Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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256 Leadership Through Communication with Lisa Knowles : Dentistry Uncensored with Howard Farran

256 Leadership Through Communication with Lisa Knowles : Dentistry Uncensored with Howard Farran

12/13/2015 2:00:00 AM   |   Comments: 0   |   Views: 466

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AUDIO - HSP #256 - Lisa Knowles

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VIDEO - HSP #256 - Lisa Knowles

• Leadership in marketing aspects of a dentist's practice.

• Leading the profession with changing demographics, particularly relating to the influx of women in dentistry.

• Leading with LEED (leadership in energy and environmental design) knowledge and eco-friendly dentistry.



Dr. Lisa Knowles offers real-life dentistry expertise in the areas of business communication, oral & systemic health, and leadership development. She is a strategic, big picture thinker and thrives off of helping others be better. She is a natural teacher with a competitive coaching edge. Dr. Knowles speaks internationally and writes prolifically. She graduated from Alma College with a B.A. in Communication, and then graduated from the University of Michigan School of Dentistry in 1998. Her blog site is Find more on her website at


Lisa Knowles, DDS


Howard Farran: It is a huge honor today to be podcast interviewing one of the most prolific writers in Dentistry. You write all the time, I love your stuff. Lisa Knowles, in Lansing, Michigan. How far away, now, how far away is Lansing is Grand Rapids? Is that, what, an hour up the street?

Lisa Knowles: About an hour. Mm-hmm (affirmative)

Howard Farran: Yeah. Which was the first city in the world to adjust the fluoride in their water. 

Lisa Knowles: Yes, that is our claim to fame here in Michigan, for sure, one of those big dental things.

Howard Farran: If you're a Dentist, that is our Mecca. I've been there several times. That's an amazing legacy. So, how are you doing today?

Lisa Knowles: I'm good. 

Howard Farran: So, tell us about your website. Your blog is "Beyond 32 Teeth," but your website is "" And that's even your email, What is Intentional Dental?

Lisa Knowles: That's my consulting business side. My business arm, if you will. And then, I started a blog site, and I wanted to name it something that I was into. The Beyond 32 Teeth concept kind of came up and, actually, I'm going to merge the two of them. The Beyond 32 Teeth kind of branding and concept has kind of taken off, more so than the Intentional Dental consulting. Although, I will still have that piece of the consulting, as well, under the big umbrella of Beyond 32 Teeth.

Howard Farran: Well, that's pretty rare, that you're a Consultant and a Dentist. Most, I'd say 99% of Consultants aren't Dentists. Would you agree with that? 

Lisa Knowles: I would agree with that. I think that kind of sets me apart a little bit. And, honestly, Howard, I never thought I was going to be a Consultant in my whole life, either. I thought I was just going to own this dental practice in Charlotte, Michigan for the rest of my life, until I was like 60, practicing. It was kind of a big surprise to me, as I let that phase come into my life. So, I will say ...

Howard Farran: What started it? What made you start consulting? How was that journey begun?

Lisa Knowles: It was kind of a realization when I had my own practice, that I started seeing these patterns with my patients and their oral and systemic health. I realized that I was communicating to them in a different way. Basically, a couple of hygienists who subbed in my office pulled me aside and said, "How did you learn to do this?" 

To me, I was like, "Do what? This is just me." And, well, "Talk to the patients and get them to change their behavior, and get them excited about their health, and seeing all these things and talking to them. We've never done this before." 

It was a little bit naivete on my part, I just thought every Dentist kind of evolved like that. We get in our little practices, and some silos, and we go to our little CE courses, and learn our certain things, our clinical things. I thought everybody kind of ended up doing that, and that was the goal, is to have our patients change their behavior, not have cavities, brush their teeth better, yada, yada. 

I didn't know it was going to happen, but then when I figured out that I was doing something a little bit unique, and I had this background in communication, I think that dramatically helped what I was doing. Then I thought, "Wow. If I can get this kind of change in my patients, and I'm doing something a little bit differently, we all could be doing this." 

And then, kind of at that same time, the whole oral and systemic health picture started kind of blowing up, and becoming more known in Dentistry. And I said, "As a Dentist, I do have a little bit of credibility of seeing the things clinically and then, being able to talk about it, too, and then write about it." Which, with the third part, about writing, a lot of Dentists don't like to do a lot of writing, just haven't had a lot of background in it. So, I was lucky. I chose that as my undergraduate major, kind of as a backup plan, really. I wasn't sure I was going to get in to Dental School. I didn't want to be a Chemist, or a Biologist. So, I said, "You know, um, Sports Broadcasting or Journalism." That was Plan B. So, luckily, Plan A worked out. But, hit it just perfectly right. I mean, communication is so hot right now. We need that so much, with our doctor/patient relationships, and getting along with our teams, so it's worked out very well. Good timing on my part. 

Howard Farran: So, you're talking to thousands of dentists right now, and they're probably all alone, driving to work. The reason our podcasts are an hour long, is because that's what they're all telling me they want. They have an hour commute. So, talk to the individual. Who would be a perfect fit for you? What does your Consulting do? How much does it cost? Who are the people that invest in you, and make a good Client, a good fit?

Lisa Knowles: The vast majority of my market, or in my Consulting business, goes after speaking and writing opportunities. So, I'm looking for those people in their Dental Societies or Dental Groups who want to have a little different picture brought to their group. They want to learn how to be more effective communicators. They want to understand more of this oral and systemic health picture. They are hearing about it, the research about it, but, "Yeah, what now?"

So, they don't really know what to do with it. You know, we have this "expert role" as Dentists, we keep telling people, "Oh, about this, you know, your periodontal disease is correlated, could be correlated to your heart disease." But, we keep doing this kind of top/down type of management, with our patients. Patients still aren't really changing their behavior, and it kind of goes in one ear, out the other. We're not getting as much value and purpose out of what we're doing. 

So, that's where I come in. I talk to the groups, and speak to the Dentists, and say, "Hey. Have you thought about this angle? What about this?" And related that to the oral and systemic health connection, but also in how to be a better communicator and truly evoke change. So, that in turn, sometimes has turned into some coaching, mentoring, for specific teams, or even Dentists in general who just want to kind of up their game a little bit. They know that they're not being as effective in getting some of the change, or doing some of the things in their office that they want to do. So, I've worked with teams as far as working through some conflict resolution, creating goals. I love the business side of Dentistry, too, having owned my practice for a number of years. It just, I have that little bit of wealth of knowledge that I can help most Dentists through what they're struggling with.

Howard Farran: You know, it's kind of funny, because humans think at 2015, we're really advanced. But, when you think about the fact that, from now to Cleopatra, was a shorter time period than from Cleopatra to the building of the pyramids. And when I stand back and I look at all human history, we're still really on the witch doctor theory. You've said "changing behavior" several times, and nobody on earth is really starting to get that. I mean, they still, they have something wrong, they go to a witch doctor. He pulls out a knife and cuts something off, or he gives you a lotion or a potion. 

Lisa Knowles: Right.

Howard Farran: And today, the lotion and potion is Pfizer, and Merck, and Johnson & Johnson, and GlaxoSmithKline. They still just want to do surgeries, surgeries, surgeries. And the medical model is really the witch doctor theory. It's really extinct, and trying to get people to realize that, you know, I think AIDS was the first one that brought it to the planet, that you have a behavior, you have unprotected sex, and you get a virus, and you die. 

Lisa Knowles: Right.

Howard Farran: And that kind of started it, in 1979 in Los Angeles, and today, it really comes down to, if you're going to be an effective "doctor," a doctor, Latin word, "teacher," you have to teach them to change their behavior. And that's not really what Dentistry is based on, or medicine. It's drill, fill and bill. It's do procedures, bill ... How do you think we'll change that model?

Lisa Knowles: Well, I, you know, another one of my great choices in my life was marrying my husband, who has a Ph.D in higher education. So, he comes from a whole background in education and I've kind of learned with him, and grown up with him, the education model to teach. And, so, he has studied a lot in Leadership. We were both RAs, that type of thing, in college, so we got the counseling little bit of background, and that teamwork development. All that touchy, feeling, soft skills that people kind of poo-poo, but really, in reality, that's what it's all about. You have to have the hard skills, you have to have the clinical knowledge, so that you know what you are doing. But, you also have to match that with those soft skills, and the education background has been awesome. Studied that a little bit more than I ever thought I would, and I think that's key. We have to be able to do that. And probably in our curriculums, too. 

I think it's coming. The Dental Schools are realizing, that it can't just all be clinical information. It's how to teach. Like, I love that, the Latin beginnings of doctor is "to teach." We forget that so often. I think that's another reason that spurred me to go into the Consulting and speaking role, is I love to teach. I get great satisfaction out of other people succeeding. I think you probably have that in you, too, as I've listened to some of your podcasts and writings and things, so ...

Howard Farran: Well, the biggest secret in wanting to teach more is that, I think there's about 278 Dental societies that pick speakers to come in, and they're all volunteers. They'll go into a room of Dentists, say "I need three people." And they'll give them three subjects. Well, they go to the online CE course on Dentaltown where all the courses are an hour. So, let's say I picked you for Endo, and you go listen to six guys do Endo for an hour, and you'll pick one of 'em. I know a guy who put up an Endo course, and got booked 76 speaking gigs in one year. 

Lisa Knowles: Wow. 

Howard Farran: So, if you or any of your friends want to speak more, have them realize that online CE at Dentaltown, we've put up 350 courses, they've been viewed over half a million times. And everyone who puts one up gets, "Get you speak to our study club" or whatever. But, what are you, so what are you, what behaviors are you trying to get your patients to change? What are you telling them about the oral-systemichealth connection?

Lisa Knowles: A lot of times it's an awareness. So often, we've just been taught to disconnect our bodies from ... Like, we've relied on our physicians, our dentists ... The Dentist to take care of our teeth, and the Physicians to take care of our bodies, and we've almost just separated from that. So, kind of, having ownership again. We all talk about having our patients own their own disease, that's the big Holy Grail in Dentistry, of not making them feel like, "Well, you did something. After this filling, it hurt, and what'd you do, Doc?"

You know, "Let's go back to how that all started. How did you get the cavity in the first place? What types of things are you doing?"

"Oh, well, I work all night, so I have to sip on coffee."

"Well, do you have anything in your coffee?"

"Well, I have creamer and sugar."

So, just really stepping back with them and helping them identify what it is that is the root cause of their problems. I think we get so busy, and so distracted in Dentistry, and focused on their teeth, that we don't always take the time to step back with them and help them own their disease. It's become so much more satisfying for me, as a practitioner, "It's not my fault. I'm here to help you. I'm here to help you learn about your body, and what's going on, and how your choices are affecting that." That just creates so much more satisfaction. And the patient is empowered, too. I think that's about what I'm about, too, is empowering my patients to take control of their lives, their health. It's your health, you have one body. I say that a lot. And I'm here to facilitate that process, to help you keep your teeth, keep your health, and just getting them to floss is almost like an empowering event that they don't even think about.

So, when they learn how to do that, and they are making change, one small little change, and they see the effect in their mouth, "Oh my gosh, my gums aren't bleeding and I'm not spitting out blood anymore." All of a sudden, they realize they can do something. Even if it's the smallest little thing. Like flossing their teeth and making change in their health, well, that usually leads to, "Oh, then we can have ..." You know, you build that relationship, have bigger discussions, go into deeper things like, their weight loss that they've wanted to do, or they're just beating themselves up self-esteem wise, so we have deeper conversations, the more you get to know your patients, the faster you get at it, too. 

I know a lot of people probably listening are saying, "When the heck would I have time to do that? That's crazy. I didn't go to Dental School to be a therapist, or a Counselor." And you know, I had no idea that would be part of what I was doing, either, but it seems to always go back to that if you want to really help a patient change. 

Howard Farran: The model, I think, is crazy. You look at studies from the American Dental Association that say 60% of kids at age 10 have never flossed. I mean, just never. And then they come in, and that hygienist flosses their teeth for them. And the research on getting your teeth cleaned twice a year, you really can't correlate that to any changes in really anything. But, if you spent that session on saying, "Well, okay here, Lisa. Here's a piece of floss. I want to see you floss your teeth." And then coach you while you floss your teeth. And then put stain on, and then give you a toothbrush and a toothpaste. But they think, "Well, I've got to floss your teeth and I'm going to use a prophy cup and I'm going to use the dill." And they do this automatic car wash. But, it's what they would teach that patient to do, every morning and every night the rest of their life that would eradicate their disease. Not that you can come in every ... That's that witch doctor mentality, that, "Well, you don't have to do anything every day. You'll just go to your hygienist twice a year, and she'll be my witch doctor and take car of it for me."

What percent of hygienists, do you think, doing the prophy, would stain the patients teeth and then watch the kid try to brush off all the plaque removing stuff? 

Lisa Knowles: Fortunately, that's the other thing. I've been in a lot of other associate-ships before I owned my practice, and now I'm associate-shipping again after I sold my practice. So, you know, when you're solo again, and you've only been in one or two practices, you just think that's how it is. And you're so busy, and you kind of let your hygienists do that they do. "Well, they went to hygiene school, clearly they're the experts on this. They're doing what they want to do."

But, what I've learned over the years, is that they, that's what they do. They do it for them. It's the whole concept of giving a man a fish, you know? You either teach 'em to fish and they'll eat for a lifetime, or you can give 'em a fish and they'll eat for a day. Well, that's crazy. We're here to let them have a healthy mouth for a lifetime, not just for twice a year out of the days. So, I'm kind of a stickler about that. And then, so I would end up needing to teach my hygienists how to do that. And, it was a surprise for me, as a leader, as a Dentist, I thought that's what they were learning in hygiene school. And I think we take that for granted. And I'm not dissing hygiene school, by any means. They're learning great things. Just like we do. We didn't learn everything in Dental School. 

So I think it's having that new perspective that, yeah, you're going to have to teach your team, you're going to have to coach your team, how to teach your patients. If your end goal is to have overall better health for a lifetime, well, it starts with us. And a lot of times, we've got to teach the hygienists, "Okay, you're going to have to stain their teeth. You're going to have to show them about plaque. You're going to have to show them about flossing, because they have no idea." 

I do something with the hygienists a lot of times, a concept called "member check-in." So, after I go ... The hygienists talk to them about brushing their teeth, and where they are missing their brushing, you know, they have a lot of plaque. I'll walk in and I'll say, "Oh, how's it going?" And then I'll say, "Okay, so what'd you find out? Where are your trouble spots?" And I'll ask the child. And they'll kind of look up at me, like, "Uhhh ..." They're maybe half listening, maybe they weren't. So, it's one more time that we have an opportunity to show them, and and explain to them, "Well, this is where your trouble spots are, this is where the plaque is hanging out. I want you to work extra hard. Next time you come in, we're going to look at his area and see how you're doing." Give them a little pep talk, but yet, know that we're holding them accountable. We want them to learn. That's a new concept, usually put into a new practice when I go into it. If they haven't already done that.

Howard Farran: Lisa, I want to ask you a question, very delicately, because I know in our society, if men talk about women, they're sexist. If you talk about different races, you're racist. But, this is what I see, if you were me - I get, if I've got ten emails about leadership skills and trying to lead a staff, about 9 are from women. A lot of Consultants think women Dentists are having more leadership challenges in their office, with an all women staff, than men. Some say, "Well, when these little girls were young, their dads sat in a chair and said, 'Honey, get me a beer' and she'd jump up and get him a beer, and you know, do all the cooking, cleaning, whatever. And that, and that, all the people in our country grew up with that behavior, and they say that they go into a, they got an Associateship in a man-practice, and he would come in, everybody would scramble, everybody would work, he'd say, "Do this, this, this," and everybody would run and do it. Then she buys the office for $600,000 and then she says that, and they don't do it. They don't jump. 

So, I've talked to many other Consultants. I've talked to Linda Miles, Sally McKenzie, Sandy Pardue, I've talked to so many. I said, "Are you hearing this, too?" And they go, "Oh, yeah."

Lisa Knowles: Mm-hmm (affirmative)

Howard Farran: In fact, the Arizona Dental Association just had a special conference for Women Issues in Dentistry and leadership, it was the whole deal, what would ... Do ... So my question is this, do you think that when the boss is a woman, like Dr. Lisa, versus Dr. Howard, that there's different issues, when you're dealing with an all-women staff?

Lisa Knowles: I think there can be. You know, we definitely were encultured differently. What I see some time is a lot of women who are Dentists, they're very driven. They are very competitive. I mean, let's face it. It took a lot to get to Dental School, and to graduate, and to survive that. So, these are some very strong, driven women. That being said, a lot of times we're in a culture that says women are accommodators, and we are pleasers, people-pleasers. So we get mixed messages from what culture, you know, what we want. We want you to be strong, but we want you to be soft. We want you to understand us, but we want you to be tough. So, I think women struggle with that a lot. That's one of the things I kind of do a little Executive coaching, with men and women actually, when you're bringing in a female Associate, if you're an older male. There's just differences, whether it's generational or gender or, you know, there's ... It's just very difficult.

So, I do think there can be issues ...

Howard Farran: Well, what did, what advice would you give ... Sally's driving to work right now. She's 30 years old, and she's got a hygienist, two assistants, two receptionists. What advice would you give her, to, how ... Can you learn leadership? I mean, is this something you're born with? Have they already been built with their culture? How can they be more of a leader?

Lisa Knowles: Yeah. I think it's actually, I think you might have some tendencies to have some inner leadership qualities, but I think you have to learn it. Totally. Men and women. And we certainly don't get any of that in Dental School. A little bit, maybe, if you're involved in groups and you're working with people. But, it's interesting because we are working with really high achievers in our groups in Dental School. So, you know, something needs to be done, and six people jump up and do it, and try to out-do each other on who can do it the best. So, it's a little bit different when you're working with all different age groups and you're thrown into a practice who's had two hygienists already there, and you're trying to hire another assistant. 

My advice would be, you don't have to be friends with everybody. I think a lot of women fall into that trap of, "Oh, everybody's got to like me." And the other thing that I wanted to go back and speak to, is you said, "A lot of women are calling, or asking, or speaking about having trouble with that." The other thing I really think is different for men and women is that women will ask for help. You know, traditionally, men will, like you said, the proverbial drive around the block for like ...

Howard Farran: I know ... 

Lisa Knowles: For like 80 hours, and not find where they're going. Whereas women, we're like, "Give me the ... Where am I going? Give me the answer. You know, I'm going to ask for help." Where I think, in, you know, men will just say, "Ah, just take care of itself," or, I'm going to say this, and this, and this, and if it happens, it doesn't, or I'm going to go close my door in my office and it'll take care of itself.

I see that a lot, too, and from the male side of the ...

Howard Farran: Well, I want to, I want to ...

Lisa Knowles: But they won't ask for help, whereas women are saying, "All right. Help me. Let me, I've got to do this. I've got to manage my home, I've got to manage my business. I've got to manage these teams ... I don't have time. Let's just get it ... Help me out."

Howard Farran: You said you're backup was a Communications major, and it would have been Sports Journalism, or Sports Broadcasts, so you're a big sports fan, I take it. 

Lisa Knowles: I am. I played a lot of sports.

Howard Farran: What did you play?

Lisa Knowles: I played basketball and softball, and a little bit of volleyball in High School. And I played softball at Alma College.

Howard Farran: So, I'm assuming you're over 5'10"?

Lisa Knowles: No. No. I am 5'7". 

Howard Farran: 5'7" and you played basketball and volleyball? That's amazing. But, tell me if this is a fair analogy or not. I love sports because I just, luckily live in Phoenix, Arizona, the town of the greatest NFL football team that ever existed, The Arizona Cardinals. Second to none. But, you notice when you watch sports. The coach is just in the game, on the sidelines, calling time outs, is just totally the conductor of the sports orchestra. 

Lisa Knowles: Mm-hmm (affirmative)

Howard Farran: And then I go into every dental office, and as soon as Dr. Blind-in-one-eye finished a root canal, he goes right in his room, and shuts the door. And sometimes you walk in there and there's like two assistants, or just, two people standing there and I say, "What are you doing?" And they'll say, "Oh, I'm waiting for him to come out because I need to ask him ..." and I'm like, "What? You're waiting for him to come out?" Why don't you kick the door down and say, "Coach ..." 

So, when you say leadership is skill, do you think when a Dentist is done with a root canal, they should be walking the floor? I mean, I'm walking, I'll go into just hygiene rooms, and tap the patient on the shoulder, and, I'll go out in the waiting room. Or someone says, "Well, John up front is upset because we're running 10 minutes late." While they're setting up the room, I'll go out front, I'll apologize to John myself. 

How do you ... Is that something that you think is trainable?

Lisa Knowles: I think it is. You have to have the right attitude, certainly. There can be this perceived privileged attitude and expert attitude that some dentists come in with, that, "I'm the doctor, I'll do what I want, and that's the way it's going to be." But, I think you and I know that's not the reality of it, too. 

There are things that need to be done. You need to empathize with the patient who's mad out front. And if there's nobody who's doing that right now, then it's got to be, it's got to be you. So, I'm a hands-on type of leader. Excuse me. I've got to know what's going on. And I'm a constant listener. And I'm always listening, and my staff or my team in Charlotte, they always accused me of having bionic hearing. Because, I'm always listening to what's going on. I'm with the patient, but I'm also hearing that upset patient up front. Or I know that the hygienist is polishing, so it's about time for the check. It's just that awareness, and probably from my sports days, that court sense, that court awareness, of where everybody is on the team and what we're supposed to be doing. 

I think it's hard if you haven't had those experiences, but it is trainable. You need a coach. That's, again, where I went into the speaking, the writing, and just hopefully being able to impart some of that knowledge on those who are struggling, and who haven't had those group experiences, those team experiences. I think that's really hard, and a clear disadvantage, if you haven't had some of those team experiences, to know even, what you're looking for and understand your role and realize that, "Oh, I might be having to help define the role." Not just try to figure out what my role is. I'm trying to help others figure out what their role is. 

So, we clearly need more leadership guidance in our profession.

Howard Farran: It's funny, I was talking to the Dean of Arizona State University, and he was telling me that, for almost 20 years, the main feedback they're getting from all the major employees is, you know, this kid graduated with a 4.0, but he doesn't know how to work with other people. So, they've been massively changing their curriculum for two decades, with all these group projects. 

It's funny, when my boys complained about college, they never complained about anything they were doing solo. They always complained about all the stress of the group, and "Mark didn't get in on time" and "Shirley disappeared" and all that stuff. I kept telling them, that's real world. Who cares if you know Algebra and Physics, you've got to know how to work with this group. What's funny, is what are Dentists? What is their sport? If you ask a hundred Americans, "What is a Dentist's favorite sport?" What sport would they say?

Golf. An individual sport all by yourself. Out there ... And the reason I don't like golf, and I'm a Dentist, is because they don't like to talk. I can't go 18 hours without talking. 

Lisa Knowles: That's me, too. Golf and extroverts don't go very well.

Howard Farran: Yeah, it's like, it's like, if you think it's fun to go out there and not talk for 18 hours, I mean, you know ... So, they're introverts, they like golf, they don't like team sports, they're ... And if I lined up 100 Dentists, every year, for the last 20 years and said, "What is the number one thing stressing you out in your Dental career?" Every one of them would say, the team, the staff, the hygienists, the assistant, my crazy receptionist. Blah, blah, blah ... And that's the whole game, isn't it?

Lisa Knowles: Yeah. It really is. And you know, I guess I give a glimmer of hope to those people who are more introverted, and that's not their style, is, but you've got to recognize that, and you've still got to play ... You've got to know how to be an extrovert. Like, my husband is an introvert, and I'm an extrovert. But, he knows how to be an extrovert. It's tiring for him. At the end of the day, he's much more tired than I am. I'm energized when I'm in a group of people. I get a lot of energy from that. Whereas, that's very energy-zapping for him. And he's ready to be done. He just wants to come home and not talk to anybody. But he knows how to be an extrovert in a group. And we have to know how to do that, as leaders. 

It doesn't surprise me, too, that a lot of Dentists like to golf.

Howard Farran: So, what website are you ... Would my listeners learn more from if they wanted to learn more about oral-systemic health and leadership? Would it be Or

Lisa Knowles: Yeah, that's where they can read a lot of my articles. 

Howard Farran: At

Lisa Knowles: Yeah, and I write ... I try to cover all the issues beyond 32 teeth. And you know, sometimes I get criticized for that. You know, "You've got to pick a pathway, you've got to pick a lane." And I have, to some extent. To talk about the oral-systemic health, but so much of being able to communicate that is about the communication and the business side, too. I mean, you can't just ignore the business side of your practice, either, and say, "Well, I'm going to be the best communicator, and I'm going to take 45 minutes to talk to Mary Smith here." 

You can't do that. You have to be mindful of your business side, as well. So, that's where I really kind of talk about the middle ground, or the middle path of, you have to be able to do both. You don't get to choose one or the other. It seems frustrating, and like an unending achievement opportunities when you're starting out. But, truly, you've got to learn a little bit about everything, and maybe not master everything. I think we dive into some things, "oh, I want to go learn Endo" and we spend a year just honing our Endo skills and the wheels are falling off in the practice, but they're doing darn good Endo work. Which is important, but you can't just focus on that solely, you've got to keep track of your human resources component. You've got to keep track of what the bottom line is looking like. 

So, again, I feel like that's what I offer when I speak, when I write is ...

Howard Farran: My gut tells me on the 80/20 rule, that 80% of the people flying off to these continuums on the weekend, to learn how to be Cosmetic Dentists at LVI, or occlusion rehab guys at Panky or Spear or Kois, or whatever. They're flying out of their town because they're leaving this crazy, stressful thing, and they think that if they go and become an expert in occlusion or sleep medicine or Endo, or implants or the pen-ul technique, that they'll come back and all their problems are solved. I mean, I've thought that all the time.

And then it seems like, if you're house is very, very healthy, and you learn how to navigate the staff, and then you want to learn how to place an implant, you don't have to fly across the country. You just call your Oral Surgeon or your Periodontist across the street, and say, "Will you teach me how to place implants?" And he's like, "Sure." And then you don't even spend a dime. 

So, I think a lot of it is that Holy Grail. Well, if I just go to the Panky Suit, for six weeks ... I went there, I made it through five. And, they think, "If I just really learn occlusion when I come back, my business will take care of itself, the staff will all get along ...

Lisa Knowles: If it was only that easy, right? You're right. It's like a myth. We want that, I think, we're just looking in the wrong way. And again, not that we shouldn't be keeping up on our clinical skills. Certainly, we have to know those things, and want to keep up. 

Howard Farran: But, but, but ...

Lisa Knowles: But again, I talked a little bit before, and I've written about competitive side of us. We love ... I think one of the ADA studies show that we're compulsive, and that it ... Compulsive people tend to attract to Dentistry. That competitive, compulsive nature gets into us, and we think, "Oh my gosh, somebody up the street has a, you know, a new 3-D scanner; they're doing Endo now, and we're not ..." So that starts nipping at them at the back of their fears. Then they want to go, and learn a different trade or different technology, and they miss the mark. You know? Like you said. Get your ship in order first, and then, when you get that figured out, then there's your time to go expand and explore some other things you've been wanting to do. 

Howard Farran: I don't know if they really even have to learn the clinical skills. You look at ... What was the big implant chain? Is it Clear Connect, or what was it? 

Lisa Knowles: I don't know.

Howard Farran: Do you remember the big implace place? What was it? Four on the Floor.

Lisa Knowles: Oh, okay. 

Howard Farran: That was sponsored by Novo ... Who's Four on the Floor? But anyway, you know, they would get Periodontists and Oral Surgeons from smaller towns, 25,000 to come into these big cities and place all their implants, and do some type of fee split, about 50/50 or whatever. I mean, if I go to a Dentist and say, "How much money did it cost you to go take all these implant surgical courses, buy the equipment, buy the CBC, learn how to trace it ..." I mean, they might be 100 grand, to 200 grand, before they place one implant. And then I see another Dentist, who does the soft stuff, is the Conductor, running the business, and he just has a Periodontist come in the last Friday of every month, and place a dozen implants and splits it 50/50. Same as a small town Endo, etc., etc. 

I still think the return on investment is ... Look at Rick Workman. He's a Dentist. He hasn't touched a patient in 20 years, has 1500 offices. I mean, you don't have to do clinical ... Look at Comfort Dental, Rick Kirshner. He hasn't touched a patient in 25 years. Steve Thorn or Pacific Dental Services, his dad's a Dentist, and he thought, "Why should I go to Dental School? It'd be a hell of a lot easier to just hire a Dentist." He has 500 offices. 

So, I don't think you have to learn any clinical skills, if you master the business skills, the leadership skills, the conductor skills ... 

Lisa Knowles: Mm-hmm (affirmative)

And what your purpose is. I mean, my purpose was to help people, and patients. I enjoy the hands-on experience, the day-to-day interaction, I get something out of that. When I figured out that I was helping people in the way I wanted to, that was when I made the jump and wanted to leverage my skills. And say, "okay, not let me help, let me give back, let me help where I can help." 

I had a ton of mentors, amazing mentors along the way. And that was crucial to my development. So, people-development is also one of my passions, as much as helping my patients. So, ultimately, I think if I can help more Dentists get what they want, than the more patients are going to get what they want, too. So, it's kind of a win-win. I always look for those triple, win-win-win, I know it's kind of cliché, but I look for those type of opportunities. I think it makes you much more happy in your purpose. 

I mean, if you want to go own 500 dental practices, and you have the entrepreneurship spirit, and that's what you've always wanted to do, then go for it. We have the opportunity to do that. But if you truly just want to practice, and make a difference in one or two practices, or whatever it is, I think we still have that option, too. Getting a little bit more scarce, I guess you would say, but I think that's always going to be around, and an option. 

Howard Farran: You talked about leading with LEED, L-E-E-D, Leadership and Energy in Environmental Design. Knowledge and eco-friendly dentistry. What's all that about? 

Lisa Knowles: Well, you know, I've always been interested in environmental issues, since I was a kid. I started the Environmental Clubs in High School, and the reducing/recycling, and all that. It was really kind of a side hobby, really. We've always been exposed to being outside, and camping, and all that. So, just a passion. And then, I realized, when I brought that into my office, and we redid some of the office things, putting in the fluorescent lighting, and hiring an after-school student to do our recycling, that was also fulfilling a lot of my purpose, too. I am helping out a younger student. She's our Recycle person, a part-time after school student. And then I realized, I reduced my dumpster pick-up to once a month from twice a month. So, I'm saving money, too, and getting an award from our County, telling us great things from a Dental aspect. Before I know it, patients are very interested in what I've been doing, and how great that was. 

I thought it was an amazing, unintended marketing help to my practice. We should be doing this more, and I know there are other Dentists who are interested in maybe building a LEED-certified practice. The US building council has all sorts of certification when you go to build a new building, or it's even remodeling, you can get certified. I just try to heighten that awareness that if you are building your own dental practice, you could become LEED-certified. You could become different levels. You could be silver, gold, platinum levels. You're looking at air quality, you're looking at the energy and feel of a building. I don't know if you've ever been into a LEED-certified building? 

Howard Farran: Is LEED, is that a Federal, or is that State of Michigan? 

Lisa Knowles: Nope, that's Federal. That's all ...

Howard Farran: It's called LEED-certification? 

Lisa Knowles: Mm-hmm (affirmative)

Yup. And you can get that if you're thinking about building a building, or in my case, we just remodeled mine. I didn't get certified, because I just wend through and did little-by-little, but you can, for sure, get that certification. And you get this beautiful plaque in your office, and it is an eye-catcher. Patients are always asking about it, and more and more people ... You know the Green Movement is so prolific now, and people want their whole foods, and their natural products, and so, when you exemplify that, as a Dentist, it really sets you apart from the others. The ultimate message to my patients is, and what they've said, too, is "Wow, she really cares about something besides herself and how many crowns she's doing today. She cares about the environment, she cares about what happens to the waterways, she must be a very caring person." 

Lo and behold, that's true. So, I wouldn't recommend doing this just for a marketing ploy. So, they're, "Oh, that doctor's green." And then you know nothing about that, patient's will see right through that. But, if it's something that you truly believe in, and you're already using your products at home that are green-friendly, and you're already into environmental issues and awareness, then I think it's a really good concept and idea to bring into your practice. And then, market it, and let everybody know what you're doing. 

Howard Farran: Well, I ... You know that eco-friendly organization started by Ina and Fred Potcrass? 

Lisa Knowles: Yes, yes. 

Howard Farran: I spoke at their annual convention one year, in Utah. And these Dentists were telling me that they were into environmentalism, but when they started marketing it, they were stunned at how powerful the marketing was, and that, when they were a dental office, and off-the-grid, and recycled and certified, that people were driving like an hour away. I come from ... I'm 53, so I'm from a generation ... I'm always reminding young kids, when they're talking about how horrible their grandfather's were with the environment, I'm like, "Dude, they were trying to defend themselves from Nazi Germany. And, when you're getting attacked from Adolf Hitler, no one gives a shit about the creek or the pond, or whatever." 

Lisa Knowles: Right. Yup.

Howard Farran: In fact, the Federal government was telling General Electric to dump all that stuff into the river. I mean, they were trying to win a war. It's really easy to be alive in 2015, to sit there and you know, health, clean water, clean air, that's a luxury item. And that's a luxury item anyone will give away when you're defending yourself against Nazi-ism. But I think it's a powerful marketing deal, and so I've heard Dentists in certain states, that you can buy your electricity just from solar. 

Lisa Knowles: Mm-hmm (affirmative)

Howard Farran: So, you can say, "I only want to buy my electricity on the grid from a renewable resource, and then they go right on their website and say that they're environmental and their dental office is off-the-grid, and it's huge. You're getting all these ... Now, I wanted to ask you, is the environmental thing, is that a younger thing? I mean, is that like a 30-and-younger thing, more so than, like, a 60-75 ... I mean, I've never heard of an environmental remark from a Grandma or a Grandpa. But I always hear it from the skateboarder.

Lisa Knowles: I'm sure it's the circles that we all run in. When I go to environmental meetings and things, there's people of all ages. But, I do think maybe like the 40, maybe ... I don't know. I'm 43, so, I got it in school. You know, I started being educated about it in school. So, I think we all started hearing about it more at this age, the 40-somethings, and then below. And then, now, I mean this whole climate change, that whole talk, I mean that's huge. That's media coverage all the time. All those weather changes and things, so people are really starting to learn more about it, and have more of an interest in it. And you know, they're getting ... People have gotten sick from it. So, from a health standpoint, for us as Dentists, I think it's almost necessary for us to be aware of what's going on, too, from an environmental standpoint. And how we can help impact those things from a health standpoint. 

That's another reason why I'm also involved in that, those aspects and issues. I think if we can continue to talk about things, like the mercury issue always gets brought up in Dentistry, and dental amalgams. And yes, we're putting amalgam residue into our waterways. In Michigan, we have to have the filters now. So, we have the separators. I know a lot of states don't have that. But, if you look on the grand scheme of things, coal-fired plants put the most amount of mercury ... 

Howard Farran: Half. Half. 50%

Lisa Knowles: In the atmosphere, and so, I feel, once I learn about these things, it's hard for me to ignore them. We have two coal-fired plants here in the East Lansing, Lansing area. One is actually MSU, which is actually stopping. The students have been so adamant, and working that so hard, that they are actually changing, and they are going to all these solar-arrays, and bio-generated energy, so they made a huge impact there to change that. And Board of Water and Light here, in the area, is looking, they're going to more of the natural gas type of things, versus the coal-fired plant. So, it's all around us. It's there. Whatever age levels, I guess. I think more of the younger people have heard about it in the media now, and they're more interested in it and realize, "Oh, wow. Maybe we should do something about this."

Howard Farran: You know, mercury is one, and I think the bizarrest thing about mercury, is half of the mercury contamination comes from burning coal, and, but 6%, the dental-related, comes from cremating dead humans with mouthfuls of amalgams. So, one thing they could do immediately, is not cremate anyone until a Dentist has gone in with a pair of 150s and 151s and extracted all the amalgam teeth. 

I wanted to ask you, I helped fluoridate Phoenix in 1989, and got the Arizona award from the Arizona State Dental Association and the Public Health Dentist of the Year Award, and I did it again just recently because it expired after 20 years. But, I'm telling you, 25% of Americans do not want fluoride dumped in the water. And, man, they are militant. And they, if I ... I mean, they're interested in any scientific debate or whatever ... What do you think the ... And you're right up the street from where it all started, in Grand Rapids, Michigan, January 21, 1945, at 3:00 pm. What do you think of the water fluoridation? Do you think that's something where the next generations are going to say, "We don't want the government pouring fluoride in our water." Or is that the same line as mercury? Or, are you an environ ... Can you be a LEED-Dentist and certified, and mercury-free, and still promote fluoride in the water?

Lisa Knowles: I think so. I don't think it's to that level. For me, fluoride is kind of a 'yes, and' topic. I think we've spent a lot of time, energy, and money on fluoride. And I hope and wish that, in the future, that we'll spend an equal amount of time and money on nutritional counseling and relating that to how much sugar has impacted the diets of young kids and Americans, nation ... Worldwide. It works. Is it ...It's hard because I understand the holistic aspect and argument that, "I don't want anything unnatural", and so, I see that point. But I also, from the healthcare background and the Dentist standpoint, I put that hat on, it's a Public Health issue. It's helped save a lot of suffering from kids who's parents maybe weren't as adamant with their diet, and couldn't supply as many nutritional good things, as maybe my parents did. 

So, I think it's going to be a controversial topic for years to come. 

Howard Farran: I mean, it is amazing, because, I mean, you talk to these people about the vaccination issue, and you know, they are not interested in anything that's written by a PhD, the Centers for Disease Control is "the Government," it's the conspiracy, they talk about things like "natural." I try to explain to them that gonorrhea is natural, that black holes are natural, that, you know, a meteorite landing on your head is natural. They ... It's just amazing. In fact, I even got a visit from a police officer because I got a death threat on this ... On the fluoride deal. 

Lisa Knowles: Wow. 

Howard Farran: Yeah, a death threat. They said they were going to kill me. So, yeah, I called my patient who's a police officer. Long story, short, he came back and he said, "What do you want to do? She's like 87 years old, and she can't even get out of her chair." And I said, "okay. Cool."

Lisa Knowles: Well, there's piece of mind. 

Howard Farran: Yeah. There's piece of mind. 

Lisa Knowles: The only thing ... At least it offered you piece of mind. 

Howard Farran: I may be, I may be 53, fat and old, but I can take an 87 year old lady in a walker any day. But, yeah. It's amazing. I tell you what. I don't want to sound cynical or anything, but I would be interested in this LEED-certification, and eco-friendly, and advertising that my dental office is off-the-grid, just because you're going to get every granola-eating hippie, snowboarder, lover with crystals, driving an hour to go to the recycle ... I mean, they love this stuff. 

And, in fact, I'm even thinking about, why fight 'em, why not join 'em? I've been telling my boys, you know, if we were smart, we would just cater to them. We'd just build an all natural toothpaste and say, you know, 'no communist fluoride, no evil government regulations, just all-natural stuff made from exploding stars and black holes' and just cater to them. Because I think it's my job to sit there and say, "I know what you need as your doctor. And I know that you're batshit crazy, and I need to try to figure out a program to where batshit people, batshit crazy people, can save their teeth and not have a life of decay and gum disease." You know, kind of, where does crazy meet the road? 

Lisa Knowles: Right. And I think some of that, I mean, that was very traditionally stereotypical, those types of people. But, it's becoming so much more mainstream. And that's why it's flipping. Because people like me. I mean, I'm a 43 year old professional woman, and I buy all-natural products and eat organically, and so, there's that market that's ... And I can afford Dentistry. I can afford good Dentistry. So, you know, I think we have that perception that it could be these types of people that are gonna .... And I'm sure. You're going to get all sorts of people. If you build something like that. But, you're also going to get some very mainstream-type of people who are just interested in the environment and overall health, and eating well, and being organic. You're probably going to get them to buy into a better, healthier diet. Okay. You're not going to ave fluoride, but that means you're going to follow the 25 grams of sugar rule that the World Health Organization has set up. 

You know, you eat 6 teaspoons of sugar a day. That's it. That includes your honey, your syrup, your everything. If we all did that, then we wouldn't have as many cavities. 

Howard Farran: But, honey doesn't cause decay because it's natural. 

Lisa Knowles: Well, the World Health Organization says that's on the list. I would probably argue that, too. But the concentrated sugars, and I guess, make it, as a sweetener ... 

Howard Farran: The research I'm reading, where you totally link it to, is when the food has added sugar. And they're really isn't really much of a connection, as it is added sugar. It's the added sugar in our drinks and our foods ... It was amazing that last year was the first year that America drank more calories than it ate. 

Lisa Knowles: Ugh. I know, it's ...

Howard Farran: They consumed 51% of it's calories liquid. And ... 

Lisa Knowles: It's pretty scary.

Howard Farran: And a McDonald's Big McCafe has more calories than a Big Mac. 

Lisa Knowles: Yeah, and so then, as Dentists, we have that ... Again, that's why we're seeing this need surface, to need to communicate better, and have behavioral change tools in our arsenal. Because, we're fighting all this. And the sports drinks, the energy drinks, it's just one thing after another that we are having to educate our patients on, and taking that time. And reeducating. Like I said, reeducating our hygienists, reeducating our dentists, to say this is the problem. It's not enough any more to just say, "Well, you need to drink less pop and don't get too much sugar. Don't eat too much candy." And I see that so much. And so often. It's kind of like what you said, "We're doing it for them." And we're just telling them. We're not helping them think through their processes. 

Howard Farran: I really love the study where they took identical twins who, after the last 50 years or, one had luckily, health insurance, and got the $100,000 coronary artery bypass graft. The other twin didn't have insurance, because you know 50 million Americans didn't have insurance the last several decades, but changed their ... You know quit smoking, lost weight, started exercising, you know, because they couldn't get the insurance paid for surgery, and the group that didn't get the by-pass but changed their behavior lived three years and six months longer. 

We see this in Dentistry all the time, where they would come in, they had insurance, we do the [inaudible 00:50:06] we did the four quadrants of surgery, and I swear to God, two to three years later, you couldn't even tell you'd ever been in there one time in their life. And then there were people who said, "No, I don't want that. I don't want you cutting my gums. I don't want the surgery. I don't have insurance, whatever, but they start brushing and flossing every morning, every night, and all that type of stuff ... 

Lisa Knowles: And they stop smoking. 

Howard Farran: Yeah, and they got better. So, the whole thing is back to changing your behavior. I want to call out one thing that I lived through. 

When I was in Dental School, and that was when they started putting women in the class. They started putting women in the class, and I remember talking to the Dean. He was telling me the Chancellor, they had quotas. And if they didn't, you know, he could not go back to the Governor with a whole class full of men. They were doing everything they could to fill the class with women, and they would all complain that it was a waste of government resources, because these women were going to come out of school, and in two or three years, get married, get pregnant, have three kids and these degrees were just going to be wasted. 

It was funny, because I was having lunch the other day with one of my classmates, Becky Cecil, and all the women that graduated my class 28 years ago, they're all working just as hard, just as many hours, as all their male counterparts. So, I want to ask you, you know, there is so much talk about the changing demographics in Dentistry. When I go into these Dental Schools, half the class is women. How do you think the profession ... How do you think it's going to look differently than going back to 1950, when they were all males, to now, by 2025, they're going to be half women. Do you think that will have any impact on the profession? Any change? What will that do to the profession?

Lisa Knowles: Oh, yeah. I mean, actually, when I was ... I graduated in 1998, and when I was in Dental School, too, that was what they were telling us, was that there was going to be a shortage of Dentists because women were going to be working more part-time, and so, we're graduating a higher percentage of women, so it's going to be another heyday for Dentistry. We all were like, "Oh, good, good, good." 

You know, I think some of that is true. Women might take time off earlier in their career, but then they make up for it later on. I think I've read some of that research, too, is that they'll work longer, later on after their child-bearing years or whatever. I think it's really going to change. 

I teach a course in the summer at University of Detroit Mercy on Communication, and the demographics is so, so different. So many women. So many minorities. In the whole face of Dentistry is just changing, so rapidly. I'm sure some say not rapidly enough. But, you know, when I graduated, I think there was about 13% women, in the nation, when I went out into pool. Which was interesting, because when I was in Dental School, it was about 40% women, and women were everywhere in the Schools, and even our professors and things, but then, when you get out in the real world, there's hardly any women. Not a lot of support groups, not a lot of networking opportunities for women specifically. And now, 18 years later, there's about 26% women nationwide, as Dentists. 

So, it's definitely changing. I think this changes the way sales are, to women. You know, products. I think, I just read an article the other day, and I saw this nice small little handpiece made specifically for women, and I was like, "Ooo, I would like to try that." So, the product lines are adapting more. Sales forces are having to change their approach. Instead of hauling the Dentist out of his office to get him to come look at things, the women are asking questions, wanting to know what you have. It's just a whole different way of thinking and selling to women. 

I was just at the ADA conference at Washington, DC, and it's a big issue for organized dentistry right now, with membership declining a little bit, how do we get more women and minority voices in our organizations and involved and want to be a part of this. Women, we're busy, everybody is busy. Even men, men are taking a different role in the families a lot of times. Their wives are professionals, as well, and they're working. So, everybody is trying to do childcare, and there's not a lot of time to volunteer for these organizations. Go to these annual sessions. It's a real, I don't know, it's a real troublesome point right now that I think we're working through as a profession. It will be interesting to see, in the next few years, how does that all pan out. 

I think it's just going to blend, and blur, and ten years from now it's not going to be as much of an issue as it was. It's just going to be the norm of, "Oh, we have men and women. Okay. Now what?"

Howard Farran: I also think it's funny that when you look at the world pool, of two million Dentists, a million five hundred thousand of them are women. So, there's only a male-dominated profession in the 20 countries where there was a lot of money involved. Men always go to where there's a lot of money. Insurance. Banking. Finance. Law. And in wealthy countries, the men all showed up. And I always thought that Dentistry as more pure in the poor countries, because the women that go into Dentistry in poor countries are like the women who in America that go into teaching. No one goes into teaching for money. And no women goes into Dentistry in Nepal for money. They go there because they genuinely because they just generally are there for all the right reasons. 

Lisa Knowles: And I think that's probably a good influence, in a way. If I had to say something in the future. You're seeing all these communication and soft skill issues surface now, because women are now entering and calling out our male colleagues and saying, "No, you're not doing that. We can't just not talk about this. Or, I want to talk about this. Or, help me do this," or whatever their personality traits are.

They're asking for help, they're looking for some help on these issues, whereas I think men, again, didn't always want to admit or ask for help. This kind of elephant in the room just became kind of ubiquitous in Dentistry and women, for better, are bringing some of these issues out. For men and women. And I think it's making the profession better, stronger, and we're better communicators with our patients as well, men or women. 

It's good. I think ....

Howard Farran: How many children did you have?

Lisa Knowles: I have two. I have a 13 year old and an 11 year old. Boy and girl. 

Howard Farran: My mental checklist of going ... When I try to figure it out, I'm seeing about a quarter of the women Dentists don't have children. Are you seeing that? Or are you not seeing that? 

Lisa Knowles: I think they're deferring, too, that's the other thing. It's like, "I don't know, are you going to have children? Or are you not going to have children?"

Women are having children into their 40s now, and so, it's hard to still predict I think, where that's all going to pan out. Or they have one child, and because ... It is hard. Trying to juggle all that. That's what I try to incorporate and help the women when I'm doing some coaching and things with them. "Here's how we're going to manage this. We're going to have some systems. Some strategies, and we're going to have to delegate." If you don't have those skills, it's really hard to be successful in our profession. 

Howard Farran: Okay, I've only got you for a couple more minutes. So, your email is If they have a question for you or want you to speak at their organization. And walk them through, what will they find at And what will they find at 

Lisa Knowles: So, at the Beyond 32 site, that's my blog site. But, soon transforming into my full website. At the first of the year, it'll be one-stop-shopping, they can just go to Beyond 32 ...

Howard Farran: And then will be gone?

Lisa Knowles: Intentional Dental will be the speaking and consulting component on the overall site. So, that'll still be there, but that's more the logistics. If you want to book me as a speaker, you want me to come talk to your group, you want me to write an article, you want me to consult your team, you want to have a team retreat. That's something else I've been doing in the last year and I've always done with my teams, is a retreat where we work through some things. So that's more of the site, where the logistical pieces are, and you can find out more about me and kind of what courses I offer and things like that.

Whereas the Beyond 32 Teeth is more, you get a flavor for me. Would you want to hire me? Would you want to ...

Howard Farran: I love reading your stuff. You are a prolific writer. How often do you release something? How often do you write something? 

Lisa Knowles: Gosh. I've been writing for Dr. Bicuspid at least monthly. Dentistry IQ, some dental products report, probably at least a couple of others a month, and then my blog, at least a month, if not more. Every month. So, I probably, I don't know, I probably release something every couple of weeks at least, if not more. 

I'm a social media fan, too, so I love my Instagram and Facebook and Twitter. So, if people like to do that, they can find me on those social media sites. I love to create memes and put out public health messages, if you will. 

Howard Farran: That's, I don't do Instagram. That's one where I because you can't do that on desktop. You can only do that on your iphone, smartphone. 

Lisa Knowles: Yeah, and I'm always on the go, so it fits me well. And I love pictures, so I love making those little memes. You know, life is a picture to me, and wherever I am, I'm always snapping pictures, like, "Oh, that would be a great message. Oh ..."

Howard Farran: Is Instagram, you know, first it was Pinterest, if you were a visual person and liked just visual, it was Pinterest. And Pinterest was huge and exploding, but I noticed when Facebook bought Instagram, do you think that kind of was the end of Pinterest, and now the real Pinterest fans are going to be Instagram?

Lisa Knowles: I don't know, a lot of people still really love their Pinterest. You know, I have a lot of friends that are just huge into Pinterest. I just never got into that. I guess I was saturated with social media to a point, at that point, where I was like, "I can't take on one more thing." But I know if you get hooked on that early, then you just love Pinterest. 

I just happened to get hooked on Instagram earlier, and liked that avenue. But you're right. It probably did influence it a little bit when Instagram was bought by Facebook.

Howard Farran: What I liked about Pinterest was you could, and like, when a lady asked, "Well, when are my child's teeth going to come in?" 

I'd say, "well, are you on Pinterest?"

She'd say, "Yeah." 

And I'd say, "Well go to @HowardFarran and I have all the tooth eruption charts, I have all the homecare instructions. It just seems like all the women in the practice were on Pinterest and instead of giving them a physical sheet, and then they'd pull out their iphone and they'd pull up @HowardFarran and then they'd have the tooth eruption chart. 

Lisa Knowles: I think that's savvy. I mean, we have to do that. We have to be communicators and know what our patients, what their channels of ... I might love Instagram, but if my patients love Pinterest, then I need to be on Pinterest, if that's what I'm trying to use social media for. For me, I'm looking to see where my clients might be. Facebook is heavily my generation. A lot of people are on Facebook. So I use that quite often. 

But, Instagram gets a little bit more of the millenials in there, and you know, it changes every week, from snapchat to something, it's hard to keep up. But I think we have to know how our patients are communicating. And target them. 

Howard Farran: I love it. 

Lisa Knowles: That's a whole other thing to learn.

Howard Farran: I have so many moms come in, and they'll say, "Oh, I really loved that, what you posted on Pinterest on gum disease was contagious, and you had the knife and the fork and the pink, and all that stuff." What I like about it is, not only did she get her home care instructions or got her questions answered by a graph on Pinterest, but now she's connected to me. 

Lisa Knowles: Absolutely. 

Howard Farran: But hey, we are completely out of time. We went two minutes over time, but ... 

Lisa Knowles: Okay. 

Howard Farran: Hey, I'm your biggest fan. Lisa, thank you so much for giving me an hour of your life today. 

Lisa Knowles: Well, I'm a big fan of yours, too, Howard. I appreciate what you're doing for the media and Dentistry and all. I really appreciate the opportunity of being here today. Thank you so much. 

Howard Farran: All right. And I want to be on your show someday. 

Lisa Knowles: Yes. Soon! 

Howard Farran: And what is your ... Tell 'em the name of your show? Your podcast?

Lisa Knowles: Well, I'm ... I have a youtube channel. 

Howard Farran: It's a youtube channel? What is your youtube channel? 

Lisa Knowles: It's, you mean, what is it? What's the name of it? Or what is it? 

Howard Farran: Yeah. How do they find it?

Lisa Knowles: It's Lisa Knowles. It's, just catch me on youtube. 

Howard Farran: So, go to youtube and put Lisa Knowles. K-N-O-W-L-E-S. Do they put the DDS, or just Lisa Knowles? 

Lisa Knowles: It's just Lisa Knowles. The funny thing is, there's a singer. Named Lisa Knowles. So, not the singer. She's African American, there should be ... I'm white, Caucasian. The white, Caucasian Lisa Knowles, non-singer, the Dentist one. 

Howard Farran: And what's the other one, you said, she's Jamaican?

Lisa Knowles: I'm not sure. African American.

Howard Farran: And what's her ...

Lisa Knowles: I think she's related to Beyonce. I keep trying to figure out how I'm related to Beyonce Knowles, as well. But I think this woman, Lisa Knowles, is some relation to Beyonce. 

Howard Farran: Beyonce's last name is Knowles?

Lisa Knowles: Yeah, that's how I tell millenials to help remember me. Knowles, like Beyonce, and they laugh. Other people look at me like, Huh? I was like, nevermind. 

Howard Farran: You know you're really at the top of your game when your name goes down to one, like Bono or Madonna, or Beyonce. When you don't even have a last name, that's the ultimate brand. 

Lisa Knowles: Yeah. 

Howard Farran: Okay. Well, thank you so much for an hour of your time. 

Lisa Knowles: All right. Thank you Howard, bye bye. 

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