Exclusive DentalTown interview Howard Farran

Rick Kushner: Apparently so. I certainly respect and appreciate differing philosophies within the profession. I’d sure appreciate the chance to tell your readers that the article was condensed through an outside editing process after I wrote it and the version that was given to DT didn’t convey my complete philosophy about using hygienists. My original article was intended to be a pro-new patient article, not an anti-hygienist article.

HF: Are you saying that editing changed the meaning of the article?

RK: I’ll certainly stand behind my belief that we should stress new patient attraction to an even greater degree than recall patient retention, but to interpret that belief as anti-hygienist detracts attention from the valuable point of the article.

HF: Do you consider yourself anti-hygienist?

RK: Absolutely not. What I wrote in my original article that did not appear in the printed version was my comment that nothing in this profession is more satisfying than working with a hygienist in an accelerated “Lean and Mean” hygiene department. I created and pioneered productive hygiene with a hygienist team in a 2-chair format more than 20 years ago. The “anti-hygienist” comment in the article is an anecdote from a true incident with a practice management consultant almost 25 years ago.

HF: Why then, did you apparently irritate many hygienists?

RK: I simply hold hygienists accountable, as the professionals that they are, for the minor role they play in the vicious expense/overhead/fee increase cycle. Dentists, of course, are most responsible but I won’t let hygienists off the hook completely. I’m always incredulous when hygienists tell me they’re not responsible because they don’t have input in fee establishment.

HF: I take it then, that you believe fees are too high?

RK: Absolutely yes. I am grounded in the belief the good dental care is still far too expensive for an extremely large segment of our market. How large a segment? Maybe as much as half.

HF: Believing fees are too high must make you quite unique within the profession.

RK: My 63 partners agree with me.

HF: Does your Comfort Dental organization hire hygienists?

RK: In recent years, we’ve employed only a small handful of hygienists. Presently, we are attempting to hire as many as 40 part-time or 20 full-time hygienists. We will undoubtedly fall short of our hiring goal because although we pay market salaries, we can’t offer 9-to-5 hours or one-patient-per-hour schedules. That is not a criticism of hygienists. I can’t blame them if they can find positions at similar pay with easier schedules and no evenings or Saturdays.

HF: Did you personally receive much negative feedback from the article?

RK: I’m used to criticism within the profession, but honestly, my direct feedback was positive. There were very few personal attacks. I want readers to know that I’m willing to professionally discuss and debate a philosophical point with a dentist or hygienist any time. Anonymous attacks only degrade our profession. I learned long ago that pioneers and folks who think outside the box will be in for a rough ride in a profession like this. We’re doing too much good for too many people to allow it to discourage us.

HF: Why do you think the profession is so critical of you?

RK: Maybe you could help me answer that. The facts are that we treat patients most can’t or won’t treat, we accept plans they won’t accept, we do procedures they won’t do, we work hours they won’t work for fees they can’t afford to charge. We do it all successfully and for that we are criticized. We ought to be thanked...if we don’t help these 200,000 folks, who will?

HF: On another subject, how have you avoided selling out to one of the many DMSOs?

RK: I’ve turned down millions of dollars and I’ll continue to do so because I have 63 partners who have entrusted their careers to me. They take good care of me and as I long as I continue to enjoy their loyalty, we’ll remain as we are.

HF: MSOs seem to struggle universally and you continue to prosper. How do you explain that?

RK: It’s taken the partners and me 25 years to build what we’ve built. We’ve done it with the partners’ and my money. MSOs think they can do it in 2 years with other people’s money—can you see the flaw in that? They will always pale in comparison to us in three aspects: Equity, fee-for service income, and passive income. Our partners own 100% of their practices, they all earn in the top 5%, and they all eventually develop passive income from partnership sales.

Contact: Aaron Ferstman of GD&A Public Relations for Dr. Kushner and Comfort Dental Inc., 303-623-2529, aaron@gda-pr.com