Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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Howard Farran:  It is an honor to be interviewing today my favorite orthodontist in the entire world, Dr. Ann Marie Gorczyca. You’re an amazing person at so many levels, this is so exciting for me today. You just finished your second book, correct?

Ann Marie Gorczyca:  Yes and thank you Howard, the pleasure is all mine.

Howard Farran:  So before we talk about your second book, first of all, I don’t want to draw into the fact that you’re a woman but I really feel like I have to because things have changed since I became a dentist.

When I was in dental school there was only one girl in the senior class and now I’m in a dozen dental schools each year and its half women and you were telling me the other night at dinner that when you got out of school it was even hard for a woman dentist to get a job.

Ann Marie Gorczyca:  That’s correct and I’ll just share one thing with you; when I was in my residency program I was the only female resident with eleven guys and I showed up the first day for my residency and I was like oh boy, here we go but my classmates were like my brothers and now in 2014 I’m happy to report that at University of the Pacific Dental School we actually had one class that was seven women and one male student in the orthodontic program, so the women are here especially in the field of orthodontics.

I just want to bring your attention, the other night when you were at the Sacramento District Dental Society, the president of the Sacramento District Dental Society was also a woman orthodontist and we probably should have got her in the picture with you as well.

Howard Farran:  And the new elected president of the ADA, is she the second woman now?

Ann Marie Gorczyca: Probably, I’m not sure but the American Association of Orthodontist, last year we had our first female president.

Howard Farran:  So I know you weren’t expecting to be interviewed with this question but the first question that I have to ask you because I’m not qualified to answer it, is I have been hearing women dentist tell me for 27 years since I graduated- the male doctor tells the five or ten women staff to do something and they just go do it and then I tell them to do something and they give me a completely different reaction. So my first question to you, and I want to highlight this when we’re pushing out this podcast, is it different for a woman dentist doctor to manage- in dentistry, 98% of the employees are women, is it different managing women if you’re a woman and they’re hearing their leadership from a woman as it is from a man?

Some women tell me that girls grow up and their dad would sit in the chair and say to the wife give me a beer, and she’d jump up and go get them a beer, and it was never the opposite. So is there something in the childhood, growing up at home were women employees respond differently from a male doctor who might remind her of her dad or grandpa versus a female doctor who might remind them of their mom?

I always teased my four boys when they were growing up, if they fell down or hurt themselves or anything went wrong they ran to mom, and if they got an award or something exciting they came and showed it to dad. Is there a difference in managing women if you’re a woman versus a man?

Ann Marie Gorczyca:  There are pros and there are cons. So let me first tell you the pros.

Howard Farran:  So you’re saying there is a difference?

Ann Marie Gorczyca:  There is a difference. Well obviously, there’s a difference between men and women and you spoke about this Tuesday night at your talk. Women communicate more. Women talk more, they communicate more. So let me give you an example. If I have an undesirable behavior in my office, I will immediately take that team member aside quietly and say I notice that you said this, next time I would really appreciate it if you didn’t say it this way, if you said it this way and the team member would say oh okay, thank you, I didn’t realize it and it would immediately be nipped in the bud.

The communication is very good. The teamwork is very good. The team meeting are very good. That’s one positive aspect to a woman manager, the communication is very, very good.

On the opposite side, I think you hit the nail on the head when you said some women will probably jump a little higher, a little faster when given a request by a male dentist versus a female dentist. In the short run, that is a positive but in the long run there’s a negative that the communication is not as forthcoming and I think a lot of male doctors, in my opinion from my friends that I have in the dental world, they tend to keep things in a lot.

If they have a gripe with a team member, they don’t address it and they keep it in sometimes for months and then maybe, eventually it will blow up where they come forward and say you’re driving me crazy. But I don’t think they communicate so readily on a daily basis.

Howard Farran:  I saw it raising boys. You’re bothering, you’re bothering, you’re bothering all of a sudden I just clock you one and it wasn’t until I saw little boys clock each other before the other boy realized am I doing something wrong? And that’s what you’re saying. The exploding.

Ann Marie Gorczyca:  The other thing I’ve noticed is I think female dentists or orthodontists, they tend to relate better to their team. So for example going out to dinner or going to Thursday night little get-together after work is not big deal, it actually brings the team together where I’ve had some male dentist friends of mine go to a conference and say oh, I’ve got to go out to dinner with my team tonight and they almost dreaded it.

So I think that’s another difference that I’ve just noticed with my colleagues.

Howard Farran:  Then let me ask you this, there’s so many one liners in management, there are so many fad managers, your employees can’t be your friends. You’ve got to keep a distance. Why are you going to dinner with your team or going to happy hour, why are you having a little get-together?

Ann Marie Gorczyca:  Okay I think once a quarter for teamwork, for camaraderie, for trust- I think at least once a quarter the team, including the doctor, should go and do something outside of the office and in terms of teamwork, one of my favorite teamwork people is Coach K from Duke University, and he would always say in his books that he’s written that he would have the team over to his house because he felt that he gained a lot of valuable information about what was going on in their personal lives and that he could be a much more effective coach if he knew his team well and he knew their families well.

So I’m not advocating that you are best friends with your team, I think you should keep a little professional distance and keep your personal life a little bit separate but I do think you should get together at least once a quarter outside of the office to sort of let your hair down and get to know each other on a personal level.

Howard Farran:  Oh you had to bring up hair already, only seven minutes into this you’re pointing out on the short fat bald guy. Hey dentists are always too legal-esque for me, they won’t let their hygienist read an x-ray because they say that’s illegal and I’m like, are there any hygienists in jail for reading an x-ray?

A lot of dentists say to me I don’t want to meet my staff after work for dinner because if I pay for the dinner and she had a couple of beers and stacks the car on the way home, I’m liable for her DUI casualty.

What would you say to that dentist?

Ann Marie Gorczyca:  Well I think you have to watch the professional behavior at the event. I’m not saying that you go to that extent and I think you’ve especially got to be careful going in the car with one of your team members, and this is a strange thing, I’m glad you brought it up because as a woman dentist, or as a woman professional, I was always taught and told that one thing you have to watch out for is try not to go in the car with your colleagues because no matter what you’re doing, someone in town is going to say hey, did you see you know the two of them in the car.

So you have to keep a little bit of professional distance.

Howard Farran:  I like that whenever a dentist says well I’ll swing by your house to pick you up, my first thought is no, I want to drive my own car because I want an exit strategy.

Ann Marie Gorczyca: Right, and everyone is responsible for themselves. So you have to have limits, however you don’t want to be untouchable, distant, not approachable manager or coach of your team. You want to be in there with them.

Howard Farran:  Okay I want to ask you about leadership. When anybody meets you, they’re probably wondering, were you just a natural born leader? Are you just naturally born good in music or singing or athletics or leadership, or is this something that’s been a journey for you. Were you hard-wired born a leader? Did you learn- because most dentists resemble more of an engineer, a scientist, a physician, a dentist- what do you say when you describe a dentist? Quiet, shy, introvert. You’re gregarious, you’re warm, everybody loves you, were you born that way or can a dentist become a better leader?

Ann Marie Gorczyca: Well thank you Howard, I mean that’s a compliment I don’t really see myself that way, but if you see me that way thank you very much.

Howard Farran:  You are. You are, trust me.

Ann Marie Gorczyca:  Thank you so much. I don’t really know how to respond to that. I think that inherently I really, really love people. I love being with people- just like you, you’re the most gregarious person I think I’ve ever met or seen, you’re the same way so I just think I really love people and whatever activity I’m involved in I give 100%. I don’t waste time on things that I’m not passionate about.

So maybe that’s what you’re talking about.

Howard Farran:  So then let’s jump to- before jumping to your new book. What made you write your first book? Talk about your first book. Tell the viewers about your first book, how they can buy it, what made you write that book?

Ann Marie Gorczyca:  Well I’ve been teaching over at University of the Pacific Dental School for many, many years. I’ve always been in education, but the last 10 years, one of my girlfriends, her name is Dr. Maureen Valley, we were at Harvard School of Dental Medicine together, we were at the Harvard School of Public Health together and we did our master’s degree in public health, health management and policy together and Maureen took over as the clinic manager of the orthodontic residency program at University of the Pacific Dental School.

When she came, she said Ann Marie, let’s put together a business management course for the residents, and I said Maureen that is a fantastic idea, let’s do it, you and I. So she put it together, it was every Friday afternoon and I told her Maureen the six topics that I’d like to speak about that in my opinion everything I’ve done in orthodontic practice the last 25 years can go into one of these six categories and those six categories are: marketing, teamwork, treatment coordination, customer service, management systems or human resource management.

That basically there’s not a single thing that I do in practice that doesn’t fall into one of those six categories and I decided to start with marketing because I truly do think that when you start a practice, the most important thing is the marketing.

The very first year when you open your doors, you’ve got to know how to get known in the community and if you open a practice from scratch the way I did, you want to do that relatively quickly. So I thought the thing that would help the residents the most would be if we started with that lecture and I was fortunate to be asked to give that lecture at the American Association of Orthodontists national meeting.

I gave it three times, I gave it in Chicago, I gave it in Honolulu Hawaii and I gave it this year in New Orleans and people came up to me afterwards and said could they hire me or you know could they buy my book, and I thought well- I better write this book because people want this information.

So that’s why I wrote the book. I really wrote it for the residents, but I wrote it so it could be a resource for everyone in dentistry.

Howard Farran:  I’m going to ask you online so I’m going to throw you under a bus to get this answered- I would kill to have you create an online course on Dentaltown. We put up 255 courses, they’ve been viewed 600 000 times.

Ann Marie Gorczyca:  Oh my goodness, I’d be happy to do it. You just tell me how to do it, I’ll be happy to do it.

Howard Farran:  I would love that and Howard Goldstein, hogo@dentaltown.com is the guy who does this. He’s in Pennsylvania and another thing we’re pioneering now is these young kids are multitaskers and a lot of them just can’t sit down and read a book, they’d go crazy and audiobooks are the rage. At Amazon, audiobooks and eBooks are taking over print.

I wish you’d take that book and read it.

Ann Marie Gorczyca:  I will do that. I haven’t gotten to that yet but I’ll call my publisher this afternoon and I’ll do that. I noticed that Fred Joyal did that and that’s a good idea so I will definitely do that. Thank you for that recommendation.

Howard Farran:  In dental school they’re all telling me that I like to listen to my CD when I’m on the treadmill. They tell me Saturday mornings I have about four hours of work to clean up my apartment, do my laundry and wash dishes and I listen to eBooks or audio podcasts for about four hours.

So can we go through those six topics? Marketing, teamwork, treatment coordination, customer service, management systems. Give me the low hanging fruit of those six, or what did you want to-?

Ann Marie Gorczyca:  No, let’s talk about the young dentists. Let’s talk about the young dentists for a minute because obviously I want this podcast to help people, so let me give a little bit of advice to the young dentists, may I do that?

Howard Farran:  Absolutely.

Ann Marie Gorczyca:  Okay. When I opened my practice in Antioch, California in 1996, first of all I went to a community that needed me and that’s the first thing I would tell young dentists is don’t necessarily open a practice where you want to live because the most beautiful areas in the United States, let me give you an example- Pacific Heights, San Francisco.

How many dentists do they need? I would tell the young dentists, look at the demographics, looks at the population ratio and go to a community that really needs another dentist. So when I opened my practice, that’s what I did.

I did not know anything about Antioch, California, I was 35 years old, I was living in an apartment in Walnut Creek California and I turned on the 10 o’clock news and the feature story that year was Antioch California, fastest growing community in California. Seven new elementary schools being built. Parents wait in line to get their kids into kindergarten and the first thing I thought was wow- they need an orthodontist so badly.

So somewhere in the United States there are communities like that where there are not enough dentists.

Howard Farran:  Where were you living before you moved there?

Ann Marie Gorczyca:  Before Walnut Creek California?

Howard Farran:  Where you moved to open up your practice?

Ann Marie Gorczyca:  Well I had been in California since 1991, I originally I was teaching at UCSF for a few years and then I transferred over to UOP and before I opened my practice at age 35 I worked in a group practice for seven years.

Howard Farran:  The point I’m making is from where you were living when you were working at UOP to your office, how far away was that?

Ann Marie Gorczyca: From Walnut Creek my office is 35 minutes.

Howard Farran:  Okay.

Ann Marie Gorczyca:  35 minutes away. Now the other thing I did was I went to the community, I found an office which had been deserted. I found a dental office which had been deserted and it already had the chairs, it already had the plumbing and it literally cost me $30 000 to start my practice and I had that paid off in one year. There isn’t any reason why young dentists can’t do that.

Find an office that’s been deserted, it doesn’t even necessarily have to be a dental office, it could be some other medical office but don’t get in huge debt, just get started and I didn’t put in seven computer terminals, I put in one and when I needed more than one I put in two.

Just gradually I built up my practice. Then I went to a new building and that’s where I am now. I’m in a professional building that’s three stories high with thirteen dentists and I’m right on the first floor.

Howard Farran:  So on marketing, you were talking about first go to demographics. Don’t just go where you want to live. I stay in California within a mile of the ocean, there’s a gazillion dentists and you drive an hour inland and there’s not. So in marketing, you’re saying first let’s find a place that actually needs you.

Ann Marie Gorczyca:  That’s correct. You’ve got to drill for oil where the oil is.

Howard Farran:  Great axiom, I love that. What other thoughts on marketing?

Ann Marie Gorczyca:  Well marketing is divided into three segments. You’ve got internal marketing, which is the marketing to your patients, you’ve got public relations marketing which is marketing to the community and then you’ve got relationship marketing which is marketing to the other dentists and other dental professionals in town.

So if you want to talk about internal marketing, one of my favorite things to do for internal marketing is to have a patient appreciation party. Every year I have a water park party. I invite every single patient I’ve ever had contact with in my database and if nothing more, it tells your patients that you appreciate them. They get a phone call from me, I use TeleVox. I think TeleVox is one of the most powerful tools you have in your office. You have the capability to call every single patient in your database and think about a campaign Howard.

Howard Farran:  I got to stop you with TeleVox. T E V E L O X?

Ann Marie Gorczyca:  T E L E V O X.

Howard Farran:  And what is TeleVox?

Ann Marie Gorczyca:  TeleVox is a company, they make websites they do phone messaging. What I use them for is mass telephone service. So just like when the politicians called you last week and asked you to vote for them, you have the ability to go into your computer database and call every single patient in your database.

Howard Farran:  So is this a piece of software you bought one time or just a service?

Ann Marie Gorczyca:  It is a service that I have continued to use in my practice and I feel that I cannot live without it.

Howard Farran:  And how much does the service cost and how often do you have this, like a politician, calling all your patients and leaving a message?

Ann Marie Gorczyca:  Well it started out with TeleVox that I used it for my summer splash party and it was very, very effective because even the people who don’t show up for your party, they still hear your voice, they say wow isn’t that nice she invited us to her party- oh by the way I need to get in and get a new retainer, or you know what, I need to get Johnny in for an orthodontic evaluation and it’s a reminder and it gets people into your office.

One thing I do in my office that I love doing and it’s in my book is every month I call 750 patients in the database to just say have you been wearing your retainer? Your orthodontist cares. Please call us if you need any additional treatment. We’re looking forward to hearing from you and any patient I’ve had who’s been out of treatment for 10 years, I call them because I want to make sure they’ve been wearing their retainers and that their teeth are still straight.

Since I started doing that a remarkable thing has happened- my patients now 27, 28 years old are bringing in their children for orthodontic treatment so it’s a great way for an orthodontist to reach out to the next generation of patient.

Howard Farran:  That is amazing and how much does this TeleVox cost you a month?

Ann Marie Gorczyca:  Oh it’s- don’t quote me but it’s like maybe $199.

Howard Farran:  So very low cost.

Ann Marie Gorczyca:  Yeah and for $199 you have the capability of calling 750 patients a month. So I use that service to call 750 patients a month and when it’s the off season and not the summer splash party, I give the retainer message when it’s the summer splash party season, probably starting January 1^st I start inviting people for the summer splash party which is in July.

Howard Farran:  So you’re talking about demographics, go where you’re needed, drill oil where the oil is. You talked about TeleVox. What other types of marketing?

Ann Marie Gorczyca:  Well I’ll tell you one other story for internal marketing. You saw my picture yesterday when I was the salesgirl on the vegetable stand in Massachusetts, right Howard? My grandmother from Poland taught me when I’m there as the salesgirl, be nice, smile, give everyone something and tell them they’re special.

So I was sort of brought up- give your patients something. I don’t care what it is, I don’t care if it’s a poem, I don’t care if it’s a sticker, a bracelet, but leave them better off than when they came into your office and I’m going to tell you a remarkable story. It’s about my mother and it’s in the book and it’s called the power of a pencil.

It goes like this and this is a true story. My mother was a principal of an elementary school and her elementary school had a bookstore. One year the bookstore made a big mistake, instead of ordering a gross of pencils which is 144 pencils, they mistakenly ordered a gross of gross- so that was 20 758 pencils and they were all engraved with the name of the school so they could not be returned.

So making the best of the situation my mother decided we’re going to have school wide pencil sale, we’re going to sell these pencils for a dollar each. They earned a lot of money and they took the money and they decided they were going to have an international year at the school of art, poetry and culture of every student in the school, so she sent around a questionnaire to get the nationality of every student in the whole school and even if she had one child from Ethiopia, they were going to have Ethiopia day.

So every culture was celebrated. She got so many civic awards for that, I mean every single group in the entire city invited her and gave her an award. Then she got written up in the US News and World Report as a school of excellence but the most remarkable thing, and I’ll never forget this- that year for the fourth of July we were walking down the street in the city of New Bedford, Massachusetts where her school was. Absolutely every single person knew who she was. Everyone- Mrs. Gorczyca, Mrs. Gorczyca, hello, hello, hello- and that is the power of a pencil.

The power of 20 000 I don’t care what it is- I don’t care if it’s a bumper sticker, a pencil, whatever. That is marketing and sometimes we lose out on the smallest things that can make such a huge impact in getting your name out there in the community and I think that that’s a powerful story- her school was given an award, being a school of excellence and it became very well known just because of that mistake of getting the 20 000 pencils.

Howard Farran: That’s a lot easier than my first marketing story. Can I tell you my first marketing story?  

Ann Marie Gorczyca:  Yes please.

Howard Farran:  So I opened up my practice and I had basically Monday through Friday, half day on Saturday and so Sundays I had nothing to do so I got a map of my five mile radius and I got a colored pencil, highlighter and I went down every single street, knocking on every single door and just saying- Hey, my name is Howard Farran, I just graduated from dental school, I’m on the corner of- I’ll be practicing here for 40 years, I just wanted to go out and shake everyone’s hand and meet the neighborhood. It took me six months to knock on every single door and it was the single best marketing I’d ever done.

Ann Marie Gorczyca:  Well good for you, and that’s the way it’s done. That’s the way it’s done, right? Its public relations. How many hands can you shake, how many babies can you kiss?

Howard Farran:  That was an amazing story. Well first of all you made reference to your book. How could my listeners find your book? What website, where would they go?

Ann Marie Gorczyca:  My book is on Amazon so if you go to Amazon and just put in dental marketing, it will come up. If you put my name which is a little difficult to spell but Ann Marie, the last name is Gorczyca G O R C Z Y C A.

Howard Farran:  And everybody’s wondering, is that Russian, Ukrainian or Polish?

Ann Marie Gorczyca:  It is Polish and it means mustard seed in Polish.

Howard Farran:  You know I’ve lectured in Poland every three or four years for 20 years.

Ann Marie Gorczyca:  Oh you’re so lucky.

Howard Farran:  Oh my God I love that place.

Ann Marie Gorczyca:  Take me with you please.

Howard Farran:  I love classical piano and I love Chopin and I love the stories about Chopin. Most people don’t realize who Chopin is- people who play a lot of classical music can’t play Chopin because he had a freakishly long reach between his thumb and his fingers and if you’re a little person and you’re a great pianist you just mechanically, physically can’t play Chopin. Very wide reach.

So that’s how they find the book. So then go to teamwork. You’ve been talking about basically you can break everything into six categories; marketing, teamwork, treatment coordination, customer service, management systems, human resource management.

What would you say about teamwork?

Ann Marie Gorczyca:  Well teamwork in my office, we have this little saying that we spell teamwork- T C care. T C C A R E and what that stands for is trust, communication, commitment, accountability, results and excellence.

That’s our little motto.

Howard Farran:  Nice.

Ann Marie Gorczyca:  And the thing I emphasize is the trust. We do a lot of work on teambuilding but that trust is a fundamental principle of teamwork. I don’t know if you’ve ever read the book The Five Dysfunctions of a Team by Patrick Lencioni?

Howard Farran:  Yes.

Ann Marie Gorczyca: Well in that book there is a trust exercise that you can do with your team and it basically focuses on vulnerability and you’re asked questions like what was the hardest thing you ever faced in your life, what was the most difficult challenge you ever overcame and sharing things like that as a team, it build the unity of the team.

If you have someone who’s not a team player, it becomes blatantly obvious when you do that exercise that they really are quiet and contained, they keep to themselves. They don’t reach out to their teammates and it’s a very, very good exercise to do.

Howard Farran:  So when you have seen other dental offices where you think trust is an issue, what is going on to make trust an issue?

Ann Marie Gorczyca:  They’re walking on eggshells. They just don’t address the problem. They don’t address the white elephant in the room, whatever that might be.

Howard Farran:  And what would be red flags- because I believe a lot of doctors don’t realize what’s going on.

Ann Marie Gorczyca:  A red flag? If you have- okay, when you have a team meeting, it should be lively and there should be a lot of discussion and people should not be afraid to speak up and voice their opinion. When I have a team meeting, I individually call on every single member of my team and I want them to talk about what they see what is important to them.

I frankly don’t even want to talk.

Howard Farran:  I agree.

Ann Marie Gorczyca:  Because it’s like, I’m the coach, I’m like Coach K and this is my basketball team. They’ve got the plays. They know what needs to be improved in the office and I want to hear them and I want to act on what they see needs to be improved so I think if you have a team meeting and arms are folded and eyes are rolling and no one is talking or if there’s a meeting after the meeting, then you’ve got a trust issue and you do not have open communication.

Howard Farran:  And I’ve give you another feedback of that, is labs. Labs tell me that only 5% of dentists can they call and say hey Ann Marie, you know on your preps, I wish you’d do this or this, or a little more reduction, or- most labs are afraid that if I call you and tell you that your impression is not perfect that you’ll change labs.

Ann Marie Gorczyca:  I would actually see that as a sign of excellence. Really, that’s what you’re paying them for. You want to be the best you can be, in fact I tell my retainer maker, if you don’t have a perfect impression, don’t make the retainer. Call me and tell me I have to retake the impression.

We have, in management systems, we have an agreement in my office, if that impression is not right, if you don’t have the second molar, if it cracks when you take it out of the impression tray, just automatically call the patient and redo it.

Because that’s our standard of excellence. Don’t even ask me, just do it.

Howard Farran:  During staff meetings, when I was talking too much or too many people were asking me, I quit going to them for a long time because when I was gone, the office manager and the whole staff would talk and I see dentist staff meetings as like a lecture. The dentist just goes out there and talks for an hour and that’s just not a meeting.

So TC CARE, trust was number one, what was the next C?

Ann Marie Gorczyca:  Communication, commitment, accountability, results and excellence.

Howard Farran:  Okay that is awesome. So treatment coordination, I’m going to ask you a specific questions since you are an orthodontist- many consultants say that 95% of orthodontists get a treatment plan presenter, but in dentistry its not even 5%.

Do you agree with those numbers? Is that true? What are your thoughts on that?

Ann Marie Gorczyca:  Well I can’t comment on general dentistry because I’m not a consultant, I don’t go into general dental offices but in the orthodontic world, because we’re seeing multiple patients at a time and our offices have six chairs and six patients at a time, we need a treatment coordinator and our treatment coordinator is our right hand, it’s perhaps the most important team member in the office.

Orthodontists don’t even consider practicing without a treatment coordinator.

Howard Farran:  Okay so for all these viewers, explain what a treatment coordinator is and what does this person actually do and why are they so important?

Ann Marie Gorczyca:  Okay well some day when I write my book on treatment coordination, I don’t know what I’m going to title it but the word sales is going to be in that title and in dentistry and orthodontics, let’s just get over it. Treatment coordination is sales. So my treatment coordinators, they’re reading sales books, they’re reading sales manuals and if you want a reference, I think the most powerful sales book I’ve ever read is Jeffrey Gitomer: The Sales Bible.

My team and I we read that book once a year. It’s really, really excellent and yeah it’s just very important. You mentioned in your lecture about your conversion rate. Orthodontists, every month we look at our conversion rate. We’re trained that every month we have our team meeting- what’s the conversion rate and like you were saying Tuesday night, you know if you have a treatment coordinator and you’re success rate is 80, 90%, you’ve got a good one. If your success rate is 69%, that’s the national average, that’s an average one and if your conversion rate is 45%, 50%, your treatment coordinator isn’t very good.

Howard Farran:  And that Gitamor, is that?

Ann Marie Gorczyca: G I T T O M E R.

Howard Farran:  G I T T-

Ann Marie Gorczyca:  O M E R.

Howard Farran:  O M E R.

Ann Marie Gorczyca: Yes.

Howard Farran:  Outstanding and what is the- any low hanging fruit from that book? If you had to summarize that book to another dentist, what is the takeaway from that book? Or do you recommend they just read it and just bite it and read it.

Ann Marie Gorczyca: One takeaway thing from that book is that when the treatment coordinator presents the information and basically next thing they do is say okay, so let’s get you scheduled for Thursday at 12 o’clock.

Howard Farran:  So this book is written just for dentistry?

Ann Marie Gorczyca: No it’s for all of business.

Howard Farran:  Okay.

Ann Marie Gorczyca: This is a very well known author but the thing that he points out is at the end of your sale- I have to take a drink, excuse me.

Howard Farran:  You’re polish so is that pure Vodka you just slammed? Chopin Vodka filtered four times?

Ann Marie Gorczyca: Got a little tickle in my throat. But anyway- he emphasizes, you’re going to cut to the chase and say okay, let’s get you scheduled for Thursday at 2 o’clock and then be quiet. Don’t say anything.

Whoever speaks next, loses and actually in dentistry we probably un-sell a lot of what we’re trying to accomplish by talking too much. We scare the patients away and you talked about this Tuesday night a little bit.

So the other thing he talks about is, when you get one of five hesitations- there are only five hesitations. I don’t have them memorized at this second, I can try to come up with them but it’s usually like, I have to talk to my spouse, I have to think about it, it’s too expensive and I have to go for a second opinion.

When you get that response, continue the conversation. So when they say I have to talk to my spouse, say would you like to call them right now? Yes, call them right now.

One time I had a patient, I’d like to talk to my spouse, would you like to call them right now? Well he’s in the car. Well go get him and bring him in. Let’s get this taken care of. I think a lot of times we don’t follow through and we could close the deal right then and there but we don’t follow through with the next question.

I have to think about it. Well what will you be thinking about? Is it the price, is it the location, is it the service? What will you be thinking about? Well maybe they’re thinking about the price. Well let’s talk about the price, what’s the problem with the price? Is it the down payment, is it the payment plan, what is it? You need to go to the next step.

Howard Farran:  Ann Marie, do you think- it makes me think, this might seem off topic but it is in management, some of the CEO’s of these corporate chains, like Hartland Dental are saying that half the dental students in school today will never own their own practice. You and I have seen this industry for many, many years. Do you believe that’s true?

Ann Marie Gorczyca: No, I don’t believe that’s true.

Howard Farran:  And why is that?

Ann Marie Gorczyca: I’ll tell you why- two things. Freedom and equity. You mentioned it Tuesday night, why did you become a dentist? You became a dentist for the freedom of your lifestyle. The freedom to work the days you want to work. Also equity, in terms of retirement, in terms of stability. You want to own your own practice because you own something. I worked in a group practice, it was a great opportunity for me as a young orthodontist, it was a great opportunity for seven years. I got to set up a practice in a group practice where I didn’t own it so it was a great exercise and I got to spend someone else’s money so it was even better.

But if it were a great thing I would have stayed there for the rest of my life but you get to a point where you’re at a ceiling, you have no equity, you have no freedom and it’s time to move on. I think that it’s an excellent stepping stone and I think that’s it’s good that there are opportunities for young dentists to work in group practices, but I’ve never heard a dentist say that that’s their ultimate goal to stay there for the rest of their life and work there for the rest of their life.

Howard Farran:  I agree. Back when I got out of school in ’87 so many of my classmates felt so lucky that they got hired by the army or the navy or the air force, but it was a stepping stone. Hardly anyone said oh yeah I went to school because I want to do army dentistry until I’m 65. That was like hardly anybody, it was a stepping stone.

Ann Marie Gorczyca: Yeah and I think that’s what it is now.

Howard Farran:  Ann Marie, I don’t know if I’m getting old fashioned or whatever but is it just me or do you see it too- do you think that the average kid coming out of dental school might have a less of a work ethic than we did in ’87, or am I just old school?

Ann Marie Gorczyca: We are a different generation Howard. When I heard you speak the other night and from what I know about you, you and I are a different generation. We have a very strong work ethic and when I graduated and moved to California I literally had $300 in my checkbook when I moved to California.

I owned no car and I had my first job at UCSF, I had a grant and then I got another job teaching and then I got another job in the group practice. I had three jobs, I worked six days a week. I worked until 8 pm at night and that’s the way it was. The first car I bought was a used car from a woman whose husband died. It was a 75 000 mile Volkswagen Rabbit and it was for $4000 and I offered her $2000 and I got the car and I drove that for a while, then I got another car.

I didn’t buy my first house until I was 35 and I paid for everything as I went along. So the students I have now at UOP, they graduate and the day they graduate they buy a new motorcycle and they put it on their credit card or they live in a rent controlled apartment where they could live there for the next 10 years until they buy a house for $500 a month, but they move to a luxury $1500 a month apartment and the lifestyle expectations are different.

I also was taught that you don’t buy a house until your business is set. So I didn’t buy a house until my practice was built and I was financially set with my practice. Then I bought a house. I think some of the graduates think they’re going to buy a house right away so the other thing I see that’s a little bit different is the orthodontic residents, who I love and they’re fantastic, but I always have this talk with them that when they graduate and they’re looking at getting their first job, their goal is to get their foot in the door.

When I graduated Northwestern, I have to tell you a funny story. I picked up the phone and I called TM Graber. He was about the most famous orthodontist at that time and I called him because he was number one on my list and I wanted to work with him. So I pick up the phone and I say hello, is this TM Graber? He said yes? I said is this really TM Graber? He goes no, it’s the president of the United States, what do you want? And I said I want a job. And he said really, you do? Why don’t you come on down here? Okay I go down to his office. The salary was never discussed and this is something that Warren Buffett, when he goes to speak to the MBA students at University of North Carolina or these school programs, he says when you go for your job- say you’re going to be considered for CEO, the salary is not discussed. They’re going to pay you what they think you are worth and it is your goal to get that job and get your foot in the door.

Once you’re there, you can show them how great you are and I tell the residents this, and they go; well what if I’m taken advantage of? And I’m like what? You be taken advantage of?

Are you kidding me? I mean this person is giving up part of their salary to educate you, train you, hire you and your thinking of yourself and that you’re going to be taken advantage of? Completely different mind set from I think our generation.

Howard Farran:  My mind is absolutely blown away by this next generation. I mean I don’t want to hack off all the dental students but you sit there and talk to them and you say well, is your practice, is it all about you? Is it dentist focused or is it about the patients? And they go oh, its dentist focused. And after they’ve been whining about $300 000 in student loans and their office debt- what are your hours? Monday through Thursday, eight to five.

It’s like that’s not even a full time job. I mean my dad worked seven to seven, seven days a week until he dropped dead. Over at my practice, seven to seven Mondays through Saturday and I’m like all you’re whining about is all your debt, but you go home at five? And they don’t even cook. They eat out 19 in 30 meals. It’s like how do you leave at five and go to a nice restaurant? And then in dental school they’re all whining about their debt and then I start asking questions- will you even use student loan money to go on spring break? Yes every year. To Jamaica. How much did you spend on your spring break in Jamaica? Five grand. And I’m like oh, so you’ve got $300 000 in student loans, $20 000 was vacation money and then another $30 000 was a car and then they’re living- I’m just like wow.

And then when Americans are anti-immigrant, it’s only the wave of immigrants that keep the work ethic so high. By the time you’re second, third, fourth generation American, you’re just a spoiled brat.

Ann Marie Gorczyca: Well that’s an interesting point. The other thing I’ll just share with you is a lot of my friends in my generation, when we got out we did whatever job we could get and even if you were an orthodontist, if you didn’t have a job, you’d go to a temp agency and you’d say I can be a receptionist, I can be a hygienist, what job do you have for me?

I mean one of my best friends, excellent orthodontist practicing now in Oakland, California. Huge practice. She got out of University Washington Seattle, moved to the Bay area and she couldn’t get a job. So she went to a temp agency, she worked as a hygienist like six days a week and finally she worked for a very nice female dentist whose husband happened to be an orthodontist and the orthodontist wife said hey I know this great orthodontist, she’s working in my office as a hygienist.

Why don’t you hire her? And that’s how she got her first associateship.

Howard Farran:  I tell older dentists looking for an associate, I say let me give you a couple of pointers. If the dentists applying- you have two applications for the job, if one wasn’t born in the United States and one was, oh my God get this one. I don’t care what country they came from, if they weren’t born in the United States- because I have two huge observations that many of my consultant friends have noticed.

If you’re a graduate from dental school and you weren’t born in the United States you’re consumption spending will be here and you’ll be out of debt in five years. If you were born in the United States your entire life you’ll be paying interest on the cars that you buy, the houses you buy and if they were born in the United States, they’re done at five o’clock and they have three day weekends and if they were born in Laos, Cambodia, Vietnam, Russia, Czechoslovakia, Africa, Brazil- if they were born anywhere else and at five o’clock someone walks in with a toothache, they will sit there until seven and finish the root canal, build up, crown, I mean the work ethic is just amazingly different.

Do you agree or do you think that’s just a racist comment against my own people?

Ann Marie Gorczyca: Well I do agree. I mean all we can do is just work on it, try to improve it and try to explain it.

Howard Farran:  So you talked about your six lectures- marketing, teamwork, treatment coordination- the next three were customer service, management systems and human resource management. Tell us more about those. Go to customer service, number four.

Ann Marie Gorczyca: Well customer service- it’s a lot of greeting the patient. Do you have a greeter at your front desk? Whoever sits closest to the door, they should have on their computer terminal the names of the four or five or how many new patients you have that day with the times that they are walking into your office.

They should be waiting for those new patients so that the minute they walk in, they stand up, they extend their hand, welcome to the office. How can I help you? Please have a seat. May I get you a drink? It begins at the beginning of the appointment, that the patient is greeted, that they get a warm welcome and throughout the entire appointment, an office tour, you want everyone on your team to be smiling, you want them to look good and at the end you give them a fond farewell and you thank them for choosing your office and for coming to your office.

The customer service is no different than Walt Disney World or The Ritz-Carlton, you’re aiming for quality customer service and the highest level of customer service is knowing your patient individually- what are their likes? What are their dislikes? Knowing them as an individual so that you can make them happy and you can talk about what they want to talk about.

The talk in the office should be all focused on the patient. I tell my team, I don’t care if you talk about Dancing with the Stars, as long as you go up to the patient and you say to the patient- Nancy, did you watch Dancing with the Stars last night? And you have the conversation with her if she wants to talk about it. But what I never want to have is my team having a conversation between themselves and they’re not interacting with the patient and that’s something we have to be careful of, that we’re always focused on the patient.

Howard Farran:  I’ve only got your amazing mind for six and a half more minutes and you’ve still got to cover two more- management systems and human resource management. So what would you say about those two things in six and a half minutes? Starting with management systems.

Ann Marie Gorczyca: Management systems- have some management systems. One thing you said Tuesday night that I absolutely loved and you’re the only person I’ve heard say it other than me, is every person in your office should be cross trained.

That is so important. Every person in my office is cross trained and actually we have a grid that every person in the office is a champion of something, so we have an insurance champion, but who is her number one replacement? Who’s the number two? Who’s the number three? Who’s the number four? Who’s the number five?

Every person in the office should be trained how to do insurance. Every person in the office should know the management system. So many dentists are held hostage because only one person in the office knows how to do the deposit, or one person knows how to write the contract.

You’ve got to put the time in to cross train everybody. Not only is it excellent for backup but it teaches respect among the team members for the difficulty of each other’s jobs. For example if the front office understands the back office, how difficult it is to seat the patient on time, finish up on time, clean up on time, restock the unit and if the back office realizes how hard it is to schedule an appointment when the phone’s ringing and you’ve got three people deep standing at the front desk, their going to get along a lot better as a team and their going to respect each other more as a team.

So cross training is just an A plus thing that you can do in your office. It’s worth the time and attention that you put to it and it is a military thing, like you said. You can look to the military or you could look to a baseball team or a basketball team- you’re always thinking what if this person’s out sick? What is this person is injured? Who’s going to step in and keep the flow going?

I like that concept and you’re the only person I’ve heard talk about that other than- I’ve thought about that for a lot of years and I’ve done that and I think it’s one of the reasons my HR costs are very low, they’ve always been very low because everyone can do every job.

Howard Farran:  It also prevents embezzlement, I mean when I look at- many consultants say if they go into any office and do a check for embezzlement, they find embezzlement half the time. It’s usually by someone who is the only one who does the deposits, write the checks, they have all the functions on one person. No one else is cross trained to know what they’re doing. And then the last thing I should say, I hope you don’t find it inappropriate, is that person is having relations with the dentist and they’re braver to do this because if they ever got caught, they have blackmail on the dentist.

Ann Marie Gorczyca: That’s very sad. But you’re absolutely right I think in terms of cash- first of all in my office I have a sign at the front desk- we do not accept cash. I don’t really want cash. If someone pays cash, great, I’ll take it but we’re not encouraging cash and we put the sign at the front desk, we do not accept cash because I don’t want to be robbed so I want anyone who would come into my office to think I have absolutely no cash in my office.

Then one person at noon deposits the checks, collects the cash or whatever, a different person at the end of the day does the deposit. The cash is given every night to me, the doctor. I deposit it in the window myself so they know that every night I am checking the cash, I am taking it myself to the bank.

Howard Farran:  So then last but not least, in two minutes explain human resource management.

Ann Marie Gorczyca: Okay well human resource management basically is divided into six sections; it starts with the recruitment of team members, it moves onto the integration- the first 90 days of team members, then it goes to the daily schedule of team members, the evaluation of team members, the costs of team members and then finally the termination of undesirable team members.

That’s all of human resource management. The thing that my new book will point out, that I think is very important, is that there are desirable work behaviors and there are undesirable work behaviors and these are well known in the HR world, they’ve been studied by psychologists, they’re known by HR experts and every dentist should know what are those behaviors and I have them here so I’ll read them to you.

So you get a team member, these are the desirable behaviors- there are eight. They should be willing to fill in for any job that needs to be done. They should volunteer to help. They should take initiative to get things done. They should assist the doctor, they should assist their teammates. They should improve the office so that when they’re absent, they should be missed. If someone’s absent and your office actually runs better, you should get rid of that person. They should be punctual and they should have excellent attendance. Those are desirable behaviors. Those are eight things you could grade your team on, give them a score.

Here are the undesirable behaviors- they exaggerate their work hours. Excessive overtime, etc. They start rumors. They gossip. They make mistakes. They compete with their teammates. Their out of sight, they disappear, their out of sight. They take things. They blame others and they work slow. Those are nine things that if you have a team member and they’re exhibiting those bad habits, that’s not a good team member and at some point you’ve got to cut the cord and say- I can get someone better than this.

Another thing in my book, I list a 12 step interview process and I describe the interview process as dating. You’re making a decision to hire a person that you’re going to spend the rest of your life with. You’ve got team members that have been with you for 20 something years. You don’t jump into that decision. So I talk about how you’re going to interview the person, hopefully you do a working interview, you ask for the feedback of your team members, you do a second working interview and then you make the decision and in my office we do it by unanimous decision.

If there’s a team member who says I don’t think this person’s going to gel, then you don’t hire them. I think if there’s a dental office where the doctor alone is making the decision, that’s not a good way to hire someone.

Steve Jobs in his book wrote, you hire a new person, it’s the team that decides who to hire. Not necessarily the CEO of the company.

Howard Farran:  So this second book, Beyond the Morning Huddle, is that out now?

Ann Marie Gorczyca: No. Howard, you just got your copy of the manuscript. This week is went out to eight people that I would consider dental experts in HR, you’re one of them and I’d like to get everyone’s feedback. I’d like to get an endorsement and the editor also received the manuscript this week. It’s probably going to take two or three months for me to get it a little bit more fine-tuned and then when that’s done I’m going to send it to Bruce Tulgin who’s going to write the forward for the book.

My goal is, I want to get it out by April and in May 2015 I’ll be giving this talk at the AAO in San Francisco.

Howard Farran:  So will you send me an email with the JPEG of your first book and then how to order that, and all that, tell them about your first book again.

Ann Marie Gorczyca: Sure, okay so thanks so much Howard, I really appreciate this. The first book is called It All Starts with Marketing: 201 Marketing Tips for Growing Your Dental Practice, and these 201 tips are things that I’ve done in my practice over the last 25 years. I guarantee you that every one of those tips will lead to a new patient. It has worked in my practice. It’s on Amazon, you can just go under dentistry and put in marketing and you will see it, or you can out my name and then the second book will be out in April 2015.

Howard Farran:  Well that was the fastest I’ve ever had anyone in overtime, an hour and three minutes. Seriously, I just think you’re an amazing person. You’re my favorite orthodontist, I love your energy, your karma, your passion. Thank you so much for spending an hour with me on a Friday afternoon out of your busy schedule.

Ann Marie Gorczyca: Same to you Howard, I feel the same way about you. Let’s do it again.

Howard Farran:  Let’s do it again.

Ann Marie Gorczyca: Okay thanks Howard. Bye.