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AUDIO - HSP #141 - Jay White
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VIDEO - HSP #141 - Jay White
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Forget dental school; they don't even teach some of these concepts in business school. Jay White, MBA shares what you should be focusing on. And it might not be what you think.
Jay is the founder and President of J White and Associates LTD a dental managment, coaching and marketing firm. For over 40 years Jay and his team have coached dentists and team members on how to improve the profitability of their practices. Choosing to have dentistry is a decretionary decision, so suddenly the behavior and training of the team become exceptionally important.
Jay Graduated from the Northwestern University Business school and earned an MBA in marketing and finance from Univ. Of Southern Calif.
website: JWhiteAndAssoc.com
cell : 612 599 3219
Office: 952 432 3322
Howard Farran: Today, it's a huge honor to be interviewing Jay White, and we both have an MBA. I'll tell you, you are one smart cookie. I have been following you on Twitter for years, and, dude, you just tell it like it is. I don't know if that's because you're from Minneapolis-St. Paul, which is kind of more representative of the real country than a lot of the dental education that comes out of Beverly Hills or rich Manhattan, where there's ten million people. You're just in down-and-dirty Minnesota, and you're a legend in practice management. Thank you for spending an hour with me today.
Jay White: Oh, I'm looking forward to it, Howard. Any time I can spend with a bald-faced Yul Brynner, we're all set.
Howard Farran: I wish I was that handsome. He was a handsome dude with his bald head and his earrings, everything. I'd trade my house if I could look like Yul Brynner. But I've gotta tell you. Do you know why I'm so familiar with your town?
Jay White: Tell me. Tell me.
Howard Farran: Well, my sister is a cloistered Carmelite monk in Minneapolis-St. Paul for 25 years, and to visit her, to make it a business expense, I have to spend four hours and one minute doing something. So, every time I went and visited her, I'd either stop three hours, four hours and one minute, talk to her. And they've got a dozen people that have PhDs in organic chemistry, and they talk way over your head. I go to Patterson, and the CEO there was my buddy forever, Pete Burchett. I sit in his office, I'd talk from 8:00 to 12:01, and then I go drive out to Lake Elmo.
Jay White: Lake Elmo Inn is out there. Great place for dinner.
Howard Farran: Yeah, and I'd go spend the rest of the day with my sister. I have to tell you a story, and I don't know, maybe you'll believe it. No one else believes it, but one time that I went and visited my sister, I live in Phoenix, Arizona, the desert, and I left my house. When I got to her convent, it had dropped 100 degrees.
Jay White: Easy, easy. Come in February. Come in February, when we're having a nice day in Minnesota, when it's not snowing, and it's not 20 below, and we got sun. That lasts for probably two weeks.
Howard Farran: So give us the background, in case there's someone out there living under a rock. How did you go from an MBA and get into the dental business?
Jay White: Interesting story. I went to the University of Southern California for an MBA, great spot, very good school. As soon as I got my degree, I got drafted into the US Army and went to Vietnam. I came home and grew up in Fairview, North Dakota. There was a guy there who was starting a company doing management consulting, and I thought, "God, that would be a great place to do, great people to work with, smart cookies. And they need help in the business area." So I've been doing it since then and enjoy it very, very much.
Howard Farran: Well, what year was that?
Jay White: 1971.
Howard Farran: 1971, you started in dentistry.
Jay White: Right.
Howard Farran: And this is 2015, and I don't understand geometry or calculus, so how many years is that?
Jay White: That'd be 45, 40-something, yeah. If I'd stayed in the army, I could've retired by now.
Howard Farran: Well, it'd be 44 years.
Jay White: Yeah.
Howard Farran: And you look great.
Jay White: Well, thank you.
Howard Farran: Thank you for serving our country in the Vietnam War. I just read last night that 25% of Vietnam War still suffer from PTSD.
Jay White: I read that also. The Lord looked after me. I was well taken care of. I had a great job, and I had gone back to Vietnam four times since then just to take pictures. I have a photography hobby that I do, and I've got some very close friends in Hanoi, of all places.
Howard Farran: Yeah, 90 million people live there. That's three Californias, right?
Jay White: Yep, it is.
Howard Farran: That is an amazing country, a beautiful country. So, you and I both have an MBA. I want to start out with the obvious. You've been doing this for 45 years; I've been in this for 28 years. We both have MBAs. What did they not teach dental students in dental school that you wish they would have learned along the way of eight years of college while we were memorizing geometry and trig and physics? I swear to God, I've never used geometry or algebra or physics. I can go on the record to say that of all undergrad and the first two years of dental school, I don't think that I've used 90% of that knowledge. Then I graduated dental school. The first week, I have to make payroll, and oh, they forgot to cover payroll. You'd think they could've at least gone over Quicken Payroll. I mean, you didn't know the difference between a statement of income, a statement of cash-flow, a balance sheet. They just skipped pretty much everything you have to know-
Jay White: How to write a check.
Howard Farran: Yeah. So you consulted with so many offices. What are the low-hanging fruit that you can talk about? That they just don't get, or they need to focus on?
Jay White: I'll tell you what. We've got a great dental school here in town, Minnesota Dental School. It's wonderful. It's well-known. I went over to teach the juniors and the seniors as much as I possibly can. I've spoken to the group, and, I'll tell you what, everybody is focused on doing perfect, wonderful dental procedures. When you really get out there, and get out into the business world, and you're mixing elbows with patients, that is not what's the important piece. You discover very quickly that dentists need three things to be successful, basically just three. 1) They need competence. They need confidence. Somewhere along the way, they need to pick up some patience. You know, you just don't hang out your sign anymore, and people just flock to your door. It just doesn't happen that way. I started out in '71, and there was a six-month wait to get into most dental offices. It was a real difference of problems than we've got today.
So the dentists, unfortunately, when they get their license, go to work for these huge corporations that I don't think do anybody any favors. They try and push patients through as fast as they can to make money and keep their numbers going. If you want to do dentistry today, I think the key is slow things down and build the one thing nobody every taught you in dental school is, relationships. It's all about relationships and trust. If you think about what is your business, your business is basically relationships and trust before you get to do anything with clinical dentistry.
So you ask yourself, "How in the world do you build a relationship with a perfect stranger?" Well, you did that with your wife. How did you do it? You sit down and listen, and you listen some more. You ask really good questions. If she's boring, even pretend that she's interesting. Basically, you listen and you spend time with them. You find out what their story is before you actually do any dentistry because the dentist who's coming out of dental school does not know the fact that if you're going to have a patient say "yes" the patient usually says "yes" for their reasons and not yours. Lord knows we've got 210,000 good reasons why they should do MOD or a crown or an implant. They're all very good, but they're all clinical. If all the patients were dentists, we'd be in good shape, but most of them aren't.
So what's the reason that the patient wants to do this? It's their reasons and not yours. Take some time and listen to these people. If you're new starting out, guess what, you don't have a whole lot of people to see anyhow. They're going to be good people. Listen to them. Ask good questions.
Howard Farran: I think it's funny how they'll go numb up the patient and then leave the room to go do nothing, when they could've sat there for four or five minutes and gotten to know the patient and all these things like that. It's funny because whenever you talk about this kind of stuff that we're talking about right now, 80% of the dentists in the community says this is that soft fluff bullshit. I want to hear about the working length of a root canal. Should you screw or cement an implant. It's like "buddy." Even though I'm a dentist, I'm guilty. I want to know all about that stuff. It's the soft fluff stuff that is the whole game.
Jay White: Yes, yes it is.
Howard Farran: It's the same skill with your patients as it is your staff, as it is your kids, and brothers and sisters and uncles. It's all people. Life is just managing people relationships.
Jay White: It leads somewhere along the way from birth to the point wherever you are on the planet right now, you've got to absorb a philosophy of people. They're not little tiny people you can boss around. They want the same thing you do. They want to be successful. They want to do something really great in their life. They want to be appreciated. If you can get that at the dental office, you've got a really big deal, A) as a staff member, but B) I mean, what do dentists do for a living? They make people's lives be wonderful.
Howard Farran: Say, in addiction, in AA, the first of the 12 steps is to admit you have a problem. Right now, you're talking to about 7,000 dentists. Of these 7,000 dentists, how many dentists have you been with in the last 44 years, would you guess?
Jay White: Oh, I've lost track. Over 10,000 probably.
Howard Farran: Okay, so most of these guys are in denial. So let's start there. You've got to admit you have a problem. This guy's driving to work right now, and he's in his F150 pick-up truck. He's leaving his town, his house of 5,000, driving into the city of 10,000 where his office is. The average commute is about an hour, even in the rural. It's amazing. I always thought a commute would be someone living in LA, but all my podcast people are saying they have a 71-mile commute, and it's across the plains of Nebraska. What are some red flags that this dude doesn't even know what he doesn't know, that he has problems that a consultant like yourself can fix?
Jay White: Well, you should be able to come away from a patient interchange and know about ten things personally about this patient before you do any dentistry. I mean, sitting down and engaging with a conversation or someone in the office doing that, because the patient is wanting to be understood more than they want to understand they've got an MOD on five.
How in the world do you get someone to feel that they're understood? And this is particularly true with women. Women have what I call a mock-one crap detector strapped to their waist, and it's highly-tuned. They can tell when someone's giving them a line. You've got to look them in the eye. You've got to be genuine. You've got to talk about why in the world are you coming to the office? The dentist knows, in that car as he's driving to work, he knows A) what he's going to do when he gets there 2) he knows how he's going to do it. He knows he's got technology all over the place, but what he's got a difficult time seeing is why I'm doing this.
It's got nothing to do with money. It's got nothing to do with money. It's all got to do with purpose, why I'm here, and what I'm trying to give to my community, people that I'm working with, and how can I help you, being someone who's got some special training? It's a bit of a philosophy piece; it can't be too long; it's got to be 30-seconds, 40-seconds, but it's got to be genuine. You've got to look them straight in they eye, and they can tell if it's not true. That's the beginning of trust.
Howard Farran: How many people work at your- Your website is jwhiteandassoc.com. How many people do you have working for you? I mean, your website's got half a dozen consultants.
Jay White: Yes, we've probably got a team around six to ten people.
Howard Farran: I first started with denial; first, you've got to admit you have a problem. Let's go with the people who are calling you. What are the reasons people are calling you? Who calls you? Is it the dentist? Is it the dentist's spouse? Is it the office manager? Who's calling you and why are they calling you?
Jay White: Usually, it's the dentist who has achieved a point where he's just asking himself "I can't keep doing it the way I've been doing it. It doesn't work. What can I do differently?"
Howard Farran: What is the straw that breaks the camel's back? Are they missing payroll? Did the accountant say, "you owe the IRS $30,000?" Is it financial? Is it emotional? Is he burned out and says, "I just can't do this anymore?" What is the straw that broke the camel's back on these thousands of dentists that have called you over the years?
Jay White: It's basically a couple things. 1) It's a personnel issue because they don't know how to handle the staff. If I look through my files, Howard, and look at the material I've got, I've got more stuff on staff issues than practically anything else. They were never taught how to handle staff issues.
Howard Farran: That's the hardest thing. When I went to Creighton in 1980, I seriously believed that if you got an A in calculus and physics and chemistry, those were the three secrets to the universe.
Jay White: No, no.
Howard Farran: I lived in the library for three years and got As in all that stuff, but now I realize at 51 that that was just a complete waste of time. I should have been in a fraternity, dating and figuring out people. The chemistry and physics and geometry got me nothing. It's all understanding people, isn't it?
Jay White: I'll tell you what, Howard, if you go to any gathering of dentists, of any number, you will discover the conversation eventually turns to clinical dentistry. What I'm doing here and what I'm doing there and technique, da-da-da. The continuing universe is focused on providing training to do a finer procedure, and I'm telling you, most of these guys and gals know how to do a fine procedure. They don't know how to do a fine person. They don't know how to welcome someone in a warm caring way so they feel like, "God, this is the place for me." They don't know how to keep staff either. Throwing instruments is not something people are fond of, okay? Telling people that 'you can be replaced' is not a good way to motivate people and keep people long-term. Patients want service; they want personal service, and they can't get it from a stranger every time they come to the dental office.
Howard Farran: What are the most common HR, personnel issues? And how do you coach these dentists to solve that? Is it because the dentist wants a raise, and he thinks the overhead's too high? Is it because people are showing up late? Is it because they're rolling their eyes whenever he says anything? What are common HR problems that you deal with? What are the most common HR issues?
Jay White: Well, of course, no matter how successful the practice is, everyone wants more money, including the dentist. That's a terrible thing to say. No, there's nothing wrong with having more money, but how in the world do you earn it? How do you get it? The dentist feels a heavy responsibility on his or her shoulders to provide the income to pay these people. Often times, they get more raises than the doctor does. The doctor actually takes a cut in his salary. The reason for that, I believe, is because the system that we're following puts the doctor as the leader of the band, and he shares no power whatsoever with the staff.
I will tell you, point-blank, unless you've got dolts as staff, you've got some great people who have ideas. You have to give them some power to feel like they've got a contribution to make to making the office successful. I've worked with a really good system of compensating staff and making them entrepreneurs, so that they're in charge of their own compensation. The doctor hasn't got anything to do with it at all. We make sure we do budgets, and we set goals. When the goals are met, we pay people extra money. It works out really well. In fact, the ones who are really, really serious about having a career in dentistry, we make them partners in the staff, attitudinal partners in the enterprise. They guarantee they'll never get their salary raised as long as they live in the dental office.
Howard Farran: Now, can you give that away on my podcast? Or do they have to call you and buy your services?
Jay White: I'll tell you what, it's not possible to do it without some coaching on the way. It's a philosophy I believe in. It's a philosophy to make people successful, make them successful. Everybody wants to be successful. When they're successful, reward them. You don't have to give them a salary every year. You can reward them when it happens. It's just wonderful. I've been doing it probably over 30 years, and it never fails.
Howard Farran: If a dentist wanted to get your coaching, how does that work? Do they just go to www.jwhiteandassoc.com? Do they email you? How does someone contact you?
Jay White: They can email me; they can call me. First thing I'd do is tell them what I tell our clients to do, it's listen. Let me listen to you.
Howard Farran: What's your email?
Jay White: Jay@jwhiteandassoc.com.
Howard Farran: And what's your phone number?
Jay White: Cell number is 612-599-3219.
Howard Farran: And that's your cell?
Jay White: That's my cell.
Howard Farran: That's your cell. And how much does consulting someone cost? This guy's wondering how much what does something like this cost? Is it $30,000? $50,000? How much is something like that?
Jay White: You know, I get asked that a lot. Each practice is a little different. Do you have a four-man practice, a four-dentist practice? A solo practice? It's different. I can't say specifically, but it's not that expensive. It gets benefits like you wouldn't believe. Our first year, clients are usually up 20-30%.
Howard Farran: Is it like you have to sign a year contract? Is it month to month? Is it a two-year contract? Or an 18-month program? How long is it?
Jay White: No, I've found that what we end up doing is a lot of working with the team. It's behavior change; it's attitudinal change. You know what, Howard? People don't change their attitudes overnight? It takes some time. Usually I work with a client over a year. We're into the office, working with the doctor and his team as a coach, many times throughout the course of the year.
Howard Farran: Like once a month?
Jay White: Well, monthly? Sometimes more often than that.
Howard Farran: It depends on if they're having a crisis or if they're just fine-tuning? You know what I've always seen? Success is always counter-intuitive. Every time I find a really successful dentist, they've used a half-dozen consultants. The most successful office I know is Jerome Smith, in Lafayette, Louisiana. He uses a consultant everywhere. All the people think that someone that successful would never use a consultant. Dude, that's why they're successful because everybody that's very successful like me is thinking, "well, if I give you a dollar, I'm sure I'm going to get that dollar back and some more by the end of the year." The other thing that's a weird human phenomenon is when I say something to my staff, and I'm a short, fat, bald guy, and they know I'm just like them, they'll take it all with a grain of salt. When someone a hundred miles away from home, it's just "they're the expert." People just listen to everybody that comes from far away because if you're from far away, you know something they don't know in Bubble-butt Meetings, Arizona. It's true, though. Have you noticed that?
Jay White: That's true. It's true. The other thing that you kind of have to realize is this: Mom and Dad can tell the children one thing, but Grandma and Grandpa can do it, and they'll do it really quickly.
Howard Farran: I carried on really bad trait to my granddaughter. I had four boys, and I finally got rewarded. I have a granddaughter now.
Jay White: Oh, wonderful.
Howard Farran: I always tell her she's my reward for not killing my four boys. When I was little, I had five sisters. We drove from Wichita, Kansas to Parsons for three hours. You know, six kids can't stay at one grandma's. So they divided us, two kids each- great-grandma, grandma, and grandma. I always picked great-grandma, and my Dad and Mom used to always say, "oh, that's so sweet. You always want to go to great-grandma's." Because she was the oldest and could barely get around. Everyone always thought I was so sweet that I wanted to stay at great-grandma's, but the only reason I wanted to stay with her was because she always had a bag of Milky Way candy bars in her refrigerator. So now I'm a dentist, but I always say I'm on the bottom shelf of my refrigerator, all the crap you could ever want to eat. When Taylor comes over, she goes running for that.
Jay White: Yeah, yeah, yeah, yeah. Good stuff.
Howard Farran: Do patients come to your office because you have a CVCT and a laser and Darth Vader standing in the corner? Is technology driving new patients?
Jay White: The biggest fallacy in dentistry today is that if I buy enough technology, if I go to enough continuing ed courses that are expensive and Frank Spear. You've got Pinky; you've got Face. You become an expert-expert-expert. The greatest fallacy is that people will come because of that, and it is not true. It is not true. Those are things that make you competent; by golly, you need them. That will help you in your confidence, which happens to come through in your tone of voice, in your behavior, in how you handle people. People come to you because they want to trust you, and they like you. And some small things, Howard, some small things, like are there weeds in the parking lot? They make a difference. Is it lighted? I was in one dentist office here, and there was a dead rat under the radiator. Well, she didn't last very long, okay? I mean, you've got to pay attention to some things that people look for. It's got to be pleasant; the people have got to be welcoming. It's got to smell good and look good. It's common sense.
Howard Farran: I want you to have a dad talk with these young dentists that are 35 and under that won't delegate anything. They just think that they're a dentist because they were valedictorian. They made straight A's. They were honor roll, and, by God, they're not going to delegate to someone not as smart as me. How do you change and attitude? And another one is, I go into their office, and I say, "what do we have to do to break even today?" No one in the office knows because everything has to be a secret. You go to talk to them. That's cool.
Jay White: No, someone just came in.
Howard Farran: They won't delegate and they won't be transparent. Then there's guys like me who delegate everything and everything is transparent. Why do you think, and how do you coach someone to delegate who won't delegate? They're afraid to. I'm like, "why are you afraid to show your numbers?" Because they're going to figure out how much I make. I'm like, "hell, let them go to dental school." I don't get it. I just don't get it. Talk to that person right now.
Jay White: The person who feels he's in charge and must make all the decisions and everyone must follow his directions, or hers, is going to die young. That person has not got a life that'll live long enough to make that work. Dentistry is stressful enough without having to have all of this on top of your shoulders also. The dental student who graduates, I'll tell you, it takes you probably five years out in the world to become a really good dentist. You're learning your craft. You're learning people. You're making some mistakes, and sometimes people never learn from their Grandma and Grandpa. They have to experience the pain themselves and come to the point where, "God, I have to do something different. I'm not liking what I'm doing anymore, and I just paid $300,000 for this. I'm still paying my monthly payment on the loan." There are other people who, because they were brought up right or differently, think people are wonderful. They're trustful; you can trust them. They do good things. Those are the people who are most successful. They just are. You have to let go. You just have to let go. These compensation systems have got guarantees that people will perform, be accountable, and the doctor can relax.
Howard Farran: So, Jay, the number one problem, financially, is obviously there would be too high of overhead. Do you think too high of overhead is because your staff, labor, rent, mortgage, and lab you're paying too much for that? Or do you think it's because your production and collection is too low?
Jay White: When you actually start thinking about the business of dentistry, which is not something covered in the dental schools, you discover very quickly that dentistry is a very high fixed-cost business. The level of fixed-cost is determined by the mind of the dentist; it's how he or she wants this to go.
As a dentist, starting out, you don't need a grand piano in the reception room, hooked to a tape recorder, playing Beethoven. You just don't need that. That may be down the road a ways. The way to make money in dentistry is to have people accept your recommendations and build the productivity of the practice, given the overhead you've got. That does not mean you need to do a finer crown prep unless you really don't do a good one, you know? It means that you've got to know how to handle people; you've got to know how to present dentistry. People don't buy procedures; they buy benefits. Guess what? None of them went to dental school, so they will not be clinical. Our new patient experience that we try to work with clients is spend an hour and a half with a new patient. Be happy. Don't see a hygiene check in the middle of that. Focus on this patient and figure out what they want.
Howard Farran: You think you really do need to focus on the new patient experience and the case presentation?
Jay White: This is true. I've read it. I've experienced it. There's an average of a million dollars of undone dentistry in most dentists' chart, unless you're just starting out. They'll go home and think about it. Well, ask yourself, "why are they thinking about it when they really need it?" Well, it's their mouth; it's their body. They know more about it than you do, so maybe you ought to reexamine them rather than how you're doing your case presentation.
We had a $96,000 case presentation here last year by a dentist. How in the world do you do that much dentistry? The case presentation lasted probably about a minute or two. The doctor listened to what the patient was concerned about, and he said, "listen, George, let's take a moment here. Tell me what life is going to be like for you if everything you want we can take care of. What was it going to be like?" The patient didn't talk about tooth number 5. The patient didn't talk about the endow on number ten, didn't talk about the implants he needs. He talked about, "I'd like to eat some salad. I'd like to eat a steak. I'd like to meet people without having them think I'm stupid." The dentist said, "I can do that. All I have to do is rearrange the landscape in your mouth, and I'm trained to do that. Let's see if we can't make that happen for you." Before that, he spent about 60 minutes with the patient, trying to understand and listen to what he's saying. He built trust.
It's not rocket science, but you have to be personal. You have to be interested in these patients, and they will tell you the story of their life if you just listen.
Howard Farran: Some offices have treatment plan coordinators that present the treatments. Some dentists don't. I noticed orthodontists have a far higher utilization of treatment plan coordinators. Talk about that.
Jay White: Howard, if you want to do really fine dentistry, [inaudible]. If you want to do it in large amounts, the patient coordinator has to be trained to do some specific things. Let me give an example. Howard, you and your wife are going to retrieve an engraved invitation to the next Inaugural Ball of the President of the United States. Your invitation comes in the mail. It's embossed; it's high quality. You show it to your wife, and you say, "dear, we've been invited to the Inaugural Ball of the President." What's the first thing she's going to say to you? "I've got nothing to wear!" She's going to spend a lot of time and energy and money looking for the red dress. That red dress is going to set you back about twelve to fifteen-hundred bucks. You ask her, "what's it like? Do you like shopping for the red dress?" Yes. She's got words. She wants to look good. She wants to look good for you. She wants to make a good impression, and she's gonna do it.
You know what? Most dentists charge twelve-hundred, fifteen-hundred dollars for a crown and don't give the patient the red dress because they don't know what the red dress is! They haven't listened to the patient to understand what in the world they want. The client coordinator is a woman. Let me tell you something. Women are intuitive, and they can read between the lines better than you and I can, even with an MBA. Listen to the women. Carol, my wife, and I can go out to a party with a bunch of people, but as we're getting ready for bed she can tell me what happened. They are intuitive. They understand things that we never will understand. This woman, who is a client coordinator, can spend 30 minutes with this new patient and know more about them than you ever will in a clinical exam. The key is to merge the clinical exam, which obviously is important, with the non-clinical piece.
Then you get to talk about something important; it's called the non-clinical benefits and how these great procedures you do in your little black kit bag, which you carry around by your side all the time, can be applied to benefit the patient. They will say yes to larger cases, but you have to know what the red dress is. You have to take time to learn the red dress. Everybody's got one. You just have to ask good questions.
There's a whole set of questions that you ask. Howard, there's only six ways you can ask a question in the English language: who, what, where, why, when, and how much. There's one question you never, never ask. You never start a question out with the word, "why." You know why? Because when you were a little boy, your dad said, "how come you haven't mowed the lawn?" "Why haven't you made your bed," your mother would say. Why, why, why, why. It implies judgement, and that's not what we want in a dental office. It is an art of asking questions. You don't tell people what they need. You ask them what they want and how they want it. Then you deliver it.
Howard Farran: Give us some verbiage. Exactly how would they ask that?
Jay White: Let's say we've got a patient who we learned, because we spent time with them, is a, let me just pick one out of the blue, manufacturer's rep for Jansen's swimwear. He sells swimwear to Macy's, Nordstrom, whatever it is, and he's got to meet the buyer over here at Nordstrom. He needs dentistry to be done. In the course of the conversation, the question might come up, say, Howard, in your line of business, how important are first impressions?
Howard Farran: Very.
Jay White: Chances are, he's never really thought about that. If he has thought about it, he knows they're very important. Howard, if there's an area of your life that I can help with on that, would you be interested in that? We begin a conversation, basically asking questions about, and getting the patient to say what he wants. If making a better first impression will help him in his profession. Dentists are primary providers of first impressions.
Howard Farran: I want you to talk about this fear because it's one I've had my whole life, and I still have it because I don't know how to navigate around it. I never want to say to a woman, "oh, have you ever thought about bleaching your teeth?" Because that's like her asking me, "have you ever thought about losing 50 pounds, wearing a wig, and getting a tan." I mean, women are so objectified; I don't want to contribute to it by saying, "oh, you're a woman. You're an object. You should have whiter, brighter, sexier teeth. You want bleaching or verniers?" I just can't go there. No one's looking at me saying, "you should wear a wig." So how do you do more bleaching or bonding or verniers- how do you find out if the woman already wants that as opposed to a man trying to objectify a woman, telling her she should need that. Does that question even make sense?
Jay White: A woman, much more easily than a man, if you give her the opportunity, will unwind her story to you, especially if it's in a private place with someone who's obviously been behaviorally trained and who can set them at ease and feel that their trust is being honored. The conversation has got to be started from our dental office to get the patient to talk about their story and what's going on in their life that they'd like to have work better. You talk about that first. Is there anything we can do to help you with that?
Then the subject will turn to their teeth. Is there anything that you'd like to change about your teeth? You don't tell them, "we can go to shape whatever it is and make your smile wonderful." It doesn't got that way, and you know that. It's like the patient who is going to go south for the winter and needs some dentistry done. How important is it, Howard, for you to have a really good experience down there in Florida with the family and not have any problems with your teeth? Their mind never went there; it wouldn't go there on their own, but simply asking the question brings the patient to think about a picture in their head of how Christmas dinner is going to go and what might happen.
Howard Farran: It's funny you say that because that's my trick for wisdom teeth. My favorite procedure, for me personally, is for wisdom teeth. Second would be molar endow, but I just love fours. My big close is like, "well, you know, you can choose to have those four wisdom teeth come out when you and I want to do it. Or you could not schedule it, and it's just going to blow up in your face, and it might be in the middle of finals week in college or whatever. So it's either we schedule it or the wisdom teeth will.
Jay White: That's a good way of doing it, but take that same thing and turn it into a question rather than a statement. Don't ask the word, "why." Start out with "how." How important is it, Howard, for you to have a benefit? You name the benefit, and let them think about it.
Howard Farran: How do we word that? Would you say, "how important is it to you that you schedule the wisdom teeth to come out when you want them to come out?"
Jay White: No, no. How important, Howard, is it for you to avoid problems? How important, Howard, is it for you to avoid future problems with those teeth there in the back? They're impacted; they're causing problems. How important is it for you to avoid problems with those teeth, at a time when maybe you're out enjoying yourself? They'll say something. "What do you mean? What do you mean? Am I going to have problems with those teeth?" The answer is, "well, it looks to me like they're active and looking to happen," or whatever the situation calls for. I had a patient here last week who we had to get in on a Sunday because they were having problems with those back teeth.
Howard Farran: I'm a big fan of your tweets, and I wish you would post those on dental comedy, your just amazing tweets. By the way, Dental Town just passed 200,000 members, four million posts, and I think that your Jay White and Assoc. would get a ton of marketing if you would build an online z-course. We put up 300, I think 325 1-hour-long z-courses, and they just passed 550,000 views. I would love to have a course up on there, but when I think of you, and I'm a big fan of your tweets and all that, I wish you would multi-post those on Dental Town. I just think of you as marketing. You have a lot of marketing wisdom. How many new patients do you think a dentist really needs each month, the average dentist? What would you define as the average dentist, one dentist, one hygienist, two assistants, two front-desk? Is that about the average?
Jay White: You know, what I find amazing is that if you listen to what the people are saying out there, they can deliver you could get 100 new patients a month. I think that would be absolutely the end of the world because you can't treat people- you can treat teeth, but you can't treat people- in that huge number and do it one at a time. We kind of do some research here in Minnesota before- well, let's see if I can say this correctly- the number of new patients per 1,000 patients of record is a good way of looking at it. Before the recession, in our area here, that number was in the high teens. Every year from 2008 down, it's gone down to where it's now about seven. Now that the economy's coming back, we're watching that beginning to increase.
Howard Farran: You would say it's about 18,000?
Jay White: 18-25 would be a good number for a single dentist.
Howard Farran: 18-25 was in 2008, before Lehman's brother collapsed? Then it went all the way down to seven new patients per 1,000, and now you're starting to see that trending up?
Jay White: That's exactly right.
Howard Farran: When was the bottom? When did it start trending up?
Jay White: Well, I would say it started coming up last year.
Howard Farran: Last year?
Jay White: It's been recently, yeah.
Howard Farran: Do you think the fact that, if the stock market drops 20% it's a bear market, and China's 1/5 of the world, and their stock market just dropped 30%, do you think that could have material impact on the US economy?
Jay White: I do not. That's got nothing to do with it. Their stock market is so out of whack; there's so many strange rules. It's not worth paying attention to.
Howard Farran: I want you to keep talking because a lot of dentists, when they have problems, they say, "yeah, but Howard, the economy sucks. Obama's the president. They've closed down the factory in my backyard." They always say everything but the man in the mirror's the problem.
Jay White: Well, there's a story about a gentleman who sell hot-dogs on the street in New York City. His son went to Harvard and took marketing. His son came home and told his dad, "Dad, don't you know there's a recession on?" The dad closed his business for no apparent reason. It was just hearsay. You have to drive your own business. You have to excite people about what they can get from you, other than teeth. I tell dentists, the product that you have is the feeling the patient has in the parking lot after you deliver the procedure. Your product is not that funny, little, white thing you just spent a whole lot of time learning how to put in their mouth. That is not your product; that is not your business.
The business is the feeling. Well, goodness sake, if it's a feeling, you can reverse-engineer that to make it be what you want it to be, but the staff have to come with you. That's why the personnel become such a big part of this thing. Do you have to do marketing? Yes. You have to spend money on marketing? Yes. But if you're doing a new patient experience, where you're getting to know these peoples' stories, you don't have to do as much marketing because these people feel trusted. They feel you trust them. I went to school at Northwestern University before I went to the USC, and I had a great, great, world-known marketing professor, by the name of Stuart Penderson-Brit. He had a handle-bar mustache. He was an iconic figure. He had more hair than you do, and he has a great quote that I'll never forget. It goes like this, "doing business without marketing is like winking at a girl in the dark." You know what you're doing, but nobody else does.
Howard Farran: I like that. That's nice.
Jay White: You can't do business today, you can't do dentistry today without marketing. How much money should you be spending marketing? Well, it depends on your case presentation goes and how you're doing on new patient experience, but two-ten percent is a good number. In Minnesota, we have a little thing called Delta Dental. We do not worship Delta Dental, let me tell you. Our dentists are writing off to Delta between 10 and 28% of production. I say to my clients, "look, you're already spending 10-25% marketing already. You're giving it to the insurance company. If you could spend that same amount of money on marketing, you would be free of the insurance company.
We have a gentleman buy out $250,000 and spend it all on marketing- a four-man group. The man is wildly successful. The problem we have in dentistry is marketing is not like doing a crown prep. At the end of 60 minutes, you're done. Marketing never stops. It requires repetition, repetition, repetition. There's a reason, when you get home tonight and watch TV, you're going to see five ads for a Ford 150 pickup. You're not even in the market for a Ford 150 pickup, but, should you be, they want you to have Ford on the top of your hear.
Howard Farran: Do you do marketing? Is that one of your consulting services?
Jay White: We are engaged in digital marketing. We find that it's much more effective than the traditional methods of magazines and postcards. With digital marketing, you can see who you're talking to, communicating with. You can see the numbers of how good your ads are, and you can track them. We do things with Pay Per Click; we do Facebook Marketing. Facebook is the absolute wonderful way of beginning to segment a market. The dentist just thinks he can. Most dentists do what is called spaghetti-money marketing. They throw something on the wall, and if something sticks, they stick with it. That's not the way to do marketing today. You have to have a plan. You have to know what you're doing. You have to plan it out.
We have a client over here in one of our suburbs. September is the month to take a vacation in dentistry. September, the whole place falls apart in September. Nobody comes to the dentist's office in September, so take a vacation. In the month of August, we decided to do a Pay Per Click marketing and Facebook Marketing for Invisalign. We did it through the entire city. The client at the end of September, and getting into October, had 30 new clients and did $20,000 more dentistry in the month following that. The ads that they ran cost about $400. It was not expensive.
Howard Farran: How many new patients should a dentist be getting? Did you say 18-25 per 1,000 charts?
Jay White: In the teens somewhere per thousand, right.
Howard Farran: In the teens somewhere per a thousand is a good range, healthy. If someone wants to do a marketing program, that's one of the services you offer?
Jay White: Yes, it is.
Howard Farran: Name all the services you offer.
Jay White: We do websites, and the important thing you have to know about websites-
Howard Farran: You build the website? You create the whole website?
Jay White: We create the website.
Howard Farran: Do you host it?
Jay White: Yes, we do. We host it. The thing you have to know about websites is our websites are customized to our dentist, our client. It's not a customized knock-off website where you go to Dental Economics, you can buy a website for $400. I can go to that website and tell you how many thousands of other dentists have the exact same website. Google knows that before you do. They rank you down in the rankings because they want something original; they want something current for their customers, and you're not that. If you want to do really well in marketing, you need a customized website. Well, guess what? You need to know a little more about you, the dentist, in terms of are you marketable? What is so wonderful about you, that sets you apart from every other dental office? We do websites. We do logos. We do the design of the website, and we do Pay Per Click marketing once it's all set and the SEO as well.
Howard Farran: Explain what Pay Per Click marketing was because my job is to guess the questions of 7,000 dentists from here to Kathmandu. What is Pay Per Click marketing?
Jay White: Let's say, for example, you've got a website and you just put it out there, okay? Nobody knows it's there, nobody, so how do you get recognized? There's two ways; one is, you can go to Google and you can pay Google some money. You can buy certain words; you pay money for them. It's a 24 hour-a-day auction going on on words. So, for example, 'dentist' 'Minneapolis,' 'dentist' 'Cottage Grove,' 'Crown & Bridge' 'Fargo North Dakota,' and you pay some money for those words. So when someone clicks on those words or types those words into their computer, your website will be promoted on the very top of the page, instantly.
Howard Farran: Now, when you say Pay Per Click, are you basically talking 99% Google?
Jay White: Well, Google is the big guy in town, and, yes, that's where I'd spend money before I spend anything else.
Howard Farran: You wouldn't waste time on Bing or Yahoo?
Jay White: It's a second-class place to go.
Howard Farran: You know Google's the winner when your grandma says, "well, Google it." Explain this. You're a social media legend. Really, you are really good at it, and these dentists are looking at this stuff. Like, which words are you talking about? You have Facebook; you have Google; you have Google Plus; you have Twitter; you have Instagram. There's just so many social media sites. What ones should a dentist focus on? What's not worth your time? What is something you can't leave, you can't have a no-show presence on?
Jay White: The one's that are the most looked at, the most visited are Facebook, by far, and, if you're a specialist, I would look into your- oh gee, Jay, I just lost it.
Howard Farran: Twitter, Google Plus, Pinterest, Instagram?
Jay White: Instagram is not quite where I'd go.
Howard Farran: Instagram, wasn't that bought by Facebook?
Jay White: That's a possibility.
Howard Farran: I think it was. Well, what's the one a specialist should go to? Google Plus?
Jay White: No, no, no. I'm just having a block on my mind here. Oh, Jay, come on.
Howard Farran: LinkedIn?
Jay White: LinkedIn is the one I'm saying it is!
Howard Farran: Really?
Jay White: You can't be a specialist and not be on LinkedIn.
Howard Farran: Well, why is that?
Jay White: Because, as you gather the people on LinkedIn who are other general dentists, you can communicate with them directly and not have to go through a receptionist.
Howard Farran: That's interesting.
Jay White: It's a direct piece of communications. They have the ability to market to a targeted group of other general dentists.
Howard Farran: I bet you out of 7,000 listeners, 5,000 don't understand one thing you just said about LinkedIn. Repeat what you just said to someone who's never been on LinkedIn.
Jay White: Well, you join LinkedIn, and you put a profile up on LinkedIn as to who you are and what you're all about. Other people begin endorsing you for different things, endorsing you for cosmetic dentistry, endorsing you for management, endorsing you for a bunch of stuff. As you get more endorsements, more people get to know you. You can endorse other people, as well. You go out there and endorse other general dentists who are on LinkedIn; they are there. You begin to have a coterie or a group of followers on LinkedIn, and you can communicate directly to those people through LinkedIn. They'll read your messages about continuing ed courses you might be putting on for your general dentist about whatever training you're going to go to to get specialized implants, whatever it is. They begin to, then, think you're wonderful, and you become the go-to person.
Howard Farran: You're saying that's for specialists?
Jay White: Well, it's particularly good for specialists. General dentists do it too, but I would spend more money on Google Pay Per Click than I would on that for a general dentist.
Howard Farran: Okay, we're at 55 minutes, so we've got to start wrapping this up. I've only got five minutes. I want you to be more specific to- there's dentists listening to you. Most of my viewers are listening to this sound only. They're multi-tasking. Almost everybody I talk to has about an hour commute. In fact, the only complaint I really get on my podcast is that they have an hour commute to and from work everyday, five days a week, and they want ten shows a week. They're like, "dude, you're only giving me four or five shows a week." They want more shows driving to work. What are the best problems you saw? This guy's driving to work. What are the best reasons that, if they called you, you're really confident you could help them with this? What problems are they having that, if they called you and gave you money, you could fix this problem?
Jay White: We can help solve staff issues and build a team that's cohesive, coherent, and anxious to make things happen at the dental office. We do that through making them an entrepreneur. I've done it for too long. It works every single time. Number two, I would begin to learn about people and go to continuing ed on people things not clinical things, unless you're trying to expand your offering and you need some help on how to do implants. I would learn how to do implants. Then you've got to know how to get people to want implants. I would pay attention to the ability to make my staff feel like, "this is the place I want to work." It's a great place, and, more than anything else, women want to be acknowledged and praised. The dentist typically only says when they're doing something wrong, and that's not the way to raise children.
Howard Farran: You said in the beginning that you've done this since 1971. What would you say to these young dentists? Is corporate dentistry going to take over? Did I make a mistake becoming a dentist? Is corporate dentistry going to take over dentistry? It's going to go Walgreens, and every single independent pharmacist is going to lose their business and work in a chain like Walgreens?
Jay White: Howard, there is always going to be a place for a private, fee-for-service dentist. However, he's got to be able to say, "this is what I value." It's a values-centered practice, and you've got to be able to enunciate what your values are. The answer is "no." Right now, the corporate dentistry is expanding, and they're getting a lot of attention. But there will be people who always want a relationship with a healthcare provider and not just a machine where they go to where it's cheap.
Howard Farran: You've been doing this for, what did we figure, 40 years?
Jay White: 210 years!
Howard Farran: In 40 more years, what percent of the market do you think the big multi-state corporate chains have? What percent of the market do you think they have today? What percent do you think they'll have in ten, 20, 30, 40 years.
Jay White: Well, it's going to grow. It's hard for me to say what the market penetration is right now. In our town here, in Minneapolis, Minnesota, the corporations are just coming in, and they're spending a lot of money on marketing. They're single-handedly raising the salaries for dental assistants because you can't find them. It's probably going to be more than 50%.
Howard Farran: Probably about 50%?
Jay White: Yep.
Howard Farran: And do you know why I think it's going to be 50%?
Jay White: Why?
Howard Farran: My son Greg always points out that lawyers went corporate first. Lawyers and dentist positions, they all have eight years of college. They're like herding cats. There were big law firms way back in the 70's, 60's that are still in business. About half the lawyers, there's one million attorneys, half of them work for the big firms, and half of them work by themselves.
Jay White: Right.
Howard Farran: Greg thinks that's the best predictor of where dentists are going to go, and I think he's right.
Jay White: Those gentlemen or ladies who are going to be out on their own, who are wanting to be in charge of their own show, have got to find a way to publicly wave the flag above their office and say, "this is who I am. This is what you can expect when you come to see me." It's not fast-food.
Howard Farran: My last question, because I've only got you for another minute, is what's the best way to compete with corporate dentistry, then? Just a relationship? You're not a chain; you're a human relationship, is that what you're saying?
Jay White: The corporates have no way of building a quality, long-lasting relationship with these people. They're not interested in it. They're interested in getting people in and out. It's the teeth that are the important part. The private practice of dentistry is built on relationships, and you will have lots of people if you can do that well.
Howard Farran: Is there any middle of the road corporate? Some dentists say, "well, I can kind of compete with a corporate maybe if I get an associate and have extended hours." Do you think you have a more competitive advantage if you have an associate or have extended hours, or do you not really see that in your practice, where the rubber hits the asphalt?
Jay White: There's some real technical issues behind that that you kind of have to think about. Just having extended hours doesn't mean you're going to get more new patients. I have not seen that happen.
Howard Farran: So the old adage, if you build it they will come, you don't believe that? So a dental office that's been open Monday through Thursday 8:00 to 5:00 for 25 years, if he gets an associate and blows open Friday and Saturday, that doesn't necessarily equate to more new patients.
Jay White: No, it doesn't right away. He has to be able to market those hours. Some people will come, and some people won't. Hopefully, he's got enough patient base where he's already got patients who will come at those times. He just expands the hours, but new patients won't necessarily come directly because of that.
Howard Farran: Do you consult mostly in Minnesota? Or do you take clients all over the United States?
Jay White: We're primarily the upper Midwest, at this point, but our marketing activities kind of can go almost anywhere.
Howard Farran: You'd be of value for any 50 states, but you're primarily-
Jay White: Yep.
Howard Farran: I follow a lot of your consultants. Do any of them- Would any of them be worthy of- Did you cover pretty much your consulting firm or do you have any other consultants that cover core specialty that might be a good interview?
Jay White: We have some people who are very good at simply front-desk training, especially if you had a new staff member coming in who needs to be trained on how to operate the front desk.
Howard Farran: I mean, worthy of an hour podcast?
Jay White: I would bet so, yes.
Howard Farran: Then, set them up. If someone you think would add value for an hour, I want to interview them. I'm a big fan of yours. A lot of my friends in the Minneapolis-St. Paul area know you like the back of their hand. They say nothing but great things about you. I'm a big fan. Would you commit maybe to an online z-course on Dental Town for maybe 200,000 townies?
Jay White: I would do that.
Howard Farran: I think it'd be the best digital marketing you do.
Jay White: Okay.
Howard Farran: Our business model is, you know I have about 50 employees, so if you put up for free, we will do it for free. If you charge a buck, we split it with you. That's our business model. So if you want it free, if you want to charge whatever, we just split it. Also, to my viewers, I just want to make sure that, in Dental Town, our business model is that we give everything for free to the dentists like the website, podcasts, whatever, and then we make money on advertising and those two departments are separated with the Great Wall of China. Nobody's ever given me a dollar to be on my podcast or to be a column or anything I lecture about. Those are just completely- seven people do advertisement. The other 43 are fixing teeth or doing a magazine or whatever. I just want to thank you, Jay. I know you're a busy, busy man. Thank you for all that you've done for dentistry. Thank you for serving our country in the Vietnam War. I'm your biggest fan, and thanks again.
Jay White: Howard, thank you. You're wonderful, and someday we'll get some hair on top of that head.
Howard Farran: Next time I'm visiting the convent, maybe we'll do dinner or lunch or something.
Jay White: I'd love it, I'd love it.
Howard Farran: Okay, all right. Have a great day.
Jay White: You too. Thank you, Howard.