Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1100 Collaboration in Dentistry with Paul Goodman, DMD: Dentistry Uncensored with Howard Farran

1100 Collaboration in Dentistry with Paul Goodman, DMD: Dentistry Uncensored with Howard Farran

10/16/2018 7:58:39 PM   |   Comments: 0   |   Views: 335
Paul Goodman, DMD’s courses offer chairside and behind the scenes, easy to implement techniques and strategies that decrease stress and increase practice revenue. From cutting edge implant technology to practice management skills and techniques, participants gain a roadmap for improving patient health and satisfaction, practice profits, and their personal joy.

While chief dental resident during his general practice residency and hospital fellowship at Albert Einstein Medical Center, Dr. Goodman received advanced training and also placed and restored 150 dental implants. He has been a faculty member for Hiossen Dental Implant Training Program for the past 10 years and has helped over 100 general dentists place their first dental implants. Additionally, he teaches dental residents at Albert Einstein Medical Center lecturing to dentists on placing and restoring implants.

A graduate of the University of Pennsylvania School of Dental Medicine, Dr. Goodman has been practicing dentistry for over 10 years and works with his brother in two locations in Mercer County, NJ. Dr. Goodman has purchased three dental practices and shares his personal experience with retiring dentists in managing the expectations of their patients and team members during the transition process. He is the founder of Rising Dentists Study Club and Rittenhouse Consulting, LLC – both in Philadelphia.

AUDIO-DUwHF #1100 Paul Goodman, DMD

VIDEO-DUwHF #1100 Paul Goodman, DMD

Howard: It's just an unbelievable honor for me today to be podcast interviewing one of my idols one of my mentors Paul Goodman DMD who offers courses offers chairside and behind the scenes easy to implement techniques strategies that decrease stress and increased practice revenue from cutting edge input technology to practice management skills and techniques. Participants gaining a roadmap for improving patient health and satisfaction practice profits and their personal wealth. While chief dental resident during his jet drill dentistry practice and hospital fellowship that Albert Einstein Medical Center Dr. Goodman received advanced training and also placed Resort a hundred and fifty dental implants. He's been a faculty member of the highest and dental implant training program for the past ten years and has helped over 100 general dentists place their first cell implant. Additionally he teaches dental residents at Albert Einstein Medical Center lecturing to dentists on placing and restoring implants. A graduate of the University of Pennsylvania School of Dental Medicine Dr. Goodman has been practicing dentistry for ten years and works with his brother in two locations in Mercer County New Jersey. Dr. Goodman has purchased three dental practices and shares his personal experiences with retired dentists and managing the expectations of their patients and team members during the transition process. He is founder of the Rising Dentist Study Club and Rittenhouse Consulting LLC both in Philadelphia. Dude your bio doesn't even mention your big badass dental nachos. So it's just an honor to have you on the show how are you doing today?

Paul: Oh thanks Howard, thanks for that it's really just a really a dream come true for me to be here. I remember you know being part of dentaltown a decade ago and you know just just that was the way for dentists to connect there was no Facebook for anyone back then and it was just to me just the best thing to be able to kind of share with dentists all over the country. As you read my bio I love teaching and connecting with dentist and I always found that you know doing that in Philadelphia is fairly easy I'm here in Philadelphia my work my office the dental nachos office and you know bright and broad and Locust so you can you know you could walk a five and hit a hundred dentist and you know Philadelphia is a city but most places where I practice in the suburbs you know dentists are even if they're a mile away from you they could be a hundred miles away from you because they don't really talk to each other so dentaltown really got dentists talking and you know I just appreciate you creating that and I've also just I mean my lab relationship which I started in 2009 you know change the lives of my patients myself John Wilson was someone who I met on dentaltown and it prior to that time my dad was a dentist my best friend we worked at it for 11 years and fortunately he passed away two years ago but we were just super close and I remember working his office and they only could use the lab down the street right because that was all that was available and you've created a way for us to connect, so I just really appreciate it.

Howard: That was some time I don't know if I've ever told you the story about starting dentaltown but I'm so proud of myself I started that four years before Facebook and when I when I did it a hundred percent of everyone who loved me said I was the absolutely insane and when I went out to hire there was 1998 we took from 1998 to 1999 to get up but I hire these programmers even the people I was hiring to say dude this is probably a bad idea and I'm like I'm like I just I was so selfish. I just wanted to talk to other dentists like you that's all I wanted use selfishly that for myself. I was home I had four kids and I mean sitting there in the chair with a knot my stomach thinking about a root canal or something and all I wanted I thought was priceless was just to be able to talk to another dentist like you and know and in 1998 that was the strangest vision in the world and now it's just a routine vision. So when you ever when you started them Dental Nachos on Facebook did you ever think it would get half as big?

Paul: No I mean that's what part of my you know being on podcast I tell an origin story I mean you know I thought at the time there was a large Facebook group called dental hacks that was a member of this was believe it or not it was a February of 2017. So I mean this is only you know the reason it's not my bio is I completed that website prior to dental nachos and I need a I think there's a page with it on there but I thought it'd be 500 people talking about implants and practice management that's all I thought it would ever be and I just thought it would be a finicky group that I could share you know I kind of call myself a kind loudmouth or you know kindly annoying so I figured hey if it's my group I can just sort of share what I want and maybe a few hundred people will be on it and then it's just sort of turned into this Facebook group Frankenstein a bit because you know there's there's a lot of management of a lot of dentists in one place and my wife is a kindergarten teacher and sometimes I feel like that I go behind the scenes and message them you don't try to be nicer to each other and as you know it's not easy but I love it I mean I really do I would just like you I I enjoy it sometimes even people who disagree that's no problem I always say disagreement is the salsa of life. So you know no big deal there but I had no idea it would grow to this number of people and I just think it's awesome you know the precursor you know I still connect with people on dentaltown I close friends you know became real-life friends you know they that's the lingo for the kids Howard even me I'm 41 like IRL you know what that stands for right?

Howard: In real life.

Paul: Yeah so it's like you know I've made a lot of IRL friends from dentaltown Matt pickle Matt Costa a number of ones who you know we're close to me geographically but now with people flying all around for CE courses you can make some IRL friends from Nebraska and you know Texas and California and Arizona. I'm in Arizona a lot now with different courses so

Howard: Well next time your in Arizona come by my house and we'll shoot a part two to this podcast.

Paul: Oh sure I'd love that I'm gonna be there...

Howard: Well first I want to go back to the journey the very beginning  of dentaltown they didn't they hadn't even been in emoticons. So here my buddy and I said Oh kiss my ass well you might read that same time he just told me I mean he's mad he's upset they didn't have to the smiling faces and I also think I've read a lot of psychology papers and I think when I'm sitting here looking at you our faces are doing a lot of the communication and things like that and so when dentists get on Facebook or they get online or they get on some like it's hard to tell this is a toxic jerkers or is he laughing. I watched three football games at the bar yesterday with three dentists now we were saying the craziest stuff but if it was just texts and emails you might from people I've never even met you I don't even know what was going on.

Paul: I mean I don't want it I'm not a official marriage counselor but I will tell you from my own whose wife I will not text her and this is a true story if shell listen and I will not text her if we were out of paper towels at the house because if I text her are there any ex are there any paper towels she will say what do you mean I you don't think I ordered the paper towels or look in the closet you idiot. So I only do that on the phone or sometimes I'll just you know I to young children four year old and a six week old so it's quite a scene in our house but I I'll just deal without a paper towel use that example with my residents because we have all this communication that I mean I'm sure Howard that when everybody was on the phone there were parents being like just walk over their house and talk to him right you know now everyone's texting and say just pick up the phone and call him and there'll be something different you know I can't even imagine, I don't foresee a need for my own daughter who's four years old to ever need to use the telephone to talk to someone I can't imagine her life is gonna need that because you think about it she can text she can email she can Facebook she can Instagram she can snapchat and the phone is. I mean I'm one of my favorite comedian Sebastian Maniscalco always says that you know now when a phone rings in a house like nobody wants to pick it up because you know it's a stranger where we just pick up and say hello, so I agree with you because I'm when you read things online and something interesting happened to me I went to a big lecture last year and it was the first one after being the dental nacho guy and two guys walked up to me at the end of my lecture on transitions and they said to me man we really like you we didn't expect to like you I said well that was an aggressive thing to say say yeah because all the things you're right online we think they're negative and I said you see when I can share with you like this they're just my thoughts but they when you read them in your own head it can be you know just like my wife with the paper towels so I hope you know I agree with you completely and that's why I think without emotions they need a sarcasm emoticon they need a you know but I'm sure they'll come up with it but...

Howard: and then the other issue I think it's there's enough evidence say that a universe of dentist has different behaviors and say a University of kindergarten teachers.

Paul: Totally

Howard: and dentists are there a different breed of cat I mean if someone was sitting there next to you on it on airplane ride and said hey this guy to me it was an average and it's like well yeah you just got the average dentist?

Paul: I would always say this they're very good with patients but they're not good with people. So dentists are good with their patients and I think they're genuine that way but it's it's in a bit of an artificial relationship the patient has come to you to help solve a problem to be able to get them to do it and open up their mouth you have to be nice and I think patients genuinely like their patients but then when they closed the doors done with their office and go to a CE course or go out somewhere else they they're fairly introverted and I have this you know just be nice slogan here and we'll have my CE courses the first thing we have to do is go around and share some very tough questions Howard if you ever come, what's your favorite movie of all time, if you could recommend a show to binge watch what would you pick because I make them sort of you know the traditional dentist icebreaker because I know you lecture extensively and you'll be in a room with a hundred dentists and you'll see they're all those round tables same deal with the you know the glass is filled with water that you know get knocked over and spilled. A dentist won't talk to the guy next to them or girl an excellent for eight hours and go home and I think that's why we're in a bit of this predicament that we're in in right now is that dentists are not communicating with each other and that's how we're able to be I don't want to say take it's not totally fair to say taken advantage of but that's how we're able to be influenced by factors sometimes outside of our control.

Howard: Is that not as TSD, does your TSD mean that's so deep?

Paul: No JBN is just be nice so TSD is that so dentist yeah so that's so dentists it's not a compliment it's not an insult but it's more towards an insult, that's so dentist is I do an implant course I say hey I helped someone place their first implant this is a true story by the way I post it on a big Facebook group I said hey I'm excited I helped Joe Smith do this implant here's an x-ray of his case and the first comment on a thirty thousand member group is why is the implant so short, I said you know that's so dentist not saying hey that looks pretty good could you just share with me why you picked that size totally different question so that's so dentist...

Howard: or at least say congratulations good job buddy.

Paul: I mean I always say that's so dentists and life would be if your wife came down dressed for a wedding and said how do I look and they and you said that was a bad choice of shoes she'd throw shoe your head and you deserve it because you know no one would say that because you'd say oh you look like you look great your hair looks nice but we are gonna be walking a mile to this wedding so six inch heels aren't gonna be a good choice maybe you want flats it's all it's not about the content it's just the way it's delivered so that's so dentists I'm trying to make more just be nice less that's so dentists.

Howard: I asked my dental assistant the other say I said are my scrubs getting too tight just these tights make me look fat she goes no your face makes you look fat.

Paul: I like that what she like you know so that's a that she doesn't mind saying that where she knows you but uh dentist you know they...

Howard: One of the most expensive cost from how you're describing that so dentists is they travel clear across the country to learn how to place an implant and there's a lonely periodontist across the street oh and they're just both are two that's so dentists just walk off street and saying I was going to pay $3,000 and fly across the world to this course you know I don't work Thursday afternoons is there any way I could come in, the periodontist wants a friend the dentist wants to learn but the problem even with that is half the dentist's thinking fear and scarcity. Like I've invited people on my show before oh I can't I'm with what are your competing magazines am I who gives a do you know anything have you ever met a dentist that only read one dental magazine?

Paul: Yeah it's also this it's that's the dentist's trauma response and and I love that you said that I if I was coaching a new periodontist or oral surgeon or anyway I say go out there and run hands-on courses for your general dentist because for implants because they'll do the easy cases and you will get back so many cases and everybody wins you know I believe link plans have the chance to unite everybody patients dentist specialists if we don't mess it up if we don't that's so dentist it but I say that to my specialists that are friends with I mean they could be anywhere I say get a meeting room just run a hands-on model course invite your especially referrals for free and just say hey I'd like to share with you what goes into placing an implant. I mean it would have just the most synergistic effect and they're the one thing Howard is that there's millions and millions of implants to place is the one thing that we have a lot of and we should just share it nicely and I work with an in-house periodontist and obviously I know that's a different model cuz it's under my you know my building but we walk the walk and that you know we plan the cases we do the stuff and there's no reason that can't be done in a guy down the street in your office but the specialist just needs to create an environment for his local general dentists to learn.

Howard: and it's not just I'm gonna do the single tooth implants and give you the bigger cases it's also I just don't like this lady she kind of scares me.

Paul: I referred my first implant I came from Einstein like you said you and I aren't such the same page I came from Einstein placed all these implants this back in 2005 too so that was a bigger deal for general dentist place implants but I'd done a lot and my dad referred me a lady a patient and I refer to the periodontist because she couldn't open wide enough. I went to take her surgical guide impression and you never have a patient oh say they're opening wide and they looks like you could barely get you know a q-tip or the topical in their mouth so I just said you're gonna be go to the periodontist and he loved the referral you know so we can share and I refer people all the time because I don't want to deal with them that's why specialists are there.

Howard: I know I have to be about three or four times where she says well I can't lean back that far and and the husband's sitting right there in the room I said really you sleep sitting up in a chair pretty much and I think I said really she sleeps in a chair he goes hell no she sleeps in bed flat as a pancake.

Paul: I agree with you, I actually had a lecture with Kois this summer which was just amazing for me I got him to say dental nachos I was like hey you know Dr. Kois I don't think you've ever introduced someone like that because I haven't but he he says a lot of the same stuff you know where the patient you know one of his examples that I love is we treatment plan based on how annoying the patient is because you see a guy who opens wide and you can has decay on 15 occlusal towards the distal and you say I will fix that for your buddy no problem then you see another patient who you know never wants to come never wants to open barely can get back you say well just keep an eye on that filling and I just think that's such a great story because it's just so true that dental school I said this at my lecture this weekend dental school trains you to work on dennah forms but there's no dennah forms in the real world there's all people and that's the part that's most difficult for a dental school going into the real world to work.

Howard: and you know it's starting to change because dental schools when I was in there 30 years ago over 30 years ago from 83 to 87 it was all that Marine Corps boot camp mentality yeah the more I was hard on you that was somehow gonna make me a better dentist.

Paul: Yeah

Howard: and then it was the guy that pioneered the change was a university of Pacific art Ogoni yeah is the one lecturing all the Dean saying dude you know how much like the Dean of Notre Dame if he writes just a fundraising letter like I'd like some more money 100 million minimum because they love their experiencer are you going he's like dude look at your alumni contributions those people don't like you you can't like crap for four years so then Jack Dillenberg was his protege. Jack Dillenberg when he was Dean ten years at AT Still in Mesa every one of the students were invited his house night before his only goal was to get him so drunk they were too hungover on their first day at dental school to even function and he wanted to be called Jack you know so it's really changed. I want to go back to the implant comment he said or enough implants everyone. I was lecturing last week in Vegas at the Megagen implant seminar and these guys were showing the amount of implants placed per million people the United States was near the bottom. I mean developing world countries like Brazil places more implants. So one of the reasons some of these publicly traded dental implant stocks are doing so good it's cuz Wall Street look at us that's the man there's only upside on dental implants oh why would the United States be number 20 on implants per million place for year I mean so it's total upside from here.

Paul: I agree with you completely I was just I mean I think one of the problems is if you want to teach dental students three toothbrush is in the back of the mouth you should competently teach a single tooth implant at least on the models they can use models so that their mind knows about both these things but weirdly dental schools are kind of hiding this from the dentist then you get out we talk about those politics with the specialists in general dentist. So I teach a lot with Hiossen and when people you know people will say you you know you work for Hiossen and I really work with them I mean if they sell more implants I don't benefit I get I get paid to teach the courses but when I learned ten years ago with my mentor Alex Cho you know in Korea dentists, general dentists are doing a lot more than general dentist in the US and that comes with double-edged sword but they're just able to them doing implants as normal. So even even in 2018 you take five general dentists and you say hey is placing an implant normal how many do you think are gonna say yes one you know two maybe.

Howard: So that's so dentists I know what they said when you said you were four Hiossen they first thought okay well hi so that's a cream implant right?

Paul: Yes

Howard: Megagen is a Korean implant there's over last year at the International Dental meeting in Cologne Germany my favorite meeting it's every year there was over 450 different implant systems being offered. So she's dessert dad and so she was somewhat why hyacinth why not one of the other 450

Paul: Well the real reason is Hiossen you know I'm a really way your call straight shooter transparent genuine so I will be glad to share with you challenges I've had working with that company on a customer service level but what I give them a lot of credit for whatever the reason was whether it was a combination to train dentist and sell their system in 2007 when they came over here I was asked to be part of a local teaching team with Alex Chow a periodontist another pareo process their general dentist and I loved it because in Korea they would have these AIC centers designed to Train local dentists in implants and they mimic that over here so I was the fill it up art of the Philadelphia team so I used hyacinth a were promoting training for general dentists because to be honest when I got out of my residency a lot of the bigger companies that are so bigger today they would they wouldn't really hear about me teaching because they said that's gonna make their specialists mad and I said I don't understand that I'm just trying to you know help promote implants in general and they said our specialists won't like it so I felt a little discouraged and I actually still used their systems in my office Howard before Hiossen but Hiossen on was the first one that allowed me to teach so of course I was that so dentist because you know what I did Howard I said I'll teach with high esteem but I'll still use my fancy implants but they kept saying hey Paul we'll give you some implants try some implants I kept him in a box and then my friend's sister had a retained baby tooth and I was gonna place an implant on her so I said you know what I'm gonna do I'll use one of these knockoff implants right I'll try a knockoff implant on her and charge your half price, lo and behold it worked out well and then like a Seinfeld line yada yada yada thousands of implants later Hiossen Well and Megagen works well and Neodent works well and Nobel works well and it's like composites like I always use your line Howard where you know all the bonding agents work well right and I give you credit you know what you say we argue about bonding agents and they're all good implants have become so similar I mean I say to my residence if you're I say to a dentist if you had to do a filling in my office and you wanted to use Herculite and you showed up and there was Venus composite would you walk out of the office or refused not to do the filling, no you would use that composite. So I'm trying to do the same thing with implants it's just that like an endo system it's a little more complex the tools because there's different drivers but I think we all should be open to just learning about how the process works and then use whatever system you feel is best.

Howard: So my homies are commuting everybody I talk to each other about 85% of their commuting work and the other 15% on our sub poor bastard and stuck on a treadmill and but anyway so I like to retweet their last week so that they can get to work and find you. So you're on I know you're huge on Facebook on Twitter you're at Dental Nachos your last week buying a dental practice and having a baby or a lot alike I have done both twice but your youtube link doesn't wasn't activated, there's something wrong in your YouTube.

Paul: We were adding a few videos every now and then I apologize.

Howard: Make an active link and I'll retweet that. I'm so honored 25000 dentists follow me on Twitter and it's such a huge honor then you guys follow me @Howardfarran and then his website what are they gonna find at

Paul: I mean in general that's I really do love nachos it's a genuine thing I worked in a Mexican restaurant when I was 19 I could eat whatever I wanted i when I was a chubby little kid I used to see always asked to go to the Mexican restaurants because they gave you the free chips when you sat down and then I worked at Mexican restaurants and I loved the ones in Philly. So dental nachos there's like a nacho plate of me you know there's stuff on brokering their stuff on implant courses there's stuff on dentist you know connecting with dentists. There's ways to ask you know people connect with me for finding associates too, that's a big thing it's sort of like the online dating or mass comm of a associate world because you know people are asking behind the scenes hey you know I need an associate I might be retiring that's a whole nother that's so dentist thing Howard where people talk about corporate dentistry. Corporate dentistry isn't good or bad but there's plenty of practices that are just not making any room for young Dennis to join them and they could but they just don't want to share.

Howard: So when you go to dental nachos you have to enter your first name last name email then he'll send you a an email link which you gotta tap and then you then it's on continue to your website. So do that I know a lot of people want a little firewall I think comes up yes freak out twice your first name last name and your email address do you think I think Facebook and on amazon my or do you have that on you anyway you think so.

Paul: I share some newsletter email newsletter rants on my thoughts and they're just supposed to be fun and funny and get you to think so you can follow that too. I have like a you know uh dental dot deep dental nachos thoughts like at the Jack Handey from SNL back in the day.

Howard: Well I'm a huge fan of your work I think your you went to Albert Einstein they should rename that school Paul Goodman.

Paul: Oh thanks thanks Howard.

Howard: and your motivational tips oh you're you're damn smart you're wicked smart and damn funny, it's a amazing combination. You also do it you're in the practice transition space tell him you're back down tell me what you're doing in practice transitions.

Paul: Yeah that was interesting so about two-and-a-half years ago it's teaching a highest course I got very friendly with the young dentist and her husband we became personal friends and she moved to Oregon and she was doing part-time practice transitions and I jokingly said if I give you move can I try your part-time job and she just said yeah so this company United dental brokers of America this always sounds good when you say this right Howard if I say we're a small practice transitions firm that's like not good if I say this word boutique practice transitions firm run by an amazing guy's an accountant Bob Septac and he has brokers throughout the country and just like a dentist you know I said to him Bob when I was sort of interviewing I said how do you compete against you know shine and Affco and blah blah blah and you know just like a dentist he goes you know there's plenty of dentists to sell practices and we're just trying to get our own piece of the pie and I said you know that was that was a very stable thing to say but I love doing that because that's ultimate problem solving. A dentist has to leave the space another dentist needs to get their new dental child and you know how buying a dental practice I say this all the time buying a dental practice is the most important decision you'll make in your life more important than who you married because there's many dentists that I meet with three wives but only one dental practice. So you know that just shows you that you know if you people get divorced one person goes to San Francisco to drink wine in Napa the other one goes to Texas but if one of them has a dental practice they're anchored to where they are because I you can't just return it, so you got to make sure it's the right fit for you because at the end some of this is poignant stuff and some of this is not you know because the dentist and it was the end of your career sometimes your dental practice is one of the best relationships you have in your life and it's a shame it's like they don't teach us anything about this in dental school and they should because it's one it's so important for young dentist to know more about and we kind of say oh you'll learn it on the streets but brokers, remember brokers are like a lot of times landscapers and things like that like you don't have to pass a lot of tests to be a broker me either. So when people get into the space they can be there's no dental board there's no Law Board so it's just important that dentist going with eyes wide open to these scenarios with brokers and I love doing that do buyer coaching where I help on the other side if I'm not selling that's what I want my favorite things to do.

Howard: You know it's funny because if I said what is the average dentist I don't think I'm qualified to say what the average dentist would be like as a millennial but I think lecturing a thousand times I'm pretty qualified to say what an average baby boomer does, your 41 what are you?

Paul: Yeah I'm a medium age dentist that's why I call myself so I always say a medium age I guess I'm Generation X technically I'm not sure about what I don't know what the cutoff is but whenever people you know if I say I'm old too my 80 year old patient doing implants they say oh I'm old but if I'm I just had this implant course a nice nice young dentist three months out of school 26 you know I'm 41 so a medium age like a steak medium I guess.

Howard: Well you know the baby boomers they were all pretty much conservative Republicans so anything the government does is a bad idea but you were talking about how brokers are regulated so they don't like any regulations they they basically hate the government well that's why everything in America kind of sucks. When you go to the only two countries that can make perfect stuff it's Germany and Japan and if you want to be a plumber in Germany you're gonna have to go to a princess school and join a trade union and you're gonna be regulated, well guess what when he comes in fixes your toilet it actually works. When you live in America we say well our economy is so huge yeah just half of its rework you know. I mean I'll never forget you know Austria is actually in my mind it's Austria, Germany and the German section Switzerland's the same tribe the people. I'll never forget I was lecturing over there and I just wanted to take a shower I thought I was in like the space shuttle Columbia it had so many knobs and levers and I just stood there the basement they get only a German could he over thunk this shower to so many degrees we're in America some kid with no training would have come in slapped it in five minutes but you're saying these brokers aren't regulated. Now is your broker business at your website ?

Paul: There's a link to it but United Dental Brokers of America or is a good resource.

Howard: United Dental Brokers of America

Paul: Yeah and it's is because they have listings over the country. One thing I think that's tough Howard and even me sometimes I look for other practices but you know it's like the third child I'm like you know I don't know if we're gonna have a third child or a third practice but I'll still search and it's really hard to find what's available sometimes because with all the technology it's private to sell practice so it's not like an MLS listing so you know all these sites whether ours you know we have listings over the country that probably some people don't know about because there's no really good way to get this information out to dentist and I think that's part of the problem too but I did want to ask you or actually want to compliment you you always talk about how dentists should be willing to commute further to work to an area where they need and then live where they want I just talked to someone today super nice person as a buyer coaching client said they want to practice I won't say the accident let's just say they want to practice in Miami Florida right and I say what if I have a good practice for you in Pittsburgh they won't move there what if I have a good one in Austin they won't move there what if I have a good one in Philadelphia so now they really constrain themselves and I tell these young dentists you could cry about it you could be upset about it but you need to be more geographically flexible for your career and be able to go where the practices are and where the jobs are because there might not be enough in these areas that are popular to live and maybe they think oh well you're in New Jersey and Philadelphia Paul I'm like yeah that was my generation I mean everybody from my class Howard went back and work where they grew up you know but now it's a different world.

Howard: So now so you work with a bigger national broker United Dental Business, UDBA

Paul:  United Dental Brokers of America, UDBA

Howard: .biz?

Paul: Yeah .biz.

Howard: That's the only time I've ever clicked on .biz its always been .com.

Paul: Yeah I didn't know that he's got in the .biz it kind of stands out I guess now I've gotten used to it over time.

Howard: Yeah and so that United Dental Brokers America they covered the whole United States with you just how much where you live in New Jersey?

Paul: Yeah I mean it's interesting it's you know there's this popular thing I don't really understand it Howard maybe you do it's called like they're talking about what I don't know what tele-dentistry is but I feel like it's like doing dentistry like we can do tele-brokering meaning Bob Septac has sold perio practices in Texas even though he's in Pittsburgh because there's not a lot of on-the-ground work that has to be done but there are states like California needs a real estate license so you know if anybody was interested in a broker there they would have to get that but you really can the world is flat like the Thomas Friedman book to some degree it's like you can sell practice is anywhere you know people contact me from dentaltown from Dental nachos and say can you know sometimes it's flattering there but hey Paul do you own any practices that I could buy for in Iowa and I said I'm in flattered you think that I do but I really don't but if I found one I could sell it there.

Howard: I got to tell you my first of all the matter you said you have two kids should have three or four I'm the luckiest gather oh my four boys have already turned into six grandkids but I got to tell you one tele-grandkid. So I saw this granddaughter several times but I didn't get to see her at a critical juncture I don't know six months to a year there's a four or five month period I didn't see her right when she was really developing and but I talked to her every day on Facebook so then when I finally got to see her she was scared and she didn't want to come and I was shocked she didn't want to come and a moms scared and I thought to myself oh she only knows me on facetime, so i facetimed her mom I'm on FaceTime he's like that and I thought in the FaceTime and then I'm telling her going Raya Raya she's leaving me funny so the mom just kept moving the facetime closer closer closer and then you can see in her eyes she finally realized oh that's that guy cuz she finally thought maybe I lived in this box.

Paul: I love that

Howard: I mean she I mean how would she not know that that her friend didn't inside the iPhone that was oh my god so yeah you can tell it any relations can be teledent. Dentists always call me anything excite any let's do lunch or you know I'm gonna meet dinner I want to talk to you, I'm like dude you're talking to me right now.

Paul: Yeah I say that all the time, yeah.

Howard: Let's go let's knock it out, if you want to go drink beer and watch football that's one thing but if you really got serious do it right now you don't need to smell me to scratch me hold my hand just let's just do it.

Paul: I agree with you and real quick like a lot of business people will connect with me because I know dentists do with you whether it's a financial planner or a real estate person and they'll say I want to take you to lunch and I say I don't want to go to lunch let's just do this and tell me what how we can help people because I can't take two hours out from 12:00 to 2:00 to hear about you know kind of I mean a big Gary Vee fan out if you listen to any of his stuff he's at he's an East Coast guy but he's a he's an interesting character it's like that I don't have time during the work day to have a two-hour lunch and that's the same thing with the specialists they'll say some of my staff will say there's a new specialist who does endo he wants to take you to lunch I'm like can he just stop by the office and we can shake hands and that'll be good enough like I don't need a lunch because it's too hard to cram this stuff into your life nowadays.

Howard: Yeah, so it seems like the Millennials are different than the baby boomers mean I graduated May 11 I had my office open a hundred and thirty three days later on September 11 is going on it seems like they just go from associate ship to associate ship's associate. I mean when I see a millennial out of school the average limit of living out five years have five different jobs and then they finally go buy or start a practice why is that true I mean do they live in a world where they think that it's gonna be awesome at a DSO,it's gonna be awesome to work for somebody?

Paul: I love this question and i'm happy to share, there's a popular book by John Gray like men are from Mars Women are from Venus it was like I about ten years ago or the bestower. I really want to create some content about you know sellers are from here young dentists are from here because I am in the middle and I see both ends and I like both groups in my own group but it's a shared understanding. So first this I grew up in a dental practice right and my dad's team when I was 24 to 30 they were kind of all the same women the the staff didn't change that much so first of all owning a practice I will say as a practice owner of two practices it's becoming very complex with just staffing the place because people change jobs quicker people move quicker and dentistry you need a lot of people to put on your show. I had a chiropractor once I'm like that must be a relaxing job all that needs to show up is the patient and the table right it's like you know for us we got all this intricate equipment and then we got human beings. So first I think you know my dad did the air force for two years and pretty much came back and going to practice and bought him with the guy and they were they were partners their whole life I mean it was a it was a great story. I think a lot of times they're not ready to dentist and run the practice I think it's two totally different you know skill sets and they they don't get enough dental experience in dental school where they're comfortable dentisting. I used that term dentiststing and making all the decisions right what happens when you can't get contact with your filling and your assistants are crying in the back that's pretty stressful right so and the other thing is it's just that the the practice transition space, corporate is purchasing a lot of the larger practices taking them off the table and just I talked with a woman today you know let's just say let's just say they make $150,000 a year as an associate buying a small practice might not change their income level a lot. So I say this when I graduate one of the scariest trends I think Howard is that when I graduated from dental school the starting compensation for a dentist out of a GPR was about a hundred and twenty five thousand dollars a year and now in 2018 it's the same number and the debt load is three or four times as much so I think for them they're in a place where there's no enough practices to buy and even though I agree with me when you say commute an hour and work somewhere and move back right but I do think it's hard to ask a 27 year old remember they went to high school they went to college they went to dental school maybe they did a GPR their whole life in school under pressure and now you're asking them to move to the middle of Ohio and leave their family and friends to practice there, it's a hard ask from an emotional perspective because they didn't know that going in, I want to be a college professor for years but I didn't I said I didn't want to do it because I knew you had to move anywhere for the job so I didn't want to go from New Jersey to Louisiana because there's an opening in the philosophy department and dentistry has become a little bit like that. I mean whatever we say you know so to me that they work for corporate because it's safe and comfortable and this is what I say corporate dentists out of school or out of a residency they shouldn't be called associates Howard you want to know why?

Howard: why?

Paul: because they're not associates they're working as absentee owners so they're non owner dentist so the reason they earned so much is because corporate had an owner they bought it from the owner has moved on and now that dentist is taking over the owners work and in my world an associate is someone who works with someone in private practice shares the work. So it's an interesting change in the dynamic of what's out there because for the first time they're offering you know two hundred and fifty thousand dollar year jobs two thirty year olds and I never had that worry because none of us when we were young made over a hundred and fifty thousand dollars a year, so as soon as you buy a practice you double your income now I got corporate oh I got corporate associates making 270 a year I say by this practice you'll make 210 they say I don't want to I'm gonna take a pay cut I said yeah but you want to own your own place they say yeah but I don't want to take a pay cut I said well you can't fire yourself from your own place you get fired from corporate. So it's a it's a messy nacho plate right now, it really is.

Howard: and it's they know what they're doing they pay you just enough money to kill all your dreams.

Paul: Yeah I agree.

Howard: and that that's what they I already tell you different scene school in 87 what year do you get out?

Paul: 2002

Howard: Okay in 87 the practice transition the 400-pound gorilla on the block was Affco and it's it for Allan F Thornburg company out of Atlanta Georgia and he did something one of the reasons he got so big is because he believed in dual representation he's allowed me to dentists am I allowed to steal your TSD

Paul: Yes steal it.

Howard: Okay well he would say look I'm not going to get to dentist that so we're just gonna argue and fight and lawyers and whatever you need to do that so I believe in doing rubber so I'm gonna represent you both and we're gonna slim this contract and reenact a nice deal that was they pretty much the major aims done in the eighties now it's 2018 it's forty years later what do you think it dual representation?

Paul: I mean I'll be diplomatic but honest

Howard: Don't be diplomatic your on Dentistry Uncensored.

Paul: Yeah that's true, I mean if I did a podcast with my very close friend adviser Rob Montgomery who's a dental focus attorney and he's taught me a lot so...

Howard: What is his podcast name?

Paul: The Dental Amigos that's what we do that we do that together It's fun we have all kinds of people and you know we can have you on Howard, that'll be awesome. We have all kinds of people business a dentistry non clinical stuff clinical...

Howard: What is that on Twitter?

Paul: We don't we don't have a Twitter handle for yet we need to get one we've made the website.

Howard: That's so millennial.

Paul: Yeah I know tell me ghost calm rob has helped me personally professionally and I didn't really understand why it was so toxic dual representation now I definitely do as a broker. So when I'm a broker I work just for the seller paid by the seller that's it the buyer gets their own representation remember this is the most important decision of their life right. So dual representation the broker says I'll work for the seller and the buyer but they're really just working for the seller because they're getting the lion's share of the commission from the seller but the buyer has to pay this vigorous for for I think being taken advantage of quote-unquote or at least being misled because Rob I'll use Rob's thing I imagine you know if you someone you met someone and they said my favorite team is the Eagles but it's also the Dallas Cowboys you would say that person doesn't sound right you know. So all the dual representation brokers on my and I just wish they would shift to seller brokers and we would create a landscape that has less confusion out there right they don't have to get out of the industry they can just shift into a protocol that's normal but sometimes they're asking the buyer to pay 3% of the Commission it's a significant vigorous on the deal and also are they getting the best information because the persons claiming to represent both but I don't that's not possible.

Howard: You're right it defies physics I mean it's just not when you're representing me here you're representing him and if you're representing both of us the brokers really representing himself because these real estate agents the ones I've seen as patients for 30 years they say you know when you're making your commission who cares of the house I'll stir to 85 or to 70 driver it's so small what they will do this want to close the house.

Paul: There's a chapter on that for every right Freakonomics there's a chapter there's a chapter on that where there's no incentive for them to get the most for your house but my uncle is a realist agent and like you know real estate into a co broker split but remember a house is an inert thing that is just gonna keep you sheltered, a dental practice is your livelihood so those two things are drastically different because you can mess up on a home purchase and unwind it there's a mess up on a dental practice it may ruin the rest of your life I mean I'm not saying that with any trace of exaggeration.

Howard: and I can't tell you how many times on dentists don't follow their own advice I you'll be going around in a poor neighborhood really poor there's some neighborhoods in Phoenix where the majority of house of dirt floors and people have said they're saying why would that kid buy that $30,000 muscle-car lived in this neighborhood. I'm like huh interesting cuz why did you get our dental school and you bought a big house and my car but you work for somebody else ha it seems like the same exact behavior to me. I want to go back to you know Socrates said we only have two emotions right fear and greed and he said fear was much bigger than green there's a lot of research on that I mean the 10 biggest plummets on Wall Street are much more significant than the 10 biggest best days. You're a monkey sitting in a tree you're really thirsty but there's two crocodiles sitting in that pond you're not that thirsty and a lot of the Millennials tell me I don't know I don't you know I don't know if an individual can compete against a DSO. So I mean maybe and a lot of people say I get this feedback the most how our time to change dude you're old I mean you know children I have six grandchildren you can't go out there like you could like you did 30 years ago and compete against a DSO, what would you say to that?

Paul: I mean it's great I've had a great opportunity to also develop close relationships with corporate dental groups in this area and I learned a lot. So first of all I'll do headhunting for corporate groups and some dentists will say why are you trying to help them I said I'm not that's I mean I'm trying to help both people mainly I'm trying to help the young dentist. So I'm just going to give a quick example I know a group here in Philadelphia their main dentist is gonna be retiring and they need a good dentist and they got a good position like quarterback for someone to go in and make 250 or 300 thousand dollars a year, they need a good dentist for that like a good chef and that's not easy to find. First I'll tell people corporate is not trying to hurt private practice you know I don't know why they don't even care about it. So private practice solo people are in this sort of competition that the corporate people they don't even understand because they're miles ahead of it meaning they're not trying to squash private practitioners they're just trying to expand their footprint print and grow their business, it's the emotional dentist that feels this this like they're a person trying to take away their lunch so I've said Howard people say oh Paul you know you're negative I call it realistic they say you're negative I see realistic, what should we do I said here's what you need to do you need to get like four owner dentists if they could get along and take their 1 million dollar practices and buy a big building together and take your 4 practices into that building own it together four owners and now you've got four or five million dollars one place and corporate has four or five million dollars all in place and now we got Chipotle and another Mexican restaurant that's owned by four guys but you know Howard dentists don't like each other and you know if they work together they would get caught up in the small stuff oh you use shampoo burrs I only use shoulder birds we can never get along you know like it was a Romeo and Juliet. So I give that advice and I tell I'm walking to walk like I kind of I got a two owners in our office we got multiple dentists we got multiple locations I'm talking to young dentist in my group I am setting my own practice up to come competes not even how about it's like exist right coexist to coexist with corporate but if you're doing under $600,000 a year and you're 65 no problem you only got a few more innings to play until you get to go to Arizona and play golf with you Howard or you know relax and drink beer with you but if you're 30 years old that you want to buy a three-opp practice at that's six hundred thousand dollars a year it's gonna be a tough career to grow that and compete with offices that are doing three or four million.

Howard: I can't believe this is so bizarre on your website that your last podcast was with Richard Lowe oh yeah oh I love Richard so much I woke up thinking about him this morning and reposted the podcast I to them so we're both thinking about Richard Lowe that's amazing but also if you go to dental amigos boot camp, the dental amigos You also talk about a new dentist boot camp 2 and one of them's coming up in yeah just what...

Paul: We're doing one this week which I love...

Howard: I know October 19 to 21, well first of all is it sold out?

Paul: Well interesting I would love to share thanks for that so we it's small its new dentist boost camp so I like to be boost positive. So we take 20 dentists live young dentist and that's all I take Howard no more but then I live stream or Netflix the event and last time we had a hundred people sign up for that and they can pay to get CE and watch the whole boo scam and it they felt like they were sitting there so I have this amazing guy who who does our podcast who he he produces this boost camp I'll show it to you I'll give you a link to check it out it's actually just fun so it's myself and Greg Charles and some guest lectures we talk about restorative, we talked about practice management all about buying practices talk about Dennis decision making our trifecta is you know making decisions with your mind talking with your mouth and using your hands but I had a dentist from the middle of the country Kansas it was very poignant and she said hey Paul I really appreciate your doing this I'm a young mom of two kids and I'm seven years out of school and I didn't take enough CE when I got out of school because I was dentist cheap and she said I love that you did this because I'm able to now you know talk to patients like you were or try these crown preparations like Greg and I'm so proud of it because not everybody can come live to stuff but why can't we bring it to them to their living rooms. So it's never sold out because the Internet has as many sheets as possible so I appreciate that Howard very much.

Howard: I use that same exact streaming technology but my website is called

Paul: You'll get more hits with that, you'll have out done us.

Howard: So they go to the dental amigos... how do they sign up?

Paul: and just for $395 they can get 12 hours of CE over 2 days oh and here the Howard we're very simpatico and I think so you know what dentists are gonna say I don't know if I want to sign up cuz I got my sister's grandmother's birthday party on Sunday or whatever right so I say no problem we send you a copy of the course for free afterwards that you can have forever like a talking textbook so dentist can't wriggle free I say hey you missed three hours of it you get that you get the recordings for free afterwards I'm really excited to share.

Howard: Here's the thing you know I want to be a leader I really do you know I look at Kenny Anderson in my next-door neighbor who was all not to be my dad he helped me so much and there were so many dentists on the west side which I'm none of them thought in fear and scarcity in Wichita all the dentists on the west side they all ate every Thursday at the like Rose Bowls and then the other days was at another place I forgot the name of it but no one thought in fear and scarcity they helped me so much and in me at 56 try to help these young dentists the thing that just drives me insane if they don't blink it buying $100,000 laser if they don't blink it fly into some Institute to spend $3,500 on doing some full mouth rehab and they dude how many full mouth rehab do last year I never did one I like it's like the biggest return on investment is continued education whether it be dental consultants. I mean get your house door and the thing I like the most about in the in fact probably the only thing I love the most about live CE, is you get to hang out with people that actually love dentistry and are moving forward I mean when I went through the Misch Institute I was making these lifelong relationships of people who were telling me what they're excited about in far other areas. I mean I went all the way to the Misch Institute one guy decided that he didn't want to do implants but he loved the Misch Institute because he met all these other people you know. So you know if you if you win if you live through dental school with four drunks who hate dentistry think the sky is falling and now you only have those friends to call dentistry is going down but what I like the most about earning my FAGD and my  MAGD is the AG would have a course in Phoenix Arizona with 3.8 million people in the metro 3800 dentists but it was just the same hundred dentists every time they turn into a big family reunion of positive activity.

Paul: I mean my dad would be 70 he passed was 68 so I actually say this in my lectures so their group didn't they had to show up together so I actually believe they made better friends so we a golden retriever growing up and the way I do CE who I love they're going true where my dad used to she used to take this pill and he would wrap put it in ice cream give it to her so she wouldn't notice she was taking the pill. So a lot of dentists want to learn about how to talk to patients but if I make a course that says how to talk to patients they won't show up so I make a course that says dentist boost on all this stuff and inside this course is the secret sauce of how to communicate with people and I scream at Howard for for many reasons but my hope is that I'm you know people would want to join live sometime and meet some dentist and I do these big I do two big events in Philly, Nacho pearls festival in a big room where I get like a hundred and fifty dentists around the country and that I love because I think we need this hybrid CE. See people locally make friends do stuff online because we're busy and then go to fly around there's some big events like I'm coming to Arizona for stuff I mean I love that I learn myself. I mean you know we I think I don't think it was dentaltown was dental not they said how long should someone have to do something before they speak on it and call themselves an expert and I said whether you're looking at John Koise or you or me I've never walked up in front of a room and said hey everybody I'm the expert because people who do that they don't they know that's a silly thing to say because LeBron James misses free throws right but he's an expert basketball player. So I think if we just sort of get in these spaces together we'll just learn more together and hopefully just I think I have in my little scrubs my new I things just collaborate not collude I mean you know I have a joke Howard and it's one of my favorite ones where you know my dentist can't collude and I mean you know people say dentist can't collude and do all this stuff I said no problem dentist you're never gonna do it right because they would never be able to even agree on when to have the secret collusion meeting to do it right so it's like I just want them to collaborate like you, you know bring them together help out young people and you know it's I just think it's an awesome message.

Howard: and the other biggest thing about Wilfred I think whatever you want me to post I mean I know you don't need a marketing monster but did you start a thread on dentaltown to tell the townies?

Paul: Well I hope this podcast helps the dental town he's from the old see me my face it up because for some reason I can take the same content on Facebook and I'll take on dental town it and I get a little blowback for it being just about promoting myself but I try to tell them it's really for helping but

Howard: Have you ever met Howard Goldstein?

Paul: I have not met him.

Howard?: First of all he's really like your dad and he's almost old enough to be your dad, Im 56 and hes older then me but he's in Bethlehem Pennsylvania so your in philly.

Paul: I'll go visit him at his office.

Howard: Email me what you want me to post on dentaltown on Facebook Twitter Pinterest by the way people make fun of me that I'm on Pinterest. I grew up with five sisters I think I might be 80% female because I have eleven I have eleven thousand dentist follow me on Pinterest I mean is it but but send me whatever you do but oh you should go meet Hogo, just go meet him.

Paul: I would like to...

Howard: and it's funny because Tom Giacobbe is actually he's like seven years younger than me and I always say to him how could you be seven years younger than me and your as big as grandpa as Howard Goldstein but back to the personalities like like Tom's been the editor dentaltown since 2000, 18 years I'm so lucky you know Howard Goldstein I think what he does amazing job which is the hardest thing just trying to get people to play nicely in the playground but I think I always think it helps Howard Goldstein if he actually gets to meet the person that he's trying you know mean it to kids to play nice together but you never met either kid it's tough but back to this deal you know I really I don't know personalities changes over time I don't know I'm a dentist on a psychologist but man you didn't you need to meet all the dentists within 30, 40 minutes of your office and you walk in there and they think in fear and scarcity and they they don't want you in there they don't want you to observe they know then that's still positive because now you can check their fear and scarcity name off the list and the next dentist might invite you to his house to barbecue and um you and have the you need to find the people because many many many many successful people and that's why Kois is so successful just adorable guy and you can make fun of all day long he's a hundred percent Greek. So every time I see him I always have another Greek joke for him now a lot of times I have to google it you know ask guest place could be he sprays Windex on all of his crowns...

Paul: Out of My Big Fat Greek Wedding

Howard: but my god most experts think that when you're depressed that you're a summation of the 5 most important people that you're spending all your time with and there's something toxic in there and a lot of times with dentistry the only time they call someone at night it's one of their friends from dental school it just happens to hate dentistry.

Paul: Yeah I totally agree with that, that's why I love the Gary Vee it's listen I his stuff and a hundred percent agree with you and and you we all should pay it forward for these events.  I have students sponsored I have dentist you know it probably isn't PC if you know that Sarah McLachlan commercial where they're doing the pets and you know adopt a pet I tried to mimic that and I got nineteen humans to pay for nineteen students to come to the last event and they loved it I connected them together and you know you just need sometimes that spark of positivity to turn things around cuz dentistings hard I mean you know you're in your office nobody wants to be there it's not easy to run your team there's you said there's no crying in baseball there's a lot of crying in dentistry and you know we I think us as dentists need to support each other and just be there for each other and help each other but dental school messed us up, so we need to unlearn it hopefully.

Howard: Just don't think in fear and scarcity cuz you like you got the other podcast I would never see I mean I think anybody doing anything good for dentistry is good for my homies and if you send them a magazine you send my podcast same thing with my patients. Here's another thing one of the reasons that I've had so little issues in the courts or anything with it price of dentistry because I'm so funny when somebody gets mad you and what's the transfer their records and it's like the guy across the street you've gotten drunk with like 50 times yeah you know how would you like that situation as opposed to some guy who can pick you out the police lineup in might think that you're something you're not or whatever I did just don't friends and by the way are you putting your podcast on the on that dentaltown app?

Paul: I would love to am I am I allowed to do that?

Howard: Of course, so now we have 60 dentists uploading their podcasts and what then I'll tell you I'll tell me as they say you know I get up in the morning I got hour cue to work I go to the dentaltown podcasts or 60 different dentists and a lot of things are looking for something maybe maybe they're driving to work and they're gonna have a molar endo and they're scared so they're looking for an endodontist, maybe they got a staff meeting and they know they're you know they're looking for something and everybody that's up the 60 dentist that put their podcasts on told me that their views on iTunes and YouTube exploded because that they found it off that.

Paul: Like that Richard Lo one was just that I just love sharing this information and I love podcasts and I'm really just thrilled guys because sometimes people come up to me and say I just heard you on a podcast I really liked it and it was from a year and a half ago which I just think is so cool because it's almost like it stays up there and people can consume it whatever they want.

Howard: Well okay so I'll tell you the creepiest story so I came out with a 30 day dental MBA in 98 and it was VCR that was the hottest thing out and then it eventually got so hot it turned into DVDs well eventually YouTube came out you heard of this company Google bought it for 1 billion dollars. I uploaded the 30-day double MVA on YouTube when it came out so now that it's 20 years old it still gets 1300 to 1500 downloads a month on YouTube for free and I look at the views on the YouTube every single day even for the ones so this is I think we're at a thousand 90 so it's about three years every single podcast on YouTube gets more views they just keep doing and a lot of times I realize myself like all these to be out there on the patio and I'll go to youtube and I'll see some video about you know so that I'm interested in and I start listen to it and say it's on blast size watching that you know the seven shoulder exercises that make you know yeah after the video was made eight years ago and it was just fine oh hey I don't need the updated version on the seven perfect shoulder, I'm sure if they were perfect seven years ago they're not like the seven worst ones so yeah.

Paul: In our office we have a motto for the associates you don't strive for excellence until you've gotten goodish and I you know with it we strive for goodish and those exercises were goodish and that's why I think this content that we're sharing we should feel so lucky and a lot of it's totally free I mean it's amazing I can you know I go to the gym or walk around Philly listening to all kinds of great information that's just streamed into my ears so you know I just think that's we're lucky to be in a time in dentistry where you can get this brought to us I didn't have this when I graduate from dental school and I know you didn't either.

Howard: Dude if you told me when I walked out then I was no first of all no I can't ask oh we thought we were so lucky because the stupid idiots behind as they were installing computers and we thought how would you like to be those poor bastards ah we snuck out never had to learn that computer thing and that famous last words not. Back to your to Hiosson and dental implants restore it seems to me I believe that if you don't place one implant a week you never really get not only technically good but not even profitable same thing with people that are doing Invisalign cases if they did Invisalign case every other month they never really you can see him fumbling around on the software and you can just saw say the way to dentists suck at dentures because they didn't find fillings every day and a crown every day and they do a denture every other month. I believe there's a critical mass to anything like if someone says they want to go learn to sleep apnea I said well are you gonna do one that case a week so do you call I you know I need it's here I don't think I should be doing it.

Paul: I think a couple things is that I'm 41 and probably before the end in my dental career there'll be something new that I don't even know exists right now that we'll be doing in the practice or me so let's say you know you're a 38 year old dentist and you want to take an implant course the challenge to get that one case a week is they don't know how to talk to the patients about it. So I say if you brought me in and just let me talk to your patients and leave you'll get five cases a week and maybe you'll do two and you'll refer three but I it's not fair I got all this training when I was in you know a GPR. So dentists don't want to learn they want to learn how to do they want to learn how to make their the better they want to learn I make their nachos better and I tell them to be able to make those nachos you have to create a system outside of the nacho making to talk to the patient's talked about money which is a big thing they don't talk about that in dental school have your team on board. So when I set up these courses and I bring the patients and they do the implants great clinical experience but then the ones that really do it well say they go back to their office isn't talk how I told them to talk say these words I believe that I could give someone a communication checklist just like a veneer checklist I would say you know when you're cementing veneers everyone's got to read that little like pamphlet you know silent eight this obviously what if the patient's so he's like are you reading the directions like sort of but I believe I could give you that pamphlet for communication but dentists get bored by that but I say without communication nobody does the implant. So there's it's every general practice has nothing and right and I start out with one a month for new people that I want to make that to a month and I agree with you you want to be doing the equivalent to one a week but implants you see they the cases come in all shapes and sizes so once you get good ish you can do more than the single tooth implant responsibly you could do over dentures but I didn't understand this Howard, I ask you this people see some kids they refer some kids they do some extractions they're you first some why is implants this only world where it's you have to do so much or none why can't we just like get back to the same thing get your periodontist and you in sync and do some and refer some. It really boggles my mind and bothers me that I don't know if I've made as good an impact over the last 12 years taking place helping dentists place implants as I wish I have I mean I hope the next 12 years or better.

Howard: I want to ask you on this critical mass do you think the dentist you've reached the critical mass placing an implant a week do you think they're more likely to buy all their implants online because they're all at the value chips on anybody or do you think they're more likely to have a relationship with the local rep in the field?

Paul: I think it's gonna be a combo just like shopping for groceries or I have a lot of strong thoughts in the Amazon but I still use Amazon I think it's a hybrid because even me and our practice many into this I'll stop the call my Hiosson rep and say I need this doodad for next week because my assist didn't tell us we were low on these doodads. However I don't like to talk to him too often so most of my orders are done via email by my assistant so I think it can be bought online but they just need to get their proficiency up so they're comfortable with the parts and pieces the thing with implants is just like to surface composites Howard way too much stuff you got to put out to make it go it's just too many things like we got a streamline it. I don't ever know if I meant an implant system but I'm gonna make my implant kit like an endo sponge like five drills you take it out for this not you ever see an implant mean you've seen an implant kit right it's way overwhelming I mean I'll send you a picture you know I take the drills out I put them on a sterile sponge first cause I say to my new implant guy or girl this is all you need to use don't look at this big kit because it's overwhelming. So I agree I think our minds gonna be the way it goes just like everything else with supplies but still have some personal touch to it.

Howard: Well you know in my 31 years a binds fight feel say well who do you buy from Patterson, Schine, Banco, Burkheart. What's funny is I've used all four of those companies you know why I changed every one of them because my rep changed I've been following this girl for 31 years and I don't even have the relationship with her she has relationship with my assistant and the same thing in implants. What I think is the most benefits of implants is when they have a local rep in the field because like there's a guy in Arizona named Joel Gonzalez this guy is the master networker like if you have some question or you're having a problem he's like I know the guy you need. So he would he would send you these texts and say hey here's five dentist and we're all meeting here after work there's an MMA fight on and he'd want to go because you want to see the MMA fight have some beers and nachos and then and then he's introducing you to chemistry and like minds.

Paul: Oh yeah Malcolm Glidewell and connector are you I don't know you're Game of Thrones fan at all?

Howard: Never seen it.

Paul: Well if you ever see it so your listeners are gonna know this that guy is a good Peter Baelish so in Game of Thrones they had this one guy who knew everybody's secrets and would go behind people's back that implant rep is the opposite of him he's a good version that he'll say oh Howard Farran has does some implants you should meet him at this thing and he's really connecting people like a Malcolm Gladwell from the tipping point and I just think those people are awesome they probably helps the whole industry he helped patients because he helped patients get better care I mean that's the way things should be so I think it will be like that but dentist Howard that's so dentist I don't know understand this everybody talks about saving on supplies right but we've done it they're all cost effective I like Patterson Schine Benko I'm probably missing some Darby this and that we've got them, we've got them where we want them right like like you know do some price shopping but don't chase the cheaper cotton roll at the expense of not training yourself on something that's gonna really bring in production.

Howard: Well last point I'll let you go when people focus on supplies they're completely under my number number one overhead in dentistry for the whole country forty two percent is your adjusted PPO production from a fee schedule I charge a thousand for a crown but the PPO you sign up for giving you six hundred that's forty percent. Number two labor at twelve months would be twenty five it's routinely now thirty one the dentist thirty five percent a lab bill ten percent supply six. What I look when people ask me what supplies I'm like dude if your house is on fire are you gonna check your electric bill and and and last but not least my party shot is the reason when you go around the world implants and in this Invisalign is taking off because when you go to the greatest civilizations of Tokyo and Paris and London you're good socialized medicine government will only give you one hundred dollars us for a molar root canal well know everybody needs four or five hundred a break even so in all those markets and I've done podcasts live from Tokyo, Paris, London they won't tell you on the podcast but they all told me and my three sons witness that they have to pull the tooth because they can't do a root canal for a hundred dollars. They say that you're ended on its charge over a thousand he said in Tokyo Tokyo has higher overhead than any city in America maybe it's close to Manhattan. So the reason implants are taking off around the world and invisalign because they're not covered by fee schedules so a lot of these few noted dental offices and took you all and and London in Paris they lose money on everything but if they place one implant a week and do one Invisalign case a week yeah they're dentist making two or three hundred thousand dollars here so you know once you get in bed with insurance you'd be getting better than anybody you get screwed and implants and invisalign I just post a deal today across that'll tell suppose me we're even The Motley Fool says in this line is a better buy over DENTSPLY Sirona but hey I'm out of time you're a time. I'm your biggest fan I think what you're doing for my homies is amazing you love you on Facebook, your dental nachos if they could go to one of your multiple web sites which one should they go to, would it be

Paul: would be great because that as our our most up-to-date stuff for the next training course so or and I'm really proud and happy that you allow us to share our podcast on downtown the and we'd love to have you on it sometime, we'll do the heavy lifting and you we'll interview you.

Howard: Anytime I'm never thinking in fear and scarcity, let's help the next generation.

Paul: I agree this is awesome Howard so I just can't thank you enough Howard this was a really just great hour of my day and I really appreciate it.

Howard: Well thank you for all that you've done for dentistry you're unbelievable.

Paul: Thanks Howard.

Howard: Have a rocking hot day bye bye.

Paul: You too 


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