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VIDEO - DUwHF #936 - Christina Blatchford
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AUDIO - DUwHF #936 - Christina Blatchford
Christina is a mother and wife first. A dentist second. She loves dentistry but understands the value of quality time spent with her family and friends. She enjoys the aesthetics of dentistry and has learned how to pursue her artistic talents in this field. Her father, Dr. Bill Blatchford was a successful dentist and it seemed the natural progression for her to follow in his footsteps. Originally, Christina pursued a fashion path and received her B of A. After working at Nordstroms for a bit she realized she needed more. She went back to school and became an interior architect specializing in dental practices. After a bit of time she realized she wanted the lifestyle she was given growing up and needed to pursue a career in dentistry to allow these opportunities for not only her but her husband and young daughter. She now works two to three days a week and takes eight weeks off every year. There is a specific formula to this lifestyle that Christina and her father would like to share with more dentists. Blatchford Solutions is a practice management company that helps only fifty doctors a year pursue the lifestyle they want to live. Too many dentists run on a rat race of a huge overhead, working four to five days a week and taking maybe two to three weeks of vacation a year.
Howard: It is just a huge, huge honor for me today to be podcast interviewing Christina Blatchford of Blatchford Solutions. She is a mother and wife first, a dentists second. She loves dentistry but understands the value of quality time spent with her family and friends. She enjoys the aesthetics of Dentistry and has learned how to pursue her artistic talents in this field.
Her father and my idol, Doctor Bill Blatchford, was a successful dentist and it seemed the natural progression for her to follow in his footsteps. Originally, Christina pursued a fashion path, which is why I'm wearing a black shirt and a pink bow tie, and received her Bachelor of Arts. After working at Nordstrom's for a bit she realized she needed more. She went back to school and became an interior architect specializing in dental practices. After a bit of time she realized she wanted the lifestyle she was given growing up and needed to pursue a career in Dentistry to allow these opportunities, not only for her but her husband and young daughter.
She now works two to three days a week and takes eight weeks off every year. There is a specific formula to the lifestyle that Christina and her father would like to share with more dentists. Blatchford Solutions is a practice management company that helps only fifty doctors a year pursue the lifestyle they want to live. Too many dentists run on a rat race of huge overhead, working four to five days a week, and taking maybe two to three weeks of vacation a year. How are you doing today, Christina?
Christina: I'm doing great. Thank you so much for having me on this show. It is just quite an honor and you are a dental legend, so this is just so much fun.
Howard: I'm only a legend in my own mind. No one else’s. It's really interesting, thirty years ago it was Indemnity Insurance, you submitted your own fees. I'd do a crown for a thousand, a root canal for a thousand and submit it to Delta and they'd pay half of the crown and 80% of the root canal. Now it's gone to all these insurance companies send you the fees and a lot of dentists say "I don't take PPOs." It's like: "You don't take Delta?" they're like "Oh, I take Delta." It’ like: “Dude, Delta is a PPO. And now, thirty years later Christina, I get paid six hundred for a crown and, or six-fifty for a crown and six-fifty for a root canal.
Christina: It's a racket.
Howard: So, my fees have gone down 42% but every time the earth goes around the sun, the staff wants a dollar an hour raise and there's just so many fifty, sixty-year-old dentists that have seen their staff labor migrate from, thirty years ago, 20%. Now, it's north of 30% and when you look at the macroeconomic numbers, it was 2005 that dentists maxed out at $217,000 a year net income for general dentists and it's gone down $4,000 a year for the last decade. Now, they’re at one-seventy-four and there's no change in that direction. So, what can you at Blatchford Solutions do for that mess?
Christina: You bet. Insurance is a racket but I think that one of the things that we need to just step back and big-picture this is that, dentistry is a wonderful profession. It really is. We get to create smiles for patients, create their aesthetics or a function that they didn't have before and we have the power to change lives and we get paid for this, so that's something that I think is really important to step back and big-picture this, but yes, insurance is definitely, it’s a challenge.
What we do with Blatchford solutions, really encourage our doctors to do is, create value. Create value in your dental practice so that patients actually will move forward. We talk about sales as uncovering patients wants, because who wants to be a used car salesman and in your dental practice that doesn't work well and it doesn't feel good to patients. But you know creating value and uncovering patients’ wants and looking at the big picture, people are spending money somewhere.
They're spending money on vacations; they're spending money on even like tattoos. I know there's plenty of patients that we have coming into our chairs that will say: "Gosh, nope I can't afford that crown" but they have this monster sleeve, full sleeve tattoo that somehow they afforded and what we need to do as dentists is think about this, other people, other professions are obviously much better at sales than we are. If we have patients that are coming in that are fresh from their Hawaiian vacation but they say "we can't afford a crown", we need to do a much better job creating that value in our dental practices.
Howard: You know why I never got a tattoo?
Christina: I don't know.
Howard: Because I've never seen a bumper sticker on a Ferrari. Now, if I ever see that I'll consider it. But you just said the dirtiest four-letter word in all the dentistry which is sales. They don't sell and they're up front with this. They say "I didn't go to eight years of college to be a used-car salesman. I'm not going to sell. I told you, have three cavities if you're too damn dumb to fix it, the hell with you." Christina, when we look at case presentation data - I like big, big data - I mean America's got three hundred twenty four million people, there's two hundred eleven thousand living humans alive with an active license to practice dentistry and when you look at the hundreds of millions of dollars of insurance claim, a dentist will tell you his root canals never fail but the insurance will tell you that if the general dentist has a root canal in sixty months, five years, 10% are extracted. If an endodontist does it, 5% are extracted. But back to selling, just talking about decay radiographic on Bitewing's interproximal lesions, they only close 38% of them.
I'm not talking about bleaching, bonding veneers and implants; I'm talking about a frickin’ M.O on number three. They could only convince one out of three people to get her done and then you just said sell and they probably just made the sign of the Cross and drink holy water. How do you convince this guy who's up front with you tells you he hates sales, he doesn't want to be a salesman but if he doesn't sell dentistry, his patients are not benefiting from walking out the door with cavities. I wouldn't want to send my grandchildren to a dentist that can only convince one out of three of my grandchildren to get her cavity fix. I'd want to send her to the dentist that convinced all of them they need to get it fixed.
Christina: I love that question because when you say convince this is exactly the way that we do not want to do things. No one wants to be convinced of something. We joke and this is kind of politically incorrect but I think you will think it is funny, but we joke about not saying the N word to patients, and the N word in this case is "need". So, saying to patients "you need this". The thing is you haven't done any work on the front end to help the patient discover what do they want with their lives, with their teeth. What do they want their smile to look like? How do they want their teeth to function? How long do they expect to even keep their teeth? These are questions that these doctors and teams are definitely not asking. These are part of our power questions that my dad has put together and really work great with patients and it is easy to have these conversations, but if you're not taking the time to have the patient really tell you what they truly want, then when you tell them you need this, you need this, you need this, and perhaps I can educate you into submission, which we do by then if we see a patient that seems to be on the fence of whether or not to do these MO fillings or not. We then go ahead and bring up the radiograph and think perhaps if you could know what I know then you would go ahead and do this and it doesn't work. I mean, it works maybe, you said, like a third of the time but you have not created value, haven't gotten that patient to buy into what do they truly want with their teeth, what do they want with their smile because if they tell you "this is what I want" then, "OK, great! Well, in order to get to that end result, this is what I see that you might need to move forward on" that's a much easier conversation than "you need this", Howard. Right?
Howard: When you analyze a dental-- let's just talk the average practice, one dentist, one hygienist, two assistants, two receptionists, now the average median, mean, mode dental office the United States for general dentists collecting
seven-fifty taking home buck seventy-four, when you see they diagnosing a hundred radiographic interproximal lesions and only drill filling bill 38%, how much of that is the dentist problem versus the staff problem? Because if I ask, and I've surveyed a lot, a lot of dentists just throw numbers around. In Dentaltown, when you start any thread you can start a poll and in Dentaltown we formally do a poll. So, I've been polling dentist since 1998 and a lot of dentists they'll say these numbers. I'll say "where did you find that?", "Oh, I just heard it." But when you poll dentists say, "what keeps you up the night at the most?" It's never my root canals fail, my fillings fall out, it's always staff.
Christina: You bet.
Howard: After they're done doing a filling they always go in their office and shut the door and hope that when they come out they're all gone, and then if you ask them what's the second most difficult thing in your life, it's the patient. So clearly dental schools are accepting you because you got A's in calculus physics, geometry and biochemistry. They've collected all this library nerds. I remember at Creighton, I didn't have one date in undergrad, it was just dental school and every single night I heard this at midnight, "Ding! The library will be closing in ten minutes," and then we walk back from the library to Swanson hall and there'd be all these business majors and pre-law and they're all drinking, and playing pool and they got girls hanging on them and I was so crazy that I thought that they should all be kicked out. They're not even taking school seriously. So that's what you got into dental school, a bunch of library freaks and what do they do? Their receptionists is the librarian.
Christina: That's hilarious.
Howard: So you got some guy sitting in the corner of the library who's only attracted to librarians because they don't talk and now he's got to deal with talking staff, talking patients. How much of that is the component to treatment plan case acceptance? How much you blame on the doc? How much you blame on the staff?
Christina: Good. So here's the thing is that in dental school and you are so right about that, we have to study, study and study to get into dental school. It's not easy and so yes, I can totally understand what you're saying. We don't have any leadership classes in dental school though. So you get out into a private practice and all of the sudden you go from this what you call a library freak to a leader of a team, and you have to be the person who is in charge, you have to be the person who is inspiring these team members to really do their best job and you have no training in that, and so obviously that's where Blatchford solutions comes in to really help you develop yourself as a leader so that you really have a team that can function and reflect you in every area of the office, but how much of it can be blamed on the team? When we want something different, we need to look at what can I do differently to make this change instead of blaming the challenges on other people? Because we can't necessarily change other people, although in a dental practice, you can hire and we strongly suggest is to hire the best. Don't have two people at the front and at seven-fifty--
Howard: But when you say hire the best, you say "why did you hire the hygienist Amy and not Sally and Mark?" and you'll say "well, Amy won the "Hu Friedy Golden Scaler Award" in Dental school. She was a 4.0. She graduated summa, cum, magna. You got the worst hygienist in the entire class. The girl that made straight C's and had a drinking problem, that's probably the one that has the most personality and talk and build rapport.
Christina: It's all about that. Who is going to do the best with patients? We encourage our doctors to hire the best, hire the people that are going to really do well with patients and also that are mentally flexible so that when you go through a coaching program they can actually move and change with you. Don't hire that person who is the Hu Friedy, gold standard, although we expect our hygienists to do their job.
Howard: It's the Hu Friedy Golden Scaler Award. Please get the name right. It is the most sacred prize in all of dental hygiene. It is the Tonys, and the Grammys, and the Oscars all rolled into one.
Christina: Yeah. Hygiene is important into practice but certainly I expect everyone on the team to be part of the sales process, to be part of uncovering patients' wants. So if I have a hygienist who is not part of that process, who's not asking the questions that I need them to ask before I get into the room, then they're not doing their job even if they do have the "Golden Scaler Award"
Howard: The "Hu Friedy Golden Scaler Award".
Christina: The "Hu Friedy Golden Scaler Award".
Howard: I understand my homies. I'm a dentist. Even when a dentist retires, you're still a damn dentist and I understand the love affair and attraction, and seduction of learning surgery, and placing implants, and sinus lifts and bone grafts, but the problem is they always take their CE budget in time and they go to Pankey and Quays and Spear and they learn this love of dentistry but they'll go to Spear and learn how to do full mouth rehabs and I'll say, "buddy, how many full mouth rehabs did you do last year?" "Oh, I haven't done one." OK. So you go to Pankey for six weeks. I did it. I went through all the continuum's and they're learning all this TMJ and occlusion and they don't even do the cases, and then I look at everybody my age who's doing two to four million dollars a year and those guys instead of buying CAD cams they buy consultants and they'll buy a $150,000 CAD cam but they won't buy a $50,000 consultant. They'll buy a $150,000 CBCT but they won't get a $50,000 consultant, and I keep telling them that the number one return on investment is a consultant. Then they say, "well, which one would you get? I'll say, "well, you know everybody that's my age doing two to four million a year, they've had five or six different ones in the last decade." Their mindset is, if we have a consultant for it come in for a year and I pay him a dollar, I know I will get that dollar back by the end of the year plus more. They say, "well this consultant helped us with insurance and this consultant helped (inaudible 00:16:38). What is different about your consulting versus the others and why should they buy consulting instead of a laser which stands for losing all savings equal reality, not light amplification stimulation and radiation?
Christina: Right. I love that question, yes. So you mentioned continuum education, you take these great courses and then you have the ability to do full mouth cases, which we strongly encourage for all of our doctors to continue that and really be the best that you can be going back to creating value in your dental practice and being able to do what a patient wants, I think is definitely so important but if you if you can't sell that, it doesn't make any difference. It doesn't make any difference. I think that in dental school, we're kind of taught that to be the best dentist that you can be and the rest will just fall into place, but that's not the case. That's why we're in business. Why we have a consulting business is because, yes you are so right, you can buy the latest and greatest equipment but if you do not have your practice together. If you're chasing a high overhead, our consulting company is really big on getting your overhead under control, putting your systems together so that when you do have these patients coming in, that you really have things dialed in, you can present or you can uncover the patient's wants and then present the dentistry that you've taken the classes or you have the equipment to do, otherwise, that's just a nice shiny equipment that's good for hanging coats on and that's about it.
Howard: You know what's weird? Only dentists talk about their equipment. You'll never hear a physician or an advertising of physicians "we just bought a new ultrasound machine". Physicians never mention equipment. It's only dentists. It's the weirdest bizarre thing.
Christina: Isn't that so funny?
Howard: If you're listening to me, shoot me an email, email@example.com. Tell me what country you're from, your name, how old you are. When I get these emails, Christina, we need to redirect this conversation because 25% are still in dental school and the rest are under thirty. I got an email yesterday from a guy and he said I am an old man, not as old as you, I think he said he was fifty-three but anyway, so what are they going to find at Blatchford.com and does Blatchford.com offer or when you only accept fifty new clients a year, do you ever help these kids come out of school and I also, before I forget, I want to ask you a very personal question.
Howard: I get a lot of emails and there's a lot of posts on Dentaltown. Girls like you, graduate, go work for their dad and they love their dad but he just makes her want to pull all of her hair out and jump off a cliff and the dad's maybe doing sargenti root canals which are illegal or you know he doesn't want to upgrade a pano to a CBCT or all this things like that. What would you tell - and I get this email a lot - what would you tell a twenty-five-year-old girl, working for her dad, who she idolizes, or maybe her mom, I don't know even know why I said dad. You know, working for her parent and they love each other, they want to spend the day with each other, they want to work together but it's really, really stressful.
Christina: Tell me about the stress. The stress is because they have different practicing style and different vision for their practice.
Howard: Because they're doing Fred Flintstone dentistry and don't even know what Instagram means and they're trying to take-- basically this is what it is, they're trying to take the office into a new direction and Mom and Dad are kind of winding down and just milking the cow and they want to feed the cow and make the cow better and healthier, maybe have the cow make a few babies. So they're just going into different directions and she knows her parent isn't going to retire for a decade and oftentimes they put on Dentaltown, "should I wait a decade or should I just jump out on my own?"
Christina: This is a really good question and going back to when we see - this goes not just with parents and children but everyone here is - first of all, is this a single-doctor practice that we overnight decided to make it into a two-doctor practice? So that's the question. Can this practice actually even support two people? It's really one thing to look at because oftentimes we see this where we have a doctor who thinks "what I'd like to do is, I'd like to do the bigger cases and I'm going to sell half of my practice to-- I'm going to get an associate, I'm going to sell him or her half of my practice" but the problem with that is overnight, we've taken a single-doctor practice and we've made it into a two-doctor practice. What the selling doctor or it could be that the parent doesn't think about is how is that going to financially affect me and the associate when we cut that salary in half. So that's one thing to think about because that can definitely be very stressful in a relationship with a parent and a child. Is there a financial stress in the practice?
But you know, if you have a partner in your practice, you have to have the same vision. If you have two different visions for your practice, two different goals of what this practice is going to be, there is just going to be that friction. It can be tough and that is one of the reasons why partnerships are very difficult. We have a few partnerships over the years that we've worked with but often times two different people have two different visions. What would I tell that person that is just thinking about potentially going into practice with their father and not super sure if that's going to work out. Number one, numbers. Is this practice a one-doctor practice or a two-doctor practice? Number two, if you have a different vision, go out and find your own practice. You will be a lot happier and your relationship with your family will be that much better so I think that's what I would say.
Another thing about that is we do see a lot of women graduating from school and thinking "gosh, how can I possibly go into private practice when I want to have a family and I'm not sure how this is all going to work. Should I just go into corporate dentistry?" And the answer is, no. Do not go into corporate dentistry or do it for a year so that you build up your speed and feel good about that, but a private practice is so much easier and I can speak personally about this because I did buy a practice right out of school and no, it wasn't my dad's practice. He stopped in a wet finger dentist for about thirty-five years.
I did buy a practice right out of school and my husband and I had a daughter just two years in, and it was very easy. I was able to set my own hours, which is one thing and financially able to really make this work and so with Blatchford Solutions that's something that we feel very strongly about is that practicing dentistry in a private practice is the best way to really enjoy this profession.
Howard: Well, the bottom line is the ultimate soccer mom dentist doesn't have a boss.
Christina: Right. Thank you.
Howard: The ultimate soccer mom is when the school calls says "your daughter's really sick" and she tells her receptionist "cancel the rest of the day", you can't do that when you're working for a DSO. I see the ultimate soccer moms own their own practice and you can't be the ultimate anybody working for a boss telling you that you have to put your job till five o'clock and your kids home at 5:30 after you get home. I ran out of my dental office one time because Eric fell off the cabinet and they rushed him to the emergency room. I just left. I didn't even tell-- my assistant heard the message and I didn't even have to worry about what happened because I knew my team could take care of them. What are you going to do when you come out and said "the doc had to go to the emergency room because his kid fell off" what are you going to say "well, I'm upset." I'm a narcissist, it's all about me.
Howard: Now, can I ask you a really personal question?
Christina: You bet.
Howard: What does your husband do?
Christina: He was an architect for 20 years. Now, we have started a--
Howard: OK. Stop right there. Now, you started what? Go ahead and finish.
Christina: Now, we've started a transitions business - Blatchford Transitions - that he is part of. A dental practice brokerage that goes hand in hand with Blatchford Solutions.
Howard: You should have him come on the show and talk about all that.
Christina: Let's do it!
Howard: The point I'm going to make is this: the male dentist, they want to be the four-hundred-pound gorilla so they always walk out of school and marry the waitress from the Waffle House and then she only trades her beautiful looks because now she gets to live like a rock star because she married a rich dentist, physician, lawyer. Those guys seem stressed out of their mind. Whereas, the women dentists, 30% married a male dentist in the class, the other 70% like you married architects, bankers, physicians, engineers. The women dentists always have a spouse who has full employment and makes bank and the dentist always has a dependent and the dependent who - she hears things like, "oh, how much you charge for a crown? Thousand?" and then he'll come home and she'll say "how much crown did you do today?" he'll say five. So she's thinking damn, he made five thousand. She doesn't understand the PPO adjustment, that he only got six hundred for those. She doesn't understand (inaudible 00:27:24) has 65% overhead and is in a 30 1/2% tax bracket. They say marriage fails a third on sex, a third on substance abuse and a third on...
Howard: Yeah. Money, sex and finances. As far as money and sex-- especially if you're trading money for sex, (inaudible 00:27:48), money, sex and substance abuse. Even with those three things it still comes down to communication. They're not communicating about money, they're not communicating about sex, not communicating-- when we got married, you came home and drank two beers every night now you're up to six and the weekends were a twelve pack, a decade ago now it's a case, they just don't talk and so these dentists are very, very stressed. Talk about both sides offense there because I look at the women and the women they tell me well-- if you're a woman dentist and you married a male dentist or architect or whatever, in America you're still a woman so when you come home, he's still going to sit there on TV and watch ESPN, I'm the one cooking and cleaning and doing the homework and I'm doing all this stuff and then she resents that. Talk about both sides. What do you think about the man who married the waitress from the Waffle House who doesn't go over the finances and the numbers the billing and get her involved so she can see how much blood, sweat and tears goes in to her spending just one Benjamin?
Christina: Yeah. Communication is so key and I wouldn't say that I am any type of marriage expert but I think that communication about these different things is so key so that when this, the Waffle House situation, when that occurs so that the wife does really understand. OK, these are the numbers. This is what we have as our monthly budget and you just really know-- we really need to communicate so that everyone is understanding what each other is working through. Now, on the other hand, the other side of that you were talking about - you're still the woman. You're still doing a lot of the different things at home with the children and things like that, you are absolutely right and what we suggest and we have our doctors do, male or female, is we have them fill out what we call our task analysis sheets not only at the office. We figure out what we truly are doing besides dentistry in our office.
Because in our office we are the person with the highest production potential, so if we're spending a lot of time and energy doing things besides dentistry that somebody else on the team could do, we're not going as far as we possibly could. That's one thing. Now, doing that task analysis at home and there are the questions with this task analysis is first of all, what is the task, why do I do it, how much time do I spend on it, who else could be trained to do it. Now, that's a slippery slope when you talk about training your husband, I don't pretend that I'm able to do that necessarily and could I potentially farm this out to somebody else that I pay. For example, when I am practicing we actually have like a food delivery service, so their meals are already done, that type of thing or we have somebody come in and do the laundry. You don't have to do every single thing in your house or your office even though you think you can do it better than anyone else but you don't-- delegation is really so very important for being able to have a balanced life and do all the things that you do.
Howard: I have all my meals delivered too, from Domino's. I even have the app. I know my homies and they're always saying-- they're listening right now and they're saying, “yeah, but you don't understand”. I'm in Parsons, Kansas and they always have this unique scenario and what I love about your-- if you go to Blatchford.com is to schedule your complimentary fifteen-minute call now, you click that and then you have time, so you look at the date and you pick the date and then it shows what increments you have. I think that's very cool and that's all free.
Christina: Yup, it's all free.
Howard: You know what, your mom and dad read "Dear Abby" every day in the newspapers. That's my favorite part of the newspaper - Dear Abby - because I just love that. What do you have to lose? Right now, I know what you're thinking. You're thinking "should I get the LAP laser for eighty-five? Should I get a CAD CAM for one forty-five? Should I go to the Dominican Republic and drop a gazillion dollar?" You know, look at implants. When they decide they want to do the implants, they'll upgrade their pano to a CBCT for a hundred grand.
Christina: You bet.
Howard: They'll go take $50,000 in implant surgical training courses. They'll buy some system and by the time they place that first implant for $1,000, they've already dug themselves into a hole of two hundred thousand or more, and then you look how long does it take them to get that money back because that $200,000 wasn't their rent mortgage, equipment (inaudible 00:32:59), computer insurance, malpractice, it was the 35% profit margin.
A lot of these guys, they decided they're going to get implants. It doesn't help their bottom line for five years and I'll tell you another thing about all these specialty things you learn. I got an MBA from ASU and if you don't do a procedure every week, you're never (inaudible 00:33:19). You learn how to place implants, you better do fifty a year. If you're going to get in sleep apnea, better do fifty year. If you're not doing that procedure once a week, you never get fast enough, good enough, profitable enough, you're never in the profit zone and it just turns out to be a big loss and then I'm thinking if you're in Phoenix why didn't you just go get a periodontist from Tucson to drive up one Friday a month to place all your implants at a thousand, and split it with them 50/50? Now, you didn't dig anything in the (inaudible 00:33:46) and furthermore, if you need an implant, who would you rather have place it? Some periodontist that's done twenty-five hundred implants or you that just got back from Mexico on a three-day weekend course?
Also you said you weren't a marriage expert and I just want to say in dentistry you are never a marriage expert till you've been married at least five times. When you get to work, schedule fifteen minutes for free, call Dear Abby aka Christina Blatchford, by the way this is not a commercial. I begged her to come on the show for almost two years. Nobody changes hands but tell me what these fifteen-minute phone calls. Tell me what the average phone call like? Are they calling you crying about their overhead or are they crying about their hygienist or--
Christina: Absolutely! They got to a point where they're finding: “You know what? I spent so much time becoming a dentist and I expected to have this great lifestyle and really have this wonderful profession that I felt like my patients love what I do, it's financially rewarding, I have a balance in my life, I get to take vacations.” They're finding they don't have that. They don't have that. They don't have what they wanted when they originally decided to become a dentist. They're frustrated usually, and so with these phone calls we're finding out what they would like. That is our program. It's custom.
We look at any practice and what do you really want in your life and what do you want your practice to be like and then we give it to them. That's what we do and most of the time that means that the dentist then is much more profitable because that's always something that we get - that people want to really have the finances to be able to make different choices in their lives, number one and number two is time. Time to spend with family, time to spend with friends, time to enjoy their lives and so you can take whatever continuing ed course you want but if you don't have your practice together, if you don't have your overhead under control, if you and your team are not able to present dentistry, case presentation is not strong in your practice and you have very low case acceptance, it doesn't work, so that's where we come in and really make this whole thing work and help the dentists rediscover why they decided to go into dentistry in the first place.
Howard: Your dad is a phenomenal athlete. He's been an inspiration of mine, where every year on his birthday, he does his age in push-ups.
Howard: How old is your dad now?
Christina: He's seventy-four.
Howard: I'm fifty-five and whenever our birthday people say: "How old are you?" I always had ten years. I always say sixty-five because if I say sixty-five they say, "Damn! You look good!" If I say fifty-five, they say "dude, what went wrong?" The best analogy for your father to me is, when you're talking about hours and taking time off that, if you set out on a hundred meter, you run as fast as you can, if you set out on a five k, it's just a steady pace, but man, when you set out on a marathon, you set out on a slow jog and …
Howard: I have noticed so many times that the dentists who work five and a half days a week, they’re like: “Ah, it's a marathon, and they just go slow, slow, slow, slow, but the ones who say, "No, dude. I'm taking three-day weekends" …
Christina: You bet.
Howard: Or the best were two days, take off Wednesday, didn't work two days and take off the weekend they're going in there…
Christina: Okay, yes.
Howard: They’re going in there for the hundred meter and their hours are never ten-hour days, eight-hour days, in fact I would say this is the bizarrest thing in dentistry. The dentists I know that go in and work Monday through Thursday, like six to two, they just crush it because they know you can run full-speed if you know it's just a hundred meter…
Howard: But when you're going like six days a week you look like a snail on morphine.
Christina: You know what, it’s important to be able to really make that distinction and one of the things that we as dentists get confused about is capacity and demand, thinking that "okay, perhaps I will open one extra day and therefore more patients will come to me because of that" that is confusing. You don't have the demand there then you have the capacity. You're just moving your week out a little bit more. So, yes. Let's tighten up that schedule, that is definitely what we really work on. With Blatchford Solutions is let's do those sprints so that then we can have that time to rest and be prepped for the next sprint instead of just "oh, here we are again". It doesn't work.
Howard: Yeah. You guys always talk about the four rules of success.
Howard: What are the four rules of success?
Christina: All right. Well, first of all, what we suggest is number one, you need to define success for you. That is something that I think is really important because if you are measuring yourself by somebody else's yardstick, you're always going to come up short. You're never going to be happy with what you have because you're comparing yourself to somebody else. So you've got to figure out what to you really defines success. What does that mean to you personally and really stick with that. That is really important and then we suggest staying married to your first spouse. I don't pretend that's easy but the thing is that every time you change spouses, there's usually a division of assets and we as dental nerds took plenty of math to get into dental school, we can figure out "okay, you divide it by half and then you divide it by half again and again" that can become financially draining, however, every individual situation is different but that would be a goal, that would be the second goal.
Howard: My divorce only cost 3.8 million. I graduated $87,000 in student loans and I thought that was a lot of money. My divorce was forty-three times more expensive than my student loans. If you take 3.8 million and divide it by eighty-seven thousand, the number is forty-three but I never think about it. Continue.
Christina: Exactly. Every situation is an individual situation and so that's a goal but yeah. Number three, live within your means. Live within your means. Just because you think "you know what, I'm a dentist. I should have the latest Jaguar, a car or whatever" let's be reasonable here. Do you make enough money to support that? Let's make good financial choices. Live within your means. Certainly, as we've touched on before, we want our dentists to be very profitable. So that, yes if you wanted to have that latest and greatest car, go ahead. But if you can't afford it, if you're not profitable enough to afford it, don't buy it and live in debt and live a life that is kind of, it can be a little bit of a lie and stress you out. That really doesn't work and the last--
Howard: Wait, before your last, I've got a comment on number three. Every time I see a dentist living in their means, they're married to another dentist and every time I see a dentist that married the young-- I mean, you got to ask the dentist, so why would a library geek like you have that hot babe from the Waffle House? Because she traded her beauty for that lifestyle so he's got to get the big mansion and the Jaguar and the vacations but again I tell-- when I go to dental schools, I tell those boys I say, they say, "well, do you think I should go and to specialize in the ortho, endo?" I say, "No, I think you should marry one of the girls in your class". Why would you want to go to grad school when you can marry some woman who's going to make $10,000 a month and if you don't marry her now, you're going to marry someone who destroys ten thousand a month, that's a $120,000 a year, and a $120,000 from age twenty-five to sixty-five for your little, blonde, trophy wife who looks hot for about three years, it's a $5,000,000! It's a $5,000,000 negative to marry the hot, young, little trophy wife, who's never going to work, destroy and buy Jaguars, on vacation in Hawaii versus plus five million marrying that geek chick sitting next to you who hasn't said a word in four years. That's a difference of $10,000,000.
Christina: So, make good life choices.
Howard: Blatchford should make five rules and the fifth one should be "marry one of the chicks in your class".
Christina: That's awesome. Well, we do have a lot of clients who did that.
Howard: Yeah. Those are the smart ones.
Christina: The last one is, pay off your debt first. Before you start investing, go ahead and get rid of your debt. There's plenty of apps that you can use that organize the different loans that you have so that you know what the different percentages are and if you paid a little bit extra on each loan, when you might be able to pay them off, but really, go ahead and do that before you invest because paying off debt is something that we think of interest as optional. You don't have to pay all that interest if you go ahead and really focus and get organized on the different loans that you have and make some good, mindful choices on that. You really don't have to pay as much interest as you have the option to do.
Howard: Okay. Those were the four rules of success.
Christina: Plus, marry one of your classmates in dental school.
Howard: And I fortified that to five rules but I want to go back-- I want to hold your feet to the fire because I know how dentists think. They're listening to you right now. The reason we did the hour is because that's their average community, doesn't really matter if it's urban or rural which is kind of really surprise me. If you practice in a town of five thousand, you might live an hour away in a town that's fifteen thousand and this podcast went viral. They asked for it. It was a year before the election they said, "Howard, I can't drive an hour to work and listen to Bill and Hillary and Putin and Trump and emails and ISIS" and they told me they were listening to podcasts on quilting and cooking and raising children and all that stuff. I know that they're always alone and they're not the 85% driving to work, they're on the Stairmaster, a treadmill for an hour or whatever and they always think they're this unique snowflake with this totally different decision and so you told me your four rules, I want you to give me the top four subject categories on the free fifteen-minute phone call to you? Because this girl wants know is she the only one thinking this or others saying this but go over the top four reasons people are calling you.
Christina: You bet. I think that what you touched on is very good. About every doctor thinks that their practice-- that they and their practice are very unique and you know what they are, but here's the thing is that we have worked with over thirty-five hundred very unique and individual snowflakes across the country. The concept that we bring two practices really can work in any situation whether a doctor practicing in a small town, in a large town, that they have a big practice or they have a smaller practice. Although, we typically don't work with practices that are producing less than six hundred thousand just because we need to be able to have a benchmark to work with, but you know that it really doesn't matter what type of Dentistry they're doing, whether they're doing kind of bread-and-butter type of Dentistry or they're doing big aesthetic cases. All of our concepts really work well. So first of all it is money. It's money. It's the number one thing. I thought that I was-- I went into dentistry because I wanted this lifestyle or I wanted to be able to make some choices that I financially am not able to make. So number one is money. It really is.
Number two, is going to always be time. Time that they just feel like they are on a hamster wheel. They're in their practice four days a week but certainly on that fifth day they're in their practice working on this or that, doing administration and sometimes they go in on the weekends and they’re treatment planning cases and things and so it just that time. They don't have the time they thought that they were going to have. So money, time and then team.
Team. You know they thought that they were going to be a great leader and they're super frustrated with the team that they have and why isn't this person performing to the level that I wanted and this just really isn't working well for me, and of course the fourth thing that it really ties in with the number one but I think that it really is a blanket for the whole thing is overhead. Overhead. My overhead is just out of control and I have no idea how to get it back under control.
Howard: Wow! That's more than awful. When I got out of school in 1987. Thirty years ago, at the age of four, I'd say average overhead was 50%. Now, according to the UK, it's 65%, it's two-thirds.
Christina: Yes. Absolutely.
Howard: You know what I love most? Oh, by the way on your consulting, you said you were with thirty-five hundred dentists. Does that include Canadians? Do you help them?
Christina: Yes. It does.
Howard: Do you find the Canadians to be ten times more polite and sweet and understanding than Americans?
Christina: I don't know how it is possible but they certainly are a great group of people and yes that's how my dad did get his start in doing what we do. He started out in Canada so we have a strong background in Canada and we enjoy our Canadian clients too.
Howard: They say the cream floats to the top, that's why they're north of us. It is just a better society. In their economics, they have a higher percentage of foreign-born citizens, they have a higher median income, they have socialized medicine, you know. They carry the poor. They're great but I wouldn't ask that. When you talk about overhead, what do you think is the root cause of going from a country where everyone was 50% overhead to 65% over? What do you think was that 15% difference in the last three decades?
Christina: I think that is caused of just the general cost-of-living increase. That can be part of it but I also think that we see a kind of a myth in offices where we think that if we hire an additional team member to do something in the office that's really going to make a big difference. We see doctors that have too many team members. Too many team members that are not great team members that are just they're not playing as we have our book playing your 'A' game. They're not playing their 'A' game and whether or not that's a capacity issue, whether or not they can bring in 'A' game, that's something for us to take a look at but you know often times we really need to look at the leader and is the leader able to really help these team members rise to the occasion to have them play their 'A' game, so that we actually can have our team at 20%. I know that seems like, "oh my gosh 20%? That's crazy," but here's the thing, is that we also and we encourage our doctors to really pay these great team members well and we have them on a bonus system. That is really key to making this whole thing work. Your team, when our program works really well. We have team members who think like owners and they're actually even pushing the doctor, encouraging in a very positive way to get that doctor to do more of the dentistry that they've taken the education to do. So that is really something that I think is so critical in making a practice work well.
Howard: So this is dentistry uncensored, so get to the nitty-gritty. What is your program cost? Is it all online and Skype and phone call? Do you make a site visit? Tell us the nuts and bolts of your program.
Christina: You bet. It's sixty-five thousand and it is fourteen months. So we have two seminars that are with our team, we added another seminar that we do and those are two-day seminars so you bring your team to two seminars where we really talk about the different concepts that are going to make your practice work well and so your team gets to hear these firsthand and we then have a consultant come in into your office for two days to see how you've done and putting some of the different concepts in place and where we might need to work on things.
One of the main things that I think is really different from other consulting companies, how we differ is that we are dentists - coaching dentists. I'm a practicing dentist, my dad is another one of our coaches and then we have two other doctor dentist coaches. We then talk with our clients one-on-one, an hour plus each month. So we have doctor calls each month, we have group doctor calls and so we actually then added another doctor on the seminar, one-day doctor only seminar and so what we do in these fourteen months is take you and I should also say we start the fourteen months with a either web or in-person, what we call our summit, which is four to six hours with you and your spouse or significant other and we talk about what you would really like to get out of this program, where do you see yourself going in five years, ten years, twenty years, so that we really can define what this program wants to look like for each individual doctor but inevitably increasing profits and increasing the amount of time that the doctors can spend outside the practice seem to be the big things that we run across. So that is it in a very small nutshell but we feel so very blessed to be able to really coach these doctors to achieve the life that they want, that they really see for themselves. There is nothing better in my professional life than to see our doctors reach their goals.
Howard: Did you see that last month? Chinese robot placed the first dental implant.
Howard: So people are asking me should they buy a CBCT or a CAD cam or laser. I'm buying the-- I'm going to replace all my staff with droids and in fact I'm not going to get married. In fact what I want to do is I'm not going to get married again until they come out with a robot that can be your wife and place implants. She'll be a multi-purpose droid. I'm waiting for that. So on that sixty-five thousand, that's $4,600 a month for fourteen months, do they pay $4,600 a month? Do they have to pay for the whole sixty-five up front? How does that work?
Christina: There are definitely different options. Some doctors go ahead and do the whole thing up front and we work with a company called Fundation to help doctors do the financing for that. We also do some different payment options that divides the payments. Once we decide to work with a doctor, we want to see them successful. Our reputation depends on it so we want to make it financially feasible for them to do this program. Typically when we work with doctors they increase their net a hundred and fifty thousand in the program.
Howard: I know. I've been telling that for thirty years and then you tell them that the number one return in investment is always a dental consultant. You'll always get all your money back plus more in the first year and then they say, "Okay. Thanks for that advice. I'm going to go take a bone grafting course in Syria". So, do the other two dentists, are those the ones who do the majority of the on-site calls as opposed to you and your dad?
Christina: Good question. We actually have three consultants that go and these are Kerry (inaudible 00:57:19), Nancy (inaudible 00:57:20:20), and Kate (inaudible 00:57:21). They've all been with us for fifteen plus years and they go into the offices and do the--
Howard: And those three are dentists too?
Christina: They are not dentists. They have been in the office in some capacity, either an office manager or as a dental assistant.
Howard: You know, we should do for a follow-up to you on the Skype thing. We can do the Brady Bunch (00:57:43). So you could have all three of those girls come on...
Howard: And then they'll be watching this podcast with four people. Me and then these three people, Kerry and the other two you said, that would be a hell of a deal because I want to be a leader. I really do want to be a leader and I don't have to beg them to go learn how to do crown and bridge, composites and bleaching, they're naturally-- I'd rather pull four impacted wisdom teeth, then play golf, go to a Christmas party, or see the latest Star Wars maybe, I think the ultimate high is getting out four impacted wisdom teeth in under four minutes. I don't even want to do a root canal number eight. I think dental assistants should do all single canal, root canals. I only want to do a molar, in fact, I don't even want to do a virgin molar. I want to do a retreat. I want to dig out a broken post. I love the challenge of dentistry. I do.
Christina: You go, Howard!
Howard: They have no natural inclination to figure out a statement of cash flow, balance the profit and loss. They have no idea what their return on equity, return asset was. They have no idea and whenever they tell you their numbers, when you go dig into them, I've never met one that was right. They'll say, "Oh. My labor is 25%," really, 25%? Does that include FICA matching, payroll, uniform? Don't know and then you go digging the numbers, say well the number was actually 33%. You go look at their supply bills, last month it was 4%, next one sits 7%, the other month it's 2%, it's like you accept a 100% variance in your (inaudible 00:59:22) supply bill because again the dental assistant, she's an artist, she's a cosmetologist mani-pay, she loves to work with her hand, she loves to make temporaries, she loves that but she doesn't even know how to balance her bank statement.
Christina: Yeah. You got to know your numbers.
Howard: So you have your whole collection of people who love their craft, and they hate math and they hate numbers and then and that's why they have an-- I don't have to nudge someone to go get their FAGD and learn all that clinical dentistry, that's a question, but you gotta beat them with a stick just because they'll say "$65,000? That's so much money!" then they'll go buy $145,000 CAD CAM. "$65,000? That's a lot of money!" then they'll go buy a $135,000 LANAP laser. "$65,000, that's so much money" dude, when you buy a CAD cam, there is a 0% chance you would earn all that money back, plus more, in the first year and you say your clients at sixty-five thousand all bring back home a hundred and fifty thousand in the first year. This is what I have been begging these guys to do for forever but do you want to follow up you with those three girls that have been in the field in fifteen years.
Christina: Let's do it! I love it. Absolutely.
Howard: My job will be to embarrass them so bad, they will regret the day they were born.
Christina: You never know what you're going to say, Howard, but this has been very enjoyable. You are hilarious and I want to wish you very good luck in finding that implant placing droid.
Howard: She'll be from China. How cool is that? I'll have a Chinese wife droid. Somewhere between OB-- somewhere between C-3PO and what was the other one? R2D2. Slightly taller than R2D2, and slightly less gay than C-3PO but anyway, so final question, now we went into overtime, we're five minutes over, they're sitting in the parking lot, saying "I wish those two would stop talking" so I could turn off my car and go in. Final question, this is what I hear all the time. Christina, you know the difference between you and her? You graduated in the golden years and I'm twenty-five years old, I'm $250,000 in debt and now I'm starting to think I made a really bad decision being a dentist.
Howard: What would you say to that little girl?
Christina: I'd say, you made a great choice. We know right now in the U.S. we have medicine as, we don't really-- it's kind of an unknown and so we see more and more people going into dentistry because we know the private practice is still possible, so you made a great choice and yes, you have $250,000 worth of debt, but you can definitely get through that and I would suggest reaching out to us. We also can help you look for a practice through our Blatchford Transitions program. We really feel, so very strongly, that dentistry is a fantastic profession. She made the right choice and let's make it work really well for her.
Howard: I want to get your husband on the transitions…
Christina: Okay, very good. Let’s do it.
Howard: And the reason I'm trying so hard to help you because not only do I know that consulting is a better return on investment than anything you could buy in equipment, but your dad-- it was 1987, I packed up my whole staff, he was in Tucson, we drove ninety miles south, we listened to him, it just like hit me over the head with a baseball bat, very defining moment. I got to listen to my dental assistant for thirty years, Jan, say "well, that's not what Dr. Blatchford said. Dr. Blatchford said this...Dr. Blatchford said this." So after ten years I was like, "well, you know, the hell with Dr. Blatchford". I'm just kidding.
And then I was so lucky cause after summer I said, "Hey, guys. I gotta go. I gotta go get a taxi. My flights taken out of Phoenix" and I jumped out of my chair, "I'm driving back to Phoenix. I'll drive you straight to the airport." So then I got a ninety-minute, one-on-one, driving five miles beneath the speed limit. I drove there as slow as I could and he's just a hell of a guy. I can't even count how many times I heard him lecture over the last thirty years but he's the real deal and he's got an unbelievable family. He's all into health. He's a personal role model of mine in so many different ways, so I will do anything I can to help your family and your company…
Christina: Thank you so much.
Howard: So let's get your husband on talking about transitions
Howard: And tell your husband this is what-- I already know they're all going to say, cause again when you come on my show you're talking to people in dental kindergarten. You're not talking to a bunch of fifty-year-olds. They're a quarter in school and everyone else under thirty, so their questions are "well, I'm working at Heartland or Pacific…
Howard: Because no one's going to qualify me for a loan, I mean hell I've got $250,000 of student loans" and then they want to know should they do a Denovo or should they buy one from scratch? That's a big million-dollar question.
Howard: And they wanna know “Should I go into urban or rural?
By the way, I want to end on this cause I know we're in double overtime. I've been posting these on Dentaltown and this is not only on Dentaltown, I posted on Facebook, Twitter, Linkedin, but Kansas had a big article there, they have six counties that don't even have a single dentist.
Christina: Isn’t that wild?
Howard: I can give you names-- there's a dentist buddy of mine that listen to me on this show and he went and found a county in Iowa that did not have a dentist. Opened up a dental practice, he has no openings for three months, doesn't take Medicare, Medicaid, nothing at all…
Christina: It’s crazy. Yeah.
Howard: And these dentists, what they do is they go work in the middle of nowhere, Monday through Thursday, four ten-hour days, then they're taking home three-fifty a year, then after work on Thursday they get in their black, paid-off, paid-for-cash Porsche and drive two hours into Kansas City or LA or wherever they are…
Howard: I mean, there's so many counties without a dentist
Howard: And these millennials, I don't get, cause their mom and dad came from the other side of the earth, they came all the way from India and Pakistan to give their children a better life and then the millennial can't even go two hours out of town.
Howard: Her mom came eight thousand miles and she can't go a hundred and twenty miles out of Kansas City and I so those are the talking points for your husband …
Christina: Very good.
Howard: And the talking points for the staff is this individual solo dentist, always thinks their situation is unique.
Howard: What are they seeing in the field?
Howard. So their unique world that they think is only them? If we're transparent with the cases they have seen for the last fifteen years, what's doable, what's fixable.
Howard: And they have very stressful questions like, "well, I know my overheads too high. I know you're going to come in and fire all my legacy staff. They're all making way too much money and replace them with clerks from Walmart" and other than that, thank you so much. The only reason the show is a success is cause I'm able to get people, amazing people, like you to come on the show. Thank you so much …
Christina: Thank you so much.
Howard. For giving up an hour of your life today, to come talk to my homies on dentistry uncensored. Thank you very much.
Christina: I really appreciate it. Thank you.
Howard: And thank you, Ryan.