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VIDEO - DUwHF #919 - Erin Doffoney
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AUDIO - DUwHF #919 - Erin Doffoney
Erin’s passion is to bring skill, comfort and care through dental hygiene. Her goal is to focus on patients who’ve had compromising dental experiences. There have been situations where some patients have gone untreated for extended periods of times, which allows her to help patients find healthy perceptions of themselves and strengthen their confidence.
Erin knows there is no single approach that is right for everyone. Her vast experience in the dental field since 1995 includes a range of modalities consisting of; Soft Tissue Management, Paradigm Shifts in Technology, Clinical Behavior as well as Clinical Verbiage and Techniques. As the founder of Techs For Teeth, Erin has become particularly sensitive with coaching individuals and helping them structure an ACTION analysis, Clinical Excellence Through Team Work, Perfecting Team Efficiency, Understanding Your “Why”, and Team Mission Statements that aid in patient and clinical proficiency.
Erin’s educational and professional background includes a Bachelor of Applied Science Degree from Clayton College & State University in Atlanta, GA. Dental Hygiene Board Certified & Licensed in Georgia and California, with Certification in Local Anesthesia, Nitrous Oxide and Curettage from Southwestern College in San Diego, CA, a proud member of the American Dental Hygienists' Association (ADHA), National Association of Professional Women (NAPW) and a sponsor of AACD's Give Back A Smile program.
www.techsforteeth.com
Howard: It is just a huge honor for me today to be podcast interviewing Erin Doffoney, RDH BAS – the BAS, Bachelor of Applied Science. Erin’s passion is to bring skill, comfort and care through dental hygiene. Her goal is to focus on patients who've had compromising dental experiences. There have been situations where some patients have gone untreated for extended periods of times, which allows her to help patients find healthy perceptions of themselves and strengthening their confidence. Erin knows there is no single approach that is right for everyone. Her vast experience in the dental field since 1995, includes a range of modalities consisting of soft tissue management, paradigm shifts and technology, clinical behavior as well as clinical verbiage and techniques.
As the founder of Techs fort teeth, Erin has become particularly sensitive with coaching individuals and helping them structure an action plan. Clinical excellence through teamwork, perfecting team efficiency, understanding your Y and T mission statements that aid in patient and clinical proficiency. Erin’s educational and professional background includes a Bachelor of Applied Science degree from Clayton College and State University in Atlanta, Georgia; Dental Hygiene Board Certified and licensed in Georgia and California, with certification and local anesthetic, nitrous oxide and curettage from the Southwestern College in San Diego, California. A proud member of the American Dental Hygienists Association, National Association of Professional Women and a sponsor of AACD Give Back a Smile program. My first question for you is; you're from Atlanta Georgia, have you recouped from the Super Bowl yet or are you still in therapy?
Erin: You know, can you believe that?
Howard: At half time I would have bet my house, car, four kids and grandchildren that they were gonna win.
Erin: The Falcons were gonna win, right? Can you believe that? It was just unbelievable.
Howard: That's what we share in common because when the Arizona Cardinals went to the Super Bowl they were winning. The street was crazy. They were already celebrating and with one minute to go those damn Steelers threw a Hail Mary pass and the street went silent.
Erin: Yes.
Howard: Oh my God.
Erin: I know. Now we have a new stadium. So they're going to have to redeem themselves. They will have to come back from that and win it for the new stadium. So we'll see.
Howard: So I called you, you didn't call me. I'm a big fan of your website Techsforteeth.com, I've watched you on YouTube videos, I just think what you're doing is amazing. Tell us your journey. What was your journey on becoming a dental health care provider?
Erin: Well, it started, you know, we all have this big dream of graduating from high school, going on to college. So, when I went to college I went to the college that my mother and father, aunts and uncles, everyone went to. And, Dr Farran, I was completely lost. Changed my major a couple of times and went on to kinda explore who I was, and I figured out something about myself; I like working with my hands and I know I like talking to people one on one. So my first thought was, “Well, let me go into nursing.” And then I thought about it, I was like well, I really don't want to work holidays and weekends and eleven at night to eleven in the morning so then I went on to, paralleled over to dentistry and I found my passion with that. I went on to Dental Assistant School to make sure that it was right for me because I wanted to have a base and a foundation. And the journey started there.
Howard: And where along to your journey did you come up with Techsforteeth.com?
Erin: That came up probably about a year ago. To make a long story short, Techs for Teeth, techniques and technology, I'm a techie girl, I love everything technology. If you look in my purse now, I have every wire to go with every device and I carry it around my Apple Computer and everything else. I don't want to be left without any of my technology, so I can keep moving forward.
Howard: So you're a nerd and a geek?
Erin: I'm trying to be. That’s the obvious thing, with the teeth, I’m a hygienist so I just married the two together. And here we go. I love everything technology especially in the operatory.
Howard: What technology are you passionate about today that they didn't have thirty years ago when I got out of dental school?
Erin: Well, I'm glad you asked. I am obsessed with using the Carivu by DEXIS. It’s a Trans-illumination technology; it can actually trans-illuminate to structure from the lingual and the buccal side, so it can transmit light up to the tooth so you can actually see decay a lot sooner than you can with x-rays but it's in conjunction with digital x-rays. I think it is great. It’s one of the best pieces of technology I’ve used in my seventeen years as being a hygienist, twenty-two years total, actually, if you add assisting with that.
Howard: So tell us about Carivu. Is it very common? What percent of dentists and hygienists do you think use Carivu by DEXIS?
Erin: I’m not sure of the percentage of how many people use it. It’s pretty popular. I’ve been accustomed to it for about three and a half, four years now and I can tell you that a lot of patients like it because it takes some of the worry as far as a lot of radiation exposure, people have a big concern about that. The Carivu eliminates that concern a lot, especially with young children, parents don’t like to have their children with a lot of x-rays so it’s good for them as well.
Howard: So how much is this Carivu trans-illumination?
Erin: It’ll probably cost you about $6500 but trust when I say is gets used every day. You have to use it. And if you're really proficient in it, it will most likely pay for itself in about two months.
Howard: I love it and I love those pictures they have on their website.
Erin: Yes. Yes exactly.
Howard: Let’s say you and I met at a party and you tell me your name is Erin and an hour later, they’re human, their ear doesn't remember but their eyes know it’s you, so they walk back over to you and they you say, “I’m sorry, what was your name?” and you say “Erin Doffoney.” and then you give me your card because my monkey thumb can hang onto your card but my ear can't hang onto the sound, so seeing is the way you communicate with humans and when they see that cavity, I think anything visual. That's why I like digital x-rays because they can't see the little Kodak film. That's why I like intraoral cameras. That's why I like Carivu. If a human being sees, they understand.
Erin: I'm all about seeing is believing. It’s an old term but seeing is definitely believing. You show people what's going on you, you make a story about them and then they can relate to their own story as far as data collection. Seeing is believing and I truly believe that.
Howard: I like that study on their website that a visual inspection of (inaudible 8:10) decay, you can find 2% of them and with Carivu you can see 96% of them. The thing about x-rays is, how many times do you take bitewings and the bitewings aren’t perfect, they’re not an open contact?
Erin: Not only that, Dr Farran, because a lot of people are insurance-driven, it’s limiting us to one time per year where we can get a whole series built. With Carivu, you can use it every day if you like. It doesn't have the exposure with it.
Howard: Besides Carivu, what are you passionate about, what other technology?
Erin: As you mentioned before, the intra oral camera, the digital x-rays, I'm all about making sure that people can see what's going on in their mouth. And even in the office that I work in now we use an iPad so we can sit shoulder to shoulder with the patient, they can actually move the picture around the screen themselves, they can expand it themselves so that's a good little titbit to have in offices as well.
Do you have a name brand on intraoral cameras or digital x-rays or are you agnostic towards those?
Erin: I’ll just do whatever works, whatever can relay the picture, as long as you can get a good quality picture. A lot of different types of techniques go into making sure that you have the right picture. For example when I'm taking oral camera pictures, I want to make sure the overhead line is out of the way because then it ends up putting too much light onto the tooth and you really can't see the contrast that well, from what I've experienced.
Howard: I take the overhead light and I bounce the light off my bald head and it spatters all over the room and it looks like a laser show. So what are my homies going to find if they went to Techsforteeth.com?
Erin: They're going to find information about me of course, they're going to find different services that I provide. I can help you out with some temping if you like. I'm starting to do some speaking engagements and some presentations and if you’d like for me to come into your office and help your staff members to navigate how to use all of this technology within a certain time frame, because I know that's hard sometimes. We have all this technology and in the office and then we try and figure out, “Well how am I going to get it into my hour’s or forty-five minutes’ worth of time that I have with my patients so I can relay the whole story.”.
Howard: You need to brush your teeth every day, you need to floss every day and teams need motivation every day. And some people say, “Well I took them to a seminar and it was all good for two or three months but then it went back to normal,” and I said, “Well you don't say that about brushing, flossing or bathing. Well I took a bath and I was really good for a month or two, then three months I started to stink again!” Teams need motivation and I think the hygiene department is the stepchild of the dentist, the dentist is always wanting to go to courses that are for dentistry and a lot of hygiene departments are thrown on the back seat and they're the foundation. I was reading an article yesterday by an ophthalmologist and he said that he was so jealous of dentistry because the biggest problem in ophthalmology is people don't have that six month check-up and they're not coming in. And he said that dentists were the best because they developed this program where they get all their patients to come in once, twice three four times a year and in ophthalmology some people start developing serious glaucoma and all these issues.
Erin: And they go once every five years or so.
Howard: By the time they come in they're sitting here thinking, “Oh my God if only I could have diagnosed this three or four years ago, so I'm a big fan of getting you in front of more dental offices and hygiene teams because like I say, it's the overlooked stepchild of dentistry when it comes to CE. You talk about how learning new technology techniques can be daunting, whether it be software, caries detection services, digital impression scanners or emotional dentistry it's all necessary for building the patients’ oral health story for them to review. You talk about create a diagnosis cycle for optimal care. Talk about what is emotional dentistry and what is creating a diagnosis cycle for optimal care?
Erin: Emotional dentistry, if you have software within your office that can actually simulate a different smile for a patient, the patient may come in they don't like their smile. We all know that smile is good for self-esteem and just putting people more out in front of people. If you have a software in your office, you can take a picture of a patient, put it on a screen and then put different teeth in there to simulate what they may look like and then you can print off a picture so this person can take this home and they can mull over, “Hey I might want to look like that one day.” So that's what I mean by emotional dentistry, you catch the emotion of the patient, what their needs and what their concerns are and you turn it into a want.
Howard: Now are there any technologies you like that help do that?
Erin: Stick to the basics, cameras, be very good, be very proficient at taking photos, regular photos because you have to upload photos into the software to make sure you can get the right teeth in place, the right coloring in place, so you want to make sure that everyone in the office is trained properly on getting the right photos.
Howard: Photos is really the basis of marketing because when you look at dental office websites the average office website only has a 5% conversion.
So twenty people have to land on your website before one person calls the dental office and when dental offices have a YouTube video of the dentist or the team or the hygienist talking it, makes them feel something that doubles the conversion from 5% to 10%. If they have an online scheduling deal, that's another 5%, if they have a chat box or a little deal pops up and you might look at that checkbox and say, “That’s stupid, I would never do that.” Well, it doesn't matter if 19 out of 20 people don't do it, I don't care about that. I care that it gets one more out of twenty, a YouTube video of you on the website gets one more out of twenty, online scheduling gets one more out of twenty. But pictures are huge. And when they start putting up before and after cases and pictures - I know dentists who got serious about their website and doing cosmetic dentistry or implant dentistry. And now the people flying to their office from Southwest Airlines and they'll tell me, “This guy flew from Wichita Kansas to Kansas City to have me do the case. And when he left Wichita four of my best friend diplomats in the International Congress of implantology were in that town. He flew over a bunch of other diplomats and they just didn't know that these dentists that were literally in their zip code, 67212, were actually so good at implantology that he would have them place implants on himself but you go to their website and you don't get that.
Erin: A lot of times you just don’t know. The regular dentist that you go to, you just might not know that this is what they do, for example, some patients come into the office and they want to go to this other dentist saying, “Oh, but I didn’t know my dentist does cosmetic dentistry.” It is very important that you highlight the things that you do in your office and do them efficiently and do them well.
Howard: I have sent several patients back. My thirty year dental anniversary for my dental office was yesterday September 21st, thirty years we’re open, Phoenix. I have sent ten or twenty new patients back. They’ll come in and want to have an implant consultation and I’ll say, “Well did you just move here?” “No, I’ve lived here thirty years” And I asked ”Who was your last dentist?” “Oh, I've been going to so-and-so for ten, twenty years.” and I reply, “Well he is five times better at implants than I am and why didn't you ask him to do it?” And she says, “Well I had no idea that he places implants.” And I go “He’s one of the best implantologists in Ahwatukee.” Crazy how your own brand or what makes you all about, you just don't feel that from the dentist’s website.
Erin: Not only the dentist website but you have to get out there and network yourself. Whether it's making a YouTube video, speaking about it for five minutes, plugging that into your website, you have to put yourself out there and make yourself noticeable. Seeing is believing, hearing is believing. Like you said earlier we don't always continue to catch on and grasp what we hear. But if you're seeing it more, all the better, you have to put yourself out there and network.
Howard: Everybody says your network is equal to your net worth.
Erin: That's a good one. I believe that and what you put into it is what you get out of it.
Howard: The only people I know crushing it in sleep medicine are the ones who went out and visited every physician within a five, ten mile radius of their office.
Erin: You have to put yourself out there Dr Farran, to say, “I'm down the street for you, let's collaborate on this idea, what do you think about it?” All you have to do is ask.
Howard: My biggest referral has always been from the pharmacists. No one ever pays attention the pharmacist and I've had every one of them to my home for dinner, wine whatever because people always go to Walgreens or CBS and they go to the pharmacy and they go “What's best for a toothache? Would you get Anbesol or would you take Motrin or Excedrin? What would you take for tooth ache?”And they say, “I would go see Howard. Go see Howard Farran, he’s right by Safeway, he can give you all the advice you need.”
Erin: That's a good point.
Howard: And some of those pharmacies are open 24 hours a day and they know me. They say, “If Howard's asleep his phone’s turned off. So it doesn't matter if it's on Sunday, just call. That's his actual cell phone. Just call him or text him.” I also think dentists are so much better businessmen than physicians because 80% of the physicians’ websites in Ahwatukee don't have an e-mail on the website, they don't have a contact form box. I have to call the number and then ask whoever answers the phone if I can have a cell phone number. They almost always say no. A doctor in the same zip code and you wouldn't give him the cell phone number? Then I would ask for his e-mail address and they don't give out his personal e-mail address. He’s a cardiologist. Are you out of your flipping mind? Does he not want patients? It’s almost like physicians go out of their way to not be accessible.
I'm always being hard on dentists saying they have to do better but compared to physicians, they’re the genius child.
Erin: They're under lock and key. You cannot touch them. You have to probably go through five channels just to get to the cardiologist.
Howard: Isn’t it bizarre?
Erin: It is very bizarre.
Howard: I love your website. You also talk about, on Techsforteeth.com, “Action analysis; effectively incorporate action within the dental team. Do you want more positive connections with your patients? Taking action is not only movement towards a specific object or goal but it's a mind-set.” What are your thoughts on action?
Erin: My thoughts on action is that you have to know what action means. We all know that action is movement towards a particular path, whether it's mentally or physically, we know that. But you have to break down action as an acronym and plug in what you want that acronym to mean and then follow that. That’s the whole analysis that I come up with people, something like, “What’s your action?” “Well, I do ABC and D.” Break that down for me, what does that really mean? We know action is movement but how do you go about that movement? That’s my action: Help people go figure out what action means to them by breaking action down as an acronym.
Howard: I want to take this interview to a whole other discussion. We'll take it to the other side because you're very motivational, your calm and energy is amazing but you know a lot of dental offices are burned out. There's a lot of hygienists out there listening to you right now, a lot of dentists out there are saying, “The only reason I'm going to work as a hygienist or a dentist (inaudible 22:51) because if I threw my dental license away I can't make this kind of money without trying. I mean my hygienists make $40 an hour. If they threw away their hygiene license what's the chance they could go make $40 an hour? And these dentists always complain that the average dentist only makes a hundred and seventy-five thousand. I say, shred your dental license. And what do you think the odds are that the average dentist could go find a job in Atlanta making a hundred seventy-five thousand a year? He'd find three unicorns and meet the tooth fairy before he found that job.
Erin: With a little fairy dust sprinkled in to it.
Howard: So what would you say right now to hygienists and dentists listening?
They’re asking why are you so motivated. Are you on drugs? I'm burned out and fried. Why are you so happy?
Erin: You have to figure out why you got into it to begin with. If your reasoning why you got into the field to begin with was short term, then you’re right, you're going to get burned out. But if you go into dentistry with the notion of knowing that I want to help people but also form relationships at the same time, then it’s a no-brainer. Form relationships and inform people at the same time. You’re going to have to make some aches and pains. Your back is going to hurt and your neck, your hands. All that is going to hurt, you’re going to be worn out at the end of the day. But with that being said, at the end of the day, what did you do? What was your purpose? Did you accomplish it yet? You have to ask yourself those questions Dr Farran, because you need to understand if you're in it just for the money, you are going to get burned out real fast. When I was in hygienist school I used to hear it often, “I want to be a hygienist because I like the money and I like the schedule,” and I remember saying to a couple colleagues at the time, “How long are you going to stay? Don’t you want something more than that? You're not only treating teeth, you’re treating people that are attached to these teeth and you have to remember that. And I think that's where we get all bogged down in this whole thing that we are only focused on the teeth and we're not treating the people attached to the teeth. I've had instances this week where I probably cleaned somebody’s teeth for twenty minutes but we talked for forty because they were going through some things and you have to learn you have to be able to do those things. Number one for retention, and we know we do want to make all (inaudible 25:45) and all those things that go along with it. But you know we're all connected in some kind of way in this world and you want to make sure that you are connecting with your patients in some way because guess what they're going to go on to the next office, they’re going to find their connection somewhere. Read body language, listen to what your patients are going through. If you can help them with something else besides what's going on behind their lips, guess what, that patient will stay and continue to come to you. I’ve heard it over the years, “You know Erin, I feel I can talk to you, I'm comfortable with you.” You have to make these people comfortable with you. And you'll be rewarded at the end of the day. You will if you're in it for the right reason, you have to make sure you are in dentistry for the right reason.
Howard: I think it's so amazing, you'll look in some new patient’s mouth and they'll have one bridge or one gold crown I'll say, “Who made that gold crown?” They never, ever remember.
Erin: They don't remember because maybe that connection wasn't there.
Howard: They never remember what you did, they only remember how you made them feel. And when you talk to so many patients, I always do a psychological (inaudible 27:03) exam when they come to my office. I say, “Did you just move to Phoenix? I mean where did you move from?” “Oh no I lived here twenty years.” “Have you gone to the dentist in the last twenty years? Well why did you not go back to the last one?” and it seems like more times than not, the number one reason is somebody in the team made them feel bad. They talk down to them, they're condescending and what's really weird is even the business. I know so many dentists that when someone hasn’t been in their office for five years and walks in unannounced with a toothache, they say, “What a pig. He hasn't even been in in five years and he expects me to drop everything and see him”. First of all, it's a root canal, build-up and crown. It's two grand. If Santa Claus came down the chimney and put two thousand bucks in your stocking, would you say, “that's stupid, Santa Claus?” and furthermore, everybody needs a doctor. You have patients who don't come in, that's no reason to make them feel bad.
Erin: That's right, exactly. They're coming to you, they’ve made that first step. So applaud them, champion them for making that first step and then just go from there. You have to make people feel comfortable. Your bedside manner is going to determine that those patients are going to continue coming back to you.
Howard: When kids are in dental school and they say, “If I own my own office, do you think I'll be successful?” I always tell them, almost all of it is your chairside manner. If you're warm, loving, caring, smile, passionate, empathy sympathy, you'll crush it. But if you're a librarian geek that is condescending and doesn't connect with people, it's going to be tough.
Erin: You know Dr Farran, before I got into hygiene school I was working as a dental assistant and the dentist I was working with, I have always held onto this one piece of advice that he gave me. He said, “Erin you know what makes a good hygienist?” I said, “what, give it to me, tell me?” “It is 30% skill and 70% personality. If you can hold on to that, you'll do fine.” And I've hold on to that for at least seventeen years now. And it’s true. Until you get out of hygiene school and you learn your style and you figure out who you are on this operatory and how you're going to figure it out. And once you calm down a little bit you realize that the skill is there. We learn the skill but if you don’t have that personality to capture that connection… you’ve got to have it.
Howard: Oh my gosh, You can't believe how many dentists I know who are really below average technical dentists, who do one and a half million a year and take home three fifty, because when you walk in that office its just energy, it's karma, it’s balloons, they just crush it.
Erin’: I'm happy you're here. Thank you so much for coming. I have to attribute this particular statement to a cousin of mine, that’s Desirae James. She’s been an hygienist for over twenty five years now. One particular statement that she always says is, “Take your ego out of the operatory. If you can take your ego out of the operatory, everything will be fine.” I believe that.
Howard: I have patients that come to me in a wheelchair with oxygen tubes in their nose and they're out by the front door smoking cigarettes before their employment. And some people see that and they start getting all judgmental and condescending and she's an idiot and blah-blah. You don't do that when you go to the zoo, you don't look at a giraffe and say why is that giraffe being an asshole?
Erin: It’s just standing there, looking at me. Why yeah?
Howard: People are zero judgmental to their dogs, cats and goldfish and all the animals at the zoo and then here's human, they're homo sapiens, they're an animal but we’re so judgmental towards our fellow humans and I just think it's all an attitude. I hire on attitude and train for skill. I can teach you how to do technical stuff but I can't teach the attitude living between your ears.
Erin: And you know what Dr. Farran, where it starts? In the huddle. The morning huddle. I believe it. If your morning huddles are not constructive and upbeat, and happy, guess what, you’re going to be down the tubes for the rest of the day. And not only that, you’re just focused on making the money, you’re not focused on the people that are actually in the chair. We have to give back to them.
Howard: They're focused on making sure everybody pays but not making sure everyone stays.
Erin: Correct. I love that. I love that.
Howard: Yeah.
Erin: I mean, they’re focused on looking at the day sheet or looking through the charts. Oh let me see how many crowns I can get out of this person. Yes, if they need it, treat it, but remember the patient didn't do it for some reason because there's some circumstance and you have to be empathetic to that. You have to learn how to have some empathy somewhere.
Howard: I like the word empathy better than entrepreneur because if you really look closely to entrepreneurs, they have a high degree of empathy because they see you need something, so they build a company trying to get you what you need as opposed to them making something and then trying to sell it to you.
Erin: Trying to sell it to you. Right, exactly.
Howard: I'm not selling you something. I have empathy and I create a whole business trying to get you what I think you really, really need.
Erin: Correct. And making sure that you're happy along the way while I’m providing that need for you.
Howard: So, tell me what you like to do more. You like to speak to study clubs, you like to go into office and do consulting? What do you like to do? Do you put on programs in dental offices? Talk about how you get out there and help offices.
Erin: Well, right now I’m keeping it small. I want to grow bigger as far as doing presentations in front of larger study clubs because you have to get the message out there like you said earlier, so many people in the dental office are burned out. We have to get that momentum and that motivation and that action back into play. So if I can start small with that one person, that one assistant that is just always getting fussed at, foot put on their neck, they’re not doing anything right - I'll start there. If it’s in front of a group of five hundred, let’s do it there as well. But, we need to get back on track, as far as putting that motivation, and putting that feeling and that empathy back in the right place. It doesn't stop when you hit the door in the morning and then when you leave, because when you go home to your family, friends, dog or cat, you’re going to treat them better than you treated the patient who’s actually giving you two thousand, ten thousand, thirty thousand dollars for this service that you're providing to them.
Howard: I’m talking about hire on attitude, train for skill, you're saying that it all starts in the staff meeting. How many of these offices do you think one of their biggest problems is that on that team somebody is not a team player, somebody is toxic, someone is a morale booster? Do you think that's very common, common or not very common?
Erin: Very common. Highly common. And I believe sometimes when you're interviewing both for the leader and also the person looking to have the job, you need to know what you're looking for. You need to know what talent that you need to place in that office. And when you are interviewing for a job, you need to have a good understanding of what that office needs. It works both ways. But I believe that old saying, one bad apple can ruin the bunch. Don't be that bad apple.
Howard: It's so bizarre because every time I've ever had a dental office consultant come on the show or met one, I say, “When you go into an office what is the biggest most common problem you see?” and they go, “Oh my god, it's lucky if there's just one toxic person. Sometimes there’s two and you talk to someone who's done this ten, twenty, thirty years. About every decade they have to go in and fire the entire flipping team and start from scratch, they say. And now what's amazing is these big corporate chains, they used to just prefer to go out and acquire practices. They would roll them up, get a big line of credit and go buy them. But now they're all switching to starting new ones from scratch just because going in and buying an office and getting rid of the toxic people and turning around their morale, they've just found out through trial and error the last ten, twenty years that hell, we'd rather start an office from scratch and lose money for six to twelve months than go in and buy Henry's office and deal with the crazy toxic blah-blah.. Why do you think this problem is so common and allowed by dental offices owned by dentists?
Erin: Dr Farran, you know what, I believe you have to find that common denominator of who is the toxic one. It usually starts with one common denominator and it trickles down, you know, water flows downward. You have to address the problem with the initial toxicity and if you can try to hone in and fix the initial problem, the root of it, where it starts from, then morale can change. I truly believe that but people have to be vulnerable and transparent on what they think their own issue is so that it can be fixed. And it's no problem with being vulnerable. A lot of people are afraid to do that. They shouldn't be. Because guess what, if you are toxic, your patients are going to be toxic. And then that's why you keep complaining when Mary Sue comes in and she's smoking with her oxygen tank and it needs to be sitting right in the chair and it’s in your way. If you look at it differently, you take your own toxicity out of yourself, then it can be the better for everyone but you have to figure out what the common denominator, or who is the common denominator with that toxicity in the office. And it can start right there.
Howard; The other thing I always see in dental offices is, the dentist is in the operatory for an hour doing a root canal and as soon as she's done what does she do? She gets up and she goes to her private office and she shuts the door. You have your biggest expenses payroll, you have a whole team out there right now. The assistant and the hygienist are slugging it out and your receptionist is letting calls go to voicemail while she's surfing Facebook. Why aren’t you engaged with your number one investment, your number one expense? Why don't you engage with your team?
Erin: I ask that question all the time. Where's the disconnect.? Are we all just minions, so to speak? No, we're all individuals with separate lives. We're all there together. Matter of fact, when you're in the office you probably spend more time with everyone that you're working with than you do at home. So you have to nurture those relationships and collaborate. Everyone might not like doing the same thing but you have to have respect for what's going on in the office and understanding, making sure gaps are filled when they need to be filled. But you're right, don't talk down to anyone, let's all be positive. If someone has a problem in the office or they're going through something, maybe a death in the family, or they're just not financially making it, don’t go in your little corner with your clique and start talking about that person badly, that’s how things snowball. Let’s help each other.
Howard: A hundred times I've been at a dental convention or lecturing and I’m talking to some staff member and I’ll say, “Who’s your dentist?” The first thing they do is roll their eyes and say, “The guy right back there in the blue shirt.” I say, “Oh my god, either you need to man up and quit an office you shouldn't be working for someone that when someone says their name you roll your eyes. If you do something every single day that you don't like to do, for money, that's going to lead to disease and depression and alcoholism and kicking your dog and drowning your goldfish.
Erin: Constant headaches and body aches, we’re going to get aches and pains, I said that earlier. Not being well or doing the right thing makes your body hurt even more.
Howard: What do you do when you go into an office? Do you have them close down and you give a new lecture for two or three hours or do you work with the office while it's running? Talk about your consulting services.
Erin: I like to go in and see them at their norm, see what's going on, go in and say, “I'm not here to judge, just do your thing. I want to see how your normal day is. And then at the end of the day or at the end of the second day we can go on and talk about what I noticed. How do you think that could be better? I'm not there to dictate to you how you should run your office because you consultants come in and they're there for a day or two and they leave. What you need to do is go into the office and you have everyone else tell the consultant what you think how your office should run because it happens a lot, consultants come in, like I said stay, for a day or two, hurricane things up and leave you with the mess and you have to try to figure it out and I don’t think it should really work that way, I think the office should decide how it should run and again, you need work out the toxic stuff first, let's get that on the table, it’s off the record. Nobody’s going to have any judgment. No one's going to be mad next week because you said such-and-such about Mary was acting this way to Sally-sue. Let's not do that, let's get it on the table, let's leave it here and let's talk about how you want your office to run.
Howard: Techsforteeth.com on your blog you’ve got a share button. I love that article: “Three things patients look for in their dental care provider” and you’ve got a picture of my buddy Jack Nicholson in The Shining and I just retweeted that because right now everybody’s listening while they're driving so I retweet my guests on @HowardFarran. So I just retweeted to twenty thousand Twitter followers. Thank you so much for following me on Twitter. It’s free, it's cheap, it doesn't cost me a penny. But talk about that article. You talk about three things patients look for in their dental care provider.
Erin: Creativity, honesty and being organic. That means being yourself. Telling the truth about what's going on as far as what needs to be done and being creative, don't always give that patient the very low end treatment plan and then you skip to the very high end. Make sure you're giving that patient something in the middle and if we can't figure out, figure it out. Patients come to you for your expertise and your creativity. Give them that.
Howard: I'm fifty five. I’ve got grandchildren. People my age are on Desktop Dentaltown. The dentists and hygienists that download the app, they’re millennials and so podcasting is more a millennial thing. Most of my friends who are fifty five to sixty five, they don't know what Yelp is,they don't know what a podcast is and they don't know any of that stuff but these young kids they come out of school and they're sweet and they're shy and they just feel bad telling you, “Erin, you have eleven cavities and I can't do a regular cleaning and you have gum disease.” They just go to the tooth that’s bombed out and has to be pulled or root canaled and they do one-two dentistry because they're too sweet to tell you that your whole barn is falling down.
Erin: That's where the organic comes in. Be yourself first, matter of fact, ask the patient at that new patient exam, “Do you want me to be completely honest with you in everything that I see?” Get that permission from the patient. And if that patient says yes, be yourself, tell him what's going on. You have to make the patients aware of what's going on. That's where the whole thing of being organic comes from. You want to make sure you're being yourself and again forming these relationships because people are going to have more respect for you for being honest with them. Be honest with them and tell them the truth.
Howard: This is a this a marketing day bonanza for you. I just re-tweeted another one of your amazing articles to twenty three thousand on Twitter, called, “What do you mean I have bugs under my gums?”
Erin: How do you like that one?
Howard: And I just posted it on Facebook too but to talk about that one, what do you mean I have bugs under my gums?
Erin: In a particular office that I work in, we have a microscope. It’s all for validity. So if you're coming in as a new patient, guess what, I am going to take a plaque sample and we're going to go to that microscope together and we're going to see how much motility you have going on and you can just imagine the expletives that I get from people when they see how much activity they have. It is not to scare them but it’s just validity for us as oral health care providers to say, this is what's going on, that bacteria is real. This is what's causing that bleeding, this is what's causing that bone deterioration. It's real, it's here. You can see it for yourself. You saw me take the plaque, your plaque, put it on a slide, we went to the microscope together, you were with me, this is real.
Howard: Do you know who started the microscope?
Erin: Who did? Who started it? I know it's been around for years.
Howard: It was Paul Keyes, it was the Keyes technique. He just died February 20th of this year at the age of ninety nine and Ryan and I still have the biggest regret about that because when I started my podcasting I tried to get Paul Keyes on there but basically when I started the show he was 98. They're not on Skype or anything and I couldn't find anybody to go do it. And then when he died I thought, that was so dumb, we should have flown out there and got this guy. He was a legend to so many and I don't know why, I did this thirty years ago, you use it today. I need to get back into that because Omar Reid was the one who showed me the Keyes technique first. You would take a toothpick on a slide of someone clean and you could see the bacteria and everybody thought it was cool, but if you were really healthy the bacteria all looked like they were sleeping. And then you put some on there with someone who had perio and the bugs were doing backflips and somersaults and jumping jacks. And it was a very powerful teaching technique. And I don't know why I stopped doing that but you're doing it in your office?
Erin: I’m doing it in my office. Absolutely. You know, seeing is believing. A lot of people give you this excuse, “Oh my gums have always bled.” Well, it might be common but it's not normal. Bleeding is common, yes, but it's not normal to bleed. And I always give people the analogy of if, especially the ladies, you're going to get your fingers manicured and your nails done, if they're pushing back on your cuticles and you start seeing blood, that would be a problem right? Absolutely. It's almost the same thing, your gums are not supposed to bleed, if they bleed that's a sign of active disease and infection. And we need to take care of that.
Howard: I wish you'd make it an online CE course for us on Dentaltown. We have millennials, old guys like me go to conventions and every convention has been complaining for the last ten years that their annual attendance just keeps drifting down and it's because its moving to online. We’ve put up four hundred and fifty courses on Dentaltown and they're coming up on a million views. But dentists always want to learn the technical stuff on how to do root planing and curettage, how to do a root canal, but they never want to take a course on how do you sell, how do you get the person involved, how do you teach? And that microscope, that Keyes technique, that is a rebirth in dentistry.
Erin: And the funny thing about it is, patients end up teaching themselves because they see all of that going on on the screen, with the microscope you have it hooked up to a laptop or desktop computer, big enough screen so they can see everything going on and they start teaching themselves. They say, “You don't have to show me that again” especially when I tell them that a lot of this can be transferable. If it’s going on with girlfriend boyfriend, guess what, you might be having the same bacteria. That gets them on board as well.
Howard: I got to school in 87 and the first guy that died in my dental school class actually died of HIV/AIDS. That was the first class member we lost. And I still think it's bizarre that now I've been out of school thirty years, and the whole planet, because of AIDS, understands disease transmission below the belt. Today, the whole planet doesn't get that you can't treat grandma every three months for periodontal disease and you never seen grandpa and her kiss each other every night and then grandpa shows up and he's got a bombed out molar, he’s got nine millimetre pockets. Would you have treated grandma for gonorrhoea every three months for ten years without ever asking to see grandpa?
Erin: Exactly.
Howard: Even when you tell patients they look at you, “Really, I can catch decay?” and what I tell them is, “If you went out in your backyard and you saw a giraffe, wouldn't you first ask, where the hell did this giraffe come from? That giraffe just evolved in my backyard and that giraffe came from a momma and daddy giraffe somewhere. And when you're born, you don't have in your mouth, streptococcus mutans that causes cavities, P gingivalis, HIV, your babies aren't born with chlamydia. This all comes from somewhere. And so you have to treat a family and when you start talking to a family, my biggest passion is when a little girl comes and is pregnant and I learned this from, the only people that got religion on this are in Austria, Germany and Liechtenstein. They get this girl in there and they say, “Look you're pregnant with a baby. And that's her diseases. Most of these diseases your baby's going to get its whole life are going to come from another monkey in the herd. So I need a complete list of who's going to kiss this baby, share a spoon with it, blow on its food.”
Erin: Put the pacifier in their mouth and then put the pacifier in the baby's mouth. Come on.
Howard: They'll get the entire family all checked out. They will culture their saliva to see if they can culture streptococcus mutans out of their saliva, and the company that sells that technology is Ivoclar. Ivoclar won't even market it in the United States because no one will even buy it. They said that the only people that understand epidemiology in dentistry, live in Lichtenstein, Germany and Austria. And you go talk to a dentist in Austria and he’ll say things like, “Yeah, I have eighteen hundred patients and six hundred of them are under eighteen and four hundred of them still don't test positive to streptococcus mutans, and then in America you have a newborn baby, you hand it to your grandma who's got an upper partial lower denture and hasn’t had a cleaning in six weeks and she gives it a slobber kiss right on the mouth...
Erin: On the mouth, right.
Howard: And you could start training these little pregnant girls and say don't let grandma or grandpa kiss this baby unless I've seen them and can tell you they are disease free. We don't want to transmit.
Last question, I can't believe we've been yakking for an hour. My god, that was a fast hour. My last question to you is, my biggest passion is, when they talk about the oral health continuum. America’s about “Money’s the answer, what's the question?” I listened to (inaudible 55:39 United Concordia), their dental director used to be the Executive Director of the American Dental Association. But they were saying the most expensive thing on the oral health continuum is that pregnant girls with gingivitis or periodontal disease have pre-terms and the most expensive thing on a health insurance rate, if you drop a one pound baby, at the minimum that's going to cost me a million dollars, that baby’s going to be in ICU for a year. And so they're starting to realize that when they're insuring young girls in reproductive years, that it's cheaper to cover your cleaning exam and X-ray because they don't want you to drop a premature baby. And I think that might be the first oral health continuum where medical insurance companies are saying, “If I'm going to cover Erin and there's any chance she's gonna get pregnant this year she's got to get her teeth cleaned.” How close do you think we are before getting health insurance and dentists and hygienists to really realize that the money spot is a pregnant girl because we don't want her to have the baby and then let grandpa kiss it on the mouth. And we don't want her to drop that baby out of the oven because of periodontal disease?
Erin: Well you know Dr. Farran, I don't think we're that close because we have to get out of the mindset of only wanting to make the money. Again like I said earlier, we have to make sure that we are treating the people that are attached to the teeth. And until we get to that concept of understanding that there are people attached to these teeth, I don't think we're that close.
Howard: Well if anybody’s gonna make us all get closer it's going to be you and your amazing karma and energy. I've done a thousand podcasts, you're the only one who has lit candles during the podcasts.
Erin: How do you like that zen, do you like that?
Howard: I love it. Read all these things behind you, what does it all say? “Live joyfully, laugh.” Read some of them.
Erin: The happiest people don't have the best of everything, they just make the best of everything.” Right? Then you have, “Love affectionately, live joyfully, listen carefully.” I'm all about listening, that is one of my (inaudible 58:26), I'm all about listening to people and giving people a voice. And, “Hug tightly and forgive freely.” We talked about that earlier, you’ve got to forgive.
Howard: For the record, I contacted Erin, she did not contact me. It was a huge honour. I love your website, Techsforteeth. I hope you contact her, I hope you have her come in your office, speak to your next group. I hope you make an online CE course for Dentaltown. I love everything about you Erin. The only thing I don't like about you is your football team, you should only be supporting the Arizona Cardinals.
Erin: Right, okay. I’ll go get a hat today. How about that?
Howard: You'll get a Cardinals hat just for me? But thank you for all that you do for your patients, for dentistry and it was just an honor and a privilege to be able to podcast interview you.
Erin: Thank you for having me Doctor Farran and I appreciate the opportunity. Thank you so much.
Howard: Okay, well, always call me Howard. And thank you Ryan. Thank you so much Erin, I hope you have a rocking hot day.