|
Howard:
|
It is a huge honor for me to be podcast interviewing my buddy forever, Daniel Greenstein. You go by Dr. Dan, though?
|
|
Dan:
|
Yeah, Dan, Dr. Dan.
|
|
Howard:
|
My God, I've known you forever because you did stand-up comedy. You'd been doing stand-up. I remember seeing you at the Profitable Dentist in Destin, Florida with Woody Oakes way back in the day. How many years ago was that?
|
|
Dan:
|
That's probably 25 years. I saw they're going to have their 25th anniversary gig this spring in Destin. Because of you, you helped me get that gig, so that was one of my first dental jobs, and I really appreciate it. I'll never forget that.
|
|
Howard:
|
He's having a 25-year anniversary?
|
|
Dan:
|
As far as I know. I got one of The Profitable Dentist pamphlets, their newsletter.
|
|
Howard:
|
Oh, Google Profitable Dentist and see when they dates are. Are you going?
|
|
Dan:
|
I'm not sure if I'm going. I wasn't planning on going. I wasn't asked, to tell you the truth.
|
|
Howard:
|
It's in Destin, Florida?
|
|
Dan:
|
It's always at the Sandestin as far as I know. I haven't been there in a long time, but I was the entertainer for the first five years, yeah.
|
|
Howard:
|
Oh, man, I love Woody. He's a good ol' boy. He actually had The Profitable Dentist Newsletter.
|
|
Dan:
|
Right.
|
|
Howard:
|
At one time, back in the '90s, there were three newsletters. There was Woody Oakes, the lead king-pen, The Profitable Dentist Newsletter, and then the Madow brothers started The Madow Report, right?
|
|
Dan:
|
Yeah.
|
|
Howard:
|
Then I had The Farran Report, and back in the day, I think, those were the three best sources of quality information because those were all down-home real dentists getting material submitted from real guys in the trenches doing it as opposed to these professional writers for all the throw-away magazines that all they do for a living is write stuff as opposed to learning this stuff the hard way. It reminds me of McDonald's when Ray Crock set up the R&D Center, and ... Where was that, in Illinois, their headquarters? Des Plaines, Illinois. Their R&D Center never invented a single successful product. The fish sandwich came from a guy in St. Louis because none of the Catholics would eat on Friday night because they couldn't eat meat. All the big hits came from real franchise owners in the trenches, and then all this stuff from the academics in the McDonald's R&D Center ...
|
|
Dan:
|
This is going to blow your mind because I still have your cassette tapes.
|
|
Howard:
|
Oh, my God.
|
|
Dan:
|
This is how I met you, and these are cassettes. Now, I know, you said ...
|
|
Howard:
|
Oh, my God.
|
|
Dan:
|
You said that most of your listeners to your podcasts are kids under 30, and I wanted to tell you, these are cassettes by the way. I don't know if they have ever seen tape cassettes, but ...
|
|
Howard:
|
They probably haven't.
|
|
Dan:
|
This is before CDs, before mp3s, before streaming, and this came right after 8-track, so I still have this. I took this out of a closet, and I still remember listening to this when I first met you, and I said, "This guy is crazy. I love this guy," and I had to find it when you invited me to do this with you.
|
|
Howard:
|
I wonder what year that was.
|
|
Dan:
|
I'm not sure, but it's Dental Mania. I recall you mentioning that you had just opened your office, and I still remember the town, Ahwatukee. I don't know why I would remember that.
|
|
Howard:
|
Oh, my God, that was so long ago.
|
|
Dan:
|
You rode a unicycle, I think, on a parade, and you promoted yourself by handing out toothbrushes on this parade for 4th of July or something, and you were riding a unicycle. Is that correct?
|
|
Howard:
|
It was the Easter parade. They have it every year, and it's a mile-long stretch down Ahwatukee, and at the end, where the park is, they have all these booths. I filled up big ol' bags of toothbrushes with my name and phone number on it, and I got on my unicycle, and I was the float. I unicycled down the road handing people toothbrushes with my name and phone number on it. It was so damn funny.
|
|
Dan:
|
Out of all this stuff that I remember listening to, that stuck in my mind.
|
|
Howard:
|
You know what, the funniest thing, that was in my first house. That was in '87. I remember the blue chair in my bedroom, and I went in there, and I wanted to talk to dentists, and I set this automatic set, and I taped it. How many sets was it, 12 tapes long?
|
|
Dan:
|
I think, yeah.
|
|
Howard:
|
Somewhere during the tape, my oldest boy, my firstborn son, Eric, who was about one, he walked in the room, and he said something like, "Daddy, I want a drink" or something. Anyway, here it is, 10, 20 or 30 years later, and the only thing people ever remember is, "Yeah, I bought your first cassette, your program, and I'll never forget when your son came up and asked you for a bottle or a drink or something." I thought that's really the essence of marketing. They don't remember the technical stuff; they don't remember the price. They remember how you made them feel.
|
|
Dan:
|
Now, look, you've come from this, from cassettes, to being the king of all of dental media, and got doing this podcast. It's an honor for me to be here, and to think that I am following Carl Misch because you just did interview Carl Misch, during this week. To think that me, Dan Greenstein, Dr. Dan, is following him, a legend, blows my mind also, so it's fantastic. Thanks for inviting me.
|
|
Howard:
|
Since that cassette, I went from riding a unicycle, to being carried around in a wheelbarrow, so that's the main difference. Yeah, Carl Misch ...
|
|
Dan:
|
Now you're doing Iron Man. Come on, that's really impressive.
|
|
Howard:
|
I am trying to reverse 50 years of bad habits, and I have done three Iron Mans in three years.
|
|
Dan:
|
Wow.
|
|
Howard:
|
I figured I didn't get into this mess overnight, and I probably won't get out of it overnight. Speaking of health, you had health issues a while back, and you scared me, when I heard about my buddy. Is that too personal to talk about?
|
|
Dan:
|
No, I want to talk about it. I want to tell dentists, and I want to make sure that people are taking care of themselves. Five years ago, at age 52, I had to drive my wife to the airport, and I woke up early at 5:30, sweating and short of breath and with this tightness in my chest, and I'm thinking to myself I'm sitting here, in bed, and I'm having a heart attack. My wife is like, "Come on. We've got to go. You've got to take me to the airport. Let's go to Fort Lauderdale. Come on," and I'm like, "I think I'm having a heart attack." She is like, "You're not having a heart attack. Get off your butt; take a shower. You just don't want to take me to the airport," and I'm sitting there, and I'm in denial, and I'm having all the signs, sweaty palms, sweaty feet, reading really weird, and this strange tightness.
|
|
|
I was spinning the night before at the gym, and never had any issues of cardiac problems before. I had been on Lipitor for a long time. My cholesterol was always a little high. I was on Losartan for blood pressure, but aside from that everything was fine. I had this tightness, and I said I'm going to double up on my Lipitor and take three baby aspirin, and my wife says, "Come on, get up. Let's go. You've got to take me to the airport." Should I go? I'm not sure. It wasn't this crushing feeling, but I didn't feel right, and I've got this huge deductible and co-payment, $7,000 and $500 pharmacy deductible. My wife is like, "Come on. You're not going to blow $7,000 to find out you're nervous. You don't have a heart attack."
|
|
|
Stupidly, I got in the car, and I drive all the way down I95, and I take my wife to Fort Lauderdale. I drop her off, and I'm still having this chest pain. I go to the local hospital, Broward General. I walk in, and I said, "I think I'm having a heart attack." They hooked me up to all the EKGs and the monitors. "No, you're fine. You're not having a heart attack. Everything seems okay," but I till had this tightness. I went back to the leave the ER. My brother-in-law is a medical doctor. I give him a call, and he says, "You're not leaving the ER. You're staying there, and we're going to find out what's wrong with you."
|
|
|
Next thing, next day, they did a cardiac catheterization on my heart, and the cardiologist, the interventional cardiologist, says, "You're under a lot of stress. You're a dentist. You live in Boca Raton. You have two kids. They're in college. You've got 30 years of fixing teeth. Let's find out what's really wrong with you because I am pretty sure you probably need a couple of stints." I almost took myself off the cardiac cath lab when they told me, "We've got to go through your groin and put that tube up inside your heart." Once you hear groin, that's not good. Once you hear the word groin, it's never good groin.
|
|
|
That freaked me out, and the next thing you know, they woke me up, and they said, "You need a triple bypass. We can't even do stints, you're so clogged-up. You're 90% clogged-up," and I was like, "What? You didn't do the stints?" They said, "No, we couldn't do it. You need open heart surgery." Obviously, that's a big wake-up call. Three days later, I get transferred to a different hospital, Boca Raton Regional, and I'm ready to go. I was lucky. I had a triple bypass, and now here we are, almost five years later, and I'm lucky to be here. It was pretty close. They were amazed that I never had any symptoms before. The last five years have been great, and I am very thankful.
|
|
Howard:
|
Wow. Now, Clinton talked about that, when he got a bypass, what he didn't realize ... He thought he was fixed now. He realized that that tied you over for not even a decade. Has that changed since Clinton had a bypass?
|
|
Dan:
|
I hope not. I don't want to go through that again.
|
|
Howard:
|
Is the follow-up a six-month recall with a hygienist, or is it an annual follow-up, or what is a follow-up like after a bypass?
|
|
Dan:
|
You have to have ... I go twice a year to the cardiologist, an EKG and regular check-up, and blood work, and every two years, they want to do a nuclear stress test. I had a nuclear stress test done about three or four months ago, and they put some dye inside you, they put you on a treadmill, they take radiographs before the exertion of the heart, after the exertion of the heart, during the exertion of the heart, and they monitor how your valves are doing .. not your valves, your vessels are doing, and the bypass graphs are doing. I had two graphs taken from the center of my chest, the mammaries.
|
|
|
They open you up, and they can dissect off the mammary arteries over to the heart, and then they took one from the leg. The one from your leg is a vein, and that is the one that sometimes can close up, but the ones from your chest, when you're young enough, they can take that, and those are supposed to be a lot better. They move them somehow over to your heart, and they go over the blockage, and from what I understand, I had a great guy at Boca Regional who's not there anymore, and the surgery that I had was a very advanced procedure. They didn't stop my heart at all. My heart was still beating. They didn't have to put me on one of the long heart bypass machines, so my heart was never stopped. That was good thing for me.
|
|
Howard:
|
Wow. What advice would you give to the dentists out there listening? At what age should you do our first ... ? They say your first colonoscopy ... I had mine at 50. It was the first time I let some man go where no man has ever gone before, did that, and I'm glad I had it done because he found three glass rings and hubcap. I don't know how they got up there. Then he took the MRI of the brain. He said that a lot of the stuff you die of at 60 in the brain, you could have picked up at 50. I've never gone to a cardiologist. I'm 53. When do you think dentists should for the first time go to a cardiologist and have someone who specializes on the heart?
|
|
Dan:
|
I was really mad at my primary, and I dumped him since this happened, for a couple of reasons. Other people had told me, because of my cholesterol levels and history of hypertension, that they were surprised that I didn't go to a cardiologist earlier, like at 45, and I said, "No, I never thought about it. My primary never recommended that I should do that." I've talked to other people, and they were telling me that people who have that kind of history should go earlier at least to a cardiologist and see what they think, to get yourself checked out. They also have now some different tests that they can do where they measure the calcium inside your coronary arteries. Obviously, it's a lot less invasive than a catheterization of your heart, but the catheterization is still the gold standard to see what the heck is going in there, but for a screening test, they're not going to do that.
|
|
|
You can have a stress test and get on the treadmill, but there is a lot of false positives and false negatives on a stress test. I took myself off the catheterization lab because I was afraid, and I didn't want to go through that. Anyway, I was just going to do the stress test, and if it wasn't for my brother-in-law, the medical doctor, insisting that I have the catheterization, I could have walked off the stress machine, got in my car and still had an MI driving home because there is a lot of false negatives on a regular stress test.
|
|
Howard:
|
Your wife's brother is an M.D.?
|
|
Dan:
|
My sister-in-law's husband. My wife has got a twin sister. Her husband is an anesthesiologist.
|
|
Howard:
|
Do you ever worry that you get those two girls mixed up?
|
|
Dan:
|
On the phone sometimes, they have tricked me, but nothing personal.
|
|
Howard:
|
I went to high school with two twins that, I swear to God, I didn't know how anybody could know them apart.
|
|
Dan:
|
My kids, there is a set of twins, and my kids have known them ever since junior high, and I still can't tell you which one is who.
|
|
Howard:
|
I know I'm getting old and senile because last week I was in the grocery store, and there was this lady pushing three triplets, and I freaked out like, oh, my God, I haven't seen triples for, I think it has been, 25 years. She said, "Yeah, they're not triplets. In fact, there is not even twins there. They are one, two and three, and you're old and senile." Dan, you guys were in dental school in '83.
|
|
Dan:
|
Yeah.
|
|
Howard:
|
You've been a dentist for 33 years.
|
|
Dan:
|
33, yeah.
|
|
Howard:
|
When I get an email from a podcast ... I think I had the Carl Misch downloads, and it's already past 30,000. We have already passed a half million downloads, but whenever I get an email from a dentist about the podcasts or whatever, they are two years out of school, three years out of school, or in dental school, so they're all kids. They're all under 30. We are in our mid-50s. What advice would you give these young kids about lifestyle, stress, dentistry? Because I know you and I are cut from the same cloth, we lighten things up, and we can joke around, but some of these guys are intense. What would your advice be to these kids?
|
|
Dan:
|
Since you said that, and since you talked about your colonoscopy, sometimes I find it amazing that gastroenterologists can even do colonoscopies on dentist sometimes. It is so ...
|
|
Howard:
|
That's a good one.
|
|
Dan:
|
You need an Apex locator to find your butt crack, beep beep beep, and people are uptight. You've got to chill out. Since I had a lot of stress before my wake-up call with my triple bypass, and I had financial stress, and I had office stress, and I had some personal issues, a lot of things that were building up, when I was in that hospital bed, I made a commitment that I had to change my life. When I realized after there was this huge scar on my chest, when I first saw that, I said, wow, something has got to change. I did a lot of reading, and I looked back, and I read stuff about dentists and stress, and I saw myself in all those things. The things that you talk about, dentists should never practice alone, that is a big thing, that isolation.
|
|
|
We're in this little room all day. We're working in this little space; we're working on this little tooth; we're thinking about eight million other things. I was such a control freak over every little thing, sticking my big nose into the schedule, reviewing everything that the staff would order, listening to everything that the front desk would say, and making comments, over-managing and not letting the staff do their thing. Instead of taking a step back, worrying about the schedule so much, this constant pressure over you, to run things like Superman, just perfection. It's impossible to attain, and you've got to take a step back and take a deep breath and realize that you're doing the best that you can. None of us are going to make it out of here alive, so you've got to chill and ... Here, I am. It's a beautiful day here, in South Florida, it's a fantastic day, and ...
|
|
Howard:
|
Is that where you're officing?
|
|
Dan:
|
Yeah, yeah, this is from our operatory. This is our operatory right here ...
|
|
Howard:
|
Oh, my God.
|
|
Dan:
|
I thought, with such a beautiful day, with the palm trees right here, I had to use that as my backdrop.
|
|
Howard:
|
Now, can coconut trees grow down there?
|
|
Dan:
|
Yeah, yeah, yeah, we have coconuts, sure.
|
|
Howard:
|
Because in Arizona, we've got the same palm trees in my front yard, but there is no coconut trees down here.
|
|
Dan:
|
Yeah, I don't really know the difference.
|
|
Howard:
|
My gardener says they won't grow. It's too cold.
|
|
Dan:
|
Oh, I don't know.
|
|
Howard:
|
I guess Florida must be warmer than Arizona.
|
|
Dan:
|
I know it's a lot more humid. That I can tell you.
|
|
Howard:
|
Yeah. That stress, you talk about working in a small area and in a small mouth and whatever, but when you're next to a human, we're hard-wired for empathy and sympathy?
|
|
Dan:
|
Oh, yeah.
|
|
Howard:
|
When they're feeling pain, and they're grabbing the chair, I feel my heart go up. I feel my breathing, so unless you're a sociopath, when that person ... When you are working with people who are stressed-out ... I know oral surgeons that say, "No, I put everyone to sleep because it's too hard on me. It's too hard on me when they're feeling the pressure or whatever. I put them out, so I can relax."
|
|
Dan:
|
Exactly. The patient anxiety is definitely transferred to you.
|
|
Howard:
|
Absolutely.
|
|
Dan:
|
That's another factor. That's definitely another factor, that you're watching them, you're seeing their facial expressions, you're feeling what they are feeling. You're feeling badly that you're doing this sometimes to these people. I was reading that general dentists and oral surgeons have a higher level of emotional illnesses, more than other dentists, and then the fact that you said that this other oral surgeon says, "Look, I am just going to put them to sleep. It makes it easier on me," and then on the flip side it also talked about that studies have shown that orthodontists have less of these issues with stress. Orthodontists, their only problem is are the parents going to stay together for the entire treatment. That's the only thing that they're worried about.
|
|
|
They're not inflicting pain; they're not giving injections; there is no bleeding; no one comes in, getting all crazy that they are going to the orthodontist. Here we are, as dentists, and, as you said, the stress of the transfer of watching the patient's anxiety into you, I agree. Blood pressure, heart rate, sweating, all those things, you feel.
|
|
Howard:
|
I always take over ... When I feel that, I jump on it for me, the patient, and my assistant. I start talking slowly because I notice, when I am starting to feel that, I am holding my breath now. Then, instead of me taking a deep breath, I verbalize it and say, "Take a breath, and relax your hands." I am relaxing my hands when I'm giving a shot. Wiggle your toe. I'm doing all that for all three of us because we're all feeling it, we're all hurting someone, and let's all ... We're all in this together, and I taught myself to do it.
|
|
|
The other stressful thing is, I think, dentists always have people on the payroll that they don't want to play with in the sandbox. Rule number one is, you've got to build an environment where you want to play with these people in sandbox. If you don't walk through that door and crack a smile ... The instant I saw you, I burst out in a radiant smile, but when you walk into your office, and under your breath, you're thinking, God, I hate that bitch, you can't give her money to be in your office. You need to build an environment because it all feeds. It turns into a cancer. Don't pay people ... Don't work in a cage and pay people money that you don't want to be in there. Build a sandbox where you want to play with your buddies in the sandbox. That's a big factor on the stress.
|
|
Dan:
|
That's another thing, yeah. I've gone through a lot of staff. Some people can keep staff for years, and sometimes my relationship with my staff, that's another factor. You're right. You definitely have to get the right people on your team and be able to all get along and have fun. I am here in this beautiful plaza now, and there is five great restaurants, there is three bars. It's very easy to have a fun time, to go out to lunch, have a couple of drinks after work, so that is something that we definitely do, enjoy going out sometimes, getting to know each other out of the office. It's easy here because it's right here. I am on the third floor, so you've got to go down two flights of stairs, and there is this whole beautiful environment that we can chill out and have some fun.
|
|
Howard:
|
I'd say, after owning a dental office for 28 years, if I had to ask what was the coolest thing about having a dental office for 28 years, I would say that it is a hygienist and a dentist have come and gone over the last three years. They worked for me, for seven to 10, and then they became teachers at schools or moved or opened their own dental office. Now half a dozen of them are my best friends. I always take the people part the most serious. I always think everything we talk about is the details. Say we're in playoff Saturday where it's eight teams this weekend, or you've got a wild card play in the NFL, and the bottom line in the NFL is did you get the right players on the team. It's just all the players when I think of stress.
|
|
Dan:
|
Since I have here, in South Florida, that's been a big issue. Ever since the Marino has left, they haven't been able to get the right players on the team, so I definitely hear you with that.
|
|
Howard:
|
Another thing that I think causes a lot of stress in dentistry is all these institutes that are not really grounded in reality, and I don't want to mention their names. I don't want to get back to the Pankey Institute and the Spear Institute and the [Inaudible 00:22:15] Center and LDI and all this, things like that, but they all talk about this perfect dentist, and they're dealing with someone who is already OCD, ADD, undergrad ...
|
|
Dan:
|
ADDHD.
|
|
Howard:
|
Yeah, and they only got into dental school because they sat in the library for four years, memorizing geometry. They are already freaks, and then you're telling them to do this A plus dentistry. What I always thought to myself is, I do A dentistry, A plus dentistry, when I'm working on dentists and hygienists and people that brush and floss every single day and take care of their mouth, but when I'm working on your cousin Eddie, and he's a pig, and he's not opening his mouth, and he keeps sitting up, and he's going to the bathroom and ...
|
|
Dan:
|
His phone goes off, and he has to be texting while you're working on him ...
|
|
Howard:
|
I finish my filling in the [context 00:22:40] light, I am not going to sit there and run 15 minutes late and stress myself out for my cousin Eddie. I match the dentistry ... I always try to do A dentistry, and I will try and retry and redo and redo when the patient respects what I give. Why do they come here? Oh, because you took their PPO, and they were 10 minutes late, and they don't behave, and I had to prophy- cup the shit off their tooth before I could even start working on it, and then I finished my restoration, and it's a C plus?
|
|
|
That's an A plus for that patient. I think a lot of people ... These dentists will go crazy over a margin on a crown, on a person that has never flossed. They are sending it back to the lab, and you find another lab, and you've got to do it free, and they're running late, and they're doing all this stuff, for some idiot who is going to drive out of your office and go ti Circle K and buy a Mountain Dew. Every time you hand him floss every six months, he thinks it's a yo-yo, a broken yo-yo.
|
|
Dan:
|
To do your best, you've got to do your best, and you can't ... You're a human being, and you're not a robot, and it's going to come out. You've got to do your best and give it your all, and sometimes you are on your A game, and sometimes it's not going to work out like that. It seems to unfortunately happen sometimes, that things don't work out. Everyone has that. I've got a patient right now, crown isn't working out. The patient is not happy. We're doing the best that we can. It's one of these things. I can't explain it, but you can go a month with no problems, and then all of a sudden you've got three days where ... What the heck is going on? What happened to my hands? Which stars did not align today, that this is happening?
|
|
|
You've got to wake up the next day and take a deep breath. I'm taking a lot of yoga now. I am meditating. I read Dr. Dean Ornish's books. There is a cardiologist named Stephen Sinatra online that I go to his blogs, and there is a beautiful yoga class every Saturday outside, here, two seconds from this plaza that I was already at this morning, Just fantastic. I go to that studio at least twice a week. I have to realize do the best that you can, and that is the best you can do.
|
|
Howard:
|
Do you know Jeffrey Gurian?
|
|
Dan:
|
I do not know Jeffrey Gurian.
|
|
Howard:
|
I can only think of ... The only dentist I know who do stand-up comedy are Dr. Dan, you, the man, Jeffrey Gurian, and Jimmy Earle and me, and Jeffrey Gurian had a heart attack last Wednesday. I wish you would call him because he was in total shock. Same story as you. He had no symptoms, nothing wrong. He is a dentist in Manhattan. Can you ... ? Ryan, can you pull up his website? Jeffrey, J-e-f-f-r-e-y. Gurian, G-u-r-i-a-n. He's been doing stand-up for 30 years. He always goes to that Canadian film festival, so they actually, the sponsors of the Canadian film festival, I think, he is one of the judges on comedy or something like that.
|
|
Dan:
|
Canadian Film Festival or the Montreal Comedy Festival? I don't know this person.
|
|
Howard:
|
Yeah, I think, the second one you said, Montreal. He is a legend. You can't find his ... ? Anyway, it's Jeffrey, J-e-f-f-r-e-y. L, period. Gurian, G-u-r-i-a-n. Love the guy. He saw me lecture 25 years ago, and at the end of the lecture, he goes, "Dude, you're pretty funny." I said, "Thanks, dude," and he goes, "I actually do stand-up." He was doing bars in Manhattan as a dentist.
|
|
Dan:
|
I didn't ... 22 years ago, Colgate had a contest.
|
|
Howard:
|
That's right.
|
|
Dan:
|
For dentists, and I won in Atlanta, and there was other face-offs, they called them, in California, in Chicago and in New York, and I was praying that you hadn't heard about it because I was thinking, if you had heard about this, there was no way that I was going to win the company title of America's funniest dentist. I am in Atlanta, and I chilled. There was about 18 or 20 dentists who had never gone on stage before. I had an act already, and I won, and they flew me and my wife to Manhattan for the finals, and you weren't there, so I am like, all right, at least I have an act, and let's see what happens. There was a guy from Dallas who ended up winning, and I had never heard of him, again, since. I don't recall the guy's name, but he did a Southern Baptist preacher bit, dressed in this lavender shocking-pink leisure suit, and he chilled at this little club in Manhattan.
|
|
|
He won the title for Colgate's America's funniest dentist. I don't know this Jeffery Gurian because, as far as I know, I don't recall him being there. There was another gentleman from Queens, and there was a woman from Chicago and myself and this guy from Dallas, who was the winner.
|
|
Howard:
|
Will you text these email numbers to Dr. Dan?
|
|
Dan:
|
I wish you would call him because you guys are two dentists, two comedians. He just went through this, I think, this month.
|
|
Howard:
|
Wow.
|
|
Dan:
|
In fact, he posted on Dental Town. He said, "I can't believe I'm posting from a hospital. I am in a hospital, having a heart attack." You can tell he's in shock.
|
|
Howard:
|
For me, actually I saved my heart. Actually, I never had a heart attack. I was very lucky in that they did the bypass before actually I had an MI, so my tests all came back negative for having any heart wall damage, all my scans, all the, like I said, nuclear stress tests. I was very lucky that they caught it before I actually had a heart attack. I just had angina, not crushing, just this tightness. A lot of people would have blown it off. Like I said, I drove all the way to Fort Lauderdale from my house, which is about a 35-minute drive, and I am saying to myself, oh, my God, I am going to die here on 95. This other doctor that you're mentioning, if he has actually had a heart attack, that is a situation that luckily I avoided for myself, so I was pretty lucky.
|
|
Dan:
|
The stereotypes, people have all these stereotypes about dentists. Do you believe they really have high rates of divorce, alcoholism, suicide, or do you think that is old ... ?
|
|
Howard:
|
From what I've read, since my own personal experience, with what I think caused coronary disease for myself, there is evidence that dentistry ... other people in healthcare, too, that people in the medical professions have higher rates of these stressful symptoms that bring on emotional problems, mental illness, and unfortunately suicide. Right here, in South Florida, from what I understand, recently, somebody in his 40s passed away, and the dental grapevine has it that it was suicide. I was pretty shocked to hear this, but the things that I've read, and I've read things in the ADA Journal that do point to studies that do show that dentists do have a higher rates than the general population.
|
|
Dan:
|
Do you think that is because 99% of all the employees in dentistry are women? Is that what causes the high rates of suicide and alcoholism? Is that correlation, or is that cause and effect?
|
|
Howard:
|
That might be divorce. That might cause the divorce factor.
|
|
Dan:
|
We should compare it because, I believe, the last I saw, healthcare is 17% of the U.S. economy, and it was 96.4% women employees, and the exact opposite at the other end was mining at 99% men, and the same one as dentistry but for boys was construction. They were 94.6% or ... I think it was 96.4% or 94.6% or something like that. It is an all-female employee ...
|
|
Howard:
|
In the literature that I have read, because guys ... Look, now, I think it is, 50% of dental schools are women, right?
|
|
Dan:
|
Yeah, it was a joke, Dan. It was a joke. I'd say the funniest part of that joke is my boy's grandfather, Bernard, every time, for 20 years, said he would come visit his grandchildren, and he would walk into my dental office, and he would always have to pull me aside and tell me the same stupid story about how he worked a machine at a machine shop, in Mays, Kansas, for 40 years with six of the ugliest men he had ever seen in his life, who all wore overalls, and there was no air conditioner, and there was no light, and it was dark, and I get to work inside this beautifully lit, air-conditioned room with 15 of the hottest, most beautiful girls, and it is something I would tell all the girls, that he had said that. Of course, they would all be silly with him and everything. He thought I was the luckiest man that ever lived.
|
|
Howard:
|
He should see some of the staff that work with me. These guys, one of them just got married, and some of my male patients are so disappointed that she got married. They are like, oh, no. That's why I miss the dark room because I used to have that little dark room, and it was very convenient to bump into the girls while you were in the dark. Now you don't have the dark room anymore because you've got digital x-rays, so I miss that.
|
|
Dan:
|
How did you get into stand-up? Did you get into stand-up before dentistry or after? Were you a dentist before or after you got into stand-up?
|
|
Howard:
|
Yeah, I was a dentist first. Like you said, I graduated in '83 from Stony Brook, and I was bored, and doing a lot of amalgams and bored, and then I opened this office in this town called Coral Springs, and I wanted to promote my office. I heard Zig Zigler speak at a local university, talking about self-confidence, and he mentioned that you've got to get out there and speak in public, and he mentioned this group called Toastmasters, and there was a Toastmaster Club in this town that I just opened up my office, and they had a humorous speech contest which I won. Then I went to the next level, and I don't remember how far up, but they said, "To really challenge yourself, if you want to do humorous speaking, do open mic. Go to a comedy club and do open mic."
|
|
|
This is the late '80s where every bar in the United States turned themselves into a comedy club, so laughs a lot, smile, happy now, whatever. They would throw up a microphone at least once a week, and they would turn themselves into a comedy club, and I started doing open mics. My first open mic, I thought I was going to actually explode, and I think I was vomiting outside the theater, outside the club. It went fine, and the next thing you know, one led to another open mic, led to another open mic, and then I used to do this bit called The Hairy Club for Men, and the Hairy Club for Men got me on America's Funniest People, and it was a parody of The Hair Club for Men commercial, which your young listeners won't know about, but this guy, Sy Sperling, used to have this company, The Hair Club for Men, and he was also a client. He was bald, and it was all about selling this toupees, and I'm really hairy. I did a parody of The Hair Club for Men.
|
|
|
I called it The Hairy Club for Men. I would take my shirt off, I would comb my hairy body, and the next thing you know, I'm on America's Funniest People doing the Hairy Club for Men. I come in second, and I get tons of publicity. They had a PR department, and the Miami Herald picked it up, and thee Fort Lauderdale Sun Sentinel picked it up. Next thing you know, they are doing big articles about this dentist who does stand-up. Then open thing led to another. A dentist in Miami read out it. He invites me to do their local dental society meeting in Miami. It didn't go over so well because I didn't do it in Spanish, and there was a couple of gringos and all the other Cuban dentists, and they were basically ignoring me, but me and my wife got a free dinner.
|
|
|
Another dentist was there, and he was an oral surgeon from Hollywood, and it just grew. Then I'm in Manhattan, and I heard about the contest that we were talking about, the Colgate contest, and then I met you somehow. I don't recall exactly. Maybe I saw your seminar, and then you had told me ... or something happened with Travis and Woody, and I asked you could you recommend me, and you said, "Yeah, tell them that I have seen your act, that you were really funny." Then Travis and Woody really helped me, developing my dental comedy show, and one thing led to another, led to another. Then I got on National Public Radio because I do these parody songs, and I sent them my CDs. It was a slowly building, building, building of steps, to create the Dr. Dan Show.
|
|
Dan:
|
Now, did it ever translate into more patients?
|
|
Howard:
|
I'm sorry?
|
|
Dan:
|
Did you ever get any patients from all this?
|
|
Howard:
|
Sometimes. At the comedy clubs, the other dentists ... not the other dentists, the other comedians would say, "Oh, you're really a dentist?" Or patients in the audience would say, "Are you really a dentist?" and I would go, "Yes, of course." "Oh, I've got this toothache," "Oh, I've got this and I've got that," and I would give them my card. Rarely would they come in, but I thought that, as a hook, that would be something unique, and I would try to help that in my marketing as something different, but it turned out that it backfired on me where a lot of these newspaper articles were on my walls, and patients would see all this, and they would think I really wasn't serious about being a dentist.
|
|
|
I realized that they really wanted someone who was serious about their needs instead of thinking that maybe I wasn't so into practicing as a dentist, and I had all these big newspaper clippings and other accolades and other things from my comedy world. I liked doing both, so I didn't see why it was such a paradox, but ...
|
|
Dan:
|
I think comedy is the ultimate art form because there is no props, it's live, and I think there is a lot of lessons to be learned when the doctor is talking to their patient. They are using the props of their radiograph ... You go to a dental lecture, and they're glued to their PowerPoints and their handouts, and they don't ... Even the dental societies say, "Did you like his handouts? Did you like his presentation? Did he follow his presentation?" and that's all what's going to ruin the information. I interviewed Carl Misch yesterday. Carl Misch, me and him, two faces and two microphones, and we transferred more implant knowledge than if he was set up there with 3,000 PowerPoint slides and this and that ... Do you know what Einstein said? Learning is what you remember when you have forgot everything they taught you?
|
|
|
You memorize all the crap in school and college? What algebra do you remember today? That was what you learned, not all the formulas and all the laws and stuff like that. In fact, I saw a dentist ... Several times in my 20 years, I have seen a dentist talking to even his two-year-old. We always tell the dentists, "You drop 5,000 words of Latin and Greek, and no one knows what Latin is." It's a dead language; we don't live in Greece; no one has had it. Several times, I have seen a dentist, eight years of college, talking ... I remember this distinctly. His daughter ... she's two ... she says, "I'm cold," and he is talking to her, telling her that she shouldn't have taken off her jacket, and then, when he shuts up, she says, "I'm cold," and then he repeats the whole damn thing. I'm like, dude, she doesn't know a damn word you said.
|
|
|
Do you remember when you were watching Peanuts, whenever the adults talked, it was Mwa-Mwa-Mwa? I said, "That's all she hears. She has probably got a 200-word vocabulary, and you're talking to her in full paragraphs. You might not think that's important, but it transfers even to your patients. They're talking to their patients. When you're giving a lecture, you don't rely on your PowerPoint and your handouts. In fact, I don't really like comedians that walk out there with a puppet or in carrot-top and open an box and start pulling out all these props. If you want to go do Hollywood where they can cut it and retape it and do dubs and sound-overs, go do it, but stand-up is just you and a mic. When you're talking to a patient, you don't need to be pointing to an x-ray, you don't need to be pointing to ... What are those programs Patterson sells that explain what a root canal is?
|
|
Dan:
|
I have got my model of a cracked tooth, so I do use my little cracked tooth model, I must say.
|
|
Howard:
|
It's a crutch. It's a crutch.
|
|
Dan:
|
You think so?
|
|
Howard:
|
I absolutely think so. You know who explains it the best? It's all those down-home country boys in Texas: "That old crown is like boots on a rooster, and we need to take that off and make it all natural." You've got to paint a picture so simple with the least number of words. It's the ultimate joke. The ultimate joke is, with fewer words, you're describing, and the person can see a red balloon. Then, with one word, you take a pin, and you pop it, and all of a sudden the person realizes it's blue, and a laugh is involuntary. It's surprising. It's like if I walked up behind you and went, "Boom," and you jumped. That's why some can be clean, and some can be raunchy. It doesn't matter. You pop a balloon.
|
|
|
You can do it with the F word, or you can do it with another word that starts with an F, and when you say K, that's fire truck. You can be rated G or rated R. It doesn't matter because it's a surprise. You didn't see it coming. You thought you were seeing blue, and now it's red, and you should be able to paint that image in your head about a root canal, a crown or braces, with the fewest number of words, and transfer it. Everything else we use is a crutch, and stand-up will teach you that.
|
|
Dan:
|
I don't know. In terms of my treatment planning and educating of my patients, I have got to tell you, I am more like carrot top and Jeff Dunham because I definitely use props, and I definitely explain things, and I definitely show things on a radiograph. I think visual aids in dentistry does help the patient know what's going on, but, look, I just saw Seinfeld, and, like you said, Seinfeld did an hour and a half, he chilled, and I love the guy. He doesn't curse. His whole act, never, ever, in 30 years of doing this, does he curse. There is a lot of young guys out there today who just "F this," the whole thing, and it doesn't do it for me, but in terms of the props, in dentistry and explaining things to patients, I don't know. I've never really thought of it as a crutch. [Inaudible 00:41:55] understand better.
|
|
Howard:
|
Think of one story Seinfeld was telling you, that he was painting this image in your head about something that happened with his mom or his daughter, or at work or at the bus stop or the subway. Did he have to pull out a little subway train? Did he have to show a picture of his mom? The geniuses, the best, can put the image right into your head, from their mouth to your ears, right in your head.
|
|
Dan:
|
The great thing about the comedians that people like, they have a reference point that you're on the same page. If you don't have the same reference with the audience, then your joke isn't going to go over, and that is why some people, younger comedians today, seem to attract a younger crowd. The comedians that my kids like aren't the comedians that I am going to like, so what I am trying to say is that that reference point needs to be common. In terms of the fact, in dentistry, that we understand what we're talking about in terms of anatomy and in terms of how we can help the patient and in terms of what they need, but they're not at the same place, so the reference point has to be on the same page. That is how I use my visual aids so the patient can understand what I'm talking about, so on that note, I think, we are thinking of different things here.
|
|
Howard:
|
Speaking of world-class comedians, did you see Rosie Barr's last ... No, Rosie O'Donnell's last deal about her heart attack, her HBO special where the first 15 minutes was all making fun of her ... ? Same thing as you. She was at her home, she was in her bed, and her whole point of having it at the beginning of her show was saying, "Dude, if you think you're having a heart attack, call 911." She was sitting there ...
|
|
Dan:
|
Yeah, I didn't call 911. I got shit for that at the ER. Let me tell you, they gave me so much crap. They said, "You could have killed your wife. You could have killed other people on 95. You're a dentist. What, are you stupid? Why didn't you call 911?" and I'm thinking I'm not really having a heart attack, I've got a $7,000 deductible and $500 pharmacy. It's going to be another $1,000 for the ambulance. There is no way I could be having a heart attack. I'm rationalizing this, that this isn't happening to me, and I drive myself to the emergency room. Once I got there, they're like, "You drove yourself to the emergency room? What are you, stupid? How come you didn't call 911?" I was in total denial, but that's my story, that if you're having chest pain, or if you think you are having something like that happen, then you shouldn't follow my example on that, that you should call 911 and let them help you.
|
|
Howard:
|
That was exactly Rosie O'Donnell's message. She was like how could I be Rosie O'Donnell, how could I be this 50-year-old smart lady who's accomplished so many things and talking myself out of the fact that, dude, you're having a heart attack? She thinks that it almost cost her her life. Hey, I want to switch back to you're down there in Florida. How many dental schools are in Florida now?
|
|
Dan:
|
The University of Florida is obviously the one that's been here forever.
|
|
Howard:
|
That's in Gainesville?
|
|
Dan:
|
Correct. Okay? I think there is 85 students there. I'm not really sure. Then there is Nova Dental School now, in Davie, which is near Fort Lauderdale.
|
|
Howard:
|
That's in Davie, D-a-v-i-e?
|
|
Dan:
|
D-a-v-i-e. Yeah, Davie, Florida. That's called Nova, and that's a private school, and that's been about 15, maybe 20 years, that it's been there, at least 15, I would say. Then there is a new one, LECOM, which I believe is in Tampa, and that was started by this LECOM osteopathic school in Pennsylvania. I don't know that much about it, but I think it's open now two years.
|
|
Howard:
|
Is it Quaker? Is it a religious school? Is it private, religious, Quaker?
|
|
Dan:
|
I don't know anything about the Quaker thing. I know it's private.
|
|
Howard:
|
Are you telling me you don't eat oatmeal? You've had a heart attack, and you don't eat Quaker oatmeal? Are you kidding me? My God, I'm going to make you ... You are now a Quaker. You should go down there and start teaching, say, "Hey, I should get a job here. I've had a heart attack, I'm a dentist, and I eat Quaker oatmeal."
|
|
Dan:
|
I did eat oatmeal. On this commercial, the [inaudible 00:46;04] ...
|
|
Howard:
|
He doesn't eat Quaker ...
|
|
Dan:
|
I don't know.
|
|
Howard:
|
It's in Tampa. Is that one open?
|
|
Dan:
|
Yeah, yeah, yeah, it's open. It's around Tampa, around there, yeah.
|
|
Howard:
|
Huh. It is open?
|
|
Dan:
|
Yeah, as far as I know.
|
|
Howard:
|
I had a dental assistant that went to NOVA. Elena, she was probably the best dental assistant I ever had, and I told her she had to go to dental school, and she was in denial for a couple of years. You know how I knew? I've had two dental assistants become dentists, Elena and Nova, and Kelly went to Oregon. Do you know why I convinced them to go to dental school, they had to do it? You always know this with an assistant. You know how some assistants, they're retracting and suctioning, and they're afraid to touch it, or it's going to burn their finger or whatever?
|
|
|
I am a bald guy. I have no head, no hair, no cushion, no nothing, and they would always be bulldog bumping my head, and I remember about three times the first month Elena worked there, I was getting frustrated. I would literally reach out my hand, put it on her head and push her back. I felt like, damn, I need to see. They were so eager, especially during surgery and wisdom teeth. When an assistant is continually bumping your head because they are so excited, they have to see and they have to get in the shit, you have to sit there and say, "Dude, you were born a dentist. You want to be in there. You love blood, you love guts, and you want to see more than the dentist. You're supposed to be helping me, and you're blocking me. I can't even see because of your head."
|
|
Dan:
|
They're telling you what to do.
|
|
Howard:
|
Yeah. The other thing both of them could do is, some assistants, you say, "This is what you're going to do," and they will say, "I'm not certified," or, "Is that legal?" or, "Are we able to do this?" When your assistant, if you told her to do anything, she would jump in and do it without question, she needs to go to dental school. I could have told Elena and Kelly to place the implant, and they would have done it. They would have said, "Oh, thank you, thank you." They wouldn't have said, "Oh, that's illegal. I'll go to the board" or whatever.
|
|
Dan:
|
You know what?
|
|
Howard:
|
Is it a religious school, a government school or a DO school, osteopath? I'm trying to find out about that LECOM. I haven't heard of that one. Is that their only dental school, in Tampa?
|
|
Dan:
|
As far as I know. As far as I know, it's an osteopathic school somewhere in Pennsylvania, but I might be incorrect, and they decided to open a dental school. That's the only information that I've heard.
|
|
Howard:
|
I want to ask you another question that's off-topic because we're in our 50s, and these kids are coming out of school at 25. Going back 30 years ago, let's say you walked out of school. It's 1983, you're in your ... We're both in our 20s. Looking back, dentistry, my buddy Greg Salle says, "Success has become more unforgiving." Back in the '80s, you could have made three or four major mistakes and still made it. Today, you can still make it if you do a lot of things right, but if you do some wrong things, you can really dig yourself in a hole. What advice would you give if your daughter just walked out of dental school? You've got two daughters, right?
|
|
Dan:
|
I have a son who's in medical school, and I have a daughter who [inaudible 00:49:02} ...
|
|
Howard:
|
Let's say one of your two kids walks out of dental school. What advice would you give them?
|
|
Dan:
|
When I graduated, I had $30,000 in debt, and I understand there are people who are graduating with $200,000 to $300,00 in debt, between undergraduate and graduate school, and those numbers blow my mind. I can't even wrap my head around that kind of debt for university, for going to school. That's obviously a big factor. That's a big factors in all these DSOs and all these big corporate dental boxes that have opened across the country. The bank isn't obviously going to give people money, $300,000 to $500,000 in additional debt, to go open an office. I don't think they are, and that's going to be a big problem for these people who are just graduating.
|
|
|
The only thing that I see for a lot of these young people is to find situations where they can get their feet wet and their hands wet and learn, and then try to go it on your own and do your own thing, but at the beginning, I would think that you are going to have to be an associate and learn how to get some speed, learn what it takes to sell dentistry and to deal with patients and to deal with the business of dentistry, which somehow you grasped right away. I showed those tapes at the beginning, and that seemed very easy for you, and a lot of people, including myself, have had struggles with that, the business side of dentistry. I'll admit to that. They should ... That would be my advice, to get some experience and really see what the real world is like.
|
|
Howard:
|
There is a lot of different business models. There is everything from a denture clinic to whatever, but do you think there is any business models that are a must-have? There is CAD cam, same-day appointment crowns. There is lasers. There is some dentists place implants; others don't. Some do molar endo; some don't. Some do ortho; some don't. Do you think, if a young kid said, "Is there anything that I didn't learn in dental school that I really need to learn," if someone came to you and said, "Dan, I want to have the typical American practice. I want to own my own office; I want to do $750,000 a year and take home $186,000. I want to be that guy, the $800,000 office taking home $180,000, and if I want to do that, tell me what I have to do. Do I have to buy a CAD cam, do I have to learn how to place implants, do I have to learn ortho, do I have to do molar endo? Are there any things that I have to do or I don't have to do?"
|
|
Dan:
|
I would think that all those things that you said make it more fun, for sure, to learn how to do Invisalign, to learn all the new technologies that are coming out with the scanners and same-day dentistry, to learn to be comfortable in surgery. Where I went to school, out on Long Island, you didn't have a lot of surgery experience, and it took me a while to take other classes and to learn more. Those things, I felt, held me back because of the location of my school, out there in suburban Long Island. All these classes, you really have to feel comfortable to do a lot of these techniques that maybe you're not learning in dental school, but I think, to have the type of practice that you're describing, and also to enjoy it, is a key factor, to grow and to be successful today.
|
|
Howard:
|
Now, did you go to Long Island? Were you born out on Long Island? Are you a New York boy?
|
|
Dan:
|
Yeah, I'm from New York, but I'm from the west side of the Hudson River, northwest of Manhattan, west of Westchester County, another county called Rockland County, north of New Jersey. That's where I grew up.
|
|
Howard:
|
Can I ask you the stupidest question in the world about New York City?
|
|
Dan:
|
Yeah, I'll see if I can answer it.
|
|
Howard:
|
I still don't get it. I'm an American, and I still don't get it. New York City, when you go to that city, it really seems like, when someone says New York City or New York, New York, they are only talking about Manhattan, but the city actually is five cities under one name of a city? A lot of times you will say, "Oh, you're from New York City?" "No, I'm from Brooklyn." Or, "Are you from New York City?" "No, I'm from the Bronx." It's like, dude, isn't that the city? What the hell is the name of that city? Is it five cites?
|
|
Dan:
|
If you're from New York and you say "the city," that's Manhattan, exactly. Right? I grew up in the Bronx, and then we moved to the suburbs, but you're right. Each county, the Bronx ...
|
|
Howard:
|
Oh, those are counties?
|
|
Dan:
|
They're called boroughs, but it's like a county. Brooklyn is also called King County, and Queens could be another county, so ...
|
|
Howard:
|
When you say New York City, it's really just Manhattan?
|
|
Dan:
|
No, if you say New York City, it's all five boroughs to the average person, but if you talk to someone who is from New York, and you say, "I'm going to the City," or, "I'm going ... " By saying the City, or, "I'm going to New York," you're talking about going to Manhattan. Otherwise, you would say, "I'm going to Brooklyn," or, "I'm going to Staten Island," or, "I'm going to Queens." Yeah, usually you would say that. This is the sixth borough, down here, in South Florida. This is the sixth borough. All the Northeasterners have moved down here. It's like being in New York. You're in Latin America or you're in New York by living down here. My practice is either oy oy oy or ay yi yi, all day long. It's either all Jewish grandmas from Brooklyn or hot young Latinas from Bogota. That's my demographics. It's like I never even left New York, so South Florida is the sixth borough. If I am talking to my fellow New Yorkers, and they're talking about, "Oh, I was in the City," obviously you're talking about Manhattan.
|
|
Howard:
|
The funniest thing about New Yorkers and Phoenix is, when the New Yorkers come to Phoenix, they all love Scottsdale. When they retire from Minnesota, North and South Dakota, Iowa, they spread out all over, Glendale, Chandler, Mason, Tempe and Phoenix. They spread out all over the whole city, but all the New Yorkers love Scottsdale. They will tell you how it's the greatest city in the world. It's funny because, when I go to Scottsdale, nothing there reminds me of New York City. It's like I wonder what they see in Scottsdale that they don't prefer in Ahwatukee or Chandler or whatever.
|
|
|
Back to the toys, I like to focus on the toys because you've mentioned money a lot. You mentioned that when you thought you were having a heart attack that you even thought about your $7,000 deductible. I think you mentioned that three times in this. I don't know how much that is tongue in cheek because that's the name of your website. It is Tongueincheek, isn't it? What is your website?
|
|
Dan:
|
Yeah, Dentalcomedian.com.
|
|
Howard:
|
Dentalcomedian.com. I always thought it was Tongueincheek.com.
|
|
Dan:
|
Right. That got too confusing.
|
|
Howard:
|
It's Dentalcomedian.com, but I didn't know. A lot of times when you say something, I don't know how much of it is being funny. Back to that, you were talking about your $7,000 deductible. A lot of these kids are faced with they are told, to be a rock star, they need a $100,000 CEREC machine, they need a $100,000 CBT machine, they need a $75,000 Biolase machine. You've been practicing three decades. Do you have all three of those toys?
|
|
Dan:
|
No, I don't have those things.
|
|
Howard:
|
Do you have any of those three?
|
|
Dan:
|
I am still taking regular impressions. I am still sending it to the lab. I don't have those things. I use rotary endo. I do Invisalign. I do some simple placement of implants, BioHorizon, Intra-Lock, none of the complicated ones. In terms of the anatomy, I don't do sinus lifts. I try to do bread and butter dentistry, and I have not made those big investments. At my stage and also, like we were talking about, with stress, I am not ready to commit to those big numbers right now. I go to meetings. I think they're amazing, all these things, but I am still waiting for them to come down a little bit.
|
|
Howard:
|
It's funny because Warren Buffett ... I went to Creighton University in Omaha, Nebraska, and he came over and talked to our business school in 1980. He still says to this day that 95% of CEOs in the S&P 500 go to work all day to try to figure out how to do everything slower and more complicated and more expensive. It's like you tell a dentist, "Here's the deal. You take this impression. It will cost you $10, and you will send it to the lab, they will make the crown, and you will get it back in two weeks," and the dentist says, "Really? I can mess that up. I'm going to go buy a $50,000 oral scanner, and then I am going to reduce the country from 7,500 labs to 20." The more money they spend at CE, the more they go in debt, their overhead ticks up.
|
|
|
I look back at 1975. Average overhead for the whole country was under 50%, and now it's north of 64%, now it's 64.5%, almost 65%. It's like every time they read something, they figure out how to drive their overhead up higher. The patient ain't willing to pay more, the insurance company ain't going to pay it anymore, and it's like their definition of learning is trying to make the longest distance between two points until they are 10 years out, in debt, and they have to work twice ...
|
|
|
It's like when you buy a $10,000 car, and you have to pay for it over 60 months, you might pay $30,000 for that $10,000 car. The average house in America, you buy a $100,000 house and you finance for 30 years, you pay $300,000 for a $100,000 house. That's why GMAC makes more money than GM. These guys, they will say, "I'm going to buy this machine. It's $150,000." Dude, it ain't $150,000. Count. Take your payments and add it all up. You just bought a house because no one ever asked you if they could have their crown at the same appointment, so you went and bought a house." I like interviewing real guys like you because you will say the real shit. No one owns Dan, Dr. Dan.
|
|
Dan:
|
I'm not in the position to ... I haven't made those investments to the high-tech things. I see that they are ... I would like to do it, and I think, for the young people, the young students, that are coming out right now, that does seem like the way things are going, and it does seem exciting. It does add a different level of patient. I've had patients ask me, "I've heard about this. Do you have this?" In terms of the single-day crowns, I have had patients ask me that, and I've had to tell them no.
|
|
Howard:
|
What percent of your patients have asked you that versus, "How much does it cost? Will my insurance pay? Can I make payments? Are you going to give me a shot? Is it going to hurt? What's it going to look like"? Where did, "Can I have it in the same day" come in the myriad of "How much does it cost? Will it hurt"?
|
|
Dan:
|
Very few. Very few patients have asked me that.
|
|
Howard:
|
Give me a percent, give me a percent.
|
|
Dan:
|
3%.
|
|
Howard:
|
Yeah, yeah, so when half the people are talking about how much is it, and then your beloved staff who's been with you forever is always coming up to you saying, "Dr. Farran, can you do me a favor? My sister's roommate's brother's cousin who married my nephew needs ... Can you give him a deal?" I'm like, okay, but can you show me how to make this deal possible for everybody? You're asking me for a raise, you want me to buy this, you want me to remodel, but when it comes to your sister's cousin's nephew's roommate, you want me to cut my price. If your lovers want a lower my price, let's all figure out like Southwest Airlines how to do this stuff faster, easier, higher quality, lower price because we should treat ...
|
|
|
You should build a dental office where you would want to be a patient, and you don't want somebody doing an onlay if you would prefer that it would have been a DO direct. You wouldn't want to go to a dental office where they [inaudible 01:01:19] down for a crown if you thought it could be a direct. You wouldn't want to go to a place where it cost $1,000 if you thought it could be $500. Let's build this place like where you wanted to be a patient. Let's use our God-given brain to keep one eye on the customer and one eye on cost and use our brain to drive down cost so everybody can afford the freedom to keep their teeth.
|
|
Dan:
|
In terms of lowering the cost, aside from the actual machine, doesn't the cost get lower from sending the scan? I know the labs are charging less, so that's going to be less overhead. Once the cost of the machine and the scanners go down, don't you feel that that's going to be something that's going to bring the cost down? You don't have to have the machine to mill the crown. You can just have the scanner, and that's $15,000 or $18,000 or $20,000, so that is something that I am considering, and then sending it over the Internet and getting the crown that way.
|
|
Howard:
|
It's 2016, and Dr. Dan, the man, Greenstein hasn't pulled the trigger on it. Is the whole world going to go from analog to digital? Absolutely. Are there people making digital faster, easier, higher quality, and cheaper? Absolutely.
|
|
Dan:
|
Yeah.
|
|
Howard:
|
Is most of what we hear bleeding edge instead of leading edge? Absolutely.
|
|
Dan:
|
Yeah, that's true.
|
|
Howard:
|
If it is leading edge, and it is a return on investment, and it will satisfy faster, easier, higher quality, lower in cost, you would have pulled the trigger because you are one of he smartest dentists I've ever met. You are, you are, and you always keep it real. We are out of time. We are three minutes into overtime. Hey, I am so glad that you did not have a heart attack. If you would have had one, it seriously would have brought tears to my eyes. I am your biggest fan. I love what you do, and I can't believe you showed me those cassettes. I haven't even remembered that concept, that image. I don't think I have even seen that for a decade. You also mentioned Travis McFee. I am going to hang up from you and call Travis. I don't think I've talked to Travis in a decade.
|
|
Dan:
|
Ask him how he's doing because I've tried to reach out to him. It has been unsuccessful, so I would like to see how he's doing.
|
|
Howard:
|
I'll tell him you said hi. He's a good ol' boy out in Oregon.
|
|
Dan:
|
He's a great guy, and he really helped me a lot. I really appreciate it a lot, everything that he had done for me. It was really a pleasure being here with you. Once again, I appreciate that you asked me to do this with you. It was really a lot of fun. I wanted to give a plug once again to Dentalcomedian.com.
|
|
|
If there is anyone out there who is having a meeting and wants something different, it's really great when the team is there. It's not just for the dentist. It's for the whole office, and especially the songs that we sing together, the slides that I show, and all the stand-up that I do, about going to work every day in the real world, in a real office, and the patients and all the interactions with the front desk, the "Hi, Janice," and the doctor, and it would be great to be at your next study club or at your next meeting. From anywhere I've gone, from Florida to Alaska, from Bangor, Maine to San Diego, and everywhere in between, it would be a pleasure to entertain your group. You can go to Dentalcomedian.com to learn more.
|
|
|
Once again, Howard, it was really great, and I wanted to thank you again.
|
|
Howard:
|
Did you talk to my son, Ryan? You're going to put a bunch of his material at the end?
|
|
Ryan:
|
Yeah, he sent us over a couple of CDs, so we're doing to take a couple of files off the CD, and we're going to play it at the end of the podcast.
|
|
Howard:
|
Then, on those CDs, give that to Marie Leland because she is the one who runs TownieMeeting.com. I think we're coming up on our 13th or 14the meeting or whatever. Townie Meeting is about the end of March and April. Go to TownieMeeting.com. Marie Leland is the one who picks all the dental speakers and all that stuff, so I will have Ryan give Marie Leland your stuff, and maybe we can get you out to a Townie Meeting.
|
|
Dan:
|
Sounds great.
|
|
Howard:
|
I'll take you to the bar and feed you bacon-wrapped cheese balls to help with all your health and wellness.
|
|
Dan:
|
Fair enough. That's when all my friends are like, "Come on, dude. Come on, let's go. You're all fixed now. What are you worried about? What are you taking [inaudible 01:05:19] for and eating vegan? Give me a break. Have a pepperoni pizza for breakfast. Let's go."
|
|
Howard:
|
You would have to be healthy because look at Keith Richards. Every time I see that guy, I am like ... He is proof that you don't have to do anything right and still live, right?
|
|
Dan:
|
He doesn't have stress. That's the problem.
|
|
Howard:
|
That's the key.
|
|
Dan:
|
He's up there having fun.
|
|
Howard:
|
Yeah, when you look at Keith Richards, that's probably a big part of it, isn't it?
|
|
Dan:
|
I really think so. I'm telling you.
|
|
Howard:
|
Have fun, and shoot lots of heroin, and you can live forever with Keith Richards, and have your own album someday. Okay, thanks so much, Dr. Dan.
|
|
Dan:
|
All right, Howard. Thanks a lot.
|
|
Howard:
|
[Plays audio 01:05:56] "Imagine no insurance. It isn't hard to do. No more stupid phone calls. No more paperwork too. Imagine all the patients showing up on time. Imagine no deductibles. It's easy if you try. No more yearly maximums, never hearing "denied." Imagine all the patients showing up with cash. Yoo-hoo. You may say I'm a dreamer, but, hey, I am just a GP. I know some day you will join me in getting rid of this insurance company."
|
|
|
"It's 5:00 on a Friday, another jerk bag rolls in. You can tell by his car and that nasty old scar, he ain't looking for plain Vicodin. He says, "Doc, I believe this is what's killing me. Now, don't ask me for heroin. Don't be giving me none of that Darvocet because I know that it ain't very strong. Write me a script for some Percodan, write me a script today because I am trying to erase my whole memory, and you're my excuse for the day. It's a pretty good crowd for a Saturday, as my manager gives me a smile because she knows that it's me they've been coming to see, to get out of pain for a while. My high-speed, it sounds like a carnival, and the office, it smells like cloves, and they sit in my chair and throw spit in my hair as I watch them curl up their toes.
|
|
|
"How about some crack? Would you like some crack? I've got a little cocaine here if you like. How about a nice script for Demerol or Oxycontin? That would be really good. I think crack is the way to go, though. Yeah, why not? Go for it.
|
|
|
"Write us a script for some Percodan, write us a script today, because we're trying to erase our whole memory, and you're our excuse for the day."
|
|
|
"Hey, it's past 10:30. Where the hell are you? We had you down for 9:00, and you missed that one too. I'm sitting on my butt here. It's all because of you. Could have done those crowns that we had planned to do. You want us to reschedule? Who the hell are you? You're giving me a case of the cancellation blues. You cancel in the morning, you cancel late at night, you leave us the message like, "I hope it's all right." You cancel to play tennis, and then your kids get the flu. Now my whole staff has got nothing to do. If you ain't going to cancel, then you don't even show. If you didn't owe me money, I would tell you where to go.
|
|
|
"You cancel when your fish died. You cancel because it rained? You wife didn't remind you? Now, that one is really lame. Your family came from Cuba to visit you? What I lost in production is giving me the blues.
|
|
|
"Doc, I hate to tell you, but I've got some bad news. Your 8:00 is a no-show, and your 9:00 is not coming too.
|
|
|
"We called you on your cell phone, but it wasn't up. We tried you at work, and they said you were gone. Your home phone is disconnected; your beeper didn't beep. I bet you missed you missed your funeral because you needed extra sleep. I'm tired of your reschedules. I'm sending you a bill, too, for giving me a case of the cancellation blues.
|
|
|
"The cancellation blues. You're never going to make it. The cancellation blues. "Hello, this is Tyrone. I'm stuck here in traffic." The cancellation blues. "Manana no bueno por me familia." "This is Stella. I forgot. I have a nail appointment." I have the flat tire, house on fire, no one called me, cancellation blues. I've got the wrong day, I can't pay, I'll call you later cancellation blues. I have got the no show, didn't know, what appointment cancellation blues.
|
|
|
"I told you I couldn't make it."
|
|
|
"Acute necrotizing ulcerative gingivitis, if you've seen it more than once, you know it's not a virus. When you take a whiff of it, you know it's not the nicest, acute necrotizing ulcerative gingivitis.
|
|
|
"Since my patient couldn't speak, he really did look sad. I asked my staff to take a peek, and they said it looked bad. I went into my books to find out what was wrong. The biggest word I ever found, and this I show it sounds: Acute necrotizing ulcerative gingivitis, if you have seen it more than once, you know it's not a virus. When you take a whiff of it, you know it's not the nicest, acute necrotizing ulcerative gingivitis.
|
|
|
"When the guy has got some gums that really look disgusting, memorize this word, and it will look like you know something. You can call it, but it sounds worse this way. One time I told a patient, and he fainted that same day. Acute necrotizing ulcerative gingivitis, if you've seen it more than once, you know it's not a virus. When you take a whiff of it, you know it's not the nicest, acute necrotizing ulcerative gingivitis."
|
|
|
[End 01:16:09]
|