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VIDEO - HSP #134 - Steven Mautner
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AUDIO - HSP #134 - Steven Mautner
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Born in Brooklyn NY in 1962. Went to Poly Prep High School, NYU and NYU Dental (graduated in 1987). Interests are sports , current events, running, stock market, dentistry and naps.
sgmdds@gmail.com
Website sgmdds.com
Howard: It is beyond honor to be interviewing who everyone affectionately knows as Mauty. Mauty, I swear to God dude, I love you. You have 17,200 posts on Dental Town and it's not that after 17,000 posts, I know you probably as well or better than my mom did, brother whatever. The fact that, I got to put you in a historical context. In dentistry, it's a profession where the hardest way to do anything is the sacred way and everybody is pushing the [pankion 00:00:40] stew and the spear center and the most complicated way to do anything. The high cost, the Beverly Hills, the [Perkiba's game 00:00:49], the rich and famous. Dentist, like they go to a convention of someone, says, "I trim my own dyes." The next guy says, "I quarry my own stone and then I trim my own dyes." The next guy is like, "I have my own beehive, I grow my own wax, I quarry my own stone, I trim my own dyes. It takes me 40 days and 40 nights to do a crown." Everyone is like, "My god, I'm not worthy." Whoever buys the most expensive overhead builds the biggest Taj Mahal and takes the longest period of time to do a filling. It's a sacred saying in dentistry.
Dude, from day one I think you were attorney in 1998 or 1999 and you were the guy saying, "I do low-cost dentistry. I take insurance, I take HMOs, I take PPOs and I'm extremely successful." Many people through mud and dirt at you and you just smiled and grinned all the way to the bank. You held your ground, you never budged and I just thought to myself, "My god, you're an amazing person." Thank you for that.
Steven: No problem, no problem.
Howard: How was your journey on Dental Time? Do you agree with my assessment? Do you agree that some people wanted you to be like a Pankey dentist and you just held your ground saying, "No, I'm doing HMOs and PPOs."?
Steven: Yeah and not only that, just a deal raw of tone of the website and all the magazines I read. Especially issues like the Dental Economics, sets the whole concept of dentistry, is you have all these stuff to succeed. Besides going to Pankey and all that stuff, you have to upgrade your office to the most expensive equipment and you have to have a layout in your office of a certain way. You have to spend an hour with your new patient exam. A real comprehensive exam and talk to the patient. You have to push comprehensive dentistry and cosmetic dentistry. Your hygiene should be taken three times of the salary is. There's all these ridiculous benchmarks that just drove me crazy reading this stuff. I cannot believe we're expected to practice that way.
Howard: It's almost-
Steven: Other than that it's like drop amalgam. It's very annoying to read all that stuff.
Howard: It's almost like in, I shouldn't say this it's going to get me into a lot of trouble. It almost seems like if you try to treat the poor, you're thrown under a bus even that person goes to church every day and they're like, "Everything I ever read in religion is treat the poor, serve the poor, serve humanity." It's like if you're not going to be a Beverly Hills cosmetic dentist you're supposed to like not talk at a study club.
Steven: Exactly.
Howard: Only the AACD fellows can talk. We're not talking about [Ten veneers 00:03:32] on some psycho lady who had [phyladomathyl 00:03:37] and plastic boobs and a runway model, you just supposed to shut up. Treating the vast majority of earthlings with low cost, fast dentistry for the poor, that's just not moral, that's just not right. You just almost looked down on which is crazy to me.
Steven: Yeah. How about this thing, "Don't do dentures." I cannot believe how many dentist don't want to do dentures. That's absurd; there's a huge demand for dentures.
Howard: Yeah, like every one of my uncles. I got 100% of my uncles.
Steven: Yeah, I don't get, I don't get it.
Howard: What would you say ... Describe your business model and is it successful? Describe what you do to our listeners?
Steven: My business model-
Howard: If you say you do amalgam, I'm going to have to cut you off.
Steven: That's okay; that's okay. [inaudible 00:04:24]. No, my business model it's just basically like the business model of a McDonald's or Burger King and anything like that. It's just give the people what they want and they have insurance take it and if they want to do a crown for $350 just do it as fast as you can. Delegate it to the staff. I try and delegate as much as I can to my staff. The negative of that model is people will wait. It's basically I'll give them whatever they want as long as I'm capable-
Howard: You are in Margate, Florida, describe that? Is that like a suburb for Miami or for Fort Lauderdale, where is that?
Steven: It's like a small town in northwest Broward County.
Howard: Okay, where's that? Like what's your closest major city that I know of?
Steven: Fort Lauderdale and maybe [inaudible 00:05:21] town.
Howard: What is the demographics of your neighborhood?
Steven: I would say, middle class, retirees and families.
Howard: Is low cost your unique selling proposition? Are you more low cost than other dentist in your area?
Steven: There some in the area that advertise a less but I'm pretty much at the bottom. I'm pretty much at the bottom.
Howard: Is that been a successful financial business model for you?
Steven: Yeah, it made me very busy. When I first started out, I was a pretty much new dentist not too far from out of school and I figure I got to give them some reason to come to me. Why would they come to me over a guy that's been in the area for 20 years? I don't have as much experience [inaudible 00:06:12]. I came up with that model. Of course, I had a few insurance plans that were already low fee. I was able to deal with those successfully. I decided to expand it to all my clients. Not just the ones that had that particular insurance.
Howard: Would you say your biggest attraction for new patients is that you take your insurance or the location, marketing, advertising?
Steven: I say the biggest attraction is the insurance then advertising and third a lot of them like me when they meet me and refer their friends.
Howard: Yeah, I know I like you. I really do dude. I think you're an amazing guy. Everybody's out there, they're just, "I know." I always try and ask them to make the question of like 7,000 individual dentist listening to this podcast. The first thing they're going trivia out. "Excuse me, did you just say you do a crown for $350 and you make money out of it? How can you do a crown for $350 and make money on it?"
Steven: It's hard. Luckily my lab only charges me a 65 and I [inaudible 00:07:20] very quick.
Howard: For what? Is that a PFMs or zirconia?
Steven: It's a PFM. If it's zirconia, I'll charge maybe another $50 for. It's a PFM, non-precious. I do it fast; the assistance does most of the work and plus I do a lot of them as an emergency. It adds up; it's 350 minus 65 is what? It's like 280 so you do two or three or four or five 280s and you got like $1400 profit minus the materials and other overhead. It works. Yeah, you have to work fast.
Howard: How many operatories and how many staff do you have? What's your layout like?
Steven: I got ten operatories; I got four on the front that I work out of. I have three in the back that I used to have associates work out of but now, it's just my periodontist works there when he comes in and I have three hygiene chairs.
Howard: You used to have associate... Now, how long have you been practicing? When did you get out of school, how long? You got out of school in 87, same year I did right?
Steven: 87 I graduated, right.
Howard: Then are you 52 also like me?
Steven: 53.
Howard: Your 53, I'll be 53 next month. How comes you look so much damn better than me?
Steven: I'm lucky, I take care of myself.
Howard: You got lucky genes?
Steven: Yeah.
Howard: Did you used to have associates and then you find out that's not really a profit center or you didn't like that? Talk us about that.
Steven: No. The last associate left in 2007 and then while I was in the process of looking of a replacement ... I knew the economy in South Florida was going down the tubes and I was doing pretty much the same numbers anyway. I decided to go it alone.
Howard: What are your hours?
Steven: I start at eight; I typically end at five. Except on Friday, I end at 12.
Howard: You're eight to five Monday through Thursday, eight to twelve on Friday?
Steven: Yeah.
Howard: Then Saturday's?
Steven: No weekends.
Howard: You work four and half days a week?
Steven: Yeah.
Howard: You make a good living doing that?
Steven: Yeah, making a good living. I could be doing better or I could be doing worse, I consider it a good living.
Howard: Yeah?
Steven: Yeah, I'm happy with it.
Howard: If someone's says to me, "What do you think of Mauty, describe Mauty?" The first thing that would come out of my head is, "The dude has more common sense than anybody I know." It seems like dentistry is almost like a religion. It's almost talk about ... I mean even yoga. Have you ever do a hot Bikram yoga?
Steven: No, no.
Howard: When I go to yoga, I've been doing it like two or three days a week for like three years. Sometimes you like ask the guy that you came with or something a question on something about, "Hey after class, could you drive me?" Then, like, "Hey, no talking in yoga." One lady was laying down and her feet were facing the front. She got in trouble because your feet were supposed to face the back. It's like, "Dude this is yoga, where do you have to act like sister Mary on [Allwili 00:10:24] Show? You know what, you really have to freak out during yoga?" Humans are just hard wired, so many people just take everything crazy. What do you think is the biggest common sense? What is all those comically uncommon ... Common sense is uncommon. What kind of uncommon sense do you find uncommon in dentistry?
Steven: The three worst. The drop insurance, don't do dentures and don't do amalgams and you can't deliver a crown under $1,000. That kind of thing is just absurd.
Howard: Amalgams is where it's almost kind of scary because your dentist friends are smart, they have eight years of college, they know math, physics, calculus and they look you in the eyes. 100% of all the research shows that the amalgams lasts longer than composites. They just look at you and go, "Well, not mine." No, no, no, not if you do it right. No, not if you do it like I do." Dude, one's metal, one's plastic. One is filled with all anti-bacterial ingredients. A mercury, silver, zinc, copper, tin. Every one's anti-bacterial and you just put in a plastic. You think there's more recurrent decay under an amalgam with six anti-bacterial metals. It's like you can't make this shit up.
I want somebody to look at me and say, "Yeah, I know composites aren't bacterial static. I know they don't have anti-bacterial, I know they're made of plastic. I just really like tooth-colored and that's what I call the aesthetic health compromise. All my fillings not last as long and be more susceptible to current decay because you just so pretty." That's not what they say. They actually believe they last longer.
You're like, "Okay, here's Crowcours studies, here's the Elf, here's every piece of literature." It's like religion, they start with what they want to believe and they work backward.
Steven: Yeah. The other thing that drives me nuts is this thing; dentistry has to last forever. Otherwise, it's not successful. How could any of these stuff last forever? It's under constant assault from food, clenching, the patients that don't keep their mouths clean. How is this supposed to last forever? If it does to me, that's fantastic but I think we've held ourselves up to impossible to meet standard. When it doesn't work out, the patients blame us.
Howard: Where are you getting this vibe that you shouldn't do dentures? What do you mean by that? Where are you hearing this and what?
Steven: I read it on Dental Time, so many guys are complaining about the dentures. They do a denture and the patient inevitably comes back and complains and instead of just dealing with it, they give up. "I'm not doing dentures anymore." Dentures is like easy money; it's easy. We know it's not going to ... The patient doesn't like it. It's a miracle that anyone likes that kind of a procedure but most of them deal with it after a while as long as you prepare them for it. It's not going to be the greatest thing; they deal with it.
Howard: Do you do many implants underneath your denture patients?
Steven: Yeah, I do a fair amount of those.
Howard: You like mannies?
Steven: I like them but we've had some failures recently so I'm kind of a little disappointed. We do them; I still do them because it's a low-cost alternative to implants.
Howard: I know and I still can't believe it. In America with 330 million people if you send a 100 grandmas to oral surgeon a [periodont 00:13:58] some post on it about she can't wear her dentures. All of them will only present a $50,000 treatment plan with science list, full implants, bars, bridges and not one of them would send back to grandma and say, "Well, I had two alternatives. A low cost $5,000 denture with four mannie implants on the bottom and six in the upper and a little more money for two implants in a bar, four implants ..." it's just like a Porsche or hit the door.
Steven: Exactly.
Howard: It's like, "Are you kidding me? You really think 330 million Americans are all going to buy a Porsche? I mean most car dealership don't even sell Porsches, Mercedes or any of these things you're doing. "
Steven: That's right. I had a patient lose his teeth because of that. He was presented a [chewing 00:14:46] implant was like $50,000 and of course, he didn't have the money and didn't want to do it anyway. He was all frustrated so he let his teeth go and of course, I did immediate dentures for a few thousand dollars. That's what happens in dentistry today. The patients give up; it's too expensive.
Howard: Yeah. Why can't dentist understand that? Everybody talks about Henry Ford invented the car and they didn't and there were 100 car companies all over. Most of them were just small but he started the assembly line. He had one model, the Model T. You can have any color you want as long as black and is one price. It was actually GM who closed down the Model T line because they come out with the Chevy to go against the model T. Did a little more money and nice was a Pontiac, little more money and nice was little more money nice is the Buick and the most nicest was the Cadillac.
Having five different price points adding features and prices up, Chevy was just like a Model T. Then the Pontiac had an electric starter. The [oddzone bill 00:15:48] had a roof over it, the Buick had all those with removable wheels and the Cadillac even had all those and the first radio, a Motorola, rock and roll radio. They had five price wings but if you send grandma to anybody for an implant deal for her ill-fitting denture, they just come back and say, "Well they said there's a Cadillac for $50,000."
Steven: Yeah.
Howard: They're like, "That's it? There's no Buick, no Pontiac, no Chevy, no nothing just a Cadillac?" "Yap."
Steven: Why is that? I don't get it.
Howard: Yeah. I think a lot of the CE market is like that. You're not validated unless you go to these finishing schools. The finishing schools are always going to teach the most expensive way to do anything. I remember the opening words I got in the [Pingeston 00:16:39]. Remember, this is 20 years ago slight changes so I hope they're different now. This [teacher 00:16:45] said, "You want to work on the right people." They start describing the A patient. "You don't want to work on the B or C or D." They start describing them and as they're describing the D patients, they just described the entire Farran family tree from which Wichita Kansas.
Steven: Right.
Howard: All the examples were all my cousins and brothers and sisters and moms. I'm like, "Really? You want me to not treat my entire pedigree of Kansas trailer trash?" Our family tree has more white trash than a paper plate factory. I just thought McDonald can make money. You don't have to be Ruth's Chris. You can make money at McDonald, you can make money at Ruth's Chris but the bottom line is serve your fellow human being and make a profit off it." That's what I loved about you and how many times did someone try to talk you out of your business model on Dental Time in the last 20 years?
Steven: Many people. Even one of my supply reps the other day told me I'm too low; my fees is too low.
Howard: Let's talk about amalgams because obviously those metal fillings with all those anti-bacterial, mercury, silver, zinc, copper, tin they don't last. Did you realize that a barrel of oil is trading at $50 a barrel and barrel of bonding agent is $1.5 million? Go ahead, look at your bonding agent and do the math and calculate. You just paid $50 that little 50 milliliter bottle. Do the math on how much that would cost for a 50-gallon barrel. The cheapest one I can find is still over a million dollars and the average one, the most common ones, are about $1.5 million a barrel.
Then that same dentist say, "How come my supply bill is so high?" I'll say, "Well, how come that little Blake came in, he need an a clausal on a six-year molar and you could've drilled it out, put amalgam in and probably would've lasted 30-40 years. You had to drill it out, put a rubber dam, do bonding, axing all that stuff like that and it will probably last ten." Why did you do all that for something that no one will ever say, "It's a boy, he has booger in his nose. His hair is sticking up on the side. He cries when he has to take a bath. You just did a cosmetic procedure. You had to use rubber dam, you had to use a bonding aid, you had to use all these disposable stuff.
I get it with girls; I do. I get it. Girls will do this, "I can't come out." The girls just want tooth color. I get that but half the world is boys and half the fillings are molars that can't be seen and they just can't do an amalgam. What do you think that is?
Steven: I have no idea. I can't explain it. Insanity, I don't know. I just can't explain it. Maybe they fill they're not ... Maybe they got caught up in the latest health craze that the amalgam isn't healthy or the mercury. They feel that they want to present themselves as more of a modern cosmetic dentist, not an old school guy that still pushes silver. I have no idea.
Howard: The funny thing about the mercury is when the mercury is bond and the amalgam is silver, zinc, copper and tin. If you swallow the amalgam, it comes out the other end in 24 hours later and it's the same weight. It's the ethyl and methyl mercury the ocean that's absorbable. In all the seafood and all the anti-mercury people are always the seafood. "I've just eat sea bass and shrimp and lobster. "Just loaded with ethyl and methyl absorbable mercury." I'm like, "Dude come on, be consistent." If you're anti-mercury, the first thing you will give up is tuna and shellfish. If your anti-mercury and you're eating a tuna sandwich or shellfish now, we love science again. Now we no longer don't believe in gravity or math; we're just talking feelings."
Steven: That's right.
Howard: What else did you want to talk about today? Fees too high, inefficiencies, auxiliaries. Do you own a CAD/CAM?
Steven: No.
Howard: Do you own a CBCT?
Steven: No.
Howard: Do you own a $35,000 or $50,000 bio laser or Millennium laser?
Steven: No. The only thing I own is I do have a digital pen with external bio wings. I thought that was a good investment. We're doing implant, so we need a panel. I just got digital X-rays, I have that. I take digital PAs and that's about it.
Howard: What kind of implants are you placing?
Steven: I use OCO biomedical.
Howard: Why did you pick that one?
Steven: My periodontist liked it; that's all. They give us a good deal on the implant and on the abutment.
Howard: Where did you go for training?
Steven: Me, I didn't get any training. My periodontist places the implants; he got the training.
Howard: He comes in your office?
Steven: He's a freelancer; he comes in on Wednesday afternoons and places them.
Howard: Are you allowed to talk about how does that work? How do you pay him? Is it a percentage or are you-?
Steven: It's a percentage. It's 50-60% depending on what we're going to charge the patient. If I'm making a fee a little bit lower, maybe a little bit more of the case. If it's a standard fee, well, we'll split it pretty much.
Howard: Some of it you're doing as a service or is that a profit center for you?
Steven: No, that's a big profit center there the implants. There's a huge demand for that.
Howard: How often does he come in?
Steven: He comes every Wednesday. Every Wednesday afternoon but he takes probably two months vacation throughout the year. He works like ten months out of the year.
Howard: Just Wednesday's afternoon for like one to five?
Steven: Yeah but we work late. If someone wants to come in late for that type of case, we'll stay late. Maybe it's like one to seven.
Howard: It's a good deal for both of you then?
Steven: Yeah. For him, it's great because he has no overhead. He comes in, does a few implants and leaves. To me, it's great too because I get a little cut in the implant and I do more crowns than I would normally would do if we weren't offering that service. Plus also for the dentistry.
Howard: Why did you not get a CAD/CAM?
Steven: I don't know because I don't think that fits into my office. I don't have time to do crowns; I do too many and it's too expensive.
Howard: Yeah.
Steven: I'm not even supposed to comment on the CAD/CAM. You got your administrator said I can't talk about CAD/CAM writing stories, make fun of it.
Howard: I remember. My problem with dental if I have to look back at one mistake is when I started Dental Time in 98, I'm still a rigid Libertarian. I believe as far as Republicans and Democrats one robs the bank, one drove their gate-away car, [onogoply 00:23:46]. If you're proud of one of those two parties I don't even get it. I was a Libertarian and I just believed that every dentist had eight years of college and I sure as hell wouldn't get added or matter. It's self-policing or whatever but I didn't understand the concept of cyber bullying, I didn't the concept that there was just psycho people that just want to throw mad at you. Somebody would post a really nice case and some anonymous person would just be mean.
I finally realized that libertarian is between you and your Government. You have the right to free speech against your Government; that's your constitutional right. They don't announce private property. I finally realized, Dental Town is just me, I own the thing 100% and it's like my house. I finally realized that we're having a party in my house and you can walk up to one of the other people in the party and say, "You're ugly and you stink and you're asshole." Then, I'm going to ask you to leave the party. I'm going to throw you out.
Yeah, it was Howard Goldstein who kept telling me, "This guy is just dysfunctional, this guy's great." When he came in years ago, four or five years ago, we programmed a report abuse button and we got some monitors. We said this is a fraternity; this is a party at Howard's house. You can say anything unless you're hurting someone else feelings. Anybody can ask you questions. There's a way to save everything but if you're just being mean. He tried to change the whole town and the whole pitch to saying, "Let's be constructive." Some people like on CAD/CAM like ... Some of them are buying it E4D which is there as not as many E4D users as Sirona or CEREC users. Some people every time they post a E4D case, someone starts saying, "You should have bought a CEREC, you should have bought a CEREC." We're like,"Dude; they're past that. Can we talk about this case?"
Finally, we had to separate them like children saying, "You can't ..." We had to do the same with implants and mini-implants. Many implants, you post a mini-implant case and somebody that's never impose one, he only does the big As is like, "You shut down the entire system, place a real implant. It should have been a mile long and five miles wide. Real men only place roots for blah, blah." Finally, we had to separate the many and the emblems like say so.
I think what Hugo has done very successfully is now we're all in the same team and if you're not nice, he gives you baseball. He gives one warning, he gives you a second warning and then he boots you. He's booted probably one a week since he's been there and just be nice. Every dentist we're getting beat up by the insurance, we're getting beat up by patients, we're getting by everybody, Dental Time needs to be a refuge where we all go in a safe attorney, it's a party in my house and let's talk through problems in a safe, fun way.
He knows you. He knows you're probably kidding but he's trying to curb your cynical enthusiasm.
Steven: Yeah, he threw me off for a month a few years ago.
Howard: Did he really? I did not know that he threw you off for a month.
Steven: It's okay.
Howard: What's funny he deletes a lot of my posts too. I'm like, "I own this site and they delete my posts." If I meet someone and I really feel in the heart, it's great but even though it's a company or they sell something. If I'm using it now, I'm buying it. I buy all my stuff with my own money. I don't take any freebies from you. I could've got free shit. I pay real money and sometimes I'm going to plug in and someone goes, "Well, that's a commercial plug." I'm like, "Well, it's from the heart, I did this." Yeah, I get deleted too.
Steven: Right.
Howard: I do think he's turned around the environment to more positive and when someone clicks at ... If you're listening and post something and someone makes you feel bad, hit report abuse and people will look at it and say, "Did he say it mean or whether it's a motocon." Some people don't use the motocon like they're absolutely kidding but they don't use the motocon, ha ha ha ha or LOL or whatever. I'm going to ask you this Mauty, what would you say since you're a conservative dentist, what would you say to these dental graduates who walk out the school with $250,000 in debt and they're scared and they got a lot of debt? What advice would you give them?
Steven: I don't know because of the debt?
Howard: You got out of school in 87, did you have student loans or did you have mom and dad pay your way or how did that work?
Steven: No, I was lucky they paid. I was fortunate, they paid. I had no debts and my dad was a dentist. I went to work for him and then I went to work at another office before I moved to Florida and bought my office. I was lucky.
Howard: I didn't know your dad was a dentist. Where does he practice?
Steven: Now he passed away but he used to practice in New York City, in Manhattan and in Brooklyn.
Howard: Are you the second dentist in the pedigree or third?
Steven: I'm like the third. My grandfather was a dentist; then my uncle was a dentist. I come from a family of dentists.
Howard: Your grandfather, your dad and who else? Your dad's brother?
Steven: My Uncle.
Howard: Your grandfather and he had two sons that both become dentists?
Steven: No. My grandfather had ... No, they were both his sons-in-law. There were sons-in-law and both were dentist. My dad and uncle were son-in-law.
Howard: What lesson did you learn from your family tree of dentists? Do they have a formative impact on how you would do dentistry or were you the rebel kid?
Steven: The main thing they told me is dentistry is a great profession; you can always make a living. That impressed me because my grandfather made it through the depression doing dentistry. That was a big thing that really impressed me. People are unemployed, going broke and he was still plugging away making money. My girlfriend just walked in. I'm sorry, my girlfriend just walked in.
Howard: You got to introduce your girlfriend. You're going to have the most viewed podcast because with 70,000 posts most people are going to watch this because they want to meet Mauty. You got to introduce your girlfriend.
Steven: You want to bring her [inaudible 00:29:35]?
Howard: Absolutely, hello.
Steven: Hey, Elizabeth come here.
Elizabeth: What?
Steven: I'm being interviewed by Howard Farran; he wants to meet you real quick. She will be here in a second.
Howard: What's her name?
Steven: Elizabeth.
Howard: How long has she been your girlfriend?
Steven: Like six years.
Howard: That's not a girlfriend; that's a-
Steven: You're going to say hi to Howard? Come here. This is Elizabeth.
Elizabeth: Hi.
Howard: Hello Elizabeth, how are you doing?
Elizabeth: Good, good how are you?
Howard: How does it feel to be dating the most famous dentist on Dental Town, Mauty with 17,000 posts on Dental Town? Out of the 200,000 dentist, it's probably two who don't know who he is.
Elizabeth: I feel wonderful.
Steven: Very happy. She's very happy.
Howard: we all have to ask Elizabeth. What is like being a Dental Town widow to your boyfriend who is always on Dental Town all the time, posting and not paying attention to you? How do you deal with that?
Elizabeth: I think that's awesome.
Steven: She doesn't know. I sneak them in; she has no idea when I'm doing it.
Howard: Are you mostly on Dental Town on your ... What did you say you have, a Samsung?
Steven: I'm on my phone sometimes. Usually, I post when I'm doing my bills on Sunday and on Saturday.
Elizabeth: Hold on, I'll be right back.
Steven: Usually, I'm doing ... That's why I post much on the weekend. I'm doing my office work. While I'm printing the checks or I'm looking over a chart, I'll write off a few post.
Howard: Interesting and right now, you're doing this podcast on Skype on your Samsung?
Steven: Yeah.
Howard: I think this is the first podcast I've ever done where someone wasn't on the desktop. Leave to Mauty.
Steven: I don't have a webcam on my computer.
Howard: Leave it to Mauty to be the first one to do low-cost web-cost on his Samsung smartphone when 100% of the first 130 podcast all use an expensive desktop with a webcam. You even brought your low-cost mantra to my podcast, unbelievable. How did your grandparents and uncles and dad shape your view on dentistry?
Steven: They just did basic dentistry. My dad just did basic stuff; dentures, crowns, bridges, fillings basic stuff. The funny thing is, my father hated composites; he hated them. He used to let me do them. Started working for him, the patient would want a bonding or a composite, he goes, "Go see my son." Even though I did it, I guess it sipped to my head that the composites are annoying. I don't like doing. I hate doing free-hand composite veneers, I hate that. I'd much rather do a crown or even a porcelain veneer.
Howard: Mauty, you've lived half a century. What advice would you give a young kid, now walking into a school and he or she is got to go with dad or mom as a dentist? Was there father-son stress that kind of said, "You know what? I don't want to work for my dad because I don't want to ruin my son-dad relationship. I'm going all the way to Florida." Did you just go, "Most New Yorkers don't move to Florida till they're 65." You're just a visionary, you said, "Okay, I'm going to end up here at 65, I'll just make the move now when I'm young and save some kind of money on that." What was your thinking of moving from Manhattan to Florida? Was it the weather bad?
Steven: I met my wife down here. Once we decided to get together, she was living in Florida, I was living in New York. We had a long distance thing. I knew once I was going to be with her, Florida is much better place to practice dentistry than in New York, it's not even close.
Howard: That was 30 years ago?
Steven: It was like 1991.
Howard: Yeah. They say only of the seven billion earthlings only 1% of earthlings live in a country they weren't born in and they only leave for a job or for love or they're running from the Government. Whether they were guilty or innocent is another story. You moved there for love?
Steven: Yeah, pretty much.
Howard: Do you have any advice? At 50, we're so much been around the block more than when your 25 I'm going to ask you. What would you say to a 25-year-old dentist, boy or girl working for her dad, what would your advice be for that?
Steven: For that, I would say if your dad's office really has enough patients that you can make enough of a living like a real dentist makes, then work for your dad. If they don't have a big enough practice, then go work some place else part time. That was the situation with my dad. He didn't really have enough patients to support two full-time dentist. I had to go off and find another job. It was the greatest thing; I worked at a Medicaid office. That really made me, working in a Medicaid office.
Howard: Yeah. Did working for your dad, did you think that kind of strengthen your father-son relationship or was that strain on it?
Steven: Sometimes it was a strain because sometimes I felt like when he was giving the paycheck it was like giving me an allowance. Like, "All right, here's your paycheck, you can go buy a couple slices of pizza and coke." I felt like it was that type of a thing but he taught me a lot. I learned a lot.
Howard: Yeah.
Steven: Yeah. I think overall, it was a positive.
Howard: Your dad's dad was a dentist too, your grandfather?
Steven: No, his father-in-law. My mother's father.
Howard: Okay, amazing. Did they ever work together?
Steven: Yeah, they actually together for a few years, yeah. They had a very good relationship.
Howard: What advice would you give the young graduates?
Steven: I will just say, go work even for a corporate dentist just go work for somebody for several years until your really build up your speed and your treatment planning ability and your ability to deal with people. Once you do that, go out and buy a ... If you're really a good producer, take out a loan and buy a decent producing practice and your own practice eventually.
Howard: Okay. Would you got out of school in 87, there was orthodontic centers of America on the New York Stock Exchange, there was a dozen on Nasdaq, they all disappeared. Nothing for a decade and now they're all back. You got Heartland's and all these corporate dentistrys. What do you think of corporate dentistry and do you think that they're reaching there peak and they're going to go away again or do you think they're here for stay or do you think they will get bigger? What is your view on that because that's a very controversial topic?
Steven: I view them in a way as a positive because it's market for a dental practice when some of us want to cash out. I also view it as a ... To some dentist, it is a negative because there's competition but I like them around. They're alter aggressive with their treatment plan, up to the point of making stuff up. I get a lot of new patients from these places because I'm offering the same fees but it's a personal touch. It's me in the office; I'm not answering to some corporate guy. I'm not afraid of them. In a way, they're a positive because a lot of dentist don't have their retirement fully funded due to the stock market crashes over the years. It gives you somewhere to sell your practice to.
It's negative also because patients get turned off by their aggressive sale tactics and I think it's given dentist overall a bad name. I don't think our reputation is as good as it used to be.
Howard: Do you think that some change, you have more than others or do you think they all do that? Is just local ones of Florida in Margate?
Steven: From what I see, they all do that. Unfortunately, even solo dentist just do it. I see ridiculous treatment plans all the time. Everyone needs $10,000 worth of work, everybody.
Howard: I know. I just saw one just yesterday and every single silver filling need to be replaced with the crown and the lay on lay. I just said, "Well, they're all old, none of them have a cavity, they're not broken." They have all these intro cameras and it's just craze lines and cracks, all that. I'm like, "Well, just go out look in the mirror." His eyes were covered with craze lines in his forehead cracks and you're, "Hell, he's falling apart. Have him do a couple of squats until his knees pop but doesn't mean you're going to take him down to the vet."
That's why I think dentistry ... I still think for you young kids out there back in the day when Mauty and I got out of school, Readers Digest was probably one of the most popular magazine in the world. This guy took FMX and study models around to 30 dentist and got 30 different treatment plans that went from zero to $30,000, almost like a straight line. Readers Digest basically the writes up stories like, dentistry is not even a science. You couldn't get 30 dentist to grab one tree plant. I still see that today. That's why I don't understand corporate dentistry because I don't think you can standardized a can of coke, a can of beer, a Big Mac. You can't standardized dentistry. If 100 dentist looked in the same mouth, they'll have 100 different treatment plans. Would you agree with that statement or would you say that's not true?
Steven: Yes. It's totally true.
Howard: Yeah, so it's an art, it's an art form. It's not even it's-
Steven: Yeah. Some patients they don't believe me when I tell them I have one. Got jumped in a few years he was quoted $7500 to fix his mouth and he came to me and I said, "Well, according to your plan, you need one extraction, $75." He couldn't believe it. He came back three times to ask me, "Are you sure, are you sure, are you sure?" Finally, we extracted the tooth, gave me the $75 and that's it, he's done.
Howard: The funniest one is when the dentist always says on the [Old Town High 00:39:45] "These silver fillings have all these decay." Then they show a picture of the black scars underneath the silver fillings. It's like, "Seriously you made it all through dental school and you think there's a life form called black scars? Really?" Some metallic staining and some stuff and that's a life form. Really? Did you get the DNA of that? Can we sit there and sequence out the DNA on that black scar." I can't believe on some of the stuff you hear.
Steven: Yeah, it's crazy.
Howard: I say if someone comes in and they value that and they're just like, "My smile means everything, I want all the black stuff removed and I want everything translucent. I want a million dollars smile." Awesome, I do that too. I'll do all that.
Steven: I do that occasionally.
Howard: I'll do that too but don't sit there and tell someone they need it as opposed to want it and don't have that money for it and all that stuff. What other common sense do you think is uncommon in the industry? You said the big three are drop insurance, don't do dentures and don't do amalgams. What other things you find uncommon sense under Dental Town?
Steven: Wait, I said drop insurance, don't do dentures, don't do amalgams. You can't do a quality dentistry fast; dentistry has to be slow. Those hours exams, those new patients exams where they reserve 60-90 minutes for a new patient, that's absurd. I don't understand that. Patients don't want to even to stay in the dentistry that long. Patients love it when I look at their mouth, do a five, ten-minute exam and say, "That's it, I'm done." They sprint out of there. You think they want to sit there for 60 minutes while you go over there X-rays and you take study [miles 00:41:29] and photos and you mount them? That's absurd; I've never heard anything like such a nonsense.
Howard: Do you follow anybody on Dental Town? On a person's profile, you can have follow. Whenever they post your Email that they made a post. Do you follow anybody?
Steven: I just follow the topics. I like whatever topic is interesting I go for that. There are posters that I like but I mostly[inaudible 00:41:54]
Howard: What posts do you like and why do you like them?
Steven: Believe or not, I like Mike Bar because he's kind of like me, he sticks to his position and also he has got a good sense of humor about it.
Howard: Isn't he right around you, in east side Florida too?
Steven: Yeah.
Howard: Yeah, I love Mike Bar, love him to death.
Steven: Great.
Howard: You like Mike?
Steven: I like a lot of the posters. That Crispy Freestyle guy is pretty funny and South Florida dentistry... I forget the guys name. He is the guy that started my recent thread; I like him. Doctor Wyatt. There's so many I like. It's hard to really pin point them. Who else do you I like?
Howard: I have to thank you for all the years.
Steven: I like you of course.
Howard: You're just saying that. I like to post a lot of the images that people can give them ideas. The American Dental Association doesn't like a massive advertise. If we owned the McDonald's franchises, a lot of our franchise may be going for lots of our franchises may be going for lot's of broadcast advertises on TV and radio trying to sell our product. Our American Dental Associations are non-profit and they're really not marketing and advertising. I always like to post ideas for social media marketing for their Facebook and Twitter, Google or their websites or digital. I really get into that.
Steven: I wish ADA would do an advertising campaign. all the others, who needs the other stuff?
Howard: They can't because every time they've ever made a commercial, they'll put it in front of a community and they would sit there for a year and a half splitting hairs on a paragraph of words. The periodontists and the dentists. The only way they could do it is if they sit there and gave it to a advertising agency pharmacy. "Just take the money and do it and don't ever even show us the Ad." If you get ten dentist in room and show them the Ad, it's like putting a kid in a round room and tell him to pee on the corner. They'll just fight over.
Steven: Yeah but it's so easy. They could just do it like a little bit of milk like, the milk industry did and the beef industry. The milk industry said, "What, got milk?" The beef said, "Where's the beef." You make it simple. You can have an Ad say, "Where's the teeth?" Have someone smiling. It's easy; you don't have to make complicated.
Howard: I know. That's what dentist specialize in, the longest distance between two points. I have heard the stories from the ADA about the communities and the fighting about the commercials. They can't even agree on the message or that. Let's say you can't get two dentist to agree on the same treating plan.
Let's talk about retirement. I'm anti-retirement because it's pretty clear that when people retire they're less active, they sit on the couch, they gain weight, they drink more. Next thing you know, they're day-drinking and they're dead. One of the greatest things for longevity is having a purpose to get up and go to work. If you had a ... Let's say you wanted to make $100,000 a year what you'll take in retirement, you'd have to take and you want to be safe. You want $100,000 a year; you divide 0.5 for treasury. You'll have to have $2 million in bonds to make $100, 000 a year. Whereas, I know a ton of dentist at from 65 to 75 worked Monday, Wednesday, Friday from 6 AM to noon and made $100,000 a year. That's equivalent to another $2 million in bonds and unfortunately, get up and take a shower and go interact with their patients and staff and purpose.
The oldest dentist that I've ever met, the oldest ones, were still seeing patients in their 80s and 90s. This year alone I had a dentist come to me who survived Auschwitz in Poland and is 94 years old in LA, still practices. That's the only reason he is still alive at 94, I guarantee. That guy would have retired at 65; there's no way. He was so excited about placing implants on. Another one was 92. Every time I meet a dentist who's 80 or 90, they're still practicing. I just think a lot of incidence I say, "When do you want to retire?" "My god, I hate." "What do you hate about it?" "I hate indoor." "Well, don't do indoor." I can't stand my [highgenes 00:46:34]. Well get a new [hygenes 00:46:35]. Keep changing your playpen until you just want to keep playing.
I'll give you an insight. I might get in trouble for this one but you know the inventor of Rembrandt toothpaste, Bob Ibsen? He sold out for a gazillion dollars to Procter and Gamble and then was like a month or two later; they were swallowed up by Gillette. All these money and he still goes in... I think he's 80 now or 81. He just found women's shelter that got their teeth knocked out or whatever and he still has his office and just goes in there Monday through Friday. Does free rehabs for women whose lovers knocked their teeth out and that's the only reason he started Rembrandt. He loved it. He's 81 and he's still doing it.
I swear if Bob Ibsen would have retired at 65, probably would have started eating more, gaining weight, got saved. Probably wouldn't be alive now. I bet you the only reason Bob Ibsen is still alive at 81 years old is because he always loved it and he has a mission. He always showing cases about this luminiar case he did or whatever whatever on some ... He just loves it. When I go up to his house and sit out there and I have lunch with him, you just see the sparkle in his eyes about some girl he fixed up and this and that. He's all excited and all that. You take that away from someone. I don't get the whole retirement thing. Sam [Walters 00:48:02] was found dead at his desk.
Steven: Maybe they would like to retire. I may have mixed feelings about that because it does get stressful and tiring the way I practice sometimes.
Howard: You could slow, down though; you don't have to go seven to seven, four and half days a week. You could go Monday, Wednesday, Friday, six to noon. Think about Monday, Tuesday, Wednesday six to noon versus nothing till you drop dead?
Steven: Right. That's a good point.
Howard: Again, I've lectured 1500 times in 50 countries and I swear all the old dentist are still practicing. Other dentist like ... I think it's a huge health thing, personally.
Steven: Also, I don't like the rubber dam I have to admit. Everyone's obsessed with the rubber dam. I don't use it; I hated it in dental school. I don't use the rubber dam; that's another thing.
Howard: What you do Mauty is you tuck the rubber dam into the ceiling above you so you can say you always practice under a rubber dam.
Steven: I'll do that.
Howard: Yeah. That way you can just look at them in the eye and say, "I always practice under a rubber dam." You don't need to use a rubber dam as much because you're doing amalgam, right?
Steven: Yeah.
Howard: Do your [bisua 00:49:23] composites?
Steven: Yeah, I do but if it's a, I get... I think I get good enough isolation with these saliva ejector and the cotton rolls. If it's really a problem, I have the assistant come over and suction.
Howard: Yeah and the bottom line is a dentist doesn't want to hear that you can get isolation with isolite. That you can get isolation with three-inch cotton rolls. It's more of a religion, it's like, you use a rubber dam or that's a mortal sin and you got to go to confession and you got to say three Hail Mary's and you're bad. It's not like isolation is the objective and you can get it five different ways. I know people that just love the isolite. They just love it. Especially for older folks, it sheds so much light in there, the suction is better than your assistant plus your assistant has to stand there suctioning. She can be doing up, cleaning up, entering the notes, doing anything. I love isolite. You can get absolute isolation with isolite flooded with light plus I got my headlight on.
There are still great friends of mine that will just sit there and say,"Dude, if you didn't a rubber dam, you're not a real dentist." It's like, "really, you're not even there." What else? I've been sweating 50 minutes. What other infinite wisdom can the famous Mauty share?
Steven: Blocks. Stop giving blocks. Every time I keep reading these threads about failed blocks, I haven't done a block in like over 10 years maybe 15.
Howard: What are you doing?
Steven: I use a regular syringe with septocaine and I'll use a ligajet and I inject around the tube with a PDL with septocaine.
Howard: You buckle infiltrate with a short blue gauge needle-?
Steven: Long, whatever I have, doesn't really matter. Then I use the 30-gauge a ligajet syringes and I do the PDL with septocaine. I get very good anesthesia. Occasionally, there's some pain in the injection site, that goes away but it's much more effective than a block. Everyone is always debating about these missed blocks or they have [gould 00:51:27] gauge, aim high, aim low. If it was such a successful technique, why would there be so much debate about it? Also septocaine, that's a great anesthetic. These guys always say it's poison, it's polluting the universe. It's great, septocaine is one of the things I couldn't practice without.
Howard: Do you think it's so great because lignocaine is 2% and septocaine is 4%? Do you think a lot of it is just because it's double the concentration?
Steven: It could be, it could be or whatever works better. After you use a septocaine in lighter things, like water. It's almost like just water.
Howard: True. Yeah, I pretty much only use it. What other threats or what other controversial topics you see today on those extra topics?
Steven: Other controversial topics. Just dealing with problem patients. Some people get too upset when the patient criticizes them or does a bad review online or they have to give money back. That's another big thing I see. Dentist are afraid to refund. If it's a problem case or problem patient, giving them the money gets rid of him. That's easy.
Howard: Right. When somebody owes you $1,000 and they're upset. Now they have a 1000 reason to sue, 1000 reason to get on Yelp online, follow the board. I think one of the reason I've never been sued in 20 years is because I've always given the money back to anybody upset or got it fixed. "You don't like me, got my associate to do or you want me to give you your money back, what do you want me to do? Walmart says they refund 1% of sales. Walmart has to refund 1%; I guarantee you the entire dental industry didn't refund 1% last year and that's why they get sued.
When people are feeling helpless, they go to Yelp. I also think what's funny with Yelp. I think this is the funniest thing. They also get your Yelp review and their immediate reaction is, "Hire an attorney, sue him, have it taken down on force whatever." They may turn around and pay $50,000 for a consultant to come into their office and tell them what they're doing wrong. I'm like, "Dude, the lady just gave you free advice on Yelp." She felt she had nowhere to go, she's very frustrated, she's whatever." Instead of calling her, I'm saying, "Yeah, Mary I'm so sorry this happened. My god, what can I do to make you happy? I'm just embarrassed and sad that this is the way you feel. What would make you happy?" You make her happy, they may take it down and you get advice and you can talk about that in your next staff meeting or the morning hurdle whatever.
Success is very counter intuitive. When somebody comes in there and just opens up, well, there's a chance she could be nuts. People are crazy. I keep saying she. Most of the data I'm shown, probably 80% online abuse are posted by women. Is that what you're seeing?
Steven: Yes.
Howard: I see it as just feedback and it's just feedback. It's a new era. By the way, when you go out, when you go buy something, do you look at online reviews?
Steven: Never. Except-
Howard: I've never had either.
Steven: I've never had except one time my girlfriend she had a juicer that wasn't working. I Googled the best juicers and I got a very good juicer. Other than that I don't care. I know what I like, I know what I don't like. I know where to go and get it pretty much. If I don't, I just research like the location online but the reviews I don't read.
Howard: They say I've read a lot of credible stuff saying that the reason Amazon ... Amazon is now the fourth largest retail in America. It's Walmart, then Costco, then Kroger and then Amazon. By the way, if you don't know Kroger, Kroger is a group of grocery stores. Like in Kansas, it's Dillons and Arizona it's Frys. They own, they keep things local. Kind of what Heartland does. Heartland doesn't brand Heartland Dental Centers. They buy an office; they keep your name on it. Whereas, Pacific Dental Service, Steve Thorne, they're branding a name like war rings.
Steven: One more thing that drives me nuts is confirming patients stuff. Everyone's concerned about no-shows. You going to have no-shows no matter what you do. I've done all of it, I've done everything to prevent no-shows and I just gave up. I don't even confirm anything anymore. I think that's just a big waste of time.
Howard: People are crazy.
Steven: Who wants to go to the dentist anyway? Why do you want to convince someone to do something they don't want to do? They don't want to do it; someone else would want to come in and see you.
Howard: How many times if I had dollar for every time I heard this? "How was your day?" "My god, it was swamped. In fact, I was supposed to leave at three to go get my blood work done on today and I couldn't even get out of there." "Doctor, so you no-showed your doctor's appointment? Interesting." Interesting how the doctor no-showed his doctor appointment because online you're just, "These people are just crazy and you got to prevent this." The bottom line is you just did it. It reminds me back in 87 when every dentist would tell you that they would never want a patient that came from the yellow pages. Them are just the worst patients in the world. Then, in your eye you could see your wife sitting in the kitchen going through the yellow pages, using it. Is that your honey bunny, is she asking to go.
Steven: No, no I'm okay. She just wanted to see if I'm still on so I told her yes, that's all.
Howard: Okay but that was funny. If somebody comes out off the yellow pages, he is a bad person and your wife sitting in the kitchen right now using the yellow pages. People that no-show their appointment are evil animals and you just missed your doctors appointment. That's funny. I only got you for three more minutes. What would you advice be to the people listening to Itunes that have never been to Dental Town before? The website?
Steven: The people that listen on Itunes and never been to the website?
Howard: Yeah. What would you say to dentists listening to this on Itunes? They may be in [Campman Doo 00:57:22]; they may be in Tanzania, Ethiopia around the world and they've never gone to the website. What would you tell them about Dental Town?
Steven: I would tell them to log on to Dental Town and just read it. You will learn something and also be entertained because there's a lot of funny stuff in there. You do learn things and you get a good entertainment. You have a place to vent. All of us have to vent. Dentistry is stressful so if you have a place to vent, you let it out.
Howard: Hey, that is an hour and i just want to say this Mauty seriously. You have given more smiles and more laughs and more laugh out loud. I have spit out my coffee ten times in the last 20 years. Man, I just love your humor, it's always fun and you're right, it is like my bar. You and my bar, you're going to weigh-in the same way every single time and I love you for it. I love you for holding your ground.
I can't believe how many times I've lectured around the world and people would come out to me and specifically ask like, "Do you know Mauty or whatever?" Dude, you have ... My final question. You have 17,000 post and 95% of the dentists log on to Dental Town every day would never ever post. I always ask them why and they're afraid. I think it's because obviously you're a social animal, you're a pack animal. You don't want to draw attention to yourself and you're just hard-wired to get along so that you all work together. What would you say that person who just so much wants to say, I agree or disagree or whatever but they don't have what you have? What is you and I have where we don't care why we post and other people are afraid to post? What do you think it is?
Steven: I think it's my upbringing because my parents didn't care about stuff. They were very thick skin and pretty much they used to tell me, "Life is like a big game and just roll with the punches." I don't take things personal. It doesn't really matter; it has no affect on me. People should post, they should post their opinions. If they can't post o n a website in the privacy of their own home, how can they go into an office and tell patients what to do about their dentistry? That's actually more scary than posting on a website. If you think about it, while you're talking to another human being and trying to convince them to do something. If you think about it, that's more nerve-racking than an anonymous post on a website at 12 in the morning, midnight or whatever you do it. I think so. You shouldn't be afraid.
Howard: I always tell that to each other. There are always worried what someone is going to think of them. I say, I can assure you at seven billion people in the planet right now, nobody's thinking about you. People always think about themselves. They're not taking a shower wondering what Don posted yesterday or what Mike Bar said this or whatever. No one is thinking about you. If no one's thinking about you, why are you afraid what everyone else is thinking about you? Everybody else is totally thinking about themselves if they can get through their breakfast and work and lunch and commute and dinner and laundry and this a and that. No one is sitting around thinking about you.
Steven: That's right.
Howard: Every day on earth, 150,000 earthlings die every day and you didn't know one of them died yesterday and you didn't go to one funeral. Yesterday, you didn't shed one tear for one person who died. Life goes on, the circle of life. 150,000 die every day, 200,000 are born, no one is thinking about you. Success is counter-intuitive, if you have a problem, if you don't log on and share and tell what your issue is, nobody can help you. Don't spend any time worrying about what everybody thinks, spend all your time on here is a free resource where you could go on and say, "I'm kind of stress, here's my problem." All of these free volunteers like you and so many will get on there and give you their advice for free. It's special; it's romantic.
It's guys like you who made Dental Town so damn special Mauty. For that, I will always love you. You're like a brother to me. Thank you for all you've done for your own patients, thank you for all you've done for dentistry and thank you so much damn much for all you've done for Dental Town.
Steven: You're welcome.
Howard: All right. We'll see you at a town meeting again some year.
Steven: Okay.
Howard: All right buddy. Take care.
Steven: Take it easy.