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AUDIO - HSP #171 - Jacob Puhl
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VIDEO - HSP #171 - Jacob Puhl
Learn the biggest mistakes dentists make when marketing online, how to compete with corporiate dentistry, and how patients' buying habits are drastically changing.
Jacob Puhl is an expert in new patient marketing and digital marketing, and he works with dentists ONLY. He specializes in SEO, Google Maps Optimization, Facebook Ads, Yelp and any other form or digital marketing that can attract high-end new patients.
Author of the #1 best selling book on dental marketing on Amazon right now http://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3Daps&field-keywords=dental+marketing
Jacob Puhl is a long time Dentaltown.com lurker but is occasionally very active Townie. He is a speaker at dental study clubs and dental events.
His mission is to help dentists live the lives they want by helping them attract new patients to their practice.
Howard: It is a huge, huge honor for me today to be interviewing Adam Zilko from Salkum, Washington and Jacob Puhl from Seattle who goes by Jake, and I'm doing both these guys a favor by interviewing them since I am an Arizona Cardinals fan, and I know the Seattle Seahawks are going to deprive us again. Are you guys Seahawks fans?
Adam: Oh yeah, big time.
Howard: Big time? Yeah, I have to admit it's fun to watch those guys, but hey, you guys are on the hottest subject because when we look at consumers, they're born at 0 and die at 85, but when we look at dentists, they're not really born out of dental school until they're 25, and they don't retire until they're 65. The average American might only be 30, but the average age of a dentist is 45 to 50. Me being 53, I'm just a little over the hump of the hill. The back half, the older guys, we graduated when the big, hot, new thing was the Yellow Page ad, and they were throwing a Yellow Page book on every door, and if we did direct mail, it was just radical, doctors just didn't do that.
In fact, it was illegal until 1973 when 2 lawyers from right here in Arizona went all the way to the Supreme Court because it was illegal for lawyers to advertise, and they said, "Hey, this is a violation of free speech. Why can't we tell the consumers what we lawyers do?" When that case went through, it opened it up not only for lawyers, but physicians and dentists and then later pharmaceutical companies, that's why you see so many ads for all kinds of medicine on TV.
I guarantee you, any time you go to the bar and watch a football game with a bunch of older dentists, they always say things like ... A guy asked me last week, I kid you not, and he's exactly my age, 53, he said, "Have you heard of Yelp?" I'm like, "Dude, you can't be just saying I heard of Yelp in 2015." That should have been a question in 2005, not 2015.
Another thing everybody's talking about is, back in the 60s and 70s, a lot of business staff were finding out that there's different needs and wants for Asian-Americans or Latino-Americans or African-Americans or what have you, but now, everybody understands any peculiarities and market preferences. Now, the elite thinkers are realizing that it's not race, it's how they think. Baby boomers think very differently than Generation Xers or Milleniums and things like that. What I notice, an older guy like me, is that none of my 50 to 60 year old friends are saying before I go to a restaurant I'm going to check the reviews on Yelp, but it seems like the 25 and under kids wouldn't even think of going to a restaurant without checking the Yelp reviews if they'd never been there.
This is going to be a difficult podcast for you today because you're talking to dental students and have been out 5 years. You're on Yelp and Google Reviews and have left Yelp reviews because you can't leave a Yelp review unless you've downloaded the app, right?
Adam: You can go through their website to do it.
Howard: You can go through their website. Good luck to you because this is a hot area because online reviews and everything that you do is just hot. New patient pull equals cash flow. I do want to say one thing on the new patient though before you get into this is you're not going to solve all your problems with new patients because when I go and look at an office, if 50% of their new patients aren't word-of-mouth referral, then they have a customer service patient experience problem.
The red flag on that is if a hygienist works 40 hours a week 50 weeks a year, that's 2,000 hours, so he or she can only clean 1,000 people's teeth twice a year. If you have 1,000 capacity, you divide that by 25 new patients a month, that means every 3 and a third year, you'd be adding another hygienist. I kid you not, almost every dentist I walk into has had the same hygiene capacity today that they did 10 years ago, which means however many new patients they're getting in the front door from guys like you, they're losing out the back door.
Here's my marketing tip for you guys: you guys should do an advertising tip with the Hoover Dam and say we'll give you the water coming down the stream, but if you don't have a rocking hot patient experience and engage them and all that stuff, you don't have Hoover Dam, and that water's just going to flow down the river. It's both. It's the new patient experience to get word-of-mouth referrals.
Tell us older guys about online marketing. Tell us how we can do it because you know the DSOs are doing it, right?
Adam: Sure. Absolutely. A part of what you said, Howard, is patient experience. We refer to it as a 5-star experience. The way that we approach marketing is not only what people need to see, like where dentists need to show up, but what is the experience for that new patient as they're going through this entire cycle. Internally, on our company, we're actually looking at how that practice is doing with those patients. We don't do a lot internally in terms of how they're internally marketing back to existing patients, but we're very big on the 5-star patient experience if that makes sense.
When somebody's marketing, you need to understand what they buying process looks like, what the shopping process looks like. As a consumer, and you look at it yourself, when you have a need, let's say that you get into an auto accident, right? All of a sudden, you have that need, right? Or you need a dentist, in this case. You are likely to go to the Internet to figure out who you want to do business with. You've got a lot of options there, so who there is differentiating themselves and what type of experience are they creating upfront on the front end of that?
Then we manage that all the way through to looking at even how they're answering their phones. Are they answering these inbound calls and what is that staff saying on those calls and are they providing the experience that consumers want? That's going to determine if they even get to that stage of being scheduled. At a high level, that's the front-end and the back-end of what we look at.
Jake, do you want to add in on this?
Howard: Wait, back up a little bit. Your website is firegang.com? What does Fire Gang mean, where did that come from?
Adam: Jake, go ahead.
Howard: It was obviously Jake's idea.
Jake: [crosstalk 00:07:08] I'm glad you asked, actually, because I really love it. Basically, we had this idea of when fire came into existence and how powerful that was, and that's how we see the Internet. It's this thing that just all of the sudden started existing, and we joked around over a beer about the first people who actually discovered fire, how they were just dominating society. We figured the people that jump on the Internet and figure out how to use it, they're going to be like the first people that discovered fire.
Howard: That is so cool. What was the movie that came out in 1980? I think Cheech and Chong's daughter was in that movie, it was a no words, a movie with just sound, and it was cavemen and the discovery of fire. Do you remember that movie?
Jake: No, but I mean Cheech and Chong ...
Howard: Cheech and Chong's daughter I think was in it, but I saw it freshman year of college at Creighton University in Omaha, Nebraska in 1980, and it was a wild movie. I think fire was the first invention.
Howard: It was huge, and the American Indians used to use it. If they burned down the plains, a few days later, the new, green grass would come up, and that would attract all the buffalo. I'm glad I asked that question, that is very cool. Explain to our listeners, what does firegang.com do? Why do dentists call you? What do you do? How much do you charge? What are your services?
Adam: Good questions, Howard. We like to say we basically help dental practices acquire new patients in terms of everything from the click to the call. We help get dental practices of ours to market in the right places, to create the right messaging, to attract the right types of new patients, and work them all the way through to even the back end of it and looking at how they're managing those inbound leads. We work with them on how they manage certain things internally, like how they track their numbers, certain things they do with their staff in terms of re-engaging existing patients.
In a nutshell, our goal is to help them get new patients from the Internet. Obviously, it's not that simple, but that's, on a high-level, what we're after.
Howard: My job is to try and predict questions from thousands of dentists on their commute to work or home form work. The dentist says, "I already got a website." Do you enhance it or is there SCO things you do? Do you put hashtags on them? Especially for a guy like me, when I hear a guy whining about SCO and he's in Parsons, Kansas, I'm like, "Dude, I'm in Phoenix. There's 3,800 dentists in my town. All the dentists in your town could fit on page 1."
If this lady's driving to work, and she's saying, "I'm in a big city, I'm in L.A., I'm in Seattle, I'm in San Fran, and I'm on page 3. I call Fire Gang, how can you get me to page 1?"
Adam: That's kind of a loaded question because there's ...
Howard: I take that as a compliment.
Adam: I'd have to understand why she's on page 3, but one of the biggest factors we believe contributes to why people aren't showing up higher is consumer engagement within the site itself. If you look at 30 different dental websites or 50 different dental websites, every single one of them is doing the same exact thing as the next. One exercise I do with a lot of clients we talk to is I say go to your dental implant page and tell me what you see, and it's the same thing. It's here's what dental implants are and here's how they work and here's the process and those types of things.
As a consumer, I don't go to your website to learn about dental implants. I can go to Wikipedia, I can go to YouTube, I can go to any other educational site and source that's far greater than what you can give me on that one little blurb. Why I'm at your site is because I'm trying to understand why I should do business with you. That's it, so you have to differentiate yourself, and with that differentiation comes engagement. If a consumer gets to your site, and they engage further and go deeper into your site, they're actually reading it, they're watching the videos, and they're looking at the content, Google's picking up on those signals because Google understands that better engagement means that Google gave them a better search result. That's part of it.
Howard: I'm sorry, I'm old and senile. How does Google know that people are engaging with my site?
Adam: They can channel bounce rates. When somebody clicks to your site from Google, they can see how long it took them to come back to Google. If I click into your site, and after just a couple of seconds I hit the back button on my browser, Google can detect that. Google's also got other things to detect if somebody clicks from paid ads or if somebody's running ad wards on the site. Google's tracking all these, not ad wards, but analytics, Google's tracking all these different things, and they can tell if people are staying on a site or if they're just hitting the back button. They've got a lot of signals to detect those things, so we believe that more and more, Google's looking at these factors to determine relevancy because there's no greater tool to determine if that result is good than to understand what that consumer is doing. If a lot of people are clicking on that page and staying, then that's likely to be a better experience.
That's one factor, but there are a lot of other things like reviews and search engine optimization and citation elements and all those that go into it.
Howard: From your years of doing this, your average client, what percent of them would you say, "We can work with your website" versus "You need a whole new website"?
Adam: I would say high percentage we want to work with a new website.
Howard: Do you develop that website?
Adam: Yeah. We build one from the ground up. We'll write the copy, we'll design it from the ground up. We build all of our websites in wordpress, so they're open source, and if somebody parted ways with us, they can take them to a million other web companies or developers to host anywhere in the world.
Howard: Can I break in and ask a selfish bastard question?
Howard: Somebody started a thread on Dentaltown: what do you think of Howard's mobile site? I wish you would log onto that thread and chime in what your thoughts are because a lot of dentists like me think we're doing the right thing because we're going with a big company to do our ... I've been with Sesame probably for 8 years. They're in your neck of the woods, they're in Seattle too.
Jake: In Seattle, yep.
Howard: I feel, being in Phoenix with 3,800 dentists, it's so important that, I think a lot of people that listen to this podcast, they don't want to mess up on the website. The Yellow Pages turned into the PC, and now I don't think the PC is that relevant anymore, I think it's all the phone. Do you agree with that?
Adam: It's moving there for sure.
Howard: What percent is it right now, do you think, phone book versus PC versus a smartphone.
Adam: I would say phone books are like under 5%, and I would say that the other 95% is probably split 50/50 or probably 60/40 still for local search. Google says it's 50/50 for mobile to desktop search.
Howard: I wish you'd chime in because, me personally, I don't want to get this ...
Adam: The big thing, Howard, is differentiation. No one's talking about that, no one's doing that, and that's what we see as the next thing is really trying to stand apart from the masses. You look at every DSO or every corporate chain, they've got it right, they've figured it out, and they're differentiating themselves. They're giving those consumers what they want to see right from the get-go. They're providing them with all the right answers, they're giving them the why choose us elements, they're running promotions in some cases to get them in the door.
At least on the front end, they're giving them the 5-star experience that they're going to want to see out of a big box store potentially like Best Buy. When I go in there, I usually have a pretty excellent experience. To get to them, to use them online is even easier. That's the thing, it's the differentiation and not saying the same things and doing the same things as every other dentist out there.
Jake, you got anything to add here on this?
Jake: Google, every single day they wake up, they're trying to figure out how to determine the best practices, and they're getting better every day in doing that. We're finding the practices that are winning are the ones that are actually giving experiences A to Z. They have the good website, they're doing a lot of branding, they have a lot of people doing searches for them online. We switch tactics all the time. Go to Yelp, or build links here, or do this on your website, but the practices that are actually serving the patients and becoming the actual best practice in that area, those are the ones that are floating to the top.
Howard: Talk to the dentist driving to work. What are red flags that they're not optimized, they're not crushing it on digital marketing, online marketing.
Adam: I would say cookie cutter, templated website with pre-built content is one issue, no reviews is another one, not being open during normal business hours, not answering their phones which isn't something you could detect on the technical end initially, but consumer experience will obviously figure that out.
Howard: It's actually the main reason why I return dentists phone calls. They email, and they say, "Can you call me?" One of the main reasons I personally want to call this dentist back is just to see what that answering is going to be, and 50% of the time, they're closed, and, if they're open, 50% of the time, it still goes to voice mail. It just blows my mind.
Adam: It does, yeah. It's unreal. The staff doesn't know how to answer the phones half the time. Another half of those are just turned away because consumers are having a bad experience. In terms of the technical elements that you asked about, amazing website, loads fast, it's got images that are personal to that practice, we don't want the cookie cutter or copied images or stock images.
People want to feel like they know who they're doing business with, right? They want to see your practice, they want to see you. If you have video, that's even better. They want to see testimonials of happy patients that are recent. One thing that we tell practices though is that it's not okay, in our opinion, just to go get reviews from anywhere like a proprietary system and dump them on your site. Consumers want to see reviews from sites they've heard of. If I go look up a hotel, and they've got a bunch of reviews that they acquired inside their own hotel, I don't want to read those. I want to go to TripAdvisor and see what people on TripAdvisor say because I trust that site.
If I'm a dental practice, I need to be showing people what the reviews of Yelp and Google are versus a proprietary system that curated all these in house. As a consumer, I need that additional information to build credibility. It's like when you go to Amazon and you see it says verified Amazon purchase, Amazon's saying, "Hey, this is a testimonial about the product, but this guy actually bought the product, and we're going to back it up with showing you that." It's just like getting a review on a site that people have heard of.
Everything that we're doing is trying to add that extra level of credibility.
Howard: Ten years ago, there were at least 25 review sites. Has it really consolidated down to just Google and Yelp? Is that the 80/20 rule? Should you mostly be concerned about Google and Yelp? The follow-up question to that is, the older dentists I talk to think Yelp is for restaurants and not dentistry, but the younger dentists disagree, and the older dentists just concentrate on Google.
Adam: The way that I answer that question is I come back to this buying cycle. When I'm at the beginning of my buying cycle, where do I start my search? If I need a dentist, where do I go? Go to Google, probably, maybe it's Yahoo and Bing, and so you can get reviews there, but it's most of the time, it's going to be Google. What does Google serve up? If I type in dentist in Phoenix, what's Google showing me? They're showing me all these Google results with Google reviews.
As a consumer, that's my first experience to you. That's my first impression of you is the star rating on what Google is showing me. Until they change that, in our opinion, that's where you need to focus the bulk of your reviews because, again, that's what's in the public eye. That's what they're seeing to begin with.
Howard: It would be smart for every listener to this podcast when they get to work to open up Google and do a search for their name and then see the reviews?
Howard: Let's go to that then. How do you recommend managing your reviews. Is 19 reviews better than 9? What would you do if there's a bad review? Should you be asking at least all your friends and family and close buddies to be logging on and creating reviews? If your best friend's your patient, should you just be calling them and say, "Come on, Mike, you're my best friend. Get on Google and write me a review."? What do you think about that?
Adam: To answer your question about if you Google your own name, you will see reviews on other sites, and you can look at targeting reviews on those as well, but I would always start with Google. In terms of how many you should have, I typically base that off what your competition has. When you look at those top few results, if they've got 80 reviews, you need to target that and then some, right? That's what other consumers are going to do.
Howard: Does the number of reviews bump me up the deal? If someone has 80 reviews, and I have 8, are they most likely to show up higher on the Google search than me?
Adam: I don't believe they're going to show up because of the number of reviews. If you've got constant reviews coming in, those do send good signals that people are engaging with that, but I think it's more that consumers are likely to click on that practice that has 80 reviews than the guy that has 8. For signals for Google, that result's more relevant, so Google's more likely to show it higher.
Howard: How do you manage your online? What if a dentist gets a bad review?
Adam: We have systems in place that track every place that people are likely to leave a review. We know good or bad if a review's coming in. I would say any practice can reasonably expect to get a negative review at some time or another. The thing is to identify it as soon as possible so you can deal with the issue. A lot of times, it's somebody that just had a bad experience, and they're venting. If we can get the receptionist on the phone with that upset patient and resolve the issue, that patient will pull that review down or they'll change the review altogether.
That's, in our opinion, the best approach to it. If that doesn't work, you can't get ahold of them or they're just unreasonable, then our way is to publicly respond to those reviews on those sites. I would say that [inaudible 00:22:29] that you are going to see some negativity, and they almost trust that more. As long as it's not overwhelming, and as long as you're still getting positive reviews in addition to that. If all they see is that one negative review, then that's the only experience that anyone's had at this practice, and that's going to kill your business. If you had one, and then they're still getting great ones and they had great ones before it, you can look past it.
Every product that you buy on Amazon has got at least a handful of negative reviews, right? When you read them, usually they're pretty unrealistic or unreasonable. As consumers, I think we're used to seeing a little bit of negativity, it's just how you handle it and staying on top of it. It's, at least in our opinion, probably the most effective and important part of online marketing at this stage in terms of conversion rates and what people are going to do moving through the process.
Jake, do you have anything to add?
Howard: What about asking your friends and family to leave a review?
Adam: If somebody's a patient of yours?
Howard: Yeah, I'm talking about a patient.
Adam: Then I'm all for it because there's nothing that I see that says you can't ask people to give you a review. Google doesn't want you to incentivize them to leave a review, but there's nothing in there that says you can't ask patients, at least the last time I looked.
Jake, you can maybe answer this, but you can ask your patients to leave reviews, and I would encourage it. In fact, we have products and systems in place that actually teach doctors and work with doctors and their staff about how to go about doing this the right way and the ethical way and staying within the terms and conditions of sites like Google and Yelp.
Yes, I would say go ask anyone that's a patient to leave reviews if they've done business with you.
Howard: There's people talking about Google Maps and that that's a new thing and a big thing. What should dentists driving to work be thinking about when I say Google Maps to find their dental office. How do you optimize that?
Adam: Jake, do you want to take this?
Jake: Again, I would advise every doctor to think about any Googles. If they were in Google's shoes, what would you do? To touch on the reviews, if you're Google, and you have a practice that has a 4.7 rating and you have a practice with a 4.1 rating, if you're Google, who would you rank first? What's the better practice to you?
Jake: It's quite clearly. In fact, there was recently an update and nobody really notices but on your phones now, there's a little button where you can filter out, so far there's dentists, and they're just testing this right now. I can click one button and filter out anyone that has lower than a 4 stars rating.
Howard: It's 4 or 5? Oh okay, it's 1 to 5.
Adam: You can choose.
Jake: You can choose. Think about it from Google's perspective again. They're representing the consumer. Why wouldn't they give them the best dentists that have between 4 and 5 ratings? Why not just filter out everyone? Give the consumer the option to filter out anyone who's under a 4 star rating. If I was a doctor, I would be obsessed right now with getting my rating up as high as possible because Google has no incentive to show my practice if I have a poor rating.
Howard: Wow. When did that come out?
Jake: 2 or 3 weeks ago they really changed Google Maps. They made the desktop experience look very similar to the mobile experience. What they're trying to do is unify everything so it looks the same. If it looks the same on desktop and mobile, that's what they're going for.
Think from Google's perspective. You can predict what they're going to do later on. If we know they're going to show the best practices. Here's a great example, Howard, you'll like this: when I do a search, why would I want a dentist to come up right now that's closed? Right?
Howard: Right, right.
Jake: It's during the day, and so they're making it more and more clear when I do a search who's open and who's closed. We're noticing doctors that they're showing up everywhere, and they want to get patients, but they're not getting any phone calls, and if you do a search, it says there in big, red letters "closed". The four competitors are open, so why would anyone call a closed practice?
Google wants to show more and more who's open and who's closed. The practices that are serving patients are just going to continue to rise to the top.
Howard: Wow. That is profound. That means a lot to me. You Google a restaurant and automatically right there "closed" or "in store".
Jake: Why would you even want to show up?
Howard: I love that feature, and I hadn't really thought about that from my own office.
Jake: I understand doctors don't want to work every day of the week, and I get that we want to get more fees per service, we want to work less, I get that. There's strategies you can put in place. If we had a practice, Adam and I, we would have phones being answered throughout the week, and maybe not taking appointments throughout the week, but at least our office is quote unquote open, right? [crosstalk 00:27:24]
Howard: That's sweet.
Adam: 7 days a week.
Howard: You don't have to have the restaurant open, but you should have the maitre d' open so that Google hours, when they're searching, you're open.
Jake: Exactly right.
Adam: My resolution to any dental practice is hire someone to answer your phones from 6 or 7 AM to 8 or 9 o'clock at night and mark yourself as open during those times so you can accept calls, and then tell your patients we don't have any openings at this time, but we have openings at this time. I would do that 7 days a week.
Jake: Just to be clear about it, I did get a doctor recently who a patient called up and said, "You said you're open on your website, but you're not taking appointments." We just put in parenthesis as taking appointments on Monday through Wednesday and then answering phones Thursday and Friday.
Adam: Right. I mean that in terms of Google.
Howard: I live 3.0 miles from my office, and my associate lives across the street from the office, so we can say it's home because if it's a true emergency and they had to come down, I'd be there. I can be in my office in 4, 6 minutes.
Jake: That's about having your phone staff trained in a way that can explain that. You can explain it to the patients in a way that they don't get upset. Google's going to continue to reward the best businesses, and from a new patient perspective, yeah, I want a doctor's office who's open more than not open. If you're only open 2 days a week, Google's not going to reward that over time.
Adam: Also, like I said earlier, Howard, if they're tracking engagement and people aren't clicking on that listing, but they're clicking on all the competitors' listing, that's natural selection. It's just going to move them down the list because people aren't engaging with them because Google's saying that they're closed.
Howard: Could you say Google to Yelp is the 80/20, or do you think they're equals in importance?
Adam: In terms of?
Jake: I would say concentrated on Google, but a negative Yelp review is very, very detrimental. People trust Yelp a lot more because it's very hard to leave a review. Doctors get upset because good Yelp reviews get taken down a lot of times if it's somebody's first review they've put up. I say, "Howard, can you give Fire Gang a review on Yelp?" If it's your very first Yelp review, a lot of times, Yelp will say, "We don't trust this Howard guy. Who is he? This looks fake," and they'll take it down.
It's very hard to get a review on Yelp. The people that do use Yelp very much trust it. We say build positive reviews on Google, and if you have a negative review on Yelp, definitely address that because people trust it very highly.
Howard: Definitely address it by calling the person who left the review and trying to get it taken down?
Adam: If you can.
Jake: If you can. Everyone has different opinions on this, and the terms of service for Yelp and Google change, so we have to constantly be adapting to that.
Howard: Let me just throw everything you said into the trash can and say, "Hey, why don't you just buy the first place listing with a Google ad and forget all the SCO and just buy a Google ad so when you put in 'Phoenix dentist' I bought the first position." What do you think about that?
Adam: Most of our programs we do work paid ads into them as well. The thing is is search engine optimization and all these other things are a long term strategy, a long term approach. SCO isn't overnight. However, paid ads are, right? The moment I put a credit card on file with Google and tell them to start running ads, they start running ads. It's a double edged approach because I can get immediate traffic and immediate leads through that, but it's going to cost a lot over the long run, but it still could be a positive return. Practices still do that.
We look at it as you should be running ads, and that could subsidize the investment into the search engine optimization.
Howard: Does Fire Gang help dentists buy Google ads for their office?
Adam: Yes. We do Google ads, we do Facebook ads, we do ad targeting.
Howard: What percent of your customer dentists have you buy Google ads for them and wlak us through that. How much is a Google ad, how long does that stay up, are they working for your clients? Compare that to a Facebook ad.
Jake: A great example is let's think like we're Google. What percentage of Google's revenue comes from ads, their ad network?
Howard: I assume 90%.
Jake: Yeah, it's like 95, 96%
Adam: 97, yeah.
Jake: They obviously want to make those work because if we threw up ads and no new patients called, we'd stop using ads tomorrow, right? Every morning when Google gets up, they're trying to figure out how to make ads more effective and more useful for us so yes they absolutely work. Over the past 5 years, Adam, you agree, we see them working better and better.
Adam: Oh yeah, yeah.
Jake: Because Google wants them to work.
Adam: They're all predictable. You can replicate results.
Howard: Walk my listeners through it. How much is an ad? I wouldn't want my ad on a day I'm closed, if I'm closed on Saturday and Sunday. How much is the ad and do you have any feel for like a dollar per ad, do you usually have to run 100 dollars of Google ads? Talk about that.
Jake: The way we're structured, we let the doctor decide how much they want to spend. If they want to spend 300 1 month and then 1,000 the next month, they control that. We use a lever up and down based on what the doctor says. Anything less than 500 a month is really tough, so most of our clients are 500 to 1,000, and we call them up every couple of months and say, "Hey, are we good with this spend?" We just like to give that control to the doctor.
If a doctor's doing it themselves, a lot of doctors try it out and they don't have success because they're not spending enough. You need to spend, I would say, at least 3, 400, really at least 500, and if you really want to be in the ball game around a grand.
Howard: A grand a what? A grand a week?
Jake: A month. A month.
Howard: Spend a grand a month.
Howard: A grand a month would be 12,000 a year.
Howard: What does the average dental office collect a year?
Jake: Collect as far as production total?
Howard: Revenue. According to the ADA or something like that.
Jake: I don't know that exact number. I could tell you from the people that contact us, would you say it's 6, 700,000, Adam?
Howard: No, you're getting a number 6, 700,000 because people who collect 6 to 700,000 use people like you. The average dentist is more close to like 450. Any time I meet a dentist and they have an in-office consultant working with their practice, and they're working with people like you, yeah, they're million dollar practices. That's why they're million dollar practices.
Adam: Yeah, most are around the million dollar or more.
Howard: What's funny is if I could go through all my friends right now who are using a $50,000 per year consultant, none of them even need it, and they're all doing 1 to 3 million, and then every poor Nick and Harry that's just about ready to hang himself on the ceiling fan doesn't use a consultant because they're trying to save $50,000.
Jake: That's exactly right.
Howard: You've got to spend it to make it, and these consultants don't make a living because they're charlatans, they make a living because you give them a dollar, and they get you to earn your dollar back plus some.
Jake: It's really interesting, this is what Adam and I ...
Howard: You're saying your average customer dentist is doing 600 to 700,000?
Jake: Minimum because here's what we find, Howard, and this is where we really are passionate because the doctors that call us up that are at 500 or 400, we can get them phone calls for the budget they want to spend, but it doesn't matter because there's much bigger issues. If they're only a $400,000 practice and they want to be bigger, I understand if they want to stay that size, and they haven't been able to get that big, there's fundamental problems in the practice. The internal marketing's poor, their staffing, they're turning over staff too much, they can't answer the phones correctly. No matter what we do for a $500,000 practice, it's going to fall flat because they have structural, foundational issues in the practice.
Howard: What do you think your average doctor is spending a month?
Jake: 1,500 to 2,000 a month on average.
Howard: Just on Google ads?
Adam: Not including ads, no.
Jake: Not including ads, no.
Howard: I'm talking about just on Google ads.
Jake: On Google ads, let's say about 750.
Howard: 750. Would that be the same for Facebook ads? What's more potent, a Facebook ad or a Google ad?
Jake: Google ad.
Howard: A Google ad?
Jake: Right now. We are seeing some success with Facebook ads, but it has to be done very particularly. In fact, I haven't seen anyone doing it right, but we're doing some testing right now and getting good results. I would just concentrate 80/20 I would just say all Google for right now.
Howard: Dentists are more pro-Facebook than Google because the founder of Facebook, Mark Zuckerberg, his dad is a dentist named Ed Zuckerberg.
Jake: I like the loyalty.
Howard: Sergey Brin and Larry Page's fathers were not dentists, so that's a huge minus. I should leave them a negative Yelp review. They had the wrong father. You're saying concentrate on Google reviews, concentrate on Google ads, spend at least $1,000 a month, and you just do the whole ad for them? You can just one stop shop, you do the ad, they don't have to get involved with that?
Jake: The key to ads is you have to have a lot running to see what's working. Versus a doctor that just wants to throw up ads themselves, and we have the advantage of working with lots and lots of ads, and so we know in every market exactly what patients are clicking on, right? For example, we know if you want dental implant patients, you need to run ads about dental implant costs because that's what people are searching. They want to know the costs. Once you get them in your funnel and reading your page, and then maybe they get the confidence enough to give you a call, and then you answer the phones in a really good way, then you potentially have a dental implant patient. We know from lots of testing that that's a key word that you want to run ads on.
Howard: We hear a lot on Dentaltown people saying that the top keywords that people are searching for are dental implants, cosmetic dentistry, and pediatric children's dentistry. True or false?
Jake: We're getting a little bit of our secret sauce here which I'm happy to because for you, Howard, we can do it. Cosmetic dentistry, we haven't seen a ton of people. Here's another thing I would say for doctors. If I were a dentist, and I really wanted to increase my patients, I would become obsessed with getting in the minds of new patients, and it's really easy to do that. At dinner parties just ask people if you've had a tooth ache or you wanted to get a smile makeover, what would you do? Become a connoisseur, like a wine connoisseur, for what people think and search. They'll answer all these questions for you. Just me and Adam have done this a million times already. Cosmetic, not really. We don't see a ton coming in for the word cosmetic dentistry.
Howard: I agree. You look at all the cosmetic dentistry, and it's always veneers, veneers, veneers.
Jake: Exactly, or a smile makeover.
Howard: You walk into every dental office in America, and it's not even 1% of revenue.
Adam: Right, right.
Howard: It's all the buzz, and it's all smoke. It's like, really? You mean you pay your mortgage each month from whitening cases and veneers?
Jake: Think about it from a patient's perspective. If you asked a patient actually what they search is "I hate my dentures". They say dentures replacement. That's how their brain works. They don't even know a lot of times that implants are an option.
Howard: People actually type in the Google search bar "I hate my dentures"?
Jake: Tons. Yes. You can ask Ryan, give him a call, who does a lot of denture work.
Howard: What's in their head? I think most of our viewers only want to hear about what they're thinking in Phoenix, not where they live.
Jake: In Phoenix, what they're saying. They search things like "tooth ache", "I have a tooth ache". I've got to question whether to give out our secret sauce away, Adam. You give me a look if this is bad.
What they search is insurances. They search specifically by insurances, and I know a lot of doctors want to move away from insurances, but you're swimming upstream because patients are moving towards, they're searching more and more "dentist that accepts Delta Dental".
Adam: One thing I was going to mention is that for practices that want to get implants or cosmetic, we see the bulk of those patients coming in as normal patients that are worked with and given a 5 star experience and educated internally and they then trust and then they can be sold. Most people aren't swimming around the internet with 40 grand in their pocket saying, "I want to go spend that on my mouth because that's exciting to me." I could go do a lot of other things with that money, but if they come in because of a smaller issue and they have this amazing experience, you could build them into that $40,000 case. We have clients, large clients that do this every day, and they are very successful with it, and they get that. That is their model. They will get people off the street for implants and people off the street for veneers, and the secret sauce of those guys is reviews and creating videos and things like that.
Jake: You know what I think the secret sauce is? I think the secret sauce is that 99% of dentists want to build this Ruth's Chris Steak House for a handful of Americans, and McDonald's and Burger King are making all of the money.
Adam: Right, exactly.
Howard: Why do they not realize that Ray Kroc owned a baseball team in San Diego, and Henry Ford said, "Build a car for the rich classes, and you'll be poor and eat with the masses, and build a car for the masses, and you'll be so rich you'll eat with the classes"? Why do dentists always want to chase this mythical unicorn dental office that's limited to veneers and full mouth rehabs when 90% of their own pedigree from their own family reunion can't afford any of that crap? The dentists that go in there and focus on the vast middle class, they build million dollar practices.
Jake: They crush it. What we have people tell us is they get tired of doing the same cases, the monotony, they get tired of dealing with the insurances, and all of that, and I understand that, but from a business owner's perspective, if that's the case, the most successful practices realize that early. We have a lot of young doctors who are realizing this, and they're crushing it because they bring in associates to deal with the stuff that they don't want to deal with. Our biggest clients just deal with the smile makeovers, the very artistic type things, and they have associates that deal with stuff, but they build 5, 6, 7 million dollar practices by this. You have to build somebody up. You have to build their trust to spend 50 grand with you, and they're not just going to call you up off the street, especially when they have so many options. They bring the people in, associates cleanings, tooth aches, wisdom teeth extractions, and then when they're ready for that smile makeover, then they get to the head honcho.
Howard: The same dentist whining about corporate dentistry. Corporate dentistry exists for two reasons. Number 1, they're providing jobs for all these associates. If you've got 125,000 general dentists, they don't employ the 5,000 general dentists, of course 1,000 of them will go to Heartland and Pacific and the people that are taking care of these guys and giving them CE and all this stuff. Go back to hours. What are the successful dentist hours?
Jake: I'll put it this way. If a practice comes to us, and they're open for convenient hours, and it doesn't have to be crazy, we're just talking being open 5 days a week maybe, if you can stagger and be open in the evenings, it's all really basic business stuff. You're going to open yourself up to a huge amount of people, but you're open 4, 5 days a week for 10 hours, 12 hours a day, and you have good phones and a good new patient experience, without a doubt, those patients explode online. It's actually not that hard to be really good online, Howard. We're SCO people, and we're marketing people, but you hear us talking about phones and hours and providing patient experience.
Adam: Basic business sense.
Jake: That's what's going to drive a practice.
Howard: My motto on dentaltown.com, none of us have to be alone again, so there's dentists driving in their car, and they're thinking, "Okay, well, be more specific about hours." What is your average hours crushing it, specifically? What time do they open, what time do they close?
Jake: For me, I always picture if I had a practice, I would do, in a perfect world, and Howard because we get push back in all of this, so a lot of it I just don't want to hear it. I would be open a couple of days in the evening. Think about it, everyone's at work.
Howard: What is evening?
Jake: Till 7.
Howard: Okay, till 7.
Adam: Maybe even 8, yeah.
Howard: A couple days till 7, maybe 8.
Jake: 10 to 7 Tuesday Thursday, 8 to 5 Monday Wednesday Friday, perfect hours.
Adam: If you want to kill it, do a Saturday. Work on a Saturday.
Jake: You want to know what people are searching? People are searching "dentists open Saturdays". Tons.
Adam: Yep, all the time.
Howard: Go through the top 10 searches that you think. You mentioned insurance companies, hours, I hate my denture. Rattle through things they're searching for.
Jake: You want me to go, Adam?
Jake: If you're a general dentist, and you accept insurances, they're going to search, here's a big one, "dentist near me", they search "dentist near me" a lot. A lot of people do search "dentist + city", they'll search suburbs, "dentist east Phoenix", or whatever the suburb around you is. You may want to target anything within a 10 mile radius. Every city has its own little names. People search that. They search emergency a lot. A lot of times they have an issue. Somebody wakes up in the middle of the night, and their tooth's killing them, and they say "tooth pain", or they do a little research and see it's an abscess, and they say "fix my broken tooth" and things like that.
Howard: Back to insurance, are they typing in "dentist near me who takes Blue Cross Blue Shield"?
Jake: Absolutely. They can go to Blue Cross Blue Shield's website and sift through it. I don't know if anyone's done that, it's a terrible experience to do that. Or they could just search that, and then the dentist whose search comes up on Google, so you need to be specifying on your page with the words "I accept Blue Cross Blue Shield".
Adam: You should have an insurance page, you should be talking about it throughout your site. That's the stuff you got to have.
Jake: People care about, yeah.
Adam: They care about, and you look at all these sites, and they're just missing this altogether. They don't even list these basic things that consumers want to see.
Jake: Financing. Finance is another big one. "Dentist who has financing". The data is showing that search terms are getting longer and longer, which means people are getting more specific.
Howard: I heard Larry Page say on a YouTube video I was watching that since he's had Google that the length of the search has been steadily growing at 5 per semi year.
Jake: Exactly. It basically goes from our brain into Google, right? People don't really think "I need a dentist", they think "I need to fix this tooth that's absolutely killing me", "my tooth hurts".
Adam: You start to see more with voice search through your phone. You can do Okay, Google or Okay, Siri, or whatever, and people are starting to type in search terms through their phones, and they're just talking as they would normally say them.
Howard: That is interesting. I love asking Siri the bizarrest questions like "Siri, where should I bury the body?"
Jake: She has an answer, too, she always has an answer.
Howard: It's funny. If you ever got kids under 12 in your car, and you start doing that, they just crack up laughing. We talked about Yelp. Talk a little about Facebook. You said concentrate on Google.
Adam: There's 2 parts to Facebook. There's the ads, and then there's the social aspect of it. Consumers starting their search for a new dentist aren't going to go to Facebook and type in "dentist in Phoenix", they're not going to type that into Facebook. We get a lot of practices that think they need to start their marketing efforts there, and it's not there. Facebook is good for re-engaging existing patients if it's done right, but that's a step down the road.
They've got to figure out how to get new people in the door to begin with. How do you do that? You get out in front of people where they're starting their search. You can acquire new leads and new patients through Facebook ads. Again, like Jake said, most aren't doing it right. We initially weren't doing it right. We've been doing a lot of testing, AV testing, we do a ton of that, spend a lot of money on testing so that we can understand how to leverage it and how to maximize it, and that's something that the small dentist trying it themselves, that's probably why they're going to fail is because they can't scale the testing at capacity in some cases.
On Google, you got a lot more leeway, right? You know that people are starting their search there, and it's just being where people are looking initially. In a nutshell, focus your marketing efforts on where people are starting their search, which is Google. Don't dive into social media because that's not going to attract new patients.
Howard: When I Googled you, I found out that you have the number 1 book on Amazon.com in dentistry and marketing. Talk about that.
Adam: If you go to Amazon, just type in "dental marketing", it's the number 1 book.
Howard: Congratulations, guys.
Adam: Thank you.
Howard: That can't be legit because you're in Seattle, you probably were at a coffee shop just like those [inaudible 00:50:04] said, "Jeff, I'll buy you your coffee if you make my book number 1." Is that how it went down?
Jake: It's exactly how it went down.
Howard: That's exactly how it went down? That guy, talk about think outside the box. Does he even know where the box is? That guy's literally a genius freak. Anyway, talk about your book. Congratulations on Dental Marketing getting number 1 top spot. Hell, you even beat Fred Doyle. Talk about that book. I think last I looked, 7,000 dentists are listening to my show, tell them why they should go to amazon.com and buy that book. Can they find the book if they go to your website firegang.com?
Adam: As part of this dental podcast promotion, we'll actually send everyone that registers a free copy. Meaning that if they go to our website and they ask for a free copy of our book, we'll send a copy out, and we'll pay for the shipping.
Howard: Why don't you just send a digital like a Kindle reader?
Adam: We find there's value in a real product. It costs money of course, it costs us between 5 and 8 dollars a book after shipping to get in the hands, but it's the experience. Like anyone else, we're investing money to create an experience with these dental practices because we know a percentage of them will call us after reading the book and after seeing that we gave it to them.
Howard: Ryan, what number of podcast is this for the Howard Speaks? It took 150 podcasts for my listeners to get something free. They'll say, "Finally. I had to listen to that dumbass for 150 hours before I got something free from Howard."
Adam: Hey Howard, can we promote this on Dentaltown now?
Howard: What I'm thinking is this. The one thing I've learned, I don't really know the 7 billion people in the world, but I know my 2 million dentists. I wanted to be a dentist in the 6th grade, so from 12 to 53, 41 years. What I find interesting about dentists is we put up about 325 courses on Dentaltown, and they've been viewed about a half million times, and a lot of them don't want to do a podcast. They even tell me because they don't get the credit. The AGD credit. They're trying to get their fellowship. Anybody can get their state requirements, but when you're trying to get your fellowship in the Academy of General Dentistry, you need 500 hours. When you're going on to get your mastersship, you need another 600 hours. There's an obsessive group that they would never listen to you guys for a minute if they weren't going to get an AGD credit.
You guys are doing a podcast now, and that's a totally different behavior. That's a multitasking behavior. All my dentist friends tell me, 80% of them, on an hour long commute to work, or they're on a treadmill, a lot of people say they listen to 4 podcasts every Saturday morning because it takes about 4 hours to do all their laundry, dishes, shopping, everything. I think you should do an online CE course on Dentaltown, and tell them if they watch your course, that when it's all over, you'll send them a free book. It's a totally different behavior than a podcast.
Believe it or not, this is what's silly about dentistry. The most successful thing in Dentaltown, when you talk to any dental manufacturer or any dentist about Dentaltown, when some guy comes up to me and says, "My god, I love Dentaltown". 4 out of 5 times, they're only talking about the magazine.
I went through dental school with 4 guys, my best friends for life. They've never been to my website once. Every time we go fishing out in Cabo or meet up at Vegas, I'm like, "Dude, did you ever out of just respect and courtesy go to my lifelong magnum opus work dentaltown.com" and they're just like, "No."
You know why that is? When the answer machine came out, that technology disrupted all the secretaries, and they think the answer machine got about 3 million secretaries fired. Guess who was 2 secretaries till the day they die? If I say to my best friend Craig Syken, a dentist in Albuquerque, "Well, Craig, how did you get that book?" "Oh, I just told Anna. I just walk up and tell Anna." "Well, how did you buy the plane ticket to Vegas?" "I just asked Anna."
Every dentist has 2 secretaries so why would Craig have to go onto Amazon to buy a book? Why would he have to go figure out how to buy a plane ticket? Why should he book a reservation with the Cosmopolitan when he could go in there and do a root canal and have Anna do it?
Dentists are going to be what we call enabled with secretaries till kingdom come. They're just never going to lose their secretary, whereas in the Fortune 500, most of your key management people lost their secretaries. Dentists are a unique bunch of people, and that's putting it mildly.
The last point I'm arguing, next month, when they do this podcast which has exploded. It's only an hour segment. The next segment next month we're adding audio books. You could have someone read it, but they might want to listen to you. You could go read that book. How long would it take you to read that book?
Adam: It's about a 200-page book, but there is a lot of images and stuff in it. The book itself, the reason that it's been successful is it's very hands-on. Our goal was to be able to enable any dentist to pick up the book and follow it step by step by step with the actual, executable secrets at a pretty realistic level and actually go and do it. There's a lot of meat to the book, and that's something you don't typically get.
Howard: Are you saying like do-it-yourself cookbook where they wouldn't even need you?
Adam: Yeah. To a degree. It's obviously, you look at the pyramid, and it's teach, show, and then do. We're teaching them what exists. If somebody wanted to go out and run their own paid ads, they could open our book, open the section about it, we'll teach them exactly how to create an ad word campaign on Google, how to write the ads, what to look for, what negative keywords are, all these other elements so that they won't waste time and money, and it's all broken out. When they want to go next level, that's when they call us, or they get busy, and they don't want to do it themselves, but now they understand it, that's when they call us.
Howard: Let me tell my secret sauce for my homies on how they think about consultants. It's very counter-intuitive. Consultants always think if I tell you how to do everything, dentists are smart people, they got As in Calculus and Physics, they're going to do it themselves.
Adam: They won't.
Howard: It's exactly the opposite. Dentists know they're smart people. You can't get As in Calculus, Trig, and Geometry, and Bio, Chem, and they know they're smart people. They first want to know how you think. The consultants who share everything they know and the dentist reads it and says, "I'm a smart guy, I had a 4.0, I like the way these guys think, but I don't want to do this. I don't want to implement it."
It's kind of like when a dentist goes to a restaurant. He wants to know is there pizza or steak or fish, and then he wants it all transparent, and when he picks a fish, then he wants you to cook it.
The consultants that hold all their cards their best don't do any business, and the ones that share exactly everything because dentists are afraid of consultants like, "Well, I don't want to bring in this consultant because I think they're going to tell me to cancel all my insurance and become an implant dentist, and I don't like surgery."
If the consultant says everything they're going to do, then the dentist says, "I like the way you think, and I don't think I'm going to get her done, and I'd rather write you a check and you just get her done, than me sit there and know what to do and never get it done."
It's like why I have a personal trainer come to my house every morning at 5 o'clock because if she calls and cancels, I think there really is a god. There's 0.00000 chance I would get out of my bed on my own and go run 8 miles. I've got someone screaming at me by me the whole way. They just want to know how you think. What's the best way to get ahold of this book? Go to firegang.com.
Jake: Slash Dentaltown. We'll make a specific Dentaltown giveaway for Townies, and we're going to add some other stuff in it too. If you're all right with that, Howard, we'd love to just give your audience.
Howard: Yeah, do it. I don't know if the slash Dentaltown, I don't know if my viewers are that sophisticated. I know the ones 50 to 65 probably don't even know where the slash is.
Jake: All right, we'll just put it on the home page then.
Howard: Yeah, put it on the home page for the older, senile group.
Adam: We'll put a link too, a Dentaltown link.
Howard: Do you think you might do the audio book?
Adam: Maybe. We haven't actually thought about it.
Howard: Our business model, just like our online CE, you can charge for the online CE and make a profit, that's fine too, and the audio book same thing. You can put it up there for free or put it up there for a settlement, but I do think the smartphone is going to be bigger than the PC because this is what I've noticed in my half century on this planet is sometimes you're going out the driveway, and a kid will stop and say, "I forgot my phone." They never made you go back to get a thousand other important items in your life, but now it's like people almost feel like they left their hand or their foot or their head on the kitchen table if they don't have their smartphone. It's like a part of their body. They're very attached with it, and they get anxiety when they're separated.
I only got you for 60 seconds left, so what's your big close? Tell them how much it costs, and tell them how much they should spend on marketing. Give a close on why I should hire Adam and Jake at firegang.com. Why should I hire you? How much does it cost? Give me your best close.
Adam: Can I have more than 60 seconds?
Howard: Sure. We'll call that overtime. Take it away.
Adam: The reason that we believe you should choose someone like, and I'm not going to say just us, but someone like us, is that we aren't just after improving the marketing, but we're trying to improve the practice and the patient experience at the same time. We look at it as a partnership. We want to come in and partner with the practice to make them more successful overall. Help them do the right things in their organization that will help them improve, not just with the marketing, but everything else overall.
We're not a full consultancy or anything like that, but we are trying to instill some of the basic business principles that they should employ to be successful.
Howard: Does that mean you're going to go physically to the office?
Howard: You do it all online?
Adam: It's all remote, but many of the things are like just basic tracking. We talk to dentists all the time that don't know their numbers. Showing them how to read their numbers and understand them and what to look for and how to track them properly. We do a lot of tracking ourselves. How they should answer their phones, what hours they should be open, how they should deal with inbound leads.
Howard: Do you actually call the office and report back, "Look, I've called your office 5 times, and 3 times went to hold, and the other 2 times."
Jake: We listen to calls.
Adam: Yeah, we listen to calls.
Jake: We tell them, "Look, this receptionist Diane is answering this question really poorly and just lost you a $10,000 case."
Howard: Do you think you should change your name to Fire Gang Dental Lawyers? Bottom line, how much is this service? How much money am I going to give you?
Adam: We have packages on the low end for practices that are trying to build the foundational elements to their practice, and then we have programs on the high end for practices that are 4 million a year plus. On the low end, we typically are going to come in just over $1,500 at the very minimum.
Howard: 1,500 a month?
Adam: Yes, and then you might see that range up to 2,500, $3,500 a month. That's usually kind of the spread, if you will.
Howard: Another number would be to look at, what percent of revenue should a dental office be spending on marketing?
Adam: Easy 6%.
Howard: Of that 6%, how much of that should be digital marketing as opposed to traditional yellow pages, billboards, print, flyers, these things.
Adam: I would say 95% easy.
Jake: I would say, if tracking is in place, you just divide them out and you can figure out how much cost per patient each medium was. We have doctors that send us reports, and the Internet continually ranks the cheapest per patient.
Howard: What is that number per head about usually?
Jake: There's a lot, a lot of factors. Anywhere from 150 to 400 maybe 500 per head depending, but there's so many different factors, but that's kind of a rule of thumb.
Howard: Yeah. Is this true or false: do you still think Yellow Pages does work in some small towns in rural America?
Adam: Potentially. I would say though, track it. Put a tracking number in that ad.
Howard: It's all about tracking.
Adam: It is. 100%.
Howard: Okay. Will you do me a favor. Will you go to my website todaysdental.com and whatever your thoughts are, email that to me firstname.lastname@example.org? Or what I'd really love, there's already a thread, what do you think of Howard's mobile site because like I say, I'm not being just selfish and self-interest on I want my website to be the best. I'm in a damn competitive market. It's so different if you're in San Fran or Phoenix or Manhattan than it is if you're in Kansas.
Adam: We work with people in Phoenix and Mesa, we know.
Howard: Yeah. Okay, well hey. That's an hour and 3, we went into 3 minutes overtime. I think you guys are just awesome guys. I'm your biggest fans, I think you're crushing it. I hate you because you love the Seattle Seahawks, but other than that, you guys are rocking it. Best of luck to you, and if there's ever something new after this podcast since it's such a hot topic, if you ever want to come back and tell us more information, just come back because when you talk about getting more new patients, every dentist ears perked straight up.
Howard: We're firemen, we want a house on fire. We're policemen, we want to chase a bad guy. Dentists, my dream every day I walk in my office is to get some emergency that's swollen, in pain, hasn't slept for 2 days, that's what's my adrenaline rush. I don't want to go play golf, I don't want to go bowling. I want the hottest tooth in town by the scariest person that would rather get hit by a truck than get a shot. That's what turns me on.
Jake: You're a sick man, you're a sick man, Howard.
Howard: Thank you for all you do for dentistry and good luck to you.
Jake: All right, thanks.
Adam: Thanks, Howard. Bye-bye.