Dentistry Uncensored with Howard Farran

How to perform dentistry faster, easier, higher in quality and lower in cost. Subscribe to the podcast: https://podcasts.apple.com/us/podcast/dentistry-uncensored-with-howard-farran/id916907356

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Howard: It is just a huge honor for me today to be podcast interviewing Paul Etchison DDS FICOI FAGD he's a practicing dentist and his South suburb of Chicago called New Lenox. He is the author of dental practice hero from ordinary practice extraordinary experience he is the host of the dental practice heroes podcast recently along with Dr. Justin Bhullar, Dr. Etchison founded dental business mentor an unlined curriculum teaching all things dental business as well as systems used in his practice he currently practices only six days a month and enjoys twelve weeks off per year he is married and has two daughters Briella and Alices and it is just an honor that you would come on the show today I we have something in common in the fact that dentists they always want to go learn TMJ or implants or bone grafting or they always have a restaurant almost bankrupt but they think they need to learn how to make lasagna it's like when are they just gonna say that's all great and I love and adore the fact that you want to make the best lasagna in the world but if you don't know that if you just stop using a table top cloth on every table your laundry bill which is $1,000 a month would be gone they just don't like the time so my question to you is um where did your journey go where you actually got interested in the business of Dentistry and creating a practice with the extraordinary experience where does this come from in your journey?

Paul: Yeah yeah well first of all Howard I say thanks for having me on I had been a longtime listener and really happy and honored to be on your show for me it's always been kind of I've always had this like thing in my heart where I'm likeokay I want to be the best at everything I possibly can be and when I got into dentistry and opened my practice it's just I realized immediately that there are so many different little things you could do that could add to a big result and there's really no there's no ceiling you know there's nowhere where it could stop so as much as I also did all those clinical CE's vehicle you know a CE junkie I saw the most you know it's bottom-line practice success those came from the stuff that I learned from the people at the bar at the CE's or going to these practice management seminars so as much as I might totally agree with you you know it's great to know this TMJ TMD and all these like really hardcore clinical things to know how to do these surgical procedures but what most dentists are really lacking is just the general business knowledge of how to create an experience and how to create a product or a brand that patients actually want to go to so that's kind of what I focus on and it's always been a big focus to me I could tell you I still haven't got a completely figured out and I don't think I ever will I'm always learning but it's been a cool journey and I've enjoyed every part of it and I'm still working on my practice even though it's like very successful I still know it can get better.

Howard: You know even the clinical guys let's you're better at the bar I remember one I mean you go to their lectures and half the people are gone at lunch and never to return and then when it's all over he goes to the bar two beers later he's talking you know and everybody's listening and it's like you know like at the bar they'll say oh yeah that's the worst product in earth that that product sucks it's like oh wait you say you were saying well the nanometer and the wavelength and the wear rate and what he lost everyone if you just would have stood there and say no this this stuff is horrible they all would have got it. If you go and do any dental school you know this is true Paul every dental school once a month they all get free pizza lunch for someone to come in from a major DSO and tell all the kids that all the guys in private practice like you and me we're all going down we're all going bankrupt Howard's a thousand years old and when he was little all the pharmacists used to own their own practices and now they all work for Walgreens and hinky dinky so is I want you to put on your amazing mind ten years out is where we're headed is it all gonna be are we all gonna be working for McDentals's in ten years?

Paul: Well you know what I think there is a little bit of truth to that but only in the sense that I think there's gonna be a thinning of the private practice herd I don't think it has to be that way but I think a lot of people just are not gonna put in the energy and the effort that it needs to stay in private practice and I think also to some extent I mean there's gonna be a place for it always I mean some people want to go to the DSO and that's cool for them they want to make sure your insurances some people want to go somewhere where they feel like they see the same people every six months and stuff like that but I think if you're just gonna be an average private practice dentist you want to graduate from school you're gonna come up you're gonna buy some old dudes acquisition or something like that and you're just gonna keep doing the things they've been doing them for the past 50 years you're gonna get lost and not completely lost where your out of business but I think you might have a little bit remorse that you chose this dentistry career and you're gonna be on Facebook bitching about it or on dental.com bitching about it and it's it's just the fact that you don't want to evolve any if you don't want if you expect to make top dollar and have a lot of people love your practice and it's just everything's gonna be gorgeous as soon as you don't get out of dental school and you're not gonna focus on your business or creating a great patient experience I think you're gonna get lost.

Howard: Okay that's the second time you said patient experience I almost I'm almost starting to wonder if your customer focus instead of dentists focus I mean aren't you supposed to be just staring in the mayor building the perfect mousetrap for the dentist I mean dentists want to look at crown margins not profit margins they want a schedule that's perfect for their experience not the patient's experience and eight and a half percent of every American that walks into an emergency room is there for odontogenic reasons because they can't get a hold of doc so how do you so what would you tell these kids how do you get them to look at profit margins at a crown margins and look at customer experience versus occlusion?

Paul: Well I think it's something worth looking at just for the sake that our colleagues are doing so bad at the bar is so stinkin low okay the bars are so low if we put a little bit upper to effort into it we could blow everybody wait now if we put a lot of effort into it people just gonna be telling everybody about us I'll tell you from my practice almost eight years old now we have seen at least at the lowest eighty new patients every month at the highest 190 new patients a month and that has been consistent and that's been without marketing often it's because people talk about us people areremarking about us because people like the experience that we provide now I think as much as you want to look at the crowne margins because we're all dental focus and we were taught the lie that if we just have those solid crown margins that if we build that the people will come I think we're putting our eggs in the wrong basket I think we really need to get critical and just say what does the patient feel as they move through the practice and that's what we're missing the boat we're not focused on it because we think it's dumb and we're not focused on taking care of we're not looking at our patients as consumers that have choices so we're closing a three you know we're opening at 9:00 a.m. we're closing at 3:00 we're not open on Saturdays you know people wake up in...

Howard: You said that really really fast well you say a little slower remember I'm 57 I have a major so what was your hours again?

Paul: So our hours we're all actually open at 7 a.m. and we go till 8 p.m. we do that Monday through Thursday on Friday we get out early but early for us is 3 p.m. for a lot of people that's the normal let's get out time and I can tell you if you look and you're struggling for new patients stay open late now do I want to be there until 8 p.m. 8:30 on Monday nights that's my late night absolutely not but I see it as a necessary thing for growing my business and I see it as some way to get new patients into the door to be more accommodating to the patients and when you get all those new patients that come in at night they've got family members that can come during the day so if you're struggling to fill your schedule I mean that's just such a low hanging fruit and it's amazing how many dentists are just so resistant to that.

Howard: So to be clear Monday through Thursday 7 a.m. to 8 p.m. Friday 7 a.m. to 3 p.m. closed Saturday Sunday?

Paul: Yeah we're actually closed Saturday and Sunday that's something that might happen in the future but I don't know if it ever will because I don't want to work Saturday or Sunday and I can't really it make my team do it if I have...

Howard: How ,any ops is that and that's 11 ops?

Paul: We have 11 ops yeah we expanded we had 5 ops all the way up till last October we just came up on our year anniversary of 11 ops so out of our 5 OP we actually were able to collect 3.4 million last shot last year well you're on track for about a 4.4 maybe high 4 3 and I think at a capacity point for this 11 op practice is probably gonna be right around 6 million.

Howard: Wow and how many how many dentists I mean so if you have 11 ops on a 7 day are their like 2 different dentists in the morning and 2 different dentists in the afternoon or does one do a 13 hour day with a 1 hour lunch or how does that work?

Paul: Yeah so we have two shifts we have the morning shift which goes from 7 to 2 we had the afternoon shift that goes from 12 to 8 now it's not the a team and the B team everybody switches around every....

Howard: 7 to 2 and 12 to 8?

Paul: Yeah yes there's about to our overlap where everybody is there now everyone will work 2 nights that's that's just how it is so it's not like the morning crew shows up every morning and the night crew shows up every night but when I am there which is only 2 days a week there's two dentists but other than when I'm there there's only one dentists at a time and that's not by design that's how it's going to be forever we're gonna grow into that we're just not at that point yet two days a month I have a periodontist in there that's just chucking wisdom teeth and in doing like implants and stuff

Howard:  A periodontist and chuck wisdom teeth?

Paul: They can yeah

Howard: I never even thought of that I always think of them as implants and gum work but yeah they can do the wisdom teeth for you.

Paul: Yes yeah

Howard: Why did my walnut brain not think of that but go on so one how many days does the periodontist come in?

Paul: So he's coming in twice a month

Howard: Okay

Paul: So twice a month he's coming in we think that's about a good flow there might be in room for an additional day for him but for our patient volume that we're seeing right now twice a month he is very busy I think he could probably come in a third day but as our practice grows and we continue to get more and more new now more and more new patients but keep more and more active patients I know there's gonna be room for him to be a little bit more maybe once a week.

Howard: So okay so in summary ours is a big part of patient focused and said a dentist focused so after hours what would you say is the next weighted patient experience versus dentists experience?

Paul: Well I would say you know we're talking about patient experience now there's a lot of things that would go into our patient experience we have a very rehearsed very I guess scripted play it's not scripted to the point where we're saying certain words or saying certain lines but scripted that we do certain things the chairs are set up a certain way everything will be a certain way when the patient comes in the patient will enter in the one side of the OP and the provider and the other side of the aisle will ask to take their coat and hang it up just little things like that just make the patient experience more smoother but I think we're talking about being more patient focus I think something that we also get very hung up on is the insurance stuff and in the insurance it is there not for the dentist they they'll tell you one thing on the phone and they'll deny something and then somebody's left with the balance and everybody's saying whose fault it is in my practice we do a treatment plan we sign it and I honor that like a contract now if there's a discrepancy the patient's upset about it I am 100% comfortable just writing it off because I think that you need to honor those even though it's not my fault it's not the patient's fault though but still I think upset patients it's not worth it if you look at our practice we have I think we have seven hundred sixty five star reviews and maybe two one-star reviews and that is because every time somebody is upset at my practice we're gonna take care of it now I will ask the patient what do you think is fair and sometimes the patient thinks I want all my money back and I say that's fine and I mentally move on I don't give it a lot of thought and I just say let's just let's just go forward because I just don't have the emotional energy to waste on little piddly stuff like that.

Howard: Well I don't even know where it comes from, I mean you think this dentist would just be all that and a bag of chips and just be like and on dentaltown having a meltdown over what some somebody set on a yelp review it's like we're we're that where does that sensitivity come from I'm a nerd sometimes like the benefited out and say well it's 10 o'clock at night maybe he's drinking, maybe that's not a sober thought but then but where does that come up why does one person saying you you're horrible caused a meltdown?

Paul: I mean it's the same thing, I think it's just natural ego it's rejection of its it's someone viewing us in a negative light I mean someone not feeling that we're not respected I mean we see it all the time in the forums where someone will get on and say something like I had a friend maybe come in and they didn't expect to pay any kind of copay but you're like well this is your insurance and then they get into argument over their friend and then they're spending so much time on the internet going back and forth what should i do should I send them the collections how dude just let it go, you know that you've wasted more time bugging out on the internet then you could more emotional energies you just let it go with a who cares.

Howard: You know what I did every year for 32 years you know this country depends on what country live in like some countries are big into Ramadan that's a big month for them and in this country Thanksgiving to Christmas I mean it's just huge it's just the huge mostly the Christmas to New Year's week I mean hell I bet half of Americans missed a week of work between Christmas year so I would just sit there and I'd look at all this over 90 stuff they're not gonna pay for whatever reason we have a great collection policy but I just get a bunch of Christmas cards I'd say hey with a spirit of Christmas around the corner you know we had a great year and obviously you didn't have a great year because Paul you didn't pay your bill so you know what I'm gonna do I've zeroed out your bill you don't owe us a dime all I ask in return is that if you a friend or loved one needs a dentist we're right here so I zero out all oh my god they come in they cry they bring you cookies cakes all this and then here's a bozo cross street wanting to take him to small claims not knowing what went wrong in their life who knows her dog got ran over who knows but now you just took someone to court who lives eight blocks from her practice is gonna live there for 40 years people are crazy life is crazy I just podcast interviewed a dentist where his office manager of 18 years walked in during work hours and shot his wife dead I mean horrible things happen but you know what you know what you're my dental practice hero?

Paul: What sorry

Howard: I'm dead serious because I know the most important thing is culture and you culture first and um how many employees I mean you so far you kept what all your employees

Paul: All of them every single one 27, 8 years.

Howard: My assistant quit on me after 30 years I still haven't forgiven Jen for that I mean she only gave me 30 years but but III think culture is so important and I witnessed with my own eyes a hundred times where you're you're going into work with the office and you're talking to the dentist and he's all cool and he's all fun and he walks up front he looks at a schedule and says you know uranium that was wrong my schedule what are you guys doing have you guys and I'm like man it's eight o'clock in the morning and you're ripping your receptionist her head off and she's gonna be answering the phone all day talking to patients I fired my best friend from my practice cuz we had the morning huddle and I could tell everybody was frazzled that my best friend was coming in I said well what's wrong with John and doctor he's an asshole and they start telling me all the stuff he does so I just pulled out my smartphone called my buddy and said hey you're fired give me the name of a dental office I recommend my buddy across the street but I was afraid to send him there but it's like it's like and then dentists say oh well the patient comes first well no not if they're standing there cussing at your staff and dropping profanity know that I'm so I want you to rant how are you if I lightened up a hundred dose I said what is the number one stress in your dental world the answer is only staff or staff and I mean it's a staph infection streptococcus mutans or it's the staff you pay on the 1st and 5th so what is every dentist afraid their staff the staff causes all the stress in their life and why is this your cup of tea?

Paull: Well I would say it definitely is my cup of tea and I have a great team we have a great culture and like you mentioned we were going on almost eight years we've never lost a single team member we've added people because we've grown we lost somebody who went to nursing school and became a nurse that's I don't count that because she was always planning on going to nursing school but what I would say about that is just what takes my practice to another level is my long-term team and then they have been there they know my systems they are part of this culture where we are gonna constantly do better and we are gonna constantly improve and we are never good enough and I have set the tone of a culture where there's failure is not it's expected we expect it's gonna happen but we're always gonna talk about it we're never gonna make anyone feel guilty about it and that's kind of just been the big thing for me is that I've always sat down and I have these meetings one-on-ones with my team and I say what is going on tell me everything how am i doing is a leader please hurt my feelings I mean I want that feedback and when I get it it doesn't matter if it's about somebody else or it's about me or something negative because everybody has something negative to say if you prompt them enough but I will be very very keen on how I'm gonna respond to that because how you respond to when you hear negative criticism is the way that that's what's gonna determine whether you get it in the future because if you get very defensive or if you cuss somebody out because they tell you something you guess what you're never gonna hear about it again so I know everything that's happening in my practice at least I think I know everything that's happening in my practice but I will agree with all the other dentists my number one problem is staff you know it's not a huge problem for me I'm not turning over people I'm not constantly retraining people and rarely I think I have to put out maybe a fire once a month but yeah I the staff is it's if you can really nurture your team build them up encourage them to make them feel valued you keep them there for a long time I mean they'll take bullets for you.

Howard: Why do you think most people will get on dentaltown and say I ain't my assistant once to go to lunch with me today and I don't want to go because I think she's going to ask for a raise, what advice would you give I mean when you when you're doing your podcast when people are writing your book what do you think their biggest stresses are on staff?

Paul: A lot of it's gossip a lot of times it's gossip and I'll tell you the instances that I've had with team sometimes it's gossip somebody says something about somebody else and they hear about it and then and then we have to address it you know we address it as a team we just had recently something happen where hygienists was talking to someone about how the front is putting in 30-minute hygiene appointments so you get to the bottom you talk to people involved and then I just said it our meeting you know I said we I am comfortable with you know I think there's a natural human tendency for everyone to have an us-versus-them there's an us-versus-them dichotomy and this is just natural with being humans but I said sure as shit there is not gonna be in us with the front and a them in the back it could be us versus the patients we can be versus the insurance company we can be versus other dental offices but it is not we are always going to be in us here and people need to vocalize there are things and I think it kind of put everything in perspective and sometimes you just have to reiterate to your team I mean people are gonna have disagreements but there's always two sides to the disagreement and it's very important for us to communicate as a team so that we can both understand each versus aside not pick a winner or a loser who's right or wrong but just say hey this is how you feel this is how this is making you feel this is how two parties are feeling what can we come up with as a team so that everybody can feel better and I think we're the dentist's drop the ball is that we have this ego where we're just gonna hammer it home it's my way or the highway just as this fear-based leadership you know I went to school for eight years and I'm gonna tell you how to do this no you're not you don't know is I'm the boss me me me and that's where we get screwed up because when you're me me me those employees are okay well it's all about him or her and eventually they're gonna find another opportunity and it's gonna be for a dollar raise I have had eight years maybe I've been asked for a raise three times by 26 people so does that mean that I'm just paying so incredibly high that they don't think they deserve a raise absolutely not but I'm telling you it's not about money I mean you make it about appreciation and teamwork and common goals and just love and commonality and just accepting people as they are as fallible humans that make mistakes.

Howard: I think a genius thing I learned from you today is that you had your shifts overlap because every place with two shifts it's the morning shift the night chef and the reason the DSOs you know they have a couple of serious fundamental problems number one you know you look at give your Walgreens or your CVS you'd wanna know how many pharmacists are available I mean when you look at dentist they come out of school and six thousand a year and they want to be associates for five years before they open their own place and so that means you have 30,000 people to work with when you look at that 30,000 they're pretty much all employed it's almost like a full employment system right now so when you but when you look at DSO's from a patient point of view I mean I'm in Phoenix Arizona they all come in they say anything well I went in there and Dr. Paul said I had five cavities and I went in to do one and now Paul doesn't even work there anymore then they brought in some new kids Cindy and I asked the assistant if she what she thought now she quit so they're revolving doors like it's like I wish every single dental office was a DSO because I can beat up that all day long I mean if you can't I mean when they come in every six months they want to see the same hygienist at the same bat station and say are you old enough to are you too young to remember Batman?

Paul: I'm almost 40 so yeah I remember Batman.

Howard: Well when I got out of sacrament school at 3:30 Batman it was the ain't block walk home and Batman came out at 4:00 that would that was your only deal in fact we get so nervous me and Mark boardland you'd almost start jogging the last block because you just had this fear that you're gonna miss the opening about man and what did they always say every day at four o'clock on channel 10 on kake on the same bat station on the same bat-channel it's Batman and that was the best 30 minutes of the day and then they walk in there and they say well where's Batman that clean mighty 36 months ago oh she's not here anymore where's my dentist Paul oh he's gone. I mean if they can't keep their staff they don't have a chance do they or do they?

Paul: No and I think when we're looking at it in and I was an advertising major so this is kind of this is my advertisings perspectives feeling is that there's brands okay and all these brands all these all the consumer wants from a brand is consistency we just want to have a consistent experience that what I came for last time I'm gonna get next time and if I tell my family or friends about it they're gonna get that same exact experience so our job is dental practice owners is we need to create a consistent experience now that's staff that's a lot of other things but then when we look at the most successful brands be a coca-cola maybe Marlboro Apple things like that these are product brands these are product brands whether your only interaction with them is essentially you're consuming a product now we're in a service industry and it's very hard to be consistent when you have a patient that will move through an office and they'll have a touch point with literally six or seven people one of them could be having a bad day one of them could say something that contradicts what the other one's saying so it's all getting on the same page and one thing that you mentioned about the different dentists is that say you said Cindy comes in the next time in the last time they had five cavities Cindy might say they have ten and you might say you know what I think we should only do two of them so where's the consistency there now they're saying it was the other guy ripping me off what is this now so there's there's so many elements when you have a lot of people to be inconsistent but I think that's the struggle is keeping things consistent but where a lot of dental practice owners are the owners fall short is they're not even defining what it is to be consistent about it's just a hodgepodge let's just go to work and figure this stuff out and just see what happens.

Howard: Well I want to talk about your book I mean it only has five star ratings I mean your dental practice hero from ordinary practice to extraordinary 40 out of 40 5 star ratings now you know Paul doesn't have 40 sisters and aunts and cousins and nephews but no the dentists actually sign their name they said most books give you our cheerleading okay this motivation this book however breaks down piece by piece every component of a highly functioning practice and provides the tools insights take your practice to highest level all you get in this book his nuggets Dr. Lance because anyway it's an amazing book and you have two daughters I always tell people that you know it takes nine months to make a baby it takes nine months to write a book what was going on in your life that made you want to have a third child after Briella and Alicea and having a third child the longer nine months to make Briella or nine months to write that book?

Paul: The book took a lot longer sitting down and writing it if you did hour by hour I mean it doesn't look like such an immense project but you can only spend maybe two hours a day on it you can't sit at a computer and write for eight hours you just can't now I'll say when I was really focused on it when I wrote the second draft I probably did that within like three or four weeks you know that's all took but the editing process going back with the fifth the sixth the seventh draft I mean that was almost a year but what hits wanting to do that is that something I've always wanted to do and I went from four days a week clinical down to three days a week clinical and I just got a little bit bored and I was like well let's just do that let's make that the new project and it's something I really enjoy I'm actually about a hundred and eighty pages into my second book right now and I just have to put I think it's gonna end up being about 240 I just kind of there's something I enjoy doing I like to write and I like...

Howard: Will it take so much time as a baby I mean did you ask Briella and Alicea if they wanted a brother a little brother or a book.

Paul: Yeah they get book.

Howard: Do they get a vote on book or brother or you just giving them the book? Who who is the target market for this book I mean which one of my homies listening to this needs to read your book the most and did you do an audio version?

Paul: Yeah we did do an audio version which I was I did that maybe four months after the book came out and to my surprise the audio book actually sells out the paperback because I did yes I didn't really read I read I read Kindle but I was surprised I thought people still read books but apparently they just listened to him now but this that's cool.

Howard: You know they're all commuting to work or there on a Stairmaster treadmill and and I have a lot of them I have a lot of dentist friends who you listen to my whole week's show it's four shows a week Monday morning every Saturday from 8 to noon is when they get up clean their house vacuum do all the laundry go to the grocery store and and she says it takes about four hours to do that and Ihave my little iPhone my headsets in even at the grocery store so sound is so if you wrote a book my god even if you don't want to read it you can hire a reader to read it for you but anyway but who needs to read your book the most so the most?

Paul: I would say a dental practice owner needs to read it now it's a second would be a dentist because even though you're not in the ownership I still think you can fulfill a leadership role where you're associating and I think you can always improve now I think people would say well I'm just associate and why would I want to change all this stuff and then and the owner Doc's not gonna let me do this I'm telling you the owner doc would love for someone to take this and I have to tell you that the team would love for someone to take to define the rules of the game so that they can win it and that's what's missing from so many practices there are no rules there are no expectations there is no communication so how do you win it a game when you don't know the rules so any dentist could read it I mean hygienists anyone could read it they could bring it to their doc but it's mostly targeted for owner Doc's and associate dentists.

Howard: Well I think I think the most amazing thing is you're in Illinois and that's where that's really where McDonald's started McDonald started in California with ten locations but Ray Kroc was actually up the street from you where we see, do you know where he was?

Paul: HolBrooke which is about maybe 30 minutes for me.

Howard: and what Ray what I can't believe I met ray when I was ten my dad started sonic drive-in so he delivered bread for 10 years then he bought a sonic drive-in franchise so when you went to the like the American Dental Association area when you went to the big restaurant convention in Dallas guess who the big speaker was in the restaurant conventions and the bottom line is the bottom line is the whole franchise deal was that if you get a core bunch of people only working on the systems where they're not bothered by seeing customers all day long we can on the systems and like people would always blame Ray kroc is the bad guy like well you came into this town and Paul and his wife and two kids had this beautiful restaurant for 40 years and McDonald's opened a bankrupt he's the bad guy and Ray's like dude I've never been to your town how did you not know that sixty percent wanted to drive through yeah you were born here lived here your whole we knew this and we're from Illinois and you didn't know this and you're in Coffeyville Kansas. So how I've always thought it was an error here's how I see it the dentist works his butt off Monday through Thursday and he's just exhausted and then Friday he doesn't see patients he goes in to do the business and the admin work but when the alarm goes off he said screw it and then he rolls over and then he goes hits a bucket of balls and and so he tries to do the business of Dentistry the last day of the week when he's completely tight and fryer and then whenever I see a stud monkey like you the the business working on the business is a top priority and and treating the patient is almost second priority.

Paul: Yeah it's so true and this is actually what my second book is about it's about getting yourself down to three days clinical because what I've realized and this was just anecdotally is that once I got down to three days clinical my business started growing very very fast like faster than it ever did when I was at the helm and just for the reasons you said I would do four days of dentistry every week and then my admin day I'd be writing up charts and doing all this other jazz and then I'd be like okay let's look at the business I'd be thinking about things while I'm laying in bed but the thing is I'm just exhausted I don't want to do in the business anymore I want to golf I want to hang out my family so I think and I've noticed from my podcast that the most successful dentist I speak to are ones that are doing three days of clinical or less and it's because then you have the energy to work on your business and and I'm not talking about doing the admin stuff I'm talking about doing that deep thought deep strategy deep work where you're planning long-term and you're coming up with ways to accomplish your goals and you're actually implementing and doing it with your team so I see patients two days a week right now and know everyone's like wow it must nice to show up Monday and Tuesday and go home no I'm still there all day on Wednesday and I'm doing like I'm talking to my team I'm looking at the numbers I'm discussing with my office manager but I need that day and with 26 employees and for the sake of being consistent I absolutely need to spend a lot of time with my team but having said that's what allows my business to grow and that's what allows us to do the numbers that we do and for me to have the lifestyle that I have and that's you can't grow a business without working on the business.

Howard: So how many dentists are on that team?

Paul: So we've got two full-time dentists GP is the one periodontist that...

Howard: Are you one of the two dentists?

Paul: No no I'm not no.

Howard: So you're the one owner are you the only owner?

Paul: I am the only owner yes.

Howard: So you're the only owner what do you call dentist operator or operating dentist or what do you call that dentist CEO?

Paul: I just call it me

Howard: Okay one owner dentist they're on to associate dentist

Paul: The two full-time associates yeah

Howard: and then one periodontist?

Paul: Yep one periodontist and it's soon probably an endo really soon but we haven't really figured out the logistics for that as far as working assistants and what days of the week are gonna be like that but that's something that's happening soon as well.

Howard: and so you're Webster your dental office your b2c business to consumer websites NelsonRidgedental.com

Paul: Yeah

Howard: but for your b2b from dentist dentists businesses you have two websites dental practice heroes and dental business Mentors

Paul: Yes those are two different sites.

Howard: What are the differences between dental practice heroes and did you steal that name from who is that oh who was that guy who sing heroes who was that song....

Paul: I wouldn't steal it.

Howard: No the oh my god David Bowie oh boy that's like one of the greatest songs did you did you want to name it David Bowie heroes so then at the very end you switch to dental day you should have dental practice heroes you gotta get Bowie in there somehow but anyway yeah so what's the difference for my home is why between dental practice heroes and dental business mentors and by the way the reason I always make jokes about names I'm trying to see a vision in your head so you know who David Bowie is you know you love this song so dental practice heroes just thinking David Bowie and you got that David Bowie handsome hair look thing going on so what was everything dental practice heroes and dental business Mentors?

Paul: Yeah yes so dental practice heroes that is my site that is my site for my podcast it's got all my podcast episodes that has my book is on there also like anything for speaking if anyone's to hire me as a coach that is all dental practice heroes now dental business mentor was a joint venture with me and Justin Bhullar and what we created was 175 videos on practice management how to run a great practice what systems you should be employing while you should speak to your team leadership things how to conduct meetings how do you answer the phone and these are trainings that are not only for the dentist but they're also for the team and we just wanted to put a product out there that was more or less like you know maybe a five day seminar all into little small videos that somebody can do at their own speed and also share with their team to train so that's what dental business mentor is we just launched that about two months ago.

Howard: So dental business mentor is only launched two months ago?

Paul: Yeah we just got it done yeah.

Howard: So and the goal of that is to train them in the business of Dentistry?

Paul: Yeah yeah it's just it's to reach more people it's to have I mean I I'll tell you Howard I really in my heart I mean I know a lot of people might disagree with me is a dental practice ownership yeah it's hard but we're making it way harder than it needs to be there's no reason why we have to figure everything out our own we can learn from other people that are doing it well and in all the things that I put in this dental business mentor site that me and Justin did these are not things that we invented these are things that we've learned from people that are doing it well and it's just from taking their millions of CE and reading a bunch of business books and just constantly asking questions of people that are better us that allows us to have our successful practices and now we're sharing with other people so I think it's just to put something out there so people can actually enjoy the type of practice that I have. Now is my practice zero stress as much as I say like it's pretty damn close but no it's not zero stress we still have stress I mean that's every practice I'm still gonna have staff issues absolutely I'm not the same issues that you have but my practice is going to be a lot more smoother and we'll be able to handle those issues and I have a lot of help for my team now but those are all things that I have set up with my team and it's taken time in leadership and just clarity and expectations and that's what the site's about is it's everything if you want my identical practice go to the site you should be able to figure it out we put everything out there.

Howard: and you on the so yeah so the to site the dental business mentor you did that with I'm Justin Bhullar and why did you get a Canadian I mean you couldn't find a hoosier how did you go all the way to Canada to find Justin?

Paul: You know we just we met it voices of dentistry and then we ended up hanging out at practice on fire that year and then we hung out in another seminar I can't remember which one it was I just have kept running into this guy and then that voice is a dentistry the following year we were hanging out.

Howard: Was that this year in Phoenix?

Paul: Yeah just last year yeah just as last year.

Howard: I wanted to go to that so bad but I lectured the Friday and the Saturday but anyway so you met Justin at voices of dentistry?

Paul: Yeah and then we just we were talking about what we were planning on doing like what our goals were for the year and I wanted to put together an online curriculum he did as well and I'm someone that has one large successful practice he has six he's had more he's he's sold a few of them but he has six that he's running from living in Florida and there he's the practices are all in Canada so it's two very different perspectives but it's very amazing when we came together with everything in outlined and collaborated a lot of there's different perspective but there's a lot of similarity and what him and I do and it's just it was a great collaboration it was so much more fun doing it with someone too so he's a great business partner and a great dentist great leader and I think he really added a lot of great material to my material I think it's just a good collaboration.

Howard: You know that's what I feel I I've said this for 32 years that I see solo practicing down I see a four operatory one dentist one hygienist one receptionist one assistant I just don't see the excitement group practice is so much more fun I mean I hired my first associate long before I need one I mean I opened up my office and met this young kid equally young and silly as I should have gotten an older I should have gotten like a 65 year old Grandpa to come give us some knowledge but I just wanted to play so I found someone equally my own it I think group practice is so much more fun I bet you have so much more fun doing dental business mentor with Justin Bhullar instead of doing it all by yourself but when I look at these dentists night I see what you've accomplished I've seen what Justin's accomplished just like and and then and then you hear these kids say that they they missed a golden year said no Howard's lucky he's old he he was born in the 60s he was in the Golden Age and I am in there and they always whined about their student loan debt and I always tell them that there they averaged two hundred eighty four thousand dollars a student on some like look your first divorce will cost well over a million so you know it's not gonna be it's never gonna come down to student loans so now let's so let's go back to dental practice heroes who's listening to you right now who would best be served to go to dentalpracticeheroes.com?

Paul: Any dentist dental owners we have a lot of dental students that listen that reach out to me and that just reach out for advice and stuff like that but the majority of its dental practice owners and it's cool is when I go to Voices of dentistry I get to meet everybody and all these people that have written into me are just people that listen to the show and I've never reached out and it seems it's like a different breed of people I mean it's just all you just like your podcast how are the people that listen to podcasts are way more focused on growing their business they're way more excited about dental business and just dentistry in general and I think those type of people tend to have better results which is why I really like the voices of dentistry because it's a great group of people and from it's almost like a networking event I'll have some...

Howard: That's Voices of Dentistry?

Paul: Yeah

Howard: That's Alan Meads is that Alan Meads?

Paul: Yeah Alan Alan Jason and Mark Costas yeah

Howard: Oh Mark Costas

Paul: Moody's part of it too as well yeah.

Howard: Oh yeah yeah it's amazing and I love that group there's no fear and scarcity I mean anybody does a podcast come down I always think about my boy so me my four boys on have a daily text going on 20 30 times a day and I always think how me and my dad didn't get to have that technology and I think it's so just cool that this smart this crazy smartphone that when I got out of school there was no computer and this go in fact they're gonna tell you the funniest thing when I left dental school in 87 me and my roommate high-five each other because they we were giggling because they were installing computers for the next year's class and we thought oh we're so lucky we got out before computers and no one had a cell phone in fact the biggest new technology of the time was a remote control TV changer and automatic garage door opener and I thought those were the two coolest things in the world but I just think it's so cool how you in Illinois and Justin in Florida with offices in Canada talking to me I mean the whole world is reduced to a little two and a half by five inch screen and you never think in fear and scarcity I don't know anyone who's ever I've never talked to anyone who's ever listened to my podcast sat in the conversation didn't talk about five other podcasts and that the thing that now if you want to do the work it's all there in your iPhone all you got to do is listen to that instead of what they are doing three hours I've read the stats I mean that the stats are crazy and video games the people do video games three hours a day you're not gonna believe this for the people who do pornhub it's three hours a day I mean if you got three hours for a fortnight pornhub Facebook then you got an hour for someone's podcast and what I don't understand is if you're totally getting beat up by molar endo or your staff or your employees and then in the same sentence you tell me that your goal is to read all the Lord of the series or you know or that you never missed Joe Rogan's podcast is like okay so you listen to Joe Rogan but you're you're crying to me like a whiny little kid about your hygienist but you're listening to Joe Rogan and they're talking about you know whatever the heck I mean I just think I mean I'm looking at your podcast right now there's not one podcast that you have double your practice in just one year, if you are right then you are wrong, unleashing your power and business through reflection, I mean one reason your team does not unhold the policy, bigger cases and confidence, the easy fixable thing is holding you back, big growth in just 21 days, Melissa Holmes she is so amazing I actually lectured in Jamaica she is just I got your lecture in Jamaica but anyway I mean so talk about your podcast journey what were you thinking in writing what when you wrote a book was that just for old guys like me with diabetes erectile dysfunction and then you do the podcast for all the Millennials I mean how does that work in a podcast?

Paul: Yeah so the book was just a personal goal was something I wanted to share with you what I knew and what my practice success wasn't share it with the world and then the podcast which is kind of another hobby too it wasn't a thing like where I was looking for coaching clients or I was looking to sell more books I wasn't selling anything when I started now now I just recently started doing some coaching now we're doing dental business mentor so now we're actually selling things but this wasn't my end goal when I started the podcast I just wanted to interview some people and have a hobby you know and in develop with what you're saying to Howard is that I've noticed that I ask every podcast guys I had asked him the same six questions and one of them is what are you reading right now and another one is like recommend a book that all dentists should read and I haven't had on a single guest that doesn't read books and I would say I mean they're they're constantly looking for that wisdom looking for new knowledge and this is what breeds success so when you talk about the dentist that have complaining about this and that and all these extrainsant things the insurance and in my competition down the street and all this jazz hey you pick up a book and try to make yourself better because everyone that's every successful dentist I know is doing it they're all doing that they're all taking a bunch of classes they're learning from other people they're getting on the phone and calling people there are they're on forums asking questions learning and we don't have to reinvent the wheel I mean it all this knowledge is out there if someone has just to take it and I agree with you I that really frustrates me when I hear that sort of talk.

Howard: I think that III think I know where your consulting business is going did you say you were 42?

Paul: No I'm 38

Howard: You're 38 so I always have to ask how old were you in 1980?

Paul: I was in utero.

Howard: You were not born yet?

Paul: I was not

Howard: You were not born okay so here can I tell you where your where your consulting business is going?

Paul: Okay

Howard: Okay this words going so mmm I was born in 62 in 1980 I've lived through for economic deleveraging the worst by far was 1980 21 % interest rates double-digit unemployment though there's nothing I'd ever seen anything that bad ever even close so then it expanded to 87 I graduated May 11 opened up my office a hundred and thirty three days later just 28 days before Black Monday the largest one-day drop in the market that was 87 so you remember you were six or seven that then is the longest expansion 87 to march of 2000 when the y2k bubble popped and what the y2k bubble meant is that everybody did all that stuff to get ready for Y2K who came when y2k came they were all done so the cells plummeted the market plummeted and then the next one was Lehman's day about 10 days ago so I've gone through ten economic deleveraging and right now if anybody predicts the future they're batshit crazy and they're a palm reader and there's no such thing as the future or the past you only can live in the present but yeah it smells like teen spirit we're going to go through another economic deleveraging the smartest investor in the world Warren Buffett is sitting on 137 billion dollars in cash because he can't find any value but here's what's gonna happen the average DSO is about 30 locations they got about 10 great offices because they had just bought those the owner doctor is still there on his contract for three years they got about ten other offices that are kind of iffy where the owners are leaving the new replacements aren't are they're good they're okay and then they got ten dogs and then when they go to sell this stuff they you know that their debt is rated and all the DSO debt is rated junk there's no B+ dental debt in the DSO and then out by you well out closer you than me in a Charlotte East West Bank red line dentistry and said we got so many problems in our DSO portfolio no more loans to dentistry so during the next economic deleveraging all those DSO is out there they're gonna have to deleverage unload clean up their balance sheet about one third of their offices and the only way that office is gonna be fixed is to go from some employee dentists with no skin in the game who doesn't even care to get someone in there with skin in the game that got the mortgage I mean when you show me a dentist like you married to a woman with two little kids at home when you come home you just see two little bird bakes wanting a worm and here's daddy bringing home the food and when you go from a single kid on tinder who doesn't even care about the practice and listen to the podcast now it's an owner/operator with two or three little birdies I always tell them you only want Mormons only hire Mormons because you have two kids you're probably what Irish Catholic.

Paul: Yeah

Howard: You need LDS Mormon because they got twice as many birds to feed as you do and they're though you-you-you finance a Mormon boy to a dental office he'll work 7 a.m. to 7 p.m. 8 days a week until he's a hundred and forty to feed them kids so so all you want is skin in the game no one knows when the next economic deleveraging is but I think it's way sooner than later and then these DSOs are gonna be called up if I was if I was a dental supply rep I would get into the dental transition business because the dental transition business you're gonna have all these DSOs trying to get rid of about a third of their portfolio and it will end up and then who are they going to sell that portfolio just to some young crazy boy single who's only thinking about tinder but now he got married and he wants to get rid of his associate job and he wants to have skin in the game and then when he buys that thing then he's gonna be calling you up begging you saying Paul I just bought a dental office oh I'm want to play that scenario I Paul um I just I went from a great single life chasing girls on tinder and I married my friend and she's pregnant and I just bought a dental office for 750,000 and I have $250,000 of student loans I'm 1 million dollars in debt I'm scared out of my mind talk to me what would you tell me to do?

Paul: Well you say you anytime Sony buys a practice what I want them to first do is just look at what the mark ability of the practice is so let's look at what what what is the product that you're putting out there what does the brand look like so that's going to go down to the decorations the finish is the way that you answer the phone it's all experience for me but it's gonna be your website it's gonna be your online reputation so I would say the lowest hanging fruit where you would start with any office is just make your place look nice and marketable do things that are market all such as late hours and then really work on your online reputation in your website because those are going to be the things that people are gonna see before they call your office now once you get that in line then it's time for phone skills that's the next part so and then other what following that it's just there's all sorts of different ways you can go it but it's just training your team and how to provide the best patient experience and also be the more persuasive is I did not persuasive like we're tricking people but ethical persuasion where we're just we're making it very easy for patients to say yes so that would be it in a nutshell.

Howard: Okay so I know my homies I known him for 33 years you know whatever dentists just said in the late hours Paul I'm with you 100% but my hygienist she'll never do it my assistant down there so so late hours my staff will never do that Paul what do you tell them?

Paul: Yeah it's a tough thing to change when you've never done it no when we did our start up we did it right off the get-go so I have never had to personally transition people into doing that that has always been my culture since we started I know some people that have done this where they've taken this on is that they've had to hire some new people to do these night hours but they also offered like a $2 an hour kind of like almost like bonus on top for the hours that they worked and that would help people to do it as well if you have to pay people more to work nights I think you're gonna get that money back because anyone who I know who is open night I mean we have somebody that cancels an appointment at 6 o'clock 7 o'clock we'll have that filled within 10 minutes I mean there's just a line around the block around the building waiting for people to get in at those times.

Howard: Wow when you talk about online reputation and website that I don't have that much time to go with I mean I could talk to you for four days and 40 nights but here's my problem because this is in my world I want to be selfish and talk about my world when I call any of my dental buddies to go eat sushi or watch the game like tomorrow by the way Kyle who's gonna beat, who's the Cardinals play tomorrow night oh he's on he's focused on the World Series game but anyway even the World Series game if I call one of my friends a day and I and the receptionist that's how they're gonna answer the phone when I call it an office can you please hold that's all I get with my own friends.

Paul: Right

Howard: and then when I look at when I talk to people who own DSOs where they have really good data on hundreds of dental offices they say one-third of all dental office incoming calls go straight to voicemail yeah so talk about that what are your thoughts on that?

Paul: Well I mean I think one-for-one you're setting the tone of the entire patient experience when you when you when you're on the phone now that that's gonna be the first time a patient will have an interpersonal contact with your office every previous impression everything that other perception of your brand in your practice has always has been formed by what they heard about you from other people or what the reviews that they read but now if they call your office and it's not in line and consistent with what they've already heard I think you just lost a huge opportunity as far as case acceptance and you've already started this process of making the patient experience worse so as much as I'd say let's call my office right now on the air and let's see how awesome they answer the phone I hope to god they will but I tell you every time I go through and listen to phone calls there is never a phone call that's perfect you can always improve on them but the thing is is if you haven't listened to phone calls in your practice and maybe a year or you never have you will be blown away with what is being said on your phone line and there is a like you said people are not even answering the phone or they're doing it rudely like one thing in my office you said putting on hold when we put people on hold we always ask permission and then we wait until they say yes and then we put them on hold and that's just a little thing but like I said you got to create the rules to win at the game and if you're not clear on how you want the phone answered you can't expect the people at the front to do it that way so that is the lowest hanging fruit in every dental office is phone training.

Howard: That is so well said by the way the reason I'm not playing the World Series and I'm a dentist is because in 1987 my baseball card came out there was no picture on it I just I just went into dentistry. Phones are I always do because they I love my dentist I really do and I love the fact that they come to Scottsdale and go to hear Frank sphere and cause and Seattle and Ross Nash and Charlotte and the paint you they love to learn the nitty gritty but then when I go up to my say okay the funnel how many people have to land on your website before they convert and call you how many how many incoming calls did you get last month I don't know have those incoming calls how many did your research just convert to a patient I don't know for every three people that come in with one cavity how many of them convert to get it filled and this is what I believe in my heart of doing a talking to all the DSO guys and everybody that really has good data they this is what we believe they notice she has that for every 100 people that land on your website three convert to Col for every three that call you your receptionists converts one to come in and then you need three people to come in with a cavity before you'll fill one so there yeah they're doing seven hundred and fifty thousand dollars take make taken home a hundred and seventy five by basically getting an F on every single test offered at the school and they make and they make I mean it's like dude you could fix anything on that funnel and be better what we...

Paul: Like about answering the phones I mean answering the phones is a huge one I mean it's just answering the damn thing and so you having phones all over your office so anyone will pick it up I Picked up a phone before I done it once it was strange but I now I'll pick up the phone I'll run down the hallway and hand it to somebody else but answering the phone getting your team to understand that you know I'll share another example we just your point we just realized that our looking at data that are late cancellation no-shows we're almost 14% this is last May so then we really dug deep on what is our policy what are we doing when people try to cancel what are we saying to people when they're making these appointments and we got really clear on what we wanted to do and we change that and we got it down to eight and a half percent within three months now eight and a half percent with a prep with going from 14 to 8.5% failures was almost 70 something patients a month from my office if you establish that that's 250 or $200 per patient I mean this is two hundred and ten thousand dollars for the revenue at the end of the year just by changing one little policy so just like that if you just go ahead and dig a little bit deeper and train your team on the phones what big ripple effect this will happen it have all the way across your and your numbers.

Howard: That is amazing that is just so amazing oh my god I could talk to you for 40 days and 40 nights what what did I am what did I not what was I not smart enough to talk about or bring up that you're thinking I was going to talk about?

Paul: I can't really think anything I mean you just kind of want to go around just shoot the shit about practice ownership I guess I can't think anything else but yeah I mean my main person and I hope the listeners got this to Howard is that we need to create rules to the game we need to discuss with our team we need to communicate how we can become better because it's if you want to see a different practice you have to start from the top your team is not going to do that on their own you need to be the leader that's doing that and everybody's got fantastic ideas on your team if you would just let them say them let them vocalize them and you don't make them feel like crap or make them feel stupid when they might say something that's just not the smartest but you want that collaboration.

Howard: and I want to thank you I mean you've posted on dentaltown 581 times you're one of the top 100 most followed people on dentaltown every time you post your it's very it's been very very fun watching your journey and when I read when I study social media it turns out all this is this doesn't matter if it's a dental website doesn't matter what a Facebook Twitter Linkedin Instagram 1% posts all the original content 9% engage and say lol or agree or disagree or thumbs up 90% do nothing so go to your open up your Facebook you says you have 500 friends just start Scrolls start with a starts going down 9 out of 10 of your friends have never posted this year and in dentistry there extra shy there my gosh they're they're introverts are shy my last question to you is why we're where does this transparency why are you able to fly above the rain our be transparent write books do podcasts post 581 times on dentaltown we're 9 out of 10 people just they just they don't want to climb up the tree because it's someone's see's them it just just scares them they'll email me and text me x-rays and dental questions all the time and I say dude why are you asking one guy posted on dental town and everybody can share like oh no I can't I mean even my some of my best alcoholic drinking friends and Phoenix I mean I mean I'm your friend if you're an alcoholic and have to watch all the Cardinals games and but the bottom line is why are they 90% could never even think about doing everything you do?

Paul: yeah I think it's just you know I keep saying ego but man I'm gonna admit and just be transparent and say it was a struggle for me to put myself out there because when you put yourself out there you get criticized and I think for me it was just a general confidence saying you know what I'm gonna put what I have out there I'm gonna put my opinions out there and just being okay that I might not be right all the time but this is what I think and I think I have the statistics and I have the I can display what I've done and I have the I can back it up that I've actually done these things I'm not just pontificating on on Dogma and theories that I've heard from other people I've actually put this to practice and I'm just sharing what my experience is that you know there's a million ways you can run a practice this is what I have found that has worked very well and that has worked very well for people that I've coached or have helped so and if you take it or leave it if you don't like it that's cool I'm still gonna sleep at night and I'm still gonna work two days a week and you can just hammer away and just get pissed off at DSOs and insurance companies I don't care.

Howard: Yeah I remember how old are your two girls?

Paul: Almost nine but she's almost nine and four.

Howard: So the nine year olds probably starting to experience just a little bit of the first social stress things and I had four boys they never had a sister and they'd come home from school in the first grade and second grade and they almost couldn't go back to school because little Sally Sue was saying something and so I remember coaching them one liners and I say okay when she comes tomorrow and tells you you're stupid or whatever say well then if that's true then how come every night you dream about marrying me and then Erica come out with a school say dad she ran clear across the playground screaming and I mean so the whole thing was coaching them like what would you say when that girl who you know is about two years ahead...

Paul: That's my nine year old right now and I'm giving my nine year old this is what you should say this is because she's on cheerleading and I feel like nine third grade is that age where people start getting clicky and mean and you have the time when I'm what I'm telling her to say my wife's yelling from the other room I don't say that I'm doing what I know.

Howard: Well and here's our I coached my older four boys and when they have that deal I say look okay um we know that homo sapien is a half million year old species and we know about a hundred and ten billion of them have lived and died so a hundred and ten billion of the humans that got you here if they wouldn't have done their job if they wouldn't have lived through those caves and those ice dens if they wouldn't have lived through hell for a half million years you wouldn't be here and they're all dead in the 8 billion people alive today you're never gonna meet seven point nine billion of them so everybody in the world is either dead or you're never gonna meet so why the hell do you care what Sally sue says I mean I don't care. I mean ninety-five basically the fact...

Paul: That's a great way to put it.

Howard: Ninety-three percent of all your critics are dead and seven point nine billion of them are never even going to know your name so to sit there and care what one little person says is crazy but here's what I want you to do I'm go to amazon.com go to dental practice hero from ordinary practice to extraordinary experience or you can get it from his website dental practice heroes Dr. Paul Etchison thank you for being my dental practice hero and coming on this today.

Paul: Thank you so much for having me Howard, I had a lot of fun.

Howard: Alright buddy take care