Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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860 Ask4Review with Michael Austin Brown, DMD : Dentistry Uncensored with Howard Farran

860 Ask4Review with Michael Austin Brown, DMD : Dentistry Uncensored with Howard Farran

10/16/2017 9:16:49 AM   |   Comments: 0   |   Views: 180

860 Ask4Review with Michael Austin Brown, DMD : Dentistry Uncensored with Howard Farran

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860 Ask4Review with Michael Austin Brown, DMD : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #860 - Michael Austin Brown

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AUDIO - DUwHF #860 - Michael Austin Brown

Michael Austin Brown, DMD, is a seasoned Dentist, Entrepreneur and Web Developer with over a decade of experience in the healthcare space. Currently, he and his wife, proudly serve as the Owners of Hurstbourne Dental Care in Louisville, KY. Most recently, he also launched the Ask4Review website and app. 

Combining his expertise in both dentistry and programming enables Dr. Brown to develop leading-edge applications that improve workflow for dental practices of all sizes. 

Howard: It is just a huge honor for me today to be podcast interviewing Dr. Michael Austin Brown all the way from Louisville, Kentucky. He is a seasoned dentist, entrepreneur and web developer with over a decade of experience in the healthcare space. Currently, he and his wife, Amy, proudly serve as the owners of Hurstbourne Dental Care in Louisville, Kentucky. Most recently, he also launched the website and app. Combining his expertise in both dentistry and programming enables Dr. Brown to develop leading edge applications that improve workflow for dental practices of all sizes. Man, great to have you on the show today.

Austin: It's a great honor to be here with you today.

Howard: You know, I actually spent a summer in Louisville.

Austin: Did you?

Howard: Did you know that?

Austin: No, I didn't. So, what were you doing here?

Howard: My dad ... so in Wichita, when I turned 10, he started ... he went from delivering bread to buying Sonic Drive-In franchises. And he bought ... he had five in Wichita and that was just ... he could manage that. I learned so many lessons from my dad, not only on what he did right but on what his biggest failures were. And he had five in Wichita, so he had a management team - it was all going great - but then he wanted to go national. So, he went north and put one in Abilene, Kansas, and [00:01:22] Kearney, [0.3] Nebraska. He went south, put one in Childress, Texas, and he went east and put one in Louisville. And to drive from Wichita to Louisville is how long? I mean, that...

Austin: It's a long way.

Howard: But, anyway, when we would drive to Louisville we would go ... I know we'd always go past the St. Louis Arch. Does that make sense or is that kinda on the way?

Austin: Sure, yeah, [00:01:43] 64. [0.3]

Howard: And you just can't manage something that takes you, you know, twelve hours to drive to Childress; I think it was six hours to [00:01:52] Kearney, [0.1] Nebraska. It was ... I think it was like a twelve-hour trip. Did you...?

Male Voice: Ten hours...

Howard: Ten hours and twenty-four minutes according to the map, but you just can't manage something like that.

Austin: That's a hike, yeah.

Howard: And now I see it in dentists where they'll have a dental office and then they'll put, you know, they'll have one in Phoenix and it's concentrating on implants, so they'll go put a satellite office in like Albuquerque and, you know, in L.A. and it's like...

Austin: Oh, yeah.

Howard: You know, you can't ... it's very ... that's a whole different level of logistics. But, you know, I got to tell you something about your business - and thanks for coming on the show because I podcasted probably every practice management consultant who's done it for a decade in America and every single one of them said on this show that when they come into a dental office, you know, the first day they just want to review what's going on. So, they're just going to come in there for a half day or full day and just see what's going on in this office. They all agree - the only thing they all agree ... well, they agree on a couple of things - they always agree that the number one problem in every dental office that's ever brought them in, is they don't realize they have a toxic employee, sometimes two or three. So, there's always someone that's rolling their eyes and killing morale and here's a doctor trying to motivate the team and then they've got this toxic, cancerous person; and number two they never witnessed someone asking for a referral. They've never seen it one time on the first day. So, you've actually started a business about something dentists can't do. They just can't find it in them to say, "Hey, Mike, would you mind leaving me a review?" So, why did you go into the business? Don't you think it would have been better to go into business selling unicorns and tooth fairies?

Austin: Well, this was my second choice. It's challenging but it's not rocket science. You really just need to ask a patient for a review and if you don't feel comfortable doing that, delegate it to a staff member because honestly, they're spending more time with the patient than you are in a lot of cases, so ... And we train our team to look for cues. So, when a patient says that they had a great experience, you're a wonderful dentist, I mean, that's your cue to jump in and say, "Well, we really like patients like you and we'd like to have more like you. Would you mind spreading the word for us and write a review?" And then the second thing you do is make it easy for them to leave a review. I mean, it's not that difficult, and I just didn't feel like it should cost us thousands of dollars a year to get reviews. So, that was the main motivator for creating it and it's ... I made it for myself and I'm just trying to share with other practices now.

Howard: Well, I tell you, you know, when you go on Shark Tank or you go on ... or you talk to Warren Buffett, you know, Mark Cuban, Mr. Wonderful, Warren Buffett, they always say when you're going to start a business, you know, "Well, what's different about you than anyone else?", and you should have a protective moat around your business - is it a pattern, is it a ... but when you're the low cost provider, you know, when you're the Ikea of furniture, the Wal-Mart of distribution, the Costco of selling wine, I mean, when you're the low ... Do you know Costco sells more wine than anybody in the world?

Austin: Yeah, I believe it.

Howard: Yeah, but when you're the ... how many review sites are there and how many of them ... what is the average price per month? And what is your price per month?

Austin: I mean, it's ... it ranges ... it's all over the place. But a good average is two to four hundred Dollars a month, and our app's free, so...

Howard: So, why ... so, how do you make money on a free app?

Austin: I'm not trying to make money. This is something that I enjoy doing so I'm ... I created it, like I said, for myself and now I'm letting others use it so I can get feedback to make it better for myself and hopefully help some other people too.

Howard: Right, so, god, that's crazy, so, yeah. You know, a lot of people, they always think they're going to start all these businesses in dentistry...

Austin: Sure.

Howard: And that everybody will sign up for these two hundred Dollar minimum contracts. Like, look at the oral scanners. Like, they'll tell the oral scanner, "Well, if you get an oral scanner, you'll have to buy the impression material." Well, if you buy an oral scanner, the software update is two hundred Dollars a month!

Austin: Exactly!

Howard: That's two thousand four hundred a month. And so, 3M wants me to buy their True Def Scanner and I'll save money on Impregum . Well, s**t, I don't buy $2400 of Impregum year and I've been using that stuff for...

Austin: Sure!

Howard: ... 30 years. So now, I've got to buy a $17000 intra-oral scanner and then I've got to sign up for $200 a month in total. So, by the time you get your $200 software update for your oral scanner and your $200 update for all these different things, next thing you know you've got three, four thousand Dollars a month and all these software licenses, and it starts adding up.

Austin: Exactly! And that's kind of my point too, because we started out with a closet full of thousand Dollar gadgets and now we're ... we've progressed just like everything else. Now we have a bundle of services - except the services are a thousand dollars a month, but we have to pay for those every single month for our lifetime. So, it's gotten worse. So, the software has actually experienced feature creep, or what I like to call "me too" features. So, they keep adding features to justify a price point. So, they all start to overlap, and they get so complex that you really don't know everything that the software does. So, that's kind of how I built the app, is I stripped away all the extra stuff and just focused on getting reviews - quality reviews - and that's kind of the main focus.

Howard: Well, I'll tell you the ... what kind of business model is it called where you set it up to where you automatically bill the credit card every month? What is that business model called?

Austin: Recurring billing?

Howard: Because, you know, like gyms have built their life on it. I mean, they know when they sign you up for a gym, that they're going to ding your credit card every month and you give them permission. They know the average American only goes for eight months. Then they know the average American takes about forty-two months to unsign off their deal, so from eight to forty-two they're dinging you every month and they don't have to provide any service. And if everybody that had a gym membership showed up at the same time on that one day, the Fire Department would come and close the place down for exceeding their maximum occupancy. So, that is just amazing. And I love what you all say, to justify the $200 a month they started doing what you just called feature creep, where they keep adding these psychological things to make you think it's worth giving them two hundred a month, $2400 a year. And, I mean, hell, think of how much money that is - if you practice from 25 to 65, $2500 a year times forty years, that's a hundred grand.

Austin: So, yeah, we're saving you a hundred grand right here.

Howard: Yeah, you saved a hundred grand on Dentistry Uncensored with Dr. Austin Brown from Louisville, Kentucky! So, why did you do that? You're just a nice guy? Or is it just your hobby? Or...?

Austin: I'm a nice guy but I like, I enjoy doing it. So, I spend all my time working on computers when I'm not doing dentistry, so that's ... it's fun for me.

Howard: And what do you ... okay, so walk my homies through this. They're at - the numeral 4 - Ask numeral 4 Review dot com. So, what are they going to find when they go to

Austin: So, they'll see the website and there's a couple links. If you click on the app link you will ... it will take you to a download page and you can download the app from there, and you can create an account. And once you have everything set up - it only takes a couple minutes - then it consists of a button you click on: it creates a review message asking the patient for a review and it includes a link to one of the major review sites and then you send the message, and it's a text or email. So, it's a pretty simple, straightforward, it's not too complicated.

Howard: So, you think that just explained it enough to them?

Austin: It's a good start. And then there's an explainer video on the website and if they have questions there's a [00:10:44] clicking in system [0.5] or they can call me.

Howard: And you've also got a video?

Austin: Yes. Yes.

Howard: Now, do you have that on YouTube where you can e-mail that to me and Ryan?

Austin: Sure. Sure.

Howard: And, Ryan, shall we splice that in right now or at the end of the show? Yeah. So, we're going to splice that in right now.

Male Voice: "Reviews matter and Ask4Review helps you get more reviews with three easy steps. First, register for a free account. After registering, log in. The next step is to generate your review buttons. Select the Google tab to get started on your buttons, then select or enter a custom message for your review request. In the box below, enter and select your business name. Next, click 'Generate Button'. The final step is to send the message. Use the Ask4Review app or go to the Ask4Review website on your phone. Click the 'Send Text' or 'Send Email' button to generate your message including a link to your review site. When a customer clicks the link, it will take them straight to your review site. Join Ask4Review today for free and start getting more reviews."

Howard: And by the way, Happy Birthday to you, buddy.

Austin: Thanks a lot. It's like the greatest birthday present.

Howard: This is a birthday present? You know you're a dental nerd if coming on Dentistry Uncensored is a birthday present.

Austin: Definitely! And I think that, yeah.

Howard: So, how old are you now?

Austin: 38.

Howard: 38. Gosh, darn, 38. That's still a baby, man. I'm 54. I can't even remember when I was 38. That's how young you are. When you ask for a review ... now I'm sure you Millennials are ... I believe ... are you a millennial? Were you born after 1980?

Austin: 1979.

Howard: So, then you're not a Millennial. So, then, what are you technically?

Austin: I have no clue. Generation X?

Howard: Yeah, you've got to be Generation X, because Boomers - a Boomer is '45 to '64, I was born in '62; and then Millennials are '80 and over. So, I think from '65 to '79 that's a Generation X-er, is it? But, when you're writing a review, you're talking about a review on Google or Yelp or where? Where are ... where should the reviews be mostly?

Austin: OK, so, there are a couple of major review sites. Of course, Google, Facebook, Yelp are the big players. If you don't have any reviews, I would start with Google or the largest search engine, but Yelp filters out your reviews pretty hard. So, it's difficult to get reviews on Yelp, and Facebook is a good place to have your ads and your reviews.

Howard: OK, riddle me this: if you go to Dentaltown - and I wish everybody ... have you seen that search bar feature on Dentaltown where you can do a search?

Austin: Sure, yeah, I use it all the time.

Howard: I want everybody to use it because that damn thing cost me $50000 from Google. And when you want to update it, it's not like a software update, you got to buy the new box; and if you walk into Dentaltown, all the servers are black, but the Google box is yellow and it says 'Google' in fancy colors and all that stuff. But whenever I sit there with my programmer and I say, "You know, let's update that thing." And he says, "Alright, but it's fifty grand." But anyway, so I want you to use it just because I paid fifty grand for it! But if you search Yelp, every thread on Yelp is a bitching, moaning, complaining; I mean, there's not a happy camper on the Yelp thread. But you don't see that when they're talking about Google reviews or Facebook reviews. So why? Why does no one complain about a Google review and why does pretty much every thread take a negative tone when they start talking about Yelp? First of all, do you agree with that sentiment?

Austin: It's a major thing and I think it has to do a lot with the culture they have. So, they ... the filters are set up to collect more negative reviews through than good reviews. So, it's just a matter of filtering. Because Google reviews, they accept a higher percentage of your reviews.

Howard: So, why would Google not accept reviews? Because they know it's my mom writing it for me?

Austin: They have their algorithm and they don't share it, so...

Howard: Huh. Well, I wish they'd write an algorithm and explain why if I get on Google and I go to Louisville and I do a search for a Mexican restaurant near your office, it will find it in .0001 seconds, but they can't seem to realize that my Gmail from a Nigerian prince who needs a transfer of $56 million from my bank account is like ... how does Google not know that? I mean, can't they just add it to their algorithm? Nigerian prince! I mean, they can't ...

Austin: Well, priorities.

Howard: What's that?

Austin: Priorities.

Howard: Oh, my god, it's like the minute you read a large sum of $50 million you just, you know, and then you take ... waste your time to block them because they just keep coming every day. At this point I think I'm just going to move to Nigeria for once and for all and find my $50 million. But, so, you'd say Google is the most important. Who would be the second most important: Facebook or Yelp?

Austin: Well, it depends on what area. Because, I'm sure in your area out West, that it's ... Yelp is probably larger than it is in Kentucky at this point. I mean, it changes over time but you just kind of need to look at your own market and determine.

Howard: Yeah. Man, I love Louisville. So, what I did ... so, here is my life. So, I'm in Wichita and in high school, every summer - so between freshman and sophomore, sophomore and junior, junior and senior - I went on an opening crew to open this new Sonic. So, I spent one summer in Abilene, Kansas, one in Carney, Nebraska, one in Childress, Texas, and one in Louisville, Kentucky. And I swear to god, that was so fun because we left right when school was out. Back then ... my birthday is August 29th - so yours is August 10th...

Austin: 10th, yeah.

Howard: ...and mine's August 29th - August 29th, my whole childhood it was still summer. I mean, like right now in Phoenix all the schools have already started. But when I grew up, my birthday was always still in the summer, and that was the weird thing about my birthday is that I knew, when it was my birthday  that the next weekend was ... school would start, you know.

Austin: Right.

Howard: And then it would get out ... school would get out like, I think, the first week of May or something. But anyway, the day school was out me and a cook and a carhop and a receptionist, and my dad would take off and he'd get us going, and, you know, he'd come back and check on us, but I'd stay there the whole summer and it was just ... god, that was fun. I spent a whole summer in Louisville. And it's right next to Indiana too, isn't it?

Austin: Oh, yeah, it's right across the river. [00:17:49] So, it's ... we like to sit in their lap. [0.9]

Howard: Yeah, and I want to do that ... I've done Iron Man three times and all my Iron Man friends have done the Iron Man Louisville and they say that...

Austin: Yeah, definitely, it's huge.

Howard: It's huge out there because it's a river swim. And you know why everybody loves it?

Austin: Why's that?

Howard: You know why?

Austin: No, why?

Howard: Well, because they let ... you're swimming downstream. So, you get a rocking hot time because they ... it's really not fair to compare Louisville Iron Man time to a Tempe, Arizona, where you're swimming in a lake. And everybody loves Louisville because ... and then they pray for rains and they pray that they'll let more water out of the dam and all this stuff like that, but, oh yeah, everybody's talking like, "Oh yeah, it's a three mile an hour current", you know. Well, in an hour of swim that's significant, you know. But, yeah, I want to do that some time, and then it'll be free because I won't stay in a hotel - I'll just stay with you and Amy for free.

Austin: Yeah, come on over. We'll have you. You can come for the Derby too.

Howard: Are you going to do that Louisville Iron Man?

Austin: I don't think I'll get in the Ohio River. It's a little ...

Howard: Is that what it is? It's the Ohio River.

Austin: Yeah.

Howard: And it goes all the way to the Mississippi, right?

Austin: Yeah, yeah.

Howard: Yeah, right on. So, I want to ... we don't have to talk about this if you don't want to, but I want to talk about also your practice is ten years old, right?

Austin: It's older, but, yeah, a little bit.

Howard: And you met your wife in dental school. She was two years ahead of you and right now there's ... I keep asking on my show and I'll ask it again now, shoot me an email:, and tell me how old you are because, you know, I can't really tell who's all listening to this, and I have been blown away, I mean, I knew Dentaltown on the website has a quarter million registered dentists from 220 countries - every country on earth. But when we came out with the app, when Steve Jobs put the Internet in the phone and we came out with the app, it was downloaded 50000 times. But it's pretty much entirely by people born after 1980, so it was a Millennial thing. So, I mean, I've got strong data that shows that Baby Boomers like me are on the desktop, the Millennials are on the app and on the podcast. I knew it was a Millennial thing just by the emails when I started asking for emails. What surprised me was the number of emails that they're still in undergrad and they're in D1 or D2. I mean, the other day I had 30 emails that were from D2 or D1 and I'm sitting there thinking...

Austin: That's amazing!

Howard: I mean, when I was in dental school it seemed like I was the only guy talking about starting your business after dental school. I mean, it seemed like when I was in dental school, everyone was just worried about getting through their finals and getting into clinic and then graduating and ... so, the point I'm talking about is right now there's probably a lot of people listening to this that are dating their honey bunny in D2 or D3. And so, you married a woman dentist from your school and you've been married ten years. What advice would you give these young kids dating in dental school?

Austin: Just, it's an amazing experience and you just take care of your spouse and try not to let the stress get to you and just hang in there because everything's going to be okay, just figure out what you want to do in life and make it happen and just do it, and don't make excuses, so.

Howard: Now do you practice with your wife or ... do you guys practice together, or do you practice separately?

Austin: Well, right now we manage the practice. So, we're ... we've kind of moved out of dentistry. I practice dentistry a couple of days a week in public health, so.

Howard: So, you own the dental office, but you and your wife don't see patients there?

Austin: No, no, no. So, my wife is recently disabled, so.

Howard: Okay, so she's retired.

Austin: Yeah, she's retired.

Howard: And then ... but you still own the dental office?

Austin: Yeah, we still own the office and we manage it together.

Howard: You manage it together. And then you work a couple of days a week in public health?

Austin: Yup. And then I do computer programming. I like diversity.

Howard: Wow, that is ... well, I'm so sorry that your wife got disabled. Is she alright?

Austin: Yes, she's fine. Life has never been better. We just had to transition and transform our roles in the practice. But we were able to help it and Dentaltown helped a lot. We learned a lot of good information and a lot of consultants and it's been an amazing experience.

Howard: So, you used some consultants from Dentaltown?

Austin: Sure. Yes.

Howard: Any of them that you want to give a shout out and a plug to? I'm sure they'd love it.

Austin: Sure. Dental Intel, Chris and everyone there, Weston.

Howard: Now, okay, so Dental Intel, that's so when you can manage your ... the practice that you have you're using the dashboard from Dental Intel?

Austin: Exactly. We manage everything by the numbers. So, it's .... it was a hard process to go from running the practice based on emotions to transitioning over to numbers and so, but it's a good thing to do.

Howard: Ryan, what number was that podcast that we did? So, go back to Dentistry Uncensored, we did the ... Curtis Marshall? Is that the owner? Ryan, was that the founder? Curtis. Curtis Marshall was number 21 and episode 284 was "Watch the Numbers with Weston Lunsford and Kirk Behrendt" and, you know, that Kirk guy is smarter than s**t? I mean, look at that bald cue ball head of his! I mean, the smartest people in dentistry always are a cue ball.

Austin: Exactly.

Howard: Yeah, that guy. God, you look at me and him on that deal, that just looks like two cue balls laying on a table. But, so, it's amazing though, but, you know, the software programs are just really lacking in any managerial economics, financial accounting, managerial accounting, I mean, they just...

Austin: It's pretty sad what the practice management systems won't do. And that's why you have dentists creating their own programs, like me, or other companies coming up with programs that integrate with our database to pull the data out to actually do something useful. And that's ... I wish they would do it all because it would only be one company to deal with, but they don't, so.

Howard: Here it is. It's I should have been able to figure that one out. You know you're a walnut brain when you forget that Dental Intel's So, talk about ... so, how much does Dental Intel cost a month?

Austin: It's reasonable. It's definitely worth what we paid for it. The return's been ... far exceeded what we pay.

Howard: But you don't remember exactly what it cost?

Austin: I think they have a, like, floating schedule for different...

Howard: The different sizes?

Austin: Yeah.

Howard: Yeah, that is amazing. So, what else other help did you get from Dentaltown?

Austin: Just everything...

Howard: Any other consultants or anything or ...?

Austin: It's ... from managing employees to different services to use and just any time that I had a question, you can get on there and ask someone or ... it's like an encyclopedia. You can find anything that you could ever what to know - someone's probably already asked it in one shape or another. So, it's a good resource to have. So, thank you for creating it.

Howard: Oh, it's just like you doing this deal. I mean, it's just ... it was ... actually I ... you created this for yourself: Ask4Review, right?

Austin: I did, yes.

Howard: Yeah. And Dentaltown was a total selfish act for me. I would put my four boys down to bed - Eric, Greg, Ryan and Zach - and they'd be in bed by 8.30 and then I would sit there in the chair and implode because I, you know, did a root canal and it swelled up, you're sitting there in the chair wondering if you shouldn't have done it one appointment, or should I have put him on [00:26:08] penvekay, [0.9] should I have added metronidazole. You know, you're just sitting there and ... if I ... anybody that loved me, if I called my dad he would just say, "Well, you know, tomorrow I'll say a prayer", you know, at church, or my mom would say a rosary, or my sisters would say a Novena, and I just wanted to talk to a dentist. And then when I realized that you could, you know, the internet - that was in 1998 - that we could actually set up a message board and I could just ... all I wanted to do was just talk to another dentist and be able to post an x-ray and a picture and I just wanted to talk, you know, to a Dr. Austin Brown, and say, "You know, what do you think?" And maybe if all you said is, "It'll be okay" - I needed that.

Austin: Sure, right.

Howard: And I ... my walnut brain was so small, I figured best case scenario, maybe like the last Thursday of every month there would be this little Dentaltown study club and I could meet with, like, maybe twenty guys online and talk about cases. So, that's what I actually thought was like the best-case scenario. Like twenty guys one night, you know, the last ... the first Monday of every month or the last Thursday of every month. And the first month a thousand people signed up for it and I thought, "Okay, I'm not the only one...

Austin: That's amazing.

Howard: ... sitting in a chair coughing up blood clots. There's someone else out there, you know." And it's been great, I mean, it's just been great. And that's what the Internet does well - it connects people who are very far away from each other. Like right now, you know, you're two thousand miles away from me and we can Skype. I mean, it's just amazing how technology has come.

Austin: Yeah.

Howard: You know, I want to ask you some ... you know, every generation, if you read literature, every generation thinks the next generation is all wrong and society is going the wrong way and it's all going to hell in a handbasket. And then each generation is better, better, better. When people talk about the sky falling and all this stuff like that, I mean, I remind them, like, just flip back 100 years. So, this is 2017. Let's just go back to 1917. We already would have had the Spanish influenza, which dropped five percent of all Americans. One in twenty Americans dropped dead. And now, what do you have a hundred years later? All these people thinking vaccines are crazy and they're, you know, they're a communist plot and they don't work, and these schools are, you know, insane for making you get immunized. Do you realize in Australia, you get immunized or you leave? I mean, that country doesn't screw around. If you want to walk around and say, "Well, I don't believe in vaccines", they're like, "Well, we don't believe you should live in Australia, so, bye!" I mean, you know, so, you know, I can't believe ... you know, people just don't know history. I mean, when they came out with the polio vaccine - when my mom and her three brothers were growing up in Parsons, Kansas, they closed down the public swimming pools for years because people thought, well, maybe they're catching it in the swimming pool and they didn't know where it was coming from. But when Salk vaccinated himself first and then he vaccinated his research volunteers; when they came out with that it was parades! And when they came out with the vaccine, people were lined up for blocks, there were balloons, parades, I mean, that guy was like ... that was like landing on the moon. And now you have ... and then the 'flu shot. And now you are a hundred years later, and 25 percent of Americans believe that vaccines are crazy. And then also, by 1917 you already had a World War One. I mean, right now, you know, you're talking about ISIS and you have isolated terrorist activity, well, s**t - World War 1, it was full scale mowing down a hundred million people in Europe. So, I mean, it just keeps getting better and better and better, but a lot of Baby Boomers look at you Millennials - and I know you're not a Millennial - but they say, "Well, Millennials don't want to own their own practice". That's what's fueling corporate. That's why Heartland and Pacific and Aspen are kicking butt because the Millennials, they don't want to own their own business.

Austin: Sure.

Howard: Do you believe that they went to eight years of college to be an employee at Aspen or do you think that they're an employee at Aspen because ... what do you think, their mindset? What percent of the graduating class of 2017 has no wants of working for themselves someday, do you believe?

Austin: I think a majority of them feel like they don't have options, I feel like they feel pigeon-holed because of the debt. They don't see options ... or they don't want to take the risk, or what they feel is risk, of taking on more debt to buy a practice, because, I mean, what's the debt level up to now, right, three hundred and fifty grand for dental education, or more? And then to add ... to purchase a practice on top of that, it's just ... it's too much weight on them, so.

Howard: So, it's an emotional reason really, because...

Austin: Emotional.

Howard: ...because if you're three hundred and fifty in debt, the fastest way to pay that down would to be buy a cash flow of a big practice for seven hundred and fifty thousand, so if you're three hundred fifty thousand in debt, the fastest way to pay that down would be to go all the way to a million in debt and then you could pay that whole thing off in ten years. But if you're three hundred and fifty thousand in debt and you get a job at Aspen, unless you were smart and move back in with your parents and drove a thousand dollar beat-up car and just put your entire paycheck toward your principal, you're probably not going to pay it off in ten years.

Austin: Yeah, but no-one's telling the students that. They're getting marketed to by the big box companies to come work for them and they don't have to worry about anything, just come work for us. And no-one's saying you can pay your debt off, you can have a great life, you can actually be better off if you purchase your own practice, so. It's a good message, so hopefully you can get it out to more people.

Howard: Yeah, well, what would your advice be? If you were giving a commencement graduating class - because you're a lot closer to Ground Zero than I am. I mean, this May 11th, just this last May, was my 30-year anniversary from school and September 21st - Ryan, you told me the other day, how many days was it from May 11 to September 21st. I don't know. Will you figure it out again? But, I mean, I got out of school May 11 and September 21 I opened up. And now I see these Millennials, they just keep pushing back. They're like, "Well, maybe I should do a GPR? Or maybe I should go work on the Indian reservation for two years? Or maybe I should join the Army, Navy, Air Force, Marines? Or maybe I'll just go work at Aspen," and it's like, "Well, maybe you should just open up your damn dental office."

Austin: Yeah, right.

Howard: I mean, do you and Amy have any kids?

Austin: We do. We have two kids.

Howard: Well, you know, I tell people: there's never a good time to have two kids.

Austin: No, no, there's not.

Howard: I mean, if you're going to sit around and think, "Well, when would be the best time to have a baby human grow from zero to ten pounds in my belly, and then need twenty-four-hour maintenance for twenty years", you know...

Austin: But we went to school. We planned everything out. And then we were faced with reality - life. In life, you can't plan everything. So, it's scary and to have something known, like a secure job and income to pay off your debt levels, it's comforting to a lot of people; but if they can know that they can own their own practice, if they pick the right choices to set themself up for its success, like don't ... just pick a place where they need a dentist, pick a visible location, answer your phone, if you can't answer your phone, have somebody do it for you, and then take care of your patients. Don't lose them out the back door - because it's a lot easier to grow your practice if you're retaining all your patients and using them as a referral engine to get more patients - and don't turn your practice over every couple of years and not add any hygiene chairs or stay stagnant, so it's going to die by atrophy. It's just ... set yourself up for success by making the right choices. I

Howard: I like data. I like numbers to prove a point. And the reason I think they should open up their own office is because it doesn't matter if you're talking about corporate or if you're talking about private practice, employee associate dentist turnover is off the charts. When you look at ... there's only two ... there's only three publicly traded dental offices where they have to show you their numbers and if the numbers are wrong it's go to jail stuff, you know what I mean? And there's two in Australia: there's 1300SMILES and Pacific Dental Group. Pacific Dental Group, in their deal they say, "Okay, we have seventy-two locations, we have three hundred and fifty dentists working for us, and twenty percent of the dentists turn over every year.

Austin: Seriously?

Howard: And when you look at all my friends that are my age in Phoenix, I mean, they're ... so I've had associates for 30 years and for every one that stays with you seven to ten years, there's another one that only stays a year or two. So, the point I'm trying to make is this that if you think becoming an associate is such a great job, then why do all the associates always quit their job? Why are they always changing their job? Do you see associate turnover high in your area?

Austin: We do with the big box, the larger corporate chains. Not so much in the general practices that really take care of their associates. And like us, we've been blessed with a great associate and we couldn't ask for anyone better to work with, so, you know, that's kind of what I see in our area.

Howard: Yeah. I mean, I've had a bunch that stayed with me for a decade. But for everyone where someone stayed with you for a decade, someone else stayed a year then they decided they wanted to start their own or they wanted to do this or they're going to move back across the country or... The big boxes ... one of the ... there is thirty-five corporate chains that have fifty or more locations, some of them their average associate only stays one year.

Austin: Wow.

Howard: And some of the other chains, its considered a success if you can keep your average associate two years. My point being this, that if becoming an associate was so great, then the associate turnover wouldn't be such an issue in private practice and corporate. Corporate is bigger and more transparent, so everybody points to them. I just think it's so unfair because they'll point to ... you know, like, corporate lives under a microscope.

Austin: Oh sure.

Howard: So, if they slightly billed Medicaid or Medicare or something wrong or whatever, you know, it would be on the front page of the paper, but there's five dentists across the street from them where the dentist doesn't even know how his receptionist is billing Medicaid and half of it is wrong and very rarely does some dentist go to jail because his receptionist was billing Medicaid or Medicare wrong for 30 years and he doesn't even know how to bill Medicaid. He doesn't even know how to bill Medicare. I mean, I saw this one fraudulent case - it was in St. Joe, Missouri - and, I swear to god, this dentist lost his license and he didn't even have the wherewithal to go up to the computer and generate a Medicaid billing. I mean, how could this guy be guilty? He didn't ... he couldn't have done it if you put a gun to his head because he had no idea how the practice management software worked, what the codes were; and his poor receptionist, well, she was never trained - and then it turned out that she was fraudulently billing Medicare for 30 years and it was like, "Well, do you want to go to jail or turn over your license?" and he just said, "Well, here's my license."

Austin: That's sad.

Howard: Yeah, and some have gone to jail. There's a guy out there on the speaker circuit - who did we podcast interview that went to jail? Roy Shelburne? Did you ever hear that podcast?

Austin: Yes, yes.

Howard: I mean, Roy Shelburne, he went to the ... what do they call it, the can ... what do they call the prison, slang for the prison? The Big Box or...? Yeah. He went to prison. I think it was Ron Shelburne? Roy Shelburne. What number was that? So, 391 was a dentist, yeah, Roy Shelburne. S-H-E-L-B-U-R-N-E. I think he was near you. Was he in Tennessee? You're in Kentucky? Wasn't he in ...

Austin: Kentucky, yes.

Howard: Was he in Kentucky?

Austin: I don't think so.

It was around there - Kentucky, Tennessee - something around there. But, yeah, so, yeah, so, my deal is: just do it! I mean, if being an associate was the best thing in the world, then they'd all get a great job at Heartland and Aspen and Pacific and they'd all stay there for 10 or 20 years. That's just clearly what we're not seeing. And I got some very, very good friends in the same Ahwatukee - really good friends - and it's the same thing: for every associate that stays with you five or ten, the other one's a revolving door. So, something is not quite right in there. What other advice? You know, the one thing I like about you marrying Amy is there's a lot of research floating around saying that, you know, there's ... when you look around the world, there's seven billion people - the love marriage, where you go fall in love with someone, that's a rare event. And in America it's a 50 percent failure rate. But you go to the bigger countries, like Asia and Africa, where it's an arranged marriage - and I think Americans have ... they don't understand arranged marriage 'cause they think it means your mom says you got to marry Suzy Q, and that's not what it is.

Austin: Sure.

Howard: Arranged marriages, we'll set up the lead. So, you'll only date qualified leads. You're not going to go to the bar and date someone because she looks great in a pair of Levi's.

Austin: Yeah.

Howard: We're going to set up the lead. So, you end up marrying someone from a lead and those guys only have a ten percent failure rate. So, obviously, your mom and dad are a lot smarter than you when you're twenty and in heat. And, so, but when you look at American, you say, "Well, where is the divorce rates that are as successful as the arranged marriage rates?" It's when both people, both spouses, have a Master's degree or higher in the same field. So, if two CPAs, two dentists, two chiropractors, two ... when they marry, it's like a nine percent failure rate. So, you just got rid ... you just lowered your chance of paying out a huge divorce claim - which is your student loans on steroids...

Austin: Right.

Howard: marrying someone because you have something in common. You, I mean, so now you have two kids in common, but you have a profession in common and it's just ... I tell people whenever I lecture in dental schools - and I do that a lot because I Skype into their class - my god, I tell them: the most important thing you should do in dental school is find your spouse there before you leave. And, so, how did you find Amy if she was two classes ahead of you? I mean, when I was in dental school, the two classes ahead of us, they wouldn't even talk to us. We were young and dumb and lowlifes. We weren't cool enough to talk to the class two years ahead of us.

Austin: Yeah, I was the same way, but, you know, the library is kind of a good place to find a spouse, so.

Howard: Huh, I imagine talking in the library you would've gotten in trouble, not married.

Austin: Yeah, that's...

Howard: What? Were you slipping her notes?

Austin: No, I just walked up to her and talked to her, so. I thought that that would be a good idea at the time.

Howard: Well, I mean, you know, when you look at the divorce rates, they divorce over three things: it's a third over money, a third over sex, a third over substance abuse. But when you drill down on those deals, it's just because they're not communicating about that. You know, they're not communicating about money, they're not communicating about, you know, it really bothers me that you come home every night and drink a six pack, and then ten years later, now it's a twelve pack, and then ten years later it's a case, and there was never a discussion that I don't like this, you know what I mean? And it just blows up. And I would imagine that you both going to college for eight years to learn about this one thing called Dentistry and then have a joint dental office where you're both ... it's something you can do together. It's like growing a garden together and your two kids are a garden and you're both jointly raising that and that's going to be a big source of joy. And then you have this business that you both help manage - it's just a great idea.

Austin: It's important to know when to cut it off too because you actually work at work and then home life begins. So, you know, so that it doesn't become all-encompassing because that can lead to issues too. So, just to have a little bit of balance in your life.

Howard: Yeah, I like that Winston Churchill's definition of a fanatic. A fanatic is someone who a. They won't change their mind. But B they won't change the subject. And, you know, a non-fanatic is like ... like I know with my two older sisters that are nuns, I mean, I know they're going to never change their views on anything.

Austin: Sure.

Howard: And I can agree to disagree but where it becomes insane is when you can't change the conversation, you know what I mean? And so, what do you and your wife do when you're managing a dental office and you want to add a $150000 chairside milling machine called Cerec and she does not want to spend $150000 on it. First of all, did you do any chairside milling there?

Austin: We had a Cerec for a while and then we moved away from it. But, yeah, that was a discussion.

Howard: Talk about that, because that is a huge decision. That's $150000. That's half your student loan debt with one machine and...

Austin: Sure.

Howard: ...all the noise is that you know chairside milling is the greatest thing since sliced bread but talk about the fact that you went down that road and did a U-turn.

Austin: Okay, so that was during the boom where money was free-flowing, and we were making decisions based on emotions - like, we wanted to be the best, we wanted to have the best - and we bought the best and then we had to pay for the best and then the recurring service charges on it. And it just got to a point where that's ... we just didn't see the return on having it, so we moved away from it and just went back to traditional crown and bridge, so.

Howard: Yeah, but I have to disagree with you because every convention I go to there's a bunch of dentists up there saying it's the greatest thing since sliced bread.

Austin: Maybe for some people...

Howard: How could we be so wrong?

Austin: Maybe I'm wrong, but for our practice it just wasn't the right fit for us at this time. Maybe down the road we'll go back, maybe to scanning crown preps, but at this moment in time we just can't justify the cost.

Howard: Well, again, there's truth in numbers. So, like, if you tell me that you're going to graduate and you're going to go be an associate for a private practicing dentist or corporate, I'm just going to tell you the numbers that the average dentist who has that idea is going to quit after a year or two. So, why are you going to be the happy associate when ... you can't get to dentist to agree that today is your birthday. I mean...

Austin: Sure.

Howard: ...go to Dentaltown. You can't get them to agree on anything. So, when your boss starts telling you this and you don't agree to that ... I'll give you an example of associates: some of these corporate chains say that if there's a five millimeter pocket or more, you have to put a chip in the perio pocket, like the Fareston or Minocycline or something like that, and they don't agree. Some of them get violent because corporate makes them give all adults a fluoride treatment and then it's not covered by the insurance. So, they come in and get a cleaning because your insurance pays a hundred percent, then I tell you you've got to give me $15 out of pocket because I had you switch to the fluoride. So then four times a day there's a confrontation over fifteen, you know, and they just get sick of it. Or, you know, it's one thing to do a ... to be scheduled an hour to do an MOD composite on two and three and a deal on four, but it’s a whole 'nother thing to be scheduled to do an hour with my assistant - every time I go in here it's a different dental assistant - and this dental assistant doesn't know crap about anything and she basically can't ... she can't even suction and retract and so, finally they just ... I mean, it's a stressful job because you've got a person that you've got to give a shot, do surgery on, drill on their teeth, repair it, and now I got an assistant who didn't know what day it is, I wanted these burrs and they're not in the burr block and, you know, so, finally they just say, "The hell with this whole thing!" and they walk out. So, again in numbers on this chairside scanning, what percent of dental offices went with digital x-rays?

Austin: I'm not sure.

Howard: I mean, it's ... wouldn't you say it's ... I mean, what would you guess? What would your gut feeling be for America?

Austin: Maybe eighty percent.

Howard: Yeah, it is. It's eighty percent. So, four out of five dentists went with digital x-rays and chairside milling has been around longer - as long, or longer than digital x-rays. I mean, they had chairside ... Cerec was going ... was in France going strong when I was in dental school. And, so, what percent have chairside milling?

Austin: Thirty percent?

Howard: It's more like fifteen percent.

Austin: Fifteen, oh.

Howard: So, if chairside milling was perfect for everyone then you'd have an adoption rate like digital x-rays and you don't see that.

Austin: Sure.

Howard: Same thing with CBCT. I mean, CBCT, yeah, it's great but, you know, there ... I've already read several articles on the deal, especially for orthodontists. They're saying, Okay, it's one thing when you're an implant surgeon but, dude, you're an orthodontist and this guy did a paper saying, “Show me where the [00:48:29] pano and the seth [1.6] was - change your treatment plan when you saw it in 3D.” And he can't get any orthodontist to show them the case where, “Oh, the pano and seth, I was going to do this, but as soon as I saw it in 3D, I did this.” It's like, okay, so that doesn't exist. So, you're telling me I've got to upgrade my twenty-year-old pano and seth to a $120000 CBCT? But you can't show me one case where the 3D changed my mind on the ortho case.

Austin: Now it would be another thing if you could print your aligners from that.

Howard: Oh, take your CBCT and print the aligners.

Austin: Yeah.

Howard: Yeah.

Austin: So that's maybe in the future.

Howard: Well, that's the oral scanning.

Austin: Okay.

Howard: And I think the oral scanning, whether it be True Def from 3M or -what's the one from Denmark, Copenhagen? 3Shape! - 3Sshape from Denmark, because what I'm seeing is with when you scan it and you see your prep forty times larger - I've never done that and not been embarrassed, you know...

Austin: Sure.

Howard: ...and gone back and smoothed out and all that stuff like that. But the labs are telling me that they have a six percent remake on a vinyl polysiloxane or polyether impression and a 1 percent remake on the scan. So obviously, I think it's because the dentist, with his ape eyes, I mean, obviously if you go from looking at it with your natural eyes to looking at it with loops on...

Austin: Sure.

Howard: I mean, the fastest way you can increase your quality is get everybody in the office - the dental assistant, the hygienist, the dentist - to all wear loops of 2.5 or greater and...

Austin: Definitely agree.

Howard: ...if the assistant can see better, she doesn't leave excess cement on a temporary crown; if the hygienist can see better, she doesn't leave tartar. Everybody needs to see better. And then, when you scan you see that prep forty times bigger. And yet the best endodontist will just drop a microscope and just look at, like, 8x into those clean canals and they say that one out of every time ... one out of every ten times they look down in those clean canals, one of those canals they can see crap all the way down one side of the canal and they didn't get it cleaned out and they'll go back in there. Sometimes they'll go in there and see a missing canal and not only it might be an MB2, it might be an MB3. I mean, it might be a fifth canal. So, magnification is definitely greater. So, I think that is around the corner, but again, it's one of those deals where as long as they're going to ask you for a $200 a month software charge - $200 a month again. So, let's look at that. So, two hundred a month times twelve months is $2400. And then if I practice from 25 to 65, forty years, times forty - that's another $100000.

Austin: It's amazing. They just keep tacking it on.

Howard: So, how close are you to that decision?

Austin: How close? Probably a couple of years off.

Howard: And what are you waiting for? I mean, what's going to change your mind?

Austin: Once I get a few more things work out. I have a few other issues I'm going to deal with first.

Howard: With your practice you're managing?

Austin: Yes, yes. I'm going to grow the practice a little bit more and get to the point where that $200 a month won't be that much of a difference.

Howard: So, when you're growing your practice, so, what are you thinking? Are you thinking more marketing? More new patients? Are you willing to invest, instead of an intra-oral scanner, you're thinking about investing more in what, like marketing, advertising, facilities?

Austin: Yeah, we focus a lot on internal marketing because it gets the best patients, and, that's where we focus the most of our effort on. And then the external [00:52:26] marketing, visual, [0.4] has definitely replaced all our print ads, our Yellow Page ads - I mean, those are gone. So, it's AdWords, Facebook ads, re-targeting with the Facebook and so, those are our big pushes right now to get new patients.

Howard: Okay, so you're done with print, like postcards and Yellow Pages and newspapers and...?

Austin: Well, every once in a while, we'll do like a flyer drop, but it's a lot easier to try to do an internal marketing and get your referral engine going than to drop twenty grand on flyers, so.

Howard: So, what are you doing for your internal marketing? So, does all of your ... do all of your employees have the app on their phone.

Austin: So, the front desk have it on their phones and we have a office cellphone too that they can use, anyone can use. And we have a system and everybody...

Howard: So, you have an office cell phone that you can hand them with the app on and then have the patient do a review on your own office cell phone?

Austin: No, we want them to do it on their cell phone so that the location is ... their IP address is logged with the patient's phone number on, so.

Howard: Okay.

Austin: So, yeah.

Howard: Now, is it a problem if their phone is on the ... your Wi-Fi?

Austin: Wi-Fi?

Howard: But if their phone is on your office Wi-Fi, is that a red flag to Google and Yelp and Facebook that maybe this is an internally generated review and not real or not really?

Austin: I don't really see a problem with that. It's more when you have your own tablet set up and you have a hundred reviews coming from one IP address.

Howard: Oh.

Austin: I think that's going to be more of an issue.

Howard: So, your front desk, how ... so, when they're ... so, walk me through it. How ... on the internal marketing, how do you get your patients, is it when they're leaving, to go to

Austin: So, again, they look for a cue and they will ask...

Howard: What would a cue be?

Austin: Do what?

Howard: And what would a cue be?

Austin: Like, that was the best experience I've ever had. It was painless. I just love this office. I used to hate going to the dentist and you guys are great. That's your cue to step in and say, "You know, we love patients like you. Can you write a review for us?" And then you walk them out to the front desk and that's when the front desk takes over and sends them the review request and then the patient has an easy way to write a review at that point. They just click a link, it takes them directly to the review site, there's no gates, there's no ratings to filter out bad reviews or ... because you're ... you don't really need that. If you're looking for quality, not quantity, you're picking [00:55:35] loyal hanging through, [0.9] you're only asking your best patients for reviews, that you know that like you. So, that's ... we're going for quality over quantity and so that's where I kind of go against the grain. I don't believe you need a thousand reviews. I mean, no-one’s going to sit there and read a thousand reviews - they're going to scan through the first page or two, maybe the first couple and see that you're a decent person and you're not going to hurt them. It provides social proof that you should go, you should call the dentist.

Howard: And that's what it is, it's social proof, it's herd mentality, it's like, I got to make this decision about something I don't understand, like, I don't ... if I take my car into the shop and he says I need to change my transmission fluid, I mean, I'm not even sure I know what a transmission is or what it does.

Austin: Sure.

Howard: I grew with five sisters playing Barbie dolls ‘til I was twelve. I never, ever changed the oil or spark plugs like all normal people do, growing up in Kansas. So, I would just like to have some social ... my social proof is that, well, I'm taking it to the dealer where I bought my car from and I'm thinking they might treat me like a VIP because that's where I bought my damn car. I mean, when I take my car in there ... and what I like most about my dealer is every time I take my car in, it's the same guy. I mean, I bought that car there in 2005 and now it's twelve years later and my car's got 150000 miles on it and when I first went in there he didn't have any kids. Now he's got three kids. I mean, so I trust that if they kept him there from 2005 to 2017, they must be good people at the dealer.

Austin: Sure.

Howard: Because....

Austin: That's fantastic. That's great.

Howard: And he's married, he's got kids, and they're able to attract and retain and keep him for a decade. And so, this is just social proof. So, what kind of...

Austin: That's kind of ... that story is kind of why I do this. I went to a new optometrist and they rushed me through the office, they kicked me out the door, and then I sit down in my car and I looked down at my phone and I already had the review request. And it annoyed me that they didn't take the time to build a relationship or even provide outstanding care. They just ask me for something. And then it annoyed me even more that we were probably doing it to our patients and I'm pretty sure that other offices are doing similar things. So, I kind of wanted to get away from that completely. I [00:57:58] mean, it's just [...] care for [1.6] this.

Howard: Well, I think that is a ... what you're saying is profound, as staff probably doesn't want, doesn't like the management who's saying, "Ask every single person for a review", and you're saying you don't need a thousand reviews and what you're saying is wait for a cue and then close the deal. And they didn't ... you didn't give your optometrist a cue, you didn't tell them that that was the greatest experience ever, and then they're asking you for something. In fact, I would think that would almost ... I'm surprised it didn't cause you to do a negative review, that you went on and said...

Austin: Sure, that annoys patients.

Howard: Yeah. That I was rushed, and I was, you know, and so ... and then imagine that someone has a bad experience, but your office protocol is ask everybody for a review. And then someone came in and it was a bad experience which is totally ... we can argue facts, we can argue whether or not today is August 10th at 12.08 p.m. at lunchtime, but we can't argue how you make me feel. And if you made me feel bad and I didn't like this experience and then you automatically send me a deal for review, I think I'd be more likely to say, "Yeah, this place sucks! I wouldn't send my worst friend here." And you're saying, wait for a cue, and that these reviews are so important because I don't ... I just want some social proof that this is a good guy. Now, I have to be honest with you. I've never read a review in my life. I mean I'm 54. I've never read a review. And also, the one I'm least [00:59:32] sensitive to reviews, [0.7] don't even want to hear, is movie reviews because in my 54 years all the movies that had the greatest reviews, all that means there's a bunch of car chases, a bunch of people are shot, you know, a hundred people are killed with a machine gun, and it's a family film, like Arnold Schwarzenegger or Rocky. Take your whole family to this violent ... and it seems like every movie I liked the most did not get good reviews and, I mean, the last one I saw that was just amazing was 'The Founder'. What was that guy's name? He was in 'Jackie Brown' too. What was that guy's name? Keating, or ...? Did you see 'The Founder'?

Austin: I didn't.

Howard: Michael Keating? Michael Keaton. Have you heard of him before?

Austin: Yes.

Howard: Oh, he just crushed Ray Kroc. I mean, that was ... did you see him in 'Jackie Brown' or is that before your time?

Austin: Yeah, that was before my time.

Howard: Yeah. 'Jackie Brown' was probably his first, like, great, great film. That was just a great film, and, but he did 'The Founder'. I actually met Ray Kroc. And my dad had nine Sonic's, and Jim ... Roger Garber had a hundred, Jim Williams had a thousand. That same church, Dan and Beverly Carney, they started ... founders of Pizza Hut. They had 2800 stores. And so, I grew up in that fast food franchise era when ... that when a small town got their first Pizza Hut or Sonic or whatever, it was, like, really cool. I mean, that was a hot summer when it's 1972 and you're in Abilene, Kansas, and Sonic Drive-In rolls into your town and now you have cheeseburgers and footlong chili dogs and cherry limeades. I mean, that was some really ... that was more exciting than Facebook, you know what I mean?

Austin: Right.

Howard: And, so, these guys were legends and ... but anyway the point about the reviews is, yeah, I think movie reviews. Same thing with Broadway plays. They'll tell you this is the greatest play in the world. I walked out during the intermission of about half the Broadway plays I've ever gone to, and ... but what was that one, what was that one I stayed to the end, what was the one that was so great? 'Wicked'! Did you see 'Wicked'?

Austin: I haven't watched many movies lately.

Howard: No, no, that's a Broadway play.

Austin: Oh, yeah, okay.

Howard: That was the first Broadway play I've ever gone to in my life where not only do I stay all the way the end but when it was over I like literally jumped to my feet in applause. I mean, that was just ... that was the most ... and it was just a genius plot. So, you have 'The Wizard of Oz' movie, right?

Austin: Right.

Howard: And everybody knows 'The Wizard of Oz' movie, so if you did 'The Wizard of Oz', the play's predictable and you kind of ... it's kind of like what's the movie, 'Titanic'. You kind of know in the back of your head it's going to hit an iceberg and sink. I mean, you just, you know. Even if you missed that class in high school, you know, you still kind of have a feeling this boat's going to sink. But what they did is they said, "Okay, well, at the beginning of 'The Wizard of Oz', you've got these four characters. Well, where did the Tin Man and the Lion and the Scarecrow?" So, they developed those characters for the ten years before.

Austin: Oh, nice.

Howard: So that the end of the play is the beginning of 'The Wizard of Oz'! And it is just so damn cool because by knowing the movie, 'The Wizard of Oz' you kind of know where these characters are going so the play's easier to follow. You're not sitting there in the middle of a play like lost and confused, or like what the hell's going on? You know where they're going to end up. So, it was really easy to follow. It was just a great play. But social proof is what they need, you're saying. I love what you're doing. It's free. It's wait for a social cue - I imagine staff, since every practice management consultant has never seen a staff member, including dentists, ask for a referral. Every single consultant that we've interviewed on Dentistry Uncensored says that every single office they go to there's at least one toxic employee that needs to go, sometimes two or three. And that's probably what's led you to the fact of needing a consultant is your own team, somebody sabotaging the entire team, which has probably got you to the point. And sabotage, they just won't to do their job - this is why your overhead's high, your supplies are crazy. Something's wrong.

Austin: Sure.

Howard: And then the other thing is no one's ever seen to ask for a referral and what you're saying is, "Don't ask for a referral until you see a cue that they were pleased." They just came out and said, "Oh my god, that was greater." And I love it when you hand them the mirror and some of these girls, like five tears will shoot out of their eyeballs.

Howard: Oh, sure.

Howard: They think I'm a machine gun because they knew when you worked on their front tooth ... when they broke their front tooth, they knew it was going to be ugly, it was going to be like looking at a man with a bad wig on and, you know, there was going to be a black line and it was going to be ugly and it was their front tooth. And then they see that it's just frikken bullseye and then they either go verklempt, sometimes they cry and that's when you say, "Oh my God, can you do me a huge favor, please? Will you grab your phone?" So, do you have them download the phone ... the app to their phone and write a review or do you just have them go to

Austin: No, no. So, the front desk team member would soon send them, send the patient a text or email.

Howard: Okay, so...

Austin: So, the patient would get a text or e-mail on their phone.

Howard: So, when they're back there and you hand them the mirror and they go verklempt or cry, that's when you ... shoot, I would ... I'd have the assistant in the room.

Austin: Sure, that's a fantastic idea.

Howard: Yes, let's just do it right now in the chair while you're crying.

Austin: Yeah, there's no problem with that.

Howard: And you'd rather have ten of those...

Austin: Oh, yeah.

Howard: ... than ...

Austin: ... than a hundred of "Great dentist", "Outstanding dentist", all five-star reviews, they all say it in like one or two words. It just ... it kind of rubs me as almost fake. And it doesn't tell a story, it's not ... it doesn't connect with you. So, I would definitely rather have ten quality reviews.

Howard: And the reason I think these reviews are so ... oh my God, we've gone seven minutes over - I didn't know we were! My god, I'm talking to you and the next thing I know, we're ten minutes over! The thing where I know this is important is because everybody talks about it. We know that women make 91 percent of all the appointments. That's worst-case scenario. I've seen studies as high as 93 and 94 percent of appointments are made by women, we know the women are saying seventy-five hundred words or more day, the men are saying 1800 words a day or less, and as a 54-year-old man I've never looked at a review and I've never seen another dentist that I go drinking with watching Cardinals football games ever look at Yelp. I mean, I've never been with five dentists in a car and someone said, "Well, let's get a Yelp review." I mean, we're going to this bar, we're watching the ... you know, I've just never witnessed it one single time.

Austin: Right.

But I'm not in a market that's making all appointments and I'm also thinking maybe all this review stuff is ... maybe it's more a Millennial thing and maybe it's more a woman thing. And they ... you always know in business, the worst thing you can do in business is bring your own bias to the marketplace, like maybe open up a restaurant and your favorite dressing is French dressing and French dressing might not be one percent of the market. You know it's going to be ranch and blue cheese and vinaigrette and whatever the hell. And so, you always got to be aware of your own bias and I know my own biases. I have nothing to do with reviews. But that's not the market. Do you think the market ... that I say ... do you think it's correct that it's more a woman thing and more Millennial thing and less a male Baby Boomer thing?

Austin: I'm sure it's weighted towards that. I feel like the twenty to forty-year-old female market are definitely checking reviews, so when we see new patients that have come from referrals. They're still checking reviews. They're ... I mean, whether you like it or not they're Googling, they're looking you up, trying to find information on you and if they see four stars or above, then they're more than likely going to give you a chance. If it's lower than four, then they're ... it's going to decrease the conversion rate a little bit, so. It's just, it's definitely something that's important and something most dentists should address.

Howard: Well, I believe ... I have some own proof from my own business. I wrote a book 'Uncomplicate Business' and the sales - it's been out for two years - and the sales are actually going up and up and up and I think it's because of the ... I think there's something like fifty-five five-star reviews and only one, like, one four-star review. And I think, as I keep getting these all five-star reviews, it's making people buy the book because I think, I'm sure more books now two years later with fifty-five five-star reviews than I was when it first came out with no reviews. I mean, I see that in my own ... with my own book.

Austin: Sure, it's validation that you know what you're talking about. Of course, you do but it's just further proof.

Howard: They need social proof.

Austin: Yes.

Howard: Well, hey, man, I'm ... Austin, I am so honored that you came on the show today. I'm so ... man, what a cool guy to write this for free to save my homies two hundred a month, twenty-four hundred a year, and over a hundred thousand Dollars from age 25 to 65. Final question.

Austin: Sure.

Howard: What about all my homies that are in school right ... in dental school right now. They don't even know where they're going to practice. They don't know what's going to go on. Is there anything they can start doing to [01:09:12] gaining their [0.6] reviews?

Austin: Sure, they can use the app to gather testimonials from their existing patients. So, I ... they're motivated, they're doing great care on their patients, so why not start getting reviews, showing that you're a decent person, so when you go on an interview...

Howard: So, would that review be on their Facebook page or, if you're in dental school, would you recommend they get ... they just start their own web site: so they have reviews linked to something?

Austin: No, they can actually use the app and keep them within the app, so they can give a link to ... when they apply for a job, they can give a link that the dentist can look at and see if there are 20 reviews for their happy dental school patients.

Howard: And then upload that to their new employment place?

Austin: Well, they can show it to them and then the employer can link to them, the Ask4Review website that has all the testimonials on. Or they can create a Facebook or Google brand page or wherever they'd like to do and keep them out in the open. But, if they'd like to just have their own pod of reviews, that's another option.

Howard: Okay, well, dude, love you to death. Love what you're doing for dentistry. Thanks for being on Dentaltown. Thanks for coming on the show. Thank you so much for coming on and spending an hour with my homies today.

Austin: Thanks for having me. And it's been an amazing experience. Thanks a lot.

Howard: Alright. Tell Amy ... give Amy my love and good luck on those two kids.

Austin: I will. Take care.

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