Howard: It is just a huge honor to be in Sydney and yesterday I lectured in Melbourne, Australia where you live.
Toni: That’s it.
Howard: And you came to Sydney. You’re so kind to tape a podcast with me and Ryan. So, let me read your bio. Dr. Toni Surace, BDS. Surace like Versace. Are you related to Versace?
Toni: No. No, I'm not.
Howard: But that's gotta be very Italian right?
Toni: Very, very Italian. Southern Italian Calabria.
Howard: Is that right?
Toni: Crazy ones. Yeah.
Howard: She's the managing director of Momentum Management. She’s a mentor coach and international presenter. She graduated from Melbourne University in Dental Science in 1995 and established her former practice, Smile Style Dental, in the year 2000. As a Principal Dentist, Dr. Surace went through the Momentum Management Program and found by implementing procedures, protocols and systems. She could run her practice remotely and leverage her time. This enabled her to be selective in the type of dentistry that she personally did and allowed her to fulfill her other passion by helping dentists run their business more effectively and efficiently. Today as the head of Momentum Management, Toni has become a renowned international presenter where she is able to draw on her own experience as well as her clients to help others tackle any issue impacting their practice. As the winner of the ADIA, Australian Dental Industry Association?
Howard: As the Australian Dental Industry Association Dental Industry Professional for the year in 2012.
Toni: Thank you.
Howard: Congratulations on that.
Toni: Thank you.
Howard: By the way, the Australian Dental Industry Association, won the number one –
Howard: Association of all Australia.
Toni: It’s an amazing association.
Howard: It is very well and -
Toni: Yeah. Yeah.
Howard: She was formally acknowledged by the industry for the much-needed work she does to assist other dentists. You will also find Dr. Surace further assisting dentists by addressing questions concerning the dental community within her question and answer column “Best Practices” in the Australian Dental magazine. The Australian Dental magazine – no, Australasian Dental Magazine.
Toni: Yeah. There’s a couple so -
Howard: Is the Australasian is that the one out of Singapore?
Toni: No. Australasian is out of Melbourne.
Howard: Toni is an enthusiastic, energetic presenter that delivers high value at every course she presents. She has formal training in team building and team management, positive psychology, business and leadership. Toni is passionate about people and dentistry. In her role as international presenter, coach, trainer and mentor to dental practices, she thoroughly enjoys assisting people to grow within dental practice management, marketing and communication. Toni is changing dentists’ lives and lifestyles every day, and she is living proof of the success that Momentum Management Programs have to offer to our clientele. Thank you so much for coming over.
Toni: No problem it’s my pleasure. Thank you for inviting me.
Howard: Oh, the honor is all mine. So, what are you seeing in the field? Why do people call you?
Toni: Why do people call me? Great question.
Howard: What problems are they having that you're helping them with?
Toni: Varied. Extremely varied problems but a lot of the problems are that they are not able to grow their business and a lot of it will be because their team is not right, is not working properly for them or they don't have a vision. They don't know where they really want to go. I feel so sorry for dentists because we don't learn business skill and that's what we need nowadays, is some business skill if we want to be an owner of a dental practice. A successful dental practice. So, yeah I just love going in and helping.
Howard: It's funny. We've done a daily show for two years and every time I talk to a dental consultant it could be in the United States or England. I say, “Well, what is the number one problem you deal with?” They always say the team. Why is that?
Toni: Okay you know what? It’s the team but the team is a product of the leader. So, your practice is a reflection of you and if you haven't got it all together and you don’t know what's going on and you can't direct them properly then your team is probably gonna be in a bit of shambles and we need to learn those skills. We need to learn how to become a leader that can motivate our team and can inspire our team to do what we want them to do. I love, I'm extremely passionate about teaching dentists to become better leaders.
Howard: Do you think that's something you can learn or is that something you're born with?
Toni: No. I definitely think you can learn it.
Howard: It's not like kicking a soccer ball.
Toni: I definitely think you can learn it.
Howard: To me, the problem in dentistry is the only people invited to the party were the ones who got A’s in Calculus, Physics, Chemistry, Biology.
Howard: Those are the geeks like me and you sitting in the library, studying biochemistry till midnight when all the normal people were going to bars, joining frats, getting drunk. So, how does this introvert science geek -
Howard: What I remember every night at Creighton University for all of undergrad. I had to hear this every night. “Ding. The library will be closing in ten minutes”.
Toni: No. I don’t believe you.
Howard: Then I walk back to the dorm and it’s music, beers. It was a all-boys dorm, Jesuit college or sneaking in girls or making out getting drunk and here's the dentist coming back with their library books at midnight.
Howard: So, how does that geek turn into a human leader, social skills?
Toni: Yeah. Absolutely it's awesome question. I'm a geek. I'm an absolute geek. That's how I got into dentistry. I did a science degree before I did dentistry. I'm a professional nerd is what I like to say but you can learn. It depends on what you want and if you're passionate enough about it you actually can learn. So, yes there is a certain element of emotional intelligence that you need to have. I totally agree with you, that will make it easier for you to become a leader but you definitely can learn. A lot of reading. A lot of self-reflection. It’s all about growing inside and that's something that is a bit confronting for some of us. So, actually taking the time and learning about yourself and why you do the things that you do and maybe even some of your limiting beliefs. You need to know what they are, recognize what your behaviors are to then be able to grow.
Howard: Baby boomers like us, we read textbooks, we go to dental conventions. So, you're talking to Millennials. They’re pretty much all born. Everyone listening is pretty much all born after 1980. In fact, thanks for sending. I've asked you guys email me email@example.com and tell me who you are, what year you're born, and lots of you were sending it in and they’re babies.
Toni: They’re babies?
Howard: I just got a couple just right before the show and they're D2. They're second year of dental school. So, for these millennials how could they fast forward leadership development?
Toni: I think that is a sensational thing to be even thinking about fast forwarding leadership. I wasn't even thinking about that when I was in second year of dental school. So, these guys I feel have a real advantage.. is that there is so much knowledge out there now at the access of your fingertips on your smartphone. So, definitely start reading. Start delving into some of those self-analysis. There's lots of different questionnaires and things that you can get on the internet and you can start learning. Learning, learning about yourself. I think that's something that you need to stay open to all ideas. My advice for people starting out in dentistry nowadays is that you need to be really flexible. You need to be able to not just look at the clinical side of things. You actually do need to look at things like emotional intelligence leadership and ways of influencing people. So, your success in dentistry is going to be very much dependent on how good a communicator you are and learning communication skills is one of the first things that I would be doing.
Howard: Is your book on Amazon?
Toni: No. No. My book I give away for free.
Howard: Okay, so you wrote a book called Be Exceptional.
Howard: 50 Practice Systems to Kill Average and Wow Even Your Mother-in-Law. You hand that out as E-book?
Toni: Yeah, I do.
Howard: You know what I wish you would do? You should make an online dental course on DentalTown called that and then if they take the course, you email them the book.
Toni: Yeah, cool. No problem.
Howard: So, you have three boys –
Howard: And a husband. So, you're outnumbered four to one –
Howard: I always have said, I've written a few books before. I was said that writing a book is like having a baby. It's a nine month project.
Toni: Oh, look. This is a mini book I'm gonna say, because in dentistry we're so busy. Why subject someone to a full book when you've got to run a dental business. You've got a family to be with as well and you've got to keep up-to-date with all the clinical stuff. This is a mini book so it's really succinct and it just tells you what you need to know. There's no fluff. There’s no craft.
Howard: You can get it if you go to your website, momentummanagement.com.
Toni: You can get it on my website. Yes.
Howard: momentummanagement.com.au. So momentummanagement.com.au. What do my homies find if they go to your website and how do they find that book?
Toni: Yeah. Look there's a little link there. I think there’s a link on the home page. If not, we’ll set one up on the home page but I'm happy to give a link for DentalTown anyway so they can certainly get it from there. It's all about fifty systems that I feel are essential to get in place in your practice that will help your life, okay? Once we get things systemized and organized in your practice then things tend to go on autopilot and you don't necessarily have to think so much about getting things done and team members absolutely love it. They absolutely love it because they know what's expected of them and I think that's a really big thing with our teams is that as dentists, often we don’t even know what our team members should be doing. So, often I'll hear a dentist come to me and say, “But you know? She's been a dental nurse before. She should know what to do”. You know what? They don't know what to do and it's not fair on us to ask them just to do what they've always done. They’re not mind readers. What we need to do is we need to set up the expectations properly. We need to give them good, solid, safe systems and then they're going to flourish.
Howard: You've heard of Subway?
Howard: They'll hire a sixteen year old kid and before they start on their day one, at home on their own time, they have to watch eight one-hour courses, take multiple-choice questions, get all right, and if that girl said, “Well, I wanna be a dental assistant” and when became a dental assistant. She'd get no training.
Toni: Yep. Crazy.
Howard: The front desk, in any normal business, the front desk would be called incoming cells and they would record all the calls, they track the calls, and all of you about converting the calls into sales and someone cancels their appointment or doesn't show up..that would be outbound sales and marketing –
Howard: Here's the most important position in the office. Zero training. Hire you and, “Oh, you work in (inaudible 12:25)? Well, we're gonna name your position after a piece of furniture. You're the front desk lady and I'm gonna go do the important stuff and I'm gonna go back and do some drill, fill and bill dentistry”. It’s crazy.
Toni: Why do we that? It is really, really crazy, isn't it? That is the most important piece of equipment in your practice. I think Linda Miles, I heard her saying years ago, if the phone don't ring, the drill don't sing and it's so true. So, why don't we invest in our team and help our team answer the phone appropriately but I love what you just said as well with regards to now thinking about these phone calls as leads. That's something that in dentistry especially in Australia, we have never thought of it like that and I think that if you said lead to many dentists in Australia, they would just go that sales and I don't want any part of it. Now that's what I'm trying to break through at the moment. I'm trying to break down those barriers of these our leads. Well we have a prospect that comes to our phone and we can convert them to a lead but we've actually got to capture some data to convert them to a lead as well. So, I'm having lots of fun in that space at the moment. I'm challenging lots of people and I really love what we're producing. It's getting really exciting.
Howard: I tell people if they're not into selling dentistry, just get out of it. They should go into something that they believe. Go sell iPhones. Go sell drones. I've heard did somebody a woman who had all their teeth pulled and got a full mouth denture and committed suicide. I had a patient told me that the saddest thing never happened is when she came to me and we removed all of her teeth. We did a denture and she couldn't sleep with it in her mouth that night. So she told her husband. She was snoring and he had to sleep out on the couch and she locked him out of the bedroom at night because she didn't want to see her without her teeth and so she locked him out. He slept on the couch. Now, after about a year or so he moved on and then she realized she lost the love of her life because she didn't take care of her teeth or she can’t get implants or this that and then some freaking dentist says, “Well, I don't believe in selling dentistry”. Then get out. Get the hell out of there. People kill themselves. They lose their teeth. They lose their lovers. How did sales become a four letter word?
Toni: Look. Hey. It absolutely is a four letter word for a lot of people and this whole thing, I’m a clinician. I'm not a salesperson. That's a really big thing in Australia. Okay. So it's a dirty word. Absolutely dirty word sales. So I'm out there on my bandwagon trying to teach people and educate dental people that it's actually educating our patients. It’s actually changing lives. It’s not sales and if we're not offering all the options then we're not actually doing our job properly. So that's a really big challenge we have in Australia. I don't know, is it like that in the States as well?
Howard: Well, you know the interesting thing about the States is no one talks about the EU because no one would compare Germany to Greece. No one would compare Portugal to Denmark. United States is really like ten different countries rolled up under one flag. Like when oil is booming Texas, Louisiana, Oklahoma, we're just crushing it. To compare Miami to New York –
Howard: Miami, when Central and South America is booming, Miami's booming. It’s all over the board United States. It’s really big country. It’s about ten different countries under one flag but you know what? You've been a dentist here since 1990.
Howard: I remember in 1990, the problem with dentists in Australia is they were booked out so far.
Howard: Now they've done a one eighty. The government let in, what they doubled the number of dental schools to nine?
Toni: Yeah, definitely so we have a lot more graduates.
Howard: They let in a bunch of foreign dentists from Asia?
Toni: Definitely. We've got pressures from corporate dentists. We’ve got pressures with health insurance companies and I always call them health insurance companies.
Toni: Bupa is a big one.
Howard: Bupa is now buying offices.
Toni: Bupa has already owns about two hundred eighty offices in Australia.
Howard: So, it's really competitive.
Howard: In 1990 it was like this was the place to practice dentistry.
Toni: It was awesome. I saw their needs. I was lucky.
Howard: They let in a bunch of foreign dentists. They double the number of schools, corporate dentistry, but this houses your big Bupa. It’s the medical insurance company. A very big one in Australia.
Toni: Very big one.
Howard: They’ve bought several hundred dental offices.
Toni: Yeah, yeah.
Howard: What are your thoughts on that and how does that change the landscape?
Toni: Yeah. It definitely changes the landscape in Australia and we do have that they’re even contacting patients from other practices and saying, come to our Bupa clinics and we'll be able to offer you a better rebate. You get more value for your money. So it means that we have to be better business people in Australia with our dental practices. I really do believe though that we can get together as independent dental practices and learn how to provide better services. Maybe even get together and do some collective marketing together those sorts of things and be independent. We’re never going to beat the insurance companies and I think that's stupid if we think that we're going to. We’re not gonna beat them but we've got to do things differently so that we can at least be in the race with them because people often don't know much about dentistry. So they will choose a provider based on money, purely on money because they don't know the right questions to ask about dental services. They don't know what to expect when they go to a practice. So it's something that's just like a shortcut question is that they'll ask how much is it? So that they can make a decision somehow. They use the money figure and if it's gonna be cheaper somewhere else, we might get some people going there.
Howard: I think one of the biggest problems in dentistry is when I buy an iPhone, I know what I'm buying. When I went downstairs this morning in the lobby and bought a cup of coffee. I know what a cup of coffee is but when I take my car to the oil change because I got a coupon that says you change my oil for $20 and then you come outside. Well you know what? I really need to flush your transmission fluid and change your air filter. I don't know if that's true.
Howard: When my air conditioner goes out and I called you and you come to my house you say, “Howard, I can't fix this air conditioner, it’s ten years old. You need a brand new air conditioner and its $7,000”. I don't know if that's true and so I go into your dental office and you come out then you tell me I have four cavities and I was like, I don't know if that's true. I know in America women have serious trust issues with any man in a tie telling her that she needs a new air conditioner, she needs several oil change and she has four cavities. In America I'm telling you, a hundred percent of women, when she takes her car and to get maintenance and he says, “You know what? We need to do this or this to your car”. The engine light comes on and she knows that in every car dealership they call it the idiot light because the engine light comes on. So, you're trying to do the right thing and you go in there and some grease monkey comes out and says, “Well, what it means is you basically gotta give me a thousand bucks and we got to deal with all this stuff”. She's always wondering, “I wonder if you were my dad or my brother or my uncle if I would need all this stuff”. How do you deal with the consumers who are buying invisible? They're looking at you and usually they don't know what questions to ask.
Toni: They don't.
Howard: So you just only have four cavities. Why should I trust you?
Howard: How does that establish?
Toni: Absolutely and it is that T word. It is that trust word. If you do have a look at my little book on systems, every single system is actually based around helping to build trust for that patient. It’s very hard for you to trust someone when you've just met them and maybe you've said three or four words to them. So we actually need to spend time to develop that trust. We need to build a relationship not just have a rapport with the patient and that does come down to your communication skills. So certainly building a relationship taking it slowly helping the patient trust you and also doing the right thing by people. Word of mouth is still the most effective way of marketing whether it's digital, whether it's online or whether it is just word of mouth. It is still the most effective form of marketing around and so doing the right thing by people treating them like their family and giving them treatment options like you would a family member is the way to go. So that trust is built and then they’re much more comfortable to say yes to your treatment options that you're delivering to them.
Howard: Trust is everything. Ryan's mother swears I'm the father but I don’t trust it.
Toni: He's too good looking. Seriously. How could he be yours?
Howard: He’s tall. He’s handsome and he has a six pack. I want a DNA test. I'm gonna ask you a question since you're a dentist and a woman dentist.
Howard: On DentalTown a lot of the women dentists they come out of school. They're twenty five and they're saying when you walk in the room, you need instant trust. You need instant likability, excellent professional and they're wondering, “Should I be in scrubs or do I need to be rock out in a dress with the lab coat on?”
Howard: Men in general, a lot of men say - like I wear scrubs and a lot of my friends in Phoenix say, “God, I wish I was a fat, lazy, bald dentist and could just wear scrubs all day”. It's like pajamas.
Toni: Pajamas. Yeah.
Howard: But they get in a suit and tie and they got the tie and all that.
Howard: How does that play in?
Toni: Gosh. I remember the days when I first graduated and patients would turn around and look at me as if I'm the DA, the assistant because I was young and I was small and that's what it was is that a dentist had to be a male. It’s so we're talking ‘90s. That was still expected in the ‘90s –
Toni: That dentists were male. So, I had to really work on influence and making myself look like an authority and I did a lot of reading and I'm sure you know Robert Cialdini. His book on influence.
Howard: He was my teacher –
Toni: I love him.
Howard: When I got my MBA at Arizona State University and he was my teacher.
Toni: Really? How fabulous.
Howard: He lives like up the street from me.
Toni: Oh, I adore that man. I really do. I think his book, The Principles of Influence totally changed my life. There were things in there that I was already doing, that I was naturally doing but it put a name to what I was doing. So, it all made sense and then I could work more on some of his influences, some of his ideas like authority. So actually having a name badge with doctor on it not just Toni, dressing right. Now, in Australia, we don't tend to like the white coat. That’s not something that we tend to do very much of in Australia but I do know that in the States that you do. If that means authority to your general community, then wear it. If authority means business suit, wear it. Who is your patient base and what do they see as authority or showing that you've had that education. So, certificates up on the wall, those sorts of things that you've done all of these courses and that your name is on the wall of fame, that sort of stuff. Little things that you think won't really matter but they all add up to being really powerful ways of helping people understand that you are the dentist and that you are the person that is the health professional. Also the way your staff speak to you. Definitely respectful staff speaking to you and I do like to be called Dr. Toni. I'm not so formal where I will say Dr. Surace but I like to be called Dr. Toni and patients from my staff that my patients will call me Toni but my staff will always be respectful. All of these little things add up and help the patients realize who we are.
Howard: Are you hearing that Ryan? You heard what she’s saying? You should call me Dad not dumb ass.
Toni: I think it would be hard for him to change that? Wasn’t it?
Howard: So in the States, the average dental office is doing seven hundred fifty thousand a year and they're taking home 180 but to do that seven hundred thirty thousand…
Toni: Oh, can you see my face?
Howard: What? Is that bad?
Toni: One eighty?
Howard: Yeah. So, to collect seven fifty and take home one eighty, ten people have to land on their website to convert one to call. Three people have to call to convert one day a man. Three people have to come in with a cavity for one to convert to drill, fill and bill. So to do that seven fifty to get that one patient, they needed three to come in which means they needed nine to call which means they needed ninety to land on their website. Man, if they could just change just improve any of that funnel, they could be collecting a million five and taking home four hundred. Then the funnel out the back door by the time they get to five thousand charts, four thousand of them never come back. Talk about the incoming funnel and the exit funnel. It’s amazing. If you just got rid of any degree of that funnel change, it would be twice as big.
Toni: That just exhausted me what you just said that people are working that hard to get patients to say yes. That really exhausted me. I can tell you at all angles of what you have just said. There are things that you can do to improve the whole process. Which way do you want to go? From the website or do you want to go from the patients?
Howard: Some of these website developers told me they don't like me saying that ten people land, one to convert because they say, “I can show you websites that have never converted anyone in three months”. So, two hundred and fifty people land on your website no one never called. There’s just not even a conversion and since 91% of all dental appointments are made by women, you’re a woman and a dentist. Why do you think some websites takes ten people land before someone convert? What do moms want to see on a website that make him pick up the phone and call the dental office?
Toni: I think that's such an important point is that you need to realize who your target market is first. Who do you want to bring into the practice and if it is women, then you want to see that there's flexible times available where you can bring your children, that your children are going to have a fun and happy time at the dental practice and that you need to actually make your website with a bit more of a feminine touch. We love to see those nice, happy family photos. Those sorts of things. That’s if that’s the type pf practice that you want. My biggest thing is that I find that dentists don't understand this funnel thing. Funnel and then bucket is what I how I like to describe it. So you’re funneling in your patients but then you've got a bucket of patients but most of these buckets will have huge holes so the patients will leaking out the door.
Howard: Ryan I love that. You hear what she said? Let’s do that slight. Can I steal that from you?
Toni: Hey, you have to pay me for that one.
Howard: Just give her credit. We’ll put Versace first on that.
Toni: Okay, but seriously so it's actually just first of all getting dental practices to realize that is the mechanism. That is happening. So then when you're going out and you've got your website, how do you get them to land on your website? First is you've got social media. You've got Adwords and pay-per-click. All of that sort of stuff. So you've got to attract people there first to then leave them to your website before you can even consider getting a conversion at all. We haven't even made the phone call or an email yet. Now, I’m really excited because I am involved in another product that I'm developing with a really, really good friend of mine. Do you know Dental ED at all? Have you heard of Dental ED? So, Emanuel Recupero runs Dental ED where he teaches. He has a lot of big-names.
Howard: Emmanuel Cooper.
Toni: Recupero. He runs a company, clinical high-end clinical skills for dentists. So, he brings out lots of the larger name dentists.
Howard: In Melbourne?
Toni: No, he runs it. It's in Australia, in Asia, and even in America as well. There's an arm of dental age in America. So, we've got together. I love talking if you haven't already realized.
Howard: Well, you’re Italian. Have you ever met an Italian? They didn’t do any talk, put their hands.
Toni: Absolutely, and if you tied them behind my back I wouldn’t be able to speak. You’re absolutely right. I love talking but the other thing I love doing is I love networking. I seriously feel that together we can do more. I don't believe in all this competition crap, okay? I believe that as consultants we can get together and we can do more on, we can help more patients if we become more successful with what we do. So, Emanuel and I've got together and we've created a product over the last two years called My Practice and this whole funnel to bucket cycle, we've got tools. It's a platform and we've got tools for every part of that whole mechanism. So, from social media and capturing leads on your website to helping with reactivations in your practice, helping convert people saying yes to treatment plans, it's all there. We've got lots and lots of tools. It's something that we're very excited about. We haven't fully launched it yet. We're still in a bit of beta testing but we're finding that it's a total solution for practices to help them compete with the corporates, compete with the health insurance companies, and compete with the number of dentists that are opening practices at the moment. So, yeah it's very exciting stuff.
Howard: Where does he live?
Toni: He's in Melbourne.
Howard: He's in Melbourne.
Toni: Yeah. It's really quite funny. I live about an hour out of Melbourne and Emanuel and I, we spend most evenings on my commute to home from the city. We'll spend on the phone talking about the frustrations that our clients have in building their dental businesses and coming up with solutions. I'm very lucky he has the digital arm, I have the ideas and I say, “Emanuel, why can't we do this?” He goes and he fixes it and he makes it happen for me. We've got some really exciting tools coming out very soon.
Howard: That is amazing. A lot of these corporates are coming in here. What are all the corporate ones? When Bupa bought three hundred offices, what are their offices called? Is it called Bupa?
Toni: They’re Bupa Dental but they were Dental Corp.
Howard: Bupa Dental. They bought Dental Corp?
Toni: They bought Dental Corp.
Howard: But now they're called Bupa Dental?
Howard: Then you have what? 1300SMILES?
Toni: Yeah. We've got 1300SMILES. We've got Maven Dental.
Howard: Maven Dental?
Toni: Yes. Who else do we have? There's NIB clinics.
Toni: Yep, health insurance.
Howard: That's another health insurance?
Toni: Yes. There's a number of dentists who are actually becoming mini corporates too.
Howard: There's a big one in New Zealand.
Howard: Lumino. A lot of the people in corporate think that in ten, twenty years they'll have half the market. Right now, statistically in the United States and Australia it's 12% of the offices. It's 12% now. Where will it be in ten years and twenty years?
Toni: It's a bit scary, isn't it? What’s my prediction?
Howard: Well, what's your crystal ball?
Toni: Yeah, I do think that –
Howard: Assuming that’s a lasagna. You take your crystal ball, is it lasagna or manicotti?
Toni: That's gorgeous. Look, it is hard to know because things are changing so much in dentistry now. It is something that people are definitely, these corporates are definitely taking over. Yeah, it's gonna be more than 50%.
Howard: So, let me ask you a question. I know if you read literature every generation always thought the next generation was useless. I've never read in literature where they thought the next generation was all that in a bag of chips. They're always whining about the next generation. A lot of people are saying that, we’re boomers, that the millennials don't want to their own practice especially the women. A lot of them were saying this woman, she wants to be a soccer mom. You got three boys. She saw how hard. Her dad was a dentist. She saw all the hats he had to wear and it was like this total lifestyle. Did you believe that or do you not believe that? I mean do you really think someone goes to school for eight years to be your employee?
Toni: I really don’t. Look, I still think –
Howard: Then when they tell me, when the corporate tells me that these millennials all just want a job then I ask them, “What is your number one problem?” They always say, “Well, you're not gonna quote me. We're not recording whatever, but I can't keep my damn associates”. The turnover is still through the charts.
Toni: I don’t believe it that they only want a job.
Howard: Do you see high turnover of associates?
Toni: Oh, definitely.
Howard: You do?
Howard: What do you say?
Toni: Very high turnover. So, you rarely get people to stay more than two years.
Howard: Okay. In the United States one of the biggest chains their average associate didn’t stay a year. It's not corporate because when you go to private, I'm fifty four, all my friends that are fifty four to sixty four to seventy that wanted an associate, it's the same problem. So, associate turnover in private practice and corporate is off the charts. Like you just said two years max. So, how are they gonna take over half the market if they can't even keep their damn associates?
Toni: See, the thing is though with these health insurance corporates, they actually are not providing dentistry to make a profit. They don't have to. It's about their health insurance company.
Howard: For Bupa?
Howard: And NIB.
Toni: So, we’re competing with people who were not actually –
Howard: That’s kind of scary.
Toni: It doesn't matter whether they make money in their business or not in their dental business because it's about getting patients to join their health insurance. It's actually not about the dentistry. That's what we're tackling and that is a huge problem. Now, I wanna go back to a couple of things you said there.
Howard: That is a dangerous one because that's the thing in the United States. We had this president who they still think is one of the greatest president we ever had. It was Ronald Reagan, and his qualifications where- he was a movie star and he believed in free trade. So, he unleashed free trade. Well, the Japanese, the Koreans, the Chinese, their manufacturers all run to the government and the government said we'll give you all the money you want and then all of our companies that were like making televisions like General Electric. Jack Welch went to Reagan and he says, “Hey, my competitors they can sell them at a loss because their government's funding them”.
Howard: He said, “You got to give me some money” and Reagan said, “I'm not gonna give you any money. I believe in free trade” and Jack Welch said, “Well, it's not fair trade because those governments are getting in the game and you're just turning us naked”. So, what did America do? They lost 50 million manufacturing jobs in the following twenty five years and America doesn't make a TV an iPhone.. When Steve Jobs wanted this phone built, the phone companies in China went to their government, the government gave them billions of dollars. So, they built all the iPhone manufacturing jobs in China while America's saying, “Well, we believe in free trade”. So, when you're a dental office and you have to make a profit and now you're competing against someone who doesn't have to make a profit, that's dangerous situation.
Toni: Absolutely, and that's where I said we're not gonna be able to compete with these guys. We can't compete. We have to do difference. We have to. That’s the huge issue and I don't think that a lot of dental practices in Australia realize that these guys, these big players in the insurance space don't need to make a profit.
Howard: The dental is only about 5% of their costs in health insurance.
Toni: It's nothing.
Howard: Yeah, and they can run those at a loss.
Howard: And to perpetuity.
Toni: So, then if they have got changeover of stuff, big deal to them. Now, I want to go back to a couple of things that you were saying. Firstly, I think that you can be an associate dentist. If you just love clinical and you really know that you wouldn't be good at business you don't have to own a practice. You really don't need to. So, that's something that I think is a mindset change that some newer grads need to realize as well that you can find some amazing people to work for and have a fabulous, fabulous career being an associate dentist. You don't have to own a practice but please if you are going to own a practice you need to work on your business skills. It doesn't just come. It doesn't just come like when it did when I graduated in the ‘90s. It was easy. I know my business grew by default. It's so important for women to work out what they actually want to do. I mean, I certainly had a drive where I wanted to be the best clinician I could possibly be but I also wanted to be a business person as well. I knew I loved business. I was always going to own a practice.
Howard: Let me stop you there. Was that because your mom and dad owned a business?
Howard: I see that in dental school a lot. When you look at all occupations around the world I would say a quarter of people are just in the family business. If you grew up in Tasmania and your father and grandfather and great grandfather were goat herders, shit you just become a goat herder. When they're in dental school and their mom and dad owned a dental office they get it. They know what they're going into. If their dad or a mom owned a restaurant or a corn farm, they know it but I see a lot of problems with the kids whose mom stayed home and make cookies and dad was an employee on the assembly line and I don't think they got any of that.
Howard: Family business at the dinner table.
Toni: Well, it comes back to our formational years when this thing inside the nut here was forming that we got pictures in our mind that that was normal, that that was what we should be doing, okay? We can then have a limiting beliefs and this is where the guilt comes in as well for a female. My mom stayed at home with the kids and really I should just be staying home with the kids as well. So, there's a lot of self-work there that needs to be done if you did come up in life, growing up with a life like that. There's nothing wrong with it. It doesn't mean that you can't change but it's much harder for somebody when they have those beliefs in their head that no, I really should be at home. I should be looking after the kids. So, there's a lot of pressures on women to have a family and a career at the same time.
Howard: That's why I decided I was never gonna have a family.
Toni: Right, four boys later.
Howard: My four boys are taking it very hard.
Toni: Actually, I don't think they'd be quite happy.
Howard: I told them I decided I’m not gonna have any children and they’d argue with me. Well, on that note I'm embarrassed to say this but it’s so true and I totally have seen sexism my whole life starting at home. My mom would put my five sisters in dresses and they get in trouble if they soiled their dress and she put me in blue jeans and iron patches on the outside of my knee.
Toni: Go and get dirty.
Howard: The weirdest thing was we live by a river and I was the only child that was allowed to swim in the river and my sisters couldn't get ten feet off the edge. So, I've seen this sexism thing. I've seen it where they cry hard inside my house. I've been a dentist in Phoenix for thirty years and like the woman will be you know built a million-dollar practice. She's making $200,000 a year. Her husband works for a Fortune 500 company for sixty five thousand a year and he got a promotion and he's transferred to Seattle for $80 000 and he says, “Come on let's go”.
Howard: She's like, “Are you out of your freaking mind? I built this for ten years”. Then I'm saying freaking divorce his ass and she's like, “I don't want to blow up the family” and so she sells the practice and has to follow.
Howard: Other deals, I see it all the time, where the woman is a dentist, the husband's a dentist but guess who does all the cooking, cleaning, the homework -
Toni: The woman.
Howard: The school, the whole….and she's sitting here saying, “I can't believe it. I mean we both went to dental school and he comes home and just stares at the sporting ESPN TV”. Obviously, you see in Saudi Arabia where they're not even allowed to drive cars. There's still a lot of sexism on the planet. Do you agree?
Toni: Yeah, absolutely. Absolutely.
Howard: Even here in Australia?
Toni: Look, don't know if it's that bad in Australia. Certainly you know Australian men are often really quite prepared to share the parenting if you've got children, quite prepared to look outside the box. There's a lot of men who would be the stay-at-home dad if the female was the one who is the breadwinner. So, we actually see a lot of that.
Howard: A lot of men have a problem with her. I've had men say to me that it really bothers them that their wife is a female dentist.
Howard: And makes three times as much money as they do and I say, “Well, you know what? Just try not to think about it while you're vacuuming”.
Toni: I totally agree. There's actually a really big trend in Australia at the moment and I have a lot of clients who the female is the dentist and then the husband is coming into the practice as a practice manager. So, we're definitely seeing a lot of that. That is all over Australia at the moment and I love that because they're then sharing the burden and it's certainly something that the male can understand what the female is going through because dentistry is tough. We all know that. It's a stressful job physically, mentally, emotionally, difficult job and then you've got to run the business as well. You know, it's tough.
Howard: It’s all about communicating, communicating.
Howard: A lot of men they tell their wife, “I get $1,000 for a crown” but they don't tell them that 80% of their crowns are on a PPO or the adjusted fee is 600.
Howard: So, the wife just hears, “Oh, well many crowns did you do today?” “Five”. She's saying, “Wow, you make $5,000”. She doesn't know that each one of those thousand crowns was 600 and that he has overhead rent, more labor and all the stuff in that.
Toni: Yeah. Don’t understand goal.
Howard: Then he's resentful because she went out and spending all this money but she's hearing, “Well, he did five crowns. That's $5,000”. So, getting the spouse - I saw it in Kansas. When the dad was sitting on the tractor in a wheat farm and the mom was doing the business at the kitchen table and she had the calculator and she was paying all the bills and all that stuff. They had a rocking, hot family. Wheat farm and they were very successful, but when the mom wasn't involved with the husband, he was doing all the farming, she was raising all the kids. They didn't seem to be nearly ever on the same page.
Howard: About money, business, spending.
Toni: So, it is all about at the very beginning when I said when you said to me what makes a successful practice? What would you do? Learn to communicate. You need to learn to communicate not just with your staff and your patients but with your family, with your friends, and so people understand but also it's something that when we have got a business - so we run a two-year mini course, like a little mini MBA in dentistry.
Howard: You do?
Toni: Yes. That's what I do for practices.
Howard: So, it's a two-year course?
Toni: A little two-year mini MBA in the business of dentistry.
Howard: Is it a one weekend a month. One week –
Toni: It's two days every three months and then they get coaching support as well. Yeah.
Howard: So, it’s two days a quarter.
Howard: For eight quarters.
Howard: My MBA was two years.
Toni: Well, this is just in the business of Dentistry but what we do is we invite the spouse, okay? We invite the spouse so we have particular workshops where the dentist, whether it's a male or a female, their spouse will come as well so that they actually know what's going on and how to best support each other. So, we do a lot of work-life balance work. We do a lot of relationship building work with spouses, partners, whoever it is so that we can make business...
Howard: You just do that in Australia?
Toni: Yeah. Australia and New Zealand.
Howard: On your website is any of those online courses on?
Toni: We are creating online courses now.
Toni: Yeah. It's always been live.
Howard: Do you think you’ll ever teach that in America?
Toni: I'd love to.
Howard: You know, we have had an annual meeting for fifteen years, the Townie Meeting. It's been every April in Vegas for fifteen years but the next two years we've signed up for Orlando mainly because I'm a selfish bastard and I have two grandchildren now.
Toni: You don't wanna travel?
Howard: They don't wanna go to Vegas and drink martinis and smoke cigars -
Toni: Damn. I do.
Howard: With dad and play blackjack. They wanna go to see Mickey. I’m gonna switch to Orlando deal but that department has a very hard - you can't have a department that has one program a year.
Howard: So, now we're putting on programs in the other quarters. We're trying to put something on every quarter because those people on that Townie Meeting team need work to do the other nine months a year but that might be something where maybe you have a direct flight to LA maybe we could do that two-year program in LA sometimes.
Toni: I’d love to.
Howard: You might think about that.
Toni: I would love to. It's amazing.
Howard: There's 38,000 dentists in just California and there's what? 20,000 dentists - how many dentists do you think are in Australia?
Toni: There's 15,000 dentists in Australia.
Howard: So, it’s 15,000 in Australia.
Toni: We only get the top 10% wanting to do this sort of stuff.
Howard: Yeah. Well, there's twice as many dentists in California so that might be something –
Howard: You should put an online course up on Dentaltown to build your brand and name and then because if I could hold up your picture and a half the room says, “That's Toni Surace”. We'd blow out that course. We'd blow out that course.
Toni: Sounds good.
Howard: That would be fun but –
Howard: I want to hold your feet of some fire on some specific things.
Howard: We we're talking about that funnel.
Toni: Yeah, yeah, yeah. Let's go back to that. Love it.
Howard: You're talking about you got to do all this stuff to get me to go to your website.
Howard: I'm telling you the deal on the website is ten people to land before one calls.
Howard: Three people have to call before she converts one to come in and three of you have cavity before one gets done. So I want to talk about the three people out to have a cavity before one converts to drill, fill, and bill. Should the dentist be presenting that treatment? Some offices have a treatment plan presenter. I tell the dentist that you're not a good dentist if three of your patients have a cavity and you drill, fill and bill one. Imagine if you're a fireman and you say, “Well, I only put out one out of three fires?” The other two burned to the ground.
Toni: You would do something about, wouldn’t you? Totally agree.
Howard: Imagine if you’re a policeman and you said, “We’ll only catch one out of three bad guys”.
Howard: I’ll say what's keeping you up at night? And they'll say, “Well, I don't know if I just switch from Noble Biocare to whatever” and it's like, “Yeah. That’s probably the least of your problems”.
Toni: Yeah. Definitely.
Howard: How could she convert more people to treatment? Should she present a treatment? Should a treatment plan presenter do it? What are some tips to increase that conversion?
Toni: Sure, sure. I think it's different for everybody, okay? So some people are naturally good at building relationships, helping people feel at ease and so we do have some dentists who are a natural salesperson and are able to get that work across the line. 33% case acceptance I'm whacking my head like this.
Howard: Well the United States average is 38%.
Toni: No way?
Howard: Just for decay. We’re not talking about implant.
Toni: Just for decay?
Howard: Just for decay.
Toni: Usually a 100% for that. That’s crazy.
Howard: Yeah. It has 211,000 licensed dentists and you can get insurance data with hundreds of millions of claims –
Toni: That’s insane..
Howard: And the country has a 38% close rate on decay and then he’ll go to five courses wondering if the filling material should be –
Howard: 3M or Bisco or Ivoclar..
Toni: Yeah or what bond should I use. Yeah. It’s sign.
Howard: You don't even remove the cavity two out of three times. In fact I tell dentists, America would be better if you removed all the decay and packed him with butter or you would say spaghetti sauce.
Toni: Definitely. Yeah.
Howard: They can't even remove the cavity.
Howard: So what advice would you give?
Toni: It really surprises me that it's that low to be honest with you. So definitely look, that dentist needs communication skills, needs to learn some skills to help that patient make the right decisions for themselves, definitely, but if that dentist is really, really that typical, clinical person who is an introvert can't do it, just let them be the diagnosing machine and have somebody else do it for you. Really you’re silly to do it any other way. So definitely get a treatment coordinator in. Let the treatment coordinator build the relationship with the patient. There's lots of techniques that we can put in place to help make that better. Getting a greater case acceptance is something that you have to work on and we definitely teach a lot of that about getting people to trust you and to say yes but to decay? I find that mind blowing.
Howard: Ryan, I want another slide that recalls not just for hygiene, it’s for also for implants and endo. Just write that down. Do you remember? So I want to talk about, you said that funnel goes to your bucket –
Howard: And there's holes coming out. So a hygienist has eight people today which only scheduled six for a recall. So, now a quarter of her patients she’s lost her patients. Scheduling recalls is so important but I think a lot of dentists forget that endodontics, when they do a molar root canal, it’s standard to care among all endodontics to have a one year period. They tell their patients, “I need to see you in one year”.
Howard: “Take a PA to make sure all this healed up”. Well, that's another scheduled appointment. One more reason this person might stay in your practice and not fall off. Implants, we know that in sixty months, 20% are failing from peri-implantitis and its standard to care among periodontist and oral surgeons to say at one year I need to take an x-ray of this because maybe I left a little piece of cement. There's a lot of things I can fix at one year that I can't fix at five years –
Howard: When you come in with the loose implant but that bucket, can you name like holes.
Toni: Yes. Sure.
Howard: Where are people falling out of this bucket?
Toni: One of the biggest places which you've just alluded to now is in creating value for the patients to come back. So really cancellations and people who are not scheduling in the future is often because they maybe didn't get enough value when they were there and I don't mean value for money. That's not what I'm talking about. I'm talking about value for their personal health to come back. So we certainly train our dentists and our hygienists to be creating something that we call a reason to return. So that reason to return is a solid personal reason for that person to come back for the next visit and we track rebooking rates. We’re quite strict with rebooking rates. We want 90% rebooking rates from our patients –
Howard: 90% rebooking rates.
Toni: We consistently get 90% rebooking rates when we get a solid reason to return for that patient. So can I give you an example?
Toni: I’m being the hygienist, okay? Mrs. Jones has just had her standard clean and I'm gonna say to Mrs. Jones, “Mrs. Jones, I need to see you in six months time for your checkup and your hygiene appointment”. That's the standard way. So let's go out the front. Let’s see the front office girl and she'll make that appointment for you. Anything wrong with that? Anything right with that? Okay, let's look at it a different way. Let’s now say to Mrs. Jones once she's finished. “Mrs. Jones, you've done a great job today. Well done. Now, I just want to talk about the lower right hand side of your mouth. You know when it was a little bit sensitive, when we were cleaning in that area? Well, there was actually some four millimeter pockets that I'm quite concerned about. If we don't keep an eye on them and clean them every six months, I'm concerned that could develop into future infection. So let's make that appointment for you now” and the hygienist makes the appointments. The patient is, “Yeah. I don't want that to get any worse”. She's saying, yeah yeah, yeah. There's a value for me to come back. So there's all these little things to help, get our patients to come back. Now people are going to say to me, “Oh, yeah but then what's your cancellation rate?” We’ve been very clever here and the words that we have said to the patient reason to return. Our DA has been listening and he’s charting the words that we've seid in our patient notes. When the patient rings to cancel, what we're going to do is we're going to bring up those that reason to return. We're going to go on back onto the phone to Mrs. Jones and we're going to say, “Mrs. Jones, I understand that you might need to cancel today but look I've just been having a look at doctor Toni's notes and I can see that she was quite concerned about that lower area with the four millimeter pockets. She didn't want you to get an infection there. Are you sure that you can't keep your appointment today?” So it's the whole team involved in keeping that patient in the practice. Nobody walks out of the practice without another appointment. Gosh, I can talk can’t I?
Howard: Is that your definition of an active patient, someone scheduled for another appointment?
Toni: Someone who has had a course of care over the past eighteen months in our practice.
Howard: So you say eighteen months –
Howard: Where did you get eighteen months?
Toni: Eighteen months is then we would look at the number of hygienists, dentists ratio that we would need.
Howard: So if a typical practice, let's say in the last eighteen months saw one hundred people. What percent of those people do you think would have a scheduled appointment for something? So what do you think the difference between total number of patients scheduled for something in the future –
Howard: Versus number of people I've seen in the last eighteen months?
Toni: It really depends on how solid your systems are. I'll see new practices where there's no systems and they're just relying on sending out a recall to a lot of these patients. People aren't taking notice of recalls anymore. They've got to be in your book. You need to pre-book patients. That’s really important.
Howard: Another big practice management concern is a lot of times when you ask – okay, so every consultant I've ever talked to. I said when people are calling you up, what is that number one stress? They'll always say staff. What are the top three sports in Australia? I would say it's the Australian Football League.
Toni: Yeah. Maybe rugby.
Howard: and cricket.
Howard: When I watch those sports and I love those sports. It's really interesting cuz –
Toni: They're all teams sports.
Howard: America has the NFL and that's a very unique game to just America and you have the Australian Football League.
Toni: Very unique.
Howard: I've never seen that played anywhere.
Toni: It’s awesome.
Howard: It's only played in Australia.
Toni: And not everywhere in Australia either.
Howard: Yeah. Very, very fun game but the point I'm trying to make is, the coach is totally engaged during the whole game. When I go into every dental office, when the dentist gets done doing the root canal, when he's all done, he just gets up, goes to his office and shuts the door. He doesn't even know the assistants fighting with a hygienist, there's some ladies screaming up front at the front desk. Could you imagine during the Australian Football League if the reporters were like, “Where’s the coach? Oh, he went to the locker room”. He went to the locker room after two minutes into the game.
Toni: Totally, yeah. Crazy, crazy. I totally love that you've brought that analogy in and I think that dentists ring up and say that staff are their biggest problem because they're not leading their staff properly. That's what it's all about. The staff are the problem as I said at the very beginning, they're a reflection of the owner and if the owner is not directing that team just like in a sport, what happens? It goes to crap. Absolutely. My family, my four boys are all involved in baseball which is an American sport and I bring a lot of analogies into my business trainings from baseball. Amazing game. Absolutely love it but it's a thinking person's game. It's not just hit the ball and run. So, there's everything happens and you need to know that if the ball gets hit over to right field that these are the possible plays that could happen and we're ready for it. That's what needs to happen in a practice and I love that. I think that's so exciting and empowering when you break it all down. All of those actions are the holes in your bucket. If you haven't got those actions in place and you haven't rehearsed them and looked at the scenarios, you're gonna have holes in your bucket.
Howard: Another thing that I think is very interesting to dentists is when I see physicians and vets advertising. I've never heard an OB/GYN and say, “Well, you just gonna make this. I got a new laser”. I got a new CAD CAM. They are the only people that fill this empty void in their soul to validate themselves are dentists who think well – so, my question to you is this. They're coming out these dental schools with a lot of debt. Everyone saw it, I mean they have to have a chairside milling machine. That’s a $150 000 for a CEREC.
Howard: They need to have a $100 000 CBCT. They need to have an $85,000 laser and a lot of these young girls coming out of school and say, “Howard, I could buy these three things and I'll double my student loan debt. I graduated three fifty. I could buy three things and now be seven hundred in debt”. What high tech does she need to have a successful practice?
Toni: Some high-tech communication skills.
Toni: Sorry, but that’s it.
Howard: They don’t need that stuff, do they?
Toni: Full stop.
Howard: Full stop.
Toni: Full stop. Absolutely.
Howard: What was full stop?
Toni: Period. What you would say period, some great communication skills. That's what you need.
Howard: Would you rather the dentist have a chairside milling machine or a rocking hot chairside manner?
Toni: Absolutely rocking hot chairside manner.
Toni: You can't use the machine. You can't use the technology if you can't build relationships with your patients and get the patients to say yes to your diagnosis.
Howard: What percent of the million dollar practices that you see in Australia do not have high tech chairside milling?
Toni: What percent? Probably 5-7% of the high-end practices don't. We look at things like let's say you're doing handmade crowns. It’s how you market it. They're using the technology as a marketing tool, I get that and they're getting part of the market who are time poor and want to have it all done in one day but what about the people who want the time? Who want the relationships? Who want to know? Basically all patients really want to know is that you care about them. It doesn't change. It doesn’t change, no.
Howard: So, how do you learn how to fake that? That I care about you?
Toni: You don’t faking it. My God. Did you see my face?
Howard: You should have a course called Faking Empathy?
Toni: I don't have a course called Faking Empathy.
Howard: Is that your next book?
Toni: No. I don’t think so.
Howard: Faking Empathy.
Toni: Genuine and authentic is what I would be saying. I want to go back to you where you were saying that dentists are selling things on their website. We've got CEREC. We’ve got this. We've got that. I hate it when dentists put those sorts of things on their websites. People aren't looking for a CEREC. What are they looking for? They’re looking for emotions. Ty with emotions. They don't buy with this is the technology that we've got. So what are they looking for? They’re looking for self-confidence. They’re looking for the ability to be able to eat and nourish their body properly. They're not looking for fillings, root canals, crowns. So we've got to be a bit more sensitive to the emotional side of dentistry and I know when I say emotions to men in particular, they go (shriek)… but emotions and relationships go hand in hand. So really important that we're acknowledging that in our websites as well.
Howard: So what would you say and you promise me an hour and I'm done over the hour. We’re at the hour and ten. I just want to end on a one deal. A lot of people listen to you. Let's switch from the millennials to the boomers.
Howard: I'm out here in the middle of nowhere America. I'm out here in the middle of nowhere. Sticks and stones in Australia and I’m just flat. I've been flat for ten years.
Howard: I'm flat and I'm getting burned out and they're really honest to tell you,they're saying and I've had this conversation with many dentists. They just say, “You know, I'm 40. I've been doing this a long time. It's just flat. It ain't going nowhere. I'm getting burned out”. What would you say to that guy?
Toni: Yeah. I would say, “You know what? It's normal and I think we all go through that so don't feel guilty about it. I think that it's something that is just the normal process after being in the same four walls for a number of years and I found that as well”. So, I was a practicing dentist for twenty years and I went, “You know what? I need something more in my life” and I went out and I grew myself, okay? I actually did one of those -
Howard: Is that when you got the boyfriend in Italy? Or is it something different?
Toni: Yeah. Don’t tell my husband, all right? Don't tell my husband. No I didn't go out and buy the red convertible and have that midlife crisis. I didn't, but what I actually did and I know this is going to sound quite clichéd but I did some personal growth and development. Simple little thing. It daunts some people but I wrote down what I wanted to have said about me at my eulogy, okay? You've all heard this before, haven't you?
Toni: This is a personal growth and development strategy and that I found that I wasn't actually living my life in accordance to what I wanted to be remembered for. That was extremely powerful for me. That made me change what I was doing so that I could live in that way. Now, you may not want to go down the personal growth and development pathway. That's all okay but I would say that if you're not happy, it's probably because you're not doing things in accordance to where you want to be. That's usually what I find. So that would be the first thing that I would suggest that you look into but other than that, change it up. Let's get some people in who've got a little bit more energy. Work with a consultant who can actually get you excited, hold you accountable to getting some things done and doing things a bit of a different way. Step outside of your comfort zone. You’ve probably been doing things the same way for so many years that you don't even realize that there are different ways to do things and that will give you some excitement and will give you some inspiration to keep going as well. So I think sometimes when you're in a rut like that and you're feeling burnt out, actually getting a consultant to help is really good.
Howard: The only thing I want them to say in my eulogy? “Damn, he lived a long time”. That’s all I want them to say.
Toni: That’s all?
Howard: I can't believe he lived that many years. I told him this for 780 days that watching this industry for 30 years. The number one return on investment is always an in-office dental consultant. Name someone who got a gold medal who didn’t have a coach.
Howard: Name a Fortune 500 CEO who doesn't have a leadership coach, a finance coach, a workout coach. When you listen those CEOs they don't have time to think about what they're gonna eat. A lot of them have chefs that would prepare all their calories.
Toni: Steve Jobs used to wear the same clothes every day because he didn't want to think about what outfit to put on.
Toni: All that sort of stuff. It's incredible.
Howard: They always think they're gonna take their practices to the next level if they add another procedure. Like, well if I go add sleep apnea or if I go add Invisalign or if I learn how to place implants like - Dude, if you can't make money off cleanings, exams, and x-rays and fillings and crowns and extractions.
Toni: I agree.
Howard: How the hell you’re gonna make money adding some other - It’s like if your restaurant’s going bankrupt, will adding lasagna save you? Will adding mac and cheese save you? You got to get your house in order.
Toni: Yeah. Definitely.
Howard: What's also very interesting is when I look at the most successful practices in my life in Phoenix. Not only they had a consultant but over 30 years they had every one of them.
Howard: Because their thinking is always this. If this is what you do and I bring you in my office and I learn one or two things they’ll always tell you, every dot myself included, every dollar I've always gave a consultant, I always got my dollar back and another one in that calendar year. To this day it’s so funny how I'll be talking to my staff and they'll say, “Oh, yeah. Sally Mackenzie taught us that”. “Oh no. Wow. Sandy Pardue taught us that”.
Toni: Yeah, yeah.
Howard: I remember Linda Miles. They remember who taught them all that stuff.
Toni: We all have different experiences as consultants as well as in we're going into so many practices and we pick the best bits from all practices. We have a lot of knowledge that the general dentist is just not going to get because you're busy doing the do. So my clients love it because when I go into their practices I've got fresh eyes. So things that they've been doing for years and years and they've been doing it a certain way. They don't even realize that there's another way of doing it and those fresh eyes make all the difference. They really do.
Howard: They only see their office and how many offices do you see?
Toni: Correct. I couldn't tell you how many.
Howard: I know. So that's the...
Howard: Seriously, Toni. I can't thank you enough.
Toni: Thank you.
Howard: For coming by. Seeing me and Ryan to share and talking to my homies today.
Toni: It’s been a pleasure. Thank you.
Howard: It’s been outstanding. Thank you so much.
Toni: Wonderful. Thank you.
Howard: Good luck with those four boys.