my insurance before they find out what I need to come in for. That’s how medical is, and I think we need to be different from that. So, when I wrote the book, there’s a sample conversations in there about how to have that first phone call, and it takes practice too. Just like you guys do fillings over and over again. Front office people, they need to practice these conversations

Howard: Man, I just wish I could afford to go to the doctor. I can only go to the vet.

Teresa: Better treats.

Howard: You wrote an entire chapter on Words Matter; Oops, just the cleaning, cancellations. What words do you think matter?

Teresa: So words like ‘maximum’, ‘maximum’ really bothers me and I hear a lot of doctors say this. You know, they say, “well we can go up to your maximum.” And it’s like why are you deciding that for the patient? Let the patient decided how much they want to spend with you. But when you start using the word ‘maximum’, ‘maximum’ implies a stopping point in my mind. So when you say to me you’ll reach your maximum, I’m already subconsciously going, “Oh, I better stop. I better wait until the next benefit year rolls over.” And that’s what offices tend to do; they anticipate the objection and so they make it true. So, I’d like them to take that out of their vocabulary. Just the word ‘maximum’ just get rid of that. Those yearly benefits.

Howard: I have 4 boys; Eric, Greg, Ryan, and Zach. And if I had a fifth one, it was going to be named Maximus. I love that name, Max. It’s just such a cool name. It’s a great name for a boy but not a great term in dentistry because you think you are influencing their mind as time that they’ve reached their maximum time to stop.

Teresa: I do. I mean we here we’re not supposed to say we had a cancellation, we had a change in the schedule and you know when you hear these things for the first time, there’s a lot of us—I did the same thing—a lot of us will go, “You’re nitpicking.” It doesn’t really make a difference if you say ‘maximum’, It doesn’t make a difference if you say ‘cancellation’ But in reality, when you say it enough times, it really does make a difference. So we have to give each other permission to like, ball up a piece of paper and throw it at each other if we hear us using those terms. So,Oops is the very first part of the book and that’s kind of a throwback to my boss because I was a really bad assistant, like the worst assistant ever. And what I would say a lot when I drop something or when I didn’t have something, I go, “Oops!” all the time and he finally, after 6 months he pulled me aside and said, “Look, you got to cut this out. You just can’t keep saying, “Oops!” because a patient’s thinking like I dropped something or I did something wrong and it does make a difference. Words do matter. So—

Howard: How does ‘cancellation’—how does that mess up your mind?

Teresa: Well, you’re setting a precedent that people cancel all the time. So you know and it is semantics, but I do think semantics, it makes a difference. So you don’t want to say, “Oh you know, somebody didn’t show up for their appointment.” Because what you’re doing is saying, “It’s okay if you don’t show up for your appointment.” So if you’re trying to enforce this ‘everybody shows up for their appointment’ mentality, when you constantly are telling them there’s changes in the schedule, or there’s cancellations and no-shows, somebody didn’t show up, you’re saying this is a common occurrence in your office. So we want to make it sound like, “Oh we just had an opening just for you.”

Howard: Well when I think of words matter, what I used to do with my associates and others, I would, when smartphones come out and tape recorders is, I would tape their presentation. And then I would print out and I would take a black magic marker and write out every damn word that they don’t know what it means. You know, they say, well you know, you have an inner proximal lesion on the distal number 3 and it’s causing irreversible pulpitis and you’re going to need orthodontic therapy—

Teresa: Yeah.

Howard: Then opposed to build up full coverages. I mean, why don’t you just stop all of that. You have no idea what you are talking about. I mean endodontists right now are starting this campaign where they don’t like the word “root canal” it’s got a bad look to it. So they want to call it endodontic therapy and all these TMJ idiots, they’re like, “It’s not TMJ, it’s TMD.” Dude, all the Americans call it TMD and root canals.

Teresa: Yeah, exactly.

Howard: So if you’re in an analy retentive little bubble world, once they renamed it TMD, why don’t you go clean all the sand off all the beaches. So the bottom line is, you know, we know in the back like, we need an MO, a DO, an MOD, and no one knows that they’re saying but then when I go to the front desk, it’s the same. They would say, “Well, do you have a PPO or an HMO? Is this cavitation? Are you preferred? Are you premier? Are you in network? Are you out network?” Like, shit. What am I calling you from? Insurance school? I don’t have no idea what you’re saying.

Teresa: I need to start an insurance school, that’s what I need to do. But like, they’ll say what does your EOB say? You know what, patients don’t know what an EOB is. What the heck is an EOB? But we talk about that. You know, it’s funny I used to teach implant treatment presentation way back when and I will never forget going to observe in an office and the doctor would be talking about titanium and osseointegration with the patient. I just nudged him a little bit with my foot, like stop that you know, no one wants to hear osseointegration.That’s like a horrible word. Nobody wants to hear—

Howard: And what does it even mean? I mean how would this guy know what an osteocyte is, that ‘osseo’ is Latin for bone. What it reminds me the most Is, I had to go to Catholic Mass every single day from birth to 17. My mom said, “You can only miss mass if you’re bleeding in two places. So you can have a 104 degree fever, coughing and pneumonia and for the first 10 years, it was in Latin. And you just sat there you know, [singing Latin]. I mean you’re an 8-year old kid. I mean, it actually turned out very good because it’s actually where I learned to meditate and get my daily plan and—because you had unplugged. You couldn’t do all the things that are distracting you and you had to sit there and appeal and just be alone with your thoughts for an hour. I actually didn’t like it when they switched to English. My mom actually thought it was end of the world, end of the church and the whole world’s going to hell in a handbasket because now they’re saying mass in English and but now you know, here I am, 54 years old, you know, 44 years later and the only Latin I hear is in dental offices. You need a mesial, occlusal, distal, lingual, buccal, cervical, interproximal osteocyte you know.

Teresa: Can I tell you where else we see Latin? It’s when I go check out this website of these doctors and you still have the lorem ipsum, all of that on the website because they never bother to change that. So that’s another place you might see Latin.

Howard: The lorem ipsum?

Teresa: It’s like the slug text you know in the website. They open up the website. Yeah, yeah show him [inaudible 00:41:29]

Howard: And also every flyer I get in my mailbox, every piece of drag mail, let’s say it’s a real estate agent or someone want your tax business or they got all this alphabet soup shit buying their name. Do you what any of that means? Oh what I want to do is I want to sit there and say, “Doctor Fran is so smart he has the entire alphabet behind his name.” and then just feel like A-B-C-D-E-F-G-H-I-J-K-L-M-N-O-P-Q-R-X-Y-Z. I’m like damn! That’s one smart dude. He has the entire alphabet behind his name. It don’t mean anything to anything. And then when you track the conversions, you know who has the best conversion rates?

Teresa: Tell me.

Howard: I mean this is a video world where they land on the website and there’s the Youtube video and I punch it and there’s Teresa Duncan and she’s saying, “I got into this business because when I inherited all the money from Dunkin Donuts, I invested it in the Odyssey Management. And you know why? It’s because humans want to feel something and I’m not going to feel something looking at a bunch of letters behind your name. I’m not going to feel something but when I see you talk, I’m probably going to secrete some dopamine and oxytocin and serotonin. And those conversion rates might be three people land on your website until one picks up the phone and if there’s no picture, I mean a lot of these guys are arguing with me that you can’t take conversion rates because a lot of these websites, no one’s ever converted. So you can’t even say it’s 1%. It’s you know and I say, well it’s zero.

Teresa: Well you got a better chance if you’re putting it up nice pictures and videos though. I mean I go to websites still, they have no pictures of anybody and staff is just coming soon, staff has been coming soon for years on these websites. They’re not going to put them up there and then you hear, “I don’t want to put up a picture of my staff because what if it changes?” What’s that about? Of course your staff is going to change. So don’t be afraid to do that. Can we go back to the shitty website as you said? Can I go back for a second?

Howard: Yeah, yes.

Teresa: So the whole insurance piece. So when people come to my class, they give me their email because they want to sign up for the newsletter or whatever. I’m always checking out the domains and I go to every single one of them, most of them, and what I see is the same insurance information on all of these websites. So for your homies out there, and let’s change it up a little bit. Instead of your financial page in your insurance page saying, “We accept most insurances. Here’s a list.” The list is always outdated. “Call us if you have any questions.” Let’s do something different and put on there—you can even have a video somebody doing this—put on there, “If you have any questions about your insurance, we’re happy to help you. If you have any questions about your benefit, that’s what we do all day, every day.” “Call Mary.” “Call Jean.” Put a link to the address, the email address that they can directly email Jean and find out what’s going on with their benefit. But don’t put on there, “We will be happy to file your claim for you.” Well, no. Duh. That’s what you’re supposed to do. That’s what every other office in your county does. So let’s do something different and turn it into...

Howard: I love that.

Teresa: We know you have insurance so let’s make it so that this is our customer service talking point here. Yeah, and that is—

Howard: That is nice.

Teresa: I’d love to see that more. So that’s a challenge—

Howard: Yeah and it’s more personal. If you have any questions about your dental insurance, please call our dental insurance coordinator Robert at or 480893122—

Teresa: Click here. Click here to send the message.

Howard: Nice.

Teresa: You click in the chat. I’m loving the chat. I know a lot of people doing that. That’s awesome.

Howard: What’s that? They—

Teresa: The chat? The live chat in offices on website.

Howard: And you like that? You think that’s—

Teresa: I love it. The offices I talked to that do it, they love it because even if they’re offline, something pops up that will say, “We’re not available but go ahead and put your question in there. We’ll get back to you the next day.” You’ve got questions there because everybody’s looking at websites at night. Nobody shuts up their laptops at 5:30 in the afternoon. Everybody’s looking at night. They want to pay their bills online at night. So please, put something on your websites so  you can get some payment. Just stick, it’s a code. Put it on your website. You’ve spent millions of dollars on code for DentalTown. The code for beginning payment through your website is cheaper. Let’s do it. So yeah, any way we can communicate with them and capture them, let’s do that. Let’s get them talking to us even if we’re not open. Let’s at least open that conversation.

Howard: Are there any companies that you like that do that chat?

Teresa: You know, I have not known any dental companies that are doing it right now but that

doesn’t mean there isn’t any out there. The ones who have told me about it, anecdotally, they’re actually using outside of dentistry office chats because it’s a simple chat program they can put into their website. I’m sure any webmaster will be able to do that. So—

Howard: Yeah.

Teresa: I’m no marketing expert.

Howard: I wouldn’t say that. Why would you say that?

Teresa: No, because I don’t want any calls on that.

Howard: You want to focus on dental insurance?

Teresa: Insurance and managers, you know. I love being a manager, love talking to managers. I want to empower them to do more in the office.

Howard: I want to ask you one more category of the office managers.

Teresa: Yeah.

Howard: The difference between a baby dentist, 5 years out of school, and an old seasoned dog like me is they get into trouble because the patient talks them into doing unethical things on the insurance, are doing dentistry that they didn’t want to do like they’ll say, “I don’t want to do this.” And some 70-year old man, he probably, you know, sold cars for a living, convinces this young 26-year old boy that he should do this and the whole time this young doctor’s thinking, “This is a really bad idea.” But he gets talked into it. And then a lot of times they’ll try to get the young receptionist, the young dentist out of school to do something illegal for the villain and I got a sad story for this. There was a really cool dentist that I used to see at parties back in the 80s and his patient talked him into, well, if they pay half the crown, why don’t you just build 2 crowns and they’ll pay 2 halves? And then I won’t have to that and then it worked. So he started doing that and the next thing you know, the ones he was sending to Delta of Arizona were in state and that was just a criminal and I mean, that was just a civil and give us our money back and fines and go to the board but the ones that mailed across the state line, those are federal mail fraud. That’s how they put Al Capone and Alcatraz and that boy went to jail for 5 years while he had a wife and 2 kids at home and his wife was caught really off guarded. What the hell? One day you think your husband’s a successful dentist and you’re making bank and that life’s good. Next thing you know, he’s in prison for 5 years. I mean, do you get this?

Teresa: Yeah.

Howard: I mean you cover—you wrote a chapter in your book.

Teresa: Yeah.

Howard: So talk about when patients make unethical requests.

Teresa: So patients, you know—

Howard: You just reaffirm to the Clinton Foundation?

Teresa: There’s a lot of people that could help with that, I think. So you know, they do. The come in because the doctor down the street waived their co-pay or the doctor did that crazy billing. But if I had a dollar for every time a dentist came to me and said, “Here’s what I’m doing, here’s the procedure. What code can I used to get reimbursed for it?” And I’m thinking that’s not how it works. You don’t just do the procedure and then, you know, pick a myriad out of codes to come up to the dollar amount of that procedure. So it goes back to what’s the dentist’s ethical level. Most of the time, 99% of the time, we got good dentists but it’s that 1% that’s going to mess it up. But you also have patients who are, they’re not worried about asking you to cut your— It’s not their license. So they’re asking for as much courtesy as they can. They go to the mechanic, they’re asking—they’re looking for a discount. You know, they’re always looking for coupon codes. You can’t buy anything on any online store without goggling you know, Carbonate coupon codes so that you can find a freebie on that. So the American consumer is used to asking for discounts but we have to be ethical enough to push back and say no. I gave them verbiage in the book that, you know, “We don’t do things that way. I understand you may have run into that before but that’s unfortunately, we can’t do that here, at this office. What we can do is X-X-X.” But yeah, doctors are another thing too. When you’re submitting the insurance claims, all that information that you send in with that claim, that’s your butt too. That’s your license on the line too. So as long as I’ve been submitting claims for my doctor, and I still do that part time. My old doctor I was with for 20 years, I still do his claims on the side and what I know in the back of my mind is that whatever I send in with X-rays and narratives, if it doesn’t match his notes, that’s his kids’ retirement and that’s his retirement. That’s his kids’ college. So it’s not me. They may come after me but really, the real loser is the doctor who trusted me to make the right decision. So you do hear that a lot. The doctors, especially the young ones coming out of school, you have to remember that you are the business owner and you have to do things to protect the business and not in waiving co-payments and billing like you said, that guy. That’s not the way to do it. It got to be more ethical.

Howard: So office managers. It always seems like I know half my homies say, “I don’t believe in office managers” and some of them say, “You know I have 2 dental assistants and one’s a lead dental assistant and I have 2 girls up front who wants to lead.” And other people say, “Well I know I believe that the front office should have an Orgs office manager and that there should be someone there, you need an Org chart.

Teresa: Yeah.

Howard: To some people, the org chart is, “I’m the dentist and the back office wet hands and the front office dry hands. Both report to me. I don’t believe in office manager.” Some people say, “No, I believe in office manager and I think the back office dry hands, front office wet hands should report to a single office manager and the office manager reports to me.” And then the disaster is when there’s no org chart. That’s usually when there’s a dentist’s spouse in there and yet 2 gods. Remember the 3 most popular religions are monotheistic. I mean, 1 god.

Teresa: 1 god.

Howard: You know, there’s one because like in Hinduism, when you have a god of lightning and a god of thunder, it can get to start confusing. You know, law and so they know, just like kids. They know if you want this ask dad and they know if you want this ask mom. So they know if they ask the doctor this, they ask the spouse this. So you need an org chart. So where do you think is the best org chart?

Teresa: So the org charts that I love are when there is that one ring to rule them all. You know, the one doctor at the top, the business owner really. Most of them time, the doctor’s the business owner. So let’s put that out there. So the doctors at the top. If the doctor has good management skills, not necessarily business skills, but management skills, then maybe you don’t need a manager. Maybe you don’t. But if you’re a big office, if you got high volume, and you’re doing a lot of dentistry, chances are you need a manager. So whether or not you need a manager, I think there has to be there has to be investment into learning business and keeping up on business. So if you want to manage your own practice, have at it. But just remember, for every composite course you take, you should be taking a business course as well. So if you’re going to take that on and do that but most doctors don’t want to. They want to have a manager. So if you’re going to have a manager, you need to do the same thing. You need to make sure the manager takes the classes that they need to take, and stays on top of it. You know, HR isn’t optional anymore. OSHA isn’t optional. HIPAA isn’t optional. But that’s what I run into all the time. It’s, “Oh, I’ll get to that,” “Oh, I know I need training on that. I’ll get to that.” You know, you go over to Walmart, you go over to you know, Chipotle or McDonald’s, all of that is not optional. They make sure their I’s are dotted, T’s are crossed. No one starts until they’ve looked at the employee manual. But many dentists will start an employee and then the employee manual is never gotten, they don’t even get to that until like 2 weeks later when things die down.

Howard: I’d rather eat off the floor of any dental office than at Chipotle. And I think—

Teresa: You know—

Howard: I think Wall Street agrees with me on that one.

Teresa: Yeah, I think so. They’re in trouble.

Howard: Well actually you know what it is? It’s push-bagging. They did the right thing, they wanted to buy everything local. They wanted to buy and produce local.

Teresa: Yeah.

Howard: And then the big buzz word is organic and organic. What people don’t realize, it’s like now, all these anti-vaccination. My friends are pediatricians. I mean ¼ of the girls are pushing back on vaccinating their babies and here we are 2017, and if we go back a hundred years, by 1917, 5% of America had already died from the influenza. And when they came out with the polio vaccine, there were parades and people lined up blocks outside the door. My mom and her brothers quit swimming in swimming pools, in public swimming pools because they were so afraid of getting polio.

Teresa: Is that right? Wow.

Howard: And so they went to all this organic food that’s all organic and natural. What did they not have? Pesticides. What did they not have? So now there’s all kinds of bugs and you’re crapping your brains out because you don’t understand the value of pesticides. And—

Teresa: Well—

Howard: And now we’ve had more measles outbreaks this year—

Teresa: Yes.

Howard: —than the last 3 years combined. Just in the state of Detroit versus the whole country.

Teresa: And polio is apparently coming back too—you know I’ve heard more cases of that. So the whole herd immunity needs the herd to participate. You know, if you’re going to do that. So yeah, the whole vaccination issue, let’s go back to management.

Howard: Yeah, well remind me of the water fluoridation issue because I’ve worked 2 water fluoridation campaigns. It’s like—I swear to God, I hate to say this about my own country but ¼ of all Americans are completely batshit crazy. I mean, they’ll be down there and 75% say, “Well you know, if the Centers for Disease control the American Dental Association and the World Health Organization and all the dentists that you know, if you guys all agree, 75% say, “Well it must be a good thing.” And 25% are like, “Well the CDC is a conspiracy and they’re paid for by the aluminum industry. “It’s like wow, okay. So—

Teresa: Well the aluminum industry because of the tin foil hats, Howard. That’s what it was.

Howard: Well. So you have an amazing online insurance course.

Teresa: Yeah.

Howard: Talk about that.

Teresa: So it’s for dental insurance coordinators. It’s an insurance skills training. So if you’re looking to make the insurance coordinator more robust area of your practice or a solid, worthier practice. So I talked to you about how to do narratives, how to do appeals. I’m going to talk to you about how to run the reports, how to have conversations with patients. It’s 4 really needy hours. So that’s—

Howard: It’s 4 separate hours?

Teresa: It’s 4 separate hours, self-paced. You can go back within a year to retain it.

Howard: And how much is it?

Teresa: $595 What I wanted to tell you is if people are using Howard, the code “Howard”, they can a courtesy off the book and a courtesy off of the course as well. So $75 off the course and then—

Howard: Can you put that in the tag of the video?

Teresa: $3 off the book too for that. And I have an insurance coordinator workshop coming up October 13th in Northern Virginia. So use Howard and get $50 off of that. Friday 13th.

Howard: You know what I think I would do if I was you and this sounds self-serving but it’s not. It’s just great marketing. If you have 4 1-hour courses, you should create a 1-hour course on DentalTown. We put up about 450 courses on DentalTown and the baby boomers all read textbooks and go to courses and conventions. They millennials do it all on their iPad and all, like said but we put up about 450 courses. They’re coming up on a million views.

Teresa: That’s amazing, Howard.

Howard: And so if you put one of those courses up and then you could sit there to say, “By the way, if you go to, I have 4 more hours. So yyou should do a 1-hour course on DentalTown or if you’re giving a lecture, you could film it or tape that lecture. Or put a lecture up. Just to build the brand because Warren Buffett always says the same thing. He says, “I’d rather start with Coca-Cola and not have a dollar.” I’d rather start there because he said, “With Coca-Cola, which he owns a third of, because if you gave me a billion dollars and said, “I want you to start Teresa Duncan Cola and I’ll give you a billion dollar grand to go against Coca-Cola.” He said, “I’ll give you your billion dollars right.” So what you want more than anything is a brand name first. And so, if you put that up on DentalTown, that would—I mean you’re a huge brand. I’m not saying you’re not, that you need any help or anything.

Teresa: Oh no, yeah I appreciate it. I could certainly do an hour. You know—

Howard: Yeah, do an hour on DentalTown. And then on your deal, then that can be a disintermediate DM. You do your hour and you say, “By the way, I have four more hours if you go to odyssey M-G-M-T dot com, Did you think about going with audit Homer’s odyssey management dot com?

Teresa: Yeah, but you know, I might get Homer citizen confusion. So well sometimes, I feel like when I’m talking about—about the stuff with people. So do I talk to Ryan about the course then—

Howard: No, I’m and the guy in charge of the online thing is Howard Goldstein. So he goes by He’s in Bethlehem, Pennsylvania.

Teresa: Okay. So that’s not too far.

Howard: Yeah, and he—

Teresa: I’ll go knock on his door and tell him that we are—

Howard: How far are you from there?

Teresa: I have no idea. It’s Pennsylvania. Maybe a couple of hours so you know, I could probably—

Howard: You know, why he went to Bethlehem to practice?

Teresa: Why?

Howard: Because that’s where Jesus was born. And so anyway, and then also he—

Teresa: Oh you know, podcast listeners can’t see my face. It was like, “Oh dad joke.”

Howard: Although it’s funny because my 2 older sisters when to nunnery schools, straight Catholic nunnery schools, straight high school.

Teresa: Oh really?

Howard: And my oldest sister is probably the smartest person I’ve ever met in my life. I mean she’s a freak. And she was telling me that “Well I don’t want to get in there. You should never talk about religion, sex, politics vibes.” But Bethlehem is actually, you remember the Simpsons? What what city was the Simpsons filmed in?

Teresa: You know, I don’t watch the Simpsons.

Howard: Springfield. It was Springfield.

Teresa: Springfield, Missouri.

Howard: Well, they called it—they were in Springfield. Do you know why? Do you know why it was Springfield?

Teresa: No.

Howard: Because 43 of the 50 states all have the Springfields. It’s the most common name in all states. Well, every county in that area had a Bethlehem. So there was a Bethlehem in every county and then when archaeologists finally figured out the story of Jesus of Nazareth and all the archaeological evidence where my mom went to see where baby Jesus was born, it’s actually the wrong Bethlehem. He’s from the Bethlehem in the next county. And my sister, she just said it is what it is. She doesn’t bother her 1% but it’s so funny how so many people—you know, they build up this entire tourism industry to go to Bethlehem to see where Jesus was born and now the scientists are like, “Ah, actually, it’s in the next county over. But anyway—

Teresa: All the local tourist people are all going, “Shhh! don’t say that.”

Howard: And also, there’s a, you know, we own DentalTown, we own Hide, and we also own OrthoTown. There’s a lot of work modulus in the show. Well you do staff appreciation. You do referring office appreciation training to come in. So if you’re an orthodontist and you got 25 people that refer to you. You know the average orthodontist did 1 million in collections, netted 320 and most of those orthodontists, let’s say about 20 offices, 25 offices are referring everything. So tell them what you do for referring offices.

Teresa: So this is actually a lot of fun for me. So I’ll have a specialist that will call me and say, “I want to put on an appreciation course.” The number 1 topic that they’re hearing about the pain point is insurance. So how about bringing in the speaker that tells you how to be more profitable, how to be more efficient with your insurance. They bring me in for the day. You know, I talk about how great the doctor is too because most of the time they are really good doctors because they want to bring in something for the referring office. I teach them how to be more efficient, talk about the doctor, doctor gets their time in front, they’re fresh in the flesh, they’re getting to know their people again. The staff comes together which is really important because a lot of times when you got regular general dentist, the staff is a lot of times the ones who grab the referral pads. So you want to get the staff to know each other and to feel comfortable with each other. So really—it’s been a really good thing. I’d love to do more of those. I love speaking on the big stages but there’s something about that 70, 50 to 75 mark people, it’s a really intimate conversation. I love that. So yeah, so if specialists are looking to do a thank you to their referring offices. I’d I would love to do nothing but that. But there is something nice about being up on a bigger stage, though. I think you know that. You know a little something about that.

Howard: Well actually, they bring me in for the exact opposite. They bring me for the non-appreciation, the dentists you don’t refer and I just abused them for like 4 hours and they go home psychologically traumatized. Well hey—

Teresa: Let’s do a dual class where you’re in one room haranguing them and I’m in the other room building a mob and we’ll just switch.

Howard: Oh my God. And then what’s funny is when I go into a dentistry, you know, so many people are like, “Oh my god. You know, I can’t believe you said that.” or you know or someone will walk out. Then when I get to stand up here in Phoenix, Tempe, Scottsdale, at any comedy club, they got, “God, dude, you’re the cleanest act in town.” You didn’t say the f-word. No sex jokes. So when I’m in standup, I’m the cleanest act. Pauly Shore’s mother told me, on every order she told me, she saw me in Sunset Boulevard [01:04:18 unclear]  She said, “You know the people that all go to the top are G. I mean think about it. Letterman, what’s the guy of Seinfeld, Ellen degenerate. You know all the Bill Cosby. I mean you know, all the top, the people that made it to the top are all of her friends. She said, “You’re that guy. You’re so clean.” And then I spend my whole life in the [01:04:38 unclear], “I don’t know! That was kind of raunchy.” You said farts. Fart. Fart’s still rated G. You can say damn, shit, and go to hell and you’re still PG.

Teresa: Well you know, there’s something to be said farts a funny word. I have a teenage. Fart is an everyday word in our house. You know how that goes.

Howard: Well, you know why when I fart, you know why I like it to make a little noise? It’s for the hearing-impaired and you know, they should get in on that too and but anyway, hey, seriously, thank you so much for coming on the show. I hope you email Hogo and my homies are going to see you online. I know the millennials will love it. You got to order her and the bottom line is I know that you’re a dentist. So all you hear is that all the patients want same-day dentistry, same-day dentistry, same-day dentistry but after being in the next 30 years, and I tell Miss Teresa Duncan that she needs a crown, half the patients go to fear like, “Oh my god, he’s going to give me a shot. This is going to hurt. Can you knock me out? Do you have nitrous?” The other half go to for your cost like, “Oh my God, how much is that? I’m not going to get paid until Friday. Do you take my insurance?” And if I was going to be a successful dentistry, I wouldn’t be focusing on cad/cam and chairside milling and lasers and all this high-tech stuff. I would want you to crush a chairside manner from all your staff, every touch point. The way they open the phone, “Thank you for calling today’s dental. This is Valerie. How may I help you?” And answer every call by the third ring and when they come in, the hygienist is nice, the assistant’s nice. I want the chairside manner and then I want you to be empathetic towards pain and cost and insurance is a huge part of the cost equation. And nobody ever said, “Oh you should go to my gynecologist, she has a laser and then you should go to my physician because he has a super-duper laser. Nobody talks about equipment except dentist. No one else in healthcare talks about equipment. There’s not an oncologist in the world, “Oh let me treat your prostate cancer because I have a laser. You know, they just—

Teresa: You know what you should talk about? Talk about not being ripped off. That’s what they say. They’re good people, they’ll tell you the truth. They’re not going to rip you off. That’s what I want. That’s what I want our conversations to be. Completely honest, completely clear, and then that way, we’re doing right for the patient. At the end of the day, that’s what it’s all about.

Howard: Yeah. Alright, well thanks so much coming to the show. Look forward to put online CE course and if you’re an orthodontist out there, bring in me and Teresa. Teresa, for all the referrals that you love and for me, for all the bastards that never referred you to just abuse them all day. Have a rocking odd day, bye-bye.

Teresa: Thanks so much, Howard.

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