Dentistry Uncensored with Howard Farran

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It is just a huge honor today to be sitting in Phoenix, Arizona, with Alex Zlatan, who flew in all the way from Winnipeg, which is located in Manitoba, Canada, right above North Dakota's capital, Fargo, if you're trying to get your geography right. As the CEO of dental practice management software company Maxim Software Systems, Alex Zlatan helps struggling dental professionals take control of their practices and reach the next level of success with responsible leadership strategies. Leveraging over 11 years of management consulting experience, he empowers organizations to become more productive and profitable based on the belief that successful businesses establish a genuine connection with employees, stakeholders, customers, and vendors. His passion for strategic management and business leadership began with earning a bachelor in science and technology management at HIT in Israel.

Now, is that in Jerusalem or Tel Aviv? That's actually just shy of Tel Aviv; it's in Cologne. And I was just I was there all last week, and I filmed 10 podcasts on location. If you're wondering why I'm wearing the same clothes on all the podcasts, is because I never got my luggage. It's first time I've ever gone to a foreign country for a week, and in fact, I still didn't have my luggage. I've been back home three days like they still know where my suitcase is, but anyway. So Alex immigrated with his wife to Canada where he first joined Maxim Software Systems as a director of operations. After working with the company for several years in different capacities, he rose to his current position of CEO. Do you own the company now?

No, but there's one owner that also works as a CTO. Okay, Alex volunteers his time and expertise to various professional organizations such as serving on the advisory board of AMBAC Association of MBAs in Canada as a business mentor to young entrepreneurs in Canada. I love that Futurepreneur Canada and by launching his own organization Dental Office Managers Association of Canada. So my first question is, you have a long journey, how did it end up in dentistry? You know, actually, it's by mistake like all the good things that happened. I came to Canada, I was looking for work. I was applying to many, many places and one of the places was operations manager in Maxim Software Systems. I was applying to many, many places and one of the businesses was replacing my E-money account with Allied ITS software and what happened was that originally I had background in manufacturing, security, logistics, and sales and I said operations sounds like it would be encompassing of everything.

So I applied there, they hired me, and that's how it started. So why did you leave Israel? I just left; I didn't wanna leave after five days. How long did you live there? You know, well, I lived there the majority of my grown life. From age five to Five until uh about 29, so did you meet your wife there? Yes, we got married there. Kids in Canada, but the reason I left... Don't need to meet your in-laws, you've already answered the question. You found the love of your life, you met her parents and moved to Canada. I'm just... yeah, but uh, but so... But what was the impetus behind? I think the reality is

uh, I uh, I didn't have kids yet uh when I got married, but um, I had friends with kids uh, and they were age 5 to 12 uh, and when they had the escalation situations uh down in the south of Israel um, just those kids went to uh wetting their beds and just had the trauma, and I said, 'You know what? I'm not gonna take my kids through this.' And I said like, I all my friends, all my family, they're all still there, but i have to... I have to give my kids better. Well, kudos to you because when you look at um, when you look at complex problems and you don't understand them it's Because you're up in the leaves, talking to leaves, and if you can't understand something at the leaf level, you need to get underneath it and go down to branches, twigs, trunks, and roots.

And at the impetus of all those geopolitical problems is just that when people start making decisions based on what's best for their children, and not based on revenge towards someone they hate, when the love of your child trumps the hatred of your enemies, we're all going to be fine. And it's just crazy that people still make decisions that are not good for their babies out of spite for someone they they currently hate, so kudos to. you that life can be challenging and um so so my gosh i don't even know where to start let's just start let's just start with your book um alex zelanton responsible dental ownership balancing ethics and business through purpose

so um i am um and thank you for signing this dear howard i hope you enjoyed the read keep up the good work stay great um so i you have two kids um i've written a few books i always said writing a book takes longer than having a kid takes nine months to make a child so was this did this take longer than nine months to write uh just just a little longer yes about probably about a year in the making um you know Through working full-time, you just take on, uh, evenings, uh, sit in a bar, sit at a bar, are you Irish? No, no, but I guess all of the good ideas come when you um have a couple of drinks.

Your brain um kind of soothes a little bit, uh, forgets all the daily grind, and, and you just start thinking about what are the concepts that are important to, to pass to the readers. Benjamin Franklin said that beer was proof that God loved us; yes, I love his quotes by the way, they're awesome. So, so yeah, and you know I wrote the the book um probably about uh, you know, a few years ago, and I wrote it because uh while working uh with Maxim Software Systems. with our maxident software i realized through conversations with the dentists the office managers the receptionists that there's a lot of confusion miscommunication uh lack of leadership um uh

that that creates a lot of stress and that stress leads to um just just a bad work environment and things that are being missed everyone's upset with another um and and to me because i come from a business background it was uh very interesting because i could identify key areas where you know if you get it right everything else just falls into place and and you know i decided to to write a book and just share it with with the dental World, um, have you seen that thread on Dental Town? One of the biggest, um, busiest threads with most replies is 'I gotta find it here', so it's been on today's active topics for weeks. Um, something to the point effect of uh, I hate dentistry with every fiber of my body.

Um, have you seen that thread? I believe I did not is that because of all the business and and and ownership things, uh, they all have a um, you know, when I'm um, when I'm looking at that thread, I think a lot of it, you know, satisfaction equals perception minus expectations and I think that um, um, so a lot of people have um, incorrect expectations. I mean just because like when I was little and my next door neighbor was a dentist um dentistry was very different when i was 10 in 1972 in kansas without a dental school um then it was a lot of different things um and i think it's a lot of

different things um and i think it's a lot of different things um and i think it is in uh 2020 i mean uh things are changing and um you know i mean there used to be a gold rush in the 49ers well that went away there used to be an oil rush in titsu pennsylvania where they discovered it i mean so there's boom and bust cycles and i think a lot of the older millennials long for yesterday and you know if albert einstein taught us anything there Is no past and there is no future, because we only live in the present, and just because something was a certain way a couple of generations ago has no bearing I mean on the present day reality. So, I think some of its expectations are...

then a lot of it is, um, the grass is greener on the other side, so they're got the world's smallest violin while they're making you know nearly two hundred thousand dollars a year with three-day weekends telling about how bad it is, but my gosh, how many Americans, um, I i hate it when the press talks about the median income because these rich cities, these rich billionaires, they, they skew what I think. Is about thirty-one thousand dollars a year for the um, not the mean but the um, the um, the mode uh, the nominal mode you know, the middle, and it's about thirty-one thousand dollars a year. And you factor in Bill Gates' money, you know, they tell everybody it's almost fifty thousand dollars a year, but man, when you're walking away from dentistry where the average one makes $187, and then you realize your average patient is making thirty-one thousand dollars a year, and of course that's not including all Americans under 15; it's just fifteen and a half dollars a year.

And it's not including all Americans under 15; it's just fifteen and a half dollars. A year and over that has a job, and I don't like GDP divided by a person because, what if you have a what if you're an export country like Germany and you know you're exporting all this revenue but you're factoring that into the German people's income, and that that doesn't make any sense to me. But um, I just think it's um I just think it's unrealistic expectations, a lot of it. I i have a a quote similar to what you said, I said um zero expectations equals zero disappointments, similar to what you said. I think um, you know it's all about purpose. What is the reason that you are going to dental school?

Is it because you want to earn A lot of money, or is it because you want the the you know the the uh combination of the uh art that is needed in dentistry and the science behind it uh is something that is intriguing. You do you want to help people, and and you find you know this area fascinating if those are the reasons, that's why you need to pursue dentistry, not the other way around because um of of the big money that is portrayed um you know in dentistry in dentistry especially when when you get out of school with extreme debt and not a lot of tools on on on how to deal with that debt um you know uh rise of dental uh corporations DSOs is is not helping anything heartland.

Just reached over a thousand clinics, I read um, you know, and, and, I read a few that you know, there's Medicare and Medicaid, and state coming after them, taking them to court, settling outside of court, uh, which basically means those corporations did something atrocious to patients; they paid, I guess, they returned um, the money to uh, to the state and federal, but there's no compensation for patients because it was settled out of court, um, those are very, very bad stories. I'm assuming not all DSOs are like that, um, just the ones that are running it through short-term business strategies, long-term they wouldn't do it, but you know. Hating dentistry, I hear this from a lot of dentists that own a clinic.

Their first clinic, probably after about buying it at and until up about three to four years if they don't sell it back. Um, just because a lot of times you buy a clinic and you start uncovering all of the things that no one told you when you were a kid. And you start uncovering all of the things that no one told you when you were evaluating it. Um, you start dealing with things like human resource people, which is very very different than teeth. Um, you know you have to incorporate marketing almost from the get-go. Um, you have to understand how you know customer service. Works and patients and Google reviews, there's probably three or five very active threads about Google reviews on Dental Town right now, um you know they're they're thinking how to deal with uh patients who uh disgruntledly leave a one-star review, multiple ones, you know taking them to a lawyer, contacting them all of that.

When when you talk from a business standpoint, you just have to reply to them in a way that potential patients would look at it and say, you know it's okay to have a one-star review, in fact if you only have five-star reviews I would be really suspicious, but uh how you respond to it is just you candidly respond. very genuinely in terms of what that is you present the facts and you say if you would like us to make it better please contact our office right away and we'll help you and you forget about it you know taking people to taking a patient to a lawyer is just just going to cost them a lot of money and a lot of headache

you know um united states only four and a half percent of the world's population of a billion people and lecturing in 50 countries is going to cost them a lot of money and a lot of money between those countries is going to cost a lot of money in the future and those countries dso's are multiple countries in last three decades you start piecing together a big macroeconomic puzzle and when you said dso is the first thing i thought it was you're born in yurbeka stan yes so that's was the old soviet union yeah it's it's a part of the federer no no it's separate but there when i was in israel week there was i mean i met russians everywhere and and i even asked one russian i said are you the most dominant

But when you, the old Soviet Union, dentistry was stomatology and it was a part of medicine. And when you said DSOs, there's only three DSOs in Israel and I got to study all of them and all of them are part of a hospital. It's all in the medical world. And it's amazing how the individual dentists in Israel were like Americans, you know, they were a solo practicing guy, but the DSO framework, it was part of a hospital. And all their students and residents, you know, we're going from department to department, and I just think the Soviets, I know you're not supposed to say that, it's politically incorrect to say that someone you disagree with did anything right, they just have a better system.

And what I also like about it, we start off with this thread about, you really need to read this thread, it says, I hate dentistry with every fiber of my being, what are my options? And it's 488 replies from dentists trying to help. And what I love about my homies from Poland and Ukraine and the stands is that since they're an MD stomatologist, say you lost an eye and you couldn't do surgery, well, they'll just go back and do a residency in dermatology and bada boom, bada, you know, they're off and running. But in America, you'd have to go all the way back to med school. And these design structural inefficiencies, I don't see how they work for anyone, they're just stupid.

But it's been going on that way since they started the first dental school and the world was in Ohio and then the first dental university was in Baltimore, I think about 1858 or something and it's 160 years on the wrong track, on a good track, but it could be a better track. So in explaining this story, I want to, you said Maxim software system, so I want to get that away. So on LinkedIn, it says launched in 1980. Maxim software systems has been providing dental management solutions for over 30 years, headquartered in Winnipeg, Canada, our software is used by thousands of dentists on three continents. You should have said four, you should just throw in Antarctica, there's 4,000 people there and I podcasted the dentist there.

So you should just send it to him, just say, just download it so you can update to four continents. Our flagship brand, Maxident, is a dental practice management program that enables dentists and their staff to properly run and manage dental care. Our software solutions also help dentists become more efficient through digital tools such as charting, imaging, patient communication. Our company is a recognized leader in delivering state-of-the-art dental practice management software. Our innovative, easy-to-use software suite, Maxident, integrates cutting-edge technologies like voice input, touchscreen, tablet design, electronic signature, digital imaging to help dental offices improve. So what's the hottest? So, you're in three continents - what are those continents? So, Europe: we work with the UK. And then, we have a couple of dentists in Kenya, so Africa. Yeah, and it's interesting there.

There's a dentist who owns a dental clinic and an auto body shop together. So, when we did the data conversion, we got the data together with the auto parts. So, it was an interesting thing, but that's also, you know, like you said: you travel, you lecture, and you piece things together. together it's very interesting when you work with with dentists in other countries you know how they operate and and what is the uniqueness in in their countries in terms of what how they practice and and and how their patients behave and demographics and everything so it's been it's been nice so there's about 21 000 dentists in canada who are the top three practice management software leaders it would probably start with dentrics of henry shine just by by sheer size um and then uh there's uh probably abledent out of toronto um and then there's some smaller ones that compete on uh place number three so it's us it's uh clear dent it's uh logitech uh and there's probably Another

20 or so, that are more regional and and quite smaller, so what is your unique selling proposition um in America um I would say the same thing uh and um shine uh has Denturex, that's like kind of if you get your product into Walmart they just put it on their shelves you're gonna sell a lot of they got 4,000 locations uh Patterson, big they got Eaglesoft but it seems like um those two guys have to advertise a lot but the only guy in America who's not advertising and growing rapidly is Open Dental um so um what is your unique selling proposition and how is that compared to why you think Open Dental's taking the lead or on the path.

To take the lead, you know, well before I dive into into what we uh deliver, I think Open Dental has basically two really big advantages so one it's free to download and the second thing would be that you know the the the concept of it is you know by dentists for dentists and I think that resonates with uh Open Dental as other dents yeah, and well there's many other problems with our dents with a lot of the dental industry so um also I guess on one side note I'm assuming dentists are kind of tired from the big companies a little bit yeah, that's what I you know I was trying to get the uh the head of the the CEO of Burkhart on the show because She's fourth generation, she's a woman, and when now dental schools are half women, it's like uh what an interesting story because uh um.

When you get an oligopoly of two or three major players that consume 80 percent of the market, they build up so many negative reviews over time that your best strategy is I'm just not them. Guess what? I'm not them. I mean, like if I was trying to get more accounts for supplies, I mean I just raise my hand say 'Hey, I'm a CEO, I'm a woman, and I'm not Shiner Patterson.' And it's like, God, that'd have to be the big best marketing advantage growth strategy... but you said Open Dental, the advantage. Is it's free to download, and um, what's that when you said 'free to download'? Well, that is by dentist Jordan Sparks started it because of his frustration with Dentrics, and now his brother Nathan runs it.

Um, but um is a large part of it the fact that it's open I think, open software that you can hire a programmer and just start adding to, because in these 50 countries that I've been to, a lot of countries I've been into, especially um, more economically challenged countries; they just downloaded one copy of Open Dental, never gave him a dime. Translated it all from English to French or or and um. They've been running with it for 10 years and I asked Nathan about that, does that bother him when he was on the podcast? He's like, 'No, that's the culture.' And he makes a lot of money on some of them because some of them, 10 years later, have 300 users but want the new upgraded version.

You're like, 'Okay, well for 10 years you've had all these and uh', so they negotiate a check and it's a big payday. But um, so is the the fact that it's open software as opposed to a really closed system like Apple, you know? Um, I didn't mention that component just because it's a double-edged sword. Having a software that's open source is is good for customization. And the freedom, but it's not the greatest for security, so when, when, when we are in a world today of ransomware um and and all other malicious um uh software, we want something that is extremely secure. When you have open source, it's not only then you know the the normal users can download a copy; also people who want to um get in it uh are able to download it.

So uh like I said, it's a double-edged sword there's there's benefits, pros and cons, um to anything, and that would be you know my take on it. I take very seriously, especially nowadays. In Canada, we have um quite a few... you know, you have HIPAA in the U.S., but in Canada You have the federal equivalent of Pipita, then you have uh Pipa, then you have Fipa, and then Alberta also has its own privacy commissioner with their own Health Information Act. So uh, there's a lot of emphasis on privacy and patient records uh, and electronic record keeping in Canada. And um, I just think that you need a centralized place to make sure that all of the changes that are done um, are secure enough uh for what the standards are and the expectations.

You know when I started this uh internet revolution it was all desktop PCs it was Microsoft and Intel and Cisco and Dell um, now it's all smartphone and um, a lot of people Don't like the 'um' when they're posting links to other dentists and social media where they have an amp link for the accelerated mobile pages, which makes almost instant loading on the mobile, but a lot of people say that that's a not good for what you just talked about cyber security and bullying and all that stuff. Do you or do you have an opinion on AMP? Um, not really. I think in today's world, you have to be cautious about anything that you

do, uh, when we talk about you know managing networks in your office um, you know, when we talk about using a cloud, that's great, you outsource a lot of your security to the cloud but then you Lose all of the control over how the security is being implemented to those companies and you just trust them to do what is in the agreement. But, in the case that for instance they, they get hacked, what does their agreement say and how is it going to affect you? You know, we've seen the Colorado and Wisconsin ransomware attacks, and these dentists would probably have done their best at security and their network, but they just got hit by ransomware. And you said, 'anyone' said, uh, trust so in uh 20-20 investment guides on Motley Fool, and everything, cyber security is going to be the number one sector again um and I think that in my um lifetime, um, trust.

Has been underneath the most pressure I've seen in institutions from church, government, every sector of uh trust is just going down and down and down. And I hope, I can't wait till that pendulum stops and starts swinging back the other way. Um, but um, so, so how many um users do you have for maximum um in Canada, that's your mainstay, I mean it's mostly a Canadian business, yeah, mostly uh, Canadian. We have uh, 1300 installations, 1300 nationwide, so that that makes you the pilot with a lot of information, I mean you're listening to this on your commute to work or on the treadmill and uh, you just get to see your office, your data, you know, your Personal framework, really well, um, but I loved it in your intro, uh, on your website, and said something really profound, I hope it doesn't, uh, slip over anyone's head, um, where is it, um, says, um, that a successful business has a genuine connection with your employees, your

stakeholders, customers, and vendors, and dentists, you know they, they, you know they, they don't want to run 10 minutes late on, on their next patient, and see the everybody on time, but you've got some lady out there from Dentrix that's been waiting to see you for half an hour, and you treat her like she's some third-world person, and she gets to see 50 people in your tribe. in your community they have so much information and here you're sitting on 1300 data sets so sitting on 1300 data sets for how long you been with them uh uh seven years now seven years so so 1300 dentist data sets for seven years and then i imagine that was all the knowledge that went into your book responsible dental ownership which i love the title because the most obvious thing that we all see and talk about is that um when a dentist owns their own office they have skin in the game and it's a totally different animal than the employee number one

the average owner general dentist in america nets a hundred thousand more than A employee, just like a specialist, nets a hundred thousand more than a general dentist, and that's explained because in 1900 healthcare was one percent of GDP; there were no specialties by 2000 it was 14 percent of GDP and then M.D.s had 58 specialties and dentistry now has 10. So it's all moving towards specialization. Then when AI starts ramping up in the insurance still, they're like 'Hey, we're sold! We only sell dental insurance, not because it's under the Constitution or Truth, Liberty, and Justice, it's only sold to businesses that dangle it to their employees to keep them from staying on to reduce staff turnover. To get you to work for them and not somewhere else, so they're representing the owner of this business's employees, which he values.

AI's going to come back and say, 'You know when one of your employees gets a root canal.' We notice 20 of the dentists in Canada, 20 percent have to be extracted, and then we have another set of five percent where only five percent get extracted at 60 months. So, we're going to build into our plan that when it comes to root canal, we're not going to give you six seven hundred dollars of currency towards this transaction. And when it has four times the failure rate if you would have went to another Canadian [dentist]. In the same province, so um things are going to be changing rapidly and I know that one isn't going to go over well with my homies; they're going to absolutely oh my god, I cannot wait to pop some popcorn and pop a beer and read these threads when that starts happening, um.

But so what is um, so do you, so what do you say um? A quarter of our viewers are still in dental school um, and and they're getting free pizza once a week by some DSO saying 'Howard, he's a dinosaur' and all when he was little; all the pharmacists own their own business now, and they all work for uh Walgreens, and uh. You're gonna work for us sooner or later, might as well join us today and then we see that they come out and they just job hop five years so they're so flipping miserable they don't even want to live so now they're not afraid of opening up their own bankruptcy because opening up own dental offices going bankrupt is actually less stressful than than dying and um so what what would you say to these kids who think they're going to live happily ever after as an employee that they went to school eight years to get a job i think um

i think there's there's a lot to to say to them um and i think it goes back to the beginning of our conversation and what is what was the reason that they went To dental school, if the reason was 'uh' for money then they should probably go and work for a DSO because, you know, finding they'll probably job hop and find the DSO that well it has to be multivariate, I mean nobody would go to eight years of college to make less money so they all making a better higher paying job had to be part of the equation. I'm not saying that you shouldn't be paid, all I'm saying is is that if if you only went to dentistry because you said 'well, I'm smart enough, I can do it but I just want to earn more money than all of my friends um, it's just it's just not the right reason I know that.

You know we talked about immigration. and why i moved from israel to canada i know a lot of people who immigrate from israel to canada because they want better life financially a lot of them go through one or two winters they go back and the reason they go back is because they didn't immigrate for the right reasons so when we're talking about being a dentist so what were the wrong reasons why did they immigrate well they wanted they wanted a better financial uh state for their family and you know when when you immigrate you start from zero when you start from zero you go backwards and if you're not able to to climb up fast enough then um you're just going to be frustrated And a lot of them end up going home after one or two winters in Canada, um so.

But you know when we go back to the to the students that that are still in school, um my my message to them would be: You are able to be extremely wealthy, uh and not only uh with money but also uh through just the fulfillment of having the right business and having um having the right culture in your clinic. All of this is possible: you're able to treat patients, you're able to make money, and you're able to work in an environment that is just happy all around. And there are ways uh to do it, and it starts with a journey with yourself to figure out why. Why do you want to own a clinic?

Why would you be different, and also what you would like to be known for in your neighborhood uh and once you figure that all out uh you build a team around those concepts um and they'll just enhance your message and you'll be extremely successful that way um so I think that that would be the regardless of the challenges that come from regulators and DSOs, there are always ways for the privately owned dentists to be able to work through some of those and try to get the best dentists to come up with solutions and make changes quickly to address any um any competition and any challenges that come. Their way so talk about of these 13,000 dental offices using Uh Maxim software systems what are the low-hanging obvious non-debatable fruits of happier more successful dentists that aren't that are you know are happy like dentistry and meeting their objectives as opposed to people who who are job-hopping employees, miserable, burned out, and think they made a bad decision?

I think a lot of it starts, it basically is two issues here. One, there are dentists who are not really sure why they wanted to own a clinic. In reality, there's no free lunch, right? You said, if you own your clinic, you will net $100K more than if you're an employee. That's true. But the question is that each individual must ask themselves is, that $100K doesn't come free. You are now a business owner with everything that comes with it. Now, A, you need to know what that is that comes with it, and B, you have to understand that the effort you're going to put in is going to be less than the value of the $100K. And then if you agree with that, The effort you put in is going to be less than the $100K?

Well, you have effort versus value. The value is $100K. If the effort that you believe would be less, so for instance, if you like human resource and you like marketing, then the effort you would put in would be less because you're doing something that you like. So, in that context. But the idea is, if you know what you're getting yourself into and you're okay with it and you believe that $100K is worth it, do it. If not, you're going to be miserable. That's just the reality of it. And then the second thing is, and it's also a double-edged sword, is I'm a big believer in the fact that every office, as soon as they hit about five employees, needs an actual office manager.

And the reason why I say this is because there needs to be a person that runs the day-to-day while you are seeing patients. If you spend half an hour not seeing patients, you are losing that production and you’re not treating your patients well. And the reason why it’s a double-edged sword is because I speak with all of these dental embezzlement specialists and they tell me that 90% of all embezzlements are done by office managers. So, and again, there are always ways to deal with it. So first of all, I recommend hiring an office manager and making sure that they report to you everything and that you're still under control. You see, I envision a dentist who owns a clinic. As they are wearing basically three hats. One is the clinician hat.

One is the administrative hat, which is basically the operation, the day-to-day. And one is the business owner hat that carries its own challenges. But they only have so much time in a day to deal with everything. So they have to delegate the administrator hat to an office manager that will run the operation. And then report back to them in terms of, you know, what are the challenges and what are things that are put in place to address those challenges. So you have that Dental Office Managers Association of Canada. Dental Office Managers Association of Canada is a non-for-profit organization in which we are standardizing the practice for the dental office management profession. We are providing education resources to the dental office field, building a network of experienced dental office managers together to help shape the profession.

And guiding others in the dental office community who want to become office managers. And that was the Achilles' heel of dentistry, where the dentist had eight years of college. The hygienist had four years of college. The assistants, mine went to nine months of Phoenix College training. And then you hire an office manager just off the street. She was, you know, and so there was, and the first guy that really recognized that and made the biggest impact was actually Jay Geyer in Atlanta with the Scheduling Institute. And that was just a cambering explosion of activity. And a lot of my friends all did it. I did it. Everybody did it. But more than anything, it was just like the first guy to really say, hey, they're answering the phone.

That's like the most important thing. So what are you seeing as the challenges today of dental office managers? And what, how many dental office managers do you have in Canada on your officemanagers.ca website? So right now, like I said, it's still a new organization. Right now, we have about 250 members. That's huge. Well, I would, so next year in 2020, we're doing multiple events attending all of the major trade shows in Canada. And the idea is to gather more and more members because a professional association is only as strong as its members. So that's the goal. And what I found is, because if you go and you register to become a member, one of the questions we ask is, what are the three top challenges that you have?

And what I found is the biggest one is they don't feel appreciated by the owner. And that resonated with me. And I cover a little bit about that in my book as well. But, basically, the way to become appreciated is that the owner needs to know what are your responsibilities. Technically, the owner needs to tell you what your responsibilities are. And then you have to do them. You have to actually execute and you have to show to the owner your successes and challenges. Only through working together, when the owner knows what are the challenges you're facing and what are all your responsibilities and the success, only then, there's actually some appreciation that might be. A lot of times, there are challenges and there are issues.

And the dentist is thinking, I am paying this person so much money to just do this. And they can't. And they get really, really frustrated. So, this is kind of the biggest challenge that we see with all of the members that sign up. The other one would be HR-related things. How to keep staff morale. How to get employees to be engaged. And I think a lot of that is about the culture of the clinic. If everyone knows, you know, what should the clinic be known for in their area. And what is, why are they even in business? If they all know this and they're on board, it just helps everyone be on the same page. So, those are the two things that we're seeing in the vast majority of the members who sign up.

That's really exciting. In the United States, Heather Colicchio started that in 2005. And she was on the show. She was on podcast 490. And basically, she says that this, she says, when I launched the American Association of Dental Health Managers, AADOM in 2005, there were national organizations for dental health. Hygienists, assistants, and, of course, dentists. But none of them existed to meet the unique needs of the dental office manager. And so many dental office managers, they think they're a dental office manager, but they're not. I mean, it reminds me of Tim Ferriss' Book, The 4-Hour Workweek, where he, obviously, he's an exaggerator. He's a storyteller. I mean, some people, when they start arguing his fine points, it's like, he's not a historian. He's not an economist. He's a storyteller.

He's trying to, he's trying to make you see something. And, but he'd stand behind people, and it's like, they'd come into work, and they'd go visit in the hotels, and they'd go make coffee and eat a bagel. And he's like, okay, you got here at 8. It's 9 now. You still haven't done anything. And when I see dental office managers, they're answering the phone, checking in patients, seating patients, doing financial arrangements, and you can stand behind some of them for the entire morning and say, okay, you did not do one dental office manager task today. If you don't have a private office, a phone, a fax, a computer, have an employee working on the systems. And we saw that with the E-Myth where they were like wire franchises so successful.

They went from non-existing to almost 15% of the economy. It's about the size of healthcare. And it's because we have a headquarters that's just working on Taco Bell or Taco John's or Chipotle's or whatever. And whereas all the other Mexican restaurants, they spend their whole day just trying to serve customers and make the food. They never get to work on the systems. Okay. What systems do you think office managers are having the most challenges with? You said that you don't think they get the respect from the dentist? Yeah. Yeah. And, well, that's one of their challenges. And it's very true. There's a complete lack of trust between office managers and dentists just because they're struggling on the actual process of how to build trust over time. They just think that it should exist.

And it's not. Trust is something that, you know, building trust is something that never ends. You start doing it and you continue and you continuously do it. And in terms of, you know, not feeling appreciated or respected by the owner, I think that is something you need to earn. You've been put into a position. You're paid an amount of money. You have to earn that respect and appreciation by doing your work and achieving the goals that both you and the owner agree on. I think in terms of systems, I think the weakest from a skill set point would be the financial aspects. I think not a lot of office managers are involved in, let's say, a P&L, which is like a basic financial aspect of a business.

I can probably count on, well, maybe both my hands, the office managers I know that actually get everything. But the most important thing is that they have access to view it, not to mention even participate in building it in terms of projections, in terms of looking at what are the expenses. These are things that if you let a person run your business and they don't have access to, then how can you expect them to achieve any financial goals if you don't let them participate in the financial projection? It's just, it's weird. So, you know, to me, the financial, and one of the reasons why they don't do it is because, like you said, they're the only people who do it. The office managers come with almost no relevant background.

So if you've never seen a P&L, how can you participate in creating one? But this is part of the skill gap that is out there that needs help with figuring out. And if you don't start involving them in P&L, then they will never be able to do it. Then you'll always be frustrated. Again, this is your most powerful, I mean, your about, your intro. It's three paragraphs and it's just all succinct. And in the first paragraph, you said that organization is to become more productive and profitable based on the belief that a successful business is to have a genuine connection with employees. You said the office manager at the end of the trust. You said stakeholders, so they're still in dental kindergarten. Explain what a stakeholder is to a dental student.

A stakeholder, you know, at a high level is anyone who has a stake in the business. Anyone, a patient is a stakeholder. Your associates are a stakeholder. Even your governing body might be a stakeholder. Anyone who has any sort of interest in your business would be a stakeholder. But, you know, you want to focus on identifying those stakeholders and creating value and communication always. You know, having conversations with patients about you know, let's say they waited 10 minutes in your waiting room, just asking them how the waiting time has been passed. Did they have everything they need? Did they know what they're waiting for? Things like that. Things like that. Just involving them is something that is extremely important. And continuing on your intro paragraph, you said employees, stakeholders, customers, that's your patients, and dentists don't call them customers, and vendors.

I mean, I thought it was just amazing that when I had on the head economist of the ADA, who was Canadian, and Marco Vujicic. Yes. And, my gosh, he's in the same city as Delta, who's sitting on the datasets of hundreds of millions of claims. He couldn't get access to that, period. And Delta wouldn't talk to the ADA, and ADA won't talk to them. I mean, it's, and so you're talking about the dysfunction between the office manager and the dentist. It's just, it's all relationship. In fact, when you said, what are dentists good at? Are they good at HR? Are they good at marketing? That's the same thing. Marketing is trying to understand. Understand how to connect with a patient, to try to get them to come in.

Employees, why do they work for you? Why do they not quit? Why are they not happy? I mean, at the end of the game, you just want a lot of people skills. If you get an A on people skills and you get a C on time management and financial management, you're going to be happy and wealthy. But if you get an A in financial and an A in time management, and you fail people, good luck with that. Being a hermit, you need to go live out in the wild. So, on these dental office managers, when they come in, what do they like to learn? What skills are you teaching them where they're glad they joined the Dental Office Managers Association in Canada? I think the first thing that we work with them is about trust building with the owner.

I think that's where it all starts and where it all can fail. I think you start by figuring out methods of how you can start building trust and communicate properly, understand how the dentist, who's the owner, likes to communicate, and then just keep doing that. And then build trust with the rest of the employees. That's the other side of it, understanding what they do, their challenges, and starting to help them be able to do their jobs better. Those are those are ways where you can instantly bring value. From there, obviously, we talk to them about, you know, employment standards from a human resource standpoint. Human rights is huge in Canada right now, so, everything that has to do with human rights.

We talk to them about marketing, the fact that obviously they have to get control over the marketing of the clinic because what we do is, we put in the personal knowledge. What I find is a lot of offices outsource marketing to a company, a marketing company, which is great, but then they do all of these things that might not be consistent with the message of the office. And I think that it's so important that someone in the office who has a vast interest in the success would be in control of the marketing, know when things are going out, what is the message, and make sure it's all consistent because that is key in marketing. So mostly marketing and human resource after the trust building.

And then we also train them on things customer service related, how to address an irate client, patient, how to just identify things within a phone call. A lot of times a potential patient. A patient calls in and asks, you know, how much is a cleaning? And how do you train a receptionist to answer that properly? A lot of, you know, people would either give the price or just say, well, we don't really give a price. You have to come in. Well, guess what the patient does? He'll just call the next clinic. In all essence, what the receptionist must say is, 'Oh, it sounds like you're looking for a new dentist.' Well, it's your lucky day because Dr. Smith can see you. It's your lucky day and assess all of your needs to make sure that you have everything covered. So, you can see, you know, the difference in percentage of these potential patients convert from a phone call to actually visiting the office. And then their entire experience, like we know, needs to be really, really consistent and good for them to actually become an active patient that keeps on coming. So, those are the types of things that we try to help office managers.

You know, I always loved anthropology because the tooth is the most inorganic part of the human body. And they always find the teeth and then maybe some bones, but never the skin or the flesh or the organs. And Abraham Maslow, you know, he wrote that the hierarchy needs theory in 1943, and Maslow on management was probably the most profound management book I ever read because, you know, again, you're, you're, you're listening to people bark and squawk at each other up in the trees and you want to get way underneath it. I mean, try, try to go back a million years to, to, you know, Homo erectus or something and Lucy, who's right here at ASU. And, you know, it's a, it's a well understood animal, Homo sapien.

And it's a, you, you got to understand what, what their needs are. And, uh, social needs, high order needs, uh, trust, communication, um, whether it's, uh, the doctor or the patient. I was talking to an endodontist, um, in Israel and, uh, it's like one of the biggest lawsuits in Israel about a failed endo is the file broke and you just simply didn't even tell him. I mean, I mean, cars break, refrigerators break. What have you ever bought that is impossible to break? So you're doing a root canal with an engine-driven night tie and the file breaks. Well, I mean. What do you, what do you, are you shocked? I mean, it was this not a possibility. Why can't you just say, 'Hey, Alex, I'm so sorry, but you know how a car engine can throw a rod or a brake pad.

Well, that darn file just broke off and now they both know, Oh, we're human.' The patient likes, 'Oh, wow.' The big doctor made a mistake. And, and it's just, uh, um, yeah, you look at those reviews. I look at those reviews that the dentist always see the review and want to get a lawyer and have it taken down. And so it's like this. This little wild animal is desperately screaming in the trees, squawking, squawking, trying in this haphazard way to communicate. Every time I get a bad review, the first thing I do is pick up the phone and call him. One time, uh, the wife said he'll never come to the phone. I mean, seriously, hard. If you were standing right here in the driveway, he'd probably punch you.

And I'm like, well, I'm only a mile away. I don't care if I get punched. I wrestled for four years. I can take a shot. Um, do you care if I come over? She goes, are, are you out of your mind? I said, that's what everyone tells me. And I went over there and he unloaded on me. Basically, it was the hygienist. You know, it was a new patient and she needed four quadrants replaying cure dodge and the greatest dentist in the world who he'd known for 30 years and retired said he was fine. Never mentioned any of it. And so again, it's just trust and um you know and uh but anyway it's just communication Um just you know just talk to your place So um I um It's on the chain of command.

Now, you know, the biggest institutions and the oldest ones like the Catholic Church and they got a, a Pope, cardinals, archbishops, bishops, Monsignors, priests, altar boys, parishioners. The military doesn't let you manage more than seven. So you got a colonel; seven reports. Each one of them has seven all the way down to 3 million base. And um, it's all, um, um, I see it in the dental offices all the time. I see when, when I lectured for FADOM. In San Diego, uh, they were all telling me that, you know, that the office manager would work this problem. She'd get it all solved. She'd consult on like your dental on your Facebook group on, uh, for dental office managers.

And, and then she'd implement this and then, uh, they'd run to the doctor and then he'd cut her feet out and say, 'I mean, I don't worry about that.' That's why the doctor's wife, the doc, the spouse has such a bad reputation because, uh, um, look, this spouse is sleeping with your dentist. This is what. This is what they're doing. And they probably talked about it last night in bed. And, uh, so they don't like her because she's a constraint. She's like, no, the water can't flow that way anymore. It has to flow that way. Um, so how do you, um, how do you get the doctor to sit there and say, look, dude, you're the general and that's your Lieutenant.

And, uh, if she tells the infantry that this is what we're doing, um, just like in my organization, I got 50 employees. Lori's been the president for two decades. Um, um, when I seriously disagree with Lori, hopefully Lori's the only one that knows it. You know, I, I mean, you take the reply all, all way in your reply and, and if it's, and if, and if you're an after two emails, if it's not flowing, come on, you live in the same town. So only allow the digital communication. Uh, I say, I always play baseball three strikes you're out. You know, you did it. They come back. They still like it. You have replied. They come back. It's like, okay, that's three. This, this game's over. It's out. Go back to the dugout.

And go walk in that cubicle. And, uh, and I hate meeting for breakfast and lunches and all that, because if I want to talk to you, I don't want to spend 10 minutes driving, 10 minutes ordering, eating with food. I mean, come on, let's, let's communicate. We could do this in three minutes. And some people, they have needs. They want to FaceTime because they need to see you. Other people don't want to be seen. They just want to be heard. But it's still just comes down to communication. You're talking about communicating your purpose. Why did you want to be a dentist? Um, why did you want to be an office manager? Um, why did you want me to fix your tooth and not one of the other 6,000 dentists in the state of Arizona?

Um, people, um, uh, I mean, it's just entropy. The universe is built on entropy and, um, you know, you just need to try to put order into your personal framework needs of the people that you work with. Um, that's very true. You know, um, you know, you mentioned. A couple of very, very interesting points. The, I've heard a lot of, uh, instances where the staff just run back to the dentist and say, oh, well, the office manager told me this and this. I don't agree. I'm not going to do it. You have to change the decision. Otherwise I quit things like that. It happens all the time. I think it's all about, do you, as the dentist, show the staff that the office manager is the person in charge, do you tell them that what the officer, the, what the office manager says is as if it came from you, do you tell them that as a clinician

in the office, you report to the office manager too, and the office manager is the manager of everyone. Then the office manager, like, like a CEO would report to the board, the board would be the dentist. And in that case, they talk about financials, about goals, about plans, about challenges, uh, plans for next year. That would be in a separate meeting. But in the day-to-day, when the dentist is in the office, treating patients, they are an employee. And as such, they report to the office manager as all other employees, as all associates, as all front staff, assistants, hygienists, everyone. Uh, and I think when you, when you establish this type of a culture. Then everyone, uh, is on the same page.

And if you, and if you disagree with the office manager, which is possible, then you just meet after work or you meet in an office and you have a conversation about it. What was the thought process of the office manager behind what's, uh, behind that decision. And you, you just, you just talk it out because obviously if you're on the same page, you're all, all there for the same purpose. Then, You'll be able to, to reach, um, you know, the same conclusion. So I think, you know, presenting to everyone in the staff that the office manager is the ultimate decision maker while having meetings. If you don't, if you disagree, uh, like you mentioned, just go into that cubicle or go into that small office, have a conversation that, that is how it needs to be up to present a unified front to all the staff and whatever disagreements you have, you solve them outside of that.

So, you know, there's some disturbing trends in dentistry. I mean, we just look at 2005, uh, to 2015. I mean, owner GPs' income went from 229 down to one 92. Um, um, for owner GPs, all GPs, it went from two 15 down to 180 and for non-owner GPs, it went from one 37 to one 20. Um, um, do you think that, um, um, with DSOs. Uh, with more government involvement in, um, um, reimbursement rates and, and, uh, with politicians saying that healthcare should be free and you're from Canada, which is, uh, more like the other 20 richest countries providing the free healthcare side. Um, do you think, um, what are going to be the challenges of that over the next, uh, 20 years until your, your age today to my age now?

Yeah, I think that, um, it's going to become more and more difficult to own a clinic. Um, expenses are going to go up. Revenue is going to go down. Uh, you're going to have to find ways of how to increase revenue and how to cut on expenses, but still deliver the same quality of work. Um, they're going to be technological solutions that would come to help you, uh, in your, in your aid. Uh, you know, I always, because I'm, I'm, uh, I'm a CEO of a tech company. I always get the question of, you know, what dentistry is going to look like in like 15, 20 years. So, and again, I'm not, I'm not a prophet, but, um, I'm thinking that, um, the hygienist would be a profession of the past, maybe not in 20 years, but maybe later on, uh, there's going to be nanobots that are just going to clean your teeth and provide all the scaling and all of the diagnostic of everything.

You're just going to just do a mouthwash and they will just do the job, um, there. Uh, I think that. That's part of it is going to eliminate a lot of the, um, overhead for expenses, uh, in the hygiene department. Um, uh, I know that, you know, that's been already talks, not 20 years, but maybe five, uh, five to 10, uh, dental radiology is going to be a profession of the past, uh, with AI and all of the just computer generating all of the diagnostic and everything. Um, I still feel that, you know, uh, machines. Are great in, in what they do, but you still need a person to look at it. Uh, so there probably will still be a few, uh, radiologists are just going to guide, uh, those, um, those particular companies that, that do the, uh, reading of the, uh, of the radiographs.

Um, but that, that is kind of the future. Uh, you know, we do, uh, tele dentistry is a trend right now. Uh, uh, and it helps, uh, a lot of rural communities. Um, where, uh, otherwise they wouldn't get any access, uh, to a dentist. Uh, I think those trends are going to continue. Uh, there's going to be some, um, you know, guided surgeries and stuff like that done. I, I heard they did, uh, uh, guided surgery over the internet, uh, with the help of a robot. Um, you know, so those, all of these things are, uh, technologies that are coming to help reduce some of the expenses, uh, and technologies. And, uh, that, you know, it's a, it's a, it's a, it's a, it's a challenge that we're facing.

Uh, you know, we, we have a, we have a very broad community that is developing, uh, in a, he's developing in a very rapid pace. Um, and then, you know, as, as long as people are alive, they're gonna need dental treatment. Uh, so there are patients there that need a treatment, so all of these subscription models, uh, for dentistry, uh, are not a bad idea. If you're looking at, at ways to, to help out, um, bigger population and providing some other financial ways for patients to, to pay for it. So, so those are kind of the trends that I'm seeing, um, maybe well what you said there's already a lot of data for again I think one of the greatest things to open up my mind was, um, going to other countries and seeing the same population of eight billion humans with the same disease, the same dentistry just all tackling it from different customs, cultures, and tribes.

And you already see that, the only three publicly traded dental DSOs in the world today none of them have hygienists, and when you go to um as you're opening up dental schools and expanding okay as you're expanding you can't have up if there's not down, you can't have hot if there's not cold. If something new comes out and you say oh that's great it's going to do this well if it can do something great then by simple math it can do something bad. Take nuclear technology it can be nuclear energy and medicine or a damn bomb that kills a lot of people. And um, um so um you know when you look at the

um um oral radiology i mean a human can only see down to 50 microns well i mean nobody is gonna nobody would suggest if you're reading a data set of an x-ray say hey i get an idea let's get a monkey without a tail to read the x-ray you'd be like what because there's no parakeets or can't you read the x-ray because there's no parakeets or can't you read kangaroos i mean uh so yeah oral radiology is just going to disappear rapidly hygienists are gone because what was the opposite of increasing productivity um why did you increase productivity because you go back to the 70s when there wasn't a lot of

dentists a lot of decay not a lot of Fluoride or water or toothpaste um so the whole impetus of practice management was to increase production so you're a dentist just do the big items get the hygienist to do the smaller items delegate, delegate, delegate to where you're going to be and you're going to be able to do the you're just doing only what a dentist can do so that's the perfect solution in the 60s, 70s, and 80s but when you start seeing markets where I've been the keynote speaker in like say Malaysia, Cambodia where I think Malaysia went from one dental school to 11 in five years I mean talk about an economic macro shock well what was the first thing that Died, um, delegating a lot of stuff to a lot of hygienists and assistants and all that.

And in Singapore, another very uh oversaturated market, the dentists are all in one room, the size of this their patients' call them on their iPhone; they have one chair and so they maybe they went down from a million-dollar practice where they were taking home $250,000 and now they're down to a $300,000 practice, taking home $280,000. I mean, I've seen it; I mean, so the top-line revenue drops and your number-one expense is labor. So you got to cut that. I mean, all this talk about saving money on supplies when it seems like the dentists who talk about saving the most money. On supplies, I forgot to look at the largest item of expense, labor. And secondarily, when people tell me about saving money on supplies, I'm always like, 'Can we go back to labor?' Yeah, I could go the rest of my life without talking about the electric bill, the light bill, and supplies.

Go back to labor! So, yeah, hygienists are under huge macroeconomic pressure now. When we say that for a planet of eight billion people with two-thirds being in the United States, with you know 325 million people and 211,000 licensed dentists, yeah, your location, your rural, your state, your province, it might be totally different. We talk macro trends, but yeah, the hygienists. Are you under pressure? A delegation is going to be diminished with expansion of dentists and dental therapists, and what else, what other uh predictions you see moving forward because the first two that you said are factual and observable uh 10 years ago yeah. I'm seeing a lot of transactions done online to save on some of the overhead and the front staff too, so if it's chat bots and all kinds of automated answering services um just to cut back, so you can go from three receptionists to two receptionists again like you said labor uh is the number one uh cost for the overhead, so um

ways to to remove that through technological Services, uh, is a big one. I know some, uh, schools where there's a dental assisting, uh, programs, uh, at least in Canada are doing a scaling module, uh, so they're able to scale, uh, different provinces, is until, uh, up to different depths but still, uh, it's another um you know multi-tasker versatile employee that can do, uh, many things an assistant can assist, she can do the scaling, she can do the the front office work and and having a versatile person just helps all around and you're able to be a little bit leaner in, in all of your operation I think, I think those are kind of the bigger trends and um but yeah, the future is is not About less challenges, it's about more challenges, more of the same and some new challenges coming over, and um, you know, a lot of it is is looking at practical solutions to these issues.

Uh, supplies you mentioned, supplies and saving on supply that's good, but you can go from, you know, being at six percent to three percent, which is great, but you know at the end of the year that's not a a huge impact uh, to your clinic, you're gonna feel great about it because you saved uh, you still got the same supplies, but still uh, like you said overhead for salaries, that's why I don't understand about DSOS, because a lot of these DSOS, I mean they're they're They're, they're, they're, they're, they're, they're, they're, they're, I mean they, they're, they're there for somewhere. I mean the the average norm for DSO is they're going to take what 15-18 off the top, yeah, well hell if they were so damn good they could give you a free lab and supplies it'd be equal.

Well, they're not going to do that if you if you if you sold to a DSO. They said oh by the way if you sell to us there'll be no cost for supplies and labs, you get my intention when you but they're never going to do that to your second and third third largest expense so um um but but we talked about your opening on your paragraph about you know getting Along with stakeholders, and um, you know we were talking about how these are challenges for dentists, but the other stakeholders are the patients, and um, eight and a half percent of emergency room visits are odontogenic in origin because the doctors work 32 hours a week Monday through Thursday and then spend three-day weekends crying about how hard they work, and and the the patient which when I'm gone that's going to be my five grandchildren and their children; I don't want my great-great-grandchildren to wait three days with an abscess before dumbass can get them in the office.

I mean, the patient should come uh first. And, uh, um, equal to the, uh, so, so, the patients are going to win, I'm liking the, um, I'm liking that, um, part of it, and, um, and then you know there's going to be more specialties, I think that's going to come around, so you're a not the office managers.ca is a non-profit, and you said you're not a profit, but profit is spelled p-r-o-f-i-t, I mean, I hope you're a dental profit, uh, not the p-r-h-o or whatever, but um, why, why, is it a non-profit, and what is your purpose of putting all this effort into office managers.ca for Canada, um, when it's a non-profit, or did you just marry well, no, sitting on a ton of cash, so like I said, my, my, my, my, full-time job Is with Maxim so I, I run that obviously it's a software company.

It is for profit. Uh, I started the uh association as a federally incorporated non-for-profit just because it is a professional association, um, as such, it just needs to be non-for-profit because it has it needs to have a purpose for the benefit of its members. Um, and you know, like, like the person who's in charge of the organization, and the person who's in charge of the organization that started um, uh, the American counterpart, um, it's it's all about having uh, that professional association to create to certify the the receptionist to certify the office managers. To certify dental consultants, anyone today can simply self-proclaim to be a dental consultant take $30,000 to $50,000 for their consulting services and leave and leave a clinic in havoc that is horrible.

So, creating standards certifying these individuals in the industry is going to remove a lot of stress. Beyond that, we're going to accredit uh programs that are relevant to it. So, a lot of dental uh receptionist programs are going to go through accreditation. We're already running a pilot with a dental receptions program with three campuses uh in Canada. Once that is done, uh we're going to extend it to the rest of the schools. i believe there's uh one or two schools that are training somewhat to be a dental office manager but we'll have to review and accredit those programs as well uh and the idea is for is is to help the dentist struggle with some of the upcoming challenges and even the existing ones by hiring people that know what needs to be done and how to do it and and i think that's the goal and and and it's it's like i said it's not about the profit in that particular organization it's about creating the

value uh in the dental industry and creating some standards in in a set of professions that have just been been overlooked for you know since Inception, so is the 'um' is that 'um' association completely different than Maxim software system, I mean, Arthur and founded that 40 years ago. Yes, definitely. So the association, like I said, is a federally incorporated non-profit separate legal entity, and uh, it was established in 2015. Although, like I said, I do have a full-time job, so I didn't really have much time to grow it, but I think that um now I have a good team of uh, of people that are going to support us, and we're going to probably have some local chapters as well and build them from the ground up in uh, in the upcoming year, so it's very exciting.

Um, um, so what, so what's The exit strategy of um, the founder and um, Arthur, and he still owns the companies, no, no, he sold about um, about nine years ago, okay, uh, and he was still involved probably up until and five years ago, uh, so he sold it to uh, two former employees there was Cheryl and Chew, uh, Cheryl was more of a of a business person, she started as a salesperson and then Chew who started as a developer and uh, and and rose from there, um, and about um, three or so uh, years ago, uh, Cheryl uh, sold her share, so Chew is now the sole uh, he's uh, he's a sole owner and he also works uh, as the CTO with us, so he's a technical background, so he's responsible for all the technology.

Um, and it's funny because you know he's the owner but he uh he's also an employee so it's uh our relationship is very similar to how an office manager and an owner work in a dental clinic, uh we're buying his day job, you know he reports to me while we have you know periodic meetings about um you know financials and goals and everything, um and the funny part is like I said it's not about these formal meetings it's all about communication, um you know I talk to him every day to share some of my challenges he shares some of his challenges we have great conversations and we're all on the same page, I believe this is something that's very And owners in a dental clinic, so does um, does how does the dental software business we're talking about the challenges of dentistry over the next 10-20 years?

How does the dental software challenges look? Um, do you think that's all going to consolidate? The most obvious is AI going to come in and take all this managerial accounting and uh, you know what? So, what does he think of his 20-year prospects of this line of business? And what will impact it the most? I think that uh specifically in in the dental software world, all of the software that exists right now is data entry driven. If if a user does not do the data entry correctly Uh, nothing is going to work and I think that uh with uh AI and with more tools uh that are available right now uh the software that

you know the next generation of our uh flagship product that we're building uh at the moment is not driven by data entry is driven by uh workflows and and processes um and the idea is is to remove a lot of the thinking from the end user so a receptionist comes in in the morning she sits at her computer and she's like okay, so what am I doing now and then they have to figure out what it is that they're doing well our new software is not going to be like that it's going to basically tell the user what it is that They need to do and prioritize levels, um, and then it will also report to the manager and to whoever they want in terms of what was done and what wasn't done at the end of the day, uh, and with the idea that you know it's it's also gonna, um, help hire front staff;

they don't necessarily need to have extensive training and a lot of understanding, you can just plug and play them into the software because the software is smart enough to guide them into what needs to be done. Nice, I'm uh, my god we went over 20 minutes, what did we not talk about? More of that, you wish we did talk about more, um, well I think you asked originally about what is uh Maxi Dense or Maxim software systems kind of proposition to the dentist, and we kind of went into it, and we kind of went into it, and we kind of went into it, and we kind of went into it, and talked a little bit about Open Dental at that time.

Um, so uh when when I uh became uh the CEO um, I did a a comprehensive change in how we deliver service because I believe that you know, like you said, a lot of the software is is kind of the same does uh it does the work. Um, so instead of having a tech support call center what I did was I created success teams and in that team we have a dedicated technician to a region, we have an implementation specialist who's a trainer. and we have an account manager to help um on all of the business questions so we have a well-rounded team that is responsible for a certain region and with that they're building relationships with the office building relationship with the staff they're building relationship um with the with with the clinic's vendors they uh they're building relationships with the office they're building

relationships with the office they're building relationships with the office they're building they have familiarity with their network and and through that through those relationships they're able to deliver value uh day in and day out so i think um one of our biggest advantages uh over other companies is our ability to have that dedicated success team that is completely dedicated to the success of um of those offices um the other thing is similarly to open dental uh we provide a free service to the office and we provide a free service to the office and we provide a free service to the office and we provide a free copy of our practice management a free copy

of our practice management uh software license at no cost and one of the reasons we do uh software license at no cost um and one of the reasons we do this is because we believe that this is because we believe that um you know there's there's a lot of older software out there um you know there's there's a lot of older software out there uh that don't have the capability and uh that don't have the capability and we believe that that's we believe that that's the the part we play in helping the dental industry deal with some of the the the part we play in helping the dental industry deal with some of the

rising costs the part we play in helping the dental industry deal with some of the rising costs a lot it puts the onus rising costs a lot it puts the onus on us on us uh because we become a subscription company and and as you know with subscription companies we have to earn the the subscription every single month uh and we do that through the delivery of our services so but it's so it's such a better bet because like on netflix when you know you got this many people all giving you 10 bucks a month that's a lot easier to predict than disney oh we're gonna spend 100 million dollars on a blockbuster movie and we hope it does 300 million but it might die at the box office i mean the company subscription model that's spotify netflix and that's where everybody's going because it's predictable i'd rather have 1300 people giving me a dollar every Day than every 13,000 days some guy walks in and gives me $13,000.

I mean one's just one's nerve-wracking, and it's caused a lot of dental companies to go under. But one of the problems with, uh, software um about what to, uh, program is that it's obvious to everyone that when you go into any dental office and you run utilities about what features were used, 85% of the features are never used while they just keep having I mean Dentrix had me; I remember I went to Utah one time. They wanted key out key opinion leaders to hear about their next roll-out, and that before he started, I interrupted you know; I just sat in the front row and was my total jerk self. And said, 'Excuse me, but what percent of all your existing stuff is never used? Said 85 percent.

So this whole lecture today would you just say that 85% of this is just complete noise and a waste of time? And one of their problems is they keep asking the dentist what he wants. Well, a dentist is a chef; he wants to cook; he wants ingredients; he wants to do working out; he's a surgeon. They don't... if you don't know what the difference in a statement of income, a statement of cash flow on a balance sheet is. How would you... if something's above your comprehension, you're not going to ask for it. It's an unknown unknown. And, um, so they have all their accounting and QuickBooks, and then they have all their dentistry and Dentrix, and, um, are you bridging that together like your own CFO Cindy, um, um I mean, um, you know would Maxim's software solve her problems, I mean, or are you do you think you'll ever bridge the gap between QuickBooks and Maxi Dental software?

I think uh part of um bridging that gap is um is a lot of conversations with dental accountants which we're having um and you know you have probably more opinions uh than accountants uh but it's about consolidating that data so um you know I'm in constant conversation with multiple accountants In terms of even the simplest question, 'What type of uh accounting is better? Is it open item or balance forward? Um, and the answer is, it depends. Right? So, for instance, for the Canadian market, open item is the way to go. Uh, for the U.S., my homies, a quarter of my life I've been in, the listeners are still in dental school, yeah, so, so

basically the biggest uh difference between open item and and balance forward is that in balance forward system, you are um just showing the balance for the family for the patient uh, and there's a some difficulty in itemizing what charge went with what procedure with an open item, it's Just outlined item by item, and also when you apply a payment, you can apply a payment to the actual, not necessarily just to the balance, so it just because the Canadian system is extremely insurance-driven. When you are able to apply a payment directly to the procedure, that just makes your life completely easier. Um, so but, but even when you when you're talking about that with accountants, is it better to do open item or balance forward still?

You know, the opinions kind of uh are split and it and it also depends on on what it is they're doing, so uh we're working on these particular uh items uh to bridge the gaps. Um, but I think the uh the first step is for dentists to actually understand uh that they need to aggregate the data together to make proper business decisions and not just rely on their accountant uh because their accountant although is is really uh you know uh smart in terms of the accounting stuff but they might not not really understand the dental business that much um so they need to take responsibility uh the software solves problems and you said you

know you can't ask dentists about what they want in software it's like uh uh that quote from henry ford that says uh he said uh if uh i would have asked people what they want they would tell Me, faster horses, so uh, it's it's the same thing you uh, sometimes you have to be a visionary, you have to uh, to look at things and say okay, if I was this dental clinic with all of the known challenges and all of the challenges, what is it that that I would need right? So this is this is kind of the the the software gaps that are out there that are being bridged with you know new technologies new concepts.

I just um tweeted uh your book on Twitter and um, what I love about your book is you're listening to this right now probably audio and um, your book 'Responsible Dental Ownership: Balancing Ethics and Business through Purpose' is available. on audio when i came out with my book i had a book and all the reviews like give me audio audio audio and i didn't get the audio out for like six months and the audio dwarf the uh reading and old cut down tree uh so if you're listening to this go to amazon.com his name um is alex zalatin so it's the word latin with a z in front it's a cool name i love it alex zalatin already named after alex zalatin

alex the great yes alex actually yes yeah protector of people nice and um responsible dental ownership balancing ethics and business through person purpose his uh his website is uh alex zalatin just latin with a z alex zalatin uh.com uh he's on twitter alex zalatin uh ceo um maxim maxi dent software um best of luck with that i think um um have you got a full time uh ai programmer did you bring in someone that programs uh what is it python do you got a you got any ai not not yet uh the ai right now is built by our existing um uh developers they're now like i said the majority probably more than

50 percent of our efforts are now on the cloud with uh the new tools and and the new technologies that are available there um so far in the in the uh projects that we've built probably 80 percent of the time is spent on security uh just because what's the point of building something you'll have to rebuild uh if the security is not good so uh just the security component and and it's not like it's done it's it's going to be an uh never-ending uh evolution but that's the place where you have to start when when you're talking about um you know cloud computing well alex zalatin and man how ambitious to hop in

and play do you fly in this morning or last night last night last night all the way from manitoba to phoenix arizona and when are you going back uh probably uh tomorrow around noon well before you fly back will you see if you can find my suitcase uh i still haven't seen it since last friday but uh thank you so much for flying all the way down from canada my pleasure to phoenix arizona where 10 of all the homes are owned by canadians so uh you might want to shop around i hear when you're about 65 and get arthritis you'll be my you'll be an thanks for having me so much for coming it was an honor to podcast you my pleasure anytime.