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VIDEO - DUwHF #773 - Reuben Kamp
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AUDIO - DUwHF #773 - Reuben Kamp
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Reuben has been drawn to IT since he wired his first dental office network at age 12. An Ithaca, NY native, Reuben was a pre-dental major at the University of Chapel Hill, and worked while going to college in the Dental Residency Program. He graduated in 2009 with a Bachelors in Biology.
After graduating, Reuben started working at Benco Dental as their lead tech for all of Upstate New York and began honing his skills on a variety of dental and medical software, hardware and customer service skills. Recognizing the need for enhanced, one-on-one customer service and support, Reuben founded Darkhorse Tech in March 2012. After leaving Benco in January of 2013, Reuben was able to focus on growing Darkhorse specifically in the dental field with an eye on HIPAA compliance. Now, Darkhorse Tech has 13 employees and clients in 10 states.
Reuben currently lives in Ithaca, NY with his wife, Shannon, and 3 rescue dogs, Sydney, Pepper and Kobe. He enjoys cooking at home, brewing beer, and spending time outside during the summer months either hiking, biking, or boating.
www.darkhorsetech.com
Howard Farran: It is just a huge honor for me today to be podcast interviewing Reuben Kamp, all the way from Ithaca, New York. He's been my IT director for years, big shots, Steven Glass, Steven Glass is one of your clients too.
Reuben Kamp: Yeah, good guy,
Howard Farran: Steven Glass is a infamous townie that I could not have lived without over the last 20 years. Your company's called Dark Horse Tech, why did you go with, where does the name Dark Horse Tech ... I would assume that you'd go with a Reuben sandwich that everyone ... wouldn't everybody want to eat a Reuben sandwich?
Reuben Kamp: Reuben Sandwich IT Company.
Howard Farran: What is Dark Horse?
Reuben Kamp: Dark Horse is something, to be honest I had to come up with a company name in about four days. I got my first legitimate ... I was working for Benco at the time, I got my first real service agreement, and I had four days to come up with a legitimate company name 'cause, before then they were just writing cheques to me personally. Dark Horse is something that I have always connected with as the underdog, chip on your shoulder, gonna outwork you. Dark Horse is me.
Howard Farran: Nice. Most millennials, they think you're gonna be a millionaire working Monday through Thursday, nine to five, and they're gonna be a millionaire, that nine to five means 95 hours a week for a decade. I want to read your bio.
Reuben has been drawn to IT since he wired his first dental office network at age 12. Now that would've been because your dad, Ira Kamp was a dentist.
Reuben Kamp: Yes, he had -
Howard Farran: So when you were 12 he was hiring child labor and did a ... who was that girl that got [inaudible 00:01:42] for that?
Reuben Kamp: Oh God.
Howard Farran: Oh, who was that on The Today Show? Who was that girl, Kathy Lee Gifford, the clothing line, turned out it was made by child labor. So your dad Ira was using child labor in New York, so Kathy Lee couldn't have been too bad.
Reuben Kamp: Yeah, he was running Softdent, the same software that you run. He needed computers when he got that software. Instead of going the traditional route, he decided to hand it over to his son who liked to screw around with computers a little too much. That was the genesis of, my first exposure to dental and It being in the same realm.
Howard Farran: Now when I got schooled back in the day, and Softdent was [inaudible 00:02:27], it was the biggest name. It was the dog. And then Dentrix didn't come later, until they launched Windows. Dentrix, the reason it's number one is because it followed the explosion of Microsoft. Is your dad still on Softdent?
Reuben Kamp: He's not.
Howard Farran: What did he switch to?
Reuben Kamp: He's on Dentrix.
Howard Farran: He switched to Dentrix?
Reuben Kamp: He did.
Howard Farran: And you're switching me to Open Dental.
Reuben Kamp: I am switching you to Open Dental.
Howard Farran: Yeah. And how smoothly will that go?
Reuben Kamp: So far, so good.
Howard Farran: Right.
Reuben Kamp: They're one of the best ... they're kind of like us in Dark Horse. They're a smaller company, they take their time, they dot their I's and cross their T's. They're just a really nice company to work for. When you get into ... Not to bash Dentrix too much.
Howard Farran: Please don't freight, I'll do it for you if you want.
Reuben Kamp: It's that feeling that they're such a big company, you call and you just can't get anyone that can do anything worth a damn.
Howard Farran: And you know why that is? I've seen it my whole life. You need to know it for stock investing. When the founding father sells the company and moves on or dies, that's usually as good as it gets. Sam Walton, his book was Made In America, it was all US suppliers for all of the WalMarts, he dies, you know, "We can save five cents, if we bought it all from China." Steve Jobs, of the iPhone died, the first decision for the new guy, who was hand picked, he said, "Well shall we retool our Chinese factories and go for the six inch big phone?" He said, "No, I think that'd be too much money." Samsung did.
Reuben Kamp: Yeah, Tim Cook's just the supply chain guy. They promoted the guy in charge of making sure the parts line up and they get good deals. So you're right.
Howard Farran: He missed the large one and then when he did I thought, "Are you out of your mind?" And then some of my friends, who were iPhone fanatics, switched to Samsung, which they always badmouthed Droids their whole life and were Apple religious fanatics. Is the founder of Dentrix still work there? No.
Reuben Kamp: No, God no. The culture must be ...
Howard Farran: They lose their bearing because once the founder is a hustler who takes risk. And then when that guy's gone, everyone else has got a really good job and they go into defense mode, they just don't want to lose their job. It's like the American Dental Association, they're never gonna get credit for doing anything right, but if they make a decision and everybody's wrong they lose numbers.
Reuben Kamp: Right.
Howard Farran: So their whole mindset is don't piss off the herd, don't do anything, so that founding father, whether it's a dental office or whatever, is the mojo.
Reuben Kamp: Carestream went through a similar thing, we have a lot of exposure to Kodak with Carestream, it was based in Rochester, New York, that's just a couple of hours from us. They have reps running all round New York state. Still a lot of Carestream, and Softdent, and Practiceworks as well.
Howard Farran: And who was the printer up there, Xerox? We were talking about Steve Jobs. Steve Jobs tried to convince everyone he invented the Apple computer, and who invented it? It was Xerox, had an RND deal in Park, what was it? Park Way in Silicon Valley. Every time they invented a user interface, a graphical interface, a mouse, all this stuff, they go back to Rochester and present it to the CEO of Xerox and say, "What does this have to do with the copier?"
Reuben Kamp: Right.
Howard Farran: Since nothing applied to the copier that was the end of his vision, and so Steve Jobs was smoking pot with these guys and getting all this technology, he was a great marketer, he tried to convince everyone he was the inventor of the this, the that. Xerox didn't see ...
Reuben Kamp: Sales guys.
Howard Farran: Yeah.
Reuben Kamp: That's what they do.
Howard Farran: So let me finish reading your bio. An Ithaca, New York native, Reuben was a pre dental major at the University of Chapel Hill, and worked while going to college in the dental residency program. He graduated in 2009 with a bachelor's in biology. After graduating Reuben started working at Benco Dental as their lead tech for all of Upstate New York, and began honing his skills on a variety of dental and medical software, hardware and customer service skills.
Recognizing the need for enhanced one-on-one customer service and support, Reuben founded Dark Horse Tech in March of 2012. After leaving Benco in January 2013 Reuben was able to focus on growing Dark Horse, specifically in the dental field with an eye on HIPAA compliance. Now Dark Horse Tech has 13 employees, and clients in 10 states. Full disclosure, I'm his client.
Reuben currently lives in Ithaca, New York, with his wife Shannon and three rescue dogs Sydney, Pepper and Coby. He enjoys cooking at home, brewing beer, and spending time outside during the summer months either hiking, biking or boating.
I want to say a shout out to Benco, 'cause Benco is the opposite of what I just said about when the founding father dies that's a god as it gets. Benco was Ben company. Benjamin Cohen Company, or Benjamin ... was the Co for Company or Cohen?
Reuben Kamp: It's up for debate. It depends on what story you hear.
Howard Farran: His son was Lawrence Larry Cohen?
Reuben Kamp: Yeah, Larry's a legend.
Howard Farran: He's second generation. And the third generation are Mike, Rick and Chuck.
Reuben Kamp: Right.
Howard Farran: I'll tell you what, those three guys have been mentors in my career. I cannot tell you how cool Chuck and Rick are. Sometimes, ever since I created Dental Town, I come to a fork in a road about technology, the dental market, the industry. I'll email Chuck and he'll reply at 1 o'clock in the morning, or Rick will too. They make a religion out of availability. When Dental Town was nothing to no one, and I don't think they knew what it was in '98. They'd still, you could sit in the office with them for an hour, they'd tell you everything they know. Most humble third generation family business I've ever seen in my life.
Reuben Kamp: That's a good point because the second generation is usually where it falls off, and Larry was a legend. Absolutely, 100% family run company, that's not a market line.
Howard Farran: Are they gonna get annihilated by Amazon?
Reuben Kamp: Their profit margin is 90% from consumables, yes. I think Dentrix, Patterson and everyone you name is going to find that pressure.
Howard Farran: I mean, my God. These dentists think they're all afraid because a DSO Heartland opened up across street. Heartland, how'd you like to wake up tomorrow and find that Jeff Bezos is coming after your ass?
Reuben Kamp: Yeah, it's ...
Howard Farran: I mean holy moly!
Reuben Kamp: I mean you saw. Every single grocery company their stocks go directly own after that Whole Foods purchase.
Howard Farran: Oh yeah, 15, 20%. Kroger, Safeway.
Reuben Kamp: They are in trouble.
Howard Farran: Yeah, and I think ... it's finny because so many things Jeff Bezos did I thought, "Okay, he's just being pump and dump." What do you call it, pumping and dumping stock? Four or five years where he says, "Yes we're investing in drones, we're gonna have the drones deliver the package to your house." I say, "Oh come on." I mean, how stupid are you going to get? And then three years later my son comes home with a drone, and I look at it like, "Damn, this thing could obviously deliver a package."
Reuben Kamp: Yeah. But you've got to give him credit. He tried things. When you have scale like that it allows you to experiment and find gold.
Howard Farran: I tell you, there's two guys, there's only two guys that Wall Street doesn't even care if they make a profit. Amazon basically has made almost no profit.
Reuben Kamp: Really.
Howard Farran: Stocks that are worth a tenth of that have made a hundred times the net income profit dollars.
Reuben Kamp: Right.
Howard Farran: It's Tesla, and Amazon.
Reuben Kamp: Uber's up there right now.
Howard Farran: Well Uber, they just fired their CEO.
Reuben Kamp: Yeah.
Howard Farran: I think that's gonna come down to intellectual property. I think he might have sold some documents out of the -
Reuben Kamp: Really?
Howard Farran: Yeah.
Reuben Kamp: I didn't hear that story. They've had a very bad couple months.
Howard Farran: Well, basically. When they wanted to have those driverless cars they hired some big wig from Google's driverless cars, and then Google figured out like, "Okay, did you take a lot of the work we did here over there, 'cause we think so." If that's true, that makes HIPAA. So let's stay back on dental because I hate to [inaudible 00:10:49].
Okay, so HIPAA, so it's your deal. 30 years ago, the bad guy on the block was [OCIA 00:10:55]. And I'm sure if you talk to your dad Ira, OCIA came out and scared the hell out of all ... we're all gonna get fined and sued and beat up, and all that. All the lectures were being OCIA compliant. And then came HIPAA, for the international audience.
First explain to the international audience, 'cause half this show's in 220 countries that don't have HIPAA. Tell the international guys what HIPAA is and why you're passionate about it and why does it even matter?
Reuben Kamp: To distill it down, it's essentially a patient's right to have their information protected. It defines that they have a right to have their privacy and their patient health information protected, and it also defines a set of rules that providers that collect that information have to follow to secure it. It's that simple.
Howard Farran: Is it kinda like, so I lectured in Syracuse, which is pretty close to Ithaca, right?
Reuben Kamp: Yeah, got my client sat in the front row.
Howard Farran: Yeah.
Reuben Kamp: They got heckled.
Howard Farran: Syracuse, I couldn't use Uber.
Reuben Kamp: It will be here, two weeks. It just passed.
Howard Farran: So basically, the point I'm making is, okay, so your best idea in New York is to discount the new technology of Silicon Valley and try to protect the taxi driver. I mean, what if we protected the horse and buggy drivers and the carriage drivers? HIPAA reminds me, when you talk to talking heads on TV, didn't privacy die with the internet, now is there any privacy left? Who doesn't know your name and address and phone number, birthday?
Reuben Kamp: Right.
Howard Farran: I'll tell you something frightening, for me, I had to do jury duty. Usually you go and you get out of jury duty, if they call you, you say, "I'm a dentist, I'm kinda busy." And they say, "Okay." This lady says, she says, "Well Mr. Farran, have you ever had a vacation?" I said, "Yeah." She goes, "Well, you're on vacation now. You're taking a three week vacation." I thought damn! But what I thought was amazing, I'd say, "Well Reuben did you ever talk to Ryan?" You'd said, "No, I never talked to Ryan." And then I start playing all your audio calls and your texts and your emails. These calls are going back years and years and years, what I saw in that trial, if you ever said it on a phone, text it on a phone, emailed it on a phone. It's out there somewhere. So HIPAA's kind of trying to save the taxi driver, the privacy is pretty much gone on the internet.
Reuben Kamp: Right. Well my main uneasiness with HIPAA, is the amount that has been commercialized. I went to our conference called Dental Integrators Association, or DIA. It's IT companies that are focused on dental. There were about 10 booths there, you got you appointment and reminder companies, but half of them were HIPAA compliant, like as a service. They wanted us to take a package, resell it to the dentists. The industry is projecting this image that it is highly commercialized when it should not be.
Howard Farran: I'd say the same about finance, Warren Buffet says that finance. You put money in the bank, they pay you 5% on your savings, loan out 10% and the bank makes a little spread. How did banking turn out to be 10, 12, 13% of the economy, all this bullshit, all this crazy stuff. So HIPAA ... you're saying HIPAA got overly commercialized?
Reuben Kamp: It is my opinion, is right now. In that it's hurting the people who are trying to do good work. You need to do a basic set of things to protect your network, but you don't need to go overboard. The law was written with a large institution in mind, hospital institution. In dental we need to fit it the best way possible, but some of the things ... this might be a topic of contention -
Howard Farran: What do you think actually started it? I thought it was, at the time the big new disease was HIV. I thought it was almost the privacy of your HIV status.
Reuben Kamp: HIV is a good thing to bring up, because when you think about a dental office, what critical or embarrassing information are you collecting? It comes down to health conditions and social security numbers, versus let's say a plastic surgeon who might be collecting more embarrassing information.
Howard Farran: Yeah. What is ... yeah but how long would it take a hack to find my social security number on the internet?
Reuben Kamp: If you're a target, they can take down CIA, FBI websites. To take down a dental network is ...
Howard Farran: I'm actually more worried about the NSA and the CIA and the FBI hacking into me than any rogue government. I think the dentists, the ones that are getting in trouble the most, are the ones collecting credit cards.
Reuben Kamp: That's PCI.
Howard Farran: PCI?
Reuben Kamp: PCI compliance is credit card.
Howard Farran: That is one thing we won't do. I don't want to have my credit card in your deal. I don't ever want to call you up and say, "Hey Reuben, my dental office just gave me your credit card to a rogue group of people."
Reuben Kamp: Yeah, some of the requirements do overlap. The firewall, anti-virus software. You need to know what's on your network if you're storing credit card information.
Howard Farran: So what would you say to dentists who are storing credit card information?
Reuben Kamp: Switch services. The risk is not worth the convenience.
Howard Farran: Same thing with IV sedation. I think IV sedation's great, but the risk doesn't equal the reward. Say you put someone to sleep every Friday and pulled the wisdom teeth and placed saline every Friday for four years, and the have one person die. You'd wish you'd never became a dentist. And then you go to the hospital and an anaesthesiologist has to do the anesthesia. A cardiovascular surgeon can't do the IV and the bypass, the only place you find that craziness is in dentistry. Don't do it. There are anaesthesiologists.
Reuben Kamp: And there are plenty of credit card processors ... I mean think about -
Howard Farran: How do you take a credit card without putting it in your software?
Reuben Kamp: Encryption. Essentially, all you're seeing is a series of randomly generated numbers. That information is being passed onto the credit card processor. You're never actually storing the number itself, you're storing a hash of it, essentially.
Howard Farran: And who do you recommend for credit card processing?
Reuben Kamp: I can endorse BluePay.
Howard Farran: BluePay?
Reuben Kamp: BluePay is good.
Howard Farran: You send me that right? Are they in dental, or is it [inaudible 00:17:42]?
Reuben Kamp: They're not in dental, they have really good rates. You just go onto a portal and so nothing is stored. You're under a whole other set of rules if you're storing things locally.
Howard Farran: So what do they need to know about HIPAA, what would you say about it? Lots of people I know, know that humans are really motivated by fear and greed. If they find someone getting fined, they're trying to scare everybody, "Oh look at that guy that was fined." You know. What should they do with HIPAA?
Reuben Kamp: That's what everyone else is trying to do, selling out of fear. I try to sit down and educate everyone why I'm doing this. That's why I have a tough time with the commercialization of the law itself. What it distills down to is we need to know what, if anything, is running on your network. This is gonna also overlap into something that hits dentist's wallets, which is down time. If you have something that can take down your server, we're crossing both into a HIPAA compliance issue, and we're also talking about maybe you can't take x-rays in your proprietaries. You can't take payments at the front desk. There is a monetary hit to it, you should be at least aware of it and a little bit nervous. There are some basic things you can do just to eliminate most of the pitfalls.
Howard Farran: You said something very funny, you're Reuben, but your sister's Rachel, and the difference between a Reuben sandwich and a Rachel sandwich is instead of corned beef it's turkey? Yep, that's the only difference. The Rachel sandwich. How come Rachel [Maeling 00:19:21] did not mention that when she was on the show? She was named after a sandwich [crosstalk 00:19:26].
Reuben Kamp: My parents have a very sick sense of humor.
Howard Farran: If my homies went to your website, darkhorsetech.com.
Reuben Kamp: That's correct.
Howard Farran: What are they gonna find, and what do you do? Why do you have clients in 10 states? What do you do?
Reuben Kamp: We are a bunch of technicians that have left Benco, Shine Powers, we've kind of banded together because we couldn't do the job we wanted to do. We couldn't take care of the client the way we wanted to. We've taken ... Shine wants to be an all inclusive approach, but you have to be on Dentrix and DEXIS and be on their system. We say whatever platform you're running, your office is a mixed environment, you have Softdent, you have Suni and you have [crosstalk 00:20:16].
Howard Farran: I'll tell you what I have. I have Softdent.
Reuben Kamp: You have Softdent for your practice management software.
Howard Farran: But by the time you hear this, 4th of July we're switching over, right?
Reuben Kamp: Yes.
Howard Farran: And then I have Suni.
Reuben Kamp: Suni for your 2D, intra-oral imaging.
Howard Farran: For 2D, intra-oral imaging.
Reuben Kamp: And then you have CS imagine, Care Stream imagine. That's for your 3D combi.
Howard Farran: Care Stream for the CBCT.
Reuben Kamp: Yeah, that's a nice machine.
Howard Farran: Yeah I have the Care Stream CBCT. So there's a difference between open systems and closed systems?
Reuben Kamp: Yeah.
Howard Farran: Apple is a closed system, right?
Reuben Kamp: Right.
Howard Farran: And then Microsoft is an open system?
Reuben Kamp: Yes.
Howard Farran: It's not one's good and one's bad, there's just trade offs.
Reuben Kamp: Correct. Apple is more of a seamless experience, but you don't have a lot of choices. I use Apple, for a business phone I can get done what needs to get done. There's no frills, it'll probably work and I'm content with it. Microsoft gives you a lot more flexibility and product choices. You could write your own software if you wanted to.
Howard Farran: Which is what Open Dental does too.
Reuben Kamp: Right. Yeah, they license their software as well. So you'll see a difference experience, Practice Web is company in California. It's Open Dental.
Howard Farran: Practice Web is Open Dental?
Reuben Kamp: Practice Web is Open Dental.
Howard Farran: So did they just buy a copy of Open Dental and then start adding stuff?
Reuben Kamp: You can go right on -
Howard Farran: Did they have to license it first?
Reuben Kamp: Correct, you'd license it. They actually support their own product.
Howard Farran: [inaudible 00:21:55] Practice Web. So why did Practice Web break off from Open Dental? Were they ex Open Dental employees?
Reuben Kamp: They didn't break off as much as they liked Open Dental as a core product, they started a completely different company, but they took the core product and built on top of it.
Howard Farran: Okay so now we have a lot of ... podcasters are millennials. Old guys like me read touch books, go to conventions and have already bought our funeral plot. A lot of them are on Apple and they want to get out of dental school and run on the Apple.
Reuben Kamp: Right.
Howard Farran: What if you have someone who's got an iPhone and an iPad and wants to run Dentisoft on Apple. Is that really a practical way to go?
Reuben Kamp: It is not. You're going to limit the amount of choices you have in both practice management choice, and in sensor. DEXIS is one of the only sensors that run on Mac, and that's $10,000. You have a lot of different options, and frankly competition in the PC space. If your software's not doing something you need it to do in order for your practice to function properly ... on Mac there's not really any pressure to get that done because there's no other choice. The other thing about Mac, the hardware for what you get, you're essentially spending twice to amount of money to get the same performance you could in a PC. If you want your patients to see a sign ... I've seen this in some ortho practices, they just want their patients to see a sign of quality, they'll actually run a Mac, then if you come round to the back side of the computer they'll be running parallels running Windows 7, or Windows 10.
Howard Farran: Is this true or false? If I open up the wrong attachment on my iPhone, that's very different from opening up on Outlook on my Dell computer, right?
Reuben Kamp: Course.
Howard Farran: So if I open up a sketchy, phishing, ransomware on my iPhone.
Reuben Kamp: It'd be a good place to test out the link, honestly.
Howard Farran: Yeah.
Reuben Kamp: Yeah.
Howard Farran: Have you heard of any cases of ransomware, would that be less likely to happen if you're running on Mac, what is the Mac one called?
Reuben Kamp: MacPractice.
Howard Farran: MacPractice. If we were working on the MacPractice could we not get bugs and ransomware. Is it virus-proof like that?
Reuben Kamp: No, it's not virus-proof. That was a misnomer back in the day. The thing is, if I am a Russian or Chinese virus coder.
Howard Farran: You mean the NSA?
Reuben Kamp: Or the NSA.
Howard Farran: Yeah the NSA the CIA.
Reuben Kamp: Thanks for giving us the keys on how to do it. I look at how many computers are out there, it's mostly Windows. If I want to maximize my research potential, I'm just going to write it for that. There are plenty of variants for Mac as well.
Howard Farran: One of the reasons I'm hard on my own government, I don't think you're doing your government a favor when you just say, "Oh they're perfect." I'll tell you what, I have lectured in 50 countries, I have lectured in six continents, and I have had so many dinners with so many, 50, 60, 70 year old, very smart dentists who have told me what our government has done to their countries. It's almost never a happy story that ends and everybody lives happy ever after. I mean, go have dinner in Vietnam and Cambodia. Go to those places. Right now, a lot of those hacking tools were because they were made in the NSA and then somebody in the NSA leaked them out.
Reuben Kamp: Correct.
Howard Farran: A lot of this carnage comes from the United States of America.
Reuben Kamp: The last big ransomware attack ...
Howard Farran: The 2008 melt down came from Manhattan.
Reuben Kamp: Right. Wall Street.
Howard Farran: The entire world had to take a knee because of Manhattan. [crosstalk 00:25:54] it wasn't Ohio.
Reuben Kamp: They packaged toxic mortgages ... what do you call that? Remember what they called the commodities that they made?
Howard Farran: The toxic mortgages?
Reuben Kamp: Yeah, they put them in a ... and that specific package took down the world.
Howard Farran: What was that movie that explained it? The Big Short.
Reuben Kamp: The Big Short. It was a great film.
Howard Farran: What I liked about The Big Short was ... Hollywood is Hollywood, and it's usually Hollywood. Everybody I respect in the economic world congratulated The Big Short for saying, my God this is hard to explain to kids in B school, and you crushed it on a movie. B to C, everyone gave them kudos for that.
Reuben Kamp: I think that's one of the biggest signs of intelligence, is being able to distill something that complicated down into ... my favorite part was in -
Howard Farran: At the Casino table. That was the best part, when they were explaining it all at a Casino table.
Reuben Kamp: I liked the scene with Anthony Bourdain with the old seafood, talking about how to make seafood stew.
Howard Farran: Yeah.
Speaker 3: That's the best bit.
Howard Farran: Yeah. He's a cool dude too. Okay, so back to your website. Again, I'm sorry, we keep getting off. What are they going to find on your website? And what do you do, and this Dentistry Uncensored, what does it cost? What would you be in charge of at a dental office, and how do you do that if he's in Nevada, Missouri and you're in Ithaca, New York?
Reuben Kamp: So we offer what's called a manned services agreement, we manage it. We call it the single point of accountability, because what I was hearing feedback when I was think about starting the company, was that there's just too many pieces moving around. We just want one person to be in charge of it, be responsible, and if we need an issue there's just one person we call, not three different vendors. Our plan was formulated with that in mind, where you can just rest easy at night, we're going to take care of your back ups, your anti-virus software, your HIPAA compliance. But also, if you have an issue with DEXIS, Soft Dent, Dent-O-Soft. And then on the imaging side, we see it all. What we're offering is the whole thing, managed in one. So when your staff picks up the phone, they're just calling one person, alright? We don't want them to pick up the phone and call Soft Dent. If it's a complicated issue that's just a waste of money, let our remote support technicians do that.
Howard Farran: Okay. I know what my homies are thinking, they're thinking, "Okay, so the Cloud means that instead of my server it's your server." The Cloud is really just the internet.
Reuben Kamp: Yeah, so Dentrix would store all your information on it.
Howard Farran: So what's the pro and con of this dentist having his Open Dental on his server in his dental office, as opposed to a server in your office in Ithaca, which would be the Cloud.
Reuben Kamp: Sure. So, we only have a couple environments that are Cloud based. There's only a couple of reasons that the Cloud is a major advantage, and right now the questions are: do you see the same patients in multiple locations? That's what it really boils down to.
Howard Farran: Do you see the same patients in multiple locations? Who does that, just the guys that have more than one location?
Reuben Kamp: We work for a couple of groups where one office will have a CBCT combi machine, and that's their oral surgery location, so they'll have patients going back and forth. And they'll have maybe an ortho location, a peds location. So there's a lot of patients going around. Having that patient's record available everywhere is worth more than the speed reduction. When you have a server that's 10 feet away from your computer, you're operating at the fastest possible speed that you can, also if your internet goes down, you can still see patients and take x-rays and do everything. It's about comfort level. Do you feel comfortable with Dentrix, these big organizations, owning your information? If you wanted to switch, now you have to worry about getting the information back from them.
Howard Farran: That's funny how we were talking about The Big Short, how those Wall Street brokers learnt to do the high speed computer training.
Reuben Kamp: Yes.
Howard Farran: The most valuable real estate is right by the trading, where they want all their servers, because is my trade comes in one one thousandth of a second before yours, I'd get to trade and you didn't, and those servers are on that block.
Reuben Kamp: Right. Obviously you're paying reoccurring costs, up to that provider, to store that information for you. It's frankly cheaper to have a server on site.
Howard Farran: Yeah. Another question I want to ask. Some people, they really want to measure their incoming calls, everyone that studies this stuff knows that three people call their office, and they're thinking about coming to you, but your reception can only convert one. When they're going to these phone systems, a lot of people start thinking, "Well you know what, if I switch from a cable phone, or Cox phone or cable Time Warner."
Reuben Kamp: Spectrum now.
Howard Farran: Time Warner is it called Spectrum now?
Reuben Kamp: Yes.
Howard Farran: Some of them are switching these VoIP, these Voiceover Internet Protocol.
Reuben Kamp: Yep.
Howard Farran: And then some people say, "Man it's just the greatest thing." Then other people are saying, "You know dude, it actually goes down three or four or five minutes, five times a day." Does that depend on ... first of all, what's your general thought on VoIP? And would you trust it in the United States of America to turn your phone over to VoIP?
Reuben Kamp: I do. We use it internally. We have several dental offices that use it. It's tricky. If you don't have someone who knows ... if you just have a run of the mill ... say your It guy's your patient, he comes in once in a while. If you don't set up your network correctly it'll start blocking traffic, what you're referring to is an office will pick up the phone, they can hear the patient but the patient can't hear them. Is the utility worth the reward? Is being able to record all the phone calls, educate your staff on how to be better on the phone?
Then there are some programs like Weave that integrate directly with a program like Softdent or [inaudible 00:32:12], can give your staff a snapshot, a really quick portal of what to bring up when they're on the phone, so they can be the most effective, whether it's they have an outstanding treatment plan, they're overdue for their recall appointment, that will show. Say their birthday is tomorrow, so you can be a little more personable on the phone.
Howard Farran: And where is Weave located?
Reuben Kamp: Salt Lake City.
Howard Farran: And where is Utah then? They have Silicon Valley and now they call it the Silicon Slopes.
Reuben Kamp: Right.
Howard Farran: So where is Dentrix?
Reuben Kamp: Dentrix is out there too.
Howard Farran: Yeah. And where's Weave?
Reuben Kamp: There both.
Howard Farran: Where's ... what does it say about Dentrix when they're missing the market that's popped up several companies around them.
Reuben Kamp: Correct.
Howard Farran: None of those companies should have existed.
Reuben Kamp: Right.
Howard Farran: Dentrix should have done all that for you.
Reuben Kamp: Think about appointment reminder companies, texting companies. You have [crosstalk 00:33:07]
Howard Farran: When people say, "You're hard on Dentrix and Dent-O-Soft." Dude there's a Silicon Valley of companies that are propped up in all the areas that these ... the reason it makes me so mad is because this leads to ... when a dentist doesn't know their costs and they're losing money, it hurts their family, it hurts their health. There's a lot of really stressed out dentists because they don't know why they're working so hard and not making any money, because no one will hook up the software.
Reuben Kamp: Yeah.
Howard Farran: Back to ... the dentists are asking. I want to do ... I was so glad you're coming over today because my call this month, no one's answering this guys question on my column. So the column was, I was comparing the difference between how crazy drive-thru is to how crazy dentistry is. You go to the drive-thru and the person can't see you. They're like, "Order please." And you're like, "Okay, I'd like a Big Mac." And they're like, "Okay, anything else?" Because they can't see there's four people in the car. And then so every time you order another meal they repeat the order, 'cause their best idea was they couldn't see you.
Reuben Kamp: Right.
Howard Farran: And then when you go to the window to pay, that's very important. When she's taking your money she's taking the next order. It's like, okay, I'm pretty sure you gave me three dollars more. And then you think that's all silly and they're crazy. And then you go across to In-N-Out, and they send a human out.
Reuben Kamp: Right.
Howard Farran: And she's got an iPad. And she can see into the car.
Reuben Kamp: Yeah, that's a really good idea.
Howard Farran: And she can see you talking. It's like, In-N-Out is twice as smart. Then you call up a dental office and 50% go to voicemail. If they do answer it's, "Can you please hold?" And then it's like, "How may I help you?" They don't even know who you are, it doesn't ... with Dentrix it doesn't pull up to the screen automatically. But then with the guy on my ... Neil said, "I'm hoping you log in and answer." He's saying how is everyone measuring their incoming call conversion rate? How are they measuring? Would you mind going in there and alpining on that?
Reuben Kamp: The conversion rate? [crosstalk 00:35:13] while you have the patient in the sweet spot are you?
Howard Farran: No, what technology do they have now to know when this call comes in, that they're either in your practice management system, an existing patient. Which on your marketing should be, existing patients call this number, new patients call this number.
Reuben Kamp: Right.
Howard Farran: How can they ... you said Weave. What is Weave the only one? What technologies? And would they all be VoIP?
Reuben Kamp: They should be.
Howard Farran: They should be.
Reuben Kamp: Otherwise you're going to have a box, on premise. And that's just something else to really manage the information.
Howard Farran: Okay, explain that. Because most of us know details on VoIP.
Reuben Kamp: Okay, so VoIP, there are two flavors. There's one where you have it ... Yeah.
Howard Farran: Reuben and Rachel?
Reuben Kamp: Thanks. Yeah. How about mint and bubblegum?
Howard Farran: Mint and bubblegum. I like that.
Reuben Kamp: So either you have a box on site, and that's where everything is being stored and managed, or you log into a portal, and you see eight to five call volume. The conversion rate, that is going to require some sort of manual recording. [crosstalk 00:36:19] You have to say [crosstalk 00:36:19]
Howard Farran: Would Softdent know that? That these are all the strange phone numbers that called? And these are the ones that actually scheduled an appointment, so you can get the metric, get that dash point.
Reuben Kamp: Yeah. We will absolutely do that. If that -
Howard Farran: Right, can you send me Weave?
Reuben Kamp: Weave's gotten a lot better. They added an East Coast server which has stabilized a lot of our clients. There were some ...
Howard Farran: Did they raise a major round of funding or something? Aren't they going?
Reuben Kamp: Yeah. They're pretty easy to use. You're talking price, you're talking on top of what you're doing, another 299 to 399, depending on everything else, you can add Google reviews on top of that. But what happens, is the call rings in, and since it's attached to your system, it searches for that in Dentrix, and pulls up the information right there. So there's no click manual thing, it just pops up for you.
Howard Farran: Now what if the dentist wanted to record?
Reuben Kamp: It's automatically recorded.
Howard Farran: Yeah. I've been stealing ideas and it has to be in front of my wife. When you live in a little cottage industry, and by definition cottage industry is not one player has 1% of the market, whereas in autos, it's like 12 people have the whole global market. In food, I think 10 companies produce 80% of all the food in all the grocery stores, you know like Nestle and all those. In dentistry, if I call any major companies, what percent of the SNP500 companies start offices, "This call may be recorded for training purposes."
Reuben Kamp: Every single one.
Howard Farran: And then when you ... and the first people to identify in dentistry, was the Scheduling Institute of Atlanta.
Reuben Kamp: Yes.
Howard Farran: Those guys said [inaudible 00:38:03], your system went for a year. And you just hired in off the street. She doesn't close any of these calls, and that's why the Scheduling Institute has been a major company.
Reuben Kamp: It has.
Howard Farran: And is still exploding. They just opened a location in Phoenix.
Reuben Kamp: They did.
Howard Farran: So now they've got the Atlanta [crosstalk 00:38:22].
Reuben Kamp: A client of mine, shout out to Dr. [Metts 00:38:22], he won J's Lamborghini.
Howard Farran: Nice.
Reuben Kamp: Yeah.
Howard Farran: So is Weave the only one? Is there any other ones?
Reuben Kamp: There are some lesser known ones out there, we don't like to endorse anything until we have enough of a client base, and enough dentists that want to be on the edge of modern technology that they'll be our ... what's called beta testers.
Howard Farran: We call them guinea pigs.
Reuben Kamp: Yeah, same thing. Those are the guys that are willing to put up with being on the beta versions of things.
Howard Farran: Which is the bleeding edge instead of the leading edge.
Reuben Kamp: Right, so if you're on the beta version of say, [Serach 00:38:59], you're in a whole different world.
Howard Farran: And by the way, I'm 54 so the only people that are on the bleeding edge are going to be millennials under 30. What's gonna happen, when I got out of school, the smartest cosmetic dentists were saying, "Do di-compounds and cement them with Durelon." I went to courses and paid money for that knowledge, and of the thousand I did, guess how many have broke and had to be replaced for free? All of them! All of them.
And then I tried the new Targus Vectress from [Idlaterra 00:39:34], and guess what percent of the time the Targus came off the Vertress? All the time! And the others, [Art Glass 00:39:42] and [Greys 00:39:42], I'm telling ya, you think it's all fun and games, but if you're gonna practice and show Arizona your whole life, and you try something new, and it all fails, you're gonna re-do all of it for free, and they're not going to be happy.
By the time you're 40, you say, "Let the little kids try that bullshit." One of the things I really want to try, is when you extract a tooth [inaudible 00:40:09], out of Korea has a pulveriser, what was that movie ... Fargo? Where the last scene they throw the lady in the wood chipper. Instead of bone grafting, and all this stuff. You shove the tooth in there, pulverize it and increase ... that was bone [inaudible 00:40:27]. That sounds awesome.
Reuben Kamp: Yeah.
Howard Farran: But no one's ever bone grafted with enamel, dentin, bacteria, fungi, virus, parasites. I'm not gonna try that.
Reuben Kamp: No.
Howard Farran: I hope all the fricking 30 year olds go try the shit out of it.
Reuben Kamp: And write about it on Dental Town.
Howard Farran: And then it'll take five years.
Reuben Kamp: Yeah.
Howard Farran: It will take five years on these new crows, new everything. Maybe not five. So that's the bleeding edge versus the leading edge.
Reuben Kamp: Right.
Howard Farran: So as far as leading edge, you'd say Weave.
Reuben Kamp: Yeah.
Howard Farran: And the rest would you say bleeding edge? Or you don't have enough experience to know.
Reuben Kamp: Second one. The latter.
Howard Farran: So Weave's the dominant horse.
Reuben Kamp: Yes.
Howard Farran: And they're a well funded, serious as a heart attack company?
Reuben Kamp: Yes.
Howard Farran: Okay. So you give your blessing to VoIP.
Reuben Kamp: I give it with the caveat of if your IT company's the real deal. It can go sideways really quickly [crosstalk 00:41:29]
Howard Farran: Okay, because I want to show you. I'm throwing you under a bus here. If I do a search, and I want everyone to do a search on Dental Town because that damn search bar cost me 50 grand.
Reuben Kamp: I forgot about that.
Howard Farran: Look how many threads are talking about this stuff.
Reuben Kamp: Yeah.
Howard Farran: Have you weighed in on any of those?
Reuben Kamp: Yes. I follow all the computer, hardware maintenance, all those.
Howard Farran: So you know it's a big topic.
Reuben Kamp: It is.
Howard Farran: It's a huge topic. I always wondered this, this is what I always wondered. It seems unlikely that internet service would be the same for every American.
Reuben Kamp: Right.
Howard Farran: I mean, can the internet really be the same in Anchorage, Alaska as it is in Manhattan?
Reuben Kamp: There's three. You could do DSL which is phone line based, don't even think about voiceover IP.
Howard Farran: DSL.
Reuben Kamp: Right, that's your phone line internet. Then you have broadband. Broadband is the most ... most of us will use [crosstalk 00:42:21].
Howard Farran: Tell me what DSL is again.
Reuben Kamp: DSL goes over your phone line.
Howard Farran: Broadband is?
Reuben Kamp: Broadband is co-access. Most of us have it in our homes.
Howard Farran: That's you cable company?
Reuben Kamp: Time warrior, Cox. Then the third layer is fiber. Fiber is guaranteed speeds. Broadband you're on a shared ... everyone on this house, let's say they're all on Cox, they're all pulling off the same line. Fiber, if you're paying for 100 by 100, that's what you're getting.
Howard Farran: Did you tell Kent about that over at Dental Town?
Reuben Kamp: Yeah, I spoke to him yesterday.
Howard Farran: So what is Dental Town?
Reuben Kamp: Fiber.
Howard Farran: It's on fiber. My house, could it be on fiber? I'm on Cox.
Reuben Kamp: Yeah, you could be. I mean the price is going to be ... Cox might have a fiber offering as well. We work with a couple of companies that do surveys.
Howard Farran: Well next time you talk to Kent, tell him that. When we do these podcasts, it looks seamless because Ryan is so damn good at editing, the bottom line is, what percent of time on a Skype call does a call drop? Three or four times a show?
I want to ask you a forward looking question that you have no idea how to answer, but you're so damn smart you might now.
Reuben Kamp: Fantastic.
Howard Farran: Microsoft bought Skype for $8.9 billion, years back. Not they just bought LinkedIn.
Reuben Kamp: Correct.
Howard Farran: In my little walnut brain, I'm sitting here thinking, "Will LinkedIn turn into an Apple iPhone, FaceTimey thing?" Around the corner? If I follow you on LinkedIn, since now it's owned by Microsoft, which own Skype. When I see the picture of your face I'll just push it and be talking to you on a call?
Reuben Kamp: If you own a Windows phone.
Howard Farran: Really?
Reuben Kamp: Is your attention here on LinkedIn, and there's a button next to my face and you want to call me?
Howard Farran: Where you have the phone. Where you have the phone number, I think I should be able to push it and hear it call on my phone plan, or my deal. If you own Skype.
Reuben Kamp: You can do that right now.
Howard Farran: If you and I both have an iPhone, I can call you.
Reuben Kamp: Right.
Howard Farran: Or I can FaceTime you.
Reuben Kamp: Correct.
Howard Farran: So that's my version on LinkedIn. Do you think in the future it will be like, "Oh, I'm connected with Howard on LinkedIn, so there's his landline, cell phone number, and there's a FaceTime number.
Reuben Kamp: Do you want your phone number published to all your followers?
Howard Farran: Yeah. We were talking about this the other day. I'm coming to a point where I need to get a new number. Last time I called Rick Workman, the CEO of Heartland, his number had been disconnected. So I emailed him, he said, "I got a new phone." I'm so dumb. I've given out my card at every seminar I've ever gone to.
Reuben Kamp: Your personal phone number?
Howard Farran: Yeah. And people don't abuse it, they only call when ... almost every time I've got the phone, usually my boys are great like, "Yeah that's cool that you talked to that guy 'cause he really needed something."
Reuben Kamp: That's good, I do the same thing. I give out my personal. I only have one.
Howard Farran: I got yours off the bathroom wall, actually. Like, okay.
Reuben Kamp: Do they sell Reuben sandwiches?
Howard Farran: I was buying my Reuben sandwich.
Reuben Kamp: Oh so to finish the point on the internet. Phone systems are very [inaudible 00:45:21] when they're delivered over the internet. They're very finicky to the quality of the internet. So, broadband, as I was saying before, it's a shared pool. If you have someone that's using a lot of data, your connection's gonna go down. Do if that connection's going like this, so is your phone call.
Howard Farran: Right.
Reuben Kamp: Right, so, it's highly recommended that if you are a business using voiceover IP, you get fiber, because fiber is a simultaneous up and down, and the speed does not change.
Howard Farran: Okay. I've got to tell you, my darkest hour in IT. 20 years ago, the computer crashed. We were backing it up, we were supposed to back it up to, I don't ... I have no idea what I'm talking about. I think we were supposed to back it up to the C drive and somebody was backing up to the D Drive. So long story short, in one minute we lost everything.
Reuben Kamp: Right.
Howard Farran: When you load back in all your deal, and all your damn. It was a complete, unbelievable nightmare. And guess what percent of the people who were on our account receivables called us up and said, "Hey, I keep getting statements from you." Reuben do I owe you money? What percent of my patients do you think made that phone call? No one. So all the over 30, 60, 90 was gone. But anyway, what does my homie have to know about back ups, which is another reason I'd rather have my server in your office, and you do the back ups on the Cloud.
Reuben Kamp: Sure.
Howard Farran: I know no one does that, but ...
Reuben Kamp: It's easy enough to do. So, back ups has changed from just back ups to BDR which is back up and disaster recovery. The disaster recovery is when the phone call comes in, right. The first layer, you start with doing ... what we do is a nightly Cloud back up, so everything is out of the building, flood, fire, whatever.
Howard Farran: So you do that, so you add today's on.
Reuben Kamp: Yes. So what we do for you. And then on top of that we do an hourly image back up, so if you get some sort of catastrophic event, at say 3 o'clock in the afternoon, we're not losing that entire day of production.
Howard Farran: So you back up mine every hour?
Reuben Kamp: Every single hour. Every single hour. And then on top of that we have a fail over server, okay, so that fail over ... your practice is big enough where this is ... we're talking your most down time would be about an hour at this point. If your server went completely kaput. We would be able to virtualize that and fail it over to another server.
Howard Farran: And I know you don't want to offend anyone, 'cause you want ... no one wants to piss off their value chain. But what if she was 25 years old and she was going to go start up a De Novo practice in Nevada, Missouri, and she said, "What practice management system would you use?"
Reuben Kamp: Open Dental.
Howard Farran: Yeah.
Reuben Kamp: Eagle Soft, number two. I really do not have any allegiance.
Howard Farran: Eagle Soft is Patterson and they just let their CEO go.
Reuben Kamp: I know. I really don't have any allegiance.
Howard Farran: After six years, I think that has more to do with Amazon coming down the deal.
Reuben Kamp: They were sniffing around, Patterson.
Howard Farran: I'll tell you, [inaudible 00:48:16] buying them?
Reuben Kamp: Yes.
Howard Farran: Really, so you know that? How do you know that?
Reuben Kamp: They were at the dental show, talking with Patterson. I just have ...
Howard Farran: You mean they've been in New York?
Reuben Kamp: Yes.
Howard Farran: Yeah. So that was, I don't know if you know that, because you probably don't know the dental supply business. But Amazon had a booth at the Greater New York meeting, and that was the show stopper. That was the conversation at every dinner, was "Oh my God, why is Amazon here?" Okay.
Reuben Kamp: So just to clarify, on the crash management software, any product, the way out company looks at it, we're only loyal to the products that serve our customers the best. I don't have anything that ties me to one or the other, except for our people enjoying their experience with it.
Howard Farran: Okay. Here's another question. It's an unfair question because I'm very certain. There's so many details.
Reuben Kamp: Bring it on.
Howard Farran: It seems like a lot of times you're with people my age.
Reuben Kamp: Yep.
Howard Farran: So their iPhone's not working right, or froze or whatever. The first thing they're thinking is, "You know, this thing's two years old, or three years old. Maybe I should get a new one." A lot of times you're talking to my dentist friends who are like, I don't know why it takes so long to pull it up but I can't even remember when I bought that computer. How do you know when you need a new upgrade your computers at your office? How do you know it's the computer versus some other variable? How do you know when your computer sucks?
Reuben Kamp: The first piece is you should probably be asking somebody who knows about your whole system. So if your system is a CBCT machine and the requirements are calling for more power, then we might need to upgrade those computers.
Howard Farran: Do your IT guy should know all that?
Reuben Kamp: Your IT guy should have ... let's say your scenario, should have the specs for the latest version of Care Stream, Soft Dent, and have the latest version of Suni.
Howard Farran: Does my team do that, or know that?
Reuben Kamp: Yes.
Howard Farran: And that was one of the things that Ken liked about buying all of out computers over Dell. You can always go to your Dell account and see every machine you bought. So you know the date, the LAM, all of the specs on it.
Reuben Kamp: And the other thing, is buy a warranty for as long as you're going to own the computer. Don't buy a computer with just a couple years on it. We like to see workstations five to six years, that's about the window that we like to see. It kind of goes hardware failure does on like a bath tub curve, where at the beginning there's a burning period and that's when stuff can go wrong. Then after about four, five years, that's when we see hardware failures again. But that middle period, we're not seeing much.
Howard Farran: So you'd say, one rule of thumb is that your stuff works five years?
Reuben Kamp: Yeah.
Howard Farran: And the second rule of thumb is make sure your specs -
Reuben Kamp: Make sure you have a warranty for five years.
Howard Farran: Make sure you have a warranty for five years, probably only going to last five years, and make sure that you have the, what is it, the RAM, the processor speed, matching your CBCT.
Reuben Kamp: And solid state hard drives have completely changed the game. They're extending lives of computers. If your computer's underperforming it really might just eed a hardware upgrade. The speeds of the hard drives, from a spinning disk with a needle, to going to flash memory, have been -
Howard Farran: And when did that change over?
Reuben Kamp: It's been affordable for about three years.
Howard Farran: Do I have that? What do I have? Do I still have a spinny disk?
Reuben Kamp: You have most computers still through Ken, they're performing fine.
Howard Farran: Through Ken?
Reuben Kamp: You buy them through ...
Howard Farran: You mean Dell?
Reuben Kamp: Well, yeah. Ken gets them through Dell.
Howard Farran: Mine are still the spinning disks with the needle?
Reuben Kamp: There's a major difference, but at the same time, I'm not gonna willy nilly replace your hard drive if you don't ...
Howard Farran: Can I tell you the funniest IT story on the planet?
Reuben Kamp: Sure.
Howard Farran: So I got out of school in '87. This computer guy comes up and he's setting me up. We start with Softdent. And Intel had just came out. Everybody was using the 286, do you remember the 286?
Reuben Kamp: It was before my time.
Howard Farran: Yeah. He said to me, he said, "You know what? They just came out with a 386. I'm telling ya, it costs more money, but if you bought that 386 you'd never have to upgrade your computer the rest of your life!"
Reuben Kamp: Oh Jesus.
Howard Farran: That thing has more horse power [inaudible 00:52:34] and I was like, "Yeah! We want to go with the Intel 386!"
Reuben Kamp: That's a good sales pitch.
Howard Farran: He believed it. He believed that. We were all drinking the kool-aid back then. Remember when the Pentium came out?
Reuben Kamp: Yeah.
Howard Farran: That was the end all of computers. It was the Pentium! They didn't even name it the 586, cause they have 286, 386, 486. They didn't do the 586, they were like "This is it dude."
Reuben Kamp: This is it dude.
Howard Farran: We've arrived. We're in computer heaven, it's the Pentium. And then two years later, they were like, "Okay, yeah."
Reuben Kamp: Oops.
Howard Farran: They stopped naming them. They didn't call it the 586.
Reuben Kamp: Well the good news for Dennis is that hardware's coming down in price. The initial investment's really not what it once was. Computer hardware's pretty inexpensive these days.
Howard Farran: You talk about using technology to enhance treatment plan presentation acceptance. What does that mean to you? How can technology?
Reuben Kamp: This ties back to the ... I'm 30 so I'm in that millennial category. We want to see technology, even in dental, in medical. You have that CBCT machine in your office. What we want to see is our skulls spinning around. We want to be wowed by the CEREC Machine. We want to see technology being used for our healthcare. For us it is a sign of quality. It doesn't matter what the dermatologist ... when I see a provider that is investing in their practice, that is using technology, it shows a sign of quality.
Howard Farran: Just like dentists will be spore testing their autoclave every week, and have statin trays and thinking sterilization's great. But they don't use their cleaning service and their patients are out there seeing dust on the baseboard, saying "This place is filthy."
Reuben Kamp: Right.
Howard Farran: Perception's reality. You have a cleaning crew that's not ... you don't pay your dental assistant extra coin to stay late and empty the trash. You need a crew to come in that's all they do.
Reuben Kamp: Right. [crosstalk 00:54:42]
Howard Farran: Quality, you're right when you pull out [inaudible 00:54:46] digital x-ray. Also these guys are selling their practice. They're talking on Dental Town, I've got three choices. One guy didn't even have a website and didn't have digital x-rays. They're not even going to lose the offer. They're not even gonna ...
Reuben Kamp: Yeah.
Howard Farran: Nothing.
Reuben Kamp: There's been a couple offices in Ithaca where the guy just closed his doors and put an ad in the paper.
Howard Farran: Yeah.
Reuben Kamp: Yeah. It's more common than you think, that doctors are not digital. They're like, "I've got three years left." And they're just not going to do it.
Howard Farran: That's also, for the millennials. That's a huge mental error in diagnosing an idea all the time. I'm out here in Phoenix which is a lot of retirees, and these 90 year old men come round, I would just ... I was always passing on them to someone, like, "This guy's gonna be dead by Tuesday." He's got four liver spots, he's 90 years old, he's deaf. There they are 10 years later, they're still alive.
Reuben Kamp: Right.
Howard Farran: I mean humans are as tenacious as a cockroach, and a termite and an army ant. Don't ever misdiagnose from the pocket book because she might even be a waitress at the waffle house, but she might value her smile more than a car, a boat or a trip to Disney Land. Don't misdiagnose that old fart's gonna die, because God dang those humans are ... even when they come in and they say, "I've got cancer. I've got this, or I've got this." Or, "I'm on nine medications" and he's like 88. You're like, well, "I don't think we should do ... I think we'll just watch everything."
Reuben Kamp: People have a purpose, last a long time.
Howard Farran: Oh yeah. I think the biggest joke in the world is when people say they're going paperless. You'll say, "Are you paperless?" "Yeah." I'll say, "What is that in your hand?" "Oh I'm putting a sticky note on the doctor telling him his wife's on line three." "What is this?" "Oh this is for the team huddle, we pass it."
Reuben Kamp: Right.
Howard Farran: So going paperless is 50 shades of gray. I've yet to see an office that doesn't have any pieces of paper. What is the percent of dentists on digital x-rays? What are the percent of dentists who you would consider ... what is your definition of paperless?
Reuben Kamp: My definition of paperless might be different from yours. I think paper can be used.
Howard Farran: Chartless.
Reuben Kamp: Yeah, chartless.
Howard Farran: Chartless would be a better term.
Reuben Kamp: As long as, if you're getting a piece of paper and it's getting scanned into the system then shredded. I would still consider that. If someone's handing you a piece of paper.
Howard Farran: Would the better definition just be chartless? If I went out of here paperless, I'd want to know are you still using charts? Are you chartless? I like chart or chartless.
Reuben Kamp: Yeah.
Howard Farran: Even little things like the schedule. They're taking the schedule on the wall.
Reuben Kamp: I would day percentage wise, 85%, 90% have charts. Physical charts in the office.
Howard Farran: 90% of dentists still have charts in the office?
Reuben Kamp: Yes.
Howard Farran: And you think that's cheaper, lower cost, high quality or do you think chartless?
Reuben Kamp: No, I train dentists. Dentrix has a really good template system for the chart. I have sat down with dentists and say, "These are the 19 things we do every single time we do a filling. Now instead of writing a note you're going click click click click through the prompts, and it's generating the note for you." It is a time savings, and then you digitally sign it.
Howard Farran: I went chartless, it was 1999, I'd open '87, '99, 12 years. First I got them really long phone cords so that when they were talking to ... you know when Reuben Kamp calls up, and he's telling me about a filling, you need to see the chart.
Reuben Kamp: Yes.
Howard Farran: So then it was I can't reach it. Well then it was like let's get 13 foot phone cords so you can reach it. Then it went headless. The bottom line is, this person would come in and I'd start talking to him, and he'd called up. I'm asking him, "How's the tooth been?" He goes, "Well I had to call back and refill my pain meds." I'm like well that's not on the chart. He said, "Well I was concerned, the temporary fell off and so I called the front dental line." I was like, that's not ... so I keep calling and calling and calling, then I realized one day, I woke up in bed, I thought, "You know how I get them to pull the chart, I'll take the frigging chart away." So I got rid of the chart, just so my team, they had to pull up the computer.
Reuben Kamp: Right.
Howard Farran: There isn't a chart.
Reuben Kamp: And it's easier.
Howard Farran: You think it's easier and faster?
Reuben Kamp: I think so.
Howard Farran: We always had, almost a half full-time employee, who just walked round all day saying, "Hey, you know where Reuben's chart is? Did you take his chart?" And then what concerned me, is they always asked me if I'd taken the chart home. I've never taken a chart home, we go through this three times a week for years and years and years, I've never put on in my car. There's always a lost chart.
Reuben Kamp: It's in the doctor to be filled out pile.
Howard Farran: No. And then we always had a girl from high school who was actually Marcy and her sister. They'd come after high school, they got out three. Their job was to pull all the charts for the next day, and then to re file all the charts that we had. Every time they filed a chart wrong it was lost in a pile of 8000 charts. And you say 80% of dentists still have a chart?
Reuben Kamp: Yeah. I have a lot of clients that are 50 and above. Their comfort level with it, and there's no motivating factor for them to do it.
Howard Farran: And it's also, it would have been the greatest thing. I still think that the number one problem in the American healthcare system is everybody's got all their information in different pharmacies, different doctors, whatever.
Reuben Kamp: Agreed.
Howard Farran: And then your mom passes out at the grocery store, and the ambulance get there, don't know who she is, don't know what meds she's on. When you take them to the emergency room, they're just re-duplicating every task.
Reuben Kamp: Right.
Howard Farran: And then some of the greatest people in the world die because ... The Grateful Dead, what is it Garcia?
Reuben Kamp: Yeah, Jerry Garcia.
Howard Farran: Jerry Garcia, they didn't even know he was an insulin dependent diabetic.
Reuben Kamp: Right.
Howard Farran: The Grateful Dead would still be on tour if all that information was digital on a chart, and the emergency room could see, "Oh, he's a Grateful Dead alcoholic who's insulin dependent diabetic. Interesting."
Reuben Kamp: Shout out to Dr. Epstein who's dental office Grateful Dentistry is completely themed by the dead.
Howard Farran: Seriously?
Reuben Kamp: Yeah, it's awesome.
Howard Farran: Oh my God. That'd be a great feature story for Dental Town! You got his email?
Reuben Kamp: Yeah. Phil Epstein.
Howard Farran: Email him, email me. That is hilarious. There's a guy out here in Tempe, Dr. Cook who's got guitars all over his dental. I don't know why Americans are so against having ... they're going the wrong way with HIPAA, they're making it even more difficult for the ambulance guy to figure out what's going on.
Reuben Kamp: Let's try to solve the problem, right. Let's say, what if there was a piece of technology that allowed everything to be stored on our phones. How many times are we without our phones?
Howard Farran: Never.
Reuben Kamp: Never. So if something does happen to us, there's a medical ... you know you can swipe up and go to the control center, you can swipe over to go to the camera. What if there's a gesture you had to be able to access that medical record? And since we all have our phones, that seems like the best way to tackle the problem. What else are we without?
Howard Farran: You know, this was actually, I call this special. When Jobs stuck in the summer, what was that, 2008?
Reuben Kamp: When he put the ... the iPhone?
Howard Farran: The iPhone? The smart phone.
Reuben Kamp: Seven. Because this year will be the 10th anniversary.
Howard Farran: I knew it was different in 2007, because everything else that ever came out, purses, shoes, whatever. People go in their car and then they leave. This was the first thing that, if you got in the car with your four kids and you're like, "Oh I forgot my phone." It was the first artificial intelligence, it was an extension of their body. This had their phones, their data, their knowledge. For this to start going into little chips to augmenting the ... [crosstalk 01:02:58].
Reuben Kamp: It's natural. It's the only thing that my wife, if we leave it at the house, will make me literally turn around and go get it.
Howard Farran: Right. I completely believe that the only purpose ... I'm not nuts. I completely believe the only thing the homosapien will be remembered for is the bridge from biology, to the machines. As soon as this has a opposable thumb and walking around, they'll obviously be smarter than us and even if they let us live here on earth, we can't be thrown across the universe on a billion year journey.
Reuben Kamp: Yeah.
Howard Farran: But a droid can. And right now the only thing you have on Mars and Venus and everything is all droids. We were just the connection between biology and droids.
Reuben Kamp: The technology leaders will say right now, that artificial intelligence is the biggest threat to mankind. It's not a movie anymore, [crosstalk 01:03:52].
Howard Farran: You're never going to compete. At the rate this thing is going to like ... I remember them saying that the iPhone has more computer power than the Apollo astronauts had when they landed on the moon.
Reuben Kamp: By far. That was what 1968?
Howard Farran: Scale that out another thousand years, you'll still be a talking monkey with clothes on. And that thing will be a thousand times more powerful. You'll look at where am I going to more my chest piece, and they'll go through every random possibility.
Reuben Kamp: Right. I was -
Howard Farran: [crosstalk 01:04:24] and you live in a very narrow window of biology. You've got a temperature, oxygen. Those guys they'll shut down the droid and they'll throw it through deep space at five degrees above absolute zero, and then fire it up a million years from now on the other end. We can't do any of that stuff.
Reuben Kamp: No. It dawned on me as, watching some sort of congressional proceeding, the congressman's assistant was right behind him and he was asked a question and the assistant leaned in and whispered into his ear. I think that is going to be the first neural implant purpose, is essentially that person won't need to exist because this little computer in your brain is going to be augmenting.
Howard Farran: And I won't need that, because I have four kids at home.
Reuben Kamp: Hey, back to child labor.
Howard Farran: You have a life. It would be really nice to have a little ear piece say, "Hey we got that meeting next week, Tuesday at 10." And your augmented reality said, "Actually the meeting's at 10:30." You're saying, "Five years ago I met you at New Orleans." "No it was four years ago, and it was an awesome festival."
Reuben Kamp: I didn't realize that because LinkedIn was tracking your GPS location and yeah.
Howard Farran: Yeah. But I think you're amazing. I wish you would, would you mind answering on that thread today?
Reuben Kamp: Yeah, voiceover IP [crosstalk 01:05:47].
Howard Farran: They're asking on my monthly column how to use technology to measure incoming calls.
Reuben Kamp: Yeah. I'll shed some light on that.
Howard Farran: Can you shed some light on that?
Reuben Kamp: Yeah.
Howard Farran: And I think that's the future. Yeah, Open Dental, good IT company. So how do they get a hold of you again if they want to use you for IT? DarkHorseTech.com.
Reuben Kamp: DarkHorseTech.com, my email address is either admin@darkhorsetech, or if you can spell my name correctly, Reuben@darkhorsetech.com again.
Howard Farran: Reuben. R-E-U-B-E-N. If you haven't eaten a Reuben sandwich you're not a friend of mine.
Reuben Kamp: And shout out to our newest member who just joined our team, [Julie Varney 01:06:28] who is a prominent member in the dental community. She is bringing training and coaching to our suite of services.
Howard Farran: And where's she out of?
Reuben Kamp: She's out of Syracuse, New York.
Howard Farran: Well, you know what? You have her podcast me and I want to ... have her Skype me.
Reuben Kamp: Sure.
Howard Farran: I also want to Skype your dad. Tell your dad I've got four sons and he's got big congratulations to his son, seriously.
Reuben Kamp: Yeah.
Howard Farran: Your dad is a pioneer, and he is what you would call a holistic dentist?
Reuben Kamp: Yeah.
Howard Farran: I want to podcast your dad, you know why? Because whenever you say to my homies that you're a holistic dentist, or you're alternative, it's just quack! You know the tin foil on your head, you're a nut job. But when I watch my homies, they're totally holistic. If a dentist does to the doctor and they say, "You're pre diabetic, you're hypoglycemic, you've got ED, here's a boner pill. You've got high blood pressure." The dentist's like, "I don't want to get into poly-pharmia. I'm gonna go home and lose weight, and start exercising." Dentists are the most anti poly-pharmia, ploy-pharmia meaning as soon as you're on five daily prescriptions, whether they're over the counter or not. Some people say, "Well I only take one prescription pill." But they take five things, they take Qztan, or zinc. Once you start taking five things, because this has a side effect. This has a side effect. No one's ever tested the side effects when you combine them.
Reuben Kamp: Right.
Howard Farran: And then you add a third, and every one of these five has a side effect.
Reuben Kamp: You're making a whole cocktail.
Howard Farran: Yeah, and they say by the time you're talking five daily things, even just a multivitamin, the New York Times researched the other day on this. When you take a multivitamin you usually live about a year and a half shorter. Everybody taking them thinks it's gonna be longer.
Reuben Kamp: Right.
Howard Farran: When you take something daily, if it's water soluble, that's how your kidneys start out. A, D, E and K, they're not water soluble, and then you're taking these minerals and all these things. Your dad is a holistic dentist. And then the other thing about that, the marketing of it. There are so many consumers that share the dentists view that they don't believe in the healthcare system. If you go to the healthcare system it goes back to the medicine man. They just want to make you a lotion and potion pharmacy pill, or cut something off. They're like, "Well I want to remove your tonsils or do a bypass or give you a pill."
Reuben Kamp: Yeah, my favorite was the Mel Brooks skit, where, "Your arm hurts?" And then they whack you in the head. "Does your arm hurt anymore?"
Howard Farran: Yeah, he was great. Oh my God, Mel Brooks was the man.
Reuben Kamp: Yeah.
Howard Farran: So your dad is ... I wish all the older dentists would not go crazy when they heard the word holistic and alternative.
Reuben Kamp: Yeah.
Howard Farran: I think people like your dad are pioneers and I want to podcast them. Dentists always know what they know, they don't know what they don't know, and I've said a million times. I read the first dentists book, Pierre Façade, that was 200 years ago in Paris, France. He was the first dentist. And then the father of American dentistry is G.V. Black, I bought his three books autographed and signed by him and read that. If you ever read the father of modern dentistry in America from a hundred years ago. Completely wow. I mean, he was the smartest guy we had. Most of what he truly believed was wrong, so then you've got to ask yourself, in 2017 what is it going to look like in 2117? 2217? 100 years from now what percent of everything we hold dear is going to look like the Flintstone's Cuckoo?
Reuben Kamp: Right. Most of it.
Howard Farran: I would think so.
Reuben Kamp: I mean, technology's not slowing down.
Howard Farran: It's going faster.
Reuben Kamp: And he teaches at Eastman in Rochester. He'd be a really good person to interview. He is one of the most genuine people I know. He just wrote a book about his journey to healing.
Howard Farran: He wrote a book?
Reuben Kamp: Called Journey to Mudryi.
Howard Farran: What percent of that is dental journey?
Reuben Kamp: It defines most of his life. I'm in there, I had not ...
Howard Farran: Is the book on Amazon?
Reuben Kamp: It's on Amazon.
Howard Farran: Well, pull it up babe. Email me the link. Or you can pull it up there on my.
Reuben Kamp: He's worked on the book his entire life.
Howard Farran: Nice.
Reuben Kamp: It's not like one of these authors that pump out a bunch of books. This is it for them.
Howard Farran: That was a dig on me, I know it was. I wrote the Business Dentistry, the Consumerist's Road Map, Uncomplicate Business. Each book, I say I have four children and I have three books. Each one of them is like having a baby. It's a nine month, year long process. I mean my God. Every time one of my [inaudible 01:11:26] "Oh you should write another book about this." It's like no. Journey to Mudryi. So what is M-U-D-R-Y-I? What is Mudryi, is that a city, is that a religion?
Reuben Kamp: It's one of those titles where you don't really find out what Mudryi is until you're at the end of the book.
Howard Farran: Okay, so you don't want to give away the deal. Okay, I am going to push this out on -
Reuben Kamp: Who knows, you might be in it.
Howard Farran: I might be in it?
Reuben Kamp: You'll have to read it to find out.
Howard Farran: Do you give out your email?
Reuben Kamp: Yeah, it's admin@darkhorsetech.com. We support every single system, so is you need help in any dental environment, we do a high quality customer derive. We have a great reputation and everyone at Downtown and Dr. Farran's office can vouch for us.
Howard Farran: See if your dad's on for me on Google Image.
Reuben Kamp: Oh yeah.
Howard Farran: I don't ever Google Image my name 'cause there's so many pictures of me on there from my Chippendale days, you know, dancing on the poles. Email me that and a picture, a JPEG of his book, and then I'll push out his book. I think one of the most important things people should do on all their websites is, you see a name like Howard Farran, you don't know who he is or anything but if you just have a little YouTube video saying, "Hey come to my office bod, oh there's a human." You meet all these people like you, who great chemistry, great [inaudible 01:12:54] great energy. I just think that you'd do so much more business if they got to see that chemistry.
Reuben Kamp: I'm going to take your advice. I'm a technician so the whole marketing, sales side of it, that's all new to us. We're just trying to ...
Howard Farran: Most dentist, on their website it looks like they have a still. It looks like their mugshot when they got a DUI.
Reuben Kamp: I had one doctor -
Howard Farran: And then you meet that guy in person, he's got a magnificent personality.
Reuben Kamp: Yeah, you're right 'cause it's the static versus dynamic thing.
Howard Farran: Yeah. So you're a cool dude, you should have a video on there.
Reuben Kamp: Thank you.
Howard Farran: And you should say ... and you should have your dad in the video.
Reuben Kamp: That would be funny. He'd love to.
Howard Farran: And say, "One of the reasons I've always been in dentistry is because see this crazy guy behind me? He's a dentist and he's my dad."
Reuben Kamp: He took a chance on me.
Howard Farran: Yeah.
Reuben Kamp: More than one way I guess.
Howard Farran: They'll never part with your money until you make them feel something. The way with humans, the Nobel Peace, the Nobel Econ people have been proving this with drawing blood, measuring dopamine, serotonin, oxytocin. Why do people like roller coasters? 'Cause they feel something. Why do people do smack? They feel something. Why do they like scary movies? Why like running? Everything at the end of the day, that human wants to feel something and when you go to a website, if they don't feel anything they're not going to part with their money.
Reuben Kamp: Right.
Howard Farran: If they go to your website, they should see you. And then if you said something funny with your dad and he laughed, he felt something. And when he laughed he felt something so he secreted dopamine, oxytocin, serotonin and he picked up the number and he called you.
Reuben Kamp: Yep.
Howard Farran: So what's dentists response to that? Arrogant, talk down, condescending. Well of course you've got a tooth ache, I told you Reuben three years ago you had a cavity.
Reuben Kamp: Yeah, right. Here it is on the piece of paper.
Howard Farran: And did you come in and get it done? Well no, so now I'm shaming you, I'm making you feel bad. They are free to bring in their babies with cavities 'cause they're a mom and they're like, "I'm in charge of this two year old and it's got six cavities." And then everyone makes them feel bad. If you want to shame people, and make them feel bad, that's fine. If you own a business you should try to make them feel good.
Reuben Kamp: Right, and control your stress level.
Howard Farran: Thanks for coming over to the house.
Reuben Kamp: Yeah thanks so much Howard.
Howard Farran: Thanks for working on our team. Thanks for answering that question on my Downtown [inaudible 01:15:18] and my Howard Speaks.
Reuben Kamp: Yeah, it's been a pleasure.
Howard Farran: Alright buddy, have a rocking hot day.
Reuben Kamp: You too.