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AUDIO - HSP #247 - J Elliott Brennan
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VIDEO - HSP #247 - J Elliott Brennan
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Learn from brothers J. Elliott Brennan and Jonny Brennan:
• Private Practice has changed
• How to compete in a saturated market
• How to hang your own shingle
• How to manage and evaluate student loans
• New game changers
• How to manage everything around you and get through the survival years
• What to expect for time and money
• How to hit the ground running on a long prosperous career the way YOU want it
Dr. J. Elliott Brennan is Owner and Co-Founder of Brennan Dental in Chandler, Arizona. Dr. Brennan grew up in Tempe and attended Arizona State University. After his studies in biochemistry, he attended the Arizona School of Dentistry and Oral Health. Upon graduation, Dr. Brennan was invited to stay on with the University as adjunct faculty where he has continued to work part time. He is married with three children and continues to prioritize dental technology in his practice and teaching. Dr. Brennan has volunteered his dental services at a myriad of community clinics, including the Phoenix VA Dental Clinic, Indian Health Services in Belcourt, North Dakota, Clinica Betal in Atoyac, Mexico, and St. Vincent de Paul dental clinic for children in Phoenix, AZ.
Dr. Jonny graduated from Arizona State University in 2005. He then earned his Medical Degree from the University of Toledo College of Medicine. In 2008 he joined Dr. Elliott at the Arizona School of Dentistry and Oral Health. Over the next 4 years, Dr. Jonny earned dual degrees with a Master in Public Health and a Doctor of Dental Medicine degree. After being accepted to a heavily sought after oral surgery residency at Banner Medical Center, Dr. Jonny chose a different direction returning to his passions in technology and education. Dr. Jonny Brennan is currently the director of dental informatics and innovation at the A.T. Still University’s Arizona School of Dentistry and Oral Health. In 2014, Dr. Jonny became co-founder of Brennan Dental bringing his expertise in both medicine and technology to Chandler’s foremost dental practice.
Howard: It is a huge, huge honor for me to be interviewing what I call the rarest unicorns I've ever seen, which is 2 brothers who both graduated from dental school in 2012. You guys practice up the street from me. I know so many local dentists who just think you guys are the bomb. I'm in Phoenix but in the Park called Ahwatukee. Right across from Ahwatukee is Chandler. That's where you guys are, aren't you? Am I right?
Jonny: Yep.
J. Elliott: Mm-hmm (affirmative)..
Howard: What's funny is your bald. Your name is Elliott. I am bald. I practice on Elliott.
J. Elliott: When I shaved it today, I looked in the mirror and went, "Oh my goodness, I'm starting to look like Howard Farran. I'm 25 years away."
Howard: This is what you'll look like when you're a grandpa but the reason I contacted you is because I keep getting requests from fans of the show that, "Hey, don't talk to a bunch of old guys who mastered implants and root canals." They want to hear from young guys that just got out recently. I can't think of any 2 guys that got out ... You got out in 2012. From every metric that I would judge someone on, you're happy, healthy and crushing it in dentistry. Thanks for giving me an hour of your time, guy.
Jonny: Thank you.
J. Elliott: It's an honor.
Howard: Tell us your story. First of all, everybody's got to know. How did 2 brothers graduate in the same year from dental school? Your dad has to be a dentist.
Jonny: No, actually an engineer ...
Howard: An engineer. Is that right?
Jonny: ... but I'll give you a little of the back story. I guess it starts with me. I'm 4 years older that Elliott. I knew I wanted to go into healthcare but didn't know much about dentistry because we don't have a family background. I went to medical school first. It was during my third year of medical school learning about all the different branches of medicine and what residency I might want to choose that Elliott was applying to dental school. I saw opportunity for oral and maxillofacial surgery as a potential. As soon as I graduated medical school, came straight to dental and joined Elliott's class.
Howard: You're an MD and a DDS, a dMV or what?
Jonny: DMV.
Howard: You're an MD and a DMV.
Jonny: Correct.
Howard: Now are you going to be become an oral surgeon?
Jonny: Nope. That's part of the beauty of dentistry is coming in and learning all about the field and the opportunities. My passion is technology and healthcare in general but learning that there's so much growth, so much opportunity, in dentistry with technology, I'm better off doing general dentistry and all of the stuff that can incorporate into it.
Howard: Were you born and raised in Chandler?
Jonny: No, born in Pocatello, Idaho of all places but grew up mostly in Tempe. We moved out when I was 8 years old.
Howard: My walnut brain's trying to figure out how I can live in Phoenix in the winter and Idaho or Alaska in the summer. I think I'm going to sell my house and get a fifth wheel and just ... That would be the dream. With the podcast, what so many people are asking me to know is when you came out of school, just walk us through how going from graduation to practicing and tell us your journey.
What good moves did you make because they're scared. They've got $300,000 to $400,000 in debt. They've never owned their own business. If your mom was a stay-at-home mom and made cookies and dad worked as an employee somewhere, they don't know business. Your dad was an engineer. Was he an employee for someone or did he own his own engineering firm?
J. Elliott: You know the area as well. When we lived out here, we lived at Grand Rural. That's about 3 miles from where you practice, about 5 from us. When we moved, that was the edge of civilization in Phoenix in 1990. Motorola had built a plant there. He worked for Motorola for a series of years, then on semiconductor. Then he's moved around still in the semiconductor tech industry. That's what brought us here. That's where he went.
I think the biggest thing he instilled in the 2 of us was he worked for corporate America, having bosses and working his way up to the level of a director. He was pretty firm in instilling in us acquiring a skill where you can be entrepreneurial. You can work for yourself or you can make choices to work for others. We saw that from him. He pushed us a different direction to be self-made men or more self-reliant.
Howard: I think it's the greatest thing in the world not to have a boss. That's why I love dentistry. The physician friends, the politics going on at the local hospital dwarfs the Republic debates. The price of freedom to go into work and do whatever you want to do is priceless.
Jonny: Yep.
Howard: What would you tell it again? Tell us your journey. How do you go from graduating ... Did you dad pay for your school or did you guys have student loans?
J. Elliott: No. He's been on the job hunt the past 3 to 5 years. It's not as though we come from a background where this is going to be just a cake walk with no debt or anything like that. I took an aptitude test in my sophomore year of high school that told me I should either be an Air Force pilot or an orthodontist. That's where it started for me is I looked at it. I went, "Air Force pilot? I'm going to get divorced. I'm going to have kids all over the country. Orthodontist sounds like the safest thing in the world."
I knew as a sophomore in high school this was what I was going to do. I started setting those 3 5-year goals all the way through dental school. We both went to ASU, applied and went to the AT Still University, the local dental school, the first one that opened in Arizona. Then as we got out, I found some realities I hadn't really recognized in the dental field. This may be why you're getting those requests. I had in the back of my mind that the typical dentist went to dental school and then came out.
He was able to hang a shingle and then just find ultimate success, work 3, 4 days a week, go golfing and have this 6-figure salary of this magical career. I think there may have been a sweet spot in history where that might have been the case but that's just not the case any more. Some of the realities we hit were that we were graduating in Arizona, an area that others would refer to as saturated. As we went looking for how or where to open a dental practice, every corner's already taken around here.
Howard: It's insanely saturated. It has 2 dentals schools in 1 city with fluoride in the water. It doesn't really get any worse than right here.
J. Elliott: The other new reality is we were getting out of dental school with ... We have no problem sharing our figures. I was lucky enough to have as scholarship in dental school, the WUE which is the Western Exchange that pays ... When you don't have a state school, they pay some of your tuition. That discounted my education about $80,000 but I still got out with about $320,000, $330,000 in dental school debt. My brother went to medical school beforehand. He was way, way worse off.
Jonny: I have more debt than most people I've rubbed shoulders with.
Howard: What is your debt?
Jonny: I'm over $700,000. $725,000 was the latest figure.
Howard: I thought your brother, Elliott, had more debt because he doesn't even have enough money to buy a wig.
J. Elliott: I must worry about it more.
Howard: That number seems to me ... Are you guys 50/50 partners in a dental office?
Jonny: We are. Yep.
Howard: A lot of people sit there and say, "You're $1 million in debt." don't really see why that bothers anybody because every dentist I know that's 40 years old and above lives in $1 million home. If you kids come out of school with all this debt, maybe instead of $1 million home, you'll have a $500,000 home. Then I know I say this over and over and over. It's not a joke that gets told but every time a dentist gets divorced, it's at least $1 to $3 million.
If you just thought, "Keep your wife. You graduated without student loans," ... Then if you're $700,000, you're $330,000, how were you able to open up your own practice because a lot of kids are saying this. They're saying, "You know what? I should join the Navy for 4 years, be in public health service or go work at Heartland or Pacific Dental Services and pay off my student loans first." What would you say to that advice?
Jonny: I would say if your passionate about one of those avenues, then more power to you. You should go and do that, if that's something that fits you really well. We have a close friend that graduated with us, went to Heartland out in Iowa. He approached them and just said, "I want to get fast. I want to [crosstalk 00:08:47]."
Howard: Who are you talking about?
J. Elliott: He knows who it is.
Jonny: Tanner Flattery.
Howard: I'm the one who told him to call [inaudible 00:08:53]. I had Rick Workman call him.
Jonny: We're aware of that relationship as well.
Howard: Get the story right. He's crushing it with Harley.
Jonny: Crushing it. That fits him really well but it might not fit everyone.
Howard: But why did that fit him very well because corporate America, that's the devil. Go into Dental Town and say, "Corporate dentistry." Fangs come out. Why is it working for your friend?
Jonny: For Tanner knowing him really well, he's not one that wanted to do a lot of his own business management from what we hard from him. It's not his forte. His forte really was getting in the dental chair, leaving at the end of the night, not thinking again about dentistry until the next day or especially over his weekend. He just really wasn't interested in that ownership or management piece as far as I know.
Howard: The neat thing about Tanner, which nobody wants to go to rural america because there's nothing to do, but Tanner was very happily married with a baby. When he came home at night, he didn't need bars, nightclubs, the Suns games and the Cardinals. He's totally happy in his front room with his adorable wife and 2 kids now, right? Is it 2?
J. Elliott: They might have had a second one on the way. I've got to ask my wife those questions.
Howard: If you're in rural America where there's 6,000 people needing a dentist versus downtown Phoenix where there might be 500 to 1, why not just go where everybody needs you if at night, you're going to go home and play with your wife and kids? That's the only coaching I put onto Tanner is who cares if it ... Plus, where would you rather raise a family, small town or big city? Would you rather raise your kid in downtown LA or small town Iowa?
Jonny: I'd love somewhere in between perhaps.
J. Elliott: Did you skip over Phoenix or [inaudible 00:10:37]? Yeah but you brought up a perfect point or he even answered it without calling it out exactly as it was. When I think back to dental school with Tanner, we're 2 types of students that when we had our pool of patients we're supposed to manager, re-care, the different competencies and things we're supposed to accomplish, these 2 would have a spreadsheet that would have patient name, contact information.
We'd spend so much time organizational so that we were really upbeat on what was going on. We're really good at the administration side of our treatment. Tanner would get lost in the mix of the administration but was more of a clinician in dental school than we were for sure. He had a passion for [inaudible 00:11:17] teeth, some of the things that aren't our strengths. You really have to evaluate yourself. I think he absolutely made the right decision. In where he is, he's happy. It's what he's doing, he's absolutely happy. I also wonder if he would have struggled in some of our [inaudible 00:11:29].
It's been hard road. If I could tell you how many spreadsheets I've made in 3 years of being a dentist, it would blow some people's minds but you have to be able to look at a profit and loos statement and evaluate some of those things to get to the point where you're going to own a viable practice that's not [crosstalk 00:11:42].
Howard: You're talking to thousands of dentists right now. A lot of them are fourth year kids in dental school listening to the podcast. In fact, a lot them tell me they're listening to this during dental school sitting in the back row. Describe to this individual some red flags that lets them know if they are the entrepreneur type that would probably want to be their own boss or if they're the type like Tanner that would just go in and do dentistry.
Describe some greats so this person can look in the mirror and decide which one they really are because what you want to believe about yourself ... I believe I look exactly like Marky Mark but other people tell me I don't. Describe this person.
Jonny: I think one of the first things that came my mind, and it can be viewed as a derogatory term but I don't view it that way, but there is an intensity. There is an intensity to ... The 2 of us and others that I've seen that when they graduated, they hit the ground. They said, "I want to practice ownership. It's in my future. If not today, at some point. I have an intensity about the way I want to set up my office, the instruments I want, the materials that I'm using."
There are some DSOs out there who are bigger organizations that do blend a little bit more to the dentist but generally speaking unless it's your baby, you don't get to call the shots on all those things. If that matters to you a lot and you're very intense about, "I need it to be this way. I want things my way or the highway," then ownership's really the only way you get to go where you get to say, "That's what I want my logo to look like. I don't like that shade of green. I want to change that just a little bit."
J. Elliott: I think you have to see some of those realities. You're about to graduate with that kind of debt load. The trouble there actually becomes people lending you an exorbitant amount of money to do what you want to do. You need to look at what type of grid that you want. I knew I wanted to stay here around Arizona. Some of the heartland or some of the more corporate places that want to pluck me down in Midwest America wasn't going to work.
Then I knew I wanted to establish early on in the practice I was going to show up for 30 plus years. This is where I'm going to be. If you have a lot of those desires, the quicker you can get to it, the better because I found I couldn't do it the first year out of dental school. No one would lend me the money. I didn't have production reports which showed what I could produce and the kind of work I could do. It took me 2 or 3 years to walk into Bank of America, Wells Fargo or anybody, and say "Hey, I am a dentist that [inaudible 00:14:14]. I have learned some things and can do some stuff."
If you have all of that drive and those desires to be in control truly, not have a boss, the way you have to do is right out of the chute you have to make a plan. We're a little bit different. We share the burden or the debt load that we have with the practice. We split the hours. We started from scratch 8 months ago. A start-up dental practice is not profitable right away. The 2 of us were working for free for a while. It takes a lot of hard work but if you have all of those desires, you just need to plan and have the right things in place
We can talk more about those red flags but that's just a quick answer is it's what we wanted. It's what we always wanted. The reason I went into dentistry was my sophomore year I already had a 10-year plan. How am I not out of dental school going to go? I've got another 10-year plan where I'm in the driver's seat at the 10-year mark.
Howard: When you got out of school, you did not have access to capital to start from scratch, right? You had to work for a year or 2 before banks would swim you?
J. Elliott: Yeah.
Howard: What did you do out of school? Where did you work? How long did it take you before someone would give you a loan?
J. Elliott: 3 to 3 1/2 years ago I set up and interview at Today's Dental, whether you know it or not because you were 4 or 5 miles from my house. You were open on Fridays and Saturdays. Me right out of the chute, I knew I wanted to be full-time dentistry. This is all I want to do. I knew early on in the survival period that I want to work 6 days a week because I want to get there faster, have my own thing going on. I was all about maximizing the money that I was making to put away toward savings or to accomplish production as well so I could show the bank that I can do this.
What they really wanted out of us when it came time ... I believe that if we had just called them, if you're a dentist, they will give you $300,000, no questions asked, for starting a practice or buying a practice. The moment you want more than $300,000, they need to know either the details of the practice you are buying or they need to have a business plan from you showing that you're worth of loaning $400,000, $500,000 plus. The thing that really came to us, when we weren't buying a practice and we were doing a scratch start was we needed to show a history of production. I joked about interviewing at Today's Dental but I worked around the Valley. I worked primarily in Maricopa.
Howard: Was that for Jarred Pope?
J. Elliott: No, it wasn't. He was actually hiring. I got a call a couple times from him as well but this was actually for a distant family connection, an in-law that ... It's the Lyons family. I don't know if you know the Lyons of the Valley ...
Howard: Mm-hmm (affirmative).
J. Elliott: ... oral surgery and couple different things. Smile Life was the name of the practice there. That was wonderful. They paid me very well as an associate. They had [Serak 00:16:59] in their office. I learned a lot of really valuable things there. I was only there 2 to 3 days a week but they were long days and got a lot of experience. Then the other 3, 4 days of the week I was constantly hooking up with something for 4 months, then transitioning to a new thing looking. That got to be a frustration that pushed me toward this sooner than I probably would have even planned.
I got tired of looking for an associate gig but associate-ship dentistry provides an income stream that I banked a decent amount of money that I knew I could go through a drought here during a start-up and my family could still survive off of some savings. That was really the biggest thing on me jump-starting our gig and primed in a position to startup.
Howard: A lot of viewers as going to ask because a lot of them are single. A lot of dentists are single. They're dating someone. They don't realize that they've got to keep their spouse. You said you knew you wanted to stay in the Valley. Was that your thoughts or was your wife ... Are you guys both married?
J. Elliott: Yes.
Jonny: Mm-hmm (affirmative).
Howard: Both have kids?
Jonny: Yep
J. Elliott: 3 kids each.
Howard: 3 kids each. Was it your wife telling you, "I want to stay here by my mom, my sisters and my family," or when you said that you knew you wanted to stay here, explain why.
J. Elliott: Not me. My wife was fine. She's very flexible and very supportive. Mine became more I thought that I would bump into that practice down in Maricopa or through that connection I thought, "Hey, here's somebody that I've known in dentistry," potential ownership or even starting a practice that was affiliated with it somehow but as time went on, there just wasn't a mutually beneficial relationship there. I learned after about a year, a year and a half, "Hey, this isn't what I thought." I had known him during dental school.
For 4 years I thought, "This is where I'm headed and where I'm going to work and do associate-ship to part owner to an owner," but once I learned that after the first year or 2, then I started setting my sights on something else. It was actually the prospect of working in that relationship that was going to keep me here but not the case. The truth be told, I could have gone somewhere else but after that year and a half of working here, this has become our lives, where we've been since we were 5 years old.
Howard: You walk out of AT Still School. People are not familiar with the Valley. Half of America lives in about 117 metros. The other half lives in about 19,000 small towns. In most of the metros, about half is the anchor city like Phoenix. Then the other half is all the surrounding areas, Glendale, Chandler, Scottsdale. How did you pick Chandler and your location versus say Glendale, Apache Junction, Scottsdale? Did you look at it demographically or did you look at it more emotionally like, "I just want to live here?"
Jonny: No. We actually originally were looking a little bit further up northwest in the Scottsdale area. We were considering the whole valley but one of the primary characteristics that helped us settle or land where we ended up landing was going back to that comment made up earlier about saturation, that there was at least 1 if not 1 dentist on every street corner to every major intersection. We happened to find an area here in Chandler where there were previously 2 dentists. Both had relocated for their own personal reasons. It left a bit of a void for this community, even within the saturation of overall Phoenix.
Howard: Where are you guys at exactly?
Jonny: We are at Cooper and Ray Road.
Howard: Cooper and Ray. What's Cooper, about 10 miles due east of me? I'm on Elliott and
Jonny: It's about that.
Howard: About 10 miles?
Jonny: Cooper I think is Stately as well once you hit Mesa.
Howard: That was right by your dental school.
Jonny: It's about half-way between the 2 of us. It takes 40 minutes to get to you, 40 minutes to get to here.
Howard: You've been open 8 months.
J. Elliott: Mm-hmm (affirmative).
Jonny: Yep.
Howard: Did you rent a retail setting or a professional medical dental setting?
Jonny: Retail and wouldn't look back on it. It's been great for our patients to just be able to pull up and walk in the door. Now we did a remodel of our office to make it very ...
Howard: You actually rented where that other dentist had left?
J. Elliott: Yeah. I even saw, and I think it was your Facebook or Google Plus, congratulations to Bob Savage once he opened his new office which is very pretty. He practiced here for a limited amount of time with Dr. Brown, Robert Brown.
Howard: Oh wow.
J. Elliott: When we got here, it really wasn't the lay-out that we liked. We pretty much gutted the whole thing. The only benefit was that there was plumbing for operatories. We did build from scratch bu [crosstalk 00:21:31].
Howard: You know what's funny when you get older? You know what the Number 1 reason why I recommend ... I never got a partner because I figured if half the marriages fail, and that's with a lover and children, why would you marry a dentist? You don't have those social blues. Now you have different social blues because you're blood. You're family. Dad could get involved and Mom. You have lots of glues to hold you together in the rough spots.
No, I never got a partner but the best thing I liked about having associates over the last 30 years like Bob Savage, I look at all my best friends that are dentists in the Valley. They're all people over the last 30 years that worked for me for 6 or 7 years. Sam Dominick, Tom Giocobi, Tim Taylor, Bob Savage. My best football game buddies, dentists, are all people who back in the day worked 6 or 7 years until they decided to have their own. You took Bob Savage's old place.
J. Elliott: I think he was renting it for a year or so from Robert Brown. It was Robert Brown that was in this complex. I think he wanted more street traffic. He moved to Gilbert, downtown Gilbert, bought an old house and renovated it. Then Bob Savage went next to the Oreganos' in that [inaudible 00:22:44] area. Both of them went 3 plus miles away. In general, there's [crosstalk 00:22:49].
Howard: What was the total nugget to go in there and renovate that how you wanted it? How much money did you guys have to put into that thing? How much was your loan from the bank?
Jonny: Including the working capital, we were a total of $625,000.
Howard: Then the banks give you $300,000 each.
J. Elliott: No, we borrowed together. On the project together, we had to get into details of projections of what our marketing plan was and everything.
Howard: Was it a national bank that gave you the money that opens coast to coast or was it [crosstalk 00:23:21]?
J. Elliott: Bank of America is who we ended up with. We pitted Bank of America and Wells Fargo against each other. Wells had a better rate but Bank of America's repayment was kinder to us. We told Bank of America, "We like this rate." They matched it. We ended up with the best of both worlds.
Howard: Explain that in a little more detail because most of these kids don't have that kind of banking history.
J. Elliott: When we first applied, we met a rep from Bank of America and told him the whole thing we want to do, a scratch start-up, as much working capital as possible to put into marketing and really jump-starting things. Then we knew we needed to do a remodel. In the $625,000, you have $75,000 of working capital. That takes it down to $550,000. Of the $550,000, half of it went to gutting this place and to a contractor redoing it. We through an architectural firm up on Colorado that does beautiful stuff, Joe Architect.
The contractor was about $250,000 to $300,000. Then the other $250,000 was equipment in-site. We got a lot of stuff we were familiar with coming from a new dental school of cable hand pieces, electrical hand pieces, [inaudible 00:24:27] and Crane cabinetry. I'm trying to think what else but a lot of it was equipment in that $200,000 to $300,000 that was [crosstalk 00:24:36].
Howard: Did you buy any big, expensive toys, a $150,000 Serac machine, a $100,000 CVCT, a $75,000 biolayse laser? Did you buy any toys with that or ...
J. Elliott: Not with that. We have since. We just a couple weeks ago took our a new Patterson loan for an Omni-cam. We're loving the new Omni-cam as well.
Howard: Why are you loving the new Omni-cam?
Jonny: It's changed dentistry for us. To jump in for a second, to reiterate earlier, that's where I want to invest most of my time and energy is in technology sector of dentistry and healthcare in general. Being able to get away from some of the older materials or older mindsets and into something that's much more computer-aided design, it just makes both of us more excited, more excited to present the treatment, more excited to show up to work each day. Outside of that, it has a return on investment. Again, being spreadsheet people, we got down to the point, whatever, crowns that we have to produce each month for it to be worthwhile and offset what a lab bill would be for us here at Brennan Dental.
Howard: As being somebody who's lived half a century, the most important decision you make, Rule Number 1, does that make you happy? Does it make you healthy? I don't even want to get into the science of a [inaudible 00:25:57] composite or indirect versus direct. I just want the dentist not burned out, fried and drinking Listerine all day in between patients. I want them to just love what they're doing. If you can get the dentist's head on straight where they just love what they're doing and they're excited and passionate, everything else falls in line.
You keep saying that you love technology. Talk about how technology, because you were beaming. You're just glowing when you're talking about it. What specifically in technology are you passionate about dentistry adopting and changing over what wasn't there 30 years ago?
Jonny: I think what we've seen for growth in the last 5 to 10 years is what we were just talking about. CAT-cam dentistry seems to be taking off, that even those that are not early adopters, they like to stay on the fence. We're watching as some of those doctors are starting to now peek their heads in and realize, especially with these cameras that now don't require powder, the approximation from the software that it gives you. The modeling of teeth is just so much more accurate anatomy to the patient's specific mouth, all of these features that just take away a lot of the bugs in first or second-version things. CAT-cam dentistry is a huge area of growth.
The other that's right around the corner and some of the early adopters are talking a lot about is merging that with the cone beam, 3-D skeletal scan technology, allowing us to venture out from just restorations but now do a complete digital dentistry workflow. When we talk about placing implants, we're not just sending out to a surgical guide or trying to approximate with our own eyes in the moment by getting to plan ahead of time, even mill out a custom abutment or a custom healing abutment and even potentially a provisional that just fits like butter right when you place that implant because of all that was planned ahead of time and milled precisely.
Howard: I have never heard the term fits like butter but I like it.
Jonny: I guess that's [crosstalk 00:28:02]. Food is butter.
J. Elliott: Yeah, food is butter.
Howard: My 2 favorite food groups are bacon and butter. I like the way you think. Did you do a CVCT too, a 3-D?
Jonny: We haven't yet. Mostly because of limitation of resources, we're not ...
Howard: If you were going to do a 3-D [inaudible 00:28:18] machine since you have CEREC, Seronas, CAT-Cam, would you buy the Gallileos or would you go to open format and get something else?
Jonny: No. We would get the Gallileos.
Howard: [Inaudible 00:28:32] just merged with Serona. The million dollar question is right now are you using the [inaudible 00:28:40] max box for your CAD-cam?
Jonny: Yep.
Howard: What percent of the time do you mellow restoration or are you using e-max?
J. Elliott: 90 or more %, 96%.
Howard: Do you think it will be different when now that they are married to [Denselight 00:28:54] because Denselight's got a block? What's the Denselight block? Do you know on top of your head?
J. Elliott: Even Serona has its own blocks though. For the longest time, E Max has just made a search to be the block to use but I think we're going to see a whole flock of people that come to the table with a lot of new but with the [inaudible 00:29:15] I've heard of a lot of modifications to that and a lot of new blocks that are going to flood the market but E Max is still the Number 1 block, even though Serona has a lot of their own blocks. They have [inaudible 00:29:24] and Serona brand blocks but for right now, E Max is that Number 1 that they're using as a, I don't know, race horse for ...
Howard: I want to ask you guys because you're basically both old enough to be my children. What do you say ... I mean that in a way that your generation grew up on technology. I still think my boys' grandfather, one of the worst mistakes he ever made was when they came out with the computer, he always said, "Grandma does all the typing." We're just like, "I know you type on a computer but there's slightly differences between a typewriter and the internet."
He never made the connection to the internet. I just think of all the things he missed out on because he viewed that damn PC as a typewriter. Grandmother does all the typing but a lot of people are saying, "Why would you buy $100,000 3-D X-ray machine like a Gallileos or whatever when you're iPhone ... The average person's keeping a smartPhone 3 years. They're upgrading it to later and greater.
We've seen so many big changes in the 3-D X-ray machines just in the last 5 years. Some people are saying that you just want access to a 3-D X-ray machine, that you certainly don't want to own one because you don't want to be ... Just like you wouldn't want to be on your Motorola flip phone right now. What would you say to that?
Jonny: I would draw an analogy, and it's not a perfect one, but right off the bat it reminds me a little bit of some of the reason why I send certain things to specialists and other things that I would prefer to do in-house as a general dentist. One of the primary reasons is my patients don't want to go elsewhere. They've gotten to know me, my office.
They're comfortable here. One of the primary reasons that I would do that is so that I don't have to send them somewhere else to get that scan, that they're comfortable in our office and get this sense that we're able to accomplish everything across the board for that patient. Now it requires additional training. It requires additional investment.
I really need to be able to see this buzz word in the industry, the return on investment, but I'm not going into the ground just so I can claims to have a CBCT but if it does at least pay for itself, if not turn a profit for me, then why wouldn't I consider having my own, as long as I'm capable of reading the scans and using it?
Howard: Holding onto your thought of 1-stop shopping, you go into Walmart. Now my 4 boys always get mad because whenever they ordered something, I just want to take them to Walmart. They'd say, "Walmart doesn't have it." I say, "If you needed it, it would be in here. They've got everything." If you need something and it ain't Walmart, you don't need it. End of story.
If it was something when they were little, I'd say, "We're going to go to Walmart." They'd roll their eyes and say, "They don't have it. They don't carry it," but what was I saying? The 9 specialities, what are you keeping in-house? What are you guys learning any ortho, endo, perio, pedo, [inaudible 00:32:33]? What [crosstalk 00:32:35]?
Jonny: We don't keep 100% of any specialty in-house. We still use pretty much every specialty across the board for some percentage of cases. Some of our background is based on the school we went to and where there are strengths. For example, we feel extremely comfortable with oral surgery.
Howard: AT still is big in oral surgery, huh?
Jonny: Yeah, especially [Exodontia 00:32:59] and even implant training. Those are the primary oral surgery pathways that we have but if I get some pathology or a really difficult implant case, that I'm still partnering up with an oral surgeon to do that case. Endodontics, we keep probably, what percent would you say?
J. Elliott: 75%. We send some upper second molars and if I don't see a canal, then that's going but no, I credit the university we came from with a lot of that. I don't know if all dental schools are created equal. I haven't had that experience elsewhere but our externships in the way we were thrown into the community, that is the biggest thing at AT still is community dentistry. We spent together 6 weeks up in North Dakota at an Indian Health Services Hospital. It was unbelievable the experiences we got to have, people coming with teeth broken off. We're the dentist for them.
There's somebody supervising us but left and right, we got those experiences in dental school, so extremely comfortable seeing all specialties. We do a lot of pedo as well but it's nice. As a general dentist, one of the biggest perks to me has always been but I always have that backdrop of I'm getting a little uncomfortable or I may not be able to tackle this that I always have that end-of-the-road specialist to refer to.
Howard: I have to tell you I've met a lot of dental school deans. I'm not saying this because your dental school's in my back yard but I think Jack Dillenberg is the nicest, sweetest ... Most of the deans, they come from a world where I'm sure they thought it was the best way but it was like a boot camp, Marine guy. I just think they really believe that the harder, meaner and more asinine your decisions, they make you more a man. I'm sure they had the best intentions but there was a lot of kids in my dental school that ... I've heard from other dental school where if they could have killed their dean and not got caught, there wouldn't even be a question.
It would have been, "If I could do this and not get caught, ..." Jack flipped the model and said, "No. It's not about being a Marine corp boot camp guy." He wanted to intimately know you guys. He loves his students. That community outreach is where I loved Jack the most is I've done a missionary dental church in [inaudible 00:35:13] and Tanzania where that school was paying money to send their students to the third world because Jack thinks that if you're in dentistry and it's all about the money, you missed the whole boat. He taught you guys how to want to help people, whether it be in an Indian public health service, at a mission in a foreign country. He's really big. Every time I go to these volunteer clinics and everything, it's all filled with aT Still kids.
J. Elliott: Mm-hmm (affirmative).
Jonny: Just to piggyback on that and to give a little bit more background, we've focused on the private practice discussion throughout but Elliott's really here at our private practice quite a bit more than me. He's doing that full-time. When I'm not here, I'm an associate dean at the Arizona School of Dentistry with Dr. Dillenburg for ... I do informatics innovation community partnerships with that position there. I can speak both ...
Howard: You do what there?
Jonny: Im' the Associate Dean of Innovation Informatics and Community partnerships.
Howard: Wow. Say it again. Innovation ...
Jonny: Innovation Informatics and Community Partnerships.
Howard: Explain that.
Jonny: How much time do we have?
Howard: All the time you want. You're the last one, the last guest of the day. The only thing I have after you is lunch. Since I'm 30 pounds overweight, I don't even need that.
Jonny: I'll break down the 3 areas. They really, again, deal with that passion. The innovation portion is to take a look at [Asdo 00:36:51] across the curriculum, so our didactic year is that first and second year into the Simm Clinic and even into the clinic and find ways that we can improve our systems, especially as they relate to technology. We talked about CAT-cam, CVCTs. That's been a focus for a couple of years here, leading into informatics a little bit, talking through how we use data in our school, how we grade and evaluate our students and what system we use to do that and just even setting up and maintaining our practice management software for our patient records.
Then finally that community partnerships component because I have a Master's in public health as well. That helps drive my desire or passion to be involved with that public health. It's contagious. What Jack has us as students doing, we still want to keep some component of that, if not dedicate our lives to it. The community partnerships has to do with all these sites that we set up. I work with Dr. Cottam, who's our Vice Dean now. He used to be in that position.
Howard: How do you say his name? Cottam?
Jonny: Cottam. Yep. Wayne Cottam.
Howard: How do you spell Cottam?
Jonny: C-O-T-T-A-M. That's really been his baby to his [crosstalk 00:38:11].
Howard: Is he the Number 2 Dean if Jack retires? Is that the [crosstalk 00:38:14]?
Jonny: He's the Vice Dean, yep.
Howard: He's the Vice Dean. Is there already a schedule transition? Jack's got to be 70, isn't he? How old do you think Jack is?
Jonny: If I'm not betraying his trust, he celebrates his 70th this month.
Howard: This month. Do you know the date?
Jonny: We are having a celebration on the 18th. I don't know if that's his actual birthday but I believe it's the 18th.
Howard: Will you email me that?
Jonny: Sure.
Howard: Oh my God. I love Jack. I've got to tell you my Jack story but anyway, go on.
Jonny: No. Anyway, we just team up to make sure that our sites are all sect up correctly, that they're really adjunct faculty out at those sites, that those calibrated to be able to give our students appropriate feedback and have a ton of great support staff to do that. Then we have a mobile dentistry unit. I know you know Eric Harris really well. He runs that but that's part of our community dentistry initiative as well.
Howard: I climbed Mount Kilimanjaro with Eric Harris. He is so damn cool. God, I love that guy. I actually met his dad first. I met his dad 30 years ago. I actually was honest with his dad. I told him I was going to use him. I said, "Can I just be up-front and just tell you I'm going to use you?" He said, "Sure." He says, "How are you going to use me?" I said, "I have 4 baby boys. They are 1, 2, 3 and 4. You have 4 sons. THey're all 20, 22, 24, 26. I just want to be your friend to get all the advice you can on how to raise 4 baby boys."
He said, "Cool." We'd go to a continuing education place like LDI. We'd share hotel rooms. We'd learn dentistry during the day. Then at night, we'd just lay there in our beds. He'd give me everything he knew about raising boys. He's Joe Harris. Boy, what a man. Back to that Simm Clinic. You know what would be the most innovative thing you could do with your Simm Clinic?
Jonny: What's that?
Howard: Go find the biggest 4,000-pound grow a law firm in Phoenix, Arizona and sue a state board because it's not a standardized test. These kids come out of dental school with $300,000 to $400,000 student loans. They're jerking their chain, telling them they've got to take some state board when the school is already certified. You should have found out in 4 years of dental school whether or not the kid's a dentist or not, not on a 1-day exam.
If Elliott goes in there and he's got a cooperative patient that shows up on time and doesn't move in the chair and yours doesn't even show or shows 30 minutes late or can't get numb because the nerve ... It's not a standardized test. With the Simm lab, those board tests should be in dental school for Simm labs. You should all have the exact same damn plastic tooth. If it's not standardized, it's not legal.
Jonny: There's a lot of movement in that direction, especially with the portfolio movement ou in California and now that they're for the first time certifying and counting that as essentially a board exam.
Howard: Tell me about that. I'm not aware of that. THat's [crosstalk 00:41:11].
Jonny: Out in California, their portfolio's a little different than what we do at Asdo or at AT Still or other places potentially but they can use their portfolio for certification and get their license via portfolio rather than in a board exam like you're describing where you have a real live patient. It's one of the first, very progressive thinking but you're not alone in thinking that.
Howard: Tell Jack this. AT Still's got a Simm lab. He's got some skin in the game. He could have the board in his own dental school. I'm sure he can money off that. I've got an attorney who's the best. If AT Still and Dental Town want to go 50/50 on an attorney and sue the next board, I'm totally game because I think these kids are just being harassed. They don't have the time, the money and the stress. A lot of times you go to a graduation class.
J. Elliott: Nobody ever said, "It was a good experience taking my board in dental school."
Howard: It's just absolutely stupid. It's stupid on so many levels. The only thing that will shake it up is the damn lawyer. I want to go back to informatics. You're in informatics. You love technology, management information, software. What practice management software did you get to run your private dental office? Patterson owns Eagle Soft. Henry Shine owns Dentrix. There's Practice Works, Soft Vent. There's Open Dental. What did you pick and why?
Jonny: Realize for a moment that we probably are a little bit more on the bell curve in the early adopter phase, just both of us even. I'm not alone in that. Elliott also has quite a bit of skill in manipulating new technology but, ultimately, we wanted to do something that was cloud-based, if it could be viable. We've experienced a lot of cloud-based products and decided to go with Dentrix Ascent. That's Dentrix's next generation product that they've been building for about 3 1/2 years. I have absolutely no regret for doing that for our new start-up and all of the use that we get out of our practice management software. It's been wonderful.
Howard: Since it's on the cloud, you don't have to have all your servers. You just have an internet connection with Pcs or are they done with terminals? Explain what that means.
Jonny: For practice management purposes, that's all correct but you do still have to solve the question of imaging because imaging traditionally is not part of your practice management solution. We do still have a traditional server that hosts our imaging. Even that's right on the cusp of providing a cloud-based product that we're actually based ...
Howard: It's like when I use Google. It's all in the cloud.
Jonny: Yes. Correct.
Howard: Explain to the viewer who really doesn't know what the cloud means. What is the advantage of having the stuff on the cloud versus in a box underneath your desk?
J. Elliott: The benefit really is you're going to call it home or you're wondering if your morning tomorrow morning fell through. At home I can log into my software. I can finish notes that evening. I can check my schedule tomorrow. I can look up a patient's chart if I'm getting an emergency call. There's really a lot of benefit there. Traditionally, you would have had to portal in somehow to your backed-up server in your office. There's securities questions there and HIPPA questions but no, it's just a basic log-in. You're right there. The other huge benefit is it doesn't get bogged down. It doesn't get old. It doesn't get outdated. They update continuously. If they add some feature where now I can email my patients a new cover letter or something like that, ...
Howard: Was the cloud the top-priority feature you were looking for, then you work down from there?
J. Elliott: Yes.
Howard: What were your choices on the cloud? What's the place in Utah? There's one in Utah on the Curve.
J. Elliott: [Crosstalk 00:45:18] for years down in Maricopa.
Howard: You used Curve for 3 years? Why did you use Curve for 3 years but then go with Dentrix [inaudible 00:45:25]?
J. Elliott: The way I've described it is I felt like Dentrix and Henry Shine saw this cloud movement coming. They started planning. They started designing Dentrix Ascend. They were testing it and getting very stable with the core elements to it. Curve was the first one to market. They were blasting it wide open of, "Jump on. Check this out." As a result, I watched the net 3 years. I watched us build Curve with them. They were missing things. Things were glitchy. It was really a tough build. At the end of the 3 years, yes, we had a good product there but then I wanted to look at others because I was getting tired of it. It really comes down to how my office staff does with it.
Howard: Isn't Curve and Dentrix both in Provo, Utah?
Jonny: Yeah. They're down the street from each other at this point.
Howard: In Provo?
Jonny: Yep.
Howard: Was Curve ex-Dentrix people that someone at Dentrix [crosstalk 00:46:16] because they didn't start the cloud fast enough and Ascend was after the Curve people left? I'm just wondering.
Jonny: Several. At one point their CEO had been a Dentrix lifer for a long time, and then several employees as well but the President or the founder of Curve was actually a kid out of Canada, grew up servicing dental offices, doing that build-out of servers, clients and came up with this concept of, "It shouldn't have to be this hard for all these offices."
Howard: What I don't understand is franchises. If you're a McDonald's with 40,000 locations, why is each store manager trying to do back-ups? Why aren't all franchises on the cloud?
Jonny: I think mostly because it's just now hitting its stride.
Howard: Would you say the cloud has just gone from bleeding edge to leading edge?
Jonny: Yeah.
J. Elliott: Yep.
Howard: Were there any ...
J. Elliott: In those 3 years, we were working out a lot of bugs, billing issues, ledger issues, charting issues. A lot of that was getting worked out in those 3 years but since we started with Dentrix Ascend, it's all been very stable. I think Curve is stable as well. We just wanted to start with something new. Henry Shine's a bigger bear in the game than Curve was. Curve was a garage project and [crosstalk 00:47:34].
Howard: Were there any other clouds? Open Dental, was that a cloud-based system?
Jonny: No. They do have a portal that allows you to see some limited information. It's that section is a little [hybridesque 00:47:48] but no, it's not. Another one would be Planet DDS.
J. Elliott: Latin Mark.
Jonny: Denta-Con is what they call it.
Howard: Denta-Con?
Jonny: Yeah. Dovetail is another one. That one wasn't very advanced. It was missing some real core features for us.
Howard: Since you're the Dean of Innovation Informatics, do you know the top dog at the Dentrix Ascend problem, I mean the Dentrix Ascend cloud?
Jonny: I do. We've met with them a few times to look at if project [crosstalk 00:48:18] ...
Howard: Out of Provo?
Jonny: ... goes at what opportunities exist.
Howard: Tell him I'd like to podcast him on Dentrix on the cloud.
Jonny: Yeah. He's a great guy. He's out there in Salt Lake as well.
Howard: No one likes criticism. I've told them my criticism of all the software systems since the beginning. I've told them ever since I got my MDA from ASU there fact that it doesn't merge with an accounting platform like [crosstalk 00:48:46].
J. Elliott: That's my complaint as well.
Howard: They flew me down to a Dentrix conference or whatever. I don't want to get off a [inaudible 00:48:57] because it will raise my blood pressure 50 points but every time they come out with these big updates it's like, "Dang, this dentist is doing 7 different PPOs. He doesn't know if he's making money or losing money on each fee schedule." Nobody runs a business where you don't take all that customer information in billing while it's overlaid on Quicken, Peach Tree or Microsoft's [inaudible 00:49:21], something. I just want a dentist to know at the end of the day, "You did $3,000. Your overhead was $22.15. This is what you netted."
Then when they fill out a fee schedule and they're signing up for a PPO, the schedule knows you took an hour to do a crown. If you do it for $800, it knows if you're making money and how much or if you're losing money because I know that what happens in dental offices, they make so much money, so much net, on crowns, root canals, dentures and endo, attractions, that they're blanking over what they're doing for a loss, which is cleanings, exams, X-rays and fillings. When the dentist sits in that operatory for an hour and does an MOD composite for $250 on a PPO and then the next hour he's doing a crown for an hour for $1,000, I'm like, "Do you have a 75% profit margin? I don't think you do. You just spent an hour doing a filling and lost $200. Then you went in the next room. You made $600 but that $600, you've got to take $200 of it and cover the other guy that you did for the loss."
If everybody knew where they were making or losing money, you'd start seeing a lot more amalgams. You'd start seeing a lot of dentists working faster and spending less time on patients. How many dentists do you know they go numb up. Then they go in their room and let it soak in for 10 minutes while they're on the internet, on Facebook or calling their wife but if they knew, "Man, I'm not going to make money on this procedure unless I do it in 30 minutes," hell, they'd be numbing up with septocaine, then set a timer for 4 minutes and then be putting their burr on and not changing gloves. It's just like in football. Do you notice how excited they get when they get inside the red zone?
Jonny: Mm-hmm (affirmative).
Howard: They're playing very differently when they're on the 1-yard-line than when they're back on the 50-yard-line.
J. Elliott: Sure. Football's a great example because I heard a stat this last week. It was just ridiculous that John [inaudible 00:51:17] was giving a stat about the number of yards that 1 running back was making compared to another running back from where they start with the ball. It wasn't that somebody's sitting there and looking at only at every game and every thing. It's that computers have come so far that all the information was there but the computing of it is different. Dentistry is no different. Why do all these softwares not have my employees clocking in through the software?
Howard: I know. That's your Number 1 cost.
J. Elliott: The hours I'm open and doing some averages, the days I'm open and giving me what's my on-patient for the month? At the close of business today, it should automatically calculate and tell me, "Hey, you're on pace for production of this per month," and show me it again for last year. You're absolutely right [crosstalk 00:51:58]. That's what we talk about when we're spreadsheet people or outside the box. The software's not doing it for you. You have to be an individual that either has a bookkeeper, an accountant, somebody, or yourself that you outside have the business management to go calculate some of those things. What am I on-pace for? What are our goals? What did we do last year? What are we doing today?
Howard: Do you think that poor bastard from Dentrix would be brave enough to sit here for an hour? In fact, you guys should come over to my house or I'll got to your place.
J. Elliott: [Crosstalk 00:52:26] all together? Is that what you mean?
Howard: I tried being out for 20 years. I tried love. I've flown down to Mariaville, New York and asked Stan Bergman in his office in the flesh on my own dime. I've been on this mission for 28 years.
Jonny: Not to come to their defense at all but let me at least say what I've heard from them when they set out to design Dentrix Ascend. They spent the first year and a half just interviewing people, going to dental offices throughout the people and interviewing and not dentists, front office, back office, the people that use the software the most but they did interview some dentists, not just dentists. Then they put together this offer. They really found they had 2 huge projects that they needed to prioritize, one or the other somewhat. One was setting up a core set of features that every practice management software seems to have and do it in the most efficient way possible.
The other was set it up for applications and to be able to get to that data. In the tech world, they refer to that as an API or an Application Programming Interface. That's what all of these things have that allow it to talk to other softwares like accounting software. They really rolled the dice but they said, "Even if we designed the most beautiful application interface software, if we don't have the core product, we've got next to nothing. We're going to prioritize that core set of features first for Dentrix Ascend but not lost sight of that." That's what I've been told throughout, that now that they're getting to the core, that at some point they're supposed to become or launch some sort of application interface for that software.
Howard: I'd like to get involved quick because I finally have given up on Soft End after 28 years. I don't know whether to go to Ascend, Curve or Open Dental. In my office in Ahwatukee, me and my office manager, Robert, are dealing ... We need to make a decision like that. I would like to talk to him just for that. Send me an email, howard@dentaltown.com and CC him. We'll get a dialogue going ...
Jonny: Okay.
Howard: ... but I really think the single greatest legacy I could ever leave dentistry is just to get them to know their cost at the end of the day on their gosh darn practice management software. When I first set out with that in MBA school and realized just how bloody important that was, I thought once I explained it to them because remember, you can't do customer research. If Henry Ford went and asked all the Americans, "Hey, would you like to shoot your horse and have a horseless carriage," everyone would have said, "I love my horse. I pet him very day. I feed him. I walk him. My horse is my best friend."
When other car companies are saying, "Horseless carriage," he's like, "Are you crazy? They love their horse." We're going to build a car. We're not competing with your best friend. It was very subtle that your horse can only go 20 miles a day but your car can go 20 miles an hour. Henry Ford did no customer research. Steve Jobs was the same way. He said, "I'm not going to ask these people what the future is. I have to go find the future and show it to them." That's what I keep telling these Shine people because they keep coming back with their research.
Then it says, "But they want to be able to change the font of the patient notice and change it from black to purple." It's like, "You've got to be bigger than that. Okay. You want to change your font. You want voice-activated notes. Okay. That's what they want. They don't know what they need because they're dentists. They're not MBAs. They're not millionaire businessmen." I said, "Why don't you give them what Stan Burkman needs when he does a press conference on his publicly-traded stock? They're not asking him what color his font is or if he has voice-activated notes"
They want to know earnings and price-per-share. They want to know financial data. If you just delivered that to the dentist, they'd all look at it and go, "Oh. I had no idea that every time I do a PPO Blue Cross and Blue Shield MOD composite for $174 that I open up my wallet and shed 3 $20 bills."
J. Elliott: That's why dentists will pay $20,000 for a consultant to come in for a weekend and just do spreadsheets, calculate those stats and show them that paper. They go, "Oh my goodness."Then they make 1 change. They go, "Totally worth it. I made $40,000 more last year because I had this consultant come." It's ridiculous that the consultant fees and business is so good because we're so limited there and for no reason .Computers and data has come so far. It should be so easy but yeah.
Howard: When I got out of school, none of this even existed. I just want to live longer just to see if my boys are going to go through the same experience. I can't even imagine what's going to be existing 20 years from now but the million dollar question we didn't even get to, and I've only got 3 minutes left, is how did you get new patients? How did you get patient flow? You got a retail location. That counts as marketing.
J. Elliott: Yep. We get walk-ins here. That's certainly not our primary method. We do direct mail marketing through Chris Ad. Have you ever heard of Chris Ad as marketing?
Howard: Sure. Is that working?
J. Elliott: Yeah. It works very well. We've averaged 65 to 70 new patients since we opened. We had 1 month at 95, 1 month at 60.
Howard: Explain to me what Chris Ad means. It's a coupon package [crosstalk 00:57:47].
J. Elliott: No. They're 1 mailer. I wish we ...
Howard: But it's a package of a lot of little coupons.
J. Elliott: Nope. You're it. You go directly to their home as your individual piece of mail. It's got your message on it there. The big things are that you put up no red lights to your patients. We accept all insurances. We work with all insurances. We do. If an insurance company will talk and pay for us, if an HMO won't work with us, we've worked with them and gone there but, again, it's a direct mail marketing. They get that flier at home. They call in about it. We start the process there. His name's John Christenson. They're out of California. They have a lot of dental clients throughout the United States.
Howard: Can you email me his name and link so I can put that in the show's notes?
J. Elliott: Yeah. Definitely.
Howard: What's his name?
J. Elliott: John Christenson is the guy [crosstalk 00:58:36].
Howard: Do you have his email address?
J. Elliott: Yeah.
Howard: Email me, howrad@dentaltown. Email him. Then I'll put that in the show's notes. He'll get some new business ...
J. Elliott: No, it's phenomenal.
Howard: ... because most people would think that your marketing would have been all digital or all Facebook, all Twitter, but you're old-fashioned paper through the United States Post Office.
J. Elliott: Yeah, we love patients to come from every stream out there but they research marketing. They look for ... It honestly is moms. Moms are scheduling the doctor's appointment for kids and husband. Those moms getting the mail, being at home, it targets mom specifically to be family friendly and get them in the door [crosstalk 00:59:21].
Jonny: It's [inaudible 00:59:24].
J. Elliott: He'll pull one over. This is us taking notes on our of our mailers. That's probably too hard to see from there but ...
Howard: No, we can see him perfectly.
J. Elliott: It's very [crosstalk 00:59:33]. What was that?
Howard: I say who's your model there or they designed that for you?
J. Elliott: That's all theirs, yep.
Howard: Then what about hours? Since there's 2 of you, do you cover more hours? Do you think that's a big form of marketing?
J. Elliott: Yeah. Let me tell you. That too. I told you I came in just to walk around when I was looking for just a day or 2 with you guys. The only other thing I've ever rubbed shoulders with you on or heard from, and I wish I could remember who told me, but he said, "25, 30 years ago, Howard Farran told me a story and said in the year he opened his practice he told his wife, 'I'll see you in 2 or 3 years because I'm going to have to be at that practice around-the-clock building it.'" THat's one thing I say in the theme of new dentists. If you're going to start your own thing and get after it, the availability for patients ... We're here Monday to Saturday, 7:00AM to 8:00PM.
Howard: 7:00AM to 8:00PM.
J. Elliott: There's nothing [inaudible 01:00:21] hours like that.
Howard: 7:00AM to 8:00PM Monday through Saturday? Oh my God.
J. Elliott: You would say [inaudible 01:00:26] overhead but that's been our saving grace. We had an endodontist referring us implants in our first month. We had patients repeatedly coming saying, "I'm so glad you're open on Saturday." We beat local dental urgent care or urgent cares, we beat them on hours. Once that gets out and somebody came after work, they go back to work. They say, "I didn't take off work to get a cleaning. The cleaaing's like a haircut. Why would I take a day off work to go get my teeth cleaned?" That I account for a lot of our new patient numbers being really good as well as the hours we offer.
Howard: What is the haircut? Can you explain it to me?
J. Elliott: No.
Howard: Is this something you saw your brother get once?
J. Elliott: I don't know if it's the dementia kicking in or if it's just been 20 to 30 years.
Howard: Johnny, I actually feel sorry for you because being Elliott's there's been no time spending coming, brushing, [crosstalk 01:01:12].
J. Elliott: I've hated that.
Jonny: No. It's around the corner, you're my future.
Howard: When people told me, they say, "What do you think? Did you lose your hair," I said, "No, I lost my brush, my comb, my shampoo, my conditioner. I lost 5 minutes of bologna every morning." You know what? If you guys ever get the time, I called you guys because I get so many requests for they want to hear from a new guy, the new ones starting out. We have 350 courses on Dental Town. They've been viewed over half a million times because guys like you don't want to close down their office and fly to go to another city to go hear a convention on a root canal when you can just sit in your chair at home on your iPad and watch it online.
You should do a continuing education with a class on the start-up. I bet if you just named it right like "The New Office Start-up," 2 young dental school graduates started their own practice. I'm just going to tell you their story. My God, I bet that would get so many views. That would probably get more views that root canals, fillings and crowns because they're hungry for it because ...
J. Elliott: We're good for it. I don't think we had planned ... This is very casual but I think with a little bit of thought and organization, we could have some really good points of there was a lot to the process. We haven't even touched on it today but we assessed a lot of things. That marketing ... We had a lot coming into it with marketing, location, the hours we're going to be open. We had side jobs and side income to alleviate some of the burden. Then we didn't even talk about student loans. You're right. A divorce or other things could be the same lump sum that you have on your shoulders there but you have to understand your student loans. It doesn't take much but people sit there and they fear them.