Digital Marketing Ideas to Reach Your Ideal Dental Patients

 

Chris Pistorius (00:04):

Hi, everybody. This is Chris Pistorius here again with the Dental Marketing podcast. Today we’ve got a super special guest. I’m a little star struck because I’ve been listening to and reading his stuff for years. I’m so glad to have him on the show today. This is Dr. Howard Farran. He does a lot of stuff and we’ll get into that in a second, but he’s actually the creator, founder, owner of Dentaltown, which I know a lot of you use as a major resource to help run your dental practices. So Howard, thanks so much for taking the time to be on today.

Howard Farran (00:41):

Hi, it’s an honor. We should start a mutual admiration club because I’ve been a big fan of yours for a decade too.

Chris Pistorius (00:47):

Awesome. Well, thank you. I’m going to get right to it. As you know, you’ve got tons of experience. You’ve forgotten more things about dentistry than I’ll ever know. So what I’m after here and to pick your brain is how to help my clients, how to help potential clients, how to help dentistry in general, which I know that you’re a big part of as well. But why don’t you tell me a little bit about how you created Dentaltown first and how that idea started, and just a little background there.

Howard Farran (01:16):

Oh man, you got to go back to… I got out of school in ’87 and then it was about 1994, I saw Amazon go public and I couldn’t figure out what all the hoopla was, but I kept an eye on it. Didn’t buy a share of it, and I just kept watching, watching, watching through ’94, ’95, ’96, ’97. And then about ’98, I finally realized, “Oh my God, this really is going to be huge.” I never had an original idea. My next door neighbor was a dentist. I went to work with Kenny Anderson and my dad, and my dad owned a Sonic Drive-in making cheeseburgers, and Kenny was a dentist. And I thought the x-ray machine was a helluva lot cooler than a grill.

Howard Farran (02:00):

But I was on the ESPN website and they started this message board thing. And we were talking about football and I’m like, “Gosh, darn, I wish I could be doing this with dentists and talking about root canals and fillings and marketing.” So I hired Ken Scott and then we started Dentaltown and we’ll be the first who would beat Facebook by five years. And that first mover advantage, the [inaudible 00:02:26] versus Harvard, only because it’s first. Coke was launched 11 years and for Pepsi, they’re still number one. And that first mover advantage, it’s kind of like a hall of fame website.

Howard Farran (02:37):

Then we also have Orthotown too. The orthodontist were the only specialists who wanted their own site. All of the other specialists and all of the orthodontists are on Dentaltown, but they just wanted a private community of just orthodontists. But it’s really been cool to watch social media. We had a first generation, the first 20 years and the first is always the worst and everybody’s learning how that’s going on and everything, but it did change the world.

Howard Farran (03:05):

Facebook, which owns Instagram and then Alphabet, which owns Google and YouTube, they sucked out about 80% of all the advertising dollars in America and that killed billboards, it killed radio, it’s killing TV. And that’s why these dentists got to get sophisticated because they’re competing now against DSOs. And DSOs have enough skill where they can sit there and say, “Well, let’s just get the one billboard on the corner of the two highways.” And radio, for $100 you can get an hour commercial. ClearJoy, that implant company has been served five times and now Bob Fontana of Aspen owns it because my gosh, they can do 30 minute infomercials on implants in a day. So now we’ve got this individual dentist.

Howard Farran (04:04):

And the first guys I noticed that were really, really smart about advertising was the orthodontists for a couple of exact reasons. Number one, they knew each of their new patients was worth basically 6,500 bucks and they knew where their overhead was. So if they went on Shark Tank, and if you were on Shark Tank, then obviously, the smartest man on Shark Tank is the bald guy. It’s always the bald guy. Have you noticed that?

Chris Pistorius (04:28):

I have.

Howard Farran (04:29):

And who picks your dental office, and Mr. Wonderful, first thing he says is, “Well, what’s your cost of new customer acquisition?” No dentist knows, but orthodontists, that’s an easy figure. What is the average customer value? Dentists are like, “God, I don’t know.” Orthodontists like, “It is actually 6,500.” [crosstalk 00:04:51].

Howard Farran (04:51):

So on my journey, when I got out of school in ’87, you got to remember the Yellow Pages just became Regal after a Supreme court decision where two lawyers in Phoenix said, “Well, that violates my free speech not to advertise.” It happened in Arizona first, but even by the time I got out, it was a very underused taboo thing, and the first guys that jumped out on it were the orthodontist, and it was an orthodontist who was the first guy I ever met that 3% of collections went straight to advertising. Now, I could name you 100 orthodontists where that is eight to 10% because they say, “Well, I get $6,500 for Invisalign, and here’s my marketing costs and here’s my overhead.” It’s like shooting fish in a barrel.

Howard Farran (05:39):

So the orthodontists, they get their money back in tow years. General dentists, that takes about five years, and since they have a whole distribution of just a cleaning, just a filling, all the way to a big old case, they’ve always not understood their marketing. But what’s going to really bring it to their attention is when they’re no longer competing against a single dentist across the street, but now they got some DSO that’s got 1,000 locations and they’re extremely sophisticated. So dentists, if they want to play in the big leagues with the professional players, we’re probably going to have to outsource some marketing to someone like you.

Chris Pistorius (06:23):

Yeah. I think you hit the nail on the head, several nails on the head actually in that we talk with clients a lot about that, about they’re struggling with competition and it’s not just local competition. It’s a lot of pressure from DSOs. And a lot of our strategies are around how to compete with that and there are ways to compete with that without breaking the bank also. So you just have to get a little creative, grassroots about it and you can still compete and relieve some of that competition for sure.

Chris Pistorius (06:57):

Let me ask you this. What do you see as right now, other than the competitive struggles with DSOs, but what else is really threatening local dentistry right now, would you say?

Howard Farran (07:11):

Well, I think all dentists would say it’s a very competitive environment. I would say that the reason the 20 richest countries all want socialized medicine by the government is because the same government is the one that blocks out all their competition. If you’re a dentist in India, you can’t move to Phoenix, Arizona and start doing dentistry. I’m on the Mexican border, and every time a Mexican dentist comes up here and goes to Guadalupe, which is 100% Mexican and native Indians, and starts practicing dentistry on the poor, the government arrests them, puts them in jail or deports them, or whatever.

Howard Farran (07:50):

So it’s hard to say that healthcare is competitive because when I was a little kid, they couldn’t import cars from Germany and Japan. And General Motors had half market share, they were very expensive and the cars never worked. When I was a little kid, if I walked down the sidewalk on a Saturday, every third or fourth garage was a dad, his son and two uncles trying to fix this piece of crap Chevy and get it running.

Howard Farran (08:17):

So it’s crazy to say that healthcare is competitive because they block all foreign competition from entering with their immigration policy. But within the realm of United States, competing against DSOs, competing against insurance, I’d say what threatens them the most right now is the onslaught of inflation. I turned 59 this month. I hear no one talking about it unless they’re my age. I graduated high school in ’80, and in ’81, interest rates were 20 and a half percent. Unemployment and inflation was double-digit.

Howard Farran (08:56):

And so inflation is just completely back. When this pandemic, the stock market dropped about $850 billion, not quite a trillion. And the Trump buying response was $5 trillion. So you’re looking at a global economy where three out of every $4 in circulation today were printed in the last year. And people compare this to the percent of debt to GDP as in World War II, but you got to remember those bonds were paid by real money from Americans taking their money out from underneath their bed and buying a war bond, which you pay them a nickel a year.

Howard Farran (09:39):

So the deal is, I went to Creighton in 1980. Warren buffet is from Omaha, so was his partner, Charlie Munger and Warren came over and spoke to our business class. And I remember a business 101, someone jokingly said, “Creighton was known for their medical school, dental school and law school.” Someone jokingly asked him, “Which one would you go to?” And he told me to answer and I didn’t listen, he said, “Well, I would never go into healthcare because it’s very capital intensive and someone else sets your fee.” He goes, “I want to go into a business with low capital intensive.” Like if Geico insurance doubled their business, they just need to double the number of cubicles where people are dialing for dollars and typing on a keyboard.

Howard Farran (10:21):

But you double a hospital, you got all this stuff. I’ve seen dental office routinely that by the time you do the land and the building and the Taj Mahal, they’re looking at one and a half to $3 million. So I would say if you’re locked into an insurance company and they say, “You get $1 per filling,” and your costs are going up five, 10, 15, 20%, is the insurance company going to rapidly adjust the fees to keep you up with inflation? Or are you just going to start making less and less money?

Howard Farran (10:54):

So I think the inflation on a fixed third party fee is terrible. And that’s why Invisalign… If we ignore the dentistry, for decades, selling stuff to dentists, about 40% of the market is US and Canada, 40% Europe and 20% is the rest of the world. And when you look at their numbers, it’s a 200 year old profession that started with G.V. Black in Paris, France. So it just really just grows and contracts with inflation.

Howard Farran (11:26):

The only thing that’s growing double digit is orthodontics, clear liners and implants. And the reason they’re so lucrative is because a third party is not setting your fee. They tried to set fees, like remember when the insurance companies said that you couldn’t charge you more than X dollars for bleaching and it went all the way to SpringBoard in Tennessee, I think it was. You don’t even cover bleaching. How could you set our fee?

Howard Farran (11:52):

So the dentists haven’t been fighting for equality in the eyes of the consumer. I expect that will go to a different legal dimension. But that’s up to the ADA and government and things like that. But I would say that when a dentist gets out of school and says, “I don’t know what I want to do,” you got to pick one, you either got a lot of bin guts and get into implants, or are you going to get into the soft and Invisalign?

Howard Farran (12:21):

I can usually tell by looking at their x-ray, because if you’re like me, when you do a root canal and you want to get all the way to the bottom and puff a sealer out the apex, you’re an able barbarian and you just love blood. And all of your assistants, when they see a big puss thing pop, all those assistants go to, “Ooh, yeah.” If that stuff just grosses you out, you go into bleaching, bonding, veneers, clear liners, whatever. But I’m telling you that the number one goal of the species is to survive long enough to reproduce that offspring. And the way the animal kingdom is, unlike the fungi and algae, we just don’t divide into two, we split our DNA into two pairs and we got to go mix gametes with someone.

Howard Farran (13:08):

And going out there, I think this pandemic has been a huge boom for dentistry, it’s already proven, because if you’re a man like me, think about it. I brush my teeth and floss in the shower. I don’t stand around looking in mirrors all day.

Chris Pistorius (13:25):

Me too. I do the same thing. I thought I was the only one that did that.

Howard Farran (13:30):

I grew up with five sisters, man. They’d spend an hour in the bathroom before they’d go to grammar school. So now there’s all these men on Zoom and they’re looking at their face and they’re looking at their teeth and they’re like, “Oh my God.” And male makeup, which isn’t really even a thing, it’s already up 400% since the pandemic started. When I went into Walgreens, I went to the makeup counter booth area and talked to that lady. I read there, I said, “Is this true?” She goes, “People you would never expect. ‘I want to cover up this thing or this, that.’ And they’re asking me…”

Howard Farran (14:08):

So now that the pandemic’s got everyone looking in the mirror that used to never look in the mirror, like a bunch of old ugly men, they’re ripe for Invisalign. I think the ultimate close if they say, “How do you like your Zoom conference look? Are you liking what you see in the mirror?” And I used to call old dentists…

Howard Farran (14:30):

I remember when I got out of school, the big cosmetic guru was Jim Pryde, and he was sitting there in the lecture. And another one was Walter Hailey. I made this remark twice and got the same response from them. He’s up there pontificating at the Arizona Dental Association saying, “How could you not sell cosmetic dentistry? They all want to do it.” I raised my hand. I said, “Well, why don’t you do it? You’ve got some of the darkest, brownest, gnarliest, ugliest teeth I’ve ever seen and you’re a dentist speaking to dentist.” He lost it. I mean, he almost couldn’t continue. And everybody I was with were just laughing their ass off.

Howard Farran (15:11):

And then Walter Hailey, when I talked to Walter Hailey, I was with actually great cosmetic guru. I was with David Hornbrook, and Bill Dickerson, the two cosmetic legends who had started LVI, and they told him, “It’s true, Walter, and we’ll do it for free. You’ll get $15,000 veneer case, look [inaudible 00:15:34] free.” And he’s like, “Ah, I don’t care.” He’s some good old boy from Texas. Couldn’t even give a crap, and his business was lecturing to sell cosmetic dentistry to dentists and he wouldn’t even do it.

Howard Farran (15:44):

So I think the Zoom is going to make people see the truth that, wow. I remember I lost the… I was able to keep in shape the best when I used to do Bikram yoga, because you’d go into a room in a bathing suit, and they had mirrors all over the wall, and that’s the only time you ever get to stare at yourself in a bathing suit. And I’d look at that mirror and think, “God dang, you’re fat. You need to stop eating crap.” And that whole 90 minute yoga deal was this really reminder that, “Dude, you don’t know what you look like naked.” And so I think this is going to be a big… it is already a big boom for cosmetic dentistry.

Howard Farran (16:28):

And by the way, implants, the same thing. Every study I’d seen on implants, dentists always say… I’ll give you a true story of my first major implant case. Her name was Catherine. It was back in ’87, ’88, ’89. I never had asked her about implants or anything. And she told me she wanted them. And I said, “Well, Catherine, you always told me that you had no problems eating, chewing, that you can even eat an apple and all this stuff.” I said, “So what changed your mind?” She goes, “Well, you know what,” she goes, “at my age, my girlfriends just keep dying and they keep dying while they’re asleep. And I can’t wear my dentures when I’m sleeping and I’m afraid of dying in my sleep and having them find me without my teeth.” And I thought, “Yeah, dang man.”

Chris Pistorius (17:22):

Wow.

Howard Farran (17:22):

So even they, when you look at implant cases, if you really get to the crux of it and you really ask them, they’re not doing it because they can’t eat a cheeseburger, they’re doing it because there’s a missing space there and they’ve got mold and mixed gametes and it’s a complicated meeting, ritual meets like a peacock. All the animal kingdom meeting rituals are insanely complex and having your teeth not being negative and just being neutral is a good thing. If we can make them whiter, brighter and sexier and make the peacock feathers all come out, it works better.

Chris Pistorius (18:04):

Wow. Well, I tell you what, you could unpack a whole webinar just in what you just said. That’s awesome information, and it’s going to help a lot of people watching this. But I did have a question. If you had to do it all over again, the dentistry side of this, what would you change, what would you do differently?

Howard Farran (18:24):

Yeah, that’s a great question. What would I do differently? I definitely would’ve done it because you got to go back. A lot of people, they look at… All of our heroes are failed men. They think they’re a genius and they found out that some great man had a great flaw. They never said he walked on water, but you got to go back to, I was one in 62. There wasn’t any of this technology. There wasn’t computers and this and that. When I first saw my neighbor, Ken Anderson take an x-ray through the tooth, and then you got to go in a dark room with the hottest dental assistant in the world and develop this x-ray. And then I go worry my dad make a cheeseburger and onion rings.

Howard Farran (19:06):

The technology blew me away. And the other thing that blew me away, it was just like physics in the fact that… Well, look at Stephen Hawkins. He lived his whole life and he died before they even knew what a black hole is and what’s on the other side. Is it a white hole? And I realized that dentistry was bigger than any dentist that ever lived and that you could be a dentist and study your whole life and still go to the grave with unknown unknowns that you would never even have known. And it’s part of the human body.

Howard Farran (19:40):

Health is wealth. If you lose your life, you have nothing. The health, the wealth. It was so easy for me to find a real purpose and passion when we were trying to learn, discover, and help someone else stay alive on an earth where 98 and a half percent of all the species before us are extinct and they’re going extinct every year. And the chance that we will go extinct is absolutely positive. We’re not going to go through the black hole. When this whole Milky Way goes through the black hole, I doubt my teeth are going to make it, but I just had a lot of purpose, a lot of passion.

Howard Farran (20:22):

I got accepted to med school too at Creighton, and I didn’t want to do that just because dentists forget of all of the politics that goes on in hospitals. And now it’s something like seven out of every 10 physicians is an employee for a hospital, it’s about 50%, or a big corporate DSO for about another 20%. Only 30% of physicians own their own building. And the thing I liked about what Kenny Anderson did is he owned his own land and building. He was a dictator. If he didn’t want you to work there, you didn’t go. If he didn’t want to treat you as a patient, you can’t go. Just a simple life in a small kingdom where you’re the king and you’ve got a half dozen helpers and you have your own people coming in. Gosh, I love it and I can’t really think anything I would’ve done different.

Chris Pistorius (21:18):

Yeah. Well, that’s awesome. That’s great. One struggle that we see with some of our clients is especially the ones that they’ve been an associate for a little while maybe, and now they want to start their own. And the question we get sometimes is based on your experience, is it better to buy an existing practice with a a base of patients, or do you start off scratch? What do you think?

Howard Farran (21:45):

Well, that’s another great question you have. I can tell you’ve been in this a long time, but I just want to tell you about when these DSOs popped up, the first round was way back in the days in the eighties, when Orthodontic Centers of America went public and there was a dozen on NASDAQ. And what was their business model? Their business model was if you go sell a house in Phoenix, so that’s three bedroom, two bath, you’ll get a offer today. If it’s four bedroom, three car garage, it’s totally liquid. But if you’re an NFL player and you custom built a 19 bedroom house with a seven car garage, most of your professional players, their number one mistake was the house they bought because it’s illiquid. They can’t sell it.

Howard Farran (22:30):

Orthodontic Centers of America, that founder, Gasper Lazzara knew that if your orthodontic practice did a million dollars a year, you could sell in an hour. But if you built up to three or 4 million, it was a illiquid. So he was buying all the illiquid ones and that’s what Heartland was doing. So when I look back at every single general dentist that had a dental office doing three to $5 million a year, they all had the same strategy and that was this, which to answer your question, they graduated school and went to a small town that had 10 dentists. And every five years, this guy would retire. In most towns, there’s the old guy who would just sell to some new young guy with a lot of energy, and the competition stayed vicious. And these guys would say, “Well, I’m going to buy out the old man’s practice and I’m going to have him rule all this practice, and then I’m going to tell him, ‘Well, you say you’re going to retire, but if you want to stay a day or two a week,'” and they always do.

Howard Farran (23:23):

And so what they did is when they graduated school, they were the 10th dentist in their town. Five years later, there was only nine and then eight and then seven. And now they’re 65 and there’s only four dental offices in the town. But one office has five dentists and they’re doing $5 million a year. And you know what, that was the exact same strategy that Thomas Watson Jr. did of IBM. And the reason he became big is he inherited that from his dad. He drank his way through college and swears he didn’t learn a damn thing and doesn’t even know why got the degree.

Howard Farran (24:01):

But he only notice one thing. They grew up in this small town and they were three hardware stores in this little small town. And he’d go to one lie and belong, and he’d got another one lie and belong. So he’d go to this other one. One and they had two employees and he got there faster. And one day he realized there’s three locations, but there’s just four salesmen. And each salesman has a quarter of the market. So it’s not based on locations, it’s based on salesmen and nobody knows what they’re supposed to buy to fix this, what nuts to bolts they got now. And he goes, “No one knows software.”

Howard Farran (24:38):

So when he took over IBM he told his head scientist, “Look, I’m going to stay out of your way. I don’t know what you’re doing. I don’t even care. Just go to your thing. I’m going to focus on sales.” And he started with IBM sales div. And everyone six weeks, he got 20 new salesmen, and they got him a three-piece suit and a briefcase and went through the whole sales pitch. And he once said, “If 70% of all the computer salesmen in the world worked for IBM, we will have 70% of the market,” and it came true. And they asked him. They said, “Well, why didn’t you go for 80, 90 or 100?” He goes, “Well, then I knew the government would have to step in and they would grate me up. So I just thought that was about the most I can get away with.” And it’s just absolutely true.

Howard Farran (25:19):

So we only know this about a practice. Why would you go in and start a new supply when you can buy out an existing supply? In fact, let me tell you this. There’s 168 hours in a week and the average dental office is open 32 hours a week, which is 19% a week. So if you had a uber dental op where a patient said, “I want to make an appointment,” and all these other dentists uber had dental offices they can rent… 80% of the dental operatory capacity is never being used. So it’s just insane to go build another dental office when every dental office in America is not being used four out of every five hours a day.

Howard Farran (26:11):

As far as competition with the DSOs, every major DSO guy is already on the record saying, “I’m not going to the rural,” because they tried that and by the time the kids get out of dental school, they’re at the prime time to attract a mate to mix gametes, and they have better odds in the city of Phoenix than they do two hours out in the middle of nowhere in Eloy, Arizona.

Howard Farran (26:35):

So by the time they’re well put in the rule, on any given day, 10% of the officers didn’t even have a doc in the box. So you know there’s no DSOs rural. And so that’s a haven. So I would say go to the rural. And by the time you’re two hours away from where a Southwest Airlines plane takes off, they drop insurance. You’re one of only three guys in a town of 3000 and they sell you a ticket. And you could only sell if [inaudible 00:27:09]. Well, how much is a root canal? $1000. How much crown? $1000. How much partial? $1000. How much denture? $1000. Everything’s rounded off to $1000, and they all have about 40% overhead because in a small town, labor, a 15 hour dollar a job or Walmart’s considered a bank and you have to pay a hygienist $50 an hour in San Francisco.

Howard Farran (27:30):

So I would say get two hours away from the airport, go rural, buy out an old guy instead of building more capacity. And if you’re a helluva programmer, you ought to make a Uber dental lab so that patients can meet these young dentists out of school in any office they want you. They could be working for a DSO who won’t let them do that, but on their day off, they could be meeting a dentist… Like my dental office when it’s closed. It’s closed every day at 7:00 PM. It’s closed Saturday and Sunday. So I know that was a long-winded answer to a very short question.

Chris Pistorius (28:03):

No, that was awesome. That was great. We’re going to wrap up here in a minute, but to any of those that are out there, I can’t imagine there’s many that don’t know about Dentaltown. Why don’t you tell us a little bit about what people get out of Dentaltown, how it works and why somebody should pay attention to Dentaltown.

Howard Farran (28:21):

First of all, all your scientific institutions like NASA, the jet propulsion laboratory, I’ve been to many of them, they only use the message board format. And social media that people are used to is called LIFO, last in, first out. And it’s just almost entertainment. But on a message board format, all 6 million posts made on Dentaltown are still there. They’re archived, they’re searchable. When we look at all the studies on Facebook and Twitter, it’s scientifically factual that everybody bulkinizes. So if I’m pro dental insurance, and you get on there and say, “Don’t take it,” they’ll just unfriend you. So everybody’s in this hardened position.

Howard Farran (29:06):

But when you go to Dentaltown, you can’t unfriend someone, you can’t delete someone. So a lot of people are very in a bubble, and they believe something like say that implants cause gum disease, you got to do ceramic and on their Facebook page they’re a guru. No, on Dentaltown, people just start popping holes in their bubble, and they either are on the scientists and want these observations to grow with, or they’re emotional and they run from it. So I just think it’s a treasure.

Howard Farran (29:41):

And the thing is on Facebook, I know who you are, but on Dentaltown, I know who you are registered, but you don’t want to call yourself Smiley Tooth… There has to be a place for a stupid question, like a specialist. An endodontist can’t get on Facebook and say, “Here’s a case of mine that failed. Does anybody know what went wrong?” All these competitors would be sending that to everybody. But he could on Dentaltown. So I want a place where, no, you’re not going to go and put yourself in some bubble. And you’re still a doctor. And you have to be aware that there’s people that think other thoughts. And so I think it’s a beautiful thing.

Howard Farran (30:22):

As far as the business on Dentaltown, I have my 30 day dental MBA. It’s free on Dentaltown. It’s also on YouTube. It’s also on iTunes. And my gosh, when I went to MBA school, I took my laptop, took notes just towards my dental practice. And then I came out, I ran it out the notes, it was 30 hours long. I call it Dr. Farran’s 30 day dental MBA. It still gets 1000 downloads a month just on iTunes. The views on YouTube are insane, but that’s what’s neat about the internet and Dentaltown. All the information you need to do a root canal or run a business is zero cost. You just need your time.

Howard Farran (31:06):

When I was a little kid, all that information was hidden in expensive universities that only rich kids went to, and you couldn’t do that in a poor town or a poor country. And now it’s all there on the internet at zero cost. So if you really want to work like no dentist has for a decade, you can still live like no dentist has for three decades.

Howard Farran (31:29):

So if you just want to get out there and work your butt off and hustle and do what everybody knows what to do, it’s all spelled out on my 30 day dental MBA. It’s all on Dentaltown. The opportunity is sitting right there, but it’s not going to be delivered to you. It’s not going to be easy. You’re going to have to do it the faster way, which is get out of dental school and work your ass off for a decade.

Howard Farran (31:54):

But here’s my last piece of advice regarding you and me. Number one, this isn’t a paid endorsement. He didn’t give me any money. But if he ever does come out and visit his grandma in Phoenix, you got to invite me. One beer, that’s all. That’s all I was asking.

Howard Farran (32:10):

But the deal is, dude, stay humble, stay in your real house. You think you’re an expert in everything and you’re not. And my gosh, you think you know everything about marketing, but you probably don’t. And I’m telling you that the DSOs, I’ve met their marketing agents and it’s a department. It’s five, six, seven, eight people, and they are not kidding around. So then for you to sit down as a dentist say, “Yeah, anybody can be an excellent marketer and understand Google and Facebook and all,” no, no, no. You need someone that specializes, all they do… You know an orthodontist can do Invisalign better than you. And you know that there’s a marketing guy that can do marketing better than you.

Howard Farran (32:55):

So stay humble, stay in your real house. I’m still always meeting dentists that run into a disaster with little things like their lease. There’s a dentist in Phoenix and on his lease, it was a triple net lease and three doors down, it flooded the whole room. Long story short, he was the only tenant in a 10,000 square foot building who had the money to pay for it. The yoga studio, everybody else just walked out on their lease and said, “Call it a bankruptcy.” So you need a lawyer before you sign a real estate lease. You might meet a guy who’s spent a decade in dental marketing before you start your ad campaign.

Chris Pistorius (33:37):

Yeah. I think that’s great advice.

Howard Farran (33:41):

Stay humble in your real house.

Chris Pistorius (33:44):

I really appreciate this. And if you don’t mind, I know you’re a busy guy, but maybe in a few months we can hook back up and tackle a couple more subjects if that’s cool with you.

Howard Farran (33:52):

Any time you want, man. It’d be a blast. I can talk about dentistry until the cows come home. I just love it.

Chris Pistorius (33:58):

That’s great, man. Well, Howard, thanks again. And thanks to everybody out there watching today. I know you got some great information out of this. Be sure to join us next week for another great episode of the Dental Marketing podcast.

 

Chris Pistorius (00:04):

Hi everybody. This is Chris Pistorius again with the Dental Marketing podcast. I’m with a great guest today, he’s got tons of experience in dentistry and does a lot of cool stuff. And today Steven Feit, Dr. Steven Feit, is with us today. And we’re going to really get into his 30 plus years of experience and how he’s transformed his practice from very early on in his career to more recently. So Dr. Feit, thanks so much for being a part of the show today.

Steven Feit (00:34):

Thanks for having me on Chris. Really appreciate it. Big fan, happy to chat with you.

Chris Pistorius (00:40):

Awesome. Well, let’s get right to it. I mean, we talked a little bit off air about a little bit of your background and whatnot, and I was kind of floored by how you transitioned over the years and let’s get right into that. What do you do? How do you do it and how have things changed for you over the years in dentistry?

Steven Feit (00:57):

Well, Chris, as we talked, I came out of my residency at the Goldman school up in Boston, I was an associate in New Jersey and as is typical was a bit abused, where they were taking monies and so forth, that most people have had that experience. So I packed up, went to Florida to set up my own practice, and started from scratch. That was 1991. And you know, of course the mode was just take anybody. And we became very, very busy, but we became busy treating a lot of people that were not nice, not reasonable, not respectful, didn’t refer, didn’t repeat, didn’t pay. And I got to the point where I was actually miserable being so-called successful, depending on your definition.

Steven Feit (01:41):

And I latched on with Patty Lund, who was a dentist down in Australia, and I adopted a lot of his front desk lists. We call them care nurses, even though they’re assistants, but they’re not nurses in a medical sense. But our care nurse greets the patient when they come in the office, escorts them to the treatment room, helps me render the treatment, let’s say we’re doing a crown or whatever. And then they know the next step. They don’t have to bring the patient to the front desk. And everyone in the waiting room overhears what’s the conversation. The patient pays in the room. If there’s a discrepancy, which usually never happens, because everything’s done in writing. It’s all in private, no one overhears it and everything is sorted out. And then they’re rescheduled for the next visit and they leave. They can go to the restroom or just leave. It makes a very tight relationship with the care nurse because then when they return that same care nurse is going to be with them to insert the crown with me.

Steven Feit (02:43):

And then that same care nurse will be with them if they need another procedure down the road. So then they get to know each other quite well. And it’s very simple and easy and natural for the care nurse to say, “Listen, we don’t ask everyone, we ask our special patients and you’re one of them. We really enjoy having you and your company. We would love it. If you would refer some friends, because we believe birds of a feather and that kind of thing.” And if the patient says, yes, we find it’s almost like a verbal contract, and they do, they will refer and it works very nicely. So it creates a higher level of care, a higher level of meaning for the day for the care nurse, a higher level of fulfillment. Most people leave a position, not because of money because they feel under appreciated.

Steven Feit (03:36):

And when you’re appreciated by the very person you’re serving, and then I show my people tons of love. Like I put them on such a pedestal. Throughout the procedure if I asked for an instrument, you’ll hear me say, thank you, please, please, can I have this? And I say, thank you. And what happens is the patient is overhearing that whole dialogue. And the patient sees the respect that I’m giving to my person, who is a very special person in my life, that’s why they’re there. And what happens is they in turn at the end, they’ll turn to the care nurse and say, thank you, thank you. And I’ll say, wow, that came out great. It shortened the treatment time. All because of Sarah. Sarah did an awesome job today.

Steven Feit (04:24):

And so most doctors, they feel like to elevate themselves, maybe they have to push other people down. It’s the exact opposite, because guess who hired them? Guess who picked them? It’s a reflection of me. They say, the fish stinks from the head down. Right? Well maybe it smells good from the head down also. So it’s really a nice way to envelop yourself with people all day, all day long.

Chris Pistorius (04:52):

Yeah. That’s an interesting concept. Kind of the no front desk thing. I’m probably making it too simplistic, but when the phone rings and stuff, you still have these care nurses are the ones that answer phones or how does that work?

Steven Feit (05:05):

Yeah, that’s a great point I forgot about. So our patients, being in south Florida we’re in the demographics of, they’re like as eighties, nineties, hundreds. And so their medical issues is of concern and you always want… I have phones, telephones, in every single room. I have computers in every single room, like most offices today of course do. We’re totally chartless, we’re without paper charts. And so they can take a step and answer the phone.

Steven Feit (05:38):

So I have two care nurses. So when I’m with one treating someone, genuinely, the other one is available and can grab the phone, and there’s a computer right next to every phone, and there’s the front desk. In the old days, I practice, can we had a paper schedule, we’d have to move the in a treatment room and get the schedule done and all that. It was a little more complex, but today it’s really quite easy. And with COVID, by the way, everything’s done in the room, it’s for their safety, it actually is a perfect mode of operating, you know?

Chris Pistorius (06:14):

Yeah. I was going to bring that up. That’s that’s a pretty good concept for times like we’re going through right now. Talk to me though, early on you said you took on just about anybody that would pay you, and it was great money-wise, you’re very successful. But something clicked and you just, at the end of the day, you just weren’t happy. How do you transition out of that? How many patients… If you already brought this up, I apologize. But how many patients did you kind of let go to get to your happy spot, if you will?

Steven Feit (06:42):

Yeah. So what we realized is we were actually miserable and we were busy. As Michael Gerber says in the E-Myth, “You’re doing it, doing it, doing it,” and you’re on a treadmill or the hamster wheel, and you’re like, when is this ever going to end? And so, I got to the point where like, I restore old cars. I’m like, I’d rather go to Jiffy Lube and change oil than come here. You know, that’s a pretty dark place. So, one of my friends said, well, if someone’s not going to come back to the office, why does it have to be me? Why not the patient? And whoever gives thought to let go of a patient, because we’re so used to, and inculcated in our training, like you need more patients, get new patients, need more and more.

Steven Feit (07:24):

So what ended up happening was Patty Lund, we copied one of his systems and we rated the patients as A, B, C, or D. And what we would do is say, Hey… We’d have paper charts in those days. And we’d say, okay, here’s Mrs. Smith. Who knows her? I was the care nurse for her. How is she? Oh, she’s amazing. I love her. She’s super nice. Okay. She’s an A, we’re going to keep her. So we put her in a good pile. And then the next one is, oh, this person is always late. Never brings a credit card, never pays. Never on time, all that. Okay. That’s a D. So the D’s have to go. The C’s, some of the C’s… And I was like 26, 27 years old when I was doing this. And these are 70 year old people. And I’d say, listen, Mrs. Smith, you just don’t bring happiness when you come to the office. We love you, but we would love you more if you would go somewhere else.

Chris Pistorius (08:20):

You told the patient this?

Steven Feit (08:22):

Yeah. And I said, look, I just want to be brutally honest, don’t shoot the messenger. But we just feel that you would be better served, you don’t seem happy here anyway. And some of them would say, geez, I’m really super nervous when I go to the dentist and I’m just not myself. And I didn’t realize I’m doing that kind of behavior. Would it be okay if I could make myself better and work on it? And so if they’re a C, now we can bring them to a B. Absolutely, we’ll keep you Mrs. Smith, we appreciate the honesty and we’ll both be better together. And then if it’s a B patient or an A patient, we don’t have to have that conversation. The D’s, the D’s would go. Some of them would grab their there… I would copy their x-rays back in those days, it wasn’t digital, and we would have it all prepared. And they would use some profane language.

Steven Feit (09:14):

And there’s an old saying, just because someone tells you to go to hell, doesn’t mean you got to go, right. So, the other saying is, through the front door of our office, everyone makes us happy, some on the way in and others on the way out. So let them go. And you know, what happens? You pick the weeds, the flowers grow, that you’re spending your time with really super nice people. They refer super nice people and you’ve eliminated all the people. It’s the Pareto Principle, if you will. Like 80% of your time is spent with 20% of the problems, or whatever.

Steven Feit (09:56):

And it’s gone. Like, we don’t have that. Now. I get a lot of referrals from up north, the Northern dentists. And sometimes I can’t get an A patient in. They’re a D patient. And I’ll call the office up north, and I’ll say to whoever answered the phone, I’m going to say your name, tell me the first thing that comes to mind. And I’ll say the patient’s name and it’s telltale. There’ll be silence, or, oh, sorry, sorry, you have that person there. So now I know of what’s what I’m dealing with, but.

Chris Pistorius (10:31):

Wow. You just gave me a great title for a book is, Pull the Weeds and Let the Flowers Grow. I love that. That’s great. Awesome. So how long ago was it that you started this process?

Steven Feit (10:42):

Well, I would say it took Patty Lund… I’m personally good friends with him, so he’s now in New Zealand, he’s retired. But Patty told me it took him a better part of 10 years to develop what I just described in a few minutes. It took me two years to implement, because I had all his books and I was diligent to push through. And there’s a lot of pushback from the team.

Steven Feit (11:11):

We created a consulting company a few years back. One of the right-hand people with Patty, his name is Fletcher, he’s a great guy. He’s also in Australia. And another fellow Mike. And it kind of fizzled out, because we all got busy doing other things. But we took practices to do this in six months, many of them in four months. And they were rocking. And not only does it create… You create this energy, people start saying yes. A lot of my friends took the consulting side, and they’re like, Steve, I don’t know, there’s like magic in the air. Like everyone’s coming in with money in their hand. They’re like, yes, yes, yes. And I see it’s the energy. They want to be a part of it. They want to be around it. It’s indescribable, but it’s palpable. It’s interesting.

Chris Pistorius (12:01):

Right. That’s awesome. That’s a great story. That’s one of the first times I’ve really heard the concept of this kind of like no front desk, and it makes sense to me. And I think it’s certainly something that can flourish right now, and where we are, and just a different way to really look at dentistry. It doesn’t have to be the way it’s been for the last hundred years. There are new concepts out there, and there are things… You don’t want to do things just because they’re new. But I think there’re things out there like what you just talked about that are proven to work, and it’s kind of gets a fresh look on dentistry and how you approach it. So that’s awesome.

Chris Pistorius (12:37):

So tell me, I saw in your bio too, that you’re a… Let me get the exact… a dental expert witness. And I found that fascinating, because I’ve never spoken to one of those either. Can you tell me about that?

Steven Feit (12:49):

Yeah, so it sort of happened by accident. One of my friends who’s an endodontist was asked to review a case as an expert, and it was all prosthetically driven. So as a prosthodontist, he asked me if I would get involved, and I spoke to the attorney, I didn’t know anything of what I had to do. And the attorney kind of coached me through that first case. And then I found that I was quite good at it. And then I got another case, another case, and I’ve probably done a hundred, maybe a hundred legal cases. I’ve done some cases that are like slip and falls, some that were assault and battery. And we had to determine a lifetime value of a restoring the area that was damaged in the assault and battery. And then I’m also involved in patent litigation between companies with a dental relationship.

Steven Feit (13:45):

So yeah, it’s quite interesting in the fact that like… I’ll give you, for example, the simple things like how every word means something. Opposing or adverse counsel will say to me, doctor, how much are you being paid for your testimony? And that’s a very basic question, right? Well, I don’t get paid for any testimony. I get paid for my time and expertise and knowledge base to review the facts of the case and determine, and answer questions based on that data. But my testimony is mine, mine alone, I don’t get paid for it, and no one buys me or my words. So these are traps. And so when I see these dentists get deposed, they get shredded because they’re not listening, they’re nervous, they don’t breathe, they’re not oxygenating well, they’re not thinking, they’re not prepared, the attorney didn’t prepare them, that kind of thing.

Steven Feit (14:44):

So there are really, really talented attorneys and not so. I’ll boil it all down, I know we have a time limit. It all comes down to relationship. I say to the dentist, why do you think you got sued? They’ll say, I don’t know. And I say, well, I spoke to the… Because I’m not allowed to talk to the dentist, and I only do defense. Like I only help the defense, I never help the plaintiff. So I can only debrief the two parties after the case is terminated. And so I’ll ask the patient, why’d you go after him? I don’t like that dentist. That dentist was mean to me. They never called me to see how I was doing. They never cared. They never showed daycare.

Steven Feit (15:30):

So I described for you our care nursing system. It’s interesting, the words, right? So it’s built in. Now of course, I do make my post-op calls. I find when I fall off from making post-op calls, I get more issues. Not problems, we could solve the issue. So if I make my post-op calls, people are more reasonable, they know you care. And so the second question I get in deposition is, doctor, how many times have you been sued? And the answer is none. And then they’ll… Invariably, the lawyer, the attorney, they’re doing like four or five other charts while they’re asking questions. So they’re billing like for four cases in the hour. And they’ll look up and they’ll say, never? I say, no, ma’am no, or no, sir, never. And it’s like, unheard of, you know? It’s bad.

Chris Pistorius (16:21):

Yeah. Well, that’s interesting. And it kind of gives you a little different flavor in your industry, and I’m sure it’s compelling work, it’s interesting stuff. What’s your favorite book? What would you suggest as a book for maybe a new dentist or coming out? What could help? Just do it on anything, not just being a dental expert witness.

Steven Feit (16:44):

I can give you a couple. I would say the most important book is The Richest Man in Babylon. That’s an amazing book, because that’s going to set your financial house, and set you free and put you on path on being responsible on how you handle your dollars, setting yourself up for your longterm future, and protecting your family and all that, financially speaking.

Steven Feit (17:08):

I love the On Purpose Person. That’s a very influential book in my life. We have four kids, how to stay on purpose with your, whatever your purpose might be. So if you want to spend more time with your kids, you might have to say no to other things and other people, and then the other people might not be happy with you. Well, just stay on purpose.

Steven Feit (17:34):

And then the E-Myth is a brilliant book. I actually met Michael Gerber who wrote it. It’s considered one of the top best 100 best business books ever written. And I mean, it goes on and on, Who Moved my Chair, First Things First, you know?

Chris Pistorius (17:50):

Yeah. I agree with E-Myth, I’ve heard that a few times and it’s great. And I first got into it, and it was like, okay, you’re going to build your business like McDonald’s. And I’m like, okay, I’m not reading any more of this. But then you keep reading and you’re like, oh, you know what he’s got some good points there, and it really applies for dentistry or anything else. That’s interesting. All right. So what about a new dentist? I mean, there’s more new dentists coming into the market now than ever. And in my business, competition is fierce in terms of new dentists, and dentists competing against each other. Would you advise a brand new dentist coming out of school, starting his or her own practice, to maybe go the direction you did right out of the gate in terms of kind of no front desk, and rate your patients, and only really work with the ones you consider somebody who would be nice to work with?

Steven Feit (18:41):

Well, yeah, I mean, to your point, I see it’s a massive challenge right out of dental school. So right out of dental school, I went up, did two years of advanced training in prosthodontics. And at the same time I worked in these capitation, low end clinics, where I’m using a barber chair as a dental chair and a shop vac, and doing MODBL on Malcolm’s back in those days, blowing out teeth, and it was out of control. And so you get your speed and all that kind of stuff, and you learn what you don’t want to do. And then I was an associate and I realized, okay, I didn’t really want to be in that environment. And under the thumb, because it’s like a marriage and you got to really make sure that you guys, or the people, or the parties get along.

Steven Feit (19:25):

So I took a bit of a road where I had two years residency then a year when I was an associate. And I essentially built my practice as an associate. Like he really didn’t give me many patients. So I had to go out and beat the pavement, take people to lunch, and get know them, and ask for referrals and that kind of thing. So it’s a long road, like to your point. So I don’t know that someone… None of my four kids are going into dentistry. But to advise a young dentist right out of dental school, I think he’d go work somewhere and get your speed and get comfortable just even conversing with patients, and you learn to be confrontationally tolerant, and talk, and explain, and set expectations, and verbal skills and on and on and on.

Steven Feit (20:19):

And don’t take on things that are over your head. That’s when you get sued, you know. And practice like you don’t need the money in the worst time when you do need the money. And when I started my practice, I knew, I said to myself, I’m going to make the worst mistakes when I could ill afford it. And you do, but you fight through. You never fail unless you quit. That idea. And then find your way, and then maybe a couple of years down the road, you could buy in and then buy out. And there’s a lot of different options.

Chris Pistorius (20:52):

Yeah. Yeah. Awesome stuff. Dr. Feit, I got to tell you. We could go on for hours with this, and if it’s all right, I’d love to check back in with you in a few months and maybe we can do another episode, because you’ve got a lot of stuff there that we can dive into.

Steven Feit (21:04):

I’d love to Chris. Thanks for the time. I appreciate you having me.

Chris Pistorius (21:08):

Absolutely. And thanks everybody for watching another episode of the Dental Marketing podcast. Be sure to tune in next week, we’ll have another great guest. And thanks again. See you soon.