Dentistry Uncensored with Howard Farran
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Ask Don't Tell with Sherran Bard : Howard Speaks Podcast #96

Ask Don't Tell with Sherran Bard : Howard Speaks Podcast #96

7/13/2015 12:00:00 AM   |   Comments: 0   |   Views: 455
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AUDIO - Sherran Bard - HSP #96


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Sherran Bard, founder of Dental Practice By Design, explains her humble industry beginnings, why she needed to write her book, and how to ask your patients the right questions!

 

 

 

Sherran Bard was born and raised in Texas. She worked in Dentistry for over 30 years as a Team member and Consultant.

She currently owns Dental Practice by Design, an onsite consulting company based in Texas.

 

 

 

When she began as an assistant, she was told she would basically be a janitor for the dentist and the patient; picking up and cleaning up every mess made. Immediately she began to study how to be much more than a janitor to the dentist and patients. She worked for that dentist for seven years before transitioning to another practice. The dentist there encouraged team training and growth. He was a CE junky. Her and the dentist began to work with a consultant. 

 

 

 

She then learned to talk to the patients and ask what they wanted, rather than telling them. She has since retired from the practice atmosphere and has started teaching practices how to grew to $2M a year, working 10-12 day months and with 4 team members. She integrates a bonus system for the practice, equally sharing a calculated monthly amount to reflect their production and collection averages. 

 

 

 

Sherran explains "It's my time to give back." so she's just released a book titled Successful Conversations, Successful Practices, available here:

 

 

 

https://www.tatepublishing.com/bookstore/book.php?w=978-1-63449-881-4 

 

 

 

 

"We are not destined to take our gifts to the ground with us when we die. We should leave the seeds here for the future and include directions concerning the planting and harvest."

 

 

 

Sherran Strong Bard

 

 

 

WWW.DentalPracticebyDesign.com

 

 

 

Sherran@DentalPracticebyDesign.com

 

 

 

 

979-255-2566 Personal cell





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Howard: Ready, set, go.

It's an honor to be introducing Sherran Bard today, on my podcast.

Is it Sharron? Did I say it right, Sherran? Or ... Cause it's spelled a little different than the normal Sharron, so your mother must have been a creative person.

Sherran: She must have been.

Howard: And you were telling me that your last name, Bard, is English and it means "poet."

Sherran: Yes.

Howard: An acronym for poet.

Sherran: Yes.

Howard: And you are a poet, I'm a big fan of you on social media, I'm a big fan of you. I think what you're doing is amazing and it's basically keeping it real. You started out as a dental assistant.

Sherran: I did.

Howard: And now you've been in this ... Anybody in our industry for three decades ... You've pretty much learned everything and I can't wait for you to transfer your knowledge today.

So basically ... First of all you just finished a new book that will be out in June, 'Successful Conversations, Successful Practices.'

Sherran: Yes.

Howard: And you're legendary for taking average practices up to a million or two millionaire.

So tell us, what is this book? Tell us about the book.

Sherran: The book is ... Here's just a little picture of it, this is one of the copies they've sent me in the beginning. It's not a very hard to read book, and where it began was when I began in dentistry in 1982, Dr. Farran, I was hired by a wonderful thirty five, forty year old dentist and he told me that basically I'd be a janitor. 

And I said "A janitor?"

Because I had been a manager of the company I'd worked for before.

And he said, "No, you'll pick up everything the patient puts down and everything that I put down and clean it up."

So not wanting to be a janitor, I began to try to study and learn things from other people like yourself, people that were in the industry, the different meeting that we went to. Really studied everything I can to try to bring the patient into the practice and not have so much fear. 

Howard: So how come you don't have a Houston, Texas accent?

Sherran: Well I've been told that I do.

Howard: No, I just heard a little piece of it there, it's so funny, I grew up in Kansas and the weirdest thing I thought was the different between a Kansas and a Oklahoma accent happens exactly at the state line and ... You know what I mean? Just exactly. And then my mom's brother moved to Texas and he had seven kids, and the two kids under five instantly spoke Texan, and the other seven didn't. So I thought it was very interesting to me how the age really affect your accent.

So basically, being around thirty years, what do you think is the difference between the offices that are just getting by and struggling day to day, versus the ones crushing it?

Sherran: Conversations. 

Howard: And you think that's more important than technology, or whether or not you have a laser.

Sherran: As important, it's as important because we make our relationships with the people we're going to trust our lives with, whether it be a surgeon, our dentist, or our hairdresser, and those are the kind of people we want to know that care about us. We want to talk to those people, though usually the dental assistant, the front desk person, the treatment coordinator, they are the ones who usually build a relationship initially, but it's very important to transfer that relationship to then the dentist. So that the dentist also doesn't walk in and ask the same questions. 

If you've ever been in a doctor's office, most dental offices, they ask all the same questions on the phone that they do with the interview, that the dentist asks when he walks in the door. So you've repeated it three times by the time you get to the big guy, and that's not necessary. 

It's important that your patients know that you listen and that you answer their questions that they actually came for. 

And I really enjoy the podcast, I need to say this about Jason [inaudible 00:03:54]'s podcast, what he does is something we teach as well. Because showing a patient their teeth and giving them some kind of opportunity to have an opinion about what they want, not just what they need, I have found in my training that they will almost always choose more than we tell them that they need. It's true.

I've done it before, I've dressed like I'm dressed now and I go to an office and I have actually walked in an office, set down, met a patient that doesn't know me, that thinks I work there, it's a new patient, and sold and collected twelve thousand dollars. The front desk person had not been trained, and she said "The guy doesn't have any money, so no need to talk to him about that."

And I asked the doctor's permission to have the patient come in with me, and we collected the money that day. Twelve thousand dollars, in cash.

Howard: I know you're a proper, southern Texas woman, I don't mean to offend you, but that's how the word assume came about. Assume means you're making an ass out of you and me.

And to look at someone when they walk in the dental office ... And especially for me, because I'm from Kansas and all the eighty year old multi-millionaires I knew, they all drove thirty year old Pontiacs, they all had slacks on. 

I asked a lot of the older men ... They wouldn't wear blue jeans because back during the depression a blue jean was an unemployed laborer, and if you ever ... If your ranch or your farm was ... You know, if you ever made it big you wouldn't wear a blue jean. 

And you would have never guessed any of these guys had a dime, and they had more cash than anybody. In fact, only ten percent of cars and homes are sold in cash, and that's basically the over sixty five market.

So, you know, we all know this in sports teams, that all you gotta do in the NFL is to get the best damn quarterback ... I'm out here in Phoenix, Arizona were we had the awesome quarter back, went eleven and oh, he got injured and then we ... It was over.

These dentists still will invest a hundred and fifty thousand dollars in a 3D x-ray machine, CBCT, or a hundred fifty thousand dollars CEREC machine, and they just skimp at the front desk, the assistant. They almost look at them like they're just unnecessary people that they'd love to ... They'd love to buy a hundred and fifty thousand dollar R2D2 droid to replace their receptionist. 

I mean, they just don't get it that it's the relation, and I've always said that ... Every consultant tells me that when you walk into an office you can instantly tell if it's a million dollar practice. You just feel the energy, feel the karma, feel the conversations, and then all the other struggling dental offices it's like some kind of weird library 

[inaudible 00:06:36]

And the lady up front's a librarian, technician with a ... Hiding behind a sliding door and asks you to fill out a chart, and I mean it's just like ... So what do you do? So you're a consultant, you're an in office consultant, what do you ... First of all tell us this, because when my podcast ... You know, these dentists are driving down the road, they're all alone, so as a podcast interview I'm trying to guess what this dentist driving down to work is thinking. Most of them have an hour commute, whether it's in rural America or driving across the big city.

Who is a candidate for a consulting like you? What problems is this dentist having in his stomach, or her stomach, or her gut? What kind of problems are they having in their gut that you're a solution for? What ...

Sherran: Well the first thing that I usually hear is "I can't pay my payroll this month."

Howard: So financial.

Sherran: Financial, and I print a treatments diagnosis report from their computer, depending on the software. We find that they're not not diagnosing, it's just not getting closed.

Howard: Okay, so you ... Well first of all, what practice softwares ... That's the big question on dentistry, on Dentaltown ... What practice management information softwares do you work with, and which ones do you like more than others?

Sherran: I work with Dentrix, Eaglesoft, work with SoftDent.

Howard: Really?

Sherran: Yes, the one that I worked on initially was Dentrix, and I love Dentrix, it's very user-friendly, but I also ... My daughter is my associate, she goes with me, she has seventeen years banking experience, and she likes Eaglesoft.

Howard: Okay, and what ... Okay, and Dentrix is owned by Henry Schein, Eaglesoft's owned by Patterson, and SoftDent is owned by Carestream?

Sherran: Yes.

Howard: And what do you think of SoftDent?

Sherran: I think SoftDent's a little difficult, and most offices that have it have a harder transition hiring a front desk person. Because I think Patterson and Henry Schein have infiltrated the field of software, which is a good thing.

Howard: Yeah.

Sherran: I don't think it's a bad thing.

I think that all systems needed to change to be able to facilitate the treatment and the communication things we have for patients these days.

Howard: But, for me to be all fair, on the message boards it seems like the software that has the most raving fans is Open Dental. Have you noticed that on the message boards?

Sherran: I have.

Howard: Have you worked with Open Dental?

Sherran: I have not.

Howard: It's a small one. Okay.

So this dentist driving to work could call you and the first thing you would do is ... Would you dial in to their computer and print out the diagnose treatment or how whould that work?

Sherran: The very first thing I do is send an office interview that I ask the team to fill out individually, and they send that back to me. One of the key questions ...

Howard: This is a written, or typed, or e-mail, or?

Sherran: It's typed, and I e-mail it because I have it on a Word document, and I e-mail it to the practice, they make copies ... I can fax it to them if they prefer ... And they make copies. Each team member fills it out prior to my visit and I get it back and I look and see what each team member really thinks about their doctor, their practice, and their changes.

Howard: How many questions is it?

Sherran: Ten.

Howard: Ten, do you know them off the top of your head?

Sherran: Not off the top of my head all of them, I will tell you the key question I ask "Are you going to retire from this practice?"

Well, one thing is are you going to be in the practice, how long have you been in the position you're in, do you plan on retiring. One of the most telling questions is "If this was your practice what would you change first?"

And they'll tell you everything.

Howard: And that's the assistant, the receptionist, the ... By the way what do you call ... I've noticed that you can call a dental assistant a dental assistant, a hygienist a hygienist,  a dentist a dentist, but man it's an emotional subject calling someone a ... I'm afraid to even type on Dentaltown front desk, or receptionist ... I will say receptionist.

Sherran: Yes.

Howard: I mean ... What do you call them?

Sherran: Treatment coordinator. 

Howard: But what if you're not the treatment coordinator? What if you're the insurance coordinator? Or what if you're the scheduling [crosstalk 00:10:32]

Sherran: Insurance coordinators in my office, and let me tell you another question that I ask.

Howard: Is there a generic term, though, that just refers to everybody working non-clinical up front?

Sherran: Yeah, the team, it's part of the team.

I like for them to feel like a NASCAR team, in that everybody is available to do any position other than clean teeth and/or throw enamel dust off the ceiling. 

You can't be the dentist, and you can't clean teeth unless you're licensed to do that, but when I physically left my practice after twenty years our hygienist went to the front desk. She fit in perfectly, she's still there after ten years, she's very happy, and what better person to answer your phone than a hygienist that's already been there?

Howard: So it is true, one of the consultant's biggest secrets is they come in and they interview each one of the staff members, and they usually tell you everything that they think is wrong with the practice and basically it's usually a function of the dentist doesn't listen to their staff.

They're not humble, they don't ... Dentists, physicians, and lawyers aren't humble, and the humble ones are the most successful. They listen to their customers, their patients, their staff. So basically this dentist is going to pay ... What is your fee to do consulting?

Sherran: My fee to do consulting is three thousand a month.

Howard: Okay, three thousand a month ... And do they sign up for a year plan?

Sherran: Do not.

Howard: Okay, so it's just no contract, just three thousand per month?

Sherran: The reason is I think the only one ... I've worked for two different consultants in my lifetime, and I think that contracts are made for attorneys to break or take to court. If my integrity doesn't supply the need of the doctor and the things that we're doing ... Because I've had some clients four years, and I've had some clients up to twelve months, it depend on the level that they have when we go in. But I'm not going to argue a contract with someone if they think they're doing fine and they're ready to part as friends, we're fine. [crosstalk 00:12:20]

Howard: Three thousand a month, straight up.

I like that, I like that a lot.

So you're ... First question you said "Are you going to retire at this practice?" "How long have you been there?"

So "How long have you been there?" Do you see practices suffering more likely have staff that hasn't been there very long, with a high staff turnover, or ... Talk about that.

Sherran: Both, we have staff that has been there for longevity, say ten years or more. Sometimes that's not always a positive thing because a really strong team member that manages, the other team members say "This is the first person I would want to get rid of if it was my practice."

And they'll tell you why, they're just looking for somebody to really talk to. I tend to be the mother of the practice sometimes. I was in the DFW flying to an office in Oklahoma a couple years ago, and a lady ... You know how you talk to people in the airport? One of the ladies in the airport she asked me, she said "How many children do you have?"

And I said, "Eighty."

She said, "Eighty kids?"

And I said, "Yeah, all of my team members are my children."

Because they'll call me in the afternoons, they'll call me, they'll e-mail me, they'll send me messages to ask questions, and I try to be available for those unless I'm in another practice.

They need someone to really vent with that. An office manager there's ... I don't like the position of an office manager, because she's a person with authority that can either fire them, get them fired, or give them a raise or not, and I prefer everybody work as a team, and work decisions out as a team.

Howard: So you don't like the office manager concept?

Sherran: I do not.

Howard: That is very, very interesting.

So back to staff turnover, so what do you think is a healthy ... If I just gave you a hypothetical practice that was average how many team members would be, in just the average fiftieth percentile middle of the road practice, how long would the average team member have been there?

That way this individual driving right now, listening to you on a podcast can know if he has high staff turnover or not. 

Sherran: In my practice everyone now has been there ten years or more, I'll still call it my practice because I help my doctor build it. So they've been there ten years or more, and there's four of them. 

Howard: Okay and what do you think the average [crosstalk 00:14:28]

Okay so your practice, the average person has been there ten years or more, and there's four people and a dentist. So that'd be what? One receptionist, one hygienist, two assistants, and a dentist?

Sherran: One assistant, one hygienist which is also the front desk, and two hygienists.

Howard: Okay, and [crosstalk 00:14:46]

Sherran: All trained [inaudible 00:14:47]

Howard: And what do you think the average turnover is for the average practice in America? How long do you think the average employee in a dental office has been there?

Sherran: Right now, about five to seven years for the assistant and/or receptionist, and a little bit more for the hygienist because most hygienists are able to ... You know, they're pretty much in a little closed area, it's almost like their own little business, like a hairdresser, and they have such strong relationships that the doctor will usually keep anybody there as long as they can because a hygienist is really a good partner for the practice. I mean, I think that they're very good producers, I think well trained that they can equal or make as much money or more than the doctor does in production. I've had smaller practices do that, and I have hygienist making two thousand, twenty five hundred dollars a day each. 

Howard: Their gross or you talking about what the hygienist makes?

Sherran: They hygienist producing each.

Howard: Producing two thousand to how much?

Sherran: Twenty five hundred.

Howard: Two thousand to twenty five hundred. That's amazing.

What do you say the average hygienist produces a day in America?

Sherran: A thousand dollars, maybe. 

Howard: Yeah, a thousand. I agree. 

I also want to point out another red flag we've seen when you go into an office where one staff member's been there twenty years and no one else stays there more than two, and the doctor just thinks that they can't live without that person, and that's the person running off all the staff, and that's your biggest nightmare, and it's always doctor's favorite. It's like okay, so your best friend in the office is the crazy one running off all the other staff members.

So you don't like the office manager, because you like to think of them as a team.

Go back to your questions though. First question was "Are you going to retire here?" 

Because you want them to say yes, you want them to be ... 

Sherran: I want them to say yes, and that tells me if they're willing to learn or willing to change.

Howard: Okay, so if I wanted retire here I gotta be willing to learn and I gotta be willing to change.

And then what was the next question "What would you change about this practice?"

Sherran: If it were your practice, if you owned this practice what would you change?

Howard: And what do you usually hear?

Sherran: Oh my gosh.

Ninety percent of the time it's the front desk.

Howard: You're hearing from the front desk or you're hearing problems [crosstalk 00:16:51] about the front desk?

Sherran: I'm hearing from the team they want to change the front desk, or the office manager. The doctor's daughter or daughter-in-law is that person sometimes, and they want to change that position to someone new. 

That's the first thing they do is hire a new receptionist.

Howard: So let's talk about nepotism though, because it really didn't work in government when the kings children ran over when they died, you know?

America's based on a meritocracy, but dentistry still family business.

So I'm going to ask, you the four thousand pound elephant in the room is doctor's wife, is that work in ... Doctor's spouse work in the office with them. The dentist is doing the dentistry and their spouse is running the business, is that usually good or bad?

Sherran: Usually it's not good.

Howard: And why is it usually not good?

Sherran: Because they won't talk to the, really they won't talk to the wife for fear of having the wife tell the "dad" of the practice, because you guys are the dad, something that they said, and they don't have anyone to vent to, they're afraid they're going to be overheard. Many times the wife will go home and talk to the husband about it, now they're both not happy.

I want your wife to either be at home or in a different business. I want you to compliment each other's careers, not interfere. And I feel that ... And I have seen practices where the spouses work well together, but that's maybe one in three. 

Howard: One in three, and what do you think the ones that work well together ... Because the one thing I ... But anyway, what do you think the one in three that work well together, what do you think they're doing differently, that the two in three working together are not doing well?

Sherran: In our office my doctor's wife came in two days a week, she went through QuickBooks, she paid all the bills, and if we had any reservations to make to go to meetings she took care of that. She was always gracious and kind, if there was any shopping ... We did not make her go to grocery stores, she was not our maid. So if there were things that we just needed to do that she took care of, like helping us choose uniforms, helping us choose a photographer to help take pictures for the website, things like that. She was just very graceful in that position. After she finished the bills she didn't stay eight to five, one day she may be there two hours the next day she may stay all day, but rarely was she there a full day.

Howard: Yeah, and I want to tell doctors ... A lot of doctors bring in their spouse because they think that's going to prevent embezzlement. You know, might as well have someone on your own team, your loving spouse, but a huge embezzler is always the spouse who's planning on divorcing you. I can't tell you how many dentists, by time their wife finally filed or they finally decided to pull the plug, there was six digits of money already moved out. Some of them are so damn smart they've moved it to Sydney, they've moved it out of the country.

I know a dentist who's wife hated him so much that she stayed married to him for about five years longer and said it was because she was sending five to six to seven thousand a month to an offshore bank account.

Sherran: She had to make sure she was secure.

Howard: Oh my god, and then when she got divorced she still got half of everything.

And it was just ... I mean, can of worms.

But anyway, okay so what other questions are you asking on your consulting form?

Sherran: Well I'm asking the team members "Is there a specific thing you're doing that's not working?"

This is what I find, and I know you know this. You've been here about as long as I have probably, because you're about as old as I am.

But you've been here long enough to know that if you have someone quit or retire or a death in the family and military wives, or whatever, and someone moves away quickly most ... And I take Dave Ramsey, I'm a big Dave Ramsey fan ... So most people walk in the door with a breath, that has two hands that both function, they will be your assistant, your front desk, you can't hire them as a hygienist unless they are a hygienist. But they hire too quickly and train too slowly.

That's one of the things too, is someone ... "Well we hired Mary from Dr. So-and-so's office and she's bringing all her systems here, and that's not how we do things." 

And now you have a really big team confusion about who does what where, there's not any specific, what I call "who feeds the dog." Because if the person who leaves is the one who did the ordering, or the person who leaves is the one who followed up on treatment plans, or the person who leaves is the one who helped with [inaudible 00:21:03] and they leave who's going to feed the dog? If somebody doesn't feed the dog, the dog's going to starve. And usually the new girl's not the one that feeds the dog.

So the systems that happen, we just hire people that walk in because we're a very, usually a very tightly knit practice, that we're trying to keep our overhead low and our production high, and we can't afford to be without someone a month or two. We are very guilty of just hiring the wrong person too quickly.

Howard: Well I love the axiom "hire slow, fire fast" and ... You know, again, back to sports, I mean these sports teams have half a dozen people who all they do is scout every kid in college.

Sherran: Yes.

Howard: And when they're looking for a quarterback they know a hundred percent list of every single quarterback that even could do the job, and they everything about this person ... And dentists just hire people off the street.

Sherran: They do.

Howard: And then you're saying they hire fast and train slow. I would say the last three hires I've had I'd say the average interview is thirty five people.

And when you're ... You know, I'm fifty two, and when I was twenty four you wouldn't have done that. You know, someone would have came in, you would have had fun with them and you liked each other and you hired them.

And it's like, oh my god. 

So yeah, so let's go there. I don't want to deviate off on the wrong track, but what advice would you give to these young kids who've only been out of school ten years or less, HR for an interview. How do they ... What advice could you give them on how to decide amongst seven candidates for dental assistant, or receptionist, or hygienist who you would hire?

Sherran: I know that it costs a lot of money, and sometimes it costs your time, but I think it's very important to do a background check. Really, really important to do a background check.

Howard: And by background check you mean a friend request on Facebook?

Sherran: No, but you can look at their Facebook, sometimes they're pretty telling. 

Howard: Oh my gosh, yeah.

Sherran: Very telling, we've seen everything from a pole dancer to things I don't want to talk about, and so they really do need to be checked out as far as that. I think that you should call at least two of their referrals. 

Let's say that someone applies in someone's office and said, "Well we worked for Howard Farran."

"Oh my gosh, you worked for Howard, we you must have been a really good ..." blah, blah, blah.

And they won't do a background check, and I've seen people make big mistakes more times than once not calling references.

Howard: So you recommend calling at least two references ...

Sherran: Yes.

Howard: And doing a background check.

And I want to tell the young kids, you know, the thirty and under crowd, the difference between our generation is back when I got out of school at twenty four, divorces were all fault divorces. So all the private detectives were trying to catch you with your girlfriend or something like that, and all these states got sick of all the gossip and crap so they started going to no-fault divorce saying "We don't care, the drama. You two want to get divorced it's no-fault, we don't care about why. You're just getting divorced."

And that basically unemployed all the work of the private detectives, so they all reinvented themselves and went into the background business check. I talk to embezzling consultants in dentistry, and they say this dentist hired a receptionist who was arrested for this in Florida, and five years before that she's arrested in Kentucky, and how do you hire someone who's been arrested twice and gone to jail once for embezzling? 

Sherran: We did it.

We did ...

Howard: Tell that story.

Sherran: We hired a front desk person who'd been a patient for two years, she was the ... Actually the receptionist for the attorney for the office, but she was wanting to leave because of the hours and we would only work ten days a month. She really wanted that flexibility, she had a teenage son. 

She came to work for us, we trusted her explicitly, she could type faster than anybody I've ever seen in my life. We swore she was going to burn up all our computers. She was wonderful, she was very, very pretty. She was wonderful with the patients.

I was a professional fisherman at the time as well as working in the office, and I had gone to the bank across the street and cashed a check for two hundred dollars, and when I came back I just set my purse where everybody sets their purses on a counter, doctors included. When I got to the gas station that afternoon to purchase my fuel before I left I was forty dollars short, so I called the bank and said one of your tellers is going to be off this afternoon because they should have forty dollars of my money, and they called me the next week and said no that wasn't it. So I told my doctor that I was missing forty dollars.

Well he had been traveling quite a bit, he teaches out at LVI, his wallet had been laying there the whole time and there was money missing out of his wallet, but he'd thought he'd gambled more, or he'd paid tips more at the restaurants or in the cabs or whatever. Called her up on a Sunday and she admitted that she had embezzled from the office, and taken money out of our purses that we weren't even aware.

Howard: Did this doctor that teaches at LVI, you still work in that practice?

Sherran: I was in that at that time, I worked for him for twenty years.

Howard: Wow, does he still teach at LVI?

Sherran: [inaudible 00:26:22]

Howard: How's LVI going?

Sherran: As far as I know, good. 

Howard: Really, it's all doing good?

Sherran: Yeah.

Howard: Because I know that was a big ... The cosmetic revolution was like eighty to two thousand, but it seemed like when the first NASDAQ bubble, internet economy popped so did a lot of the cosmetic industry and the [crosstalk 00:26:40] cosmetic stuff. 

Sherran: ... of the structure. Used to, I think you could go out and sign up for any class, and now they have structures where you have to take all seven cores. You can't ... You can retake one, but you can't take it out of order. So they've kind of had a test, they didn't used to have a test, but you now have to take a test, a written test, before you pass and get your fellowship and whatever.

So they've changed some things, but I've not been out there in ten years, so I can't say everything they've changed.

Howard: Okay, what other questions are you asking?

Sherran: One of the things that we have to be very careful about, and I'm sure you know why, is "Tell us about your family," and I usually say "Tell us about your family," not "Are you married?" 

Because you're not supposed to be able to ask "Are you married?"

And I'll just say "Tell us about your family," you know, do they live here, ask them about their children, what schools. It's more on a relationship conversation, do your kids go to the same school mine do, do they need a college, do they need a sports event, do they need a new coach, and we talk about that in the interview with the employee to find out ... And you can find out some really weird things by asking that question; "Tell us about your family."

Howard: So you hire ... You do a background check, now is this an online service, do you actually know a person, or a firm, or agency, how do you specifically do that?

Sherran: Yes, you hire a firm, and there's different firms locally in all communities, and there's national firms. They basically will give you a background check as far as do they have DWIs, have they ever been in jail, are they a felon, things like that. 

Howard: And do you use one nationally or do you use a local one in Houston?

Sherran: Different people use different ones, we had one in Houston.

Howard: So you just recommend they go to Google and search background check online, and how much does something like that usually cost?

Sherran: Well it can cost by the year if you're going to do it by the year, if somebody doesn't have very high turnover they can pay individually.

Howard: Do you know what the ballpark for individual [crosstalk 00:28:32] or year?

Sherran: ... for me to know that. I really don't know how much it would be now.

Howard: Okay.

So this dentist driving to work wanting to know ... What other questions is on this ten question ...

Sherran: I want to know what their accounts receivable is, I want to know what their production is. Obviously those are the numbers of the practice. I want to know is there anything specific that they want to learn, I want to know if they read books.

You know, ninety nine point nine percent of your team members never read a book. Many of the dentists don't either.

Howard: Which, I want to say to you about your book, because your new book is going to be out in June, right?

Sherran: Yes.

Howard: 'Successful Conversations, Successful Practices'

I'll tell you what, you know, I've read a thousand books, my library's full of books, but that's a rare behavior. I think books are coming back now because of the ... When the computer jumped into the phone ...

Sherran: Yes.

Howard: ... And made it a smart phone and they came out with audio books. 

It's very hard for a monkey to sit in a chair and read black and white, but to put in a audio book while you're cleaning the house, and cleaning out your garage, and washing your car, and on the treadmill. They love it. 

And Dentaltown is launching, on our Dentaltown app, which has now over fifty thousand downloads, we're launching an audio book feature in about a month. So if that's something ... You want to grace our audio book ... If you want to read that in a sound booth and do your audio book. Whether you charge for that or whatever.

Yeah, thank you. [inaudible 00:30:03]

That might be ... That'd be amazing.

But I want to go back to your question, when you said ... When I said this dentist driving to work, what is the big red flag that means it's time to call you and get some help, and you said basically it was financial, they're not going to make payroll. You said that they're producing the dentistry, they're not closing. So I want to focus in on that. 

What is a healthy ... I mean how many dollars of dentistry need to be treatment planned for one dollar to produce. I mean, should they be producing closing one dollar out of every one, one dollar out of every two, three, four, five. What's healthy, what's not?

Sherran: It depends on goals, and that's the first thing we do when we come live to an office, we set goals for the practice. I go back to last year's production and I raise their production by twenty five percent, that's just an average rule of thumb. A goal is something to shoot at, it's like a target. It's not a hire or fire number, but we want to shoot at that target. We set their goals first, and then we really try to help them reach those goals. We tell the doctor if your goal is ten thousand a day, you've got to diagnose twenty.

Howard: So two to one? Two to one.

Sherran: Two to one, and fifty percent of the treatment that's diagnosed needs to be scheduled.

Howard: Okay, so if you want to do a dollars worth of dentistry you're going to have to diagnose two to schedule one, and if you schedule it you've got to collect it.

Sherran: And schedule with financial arrangements guaranteed. Which can be pre-payment, which we recommend, or you know which ever ... They're going to do Care Credit, whatever funding that they're going to use is fine, but that needs to be guaranteed prior to scheduling the appointment.

Howard: And Sherran, what is ... A lot of dentists are thinking, "Well my practice is bad and I don't need Sherran because it's not me it's my economy, it's Obama, it's ... They closed down the factory, they did ..."

How much of doctor success and failure do you think is exogenous factors like their local economy, versus endogenous factors, how they're running their business?

Sherran: I think it's how they're running their business almost a hundred percent, because if they're aware of it they know what to do about it. 

You know, I have a doctor right now that's seventy four years old, he's still working. Has his practice for sale, he only hired me locally because I've known him for twenty years, to come in, help him build his production up. He was back around four hundred thousand, and he's going to end this year at seven hundred thousand.

Howard: And he's seventy how old?

Sherran: Seventy four.

Howard: Yeah man, I love that because you know, basically your retirement pension is only going to be ... For every fifty thousand dollars you're going to need a million saving count. I can't believe these dentists try to retire on a fixed income deal when if they just kept ... How many hours a week does this guy work?

Sherran: He's working four days a week, from eight to five.

Howard: Four days, eight to five, and how old?

Sherran: Seventy four.

Howard: Seventy four, I mean why can't every dentist who's seventy at least work Monday and Wednesday, eight to four.

How much do you think this dentist is going to make at seventy four this year?

[crosstalk 00:33:15] Yeah, how much do you think he's going to net? How much do you think he's going to take home?

Sherran: He's going to net about three hundred thousand.

Howard: Okay, so three hundred thousand divided by point oh five percent, which if he had all his money in bonds, that's ... He'd have to have six million dollars in his retirement fund ... And everything we know about this is that since he's still working he still has cash flow, it adds to their longevity, it'll add to their health, it adds to everything. It just really, really ... I think it's a red dangerous flag when you see these dentists posting on Dentaltown "How can I retire by fifty?"

It's like, "Well that's a dysfunctional thought. Why do you want to retire by fifty?"

I mean, these are humans, they have broken teeth, they're in pain, they have disease, you're a trained doctor, you're a social animal, you should want to go to your office and help fellow humans get out of disease and pain and discomfort and make them happy. Why do you want to quit that?

So why don't you just fix what's wrong in your office, you know like ... My favorite is the dentist down the street from me, he said he would rather be taken in the backyard and beat with a stick than do a root canal.

I'm like, "Dude they're called endodontists. Quit doing root canals."

Sherran: Stop doing them.

Howard: Yeah, make your environment happy so that when you're seventy four you can still earn the income of what it would cost you to have six million dollars in your savings deal. 

I want to ask you another [inaudible 00:34:40] Why do you always say that it begins with the first call?

Sherran: It begins with the first call, you can spend as much as you want to spend on marketing. 

And believe me, before I visit an office I look up their website and look all through their website so that I know the receptionist's first name, I know some of the hygienists' first names ... I want to know who's answering the phone, and I'll do random calls to the office, and probably six out of ten I would never send my family to. 

Howard: And why is that?

Sherran: Because of the way the phone is answered, the questions that are asked and not asked, and the person either puts you on hold and you stay there until fall off or hang up, and you're just not the most important person in the room that day.

Howard: So what advice would you ... I love it when dentists come over to my practice from up the street, you know? They're literally a block away, or a mile away, or they're in town or whatever. And I say "Hey, let's ... I'll put my phone on speaker phone I'm going to call your office."

And every single time I call the office "Hi, my name's Frank and I just moved here from Kansas and my dentist told me I needed four crowns, and I just wondered do you do crowns?"

"Yes we do."

"All righty then, thank you very much, you have a nice day."

And they go, "Okay, you have a nice day."

And they hang up, and I'm like ... God, they didn't even ask for my name, no phone number, and fifty percent of the time it goes to voice mail and the doctor's sitting there saying, "Why is it a voice mail? They don't go out to lunch for another hour, why is it going to voice mail?"

And I'm like, "Well dude it's Monday through Friday eight to five and I just called your office and I went to voice mail, and you want to go do more marketing. I mean you're not even answering ..." [crosstalk 00:36:23]

Sherran: Usually the dentist is the last to know. It's like the husband is the last to know when a divorce or whatever is going to happen. The dentist is the last to know, and most patients won't tell. They used to not tell, most patients, but you look at the reviews online these days, people are blowing up the internet with reviews that say that. But ninety percent of the dentists that I talk to who have a bad review don't know they have a bad review, they never even look at it.

Howard: Right, and do you think reviews are important?

Sherran: You have a website, you're going to pay for marketing, who's going to follow up on that?

Howard: So what do you do when a dentist hires you for three thousand dollars a month and you go to their website and they've got ... How many reviews does the average dentist website have, and how many of them are good or bad, and what do you do with the bad ones?

Sherran: Well there's two things you can do with the bad ones, you can ask that it be removed if it's bad bad, they won't remove it, but you ask all your current patients you know, "If you had a good experience ..." There's Demandforce, there's Solutionreach, a lot of different companies out there that will take reviews for you and you can post those on there, you can ask your patients. It's not good to do it in the office we found, because the IP address is the same, and they need to do it from their personal phone, we want them to check-in on Facebook when they get to the office, say something nice about the office or us giving them a cup of coffee, or a bottle of water. Those are the things that really help the reviews fall off, but they literally have to fall off the bottom. 

Most of the offices that I go in the very first time I've already spoken [crosstalk 00:37:50]

Howard: What do you mean fall off the bottom? 

They have so many reviews the bad ones fall off the bottom?

Sherran: People won't go down that far and read it.

Howard: Yeah, is there a bottom? I mean, does Google review hold every review or just like ...

Sherran: I don't think they hold every review, because they've told us if you get five ... Because I've called for different doctors ... If you get five then the rest of them, they won't show because most people won't read anything that's not on the front page. 

Howard: Interesting, interesting.

So you're saying ... So how important is online reviews, would you say?

Sherran: Very important.

Howard: Yeah, and what percent of new patients do you think read online reviews?

Sherran: More now than don't, if they're over sixty years old most people won't, but the baby boomer generation, or ... We're huge really on reviews right now because of travel, timing, who's going to drive us, where are we going to go, when are we going to get there. You don't want to have that bad experience, especially if new people move into their children's communities. You know, moving closer to the kids and stuff, or moving back where the kids are. They want to look at that, and I'll tell you at my age I look at a review for every hotel, every restaurant, every doctor I've ever been to.

Howard: That's interesting.

I'm fifty two, I'm not into reviews, but I noticed more and more people are talking about them all the time, and now I'm noticing that if you're ever with four, five people and you're talking about a restaurant two of them, or three of them are reading the reviews in the car. I'm totally aware of that.

I'm going to get back to specifics, I want to hold your feet down to the fire. This dentist is listening to you right now and he's saying, "Okay, this is great, she pays three thousand dollars a month, I don't have a contract. The red flag was I'm having a hard time paying my bills." 

And then you said the problem is they're diagnosing the dentistry but they're not closing it.

So I call you, so what are you going to do? I mean, what would your first step be? 

You're going to send an e-mail to my staff, and so my four staff get this and back, and then is the next date a phone call with you, a Skype on GoMeeting, or do you want to meet me in the flesh and you want to fly down and see the office? What would you do next?

Sherran: I'd like to come to the office, I do like to come to the office, but it's like coming to Phoenix, I'd love to come to your office. I'd like to see the atmosphere because some people say, and I've heard many consultants say, "Doesn't make any difference, it's four walls with dental people."

That's not always true. I really disagree with that term. I've heard that said in many meetings and I disagree with it. 

And I think the atmosphere of the patients, the atmosphere of the community that they're in, the traffic area, a lot of things really affect that first patient, new patient visits, and I sometimes just want to sit and watch that. 

I'll come and observe for half a day, not to sit there and coach, it's like "Don't answer the phone like that," "You shouldn't have said this, you shouldn't have said that."

I don't come and critique, I just come and listen and then I send an e-mail report to the doctor of the things that usually I have seen, or found, or discovered, and that's when I look at the reports.

Howard: So how are ... But again specifically, so he's diagnosing three dollars and a dollar isn't getting scheduled and collected, and he's having a hard time paying his bills. So it's a financial red flag, how do you attack that?

I mean what do you start with? I mean, do you start that big problem with critiquing how to answer the phone, or is there, or ... 

Sherran: I do listen to the phone.

Howard: What's the difference ... I guess I should say this, what's the difference between the acute emergency consulting that you do to get this person paying his bills and not going bankrupt, versus the long term chronic problems?

Sherran: The first thing we do [inaudible 00:41:31] the invitation to the office.

You know, for instance when we starting placing implants we no longer just accepted a patient in the office because they had a tooth that they wanted pulled. One of the questions we would ask is "Have you thought about how you're going to replace that tooth?"

So we listened to the follow-up, there's not enough ... The fortune is in the follow-up. They don't complete the conversation, they give you a yes or no answer.

"Yes, we do pull teeth."

And don't say anything else, they don't usually even ask for the appointment.

So we want to make sure that the patients are being invited properly, that it's being scheduled into production. That you're not famine or feast on your schedule to drive the doctor crazy. That there are very skilled financial arrangements, that the patient knows what the cost is, and that they know what their appointment recommendations are going to be. How long they're going to be there. What the cost is for the appointment. Is there a follow-up appointment. 

We want them to know that, and many times patients don't know that, and that causes a no show for the next appointment sometimes. Or if the patient comes in for a treatment plan, and then they're going to go home and talk to their husband. You know, how many times have you heard that? "I need to go ask my husband."

"Well what kind of things do you think your husband might ask you? Because we can help you with that."

"We can help you with the answers, or ask him to please come in. We'll answer the questions for him."

So one of the things ... The most important thing is the phone call, the second thing is are you really inviting the patient to the office, the other thing we do is look at their accounts receivable and how much treatment diagnosis they've had in the last eighteen months. Because if you diagnosed it five years ago, it had either gone away or it's changed, or something's happened there.

And really, the front desk ... Almost always a front desk person, I keep saying front desk because I called myself that. That the receptionist almost always doesn't have a lot of time to do follow-up treatment because they're dealing with people coming in and out. That means they need to be cross trained.

Our hygienist even today, I was in their office yesterday just to stop in and say hello, and those hygienists check their own patients out. 

No need to bother the front desk person, if she's on the phone, if she's talking to insurance. I don't like for her to spend a lot of time calling insurance companies either. One of the things I'll do with them is I'll say, "When is the last check you received from the insurance company?"

"Well the mail ran down an hour ago, I got about fifty of them here, I just haven't had time put them in."

And I'll say, "No, when's the last check you've got from the insurance company?"

"You mean personally? I've never gotten one."

"Well you're working as an insurance secretary, so how long do you want to do that?"

And you can look on people's websites, I did just yesterday. There was a guy who has a person hired, I don't know what he's paying her, but he's not paying her twenty thousand a year, and she was listed as the insurance secretary and he's paying her. So to me that just doesn't make a lot of sense.

So we try to get as much paid up front as we can, or guaranteed money for the appointment, that way the doctor's not chasing the money or doing without the money. We look and see how much is over ninety days, and usually there's a lot over ninety days.

Howard: So what is a healthy amount over thirty, sixty, ninety days?

And again this dentist is driving here and she's going to get to her account receivables, she probably hasn't looked at it one time in a year. What would be a healthy range for over thirty, sixty, ninety?

Sherran: Well, when I left my office we were sixty nine thousand dollars in the black, and I knew that if something had happened to my doctor I would've had to write checks for sixty nine thousand dollars to repay the pre-paid dentistry. 

They used to say ninety days, but I don't believe that any longer. I think you have a better chance of collecting the money, what I call it, "their feet's in the dirt" maybe that's a Texas term. That when their feet are in the dirt you have a pretty good chance of collecting the money.

After thirty days you've got a fifty percent chance, after sixty days you've got a twenty five percent chance, and if it's in the ninety days and over good luck with getting that.

Howard: Yeah, and I'll have to say that, you know, a lot of dentists used to say "Well what bothers you the most about your practice?"

It's always going to be the complexity of staff, just dealing with people, and I think that's [crosstalk 00:45:43] that's what any human would say in any business, family, you know, everything. I mean people are the greatest thing about this life and people are the most complicated part of this life. So that's a given. 

But next would be overhead, and what I tell these dentists, I mean I look at their overhead, I think one of the highest causes of overhead is if you only collect ninety five cents of the dollar and you have two thirds overhead that means the five dollars you didn't collect you had to go back and pay ten dollars to do the root canal, filling, crown, chair, maintenance, rent, mortgage, equipment, billing, computer, insurance, labor, FICA. You had to pay ten dollars for every five you didn't collect.

So every dollar you don't collect you pay two dollars, and if you can just get the collection policy to be production equals collection. You know, you go to McDonalds, you tell the sixteen year old, "I want a Big Mac." 

The sixteen year old says, "Then give me three bucks." 

And then you say, "Well I don't have three bucks."

They go "Then frickin' leave."

[crosstalk 00:46:42] And the dentist says "Oh, we'll bill ya. Here's the Big Mac, eat it, chew it up, swallow it, leave go home, and then we'll beg you money when you're not hungry."

Sherran: Yes.

Howard: I mean, it's pay to play and these dentists think that, you know, that to be new age and spiritual, and eco-friendly, that you've got to be compassionate. You're in pain and you've got a broke tooth, and you don't have any money, let's just fix you up and we'll worry about the money later. That's not the way the human condition works.

It's also every lawyer that practices only on malpractice defense say, "You know what the biggest danger is? The biggest danger is when someone owes you five grand" 

Because they're going to invent five thousand reasons to take you to the board and sue you. Because they don't want to look in the mirror and say "Oh, I'm a deadbeat. I just got two root canals and a bridge, and I'm a deadbeat. I'm a loser." 

And they're going to say, "No, no, no, no, that was never right, it doesn't feel right. It's all you. [inaudible 00:47:41]"

Because they know if they go to the state board or threaten to sue you that most dentists are going to say it's not worth it for me to cancel then go fight you so I'll just write it off.

So yeah, you gotta pay to play. You gotta collect that money. 

But back to holding ... I want this dentist to be able to get to work and see the metrics. 

What would you say the average office collects in the United States? What would you say the average collects, would you say four fifty, five hundred, what would you say, for the average fiftieth percentile.

Let's go with four fifty, so divided by twelve that's be what, forty three, that'd be thirty seven, so let's say forty thousand. If this dentist is producing forty thousand dollars a month on average what would be his over thirty, sixty, ninety. So that dentist can look at his report and say "Man, I'm about average" or "Man, I'm in trouble"

Sherran: Eighteen thousand or more.

Howard: For thirty, sixty, and ninety? For the whole AR? 

[crosstalk 00:48:40]

So you're saying if you collect fifty a month your total accounts receivable should be half that, so you're saying all account receivable should be about a half of a month's production. 

Sherran: Well it should ... It is in most offices, I'm not saying it should be, because I think it should be even. I think we should be at ninety nine percent collection. That's just how we ran our office, that's how he still is today. 

I went in as a patient last week and had my teeth cleaned, and I worked there for twenty years, and they asked for my debt card when I left and charged me and sent the insurance and my insurance check is coming to me eventually.

So you get your haircut, well you might not get your haircut as often.

Howard: I stopped doing that about twenty five years ago.

Sherran: You pay your hairdresser, you buy your groceries. They're not going to put them in the car for you unless you pay for those groceries.

Howard: I know, I don't get it, I mean I can't think of anywhere I can go from here to Kathmandu where I can take something without paying for it. Then these dentist colleagues of mine, they do it all the time. 

And I also want to tell you something else about the human condition, I firmly believe that the average dental office that I talk to is about ninety five percent collection. It's that one in twenty, is five percent, and one in twenty earthlings are out there gaming the system. They're the ones that got welfare and foodstamps, they work for cash, they're always gaming the system. It's part of their whole makeup, they never had any intention to pay. Then when you sit there and you put down these policies nineteen out of twenty people don't blink because they can't go anywhere else in society and get something for free, but it's that vocal minority twenty percent that keeps the doctor up at night. Someone is complaining and they're trying to cut out the receptionist by going to you and saying "Doctor, your receptionist said ... I told her I don't get paid til Friday ..." 

So most social animals are non-confrontational, whether apes, monkeys, dogs, cats, etc.

"Okay, don't worry about it, don't worry about it."

So that one in twenty vocal minority never had an intention to paying you, totally gaming the system all throughout life, and further more when they ever have gamed me I always made sure it was going to end up on their record. I always turn over to a collection agency. Often times would even on Friday, or whatever, tell my receptionist "Go down to small claims court and file a court." 

Because I just want this person to have a solid record, so that five years from now when they're trying to get a house they realize "Oh, this is a shady character."

Sherran: People won't do that.

Howard: Yeah.

Sherran: They just won't do it, and the reason they don't do it is ... And I'm going to test you on this a little bit, I don't know if any of your team can hear me. I want your hygienist to finish their patients this afternoon, if you accept insurance for payment. I don't know if you do or not, but if you do, your hygienist will release the patient, they will leave and you will eventually get your insurance check. That patient never knew what the cost of their cleaning was.

Most hygienists just release the patient, let them go, insurance pays one hundred percent, they never mention the fee. So now when you start to try to collect the fee up front they think you're extremely high, but you're not because they never heard the fee in the beginning. You don't even have to raise your fees and they think you're too high.

So when your hygienist releases, even if they have a hundred percent benefit through their insurance, two free cleanings a year, right? So if you have two free cleanings who pays the hygienist, are they free as well? No.

Your hygienists get burnt out, what do they stay, an average of twenty years a hygienist is ready to go mow somebody else's yard. They don't want to work or they don't want to work in your office, or they don't want to do anything, they want to change careers, because they don't feel the value either.

I don't think the patients are trained to value the hygienist because they think they work free, and so when you start to quote fees, that's the hardest transition into fee for service, is no one in the office has ever quoted a fee. 

You hear people call the office and say "I'm not going to Doctor Farran, his crowns are too high. My last dentist I only paid three hundred and thirty dollars."

No, that was their insurance part, but the patient doesn't know that. We haven't trained them to say that.

We have not trained our staff to say that. 

Howard: And all economists say the number one problem with all health care models, whether it's government nationalism, or whatever the hell you call America's hybrid system between government, medicaid at the state level, medicare at the fed, but that's only ... Medicaid states for poverty, medicare national for over sixty five, primary insurance in the middle, is that nobody knows the fees for anything they're getting. If you had just a small ... Whether it's totally nationalism, Canada, whatever ... If you had the patient have to pay, say it was just five percent of everything, no matter what, then the whole country would know the fee of a bypass, a hip, an artificial knee. 

We have a country now where a hundred percent of my patients that come in that had a artificial hip, knee, heart, whatever ... You say, "By the way, how much was that bypass?" 

"Oh, I have no idea."

Sherran: No idea.

Howard: So why would they shop between a hospital that charges a hundred and twenty five thousand for a bypass, versus hundred. Or what you can find in most markets, where if you drive to a mid-sized town a hour away it's twenty five percent less.

But you opened up a huge can of worms.

A lot of dentists are always thinking to myself "Sherran what about my fees? Should I raise my fees? Or do you only do that when the economy is booming?"

And most Americans by the way, I want to tell you psychologically, most Americans ... Like right now, the economy is adding two hundred thousand jobs a year, we've got five percent ... This is a very healthy economy, but I've noticed with Americans they never think the economy is good unless it's a bubble economy. Like when the stock market is inflating and it's a bubble about to be popped. 

From ninety three to two thousand everybody thought, oh the economy's good. No, that was a bubble. And then when there's a real estate bubble gone, where the price of houses double in five years, and people say, oh that's a good economy. No, that's a bubble. We live in a world where when it's a totally functional, normal, healthy economy like right now, and I'm looking at the deal, this is May fifteenth, twenty fifteen, your economy's rockin' hot. You're adding two hundred thousand jobs, you've got five percent unemployment, and no American thinks the economy's good because there's no bubble going on. 

But a lot of dentists are driving to work and they're saying, "Well Sherran, should I raise ... How do I know if my fees ..."

Because wouldn't that be the easiest way to increase ... The hardest way to increase my production would be doing more dentistry, wouldn't the easiest way to raise my production twenty five percent just raise all my fees. 

How does a dentist know if his fees are high or low? Or if she should raise them or leave them there, or even reduce them?

Sherran: Well sometimes we will do the shopper calls for the practice, depending on the practice, and we ask that they call five people minimum, or their team members. Not in the office, obviously because of caller ID these days, everybody knows everyone, and ask what the local fees are. 

You know, my daughter has been famous for saying "I've just moved to this community, I need two crowns, my other doctor told me I possibly might need a root canal, but I didn't have it done before I left. Could you tell me what those fees would be to come to your practice?"

And ask those questions but try to sound a little bit smarter than ... You know, don't sound like a consultant but try to sound like a person who's truly concerned about their dental care and about their fees. 

And most of the time she's asked, the first question she's asked is "Do you have insurance?"

Howard: You mean when she asks the fee they just return the question as "Do you have insurance?"

Sherran: Yes.

Howard: Does that mean, like, who cares? Do you have insurance?

Sherran: Yeah, well she's like well what if ... She'll eventually say what if I want to pay in cash?

But they'll ask that question and then they'll tell her the insurance part.

Howard: Interesting.

Sherran: Not the fee.

Howard: Interesting.

And how often should a ... Well first of all, there's professional agencies that do that for all the grocery stores. I mean you see people going into the grocery stores and they're just ... And a lot of grocery store chains as soon as they see you're in there scanning their prices they kick you out. Other ones don't fight it. But it's a whole shadowy industry for grocery stores, it's a ... I mean there's ... And the best ones at it are pushing a cart and entering this data.

But how often should a dentist call other dentists for their fees? How often should they address their fees? Once a year?

Sherran: Yeah, I think once a year, and the reason is because we were so indoctrinated, I guess, in the end of December we had two weeks off for Christmas, and during that two weeks we'd usually have a meeting in the office and we'd talk about our fees. Between that time someone should have called to see what the area fees are, and if we want to increase our production and not work any more days how much do our fees need to go up. We adjusted our fees according.

In this community there are crowns, and this is the truth, Texas A&M University is close to us so we have a really big demographic of people about twenty five percent of [inaudible 00:57:30] a year of local people moving in and moving out. Going to school, graduating, starting school, things like that. The lowest crown in this community is seven hundred and the highest is seventeen hundred.

Howard: Now what town is Texas A&M in?

Sherran: College Station, Texas

Howard: College Station, yeah. [crosstalk 00:57:45]

Sherran: North of Houston.

Howard: Yeah, I've been to College Station, several times.

So what do you think of this strategy, one of my theories was I've never heard anyone come back from a specialist and no one's ever said to me "Wow Doctor Farran, I went to the specialist and he charged a thousand dollars for an extraction and you only charge eight hundred."

Or "I went to the [inaudible 00:58:09] and he charges fifteen hundred for a molar and you only charge twelve."

No one's ever paid me that compliment, so I started saying one of the easiest ways to do my fees, if I go to court on a root canal. I'm graded by the [inaudible 00:58:21] standard, when people talk about peer review, well your peers at the board are going to be the specialist. You're doing endo, that's going to be endodontists, you're doing ortho it's going to be orthodontists.

So if your endodontist is charging this much for a molar, and half the time she's in your medical dental practice anyway, so she's in your same zip code. She makes a full time living doing root canals all day long, every day for the last decade at this fee why don't you charge that fee? You're going to be held to her level. The customers don't know the fees.

Like if I had to have my gall bladder removed, I mean if you told me a fee what would I compare it to, a can of Campbell's mushroom soup at the store? Or a cheeseburger at McDonald's? I mean, if you told me that a gall bladder is five thousand I'd say okay, if you said it was seventy five hundred I'd say okay. I don't know.

So what do you think about just setting your fees to what all the specialists in your zip code charge?

Sherran: Many of us do, many of us do, and I'll tell you something else that's happened in our community. I don't know if it's happened in yours yet, or if it will. We had a doctor that began to do implants, the single, simple, you know ... Not really [inaudible 00:59:31] or anything yet, just doing simple implants, and then he sent a patient out to the oral surgeon to place an implant and the oral surgeon sent the patient back with, guess what? A CEREC crown already on it.

Howard: Wow.

Sherran: He looked in her mouth, and he was like ....

He's asking his assistant, "We already do that crown?"

"No. It's not in our record, we didn't do that crown."

But the oral surgeon was kind of miffed because there's so many GPs doing implants now that he said, "They're going to do implants, I'm going to do crowns."

Howard: Interesting.

[crosstalk 01:00:09]

And there's a orthodontist in Arkansas who's in all kinds of trouble because he added hygiene, and he just said "You know, my patients need cleanings" 

So he started adding hygienists and it's kind of weird because it looks weird to the press when the board's trying to tell an orthodontist that he can't have hygienists doing cleanings. I mean the public's ... So it's extremely controversial. 

But I want to end on this, we put up three hundred and seven one hour CE courses on Dentaltown and they've been viewed half a million times. I wish you would create an online CE course that the whole dental office could sit around and watch and you could educate them.

Would you ever be game for that?

Sherran: I would, and I do, I have a YouTube channel, and I have placed some things on YouTube.

Talking both about marketing and some ... What I do is ... You can always learn from somebody, I say that I'm a constant student. 

Howard: Well you could e-mail those YouTube videos and that could be a framework and then voice over, talk about them, have an organized manner. 

Also this dentist driving to work, she just pulled up to work, if she wanted to talk to you could she just call you or talk to you?

Sherran: Absolutely.

Howard: What contact information are you willing to give on a podcast?

Sherran: On my website dentalpracticebydesign.com the upper right corner there is a free thirty minute consultation and she can call me with numbers, questions, any particular problem. I will coach her on the phone as a compliment to her practice for thirty minutes free. 

Howard: You willing to give out your cell phone on the podcast?

Sherran: It's 979-255-2566

Howard: And what if they want to e-mail you?

Sherran: Sherran@dentalpracticebydesign.com

Howard: So Sherran S-H-E-R-R-A-N, I'm Irish, isn't that the Irish version of Sharron?

So you're Irish?

So if you're Irish and you said you used to be a professional fisherman, I take it your fishing bait is a bottle of Jameson Whiskey and a stick of dynamite? And you just drink and throw dynamite in the lake?

Did I guess it right?

Sherran: That's pretty illegal.

Howard: How do you fish? What do you go after?

Sherran: Bass fishing.

Howard: So lake?

Sherran: Yes.

Howard: Lake bass fishing, you got a bass boat?

Sherran: Yes.

Howard: Oh my god, that's amazing.

Well Sherran, first of all seriously, I'm a big fan of yours, I have been for a long time. Thank you so much for giving me an hour of your time, and thank you for all you do.

You're all over social media, I just think you're an amazing person and thank you so much for spending an hour with me on a Friday afternoon.

Sherran: Well thank you, and I want you to know this as well, and this is something that I've learned from you, so many things looking at all the posts that you put. I spread those everywhere. Because so many people don't see the things that you see. And when you post those photos you should see the oh my gods.




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