Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
Blog By:

988 Never Stop Learning with Elizabeth Fleming, DDS : Dentistry Uncensored with Howard Farran

988 Never Stop Learning with Elizabeth Fleming, DDS : Dentistry Uncensored with Howard Farran

4/12/2018 5:10:59 AM   |   Comments: 0   |   Views: 238

988 Never Stop Learning with Elizabeth Fleming, DDS : Dentistry Uncensored with Howard Farran

Dr. Elizabeth Fleming is an experienced comprehensive and family dentist who has managed her private practice in Phoenix, AZ for over 30 years.

Working outside of private practice, she was Clinical Director for Dentaltown Magazine from 2013-2015, and while there became proficient in editing, writing and recruiting authors for the publication.

As an industry leader, Dr. Fleming continues to review dental products for Dental Product Shopper.

In her home state of AZ, her love of learning, as well as the interaction with speakers as Chair of the Council for WRDE (Western Regional Dental Experience), stimulated her speaking career and the start of Quality Dental Voices.

VIDEO - DUwHF #988 - Elizabeth Fleming

AUDIO - DUwHF #988 - Elizabeth Fleming

Listen on iTunes

988 Never Stop Learning with Elizabeth Fleming, DDS : Dentistry Uncensored with Howard Farran

Howard: It is just a huge honor for me today to be podcast interviewing Elizabeth Fleming DDS. She's an experienced comprehensive and family dentist who has managed her private practice in Phoenix, Arizona for over thirty years. Working outside of private practice she was clinical director for Dentaltown magazine for two years and while there became profession and editing, writing and recruiting authors for the publication. As an industry leader, Dr. Fleming continues to review dental products for Dental Product Shopper. In her home state of Arizona, her love of learning as well as the interaction with speakers as chair of the council for Western regional dental experience stimulated her speaking career and the start of Quality Dental Voices. So it's great to see you.

Elizabeth: Nice to see you, Howard.


Howard: I know you live in Scottsdale, so I know it's scary for you to drive down to Phoenix where all the poor people live. I assume you're packing a thirty-eight special in your purse. Were you scared driving through Phoenix?

Elizabeth: No, no, no, it reminded me of actually coming to Dentaltown. So I haven't been here for a few years but it kind of reminded me of coming a few years ago. 

Howard: Don't you love it when you get off I10 on Elliot and you see, you're high, so you see down on Ahwatukee and the mountains. I still think that's the most gorgeous view.

Elizabeth: Yeah, it's pretty.

Howard: I love that view. So I'm so glad to get you on the show because the dental school classes are half women and they don't want to listen to a short fat, bald man like me who's practiced thirty years. They want to hear it from a woman and you're an amazing role model and leader for women dentists. Talk about your journey when you were in dental school, was it half woman?

Elizabeth: No, it was about 20% women and actually at my school I think that was a little higher than some of the other schools. I was at UOP in San Francisco and it actually has grown since then to be about 50% now. 

Howard: Who was your Dean back then?

Elizabeth: De Goni.

Howard: Was he your Dean?

Elizabeth: Absolutely, yes.

Howard: There's only two dental schools on earth where people have nice things to say about their Dean. It was De Goni at UOP and Dillenberg at A.T Still. Most dental school Dean's if you could of beat the crap out of them and not gone to jail, what percent of the dentists would've done it? I mean it seemed like they were not there to help you and I understand the time because it was more, and parents were the same, it was a tough love. It was a boot camp mentality. Well, I'm really hard on you and push you hard and really be difficult, you'll be a great guy. And now it's kind of more like, well let's have a relationship with these students. And guess who has the far better donors?

Elizabeth: The UOP and Dillenberg.

Howard: Yeah, because when Creighton University where I went undergrad, whenever I had a problem on each floor was a Jesuit priest who lived there and the Dean was like an eighty ... I think he was like eight hundred and seventy thousand years old, you could go to his office, talk to him. There was a relationship and they say whenever Notre Dame writes a funding letter to the alumni, it's $10,000,000 cash guaranteed, which is so different than my experience in a public school, University of Missouri where it was totally different, but that was a different time. But and how is De Goni doing? His wife just passed away. 

Elizabeth: Yes. There is a different Dean now at the school, but he's still involved and goes to their yearly meetings so he's like ninety something. 

Howard: That is so cool. Are you going to practice till you're ninety?


Elizabeth: I doubt it.

Howard: You doubt it. So yeah, so he was more progressive at the time because you graduated in dental school in '84.

Elizabeth: Umm.

Howard: And 20% I could see that with De Goni in San Francisco, but I couldn't see that in Kansas, Texas and the …

Elizabeth: Any of the other schools, maybe.

Howard: Any of the other states, but so do you think now that the class is half women, we always hear these things and I don't know where it comes from that well since they're girls they're not going to want to own their own practice. They're going to want to work for corporate-like Hartland or Aspen or Pacific Dental, but when I go into those DSO's, their number one problem is associate turnover. But I think a lot of recruiting goes into the dental schools and tells them a very different message like, "Oh, you'll never compete against corporate. We're going to take over half." And so a lot of what you're talking to, they're still in dental school or they’re working as an associate and what do you think's better for a supermom?

Elizabeth: So I do think that it's not necessarily because they're women that are going into corporate dentistry. I believe that they also, because of the loan structure, many of the outcoming graduates do not have the financial backing to immediately open up their own practice. So, therefore, they will go into corporate to kind of get their feet wet and get some money to survive before they take on more debt to start their own practice. So it may be because they're female, but I think more likely it's the debt that is causing them to go into that area. 

Howard: You had two amazing children.

Elizabeth: Absolutely, yes. 

Howard: Obviously our children come before our work. Do you think it's easier to be a great parent being an 8:00 to 5:00 employee and then when 5:00 go home and work on your kids or looking back at your career, did you think you're a better parent because you owned your own business and can do whatever you want? 

Elizabeth: That's a difficult question. I think that you have to have a good partner to help because your role is not the traditional eight to five housewife role. You have a business to run and then kids to raise, a house to maintain, a marriage to maintain so I think that it's difficult. It's a little bit more difficult for a female to have a practice and be a parent, you're dealing with a lot of things.


Howard: You think it's more difficult for a woman dentist to own her own business and raise kids than a male dentist to own his own business and raise kids?


Elizabeth: Yes, because of the traditional roles.

Howard: Right.

Elizabeth: And so you must as a female dentist have a supportive partner because raising the kids is not all on your shoulders. It can't be all on your shoulders if you have a business as well as kids. 

Howard: And Betty, it's sad because everybody points, okay, to Saudi Arabia just legalized this year women could drive. 

Elizabeth: Wow. 

Howard: And so it's easy to look at that and say they were behind the time. They should have let them do that years ago, but people don't realize how much sexism is still around today. I've had a woman dentist in this room bawl her eyes out because she owned her own business here. She was doing great. Her husband made like $70,000 a year but got a promotion to manager and eighty thousand and he said, "Come on, we're moving." She's like, "Are you out of your mind? I can't pick up my ..." 

Elizabeth: Practice.

Howard: And it was basically you're going or you're staying here and so she had to swallow her pride to save the family and all this stuff and a lot of times when you're at dinner and it's a man or a woman couple I say in all honesty, after work, who's cooking, cleaning, doing the homework? And she says, "He just drinks beer and watches ESPN and I do all the cooking, all the cleaning, all ..." So there's still a massive amount of sexism still have to go. 

Elizabeth: Umm, yeah that is very difficult if you are a female business owner and so luckily my husband has no role separation between doing any of the normal everyday situations with raising kids, changing diapers, transporting the kids, picking them up so I think there has to be a lot of that in order to make it work. 

Howard: But can you honestly say if you had to do it over again you would have had no children?

Elizabeth: Oh no, no, I would. I love …

Howard: Oh tell the truth it's dentistry uncensored. You would have stayed single with no ... I'm just kidding.

Elizabeth: No, no no. No, it's nice now because my kids are twenty-four, twenty-three and twenty-five and they're actually decent people so it's like, wow, we did something right.

Howard: I know.

Elizabeth: And so yeah it wasn't always easy, but there's a lot of [inaudible 00:08:59] 

Howard: I can't say that Ryan's decent, but he does have a pulse. He is alive. No, yeah I mean the only four accomplishments I did was Eric, Greg, Ryan, and Zack, the rest is Trivial Pursuit you know what I mean? 

Elizabeth: Umm.

Howard: And as much as you can get frustrated by your children the reward is a grandchild and my gosh, I got grandchildren. But so you would tell those young kids that when they get out of school it's kind of like football when you lose a game fifty to nothing, you don't come back and teach them these complicated flea-flicker plays. You come back to the four basics. You didn't block, you didn't tackle, you didn't throw the ball, you didn't catch it, you go back to basics. They come out of school they need to go get a job and do fillings and single crowns and they need to get that. They need to get x rays, cleanings, exams, fillings, crowns, they need to get that down …

Elizabeth: The basics down.

Howard: Before they start wanting to place implants and do sinus lifts and learn Invisalign and all this stuff like that. So what would your advice be, that to get into associate job for a year or two or ...?

Elizabeth: Yeah, if there's an associate job that is out there, that would be good. Most of the time the associate jobs do not seem to last for a long time period, almost like the corporate. So they come in, kind of get their feet wet, get some education on how maybe to run a business and then possibly go and do something on their own. However, sometimes there can also be associates that maybe are female and maybe they want to take time off to have kids so they may not want to step into owning a private practice. Maybe they do want to stay at corporate or an associateship for a little while they have their kids and raise their kids. They don't have that much responsibility as they would owning a practice.

Howard: Wouldn't it be a lot easier though just get a cat?

Elizabeth: It would, but most people progress beyond the cat.

Howard: In fact, I wouldn't even get the goldfish. I'd get a picture of a goldfish. You know that employee turnover deal is a millennial deal, so my mom's brother lives up the street and he got a job at Mobile Oil when he was sixteen and he retired there when he was sixty-six. I just saw a study, millennials are very, very different. The greatest companies to work for and the highest PE earnings are Twenty-Nine on Wall Street, Fang, Facebook, Apple, Amazon, Netflix, Microsoft, Google, their average millennial stays only one to two years. So you're working at Facebook which gives you free lunches and foosball and every perk in the world and after a year or two someone comes and taps you on the shoulder and says, "Hey, you want to jump over to Uber and work on driverless cars?" And they're like, "You know what I've been doing the same thing for two years. It was fun. I got it, but yeah, I want to get a new experience." And then someone will come along and say, "Hey, you want to jump over to Amazon and learn what they're doing." So they're just chasing their own what's hot next whereas the baby boomers they got a job at GM or Honda or Toyota and stayed there a lifetime. So lifetime employment is not something ... 

Elizabeth: Millennials.

Howard: And when people always talk about the high turnover of associate, I think who's keeping the longest what I hear on the street is Hartland at two years. Like Facebook holds them the longest at two years, Apple yeah, ... Amazon with Jeff Bezos, not even one year. His average millennial gets a job with them and before a year quits. And they all say the same thing, burned out, fried, they just …

Elizabeth: You know what's interesting is my son got out of school as an engineer and right now he is working for a spin-off company for Google, doing driverless cars here in Chandler and he loves it. 

Howard: Now is that Waymo?

Elizabeth: Waymo, he works for Waymo.

Howard: He works for Waymo?

Elizabeth: Yes.

Howard: Now, tell us about, what is Waymo? 

Elizabeth: Waymo is a division of Google. 

Howard: Okay, that's why I get confused. 

Elizabeth: And so the division is actually to do driverless cars and they did ... he was …

Howard: Can you send me the link to Waymo?

Elizabeth: He was in the car as they were doing their research and whatever else so he was in the car but the car was actually driving and if it had a problem then he was there to take over the wheel. And so he has a large group of young people, the millennials that he works with, they play ping-pong when they have spare time and they just have all the snacks and I said this is not reality. This is not how companies are, but he loves it. He has a good time. 

Howard: So Google chose out of all the cities they chose, Phoenix. You guys won't believe this, but it started a year ago. I see one in Ahwatukee every third day. Now they're just testing it. There's no such thing as a driverless car today. 

Elizabeth: They do have, you can get rides from a driverless car so they've progressed beyond having someone maintain it. I believe you can almost like Uber, have the car come and pick you up and take you to a place.

Howard: So Waymo has a self-driving car that could come pick me up. Hey tell them, anybody's in charge that I have another podcast just for my town of Ahwatukee. I would love to podcast someone from Waymo because we see them all the time and I mean I see them all the time. Are you seeing it? Now you live in north Phoenix, but you live in Scottsdale? 

Elizabeth: Right. I see them in Scottsdale when I go to say the AZDA Organizational Building they're in Scottsdale all the time and so you might see three of them in a row at a stoplight or something. So they are very prevalent now and he's worked there probably a year. So he's coming up upon the …

Howard: But you think he'll stay with Google for forty years? 

Elizabeth: No, no, and I think though he might transition into a different job capacity, but one of his best friends is moving to Mountain View where the main Google building is or they have a compound with multiple buildings, but he's moving there today, 

Howard: Yeah, and it's so sad because the founder of Google, Sergey Brin, Larry Page, Sergey Brin was a Russian and we're not attracting the immigrants anymore. There's so many blocks to get all these people and you look at all these great companies and they were started by immigrants especially in Silicon Valley. And when someone has an idea where they want to leave their mother country and go to the other side of the world to start a business that's a passionate person and you should be meeting them at the border with flowers and roses.

Elizabeth: Welcoming them.

Howard: Not harass, not making it so difficult. 

Elizabeth: Welcoming committee.

Howard: When you and I started up, you started in '84 and I was in '87, there was no fluoride in the water. There were no dental schools. Our neighboring state, Utah had no dental school. Nevada had no dental school. Now we have a big dental school in Glendale dumping out a hundred dentists a year. We have one in Mesa, graduating seventy a year. Utah has two, Rosemary and the University of Utah. Nevada has one in Las Vegas. Is it fair when she graduates from school and says, "Betty, Howie, it was a lot easier thirty years ago than now. We have far, much more competition and far more student loans." Do you think that's fair or do you think the golden years of dentistry are still here?


Elizabeth: I think they've evolved. I wouldn't say that we didn't have problems such as the interest rates and things that when we graduated were major blocks to starting up. But I think if you go with say the technology and the Internet and doing the things that are now prevalent that weren't here when we graduated, you have a fair chance to do well. 

Howard: I think you and I both agree when I look back at thirty years, the number one variable I saw to success was the hours of CE you took. The guys who joined up for the AGD and got their FAGD or their M ... If they were listening, if they were feeding their brain with a hundred hours of CE a year they always found something they love. They always got good at something, they were always passionate and so I was really excited when you started Quality Dental Voices. Tell us about your journey. What made you start Quality Dental Voices and why would you do Quality Dental Voices when I have a voice for podcast and iTunes. You have a face, you could be on YouTube. You should be quality dental videos. 

Elizabeth: Well, it's not necessarily in relation to me speaking about on videos or podcasts or anything like that. What Quality Dental Voices is, is a dental speakers bureau and being that I was involved in the planning of the Arizona meeting for a number of years. I was on a convention that obtained the speakers and introduced the speakers, I got a lot of interest in actually helping the speakers to become better at what they're doing. Maybe get booked at some of the other meetings outside of Arizona and I also became a dental speaker myself. So Quality Dental Voices is a speakers bureau and I will help to get the people booked in various meetings and have a resource for the people that are planning the meetings to go to, to find out about what topics are available and what speakers we have on Quality Dental Voices. 

Howard: Well tell us about the May 5th event that we just retweeted. 

Elizabeth: So there is an event coming called action to win dental leaders, dentistry leaders, and it involves a number of people that we feel are leaders in dentistry and it will be a fast-paced lecture question and answer period involving probably twelve speakers and Emily Ley Tron is a speaker out of California, and she's a dentist as well. She has quite a story and she is doing coaching for dentists in a leadership capacity. We also have Sharon Lechter who is a financial wizard. Has written twenty-three books on finances. She will be attending and lecturing as well and a number of female dentists including Grace Zimmerman, who has a Facebook group, Women Dentist in Business, Mommy Dentist in Business. 

Howard: Oh, I think I've heard. What's her name, Grace Fleming?

Elizabeth: Grace Zimmerman.

Howard: Grace Zimmerman. 

Elizabeth: Grace Zimmerman and we have, let me think, Gina Dorfman of Yappy Dental.

Howard: Oh yeah. Ryan, can you send me the link for Grace Zimmerman. 

Elizabeth: She has a Facebook group, Mommy Dentist in Business. 

Howard: So I'd have to get an operation to join that group. 

Elizabeth: You might have to. It's mostly women talking about women's stuff. 

Howard: Mostly woman?

Elizabeth: Yeah, moms.

Howard: So, and also on that group is my classmate from Hum Casey Dental School, John Flucke

Elizabeth: Absolutely, yes.

Howard: We were both class of '87 and he's big in dental media too with his ... 

Elizabeth: He's with Dental Product Journal. 

Howard: Dental Product Journal or Dental Products and Report?

Elizabeth: Dental Products, I forget which one it is.

Howard: I think it's DPR. I think it's Dental Products and Report.

Elizabeth: Yeah.

Howard: But he was so fun to go through dental school with. So smart. Emily, love Emily. Ron Shelburne is one of your guys, Roy Shelburne?

Elizabeth: Roy, umm.

Howard: The guy who went to jail for Medicaid fraud. 

Elizabeth: Yes.

Howard: Delia Tuttle.

Elizabeth: She was in dentistry. 

Howard: So this is more a consulting company for people who want to be speakers or is it more for existing speakers who want to speak anymore? 

Elizabeth: It's for existing speakers who want to speak more and kind of get the word out. Maybe they are speaking, maybe they don't have time to publicize themselves and being that I have worked on the other side obtaining speakers for our meeting here, I have kind of some inside information to possibly get the word out on the speakers and to get them booked at some of the meetings. 

Howard: Nice. So how old is this company? 

Elizabeth: It's brand new.

Howard: Brand new.

Elizabeth: Brand new.

Howard: And you heard it first on dentistry uncensored. That is awesome. Anything I can help with on that, just let me know, anything, can do that. So what advice would you give them out of school? 

Elizabeth: I would say that you learn things in dental school, but once you get out there is so much more information that you don't learn in school and you have to learn on your own so therefore you have to go to CE and you have to take classes to further your education. Be a continuous student. It never ends and that's how I got involved in doing the CE for Arizona because it was we're always in these meetings and I wanted to do more, especially after my kids grew up that I started volunteering for the dental association. 

Howard: Yeah and by the way, it does irk me when I see people throwing the American Dental Association under a bus and not joining or whatever. What percent are members? Is it about 70%? Is that the number you hear? 

Elizabeth: Yeah, I am not sure, but I go to a lot of meetings and that's one of the questions I always ask. Do you go to your local meetings? Are you a member? Yeah.

Howard: Yeah, so the eighty-eights like your parents, I mean they're the only ones you got. Your parents aren't perfect, but then you got to think, well were their parents perfect. You go back past your grandma, great grandma, I just did that twenty-three and me [inaudible 00:23:34] analysis.

Elizabeth: Oh did you?

Howard: I'm four point three percent Neanderthal so if I think my mom and dad weren't perfect imagine how many generations back when we were in the Neanderthal, they were probably eating their children. So the ADA when people started bad mouthing the ADA, I mean what percent of the man-hours is volunteers?

Elizabeth: Quite a large amount. 

Howard: Oh yeah, I know a guy like you how many hours of your time have you spent at the Arizona Dental Association? 

Elizabeth: I would say probably eight meetings a year plus the convention, so probably fifty hours or so. 

Howard: Yeah, so when you throw the eighty under a bus, you're throwing thousands of Betty's under a bus who are down there. It's kind of like your church. You go to church, well, there's crazy people in your church, there's crazy priests, it's a commitment. But what they don't see and this is what I always [say? 00:24:49], like Ryan and Kevin are all on the show. If I had one piece of advice for the ADA is the duping member doesn't realize all they do behind the scenes.

Elizabeth: All the benefits.

Howard: With the government. I mean this is the United States where we have one million attorneys and the only way you get a bill passed is with the water bills and if you're not down there bribing and giving money and raising money and things they don't realize that you're a sovereign profession. We were in Malaysia, they have had one dental school forever. Then private dental schools come in now they have ten. If you were from one to ten it changes everything and there's so many things that our government is trying to do, not do and undo and if you didn't have all those lobbyists in fifty different states and in Washington DC, then all the time and money and investment you put into your sovereign profession could be really damaged. Do you agree?

Elizabeth: Yes.

Howard: Yeah, I agree and then as far as what they don't like, look on Dentaltown, you couldn't get two dentists to agree that today is Sunday. You post any case, you could post a beautiful case, beautiful teeth, beautiful woman and one guy will say, "I'd do veneers." The other one, "She needs Invisalign." They're not an agreeable bunch. Whenever you have eight years of college dentists, physicians and lawyers, it's like herding cats. If you want to get everybody on your team, like in the military, they want boys under twenty-one. They don't want a bunch of fifty-year-olds who think they know how to win a war, you know what I mean? Walmart is the largest employer in America and if you want to have the most number of employees you should shoot for the lowest amount of education because the lowest amount of education don't line up and listen to you. But you can't get fifty dentists or lawyers or physicians in a room and have them agree on anything. I want to switch to a whole different topic. When they come out of school $330,000 in debt and then they hear, well if I want to be a really great dentist, I got to have a CEREC machine, a cad cam. Or I got to have a seventy-five to $150,000 laser millennial laser for [le nap? 00:27:09] or I got to buy a CBCT. They could literally come out of school make three purchases and double their debt. You've had a very successful dental office business in North Phoenix for thirty years. What expensive toys do you think are a must have a and return on investment and which ones do you think you can survive and thrive without?

Elizabeth: I like my scanner I don't have the mill, I just have a scanner so I would say that's probably a must-have situation now. 

Howard: What scanner do you have?

Elizabeth: I have an iTero

Howard: An iTero. Is iTero is that what Align Technology and Invisalign bought?

Elizabeth: Umm.

Elizabeth: So Align Technology owns Invisalign and iTero.

Elizabeth: Yes.

Howard: Okay and how much did you pay for that? How long ago did you buy it? 

Elizabeth: I don't remember how much it was. I'm still paying on it. I have probably another year to go and I probably bought it about three years ago.

Howard: No buyers remorse, you glad you bought it?

Elizabeth: No, I'm glad I bought it and ... 

Howard: Are you using it for crown and bridge or for Invisalign?

Elizabeth: Crown and bridge only. And I don't do much Invisalign I do more Six Month Smiles than I do Invisalign and so I think learning …

Howard: Six Month Smile that was Ryan Swain, Six Month Smiles. 

Elizabeth: And so I like the ability to get a more predictable end result with using wires and brackets and the fact that they're white. People have a tendency to go towards that. If they like Invisalign, I will have them go to the orthodontist and get their options and see whether …

Howard: Now do you work with just one Orthodontist or do you work with several? 

Elizabeth: I work with several and I work with several specialists in a variety of capacities and there's a lot of good ones out there. So …

Howard: And I'm just curious why do you have iTero and not do Invisalign and you do Six Month Smiles? I mean you have …

Elizabeth: I could do iTero. I use iTero for Invisalign I just have not gotten into it to that extent. I have sent more of the patients when they want major corrections to the Orthodontist. 

Howard: So it's kind of interesting so you and I have seen this [inaudible 00:29:40] twice, bleaching I think I might have done the first bleaching case only because it was David Keel, remember it was a company out of Arkansas, It was …

Elizabeth: Oh wow.

Howard: God, what was the name of that company that came here in '87 and you could buy six bottles of bleach for $900 and it was carbam …

Elizabeth: Oh carbamide peroxide, oh yeah.

Howard: It was Omni-gel, yeah [inaudible 00:30:02]. Remember Omni-gel?

Elizabeth: Okay.

Howard: And it was out of Arkansas and just out of random chaos he moved here from Arkansas, he bought a house across the street and I see this big dental supply, yellow van, Omni and I told them there's no way I was going to spend $900. $900 thirty years ago that was big. So he gave me a set and told me to go to work and bleach everybody's upper teeth and I was back there calling Gordon Christian, you know is there any research on this? And everybody's like, "No, it's brand new. It's a carbamide peroxide. It sticks to trophic. Gordon basically said, "You know what an elephant's tusk is a lateral incisor. Ivory is enamel I don't see how this is going to hurt it." And so I just said, "Do you think …

Elizabeth: I should do this.

Howard: It's okay for me to do this on my staff?" So me and the staff all bleached the upper teeth and they were just like all white and the lowers were all brown. Oh my God, we were selling the beJesus out of it because everybody in the office had …

Elizabeth: Beautiful white teeth.

Howard: Beautiful upper white teeth and lower brown teeth then and I remember Dave always used to come and say, "You guys, you need to fill up your lower tray with like Dr. Pepper and you stir it up and but it was an amazing deal. And we charged two-fifty an arch, it's $500 and it was crazy fun, easy money and what I liked about it is the way you manage humans if they like something they'll do it. They either own a bowling ball and they're in a league or they haven't bowled one time in ten years. They either own a boat and go to the lake all the time or they haven't been to the lake in ten years and when people don't like their teeth and they're not in love with their teeth. They don't take care of them, they don't brush them, they don't floss them. But what I was noticing with the bleaching is as soon as little Sam or Sally liked her smile then she wanted to brush, then she wanted to floss and she wanted to get her cavities fixed and she …

Elizabeth: Then she wanted more.

Howard: So it turned them on, but then Crest came out and just wiped that industry away with $50 crest slips and Invisalign now has bought 17% of Smiles Direct and now they're setting up stores. They're taking a page out of Steve Jobs when everybody was getting out of retail they're all zigging out, Steve Jobs, one of the number one marketing geniuses of our lifetime, started building these Apple stores that were monuments to the brand. And the iPhone, not in sales, but just profit dollars, the iPhone makes ten times more profit dollars than the Samsung's do. And now you see iTero or Align Technology going into these really high-end malls and they're going to do Invisalign direct. 

Elizabeth:    Wow, they cut us out.

Howard:    Yeah, they cut us out so we've all seen this before. How do you think that's going to play?

Elizabeth: Well, I don't know.

Howard: What do your Orthodontist friends say? Do they talk about it? 

Elizabeth: I haven't talked to anybody about it at this point, but I remember when Clear Choice started with the implant centers relatively close by the dentist and I have one in my parking lot at Clear Choice right across the parking lot from me. And it doesn't seem to have affected the implant business because it's a little bit different than say the multiple people that come in my practice that may need maybe one implant or an implant bridge. They don't have major failures and need full mouth implants.

Howard: Well the way I see it is when Clear Choice came here how many ads were they buying on TV? How many infomercials?

Elizabeth: Oh yeah, full-page ads in the paper.

Howard: I don't think in fear and scarcity, I'm just not that guy. I think in hope, growth, abundance and I look at what percent of Americans technically could have straighter teeth with clear aligners like Invisalign. 

Elizabeth: A lot. 

Howard: 90% of all adults. So I think the orthodontic market can just explode and what I saw with the Clear Choices is they are the rising tide. They've done so much advertising that our individual oral surgeons and periodontists don't do and they've done so many infomercials and I can't tell you how many times flipping through the channels I've seen some thirty minute deal on All on 4. And so yeah, I think they grow the market segment.


Elizabeth: And I think that people, consumers will gravitate towards something that's easier than maybe going to a dental office, so they'll probably gravitate there. I don't think it's going to stay a method of having your trays done by a retail store. I think we can give them a lot better customer service in the dental field than they can in a store. 

Howard: And it will make everybody reevaluate the price. I always say that braces it's kind of been like airlines. In my whole life every time Boeing comes out with a new plane, well it still only flies five hundred and fifty-five miles an hour. It's tough when you lecture. I mean like every time I lecture in India I have a five-hour flight to New York, layover, fifteen-hour flight to New Delhi. You give a lecture to a couple hundred people and then backtrack. Then fifteen hours back here. I've lectured in Australia, I mean Ryan, what are those flights like from Australia? 

Ryan: They're long.

Howard: Oh my God. You take off Sydney and they go fly time today, sixteen hours ... and you're like sixteen hours. You can get drunk and sober back up and get drunk again and go to sleep. It's crazy.  

Elizabeth: You have to make it worthwhile if you go lecture in Australia or India.

Howard: Oh my God, no.

Elizabeth: No.

Howard: No, the first time I lectured in Australia I got off work, true story, I got off work 5:00 Friday, went to Sky Harbor flew to LA. Had a layover, flew sixteen hours to Sydney. Got there like 6:00 in the morning and they picked me up, took me to the Convention Center, lectured 8:00 to 5:00. Then after the seminar, they drove me back to the airport. I had a 9:00 return flight and I was going through the deal and they, I'll never forget this, guy is looking at it [inaudible 00:36:41], "You weren't even here twelve hours." And he's looking at me he goes, "I've never seen that." And I'm married, I got four kids. I got an office I don't have time to pet Kangaroos and yeah, those were just …

Elizabeth: Brutal.

Howard: The worst one we ever had, remember the worst one we called it the death march.

Ryan: Oh yeah, [inaudible 00:37:00]

Howard: Was it Cambodia or Malaysia?

Ryan: Eventually we were going to Indonesia, but we had a couple of layovers. We had a layover in Japan and a layover in Singapore.

Howard: We left the house and it was me, Greg, Ryan …

Ryan: That's it.

Howard: Just us three? 

Ryan: Yeah. 

Howard: By the time we checked in our hotel room - thirty-six hours. That's why I love the podcast. When I look at these numbers, oh my God we're lecturing to more people today in India and I don't have to fifteen-hour flight it from New York to New Delhi. That is so cool, but so I think the All on 4 deal I don't know really how ... I mean it's totally American where if you had the money you can just get instant teeth. There's going to be a market for that, but I see so many these All on 4's where, well why did you lose all your teeth?


Elizabeth: Right.

Howard: You weren't the vegan yoga instructor. You were probably smoking, drinking, not brushing, hadn't been to a dentist and there's All on 4's I keep seeing these implant cases where in five years the literature is saying, 20% have peri implantitis. At nine years the research comes in forty to 60% ... but when I see those All on 4 zest attachment, those ball and rings they snap into place. Well, then grandpa can go into the bathroom twice a day and pop that thing out, rinse it out,  brush it. Whereas, when I see them in the office, they come in they got an entire ham sandwich underneath this All on 4  thing. I was trying to get the CEO of Waterpik to come on because what I got really excited about Waterpik is, Waterpik is ... mom doesn't like it when you make a mess in the bathroom. And I've always said it's got to be in the bathroom.

Elizabeth: In the shower.

Howard: And I always had the shower floss where you unscrew the head and you put your floss in because if you want a water pick you don't want all these water spots on the mirror and you don't want to be blowing a ham sandwich onto your mirror. And now they have the portable ones because I think if they're going to do it in their shower, it'll get done. But if they got to open up underneath the sink and get out a box and plug it in and then make a big old mess. 

Elizabeth: Then clean the mirror.

Howard: It's just not going to get done, but you can do it in the shower. Right now all your patients already peeing in the shower so what is it to just add shower flossing you know what I mean. But I really wish dentists were more telling these people you know what, I can get all your teeth and they're All on 4. We can do it in a day, but I don't know if I'm really going to change your behavior so be honest with yourself. Do you really see yourself really getting underneath there and taking care of it every single day because if not, I think ten years later you're going to be back same place with peri-implantitis. You also lecture on lasers. What are your thoughts on diode laser procedures?

Elizabeth: So that's kind of an interesting story. I had an event here where Dr. Tuttle, Delia Tuttle, who is Divas in Dentistry had asked me to help her speak in various areas in the US. She's very popular in Europe and has done quite a few lectures.

Howard: Where was she born and raised? Was it Romania?

Elizabeth: Romania. 

Howard: Romania.

Elizabeth: Umm and so when she had her event here, she did her gumdrop technique event here in Phoenix, or actually in Scottsdale and when she came to that event I lectured on diode lasers and I worked with Ultra Dent and they lent their Gemini Laser and we had a lecture workshop and now that has evolved into I will be speaking at Ultra Dent for their women in dentistry series where they have icons in dentistry happening in June. And I will be speaking on lasers for them and they just announced that a couple of days ago on International Women's Day.

Howard: Well and how much is a Gemini laser?

Elizabeth: I think there between six thousand and seven thousand maybe and it's a dual wavelength laser and the other ones are all one wavelength and so it's more efficient, it cuts faster and not as hot so it has a lot of pluses to have the dual wavelength. Plus they have a really nice face of it where you can just, it's a touch screen and it's very easy to use. So they've lent me one. I'm doing lots of little videos and informational things for my upcoming lecture. 

Howard: You know there's two sides to a laser. I know people who on molars, basically, quit packing chord when they got a laser, but I got a buddy and he's a podiatrist and he says he could take a fifteen blade make that incision, get a big old electric handpiece and do his surgery and all that stuff, but he uses a laser, which he says makes the incision go from a fifteen blade, takes a long time. Because he says the marketing on it is insane and when people are searching for podiatry surgery and they see his laser, laser, laser …

Elizabeth: Laser, yes exactly. 

Howard: You're thinking OB1 Kenobi and C3PO and …

Elizabeth: I actually have something in my laser lecture that's like [inaudible 00:42:43] you know that's how you perceive a laser works, but I actually have a patient that had had the scalpel surgery for some frenum attachments a couple years prior and her Orthodontist referred her into my office to have the laser frenectomy done because they didn't succeed with the frenectomy that was done with the scalpel. So I've documented her case and she told me that the pain level is so much less with the laser and so it is a lot better technology than the scalpel or the electro surge for doing procedures in my opinion. 

Howard: In my opinion the only patients who are not used to dealing with pain they're all the single people, but the married people you could just hit them over the head with a shovel and they're like ...  but I have so many mixed feelings about the laser and the frenum attachment so the Orthodontists never talk about this. It's come into dentistry from anthropologists, but and by the way, ASU where I went, has Lucy the oldest [inaudible 00:43:51 ] one point six million years old, thirty-six-inch tall female. She was seventeen, her wisdom teeth weren't all the way in yet. But all the anthropologists are saying, why are there no malocclusions for millions of years, they just found a tooth in Germany, which blows everything, they just found nine point six million-year-old human tooth in a cave next to the river in Germany because before that they were all from eastern Africa. So everybody thought, well that was the cradle of civilization, which didn't always really make sense because the first study that reached a million was actually Rome. That was the first city with a million people and this was next door in Germany where they found a nine point six million old tooth. But malocclusion they don't exist until about three hundred years ago and a lot of the things I'm reading are saying because when the baby was born, they nursed for years and today if the nursing gets fairly difficult, they just stop doing it and give them a sippy cup so they don't have all those forces spread in their face. You probably threw them a mastodon leg and these kids they had all these forces and now you're feeding them purée applesauce out of a baby Gerber Jar …

Elizabeth: Formula.

Howard: And giving them sippy cups and bottles that milk comes out like a garden hose with no effort so now I am getting a lot of questions because these nursing mothers, so now they're sending someone into the hospital when you have a baby to give you nursing instructions. And a lot of them are looking at this kids frenum attachments and saying you need to get that lasered off. So I was always saying, no, I'm not going to go there. Go see a pediatric dentist, but the problem with a pediatric dentist some are very going along with the nursing coaches in the hospitals and the other ones are very against it. So then you're going to be back at square one because she's going to call you back a week later and say, "Well I talked to two guys and one's for, one against so I  want to know what you think." So I want to know what you think since …

Elizabeth: So you have to go to a female pediatric dentist and she will do what's right for the baby. No, I was just ... 

Howard: No, I agree, no I agree because no seriously …

Elizabeth: Dr. Jeanette McKlein you know.

Howard: Because seriously they always say there's a lot of truth behind humor, right? So when I was little all the OB GYN's were males. They didn't listen to their patients and the males called him hysterical, which is a Greek word, meaning uterus, histrous. So I mean when you come here to complain I call you a uterus, now, all the OB GYN's are women and when I go into a dental school and I see a pediatric graduate program it's like all women. And I think if women make 90% of all appointments I think women have a huge advantage because what percent of women don't trust men? I mean let me give you a couple of examples. Like out here the biggest air conditioning deal is George Brazil, right, and who just passed away a couple years ago. Just a great guy. But when your air conditioner doesn't work and you call George Brazil or an air conditioning company and they come out and they say, "Betty, we can't fix your air conditioner. You need a brand new air conditioner for $9,000." What percent of the women in Phoenix are wondering, I wonder if that's true? 

Elizabeth: Umm.

Howard: What percent of  the time when women pull up at the oil change deal where it says oil change nineteen ninety-nine, so you're thinking I got a twenty and then he walks out and says, "Well, Betty we need to change your air filter and flush out your transmission fluid." What percent of the women think you're just trying to sell me something? What percent would you say? 

Elizabeth: Oh I would say it's pretty high. 

Howard: Yeah. When the engine light comes on the mechanics call the engine light, the mechanics call it the idiot light. They're like, "Awesome, the idiot light went off. She's going to come in, we can sell her anything." So I think it's absolutely true. If I was a woman, I would want to go to a female pediatric dentist who nursed her own kids to answer that question, not me. If I was a woman, I wouldn't go to a male OB-GYN. Just like when I got my vasectomy done, that was my only surgery and I went to a man.  

Elizabeth: I have to tell you an interesting story. So just the other day I had to take my cat to the vet for shots, year shots and so I take …

Howard: For what shots?

Elizabeth: For shots, yearly shots. She's like a year and a half, two years old and I take her in and I have a vet that I've been going to for years and years. There's a male and a female vet so the female vet looks at my cat and says, "Oh, she's got a couple of minor things. We need to put her on medication." But she looked in her mouth and she said, "She has gingivitis." And I said, "Okay". Then so she said, "So we'll have to check on what she was being treated for in a couple of weeks, but also we need to clean her teeth. I'll give you an estimate." So my husband is there with me, so we get the estimate and the assistant goes over the estimate with us and says your cat has gingivitis and she needs some teeth out and she has all these other problems and the cost is going to be like a hundred times more than what a cleaning costs in my office. So I come out and I said, you know what it's kind of funny because I'm a dentist and the vet did not explain anything about my cat's condition. They just basically gave me an estimate. So we came out and we looked at the estimate it was like, "Ah, for a cleaning." And we came home and we made an appointment to go to a second opinion and talk about marketing,  I won a little [valpack? 00:49:49 things for free examine to this other vet. So I go in and there's another female vet at this other office and she does an exam and she tells me, really good communication, your cat does have problems because I was like, "Are you kidding me? I think they're just snowing me. I'm a dentist they're telling me my cat has all these major issues." So the second one says, "Yes you do, your cat does have problems and actually you need to go to a dental specialist who's a vet." And I was like, "Oh my God." It goes from needing a cleaning to major, major problems. So anyway, she was more communicative. I understood things and I went to the dental specialists this past weekend and my cat had to have some teeth removed and …

Howard: So it's a vet that only does dentistry?

Elizabeth: You know who it is, it's the vet Dr. Visser who does the zoo animals and…

Howard: Can you send me a link.

Ryan: Dr. Visser?

Elizabeth: Visser.

Howard: Tell him to come on the show. I've never had a vet dentist.

Elizabeth: Actually I think there was a reason why I did not have the communication with my first vet because I ended up talking to Dr. Visser. Excellent, nice guy, South African guy. His son is a dentist.

Howard: In the valley?

Elizabeth: In the valley.

Howard: Who's his son?

Elizabeth: His last name was Visser.

Howard: Send me both.

Elizabeth: And so anyway at the end of everything my cat had to have major surgery and she's like moping around like she has her wisdom teeth out this weekend, but he was so nice. He explained everything, had video, had information that he sent me home with. So make a long story short I spent twice as much as I would have with the first vet, but I felt like the communication was there. He was caring, helpful, and spent the time with me and I'm going to have him come to the Arizona dental meeting to do a lecture.

Howard: Visser, are you really? 

Elizabeth: Yeah.

Howard: And what's he going to lecture on just the FYI.

Elizabeth: Probably the dental arena because pets do have major periodontal problems. My cat had periodontal issues. She's two years old and there was resorption and erosion and decay. All of these things on the cat, but you would think that a dental pet would not have the same issues, a dentist pet may not have the same issue, but they absolutely do. 

Howard: Well you know why we should not like cats?

Elizabeth: Why?

Howard: Because I love cats. Growing up we always had two or three cats, but so when they started doing the human g-nome when they started doing that it was billions of dollars and took a decade to get through one set of chromosomes, right. Now the technology is so much faster, easier, lower cost, cheaper, better, now they're doing the g-nomes of all kinds of plants and animals. Turns out, I read a paper on a g-nome that they always wondered where the streptococcus mutans in our mouth came from dental decay and they definitely say they can measure permutations per hundred genes to get a time length on them. They say homo sapien picked up streptococcus mutans from a cat in the fertile [crescent? 00:53:15] about fifteen thousand years ago. 

Elizabeth: Wow.

Howard: And somebody was kissing a cat and that's how it entered our population and so …

Elizabeth: So don't kiss your cat.

Howard: Well, actually, a lot of [heard? 00:53:25 diseases all come from other animals. The greatest death in America was, the greatest crime scene in the world was the Spanish influenza and they tracked it all the way back from in Kansas a pig gave it to a young boy. Then he was recruited for World War 1, went to Leavenworth, which had the first breakout and then those guys were shipped out. But anyway, it followed the troops of World War 1 and then what was really sad is then as they got infected the United States postal service, like there'd be an island and they would only get their mail once a month and then the guy would come and deliver the mail and then in the following two weeks, five to 10% of everyone on the island would die.

Elizabeth: Population, oh wow.

Howard: And the reason that's so scary is because today, that was a century ago, today there's twenty thousand international flights a day. So that slow-moving epidemic would be the whole planet in a day. The whole planet would have that in a day, but yeah cats are amazing. I always have a lot of cat jokes, but I always loved cats. And were you tempted to just save your money and eat the cat and just have a good meal? 

Elizabeth: No.

Howard: Was it close?

Elizabeth: My husband was trying to understand why we went from a lower estimate that we thought was high at the time to go and spend twice as much to get the cat taken care of at a different place. He wondered where the wisdom was in that, but ... 

Howard: I think the neatest thing with the dental vets had no idea until we lectured in Africa and Tanzania that one of the number one causes of death in the Serengeti is, soon as the hippo's teeth wears down, they starve to death and die. And so they live so much longer in captivity because they go in there and do root canals and post build-ups and crowns, but if you're a hippo as soon as your tooth's worn down, it's over. If you're a cat and you break your canine off on a kill, you go away and starve to death, but teeth are one of the biggest deals for life expectancy. 

Elizabeth: You know what was also interesting when I was talking to Dr. Visser on the cats I said, "Do you do work on the animals that are in the zoo?" And he goes [inaudible 00:55:48] and he goes and gets his IPAD and he comes back and he shows me he just worked on a Jaguar this past week. And he said, "So I did a root canal on him and I'll be doing a crown." I said, "Do you do same day crowns?" And he goes, "My son's a dentist." And so then it brought in the CEREC and all these other things so it was really interesting because they do a lot of the same things on the animals that we do on humans. So that's when I thought I've got to get him to speak at the dental convention.

Howard: Oh yeah. Dentaltown has fifty categories and one of them is dental subspecialties and one of the subspecialties is veterinary dentistry and there's hundreds of cases. And I've posted a lot of his work when it shows up [inaudible 00:56:29] where they're doing fifty-centimeter root canals. 

Elizabeth: Yes, exactly. How did they get those files, right?

Howard: Yeah, it is really, really cool. And vets are under a tremendous amount of stress because a lot of the dentists don't realize this, but since everyone loves animals, the hardest thing to get accepted to is vet school. Not medical school, not dental school and there's so many people who decided when they were ten years old they were going to be a vet and they didn't let any money or anything stand in their way so they'd come out with more debt than dental students, but their jobs they're only getting sixty-five thousand a year. So you look at a dentist servicing that debt making a hundred and seventy-five thousand a year, a lot of dentists they whine to me about the three fifty and I'm like, "Well, would you pay $2 to get a job that makes a dollar a year? That's pretty reasonable." But they're paying three hundred and fifty thousand to get a job that pays sixty-five thousand a year, so three hundred and so $350,000 divided by $65,000 that's five years. So being a vet is a very emotional decision. You love cats, you love dogs, you want to do that your whole life and remember back in the day when they had indentured servants like they would take you to the new country, but you had to work free on their farm for seven years. You're basically an indentured servant.  You're going to go be a vet for five years for nothing, just trying to pay it back, whereas a dentist is two years. You also talk about finding a  balanced life. You have been successfully married for what thirty years? 

Elizabeth: No, twenty-seven close to thirty.

Howard: Twenty seven and what advice would you give on the work-life balance? 

Elizabeth: I would say that it's very important to find a way to relieve your stress, whether it is through exercise, not drinking of course. Anything to moderation, you can have drinks, but not in excess, but to exercise and eat right, sleep well. Just try to do all the things they tell you, you should do, but find the time for you, whether it's early in the morning or late at night to kind of relieve your stress. 


Howard: You're a hiker, you're always posting pictures of hiking.

Elizabeth: Yeah, we live in an area where we have the mountain trails right behind us and plus my husband and I have Fitbit's so we have to get our steps every day. 

Howard: How many steps you try and get every day?

Elizabeth: Ten thousand, which is …

Howard: That's cool.

Elizabeth: Yeah, I think it's about five miles and so it just makes you get out and do things outside or if you have a treadmill, but we like to go outside. And then we did take a couple hiking trips. 

Howard: That's right, Grand Canyon. 

Elizabeth: I did Grand Canyon with the Maddow's, well actually Dave Maddow and then my husband and I did Machu Picchu, Peru.

Howard: With the Maddow's too?

Elizabeth: No, just with us. We did one of those REI trips and that was a lot of fun. 

Howard: REI?

Elizabeth: REI, you know REI recreational …

Howard: You mean the sporting good store?

Elizabeth: Sporting good store. They had a trip and you meet the people from all over the US or all over the world, I don't know, at the facility in Peru and then they take you on guided hikes through the backcountry of Peru and so we ended up at Machu Picchu though we saw a number of different ruins from the Inca time of years, years, years ago.

Howard: And now I just saw an update on that they're finding many, many more via satellite. They got a new satellite software and so in jungles and they're saying look at that here's this big city. 

Elizabeth: I think I saw that same thing.

Howard: Yeah, that's really cool. Talk about cell phones and social media. You say your practice can't thrive without cell phones and social media. 

Elizabeth: So you know how phones never used to be a priority. They used to be flip phones, all you do is speak on the phone. So over the years now there are many computers so you don't need as much to use it for a phone by itself. You can use it to play social media. You need to get reviews and things like that on social media. That's the way that people actually look for practices. They'll use their phone much more so than any other way and if you have good reviews, you will have people coming in strictly because they look online and they see good reviews and so they choose your practice over somebody who doesn't have good reviews or doesn't have a social presence. 

Howard: Yeah, I noticed speaking of views, Paul Allen's interview ten years ago that this Steve Jobs iPhone thing was a joke. 

Elizabeth: Wow.

Howard: I think that interview is up to ten million views and it was pretty cool because I was watching that interview because I got a lot of those predictions right. I remember I was freshman year at Creighton, you remember Joe [Dovecon? 01:01:52], the Endodontist from Paradise Valley.

Elizabeth: Yes.

Howard: Who passed away a couple years ago. 

Elizabeth: Umm.

Howard: We were sitting up here with Randy Kerwin, who's a dentist in Kansas and Gary [Saldi?001:02:01] who's a dentist in Althorne and then this guy down the hall, and Paul Gosar was in that dorm?

Elizabeth: Oh really.

Howard: Yeah, I lived in Swanson Hall with Paul Gosar, US Congressman and this guy named Dave Howman came and showed us this computer from I think  it was Tandy or Radio Shack.

Elizabeth: Yeah, who knows.

Howard: And he was a computer major and we were all pre-dent and everybody on that floor is pre-dent, pre-med or pre-law and here's this computer guy and we're trying to be polite and he's showing us all this and everything and when he left we all just died laughing. What an idiot. Why would you get a degree in Fortran and Cobol and Computer Sciences, what are you dumb, deaf and blind. Yeah, just missed the biggest bull market ever. I can still remember walking into [inaudible 01:02:49] with my dad and they installed the ATM machine, I think it was like in the early seventies. And we thought what idiot would want to stand out here with this stupid machine when Shirley's right in there to help you and she's nice and get a candy sucker. And we'd go in there and do our banking, we'd come out and that guy is still going through all these steps and we're up there and we're talking to him and saying, "Why don't you just go inside?" And he's, "No, [inaudible 01:03:12]" And my dad and I said, "Yeah, that idea will never take off." And that was the ATM, it was the biggest thing. Another one is ... I've missed so many things so I get it, but do you remember what year your first cell phone was because when I was watching that interview, I was trying to think, because mine was a Motorola. It was a flip phone, all it did was …

Elizabeth: Mine was a flip phone.

Howard: Do you remember what year?

Elizabeth: It had to be probably early nineties, it's probably in the early nineties. They used to be big too. Remember the real big phones. They looked like walkie-talkies.

Howard: Oh my God, when the phones came out it was like a brick and they were originally …

Elizabeth: Clipped to your belt.

Howard: Wired to a briefcase or a car and my dad used to say the same thing. He goes, "All you got to do is go to any gas station. You don't even have to get out of your car. You just roll down the window, put a dime in, there's your phone.

Elizabeth: There's your pay phone, right.

Howard: Yeah, and I remember when I was lecturing I started lecturing in '90 I remember that one of the most important things on a layover flight is that the reason I sat in first, even though I'm only five foot seven and when you're five foot seven coach is first class. When your feet don't touch the ground, you don't need first class, but the only reason I would buy first class is because if you weren't in the first four or five rows then when you came out and went to the payphones they were all taken. And if you sat in coach, if you were in row ten or fifteen you had no phone on a layover in Chicago or Dallas or Atlanta. They only had the ten, fifteen …

Elizabeth: Rows of phones.

Howard: Payphones and you're always trying to guilt the guy on the phone. You always trying to stand behind and go [inaudible 01:04:54]

Elizabeth: You done yet?

Howard: And there were people, businessmen who want to talk to their spouse and kids on the phone and all that stuff, but men, crazy thing. Final question, you promised me an hour of your life, we're at an hour ten. Final question, tips for financial success in your practice and life. I mean they became a dentist to have a better job and career and financial success, but they come out with three hundred and fifty thousand ...what advice would you give them? 

Elizabeth: So this topic is not necessarily things to make their debt go away, but things that in the practice maybe make things easier such as accepting efts instead of getting paper checks. Things that …

Howard: The EFT there in dental school.

Elizabeth: Electronic fund transfers from the insurance companies, so if you sign up with the insurance companies to have the funds transferred into your bank account, you save some time getting the return on your money from the insurance claims much faster than if you would wait for the mail to come with the check in the mail. We also have a check scanner and so instead of having to go to the bank to deposit any of the checks that either patients write or the insurance companies do send you, we have a scanner where we just have to scan the checks so you can do away with going to the bank [honor? 01:06:24]

Howard: Who do you bank with?

Elizabeth: Chase.

Howard: Yeah, so do it. It seemed like most people ... like if I told my team they had to change to say Bank of America they would probably just beat me up. The Chase software it's so much more intuitive and easy to use than so many of the other banks. Chase is really, really good at online banking.

Elizabeth: I think I've used the variety of the banks not only for business but personally and so Chase is good. Wells Fargo's not so good. 

Howard: Right. Wells Fargo's not good and when you talk to people doing online banking with Bank of America, they call it skank of America.

Elizabeth: Oh really.

Howard: And Chase is the Apple of the online banking. 

Elizabeth: Umm, it's very intuitive.

Howard: It's got to be intuitive and Wells Fargo and Bank of America is probably more like the Microsoft of the online banks.

Elizabeth: Absolutely, yeah, I agree.

Howard: It's still hard for me to like Bill Gates. I mean I do, I like him now and he's been out of Microsoft. He's a great guy.

Elizabeth: He's very philanthropic. I like what he does with the …

Howard: But gosh, the first twenty years, every time that asshole sold me his software I had to get an IT guy. It was riddled with bugs and I pay two hundred and fifty for Gate's shitty software and then you'd have to pay someone $2,000 to get all the bugs out of it. And to this day my IT team says, "No, no, no they just came out of that update. We're not touching it for six months to a year. It's shit, it's trash." But Apple it's never.

Elizabeth: I've converted everything except my office to Apple. 

Howard: Steve Jobs said quality, quality, quality and Jobs just said, I mean and Bill Gates was just money, money, money, money, just sell that shit and everybody on his team would say it's not ready. Give us more time. "No, sales, our quarterly earnings, profit." And he basically screwed all of his customers for twenty, that's the way I feel and now I'm sitting there I'm trying to listen to him. It's like, "Ah." I mean that's the guy I wanted to strangle for twenty years and now he's like this great philanthropists, but man, sorry for that rant. But do you remember those days?

Elizabeth: Oh yes and I know that every time …

Howard: And if you don't understand what I'm saying talk to any fifty-year-old programmer what he thinks of Microsoft software in the eighties and nineties. Was it ready to be released or was still filled with bugs?

Elizabeth: It was always filled with bugs.


Howard: Yeah, so the millennials if you're under thirty …

Elizabeth: You just don't understand that.

Howard: Yeah, but he is really a great guy right now. Anyway more financial advice. Any other tips for financial success in your practice and life? You said efts.

Elizabeth: Umm, efts, the check scanner. I would have meetings, morning huddles and office meetings on a regular basis just to see where your practice is on certain percentages. Where you should be and where your practice is so you know how to gauge where you need to spend time. Get somebody who's really good to do financial arrangements and treatment planning with your patients so they understand. So you don't have the vet thing where I get the estimate, but I don't really know why it's so high. 

Howard: It's so bizarre because these kids believe like I believe that if you went to Creighton and you got A's in Geometry and Calculus and Physics and all that was the secret to success, but you know when they come out of school the ones that have a personality, the ones that can communicate. If you get an A on the soft fluffy stuff, you can be a horrible dentist, all your work fails, not take any online CE and have a million dollar practice. But if you're the best dentist north of the equator and you can't communicate to your patients and your staff …

Elizabeth: It's a problem.

Howard: Or your spouse, I mean it's the same problem you're going to take it home with your wife and kids, same one with your team, same with your patients. Either have to be a great communicator or life is very challenging.

Elizabeth: I agree.

Howard: And that's why I decided to live with cats and I will not remarry unless it's a droid. I'm waiting for C3PO's sister to come out and seriously buddy. Thank you so much for coming by.

Elizabeth: Thank you for having me. 

More Like This

Total Blog Activity

Total Bloggers
Total Blog Posts
Total Podcasts
Total Videos


Townie® Poll

Has your practice undergone a redesign or remodel in the last five years?


Site Help

Sally Gross, Member Services
Phone: +1-480-445-9710

Follow Orthotown

Mobile App



9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 · Phone: +1-480-598-0001 · Fax: +1-480-598-3450
©1999-2019 Orthotown, L.L.C., a division of Farran Media, L.L.C. · All Rights Reserved