Gene St. Louis, CEO, is a nationally recognized expert in dental practice management. She built her company from the ground up, holding both clinical and administrative positions prior to her consulting career. Having participated in the day to day operations of dental practices, gives Gene a unique, insider advantage of how offices succeed. Clients feel confident with her first-hand experience that translates into relatable, personable, and reliable expertise. Gene has worked with hundreds of clients nationwide. She writes for a variety of dental publications and is regularly invited to speak at the nation's top dental meetings throughout the United States and Canada.
What She Believes:
Gene St. Louis Consulting is passionate about creating a relationship oriented, tailored approach to dental practice management coaching. Her team provides guidance, education, and direction specifically personalized to you as a business owner. They continue to make an enormous impact through their commitment in helping dentists and their teams establish exceptional customer service and the successful practice they envisioned when they hired them. They believe every dentist deserves balance and productivity to secure their financial future.
AUDIO-DUwHF #1116 Gene St. Louis, CEO, CDA
VIDEO-DUwHF #1116 Gene St. Louis, CEO, CDA
Howard: It's just a huge honor for me today to be podcast interviewing Gene st. Louis, who's a CEO a nationally recognized expert in dental practice management she built her company from the ground up holding both clinical and administrative positions prior to her consulting career having participated in the day-to-day operations of dental practices gives Gene unique insider advantage of how offices succeed clients feel confident with their first-hand experience that translate into relatable personal and reliable expertise. Gene's worked with hundreds of clients nationwide, she writes for a variety of dental publications and is regularly invited to speak of the nation's top dental meetings throughout the United States and Canada. Gene St. Louis consulting is passionate about creating a relationship oriented tailored approach to dental practice management coaching, her team provides guidance education and directions specifically personalized to you as a business owner. They continue to make an enormous impact through their commitment and helping dentists and their teams establish exceptional customer service and the successful practice they envision when they hired them they believe every dentist deserves balance and productivity to secure their financial future. Her website is www.genestlouisconsulting.com So how did you, so your name is Gene St. Louis, so a lot of you people listening I want to know who was St. Louis named after and I literally have her on the show today how cool is that. Gee so St. Louis was named after the what was in St. Louis he was the St. Louis at ninth he was the King of France he was the only King of France ever to be canonized as a saint and I noticed that now you're in San Diego. So you just like the saint stuff, now you're in Saint Diego. So St. Louis and St. Diego. Thanks for coming on the show today I asked you to come on the show you didn't ask me. I really wanted to get you on the show because most of the listeners are millennial they're 30-under olds guys like me read books young people they you know they listen to YouTube and podcasts and all that stuff like that and what I wanted ask you first how long you been doing this since 80 since in the 80s right?
Gene: Right I've been in the field for about 37 years started out as a dental assistant went to school for that right out of high school and basically had a passion for dentistry from the beginning and moved from the clinical end to the administrative end and found that while I loved the clinical aspect and assisting I really had a passion for the administrative and that really became my niche and loved it and went from there to you know office manager and all the way through to consulting and worked with a firm early on in my career and offered to buy them out twice they were a local based firm out of Chicago which was where I was born and raised and they didn't want to sell and I decided to do my own thing and so that kind of began my consulting career.
Howard: So here's a dilemma I see when I got out of school I graduated may 11th and a hundred and thirty three days later I had my office open September 11th I just celebrated my 31 career the 31 year anniversary at Today's Dental here in Phoenix and now it seems like these kids come out of school and they think oh that's too risky or I should just go get a job and they they go work for a DSO but they're not very happy because when they go work for a DSO or they're an associate in private practice that the job turnover is about a year per stint. You talk to these kids five years out of school they've had five six or seven associate shift jobs so does did did my generation were they quicker to open up their own office then today, is that because of student loan debt it has the market changed in 30 years is it harder to come out of school and open up a denovo and you even recommended denovo should they buy a practice started to novo is that... what I like to do is ask 39 questions at once so maybe one of them is good enough for you to answer.
Gene: That's right right up my alley that's my style my kids say I always ask a billion questions and just need to chill. So yeah let me address some of those having been that is your a long time like you have it is a different world than when you started and that you could kind of hang your shingle up if you will and you know patients came there really wasn't a lot of external marketing or efforts there wasn't social media and all of that and an answer to your question you know can a doctor go out do denova absolutely and can they purchase a practice absolutely is the risk as high as it was back when you did it you know there is more student debt but the reality of it is, is that there's good debt and bad debt and student debt isn't necessarily bad debt credit card debt is bad debt but student loans are not hopeful. So when I look at a young dentist coming out what I see is that they often you're absolutely right they go into a DSO they make really great money the first few years, they're doing you know that dentistry and a high end, high technology based practice which they love kind of similar to the schools that they probably went to. I love dsos from from an associate standpoint because they get their speed up I think that's great but what I often get and I talked with colleagues and if a colleague of mine is not dealing with startup dentists or dentist's that are purchasing practices they don't encounter what I feel I encounter often which is calls from dentists saying I'm just burnt out. I'm in my late 20s early 30s and I just can't do it I don't want to do this anymore I want to own my own thing whatever that is either a startup or an acquisition and so my passion has always been to help these dentists kind of charter those waters because while they feel they have you know been exposed to practice management in the DSO setting and they and they probably have and that's a great thing they're still not where they need to be in regards to understanding the intricacies of that startup or that acquisition.
Howard: I agree that that's why I love dsos they provide all these jobs for these new graduates when I was little and got out of school at age 24 you could really only do that in the Army Navy Air Force Marines associatship jobs were hard to find so I really credit these DSOs for hiring all these people that I don't really want in my office because we hire some kid out of dental school and he takes an hour to do an mod composite and then the thing falls out in a month that's it's not very fun. So I really credit it for them but but it just seems like they're not happy even in the big fang stocks which are down 27% lately Facebook, Apple, Amazon, Netflix, Google. They're only keeping their Millennials for a year or two so when Facebook and Google give you all these perks and free food and free foosball and whatever whatever they can't even keep Millennials happy. It just seems like dentists are mostly only happy when they're a totalitarian dictator and own their own business and answer to no one they're just not good people to manage under your thumb and so but how do they get over the fear of being so miserable that they just need to do what they need to do they need to open their damn business. How do you armchair psychology them from the safety of 8 to 5 job they can't stand to the horrors of owning your own business?
Gene: I think the first thing is identifying for them first and foremost that when they started when they had the idea to become a dentist they never at the same time that they said I'm gonna go to dental school never did they say in their mind and I'm probably I'm gonna fail as a dentist. What they said is I'm going to go to dental school and I'm gonna become a great dentist and so I try to bring them back to that and say don't embrace you know don't go forward with trying to decide do I start up or should I do an acquisition without really understanding you're not doing it and you're gonna fail. So knowing that and you know armour yourself with this as much data as you can within both of those arenas, is a startup matter for you or as an acquisition. I often talk to Dennis and I say listen if you talk to a colleague that has done a startup he or she is gonna say to you oh my god I would never do an acquisition that's the worst thing you're buying someone else's horrible culture you have to change it the staff salaries are high however you talk to a colleague that has purchased an acquisition you'll hear the exact opposite like I would never do a startup that's so risky that's really. So my job or what I feel a dentist needs to educate themselves on are the nuances of each one being the startup and one being the acquisition. In a startup you have to really analyze first and foremost you know fallacy put aside the banks are lending money to startups are all banks, no. What the reality of it is is if you have anywhere from two to four hundred thousand dollars worth of student debt they are lending money to a startup dentist around five hundred thousand five fifty depending if you're a specialist to do a start-up. So in that arena when you know that the banks are lending the banks have you know really the write-off amount that a bank writes off on a start-up is less than a half a percent. So that's telling you that practices are not failing startups are not failing nor our acquisitions. If an acquisition fails it's generally because the dentist that bought the practice was did not do proper due diligence, you'll hear people complain all I was sold a bill of goods from a broker I was sold you know in missed misrepresented data. Well it's up to you just like and I tell dentists this all the time that are acquiring a practice if you purchased a home would you not get that inspection done and they all say yes of course I would. It's the same thing in a practice you have to get the due diligence done on that practice part of it is from your trusted advisors of your accounting firm and your attorney of course to review leases and things like that but the other big piece is the dentistry the business of dentistry aspect of that acquisition. So really understanding what are you buying what opportunities are there what risks are there so.
Howard: So is this true or fault well first of all just had a point blanket do demographics matter now I know if I was gonna start a denovo which means you start from scratch the demographics would really matter but if I'm buying an existing practice this business is already working in this Democratic area. So do demographics matter only on a denovo do you think they matter on a when you're purchasing a practice?
Gene: I think they matter in both the denovo and us purchasing of a practice well you have the historical data of an acquisition to fall back on to say okay historically I can see the growth and what has occurred. I think it's equally as important to look at those demographics to say what does the growth look like in the future what is the economics in that area what's the education level and yes it's not as critical in a start-up as it is in an acquisition but either one it is definitely critical I think in an in a startup you want to make sure you know that the old adage you know location location location is very very important in a startup. If you're not really paying attention to that location location location you end up getting yourself in a situation where you have no exposure the growth in the area isn't there and you're really putting setting yourself up for a situation where it's much harder it's it doesn't have to be that hard in a startup. The other question I often get asked from dentists is you know do I have to join every HMO and every you know Medicaid and things like that when I'm a startup and the answer that I have is no generally speaking except some PPO's and fee-for-service and those practices survive and thrive. So you don't necessarily have to now there are some dentists out there that say no I want to give back I really feel I want to be in a community where I accept you know HMO programs and whatnot and that's personal choice that's their own vision and mission and of course that's important to them then it's important to me,
Howard: So I think due diligence matters a hundred times more than now because back when I was little when you bought a practice the owner carried. So they actually make their money three ways which I think was a much better business model I want to talk about that for saying. So let's say you sold your practice back in the day five hundred thousand but you carried it at ten years, ten percent interest. So the doctor would have an income stream for a decade and then so they basically make another nice income stream for ten years and then third he owned the land of building and as soon as the practices paid off that he went back to the doctor and says well now that you own this practice would you like to own the land and building that assets in and then he would sell them that and carry that for another ten years so he could retire sixty five and have an income stream till he was 80 or 85 years old is amazing but when I'm carrying the money and I'm a dentist I want to know I want to make sure that you're gonna be successful in my practice. So you're buying my practice Wichita Kansas do I like you are you a good guy are you gonna tell the truth and not over diagnose and build trust in the community or you know were you born here but now that we got rid of the owner cary and now we have these big national banks that might be a thousand miles away from the practice they just want to do the deal. So that dentists buying that practice is is being courted by a slick salesmen the dentist ones to sell them everyone's telling me is wonderful and beautiful and it's going to be a slam dunk because they're just gonna get their money and run and know that since dentistry is so non-competitive that you only have a half percent chance of fail. So a lot of times I think these kids get stuck with a very bad purchase because they don't understand due diligence, do you agree or disagree is what I just said?
Gene: I would say partly agree partly disagree. I think that yes in the day when you know dentists could could carry the note if he willed versus the bank carrying the note those were different times. I mean the reality of it is the saddest thing for me is when I'm talking to a dentist that's between 60 and 70 or 55 and 70 and they are not prepared for their retirement, they're not prepared they haven't saved what they should and and then they're going to sell their practice or so they think they're gonna sell their practice and they think they're going to get they realize at this point in the game that they're not going to retire on what they saw their practice were those days are long past but at the end of the day that dentist that is selling their practice now I feel most of them want out. They absolutely want to walk away there are a select few that say I really care about that patient base and I want the good will transfer and I want to do it slowly and that type of thing but generally speaking I feel that most dentists that are selling absolutely want out and yes it's true that if you have the real estate end of it you can sell the practice and still like the old days if you will when you know you would carry the note and then sell the building ten years later that still can occur but I don't see dentists carrying the note anymore for obvious reasons they can't afford to. So I do believe that the dentists that are purchasing the practice makes some common mistakes and the common mistakes they make in the due diligence is that they simply think they know that all in other words because they've associated for those large DSOs and they've been exposed to probably more practice management than you know dentist in your day perhaps when you were starting out the reality of it is, is that they don't know what they don't know and when they're exposed to the due diligence end of you know hey listen here's what's happening in that practice they have this amount of past due recall that has a direct impact on your future going forward you can't just have your staff that have been there for 20 years operate as business as usual because there's opportunities there and you have a vision as a dentist taking over that obviously you want to you want to run that practice differently, same way but differently than the dentists that owned it previously and as part of that running of that practice well you don't want to turn things topsy tail and really create a bunch of you know upheaval by no means. You want to keep the practice running as smoothly as possible but the reality of it is is that there's much opportunity in most of those practices that the seller doesn't even realize they have and the buyer clearly isn't identifying and always on the front end and so they're kind of stuck in a spot where they purchase it and then get frustrated.
Howard: That does make sense and your point in that the reason they can't carry the note is because they're in financial, they're not financially ready but when you listen to all these financial lectures you know they always go into the details of like extreme exchange-traded funds or this or that or you know all these details of investing and they they don't even talk about the what really matters. I mean forget all the details of how to invest stocks versus bonds versus whatever it comes down to how many times did you get divorced, did you have two kids or four did you send your kids to the local state cheap Community College and in-state college or did you send into some name-brand Ivy League and it always comes down to it's not what you earn it's what you burn I mean like on your vacations are you camping at the lake and a tent and pull the pop-up trailer or did you take your whole family on a Mediterranean cruise. I mean I just I just see the people who can retire at 50, same wife moderate house they they're not big spenders they don't vacation in Hawaii they go to the lake they go camping so-so dentists lawyers physicians have a spending problem why did you buy an $85,000 Beamer instead of a $30,000 normal car but back to these due diligence it's the same thing like when when these accountants and brokers are doing due diligence they're talking about the the blue sky value of the the brand they're talking about equipment accounting but do they analyze the practice manager software the system's the HR. I mean are we am i buying a dental office filled with people who have been there two years on average versus six or eight years do these people do they have any systems do they know what they're doing, how do you think these kids are getting an accounting how this looks to the IRS report on buying this practice or do you think they're getting the due diligence of hey is this a functional business with systems and good people?
Gene: I don't I think that while there is definitely and most of my you know referrals of dentists come from accounts and attorneys. So I work with them very closely across the United States. Each professional has their role obviously you would never close on a practice without an attorney you'd never want to purchase a practice without having an accountant look at the tax returns, the reality though is that there's so much other and intricate parts of that practice as you mentioned you know the HR issues how long has the staff been there the accounts receivables, the recall system how many active patients, how is the recall system functioning, how many new patients are they getting in, how do you know all of those components of the business aspect of the actual practice management software getting into the practice management software pulling up the necessary reports and not just pulling the reports but analyzing those reports to say is the practice up down sideways are they referring out endo and pareo are they pareo turning are they six-point pareo turning are they doing a PSR system like to what extent are they taking FM X's are they doing it every six or seven years every three to five years how often are they doing bitewings are they doing periodic exams every time the patient comes in for a pro fee and so on. So those are little intricacies that should be evaluated that I often think do not get evaluated and then when the practice and the new owner are in place things kind of start bubbling to the surface, if even the doctor identifies that even if they have the knowledge most of them I don't believe do have the knowledge of knowing hey this practice could be functioning better but I don't know the opportunities that exist.
Howard: Nice you are a legend, for over the years you created a program called building the ideal practice. Do you still do you still have that system that program?
Gene: I don't I don't but I do what I do have is a that program was designed for dentists that were out of school ten years or less that were either considering being a practice owner from a startup capacity or from an acquisition capacity and so what I did was I morphed that program into the two kind of programs that I have now and one being an acquisition program or due diligence program and then a startup program and so what my passion has been over the years is not that I don't work with established dentists because I absolutely do but I really feel that the dentists that are you know purchasing those practices either in a start-up or an acquisition capacity just lack the information that they need to make good business decisions as a business owner and I found that the building the ideal practice was a wonderful program I touched many lives was very very fortunate worked with Gordon Christensen for quite some time on that and other great clinician and what I found was that dentists really they loved the camaraderie they loved the idea that they could have someone to go to, to really help them execute their vision and their mission and that really has kind of held the place in my heart for all these years. I mean and that's why I really still feel so strongly with helping dentists the way that I do so.
Howard: and let me tell you do I listener she's shy and humble but I mean Gene St. Louis I mean she was with Mercer vice president of business development for six years from 2006 to 2012 then she went over and joined Sally Mackenzie a rock star for another six years. I mean you've worked with two of the greatest ledges I mean MTS mangy and Mercer Sally Mackenzie and McKenzie management, I mean you really really know your stuff what are my homies gonna find if they go to your website www.genestlouisconsulting.com
Gene: I hope what they're gonna find is a feel about my passion for what I deliver to clients the first thing on my website that you're gonna see is a video from Five For Fighting on a hundred years and it's a great song and the reason I put it on my website is because I feel so strongly that we all you know we can only hope that we have 100 years to live and what are we gonna do with our life. You know we have a choice in what we do with our lives and how we embrace our careers and the passion that we put forth. What I hope that someone would gleam off of my website is that while this woman has passion she has in you know intelligence she knows what she's doing now yes I you know sold my first consulting business to Mercer advisors and then move down to Mackenzie management my passion and why I'm back really kind of doing my own thing again is, I realize that there's nothing like really helping dentist from your own perspective from me not directing consultants to do it not you know coaching others to do it but really going back into the roots and saying hey I want to do it myself because I'm at a point in my career I'm afforded that opportunity I don't have to work I choose to work and I choose to work because I'm passionate about what I do. I think you know when in talking to clients that have me as their consultant what I what I often hear is my gosh you answer calls in the night and over the weekends and do you ever sleep and I think you know the energy that I have comes from the passion with him and so I'm really blessed I've been very blessed with that and so I hope that my website conveys that.
Howard: So is that song on a youtube video is that the Superman song for five for fighting?
Gene: Five for fighting it's called a hundred years I don't know if it's a Superman song but it's a song that I love it's just it's about 100
Howard: Now is it okay to put a youtube video on your website like that there's no copyright problem putting some musicians youtube channel?
Gene: I haven't yet had a copyright issues
Howard: I thought that was very very interesting. So what would it if you you go to McDonald's you know they're 80 percentiles a hamburger fry and coke, you go to dentist it's a you know cleaning exam filling crown if a hundred people called you up what is your hamburger, fry and coke. What are the top three things people are calling you what problems are they having that you're solving in the marketplace today?
Gene: The problems that I'm solving in the marketplace today with existing dentists are generally staffing concerns, growth concerns, and sometimes embezzlement concerns. What I find with my younger dentists my Millennials and Gen X's that are tired of associating is you know guide me through making a decision, I don't know if I should do denovo our acquisition and so I walk them through those steps of both what looks like so that they have a better understanding of that.
Howard: So when when you know you've been doing this for three decades is it so much obvious that you're gonna be more successful in rural? I mean it seems to me that you know if your office is two hours from an airport that has Southwest Airlines you're just crushing it compared to an office that's ten minutes up the street from an airport. Do you do you let's the first do that the basics rural to urban do you think that's a really big deal?
Gene: It's interesting I've worked with many rural dentists and the biggest hurdle that a rule dentist space they're definitely serving a population and if you look at a lot of the DSOs I mean they were smart that they went into rural areas right that they hit the market of where the market needed to be served very smart. The downside is a lot of dentists don't want to live in a rural area. So I've had clients that I've worked with that you know are in rural Indiana very rule you know Warsaw Indiana County seat but yet only ten or eleven dentists in that County seat and having you know maybe four of them as clients all of them were very successful and yet they couldn't find associates to come to that area because it was two-and-a-half hours from Chicago and so if you you know if you are okay with a rural area they find the greatest rural area you can be in and serve that community you will be busy as all get up. You know a lot of dentists don't like that right they want the city or they want a mix of a little bit of city and and rural. So in those situations you have to really do a best sites review to see well in this general area that you want to go in what is gonna serve you best for future growth.
Howard: and then when you look at the business which do you think some kids starting up an office just point-blank yeah what practice management software would you use what would you what would you tell them?
Gene: I don't have stock in any one company so what I tell them is just that I don't accept kickbacks from any one company in regards to what I recommend. If I recommend something it's because I've used it or I know clients that have used it it's served well and that's why I recommend it I've done due diligence to feel confident to recommend. Typically speaking your Dentrix your Eagle soft your Open Dental or your Softdent, those are all you know I would say probably top four programs that that are out there that are servicing the clients well.
Howard: I do accept kickbacks if you want to send me a million dollars that's my minimum price send a million dollars to Howard for an Phoenix Arizona I will sell my soul for 1 million in cash unmarked bills preferably in a briefcase about anything less than a million in cash. It's funny you said Dentrix, Eagle soft, Open Dental, Softdent.I was on Softdent for 30 years and 2018 we just switch to Open Dental, what I liked about Open Dental and I have no financial connection Open Dental that even advertise and I get that Open Dentals it's just open so you know programmers, if you have Open Dental and you have some other so say it's a phone software for measuring your income accounts just any other piece of software you can hire a programmer for 50 bucks an hour and start connecting things together you know I I see it especially when I go overseas. Like a some guy bought opened dental in Toronto and once you buy open then it's open so what do you do he went in there and converted the whole thing to French and that's what I see in Cambodia and Indonesia and Thailand when I and I've lecture around the world I mean you see open all around the world just because it's open they could go in there. I mean I'm if you were in Cambodia or Vietnam and you wanted it you know and in your language so but what I what I was so excited about is trying to get long-distance scheduling. What I want to do with Open Dental is I want it so that if I roll my phone over to a receptionist and pay her and she opened and she has that call from say six o'clock late or Saturday or Sunday I want her to be able to go into Open Dental and schedule an appointment from her damn iPhone you don't mean. So that so that's why I switch it's it's gonna be a long time long term romantic journey but I think Dentrix and Eaglesoft, I mean probably what two out of three dental offices are by software probably pick those two don't you think those are the 400-pound gorillas?
Gene: They are they are and the reason being is you know as I tell dentists when a new software comes out just because it's the cheapest guy on the block or the cheapest software out there doesn't mean you should just jump into it right away because of the price. You know there's something to be said about the fact that the research behind those companies like Dentrix and Eaglesoft that can put many many users out there and they're able to you know to correct their versions as they go based on user feedback that's a plus and based on the amount of users they have that's a plus. The other plus is that because when a dentist is hiring a new staff in a denovo or a start-up situation you know the interviewees that are coming in most of them have been and are familiar with the Dentrix and Eaglesoft. Now we're seeing that switch a little bit more now towards open dental but overall the the amount of people out there have much more exposure to Eaglesoft and Dentrix than Open Dental. So those employees that you're hiring on you know especially as a start-up it's so critical that they understand the software. Now you know hey you can get training from any software company Dentrix, Eagle Soft, Open Dental, it's just you know are you having a trainer come in or is it over the Internet you know virtually people learn different ways. So either way I mean I I let the dentist do the due diligence on those softwares themselves I encourage them to you know have a demo of each one of them and compare and ask them what have they used in their associate position why did they like it why did they not like it and make an educated decision. So I think a big part of purchasing any technologies is educating yourself and not just following you know the path or the sheep's ahead of you really kind of step out of that you know that scope of who's doing what and kind of evaluate and make decisions on your own.
Howard: Well I'll tell you the other and I'll tell you another thing on you know follow the money you know money's the answer what's the question solve so many riddles and Open Dental is the only one that doesn't advertise. I mean I could barely barely I still haven't got the owner dentist to come onto a podcast show his brother came on and but they said look look we're growing too fast we don't want that we don't spend money on marketing we're just trying to do a good job in our experience. I mean it's and the other ones advertise a lot so I mean I still I know you're agnostic but is I still think Open Dental is gonna be long-term growth and one other thing about the Open Dental and the software systems or whatever you asked you what are the three reasons people are calling you and you said startups, growth, issues embezzlement. What percent of dentists that you've consulted with are being embezzled what would percent of the dentists today on this very Monday on November 26 2018 Monday after Thanksgiving are being embezzled today in their office and don't even know it?
Gene: Oh you know I wish I had that number I could take a guess the sad thing is is that they just don't know enough about their business or their systems to even know they're being embezzled and you know if I one bit of advice it would be one an adjustment you know report see what your adjustments are. The you know easiest way for a person to embezzle is through making adjustments there's other easy ways I mean I was involved in the largest case in Illinois history several years back on embezzlement and so it saddens me to think that dentists are out there and they're being taken advantage of. The message I would give to dentists that have done a bezel is please PLEASE prosecute because many of them that have been embezzled feel as if they're embarrassed you know it's like oh my gosh how could I have been so vulnerable how could I have let this happen how stupid am I instead of really taking a step back saying what can I do learn from this and secondly quit being so trusting quit being so trusting of someone with your money you've got someone at the dust that's collecting the half a million to a million dollars even a hundred million dollars and you're so trusting with everything that person does and that if anything just make sure you prosecute because the frustrating thing and you can talk with dental reps all over the industry. When they see someone at one practice they know that she's embezzle then they go down the street and she's at Dr. Jones office working the front desk doing the same thing to him unknown victim.
Howard: Yeah and I love it, you know I love humble people humble people do so much better in life because they raised her hand they asked for help it's the opposite of pride and I love it when these dentists are so humble that go on dental town there's a big thread over Thanksgiving about this guy getting embezzled and the story is so sad because it's always gonna be the godmother of your baby's baptism, your best friend, the lady. You know you just trust Trust trust Trust trust and one that embezzlement case you said it was the biggest one in Illinois how much money were you talking about?
Gene: They reported that they got about it was a reported that there was about five hundred thousand and that was embezzled and not only the saddest thing with that I was referred to that dentist by an attorney and by the you know grace of God and my years of experience immediately I told the dentist to not deposit any insurance checks going forward the employee contacted him the day I was there to close them into my program and basically blackmailed them and said if you don't meet me at the Burger King with three hundred thousand I'm going to the feds and that's exactly what she did she went to the feds within seven days the DEA and the feds came into his office pulled charts pulled chips out of the computer and basically that's where it started and again that went all the way to you know it was it was a serious case.
Howard: So she was saying don't report me for embezzling or I'm reporting you for drugs?
Gene: Well for for insurance malpractice and for insurance fraud and then
Howard: Oh I thought you said DEA?
Gene: Well I think that's who came in the DEA
Howard: Well that's for drugs, it could be prescriptions...
Gene: Well yeah it wasn't prescriptions maybe I'm wrong with the group that came in but now there were federal agents that came in to pull the chips from the computer and pulled the chart. She gave him a patient's name what she basically did was she was committing insurance fraud and accused the dentist of it and because you know as you know insurance filing is interstate it was a federal offense so.
Howard: I know it I know a dentist and he didn't even know his office manager whose wife who had a big spending problem she started doing insurance fraud and it's one thing when you do insurance fraud in state with your local dental insurance company but when you do insurance fraud across the state line, now it's federal or you do with Medicaid my swear to God Medicaid. I mean when the government shows up for insurance fraud on Medicaid if they need to hang a little picture on the wall they'll bring a sledgehammer to drive the nail in and they came down on him so hard the only thing he could do was flee to Mexico. He's been practicing in Mexico for the last ten years and as I you know but again these dentists will go drop thirty five hundred dollars on a course to learn occlusion and TMJ and all this stuff and they don't even know they've been embezzled for the last five years and or and it's just like the misdirection I mean I get it I know chefs just want to cook and bake. I get it i've watched cake Wars or the Cupcake Wars or your I I've seen these guys with all the passion of me wanting to do a molar root canal and building a damn cupcake. I get it but you know what your little cupcake business will go out of business if you don't know the business and I'm trying to take the nose from this puppy who just wants to make a cupcake and say how do you not have any checks and balances on embezzlement. Why can one when one person can do everything they embezzle and why do you think that hot receptionist really wants to sleep with you because she's holding something over you. When you start sleeping with employees and then when you catch and they say well do you want me to call your wife and tell her we've been having an affair and that divorce oh gosh a million or you want to look the other way that I sold five hundred thousand and all quit today. Same thing when they get addicted to narcotics I mean if you're addicted to narcotics call your local American Dental Association tripartite and say hey I can't quit eating vicodin and they'll give you the name of the dentist so get your help they'll get this over with but when you're sharing DEA narcotics when you're sleeping with your deal there's a reason that woman wants to sleep with you and you looking like Brad Pitt is not in the top 1,000 reasons of why she's sleeping with you and most consultants that I talked to say when they go into a dental office and they start running these reports 50% of the dentists are getting embezzled from and a hundred percent of dentists can't run one damn audit trail report. In fact I wish you'd make an online CE course on Dentaltown I really do I wish you would make an online CE course, these guys to be a leader you gotta take him from what they want to do to what they don't want to do need to do they need to do the more business stuff and they just don't. I want to switch gears completely 180.
Gene: Yeah before you switch let me just add one more thought
Gene: The one thing that I would say is that it's important to a dentist to realize what they don't know and be open to being coached and I don't mean you know I mean really being open to be coached about how to identify what to look for on these reports. To me I'm doing a great job if I can teach every one of my clients to be a consultant I don't need to be with them for the rest of their wealth career you know hey that's great I have clients that I've been with for years that's wonderful but at the end of the day I've really done my job if I can teach them how to be the best consultant they know they could be and that means analyzing those numbers and really fully understanding how that practice is supposed to work so go on to your next subject sorry about that.
Howard: Well when I asked you when you know Mcdonalds sells a hamburger fry and coke I saw a root canal filling crown cleaning I said well what are your top three orders you said staffing, growth issues, and embezzlement. I mean staffing I mean my gosh if I lined a hundred dentists up and I said what's the only thing that gives you a knot in your stomach that makes you want to puke it's always HR, it's always HR and they're always way too slow to fire I find it so amazing that when I'm lecturing I will meet an office and I'll have lunch them or they'll come up and ask me and you can I can tell that Shirley is toxic poison in like five seconds like when the dentist is talking to me and we're sitting in a roundtable and she's rolling her eyes. I'm like she's rolling her that that's your that's the person you're paying to support the team and she's rolling her eyes in front of you in front of I mean so how do you get these people to understand HR and yesterday was you know every Sunday's NFL and I mean it's just finding the right players I mean if you find the right players you win the game. You know how many teams in the NFL today with the existing quarterback they have they don't even have a chance of making the playoffs and everyone in the stadium knows their quarterback is insane I mean you here 60 year old ladies saying you know how I could have thrown that interception. So how does it dentist get his hands around HR?
Gene: I think a big way to get your hands around HR is first and foremost to identify first informal identify what is it that your vision and mission is for your team what does that team look like act like well write it down what is that vision. Then secondarily in interviewing or discover and who's on your team is laying out the expectations. I think a big problem in staffing is mismatched expectations the dentist does not clearly identify for that staff this is what I expect out of you these are this is your job description and this is how it needs to be handled, what they do is they say I want you to run the front desk I want you to you know be a great dental assistant with no sense of direction no sense of written job description and and then in addition I think there has to be a mutual level of respect. I think the human relation element to human relation principles and you know having been trained in all levels of Dale Carnegie I'm a big supporter of treating people the way you want to be treated and that goes from the front to the back and the back to the front in a dental office. I think so often dentist keep people because oh she's really good at collecting or she's really good at scheduling or she's really good at assisting when she's toxic as you said she's toxic to everyone else on the team and so what happens is you end up losing great team members because they simply can't put up with it anymore and the dentist is so blinded by I the control of that one person when really if it's laid out from the front end here's my vision and mission here's the type of staff I want this is how I want you to act this is how I want you to dress this is how I want patients to be treated and if patient care is at the forefront of that and we're constantly focused on that with those human relation elements and the personality profile types, I think you will have a successful team. I also think a successful team comes from investing in that team you know putting in dollars to train your team. So often dentists want this idealistic you know team but and they and they maybe have a vision for it they maybe have it written down but they can't train that team their dentist they haven't worked every position like like the staff has and so in order to really be a great successful business owner in my opinion you have to realize your shortcomings and be open to accepting someone to coach them and coach you to be a better leader.
Howard: Hey you just started you just added a Twitter and Instagram to your deal I'm your only follower on Twitter and Instagram that's my claim to fame that the legendary Gene St. Louis I'm here so make it tweet about that we did a podcast today and I will forward that to my twenty five thousand homies who follow me on Twitter and thank you so much that means the world to me and and when you post on Instagram tag me and I got 15,000 on Instagram and the Instagram are all Millennials and the Twitter are all baby boomers but I think that'll be amazing but back to your website you have basically four programs. I want you to go through them. What is define your startup elite program at genestlouisconsulting.com versus your acquisition program versus practice evaluations versus platinum consulting program. I'm talking about what you guys what I want to do as a leader I want this person driving to work right now to see if they're a match with you you know if this is something I saw their problem so start with the startup elite program and then just go through your programs.
Gene: Yeah so the startup elite program is a program whereby I help dentist from the front end identify where they should be opening their practice so everything from location to helping them and aligning their team, attorney, accountant, equipment. Looking over all their bids keeping their budget on track for a startup helping them train their staff going on-site helping them hire the right team members and helping them grow their business in the first year. So the startup program is really working with the dentist that wants to do a cold start up a denovo if you will. So really taking them from creating a business plan a Performa to your budget looking and helping them assess the banking, looking and helping them assess every bid that comes in from every contractor every supply person every equipment person and helping them make decisions along the way and then once they all of that work on the front end is not counted as part of their year program their year officially begins when I go on-site with them and meet with them one on one and do a leadership program for them and then from that point forward that's their first year. So that leadership program begins maybe two months before they open all the time prior to that is not included in the year so they're really getting like eighteen months or two years of help coaching weekly unlimited emails unlimited phone calls the whole relationship time.
Howard: and what does that cost?
Gene: That costs $24,945.
Howard: Yeah and let me tell you you kids you crazy crazy kids you'll spend a hundred and twenty four thousand dollars on the LANAP laser, you'll spend a hundred and twenty four thousand on a cad/cam machine when you could have sent a seventeen dollar impregum gum impression to your lab and got a Bruxier are made for ninety dollars. I mean you just I mean I swear to god you'll buy you'll slip you just your number one return on investment is that program $25,000 I recommend so many programs are fifty thousand dollars and I can tell you that when you're as old as me every dentist that's as old as me that's doing two to four million a year and taking home five hundred thousand dollars a year probably had four or five of these twenty-five to fifty thousand dollar consultants over the last three decades. They never say oh I'm a student of this person they said man I tried them all I never ever had a consultant where if I paid them a dollar to come in I didn't get that dollar back plus more inside the time period on a statement of cash flow. I mean it's the best investment and I understand why you want to spend 125 thousand dollars on a laser I get it it's a toy. My grandchildren don't want to think of bath unless there's at least six toys in the bathtub. God I had a over Thanksgiving one of my grandchildren simply wanted to take a bath just because she wanted to give her horsey a bath and it was a some horsey out of a freaking Happy Meal there and I never thought you could buy a happy meal and it ended up in the bathtub. So that is the number one return investment okay you also have another program acquisition program talk about that one.
Gene: So the acquisition program is a program for a doctor who is purchasing a practice. So I generally begin with a due diligence or a practice evaluation and those range anywhere from $1700 to $1950 for me to do a comprehensive due diligence with includes a demographics the analysis an executive summary really going over all the details of that practice from a practice business aspect. I look at two years of tax returns two years of profit loss statements I analyze that practice in much depth. I then share that knowledge with if they have a CPA or an attorney that they're dealing with so that that attorney knows you know any elements that need to be put into the purchaser's agreement. So that the accountant sees what I've identified on the practice management end, that is once they are done with that practice evaluation make you elect to use me for coaching through the transitions. So helping them with the transition letter all the way through the timeline of element of that closing, so eight weeks before the closing what does the attorney need to get done what is the accountant need to get done what do they need to do what about insurance credentialing switching over if the practice is on PPOs to that doctor's PPO. Really looking at the practice and helping the team bring in this dentist who is now their new owner. In many acquisitions the transition is totally confidential so the staff may be find out on a Friday that the doctor has sold the practice and there's a new dentist coming in on Monday and in many times that dentist that has been there for 30 years is done gone on vacation away. Thank goodness some of them stand for a period of time but even in those situations it's not you know there's so much loyalty to the previous owner that their does definitely need to be some coaching of the team and helping them. I always explain to the buyer that you know this seller this is their baby they grew it you know and they're very while they're selling it they it's a bittersweet there's mixed emotions of this you know yes I want to sell and yes I did sell but oh I'm losing my patience and my staff and all of that. So I think the acquisition program lends itself and I offer a variation of coaching with that depending upon time frame that the doctor and I choose is best for the practice, that ranges anywhere from $21,000 ish or 20,000 ish to I think maybe thirty four thousand thirty five thousand.
Howard: Yeah you would want to thank twenty thousand dollars to analyze something you're gonna buy for seven hundred and fifty wouldn't you rather just swing the whole seven hundred fifty thousand dollar purchase?
Gene: Well the due diligence the due diligence is even less than that I call it action it's like $1950 at the high end, the acquisition is only if they choose to get help once they purchase.
Howard: Yeah and and they're just so it's so crazy I know I know it dentist who bought a practice bought a practice it was in a ten-year lease and a retail center didn't even read the lease he wasn't even in there for a year and in his lease the tenant had permission to kick his butt out because the major anchor if the major anchor what needs to expand they can kick out that the little shops next to the big old grocery store. So he buys this buys this office and then he said I'm like oh my god what what did the real estate attorneys say who reviewed your lease oh oh I reviewed it myself because I thought my background in chemistry and biochem and human tooth morphology would would substitute for reading a real estate lease but your your platinum program how much is your platinum consulting program how long does that last what do you do for the dentists who are trying to take their practice in the next level?
Gene: Not the cookie cutter program, totally customizable talk with the dentist really kind of get an understanding as to what next for an existing practice owner, get an understanding as to what's going on in their practice what are their needs and then together the two of us pick what you know what does that look like what kind of help do you want, do one phone call help or do you want on-site help and how often do you want to see me do you want to see me once a month or do see me once a year or how does that look. So again I like to customize the program based on the client relationship and talking with them and seeing their needs. I know that you know every consultant out there says oh I don't have a cookie cutter operation and then you know you talked to dentist and they go they all have a cookie cutter on
Howard: Yeah but you know what every dental consultant has on their website which you don't they always say they always have reviews and it's by Dr. J.D. Indiana you have actual names Dr. Leonato Lonard Miyata you a Dr Ed Handley Cambridge dental. I mean every single one of your programs has reviews where it has the dentist picture their name the name of the a year's completely transparent. I mean if I told you I did the most famous movie star in the world and I redid her whole mouth and she's all the movies and her name's movie star from Planet Earth. I mean what are you talking about I love how the fact that you actually give a picture a name and the name of the dental practice the city it's in. I mean you're the real deal. What do you what do you mean when you talk about strategic relationships?
Gene: Strategic relationships to me are the ability to network with people in the industry to really understand who's out there what they're doing them why and to share that knowledge with my you know my potential or current customers clients. I know that I when I say a strategic relationship it doesn't necessarily mean money exchanges hands as I said from the beginning, I think the most important thing in a strategic relationship is that it's mutually beneficial to both meaning that they understand what I do as a business and I understand what they do as a business they've helped my clients and have serviced my clients well and for that reason I feel they're warranted to be on a page that's called strategic relationships.
Howard: and that's the your so it's not an advertising it's not a money change hand but I'm yeah but some of these are let's go through some of these you have five on your deal. Revenue well III bet you 90% of the kids listening this that are under thirty don't even know what Revenue Well is what is revenue well and why is that a strategic relationship?
Gene: Revenue well I find is a really great product that dentists can use in their practice and it was one of the original ones that came out from a patient perspective of texting patients confirmations helping them with you know helping the office to deliver better customer service to their patient base. How does that happen, it happens because you have a platform like revenue well that syncs with your software that allows you to be able to have your staff not be on a phone confirming patients per say, or sending out you know email notices. One of the things I love about revenue well is say you come in today and you're the front desk person and you have cancellations today later in the day you can send out a text message to patients an hour past due for those hygiene appointments and you can say something like first come first serve I have a two o'clock and a four o'clock opening today you already are sending it you can target to those patients that are already late that are within like a 10-minute drive time and you've got responses. So to me that that makes so much more sense than having a person get on the phone and dial for dollars and trying to get those patients in, yes that's important but isn't it great most people respond by a text. I mean I know you you do I do you know most of our children do most Millennials do people like text and so I think that that's a great source that revenue well has amongst other things they offer I'm just scratching on the surface there so they offer a lot of great things there.
Howard: Who's the CEO Revenue Well and where are they out of?
Gene: I work with Michele Gabrielson they're based out of Bannockburn, Illinois and the CEO is Alex and his last name is slipping my mind but great company.
Howard: Well will you tell the CEO to come on the show and talk about Revenue Well?
Gene: I absolutely will absolutely
Howard: So I want to go to another one by the way you offer being out of your life I just passed an hour can I keep your just a couple more overtime questions?
Gene: Absolutely not a problem thank you
Howard: Okay I want to go back to on these strategic relationships the other one which they don't know HR for Health, number one in human resources for doctors why is that one of your strategic relationships?
Gene: I love that company for a couple of reasons one is the CEO is an attorney who also an HR attorney who's also married to a dentist, so right off the bat
Howard: Poor thing
Gene: He is extremely knowledgeable in HR law he's not only a litigator but he also is really extremely knowledgeable not just in HR law but in in dentistry he's he focuses a lot on medical and dental his name is Ali Oromchian and HR for Health I love their program and their platform because it allows the employee and the employer what I find often occurs in dental practices is lack of knowledge of what your staff is doing or not doing, having all your HR documents and making sure that you're compliant within the state that you operate in and that your staff is filled out and signed everything and it's all online it's all in a portal is awesome the fact that they can help answer any HR questions that you have they help with you know your office policy manual that's all you know comprehensive they even have payroll service as a part of that and I just feel that they are very responsive to clients that I've dealt with and they do a really good job and so for that reason I feel they're warranted to be on that strategic relationship page.
Howard: Okay you have three more I want to go through the mob we did revenue well H over held one is Bank of America is that for mostly practice acquisition?
Gene: Acquisition and startup Bank of America is only one of a few banks that actually will work with a start-up dentist doing a denovo. What I like about them is they have a comprehensive approach they have project we have an outside person that deals with the dentist when they first come to them and that outside person works with a team on the inside of project managers and people that make sure that that project flows according to the budget. So in let's talk about a denovo situation a start-up situation, I love the idea that I can how have the bank whose lending them the money have a vested interest in how they spend their money not bigbrother vested interest but really knowing that hey Gene is working with them she set up a business plan she set up a Performa we know what the expenses are going to be for the years two years of the practices and work and we see what the expenses are initially for the start-up costs. From an acquisition standpoint I like that a bank looks at the tax returns obviously and looks at the details behind that acquisition to know is this someone we should lend the money to does that does it cash flow. I don't want a client to deal with a bank that has no vested interest in the cash flow of the practice. You know aside from the fact that you're gonna have a hard time paying back your loan if they don't look at your cash flow it's they're not gonna be good for you if he doesn't cash flow to give you an income to live on and you have to associate even though you just bought a practice makes no sense.
Howard: Well you know what makes no sense to me and that Bank of America is why you know everybody's afraid DSOs are taking over the world Bank of America, you like they're one of your trusted strategic alliances but no one ever talks about the earth-shattering fact that it was it was November 30th it was this day this 11:26 but it was two years ago this week that the big monster East West Bank stopped loaning money to group dental practices. They shut down their entire dental lending platform and left over one hundred group practices and DSO's is wondering where they're gonna turn for capital and the reason was is because they this that as the DSOs get bigger and bigger and bigger East West Bank and need to believe that face and I'm not sure all the emails I read where I can't talk about it you know I'm a journalist because I've had a month I've owned my own dental magazine since hell 1994 and so I don't know what all I can talk about or get sued over but I mean it was amazing. I mean these people think dsos are gonna take over the world and here East West Bank shuts down the entire division and not one of them can go public yet they're all sitting around San Diego thinking oh one day we're all gonna work for a DSO. It's like why why am I the only person that is not can I mean I'm completely convinced that it's gonna be what I already lived through before in the 80s where orthodontic Centers of America was publicly traded on the New York Stock Exchange or that does on NASDAQ and the every last one of them imploded and then they went away and now they came back and the dentist the dentists are afraid of this Godzilla but Wall Street isn't they know what they are and they won't touch him and either will East West Bank.
Gene: Well you know what's interesting in regards to dsos I have had lengthy conversations with colleagues other key opinion leaders that are convinced that DSOs are that's the way of the future and that's what's happening and I with you agree that dsos are not the wave of the future and that Joe dentist and Joe dentist who's been associating does not want to sell to a DSO. That's the reality the dentist's it the DSO and the other thing is dsls are not picking up the dentist that 70, 75 years old that's doing 500,000. They're picking up bigger practices so all of those practices that are out there of those baby boomers they're gonna come on the market and it's gonna be a boom and those dentists that are Millennials are gonna be buying those practices and they're not dsos and so those dentists that are baby boomers right now that are fearing the DSOs and dentistry sucks because it's all dsos now. I want to wring their necks and say get over it and like you I've been in dentistry long enough to see the pendulum has been there and it's coming the other way and just you know the reality of it is is there's going to be plenty of dentistry for dentists solo practitioners to practice the way they want in regards to the banks lending or not letting I there dealt with East West Bank I was very involved with them I trained their sales force you know what I don't have a mayor yeah as to why East West went under I have some opinions that's another whole podcast we could do. I'm sure you have opinions about it as well all I know is Bank of America treats the customers that they have dealt with them in the way that I think they should be treated you know so that's it.
Howard: Well I think East West Bank shut down the division the money's the answer was from they were average to me troubled loans and they're they don't have confidence. Well well there's another thing you know when people say DSOs they immediately think a Heartland a specific those guys have over 500 offices to a thousand dates but most all the DSOs are 2 or 3 or 4 locations and dentists has this big million-dollar practice and he decides oh I have this big million-dollar practice and a town of 30,000 I'm on the south side I want to open one on the north south east west and it's not until they expand to the second or third locations when they realize they don't have the right people the right systems and when you have that one million-dollar practice with ten ops and an associate you could muscle around all your problems that were like little Doberman Pinschers in the corner but the minute you borrowed other people's money and expanded two or three locations and there's not enough hours in the week those little Doberman Pinschers turned into King Kong and Godzilla and took you down. In fact most people don't realize the sweet spot of a dental bankruptcy is in their expansion somewhere between the 2 & 4 million dollar mark. So when you're loaning a bunch of loans to these dsos that don't have a proven model that don't have proven systems that don't have the right people driving the bus you know that 2nd to 3rd to 4th location is usually going under. I want us all switch one last question I got one more question where one of your other ones will you have two more that I haven't talked CareCredit, Patterson but what I like about Care Credit the most has nothing to do with their business what I like about Care Credits the most is that you could have Care Credit come in your office and they can show you what everybody in your zip code and county and city is borrowing money because the dentist wants to blame all their problems on anybody but the man in the mirror you know every problem is caused by their mom their dad Obama, Putin you know and then they sit there and say okay well here's a Care Credit report and if you're Bart you're financing $2000 a month and there's a dentist across the street from you that's doing 25,000 a month and he lives in the same town as you do and then some of the craziest stuff is that the number one cosmetic surgery in America is actually eyelid surgery and these girls are financing at $4,000 probably 10 eyelid surgeries for every major dental case in every major town American the average American between the age of 16 and 76 will buy 13 new cars for a median mode average price of thirty three thousand five hundred and 95% of all the dentists in America will never do a single case for thirty three thousand five hundred and every time some dentists gets financed on care credit 10 women financed four thousand for eyelid surgery and at 56 years old I still have never seen a woman who I thought her eyelid was good or bad. I didn't even know eyelids were an issue. I mean it would be like saying well don't you think that ladies ugly coz of her little toe eye I didn't know a little toe or an eyelid could be good or bad I thought that I mean it was just like a gallbladder or something. So do you agree that dentists should have Care Credit come in their office just to show them the potential health care financing market in their own County?
Gene: Without a doubt unequivocally, one of the things I do love about Care Credit it is they teach which equals exactly what I do in my industry they teach how to make dentistry affordable. The problem in dental practices is we have a person that's working behind the desk or presenting financials who may or may not be making twenty to sixty thousand unlikely but say 60 I'm a high-end and they can't present the financials to the patient of what the dentist presented in dentistry. If everyone in their mind could just make a mind shift and say my role is to make dentistry affordable that's what Care Credit allows us a practice to do, that's why I love having the rep come into the practice is because they really work with them coinciding with what I can teach them to say it is all about making dentistry affordable. Patients spend money on what they want to spend money on you just said it eyelids but let's take it back even dial it back to they get their hair highlighted they get their artificial nails done they have you know $200 pair of jeans on. I mean I could go on and on people will spend money on things they want, our job in the dental practice is creating the want. If the dentist can create the what the front desk or the financial coordinators job is to make it affordable how do you make it affordable it sure as hell is not giving them a Care Credit brochure and saying we offer Care Credit. It's sitting down I need an e having a piece of paper going through exactly what the financial arrangement could be what is the dollar amount. I remember presenting this to a team and the front desk person was in her 20s and she said to me you know Gene, if the doctor presented a crown to me there's no way I could afford $1200 and I said okay to prove my point I took the piece of paper that I was educating them on on how to make dentistry affordable and I said let me ask you something could you afford $50 a month and she laughed and she said you know I yeah I spent $50 a month at the bar I don't you know like yeah of course I can't so because we just say Mrs. Jones your crown is 1,200 not Mrs. Jones you could pay half and half 1/3 1/3 payment over 6 months or 12 months payment over 60 months what the heck do we care how long it takes a patient to pay off a crown or multiple crowns that's making dentistry affordable, that's why I love Care Credit. They have a market share hold and I think they deserve it they treat their customers well they educate they have that rapport as you mentioned that kind of really takes it broad I think the problem that a lot of dentists have is they they don't want to offer the beyond 12 months although I don't want to pay Care Credit they're expensive really how expensive are they when you're not doing the dentistry you know it's all relative right.
Howard: Yeah and it's also not the unit price it's the case price per hour. I mean these guys that do financing they just say well yeah you just come in Friday and the only question is can you afford this monthly payment for the next 36 months and a do you want to be awake or do you want to bring in a board-certified anesthesiologist to put you to sleep, half the markets afraid of the dentistry and half the markets afraid of the price and what are the dentists do they don't they and they go in there and they make in church you got to go oh well I'm sorry Gene St. Louis for them you have 28 crappy teeth and five of them are broken and infected but your insurance only pays a thousand a year so we're just gonna pick the crappiest tooth in your head and do a root canal fill and crown on this molar here and then as the first year our Lord God and Savior Delta Dental will give us a new thousand dollar maximum and then we'll treat the second shittiest tooth in your head and that's 95 percent of dental market. The other 5% walk in and say hey gene congratulations you got great credit we can do everything you and the doctor talked about for a hundred and eighteen dollars a month for 36 months is that sound like something you want to do, they're like yeah and they're like well you know you haven't been in the dentist for five years is that dental phobia? I mean do you want us to put you to sleep for that or do you just want to do it on like nitrous oxide and then I will put to sleep and those are the guys that every Friday will have one or two patients for 25 grand they do it 50 weeks a year and they're just crushing it because and then and some of these dentists will say well you just I've been in the office I say well you just told her that our interns to pay a thousand and then her portion of 6,000 and it's $100 a month for this 20 months but I didn't see anybody call the insurance company and verify that no, Howard it's a thousand it's a thousand bucks I don't even care I don't even care if they pay or not I mean it's a $6,000 case and I'm gonna do the whole damn case in a couple hours and then as they get older and older and older and they have these big cases say they're in Phoenix, Arizona and they're like oh my god I got Gene St. Louis coming in Friday and she's gonna be put to sleep with the anesthesiologist because you don't want to do that yourself because if something goes south you don't want it you don't know anesthesiologist. I don't care what how many of course you took and number two though like I don't even want to do three molar root canals on Friday morning I means three molar root canals back-to-back so they'll call an N adonis from the next town over and he'll come in friday and they split the revenue with it 50/50. I mean I know Dennis you sit there going Friday and all they do is press the flash until the patients put to sleep then it ended on us we'll come in and do three molar root canals than a periodontist comes in in places five root canals I mean five implants and I mean it's just it's just my gosh but hey I took you to triple overtime I just want to tell you that the only reason this show the smash is because I'm able to get legends like you to come on the show thank you for your 30 years of commitment to dentistry and thank you for coming on the show today and talking to my homies.
Gene: Thank you I appreciate it and I appreciate you giving me the time as well
Howard: All right have a rockin hot day Gene.