For our 1000th episode, Howard did what he does best at this year’s 2018 Townie Meeting. Howard rants on practice management, profitability, dental industry trends, and so much more in this hilarious, 75-minute seminar. The first 50 people to register for next year’s Townie Meeting will receive special discounted pricing! For more information visit www.TownieMeeting.com
VIDEO - DUwHF #1000 - Howard Farran
AUDIO - DUwHF #1000 - Howard Farran
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Tom Giacobbi: I have the privilege and honor of introducing my mentor, and who is a mentor but somebody that pushes you out of your comfort zone, encourages you to do things you haven't done before. I first met my mentor in a hotel in Orlando in 1996. I'll let him tell you what happened that night, but that was a night that changed my life. It was also my honeymoon. Two years later, I moved to Arizona. Two years after that I started working for Dr Howard Farran, who's not only a DDS but an MAGD and an MBA and sometimes an NSFW. We've been working together for eighteen years and I've had the privilege of watching him chase his life's passion, making dentistry great again. Please give a warm welcome to Dr Howard Farran.
Howard: Let's give it up for Tom Giacobbi, the editor of Dentaltown for eighteen years. So basically, I got one hour, a hundred slides, so let's try to light this candle. Basically the end of the dark ages actually came from Technology. 1440, Gutenberg's printing press, before 1440, everything you learned you took to the grave with you, maybe you shared it with your children, but you certainly didn't share it to the next county, the next country. It was never archived. It was actually the printing press; 1690 was the newspaper, America invented the newspaper, 1731 magazines, I believe that was France. There was a telegraph, the telephone. I think this one is the most exciting. This shows you how you got to think outside the box. Silent films came out in 1891 and they had phonographs. They had records. It took monkeys forty years before they added sound to the movies, which is so obvious; but it took forty years.
I always think about that, like what other obvious things are out there? And if you think forty years to add sound to film was bad,do you know how long it took to add chocolate to peanut butter? I mean that was, that was even worse. Then the computer came out, the email, ‘72 Microsoft, Apple came out in ‘76, the year after Microsoft. But here's an interesting thing; the Arabina, this is the backbone of Dentaltown, what was the Internet, all about? Do you remember what it actually was? The whole nuclear war scenario is under a mountain in southern Colorado. You guys know where that is, that mountain is? The whole nuclear war deal takes place under there. They got years worth of waters, the buildings on springs. It’s bomb proof. And they were afraid Washington, if the Russian set a nuclear bomb first and blew up the phone lines between DC and Colorado, somewhere over Kansas, Nebraska, Missouri, they couldn't communicate. They asked their scientists, “What can we do?” And they invented the Internet. They said, “We could break up this message, send it over every available wire there is, it might even go the other way; it might go from Washington to London, even through our enemies, hands of Moscow, come back the other side of the Cheyenne Mountain.” And that was the internet. And they did it. And they did it on this invention here; the CBBS to figure all this out they invented the computerized bulletin board system. That's what Dentaltown is on. And the email started in ‘72. I first did Internet social media member, it was Internet dental forum, it was route ZX for endo, it was generation next, it was dentists@compuserve, but you'd open up your email and be eighteen million endless emails, and you couldn't find the important one from your mom.
All social media did in the beginning is move it out of your email and into another website or an app like Friendster and then MySpace, and Facebook and Twitter and Linkedin and Instagram and Snap and all these weird things, which is great. I do them all. But it's fun for pictures. It's fun for birthdays. I love cats personally a lot, but it's not for organizing your material. It's not for learning how to do a root canal. It's not, it's not searchable. I still think that computerized bulletin board system is best for deep information. And then there were a Sisco, AOL and then all Dentaltown has ever done, we've ever done, we've never had a single original idea. And we came out with a friend report in 1994. That was Jerome Smith. It came out in the Farran report because I was lecturing around and I was hearing all these great ideas. When I was having lunch and breakfast with you, I was talking you into writing an article and I was sending stuff at you one way. But then when we saw the Internet we renamed it to Dentaltown because it no longer was Farran; me to you. It was flat on the board; we all just equally shared. So we can with dentaltown computerized bulletin board system in ‘99. And then we added banner ads, and promotions. And I thank you so much for the people. That's how we monetize the site. So whenever you opt into the email, I mean to pay for that whole thing, all you have to do is opt in to the email and even if you don't want to read the banner ad, I just click it.
And then I was in Phoenix, Arizona where there was University of Phoenix online.
This is how slow my walnut brain is. It launched in ‘94 and every time I went to the airport I would have to drive past the University of Phoenix online. And then after another year it was two buildings, and then it was like three buildings. It was ten buildings long before I finally said, “Maybe we should do that,” you know, I had to drive by ten buildings. They named the football field, University of Phoenix online. Finally we started dentaltownonline.ce. Where's Hogo? This is the man responsible for this. Unbelievable.
Pretty cool that you're first in class in the online university. I can't think of any place you could go. There's some specialized sites that just do implants. There are some specialized skills that just do one thing or another, but to have four-hundred-fifty different courses-- by the way, when Hogo goes through the Aba renewal process, he's like a grouch for like at least what ninety days? It's ridiculous. But thank you Hogo for doing that. It's amazing. We have courses like the infamous Sandy Pardue who's my mentor and idol and now her young protege. By the way, this is townie meeting sixteen, when I first met her she was twenty. Right now she's thirty-seven and it looks like she's twelve. When I first met her she was nineteen, and looked like she was nine. I can remember her bringing to these meetings. I was like, “Oh, she's so cute.” Like she's, she's out of high school. And I'm like, “Wow, really?”
We just got everything from A to Z. Then blogs came out, and now podcasts are just amazing. I started the genre, the only reason I started my podcast is because you kept telling us what to do. Ken Scott, the original programmer, stand up Ken, he's the original programmer of Dentaltown. He was outsourced. We, hired you through outsource at what ‘98?
Ken: It was ‘99.
Howard: It was ‘99, and then you joined our team, you quit the company we were outsourcing with, IS was it? Joined our team, but I would say that Ken’s team of five programmers were at least a year behind the whole twenty years. You telling us what you want, we have a to-do list. That to-do list is always a year in advance. You were sending all these emails saying, “I have an hour commute to work, I'm listening to talk radio. If I hear one more thing about Hillary and Bengazi and Trump and Isis...and by the time you get to work, you're suicidal. You don't want to live, you hate life.” And now podcasts are more popular than radio, just because radio is so toxic. I mean it's absolutely--you listen to radio and you start fighting with your own sister. The next thing you know you're yelling at your sister and you're like, “Who got me worked up in a frenzy?” And it's talk radio. I hate talking radio. So I just started it because we're user-generated content. And you users, I mean we got sixty people. The views are crazy. Look at this guy. Is he here in the room today? How to open a dental office? He's outside? I mean look at that; six hundred eighty six thousand views and people say, “How is that possible?”
Well, dentaltown has a quarter million dentists and they have to drive an hour each way to work. And when I started doing a podcast, people who liked the show says, “Can you do two shows a day because I have an hour each way?” And I'm like, “No, I can't do ten hours a week, can you?” What's really cool is people just, because we see the metrics, people will open up their APP, they'll get in their car and they're like, What am I in the mood for?” And don't ever think in fear and scarcity. I mean, I've asked some people to come to my show and they go, “Well, I can't because I write for a different magazine, or I have my own podcasts.” Like, dude, I've never met a dentist in the world that red one magazine or listened to one podcast. Why do you think in fear and scarcity? Think in hope, growth and abundance! I've invited every editor of every dental magazine, every person of every other podcasts. I don't think in fear and scarcity; I think in hope growth and abundance.
It's the same thing with the dentist across the street from me. When I opened up my practice, I ran across the street. I mean you leave school, and it was sad to leave dental school because you're like, “I don't know if I'll ever find this many alcoholics that hanging out with again.” And so then I moved to Phoenix. I run across the street and half the dentists are like, didn't want to meet me, shut the door, it was like, “We don't need another dentist around here.” And it was all fear and scarcity, and then the other half are like, “Oh my God, come on in.
Analysts charcoal, have a hamburger. Let's hang.” Same thing with specialists. I'd asked some endodontists if I could watch. They'd say, “Well actually that's how I make my living. I mean if you can't do the root canal, you should do what's best for the patient and send it to me.” And I'm like, “Okay, you’re a dick, next?” Then the ones that would say, “Oh yeah, anytime you got to opening, you just pull up a chair.” Same thing with orthodontists and invisalign, you know, I've lectured in fifty countries, in every city there was always one, just one orthodontist who thought in abundance said, you know what? They're all going to do invisalign, but I don't want to do the terrible cases and I don't want him to do open faces, open jaws, screw everything up. They would sit there and say, “Hey, if you're doing an invisalign case, the last Thursday of every month, bring your case to my office, I'm having invisalign study clubs. Just bring your cases down.” Who has the largest orthodontic office in every one of those cities? The average, general dentist that gets all into Ortho of them quit within two years. And then they usually call the guy up and say, “Will you finish my six invisalign cases?” Who do they send all the referrals to? I mean, it's just amazing how, when you think in abundance; like a periodontist, if you sit there and the young kids, “I want to watch you do periodontal surgery.” Well, he's not going to do it all on four. He's not going to start off with sinus lives. I mean, he's going to start in a relationship and you want fifty percent of something. You don't want one hundred percent of nothing. Every time you think in fear and scarcity, it's always going to come back to bite you in the butt. It's always a bad idea.
Now we have fifty different podcasts and they're just amazing. I just did one. I just passed my one thousandth podcasts and I gotta give credit to Ryan for that. Thank you, Ryan. He's my third son. He's tall. He's handsome. I really don't think he's my son. I refused to do DNA testing on my four children because there are too tall or too handsome and I'm pretty damn sure none of them are mine. But, the bottom line is Ryan, you writes his own music. He makes music, he puts it on Soundcloud, and when he graduated from college he said, “Dad, you're podcast is lame. You need some help.” And I said, “Come on down,” and he makes me look fancy. We've done just amazing Stanley Malamed, Dawson and inclusion, and I want you younger kids to think, to realize, you come out of school and you're taught that these guys are Gods. But if you flip back every hundred years, everything's always wrong. What were the first four elements? Earth, wind, fire and water. What do we have to now? Ninety-three.? I mean, these guys are legends, but history will prove you one thing; every generation will prove that their parents were as dumb as they thought they were. Okay? Like on occlusion; I said to him, I said, you know, when you look at other epidemiological international studies, it pretty much shows that humans have like five spasms when they're stressed. They have brain spasms, which is a migraine headache. And I know you think it's from gluten and dark chocolate. And I, I get it. You have, tmj grinding, you have the whole chiropractor, lower back pain, you have irritable bowel syndrome, and I'm smelling something over here a little, somebody's stressed, I'm smelling stress, and then you have the cardiac deal, and the bottom line is; of all the stresses, I'd rather have the TMJ. I don't want to be farting all the time.I don't want a heart attack. I don't want a migraine. I don’t want my back to go out. Grinding your teeth is pretty good, but when you say to him, you think there's any chance it might be psychological? “No!” I mean, she's grinding her teeth and her husband's having an affair. Her daughter's a hooker. Her son's addicted to opioids. She's unemployed, her credit cards maxed. Does that have anything to do with it now? “No. So all you have to do is adjust the mesial buccal cusp of number three and get that proceed on number thirty and all their problems will go away.” I mean they crazy, but when you're young it's hard for you to come out and say, “Excuse me, but I call bullshit. I think you're bat shit crazy.” But remember this; historically, your parents are always wrong about at least fifty percent of everything they told you in our dental leads are no different.
Treating the warned in Titian sinus lifts are amazing. And what I love about the Internet, I think he's the smartest guy on sinus lifts. Where, where's he from? Hogo? Romania. You say Europe. What was your next guess; Eastern hemisphere? Anybody know where he's from? He's Poland, okay. And just amazing. This guy is from Taiwan, it is so amazing how the Americans do all these orthognathic surgeries. The Taiwanese never do. They get the same results, you’re breaking it all these jaws and moving them forward and they're tilting them with bone screws. And that's what I love about the Internet, because everybody thinks America's the greatest country in the world. I've lectured to dentists in fifty countries and America is number one in military, medicine, banking, insurance, finance, movies, and music. But your cars suck, cars are made in Germany and Japan. If your car wasn't made in Germany, Japan, I'm sorry. You know, I hope it came with a mechanic. You’re number thirty-eight in education. Your life expectancy, which when I was little I thought goes up every year, it's gone down three years in a row. It's going down. And on that note, does anybody have any vicodin they can share with the crowd? Or, Fentanyl? No.
Other things that really matter; demographics matter. Now I know of 160 offices, you know, someone will do good in there, but we still have a situation where two thirds of the dentist go to the one hundred forty big metros and the other one third of the dentists go to where the other half live in 19,008 towns. I mean, people, we have 10 percent of the counties in Kansas, Iowa, Nebraska.
Ten percent don't have a dentist and I have podcasted at several and you know who are the only ones that go out? They're Mormons. You know why? They have two, three kids in dental school. They come out of half million dollars, that they don't need a nightlife, their nightlife is their family. Their party is all in the house. They don't need fancy restaurant there. Wife knows how to cook. If you want to hide something from your wife, you put it in the microwave or the oven, but the bottom line is they'll go to a county and they'll go to a city of two thousand five hundred people, but there's six thousand in the county. They don't take one PPO, no insurance, no nothing. They'll charge twelve hundred for a crown. Twelve hundred for a molar root canal, three hundred. They'll do a million for the first year and take home four hundred thousand.
I have helped them where they go to a town and they'll go to a town, say, well, “I'm thinking about going, I'm not sure which town and see there's this sort of that one.” The city, the mayor will take them to first street and main show them six vacant buildings. “You want one of these buildings?” “Yeah, I'll take that building over there. It's yours. Here's the paperwork.” They'll go to the only bank in town. “Are you? Are you going to live here?” “Yeah. Signature loan.” I mean. in those small towns a great job is ten dollars an hour, so they're running like eighteen percent labor, fifty percent overhead, zero competition and then you say, “Well I don't, want to go. I don't want to go to Blythe.” And I'm like, “Dude, your mom came from Pakistan and your mom moved fifteen thousand miles for your ass, and you can’t go an hour out of town?”
In fact, usually when you commute, you wake up in the morning, and you wake up in a house that's an area of about one dentist for two thousand. Then you commute an hour into town, by the time you get out of your car, you’re at one dentist for five hundred, but if you would have woken up and commuted an hour the other way out of town, you'd have found some town that has eleven hundred people, no dentist, but the draws like three or four thousand, no PPO, no medicaid. And this is why I'm against the pew, the dental therapists, because what I hate about liberals is really; what I do, what I hate about liberals ais they want to have a half trained doctor to treat the poor. First thing I say is, “Well, when you get sick do you want to half trained doctor? When your daughter gets sick, are you going to find a half trained doctor? Oh no, you're going to find Mayo Clinic and the Cleveland Clinic. But for the little people, they could just have a half trained doctor.”
And the bottom line is when you're a doctor, when you come out of school, you just graduated from dental kindergarten. It'll take you five years just to find your ass with both hands. Okay? And here's what we know about the underserved as privilege. Here's what we know; the problem is the deans of the dental school, if I fill up the class with a bunch of girls from Beverly Hills, how many of them, when they graduate, going to go east to Bakersfield? But see, who goes rural when they bring in rural? So, in my first book, the business of Dentistry, I always tell them these dentists, “You're in Kansas, you're three hours from Wichita, your three and a half hours in Kansas City.There's no hygienists out there. So go to your local high school, have an essay competition on why I want to be a hygienist.” And then whoever wins, I mean how much is hygiene school? Two thousand a semester; just pay for it. There's one guy called me up and he said, well, I had two. What should I do? I said send them both. But what happened in every one of those cases; they never got accepted into hygiene school because they didn't have a 3.85 grade point average. So your dental school dean, thinks that Clay Center, Kansas would be better to have no hygienist than a hygienist with poor geometry skills.
And it's the same thing in small towns that I'm driving around Arizona. We've gone to mines. We visited mines and I say to the guy, well, “What is your biggest problem out here?” And he goes, “We need mechanical engineers,” but they fill up ASU with a bunch of kids from Tempe and Scottsdale and Phoenix who got straight a's in calculus and not one of them will go. And then when the little kids from here apply to ASU, they don't get accepted because their grade point average in high enough. What we need to do as the first dean that figured this out, he's my idol. I know almost everyone disagrees. The Guy, who was Jack Dillenberg, he said “The Indian reservations don't need some government Indian public health service. You know what they need? They need dentists who are Indians,” and every single native American Indian that applied to Jack Dillenberg school he accepted, and when they all graduated guests where they went back? Do you think a Navajo Indian wants to practice in Scottsdale? No, he's Navajo. He wants to go home!
So if pew wants people in the rural, and see, and I hate the California Dental Schools, and you look at everything for dental schools publish, they'll say, “USC, which of course, you know, had the highest freshman GPA class of any of the six schools in California coming in at a 3.67, UFP was only a three point six. And what does UCLA, they're down there at the bottom at three point five those whores.” And it's that type of thinking that screws half of America. All they want to do is make the list on US news and World Report of the best damn school and they shouldn't be doing the best damn school. Those schools, half the tax dollars in America coming from the rural, and they get and they get no attention. They get no talent. They get no students and their demographics matter.
You will sit there and tell me you're going to buy a practice. Then I will ask you what the demographics are, and you're about to buy, the average dental practice is seven hundred fifty thousand dollars, and you don't even have a demographic report on it. There's a couple of companies; Real Score does it, I podcast about them, there's David James of Real Score. The other guy was out of Utah; Dr. Demographics, demographics matter, and if you say to me, “Well Howard, they don't matter. I mean you're all that and a bag of chips, it doesn't matter.” And I said, “Great. Go set up in Somalia for a year, and then after a year come talk to me. Then go to Syria, Iraq and Afghanistan. Just have a multiple chain dental office all throughout the third world, and one day you'll say, you know what? Maybe demographics do matter.” Okay? Demographics matter big time.
You don't have to do any other research. Pew does all the research, every single state they show you like in Arizona, every single state, every single city that doesn't have a dentist, every county. And the other thing that I think that is going to be a game changer is you might say, “I don't want to drive two hours, you know, I want to hang out in Kansas City,” but you realize we're this far away from driverless cars? I'm in Phoenix, Arizona, where Google starting with the driverless car program, I see them every day and it's really going to change the world because you knew who loves it the most? Grandma and Grandpa got their license taken away and they can't drive. And she hates that. Now she's eighty-five years old. She's in her driverless car going to the Catholic Church to play Bingo. And alcoholics love it.It's really going to put downward pressures on Duis because if your ship face, you just sit in the back seat and go to where you need to go. I heard that from a friend, just a friend told me all about that. You know, what's going to be; what it's going to be in the future as you might wake up at 6:00 and just, and your driverless car, it'll just be a box with maybe a bed in it, and you'll get up at six, go back to bed in your little box, and two hours later I'll go ding, ding, ding, you're here. And then you might work a three, ten hour days in Blythe, Arizona where they don't have a dentist, and then when you're done on day three, it might be 6:00 PM and you might live in Scottsdale and used to go get in your little box and go to sleep or watch a movie, pass out, wake up two, three hours later and your home in Scottsdale.
I think driverless cars is going to push these urban densities further out into the rural because the drive time is not going to matter. When I'm trying to look at business models, my oldest sister's a Cloistered Carmelite Catholic nun and you know, and she can read like seven different languages. And she used to always tell me that if you read Hinduism, Islam, Buddhism, Christianity, all of the major religions, there's not one name, city, person, place, there is nothing in common with every major religion except the quell; treat other people like you want to be treated, the golden rule. And so I always look at the deal and for me clarity is; if I died tomorrow, is this a dental office I want my four boys to go to? And now I'm sitting here say if I died tomorrow, is this where I wasn't Taylor to go through?
Or my little granddaughter in the back row, Riaa who is, she looks like she wants down grandma. Just let her down Grandma. Come here, Riaa, where you going? Riaa once out of the deal. So we know she doesn't want to be a dentist. And she loves Grandpa we know she has a poor taste in men.
So, basically, these are why people don't like DSO’s, they don't want to hear things like every six millimeter pocket needs a periochip. Thirty percent of your new patients shouldn't need four quads root [unintelligible - 00:27:06]. How would you like if you went to a family physician and he said 30 percent of all new patients should have chlamydia. And you're like, I dunno, I thought you had to have chlamydia to be diagnosed. I mean, how do you have business people that never saw the patient telling you what percent has to have perio and what percent has to have-- and they're demoralized and these DSO’s don't realize.
I mean, look at their staff turnover. I mean, they're not even holding their associates for a year or two on average. So I always look at that dental office and think, what type of office, what type of environment do I want little Taylor to go to, or my grandson? Another thing I want you to think about it is; most people never achieve their dreams because of your self-limiting beliefs. I mean, you get mad at your friends who are hard on you or something rude to you. You say the meanest things to yourself. You are the meanest person that you ever met. And let me give me some examples. Like the average new car, according to Kelley Blue Book is thirty-three thousand, the average American from birth to death will buy thirteen new cars. And then I asked you, how many of you have never done a single thirty-three thousand dollar treatment plan?
In every city, in every zip code, there is a dentist doing two to three million a year. Because once a week, fifty times a year, he convinces you to just get a new car, take out all your shit, replace it, implants, crowns, bridges, sinus lifts just as a new car. And they find it. And only ten percent of Americans buy their new cars with cash. And they're usually women over sixty-five. They're widows. That's who usually buys houses and cars in cash. It's always widow woman. The old man died and she's like, I'm getting a convertible. I'm getting a new house. I get a Cabana boy, boyfriend on the side, I want to get my teeth all done, all that stuff. But the bottom line is how come? And I was in Derby, Kansas, have lunch. And then in coffee again, just two weeks ago, I home visiting mom, and I was sitting there and talking to this dentist. He was telling me, “Well you don't understand round middle of Derby, Kansas, no freaking money out here, this is butt poor area. I mean there's no money here,” and we're sitting at this little restaurant and I can see the QT across the and I said, “How many cars are at the gas station right now?” He goes, “Cars or trucks?” I said, “It's the same damn thing, on four wheels.” He said, “Nine.” I said, “How many of them are F150 pickup trucks?” And he said, “Six,” and how much are they? Fifty grand. Fifty grand, but what does it cost fully loaded? Eighty-five. So here we are out in the middle of bumble butt nowhere and I'm looking at six F150 pickup trucks that are fifty to eighty five thousand. And it was crazy, I saw this older farm lady, I mean to get in the damn thing, she had to grab some bar, hike up her foot then grab it with the other hand. I didn't think she's going to get her fat ass in the truck. I thought some cowboy was going to have to come and say, “On three, on three.” And I said to them, I said, “In your lifetime, you’re as old as me, how many thirty thousand dollars treatment plans have you ever done?” He said, “None. Never.” See? It's all. It's my favorite Michael Jackson song; always Man in the Mirror. It's you baby, but you want to blame it on Obama and Benghazi and some emails and Putin and Isis. Like terrorism; you're always worried about terrorism. Fifty Americans die each year from their own TV falling on them.You're afraid of airplanes. Nobody died last year in a commercial airplane, forty thousand died driving their own damn car. You're always believing shit that ain't real. You're always afraid of monsters and ghosts that don't exist. But the bottom line is this is you, baby, and you know who sold her that car? A car salesman. You're getting your ass handed to you by a used car salesman. You can't beat a used car salesman, really?
You're not even trying. And then, this guy is from Georgia. He's a ten thousand dollar a day dentist, and the first thing people always say is they say, “Well, I don't even believe you.” I used to have a course and it dealt with how to get into a dental office, no money down. But I quit talking about it because when you say that, how to get in a dental office with no money down, what do all my homies think? “Oh, bullshit. That's bullshit. He's liar. What is he talking about? I used to want to listen to that guy. Now he's full of Shit.” What did I do? I graduated dental school. I sit there, I went to this twenty-four acres, Safeway, Walgreens, Chase Bank, Pizza Hut center. I want them to a landlord. I said, “How much is that bay?”
Two Thousand Square feet. He said, “It's fifteen dollars a square foot a year on a three year lease. I said, fine, I want twenty dollar per square foot lease for five years.” He goes, “Okay, so obviously you want me to do the build out?” And I said, “Yeah.” So I gave him the build-up plans. I got it shopped out by three people. They were all thirty thousand. He starts laughing. He goes, “Oh my God, they're going to screw you. I can do this for ten.” Those guys said they would take four months to build it out. How long did it take the guy who built the whole twenty-four acres, Safeway Center to build it out? Thirty days? Nothing. Build it out. Then I went down to Patterson, picked out all the finest shit. They said, okay, be eighty thousand cash. I said, well actually I don't have a freaking dime, so I want you to put it in there on a sixty month lease to own.
They go, “We can’t do that.” And I said, “Well sucks to be you just lost eighty thousand dollar sales.” Left the office, branch manager called me back the next morning, said, “About that eighty thousand dollar purchase on that five year lease to own.” So I got the whole damn build out, got all my damn equipment. Had the whole office built out. I walked in there. I walked into a dental office with no money down. I mean it was just. And then what was my marketing? I went over to Safeway, Guy said, “Who's the manager here?” And he said, “Me,” I said, “Hey, are you married?” And luckily he was not married, he had no kids. I was like, yes! I said, “I'll do all your dentistry for free if on your twelve checkout lanes I can put a stack of flyers for Today’s Dental. And whenever your stacking up groceries, just put one flyer in each sack.” He goes, “Hell yeah, let's do it.” Then I went over to the beauty salon. I said, “I'll do your before and after if you put the before and after above your deal,” because she has her own tribe going. I did a bleaching on her, but what she wanted to do is veneers. I did my first veneer case on her. They look like straight out of chicklet toilet bowl USA. And she was such a born in the barn. He was from Iowa. She was so born in the barn. She thought they were perfect. And I mean it was just amazing. Then what do they do? I know tribes, I went to each one of the--there were nineteen churches, told everyone some dentist as all my sisters dentistry for free at the cluster cart monetary and a lake ELMO, Minnesota. Another dentist gave me his name is doing all of the Dentistry for free at the Macca Heart of Mary, my other were nine in Wichita, Kansas.
So I said to each one of those churches, “So to pay back, I will do you for free. That's what we like Catholic priests the most because just the priest, no one else.” Fricking Lutheran had like five kids, you know, a wife and all this bullshit. And so what do I do? So at the 19 churches in Ahwatukee, I think twelve took it up on me. So, what do they have on their bulletin? “The Church would like to thank Dr Howard Farran for fixing up pastor Don's teeth and blah, blah, blah.” I had all these old ladies coming in, “You’re the pastor’s dentist?” Yeah. I mean it was like shooting fish in a barrel.
It was, I had a million dollar practice the first year because I hustled; I was out running for mayor, I was pressing the flesh. This is all possible. So we look at why dental care is coming down. What do we see? Dental utilization is coming down. Everybody always points first to cost because cost the big deal, but cost isn't a big deal because Americans always find the money for what they need. I mean, think of what they will do when they need a dime bag of weed. Think what they'll do when they need fifty fentanyl; they'll find the money. They might steal your car, they might flip a trick behind the dumpster at KFC, but they'll get the damn money if they want it. They want it, they're going to get the money. The problem is; you don't convince them they need it. They have dental benefits, but you know, dental benefits are real. A lot of people take a lot of them, but you take it too serious because again, when you bought your iPhone, did you use dental insurance? When you bought your car did use dental insurance? What about your house? Last time you bought a dime bag of weed? Did you use insurance?
So you know, you're in this belief that insurance matters. And then I've lectured in fifty countries and six continents, the only continent I haven't lectured in Antarctica. I would love to lecture in Antarctica because penguins look just like my sister. Every time I seen Islamic girl in the veil, I just see a nun. I mean, I don't even, I don't even see a Muslim. I just see another sister, Mary Alisha at blessed sacrament. But the bottom line is, the dental benefits is your own self limiting beliefs. You're the one that walks in there and says, “Well, you know, okay, you know, your insurance will they cover a thousand and the worst in your mouth is the molar, so if we did a root canal, we could do a root canal to build up this year. And then you'd be exhausted for the year. And then on January first we could start the crown.”
I mean, you're the one bringing it up. It's your self limiting beliefs. You didn't present the seven thousand treatment plan, just say, “Yeah, your insurance will pay. The Max is a thousand, but your six thousand dollars,” and your health history, it's don't even asking credit way. You ask questions that are so bizarre. I'll never forget, I opened up my practice and this man wanted to see me alone in my office. And so Jan took him back there and she's back there with me and he wanted her to leave. So she and I thought, God, what did I do? I just met this guy. How am I in trouble? I was like running through my mind what I did. And then he starts telling me that if at the end during World War II had a three day pass to the Philippines and that was when he caught gonorrhea and he's so sorry, but he's never told anyone.
And I'm like, “Why are you telling me this?” Because my health histories that I xeroxed from University of Missouri, Kansas City asked if you've ever had gonorrhea and syphilis as like, I don't even care. I mean, “Do you have gonorrhea or syphilis,” these are questions you ask in a bar. Okay. Not In a dental office. So what I do, I pulled out all those questions and I wanted to get in their brain, I wanted to sit there and say, “Why did you leave your last dentist, what did you like the most about your last dentist?” Oh, “He had nitrous oxide. He can knock me out. He took my insurance,” or whatever it is. And then you ask credit questions. “How long have you had your current job? How long have you lived in your current job, ask all the credit shit it questions, and then when you get done with your six thousand dollar treatment plan, you don't walk in there and say, “well, you know, your insurance only has a thousand so we can only do half a one tooth this year. And then January first we can do the other half of one.” “If we did everything that you and the doctor wanted to do, you have excellent credit. I already put it through through carecredit, it's only three hundred thirty-one a month for sixty months. And you could walk out here with a perfect smile. Does that sound like something you want to do?” And there's only one number she’s thinking. Three thirty-one a month. “Hell yeah. Let's do it!” See you’re going for it. I don't care if you had chlamydia. We're not having sex. We're going to do a crown. Okay? We're going to do a felling. I remember when the AIDS come out in 1989. Every old lady would always ask me “Dr. Farran, you sterilize your drills?” And I'd say, “Oh yes, but why do you ask?” “Well, I'm concerned about aids.” And I opened my drawer and I said, “Well AIDS is a sexually transmitted disease. And I'd pull out a condom and I'd hand her and said if you put the condom on me, I’ll wear it. I mean, you know, if you want maximum protection when I'm doing a filling, I’ll wear the condom. But I ain't putting it on. You put it on, I’ll wear it. Okay?” And then I’d say to her, I said, “If your husband came home with gonorrhea and he said, “Well, my hygienists had an infected prophy machine, would you buy that? Because if you believe that shit, I want to marry you right now.”
I mean, so the bottom line is; just talk straight with these people. When we go through dentistry CPA's, is Tim Loughton here? He's at his booth. I'm telling you, here's the problem with dentistry. Here’s the biggest problem with dentistry. Anybody individually gotta lid for this thing? So you sell, you know, in business, if you go to Seven-11, they say we buy this for ninety cents and we sell it for a dollar. So we make a dime on each one now. But what we see in dentistry is I say, “Well, how much did it cost you? They just scheduled you to do two MOD composites in room four, what did that cost you?” You have no idea. And then you take a half dozen different PPO’s. So when I asked, “Well how much you get for an MOD composite?”
You always say, “Oh, you're like two hundred fifty.” Dude. Delta tells you your fees. That's a PPO. Ninety-five percent of dentists take Delta, ninety-five percent of dentists are getting their fees, and you always state me your cash price, which you're not even getting five percent of the time. And then that two hundred fifty that you're getting like one hundred eighty-five all the way down to one fifteen, so you don't know what this cost, and you're selling it for six different prices. And then what’s sad is, I know my homies, you work hard. They'll say, “Well can I squeeze in emergency in during lunch?” And you'll say, “Yeah, and you'll do two MOD composites in a room that costs you three hundred and you'll get reimbursed two hundred and eighty.” So you just worked through lunch to lose $30 and you don't even know it! When you sell shit that you don't know what it cost for six different prices you're inviting a disaster.
And now we have specialized CPA’s that only do dentistry and they’re so damn good. And anybody who signs up, and I can’t tell you which one to go to because I don't know who's in your town. Maybe this organization might be better, but you don't like the guy in your town. Cane Waters is in Dallas. I mean, come on, Dallas is a two hour flight from any city in America on Southwest airlines. You gotta know your numbers, and you've got to go in there with your spouse. One third of marriages divorce over money, one third divorce over sex. If you're paying money for sex, it's even worse. If you combine those two. And then one third is substance abuse, but a lot of the substance abuse, a lot of the reasons you're drinking, this is your sixth beer and it's an hour long course.
It's only her fourth and so one of the reasons you're drinking Listerine is because you're stressed out of your mind. So you got to do this as a couple. I mean, I don't recommend marriage, but if you do, if you do get married, all I'm saying is that if you're not discussing the money... it's not money, it's you don't talk about it. It's not sex; you're not communicating. You know, just take off your socks and take a shower. That will, that will come a long way.
So the substance abuse, you know, when you got married, he came on a couple of nights, he had a couple of beers, and then it went to three beers and it was every night after work, he's two beers, three beers and now it's every night a six pack. But, you never talk about it. You never told them that's really starting to irritate you. Money is a serious deal. But get a full-time dental CPA.
I mean, if you had testicular cancer, would you want to go to a doctor who did ophthalmology? Would you want to go to your dentist? Would you want to go to a guy that only does tea bags? Would you want someone who says, “I only do testicles.” That's my guy. That's your CPA. He only does dentistry because it's an art and a science, because he really can get all the data he needs. Here's four dentists that all take on twenty-five thousand a month at forty percent overhead. You only got to do forty-one thousand. That's an easy day. Fifty percent overhead you’ve got to do fifty thousand. Sixty-five percent is the average dentist in America.
When I got out of school thirty years ago, the average was fifty. Now the average is sixty-five. You’ve got to do seventy-one thousand dollars of dentistry to do that. And 20% of dentists have 80% overhead. 20% of dentists have to do a $125,000 of dentistry to take home twenty-five. Which dentist do you want to be? Do really want to do a $125,000 of posterior composites to make twenty-five grand? Shit, at what point would you just sell your office and buy a Taco Bell? Where are the hygienists in the room? Raise your hand if your hygienist? Raise your hand. So we only have three. We have four? No, keep your hand up. Come on. Gay people came out of the closet, admit you’re hygienist! Hygienists, we got some serious problems, you know who's killing you? The insurance companies are killing you.
So let me tell you something about this. All of your DSO’s in America, see the greatest thing about being fifty-five years old is not erectile dysfunction. What it is, is actually the fact that I've seen everything two or three times. I'm never seeing any Rodeo for the first time. So when I get out of school thirty years ago, the first roll ups where out, what is the roll-up? Orthodontic centers of America? What is that? They go get one hundred million line of credit, and then they go buy an orthodontic practice for a million. And then they'll come out and say, “Look, we went zero to a million.” Then they'll buy ten more. “Oh look, we went from a million to ten million.” Yeah, but your debt sheet went from zero to ten million. And then they go buy a hundred more orthodontic offices and go public on the New York Stock Exchange.
The only DSO ever, and they said, “Look, we have a billion dollars in sales. We've gone from zero to a billion in five years.” All the smart people like, “Yeah, so did your debt sheet. You're just buying sales.” And then what was the problem back then? When they bought your office, they said, “Hey, selling orthodontist, you have to stay there three years.” Well, what happened at three years and one minute? Did they stay on? Oh, they all ran down the street as fast they could. Then you replaced a fifty-five year old doctor doing three million with some punk ass kid that just walked out of dental school who comes in and does a million and the whole thing crashed, imploded. There was a dozen on Nasdaq. They all imploded. They're gone for ten years, now the roll ups are back, but this time you're afraid of them, but Wall Street won't touch them with a ten foot pole.
Imagine going on Shark Tank and you and the smartest shark there obviously is Mr. Wonderful, because he's the only bald guy on the show. And you went to Mr Wonderful, “I want a million bucks.” “What are you going to do?” Well, I'm going to go buy a dental office that does a million in sales.” “Awesome. Then what? How do I get my money back?” “Oh, well I'm going to come back next week and ask for another million. And then I'm gonna go buy another million dollar dental office.” “Wow. That's weird, then how do I get my money back?” “Oh, the next week I'm going to come and ask for another million.” “No, hold the shit on. I want to give you a million. You buy a million dollar dental office, you pay down my million back over the next one or two years while your business grows to two million.”
That doesn't happen on any DSO’s,not one of them will go public. Every single one of them will do what the last round did and implode. I've been telling you this for five years, you won’t believe me, there's only three banks that give them money, and the biggest one given them money was East West Bank. They stopped giving DSO’s money as a line item two years ago. It didn't even make the news. I post on Dentaltown and it didn't even get a comment. They're cut off. They don't make money. But there are three, and only three, publicly traded dental offices on earth. There's one; 300 Smiles out of Australia, Pacific Smiles Group, Q and M, I podcasts at all of them. Daryl Holmes, founder of one; 300 miles. He has a hundred offices. He's publicly traded. Every year his debt goes down. Every year his profits go up. Then we’ve got another one; Pacific Smiles Group. I think there are seventy-five offices. Every year their debt sheet goes down and their sales and profits go up. And then of course the Singaporean, a Raymond, but what do all three eerily have the exact same business model and what is it? No hygiene. The doctors do the hygiene. This is what they say. So you gotta think about this. So they say, here's what happens in America. You're paying a hygienist forty to fifty-five dollar cleaning. So the hygienist is setting up the room. You don't have to be a hygienist for that. Then she goes and gets the patient, sees them. You don't have the hygiene for that. Then she goes and gets the patients and sees them, you don’t have to be hygiene for that. Then she takes the x rays; that could have all been in dental assistant and then she sits down to probe, so she calls in another dental assistant. Then she sits down to probe, so she calls in another dental assistant who's getting twenty an hour, so you got a forty dollar an hour hygienist, twenty dollar assistant, she's doing the probing, and then she started scaling and then when she's done the dental assistant finishes. You can do the polish, the fluoride, the flaw, set them up write up the deal, check out the patient, clean up the room, the whole nine yards. So, what they do is they do this; the assistant sets up the room, seats the patient, the doctor comes in, does the periodontal chart, the assistant, the probes, and then when he's doing the scaling, he scales each teeth with an internal camera doing the exam, going over the whole deal, scaling the whole teeth. So they're doing the exam, the scaling the same time, and then when they're done, the assistant comes in and finishes it. He said, “We can't be profitable paying a hygienist forty to do a fifty-five cleaning. Furthermore, with the hygienist is doing the cleaning, you got a forty dollar an hour hygienist getting help with the twenty dollar an hour assistant, and then she's waiting five minutes for the doctor to come in and do the exam. Then when I go into your offices, every time I go to any country, any villa, whenever I ever walk by a dental office, I see like a Gucci store and run in and want to meet my homie, and almost every time we're out shopping malls, whatever. And I bust into the dental office and I just walked right past the receptionist, they don't know what to do, and I go, “Where's the dentist?” Every time I go in there, “Where’s the dentist?” Sitting on his ass in the office, which is really good for Dentaltown but not good for your betting line and I'm asking you, “Did you even tell your receptionists, ‘look, I'll do cleanings. I don't want to sit back there with a cancellation no show and someone is saying, well, when can I get my teeth cleaned?” “Well, we don't have an opening for three more days.” You won't even tell your own staff that you'd rather do a cleaning then sit on your ass. So the bottom line is, the bottom line is, you know, I'm not here to be your friend. I'm not here to be your friend. I'm not here to make friends. Dude, you're lazy. You're lazy. You haven't done a cleaning. Most of you in this office, if I put a gun to your head and say, “Just turn on the x ray machine,” I'd have to shoot you. Most dentist, if you put a gun to their head and say, “Load the autoclave now, or I'm going to cut your balls off.” They're like, “Wow, I'm going to be a eunuch. I don't even know how this thing works.”
I mean, you have to start doing cleanings instead of doing nothing. And you look at your hygienist; here's the only way hygiene works, the only way hygiene works is if she can present dentistry. If she can take the internal camera, if she can explain disease, but if she's sitting there like Obi wan Kenobi, just chucking and tartar in polishing teeth and flossing and then you get in the room and she says, “Oh doctor, I think there's a little something on the on the upper right,” and you look in the upper right, and I was like, number three looks like it ate a grenade. “No Shit. Is that what they taught in you in hygiene school, a little something? Is there a code for that?” And she should have taken the PA and the bite wing, the diagnosis.. I just so sick of you not having your assistants diagnosis the treatment and when they come into emergency, when they take an FMX, every picture that comes in and they should diagnose treatment. You know why? Because I'm going to tell you another thing that no one wants to talk about. Okay? And I know that I'm supposed to stop right now, but we started four minutes late, so can I have five more minutes?
Nobody in America, trust men. When your engine light comes on and you take it to the dealer and they come out and says, “You need a whole new alternator.” What percent of women in America are thinking, Do I need a whole new alternator or is he trying to sell me something?” You look in the sign; 19.99 oil change, you take it in there with your twenty dollar bill that he got from hanging on that pole upside down for just one song, and he comes down and he says, “But you know what? You need your transmission fluid flushed and you need a new air filter.” What percent of American women think, really? Are you trying to just sell me shit? You call the air conditioner man, because your air conditioner don't work and you're thinking, hopefully it's just a shot of freon, some duct tape and he says, “Man, you need a whole new eight thousand, five hundred dollar air conditioner.” What percent of American women think; I don't even know if that's true. I bet if my uncle Eddie was here, he could fix it with a shot of freon. See, I don't wear a tie, because I know when women see a man with a tie, they assume the tie is to keep the foreskin from skin from coming up over your head.
You're lying, lying, lying. So now the dental assistant is taking x-rays. “Yeah, that's a cavity. Which one hurts is up here? Yeah. See that black little cavity. See how that's in the nerve? Yeah. That's gonna be a root canal or are you going to have to pull the tooth.” See, they trust the assistant. They know she's one of them, and then you're getting your teeth cleaned and the hygienist putting out that “Dude, now you say, well, it's illegal for a hygienist diagnose a treatment plan.” Yeah. Well, how bitches are in prison today from diagnosing and treatment planning? Every single hour someone drives by your dental office with three pounds of marijuana in the trunk and you won't let your dental assistant diagnose and x ray. Walk on the wild side idiots, because they don't trust you. You pulled up in a Porsche, you pulled up in a Range Rover. You're the one who comes in and says, “Yeah, you need five thousand worth of dentistry,” and they think, “Yeah, I saw you. Were you changing oil on 48th and Elliot, are you the one who told me I need an air filter and a new air conditioner and a new alternator, which later I found out was all horse shit, bullshit and more shit?” See, they trust, you're trying to sell trust. The other big thing that you overlook all the time on these chains; they have massive staff turnover. When they go up your arm and say, “Yeah, I want Megan to clean my teeth.” “Megan?! She walked out on the job months ago. We have some new girl now.” Every time they go in, that's where they come and tell me. Every time I go in there and see a different doctor, every time I go in there it’s a different assistant. I talked to the doctors that quit. Why did you quit? “Shit, I had three different dental assistants and a month.” It's hard enough to do a root canal, let alone with a brand new dental assistant who doesn't even know anything about me. You can't build trust with turnover, turnover, turnover, turnover. You want to take HR more serious than anything you do in dentistry. You want to hire people. I mean, half my team's been with me twenty years and they only stay with me for one reason; they know that when they die, they'll have no purgatory. They'll just go straight to heaven. They’ll say, “You already lived in Hell for twenty years”.
The bottom line is; what is integrity and trust? I can't see a new face every time I go to the doctor. I can't see a new doctor every time I walk in there. I can’t have some control freak, monkey doctor not letting anybody talk because he's controlling. What is a great sins of human history? No transparency; I don't want to tell you what I'm doing. Controlling you; I don't want you to have any rights, speak up, whatever. I mean in China, everybody who's got a Nobel prize, a Nobel Peace prize is in prison. I mean, nobody trusts a regime like that. They're trying to be the new reserve currency. No one trusts China; no one wants their currency because they don't trust them. They don't have any institutions, of any integrity and transparency and he checks them out and so, what did this new president of China, he just installed himself for life. He’s the same as Putin!
People don't trust that shit and then you're a doctor, and you will let your assistant and hygienist talk freely. I've been in dental offices where the dental assistant can’t even disagree with a treatment plan. She's not even allowed to ask questions about the treatment plan. You can't even convince your assistant and hygienist why you’re doing this treatment and you're the same idiot who's never sold a single thirty thousand dollar treatment plan? If your staff don't trust you, you're sitting there telling them the treatment plan, the patient is looking at the hygienist standing behind you and she's rolling her eyes. You don't know why people just walk out and never come back. It's all about trust. And once you can fake trust, you've got it made.
So, dentistry has been flattening out. It's at about one hundred sixteen billion, one hundred sixteen, one hundred fifteen, it's ticking up a little bit and it always ticks up a at the end of a cycle. Average treatment plan in America; three hundred and eighty-four for a new patient, three hundred and eighty-four. By time he did an FMX and an exam, how much would be left? How much is three hundred eighty four minus a new patient exam and x rays in your office? None.
And the problem is what the problem is, what? Your patients are flossing too much? They're not eating processed sugar? They all have a six pack? Nobody has a cavity, nobody has a gum disease or you couldn't sell shit to an Eskimo?
That's what it is. You just can't sell.
So I'm going to end on this note here; many, many, many people stand before you and they want to be your friend. They want you to like them. I don't want any more friends. I don't care if you don't like me, my own lover back there in the back row, where's Jennifer? In the bathroom, she's not in the bathroom; she just would rather be in the bathroom looking at the toilet than me. She's right. But the bottom line is, I'm going to tell you the brutal truth; too many of you are snowflakes. You peaked out in 2005 at two hundred, nineteen thousand a year and you've been sliding three thousand eight hundred a month and you're down to one hundred seventy-four and it's sliding, sliding, sliding. But I want you to look at the other number, the nine specialties. Okay? So the specialists are averaging three hundred thirty three, five hundred forty. You're averaging one hundred and eighty-eight. What's the difference? Here's the money. Molar Endo three hundred twenty-five. What do you say to me? “I don't like molar endo.” Well, you know what? Homo sapiens is 2 million years old in for last 1.9 million your ancestors were frozen in a cave all winter, eating mastodon shit.
And what if your ancestors says, “Hey, you know, I just don't like mastodon shit anymore. I think I'm just going to kill myself with a rock.” If your ancestors for two million years, ate mastodon shit, I don't care if you don't like molar endo, suck it up, buttercup. I'm tired of your snowflake bullshit. They got a toothache. They hurt. They come to your office, “Well, can you do it now?” “I don't do molar endo.” I hope someday you break your leg and you go the emergency room and they say, “You know, we don't do legs. Yeah, we just do arms, and sometimes we'll do an ear or eye but no legs. I mean I just don't like legs. I just prefer them.” Suck it up. They're begging you for treatment. It's a thousand dollars. They're in pain. It's called public health. There's nine specialties in your life. You know the thing that embarrasses me the most about my homies, that eight percent of all emergency room visits are odontogenic in origin, because you don't have your shit together. Because they come in with a toothache, then you gave him Pendacaine and Vicodin. They couldn't get into any endodontist for three days. Now it's Saturday night at one in the morning and then the ER spending one thousand five hundred just to get more Vicodin and more Penicillin. Cause you didn't do your job, because you're the asshole that just decided, “I don't like molar endo.” “I don't give a shit if you don't like it, do it anyway.”
Oral surgery, extractions and endo, every dentist that's taking home two hundred fifty to three hundred can pull a damn tooth and do a molar root canal.
You tell me, you say, “Well I don't like blood.” “Dude, that means you were supposed to have been an electrical engineer. How did you not know that humans were not filled with blood? Did you really think you carved me open and it’ll say Intel inside? What are you looking for? A PC board? No, it's a heart and it pumps bloody stuff.” And you got to learn how to pull a tooth and then you sit there and tell me what, “You don't like it.” And you know what? I don't give a shit if you don't like it. My boys wrestled year round from five to fifteen, a lot of them went undefeated for three years. I'd wake him up at 6:00 to go do their cross country to run and go to practice. They'd say, “Dad, I don’t want to get up,” and I to stand there with the light on. “I don't give a shit if you want to get up.” And I grabbed the blanket and throw it out in the hall. When I say, “Get up or I'm coming back with water.”
Because as soon as they were up and as soon as they are running, they are glad they did it. You know? I asked everyone, “Should I have not had done that?” And they go, “No, dad. That was awesome. I'm so glad you made us.” Orthodontics; I don't even understand, Invisalign just bought Smile Direct. Now they're not even going through the orthodontists. You're going into a mall. They scan it, they sent it to an orthodontist in Costa Rica, they make the trays, they send it back, but you can't do Invisalign. Oh, the girl in the mall can, but Dr., you can't figure it out. Are you shitting me? And eleven dollars an hour girl who's eighteen in the mall can do Invisalign, but not you. I mean, at that point there's a head injury going on. At that point you got to call your mom and say, “Mom, seriously. Did you drop me? I need to know because I can't do Invisalign. But the Mani/Pedi chick at the mall can. Pediatrics is the same thing. You say, “I don't like kids.” I mean, I had four kids. I have grandchildren. I hate pediatric dentistry, especially in my practice. Twenty five percent of my practice is from Guadalupe. They don't speak one word of English. I don't even know what they're saying. They're screaming. I did figure out how to say Howard Farran in Spanish. I'm pretty sure it's Gordo Cracker, but the bottom line is, okay, you don't like it, but I don't care if it's a two year old little kid. What do you want to have Ludwig's angina till 3:00 in the morning? You just got to do things you don't like. But the specialists are all making bank, and the periodontists, I mean, look at us, I just want you to remember is that once you decide you're not going to be a little snowflake, you can make third of a million a year, but you're going to have to do molar endo. You're going to have to pull teeth.
Hogo has put together--It's the first time we looked up during the whole damn seminar, I had to call his name. He's got all the courses on endo. Carl Misch, Implants, Palmetto. I love the international us. He's from Lisbon, Portugal on four Hodges up in Canada doing ceramic implants and there's a lot of people believing now the ceramic implants will have less peri implantitis. You'll see that the ceramic implant manufacturers are coming on strong now. I did the CEO of Stroman, and he just bought an all ceramic implants. A lot of people think is going to be peri implantitis.
Orthodontics is accelerating. When we were little, every case, it was two years now, they can speed these things up to a year. I've done the twenty-five world's greatest orthodontists, podcasts from Sydney, Australia, Mahoney, Richard Legg, University of Detroit.
I mean, we got everything, pdf. Here's the fees. You don't even know what it costs. You look at this, here's the typical dental office is making money, making money, making money. Now they're doing it at a breakeven and then about a third of their insurance they’re losing money and they don't even know what third they're losing money on. I can go on and on and on. I just want to end on this. This is what I want to end on; Something to do, here's what to do. If you can do something to get rich quick this is what you do: for every hundred people that land on your website, only three convert and call your office. For every three that convert and call your office, receptionist who answers the phone, only gets one to come in. Three people have to come in who each need a filling for you to convert one to do the filling, because the average dentist has about a thirty-eight percent close rate, so to do a filling, you needed three people to come in with a filling. To have three people come in. You needed nine to call. For nine people to call, you needed several hundred, you needed five hundred to land on your website. Just fixed any of that. What do we know? First of all, call centers are exploding. You need to hire a receptionist. There's my Valerie. Valerie could talk to a tree for an hour. If I hire one of you to be my receptionist, I had asked you ask just one question, I'm looking for that girl where you ask one question and she just talks, talks, talks, talks. I want a girl that if you taped their mouths shut, she'd fart to death. Okay? Just warm and fuzzy and talking and talking and talking, and here's what's weird about sales, the Fortune 500 is about fifteen percent of Americans work for the Fortune 500 and they get a hundred percent of all the news. But you know what? The average eighty percent of Americans, they work for a business the size of a dental office, and there's all these million dollar companies all sorted across America.
You know what's really weird about them? It’s that average company, the highest paid person besides the owner, is whoever is calling sells. Customers, he wears a suit and tie, he's the only one may one hundred thousand. He's called outbound sales, and when someone calls the company to inquire, let's say you're in the middle of Kansas and all you make as a side baler to make those little bales of hay, you do like three million a year. The guy calling the farmers is in a three piece suit in the office. He's making one hundred thousand a year. If someone calls, he answers the phone and the guy in the back, working on the machine shop making the site balers, those are forty dollar an hour guys that come to work and overalls without underwear and a lunch pail. In dentistry, that guy's the doctor, and he gets all the big bucks making the little fillings and crowns, and he's got eight to twelve years of college. The hygienists got four, the assistants got a year, and then who's inbound sales? Somebody you just found on the street. Who's outbound sales? Oh, some girl with no training, in every company in America that would be the highest paid position.
That's why all these DSO’s are kicking your ass with call centers where they are absolutely training. They're getting top dog people. They are getting people and they will convert seventy to eighty percent of the people that call gets scheduled a patient. You are one in three, and then they will go in there and they will take away the treatment plan presentation from the doctor, and they will give it to a treatment plan coordinator who again is someone hired and trained in sales. And they will go in there and they'll do a two-thirds close rate. So they're getting the girls answering their phone to a seventy percent conversion rate and they're getting treatment plan presentation to two-thirds and you're competing with that DSO across the street and your girl is only converting one in three to schedule, and three people have come in before you convert one for a filling.
That's why DSO’s are even alive; every single one of them has a call center. Every single one of them tells the doctor, “You know what? You're a doctor. You're an introvert, geek, you’re afraid of your own shadow. You're kind of weird. So we're going to get a normal person. Your idea of normal is; when you go into a library, you're just at home. You're like, oh, I'm at home. I'm in a library. I'm so happy.” And you can smell those offices that do seven hundred fifty thousand dollars a year because when you walk in, it even smells like a library. Nobody talks. Everybody is quiet, everybody passes their notes, and then you go into an office that does a million-five. “Hey, how are you doing? What up with you? I love your little button thing. What's all that about? The weather, or what are you doing? They're just all fun and they're having fun. The assistants taking the FMX, diagnosing each one, the girl doing the every--it’s just fun. You can feel it. You can smell it. You can sense it. They do a million five. Everybody's secreting dopamine, serotonin, and oxytocin.
That's what has to happen. So, just fix the funnel. Think about this; the reason blockbuster died is not only was these have bankers hours and this was twenty-four hours a day like the ATM machine, but when you went in there and you bought a movie and you went up to the counter and you bought it, there was no difference in customer experience than just buying it from a box. You didn't make a connection. You didn’t walk away and say, “I really love that blockbuster chick, she rocks. She asked her name. You didn't ask her name.” When your customer experience is not harmed by a box. It's the same thing with ATM machines; like you want to deal with this guy forty hours out of one hundred sixty eight or a box one sixty eight? No one went to that box and said, “I really miss that guy.” You're losing to a box and you know why you love your receptionist? Because she reminds you of your favorite librarian. The life of every party of Friday night, and you know what I heard at Creighton University for three freaking years, every single night? “Tink, the library will be closing in ten minutes” and I was such a loser, I’d say, “Shit.”
I’d pack up my bag and I would go home wondering why the library wasn't twenty-four hours a day and then I finally complained to the head Jesuit at Creighton University. Here's how big of a loser I was, he was eighty years old, the long gown always had a rosary on and I went in there and tell them this bullshit. I'm paying six thousand dollars a year. The library closes at noon. I come back to the dorm. They were playing rock and roll music. They're sneaking in alcohol and there's girls in there. And he walked around the deal, and he put his arm around, he says, “Howard, maybe at midnight you should just lighten up a little and maybe you should have a beer and sneak a woman in there,” and I'm like, “Man. When the eighty-year-old year old Jesuit priest is telling you to sneak women into a dorm, he really feelss sorry for you.” And all of those people were the only ones who got accepted into dental school, medical school and law. Everyone that was normal and well-rounded didn't get accepted. So when you're wondering, “What's wrong with my doctor,” he was like the five percent that got accepted. Normal people don't make great grades and get accepted to dental school and medical school, and what are you losing to? Your losing to a box. You're losing to a red box, an ATM machine. They're getting rid of the tellers at the banks.
That is outbound sales. That is inbound sales. You need that girl, and you won't hire that girl because she talks. You wouldn't hire her because she questioned you. “Well, why are you doing a crown instead of a filling? Why are you doing a root canal?” Because she wants to explain it to her friend, and you're like, “Look, librarians don't ask questions, number one, shh, you’re supposed to be quiet, no questions.
Find your Valerie! Find Your Mojo. Life is an attitude. You love endo, you love Kromosil crowns, you love pulling wisdom teeth, and you love this lecture because I told you you're did, so love it anyway. Thank you so much for coming tonight!
Speaker 1: That was awesome. Awesome. Thank you so much, Howard. That was fantastic. This lecture will be continued next year in Scottsdale in March 2019, we hope that you’re all there. I want to remind you to please review the courses, either through the meeting app or on our website. We appreciate your feedback, both on the content and quality of the courses as well as the meeting itself. I know this is our last time together as a large group, so I want to wish everybody a safe and healthy trip home. We do hope to see many of you next year in Scottsdale at the Talking Stick Resort. Thank you everybody, have a great evening!