Dr. James McAnally is the founder of Big Case Marketing / Dental - Trust, a specialty dental advertising and sales consulting agency focusing on the advertising and sales of full arch implant / complex dental cases. Client members treat 1-2 full arch cases every week and are located throughout the US, Canada, UK, and Australia.
VIDEO - DUwHF #1160 - James McAnally
AUDIO - DUwHF #1160 - James McAnally
Big Case’s Full Arch® Program constitutes the largest network of independent implant practices advertising and focusing on one day treatment modalities for the full arch implant patient..
Big Case’s Medicare Money Programtm is the largest advertising, billing/coding, and reimbursement network of implantologists.
He and his consulting team have been helping generalists, implantologoists, and specialists with advanced surgery and restorative skills find and gain case acceptance on major implant cases for more than a decade. He’s personally been involved with clinical dentistry for 29 years, named a global leader in dental consulting for 10 consecutive years, and authored multiple books on advertising and sales processes in dentistry for complex case dental patients.
His eLetter reaches more than 150,000 dentists worldwide every month.
Howard: It is just a huge honor for me today to be podcast interviewing Dr. James R McAnally DDS, FAGD, FICOI, FMII, what does all those means fellow in the Academy in general dentistry, fellow International Congress oral pathology, fellowship in the mission stitute. He is the founder of Big Case Marketing Dental Trust a specialty dental advertising and sells consulting agency focusing on the advertising in sales of full-arch implant and complex settle cases client members treat one to two full arch cases every week and are located throughout the United States Canada United Kingdom and Australia. Big Case Full Arch program constitutes the largest network of independent implant practices advertising and focusing on one day treatment modalities for the full arch implant case patient. Big Case Medicare Money Program is the largest advertising billing coding and reimbursement network of implantology accessing up to twenty three thousand dollars in medicare original Part B medical necessary benefits for the oral surgery patient. He and his consulting team have been helping generalists implantology and specialists with advanced surgery and restorative skills finding gain case acceptance on major implant cases for more than a decade. He's personally been involved with clinical dentistry for 29 years named a global legal and dental consulting for ten consecutive years and author multiple books on advertising and sales processes and dentistry for complex case dental patients. His a letter reaches more than a hundred and fifty thousand dentists worldwide each month and I'm so honored today that you came on the show, I asked you to come on the show you didn't ask me and the reason I brought you on the show is because every dentist I know will tell you they hate selling dentistry. So I mean so you went into a job where all your customers stopped you at the door hey James I hate this continual. How do you there mindset how do you do it?
James: Well you know the reality is for these guys that have this kind of training they either have to get serious about sales or they really aren't going to do any cases Howard. Even for these guys that are that are getting this sort of subsidy from the Medicare system to help other cases there's still a huge amount of money that the patient has to pay out-of-pocket and so when you look at these practices that do 100 cases a year they've gotten serious about sales and of course advertising because those two things go hand in hand and create those cases and the guys are sitting around going oh I wish I could do more of those cases are the ones that they don't take that part seriously either personally or they don't delegate that to their you know to a sales person internally in the practice. You know clear choice is a great example of this which is a national entity in the u.s. that sells a ton of dental implants and if you walk into their office they are serious about sales process they're going to do some things differently than what I teach as far as putting pressure on patients which I don't like but they're doing a lot of implants because they're serious about sales and so my clients get serious about sales as well to do that many cases.
Howard: By the way you mentioned clear choice we had the the founder oral surgeon on show 375 impeccable implants with old Jensen but it's amazing because when I look at data in America the average new car price in America is thirty-three thousand five hundred sixty dollars according to Kelly Blue Book and USA Today and on average Americans will buy 13 new cars by age seventy six years old source Anthony Pratt Polk director of forecasting and so when you look at the two hundred eleven thousand Americans you have an active license to practice dentistry today ninety-five percent of them will never do one case that their patient base will spend on a new car so so why white as a dentist even if he's in you know rural America and he says these farmers don't have any money and then you go to the grocery store and everybody's driving a $40,000 f150 or a $60,000 f250 I remember I was in Beeville Texas and my daughter-in-law saw an f-350 truck for ninety thousand dollars and when she saw to it she went oh my god that's the most beautiful truck. So why is it in Beeville Texas that people will spend 40, 60 or $100,000 on a Ford truck and then that the dentist that treats them things hold that they'll never spend that on on their mouth?
James: That's all a mindset thing because you go into any of these parts of the country and I mean unless you know I mean unless everyone's living under a bridge which is not the case you're going to find people spending as much on their truck or more as you've already pointed out then they spend on their teeth and most of that is the dentist it's not telling them what the options are and of course not advertising the public about most of these services so it's usually a dentist mindset problem it's not it's not a problem with the customer you know. So you know there's those people are buying those crazy trucks whatever it is. Their are trucks what kind of the cost just as much as a mouthful dentistry.
Howard: and I certainly wouldn't want to go to a doctor that didn't give me all my options I mean I saw this deal on HBO where I'm Cuba is the lead country on lung cancer and patients and the United States is running about a five percent five-year survival rate and Cuba's that a twenty five percent and the doctors you know very few doctors saying by the way have you would you think about just flying to Havana I mean I would leave the US healthcare system in a minute if I thought I had a five times greater success rate in Cuba and when clear choice came in there's two types of dentists those that always live in fear and scarcity and the sky's falling and then those that think and hope growth and abundance and I remember when clear choice came to Phoenix Arizona half the special like oh my god they're gonna steal all of our business and the other half is like my gods are on TV all day every day now I'm having my routine patients say to me have you seen those commercials can you do that and it's like my gosh I was looking at clear choice like a rising tide lifts all boats and any of my homies that want to come into the Phoenix market and do a million dollars a year in television advertising is my new best friend.
James: Exactly you know you just have this debate you know we'd always hammer on the ATA let's have a national advertising plan for dentistry while a lot well these guys have done a far better job and implant awareness and anything we've done it's profession so in these markets where you have them advertising like this everybody does more cases you know it's beautiful if you got them in your market you need to be running after the implant cases too because they're generating business or everybody, they really are.
Howard: It was me, Gordon Christian, Rich Matto of the matto report and oh my gosh woody Oaks the Profitable dentist, we all went to the American Dental Association we all met down there with the president other people tell them about this need for national advertising campaign and you know what they did they said okay so they put together a committee they put together a budget the periodontist three years later could not agree on the on the script of a 60-second commercial and the ADA people you know they don't want to the executive director doesn't want to call out you know they're homies but they're like these guys could never agree on what a commercial should say where his free enterprise how long do you think it takes clear choice to go from writing and scripting filming a commercial?
James: A week max.
Howard: Yeah so...
James: I remember that when it came through the ADA and it was like where did this go so you know and by the way Howard so you speak as a specialist like that a lot of them are even figuring out now that they have to play the game differently if they want to do these cases so like this is kind of like a little secret inside the profession that most of the specialists are not doing these for large cases you know that's not that's not the dentist who do these cases because the complexity is feeling you've got the role surgeon that Parian is trying to sell it and the restoring person so when you get this sort of like multiple players because the patient's confusing they don't die well yeah now you have more surgeons in paradise as you're saying hmm maybe we should be restoring these whether it's self which some of them are doing or they're bringing someone in-house and they're the ones who finally gotten smart about this, so it's kind of funny that we're at that place where my advertising at this point.
Howard: So are most of your clients and implant all just at place and restore the implant is that he's doing the majority of all on four?
James: Yeah the majority of these cases besides you know besides clear choice besides a few big players and the specialties they are implant to do the cases for the most part so the patient's going to come in everything that they need to have done is going to be in that facility we know Nobel calls these people Total solution providers essentially so you walk in diagnosis everything's planned there it's simpler that way you have less confusion and the patients were willing to write that check or something that well actually no one Howard now these cases are down to less than the average price of a car so they're not even having the right to check for as much as a car anymore so that's typically his doing the most cases.
Howard: and we see that total solution provider that that was the retail business model for 300 years of economic research like you go back 300 years that the stories were you know the store was downstairs and mom and dad lived upstairs and then the next generation would bankrupt them by building a store 2,000 feet the next scenario 4000 ft then 8016 and they got all the way up to 250,000 square foot Walmart's, IKEA's, Home Depot's all nine yards but now when you look at pediatric dentists and orthodontists no one lets go to a pediatric dentists air in here you know her bite looks funny I'm gonna send you down the street make another appointment with an orthodontist a week from now and these orthodontics and pediatric dentists are teaming up and the moms like one-stop shop is everything. So you just called them total solution providers if I needed to have a surgery I don't want I don't want to go to two places if I can go to one I mean that I don't think anybody's gonna change every time oh and now that the Texas Supreme Court case said that a specialist is anyone who specializes in that it's not determined by the nonprofit American Dental Association membership club that's not a government agency the courts are saying that man if you only do if that's all you do is implants and you specialize you're an implantologist.
James: Well you know that's true so is that changing the marketing or are they marketing calling them sell out in plant ologist yeah and these states that are covered by that Court ruling you know I know fur certainly for our clients we are heavily saying advertise as a specialist now is that going to be the only determining factor and what causes people to buy no but in a market where you have multiple players which is typical these ages are going to have these several people in a market that are really focusing on these cases so it winds up being a bit of a differentiator so like Southwest Florida you know my kind of my epicenter of our strengths is in the southeast.
Howard: Are you mostly doing all on four or is it just implantology in general your clients?
James: Well you know right so here this kind of goes back to the total solution provider and you know Amazon has changed the reality for all of us you know I'm sure Howard you're probably Amazon user yeah?
Howard: Yeah Amazon Prime
James: Exactly so you have Prime that has these hundreds of millions of customers around you know now it's global we got this Prime business all over the world that's changing the thought of how fast stuff should get to you and so for the implant patient, especially someone who's in the terminal dentition which is you know 45 plus years old they're babysitting this mouthful of diseased teeth they don't want to dish her you know they want something that's going to happen fast and so the reality is that the message that creates that phone call from that patient revolves around speed. So that is really it whether it's all in four hour and fix whatever the same day method is to treat this patient that's what the market wants you know for all the messaging out there and that's because if I can get it fast I'm all for it. So then your traditional implant case it takes six nine and month that's you know people don't want to buy that anymore.
Howard: So what I love most you know what I love most about Amazon is that his wife Mackenzie is single now and she's got seventy five billion dollars there if I say my resume attorney anyway you can send it to her I'm trying to get my alimony money back and I thats my best idea on these total solutions what percent of these cases does the implant ologists do the IV sedation versus bringing anesthesiologist?
James: Let's be real there's a lot of politics around sedation dentistry if you follow this closely at all you know the oral that's okay we'll just we're just going to call it like it like it is the oral surgeons hate the fact that general dentists do sedation dentistry and so in almost every state where you have bitter bitter angry oral surgeons they start attacking the generalist and trying to change the rules around sedation so depending on the state you know you have some states where you're allowed to do deep sedation in your office other states where you have to have practically a hospital facility in order to have anesthesia services so it's kind of all over the map of course from the patient's perspective the better we can be a sedation the better this case is going to be for them. So I always encourage our doctors to either be you know high V sedation credential and if they can't do that and there's because of their state laws then we need to bring in an anesthetist if you want to do a lot of cases, you know because patient comforts a big deal when you're doing surgery that that's the reality that we're also selling with this amount of money on the table.
Howard: My oral surgeon has an anesthesiologist last 20 years just because he just says it's like a hygienist he doesn't want to do his clay he's just faster he does more production Jack walking in the room and it's all set up and ready to go he just goes from room to room and does the surgery and consultations. So do you think practice management wise it's faster easier higher-quality more net income to have an anesthesiologist?
James: Yeah if you're really serious about like let's say you're going to go this game or you're going to do 100 of these cases a year you're silly if you don't have that individual in there because your stress level is going to be so much lower speeds going to be better you can build this into your fees because again if you do good sales process you're going to get paid and compensated well for these cases because they still are highly profitable and hopefully you live in a part of the country where you've got availability of these an anesthetist that will come to the office and you know you find a good anesthetist and you can keep them busy just as you know you as the main guy if you're doing a lot of cases.
Howard: The only people that have been able to show me data actual studies done by PhDs and universities it's always consistently shown for 30 years that the American market is just basically two markets one buys on price and one buys on fear what percent of what do you think is a bigger barrier to entry to getting an all on four is it the price or the fear?
James: I would say it leans slightly towards price Howard. You know again because we've been so poor at sales in general in the profession you know I have patients they really have no clue on why this stuff cost as much as it does or that it's going to cost as much as it does you know there's still. You know you're still treating each patient individually you can't you know you can't treat three people at the same time so really there's a limit to how efficient you can make this process so the price of it we're really getting down to where unless something really spectacular happens on the laboratory site or the or the component side we're kind of getting down to where you can't really cut cost anymore for this procedure to be profitable close. So you're still going to have a percent of the market you know they'll go out and are going to spend 50k on that at Ford f-350 but they're going to block it spending 20k on the arch of Dentistry no matter what. So that's that's a reality we have to deal with and on the advertising side you just have to create more prospects to deal with it because it is a numbers game. If we want to do you know if we want to do two cases a month when an average you need to have 30 phone calls coming to a practice each month to get those two cases.
Howard: So it's 59 for that same consultations or 15 incoming calls?
James: 15 incoming calls the quality calls people coming from very specific advertising we're all anything around this procedure.
Howard: and that procedure being all on four or just a big implant case.
James: Well a big implant case but typically you know again if you're in a market where multiple players are advertising if you have anyone else advertising same day treatment you're gonna have to because otherwise that person is going to be the one cleaning up and you see when I say same day cement so that's that's all in four on six whatever keep them peace today whatever you call when I call your particular version of this.
Howard: Yeah so the funnel is 15 incoming calls from marketing to get one qualified paying customer.
James: Oh right and you may and you're going to pick up some other types that may be some single teeth that kind of stuff but to get a full arch that pretty much the ratio we're looking at.
Howard: So your website is www.themcanallysellingsystem.com What are my homies gonna find if they go to www.themcanallysellingsystem.com ?
James: Well also howard bigcasemarketing.com points to all of that so that's really what we advertise it's a forwarding address if you're there to find information about what we do primarily which is helping doctors advertise for large cases because we do serve as an advertising agency for these Doc's.
Howard: Okay but I just also let's stop there because I always know you as big case marketing but if you go to big case marketing.com right now it immediately forwards to the McAnally selling system.
James: Yeah exactly and so if they buy it they go to that site they're going to find information about what we do full arch advertising and we're actually you know as always people are rebuilding their sites so we're in the process of that right now because we need to have more information up about how Medicare can play a role in these cases as well, so we don't only have much on the site about that right now but Doc's that are just barely interested in this topic they can come and just put their email in and they'll start getting you know emails from us to educate them on what we do. While most practices if there's if they're even interested in tea and selling a 10,000 dollar or larger case all the time they really need to be serious about sales and so that's also part of our consultancy which is just purely sales training as well. The ones who take that seriously they just they get to have more fun with their CE because they go back and sell cases that's the reality of it.
Howard: So I know my dentist I love them to death you know I've known him forever thirty years plus dental school it's the mindset they just they just tell you right up front I it's like I can't tell you all the advantages of going to LA with me this week and you're if you're in Phoenix saying I don't want to leave Phoenix I don't want to fight the traffic I don't want to go to LA. So you how do James reminds them would your argument talk about your book The Dentist Unfair Advantage the 39 key tenants for practice success with a bunch of five-star reviews on Amazon would that be a place to start?
James: You know Howard actually the book is out of print and I I'm not gonna put it back into print for a few reasons and here's the deal you know people buy this kind of thing and then they put it on the shelf and they keep saying oh I need to read that damn book before I actually get any help about my practice and then five years later they still haven't read the book you know. So now it's like if you're a customer of ours our client will hand out the book to you but generally now it's just better for people to get free information at the site educate themselves that way because typically it's you know it's the old saying it's like once the students are ready the teacher appears right. You know so that's kind of how our customer shows up it's either someone who's you know they think they finally got the bug for implants and they want to finally do a lot of cases or they said you know I just I'm sick of hearing no when I try to sell my cases and I want to have help with that so that's how they show up in our doorstep.
Howard: Yeah what I was like about you and I both have them our fellowship of the Missions Institute we both have our I'm a diplomat in the International College of implantology but I'm old school so before I went to Micsh I bought his book it was the number one selling book in dentistry of all time and I read the entire book and now and you know you go to these courses and these dentists will go to a course and they'll drop like $3,500 for the weekend and it's like and they're asking questions that are like dude that was in the first chapter of the book. Why are they just they just it's almost like it's an ego thing like well if I spend $3,500 every weekend at Kois or Ross Nash or Spear Panky well then I'll be smart right you can just buy smart and I'm like dude if you just buy the 179 dollars text book and read it I and then when I was doing those courses it was a boy from Phoenix of Pittsburg which is a five-hour flight each way and I would just reread the book I would reread the book going back and forth and tell the same thing with Pathways to the Pulp by Stephen Cohen I mean these dentists asked those questions it's like dude you've been practicing you spent $400,000 in dental school you've been practicing five years and you're saying something that's you're asking a question that's in Chapter three of the number one selling endodontic book of all time just read and then if you can't read I don't know how you became a doctor can't read a lot of those are audiobooks now.
James: Yeah most people you know it's the mindset thing how generationally it's changed immensely with how people will get information and use it that Misch book if you were you know if you were relegated to some horrible part of the world where there was no CE you could read that book and do the procedures. I mean he spelled it out step by step though that book could take you I mean you could do a by reading the damn book but that's you know that's not the mindset now it's a different it's a different beast out there Zoe so here's the thing for the people listening that are willing to go be a student again they have it they have an automatic advantage because everyone else is lazy, basically. So if you're willing to devote some of that time to being a good student again you're going to clean up that's my advice to young young young folks listen to this.
Howard: Yeah and I think that an enterprising resourceful intelligent person would never do anything for ten dollars they could do it for a dollar and I mean just so just read just read it maybe and you just set a time maybe it's just an hour a day you know if it's just an hour a day then I remember one of the guys he wrote the most novels was on and interview one time they'd say well how do you keep writing all these successful novels and he says because I get up every morning and I just write for one hour every day but you do that well eight nine ten months later you got another smashed novel. So they just need to get out yeah if you want to change something big you gotta change something small every day and adding reading dental knowledge instead of staying up with the kardashians would be a great idea.
James: Yeah we all have to work I mean I still write tons because that's how I felt you know two people are interested in us I have to write write write put the message out there and on Stephen King had a book out where he talks about how he writes and you get it on the head with at the side time every day and the more he grinds it out no matter how he feels you know that that's the nature of productivity you know it's not watching the Kardashian that's doing on a daily basis.
Howard: Yeah I agree I'm committed to diabetes and obesity, so every morning I get up the first thing I do is I overeat for an hour and that's how Im able to stop committed. So talk about your system now okay so they're listening to you and I know what she's saying she's saying I didn't go to eight years College of cell dentistry but man I would really like to restore some of these cases and if the average American is buying 13 cars in their lifetime for thirty three thousand five hundred six dollars a piece and then some of the some of the podcasts I've done I mean when I find these officers doing three to five million I mean there's Bill weathers and some town no-nothing town in Georgia that's been doing 10,000 a day his whole life there's Bruce Beard in a small know-nothing town and I think it's a one-stoplight town and I don't remember the city it said in Texas same thing you know he does like 4 million a year and just some Ford 150 town. So how do that you know and and then the people listen to you, you know they're how can you sell what is your program if they go to the well I do like big case market I see what you're doing there because it's a lot easier to remember big case marketing.com and then have that board link it to the mcnally selling system but if they go to bigcasemarketing.com what are they going to find in what what is their action to learn how to sell these big cases?
James: Well you know for the folks that are serious about saying look come on it started putting some numbers on things Howard you know let's say someone is going to go to a Kois course or they're going to go back to MIsch which will exist you know the dollar signs that they're going to commit to that kind of education what do you think Howard by the time someone would complete Kois?
Howard: Oh my god I spent six weeks to the Pankey Institute I think I'm by the time you buy the time you pay that $4,000 a week and then how much production do you lose by not seeing patients that week and then there's airfare the hotel and of course my four boys to go with me to all those trips because they wanted to sit on that on that beach on Key Biscayne Florida and playing the the ocean while I was in there I mean it's it's just I mean how would you measure when you talk about tuition travel family miss production I mean I probably found a quarter million dollars at the Pankey Institute.
James: Exactly so at minimum it's a hundred G's no matter what and no matter how we slice this thing so some way that walks in our door and if they're willing to spend twelve thousand we're going to add on the skills to sell at twenty-five fifty thousand dollar case you know before they run off to spend that kind of money on their training or if in the middle of it they need to be able to actually be selling this stuff back in their practice. So that's kind of a bare minimum if someone's not willing to do that kind of stuff with that they don't deserve to do those cases because you know that's just the price of admission to sell. Now if it's an implantologist type person we're going to have a different path where we do research in their market look at what the advertising costs are to see really what's viable for them to be a player in the market if they really want to do a lot of these cases so that's kind of the other camp is the implantology practice that wants to have helped with the advertising and the sales of this per case. So that's really kind of the two sort of pathways someone might take when they show up at our doorstep because you know the reality is most of your folks listening to this you know they're they're either going to be doing ortho or Invisalign or you know all kinds of dentate procedures that still cost more than still cost more than a cheap car you know the cheapest cars and so for every one of those people if they're willing to get better it sells or to delegate that and be serious about delegation by the way it's not like they are getting it not backing the person up and the practice is going to be the salesperson but they're willing to do those kinds of things they're going to open a door to finally putting those skills to work and of course if there's an implantologist and we're going to be getting serious about how many of these cases do you want to do in a year and by and large most of our clients want to do at least three cases a month at minimum you know 36 cases a year you know the twenty-five to thirty thousand dollars a case and then of course some people really want to be a big player like a like becoming a gulsta and Nevada or becoming a biggest clear choice in their market that's of course another level of the game as well when they're going after these cases.
Howard: and again I just want to say over and over and over that I think one of the mental barriers a dentist have is they think the only people have money live in Beverly Hills and key biscayne in Manhattan and I would say would you rather own Ruth's Chris Steakhouse or rather own McDonald's and in my lifetime when I was going down to the mission suit I mean this is three decades ago and now three days later I look at well who did I go through my class with that got my fellowship mission Institute that just came out of there and went from a $750,000 practice to a two to five million dollar practice you know what the one strategy it always was they would go back to some poor town like Bakersfield and there was this dental world there and they could go pick up dental world for a four or five hundred thousand dollars that had a brand name for thirty years and they keep the denturist but then on the consultation they would come in for their two hundred and seventy five dollar denture for 499 full-mouth or they could start with the upgrade to nicer teeth from Ivoclar that'd be up to 750 and that they were in Australia one implant down the middle if they're Americans two implants and then they have great all-on-four and they would go into this place and they'd say yeah when a hundred people come in to get their realign from a trailer park like they've been doing for three decades we're upgrading 20% of these people to one two or four implants and I mean it just it's not the economy I mean you live in the United States Canada Australia New Zealand England Hong Kong it's not your economy you don't live in the Congo you don't live in Tanzania you live in a very rich country and these people pay bank and what the other thing I understand is like doctor Richard Lit is a board-certified orthodontist who is the orthodontic instructor at UCSF and he was been in Detroit Michigan for a decade or two he teaches this course for orthodontics and it's for three-day weekends for five grand and everybody boxes a price it's like well what is your first ortho case gonna be five grand 6500 and on your website you'd you there's a testimonial by a dentist I know who says I did my first case presentation following your precepts and a clerk from a local nursery agreed to a $65,000 rehab. So I mean so your courses it's twelve thousand five hundred is that you said what was the actual fee is it a contract?
James: It's nothing like that Howard let's say if someone comes in they want to do sales training it could be as little as three months or they could be really slow and do it over six months but you know so they're going to invest anywhere from six to twelve G's to do sales training I mean that's the bottom line with our fees. If they're going on into where we serve as an advertising agency looking to do three cases a month then you know you're looking at about thirty six thousand annual consulting costs for that but you know the price of admission if you want to do those big cases all the time you got to have expertise help in that and that's what people are paying for.
Howard: So you're you're a one-stop shop so you're doing the marketing to get them 15 qualified calls to get one click case closed and I also see what I love the most about your website is your you talked so much about answering the damn phone I mean these dentist I mean my last piece of data I saw where he actually had real data by real people who measured it show that 39 percent of dental office phone calls go to voicemail and at the end of the day you sit there and say hey how's your receptionist Valerie oh she's the greatest, did you know that four out of ten of our calls went to voicemail and they're back there doing a molar when I do a molar root canal I lose all concept of time and space for an hour I mean you look at the clock it's nine and you finally are done you look out and it's like ten and it's like so you don't know what the phones are doing upfront. So let's talk about the marketing so part of your program you'll actually do the marketing and what kind of marketing are you doing is it direct mail is it Google AdWords is it Facebook what what's your advertising plan?
James: Howard can I back up to where you talked about people in the economy for just a second?
James: You know the reality is if you live in these Moore's what I call secondary markets that are outside the Metro core you actually have an advantage because there's usually fewer dentists advertising for these services.
Howard: What are you calling it? Are you calling it a secondary market... would you also call that rural?
James: I wouldn't call a rural this is the Rochester, New York this is the Bakersfield, California you know it's like Waterbury Connecticut and you go into these markets and these are kind of what I call average Americans right and you do gangbuster business in these places because you don't have a lot of competition there not a lot of advertising. You go into like Beverly Hills California where you have this perception of all the money blah blah blah and actually it's more brutal it's more difficult to do the cases in those markets. So that's a mindset thing that dentists need to get over because if you live in no secondary markets it's kind of like you know you're there on the track and there's nobody else going to run with you so you might as well start. So that's the thing about the economy now as far as advertising you know the reality is that you know a lot of average studying now is search space it's almost there's almost no market in the world where we don't utilize some search based advertising meaning that the patient types things into Google and certain phrases and certain keywords definitely are pointing towards this patient who is either is usually in a terminal dentition that's who we're looking for I think it's important everyone understand next everything to dental implants is edentualous, but most people who really need implant are there they're somewhere in between those two things they're you know they're either babysitting a full mouth of diseased teeth or they've got some missing teeth some remaining teeth so the terminal dentition patient is who who is a prime target these days. So search based advertising most of these markets that they have a paid page subscription newspaper that's still a very viable way of finding this patient because again the older patient is going to be reading a newspaper it might be direct mail it might be television a lot of this is market based so you need someone researching what the avenues really are for that location and then because we are a lot of our clients are so Lois there's also going to be you they can't be like a career choice you know I don't be able to match that kind of advertising dollars so there's also going to be a limit on that where we put the money and how you have to be efficient. Now as you know as a starting point for the advertising cost in almost every market in the US it's hard to go below 2,000 2,500 3,000 a month to play this game of going after a full arch implant case that's that's sort of the price of admission to get the phone calls coming that make sense?
James: and if you're in a market that's super super competitive and you're going to need something else that's special about your situation or what you go to the public with and what that special thing is for a lot of our clients is that we actually help doctors go into the 65 plus population patients who have what's called Original Medicare Part B and pick up some surgical benefits from that insurance system that can help offset the cost of comprehensive treatment. So that's kind of one of the other things happening right now and this particular niche in dentistry is those patients that have that particular policy they're very interested in those benefits if they can get them.
Howard: Yeah and another thing that you got to realize is that when you go to Beverly Hills and Scottsdale and those big old homes on half acre lot so then you figure in streets and roadways and access and all that you might only have five six people living on an acre but when you go into Phoenix or Los Angeles it's ten times that much and a lot of the data shows that dentists that patients prefer to drive to a dentist within 20 minutes of their house and so when you go to Bakersfield who Johnny Carson called the armpit of California there's just so many people where'd you go to and hardly any providers and then you go to Beverly Hills and everybody goes there because they're attracted all the lifestyles of the rich and famous and it's a would you rather be in a dentist Beverly Hills or Bakersfield?
James: Hands-down Bakersfield
Howard: Yeah and my buddies....
James: and I'll take it when one step further Howard, you probably have heard of this company called Del Webb right?
James: You know there's they're one of the biggest home builders in the country and if you look at what they pay attention to is that they're going after the 55 plus year-old at what they call active adults and they're building these lifestyle communities for this population and these people have the money and the need so if I were to dentist now I would be like getting my black close to a Del Webb community because that's you know it's sort of like the trifecta of what we're up to with dentist.
Howard: Right and when you're 40 I mean this you know we just had a bunch of snow in Arizona a couple weeks ago I'm everybody that was under 40 or 35 was heading north to go ski well grandma doesn't want to go skiing her favorite hobby is going to lunch and dinner and breakfast and which has the family over it's all about eating and meals and if she is not enjoying her eating and her meals because of her teeth she will pay for what it costs to get a new car to be able to chew and if you don't believe it then what is clear choice a figment of my imagination I mean you really have heard.
James: Yeah Clear Choice will help her out.
Howard: Right so I want to switch gears completely and go to the phones cuz that's been one of my pet peeves forever. I mean I always tell people I mean the business you're in oh yeah I have so much respect for you because you're going into a business where every dentist will tell you they hate sales so what did James McAnally decide to do get into teaching genocide yourselves the second thing they don't do is they don't answer their phone and there's a hundred and sixty eight hours in a week and they have in they you know to be a dentist eight to twelve years of college a hygienist four years of college all my assistants went to a year of Phoenix College and then they hire receptionists off the street no training they don't have any software on their telephone they can't tell me how many incoming calls came in last month they can't tell me how many outgoing sales calls they had last month I mean it's just like it's like so to talk about your beliefs in the phone system and how does your program help them with the phone?
James: Well and you know you've hit the nail on the head I did you know 39% is pretty much on target hard that's what I see when I look into clients call measurement because we mandatorily track and record everything it comes to our advertising because I you know you sort of have three things going on with the full-arch case you've got advertising generating a phone call then you've got the phone call ringing which you've already figured out is a huge problem in most practices and then you have the sales process on the other side of the phone call and anything goes wrong in these three aspects something you know we don't do the cases and so you're already identified one of the first barriers is phone sales because that's what it is you're selling consultations and the fact that most people give away a free consultation and they can't even sell that you know I'm giving it away for free but I can't even sell it you know which is that it's fat because now we're screwing the patients over but basically realizing this was so important every single advertising client we have we push them through intensive phone training and every month provides reports of how many calls are coming, if they're not doing cases from the calls we always investigate what's being said on the phone because typically that's where the problem is you know where most dentists make their number one mistake with phone is they hire they try to hire people who have dental industry experience you know they want someone answering the phone oh great you have dental experience well usually that experience brings over all kinds of bad habits that really don't help us as a practitioner so I'm all for let's find someone who had zero dental experience and we trained them to be great at phone sales or they come in from a sales background because that's going to be our real winner when we're seeing this kind of dough I'm creating the phone calls but you almost in is they they refuse to record anything you know you don't want to kind of like this whole thing of putting their there over there I like a lot I don't know what's going on up there but when unopposed - investigating too much because that I might have to do something and then you have the guy who starts listening to call and find out the staff is doing a horrible job and then he's afraid of replacing them you know and that's kind of one of your other you know AHA is as an adult is every one of us is replaceable you know for sure you know me even me doing this specialty job I'm replaceable you're replaceable Howard everybody is and so those staff that are doing a horrible job we give them the tools to get better and if they don't get better we replace them I mean that that's the reality of what you have to do if you're spitting is kind of doing the appetite.
Howard: Actually when you said all people are everyone's replaceable actually that's not true because when I quit dancing at Chippendales they actually had to close they could not they could not replace me. You said there were three parts, the incoming phone call what were the three parts incoming phone call....
James: Let's talk about you know and this is a matter where's implants or orthodontics and whatever you've got to you've got to create a phone call to some house you got advertising or you've got referrals or whatever that's creating that part of your sales process. So you get the train rolling you got to have calls coming and you know the Millennials will also hate that concept you know they don't want to talk on the phone but the reality is that's still highly mobile most of our business was really done for these large cases it's one to one on the phone to get someone convinced that were the right practitioner for them you know you have a stranger calling the office and we got to convince them never the person for them. So you have the call is coming from advertising then you have phone sales when the phone call arrives at the office and if it's picked up if it's picked up live which is best if it's if it drops the voicemail forget it that patient if they don't know you they're probably not going to call back they're going to keep looking if it's you know answer and then answered poorly and that happens a lot and also we lose the customer so you have to have a good phone sales process and you know it's a part about this it's not super sexy Howard you know it's not sexy to be training phone skills we guess that's what's required when that call arises it's someone that's trained to take it properly converts it to a consultation then we move on to face-to-face fails which is another aspect of this your you know when you're trying to take a check to 10 20 30 40 50 thousand dollars in a patient.
Howard: and you call that face time sales?
James: Yeah face to face in the office you got to deal with that whether you whether you delegate that all them all to like a professional salesperson to practice and by the way in clear choice the doctors don't sell you know they've removed them from the equation you know they have hardcore sales team not the doctor you know it's a very...
Howard: So you develop a treatment plan presenter to do the sales not the doctor?
James: You know at the end of the day Howard we're gonna get a better fee bigger fee better case acceptance if the guy who takes the check at least presents the top plane number two patient it's you know if the doctor will look that patient in the eye and say for your situation you know it's going to cause thirty five thousand four hundred fifty dollars to do this treatment and then letting this staff do the financial arrangements that's the ultimate winner because the patient of trust who's who's going to do the surgery but if the doctor can't be confident at that we've got to train someone else in the office who will do that and that's the other end of it we also have clients who you know they give they realize that that's not never going to be their forte so let's get someone else in the office you will sell the case. So that's you know yeah both both situations some dentists you they you know they they man up and they woman up and there's a salesperson and you have others just say you know I'm gonna I'm gonna present the case that ever all of Mines the financials are going to be someone else will be trained.
Howard: Yeah and I I wrote a column one time just wrote a you know a lot of people say well that's not me well I mean look at the greatest actors in the world I mean they're on Hollywood when you pull up to your office and you say I'm not really leader will quit telling yourself that tell yourself you're the best leader and then when you sit there and say well I don't want to present a fee just start telling yourself that you want to present the fee because if I was gonna go in and I had some disease say I had cancer I wouldn't want the oncologist to not just look me in the eye and say you need surgery and radiation and I want to start today I don't want him to say well I'm you know I you know and the other thing about a recording phone calls I mean when they started putting video cameras above cash registers at all the 7-eleven and circle K's internal impeccalation and embezzlement dropped to almost zero and everybody tell I mean they're humans and when you're recording the phone call and you know somebody is gonna listen you answer the phone completely different when you know your dentist is you know dreaming and looking for a fourth canal and has no idea that you're talking to your Aunt Shirley for 15 minutes on the phone.
Howard: Here's one of the other insights and the way you just said about the recording and this goes for the phone as well as recording of the sales presentation the case presentation in the office when people start committing to that and recording their results usually improve across the board ironically just because they're measuring and they think more about what they're gonna say and like oh I gotta get serious about this because you know we're gonna we're gonna have that transcribed and we're gonna look at it or James is going to look at it back it you know back where he ever used it this week and kind of give me a grade on this thing, So that one thing will also change what happens in a practice just by being serious about recording.
James: and yeah and those things about dental experience I mean my gosh um I remember the first time I know at least when my dad was going golfing I was always want to go with him and he said no he's busy in this that when he finally took me I was so excited I don't know how there was ten or something and and when we got to the golf course that's when he tell me that well you're not golfing with me you never go for you're gonna come and you're gonna take ten lessons with this deal because you go out there and develop a bad hook you're never gonna get rid of it you need to learn how to golf right from the beginning and you know when these people come in they say well I have 10 years experience really why are you leaving your last office oh he hung himself you know and you know and then and then you look at your own staff and it's like you don't you don't record their calls you don't have any big cases what I see is there's five percent of dentists that work Monday through Thursday 8 to 5 and then they go in every Friday and that's when they do their big case and anesthesiologist meets the patient sometimes sometimes they just like oh my god James McAnally is here and he needs four molar root canals I can't do four molar and so they'll have an endodontist come in and then they'll pay them 50 percent but it's really not fifty percent because the insurance company might only give you seven hundred for a root canal but the same insurance company will pay an endodontist $1,200 for a molar some of them are fifty nine so they'll just come in there and and I greet the patient the anesthesiologist put some 1/8 endodontists might come in and do a couple of root canals and then when he's done a periodontist goes in there and places four or five implants and even but they do a big case like that every Friday fifty times a year and then you go in that medical building where there's eight other dentists and the other seven dentists will never do it one time in their entire career will they ever do one big case the price of the median average new car. So how do you fix that?
James: You know it's something switches and some of these dentists Howard like the high performer a lady dentist and kinetic Waterbury Connecticut three years ago she'd never done an inflight case and now you know she had she had an associate and I'm gonna come back to that topic in just a second but now she basically is only doing implant cases you know something in her mindset that's what I'm gonna do you know and that's I don't know what that switch is and that type of business but it does happen and then you've got the other folks just like you said they're sitting on their hands in the medical dental building and that they've never done a big case you know. I just did a lecture at the Sklar Center in Miami it's one of the it's one of the better all and core training programs in the country and you all ask in the room you know how many people have done a $50,000 case and you've got these people there that are about to take the surgical training where if someone comes in and do two arches it's pretty much going to be 50 G's and yet you'll have a room full of people they've never done a $50,000 case in their life and yet here they are paying they get these skills where that's what you're selling but you know basically what I see is sort of the winning formula right now Howard with what we're doing on the implant it's usually one implantologist with an associate because you know once they start going after these large cases and all the general ministry just flows over to the associate and so that's the model right now that seems to be working the best because usually if you're a soloist and you don't associate you're going to get into this whole tug of war with the general ministry and your specialty services and not a lot a lot of folks can really navigate that as a solo just a soloist about the associate there.
Howard: and I'm going to go back to that we started this show about the retail model about you know the most successful pediatric dentistry formula is to bring in an orthodontist from one stop shop you're talking about one stop shop place the implant do the sedation restore the teeth and that one stop shop. If I was graduating room school I mean you know these guys come out of these private schools are paying $100,000 a year so when they come out of primary schools we got $400,000 student loans and then they usually get married and then go to endo school or perio school for three more years and you we saw that one orthodontist in Las Vegas who graduated an orthodontist with 1 million dollars in debt and then what do they want to do they want to go buy a land.
James: Howard that's the winning number one billion dollar debt.
Howard: Yeah it was all over dentaltown and but then he wants to go buy land building and and get another million dollars in debt, if I came out of endow school or pareo school and I was coming to Phoenix Arizona why wouldn't you just pick the five biggest practices in Phoenix yet you have no overhead you I mean a lot of negotiate 50% of their income fee and they just do all the molar endo I mean I just think at the end of the day the consumer is gonna win and the consumer doesn't want to go to five locations.
James: Howard let's talk about it the other side like I want to give you an example of someone on the opposite end your into that your was it orthodontist with the million dollar debt yeah all right okay so you know you got him trying to follow this this model of where you go out and buy all the land and build this giant building and all that and you have the other side of it or you have some smart guys less dads they've been working in corporate dentistry for a while and they see the other angle which is you have lots and lots of doubts you're more than happy to sub leave space to you you know because they've got a facility that's sitting empty a couple of days a week so you get yeah the other side over you can get in really cheap a subleasing situation and go after your big cases so that's the other that's the other side of it for some of these people that want to be smart they're younger you know you you go after the angle if I'm going to have a super low overhead and I'm going to go after a highly profitable case so then you're not taking on that you just dead of owning the facility or building a facility etcetera.
Howard: and I always will also tell you about them one thing you know I you when I'm talking to you as a dentist I I think you're Luke Skywalker I'm not Luke Skywalker you're listen to me you're Luke Skywalker I'm the old Yoda guy who's trying to give you some advice so that you can your path and that's what you got on dental town we're on Facebook and Twitter if you post something that I don't like if you went to my Facebook page and posted I'm sure fat and bald I would I would delete you I'm just kidding I wouldn't bet but when I got into dentaltown and I searched for big case marketing with Dr. James McAnally I find five patient five pages there's like ten threads per page for five pages going back years that's another thing I like about them message board is that you know it's all heart I we got a quarter million dentists they posted five million times and some of these threads are just amazing but you have so many amazing fans on dentaltown I can't wait to go in there and post this podcast and I talked to the big guy himself.
James: You hear this thing hired people you do need to love you or they need to hate you you know that's the reality you know so I've got plenty of folks sort of those battleships type personalities that are hanging on the profession that aren't changing their mindset those types they hate me, you know because I push the buttons that they don't want to they don't have pushed and then you have a whole other side of the profession when they're like oh my god I wish I could have met you you know ten years ago so that's that's kind of the nature of this business.
Howard: Well let's talk about that because the...
James: No doubt you have your own haters to Howard.
Howard: You know I've never met anyone that didn't love me I never I never have but the bottom line is I'm let's talk about that because the person who owns Facebook Mark Zuckerberg his dad's a dentist Ed Zuckerberg comes on the show once a year to tell you everything you need to know about Facebook and dentistry and but it's so obvious across Facebook Twitter Linkedin Pinterest dentaltown that 1% of the people do the majority of all the content creation and then nine percent engaged like they might reply to something you posed with lol or I disagree I agree but ninety percent across all social media platforms since MySpace everyone's a looker and if you don't believe me open up your Facebook page the average verse has 140 people on Facebook go open up your friends did you start scrolling down to the first ten when you scroll down the first ten probably nine of them have not posted this year I mean they don't post. So when when they started to come out with statistics well called 901 and we'll bill you a dollar if you vote yes and dial 900 if you vote no and it didn't take the statisticians more than a few years to realize that every single one of them was statistically invalid because you just had the crazy outliers voting and you had no idea what the silent majority is. So when you're on social media and you say something like James Mac and I well you of course you're just gonna have standard deviation two and three to the right and standard deviation two to three on the Left you're not gonna have and you're anyway after you get that reading the thread you're gonna have no idea what ninety percent of all the dentists in the United States and Canada Australia New Zealand UK actually think about it by the way we just went over five thousand Dennis on dental town from the UK and I want to tell you a little trend about the UK when I got out of school thirty years ago everyone thought the sky was falling everybody had to work for the NIH and every year they would just lower the fees and lower the fees and lower the fees and they own and the dentist literally had to go bankrupt to where they couldn't do the dentistry that they morally ethically wanted to do in the time and fees. So they almost had to go bankrupt to leave the system and now there's five thousand independent dentists in the UK who have given the finger to socialized dentistry and that's why it scares me about socialized medicine because I don't know anything about all the other medical specialties but I know a hell of a lot about dentistry and when I go to those socialized medicine countries for dentistry like in London in Paris and Tokyo which is three the greatest civilizations of all time the socialized dentistry only gives you a hundred dollars for a molar root canal and everyone knows in those very high overhead cities of Paris London that you know you it would probably take six hundred dollars to break even so what do those doctors do, they don't even offer them all a root canal they pulled the tooth because implants aren't covered and they say well I'm not gonna do a molar root canal for a hundred I'm gonna place an implant out-of-network for fifteen hundred dollars and put a thousand-dollar crown on there that scares the crap out of me when you when you start doing things you don't like to do for money that's usually gonna lead to burnout and burnout can be not pretty can Endon substance abuse depression divorce you know suicide and so that's what I love the most about implants and orthodontics is that Invisalign and an implant is that a network from here to Kathmandu and then and then you go to go to Malaysia like I lecture in Malaysia and Vietnam and Cambodia and these dentists are saying well the government Medicaid I completely lose it cost about a hundred twenty percent to do all the cleanings exams and fillings for the government plan but I harvest out of my patient base I harvest to place one implant fee-for-service and one Invisalign case and as long as I'm placing one implant and one Invisalign case a week they're the top 5% income in their society so.
James: Howard I'll speak specifically to your clients in the UK and when I say UK we mean England you know anyone in Scotland the opportunity there is like what it was here in the US thirty years ago like when we go into a market and this is a thing our advertising work as long as we're in English actually I look back that up anytime we've converted our advertising into other languages it's always worked that's a beautiful thing about the planet is you can always convert advertising to other cultures and languages you still get response it's a little easier when we go into english-speaking countries because we're already ready to roll but in the UK when we launched our advertising campaigns that we use in you know in the US our response rate is three hundred three hundred percent higher.
Howard: When you go where?
James: When we're in the UK so response rate is three times what we get in the US with the same amount of money so that's just an indication of how far back they are with catching up with these school arts cases you know so if you're if you're trained and I believe what they what do they call this in the UK when you're anyway there's another than their name you call it when you're certified to do implants if you're in that category and you're not going after cases with advertising there you're really way behind because the patients are searching big time. It may not be in central London but if you're out in any of the other cities in the country that are still very massive in population you're super busy if you're advertising that's the bottom line. So anytime we go into that market we're always like oh my god this is like when it used to be in the United States really fortunate.
Howard: and what about Australia I've gone to Australia every five years for 30 years lecturing down under what are your thoughts on Australia we have we're huge we got about five thousand in Australia another five in the UK and I think a thousand or 1500 out of New Zealand what's it like down under?
James: You know the each market it doesn't have as much room for big players because the population of Australia is less than Canada so you know you have even fewer people to sell to so that's if there's any downside to Australia its lack of population. Well in it you know every market there's one or two big players that do the most cases well that's the reality there as well.
Howard: My brother lives in Australia and I don't ever like talking about religion sex politics or violence but one of the biggest economic crazy things I've lived through is you ask any single American well what made America the greatest richest most powerful country on earth they say well for 500 years people from all around the world came here they voted with their feet and the people that leave another country and come all the way to here they're more ambitious they got a big idea one-in-four start their own business and I'm like yeah exactly every PhD winning Nobel Prize economist agrees so are you ready to open up Ellis Island and they go no I want to build a wall. In Australia I mean I'm over once you're over 50 like my brother was telling me years ago say Howard you got to move with me to Australia I'm like dude I got four boys and five grandkids I live in America so I'm sure as hell not going to another continent but I you can't even get in after 50 without paying serious bucks and signing away your rights to their healthcare system you know you're not gonna move down there at 55 and get free health care system but Australia it's so tough it's so tough when you love your dentist you love your people you love your tribe you love your country and you sit down and you try to explain to them that's the smartest thing to do would open back up Ellis Island and when did Ellis Island get closed down during the Bolshevik Revolution and one interesting thing about that is you look at all these historical revolutions they didn't take place in one country the labor movement the Bolshevik Revolution that was all around the world just like right now politically most countries have gone to the right and it's not just United States it's Brazil it's whatever but trying to get these people to realize I know it doesn't sound right but you gotta open back up Ellis Island and we're gonna I mean we've been growing that our economy has been expanding two-and-a-half percent since I've graduated from college in 1980 and you could get that back to the days of five six seven maybe even eight percent if you open back up Ellis Island but there's there's there's no chance that's gonna happen so I'm just wasting money in the wind.
James: Yeah I know Howard and I'll pipe in here you know the most I have one night when I have a newer what I call a newer American as a client now someone is you know maybe first generation after the parents are here they are more willing to work harder than most of my clients whose families have been here for generations it's a different you know different mindset.
Howard: Oh absolutely when you when you I mean only 1% of the seven and a half billion Earthlings live in a country they weren't born in nobody wants to leave their country and if you want to leave your country and go to another country you've got a big idea and when you come here I mean like look at dentaltown look at the cover of every woman who's been on the cover of magazines they were born in Russia Croatia whatever and they came over here and now they got an office with 10 15 20 employees doing several million a year and I mean and you want to not let that person in and and the dentist in Australia are like well but she's got a dental degree we don't want to let anyone in with a dental degree I'm like dude the people that come here only one in 2000 or 3000 are gonna be a dentist but anyway it's you're not gonna change someone's mind and macroeconomics. You know why no because in your economic mindset if you have all these beliefs that got in there without any science or logic no science or logics gonna get out of your mind when stuff comes in because that's why your cousin Eddie told you and that's what your grandpa believes well you just you can't get out of your head. So we talked about marketing and then one last thing I always want to say to my Millennials they're so infatuated with social media advertising because they're always on Facebook and Google and all that stuff like that but these people that need implants everyone that can show me the data Direct Mail is always the number one thing and what they're showing me the direct mail is that about one out of a hundred so if you want to do one case this week well then mail out a hundred and if you're saying you need 15 incoming calls for one pays then you need to mail out 1500 pieces when I got out of school most dentists did not advertising did not about 15 years out of school that dentist was doing about 3% of collections in advertising and now every office I know that's in the 2 to 4 million dollar collection range is spending 7 percent of their money on marketing.
Howard: You agree disagree?
James: I agree I agree it's uh you know in fact if you look at you know most of the time they're dentists to understand when they're when they're let's say a fully committed insurance practice they're paying you know 15, 20 percent of their budget for the average tithing to get them patients which the advertising is being in the plan you know so that discount you make on your fees that's your advertising cost. What if someone's going after full-arch cases or specialty services like both the orthodontics you know you're going to be at 7 to 7 to 12 15 percent that's just the reality of it but on the other side of that there's a huge amount of profit so it makes sense for the business to be at that level now where people get sort of screwed up is if they try to do a lot of advertising and they're going after an insurance patient well that doesn't make any sense your already paying the fee to get that patient you know so you don't want to put more advertising dollars on top of what you've already paid.
Howard: I also over the years you I'm not only do i associated big haste marking but you also were dental trust is that still a thing?
James: I was training we really focused on why do patients trust you more than other other dentists and there's a whole lot of contact points when someone comes into practice where you can either elevate trust or destroy it and you know in that respect a really basic good administration of a practice and you know and obviously reviews are a big part of trust and yet how many dentists have 100 reviews you know and that's kind of the bare minimum now if you want the public to really find you and think you're trustworthy.
Howard: and what is that called social what do we call that social online credit...
James: Social proof
Howard: Social proof, yeah it's also more effective with women than men I mean like I none of the guys I know that I hang out with I've never seen anybody with my own eyes use Yelp or anything I mean we're gonna go to a bar or restaurant whatever we just go check it out but women more than men they're gonna look at the reviews and it's part of social trust. So online reviews and it's the same thing but they don't have an online reviews everybody I know that's crushing with online reviews they just create a culture in their office where they ask their patients for online reviews and if you don't like selling what you need to do is know when to intercept like when someone sits there and says oh my god this is awesome you just like hold your hold your heart and get them say it's like oh my god I wish I was instead of hearing you say that I wish I was reading you say that on Facebook can you post that on Facebook and they pull out their smartphone right there in the operatory go right through their deal they check in and then they say I mean you can do that you can get one of those every day every other day.
James: Every day every day and there's some other there are several technologies now that we use one with our client base because I think these reviews are so important for everyone selling is that literally you grease the wheels between the review site and the patient's phone no essentially you send the invitation to their phone they're in the chair then right through your eye pin and these are the practices that they're past 100 review point and they you know once you're sort of past that you generate patience just from those reviews.
Howard: Yeah and everyone's doing it I had to get eight and then I'm not even making this up I had to get a colonoscopy and they sent me one of those they texted me about one on review and I just out there from it like I don't really know if I want to online review a colonoscopy I think I'm just gonna pass on that is there anything James that I didn't talk about that you wish we did?
James: You know I guess when I want one of the other aspects is like okay anyone who's involved in implants and what to get serious about it you know you should also be having a conversation about going after those Medicare dollars because that's a big deal these days and outside of that you know I've never seen dental sales for implants as good as it is right now. I mean it really is going gangbusters so people need to stop thinking that the sky is falling because these cases are out there in a lot and a lot of them are being done and I guess the last part Howard just to say thank you for everything you've been doing all these years.
Howard: I love it.
James: You made it therefore you made it easier for guys like me to stand up and like you know say it like it is so thank you.
Howard: You know I think the luckiest thing about me is I've never worked a day in my life I work with my dad who nine sonic drive-ins and five in Wichita one in Kearney Nebraska, Childress Texas, Abilene Kansas, Louisville Kentucky and riding around learning business marketing demographics leadership and then but my next-door neighbor Kenny Anderson shout-out to Kenny who's still practicing after 50 years I would go to work with my dad he'd make a hot dog and onion rings and I go worked with Kenny and he'd take an x-ray of this tooth and do a root canal and had his own lab man making a full oh my god I was it was love at first sight and I've I love doing what i doing I've never worked today my but his name is Dr. James R. McAnally DDS, FAGD, FICOI, Fellowship of Mission Institute, go to Big Case Marketing and my gosh just I just quit telling yourself, I don't care if you lie to me don't lie to yourself just quit telling yourself you hate sales you hate marketing you hate staff you eight just start telling yourself you love it and you will love it and there's I think James what you did I think you're the leader in this field and I think you're crushing it. Thank you so much for coming on the show.
James: Yeah thanks a lot Howard.