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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1020 Increase Patient Flow & Case Acceptance with Harold Meredith : Dentistry Uncensored with Howard Farran

1020 Increase Patient Flow & Case Acceptance with Harold Meredith : Dentistry Uncensored with Howard Farran

5/16/2018 12:52:49 PM   |   Comments: 0   |   Views: 183

1020 Increase Patient Flow & Case Acceptance with Harold Meredith : Dentistry Uncensored with Howard Farran

Harold Meredith has been in exclusively in the dental field helping Dentist’s to manage and market their practices since 1990. He has visited over 5,000 dental offices in North America.

VIDEO - DUwHD #1020 - Harold Meredith

AUDIO - DUwHF #1020 - Harold Meredith

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1020 Increase Patient Flow & Case Acceptance with Harold Meredith : Dentistry Uncensored with Howard Farran

Howard: So I am at the Oklahoma City Dental Convention in downtown Oklahoma City and I'm sitting here with my buddy for probably what, thirty years?

Harold: Yeah.

Howard: I mean you, me and Brock Rondo, it's Harold Meredith so you can go to I've always known him as, but Harold Meredith has been exclusively in the dental field helping dentists who manage and market their practice since 1990. He has visited over five thousand dental offices in North America. My gosh, he likes talking about elevating case acceptance through proper presentation, increase patient flow through marketing, so, Harold, you and me have been in this thing forever. 

Harold: Long time.

Howard: Why are dentists going to or Why are they contacting you? What problems are they having and what ones are you going in their office and fixing? 

Harold: Howard, so many problems. Sometimes I walk in an office and I'll usually spend a full day in their office and just analyze every move a dentist is making and what the team is doing, how they're answering the telephone, almost every aspect of the office. And they just don't understand the business and the marketing side of things, so I see just a ton of things in these offices and there's just so many opportunities for them to be able to increase their case acceptance, get new patients in the door, proper hand-off systems, they miss it all. They miss it all so ...

Howard: So, but I don't know why though because this was really thoroughly covered in Algebra, Geometry, and Trig.

Harold: Oh yes.

Howard: I mean Biochemistry was all about inbound sales calls and how to return the call. Yeah, it's really sad. These dental schools are charging them seventy to a hundred thousand a year. They're coming out four-hundred to $500,000 in debt and the day they graduate if they had one employee they wouldn't even know how to get on Quicken and do a payroll for one employee. 

Harold: No and you talk about hiring and firing, you were just speaking to the group previous about taking your time when you're hiring somebody, and firing quickly, and that's kind of been my motto. As soon as you have "cancer" in your office, you know when you know and I can't tell you how many offices I've walked in, and it's like, "So, doc, why is Beatrice still here?" "Well, Beatrice has been here for twenty-five years I can't let go of Beatrice." “Well, of course, you can. Beatrice is only costing you 50% of your business right at the moment because she doesn't know how to dismiss patients or greet patients, etcetera, etcetera.” I see all of these problems when I walk into the office and getting the dentist to actually to start making those types of decisions. It's not that easy sometimes.

Howard: But you know what I like looking at the social media data, the social media data across all social media platforms that 1% of the people, whether it be Twitter, Facebook, Instagram, 1% start all the conversations and they're called influencers. Only 9% engage, comment, reply, share, whatever, 90% just lurk. So it's pretty easy to say that the people like me who share a lot are abnormal. In fact, statistically, there'd have to be something wrong with me and these humans ...

Harold: I didn't know you shared anything.

Howard: Yeah, and so these humans they evolve to, it's our tribe and we all got to stay together, and it's so counterintuitive you almost have to be a ruthless sociopath to sit there and say, "you're fired." In fact, that was our President Trump that was his tagline, "You're fired,"  and you almost have to be ruthless.


Harold: You've got to be ruthless.

Howard: You got to be ruthless so and I get it I always said, you know I have five sisters, I always say that by the time a girl has worked in my office for five years, she starts to feel like a sister to you. Well, it's hard so when you start telling dentists they need to fire Beatrice, they get nauseous so ...

Harold: It upsets them. 

Howard: Yeah, very upsetting.

Harold: But the trouble is it's like cooking a lobster. You don't throw the lobster into two hundred degree water immediately and that's what happens. Beatrice starts with them and for twenty-five years the water just gets a little warmer and a little warmer, and a little warmer and they're just putting up with it so ...

Howard: I can't believe at these dental conventions, I can't believe a dental assistant or a hygienist coming up to you and say, "Will you talk about this or that?" And I'll say, "What's going on?" [inaudible 00:04:46:] see that guy over there that's ... and then she'll roll her eyes. That's my dentist." I'm like, oh my God, I've only known you for a minute and you're toxic. This guy has given you money and when humans, I read this whole deal, so there's some people in Washington DC that have the highest predictive on if you're going to be married in five years or not. And they do it with high-speed cameras so they sit you down like this, high-speed camera, I forgot what it is, like two hundred and fifty frames a second or whatever, and they start asking questions and in the words they're looking for things like if you sit there and say, well our friends, our checking, our parents, our, our, our, our ... they're like look at these people. They talk like they're only one entity. They'll be married in five years. Then the other ones like, well my dad and your parents and my checking, and your job, my job, my friend ... and it's like these people are only connected by a wedding ring. And, but the other one is body language, like flaring a nostril is violence. When someone flares their nostrils they're really trying not to bite you, but rolling the eyes is the most lethal thing and I was reading that and it's like goddamn, I've known you for three seconds and the first thing you did is roll your eyes and say that's my doctor.  Because it's a two-way street, if that's what you think of him, you need to quit and you need to go down the road and so, but what is ...

Harold: You talk about human behavior and it's just, it's very difficult for them to change. Human beings generally don't like change and I go into the offices and so often it's so difficult to get the ladies to realize that we need to change this and this is why you need to change it. And they still, even after you show it to them, sometimes, even after you prove it to them, it's still impossible for them to change. They still try to go back to their bad habits so it's not easy. 

Howard: Only babies with dirty diapers like change. It's really amazing only one, in any given calendar year, only 1% of the smokers quit, only 1% of the alcoholics quit so humans don't change. It's a 99% chance if you're smoking a pack a day January first, you'll be doing it all the way the next year so yeah, it's tough. But you've been doing this for three decades, is dentistry the same as it was thirty years ago. Is it getting better because a lot of kids are asking, especially with this podcast, this is how bizarre podcasts are. They're so transparent and kids are in undergrad now so 25% of the people who email me are in dental school. 5% are in undergrad thinking about going to dental school, medicine, law and then they're looking at the fact that fifty-six schools and the majority of them are charging seventy to a hundred thousand a year so you're going to walk out with three to $400,000 in debt. So if some kid was an undergrad right now and saying to you, "Harold, you've been seeing dentistry for thirty years, is the profession getting better, staying the same, is it in a nosedive? What do you think of the sovereign profession of dentistry?"

Harold: Yeah, that's an interesting question. 

Howard: What if your own kid said, "Dad, I want to be a dentist." I'd say, "Well, first of all, you can't be my kid." I want to see DNA testing and the name of your lawyer. But what would you say to that kid? 

Harold: Yeah, that's a toughie, Howard. In my thirty years, obviously, the clinical care has gotten better, an awful lot better. The technology is amazing, some of the things I find are just absolutely amazing but the business skills just really have not improved much the business marketing skills, thus you get the big chains. I remember just before I got into dentistry I was working with pharmacies and it's amazing you know try to find an independent pharmacy today, there's just hardly any of them around. Now they'll be sitting in a medical building or ... I mean you don't find a large independent pharmacy anymore. They're not out there and I got into a discussion with a doctor, Dr. Rondo's meeting this past weekend in Las Vegas and ...

Howard: Brock Rondo?

Harold: Brock Rondo, and just a little plug for Brock, but an amazing teacher and if you want to learn Orthodontics TMJ or sleep, but...

Howard: Send me the link to that

Harold: Yeah, so, but ultimately in my discussion with this young fellow he was saying that the independent dentist will live on and there's no way that change can take them over. And my concern is and I have a good friend of mine in Connecticut who's just in the process of selling his two practices and the chains were offering him a lot more money than an independent was, so how do you stop that? So to me fifteen, twenty years down the road it's not going to be as easy for the independents and it's going to get more difficult so that's my thought on it.


Howard: Well you said a lot of things I want to comment on those things. First, you said the clinical care's gotten better and I don't agree. 

Harold: Okay.

Howard: Because ...

Harold: Well technology has gotten better.

Howard: Because they got prettier, but when I was little and got out of school, all the fillings were metal amalgams. The crowns were gold or porcelain painted to gold and all my restorations are gold and the amalgams last twice as long as these pretty composites because they're neuro-plastic and so I think the fillings lasted twice as long thirty years ago. And the pharmacy, this is pretty funny, but I knew pharmacy was dead just because I lectured internationally because in France you would take your health insurance card and when the doctor did your prescription he'd load it on your card, then you take that to an ATM machine that was made in Scottsdale and you'd stick it in an ATM machine, a bottle come down, the label come on, the pills come down a hopper. When you can get your service from a robot, a machine, pharmacist are dead. Whereas dentistry with physicians 80% of the physicians never touch you. They never do surgery. They read blood work and they write prescriptions and all that stuff and only 20% of them will actually ever take a scalpel, cut you. But dentistry it's a 100% surgery, so 100% I'm touching you and humans are so finicky about who touches them. Who's leaning back? Do I trust you? Did you hurt me? 

Harold: For sure, but I've got a sharp instrument in my hands so ...

Harold: But I do got a shout for Brock Rondo, that guy, well how I measure these instructors is some instructors are very low self-esteem and they'll go teach Ortho and 95% of the class will walk away and not even start a case because they say,  "I'm not smart enough." And Albert Einstein said if you can't explain it to a sixth grader you don't even know what you're talking about and when Brock Rondo starts an Ortho class if there's thirty kids in the class and it's like four, three day weekends, every single kid will start an Ortho case.

Harold: Yeah, they'll give it a try for sure.

Howard: Because he can explain it. Ryan, what's that new thing that millennials talk about? Explain it to me like I'm Cammy or Camille or ...

Ryan: Explain it like I'm Calvin.

Howard: Calvin, yeah explain it to me like I'm Calvin and who's Calvin? 

Ryan: It might be Calvin and Hobbs.

Harold: Calvin and Hobbs I would think, yeah.

Howard: Yeah, so explain it to me like I'm Calvin. That's what all the young, cool kids are saying, but if you say in Google, does ... Google is not a person it's machine learning algorithms and the searches have been growing about 5% so it used to be like dentist and this dentist near me or ... now it's like, is there a dentist near me that lives in Ahwatukee that takes Blue Cross and then with voice searches are starting to grow even faster. But if you just type in a search, it's based on billions of searches done every day. So if you just type in can Jesus, look at the top of your list, can Jesus microwave a burrito? Next one, can Jesus microwave a burrito? Can Jesus fly? Can Jesus be God? Can Jesus heal me? Can Jesus talk to you? Now we'll say can dentist ... can dentists prescribe? Can dentists prescribe antibiotics? Can dentists have tattoos? Can dentists prescribe Xanax? Can dentists do Botox? Can dentists remove coffee stains? I just love Google.

Harold: Can dentists remove coffee stains? Oh from your teeth!

Howard: Yeah, because you know the difference between Google and Facebook? Facebook is you're posting all your greatest hits albums. Here's me and my lovely wife on our anniversary and then you type in Google divorce dentist in Phoenix. So Google is truth serum and Facebook is your eminence front. It's a put on. 

Harold: Absolutely. 

Howard: And so when you read studies on Google searches, man looks very, very different than Facebook so Google is truth serum. 

Harold: Yeah, for sure.

Howard: Okay. 

Harold: But to me, Facebook is babies and puppy dogs in a lot of respects so I mean I see my offices if we're posting for them or doing anything for them on Facebook, we try to get it as customized and personalized for them as possible so ...

Howard: So what is the top reason they're calling you? Let's put it in order, one, two, three. 

Harold: Yeah, one, two, three. Number one is get new patients in the door.

Howard: Okay so that's why your website is

Harold: Correct. 

Howard: Dentalmarketers with an 's' and  ...

Harold: Second is case acceptance and third is communication and organization. I mean most of the offices ...

Howard: Organization?

Harold: Yeah, organizational charts, team meetings, I mean generally most dental offices when I first go in there either they're not having team meetings at all or they're not having effective and efficient meetings and they're not having meetings, third, that have proper follow up and implementation systems to them. They sit there and they have a meeting and at the end of the meeting they all get up and walk away and I'm sitting there thinking, well, you didn't designate who is going to take care of what. There was no deadlines, there was nothing there and now there's no communication back as far as the implementation process is concerned. So what's the sense of having a meeting if you're going to have a meeting like that and most of the dental offices I first attend that's how they have their meetings so ...

Howard: And you always know if you go to a Fortune 500 company, the meeting has started with somebody reading the minutes last meeting. Okay, last week we had a meeting and Harold, he was going to go find a dental marketing company. We decided that if we could get ten more new patients a month, we'd really be .. so Harold present to us what you did since last meeting.


Harold: Right and Harold will be like, "I didn't know I had to do that."

Howard: What? I thought we were just bitching. I thought we'd just go to dental meetings and we bring her on board and we just stitch and ditch, stitch, bitch, nothing ever happens. Nothing ever changes so yeah, if you don't have someone in charge of the meeting and if she doesn't go around and give everybody a handout for the meeting, then the staff meeting is never going to gain enough efficiency to pay for the hour lost productivity. So you have your labor all sitting there for an hour or two and then you sit there and say, "Well what changed so that I could get that because this office does $1,000 an hour so we lost $2,000 production. Where is the efficiencies to get this two thousand bucks back for all the ..." And it's impossible, but and let's say [inaudible 00:16:51] so ...

Harold: Well, I remember sitting in on a staff meeting here in Oklahoma City three years ago and seven or eight ladies sitting around a table and I just let them roll their meeting and there was no agenda and none of the ladies had pad and paper and nobody was taking notes and at the end of the meeting I said, "Ladies are we finished?" Yeah. "Okay, I'd like you all to please go get a paper and a pen please." And off they all scurried and they all come back and they're laughing. I asked one simple question. I said, "Point number four and please don't talk out to each other, point number four please write down what the solution was to point number four." And of course half of them didn't even know what point number four was because they did not have an agenda. The two or three that had it figured out, they were completely on different levels, completely different ideas. So it was a completely useless meeting and that's what I see an awful lot.

Howard: And they always have to eat during the meeting. 

Harold: Oh, of course. 

Howard: So half the deal is someone took money, they went to [Choke and Puke? 00:17:52] they got a bunch of sandwiches and shit and they're all ... , my book was people time and money. I get it every day they say, "Well, hey, how about let's do lunch next week." Like, "Dude, lunch is an eating function. If you have a question, it's email. What is your question?" "Well, I thought we'd go out and get a bit to eat." "Dude, I don't want to eat with you. What is the effing problem?" And then it turns out that the people that can't answer it, they're just fishing for ... they're salesmen. They just want to press foot. If you're selling something, tell me right now. Email's very efficient, but if I had a lunch meeting every single day I can meet five people a week. I could answer three hundred emails today without eating a cracker with anyone. 

Harold: Well, I find and it's funny you see a lot of team meetings at lunch and it just gets in the way. People are rattling and they're just not taking it seriously you know so ...

Howard: So yeah, if you want to eat, go eat. Why don't we have a meeting after lunch? Go freaking eat, go to Arby's, go to whatever. Go do your bodily functions, come back, poop, pee and when you're ready to do business let's have an agenda, let's get something done. But a lot of dentists believe, I hear this all the time, dude I'm already paying my rent, mortgage, [inaudible 00:19:22], computer, insurance, [inaudible 00:19:22]. Goddamn, Harold, if I just had ten more new patients a month, it'd be nothing but net. What do you say to that guy? 

Harold: Well, that's not necessarily the answer. To me, the answer is you've got to become profitable with the patients that you've got and if I get ten more patients well certainly I'll garner more income, but the practice is not necessarily built or holding onto being profitable just because I'm getting ten new patients a month. I say to a lot of my practices sometimes you need to slow a little bit if you took more time with the patients that you had and set your team up for success, set your treatment coordinator up or whoever is actually closing the business at the end of the process, utilize visual tools, visual communication. One of the things that I see that just doesn't happen in dental offices is the selling of benefits. Why do we buy anything? Why do human beings buy anything? That's because it benefits us, but ultimately very rarely do I see that in my case presentations so I know I'm kind of hitting you with an awful lot here, but ...

Howard: No, no, no, I love it, I'm loving it.

Harold: But ultimately just because I get ten new patients isn't going to necessarily make me more profitable or get me to the promised land. What gets you there is taking a close look at the business and certainly the sales cycle and the presentation process, doing it properly and I can't tell you I don't think I've ever gone into a dental office and asked them, okay, can you tell me your production numbers? Well, most can tell me their production numbers and most can tell me what their collection numbers, but they can't tell me the presentation numbers. They don't know what they've presented so if you don't know what you've presented, you don't know what your closing ratio is, you're missing a huge opportunity there. So when they say I need ten new patients to become more successful or to be profitable, etcetera, etcetera, that's not generally the answer. The answer is taking a close look at your business and becoming more profitable inside it. so I hope that answered your question.

Howard: So it's so perfect because he just said something so flippant, profound, but only old people might have picked it up.

Harold: Are we old or ...?

Howard: I'm fifty-five, dude, how old are you? 

Harold: I'm older than fifty-five.  

Howard: You're older than fifty-five. Yeah, but you're a Canadian man, those are easy years. 

Harold: Yeah, exactly. 

Howard:    Your skin can't age when it's frozen.[inaudible 00:21:44] so you guys don't age half the year.

Harold: Well, it was minus-four in Toronto this morning, so ...

Howard: And you know what I actually feel like I'm Canadian because I'm in Phoenix. 10% of the city's Canadians.

Harold: Yes, I'm sure.

Howard: And my gosh, both ...

Harold: I'll be there next week. 

Howard: Both Orthodontists, Yeah, I'm in Ahwatukee, both orthodontists are from Canada. I mean it's ...

Harold: Really, it's crazy.

Howard: There's more people from Canada in that ... well, Canada is the same size ...

Harold: And speaking for your, sorry to interrupt, I'm speaking for your Buddy Harry Green at the mid-continent meeting in Scottsdale. You spoke there three years ago. 

Howard: Harry Green with Tip-Edge? 

Harold: Yes.

Howard: Nice, nice.

Harold: Yeah.

Howard: I love Harry man ...

Harold: Yeah, he's a good guy. 

Howard: Harry's a great guy. 

Harold:    Sorry, I didn't mean to interrupt.

Howard: No, no, no. Harry Green, [inaudible 00:22:29] Tip-Edge, he's an orthodontist. Brock Rondo and the other one I like is Richard Litt, but anyway what he said that was so profound [inaudible 00:22:41], okay, so you're not profitable now so then what's ten more new patients going to do.

Harold: Exactly. 

Howard: And the other thing is, well, they're not profitable with cleaning, exams, X-rays and crown and bridge and simple Endo so I'm going to add sleep apnoea and Ortho and Invisalign and veneers. It's like, dude, when you find the average Joe homie million dollar practice collected a million, taking home two fifty, they don't do sleep apnea, they don't do veneers, they don't place implants, they don't have a cad cam, they don't do any of that shit. They just do the simple real well and so you're not ... it'd be like a restaurant, "Well we're going bankrupt." "Well, what do you think the solution is?" "We think we're going to add lasagna to the menu." Really the steak and baked potato and broccoli didn't do it, but now ...

Harold: Yeah, lasagna will get us over the top.

Harold: We'll add lasagna, yeah so let's add lasagna and sleep apnea. I always tell them get your house poised for growth. Well, let me tell you this, Harold, so Ryan and I were visiting my mom last week in Kansas and we were in these small towns like Derby and Rosehill and all these things and when I go to a small town you know when I see a dental office I just slam on the brakes, run in there. I love my homies and it's so funny how you go to these, what most people would think this is a poor Midwestern farm town and you look at the 7:11 or the Circle K and there's eight F150 pickup trucks there and you walk over there and you say, "Buddy, nice truck. What did this cost?" "Well, based out it's thirty-eight, but this baby, this bitch is decked out." I mean I was talking to a kid, a dentist in St Joe, Missouri. His final bill for his F150 $98,000. 

Harold: That's crazy.

Howard: I mean it had the bigger engine horsepower so ...

Harold: It's crazy. My first house was $98,000.

Howard: I know, but so the average American finances the car sixty months, right? They start at sixteen by the time the average American is seventy-six, the average American has bought twelve and a half cars with the median average price at thirty-three thousand. Then I'll go into a room full of a hundred dentists and say, "How many of you have never sold one $10,000 treatment plan your entire life." And all the arms go up and say, "Well there's no money out of here, there's no money out here." Yeah, and Louisiana is the craziest because you go to Louisiana, people's bass boat costs more than their truck and when you get really down into the Delta there bass truck costs more than their house. So they'll buy a rig that can go halfway across the Gulf of Mexico to catch redfish and then come back to a trailer that's on telephone pole stilts. 

Harold: Exactly, exactly. Well, I always ask my staff's when I first start with them, one of the very first questions, who is your biggest competition? And invariably they always say the same thing, "Well, it's Dr. Johnson across town or it's this guy down the street, etcetera, etcetera." I always say to them, "Have you ever heard of Amazon?" I mean people are spending their money, their expendable income on Amazon and they're going into Walmart's and they're going into Ford and GM, etcetera, etcetera. You have to be able to present in a way that gets your patients to spend some of their expendable income with you, but you have to do it properly and too often I see insurance get in the way. They're the ones that are presenting it, "Well, you know, I'm not sure if your insurance will cover this or not." If you want to shoot yourself in the head go ahead and shoot yourself in the head. I mean, so it frustrates me to watch my dentists in that position and I love being able to go in there and start to turn that around and get them to start to look at it a little differently.

Howard: And it's funny how you said shoot in the head, all people on [inaudible 00:26:47] realize that if someone came up to you and said, you need to shoot the person that causes all the problems in your life, it'll be yourself. 

Harold: Right, yes. Oh, for sure.

Howard: And that's the last person to blame it on. It's always the economy, the dentist across the street. I love it when their dental offices is sinking and they want to talk for three hours about Putin, Trump Benghazi, Hillary's emails, some guy in North Korea ...

Harold: Yeah, always blame it on somebody else.

Harold: It's like, really, you're spending three hours a day obsessing about North Korea and you don't even know what your case presentation is and you want more new patients. But the national average is at 38% close rate, so three people come in with a cavity, 38% get the filling done and they want more new patients like, well the two that didn't get it, why don't you split that difference? Instead of one in three getting a filling, why don't we shoot for two out of three because I think the better doctor is one who does amalgams and gold crowns and my kids, I'd rather them go whenever I'm dead, I'd rather my grandchildren go to a doctor they got two out of every three of my grandchildren convinced to spend their money on getting their body fixed because I know Netflix is going to convince them. Spotify will convince them. 

Harold: Ford will convince them.

Howard: Yeah and Ford will convince them. I can't tell you how.


Harold: I mean probably almost 100% of the time any of these major automobile companies are trying to sell you a vehicle. How often do they actually tell you how much it is? Half the people in this country I bet you have no idea exactly how much money they paid for their vehicle. It's all month to month to month. 

Howard: Yeah, you hearing this Ryan? Did you hear what he just said?

Ryan: No, I didn't.

Howard: Most of the people in America don't even know how much they paid for their car and then you'll hear someone ask them, "Well, how much that car cost?" "Well, it was $17,000." "Really, really so you wrote him a check for seventeen." And then you'd say, "Well, how much is the payment?" Then you start doing the deal. They don't know how much money they spent on the car and how much they spent on the interest of the car. They don't realize that the average $100 000 home in America on a thirty-year loan that you pay $300,000. You pay a hundred thousand for the house and two hundred thousand of the interest. And the other thing is I have it thrown in my face every day because I have practiced for thirty years across the street from a veterinarian. Great guy, love him and my office is four thousand square foot. His office is six.

Harold: His is six, of course.

Howard: And he has always done a million dollars a year more than me and I cannot tell you how often a person comes in and says, "I can't do this. I just spent $5,000 on chemotherapy on my cat." And I'm like, a cat is dinner in most countries and you spend five ... I mean, imagine if you went to Kentucky Fried Chicken and they say, "Well actually we can't serve you chicken because it has cancer and we want you to spend $5,000 curing the chicken and as soon as he's healthy then we'll kill it and you can eat." But I mean not to be ideal, but I mean at some point you got to draw a line. When you don't have enough money to have your kids come in and get cleanings, exams and X-rays because you're putting $5,000 into a nine-year-old cat who has eleven-year life expectancy. So it just makes the point that people always have the money for what they want. 

Harold: They really do, they really do.

Howard: They just don't have the money for what they need.

Harold: And unfortunately the employees that I meet in the dental offices get into those ruts and they start to present it based on their perception of what they think that patient can afford or what they think their insurance is going to cover and I see it time and time again and to me I take insurance, and this is insurance as far as I'm concerned, so let's get that right off the table right at the moment. I'm here to help you as far as your oral health and your overall health is concerned. Here are all the benefits why you need to do it and then if I'm going to present it I'll present it just like Ford does and we can do all of this for you for $199 a month and get everything taken care of for you. So even if they ultimately don't go the monthly payment route, at least now they realize it's psychologically they think, oh, I can afford this.  

Howard: And it's amazing because the people they think they have money usually don't and it's fake until you make it. It's the young kid who buys the expensive car and the fancy watch and all that stuff because that's part of their ego or whatever. But so what's funny, so they are not presenting it to the fifty-year-old man in plaid pants that's from the farm, not realizing they don't spend their money, right. These guys are sitting on huge money and they think of money in chunks like five grand, ten grand is like a chunk and they've got all these chunks so yeah, so they're always presenting to fake it before you make it. Another one, are you big fans of Care Credit?

Harold: I think any of the finance companies, I mean Care Credit here in the US. We have Health Smart Financial up in Canada, My American clients they'll do it pretty easily. They can [inaudible 00:32:07].

Howard: What I like about Care Credit and this isn't a commercial, is they can do a printout of everybody that uses Care Credit in your zip code, county, whatever and it's so great because this guy is telling you, "Well, you don't understand man, dude. This is Maricopa and we lost the factory," and they always name some factory.

Harold: Yeah, as you say it's always an excuse.

Howard: I know it couldn't be you. Obviously, you walk on water, but I did Care Credit. Here's how much the average person in Maricopa County is financing a month and this guy across the street from you is doing almost a hundred thousand dollars a month in Care Credit. And the other guy is doing twenty-seven thousand, this guy's doing seven thousand and you're doing nine hundred a month, nine hundred a month there. Tell me again, is it Benghazi or is it North Korea or is it ...

Harold: Yeah, what's the excuse, what's the excuse. Well, I remember doing a meeting with a small group at a dental office in New Jersey and as we're in the meeting, the Care Credit reps walk in, these two fellows walk in, and I had been with this practice for sixty days and had encouraged them within two weeks, let's start presenting and utilizing Care credit and these two Care Credit reps come in and I can overhear them talking to the receptionist because she came out and they're just saying, "Well, we wanted to come in because nobody had been here really and all of a sudden you're doing $50,000 a month in Care Credit. We just want to know what happened." And she started to turn them away and I said, "Oh no, no, no. Get these two fellows in here, get these two fellows in here." Because I wanted to reinforce to all the people in the practice, not that I really needed to do it because they had become successful very quickly, but this is how to sell it. This is how to sell dentistry. You make it easy for people to get into it. And these guys were shocked that it just kind of happened overnight and they hadn't prompted it. So to me, it just makes perfect sense. I'm an old school sales guy, but I think we have an amazing product in dentistry, let's sell it. Let's not be embarrassed to sell it. Let's help people get into it so ... 

Howard: And the biggest case presenters I've ever seen in my life, the biggest ones and the best marketing I've always seen is the emotional sweet spot is when they say, "Well, I don't know. I mean I'm not made of money." And and the return is, "Dude, we could redo your whole mouth for $98 a week." And, because $98, when someone says $98 you're thinking, "Dude, I went to a Mexican restaurant and drank some Margaritas and some shots I spent $98 with me and my buddy two nights ago at the bar. I could do $98 a week. Now $98 times four, come on I've had ...

Harold: Three eighty-four.

Howard: Yeah, so ninety-eight, see I drank so much I have to back it up [inaudible 00:35:00].

Harold: I think it's three eighty-four.

Howard: Three ninety-two.

Harold: Oh okay.

Howard: So ninety-eight times four. If you said three ninety-two well then it depends on what is a car payment. So three ninety-two times a sixty-month car payment, that's a $23,000 car. If you said ninety-eight, but what I'm saying is ninety-eight is street smart because most people can do $90. So what's crazy, this is what you do? You sit there an add all this shit up. Well, it's a thousand dollars on this crown, a thousand dollar on [inaudible 00:35:32] and then the worst of the worst ones that can sell freaking a heater to an Eskimo is when they can't even tell them the final price. Say, "Well, we don't know because when we go in there we might have to bone graft and we might have to put ...

Harold: They can't say it.

Howard: So you're telling me just to get in the surgery room and we won't know how much it costs until we get out. How about I just drive home right now.  And then the dentist say, "Well, I don't know ..." Like, "Dude, you're being anal and you're being stupid." If you can't shoot this guy a case number and maybe some cases are more profitable than others. Maybe you get into one case and you use twenty grams of freeze-dried bone and the next case ... it's a closing price and you don't go in there and say it's $28,000. We need half now and half tomorrow. You go in there and you say, "You know what Harold, congratulations, you got great credit. We can do this whole thing and it'll be a $392 a month for sixty months. Do you want to do it?"

Harold: Yeah, absolutely. Well, the things that kill me is when they have these young assistants that they've put them in charge of presenting the cases to the patients and with absolutely no training and no idea how to do it. And they walk in with the treatment plan and of course most of those treatment plans that are printed out by any of these companies, the big numbers sitting at the bottom and for whatever reason, they make it twice as big or twice as bold. So I put that in front of you and I see them do it all the time and they start to explain the treatment plan while at the bottom of the paper is this $28,000 number. Well, a lot of people as soon as they see that $28,000 it's the teacher at Charlie Brown, it's what, what, what. They just stop listening to you. You've completely lost them psychologically. You can't present that way. You can't present that way.

Howard: And if we're just playing laws of averages when you're a twenty-five year old dental assistant and you've never had $25,000 in your checking account or savings account at one time. 

Harold: Very good point. 

Howard: They're just looking this like, Oh my God, I mean twenty-five. I've never even seen that much money there. Nobody has twenty-five thousand and then you talk to the people that are the biggest case presenters and they just say the doctor says, "Well, I don't like to talk about money I'm just going to tell you need all this shit and leave, but I'm not going to talk money." Dude, first of all you're a doctor and you have this much money and you have to say the number and own it because you're going to sit there and say we can do the whole thing, but the whole thing will be twenty-eight grand, but we can finance that. I think twenty-eight grand that's not even going to be $350 a month for sixty months.

Harold: Yes, I was just going to say with Care Credit you can spread it out over forty-eight, sixty months, whatever it needs to be so ...

Howard: So do you do teach case presentation in dental offices? 

Harold: Yeah.

Howard: So somewhere...

Harold: I have a little case acceptance manual.

Howard: So first of all my homies listen to you. So 40% are on Dentrix, 30% are on a Soft Dent. So they pull up to their work. How do they even figure out what their case acceptance rate is

Harold:    Well, they have to do it on a daily. I ask this question, first of all, if you present a $20,000 in treatment today, you produced ten thousand and you collected $5,000, what do those three numbers have to do with each other today? 

Howard: So say those three numbers again. 

Harold: Okay, so if I presented $20,000 today, I produced ...

Howard: Okay, but wait a minute are those Canadian dollars or US?

Harold: We'll go with US dollars, so $20,000 I presented, $10,000 I produced and $5,000 I collected. So that's what I did today so what do those three numbers have to do with each other today?


Howard: Did you know that all, seriously I'm not kidding, did you know that all my boys are millionaires. 

Harold: Yeah, well there you go. 

Howard: Do you know that? 

Harold: Good for them.

Howard: You know why? Because when we were lecturing in ... remember when we were in South Africa and Tanzania, we were in some country with, I forgot which one it was, [inaudible 00:39:35] in place ... 

Harold: Yeah, the dollar was worth nothing.

Howard: Yeah, no, no they have a million dollar bills. 

Harold: Yeah, exactly. 

Howard: And so we all got million dollar bills. I think, what was that million ... what would they cost us? 

Ryan: That was Indonesia.

Howard: It was Indonesia?

Ryan: Yeah, it was Indonesia.

Howard: Well, I've done it, I've done it.

Ryan: Yeah, we've done it.

Howard: Yeah, we've done it in several countries, but the one in Indonesia was like $5 US.

Ryan: Oh God, I can't remember. I just know ...

Howard: So I immediately bought so we were all carrying around ...

Harold: Millions and millions.

Howard: Million dollar bills. They were about $5 each, but we're in Africa, what was that one?

Ryan: We were in South Africa like five days before we got there, the currency value was about half and I gave a tip to an Uber driver and I asked the dentist I was with, I was like, "Hey, [inaudible 00:40:13]. And they were like that was probably more than his entire month's wage.

Howard: Yeah, the average tip in Africa and Indonesia was, I mean just our average American tip was a month's wages. We had so many friends. 

Harold: Crazy, I can imagine. 

Howard: We had so many friends. When you come out of your hotel room just to walk out for breakfast and your cab driver was just making sure everything was okay.

Harold: I've had one person,  I bet you I've asked this question.

Howard: So officially I'm a millionaire. 

Harold: I've asked this question I can't tell you how many times hundreds and hundreds probably thousands of times. I've had one person get it right. So the pressure's on you here. So I presented twenty thousand, I produced ten thousand, I collected five thousand, today, today, today. What do those three numbers have to do with each other today? 

Howard: Well, I mean God, if you present twenty and you did ten, I mean that's only a 50% acceptance rate. Well, that's good though 50% half because the United States is thirty-eight, but you only got paid for half. I mean this is the Titanic. 

Harold: Right, but you know what the answer is?

Harold: What? 

Harold: They really have nothing to do with each other today because what I present today I'm probably not going to produce today and what I produce today, I'm probably not going to collect today. So ultimately what I do is I get my offices to get into the mindset that you have to start tracking this starting today and then you have to keep doing it. You never stop doing this because the only way you can track your proper case acceptance rates is by doing it for a long period of time. So, and you've hit the nail on the head I use this number to my teams all the time. I mean 40% or 60% of people are walking out the front door. They're not accepting your treatment plans. Most of my doctors when I ask them that question, what is your acceptance rate? They always say 80%. I can't tell you how many of them say 80%.  I laugh every time I know he's just going to say 80%. This guy is going to say 80% to me, but when we really crack it open and we really start taking a look, 38%, 39%, 40%.

Howard: Yeah, now the number that I give 38%, okay so I lectured in Florida to like a dental insurance convention like three hundred and fifty-nine. Those guys aren't very transparent with their numbers. They'll all show you numbers, but I can't put it in Dentaltown or I can't post it because they'll get fired. What I was keen on the 38% is diagnosed radiographic interproximal cavities versus filled. So I'm not talking about fancy veneers and implants and bleaching, I'm talking about a freaking cavity. They're only doing one [inaudible 00:42:47]. Now, this is what I believe because I've seen so many medical [inaudible 00:42:47] like eight doctors and they're all collecting seven fifty, taking home one seventy-five and then the guy at the end is doing twice that he's doing. Just what is twice of seven fifty.

Harold: One forty-five.

Howard: Times two is one point five and instead of taking home one seventy-four, he'll be taking home three hundred. Same number of charge, same number of staff, same number, everything, but this is what I believe, I believe that one out of three will always get it done because they got a hole in their tooth [inaudible 00:43:25]. One out of three will never get it done because they're batshit crazy. My favorite patients are the ones that when I get there, they're out in their wheelchair with the oxygen tanks and are smoking. And they're the greatest people on earth. I love them, but one out of three they're probably never going to make one smart decision in their life but it's getting that middle one. So one person is never going to do it and they emotionally anchored to that person, that rejection letter, that bad review. God, it's funny how they get a bad review on Yelp ...

Harold: Yeah, they get one bad review and it's ...

Howard: And you're talking them off the ledge.

Harold: Yeah, for sure.

Howard: And by the way, it's not guys like me, by the way, you know what Ryan, I want to change my email. Instead of saying email me just email me That's so funny. Let's set that up, Ryan, hatemail@dentistry Hey, if you're a big fan of the show, shoot me an email at, but no it's not ...

Harold: No, but you're 100% right here I mean ...

Howard: No, but it's not that guys like us don't have feelings or anything we just don't value your opinion.


Harold: Yeah, exactly. 

Howard: I mean when some crazy person says that everything you do is wrong and you're like, well, okay, well it's all working here. If you actually had a hundred patients, you all thought they were going to leave and write you a great Yelp review. I mean, how unrealistic is your expectation. Dude, half your uncles, and aunts wouldn't write you a good review so it's getting that middle one.

Harold: Yeah, you've definitely hit the nail on the head. To take your closing ratio from 30% up to 60% there's your profit.

Howard: A third to two thirds. 

Harold: Yeah. 

Howard: Yeah, oh yeah. So I've always said ...

Harold: I mean, sorry ...

Howard: No, no, no.

Harold: I get excited about some of these things, but I mean intraoral cameras. I don't sell intraoral cameras. I have nothing to do with intraoral cameras, but it's amazing how many offices I walk into and I see the intraoral camera sitting there and I'll be in the office all day and there's not a single one of the team members that have used the intraoral camera once ever in the practice. And I'm sitting there thinking, put fifty inch flat screens in each of your rooms, show the intraoral image up on the screen. I got to tell you, that's powerful, but it's amazing how many just sit there and collect dust. So to me, there's all sorts of pieces of the puzzle.

Howard: Now are you talking about when you're consulting with Proctologist or dentists?

Harold: I'll tell you though it really helps as far as if you show visual tools and there's another little product what do they call it? That little DDS GP little unit. Now that's pretty cool too.

Howard: DDS GP. 

Harold: Yeah. If people go to

Howard: Ryan, will you go to

Harold: Yeah, that's a pretty cool little system.

Howard: Instead of texting your damn girlfriend. Ryan?

Ryan: DDS GP, yeah.

Howard: I think we podcast that guy. Is that the little handheld intraoral camera?

Harold: Yes, no, no, it's like a ...

Howard: Is it an on app on the ...?

Harold: You put it on an iPad and it just shows little snippets you can write on it and it's a pretty cool thing.

Howard: Yeah, it's the animation iPad app yep, yep.

Harold: Yeah and if they use that ...

Howard: Have we podcast him, Ryan?

Ryan: No, I typed in ddsdentistryuncensored and it didn't come up so it must be ...

Howard: Yeah, DDS GP, go to the App store. I think it's about a $300.

Harold: It is, it is. 

Ryan: I sent you a link and then you can go there [inaudible 00:47:01].

Howard: No, Ryan, you go, you go to the App store, Ryan. 

Ryan: [inaudible 00:47:07]

Howard: Okay, here DDS GP.

Harold:, is what it is. 

Howard: And DDS GP, so let's talk about that. The purpose of DDS GP is to assist you on [inaudible 00:47:12] on presenting diagnosis implants to your patients.  As your patient's gain understanding the importance of the treatment recommended case acceptance levels can increase. In twenty years the private practice general dentist, I repeatedly noticed that the degree of case, but it says in twenty years as a private practice general dentists, I have repeatedly noticed that the degree of case acceptance and amount of word of mouth referrals directly proportional and time and my staff, but mostly I spend conversing with the patient. In the past, my staff would show patients a commercially produced video clip of what they needed and then ask, are you ready to make your appointment? When I changed to direct conversation instead the answer to that question was much more often yes. To facilitate this interaction with your patient, I created DDS GP with its size, portability, and excellent battery life. The iPad facilitates the conversation we should be having by bringing us closer to the patient as opposed to looking at a video over there. This is why there is no audio component to the demonstration. You are the audio. DDS GP is presented as a series of drawings, much thought was given to this interface time and demonstration and portray dental problems and solutions without being scary were preferred. So you need not worry about scaring your patient by showing blood, needles or drill. Just below the main demonstration area of each search is a bar with  a round handle called the slider used there at each end. So but the bottom line is, what's the first rule of AA. You have a damn problem. What did Harold start this whole show with? You don't even measure your case acceptance. So you immediately default where I just need new patients or I need to add lasagna to a bankrupt restaurant, so you're not profitable today. Well, adding Invisalign isn't going to help, you're not profitable today. You can't improve your case acceptance if you don't know you have a problem.


Harold: Well, I was in an office in Calgary Monday and Tuesday and their numbers just ... I taught them everything on Monday, not everything, but I taught them some basics. And Tuesday we started to put it into effect and we had taken a look at the schedule in the morning huddle on Tuesday and we were assigning how this was going to work. Well, his numbers were up immediately. By the end of the day his looking at me thinking, my God that worked. That's actually working. Well, I said, of course, it's working. I mean you've stopped sending out predeterminations as far as your insurance is concerned. To me, it's just like, why are you doing that? Get people ...

Howard: I mean they buy a house and a Ford 150 in cash. Then when it comes to insurance, well let's do a [inaudible 00:49:49]. Dude, the max is a thousand. The max is a thousand, why don't you just sit there and say the insurance will pay, they only pay a thousand, but to do everything that you're talking about will be three hundred and sixty a month for thirty-three months. And then you always think they don't have money and that is your self-limiting belief. So the average American is going to buy twelve and a half new cars in their lifetime and you're never going to sell one to one person ever because nobody has any money and that's, what that's me and Harold's fault? That's you, buddy. That's your own self-limiting beliefs. 

Harold: It is.

Howard: There are guys, I know guys in Phoenix that do a twenty-five to $50,000 implant case every week, fifty weeks and I'm not talking about Scottsdale and Paradise Valley. I'm talking about freaking Phoenix by people who drive, well, first of all, I've got to tell you something about these Canadians and things like that. You know when you come down and you're sixty-five years old, you don't want a bass boat, you don't want to go fishing, you don't want to go snow skiing. A lot of them wouldn't even go on a cruise if it was free. It sounds exhausting. They'll say, I don't want to get a freaking Germany and walk around Switzerland, but what do they do three times a day? They eat and they want to go to the iHop or the steakhouse and they're paying $25,000 for All on 4 per arch, $50,000. They're doing it all the time. Harry Green, your Tip-Edge, did he ever tell you the first Ortho patient he did with me?

Harold: No. 

Howard: I don't know if I can say this by [inaudible 00:51:34], but I had this sixty-five-year-old lady. She just retired, I think she's from Kalamazoo, Michigan. She came out there and she retired so she got her pension and she came there and I said to her, I said, "So do you love your teeth? Do you love your smile? She says, "I freaking hate my teeth, I hate my smile. The biggest regret I have in my life ...

Harold: Not taking care of my teeth.

Harold: Is I didn't get braces when I was little and now I'm too old." So I said, "Hmm." And instead of taking courses on the other side of the country where they're not there and you're out of state, I took this course, Harry Green, who lives in Phoenix, Arizona. I get on the phone. I say, "Well, Harry, she's too old." And he says, "Well, how old is she?" And I said, "She's sixty-five. She's just retired and moved here in Kalamazoo." He goes, "Alright, well how about schedule her to come back next Tuesday, 11:00. I just want to come by." So Harry comes by and this is what happens when you learn Endo from the Endodontist across the street, perio from the Periodontist across the street, oral surgery. Harry Green comes over and he tells me, I mean I was just straight out of school, green. He goes, "Howard, this will be an excellent first case." I'm like, "What?" He goes, "I'll walk you through the whole case." He came every damn appointment, but anyway, long story short, this woman had an overbite. She had TMJ. She thought it was ugly. She laughed like this, hated her teeth. Headaches, TMJ, the whole nine yards, and me and Harry did tip edge on her. He walked me through the first case, it changed her whole life.

Harold: Yeah, for sure.

Howard: She thought that was the greatest thing in the world and then you tell me that you don't like to sell dentistry? Then quit and go find something you love to sell. If it's bass boats, don't sit there and stay in dentistry. No one in dentistry wants you if you don't like dentistry and you hate dentistry and you don't like to sell dentistry. I just say, well what do you like to sell? Maybe it's underground, what is the new thing or in cases of nuclear war?

Harold: Bomb shelters?

Howard: Yeah, maybe it's an underground bomb shelter. Maybe it's a bass boat, maybe it's a Ford 150, but you know what you need to do? You need to quit dentistry and go do something you love because when you tell me you don't love dentistry. When you're down at Harry bring up that story to him. There's no way he can forget her because he just loves her. 

Harold: Yeah, okay I will, I will do that.

Howard: She loves him and changed her your whole life. That was my first Ortho case by a woman whose life was changed. She didn't care what it costs.

Harold: Too often we assume and we assume people can't afford it or we let the insurance thing get us down and it's ridiculous. It's just not good business.  

Howard: Yeah, so I'll give some more examples. So the lady I actually bought my house from back in the day had to sell it because an American pharmaceutical company made a drug, she had brain cancer, so Americans were making it, but you know, our good old government they're here to help you. 

Harold: Yeah, absolutely. 

Howard: And you're like, well dude, I'm gonna die and so it's only approved for studies on mice and rats, okay, I'm going to die. Can I sign a waiver and get it? "Oh no, we're here, we're the government we're here to help you." So she had to go to Scandinavia so she had to sell her damn house and go to Scandinavia to get an American drug made in America.


Harold: That's crazy. 

Howard: But anyway, but the bottom line is I know I'm over the years three different patients who sold everything to go save a one-year-old baby in Scandinavia. I mean these people will find the money if they truly want it, need it. If they got to have the money, they're going to find it and I'll tell you what, another thing that dentists confuse is dental health. Dental health isn't that important, it's mental health. She doesn't like her smile. That's all in her mind. You make your teeth whiter, brighter, and [inaudible 00:55:31] and the other thing I always notice with the Americans and the Canadians is you either own a bowling ball and bowl in a league or you don't own a bowling ball and you haven't bowled in five years. You either own your own boat and go to the lake ten weekends of summer or you haven't been to the lake in ten years. Yeah, it's all or none. And when you don't like your teeth, you don't like how they look, they're not straight, they're not white, they're ugly. You don't brush them you don't floss, you don't take care of them, you don't come in. But once you start bleaching, bonding, Invisalign, once I get this little monkey to like his teeth, he'll take care of them. 

Harold: Absolutely, absolutely 100% I totally agree with that. 

Howard: So the more they spend on their teeth, the more they're gonna take care them.

Harold: Yeah, for sure and as you say, you know you hit the nail on the head here with the one, two, three. I mean 30% of them are just never going to get that.

Howard: Well, going for your close. That was a fast hour we ever did. So it's Man, you must've got that domain name early. How did you get dental marketers?

Harold: Yeah, that was probably twenty, twenty-five years ago.


Howard: Yeah, so what does this cost? What does it cost to call you? What's the best way to run there because they all have a unique situation?

Harold: Yeah, for sure and you know what they are all unique. They've all got different team members and different demographics and different personalities and the businesses are geographically different and there's a lot of constance, but there's a lot of differences as well.

Howard: So how much is a consultation? 

Harold: $2,500 and I spend a full day in the office. We do an awful lot of analysis in advance though. We do silent shoppers.

Howard: So $2500, you come spend one day in the office for twenty-five hundred bucks. 

Harold: Correct. 

Howard: Does that include plane fare, hotel? 

Harold: Everything. 

Howard: So twenty-five hundred bucks you're going to fly to my town and you're going to spend a day in my office.

Harold: Exactly.

Howard: And then what? 

Harold: Then if you decide to continue, basically I give you a report at the end of the day. It's done on an excel spreadsheet. It's all chronologically laid out, color coordinated, a lot of detail on it and if they want us to help them out, we'll start helping them with it. If they don't then they can get somebody else to help them with it or work on it themselves. 

Howard: And do they get to choose to pay that twenty-five hundred in US or Canadian or Zimbabwean? 

Harold: That's a really good question, Howard.

Howard: Can I pay you in Indonesian? 

Harold: I prefer not.

Howard: Because we have several million dollars cash in our house.  

Harold: Yes. I know.

Howard: We have several million dollars cash. 

Harold: Each of the boys have at least that much, yeah.

Howard: Every boy has several million dollars in cash in his nightstand by his bed. 

Harold: That's very cool.

Howard: Maybe I shouldn't be saying this on TV or we're going to get robbed.

Harold: No, we charge in US dollars right across the board so everything's standard.

Howard: So is most of your clients Canadian, US, urban, rural, is there any rhyme or reason to who.

Harold: Not really. We have a lot of clients on both sides of the border and I've got clients in Manhattan and clients in the middle of nowhere, Kansas City or Kansas, so I've got a great husband and wife team in Plattsburg and Smithville and western Kansas and ...

Howard: Nice, [inaudible 00:58:41] your three favorite clients.

Harold: Well, they own all three offices and I encouraged them to start buying up some offices there and they're excited about it and a great practice. That's Hildebrand Dental if nobody ever wants to check out We designed their website for them and a number of other things, mailers and logos and everything else. But I mean that's in our typical practice could be anybody. It's rural, cities, Canadians, Americans, startups, practices that have been going for forty, fifty years, so you just never know. But you've hit the nail on the head every situation is a little different, a little unique and so ...

Howard: And some of them are really emotionally tough. Like I don't even know what to say when it's a little girl dentist who went into practice with her older mom dentist and you start hearing this stuff and that's some deep complicated shit. But let's sit on that because when you and I grew up, they always said never mix business with family and now a quarter to a third of them dental schools are filled with kids who got a mom or dad that's a dentist and mom saying you're coming in with me. Yet how many times in a movie have you heard don't mix business and family? 

Harold: Exactly. Well, I am a big fan of not mixing business with family or friends. A good comparison also these kids are now meeting in school and ultimately getting married and they're both dentists and they go off and practice together and very rarely do I see it work. It adds an awful lot of fighting and arguments, etcetera, etcetera.

Howard: But are you finding a lot of problems with those?

Harold: Yeah, I do. My rule of thumb usually is when I meet a husband and wife team that are working together there's one rule. If they don't follow the rule I'm gone, is that when they close the office, they lock the office that day, you stop talking about dentistry. You stop talking about the business. 

Howard: Well, the number one problem with a married couple in the office because most married couples in the office, the woman's a dentist, the husband's the house manager, vice versa whatever, but it's the same reason the three biggest religions on earth are the three monotheistic religions. I mean there's one God and when you start getting into there's two Gods. Like they take what if there is a God of thunder and lightning and they don't have an org chart so when you're a little kid and your mom says, no, you run to your dad. And then when your dad says, no, you run to your mom. You play them against each other and you start off that you do three things, you like to do three things, new patient's, case acceptance and organization, org chart, team deals and the problem with dental offices is there is no org chart and humans are very complex. They're very emotional. So my office manager will say here's the marching orders we're going there and then, of course, the ones who have been there five, ten, twenty years are going to come up to me and I always let them vent and then I say, then I always say the person by their org chart. I'll say, "Well, what did Dawn say? Or what did Laurie say?" And you know what you do, you even do to your hygienist. Your hygienist goes in there and says, "Yeah doctor I think number three is going to need a crown." You look at it and say, "Nah, I think we'll just watch it." What? You just threw her under a bus and then we'll get three other people, follow the org chart. My God, in the military, what is the greatest crime in the Pentagon? To go over your chain of command. These guys have eighteen nuclear-powered submarines where each one has enough missiles and warheads to take out the twenty-five largest cities in America and you're telling me you're not going to follow the org chart. 

Harold: Yeah, exactly. 

Howard: So military if you go above your senior deal ...

Harold: Right, trouble.

Howard: Yeah and he could even go to Leavenworth.

Harold: Well I will tell you on that first-day analysis when I go into the offices, one of the questions and I like to sit with every single team member because they'll tell me things that they certainly won't tell the dentist. But one of the questions I'll ask them is, who do you report to? Who's your boss? Right, and it's amazing how many of them can't give me that answer properly. 

Howard: Oh my God, they got an office manager and then a husband and wife dental office team and they tell me this place, and this is the eye-rolling stuff. He's saying, "Do this, his wife saying do that. The office manager is saying that I don't even freaking listen." 

Harold: It's a mess.

Howard: It's because we're humans. They need an org chart. I don't care if you in the army, navy, air force, marine when you're an infantry you don't give a shit who the joint seats of staffs are. How many people in the army today couldn't even name the joint chiefs of staff because it's not even relative. You know what's relative, is the guy giving my marching orders. In the military, pretty much one guy manages eight and then when they get eight of them guy, then there's another guy so it's basically a one to eight. But Harold we've been friends for thirty years.

Harold: Howard, it's been great. Thank you.

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