Dentistry Uncensored with Howard Farran
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811 The Wonderful World of Dentistry with Dr. Isha Woodhams : Dentistry Uncensored with Howard Farran

811 The Wonderful World of Dentistry with Dr. Isha Woodhams : Dentistry Uncensored with Howard Farran

8/15/2017 6:39:00 PM   |   Comments: 0   |   Views: 270

811 The Wonderful World of Dentistry with Dr. Isha Woodhams : Dentistry Uncensored with Howard Farran

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Isha graduated from Otago University Dental School in 2009. She moved to  the coolest little capital city Wellington where they get winds up to 100 miles an hour. After working and living in Wellington for seven years she learnt the love of good music, food, and great dentistry.

She also got an MBA from the Victoria University in 2014. This was a lens into the weird world outside of dentistry. She now lives in the sunniest place on earth - Hawkes Bay. She practices at a corporate chain Lumino the Dentists Dental Clinic. She is also under Jedi training with her favorite dentist and mentor Dr. Gary Winter and is learning implant placement and restoration.

www.lumino.co.nz



Howard: It is just a huge honor for me today to be podcast interviewing Isha Woodhams all the way from Hawke's Bay, New Zealand. So, you are officially a Kiwi? Tell everyone what a kiwi is. It's a flightless bird, right?


Isha: Yes, and it could be a fruit, but generally, they are New Zealanders.


Howard: So, when someone calls you kiwi, is that fun and with a term of endearment or is it a slang negative?


Isha: No, being a kiwi is great. It just shows that you like traveling, and New Zealand is a place of innovation so it’s a lot of fun.


Howard: Would you consider yourself more a flightless bird or a fruit?


Isha: I think a little bit of both, a fruity, flightless bird.


Howard: A fruity, flightless bird. And then you guys, your big brother’s Australian, you call them what—Aussies?


Isha: Yeah, those guys.


Howard: Those guys. What’s the most competitive thing that you guys rival New Zealand? Is it yachting? Is it soccer? What is it, cricket?


Isha: Rugby and League.


Howard: What would it be?


Isha: Rugby and League.


Howard: Rugby and Leek. L-E-E-K?


Isha: No, league. Like the league.


Howard: Oh, league.


Isha: Yeah.


Howard: So, league rugby?


Isha: Yeah, they just have different rules, and maybe a different game.


Howard: So, actually, what’s the most counter-intuitive thing about rugby is when any American watched it, they think, well shouldn’t all those guys have helmets and pads on and all that stuff? And the bottom-line is, you actually have more injuries with helmets and pads. It’s so counter.. like boxers. Like, boxers would never punch you as hard as they could in the head except for the fact that they have gloves on like you wouldn’t punch a brick wall, but if you put a 14-ounce glove on, you’ll punch that brick wall. And when you put a helmet on a rugby player and call it American NFL Football, then they dive head first, and I think they should apply that to cars. I think cars do it backward. Cars put seatbelts and airbags so it makes you feel safe, so you drive faster and thirty thousand Americans die in their car each year. I think they should take out the seatbelts and the airbags, and right on the steering wheel, put like an eight-inch knife, just sticking right out of the steering wheel. And you get in that car, no seatbelt, no airbag and you say, ‘Damn, there’s a dagger right next to my heart.” And everybody would be driving real slow and cautious. But, you take out that dagger, and you put on seatbelts and airbags, and you put helmets on the rugby players, and you put pads on the boxers, and then all mayhem breaks out, and they call those things safety items, and they’re not safety items because they make you feel safer so then you take extraordinary risks and then end up dead. You know, concussions all that stuff. When I saw that rugby game first time, I thought, well, ‘What is wrong with these people? Why don’t they put on helmets?’


Isha: They are pretty extreme.


Howard: But, they don’t use their head as a weapon like they do in NFL Football where they wear a helmet.


Isha: Yes that’s correct.


Howard: And when boys punch each other without gloves on, they do body shots, they don’t do headshots because your hand would break before your head. But anyway so, Isha graduated from Otago University Dental School in 2009. She moved to coolest little capital city, Wellington where they get wind up to 100 miles an hour. After working and living in Wellington for seven years, she learned the love of good music, food, and great dentistry. She also got an MBA from the Victoria University in 2014. This was a lens into the weird world outside of dentistry. She now lives in the sunniest place on earth - Hawkes Bay. She practices at a corporate chain, Lumino - the Dentists Dental Clinic. And she is also under Jedi training for her favorite dentist and mentor Dr. Gary Winter and is learning implant placement and restoration. I think that you’re so damn cool. Tell us about your journey. First of all, why do they call Lumino, the Dentist Dental Clinic?


Isha: Lumino the Dentists, they started in 2002 and there was, I guess, it came to inception after a group of practices got bought out from private equity by Abano Healthcare.


Howard: By what health care?


Isha: By Abano Healthcare. They’re listed on the stock exchange.


Howard: How do you spell it? A-B-A-N-O?


Isha: Yes, correct.


Howard: Abano Healthcare.


Isha: Correct.


Howard: And is that only dental?


Isha: They used to have radiology and audiology as well. So, they’re kind of horizontally diversified in the medical industry, but their focus on New Zealand has been Lumino. And they have a hundred practices which is just huge for a country the size New Zealand, because we only have 4 million people here, Howard.


Howard: I know. I live in Arizona, and it’s got 6 million.


Isha: That’s fantastic. Well, thanks.


Howard: Just think how different Lord of the Rings would’ve been if they would have filmed in the desert instead of New Zealand.


Isha: Yeah, Arizona’s hot, eh?


Howard: That would’ve been a completely different movie if they would’ve shot it out here. But, so, you work for the largest corporate dental practice chain in New Zealand, Lumino, which has a hundred practices.  


Isha: Yes, and they think it might be slightly more now. I’ve lost count.


Howard: And how long have you worked for them?


Isha: I’ve worked for them for 18 months now.


Howard: And?


Isha: And it's been a good journey. I got recruited into Lumino. I was actually at an NBA gathering I went to in [00:06:18 unclear] Hackathon and I was presenting a project, saying dentists need something, anyway, and someone was there from Lumino and they joined my team and they started talking to me about how great Lumino is and I said  I’ll come to Lumino if they give me a job in Hawke’s Bay, which they did so I moved to Hawke’s Bay and we get to live in this great house. And, my husband and I settled here, we’ve come chasing the sun.


Howard: Nice. I love all those books behind you. All leaders are readers. And, it’s a shame, you know. I’ve always thought that I was the luckiest guy in the world because some great person would live and they’d write an autobiography. And I’d think, this great person wrote an autobiography showing you everything they learned through their journey, and you can read this in four or five hours, and then you’d look at your body, and you decide to spend those four or five hours doing something goofy. I mean, every autobiography is someone’s lifetime.


Isha: Yeah. Let us talk about your book, Uncomplicate Business, Howard. I've read about half of it and it's amazing. I love the three principles that you've outlined and learned to manage people, money, and time.


Howard: Well, that's a huge compliment coming from a dentist as yourself who also has an MBA. What was going on in your journey that made you go back and get an MBA?


Isha: I guess I was curious, I wanted to know more. In New Zealand, a small number of students get to become dentists straight out of high school, so I was 22 when I graduated from dentistry and I was working—


Howard: Oh my god, are you serious? You were 22!


Isha: Yeah.


Howard: You were barely old enough to drink, and you’re already a doctor.


Isha: Yes. We drink a little quicker here in New Zealand, we start drinking at 18. However, I’ve been practicing for a couple of years, and I thought, actually—I need to learn more about business because it became very clear quickly to me that if you have to become a good dentist, perhaps you need to be a good business person as well.


Howard: Yeah, it wouldn’t matter if you were making doughnuts or root canals or hay or movies, I mean, you just have to know business. And I also think that once you get an MBA, just like once you get a law degree or a dental degree, you never think the same again.


Isha: Now, you see the world through a different lens.


Howard: Oh, yeah. I think of so many books I read, I mean—you could just name some of them, like say, Thomas Watson  Jr, the founder of IBM. The main take away was that he knew—

Here’s his entire journey. He grew up in this little town and he noticed there were three hardware stores and whenever he went to the hardware store closest to his house, there’s a long line so he would get on his bicycle and ride to the other one because the other one had two clerks. And then after doing this, he realized that three stores—but one store had one clerk, one had one clerk, and one had two. That the one store with two clerks had—the market share is based on the number of clerks, so, the one store with 2 clerks had two force of the market whereas the other, each had one force. So, he realized that sales had to do with the number of salespeople so when he inherited IBM from his father, he said, ‘The bottom-line is this; If 70% of all the salespeople that sold computers worked for IBM, IBM would have 70% of the market. So, he only focused on this IBM Sales Training School. And every 6 weeks, they graduate a class of salespeople that all looked the same, had the same suit, the briefcase, all the talking points, the sales points, and sure enough, when he retired, he had 70% of the market. Then, you’d go to the dental office, and the person answering the phone, her job is named after a piece of furniture—Front desk. She has no training, nobody’s spent six weeks with her teaching her  how to convert someone calling up saying, ‘How much is a crown?’ converting that into getting this person in here to meet the doctor like you. And I don’t care what you do, If you don’t learn the business, you’re going to lose. And thanks for reading my book, and I can’t think of any business book I’ve read—the story of Home Depot I mean, that guy owns the Atlantic Falcons and was in the Super Bowl last year but, all those business books teach you so much. What is your favorite business book that you’ve read?


Isha: I like (11:10 unclear), this is really embarrassing, but I read a lot of self-motivational books. When I was really young, they were around everywhere. I used to read a lot of fiction, but nowadays, all the classics—Napoleon Hill, Jack Canfield. I like all of those because that’s all about your personal journey, and trying to maximize what you can out of your life, and trying to understand how to do it better with potentially avoiding some pitfalls other people have, and I think that’s the best thing, you know, in a book like this, Uncomplicate Business, you’ve already done everything under the sun with dentistry, and if you give me a suite as guide to say, ‘Hey, these are steps, don’t do this. Don’t do this,’ a 100% of that might not apply to me, but 99% of it that have applied will kindly keep you pretty safe. So it’s all about managing risk, I think.


Howard: You know, as you’re sitting over there on the other side of the world, do you think business is pretty much the same in New Zealand, Australia, the UK and America, or do you think business is quite different between the UK, New Zealand, Australia, and the United States?


Isha: I think people are the same everywhere. You know, they have a collection of peers, they have an amount of money that they want to spend, or resources and time, and they have a certain number of things in their social well-being and health they value, so that's more or less the same, I would suspect. And I think this is universal.


Howard: So, I’m 54. Are most of the dentists that are grandparents, 55 and over that are in New Zealand, are most of them, boys? Has there been a big demographic change? Like you’re a female, was your class half women, half boys? And were all the old guys mostly boys or has New Zealand pretty much always been 50-50, boys and girls?


Isha: I have met some dentists that graduated in the 70s and they are certainly a few girls, speckled around the place but nowadays, it’s more than 50% of my class, I think definitely more than 50% female.


Howard: So, a lot of people can’t wrap their head around. They don’t know until it’s been done. They don’t know. Are women dentists coming out of school now more likely to say, ‘You know what? I just want Monday through Friday, 9 to 5 job. My lifestyle, my personal journey, I want to do all these other things.’ Do you think they’re more likely to be employees or do you think they’re going to own their own dental offices at the rate as the generation before them?


Isha: I think it would look different, Howard. Like, one of the key factors ensuring the MBA so early in my career was just acknowledging the fact that perhaps my 30s are going to be tied up with childbearing and focusing on kids, and being very maternal so I didn’t want to wait till my 40s to do my MBA. I wanted to do it early on and I think, for a short period of time, women still continue to do a lot of the heavy lifting in one way or another. Not necessarily always, but I think it’s just changing. I think the industry would look different. There might be some more corporate chains, but there will still be some pretty good boutique dental practices.  I think the private practice is here to stay.


Howard: What do the old traditional dentists in New Zealand think about this new corporate business and all? Do they see it as fear? The end of the world? They’re going to ruin dentistry like they do in America? In America, all you gotta do is to walk in a room. You could either walk into a room and boom! Or you can just walk in and say, "corporate dentistry", and they all fall in a chair and have a heart attack? How is the corporate dentistry being perceived in New Zealand?


Isha: You’re joking! All these dentists are thinking great. I’ll get the books for my practice. Here’s my retirement plan.


Howard: Exactly! That’s so funny because when they opened up a dental school in Arizona, all these dentists when to Arizona Dental Associates. You have to block this new dental school. It was like 10 years ago, it’s called AT seal-- you got to block it, and I’m standing there going, ‘Dude, who are you going to sell your practice to? A dry-cleaner? I mean, you got to think outside of the box. I mean, someone has to buy your practice.”  But are the old people welcoming? Are the older dentists welcoming corporate dentistry or are they afraid of it?


Isha: I think there’ll be a mixed feeling. I mean the people that have already done and sold into the dental corporate change who have retired, they’ll have a positive view on it because they see their practices continuing to thrive one way or another and not necessarily struggling, but there’ll also be some fury and anxiety because they worry about the big guy cutting i guess margins and competition but I think it’s just different. What I did want to ask you though, Howard, was you talk a lot about how Orthodontics Association of America failed in their corporate ventures and they’re lots of corporates that come and go but what do you think the corporate dentists need to do to succeed? Not the dentists themselves, but the corporations themselves? I mean, what should they do differently?


Howard: Yes. So far, I think the business model of corporate dentistry is evolving rapidly and I think it’s very safe to say that the final business model has not been implemented yet. So, Orthodontic Centers America is what we would call in Australia, OROA. So again, you had all these orthodontic practices that were ill-liquid assets because they were too big. So, if you went to sell a house in Oakland, you know, there’s a price range where if you're selling that size of a house, you can sell it in a day, a week, or a month. But, if you have way too big of a house, now the only person that can buy you is a multi-millionaire, and most multi-millionaires want to build their own house. So what they did is they went to Wall Street and  they got a hundred million dollar line of credit and they start buying all these monster practices that were worth 2, 3, 4 million dollars a year. Well, what kind of orthodontist can do 2, 3, 4 million dollars a year? Certainly not the average orthodontist, who walks out of ortho school like at your age, 22, 23, 25. So they would buy this practice, they’d tell the orthodontist you have to stay there three years. Well, three years in one minute, he took the money and retirement and ran, then they put some kid that came out of ortho school an hour ago, so that 2-4 million dollar of practice will now shrink down to a million and so, it was a liquidity play for ill-liquid dental assets. So now, we look at all these chains that are going out now, and the biggest problem they have now, and the reason that none of them in America have gone in public, and that would be a red flag for me as an investor in these publicly-traded dental chains that you see listed in Australia, New Zealand, and Singapore, is that, ‘Okay, well why are there none on the S&P 500? Why are there none on the New York Stock Exchange? Why are there none on the S&P 500?’ And it’s because, they grow with debts, so most offices, if you bought a business for a dollar, after a period of time, you’d want it to make so much profit that you build another store. So, one turned into two. And then, two turned into four. Then, four turned into eight, then to sixteen, then to thirty-two, and it’s growing from cash flow. But what these corporate chains are, they mostly grow with debt, so every time they’ll buy a million dollar practice for a million dollars, their sales go up a million. So then when they go to 2 million, they borrow a million dollars, and they go 2 million dollars of debt and they got 2 million cash. So, by the time that they get to a billion dollar company, they got a billion dollars of debt. That’s not very sexy for Wall Street. Wall Street would rather say, ‘I’d rather loan you a hundred million dollars and then in 5 years you have no debt, and you’re doing a billion dollars,’ but so, they’re very debt-intensive businesses and that’s why I think if I was trying to go public, I would only lease, that would free up a lot of the debt. I would only buy the businesses. I would not buy the land and the building because it just looks really ugly on your balance sheet when you went and bought the land, the building, the practice. And the problem they have, the biggest problem they have, in which all dentals have, is that nobody keeps their associates. Getting dentists to all get along is like hurting cats. You know, if you got a hundred flightless kiwi birds, they’re not going to listen to anybody and the people who listen the most and the best are like, boys under 18 in the army, the navy, working at Walmart. You get a bunch of young, not very educated people and they’ll take orders, but by the time they become a physician, a dentist, a lawyer--everybody knows everything and you can’t get two of them to agree on anything. So, it’s a very tough situation when all your employees are doctors of dental surgery with 8 years of college. Like, you say things you can’t live without. You go into corporate dentistry, their mind is long because their MBA will sit and say, ‘Okay, we decided we’re just going to go with five burs. And every bur block is just going to have five burs.’ Then you have dentists, completely having an emotional meltdown and need psychiatric treatment because they can’t do a crown prep without like, twelve burs and these twelve burs are completely different than your sixteen burs, and the MBA guys are like, ‘Dude! It’s a filling. Are you telling me you need 12 different burs for a filling? And your twelve burs, Howard’s twelve burs can’t be the same as Isha’s twelve burs. And to get Asia and Howard to agree that we’re going to do all fillings and crowns for just 5 burs on the same bur block, then we both click.  Then we say, ‘Screw this, I’m going to go open up my own place!’ I mean, you can’t get two dentists to agree that today is Thursday because right now, it’s already Friday in New Zealand.


Isha: That’s correct.


Howard: Yeah, so that’s where that joke actually comes from.


Isha: You’re in the wrong day, Howard. You’re in the past.


Howard: Well, I could tell that you’re ahead of your time and I’m a day behind. No doubt. And then here’s another problem, the way humans are--they have to have hope. Every culture has religion. They have to see light at the end of the tunnel. But when they go work at corporate, they’re going to be an employee for the rest of their lives. Whereas in law firms, what they do is that they say, ‘Isha, if you just really work your butt off and you bring new customers, and you really grow the business, you know what we’re going to do, Isha? We’re going to make you a partner.’ And a partner is different that an employee. You can fire an employee at a whim and they have no say. I think the next business model that I would look at for dental corporate chains, they can learn a lot of lessons from law firms. In fact, what we should do is we should look for some of the greatest American partnership consultants that know the ins and outs of a successful partnership, because the lawyers have reduced their staff turnover by making their lawyers partners, but I think when you work for a corporate dental chain and after 2 or 3, 4, 5 years, you’ll realize—Like you’re 30. If you work for this chain from 30 to 40, are you still just going to be an employee? And employees don’t have the skin of the game. And, they don’t see any chance of getting skin in the game. Now, if it’s publicly traded, they could always pay you maybe every paycheck, and say they’ll withhold 3% and pay you in stocks. After 10 years, you might have a sizeable stock position and that would make you feel ownership. I think if the humans don’t feel like a partner in ownership, some skin in the game. And, what I would recommend you to think about, Isha, is that me being old enough to be your dad, we don’t know where it’s going but we know what’s not going to change. I mean, humans are still going to have teeth, and want to eat, and swim in the ocean a million years from now, and some things are never going to change. That’s what you really have to focus on--what’s not going to change because it’s hard to predict what’s going to change. But I do think that we see, like, how many kids do you want?


Isha: I would like three or four.


Howard: Really? Now, your husband was like, one or four boys. I have four boys, but you see, birth rate is plummeting so it’s a global phenomena that each generation has less kids than the one before it. It’s a global phenomena that they’re getting married ten years later than they did 75 years ago. So, it’s gone from 16 to 26 in the last, I think 65 years. It’s gone from 5 kids to 2 kids in the last 65 years. So, you’re 30 and you haven't had a kid yet. I mean, whereas, when I was a kid, every woman had their first baby between 16 and 18. So that's why, I'm thinking, ownership can change too. I think if you decide, well, I'm not going to get married 16, I'm going to wait until 26. I'm not going to have 5 kids, I'm going to have 2. And with that same kind of thinking, a lot of people might think, ‘You know what? I don't want to wear every hat as an owner. I don't want to be in charge of marketing, HR, payroll, accounting. I don't really want to do all that stuff.’ So I do think, there will be creep, I think it’s totally trending towards group practice, but I just think that at the end of the day, if you don't control your employee turnover, I mean, the greatest corporate dental chain in America, some of the biggest ones, their average dentist doesn't even work there for a year. And when you go to their industry convention, they tell you that for 80% of your associates your average, if you can get 80% of them to stay there 2 years, that's an A. You know, 20% that'll stay longer, that's only 1 in 5. So the question will be, what will make them stay longer? Is it a chance to be a partner? Is it giving them stock? Well, what are your thoughts?


Isha: I think corporate dentistry does offer a lot and I think that’s why so many young associates do flock to it because I think, there’s probably more pressure to be studying and less pressure to be out in the real world working. It’s very hard to get into dentistry in a lot of places, so by the time you get in, you’re an expert in organic chemistry and not so expert in understanding how a business works. So going into corporate is a safe bet, but also there’s a huge amount of affiliation that you’ll get. If you really just care about just doing dentistry for a while, and just don’t want to be bothered, then you do have some pretty good dentists and mentors that you can look into within the organization. And, I think dentists are artists though and I think this is where there is a divide between business people and the general public is they still perceive dentistry to be a commodity, you know it’s not milk anywhere because the goods that you buy at a supermarket, there’s a label of standardized care and we’re Craftsmen. We’re more like jewelers that make individual things because we make our own clinical skills. They’re not, you know—Two dentists don't have the same clinical skills or competencies. So getting two dentists to charge or act the same, or use the same tools, is just going to be impossible. So, I think, maybe corporate dentists just need to create more allowances for it, you know?


Howard: And the other thing is, every dentist has a different scorecard. Like most dentists that are artists think that tooth colored composites are just beautiful. Well then, you look into a hundred million insurance claim, your bullshit plastic fillings, lasted six and a half years, and this ugly amalgam filling lasted for thirty-eight years. So what is an A? That it looks all pretty, or that it lasted 38 years. I mean anybody that's 10 years old knows that metal is stronger than plastic unless you're a dentist.  


Isha: Yeah, and malleable. I think most old-school dentist—


Howard: Do they do amalgam still in New Zealand?


Isha: There still a few doing amalgam, but I stopped doing it a couple of years ago not because I hate amalgam, but I thought at some point, somewhere in the supply chain, someone’s gonna say mercury is bad, we shouldn’t produce amalgam anymore and then I’ll be stuck, unable to pre-treat my patients because it’s so much fun carving those things up. So—


Howard: What’s really sad is, regardless if we never placed another one is dealing with them for a hundred years and the only environmental problem that's real is that we still have people cremating humans. 6% of the mercury in the air and the ocean is from cremating homo sapiens with silver fillings in their mouth, where 50% is from coal. I’d rather they got their golden teeth, I mean, you could go to nuclear wind solar, but somebody in every state, country, county, is got to realize that somebody needs to pass law that you can’t cremate a human until a dentist, an assistant, a hygienist—someone has got to inspect that body and pull their damn molars out because you can’t bake them until the whole damn human turns to ash and I also feel sorry for the person working in the crematory because they have no idea what they’re doing. I mean, they’re heating mercury up to four or five hundred degrees. I mean, they’re turning you into a quart of ash. Where do you think all that mercury vapor went?


Isha: Well, what about the dental surgeries, what percentage of the surgeries areas mercury [00:30:46 unclear]


Howard: Yeah? So, getting dentists to agree on this, they’re not going to agree on the burs. They’re not going to agree on amalgam composite, or look at the other composite with an active ingredient, glass ionomer. I mean, why is it that it’s ten times more popular in Australia, New Zealand, Japan than the United States. You almost never see glass ionomer in the United States. Do you use glass ionomer?



Isha: Yes, I do actually.


Howard: Okay. You’re talking to a bunch of American dentists that are listening right now who probably haven’t used it one time in the last year. You got one of the smartest glass ionomer guys down there— One is Graeme Milicich. You know Graeme?


Isha: Yeah. Graeme’s amazing. He’s such a huge role model for me and a huge idol. I think he’s so ahead of his time.


Howard: Well, tell that bastard that Howard to come on this show. I’ve sent him a request five times and every time he emails back, ‘I’m on a vacation. I’m going sailing.” Tell him Howard doesn’t give a shit if he’s on a vacation or going sailing, he needs to skype me. I think Graeme Milicich in New Zealand, Jeffrey Knight in Australia, [00:32:01 unclear] went from Vietnam to Adelaide to Australia, but now I think he’s in Dubai or something. That’s probably three of the top ten smartest people in dentistry alive today. But, let’s go back to that. I mean, talking about a scorecard, why do you Graeme Milicich in New Zealand loves glass ionomer more than all the dentists in America?


Isha: I think it's more, you know, what you get familiar with and what works. Well, something might be an amazing product in somebody else's hands, however, if you’ve never used it, it’s not familiar to you, it feels weird and different and you have nothing to compare to, it’ll feel weird. My boss interestingly enough in my first job, not a corporate dental chain just a group practice, he came in and said, ‘Isha, we’ve changed your glass ionomer cement from GC to Riva, and I was like, ‘I’m not touching this thing, I used it once, and I was like, ‘No, not for me.’ I just decided and he was like, ‘What is it? They’re exactly the same. Look at all the studies book, the products are the same, and he said, ‘You guys are not mixing it right. I bet you you’re not using that amalgamator right. He turns up into practice, mixes the GIC and he squirts it into a cup and he looks at it. I'm like, ‘What are you looking at?' He's like, ‘Look, it looks good!'  And I was like, ‘How many times have you done it with any other type of GIC?’ Eventually, he gave up and we went back to using the old GIC. But, it’s great, you know. It’s great for stabilizing {00:33:45 unclear}. A lot of the erosive melts, you cannot really put composite because composite relies on bonding and that’s why you see a lot of this rapidly failing and the cements are really good for that. You can just really stabilize the full mouth. I went to volunteer in Peru a couple of years ago, and I took boxes of GIC over there and it was really great. The dentists over there, they tried them and they were like, ‘What is this magical material and it would work on anything?’ It’s like amalgam, you know. It could be sloppy, bloody, and patients coughing, drooling, whatever, screaming, kicking, and that GIC would stick.

Howard: You’re saying GAC or GC?


Isha: GIC. Glass ionomer cement.


Howard: Oh, glass ionomer cement. Yeah, I thought you were talking about the brand name GC—General Chemical out of Tokyo.


Isha: Yeah, the GC Corporation make the best GIC. I mean—


Howard: And where are they headquartered out of? Where do you think they’re headquartered out of?


Isha: Are aligned with Henry Schein, I don’t really know.


Howard: Well, they started in Tokyo, Japan, but they moved to Switzerland, but I can’t tell if they moved to Switzerland for tax consequences. I wonder if it’s really just a Japanese company still, but they’re in Switzerland for tax purposes, I mean, I see that all. Like, Apple Computer is actually based out of Ireland because they don’t pay taxes. I mean, when people say, ‘Why does Apple have a hundred billion dollars in cash?” Because they don’t pay taxes, but all their employees are in California and their factories are in China and their taxes in Ireland. This international world is pretty interesting.


Isha: Yeah, regardless of where they are, I would really like to see them, so--


Howard: Yeah, and I’m pretty sure Facebook does the same thing. Their other people are in California and they pay their taxes to Ireland. It’s a very common scheme.  But, yeah, so where did you run into Graeme Milicich?


Isha: He’s founded, I think or he’s a core member of a group called New Zealand Institute of Minimally and Race Dentistry, and I saw him going into a few lectures, and this whole thing happened because of using amalgam. I couldn’t get the composite to work. I was like, ‘I need to know more how this stuff works. It’s like wood of magic or something, so I started going to courses and Graeme’s name kept coming up and eventually, I ended up in Los Angeles, at a BioMimetics Conference last year. And, I think I sort of, can bond something now.


Howard: Was that your first time in the United States?


Isha: No, I went on a big boat trip after I graduated around California, Nevada, and I just got a really nice car and we drove around. We went to the world series of Beer Pong Championships. It was great.


Howard: So you went into California, Nevada. You’re all around Arizona. Did you dive down to the Grand Canyon or anything?


Isha: Oh no, I didn’t actually. But, next time I will.


Howard: Yeah, you should look at that. I mean, it took Americans almost a hundred million years to dig out that canyon.


Isha: Really?


Howard: So, you talking about things you can live without, you say, rubber dams, IPS e.max, orascoptic loupes. Those are amazing choices. Talk about those three.


Isha: Well, that’s all come from—just like I’m talking, learning about bonding, making it more predictable. I think, after when amalgam disappears, even if amalgam is here to stay, our aging population. In New Zealand, most of the patients live to 80 or 90. I have a handful of patients who are over 90 years old, and they still have all of their teeth, you know.


Howard: Are they women or men?


Isha: Women and men, actually.


Howard: Women and Men. In America, if you go into a nursing home, there’s a hundred women and one man named Lucky.


Isha: That’s great! He’s not moving that fast.


Howard: Yeah, so in the United States, we still have the average woman living about five years longer than the average man.   


Isha: That’s pretty good. That’s probably because I talk so much.


Howard: Actually, it’s one of the biggest things in them. You know, we have about thirty people dying in car wrecks each year right? Who pays higher insurance premiums? Who gets in more wrecks? Boys. You have thirty thousand that died from accidents every year. Well, who's the one falling off the roof and the trees? Mostly boys. You have thirty thousand suicides each year. Women actually attempt suicide twice as much, but they never complete it because women always attempt it with like, a butter knife on her vein and she posted on facebook, "I'm killing myself, I'm dying." But men always use a weapon and so, men almost all their attempts are completed because they use a gun, but women always use a butter knife or knitting pin—


Isha: And, women and men are very different, but it’s shown that men who are married to women do live longer than men who are not married so there are general benefits with being associated with women at all, I think.


Howard: No, that's right. The shortest living homo sapien is a male bachelor like me. The longest living woman is a female bachelor like my oldest sister who's a Catholic nun, in her nunnery—I mean, every nun that’s died since she’s been there for thirty-five years, they’re all in their 90s or 100s. So, when men marry women, women's life expectancy goes down and that for men goes up and it's frightening. If you're a sixty-five- year old man and your wife dies, half the men die within a year because they've lost all their self-help of cooking, eating and cleaning, and then they stop cooking, and what's sad is half of the men over 65, if their wife dies—and that just happened in America, one of the greatest companies out here, Patterson, and the guy, Pete Forchette, who was the one took the public and built this big old empire and he’s married his wife for 50 years, and she died. I don’t think he even made it three months. Richard Nixon, the president, when his wife had died, I don’t think he made it six months either. Men just don’t do well if they’ve been used to this lovely woman their whole life with cooking, cleaning, and making his life all happy and then all of a sudden, she’s dead. They just lose everything.


Isha: Well, if it makes you feel vulnerable, Howard, I don’t think so many women are excelling at cooking or cleaning these days. Maybe, things change.


Howard: If you wanted to hide some from my ex-wife, I’d just put it in the oven and she never found it. It’s just filled with all kinds of stuff. Do they have fluoridated water in Oakland? What the views on Fluoride? Is that ominous, evil, plot that’s poison, or do they accept it as science since they’re an island surrounded by an ocean that is naturally fluoridated at 1.4 part per million?


Isha: Yeah, I mean fluoride is really an interesting topic. I wasn't born in New Zealand. I was born in an Indian hydro-bed and the groundwater actually has six to eight parts per million fluorides naturally and I have fluorosis on my teeth, but I just don't—


Howard: How many root canals or crowns do you have?


Isha: None.


Howard: So, I’m still looking at it. It looks like, I mean, you have beautiful teeth.  You have gorgeous teeth.


Isha: Thank you, Howard.


Howard: So, are you glad that you had six parts per million fluoride which is three times the level naturally occurring in the ocean so that you never had a root canal or a crown, or are you traumatized from that fluorosis and currently going to therapy because there’s a spot on your tooth?


Isha: I was usually traumatized. I used to get anti-saline with brush for my teeth, but I think it made me more curious and I did become a dentist after all so, and I haven’t had veneers so I just bleached out the brown stains that used to have in my front teeth.


Howard: So, you didn’t get veneers? You just bleached them?


Isha: Yeah, those are my natural teeth.


Howard: All natural. Yeah, they’re beautiful.


Isha: Thank you. There’s an anti-fluoride network in New Zealand. They’re more of a nuisance really, more than anything else because the debate is; my kids don’t need it, this is not the way, we want to have autonomy, but it’s not about their kids. The people in the anti-fluoride network have the freedom to go into conferences. Those are not the kids that will be struggling as a result of decay and neglect, you know. The kids that get decay, you know, they’re usually in very low socioeconomic conditions where both the parents are working, and they come from large families. The food is very expensive in New Zealand so the food choices aren’t always easy, so the fluoride thing, I think it’s here to stay until we can decrease the number of children waiting on the general anesthetic list to get their dental treatment done. In New Zealand, kids actually get free treatment until they’re 18. It's really great. It's a great service and New Zealand is just exceptional. It's an amazing service. They go and check kids' teeth every single year.


Howard: Yeah, I’ve been involved in fluoride in Phoenix in ‘89 and then again that bill expired so I do it again 20 years later. It’s just incomprehensible. Both of those wages just walk away without realizing after you do this big campaign, you know, debating on the TV, the radios, in front of the city council, and you walk away and realizing that at least in Arizona, that one out of every four people is completely bat-shit crazy insane. I mean, it's kind of bizarre, that one-quarter of Arizona is completely beyond logic.  


Isha: Are they beyond logic because of the exposure to the fluoridated water?


Howard: But even well-intentioned dentists, I mean, even some of the smartest dentists I know, a few are anti-fluoridation and then when you talk to these people, and you say, “You know, mercury bonds silver, copper and tan, and then amalgam is an insoluble salt. And then if you swallow an amalgam, 24 hours later, it comes out the back door and you can weigh it all there. And then, they will sit there and then tell you how toxic mercury is. They’re eating popcorn shrimp because if I went to your swimming pool, and then threw out a fork on those swimming bowls, it wouldn't float to the top. It goes to the bottom. Mercury goes to the bottom. The shellfish, the shrimp, the lobster--they eat all that stuff, and when they eat it it's ethylmercury, methylmercury which is totally bloodborne available and they’re sitting there eating popcorn shrimp which would put mercury in their bloodstream unlike in silver filling, and they’ll tell you how toxic silver fillings are and that they’ll never do it in their life while they just ate six popcorn shrimps and eating a serving of amalgam and you're just like, ‘At what point do you say, let's just switch to the Zodiac sub-formula. Let's just base this whole argument in astrology.  


Isha: I think this ties in really well with how you started the talk, Howard, about how NFL players think it’s ridiculous that Rugby players run without helmets, and I think human beings are not good in assessing these kinds of statistics in a meaningful way. So, jumping, flying off in a good airplane, is very low-risk, but some people are irrationally afraid of it. This is like people getting into car accidents all the time. It’s statistically low likely to die in a car rather than in a plane. So, I think human beings are not good in assessing risks. And all dentists are human beings most of the time.


Howard: Well-said, beautifully said. I think we'd just need to start a campaign where Kiwis vs Aussies. The Kiwis will ban all seatbelts and airbags and put a six-inch dagger on the steering wheel. And then the Aussies, they can keep their airbags and seat belts but they have to add helmets and shoulder pads when they drive, and then after a year, we'll see how many more Aussies died than Kiwis for miles driven, or you guys say kilometers, right?


Isha: Yeah.


Howard: Exactly, and I can name a hundred people that I know that are deathly afraid of flying in airplanes. You took them into interstates in I10, and fly seventy-five miles an hour down the road for a piece of aluminum and it’s because when they drive, they’re in control. And, monkeys want to be in control. Now, when you’re sitting in an airplane, you’re not in control. You don’t have the steering wheel, and for many, many humans, it’s obscure why do say there’s a crack teeth epidemic? Is that crack teeth epidemic in New Zealand, Australia, the whole wide world, why do you say that?


Isha: I think the crack-teeth epidemic exists because our patients are living longer than ever. Before they were crack teeth, but they were just buried.


Howard: Well, it’s funny you said that because I asked you a question, I hope you are not offended by it, because today, it’s all over the internet, I posted it in Dentaltown, Facebook, and all that—they realized that they just found out a 130,000-year old Neanderthal teeth that had Dental work.  


Isha: Yes, I saw it.


Howard: Yes, so does that mean that the world’s oldest profession has now been dethroned and dentists are the world’s oldest profession?


Isha: Of course, they’ve known this for a long time that’s why we’re still doing dentistry evidently.


Howard: I had no idea that dentists predated prostitution by  130,000 years.  


Isha: We’ve been charging well ever since.


Howard: Haha, I think dentists should officially say, ‘Hey, we’re the world’s oldest profession, not the damn hookers.’


Isha: I think you should really get that out. It’s a public service announcement.


Howard: And, we charge more than hookers, right? I mean, you get a root canal or crown costs more. I want to make one point on your horoscope. I think for the young kids out there, the bottom line key to being a better dentist is always magnification, seeing better, whether you had loupes, if you’re getting a root canal, get a microscope, when you scan an impression, and you can see that impression forty times bigger. Anytime a homo sapiens can see better, they can do better work, but the error is, the doctors are the only ones wearing the scopes and then the assistant making the temporary, the hygienists' clean teeth, and anybody who has their hand in the mouth has to wear the orascoptic loupes. It’s totally gross when the doctors say, “Well, I’m the important one all by the loupe so my dental assistants, hygienist don’t need them. I mean, everyone working in the mouth needs to see 2, 3, 4 times larger.


Isha: Yeah. I think a decent dentistry is tricky, and I think amalgams, they work great, but a lot of the patients come in, you can’t even put another amalgam on the tooth because really, there’s a four surface, full occlusion amalgam that’s come off with a bit tooth structure that was retaining it has broken off. So, then you have to go to it’s relying on some kind of bonding and adhesion to make your restoration stick. I think that is tricky, because the mouth is full of saliva and wet things preclude any kind of sticky activities, and this on hand I think loupes are some kind of magnification. They will become the best practice standard, and what loupes do is that whether they make you better or not at treating people, what they do is that they reduce your plausible deniability. You cannot live in ignorance once you see what the problem is.


Howard: The point is, it’s very profound where right now, the dental software is designed for drilling, filling, and billing. It’s really not based on anything to do with evidence-based dentistry. What are your thoughts on currently dated dentist software?


Isha: Oh, everyone--Every single one in my age group will agree how horrific it is on writing notes. It’s a dreaded activity, you know. Voice recognition has been around for years, and yet it’s not mainstream in dental practices and dental software. I know some software’s trying to get out there but I really think this is a big problem in dentists’ in assessing what their business output is because they’re not looking the total diseases they have diagnosed in their dental practices, they’re looking at the total amount of treatments that’s been done. And, there’s a big gap between how much disease walks in and how much actually leaves being treated, but there’s these whole bunch of intermediary factors; your ability to communicate value, the ability for the patients to pay, the demographics of the patients to have certain treatments done, and the treatment itself is not always indicated. I think it's horrific and interesting enough to lay off thoughts on what journey you're in. I wrote an article in LinkedIn on how I think Watson HealthCare should succeed. I see this to be instrumental within dentistry. Dentistry is going to become a lot more predictable, you know, and it’s going to reduce failures, and it will become much more sanitized. Patients will get better care. Dentists will have less trouble communicating risks to patients. They’ll say, this tooth is really heavily root-filled, it’s going to fracture if you don’t have full coverage restoration. If you have the facts in front of you, it’s going to be easy to communicate that to the patient. You know, of all this other technology exist in dentistry, but I think we should go back to where the disease exists and diagnostic software in dentistry. The bulletin of information just needs to improve, and it needs to be easier. It needs to be integrated with my workflow. It needs to be easy for the dental assistants to do it. It just needs to improve, Howard.


Isha: Yeah, I love you. I love your passion. I loved your post on LinkedIn that's why I contacted you, you didn’t contact me. I’m a big fan of your post in LinkedIn. I do wish that when you go through that work, the one that you posted in LinkedIn, you should go and copy and paste it and post it in Dentaltown too.


Isha: I’d love to, Howard.


Howard: Yeah, there’s a quarter million dentists over there then I’m a big fan of your writings. Where do you think does that come from? It’s almost like you're half-dentist, half-philosopher, part-poet, part-artist. When I read your stuff from LinkedIn, I was like, A lot of people my age would call someone like you an old soul. Where did you get all that smarts at such a young age? What do you think is it in your journey that made you so philosophical?


Isha: I’m very extroverted--


Howard: Or is it all just alcohol-induced?


Isha: Oh, well actually. I’m very extroverted. I love people and I talk a lot, and I like to talk a lot to all kinds of people. When I was at Dental School, I used to work in a bar called The Bowler and beneath of it, there’s a student pub but it had a certain group of aging older men and women that were just hanging out in the pub and drinking all the time. At first, I thought it’s kind of a bit gross, but I eventually got to know them and I was like, ‘Oh, these are just people and way cooler.’ like they’ve hacked it you know. Then, I had a lot of time to introspect and I didn’t want to change myself. When I was very young and I was a teenager, I didn’t like how talkative I was, how I can be without reservations, I'll talk to anybody I want. But, I've become more accepting of myself, and it has led to some great journeys. I have lots of friends, more like dentists over sixty years old. They’re just fantastic!  They’re so cool and they’re so great to talk to. You get a lot of advice. It just gives you an insight, you know? This is where corporate dentist change I think could hugely capitalize on this market aging dentists because even if they arr not willing to pay for an hour practicing certificate, their knowledge capital is huge, their ability to asses risk on patients. They’re huge in mental resource and we should make it possible for older dentists and older professions to contribute back to society. I think it’s just amazing in the world we live in, and it’s great that they’re so healthy and they all want to travel and they want to do cool stuff. They actually care to talk to you.  


Howard: Yeah, it’s so funny that you’re a bartender. I have said for 30 years that most dentists, they double their money if on the weekend they have a part-time job as a bartender and I just learned out of time, dead serious! Because, the natural selection in a dental school is based on, you got A's in Math, Chemistry, and Physics. And, I tell these guys that the number 1 thing that's going to carry you through Dentistry is a chairside manner, being able to talk to patients, being able to talk to them without making them feel bad, not condescending.  Don’t put them in fight-flight, epinephrine or no epinephrine, but you got to make them secrete dopamine and oxytocin and serotonin, and your bartender does it because he wants a tip. And, you want to do it because you’re their doctor and if you don’t convince them to have their cavities treated, and their abscess fixed, they’re walking out in an unhealthy situation. I would always bank on a chairside manner, and I could smell it when I walk into a dental office. I could smell the balance sheet because you know, you could either go in there, sounds and smells like a library, and some lady in the front-desk hands me a clipboard where I sign in like I’m some kangaroo cattle that has a branding on my butt. And then, you go into the million dollar practice and someone will stand up and go, ‘Oh my God! How are you? How are the kids? Isha, what’s your husband been up to? What are you guys doing?’ You know, you just smell the feel good, and you create that environment then they will get their disease treated. And if you just focus on the disease, by the way, I still always love this quote, “The superior doctor prevents sickness. The mediocre doctor attends to their impending sickness. The inferior doctor treats actual sickness.” When I got out of school ‘87, there was this guy named Bob Berkeley that was going around and he spent his whole life until the went down an airplane trying to get these doctors who were just pulling down everyone’s teeth and putting dentures to start hygiene department. And the pushback was, I’m booked out six weeks in advance pulling everybody’s teeth, doing dentures. I don’t got time for this baloney phony hygiene department and look how far we’ve come in just fifty years since Bob Berkeley who basically, I mean he was going up against a wall trying to get these dentists to switch to preventing disease. The superior dentists prevent disease. The mediocre dentists attend to impending sickness and the inferior dentist is just treating disease. And I love the fact that you’re already thinking about evidence-based dentistry. The real value is when they come to you and you prevent disease, not that you’re the fastest, most efficient, tooth-drawer mechanic in New Zealand.


Isha: Yeah, I think innovation is key and that dentists need to innovate our value and it is going to become a commodity. Like, patients can't seem to differentiate between coming to see me and going to Thailand, which is a great close in New Zealand to get treatment done and I think it’s a reflection on the profession because you know, everyone's competing on price, and then the patients go shopping for price. But, I wanted to talk to you about what's happening with the Facebook groups. Some of the facebook groups have 40,000 dentists in Australia. In New Zealand, there's one that has 10000, but in 1992 that you established Dentaltown and you wanted to bring all these dentists together, to start talking o each other and collaborating. So, you’re a bit of an old soul yourself?


Howard: I started Dentaltown in ‘98. Facebook didn’t start until 2004 and it’s amazing. Basically, when I saw the internet, I’ve done everything because I would only recommend something I did in my office. I would only talk about the solution I found for my patients. And, I put my four boys to bed at 8:30, and I’d be sitting there in my chair, thinking, I’d give anything to talk to another dentist. And, I get a root canal swelled up, [01:01:07 unclear], should I pull it or should I add metronidazole? I was always sitting there with a knot in my stomach and when I’d call everyone who loved me, like my dad, he’d say, ‘Well you know, I’d pray for you.’ I’ll talk to my mom and she’s like, ‘Tomorrow morning I’ll go to mass early and say a rosary.’ And I was like, I don’t want someone to kill a goat, or go to church, or sacrifice an animal. I wanted to talk to a dentist. And then when I saw them talking on the internet, I just started Dentaltown and the motto was, With Dentaltown.com no dentist would ever have to practice solo again. And, the main difference between Dentaltown and Facebook mainly, because we’re still, Facebook hasn’t even dented our traffic. I mean, we still continue to grow a thousand new dentists every month since 1998. I think it's the tribalism. So, if I’m one of your friends in Facebook and you put up a root canal, and I say, ‘Isha, that’s horrible. You’re short, you missed the canal and you need to redo the whole thing.’ Well, you’d just unfriend to me. So, Facebook is these little tribes of patting each other on the back and telling you you're wonderful. Whereas in Dentaltown, you go post that root canal in front of a quarter million dentists, and if there’s anything wrong, someone is going to find it. So, Facebook is where you want to go to hear what you want to hear. Join an anti-fluoridation group on Facebook and start telling them the virtues of water fluoridation, you’re deleted instantly. You’re unfriended, kind of like if you’re Catholic, and then you go into a Hindu Club, and you start telling them that they should convert to Catholicism, you’re gone. So, in Dentaltown, one of the deals is where now you have to do it friendly because we have a report abuse button, and if anybody ever says anything that makes you feel bad, you report abuse. We have like a dozen volunteers that look at it.


Isha: Howard, how many people go to the town meeting? What’s that like?


Howard: We do that every year. Basically, what's that's like, so let's say I talked to you every day in Dentaltown, but I couldn't pick you out of a police lineup. You’re anonymous, your name is smiley tooth. And, basically, it’s just a bunch of townies, about a thousand dentists from Dentaltown, and this is what you’ll see all the time. They’d say, ‘Hi, what’s your name?’ ‘My name is Isha. What’s your name?’ ‘My name is Howard.’ ‘Oh, what’s your name on Dentaltown?’ ‘Smiley frog.’ ‘Oh my God, smiley frog!’ Yeah! And the reason we’re anonymous, that’s another reason difference in Facebook, in Facebook, you have to be there, so here’s a big, subtle, decision. Facebook, when I follow Isha on Facebook and LinkedIn, I know it’s you. I can go to the About. So, the reason why I don’t do that in Dentaltown because that’s what I feel that’s best sovereign profession, there has to be a place where to ask a stupid question. That’s why on Facebook, they always post their best root canal, their best implant case, it’s all showing off. And, everybody in Dentaltown wants everybody to become transparent. I say, no. I’ve lectured a thousand times, are there any questions? Everybody says no. You go to break, and then five people come up who whispers a question because no dentist wants to ask a stupid question in front of all the dentists. So, I think what’s best for the sovereign profession of dentistry is that you can go now, you can register and know who you are, but when you go to Dentaltown you could remain anonymous because some of these guys are like, endodontists. Imagine you’re an endodontist and you’re posting a failing root canal case. Now all the dentists say, ‘Oh my god, he was the dentist who posted on Dentaltown, that root canal that was upside down, fractured and broken,’ so I want there to be an anonymous place where dentists can ask a stupid question because I’ve seen that phenomena lecturing for 30 years and I want what’s best for dentistry, not what’s best for anything else, but I love Dentaltown, just like--


Isha: Sorry, I just have one more question for you.


Howard: Okay.


Isha: Did you face any challenges when you were trying to establish Dentaltown because you’re a dentist, and what do you know about computers? What was the journey like trying to get a firm setup and trying to get your head around it?


Howard: Well, I’d say the instinct thing was at that time in ‘98, there were actually a dozen dental companies trying to do the exact same thing. But they all went and borrowed a bunch of money, they all borrowed a bunch of capital money that’s called Dental Exchange and raised like $20 million of capital and, dentistry is not a sprint, it’s a marathon. And, I hired a programmer but in my dental office, and I have no overhead, but I was lean and mean, and I said the turtle will win at the end of the day, and we went slow, and we focused on the customer, and every one of those other companies is gone. We’re the only one who survived, and we only survived because we kept it plain and simple and our cost low, and we worked it all day, every day. When I started it in 1998, not one single person, my father, my mother, and my ex-wife, I mean, my dad, my sister, Shelly, and my ex-wife stood each one day, the entire day just trying to talk me out of it, that it’s a stupid idea. It was AOL. How old were you in 1998?


Isha: I was 11.


Howard: Eleven. Do you remember the AOL dial up?


Isha: Yes, I do. The cring--cring--cring--



Howard: Yes, everybody said it’s stupid. It’s never going anywhere, but I just kept thinking of only one thing. I just kept one thing and that is, ‘How nice would it be if the kids all went to bed, just as sharing another x-ray with a doctor. What would you do?’ And, I knew that for me, for my own selfish me, I wanted that so bad that I didn't know how I wanted that so bad and nobody else wanted that so bad? And now, social media looks obvious. I'll tell you the other funny things people tell in the markets. Did you realize that the planets had silent movies and phonographs for 40 years before one monkey thought, why don’t we add the phonograph to the movie? I mean 40 years--not one human thought well let’s try to put chocolate on my peanut butter? I mean, and that’s what you did, that you added the movie, to the still movie, and you added the chocolate to the peanut butter, you and I added what we have in common, you added an MBA to a dental degree, and the whole is greater than the sum of its parts. A dental degree is one, an MBA degree is one, but one plus one equals three, but the whole is always greater than the sum of its parts. And, whenever you’re on your journey, and you added a book, added another degree, the whole is greater than the sum.


Isha: And how did these first people in dentistry joined Dentaltown? How did you find them?


Howard: Same way of building practices, word-of-mouth referral. It was just simply word-of-mouth-referral. I mean, when something works, you will share it with your buddy. And when you registered, we said, ‘How did you find about us?’ and there’s always a name of someone else who’s also a member, but when you look at Google--Google never advertises one time in 20 years,  not add. They did a search, they added a search engine, and the people would say, ‘Oh my God, try to search it on Google.' and then she tells her sister, try to search it on Google, and I think that exponential growth and there is no advertising. So, if you're really doing the right thing, your customers are going to tell people. The people had to spend all their money on advertising, on billboards, direct mails, Google Ads, and all these SEO, it's because they don't have any raving  patients that are coming home, going back to work, and saying, ‘My god, I swear to God, if you're ever going to go to a dentist, you need to go to my guy.' I didn’t even feel his shot, and you know, a painless shot is worth more than a laser and a cad cat and all that bullshit. A chairside manner that makes you giggle, laugh and feel good, imagine if your girlfriend said to you, let’s say you're looking for a woman doctor, ‘You should go to my woman doctor.’ You said, ‘Why?’ ‘Well, she has an MRI machine. She has an IBM XQ5 MRI machine and she's got the new Cisco GXQ Ultrasound machine.’ That’s how dentists talk, like anybody gives a shit to what type of ultrasound laser, I mean, if you go to an Ob-gyn, you’re going to get referred by your girl friend who loves her Obgyn because she makes her feel good, not because she has the new Cisco router ultrasound laser IBM bullshit mainframe MRI CAD scan rolled into one. Dentists talk about this trinkets like they matter,  what matters is how you make people feel.


Isha: Correct. Thank you for everything, Howard.


Howard: Nah, thank you. And please Graeme Milicich that I’m going to fly over there and I’m going to fly over there and hit him on the head with a dead kiwi.

Isha: Oh, come to Hawke’s Bay! It’s so nice and sunny. [01:10:57 unclear], it’s usually in September and Topol, it’s beautiful.


Howard: Well, tell Graeme that if he comes on my podcast, then I’ll go down there and lecture, but I’ll be in Melbourne City if you’re going to be in the neighborhood, and tell Graeme that you are the first and the greatest Kiwi to ever come to my show. Tell him he’s got a big trail to follow.


Isha: That’s actually not true. There’s actually Dr. Andrea Kiefer[01:11:28 unclear] who came on your show.


Howard: That’s right. I forgot, and there’s a big dental company that makes a matrix, is it Triodent?


Isha: Yes, Triodent, and now they’re also a dental supply, Simon Mcdonald’s establishment.


Howard: Simon McDonald’s. I want a podcast him, that was before your time when composites—


Isha: Well I can send him an email and tell him--


Howard: Before your time when the composites came out, we only had the same stuff that was used for amalgam. So we had the whole amalgam armamentarium and we’re trying to do composites, and Simon--What was his name, Simon McDonald's?


Isha: Yes, correct.


Howard: He was the first one that said, ‘No, an amalgam matrix is not going to be ideal for a composite matrix and I love that sectional--What's it called? The Triodent Sectional Matrix?   


Isha: Yes, they’re fantastic. The B3, B5 series, maybe B3?


Howard: Well, could you do me a favor and tell both of those kiwis that I want to podcast them?


Isha: I will tell them. And come to New Zealand soon.


Howard: Okay, and thank you for-- and thanks for all the articles that you wrote on LinkedIn that’s why I’m a big fan of your writings. You’re an old soul, I love your spirit, you’re just a cool kid and I know you’re going to crush in dentistry.


Isha: Thank you, Howard, have a good day!


Howard: Alright, you too!




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