Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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220 How To Open A Practice with Jayme Amos : Dentistry Uncensored with Howard Farran

220 How To Open A Practice with Jayme Amos : Dentistry Uncensored with Howard Farran

11/7/2015 2:00:00 AM   |   Comments: 2   |   Views: 1823

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AUDIO - HSP #220 - Jayme Amos

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VIDEO - HSP #220 - Jayme Amos

Jayme Amos, founder of Ideal Practice, shares detailed, calcuated information about how to start a practice. Every dentist who's opening a practice needs to hear this!



Jayme Amos is the founder of Ideal Practices, Dentistry’s consulting firm dedicated to helping dentists open new practices with clinical and profitable excellence. He is the bestselling author of Choosing the Right Practice Location, host of the Dentistry’s Ideal Practices Podcast and founder of 

Jayme’s firm works across the country helping dentists open practices that give them the control, freedom and income they deserve.

Howard: It is a huge, huge honor for me to be interviewing Jayme Amos and I first actually, I know you haven't done this for a decade but, you know how I actually first heard about you? Is you started loading your podcasts on Dentaltown, and Dentaltown's got two hundred and five thousand and about forty thousand of them downloaded the app, and that's where I first saw you and I started listening to your podcast and it was ... it's an amazing podcast, and I've listened to several. You've put up about twenty of them, haven't you?

Jayme: Yeah, maybe one one hundredth of the volume that you've put out. It's crazy how you're able to create so much content that's relevant, it's not just fluff obviously. The stuff you put out there is fantastic, so that you for having me. This is a real honor, thank you.

Howard: I want you to know, I paid Jayme to say that. In full disclosure, I emailed him ten bucks to say that. I love your name, Jayme. By the way you have rocking hot teeth, I mean those are just perfect teeth.

Jayme: You crack me up. 

Howard: When I see the name Jayme Amos, when you're an old dentist, you know, the first toothpaste was Amos and Andy, with brush your teeth with Ipana.

Jayme: Oh.

Howard: They started the whole ... There were no hygienists, there was no hygiene department until Free Enterprise toothpaste company started saying, hey, brush your teeth with Ipana, and they had these two Amos and Andy characters and see your dentist twice a year. It was because of that that when dental insurance started they thought, well, you know, you're supposed to see your dentist twice a year. It was just mass hypnosis from marketing. The whole America was told on television to see your dentist twice a year, people started coming to the dentist for a checkup, and the dentist would say, I'm busy pulling teeth, making a denture, I don't have time for this idiot who wants a checkup. That was the invention of the hygiene department, someone to clean their teeth and do a checkup and all that while we were busy doing real dentistry, which was extracting everyone's teeth and replacing it with plastic. I just assume that you're the grandson of Amos and Andy.

Jayme: I'm actually the grandson of a gentleman named Eugene Amos who came from the hills of West Virginia, or as he calls it, bygod West Virginia. I still have family who lives in trailer homes and eats squirrels. That's my real heritage, not toothpaste, but squirrel.

Howard: Well, I was born literally in a barn in Kansas so there's not much difference between West Virginia and Kansas. They are just the best people, aren't they?

Jayme: Oh, they'll give you everything even when they have nothing. They're just wonderful. The biggest hearted people ever. There's a lot of good family heritage there. Real honored to be there, but I'm glad I hopped that train to Philadelphia one day, because I think it's opened up some extra opportunities.

Howard: That's where you live, in Philadelphia?

Jayme: Yep, in the city of brotherly love.

Howard: I'll tell you what, that was my first turnoff to dentistry.

Jayme: Philadelphia?

Howard: No, the ... when I got out of school and I started wanting to take three, four, five hundred ours of CE a year and I was taking all these institutes and you just smelled the elitism right out of the gate, and they're talking about how there's A patients, B patients, C patients. My grandpa, all his brothers when they got their dentures, they thought they were horrible, threw them out, and they didn't even wear teeth. They could eat almonds, corn on the cob, steak, they ate everything, they gummed it with their ridges. You would go to these places and it was actually some of these very big deals and they were telling you how you want to hang out with the right type of people. They would describe the right type of people, and there was no one in my entire pedigree that fit the description. Then what they did was describe the C, D, and F patients that you want to get rid of, that was my entire family. 

Then they would badmouth Glidewell because they were a cheap lab. It's like cheap, Southwest Airlines is the cheapest airline, and by the way their the only airline that's never had a plane fall out of the sky because they only fly one plane, the secret to lower prices, lower costs. By having just one type of plane, a seven thirty seven, they now have all the parts, all the training, it's faster, it's cheaper, it's higher quality. Jim Gladwell I thought was the person who made, by concentration on his cost and doing everything faster and more efficient and more technology, he drove down the price of crown so that my trailer trash, born in a barn pedigree from Kansas to your West Virginia could have the freedom to afford dentistry. 

So many dentists come to me with these great ideas, they want me to help them. I say, does it pass the test? Is it going to make me do dentistry faster, easier? Lower cost, and higher quality. If you don't pass those four ... What's the old model? Oh I got this way to do it and it's going to be twice as good, twice as expensive, and no one from your pedigree can afford it, so can you help me? I'm like, that's not American, that's king and queen bullshit. Go take that to somebody, to some dictator king or queen. If you can't do dentistry and make a profit, you know McDonald's makes a profit. You don't have to be Ruth Chris. I'd rather own McDonald's than Ruth Chris any day of the year. I'd rather own Southwest Airlines than luxury airlines. Also, when I look at the billionaires, one of the main thing billionaires all have in common is they come from poor, rural, poor.

Jayme: Yeah, it's true. Yeah. Watch Shark Tank, right? Everybody has a story where his father swept the floors or this other guy built a business out of his college dorm room. That's what it's about, working your way up.

Howard: You can't take the Kansas barn hick out of me, because now that I'm a millionaire, my car is two thousand four, a hundred and seventy thousand miles, I own no jewelry, I don't own a watch. 

Jayme: I love it.

Howard: I seldom bathe or shower or use deodorant. I don't buy any high price cologne. I mean, throw me a Whopper with cheese and a football game and I'm good.

Jayme: Love it.

Howard: I think it's funny, every dentist that I know that has a BMW or Lexus is leasing it or has it financed for seven years, and all the dentists that can buy it in cash are driving a truck with two hundred thousand miles on it.

Jayme: Yep.

Howard: Enough about all that, sorry I interrupted my interview with you with that stupid rant.

Jayme: No, it's good stuff. I love it.

Howard: It was your fault because your name is Amos, I mean come on, I had to start an Amos an Andy ...

Jayme: It's Pop Pop's fault. 

Howard: Tell them your story because I'm embarrassed to say it, I hope this doesn't hurt your feelings, I wasn't aware of you until you started putting in your podcasts, and then I've listened to twenty of them and I just said, I've got to get this guy on.

Jayme: Oh wow, thanks. Yeah so, I ...

Howard: I hope you're just listening to this on iTunes and not looking at the video on Dental Town or YouTube because this guy is so handsome with his perfect teeth and his hair. If you're looking at his face next to my face, my God, you're going to switch to iTunes today and only watch this on ... my own mother told me I had a face for radio.

Jayme: Howard, you have the exact haircut I wish I could have, because it's so simple.

Howard: I know. I loved it when my hair felt out, people would say, oh dude, are you bummed you're losing your hair?

Jayme: No, it's the best thing ever.

Howard: I said, lose my hair? I lost my comb, my brush, my shampoo, my conditioner, I said I lost a pain in the ass is what I lost.

Jayme: Yeah, you're ready the minute you wake up, you're ready to go.

Howard: Tell us your story, and by the way you look like you're twenty three but you must be older than twenty three if you've been doing this for ten years. How old are you?

Jayme: I'm thirty seven. August fourth, nineteen seventy eight, so that's thirty seven or thirty eight [crosstalk 00:07:53]

Howard: What are you on, like human growth hormones or steroids or how do you look that young at thirty seven dude?

Jayme: I just had my license renewed, my Pennsylvania driver's license, and I looked at it and I thought, dang it, I'm still going to get carded. My picture still looks like I'm twelve.

Howard: What's your story, how did you get into dentistry?

Jayme: I've got a degree in business. I studied overseas, Latin America and Europe. Great experience, but I loved small business so I grew a million dollar business with my cousin. It was in the recruiting industry, nothing to do with dentistry. After about four years, I sold my shares back and I started buying real estate, all bunch of other stuff. I bumped into an old friend, an undergrad, roommate from college who went to Temple Dental. He said, Jayme, I need some help. I said, what do you need? He said, I need something called a boards patient. I said, what's that? That sounds interesting, I've got some free time on my hands. So I was sitting with one of the doctors who's the head of the center for professional development, the ADA, and when I told her that story she said, oh Jayme, God bless you. There's a special place in heaven for people like you who are boards patients. I said no, hang on, I've not done the story yet. 

I was forty five minutes late because I had no idea how important this thing was to my buddy Joe, my undergrad roommate, and Joe, I'll leave his last name nameless, Joe failed. Joe failed the boards because of me, because I was forty five minutes late. So I have no special place in heaven for boards patients, I'm just an embarrassed person who tried to help out a friend and made him fail. Through that, I got to learn about him and his father's business and some of the amazing people in dentistry who are thankfully gracious enough to be my friend, even after I make them fail. Through all that, I decided that you know what, my real estate experience, my small business experience, I'd love to see if that could intertwine somehow with dentists, these good people who I've been teaming up with. Now it's been ten years of working with them. The first doctor we worked with was just outside Philadelphia. He was near his business partner, or his would be partner. He was promised a partnership. His name is Dan, I'll leave his last name empty but ...

Howard: I'll fill in all the last names later, I'll edit them back in.

Jayme: Okay. Smith, Jones. Yeah, so he said Jayme, I've got to get out of this partnership, I've been promised a partnership forever and I'm not getting anywhere. Do you have any ideas? So we did some demographics homework, we did some site selection ideas, things that I had seen work in other parts of the country with other businesses, and he grew like crazy. He was about half a mile outside his ten mile non compete radius. We teamed him up. I figured, well, if you're looking for these kinds of patients, fifty to sixty five year old patients who need this kind of dentistry you're talking about, whatever this inlay and onlay thing is, if you're looking for those kinds of patients, why don't we put you near them. So we put his office near them, got him a fantastic lease with some of the lease negotiation things we'd been working on for years in other parts of the country with other commercial real estate, and man, he ... I'm sure there are faster growth stories out there, but this guy grew to one point two to one point four million in three, four years, but his real dream wasn't just to have a successful practice. His real dream was to sell the practice and move to Florida. After some really cool successes and high fives and everything else, he sold the practice, after just three or four years, and moved to Florida.

Howard: What city was that in?

Jayme: Philadelphia. Just outside of Philadelphia, West Chester, Pennsylvania. 

Howard: That is amazing, when you go to Florida, everyone retired from New York, New Jersey and Philly.

Jayme: Yep. 

Howard: Then if they're west of the Mississippi, they all come here to Phoenix. 

Jayme: Yes.

Howard: I want to start with your first thing you mentioned with the boards, it's really not your fault. It's really not your fault that he failed the boards.

Jayme: Thank you for that. It doesn't make me feel better, but thank you.

Howard: Well, it is, it is not your fault because you're the classic example that a test should be standardized and boards are completely bullshit because how can you have a standardized test when everybody has a different patient, I may be giving you a shot and you're flinching and not getting numb, another guy might have some guy that just gets a shot, numb, my patient's late, your patient's early. There's been a lot of lawsuits, I'm not going to name states because it'll piss off people in Hawaii, but there are lawsuits that are where dentists went to the court and said look, if you were born in Hawaii your pass rate is like ninety percent, and if you weren't born in Hawaii, almost no one passes. It was actually a court system that said, I think this has more to do with protecting the good old boy country club that passing a standardized test to see if you're qualified.

Jayme: Yeah, it's a shame.

Howard: Boards are completely ... they need to be a standardized test on a mannequin, or make it written, furthermore, I went to an accredited dental school for four years and they graduate four hundred thousand dollars in debt, and the government needs to test me for a day? Why don't you go test the damn school.

Jayme: Right.

Howard: I mean, the school should be certified that says, yeah, they graduate board certified dentists. Don't be harassing some kid four hundred thousand dollars in debt where everybody has to bring a different patient. I was in Kansas City and I had to find a patient and fly them all the way to southern Cal, Redlands, that dental school, Loma Linda. My dad and mom never gave me a dime. My dad told me if he paid for my college I would just go to school and do drugs and chase women, so I never got a dime. I had to buy all my drugs with student loan money, that felt horrible when you're buying a bag of weed.

Jayme: Yeah, it sounds like you and I have a similar path. My dad said, go anywhere want, and you'll pay for it.

Howard: Yeah, yeah. Basically, so the boards are bullshit, let's just get out of the way. You should have no guilt for that. What you should have done is you should have found a fancy attorney and you should have sued the school. Sue everybody. I mean, how are you an accredited dental school, Temple Dental. By the way no one's ever said Temple Dental made it rhyme to me before. I've heard of Temple Dental school, but the way you said, Temple Dental, I mean you should be a rapper, I didn't even know those two words rhymed. You must listen to rap music if you can rhyme Temple and dental as sweet and eloquently as you did. Then where did you go from there? You built your friend's dental practice. 

Jayme: Yeah, it's been great. Did that and all the way up until last month we helped a doctor open up a new facility, so now we help doctors open up practices all over the country. We're working with doctors in Seattle, Portland, Arkansas, Portland, Iowa, Tampa, you name it, we're working in all parts of the country to help open up practices. My goal, my passion [crosstalk 00:14:33]

Howard: Who's we? Who's we?

Jayme: My team, so my team of folks, we've got seven people on the team. We're helping doctors ...

Howard: In Philly?

Jayme: Yep. We're helping doctors open up practices successfully with approval process. I think the startup process feels really scary, and rightfully so, there's a lot on the line, but I genuinely think that anybody can do it. I think anybody can open up a startup practice. There's a proven process to do it. As long as you take specific actions to make good decisions on the front end, you could be successful. I kind of liken it to, I like to mow my own lawn. I still ride my own tractor, I put in the headphones and I start going and a couple hours later I'm done, but if I start in the back corner of the lawn and I look out a couple hundred feet, if I'm even one degree off, I end up two neighbors over. That one degree of difference is something that I like to say can sometimes be the differentiator between a practice that you open and a practice that succeeds. 

I think there's a misunderstanding through lots of dentistry and excuse me for critiquing a very amazing industry, but there's this misunderstanding that startup dental practices have a really low failure rate. They say it's point five percent of practices fail. Maybe that's true by somebody's measure, like a bank that is only looking at foreclosures, but I look at it and I say, well maybe failure isn't being described right. If a doctor needs to work in somebody else's practice every year even after he's opened up a startup practice, maybe that's a failure. At least by my terms, that's a version of failure that I don't agree with. I think if a doctor is going to invest in his or her education, and then invest five hundred grand in opening his practice, or her practice, and then another five hundred to a million dollars in an actual building, in a structure so that they can own the real estate for their long term net worth games. If all those things are being done, and they're still working a few days a week in somebody else's practice, three, four years after opening? That one degree might have been a little bit off. Our hope is to keep that one degree a little bit back on track so that nothing is done on the front end, putting you in somebody else's yard on your tractor, so to speak. That's what we like doing. 

Howard: Okay, so let's specifics, so your website is

Jayme: Yep. It's the worst and the best URL ever.

Howard: I would have ended the word spanky at the end, Be specific, how much does this cost. You're talking to thousands of dentists and they tent to be younger so this should be your audience. Talking specifically, they go to this website. How much does it cost, there's probably, I bet you there's at least a thousand dentists listening to this right now who are either juniors or seniors in dental school or they've been out of school for a couple of years, they're working at corporate, in the health service, in the Navy, singing YMCA, they go to this website How much does it cost, what do you do, what's your menu, talk them through the whole process.

Jayme: Cool, okay, yeah I'd be happy to. I like rules of thumb. I like real simple, easy to remember rules of thumb. Ready? Rule of thumb number one. Six crowns. If you can produce six crowns in a month, you can afford a dental office.

Howard: Damn, I did six crowns yesterday.

Jayme: Right, you probably do them in half, in a hour nowadays, with all your experience. I think the fear of this big number and this big scary startup practice thing can scare some people. It's possible with as little as six crowns a month. What's the math on that? Well, I'll bore you with the math because I have it memorized. It's five hundred thousand dollars of a startup practice loan over a twenty year payback period at a six percent interest rate. It's three thousand, five hundred eighty two dollars and sixteen cents, so five hundred grand, twenty years, six percent, thirty five, let's call it six hundred bucks. 

Howard: It was thirty five eighty two a month for twenty years?

Jayme: Yep. Thirty five eighty two point one six for twenty years. 

Howard: Their alimony payment will be ten thousand a month for twenty years, [crosstalk 00:18:51] just to put that into perspective. You're saying for one third of an alimony payment, you could start a dental office. That is amazing. 

Jayme: Yeah, how awesome, right? Here's the thing, I figure, when we're looking at something like that, affording it doesn't mean success, right? Affording something and succeeding at something are very different. I was just with a publicly traded big bank that does a lot of business and industry, and I was speaking to a room of, I don't know, holds a hundred people, so we're speaking to them. On the top row, there's three people who keep peppering me with questions about banks and dentists who fail. That group is called the special assets division, there are three of them sitting at the top ledge. They're talking down during the presentation. Special assets division, by the way, is the group that takes care of the foreclosed and the failing practices, the ones who are about to go bankrupt. The irony is special assets division, the acronym is SAD, right? The special assets division, they were asking questions like, well Jayme, can your team help reverse this practice that's not getting enough new patients, a startup practice that's not thriving. My answer was, maybe, but it's like shifting the momentum of a boulder coming down a mountain. It's not likely. 

The problem isn't now trying to fix the dilemma, the problem was before the practice even looked at where to open. You might have seen, Howard, I wrote a book a few years ago called Choosing the Right Practice Location. It's a bestseller on Amazon, you can still get it on Amazon. 

Howard: What's the name of that?

Jayme: Choosing the Right Practice Location

Howard: Choosing the Right Practice Location by Jayme, that's j-a-y-m-e, because they don't know how to spell in West Virginia, he probably sounded it out right?

Jayme: My parents were hippies to make matters worse.

Howard: By Jayme Amos. What year did that come out?

Jayme: That was in September, second half of twenty thirteen, so a couple years ago. 

Howard: Are you looking at that book to generate leads for your primary business, or are you trying to make money off the book?

Jayme: Both. My hope is that people who pick up the book will want to get real practical tips. There's nine or ten really specific things, like this one, you ready? One is, choose your landlord. Nobody chooses their landlord, but Howard, you have plenty of experience on this topic. We all know that commercial real estate is a dangerous, dangerous game, where landlord hold all the chips. They hold all the cards. Choosing your landlord, to me means let's look at the lease just as importantly, and hold it in just as high of esteem as the way the building looks. Instead of saying, hey there's a pretty building, let's go look at the landlord and see what kind of track record the landlord has. Let's factor that into the equation. We all all know there's some lease negotiation folks out there who do a good thing for dentists. What a lot of times they're doing is unwinding really bad leases. There's forty or fifty pages. 

I just helped negotiate or review a lease in Tennessee for a client who's got a ninety page lease, it's one of the longest ones I've ever worked with, figuring out how the landlord's protected, not the tenant. It's not like residential real estate where the tenant gets all the protection, you know, in commercial real estate, it's the landlord who gets all the protection. I like to make sure we kind of look at things from a new perspective, that's what the book is. I'm not here to sell a book. 

Howard: I want you to sell the book. My whole goal with the podcast it, it's not the Howard Farran show. I'm trying to turn all these dentists on to smart minds because I believe that my twenty eight years of being a dentist, the dentists who took a hundred plus hours of CE a year, twenty years, thirty years later, they were on top of every goal they wanted. The dentists who just weren't into CE, they just flushed their whole life. My deal is don't reinvent the wheel, steal from the greatest minds. I follow all the Fortune Five Hundred, when they do something I steal it and bring it to dentistry.

Jayme: Smart.

Howard: Like the internet, I didn't invent the internet, I didn't invent any of that stuff. I'm thinking, if I, instead of them going to a study club once a month, so they're going to get what, twelve lectures a year, I could get them twelve in a week. Their study club is just going to be people from their city, whereas I can pull, the guy before you was from Sweden, Gothenburg, Sweden. My deal is I want you to sell your book because I believe if I can put a free podcast in their iPhone and they accidentally get a new habit of listening to me on the way to work instead of listening to the Grateful Dead and smoking a joint on the way to work, they should be listening to a podcast that so much information's just going to randomly slip into their head, the next thing they know they're going to be successful and they're not even going to know why. I'll be this proud smiling grandpa on the rocking chair out front saying, I know I helped you a little bit. I nudged you in the right direction. Sell the shit out of your book, sell it right now. How much is it?

Jayme: It's sixty seven dollars, so it's not a cheap book. Here's another perspective shifter that I think people could pick up without even buying the book. One is Starbucks. You said look at the Fortune Five Hundred companies. What does Starbucks do when they go and look at a new facility, or a new location? I know, because I've competed against them for certain spaces. Starbucks has a site selection team. They have a whole team of lawyers, accountants, attorneys, everybody who goes and helps select a plan that's in line with their business model. Now let's compare that to what dentists have done over the last twenty, thirty, forty years. Hey, Uncle Vito, what do you think of this space? Hey, cotton roll guy, what do you think of this space? The power team for dentists has been a pretty small network of folks, where Starbucks on the other hand, mind you, they invest maybe what, three hundred grand, to open up their facility? Dentists invest five hundred grand on average to open up a new practice. Starbucks invests three hundred, dentists invest five hundred and rely on Uncle Vito.

Howard: What will the Starbucks business do in that? What will their sales be for a year, and what will the dentist sales be for a year on average?

Jayme: I don't know, but it's usually not over a million. The average practice in America, what's the ADA say, eight fifty? Eight seventy five, sometime like that? 

Howard: Oh, I thought it was much lower than that.

Jayme: Seven fifty?

Howard: I thought it was five hundred and then that five forty five was the last I saw. Am I wrong o that?

Jayme: I don't know if it's ...

Howard: Find out and then interview me on your podcast and we'll talk about every question we have if you find out you can interview me on your podcast and that would be an honor for me and we'll talk about it then.

Jayme: Let me write it down, hold on. I'm writing this down. 

Howard: I'm trying to get their ADA audience on, it's ... I forgot his ... it's Mark, it's kind of a strange last name. It's Mark something ... let me see if I can find that real quick. Mark ... I forgot, but anyway ...

Jayme: Here, let me throw another thing up. I'm trying to give as much really good stuff as I can to the folks listening, you ready?

Howard: Yeah.

Jayme: There's another sort of misunderstanding about dental demographics, the demographics that dentists use, doctors use. A lot of docs are coming to our firm now, they'll find us online or they'll read some of our articles or they'll buy our book. They'll say hey, I did some homework, like a doctor in Texas we recently worked with. He said hey, I'm in Texas, did some homework on Google. I found this great place in Maryland. Your book says one to two thousand, right. One doctor, one dentist for every two thousand patients in a given geography. He said I did some homework, this town in Maryland is amazing. I'm moving my family from Texas, it's one to thirty four hundred. I said oh, okay.

Howard: That's nice. That's good.

Jayme: That's pretty good.

Howard: No, that's damn good.

Jayme: Get this. We unwound the numbers a little bit, we found that unfortunately, or thankfully, that one to thirty four hundred ratio in that specific zip code where he was looking, the vast majority of the patients, they were Medicaid recipients.

Howard: Right. 

Jayme: That's fine, those patients need to be served also. That's great. There are some dentists and some practices, that's who they want to serve. That's who they want to take care of. I think it was an eye opener to this doc. That's one of those one degree shifts on the tracker that I was talking about. That's one of those one degree shifts where if you line it up just accidentally, a little off kilter, you might end up a little bit in the SAD group, the SAD group, and that's what I'm trying to help avoid. That's what I'm trying to help stop. That's what we call dangerous demographics, if that's helpful. I guess it's a little like fishing. You can go fishing in a pond, but everybody knows that the pond has to have fish.

Howard: That book, Choosing the Right Practice Location, it's sixty nine dollars on Amazon and it's mostly a demographic book about how to find a location

Jayme: Yep. Actually, here, I don't know if I was really planning on doing this, but can I give you something cool for your audience?

Howard: Hell yeah.

Jayme: All right, so, it's sixty seven dollars, you can there and get it on Amazon. I'm going to set up a link ...

Howard: It should have been sixty nine dollars. That's my favorite number, you know why? Why is sixty nine my favorite number?

Jayme: It looks fancy?

Howard: That's how old mother ... My mother when I grew up was Mother Theresa and that's old she was when she got the Novel Peace Prize. 

Jayme: I like that. That's pretty cool.

Howard: They tell you all these Catholic stories and my two favorite saints whatever was really Martin Luther, who was the first Catholic priest to stand up to all the bureaucracy of the Catholic church and be the first protester, and wrote down his ninety nine problems that he had with the church which have now been all addressed. My favorite nun of all time were not the ones in school spanking my hand with a ruler, it was actually Mother Theresa who just decided, I'm going to work with the poorest of the poor. She was the coolest lady and she was sixty nine years old when they gave her Nobel Peace Prize. Anyway, sorry to ...

Jayme: Changed the world, she changed the world.

Howard: So raise the price from sixty seven to sixty nine and say ...

Jayme: I would say Howard said so. 

Howard: Choosing the Right Practice Location and ...

Jayme: I don't want to destroy my team's ability to fulfill this, but I'm going to have a website link ready for you, that's How's that? Free plus shipping, so if people can help me offset the cost of shipping for listeners to of your podcast, I'll have that shipped off so I can get a free copy ...

Howard: Are you serious, you're giving them a free copy of your book?

Jayme: Yeah, I'll ask that they help pay for shipping if that's okay.

Howard: You know what I think you should do? I mean, everything is marketing, according to Fred Doyle who a podcast interview released yesterday. I think dentists have different behaviors. Some listen to podcasts. I look at those and different ones, online CE but, we put up five hundred and thirty online CE courses and they've been viewed over half a million times. You should do an online CE course for an hour, call it after your book, and half it so if they buy your course, they get the book, or this or that, and when you put up an online CE course, everyone that takes it, you get an email notification of the doctor's name and address so who took your course, so it would be leads for you, so you'd probably get all this ...

Jayme: Yeah, that would be awesome, thanks. Seriously, Howard, it's an amazing honor to be able to speak to everybody like this. It's awesome. In terms of leads, just so you know, we only work with two doctors per month, two new startups per month, with a team as small as ours. We never want to expand or extend ourselves too much. I just want to put that cautionary thing out there, we don't want to pretend that we can help everybody. When it's a good fit, when it's a really good match between us and the doctor's vision, that's important. Oh here, this is kind of neat. Here's something that we give to our higher level consulting clients that maybe your audience could use. We spend a ton of time on part of the process called the ideal patient. We go through a pretty rigorous process of extracting from the doctor what kinds of patients they're most satisfied serving. My believe is that if we can define that really well then we can build a marketing strategy to go chase those folks down. We can build a floor plan, who I think is the best dental floor plan designer in the country, his name's John, he's incredible.

If we can create a floor plan that speaks to that ideal patient, and if we can create a marketing plan that goes and addresses those ideal patients, to pull them in. If we can wrap the whole practice culture around this ideal patient, I'm never going to promise you're going to have only your ideal patient in the practice, but you probably have a better likelihood of attracting them if we build it for that purpose. Even going back to that demographics part, right? If we can find a demographics location that is specifically situated to find those kinds of patients, then you're probably going to get more of them. 

There's a doctor in Tampa that we worked with years ago. He said Jayme, after this process, for him it took a couple weeks. After this process, I was really surprised that my ideal patient, this was his words, was a single African American professional female, age thirty five to forty five. 

Howard: Hell, that's my favorite patient, too. My God, I had no idea. Did fill out the form, were you talking to me?

Jayme: You're the one. No, but there's a guy in Arkansas I work with now who said Jayme, my idea patient isn't actually a patient, we went through and through and though. His ideal patient is a small family unit of boys who are of baseball age, he loves talking baseball. He said I want to be able to connect with Jimmy, and I want to be able to talk with Mama about how Jimmy hit the ball, and I want to be able to talk to the dad about how Jimmy stopped the short stop ball from getting through. I probably just butchered some baseball language, I'm sorry. You get the point. If we can reverse engineer the process to fit the doctor's vision, then we can probably avoid a lot of the problems that come up or the disappointment ... 

Howard: Let's back up to where you started this conversation. This guy you helped your first client and he built his first office in Philly, but he really didn't want to practice there, and then he sold that and moved it. Now dentistry is fun because you can build up your office in solid, corporate's got a ton of cash, I mean Heartland can just write you a check in a minute. Talk about choosing your right location, because a lot of guys might be in their office twenty years and say, you know I really want to get the hell out of town and go downtown. How do you find a good location? What are some low hanging fruit, or let's say you just walked out of dental school from Temple Dental and ...

Jayme: Temple Dental.

Howard: Temple Dental. What is some of the first low hanging fruit to find out where to go?

Jayme: Rules of thumb, right? Rules of thumb. We're going to go one to two thousand. We need two thousand population for every one dentist. That's a real easy one. Be careful that you're not using bad data. Unfortunately even some of the quote un quote good data online, like on Google, a lot of it's not ... you get false positives. Be very careful, please. Don't just say, one there's one to two thousand, I'm going to open a practice there. Be careful or you might end up like that doctor in Texas looking at a town full of Medicaid patients which might not have worked long term for that guy, it could have taken two decades to unwind that. But that's one rule of thumb. Another rule of thumb is we have a ... I'll set it up so you can get a free, we have a thirteen stages guideline. It goes through the thirteen specific steps to open a practice, from number one being your vision, number two being financing, and on and on and on, right.

Howard: Well, go through them. Go through some things. Vision, financing ...

Jayme: Sure. I wonder if I can show them. Can I show it on the screen? Is that okay?

Howard: Yeah.

Jayme: Boom, so there's twelve months across the bottom. Can you see that? I have your picture, Skype picture in front of it there, sorry, I moved it over. Okay, so on right here, the blue planning stage. Stage one is vision, stage two, financing. We put financing in the beginning because if you can't get financing, you're not, unless you have Daddy Warbucks as your buddy, it's not going to happen for you. Stage three is demographics, so like we talked about, dangerous demographics, using the right rules of thumb. Stage four is site selection, this is something that is crucial. Make sure you get the book or do a ton of research, interview as many people as possible, look at as many Fortune Five Hundred case studies as possible, just like Howard's talking about. Your site will determine your long term progress. 

Your site selection will determine your construction costs. Your site selection will determine if you're going to spend twice as much on marking, or half as much on marketing. It just will. Your planning stage, that's the blue stage. The pink stage, stages five, six, seven, eight, the design and floor plan, the equipment selection, your construction bidding. My team does all this by the way. We negotiate for equipment, we negotiate for construction, we monitor the construction companies, we hold them accountable to timelines and we penalize them if they're late, all those kinds of things, and we design the floor plan, with John, who is, he hates when I say this, but he's the Picasso of dental floor plans, he's amazing. Anyway, those are the thirteen stages, on and on all the way through the average.

Howard: No, keep going, keep going, keep going.

Jayme: Okay. Stage nine begins our implementation section, nine, ten and eleven. Nine is marketing and hiring, so we walk clients through some best practices in hiring and marketing. You know Ginny Haggarty. Ginny Haggarty and I just released some information on the ideal practices podcast. Am I allowed to plug my podcast here?

Howard: Absolutely.

Jayme: Okay.

Howard: Hell yeah. I think it helps growth and abundancy, not fear and scare. I want every dentist to read every magazine, read every podcast, get everything they can until they're happy and healthy. That's my goal. I want all the dentists to be happy and healthy, that's my goal.

Jayme: You know Ginny and Ginny's awesome.

Howard: Yeah. Hell yeah, she's amazing.

Jayme: Ginny is a hiring genius for dentists. Go listen to her podcast interview, I would pay money to go to her course for what she shared on that ...

Howard: Will you tell her to call me and podcast ... 

Jayme: Yeah.

Howard: Call me to podcast, email me at and tell her to get on here and plug her podcast.

Jayme: Yep. Yes. Absolutely, Ginny will call you later this week.

Howard: Is your podcast on Dentaltown?

Jayme: It is, it's

Howard: Oh, okay

Jayme: The name of our firm is Ideal Practices. is like a big white paper, tons and tons of free articles to open up your own practice. Stage ten is where construction begins. That's where we have really firm contracts to help manage the contractors, so they're honest, ethical, on time and everything else. Stage eleven is equipment installation, stage twelve is your dry run, and that's so fun. We go in for a whole day and we go through a two hundred point checklist before you open, so we help train the team and get everything going. We come in on site, we fly in, anyway, if you want to take a screenshot of this, doctors, or whatever, use this, and then we put a little worst case scenario here, I don't know if it will show up well enough on the screen ...

Howard: Actually, can you do me a favor?

Jayme: Yeah.

Howard: Actually, why don't you start a thread and say my notes from interview with Howard, and tell them that we just did a podcast, so when the podcast comes out we can post that in the thread. You could post these two graphs, so then all the users look at these graphs. All the users looking at these graphs, all they have to do is go to Dentaltown, and if they go to Jayme ... they do a member search for Jayme, j-a-y-m-e Amos, and then it will show how many times he posts. I'm a big fan, you've got seventy nine blogs posted, twenty podcasts, and then it will see you posted. Start a thread on this.

Jayme: We have three in person courses, in Miami, Austin, and Vegas next year where we're going to go though all the tips an tricks that we go through with our high level consulting clients and we're just laying it all out for two days with experts around the country for specifically for opening up new practices. 

Howard: Miami, where?

Jayme: Miami, Austin, and Vegas. 

Howard: Oh my God, those are literally three of my favorite cities on earth.

Jayme: You're going to have to come hang out with us. 

Howard: Then we look a demographics. I want to just ask some specific questions about some of these. Demographics, rules of thumb. Is it better to go rural than urban? I mean, is there really any unfound jewels in a big metropolitan like Philly or Phoenix or LA, or do you really need to go rural?

Jayme: Yes and no, it totally depends on the city, and I hate saying it depends.

Howard: I'm wearing depends now so you can say it. 

Jayme: Okay. Then it depends with fluffiness, how's that? Get this, this is a real true, thing. I won't tell the exact town because I don't want to get people sniffing. There's a town we're helping a client move from Virginia to her family where they live in let's just say northern California. The ratio there, hang on tight, it's one to thirty three thousand. It's not a ...

Howard: Now is she able to pull her house all the way there? How long did it take her to pull her house from Virginia to California?

Jayme: That's what she hired me for, to drag it with my teeth. 

Howard: You drove her house. The rule of thumb. Urban, rural, it depends? It really depends?

Jayme: I hate saying it like that, but yeah, it truly depends because it's not even so much the ratio. The ratio's important, but it's more important that we define your ideal patient and find plenty of them. Not just the ratio, but the radio with recognition for your ideal patient, otherwise you could be trapped sitting chairside with patients you hate, and I don't want that to happen.

Howard: Well you know what, the one thing all my MBA, I got an MBA from Arizona State University ... Will you pull that back up? The one thing in common, all my MBA friends have in common is their favorite book author was Jim Collins and he wrote The Good The Great, but he also wrote what was more intuitive, which was how the mighty fail. He wrote a book on, this is what made everybody go under, and I thought that was amazing. The point I'm trying to make is that when you talk about demographics, during that two thousand eight financial meltdown, two thousand nine depression, about sixty five dental offices went bankrupt in the Phoenix valley, and they were all pretty much in one area of north Scottsdale, so that's the reverse demographics. If you go into a city and say, well is there a hidden good place to go? Okay, that's good to great, but how the mighty fail, I notice when they fell, they all pretty much fell in the Richie Rich, everybody thinks that's where all the rich people ...

Jayme: Can I tell you what we call that, Howard? In my book and my publications we call that pretty towns.

Howard: Yeah.

Jayme: We say do not open in pretty towns. That's a rule of thumb, that's a generality, but if you have a pretty town where you can walk to the Starbucks from your little nice little boutique, stone-laced office with a nice sidewalk, there's a really good chance that's the wrong town. Don't open in pretty towns as a rule of thumb. 

Howard: Yeah. The other thing is that people don't realize, when you get to those rich, pretty towns, an acre of land might only have two, three people living on it.

Jayme: Yeah.

Howard: When you get to like my area, I'm in Phoenix, I'm in actual Phoenix. There's an acre in Phoenix, and by my practice, it has an apartment complex, it might have three thousand people living in it. 

Jayme: Oh, yeah, right.

Howard: The density of the people. I want you to keep going, design and floor plan. One of the things I always cringe about is the dentists will always lay out all this plumbing and electrical and nitrous lines and all that and then backfill it with cement. 

Jayme: Yep.

Howard: An old dog like me, I've seen all my friends, something happened, five, ten years down later and they had to come back in with jackhammers and start blasting the stuff out. I that, are past pouring concrete over over lines or is that not really an issue anymore?

Jayme: No, it's generally accepted and recommended to still pour concrete over the lines which is why, if possible, we recommend finding a building with a basement. A lot of times now we've been helping doctors open up practices where they own the real estate, even as a startup with a zero dollars out of pocket structuring of the loans. Yes, you heard that right, zero dollars out of pocket to purchase the real estate and do the startup. Still more affordable than leasing space. Remember, six crowns a month.

Howard: Oh my gosh, you should do, I mean I got into my dental office with no money down. Getting into a house of dental office with no money down is a no brainer, but I think a lot of kids don't even think it's possible.

Jayme: Yeah.

Howard: You should do an online CE course ...

Jayme: I would love to. 

Howard: Why don't you start ... You know it's all about, you know newspapers spend twenty five percent of their space on headlines to get you to read the twenty five percent which is news and then fifty percent is advertising. 

Jayme: Yeah.

Howard: Will you go back to that, I'm sorry [crosstalk 00:43:25]

Jayme: I keep showing my Bozo face here.

Howard: You just keep showing off your face, you're so damn narcissistic you want to make sure everyone sees you're a Calvin Klein model. Yeah anybody can get ... If you started a course, how to get into a dental office with no money down, oh my God, that would explode.

Jayme: I'll do it. That would be awesome.

Howard: Whenever you put up an online CE course we could push it out to about three hundred thousand people digitally around the world. Equipment selection, that's why I want to keep staring at your list instead of your pretty face, so equipment selection. What do you think about the big expensive equipment? Cerec, [inaudible 00:44:02], Sirona, that's about a hundred and forty thousand. CBCTs from Caresteam, that's a hundred grand. A laser from BIOLASE is seventy five grand. What are your thoughts on all that expensive toys?

Jayme: I think ...

Howard: Any you like, any you avoid, any you recommend yes, any you recommend no?

Jayme: One of my clients in Iowa right now, he'll be laughing if he's listening to this because he's fighting me to get my permission, for whatever it's worth, he's fighting us to get budget permission to go buy his CBCT, his cone beam machine, and his Serac. He wants both. I get it, but as a startup practice, people say cash is king. I actually kind of disagree with that in a startup practice. Cash is not king. Cash is the whole kingdom. Cash is everything and then some in a startup practice.

Howard: Oh, I like that. Oh, I love it. 

Jayme: If you run out of cash in your startup practice, you're screwed. It's my goal to make sure that you have a really firm budget in place, my director of consulting, his name's Steven, he actually builds out business plans or our clients where we have twelve month projections, one, two, three, four year projections, you know regal business plans, the ones that I studied in the boardroom in Goldman Sachs when I was in Europe. Those kinds of things, that's legitimate business planning where we can project for the future. My real feelings to answer your question, I think it's amazing technology. Clinically, patients deserve it. From a business perspective, if your business runs out of money, you won't be seeing any more patients. 

Howard: The other thing is, the thing about ... I don't get it about [inaudible 00:45:37] anyway because with CBCT, they're all in five years they new model is so much better than ... in five years you want a new one anyway.

Jayme: Yeah. Can I give you a way to hijack the system a little bit? 

Howard: Yeah.

Jayme: I'm not going to make any friends with the real big companies by saying this.

Howard: I don't have any friends, so continue. I've pissed off every dentist in the world at least one with some comment I've made.

Jayme: The market of warrantied, refurbished and installed equipment is exploding right now. We just helped a client get a fifty dollar pen for nineteen grand. 

Howard: Yeah, and do you want a five year old ...

Jayme: Guess what? It's a thousand images on it. Listen, just like driving a car off a lot. If you drive a car off a lot, lord knows it's worth, what, a quarter?

Howard: If you want to have a five year old smartphone, then go buy a CBCT. Yesterday in my office, I, you know ... I mean, we've got Serac, you know, every single patient it's like, okay here's the deal, I can do it in one appointment right now, but you're going to be in this chair for two hours, or I can have you out in an hour, come back in two weeks for thirty minutes. Yesterday I think I did five or six rounds. Every single person elected to come back, because it was Monday. How many Mondays do you have in your life where you have two, three hours to sit in my chair?

Jayme: Yeah, a lot.

Howard: I mean, I'm asking you, I'm asking you. If you were in my chair, what would you want? Would you want an hour on Monday and come back in two weeks for a half an hour, or would you want to give me two hours on Monday?

Jayme: I'd give you two hours on Monday instead of coming back any day of the week, it kind of meets the scale on my time, I'll give you that time. I'd rather not have to travel, not have the headache. 

Howard: Yesterday, nobody took that offer.

Jayme: Why? Why is that?

Howard: Because they wanted out of there.

Jayme: Don't get me wrong, I don't have two hours, but at the same time, I don't have two days.

Howard: That's intelligent thinking in moderation. You get a CBCT, you get a CAD cam, it will be great for some patients. Then dentists will get it and they'll do it on every patient. If you get a CAD cam, you think all your crowns are going to be Seracs, you're not right in the head, you're not right in the head. [crosstalk 00:47:51] You're just simply not right in the head. 

Jayme: I'm not a clinician, and I'm not maybe qualified to comment on it, but my gut feeling, my opinion is that it's great, it's a great care option, but it's a really bad financial choice for a startup.

Howard: Okay, I want to go back to the location. Do you like medical dental professional buildings or do you like commercial real estate?

Jayme: Yep. Yes, if it fits the doctor's vision to be associated with other MDs or other medical professionals, one of the things I love about that is for the doctors who are willing to go shake hands, one of the most powerful elements, I just released a podcast, sorry to plug it again, it's how to be the only in network provider. The concept is basically become the quasi-insurance company. You can't call it insurance, we're not allowed to call it insurance. But if you can deliver a dental benefits plan through the other medical providers in something like a medical building, if you can be the chosen dentist for the patients and or the staff of the other medical providers in that medical complex, it's a home run. Then you're technically the only in network dentist because it's your plan. That only works for the doctors who are willing to go shake hands and willing to go build camaraderie with those other professionals in the building. In those kinds of situations, I love it. That's a grand slam, I love it.

Howard: Your podcast is called how to open a dental office?

Jayme: That's our white paper site, how to open a dental office. is where the podcast is [crosstalk 00:49:24]

Howard: Is it on iTunes?

Jayme: Yep, it is.

Howard: For a complete list of the most rocking hot dental podcasts, just go to Dentaltown.

Jayme: Yep, it's there.

Howard: If you're on a smartphone, download the Dentaltown app, it's free, and then under the section more, there's a dozen of you guys. I just listen to them in order, I mean I just listen to them one after the other.

Jayme: Oh, it's awesome. You have the best guests. I'm not just blowing smoke and saying I'm honored to be here, I mean I look at your lineup and it's amazing people with amazing insight. It's really cool being here.

Howard: It's fun because I'm addicted, this is my new hobby. I've only been doing it for a year. It used to be you're always going to lunch or dinner with some dentist.

Jayme: Yeah.

Howard: Now it's like, I don't want to sit at a restaurant and eat three thousand calories and drink because I'm fat, I'd rather just podcast because it's scalable. 

Jayme: Yeah.

Howard: Instead of us going to lunch and having a few beers, why don't we just do it on Skype so other people can listen because I just think it's a gorgeous thing.

Jayme: I have had a beer, during, not this podcast, but during some podcasts I have had beer during the podcast.

Howard: Back to equipment. Is there any advantage, I mean there's dental chairs that are top of the line, like A-dec out of Oregon, there are lower cost. What are your thoughts on operatories? How much do you think you should be spending on an operatory? You got an operatory number, like how much is it for an operatory versus does ...

Jayme: Yeah.

Howard: Furthermore, do you recommend them plumbing for four and just starting with one, do you like plumbing with five, what's your model?

Jayme: Depends on the doctor's vision, right?

Howard: I said don't say depends anymore. I mean, I'm wearing depends ...

Jayme: Don't need to say it anymore.

Howard: No, no, I'm just kidding.

Jayme: Let's pretend the doctor never wants to have an associate and wants a boutique practice. I work with a doctor in New Orleans right now who probably fits that model. She wants a very specific boutique, high end practice model. For her, any more than five operatories is probably not right. Why is that? With five operatories, you've two for the doctor, two for hygiene, one for overflow or emergency, right? If you reverse engineer all the numbers of an efficient practice model, you can trust me on the math or we can play around with the math, twelve hundred patients is the number that its five ops. Twelve hundred patients fits two full time hygienists where twenty five percent of those patients are on some kind of paradental therapy where they're coming back three or four times a year, but twelve hundred patients fills two full time hygienist schedules full days a week, one doctor's schedule, theoretically, twenty percent of patients get flipped over to the restorative chair, and then one overflow chair. If you can get to twelve hundred patients who know you ...

Howard: That's four chairs. You said two hygienists, one dentist chair, and then one overflow chair?

Jayme: Oh, two doctor chairs, so two columns of restorative and then one overflow.

Howard: Okay, and then one overflow or emergency?

Jayme: Yeah, overflow, emergency, whatever, yeah.

Howard: Yeah. Okay.

Jayme: For this doctor in New Orleans, you know, for her, she doesn't need anymore than five. If she ever wants an associate, then I'd probably say that she needs six, seven, or maybe eight chairs depending on the practice flow that she's going to want. If you reverse engineer all the numbers, twelve hundred patients will satisfy a one doctor, five chair practice. If we're working with a startup, I would say if that's you, if you're like that doctor in New Orleans, if that's your vision, then this could be a possible path for you. Remember, starting with that one degree thing, on the tractor, we want to make sure we're perfectly in alignment with the long term plans. If we're doing that I would say let's start with an amazing marketing strategy that appeals to the ideal patient, let's build a facility and do the treatment planning, I'm sorry, create the treatment rooms, create the floor plans, so it's all appealing to her ideal patient. I would say equip two rooms. To answer your question, I would say two rooms of equipment, no more is needed. Why? Because we can call the dental company and have it there in like a week, two weeks ...

Howard: Right.

Jayme: To get a new chair. Sometimes we'll say to get some cabinetry for that new room if we anticipate really strong growth. There's a doctor in Virginia who we're working with right now, rather she just opened. She had a hundred new patients on her opening day.

Howard: Oh my God.

Jayme: For her, that's awesome, right? That's powerful. We know she's going to need that third room. She's got eight rooms because of her vision, but we know she's going to need that third room really soon. That's fine that's great. To answer your question, I would say two rooms of equipment. 

Howard: Also the chair, with chairs, there's Chevys, Pontiac, Olds, Buick, Mercedes-Benz, A-decs, what are your thoughts on the price segmentation of different chairs, I mean ...

Jayme: Everybody loves the A-dec brand, and I get it without kind of saying yes or no about different brands. I would suggest prioritize the warranty. If possible, buy new, because the warranty can be stronger. There's a couple brands with five year warranties that I really like, so you have no out of pocket costs. 

Howard: Name the brands. What do you mean, no out of ...

Jayme: Marus, Marus has a five year warranty ...

Howard: Marus? M-a-r-r-u-s?

Jayme: M-a-r-u-s.

Howard: M-a-r-u-s? Where are they out of?

Jayme: I think they're actually now part of the Pelton and Crane family, I'm not completely sure.

Howard: Okay, okay. Pelton and Crane. Is that owned by Danaher?

Jayme: Yep. Pelton and Crane is, yeah.

Howard: Okay, Pelton and Crane, Danaher, so they have a Marus line, m-a-r-u-s?

Jayme: Yep, it's kind of the Lexus to the Toyota, or the Toyota to the Lexus. That's my understanding. 

Howard: Okay.

Jayme: While not being a total equipment expert, what we do is we put it out to bid. We help the doctor figure out the kinds of chairs they want, the kinds of chairs they're used to, and how they want to grow, and their budget. 

Howard: You buy new with a five year warranty?

Jayme: I do.

Howard: What other brand, you said there were a couple.

Jayme: Yeah, there's SDI, SDI is a good one out there.

Howard: SDI.

Jayme: Yep.

Howard: Strategic defense initiative, that's a Ronald Reagan chair that comes from outer space?

Jayme: That's the Star Wars program, the laser ...

Howard: What does SDI stand for?

Jayme: I don't know.

Howard: Something dental. Do you know where they're out of?

Jayme: Nope.

Howard: The reason I recommend A-dec is because it's spelled a-d-e-k, those are the four soluble vitamins and that's why I carry extra fat, so I have all kinds of A, D, E, K vitamins ...

Jayme: Plus they're a good brand. A-dec's a good brand. 

Howard: Actually, I just love the founder of that because it's such an American story ...

Jayme: Oh, it's awesome.

Howard: Where he goes to this small town of ten thousand. I took my four boys there and on one end is a bunch of palettes of raw materials like beads of plastic and copper or whatever, and then a hundred yards later they're kicking out dental chairs at the end, and this guy's name is Ken and I mean, it's just so romantic.

Jayme: It's a great story.

Howard: He modeled it off of Henry Ford in that he's totally an engineer. Henry Ford, what most engineers were impressed about Henry Ford is that if your Model T broke down, and say it was a year nineteen, twenty years later, but there was one that was down, abandoned in the creek on the farm from twenty years ago, you could go pull out the part and all the parts were interplaceable throughout his Model T. 

Jayme: Oh, that's awesome.

Howard: Henry Ford always wanted you to be able to interplace your parts and with A-dec, they're most proud of that a twenty five year old chair you could steal a part from that and use it in a new chair.

Jayme: Wow. 

Howard: They only had to make one modification in the whole history of their chair.

Jayme: That's crazy. 

Howard: That was with the base plate. You know why? Because as America got so fat, sometimes you would lean back a patient and it wouldn't be balanced. When the obesity finally took over, they had to make a much bigger, wider, heavier, fatter base plate.

Jayme: Wow.

Howard: I'm so proud of obesity because I'm a hundred percent Irish, and McDonald's brothers were Irish, that was the only great thing the Irish did in America was they brought McDonald's ... you know, the Irish brought obesity to America. [crosstalk 00:57:17]

Jayme: Whoever said obesity was a bad thing? Look at all the positive outcomes here, this is great. Yeah so, A-dec's a great brand, we have a lot of clients who choose A-dec, who buy A-dec and love A-dec, it's a great company.

Howard: You like this Marus out of Pelton and Crane. You said get new, get a five year warranty, get SDI, but do you know the name o the chair of the SDI?

Jayme: No, I can look it up. We have an equipment manager who takes care of that now.

Howard: You know what, all the questions of this, all the questions of this, start a post, say, and so it doesn't look self-serving say Howard wanted me to start this post, he's not so sorry, but you're charged. Here's some answers to the questions. I'd love for you to do a CE course mainly because it's a different behavior. Some of these dentists, when I look at dentists, some will only do a live course because when I got out of school, I would buy ... I bought Carl Misch's textbook. It was just a lot easier to buy his textbook and read it over a weekend then to go sit through all these hour lectures. Later I went back and did a seven three day weekend course, I got my fellowship admissions. I like reading. To me that's the fastest way to devour information. I'm looking at summer readers and the textbook industry's a big industry, some will only do online CE, I think a lot of that is because they want their credit to get their FAGD, their MAGD.

Jayme: Okay.

Howard: Some like podcasts and podcasts is a multitasking behavior. They're only listening to us because they have to do something else, like a treadmill or driving to work or ...

Jayme: Or their lawnmower, like me, that's when I listen to podcasts.

Howard: Or their lawnmower. I live in the desert, I don't even know what that looks like. I think my whole mission is ... we give these guys enough information they'll make some good decisions and they'll [crosstalk 00:59:02] ...

Jayme: Howard, I'm not kidding when I say there is a really good path to follow to open up a practice. We hear from doctors all the time, Jayme I just want the control to make my own clinical decisions, I just want to make the money I believe I'm worth, I just want to be able to provide for my family without having to commute an hour and a half each way working for some boss who lives in another state who manages the thing remotely. There is a way to own your own practice and do it in a startup fashion so you can get what you want clinically so you can create a place that represents you really well. There's a way to do that without losing your shirt or becoming one of the members of that SAD division, the special assets division at the bank. There's a way to do it that's safe and predictable. It's my hope to keep sharing good information and if we can do that, good.

Howard: I'll just paraphrase what Jayme just said is if you didn't have, if you didn't get married and start a family you wouldn't have to do any of this shit. 

Jayme: Yeah, you could just live in a box.

Howard: Yeah, so don't get married, don't start a family. [crosstalk 01:00:01] My son's sitting next to me. Ryan, if I did it all over again, I should not have had you. Is that ...

Jayme: Sorry Ryan. Hey, can I give the website address for that free book again, would that be helpful?

Howard: Yes.

Jayme: I think it would be functional now, but I'll make sure it's truly functional later. 

Howard: Okay. If anybody else that you think, send me Gina Haggarty, have her email both of us ...

Jayme: Yeah, she's awesome.

Howard: Have her do a podcast. If you know any other people in this space that you think I should be interviewing to help you out, and by the way, putting your podcasts, or do most people listen to you on iTunes or Dentaltown or YouTube or what's your ...

Jayme: I don't really know how they find us, we have a few thousand people per month [crosstalk 01:00:46]

Howard: If you're listening out there to the podcast and you put that thing on iTunes, that's free, you don't make any money from that. Why in the world wouldn't you put it on Dentaltown because you're advertising to two hundred thousand dentists and ....

Jayme: Yeah. Thank you for the invitation.

Howard: Dentists all the time, they always tell me, oh my god, I used to listen to your podcast, but now I listen to Mark Costas or this other one, and I say, well how did you find it? They go, on Dentaltown. It's like, awesome.

Jayme: So cool. Can I put a plug in for you, Howard? Docs young, old, in between, if you're newer to Howard or not newer, there are few people who have what Howard just called the abundance mindset, as I've watched like a creepy stalker watching from the outside. There are few people out there who have an open source, abundant style mindset like Howard does who genuinely, I mean I've watched, Howard, you keep just saying, come in and play, here's my sandbox, come on in, right? You're awesome at that. On behalf of little guys like me, thank you for doing what you do and making it so that the whole community, all of dentistry can benefit. It's really cool, thank you. 

Howard: Well thanks, dude, because at the end of the day, we're all going to die and be lowered into the same sized box, so who cares how big your box is. My whole deal is, all the dentists in Ahwatukee, they all played and hung out together and we're friends, we had the most fun and were the most successful as all the guys who thought in fear and scare [inaudible 01:02:10]. 

Jayme: Yeah.

Howard: I take that from dental office, to dental magazine, to dental podcasts, and actually, truthfully, I love dentists the most, because if your friend is a dentist or a physician or a lawyer, they've read a hundred non-fiction books and they can talk intelligently. If they're not a doctor, dentist or lawyer, pretty much the only thing they watch is Jerry Springer show ...

Jayme: The Voice.

Howard: The Jerry Springer Show, maybe Fifty Shades of Grey, and when they start talking about things, it's like, come on. You know, I love dentists, I love dentists, and the people that serve in the industry like you. Thank you so much for spending an hour with me.

Jayme: Yeah, thank you.

Howard: I hope you start the online CE course. Start that thread ...

Jayme: [crosstalk 01:02:50] I will. I'll do it. Thank you. 

Howard: Thank you for all you do for dentistry, but you never did say your price. 

Jayme: Oh.

Howard: You never did say how much it costs to get your service to start a practice. You said you only take two new clients a month but you never said what that would cost. 

Jayme: Depends ...

Howard: There goes his depends again. Now I'm going to have to change my depends.

Jayme: People can through our application process and look into it. We're [crosstalk 01:03:14] not inexpensive. We're not inexpensive.

Howard: Okay. All right buddy, well thank you again for spending an hour with me. Now go shave your head.

Jayme: Thank you, Howard. 

Howard: Bye bye.

Jayme: Talk to you soon.

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