Howard: It is just a huge honor for me today to be podcast interviewing Kevin Burniston all the way from Wisconsin. He helps dental professionals across the United States create a better quality of life for themselves and their families. For over a decade he has studied the business of dentistry and worked to develop innovative and effective strategies to overcome common pitfalls. His training methods have empowered thousands of dentists to reach and exceed their goals. Kevin current curriculum has a heavy emphasis on insurance participation and exposing industry-wide misconceptions surrounding reimbursement. He coaches patient-facing education techniques to increase treatment plan acceptance, boost productivity and enhance overall patient health. Kevin, thanks so much for coming on the show today.
Kevin: Thank you. Thanks for having me.
Howard: So, you know, I wanna start with the … a lot of … you know, I … my practice is thirty years old, here in Phoenix, and a lot of these kids are coming out of school and they’re saying, “Hey, old man, you know, you graduated in the glory days, the golden years, thirty years ago, and dentistry is different now.” The kid’s got three hundred and fifty thousand Dollars of student loans, there’s corporate dentistry. Do you think the glory days, the golden years, were back in the 80s and 90s? Or, I mean, what would you say if your own daughter walked out of college and said, “Dad, I think I’m gonna go to dental school.” Would you say that’s a good idea? Or would you say, “Ah, if you were gonna do that, you should’ve done that, you know, twenty years ago!”
Kevin: Well, actually, it’s funny that - I have three daughters actually! I have three little girls – no boys, all girls – and...
Howard: How old are they?
Kevin: I’ve a nine-year-old, a six-year-old and an eighteen-month-old. So all…
Howard: Oh, my g*d, you’re a busy man!
Howard: Well, I had four. So, it’s time you fire up the oven again – you gotta make a fourth girl! Come on, if I did four, you gotta do it too!
Kevin: Wow, you really have four girls?
Howard: No, I have four boys! They’re twenty-two, twenty-four, twenty-six and twenty-eight. But my oldest boy made me a granddaughter, so now I got a girl, but … little Taylor’s five.
Kevin: Are any of them dentists?
Kevin: Did any of them choose dentistry?
Howard: No, you know, they didn’t do it, and I, you know, my dad really was upset with me that I didn’t follow him into Sonic Drive-Ins. He had nine Sonic Drive-Ins and he was telling me, “Dude, by the time you go to four years at Creighton University and four years of UMKC dental school, you could have five Sonic Drive-Ins and be a millionaire!” And I’m like, “I know that, but I just don’t wanna make hamburgers my whole life. I mean, I love you to death, but I don’t wanna spend my whole life making French fries!” And my next-door-neighbor, Kenny Anderson, was a dentist – big shout out to Kenny Anderson, just celebrated his fiftieth anniversary at his dental office, still practising Monday through Thursday.
Howard: Yeah, and, you know, I’d go to work with my dad – love my dad, loved Sonic – but I’d go to work with Kenny and he’d do root canals and take x-rays and I just thought what he was doing was just unbelievable. Yeah, I decided in the sixth grade I was gonna go to dental school and I never deviated from that ever since. But what would you say to your three daughters if they say, “Dad, do you think I should be a dentist?”
Kevin: I would love for my daughters to be dentists! In fact, if they’re interested in any way, I’d love to help them, you know, through the process and I’m sure similar to you, I’ve been fortunate to be connected with a lot of people that understand the business of dentistry really well and I think could help them. I definitely think there’s challenges today that may not have been there, you know, twenty years ago, but if they understand those challenges and have a plan, I think somebody could be very successful today. In fact, a lot of people are.
Howard: Well, you know, you talk a lot about dental insurance and that’s why I called you to be on the show – you didn’t call me. Dental insurance is very interesting because, you know, I lecture in six continents, you know, regularly and they only have dental insurance in about twenty countries. They don’t even have dental insurance in China, India, Indonesia, Brazil, and when you explain dental insurance, especially in China, the Chinese dentists, they don’t even think it’s right. They’re like, “Well, if you drink Coca-Cola and eat Hershey’s chocolate bars and don’t brush and floss your teeth, why should your employer or your government fix your cavity?” They almost say it’s a perverse incentive that when someone, you know, you drink Mountain Dew all day and you never floss and then when you get nine cavities, why should the CEO of Ford and Chrysler have to pay for your dental decay. But, so, dental insurance is something that the majority of countries don’t have, but in America a lot of people believe that it drives everything. What is your views on dental insurance?
Kevin: So, well, first I just wanna make sure it’s clear that, you know, obviously I represent Henry Schein and Henry Schein has taken this initiative to better understand what dentists are going through in practice care. Basically, that to help dentists focus on their patients, if we can help them with their practice, then dentists can focus more on their patients, and insurance, over the last five years, well probably since 2008, 2009, insurance has just taken over for one of the … either the top concern or in the top two or three concerns of basically almost all dentists. We ask our sales reps to ask our dentists when they have these meetings with them about what’s working well, what struggles they have, and virtually every time insurance comes up. And so to your point, how do dentists navigate that and how do they explain it to patients. I’ll give you one quick example: when a patient … in a lot of procedures today, when a doctor has a treatment plan, asks the patient … or explains to the patient here’s the work you need to get done, explains everything really well, shows them what needs to be done, in many cases the patient says right afterwards, “Well, does my insurance cover that?” Right? And that’s one of the first questions a patient asks and, depending on how the dentist responds to that, it could change whether or not that patient accepts that treatment or feels they need to, and it’s not always the dentist, it could be the dentist leaves the room and the assistant that’s walking the patient to the front, the patient asks the assistant, “Does my insurance cover that?” and depending on her response, or the person at the front desk, depending on all their responses, that patient may or may not accept that treatment. And so one thing at Henry Schein we try to explain, you know, in that scenario, is what’s the patient really asking? When a patient says, “Does my insurance cover that?”, their concern isn’t whether or not the insurance covers it. One they wanna know, is this procedure necessary and is it expensive? Right? I mean, that’s really what they’re asking. If we tell a patient they need periodontal disease treatment, that they need to go onto a perio program and that patient says, “Does my insurance cover this?”, really what they’re asking is, “Do I need it? Is this necessary and is it gonna cost me a lot?” and if our response is, “Let’s verify your benefits, we need to make a phone call, we need to verify that, or we need to check”, what that patient just heard is that we’re not sure if it’s important and it might cost a lot! And so, we can talk about a few things with insurance but one is just helping a patient understand that it’s … we shouldn’t base our healthcare decisions on whether or not our employer is willing to pay for that procedure. And I don’t know if I’m answering your question completely, but one thing with insurance, dealing with insurance is how we explain it to patients is gonna help patients accept more treatment.
Howard: Well, I think you’re nailing it, because I mean, you know, the ugly, inconvenient fact that a dentist doesn’t ever want to hear about is that … I’m just talking about diagnosed cavities – I’m not talking about fancy bleaching, bonding, veneers – but basically in the United States of America, when you diagnose a hundred cavities, only thirty eight get drilled, filled and billed. That’s a one third treatment plan acceptance rate. Having watched this game for thirty years, having podcast interviewed every dental consultant I can find – and thank you for coming on this show, I wanted to get you on – is that, you know, that inside the same medical dental building, in the same zip code, so the same small town, the same economy, all the same macro-economic factors, it seems like one out of three humans will never get treatment done. One out of three is the average, but there are these offices who get two out of three to convert to treatment plan acceptance, and so, if the average office does seven hundred and fifty k and that’s one seventy-five, you know, if you had double that, that’s seven fifty twice – a million five – and one seventy-five twice is … that goes to three fifty. And it’s not that you just make a lot more money. I mean, if you were a fireman, would you wanna put out one out of three fires in your town, or would you wanna put out two out of three? And I always tell the dentists that they’re misguided when they spend so much time focussing on how to fill the filling, like what bonding agent, what material, you know, is it gonna be 3MSB, is it gonna be, you know, Ivoclar, is it gonna be Sirona, you know, that’s not the question, the question is two out of three people just left your office and didn’t get any of the micro-organisms removed. I mean, so, I think treatment plan presentation is more important than how do you restore a filling.
Kevin: I don’t know that it’s more important or maybe say it’s equally as important, because if a patient doesn’t accept the treatment, then it’s not getting done and we’re in just as a bad spot as if we didn’t identify in the first place.
Howard: Well, let me ask you, you’ve got three daughters and that’s sort of what I’m talking about. So your nine year old goes to me and I convince her to remove the infection and get a filling, your six year old daughter and your eighteen month old come in and I don’t convince them and they both leave with a cavity; versus if you said that your three girls cross the street and she convinces the nine year old and the six year old to do it and not the eighteen month old, I mean, I think the dentist who got two of your three girls to remove their infection … in fact, I always joke this, I’d say dentistry would be a lot better off if we got rid of all the restorative materials and removed a hundred percent of all the decay and just packed the teeth with butter, because I would rather my five year old Taylor have her cavities removed and not filled than have her cavities left in place, I mean, maybe I’m … maybe that’s crazy but I’m just, obviously I’m just trying to make a point that we need to make treatment plan presentation far more serious and what you’re saying is that when they say, “Well, does my insurance cover it?”, you’re talking about what they’re really asking is, “Is this necessary and is it going to cost a lot?” So what verbiage … how could you help dentists and treatment plan co-ordinators and assistants and hygienists and receptionists do a better communication, narrative, dialogue so that they can convert to it? Because I’m convinced, and again I’m totally convinced one out of three is never gonna get it done. I mean, dude, I have patients that come in in Phoenix and they have oxygen tubes in their nose and they’re smoking outside my door, I mean, you know, I got … everybody’s got uncles and cousins that have been told they need to take diabetic medication while they’re drinking a twelve pack every weekend. I mean, you’re not supposed to drink twelve beers if your A1C level’s off the chart! So, humans are humans – they’re crazy.
Howard: A Farran family reunion is a pretty close comparison to the local zoo! I mean, we’re crazy animals. So, one out of three people … I mean, they bring Mountain Dew into the operatory! And I tell them, I say, “Do you take your bong to church?” I mean, you know, you just … come on! You don’t bring Mountain Dew into a dental office, I mean, goddang! So, one third of Americans aren’t gonna listen to anybody – their mom, their dad, their preacher, their dentist; one third are just completely crazy; but what I’m excited about is I see ample evidence that, you know, there’s a dentist who only gets one out of three to get treatment, and the dentist right next door to him is getting two out of three. So that’s where the football is. That’s what everybody should be focusing on.
Kevin: And it could be, I mean, it could be a number of reasons. When it comes to insurance, I think patients, because of medical insurance, they look at insurance as an authority in healthcare. So, if insurance doesn’t cover it, it must not be important, it must not be necessary. And so, if we default to what does the insurance say, then the patient hears, “Well, if insurance doesn’t cover this then I must not need it.” You know, a dental implant versus a crown or versus a bridge, if insurance doesn’t cover it then it must be elective, it must be above and beyond what’s necessary. And in reality, it could be better medicine and it could be better for the patient and the reason why the insurance doesn’t cover it, it’s not because the insurance doesn’t cover it, it’s because their employer didn’t purchase that coverage. So, an example I always give is, years ago I was driving down the road and I had a truck up ahead of me. I watched a hammer come out of the bed of the truck, hit the freeway and it went up in the air and I was trying to follow and see where it went, and it went right through my windshield, shattered my windshield; and I go home and I call my dad and I was telling my dad about it, that I just shattered my windshield and my dad said, “Well, your windshield’s not covered under the insurance, you’re gonna have to pay for it”. And I was like, “I think it is covered under my insurance.” And I looked up my car, I looked at my information and it said, “Covered: windshields”. And my dad and I get into an argument about it and he says, “It’s not covered.” He called his insurance just recently and it wasn’t covered. I call the insurance and it is covered. And I talked to him about it – it’s purely because when he purchased the policy, he chose to save a little bit of money and chose not to cover his windshield. When I called, apparently I’d picked windshield coverage as part of my coverage and so it was covered. State Farm, or whoever your insurance company is, they’re not saying you don’t need a windshield to drive your car, it’s just the coverage you picked, you chose either covered a windshield or didn’t cover a windshield. They’re not saying you don’t need a windshield. And so, dental insurance is similar, that when the employer purchased - and I think it’s like over ninety percent, it may even be closer to ninety eight percent of all dental insurance is purchased by an employer - so when that employer purchased that insurance, they’re choosing a policy just like we pick car insurance. They’re not saying you don’t need dental implants, they’re just not willing to pay for it as part of their plan. So, as a patient, I shouldn’t choose my treatment based off what my employer will pay for, which maybe I’m speaking in a perfect world that if all patients accepted treatment, but helping a patient understand that, that this treatment is necessary, it’s important, however your employer may not have purchased this coverage. And I think even helping a patient understand some insurance does cover this procedure, it just happens that your employer didn’t chose to cover this particular procedure.
Howard: Right. So, what is the terminology though? I mean, how do you think she should answer this?
Kevin: So, does my insurance cover this? If that’s the question, my response is, “Yes, insurance covers this, and the reason why insurance covers this is because it’s important to your health and there’s repercussions if you don’t get it taken care of. However, your employer may not have purchased this coverage so we’ll have to verify your benefits, but this procedure is very important and critical to your health and it is covered by insurance. It just may not be covered by your employer.” And just helping a patient understand they shouldn’t make their healthcare decisions based off their employer, they should make it based off of that relationship between them and their dentist.
Howard: True, those are all good points, and it’s really not dental insurance either. I wish people would stop calling it insurance; insurance is whenever there’s an actuarial risk analysis versus moral hazard. I mean, we all have fire insurance on our house, but only one percent make a claim; we all have auto insurance, but only a few of us wreck. In America, for health insurance, only one percent of Americans spend the night in a hospital in any given year if you take out having a baby and dental insurance is a benefit, I mean, because how can it be insurance when a hundred percent need a cleaning, exam, x-rays, a hundred percent eat sugar, a hundred percent don’t floss, you know, a hundred percent don’t … I mean, you know, I’m … in my life, every single house I’ve ever been in since I was in dental school, when I use their bathroom, the toothbrush bristles are completely frayed and flared and I walk out there and I just say, “You guys, you might as well just be using mouthwash. I mean, to remove plaque those bristles have to be perfectly straight and not only are these not perfectly straight, I mean, it looks like you’ve been, you know, cleaning your spark plugs of your car with this for two years.” So, it’s a benefit, but why do you think some treatment plan presenters have this … I know two different girls - one’s in Indianapolis, one’s here in Phoenix - where they got a job at a dental office and took them from seven hundred and fifty thousand to a million five because they doubled their treatment plan presentation. After five or six years they both asked to be paid as much as the hygienist was since they’re bringing in, you know, literally an extra three quarters of a million Dollars; both times the dentists said, “No, you’re a dental assistant”, so they quit. Then they went to a dentist down the street, the dentists they left went back down from a million five to seven fifty and the dentists they’re at doubled and now they’ve been there forever and I’ve tried to get them to create online CE courses but they’re embarrassed and they’re shy and all that, but I mean, I’ve just seen this so many times where I think that the most important person in the office is who’s presenting the treatment. Sometimes, the dentists can do it, but most of the time dentists have the personality of an accountant, an engineer, a scientist and they don’t have that flair, that salesmanship that the best treatment plan co-ordinators have. And orthodontists know it better than anything. I mean, orthodontists know that that is the key employee.
Kevin: So, a simple question to ask is in a dental practice, if a dentist asks anybody on their team why should a patient come in every six months to our practice? Why should they accept whatever the treatment is? Why should a patient accept this? And just listen to the team and hear their responses, because I think it’s eye-opening sometimes that when that … the doctor may articulate it very well, may explain to the patient very well, but that patient turns to the assistant or the hygienist or the person at the front desk and wants verification of is this really necessary, and depending on how they explain it, that patient may or may not accept that treatment. And so, to your point, having a really good treatment plan presenter or just having your team be able to reinforce what you just said, you know, reinforce what the doctor just said of why it’s necessary. I’ll give you an example. My wife’s a nurse. When she was pregnant with my six-year-old, she goes to the dentist and she gets her teeth cleaned and when she’s finished getting her teeth cleaned, the dentist says, “Because you’re pregnant, I’d like to see you in three months and you can go ahead and schedule that at the front desk.” So, when she goes to the front desk, the assistant walking her up there says, “Let’s get you scheduled for your six-month appointment.” And my wife says to the assistant, “Oh, I think the doctor said three months.” And the assistant said, “Well, it’s precautionary. Your mouth is perfect. There’s really nothing wrong in your mouth and insurance is only gonna cover it every six months. But it’s up to you if you wanna come in in three months or in six months.” And my wife, being a nurse, looked at the assistant as a nurse and said, “Well, what do you think?” And she said, “Your six-month is probably fine.” And my wife said, “Okay, sure.” And so she scheduled a six-month appointment, comes home, and - I teach total health to doctors, I teach the importance of all these things - and so I asked my wife, “So, when are you going back to the dentist?” She said, “Well, that was the funny thing. The doctor said three months, but the assistant said six months, so I went with the six months.” I told my wife the reason why everybody’s so worried about drinking and smoking when you’re pregnant is you’re two and a half times more likely to deliver a premature, low birthweight baby. So, don’t drink and smoke when you’re pregnant. If you have periodontal disease when you’re pregnant, you’re seven times more likely to deliver a premature, low birthweight baby! So, if you think two and a half times … people don’t drink and smoke because they’re scared of premature, low birthweight - I think it’s the number two cause of infant death – that periodontal disease is far more of a risk, and the dentist … it’s really important for her to come in, but the assistant didn’t understand that, didn’t know that, didn’t reinforce it, and so my wife went with every six months. So, when I called that doctor up – he’s actually a good friend of mine – and we talked through it and I said, “It’s basically just education, the team has to understand why so they can reinforce what you’re saying, because if that assistant had just said to my wife, ‘Yeah, it’s really important you come in in three months, because periodontal disease is linked to heart disease, it’s linked to premature, low birthweight, it’s linked to all these things, we need to see you in three months just to make sure everything is okay’, my wife would have accepted in a heartbeat.” And so, I think a really important piece of patient acceptance is just making sure the team understands why, so they can reinforce that.
Howard: And I’ve been saying that forever. I mean, you go to any dental conference: one third of the lecture room is entire dental office teams where every row is the dentist, the hygienist, everybody. And then the other half, two thirds is all these dentists that come alone to save money. And if you went and picked up the stats on the dental offices that bring all their staff, those are the ones that are get two out of three people to do treatment, and the ones that come alone are the ones that get one of three people to do treatment. I mean, the dentist wants to educate himself but he doesn’t realize that they’re asking questions to the receptionist on the phone, they’re asking the questions to the assistant while she’s taking x-rays, the hygienist, I mean, it’s just crazy. But, yeah, think the pre-term birth deal, that’s gonna be the first … you know, money’s the answer, what’s the question? And these medical insurance, one of the most expensive things they have is a preemie and the average preemie is a million in cash and they completely see this linked this to periodontal disease and they completely want to cover all their pregnant girls getting three-month cleanings and that is the first juncture of this oral health continuum. It’s not gonna be dementia and Alzheimer’s and pancreatic cancer and all this stuff – it’s gonna be the preemie. And the other thing is, with the silver diamine fluoride, I mean, people, little kids actually die sometimes when they’re taken to and be put under to have a bunch of (24:33) steel crowns and pulpotomies and all this stuff like that, and there’s a lot of dentists who say, “No, I wanna see your daughter, she has a high decay rate. I wanna see her every three months because I wanna coat her cavities with silver diamine fluoride because I do not want to take her under and put her under a general anaesthesia”, and, you know, then also I’ve seen the parents every three months, you have one more session where you can talk about it, you know, you only drink water. My granddaughter, my grandkids spent the night with me Saturday and Taylor’s five and she wanted apple juice, so you know what I did? I took four glass pots … I set her up by the stove and I took four glass pots and I poured in a bottle of water in one, set it down; then I poured in an apple juice and put that down; and then I took a Coke and a Gatorade and then I took a glass and I showed her that, you know, like the Coke had nineteen grams of sugar so I showed her a sugar packet is three and a half grams, so we counted out how many packages of sugar and put it in a glass next to it; and then we boiled … turned them all on high and boiled them. The water boiled to zero, but the apple juice – it’s just this black tar and I’m like, “Taylor, what is that?” And she’s like, “That’s sugar.” And I’m like, “What causes cavities?”, “Sugar!” And I said, “Now, you don’t drink sugar. You can eat sugar, you can eat an apple, but you can’t drink it. You can eat a orange, but you can’t drink it.” And my boys loved it, they actually taped it – Ryan taped it because they remember when I did that when they were little. And I just said, you know, “You can’t drink sugar!” So, there’s another, you know, opportunity to explain to Mom, you know, I’m putting silver diamine fluoride on these cavities, you can’t give a two-year old apple juice because so many of these moms, you know, they’re so innocent they say, “Well, I mean, I’m not giving her Coke, I’m not giving her Mountain Dew. I’m giving her apple juice, I’m giving her orange juice.” So, they think they’re doing the right thing and they need a coach – the hygienist, the dentist. So, yeah, it’s tough. Dental insurance is a tough play.
Kevin: I was just in Wyoming a couple of weeks ago – to go back to insurance – and in the State of Wyoming, a major insurance company just made a switch there where they’re offering a lower tier of their insurance and dentists are faced with do they join the lower tier or do they stay in the higher tier. So, dentists all over the state are trying to decide: if I don’t join the lower tier and a dentist down the street joins a lower tier, patients could potentially go to that … to the dentist with the lower tier and I could lose patients, and so, it’s this across-the-state concern or worry of who’s gonna join, who’s gonna stay on the higher tier and as more people join that lower tier, other doctors feel like they’re forced to do it. What’s scary about that is doctors look at … a lot of times they look at that decrease in payment – so let’s say the lower tier is a fifteen percent reduction in fees – so the doctor looks at that fifteen percent reduction and thinks, “Okay, if I take a fifteen percent reduction, it means my income is gonna go down fifteen percent for everything I’m getting from that dental insurance company. And so, if I’m getting a hundred thousand from that insurance company, or my income’s a hundred thousand from that insurance company, my income is gonna drop down to eighty-five thousand.” But the reality is, it’s not the doctor’s income that goes down fifteen percent, it’s their production from that insurance company. So if my production was a million dollars and my income was three hundred thousand, fifteen percent of three hundred thousand was forty five grand, so I may be down forty five thousand, I’ve gotta find ways to make that up, but if my production drops fifteen percent – so I’m getting a million dollars from one insurance provider, my reimbursement gets cut fifteen percent, my reimbursement went down a hundred and fifty thousand dollars; it didn’t go down forty five grand, it went down a hundred and fifty thousand. And that goes … my overhead stays exactly the same, I have the same supplies, the same team, I have everything the same, and my income now dropped basically in half. And so, what I don’t think people are always aware of is when they see the fifteen percent cut, they think that’s fifteen percent of the bottom line when it’s actually to the top line, and it can have a much bigger impact than they realise. It wasn’t so much I wanted to talk about a specific insurance company or anything like that, it was just to help dentists understand that a cut in reimbursement could have a bigger impact than that ten percent or fifteen percent. It could have a bigger impact on their bottom line and, because of that impact, they need to consider opportunities to optimize their practice or to look for inefficiency in their practice and ways to grow their practice, because that ten percent cut may have a bigger impact than they realise. And so, it’s not so much to talk about a specific insurance company, but just to give an example of across the country there’s these cuts that are happening and the impact could be significant and so within that practice we need to look for ways to be more profitable, look for ways to optimize insurance and, like you said, and get more patients to accept treatment and understand the consequences of not accepting that treatment. That was my purpose behind that – it was just …
Howard: Yeah, you know, so, you’re … in this year there are approx. … there’s two hundred and twenty-five million Americans and, no three hundred, I’m sorry, there’s three hundred and twenty-five million Americans and two hundred and eleven million, or sixty six percent, have dental insurance. And ninety two percent, or a hundred and fifty-three million, get those through their employer, another seven percent buy individual coverage and another forty-nine million get dental benefits through programs like Medicaid. And, so, if sixty six percent of the population has insurance, you know, the other focus is what percent, you know, do … two out of three Americans have dental insurance, one out of three people have no dental insurance, and I always thought one of the most interesting things about dental insurance is you ask a dentist to spend five percent of their revenue on advertising to get those one out of three Americans who don’t have dental insurance and do Google AdWords, do Facebook AdWords, do direct mail, get a lit monument sign in front of your practice, and they say, “Nah, I don’t like doing all that!” But then you send them a PPO contract where the fee is forty percent less, and they all sign up! Why do they not spend five percent going after thirty four percent of America without dental insurance, but they don’t blink at signing up forty percent reduction in their fee for a PPO? Explain that one to me.
Kevin: Well, I think part of it it’s not easy finding the patients … it’s not easy…
Howard: Hell, it’s one out of three, it’s one third of America!
Kevin: But not just … it’s attracting them with … patients with insurance you basically have a list … as a patient you have a list of doctors in network and so it’s a clear path to market to those patients, that if I have a specific insurance I look at my list and it’s an easy way to market. I will say it … my process, or – I shouldn’t say “my process” – at Henry Schein our process for helping a doctor with any of these problems is it’s gonna be different for every dentist, right? I mean, there’s gonna be some things that are … that work for everybody, but it depends. And that’s … so we have twelve hundred sales reps in total. So the twelve hundred sales reps go through courses, they’re taught the business of dentistry, they’re taught about insurance, they’re taught about marketing, they’re taught about OSHA, they’re taught about basically the business side of dentistry and the reason for that is because every office has different concerns, different needs, maybe similar, I mean, the doctor in Wyoming may have some similar concerns to the doctor in Florida, but just like you may have financial concerns, I may have financial concerns, they may be similar, but I feel like mine are unique to me and I want to talk to somebody that understands me and my situation rather than somebody that just says, “In general, here’s what you should do with your finances …”. And so, for our doctors, we’re asking our … at Henry Schein we’re asking what our reps and doctors do is sit down and talk through what’s working well in your practice, what concerns do you have and how are those concerns affecting you personally. And so, a typical conversation with a doctor could be, “What do you enjoy about your practice?” “Well, I enjoy helping patients. I enjoy cosmetic dentistry. I enjoy all the things about changing smiles and helping people with their health.” “And concerns?” “Well, concerns about your practice, insurance, not enough new patients, I feel like I’m working harder and making less money.” I mean, there’s all these things … it could be patient acceptance, but that particular doctor has things they enjoy, things they’re concerned about, and then ultimately those concerns have a personal impact. If insurance reimbursement’s down then that dentist may not be able to take a vacation with their family this year, or may not be able to pay for the college they want for their kids. And so, for that office, we wanna help them to come up with a plan to address those concerns and, in … I don’t know, and so, in generalities we can say, “Here’s some ideas”, but each office is gonna have nuances that they’d like help with and at Henry Schein – I mean, I could send you this image - we have this wheel of things that we can do for a doctor and in the center is Practice Care. And the wheel has Equipment Technology, Supplies, Business Solutions, it has Technical Service and CAD/CAM, or digital impressioning, but this whole wheel of services that we have depending on the doctors, what’s going on in their practice, they may need us for different areas of that wheel and what we want our team to be able to do is understand the business of dentistry and be able to have those conversations with their doctor and navigate, you know, all those things and so, I don’t know that there’s an answer or, you know, a silver bullet that works for everybody. I think it depends – it depends on each practice.
Howard: Well, I’ll tell you another thing about that. So, I, you know, everybody has recognized the pattern that implants and Invisalign, any procedure, if you don’t do it one time a week, you never reach critical mass, which includes technical proficiency and profitability. If you do … if you place one implant every other month, you’re losing, you know, you’re just, you know, all the money you put into training, the CBCT, the implant system, all that stuff, you’re not returning your investment. So, you need to do some, you know, you need to be doing sleep apnoea, Invisalign, placing implants – critical mass is one unit per week. And everybody that’s placing one unit a week, they have a live relationship with that vendor in their back yard. The people that are buying them online have no human contact and it’s because of what you just said, it’s because when you have that human contact your relationship, if you work that value chain and you have problems, it might be something as little … like, I know, my implant guy, we’ve gone to bars after work and had drinks with his other top dentists and then you’re sitting there from seven to ten, watching a ball game, talking implants. And just like dentists have no respect for Delta Dental and the dental insurance industry - and they need to break that, they need to call up the Delta CEO, take him to lunch, press the flesh, run for mayor, “hey, if you ever need a sales call with me, you know, you give me a week notice, I’ll block off time, I’ll go with you to help convince Motorola or Intel or Boeing or whatever, the importance of this dental insurance plan”. Same thing with the vendors and suppliers! I’ve always treated my reps amazing, ‘cause dentists only see their office – these reps know locally, in your region, like, you know, you take a Schein rep – you’ve got twelve hundred of them – that guy … how many offices does the average Schein rep call on?
Kevin: About a hundred and twenty.
Howard: Okay, so you know your office – she knows a hundred and twenty offices! And that’s gotta be your best friend. That’s what Dental Town was about. With Dental Town, no dentist should ever have to practice solo again. Get on there and talk to your homies, download the app, find out what’s going on. And that’s why on Dental Town we let all people who work in dentistry. I want all the manufacturers on there, because if all the dentists are saying, “Gosh, you know, I love their product but it’s red – I wish it was blue!” Well, hell, the manufacturer needs to know that more than anybody on earth ‘cause that’s the only guy that can start making them blue instead of red. So, I mean, my, you know, my reps going back thirty years would actually drive me to other offices and introduce me to older dentists when I was a kid and, I mean, it’s your link to the outside world and I don’t believe that reps should just come in and … I think you should block off time. I mean, when my supply rep comes and they come and talk to Jan, she blocks it off like she was doing a filling or a crown. And …
Kevin: Wow, that’s good.
Howard: And, you know, you gotta treat them like, you know…
Kevin: Yeah, and I would love for more dentists to know this, that their sales rep … they may not … their particular rep may not know insurance like we’d hope they would, but that sales rep will know where to go, and that’s a big part of what, you know, the field sales consultant or one of their sales reps from Henry Schein will do is, is they know within Henry Schein or within the industry where to go for help. And you name it – lease negotiations, insurance, marketing, you name it, being the biggest dental distributor, you know, in the US and in the world, we’ve got resources and that person that you’re shaking hands with has access to those resources. And I would just say, “Let us help you, I mean, in whatever, any area of your practice.”
Howard: Let’s talk to best uses of technology, market penetration. What percent of the dentists have digital radiography instead of film, would you guess?
Kevin: Oh, it’s gotta be pretty high. To be honest, I can give you a guess. I would say, I’m guessing, at eighty percent, but I don’t know for sure.
Howard: Dental Town’s taken so many polls. Every week we have a different poll. So, we’ve got so much data. So, eighty percent’s right. What do you think would … what percent of them would have a computer practice management system like Henry Schein’s Dentrix?
Kevin: I would say somewhere around the same, probably eighty to ninety percent.
Howard: Well, do you think it’s more than digital radiography or the same or less?
Kevin: I would hope it’d be more, but I don’t know.
Howard: Okay, so, the number one adopted technology would probably be - high-tech digital – would be computers at ninety percent, digital radiography for eighty percent. What do you think would be the next most adopted? I’m trying to, you know, there’s a person driving to work, she’s all by herself, she practices alone, I’m trying to give her a feel for what of all of her homies are doing around. What do you think would be the most next adopted technology?
Kevin: Intraoral camera?
Howard: Yeah, I would agree with that. And what percent do you think that is?
Kevin: So, intraoral camera is an interesting one because the number of people that have them and use them is a big difference; and not just use it, but use it on every patient every time, it drops dramatically.
Howard: One of the reasons why is ‘cause when you fly on South West Airlines, every single plane is this Boeing 737 and the only secret to lower price is lower cost. So, everybody knows how to fly it, fix it, parts for it, that’s why their fleet has never crashed, the only airline that no-one’s ever died on. US Air had like eight planes fall out of the sky ‘cause they were fixing the 727s, 37s, 47s, McDonnell Douglas, Airbuses – no-one knew what the hell was going on. And in those operatories – I cannot believe it, I still can’t believe it – and, you know, every operatory has to be exactly the same. Like a dentist will go in and they’ll have like a little occlusal and they’ll say, “Well, do you wanna come back or do you just wanna do it right now?” And they’d say, “Great, let’s do it right now.” And the hygienist would say, “Oh, well, our room doesn’t have a triturator.” We’re like a Boeing 737, but we didn’t add a bathroom in this plane and so now I got to move you to another, it’s like, “What, move me to another room?” You just added twenty minutes to the procedure. I gotta, you know, so, I mean … and then you walk into every room, every drawer should have exactly the same thing in every operatory because if I go in there and she’s like, “Oh, yeah, it’s a cavity! I wish you could do it right now.” Boom, let’s do it right now! I know every drawer I’m gonna reach. So…
Kevin: So, what you just said, I just wanna reiterate how important that is. What you just said, if you can fill that cavity right now, patient acceptance is a hundred percent, right. If the patient says, “Yes” right now and I do it right now, that was a hundred percent acceptance and my overhead for that day is … my overhead is pretty much all fixed except on that one procedure, maybe I grab a glove, the supplies for that procedure, so the profit off that procedure – let’s say eighty-five, ninety percent of that procedure is profit. So, if I can find dental work today, do it today on a patient that’s already in the chair, it’s virtually all profit. And patient acceptance is a hundred percent if they do it right now. So, it’s clinically good, like you said, and it’s extremely profitable.
Howard: Yeah, but you know what the … and then, but then you say, “Okay, assistant, I’m gonna stay here and do this”, to the hygienist, “I’m gonna stay here and do this now. Go to Room 3 and do your next patient.” And she’ll say, “But this is my room!” Whenever my staff says, “Well, this is my room”, I ground them from that room for a month! I’m like, could you imagine getting on South West Airlines, you’re about to take off and the pilot says, “I’m sorry. I just found out this is not my airplane. My airplane is two gates down so I’m gonna have to ask everyone to get off and unpack all the luggage, because my plane is on Gate 12.” You know, it’s insane! They’re right there, knock it out! And when you said to me, “You know, Delta of Wyoming is gonna lower their fees”, what doesn’t matter about that is fees are based on units and your costs are based on time. Like, if … like dentists will sit there and say, “Who cares the fee’s reduced fifteen percent?”, they’ll say, “Well, we’ll do the filling on the right side this time and then you can come back and we’ll do the filling on the left side.” Well, you know, the oral surgeon numbs up all four quadrants and pulls out all four wisdom teeth and he’s in the same medical dental building as you. They don’t wanna come back. Why don’t you go from one tooth dentistry to quadrant dentistry to full mouth dentistry – everybody busy I ask, I’ll say, “Hey, Kevin, you know, you got three cavities there in three corners. You’ll be really numb but don’t you just wanna come in here one time and bang it all out right now?” So, who cares what the price of the filling is, if I got you to do all three in the same appointment time, one hour, you know, it’s cost per hour. So, the intraoral camera, you know, back to that treatment plan acceptance, you know, the average dentist does one out of three and the ones crushing it are doing two out of three and the third guy is never gonna do it ever, but the human doesn’t understand. You started this podcast, when they ask, “Does my insurance cover that?”, that you were saying, “Is this necessary?” Now your iPhone has a recorder on it, so every time you go do a hygiene exam or a new patient exam, you can turn on your recorder, leave it on the counter and walk out. And you listen to that tape – when you leave the room, the first six questions to the hygienist or the assistant are all based on trust. “Really, do I have a cavity?” “Really, I have to get a root canal? I can’t just fill it?” I mean, so, they don’t ask the dentist the questions, they’re asking, “Is this trust?” and one of the best ways to prove do you really need to do this, is not a little film x-ray but a digital x-ray, print it out, put it on a clipboard, just like a coach would do in the NBA, and draw the play, circle it, don’t use Latin and Greek – it’s not a MO or a DO, it’s a flossing cavity in between your teeth, here it is – and then the intraoral cameras are in all eight rooms and they’re always on and then I reach in there and take a picture, but in most dental offices they’ll say, “Well, I could show you this but we need the intraoral camera. Amy, will you go get the intraoral camera?” “Well, we’re running five minutes behind.” It’s like, five minutes behind! Your labour’s twenty eight percent, your lab’s ten, supplies five, rent five, advertising three – where the hell is intraoral cameras in your overhead? Again, these dentists, the fastest way to get to two out of three done instead of one out of three, is every room is a 737, every drawer is stocked exactly the same, if a hygienist or assistant says, “No, I want my room different!” then you know what, you cannot step foot in this room for a month! Every plane’s the same and every time there’s a cavity we’re gonna take a digital x-ray, print it out, circle it with red, ‘cause ‘doctor’ comes from a Latin word docere meaning ‘to teach’ and the best teachers have drawing notes on it, printed out eight by ten sheet of paper, digital x-ray, and showing them an intraoral camera photo – then when you leave the room they don’t turn to you and say, “Kevin, do I really have a cavity?” Well, of course you do. You’re holding the x-ray in your hand, you’re holding the intraoral camera photo in your hand, and they’ve just gotta get that. So, what do you think’d be the most next adopted technology after intraoral cameras?
Kevin: Well, if you don’t mind, I wanna make a comment just real quick, ‘cause you mentioned a couple of things that I wanna come back to that … you talk about your phone and you think of how many pictures you take on your phone versus an old point and shoot camera, and really it’s convenience, right? I mean, with having three little girls I have, oh, I don’t know, probably ten thousand photos of my little girls just because it’s so easy to take pictures and it’s always there. And so, when you mentioned intraoral cameras, some intraoral cameras, they take a few minutes to boot up, they take time and so they just don’t get used or you, like you said, bring it from one operatory to the other operatory, connecting the docking station and five minutes later you’re finally taking an image – well, it’s the same reason why we don’t take point and shoot camera pictures as often, it’s just not as convenient. And so, to your point, having a really good intraoral camera that’s right at the doctor’s side, they can grab it, take a picture, you know, in a few seconds, I mean, that’s one of those … another reason why it’s important to understand, you know, what you’re buying and how easy is it.
Howard: Yeah, well, time is money. I mean, some of these self-cure composites set up in three minutes and some of them set up in one minute. I mean, the one that sets up in three minutes is three times more expensive than the one sets up … but what camera do you recommend? Give brand names.
Kevin: Well, there’s … that goes back to the beginning, it depends. That’s where we have equipment specialists and a technology specialist that sit down with that doctor to better understand, do they want … do they wanna see the perio, do they wanna see … so there’s cameras now that they don’t replace x-rays, but can do, can see things that cameras couldn’t see before, and it depends on that doctor and that situation. I don’t know that I would say there’s this one camera that oversees all cameras, it’s better than all cameras, but depending on their specialists, understand that doctor’s needs, there’s a variety of cameras.
Howard: What would be the next most adopted technology that offices - more successful - utilize and adopt versus less successful?
Kevin: So, we’ve got …
Howard: My definition of success is again, the doctor that has a two thirds case acceptance as opposed to a one third.
Kevin: We’ve got the digital x-rays, we’ve got the practice management software, we’ve got intraoral cameras … so as far as patient acceptance, what’s another …
Howard: Well, what’d just be the most common … would the next most adopted technology be? Because, you know, dentists … you know, we do the Townie Choice awards every year and, you know, so all these dentists voting on all these products, you know, they all got eight, ten, twelve years of college. It’s very different than the People’s Choice award for music or movies or whatever. I mean, these dentists are sharp, so market share information is very important. If you said, “Oh, well, you really need to have this technology”, and I’d come back and say, “Hell, eighty percent of dentists have digital x-rays, why don’t you? Eighty percent have intraoral cameras, why don’t you?” But then there’s some technologies where only, you know, ten thousand dentists will use it – so then you gotta start wondering, is this really right for me, is this bleeding edge technology that’s too expensive, or is it leading … is it bleeding edge, leading edge, and what are the nuances so I can figure out because it’s red flags if only ten thousand American dentists do something.
Howard: And it’s a red flag that you don’t do it if eighty percent of your homies do it. I mean, if eighty percent of the dentists have an intraoral camera and a digital x-ray and you don’t, that’s a huge sign that, dude, your homies are smart people, they’re doctors. Why do eighty percent of the … I mean, I don’t wanna go to a cardiologist if I found out eighty percent of the cardiologists use XYZ and mine doesn’t!
Kevin: Right, right.
Howard: And I also wouldn’t wanna go to a cardiologist that does a bypass every three months, you know. If he wasn’t doing a bypass every single week I wouldn’t want him filleting me open, you know.
Kevin: But you make a good point where there’s emerging technologies that are picking up pace, and so they …
Howard: And which ones are those?
Kevin: Well, I mean, Cone Beam and CAD/CAM and digital impressioning, they’re all growing in the market and …
Howard: Well, when you say CAD/CAM, are you referring to chairside milling or digital impressioning?
Kevin: Well, both. So, the scan only option, the digital impressioning, scan only, and then CAD/CAM or full system chairside milling and …
Howard: Is this a game-changer for Henry Schein? Because Patterson just lost their exclusive with the CEREC machine. Sirona married Dentsply now - that was probably the biggest marriage of the year last year in dentistry - and now you guys are starting to sell CEREC. Have you started already or is it … what is it, September 1st you do that?
Kevin: In September, yeah.
Howard: You think that’ll be a game changer?
Kevin: I would say our game changer is that focussing on practice care. So, because we focus on practice care, at Henry Schein we’ve grown in every category. So, in every category we’ve outpaced the market with supply growth, with equipment growth, with technology growth, and one of Henry Schein’s core beliefs is offering options, that we have a variety of options in every category, and in CAD/CAM, having another option for our doctors fits right into our core beliefs and into providing best practice care for our doctors.
Howard: When we talk about CAD/CAM as far as chairside milling, you guys have carried the Planmeca E4D for a long time and now you are carrying the Dentsply Sirona CEREC machine. What if somebody’s driving to work right now and she says, “Come on, Kevin, just tell me – what’s the difference? Should I go Planmeca E4D out of Dallas? Should I do CEREC?” what would you tell them?
Kevin: You know, it sounds like I’m dodging it, but it depends. It depends on … if I were talking to my daughter, if my daughter was a dentist today I would have a technology rep sit down with my daughter and go through what are her goals, what is she trying to use it for, how will she use it, and it depends. It depends on how she would use it in her practice that would determine which one would be better, but there’s definitely advantages to both and …
Howard: What percent of the dentists are chairside milling today with a E4D or a CEREC machine?
Kevin: I don’t know.
Howard: I mean, what number? How many total units do you think are in the United States?
Kevin: This isn’t my area of expertise so I’m guessing, I would guess around twenty percent, but that would be a guess.
Howard: Twenty percent? Okay. I think that’s high. I hear fifteen thousand units, but what percent do you think have CBCT?
Kevin: I don’t know. You’re asking me to guess again. I would … it’d probably be even lower than that. But those numbers are growing and it’s … the scan only option is growing a lot as well. If not a lot, it’s growing probably faster than the chairside.
Howard: You know what I like the most about, I mean, I got the CEREC machine … I don’t even wanna … I don’t even know how old you are. How old are you? You’ve been in dentistry fourteen years, but how old are you?
Howard: Thirty-nine. How old were you in 1987 when I bought the CEREC 1?
Kevin: Wow, you bought it in 1987?
Howard: What year were you born?
Kevin: I would have been nine years old.
Howard: Oh, my gosh! You just ruined my day! Thanks for … I’ll probably just go right out now. My gosh! So, yeah, I love technology. I had the CEREC 1, I had the CEREC 2, I had the CEREC 3, I have the CBCT, I have the Carestream, these, you know, I love that stuff. But what I love the most about chairside milling is actually not the chairside milling! What I think the lowest hanging fruit to be a better dentist is to get two people who have a cavity to get it done; instead of one out of three get to two out of three. I think that is imperative. As far as when you’re doing your cavity, to go from naked ape homo sapiens eyes to enhance with loops and, you know, I’m a three point eight, you’re a better dentist. When I scan those impressions … I have never scanned a prep where I wasn’t humiliated and humbled and ran out the room crying with my tail between my legs and always had to go back and get Sof-Lex, end smoothing burs, I mean, you take that impression and you’re like, you know, with purple 3M emper gum (56:59) and, you know, why is … you know, that’s dark, you’re looking at it, you think it’s good ‘cause it’s one to one and it’s dark purple, but, man, you scan that thing, you see it forty times bigger, you’re like, “Holy moly, someone should take my license away!” So, it makes you just keep going back making that prep prettier. And the labs are telling me that when you send in the vinyl polysiloxane and the polyether, they’re having six percent remakes and when you’re sending in digital, they’re having one percent remakes, and that’s because of magnification. Same thing with my endodontist friends. The most elite endodontists, right when they’re all done cleaning and shaping, right before they go to obturate, they drop down a scope, like Global out of St Louis or Zeiss out of Germany, and they’re looking down at those canals about 8X and every once in a while, maybe once a day, they’re like, “Oh, my g*d, there’s still crud in that one canal” or “I missed a canal” or … and the CBCT is actually now, I believe, it’s rapidly going to be standard to care as opposed to a 2D because, when you’re talking to ear, nose and throats and rhinologists (57:38), there are people that thought they had sinus infections and allergies for twenty years and then the ENT goes in and scopes them and there’s a leaking, failed maxillary first molar endo where they never got the MB2, or its failed and it’s leaking in there. Somebody did a sinus lift because they don’t believe in bridges, you know, they don’t believe in filing down the tooth on each side to the extracted because that’s sacred enamel to a dentist, but they have no problem exploding and blowing up the sinus with cow bone and membrane and titanium and all this crap doing a sinus lift, and these ENTs are saying, “These failed sinus lifts that are perped (58:42) and white candida infection and fungus and parasites and micro-organisms”, so I do believe if you have a root canal and it’s going in … a root canal tooth, a second bicuspid, a first or second molar, and it’s, you know, near or in that sinus, it … you have to ask first, “Do you ever have any issues with your sinus?” and they say, “Well, yeah, you know, I have allergies sometimes, you know, something’s blooming.” Well, they don’t know what something’s blooming is, but it’s gonna demand a 3D image of that root canal and if you don’t have a CBT, you should sit there … find a local endodontist that’ll do your checks for you. Just say, “I don’t have a CBCT, but I have Margaret in here, she’s forty years old, she’s got an upper first molar root canal and she always has sinus ills, will you take a three-dimensional x-ray and see if … make sure it’s not my deal?” Or you gotta find a ENT or a rhinologist to stick a camera up there and look at it. So, long-winded statement of saying, I just like magnification. Homo sapiens does better when they can see. You’d never want Stevie Wonder to become a dentist. You need to keep him on the piano, not with a drill in his hand!
Kevin: Right, right! Even when you said, you know, Cone Beam … you were talking about Cone Beam, depending on what procedures you’re going to use it for, depending on if you’re using it with CAD/CAM and integrating it with that CAD/CAM, depending on, like I said, the procedures, one Cone Beam may work for you, another Cone Beam may work for a different doctor; but it … that’s where I go back to rather than saying there’s a one-size-fits-all, there’s somebody that can sit down with that doctor, better understand what they’re going through, what their long term goals are, and help them choose what’s best for them. And I just think it’s a better option than saying, “Here’s the one … here’s the best one that works for everybody.” Because it doesn’t always … not everybody needs the top-of-the-line or not everybody needs … it depends. It depends on how they’re gonna use it.
Howard: I can’t believe we already went over an hour, an hour and six. So, I’ve gotta wrap this up quick. My homies are pulling up to work, they’re probably sitting in the parking lot saying, “Hurry up! Hurry up!” but I wanna just make this … I want you to talk about this thing. You know, the one thing I love about CareCredit, the number one thing I love about CareCredit, is that number one is in the United States, if you buy something for over a thousand dollars, it’s financed ninety percent of the time – cars, houses, whatever. But it’s not that, it’s the fact that CareCredit can come in your office and show you the utilization of all the dentists in your area, and a lot of dentists say, “Well, you don’t understand – the problem is the economy and the factory shut down and unemployment and blah, blah, blah, blah” and you can say, “Okay, you can say all that, you know, but you’re using CareCredit, you know, one thousand dollars a month and there’s another guy in this medical dental building that’s doing ten thousand a month and there’s a guy across the street doing fifty thousand a month. So, you know, you all have the same economy, the same city all that.” You do the Henry Schein … and just call CareCredit and have them come in and show your team that, ‘cause your receptionist might be saying, ‘None of these people qualify’.” And you’re like, “Well, why do they all qualify across the street?” So, it’s very good to get a balanced score card, okay. You do a Henry Schein practice analysis. What does it cost? What do you do? How does my homies listening to you right now get a Henry Schein practice analysis? What does it cost? What do you do? Tell me about it.
Kevin: Okay, so what we went back to is the doctors explaining what they’re worried about in their practice through a discovery meeting. The next step typically is, now let’s actually look at your numbers. The doctors said they were worried about insurance, they’re worried about cancellations, worried about treatment, will then let’s run a report and analyze the practice to look for opportunities. If insurance has made cuts in your area and you’re looking for ways to optimize your practice and look for opportunities, the practice analysis breaks down the practice in hygiene, radiography, perio, in fees - it looks for opportunities for growth within the practice - and then we can come up with a treatment plan based off that doctor, what they’re concerned about, what we identify in the practice analysis …
Howard: What does it cost?
Kevin: …and then we… Two hundred and forty-nine Dollars.
Howard: Two hundred and forty-nine Dollars. What if they don’t buy from Schein? Do you have to be a Schein customer to do it?
Kevin: No, but I will say, most doctors, if they go through this process, they’re … they’ll want to buy from us, I mean, they’ll wanna partner with us for the resources that we can provide, but it’s a service that we’ll do for any doctor in hopes that they’ll wanna partner with us and work with us.
Howard: And what I’m saying is, network with your value chain. Like when my rep comes in, I don’t care what my rep thinks about one endo file versus another. What I wanna know is, I’ll say, “Well, what is Brad Getelman using?” I mean, I think he’s the best d**n endodontist in my town and he’ll say, “Well, he uses this.” And then I’ll say, “Well, what is this endodontist using?” and he’ll say, “Well, he’s using …”, you know, I want to connect in my outside world. If someone’s selling me to do something, you know, what I like the most is this Henry Schein rep sees a hundred offices and some of the dentists think … I don’t know, probably, I think about half the dentists think in fear and scaristy (64:24) and think the dentist across the street’s competition, but the other half think in hope, growth and abundance and your rep knows who that are and ask her. Let’s say if you’re young, say, “Who’s a mentor? Who do you think’ll meet me for lunch at Subway? Who do you think’ll meet me at Brad’s Place after work for beers to talk about this?” and I just love the social network. I don’t know anybody placing a implant a week who can’t get the implant rep on the phone and she shows up and she’ll … sometimes I’ll ask my guy a question and he’ll say, “You know what, this calls for lunch with these two guys. Let’s go meet at the restaurant. Let’s go there Thursday” or he’ll say, “Actually, I’ve got nine dentists and they’re all meeting at this periodontist’s office next Thursday” and, I mean, you know, I like learning from guys across the street because when you travel across the country to learn how to place and implant, that guy ain’t gonna be there when you screw up. I mean, when I screw up I wanna have … I wanna be able to call my buddies …
Kevin: That’s right.
Howard: … and have somebody help me that’s across the street. And …
Kevin: That analysis – we do about six thousand a year, well, closer to seven thousand – but we do a lot of them, so it gives that sales rep an idea of here’s what’s happening across the country, here’s in hygiene …
Howard: You’ve done six thousand Henry Schein practice analysis a year?
Howard: Do you have a bunch of data on that?
Howard: Well, why don’t you start a post? Why don’t you start a post on Dental Town under practice management which says … I know you’re probably shy and you don’t wanna come off sales … “Hey, I just did a podcast with Howard and he wanted me to start a thread under practice management about what we’ve learned from doing six thousand Henry Schein practice analysis a year.” And share data, what have you learned, I mean, again that dentist only sees her own office – you guys are seeing six thousand a year. You have to know something at a macro-economic level that an individual homie in the middle of Parsons, Kansas, doesn’t know.
Kevin: Right, and that’s our value proposition to doctors. We focus on practice care so they can focus on patient care and these six thousand reports help us better understand what’s going on in the market to help more doctors.
Howard: Well, summarize those six thousand reports. Summarize those and post those on Dental Town. So, you waffled on shall I buy a Planmeca or CEREC, you waffled on so many questions, so I’m gonna hold your feet to the fire: who was the better quarterback, Brett Favre or Aaron Rodgers?
Kevin: Aaron Rodgers by far!
Kevin: Aaron Rodgers!
Howard: Wow! That is … I have to tell you, I … when, you know, I admit I’m so horrible at predictions, when they ran off Brett Favre, I thought that was the dumbest move in the NFL. I just like, I would just stand there like, I cannot believe they would do that, and then Aaron Rodgers shows up and proved you right. I mean, who thought … and who would ever have wanted to follow Brett Favre? I mean, you’d have to be …
Kevin: Right, right.
Howard: I mean, you’d have to be insane … that guy was a legend of Green Bay. I’ve lectured up in Green Bay, in that stadium, a couple of times. There’s a dental lab up there, Lord’s Dental Studio, that’s brought me up there a couple of times. That is just a sacred ground. I mean, that’s my number one vice, I mean, you know, I never complain to anybody who’s watching reality TV shows like Housewives of Miami or Housewives of Atlanta, because with Housewives of Atlanta, at least you know why Shirley’s mad at Lucy. I have no idea why I want the Arizona Cardinals to crush the Green Bay Packers. I mean, I have no idea! ‘Cause they’re great – I don’t even know why. I don’t know why. I think reality TV’s better ‘cause at least you know why you’re mad at someone. I have no idea why I want the Cardinals to cream everybody. But, man, I’ll tell you what, that is the most gorgeous stadium and I also think it’s so insane that they don’t put a roof over it. It’s so insane, it makes it cool.
Kevin: I know.
Howard: I mean, I’ve seen games there where it was a whiteout, I mean, a complete whiteout. You don’t even know what’s going on, everyone’s frozen, dropping the ball, and you’re like, “Put a roof over it!”, but the Green Bay people are all standing there like, “Nope, nope. You’re on our territory!”
Kevin: Love it!
Kevin: Yeah, yeah.
Howard: I love that team. That’s gotta be one of the greatest NFL franchises of all time and that’s the Super Bowl’s trophy, Vince Lombardi.
Howard: Straight out of Green Bay. So, hey, big shout out to your boss. I think your boss, Stan Bergman, is seriously one of the greatest men in dentistry and I cannot tell you, a couple of times I’ve been out in the middle of nowhere, in the jungle, and doing some missionary dentistry thing and you fly into an airport, you drive a four wheel drive for three hours, you’re carrying all your supplies and then there, out in the middle of fricken nowhere, is a brand new dental office with state of the art equipment and all this stuff and I’m like, “Who built that?” and there’s a little plaque “Built by Henry Schein” and so, I told them - this is the coolest YouTube video, you gotta find it – so I told these kids in Tanzania, I said, “My friend … I know … my friend, Stan Bergman, he built this! So here’s my iPhone, I’m gonna film a video. I want everybody to tell Stan, ‘Thank you, Stan, for building this dental clinic!’” and I started, and I said, “Okay, go!” and they started singing Happy Birthday, “Happy Birthday…!” They don’t know … Hell, I’m speaking English, you don’t know what the hell I’m talking about! So, they all sang Stan Bergman Happy Birthday from Tanzania! But you guys, Stan does more charity behind the scenes, off the record, that no-one knows about. He was born in South Africa. He is an amazing man, I mean, just …
Kevin: Yeah, yeah.
Howard: I mean, talk about the American dream, talk about the poster child of why you want immigrants to come to the United States. I mean, he is just … g*d, he is one of the most important figures living today in dentistry. So, tell Stan Happy Birthday on behalf of the orphans in Tanzania! And on that note, I hope you have a rocking hot day, Kevin.
Kevin: I will. Thank you, you as well.