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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Dr. Mike Barr owns a solo fee-for-service in Boynton Beach, Florida. His passions include cosmetic and reconstructive dentistry and online marketing. He wrote a book, “The Complete Website Owner’s Manual for Dentists” and is working on a 2nd edition (coming soon!). He has been a “Townie” since the very first days of DentalTown.com. Mike also has an active blog called, “TheDentalWarrior.com”

www.TheDentalWarrior.com

mike@TheDentalWarrior.com

Howard: It is a huge, huge, huge, huge honor to be interviewing today Mike "The Man" Barr, Michael Barr, the Dental Warrior, who has a legendary 32,000 posts on Dentaltown. Big fan of your blog, big fan of everything you do. You crush it on all things social media. In fact, you were one of the originals of kind of social media because your first big breakout and helping my practice was your book, Rev Up My Marketing, about website marketing and you sold a gazillion of those books, so first of all, and you have a distinguished personality. I know you're all things anti-big government. You're a staunch defender of the NRA's, the right to bear arm and all that stuff, but I just want to start off with man, thanks for giving me an hour of your time, Mike. 

Mike: Oh, are you kidding me. Any time. This is my first real Skype, so be gentle with me, will you?

Howard: Yeah, Microsoft bought this for like 8.9 billion and it works pretty good a lot of the time. I think its failures aren't with Skype. I think it's your internet connection. Sometimes you'll be doing one of these Skypes and someone you're Skyping, the internet breaks off or whatever, but first of all, thanks for joining me and probably everyone's wanting to know, how did you come up with the name, Dental Warrior? Why are you a Dental Warrior?

Mike: You know, I don't even recall how I came up with it. I think I was just brainstorming for a domain name for my blog and I just wanted a place where I could write whatever the heck I wanted and not have to worry about who I might offend or bother and no censorship, no moderators, none of that. It was a place for me to kind of archive my ramblings, basically, and so I was trying to come up with a name and somehow Dental Warrior, I think mainly it was available. Thedentalwarrior.com was available and so that's what I took.

Howard: That's how they can read your blogs, thedentalwarrior.com. How many blogs do you have on there? You must have 100 on there.

Mike: Oh, I think I've written, I think I'm at almost 300 articles.

Howard: 300?

Mike: Yeah.

Howard: How many of them would you say ... What percent on them are on dental related? Because some of them are other things, government or NRA.

Mike: It's kind of an eclectic set of topics. I write about dentistry, marketing in dentistry, website marketing. I write a little bit about guns, which is one of my other passions and so it's kind of oddball association between those two subjects, so it's about guns and dentistry. 

Howard: And your son playing hockey.

Mike: What's that?

Howard: And your son playing hockey.

Mike: No, I haven't written about that, actually, not on my blog. I write about that on Facebook a fair bit.

Howard: We're talking, when you're hearing this podcast, I'm going to throw Mike under a bridge right now, because I'm going to pin him down to this is the night before Game 1 of the Stanley Cup, which is tomorrow, and you're from Florida, and Tampa Bay is in this with the New York Rangers. 

Mike: Chicago Blackhawks.

Howard: Oh, I'm sorry, Chicago Blackhawks, so who's going to win Game 1?

Mike: Lightning.

Howard: Tampa Bay Lightning?

Mike: Yeah, yeah, yeah, I think I would like to see Florida, a Florida team win a hockey Stanley Cup. How cool would that be?

Howard: Will there be ... Shall we look for alligators on the ice, hockey rink? In Florida it seems like the alligators show up everywhere. I was reading the other day on the news that it caused a massive car wreck. A car actually hit an alligator and it knocked him over into the other lane and hit a semi truck.

Mike: Yeah, you don't want to hit an alligator.

Howard: That's your first talking point. Do not hit an alligator. But hey, so Mike, I want to start off with this first question. Last Thursday I just went to the graduation class of A.T. Still. They just graduated a round of dentists, so this is graduation time, so about 5,000 kids are going to graduate from dentistry. You and I are both old dogs and have been doing this for 3 decades, we're in our 50s. What advice would you give to the dental graduates? Because these kids are coming out with $250,000 student loans, there's corporate dentistry, it's a changing environment. Also, Mike, they come out of school $250,000 and if they believe everything they read on the internet, they need to buy a CAD/CAM machine for another 150 and a CBCT for another 150. What advice would you give them? If your son, who's only ... How old's your son? 12? 

Mike: 14 today.

Howard: 14 today. Tell him I said happy birthday. If he was not 14, but he was 24, which is how old I was when I graduated from dental school, what advice would you give your own son coming out of school today?

Mike: I guess it's too late if he's graduating from dental school, right? It's too late to tell him to turn back. No, I'm kidding.

Howard: Okay, you're kidding. Well, that's even a greater question. Are you going to tell your son that dentistry would be good? Follow dad's ... Because your wife's a lawyer, correct?

Mike: No, no. She was. She's a stay-at-home mom for now, but she was an investment analyst. 

Howard: What would you ... Would you tell your son to be an investment analyst or a dentist?

Mike: Definitely an investment analyst. 

Howard: Okay. Let me phrase it like this. What would you tell your son if he said, "Dad, I want to grow up and be a dentist just like you?"

Mike: Yeah, well then I would definitely encourage it. You know, I think you should do what you want to do. If you're compelled to become a dentist ... I love dentistry, I really do. But you and I have been at it longer than I care to admit anyways, and we've seen a lot of changes. I think it's a much tougher environment. They're coming out, like you said, I think $250,000 in debt is low. I think it's probably from what I've heard, 300 and up. From the local private schools here, I know of dental students graduating with $500,000 in debt, and that's a problem. 

Howard: What do you think is the difference between a dentist that walks out 250 in debt versus 500 in debt?

Mike: About $250,000.

Howard: But why do you think that is, though? Because some of these ... I have to admit, I have two dental schools in my backyard and I didn't own a car the first 5 years of college. I always worked 40 hours a week and I see these kids driving $30,000 cars and on Spring Break going on cruises, and going to Cabo, and I just like, "Wow. You're living like you're already a successful dentist, and you're doing it on student loan money." Some of that student loan money is crazy money.

Mike: Yeah, so it's funny that you bring that up. I have a local colleague who hosted one of the senior dental students at the local school here, just as a kind of a shadowing day, and they started talking about that. The student said that many of her classmates are borrowing the max that they can borrow. Apparently the institutions that are loaning this money are basically handing it out and they're going on trips ... Well, in fact, this student had been on a trip to Iceland and some of them are buying cars like you said. 

It's funny that you bring this up, because I've got my little set of talking points here, and what would I advise to a dental student, somebody graduating, actually I'd probably give them the same advice the day they start dental school is to keep your debt load low. Low. Don't borrow against all of the ... You know, I don't how some of them are ever going to come out of $500,000 in debt, you know, realistically. If they ever hope to have a practice someday, that's an even bigger problem. You start adding everything up, you're looking at well over a million dollars just to get started. My advice would be to keep your debt as low as possible, and but I think there is a different culture today as far as that goes. 

From what I understand there's also a government sponsored loan repayment program that effectively lowers their payments to something like 10% of their monthly income or their actual payment, whichever is less, and then after 20 years it's all forgiven. That's a whole other political issue that we could go on about, but I think that borrowing as much as you can is a big mistake, and the same goes for when you start your practice or buy a practice. I will admit that I borrowed and spent more than I should have on building my office, and it was a big nut to cover for a long time. If you can limit your debt, I think that's probably the number one thing.

Howard: Okay, okay, so advice for graduating students, limit your debt, and number two, when you came out back in the day, you went into the Navy to get dental experience. How long did you serve in the Navy?

Mike: Three years. 

Howard: Three years, and did you ... Looking back, I mean, that's obviously a residency, did you look back and see that as a residency. Did you learn more dental skills or was it just a lot of practice?

Mike: Yeah, I would say it was actually a fantastic opportunity. I got a lot of consignification, not only didactic, but even more so clinically. My first year I was at a big dental clinic in San Diego, where it was broken up into the various departments almost like a dental school. You got a prosthodontics department, an oral surgery department, an endo department, oral surgery, and so on, oral diagnosis department, operative department, and I rotated through those. I spent for example, 3 months of doing nothing but endo all day every day, just root canals, and I had the supervision of board certified endodontists to come look over my shoulder whenever I needed them. It was almost, it was like having your favorite dental school instructors and no grades. 

Howard: Was that that 99-chair facility that fixes up the Marine Corps down by Coronado Island?

Mike: No. This was at 32nd Street, called Naval Station, so it's on the main ... It's where most of the ships are.

Howard: Because I notice that in the military the Army, Navy, Air Force has their own dentists, but the Navy dentists are in charge of the Marine Corps.

Mike: Right. That's true. Yeah, the Marines ...

Howard: Were you working on mostly Navy or Navy and Marine?

Mike: Mostly Navy. Mostly Navy.

Howard: Mostly Navy?

Mike: Yeah, where I was. Yes. Then I was on a ship for 2 years after that. 

Howard: On advice to graduating dental students, would you recommend that they do a residency? Would you recommend the military? What would you say if somebody said, "Hey, I'm going to go work for one of the big corporate chains like [Farland 00:11:21] or Pacific Dental Services or something to get 2, 3 years [inaudible 00:11:26] experience in corporate dentistry?" Would that be Navy equivalent in modern-day times now?

Mike: You know, it's hard for me to say because I'm not in the Navy now, and it's entirely possible that that has changed, but I think it's 2 very different things, or at least in my imagination. I think it would be very different, and probably would attract different personalities. Let's face it. The military isn't for everybody. There are pluses and minuses to being in the military. The first, I guess, minus, negative, would be that the government owns you, and if there's a war and they want you to go, you're going. You have to be okay with that. I was on a ship, and when I joined the Navy, my Jewish grandma said, "What do you want to be in the military for? What if there's a war?" 

I said, "Grandma, there's not going to be a war. Everything's going to be fine." In my head, I thought, "Hey, if it happens, it happens," but I tried to reassure her. My ship was in the Indian Ocean when Iraq invaded Kuwait in 1990, and my ship turned course that day and the first thought that went through my head wasn't that, "Oh, crap. I'm going to war." My first thought was, "Oh, crap. My grandmother's going to freak out," and she did. But yeah, my ship was the first response to the invasion of Kuwait and we were up in the Persian Gulf for 118 days without seeing land or a female. It was interesting, and so you've got to be okay with that. 

If you have a family, that may factor into it. I was single, so I had no worries as far as family goes. The military I think is a wonderful thing. They did not pay for my school. I volunteered. A lot of people assume that there was a scholarship and I owed the Navy 3 years, but no, I actually paid for my dental school and then joined the Navy anyways. It was still worth if for me. I got to see the world. I got a lot of clinical experience. I made a lot of good friends, the social life was fantastic, and so I have no regrets and I would do it all again. As compared to corporate dentistry, I did actually work ... After the Navy I went into a local corporate chain. That was my first job as an associate, and I knew that it wasn't for me. 

Howard: What was the chain? Are they still around?

Mike: Yeah, they're still around. It's a local chain here in Florida called Dentaland. 

Howard: Really? Dentaland?

Mike: It's called Dentaland. Yep. Yeah. We called it Mentaland. It was a big wake-up call for me. I got used to, in the Navy, basically having the best of everything in terms of equipment and materials, and time with patients. It was a very different experience going into the so-called corporate type of a dental practice, large group dental practice with associates that kind of come and go, and I lasted about 10 months there. Then I found an associateship with a private office and I spent about 2 years there before I opened my own practice from scratch. 

Howard: That was in Palm Beach?

Mike: Yeah. Well, my current practice is in Boynton Beach, which is in Palm Beach, County.

Howard: That's north of Miami, north of Fort Lauderdale, almost half the way to Boca?

Mike: No, I'm just a little bit north of Boca, actually. I'm about 15 minutes north of Boca.

Howard: Okay.

Mike: I'm between Boca Raton and West Palm Beach.

Howard: Okay, and so what was it like ... What advice would you to say to people setting up their own practice?

Mike: Yeah, well, I think starting from scratch was a very difficult way to do it, and if I was to do it all over again, I probably would try to find an existing practice to purchase. I think that's probably a smarter thing, hit the ground running to a degree. I literally started from scratch with zero patients and it was a long, tough ride. I think probably the best thing a new graduate could do would be find an associateship in a private office, but I think those are few and far between, whereas the corporate jobs are more plentiful. If they could find a private care type practice to associate in, I think that would be the best scenario, but sometimes you got to do what you got to do and get a job, and get to work, and start paying the bills. 

I think what I've witnessed here locally, those that start in the corporate practices, which are largely HMO and PPO driven, it kind of becomes the only world that they know, and so when they do start their own private practice or buy a practice and they're slow, what do they do? They sign up for all the plans, and I know I might ruffle a few feathers. I have my own opinions about managed care and participation in that, which I don't so far. Anything could happen. But I think that becomes the only thing they know and so when they go out on their own, whether they purchase a practice or start from scratch, they tend to basically fall back on the world they know, which is managed care.

Howard: But there's another guy in Florida, who's name also starts with M, who also has 30,000 posts, named Monty, and you guys have been sparring for a decade and a half on Dentaltown. He loves HMOs and PPOs. Now, does he love HMOs and PPOs or just PPOs?

Mike: I think he just does PPOs. I think, but I'm not even sure now that you mention it. But yeah, he's a big fan of managed care. When Dentaltown first started, he and I would go at it, and we're actually good friends now, and I don't know if you remember, the very first Dentaltown meeting, the first county meeting in Vegas, they had the Sumo wrestling suits that you could Sumo wrestle. We had Monty versus Mike, a managed care versus fee for service Sumo match. We did the Sumo thing, a grudge match.

Howard: Is he near you?

Mike: I think he's down in Margate, which is closer to Fort Lauderdale.

Howard: Well, you know what? If you can figure out, because you're a techie, if you can figure out how to triple Skype, where all 3 of us can be on there, that would be an awesome debate. Mike Barr, fee for service, Monty, managed care. They're both from Florida, they're both 30,000 posting townies. Let's do it for an hour. Would you be up for that?

Mike: Oh, yeah. I would absolutely. I don't know how much I would argue with him, though. As I've gotten older, one of my philosophies is it's hard to argue with success, and he's successful. It's definitely not for me. I think it's a different mindset and I respect, I have a lot of respect for Monty, but it's a different mindset and it's not for me, and my head would explode if I was involved in that. It really would. But, he's successful, so there's no doubt it can be done successfully. I can't say, "Well, that doesn't work." He's been successful for a long time, and I know other dentists that are very successful in that kind of environment, and so hats off to them, but I think the key is you got to figure out what you want, and there's more to life than money, and dentistry, we're one-trick ponies. 

You and I both know dentists that hate what they do. There are dentists that post on Dentaltown that they hate their job. They hate going into the office every day, and I think about how awful that must be, because we're kind of trapped, so to speak. If we want to do another career, we've got to start over in terms of our education. If you have a business degree, you can leverage that into a lot of different jobs, but we're one-trick ponies, and there's not really any other job that a dental degree will help you with. I think find what you like to do, where you'll be happy, and do that. 

Howard: I want to go to your book. One of the first big breakout things you did, you were leading ... You were an entrepreneur pioneer leading the way on website marketing and you wrote a book, Rev Up My Marketing. I read it and so did a gazillion other dentists, and everybody I know loved it. Talk about your book, and also talk about how have websites changed when you first started your first website versus now, and is there anything new with websites? 

Mike: Okay, that's a broad subject. We could be here all night, but I started my ...

Howard: Well, when I'm saying that, I mean I also think of you as very marketing savvy, so website marketing, that's a big component of marketing. 

Mike: Sure. I think it's probably these days the biggest component. When I started my website, I built my first website in 1999, and at the time, my intent was for internal marketing. I thought it would be a way for me to direct my patients who may be interested in cosmetic dentistry, I could tell them, "Visit my website and check it out. Check out the pictures." It was kind of a soft sell, so to speak. It was a way for me to introduce them to that and they could do it on their own time at home, and I thought of it as internal marketing. I thought that nobody would look for a dentist online. That was my thought at the ... Actually, I was right at the time. Nobody was looking for a dentist online at the time. 

I even wrote an article for the local Dentist Association's newsletter saying, "Do I need a website?" And my conclusion was yes, but don't expect anybody to try to find a new dentist online. Do it for internal marketing. I think at the time I was probably fairly accurate, but that's changed. A lot of people will look for healthcare online, look for a dentist online, and I think a lot of times they're looking for a specific type of dentist. They may be looking for information on implants or veneers or braces, and things like that. But I started off with a ... I think my first website was like 10 pages long or 6 pages, something like that. It just has grown since then. I think I've got about 55 pages on it. A majority of my new patients come through the website. 

In fact, it's pretty much the only external marketing I do. I've dabbled in everything. I've done everything from newspaper ads to magazine advertorials, television ads, radio ads, and bang for the buck, nothing beats a website. All the other media have time or space limits. A newspaper ad only has so much space, and the bigger the space, the more it costs. A radio ad is so many seconds long, 30 seconds, 15 seconds. The more time you occupy in your ad, the more it costs. Then there's also the matter of when your ad airs, and that changes the cost, and the same thing with television. You can spend a lot of money in those areas, in those mediums, and it takes a long time to see results. Websites are, by comparison, fairly inexpensive, and your space and time is pretty much unlimited. 

Howard: So Mike, okay, so I'm always trying to guess ... We've got an audience, on the average podcast, it's probably going to be about 3 to 5,000 people are going to listen to this [inaudible 00:23:03]. I'm trying to guess their questions. I'm on the [inaudible 00:23:05] right now for an hour. I'm driving to work right now. How do I know that Mike "The Man" Barr thinks my website's good. How does a dentist know if her website's good, and what are some red flags that your website ain't good?

Mike: Yeah, signs that your website sucks. Well one, I guess the first sign would be it's not working, you know? Ask the dentist, "Are you getting patients from your website?" Unfortunately a lot of them will either say no, or they say, "I don't know." I think first of all, every dentist should be tracking where their patients come from. Is your website working? Because like I said a little while ago, I don't argue with success. I might look at your website and think subjectively that I don't like what I'm seeing, but if it's working for you and it's bringing in a gazillion patients, then who am I to argue with success? But, I usually don't come across that. 

Most dentists complain that their website's not working. I think there are a lot of factors that go into that, but I think probably, first of all, dentists think like dentists. One of my dental school instructors said that if you ask a dentist what time it is, he's going to tell you how to build a clock. We tend to tell our patients, not only on our websites, but even face to face in our offices, we start talking about osseointegration and hybridized dentin bonding, and we tell them how we make the sausage, and nobody wants to know how you made the sausage. 

They just want to enjoy the sausage. Patients want to know if they're going to look good, feel good, last a long time, basically. How long is it going to take and how much is it going to cost? Those are the questions they have, but meanwhile we're talking about osseointegration and I've seen websites, dental websites, where they've got pictures for example, on the implant page, of the implant surgery, actually a flap with the bone and the implant going into the bone. Dentists ask me, "What do you think?" I said, "I think you need to get rid of those pictures." He said, "Well, they're good pictures." 

I said, "They're wonderful pictures for a dental textbook, but people don't want to see that. They want to see smiles. They want to know again, if it's going to look good, if it's going to feel good, and if it's going to last a long time." Sell the benefits not the features. I think that's a big mistake that I see on a lot of dental websites. I saw one that described in excruciating detail how an extraction is performed, down to we break the periodontal ligaments and then we elevate the tooth. It was literally a step-by-step how to extract a tooth. People don't want to know that. It grosses them out.

Howard: Everybody wants to go to McDonald's and just eat a cheeseburger. No one wants to see the cow get shot.

Mike: Exactly. I think that's a common mistake I see. Another problem is a lot of the websites out there, you know, the dentist wants to write a check to the XYZ Company. "Make me a website, put it up, do all the SEO, and hopefully patients are going to start coming." The problem with that is that most of these website companies, they can't produce custom content for every single dentist, and most of them don't, because the cost would go up a quite a bit. They get template websites, says, "Insert dentist's name here," and it's just basically a dental glossary or a dental encyclopedia, and "This is a filling. This is a crown. This is a denture. This is a root canal."

I think that's a big mistake. One of the things that I have advocated for a long time on Dentaltown, on my blog and in my book is that a dentist needs to be involved, or somebody in the office at least, needs to be involved in creating the content of the website. It needs to speak like they speak. It needs to resonate with the visitors as a real person talking to them through the website. My website, I wrote every word on it, I took every picture, and I realize not every dentist is a writer, but I think they can throw something together and then have somebody edit it and proof it.

Howard: Now, did you actually program your website?

Mike: Yeah, I do everything.

Howard: You write the code? HTML?

Mike: Well, I go and ... Most of the website creation software kind of does that for you, a what you see is what you get. It's almost like a word processor. But occasionally I do delve into the code a little bit, but I'm not really a code writer.

Howard: But if this person driving to work right now, I think the majority of my listeners are on an hour commute, and you would think that means across L.A., but almost everyone that emails me, it's always rural. It's always, "I live in a town of 5,000, I got a 70-mile commute to a town of 8,000 where my dental office is." If the dentist bought Rev Up My Marketing and read this book, she could create her whole website?

Mike: No. Yeah, I'm glad you asked that. Well, first, my book's out of print at the moment. I'm working on the 2nd edition, and that's called The Complete Website Owner's Manual for Dentists. That's the name of the book. Rev Up My Marketing is just the company I created to sell the book, but yeah, it's the Complete Website Owner's Manual, and that's kind of the idea. It's an owner's manual. 

If you want to create the website from soup to nuts by yourself, there are plenty of books about how to do that, and I've read plenty of those myself, but what I tried to do with this website owner's manual was educate dentists on what makes a dental website work and what doesn't work, so that they can be educated consumers when they team up with a website creation company and there are plenty of good ones out there. A lot of them are on Dentaltown, very helpful.

Howard: Any ones you like?

Mike: Well, you know, I'm partial a little bit to New Patients, Inc. My buddy, Howie Horrocks. He's actually done some work for me. His company has, even on my website, the little floating head videos. They did that for me.

Howard: Would you say in dentistry you can never go wrong with anyone named Howie? I mean, I believe that.

Mike: Well, there you go. I think we're done. 

Howard: I love him. He's a great guy.

Mike: He's a great guy. 

Howard: And even a better fisherman.

Mike: Oh, okay. But he'll tell you that a lot of his clients that read my book, he loves working with them because they're educated. They understand what goes into a website to make it successful and so they're better partners. That was the goal of the book was to make dentists better partners with website designers.

Howard: Okay, well Mike, when I think of a good website or when I hear people talking about a website, a lot of the ... Talking about that if you bought a website 5 years ago and you haven't changed anything, Google says, you know, there's no activity. It's kind of a blackout, that Google SEO, and I'm just hearing what people say, that Google likes it to be updated. They like fresh. They like fresh content. How often do you freshen up your website? How often do you add a new picture? A new blog? New content?

Mike: Well, you know actually, it's hit and miss with me. It's whenever it occurs to me, really. It's not on any kind of regular basis for me. I don't have a blog attached to my website currently. I did have a separate blog, which has been rather inactive because I've been busy with so many other things, but as far as my actual website, I updated it fairly recently. I added a page and so for example, I added a page about Quality Dental Planet, in-house dental savings plan for my patients. I wanted a page about that that would be optimized for people who might be doing searches for no dental insurance, dentists where, "I don't have dental insurance." That's a real common thing. "I'm worried that I can't go to the dentist because I don't have insurance." I wanted a webpage on my website that was optimized just for that. 

That's another thing that I advocate is most dental websites, let's face it when a dentist writes the check for creating a website to one of these companies, obviously they're going to look at the price, the cost of creating the website. These website companies are competing with each other to get the business of dentists who are looking at the bottom line, and so there's only so much they can do for so much money. What they tend to do is they tend to put everything on one page. For example, they have a services page, and they've got every service that you offer, whether it's crowns and bridges and root canals, and braces and implants, it's all on one page, and that dilutes the search engine optimization.

I recommend having a separate page for every service that you offer, and that's going to be a lot better in terms of search engine optimization, because if somebody's looking for a dental implant dentist, if there's a patient out there who needs dental implants or wants dental implants, looking for a dentist who does that, and they type in dental implant dentist, Phoenix, and your website has your dental implant information buried on a long page of multiple dental services, but meanwhile, Dr. Y has a full page dedicated to dental implants, nothing but dental implants on that page, that page is going to show up higher in the Google search results. Having your services all separated into their own pages is going to be a big advantage, but it's going to cost you more. It's going to cost you more.

Howard: So you recommend multiple websites for the same dental office?

Mike: Not multiple websites, multiple pages on your website. You have one website, todaysdental.com, and then instead of having just a single services page, you can have a services page, but then from that page a sub-menu of dental implants, short-term orthodontics, root canals, fillings, white fillings, veneers, all of those individual services then have their own page within your website. 

Howard: Okay, and Mike, answer this question, because when you and I got out of school, there really wasn't websites or internets, or social media. A lot of dentists ask us, "Do I need a website or does a Facebook page do?" I'm asking you, on your new patients, how many of them come ... What is your Palm ... Or Boynton Springs, what is your dental office website?

Mike: Oh, my dental office is Palm Beach Smiles.

Howard: Okay, Palm Beach Smiles. But I thought you just said earlier that you moved to Boynton, though. 

Mike: No, no. I'm in Palm Beach County.

Howard: Oh, okay.

Mike: Yeah, I wanted to broaden. Well, a couple of reasons I chose Palm Beach Smiles, and this was back in 1999. I was trying to come up with a domain or a web address for my practice website, and I was just brainstorming ideas, and I came up with ... You know, I think the best name for a domain is what do you and where are you? If you can combine those things into your domain, that's a natural choice. Well, I'm in Boynton Beach, but I'm in Palm Beach County. I wanted to draw from the larger area. I just didn't want to draw from Boynton Beach, and Palm Beach, that name has some cache to it. Palm Beach is also a town here.

Howard: Do you also have a Facebook.com/PalmBeachDental Facebook page. 

Mike: Yeah. I have a Facebook page, a Palm Beach Smiles Facebook page. 

Howard: And you have a Palm Beach Smiles www.com.

Mike: Right.

Howard: What's really the difference and do you get more patients from your website or your Facebook page? 

Mike: Far, far more from the website, and almost none from Facebook.

Howard: Okay, so go into that because everybody just keeps hearing all these buzzwords that they're going to build their dentist office to success on Facebook, and you just said no.

Mike: Well, hey, maybe somebody has and there probably are guys that have, but I think social media is something that you have to show up. I think that's my take on social media. You can't pay somebody to be your proxy on social media. Social media is interactive and so, you can't be invited to a party and send somebody else to the party on your behalf and expect the people there to believe they saw you. I think social media like Facebook, you really need to be there yourself or somebody from the office needs to be on that and almost on a daily basis. I think the thing about social media like Facebook is it requires a tremendous amount of energy poured into it on a regular basis.

A website is relatively static, so I think that's going to be something that shows up when people are looking for ... When they're Googling dental implant dentist or a smile makeover dentist in my town, I thin having your own website there's a lot more control. My experience with social media has been somewhat lackluster but I will admit that I have not put that much into it. There's only so much I can do and so many places I can be. I'm a hockey dad, my daughter goes to horseback riding lessons, I've got a family, so I've got a practice, I've got Dentaltown that I've got to show up on, I've got a blog that I try to write for.

Howard: You son's 14. How old's your daughter? 

Mike: She'll be 11 in 2 weeks. She's sitting right over here to my left. 

Howard: I got to tell you this, true story. I live in Phoenix, so I have, my neighborhood's the equestrian center because there's a horse riding property, and then I grew up in Kansas, and I don't know what it is about girls. Little girls want a horse and you know what? As soon as they get their car keys, they never look at the horse again. They're just mesmerized by horses until they get their first set of car keys. Then you're going to get the horse. She's going to give it to you the minute you give her the car keys.

Mike: Right, right. 

Howard: You also ... I love some of your catch-phrases because they're so ... You say organized dentistry/disorganized dentistry. 

Mike: Right yeah. Yeah, I'm not currently a big fan of so-called organized dentistry, the American Dental Association. I was very active in it years ago. I'm not a member currently. I haven't been a member for probably about 10 years. I kind of got disillusioned with them. The advice is always, "Well, you've got to get involved," so I did. I got involved. I went all the way up through the President of our local affiliate association, you know, served on the board and went all the way up to President, and was the big cheerleader for it, but I don't think that the ADA really represents the typical practicing dentist anymore. 

I think there's some conflict of interest. A lot of the top people in the organization have had ties to the insurance industry, and so I don't think a lot of dentists feel well represented. They seem to be ... In fact, even when I was on the board at the local affiliate, I used to get kind of chastised a bit because their mantra was, "We've got to sit at the table. We've got to be at the table, because if we're not at the table the lawyers and the insurance companies are going to run the show for us." My position was that if we don't agree with what they want us to do, we need to step away from the table because without our talent, they've got nothing. 

I'm talking about the insurance companies and the political powers that basically want to give our services away. Somebody said, and I can't find the attribution, but somebody said, "No man owns the talents of another." We're the ones with the talent, and so there comes a time when it's time to step away from the table and maybe even time to turn the table over, upside down and walk away. I just think that they're really more focused on this access to care, so-called access to care issue, and it's really more about access to other people's money and access to our talents. Right now the ADA and I are not on the same page, and so I guess I'll leave it at that.

Howard: I want to go back to this graduating class. We talked about residencies. You learned a lot on that, but what type of mix of service do you do? Some people, you know, they have a successful practice and basically all they do is fillings and crowns. Other people got into Six Month Smiles, some people got into placing implants and learned to bone graft. Talk about that. What mix do you do, and what advice would you give for kids coming out? 

What should they learn? The most common question the senior graduating class has is the American Dental Association recommends 9 specialties. Knowing what you know now, what would you say about a specialty? Do you wish you would have specialized? What would you say to some kid who says, "Mike, should I be an endodontist or a family practicing?" Talk about specialties and if they're not going to specialize, what mix of services they should learn.

Mike: Right. No, I don't regret being a general dentist. I think one of the great things about being a general dentist is that we can do whatever we want. That's the beauty of it. We can do endo if we want, or we can not do endo if we don't want to. We can throw all of it out. As a general dentist, you can pick and choose, and furthermore, you can change your mind. You may start out loving endo and then one day, you reach 50-something years old and you're like, "I don't want to molar endo retreats anymore," and you send them out. I think that's the cool thing about being a general dentist is we're not pigeon-holed into any one thing. 

Then, nowadays, there's so many different types of services we can offer, from like you said, short-term orthodontics, like 6 month smiles, to sleep apnea treatments, facial rejuvenation, Botox and injectable fillers. There's endo. It's mechanized endo now. You've got apex locators and rotary endo. There's so many different things you can do and I think the key to that is to take as much CE as you can, learn as much as you can. They say your dental diploma is your license to learn. You and I both have probably been through, between the 2 of us, probably 5,000 hours of continuing education. I think I'm past 2,000 hours, but that's what I love about it. 

Specializing, if that's what you want to do, that's great, but I don't regret it personally and what do I offer? I don't place implants. I don't do that yet. I do restore implants and I love restoring implants. I do most of my own endo. I do most of my own extractions, but nothing ... I don't do any more complex surgeries. I do refer out to the oral surgeon, or if it's a patient management issue or a medical issue, I'll refer to the oral surgeon. What I have gotten into mostly is the cosmetics and also more the rehab type dentistry: full-mouth reconstructions, full-arch reconstructions, things like that. That's what I really enjoy doing.

Howard: But is that because you're in southern Florida, where the average patient is 106 years old? I mean, for someone around the world, what is your demographic area like? I mean, in all seriousness, I think the brand of your area in Florida is the retirement home for everyone over 80 in New York and New Jersey. 

Mike: Yeah, this is God's waiting room.

Howard: Is a lot of your mix of dentistry, I mean, do you have a lot of retirement people?

Mike: Yeah, I have a fair share. 

Howard: Or that area?

Mike: Yeah, but I also have ... I would say I'm a Baby Boomer practice. Even though we have a lot of retirees and geriatric patients here, most of my patients are ... Probably the fat part of the bell-curve from my own practice is probably 50s and 60s, 40s. 40s to 60s I guess would be the fat part of the bell-curve for me. I think you tend to attract what you want to attract. Supposedly your patients age with you as you get older as a dentist. I've heard that, too. But yeah, contrary to popular belief, I don't have a practice full of super wealthy Palm Beachers. I get that reputation on Dentaltown, not because of what I've said. But that's what people believe. 

My patients are working class people, the vast majority of them, and some of them save their money enough to have significant dentistry done. But in this economy since 2008, that dropped off quite a bit. I don't do nearly as much cosmetic stuff as I used to or full-mouth rehabs as I used to. They're still there, I still do some, but most of my days are garden variety dentistry, single tooth dentistry like most dentists. I think a new graduate just needs to diversify as much as possible, but don't get too scattered. 

Learn something well and then move on to the next thing. It's kind of like when you buy your first computer and you buy every software available and now you've got a stack of 20 different softwares and you're overwhelmed. You don't want to overwhelm yourself. You mentioned earlier, and I think it's important to bring it back up, we talked about keeping your debt load low, but there's also this temptation, especially with social media like Dentaltown, and Dentaltown is dental social media. 

It's very easy to get caught up in the Joneses and keeping up with the Joneses and getting the CAD/CAM and the cone beam. You could spend 1/4 of a million dollars just on those 2 things. I think it's easy to get caught up in that excitement and next thing you know you've got a big nut to cover and that machine's sitting in the corner or you're trying to find ways to use it. I think that there are a lot of exciting technologies available, but baby steps, especially when you're fresh out of school. Baby steps. Don't get socked down with a whole bunch of debt so you can have all the latest toys. 

Howard: But talk about the big toys because if you walk out of school 250, and you buy into CAD/CAM, that's another 150, and a 3D X-ray machine's another 150, you've doubled your student loan debt and you've bought 2 things and a gift bag.

Mike: You're right, and you don't even have a practice yet.

Howard: Are you CAD/CAM? Are you CBCT?

Mike: Nope. Nope. I'm not, and at some point I might consider the scanning side of the CAD/CAM equation, instead of traditional impressions, which I still do. I might consider that and the price has come down on that to a degree, but to me I've got to look at the ROI. I'm a solo practice, too, and I think that weighs into the equation, too. If you've got a practice with 6 dentists, one CAD/CAM machine's going to get used a lot more than it's going to get used in the single, solo practice, so that's a factor too. I'm speaking as a solo practitioner and to me CAD/CAM does not make sense for me. There could be a huge debate.

Howard: But forget about all the other people because I'm talking to you. I'm talking to Mike "The Man" Barr, the Dental Warrior. 

Mike: My daughter's laughing at you.

Howard: What's that?

Mike: My daughter's laughing at you every time you call me "The Man."

Howard: Well you are the man. You absolutely are the man and I mean that. In fact, you know what I was thinking when I saw you today, seriously? I don't want to creep you out, but I think you're the first dentist I met online. I think it was a Yahoo email, a Yahoo group, I think it was like '98 or '97. You had a Yahoo group, didn't you?

Mike: It was not ... It was ...

Howard: CompuServe.

Mike: It was yeah, CompuServe, yeah. There was a CompuServe group I was a member of and then there was also as group called Generation Next, which was kind of like a Yahoo group.

Howard: With Mike Maroon, but you were before that. I think the first name I ever saw on the internet who was a dentist, was your name. I think it was CompuServe. 

Mike: Yeah. 

Howard: Now these young kids ...

Mike: Yeah [inaudible 00:47:29]. I co-invented it with Al Gore. 

Howard: But you're a smart man, you're a businessman, and the pro-CAD/CAM people drowned the message that you know, you just got to have it, but we're talking to you. Why did that message ... Why did they not get you? Why did you resist that $150,000 toy?

Mike: Because I'm stubborn and I'm a non-conformist, but I just looked at it, $150,000, and I would get into some debates with some of the CAD/CAM advocates, and I said, "Look, I just can't see $150,000 so that I can make the crown in the same day." One of their arguments was, "Don't think of it as $150,000. Think of it as a $2,500 a month payment, which you're spending on your lab bill anyways." That was their argument, and I said, "But here's the difference. If I don't like my lab, I can fire my lab. I can get rid of my lab. I can move onto another lab. If I don't like the $150,000 machine, the company that made it is not taking it back. I can't get rid of it. It's still sitting in the corner and I've got to keep using it, or not, and I've got to keep paying for it, whether I use it or not, I've got to keep paying for it."

I can't fire the CAD/CAM machine if I decide I don't like it. Yeah, I can turn around and sell it on eBay, probably for a tremendous loss, so I just don't see the return on investment. That's just me and I'm a low-volume practice relatively speaking, and I'm a solo practice. If I'm going to drop 6 figures on a gizmo, it's got to pay. That just basically kind of scared the crap out of me, and it was a solution to a problem I don't have. I learned that phrase from another dentist on CompuServe way back in the day. There are a lot of solutions out there to problems I don't have, and I don't have a problem with my patients having a temporary. I have never had a patient say to me, "You know, I would get that crown if I didn't have to have a temporary." My temporaries don't fall off. It's extremely rare, so that's not a problem. The gooping impressions, I don't like it, but I've never had a patient refuse to have a crown because of the goopy impression. 

Howard: Well, try this on for size. I tell a patient, "Okay, we can make this in one appointment, but it's going to be 2 hours. We can just have your appointment date for an hour, and then you leave with a temporary and then come back in 2 weeks for just a little 30-minute seat," and the majority choose that. I don't know if I'm ADD or too hyper, whatever, but Mike if you told me I had to sit in a dental chair for 2 or 2 1/2 hours, I'd go crazy.

Mike: Right. 

Howard: Imagine going to your next doctor's appointment and it's 2 hours.

Mike: Yeah, well that's just in the waiting room. But, that's an interesting point. You can speak from a position of having to offer both, and they're choosing the old-fashioned way. That's really interesting. I think that patients tend to believe what you believe. I learned that from another dentist, the dentist right next to door to me and he told me ... "I actually started my practice by leasing space in his office, and he said, "Mike, you've got to choose your religion. If you believe in implants, your patients will believe in implants."

Because a lot of dentists say they can't get their patients to do implants. It's that they don't believe in it. I think if you believe in something, your patients pick up on that enthusiasm and they're going to believe it, too. I think a big part of it is confidence in whatever that you're doing. But anyways, the bottom line was I just didn't think I could justify 150 grand for a solution to a problem I just didn't think I have. [inaudible 00:51:27]

Howard: I want to ask you another question. I want to go a different way. I graduated one year before you. I graduated in '87, you were '88. You're down there with a lot of retired people. So am I in Phoenix. In my area, 25% of the Phoenix area pretty much retired after 65. Most of them, it's 10% [inaudible 00:51:48], 10% Canada, and then the rest is pretty much west of the Mississippi and in the northern states, you know, Kansas, Nebraska, North and South Dakota, all that stuff. If they're east of the Mississippi River, they go to where you are, Florida, and if they're west of the Mississippi, they go here.

But you know what? Man, I've seen so many of these root canals and crowns I did on these lovely ladies when they were in their 50s and 60s, and then when they get into a nursing home or they get dementia, or they get Alzheimer's, root surface decay, just wow. The number I keep seeing mostly is they're losing about a tooth for every month they're in the nursing home from root surface decay, so when Grandma's been in the nursing home 15 months, she's lost 15 teeth from root surface decay. In the nursing home those ladies that got an implant and a crown instead of a root canal [inaudible 00:52:42] and crown, and to me from Kansas, it just makes sense that it seems like I used to always build a wooden barn and say, "Mike, you got to brush and floss twice a day and you got to brush, brush, brush, brush, brush, brush." 

The termites eventually get the whole barn anyway. Then I'm looking back at those barns that I went out and built with aluminum and you don't have to brush it and floss it, and the termites didn't come and they're not going to eat it. Do you think ... When you and I graduated from school, some called it the Golden Era. Do you think this is the Titanium Era, and do you think titanium is going to be a game changer just because we're not really engineers, we're biologists and bugs can't eat titanium? Is this a game changer? What are your thoughts on that? Because you've been in this field 30 years.

Mike: Yeah, well I think, yeah, I think it has changed. We were taught to basically save, if at all possible, we'd save a tooth, not only to the root canal [inaudible 00:53:33], we'd do crown lengthening on it, ortho-extrusion. We'd go to the ends of the Earth to save a tooth, and implants back then, they were around but they were kind of voodoo, and so, I got zero experience with implants in dental school. Zero. I never saw my first implant until probably after the Navy. But I think it has been a game changer because by the time you do a root canal post and crown lengthening in the crown on a tooth, you could be into that tooth for 5 grand in some places, or 3 grand or whatever. But whereas an implant is more predictable, and probably more economical in some cases, in the short-term and certainly more economical in the long-term. 

I think I'm not as prone to doing hero-dontics on natural teeth unless the patient really insists on it. Implants are very predictable now and they don't decay, as you said. Now they can certainly have periodontal issues, but they're not prone to root decay, and I see that, too. I'm definitely seeing follow-ups of teeth that we went to great efforts to save, and then the gingiva recedes and then there's root caries all the way around circumferentially, and it's very difficult to deal with. Then by the time, like you said, they're that old or frail, or in the nursing home, it's too late to really do anything. I think that's an interesting point. I know that dental students nowadays, I think, are getting a lot more exposure to implants, and the implant systems are so easy. I'm telling you. Restoring dental implants, probably the easiest thing I do.

Howard: I don't like to say this very often because I don't want to offend the younger kids, but it was a lot harder to be a good dentist 30 years ago. You didn't have apex locators, you didn't have digital X-rays. The assistant would take a film X-ray, take her 10 minutes to develop it, then she cone-catted it, and you're running behind and you had to retake it at implant. 

Mike: Then you're 2 millimeters short.

Howard: What's that?

Mike: And then you're 2 millimeters short, and then you got to start over. 

Howard: Yeah, and then on implants, we had 2 [inaudible 00:55:49] and you would lay back the tissue thinking you had an inch of bone and it turned out to be some knife edge and by the time you smoothed it down there wasn't any left. I really think it's a lot easier to be a dentist now than it was back then. It had to be. I mean, farming had to be easier when they got a tractor and you could get rid of the cow and plow. 

Mike: Right, right. Oh, yeah definitely. I think we both walked uphill both ways through the 3 feet of snow just to get to dental school. Yeah, I think the technology has changed. I love my apex locator, and rotary endo, rotary files are fantastic. That makes root canals a lot ... 

Howard: You know before rotary endo, for the first 6 years out of school, I always had a blister on the end of my finger and my thumb from holding onto those files? It was like guitar player has blisters on their finger. I had 2 blisters for a decade. 

Mike: Yeah, yeah. 

Howard: I've only got you for 3 more minutes, so I want to ask something that's very, very rare and unique about you other than all the dentists out there, and that is most townies ... We're coming up on 200,000. We're at like 198,200 and we're just almost at 4 million posts, and so many of those people I meet, I say, "Well, why don't you ask someone on Dentaltown?" "Oh, I'm afraid. I don't know. I hope someone else posts it." I get emails all the time, I mean literally every single day, "Will you ask this question?" I'm like, "Dude, you ask the question." 

My question is to you, why does someone like you just absolutely not give a shit what anyone thinks, and posted 30,000 times and you're not going to budge on the NRA, you're not going to give away your gun. How come a dentist like you is just going to, "This is me. Like it. This is Mike Barr, The Man, unedited, raw, take it, leave it, fly a kite." Why do you not care, and 99% of dentists just have burning questions and they just can't post it? What advice would you give to someone who really wants to ask a question but is afraid someone's going to say, "Boo!" And they'll run all the way ... 

Mike: I just think you should tell them to grow a pair. But this is true even before the social media like Dentaltown where we could all do this online, I would go to CE courses and it's always the same dentist asking questions in the audience. Everybody else is shutting up. I think dentists, as a group, are relatively shy. 

Howard: Oh, yeah.

Mike: You know, and they're afraid of what their colleagues will think, and I think that probably goes back to dental school. There's no love lost between me and the University of Tennessee College of Dentistry. One of my classmates said I wouldn't piss on them if they were on fire. 

Howard: Was that Memphis?

Mike: Yeah. Yeah. I'll put it this way, when I went into the military, it was like going to summer camp for grown-ups compared to dental school. Dental school, we got treated pretty tough, and so we're beat down quite a bit in dental school. I think that carries throughout our entire career. We're shy, we're afraid to say anything because we're going to be struck by dental lightning from our colleagues. Dentists are really pretty shy and they're afraid of what other dentists are going to think. Why do I not give a shit? I think part of it is age. It's very liberating to not give a crap. It really is, and so I've got some experience behind me, so it's not cocky if you can back it up. 

Then I've got you as an example. You don't give a shit either. I saw you, I think it was around 1992 or '93, you lectured here in West Palm Beach and you got up on the stage there, and I didn't know you, and you went at it like ... You're like the Dennis Miller of dentistry. You go off on tangents. You do all kinds of references, and it's just ... You can't fall asleep during either Dennis Miller or Howard Farran. You cannot fall asleep. I like that about you, and so I think be yourself and don't worry about what other people are going to think. I guarantee you that if you ask a question on Dentaltown, there's always going to be some keyboard commando tough guy who's going to give you crap, but there's a lot of really good people on Dentaltown. 

There's tons of good people. The majority of them are good people, so don't let the turkeys get you down. They're going to be there, and it's easy for them because they're anonymous behind the keyboard and it's easy to be a tough guy behind the keyboard. But if you have a question, I guarantee you there's of us that have either had the same questions, dealt with the same questions, had the same problems. I call Dentaltown, it's a collective intelligence that I have access to 24/7. I can ask anything on Dentaltown and somebody out there will know it. In fact, a lot of people will have the answers, and so it's a collective intelligence that we can all tap into. To not tap into it, to me, is just a tremendous loss. Dentaltown and the other social media that I've been a member of, dentally speaking, are a big part of what I do today. Everything I do today is affected in some way by what I've learned online from my online colleagues.

Howard: We're out of time. We're in 1 minute overtime, so how do these ... When is your, The Complete Website Owner's Manual for Dentists, 2nd Edition, coming soon, how does someone on this podcast get on the waiting list for that? How do they let you know ... 

Mike: I don't have a waiting list, but I probably could. I'm a terrible procrastinator. I'm juggling a lot of things at one time, so I don't have a time frame, but I'm on the downhill side of getting it ready to go. I'm looking into making it a downloadable product instead of a paper book. They can contact me at ... I guess they could email me at mike@thedentalwarrior.com. That's the easy one, or they can do mike@revupmymarketing.com. 

Howard: Or mike@palmbeachsmiles.

Mike: Yeah, dot com. I'm working on it here and there and I'll get it out eventually, and I'm thinking about doing a downloadable product instead of a paper product, or maybe both. If they want to give me some feedback on that.

Howard: Last question. You went to the University of Tennessee in Memphis, and B.B. King just passed away. Is that right?

Mike: Yeah. Yep.

Howard: Did you ever get to see him on Beale Street?

Mike: I never, no I never saw him myself in person live, but I saw a lot of his influence there. He was a cool guy.

Howard: Would you say Beale Street is the number one jazz street in America, or would you say that's more Bourbon Street or Nashville?

Mike: Oh, gosh, I don't know. I haven't been to Bourbon Street, so I'm partial to Memphis of course, and also the best barbecue. 

Howard: I think it's utterly amazing. I mean, America, that Mississippi delta's amazing because the bands on New Orleans' Bourbon Street and Memphis' Beale Street, and Nashville ... I forgot the name of that street, but it's about 8 blocks long and just ... I mean, just every block there's a couple of bands just crushing it. I mean, America is just basked in music and a lot of people think music is L.A. or Detroit, or Motown, which is all true. But the hidden ones are Beale Street, Nashville, and New Orleans. 

I mean everybody knows Motown and Detroit and L.A. and Hollywood, but I just love Beale Street. But, hey we are 3 minutes overtime. I have got to go. Mike, seriously man, I love you like a brother. Thank you. I think you are the first dentist I ever met online on CompuServe, I'm a huge fan of your 32,000 posts. I'm a huge fan of your Rev Up My Marketing and the rest. Thank you so much for all that you've done for me personally, for Dentaltown and for dentists around the world on the internet. You're just the bomb, dude. 

Mike: Oh, you are you, too. Thanks for creating Dentaltown because believe me, all the stuff that I've done wouldn't have been possible without Dentaltown. 

Howard: No one would have ever gone to Dentaltown if it wasn't for guys like you on there.

Mike: Yeah, blabbermouths. 

Howard: All right, thank you for all you do, Mike. See you later, and tell your son happy birthday.

Mike: Oh, thank you.

Howard: Okay, bye.