Chris Pistorius:

Hi, everyone. This is Chris Pistorius with the Dental and Orthodontic Marketing Podcast. Thanks for tuning in today, or downloading, or however you listen to this. Today, we’ve got a great, great guest. I’m with Dr. Chad Johnson of Veranda Dentistry in Iowa. Dr. Johnson has three locations, and we’re going to talk a lot today about his success and how he kind of went from starting this, all the way up to three locations now, but Dr. Johnson, thanks so much for being a part of the show today.

Dr. Chad Johnson:

Yeah. Glad to join. Hey, everybody.

Chris Pistorius:

Yeah. So we, here at Kickstart, we obviously talk a lot about growth, right? Because dentists typically hire us to help them grow, right? And sometimes they just want to have a little bit more new patient flow for their existing practice, but there’s a lot of folks that are looking a little beyond that, opening up another practice. And I know there’s a lot of stressors, if you will, to go with that, but why don’t you tell us a little bit about your practice and how you got started originally?

Dr. Chad Johnson:

Sure. So I graduated the University of Iowa College of Dentistry in 2005. And so, at this point of the recording, I’ll have been open 16 years this summer. And so I just opened right out of school. It was still pre-2009, pre-2008 regulation stuff, that on a handshake while I was in dental school, I was able to get alone and open up as a hometown boy back in Pleasant Hill, Iowa. And so then I, just at age 40 last year, got done paying off my debts for the original practice loans and whatnot. And so I thought to myself, “Do I want to continue on kind of easy street after having paid all those off? Or do I double down and start investing in growing the brand that I had created?”

Dr. Chad Johnson:

So before COVID had hit, I thought it would be a genius idea to buy another practice. And while I was looking, basically another guy was like, “I really wish you’d buy mine too.” And so I ended up buying two practices and having the deal solidified legally right as COVID hit. So then I was kind of locked in to making it happen. And so for a year now, I’ve had three practices, two new ones. And so I have one on the north side of Des Moines, one on the west side of Des Moines and one on the east side of Des Moines.

Chris Pistorius:

Very cool. Nice. Take us back to 16 years ago or so when you started your first one. Were you thinking, “You know what? One’s great, but I want more,” or was one kind of the plan and this kind of all came together?

Dr. Chad Johnson:

I think my answer at that time probably would have been, “I’m open to thinking there could be more, but I just doubt it.” I think I was content with the thought of just opening up my own business. I don’t know. It’d be if you went back to Biden or Trump or anything like that, I’m throwing those key words in there, so if this gets transcripted, yeah, it’ll be a hot topic.

Chris Pistorius:

I like it.

Dr. Chad Johnson:

Yeah. If you go back to any of those presidents back when they were 20, and if you said, “Do you think you’ll be president someday?” They’d be like, “Well, I mean, I don’t want to rule it out, but I mean, I don’t know why I would be.” So, and then sure enough, after the fact, they get there. So, no, 16 years ago, that wasn’t on my radar. I don’t think I would have ruled it out if you would have said, “Do you bet that someday you might own three practices?” I’d be like, “I mean, I suppose, but it’s just not something that I want to, or care to, think about much right now.” That’s probably how I would have answered it at the time.

Chris Pistorius:

Yeah. I think that’s probably fair, and probably how most people think about that. Let me ask. So did you start the first one from scratch or did you buy an existing one?

Dr. Chad Johnson:

Nope. It was from scratch.

Chris Pistorius:

Okay. Got you. So you’re staring at a blank sheet of paper on your appointment calendar, day one, right?

Dr. Chad Johnson:

Yes.

Chris Pistorius:

And what is it that you did to go from nothing, to get to a point to where you can expand? How did you grow that patient base? How long did it take you? Maybe get into some of that.

Dr. Chad Johnson:

Sure. And I’ll even split it up into how I did it, versus how I wish I would’ve done it.

Chris Pistorius:

Okay, great. Great.

Dr. Chad Johnson:

Yeah. So how I did it was, we sent out mailers. My brother is a realtor, and at the time, he’s three years younger, he had already started his own real estate company and stuff. And so we thought, “Let’s split the difference on doing a mailer together for all the people that we know from around town and stuff like that. Let’s just kind of combine our resources of who we know, and let’s mail those people.” Basically we mailed them a Christmas letter saying, “Merry Christmas, and then here’s a magnet calendar.” Realtors are good at that kind of stuff. Especially 20 years ago, for 20 years ago. So we mailed out a mailer, a calendar, and it was a magnetic one that would stick on people’s refrigerators back when people did that, and these days, refrigerators are too pretty. But so we mailed those out and I think each of us spent $800 bucks on that we split the cost and mailed it out to, I don’t know, 500 or 1,000 people, or something like that, and we did that for a few years.

Dr. Chad Johnson:

What else did I do? For example, I coached a fifth grade basketball team around here, I joined the booster club, kind of some of your quintessential small town stuff that you would do. And I was well-known enough. I think also what doesn’t really help some people out, unless you’re really thinking ahead, is your reputation can precede you. And so if you have a good reputation, or let’s just broaden it out. If you don’t, or you don’t feel like you do, and you’re starting off in a new town, is you create the brand of who you are and what your public perception is.

Dr. Chad Johnson:

Now, what’s best, I suppose, is when there’s harmony between reality and what you’re trying to have people perceive. Then, you’ve got sincerity to your story. If you’re trying to portray yourself as a nice guy, but you’re a jerk, I suppose it’s going to play out after a while. But then again, what I’m saying is, if you want to be known as the guy who’s always helping with the sports teams and stuff like that, but you don’t love sports, well, that’s going to be dumb. But if you do have sports and you do love getting involved with that, well, then there’s going to be integrity to that, sincerity and integrity to that marketing.

Dr. Chad Johnson:

Now, what I also wish I would have done differently, but the there’s a dilemma in it. So I’ll get to that in a second. What I wish I would have done is, later on in my career, let’s see, that would have been about seven years ago, I started having a marketing manager. And so they’re in charge of reviewing my ROIs and tracking our data and putting phone numbers on stuff, so that way, we can see where our calls are coming from and working with the front desk people on how we’re answering the phones. So there was a lot smarter way to do it and more effective way to do it, and so that way we could track it. The only downfall to that is, on day one out of school, and I don’t really have a marketing budget, so that was the dilemma. I think if I went back and I said, “Chad, you should do this.” I’d be like, “Older Chad, listen, that’s cute and all, but I don’t have any money.” And I’d be like, “Oh yeah, good point.”

Dr. Chad Johnson:

So finding that dilemma of when you first can have someone that can oversee your marketing, but whether you have someone, I guess, to oversee it or not, then if I were to go back and say, “Okay, let’s compromise. Set up some phone numbers to be able to track where you’re getting your leads from, track it in your office when those patients finally do come in, and then also set aside money for a marketing budget.” If your marketing budget is 0% or 1%, then you’re probably not going to have that big of a return on the investment, as opposed to, let’s say that you spent 5%, so five times more than your 1% budget. You spent 5% budget in 2022, and you set up for that. You’re going to spend 5%, and that’s five times more than you had been doing before. You’re going to get more than a five fold increase on your marketing ROI, your return on investment.

Dr. Chad Johnson:

That’s just my opinion. And I imagine that matters from area to area, but it’s a synergistic outcome of being able to saturate your market with multiple media ideas. So for example, whether you’re doing Facebook and Instagram and YouTube and Google ads and mailers and radio and the local ball team’s banner at the little league ball field, that you’re hitting a few different venues of how people are seeing and thinking about you to keep your brand on their mind.

Chris Pistorius:

Yeah.

Dr. Chad Johnson:

Way long answer. My apologies.

Chris Pistorius:

No, no, no, no. I think you hit the nail on the head there. In fact, it doesn’t work for every market, but in some of the smaller markets, in terms of local community marketing, we actually, part of our service is that we will, on behalf of our client, we’ll actually reach out to little league teams, churches, events, anything that we can try to get involved with, and try to get some sort of sponsorship opportunities out of that. And it helps two-fold, in number one, what you talked about. They start seeing that brand kind of in the local community, which I think is awesome, but on SEO part of it, search engine optimization, which is getting your website to rank highly, you can get links from these events and from these organizations to your website, and that can just absolutely, incredibly boost your SEO positions, because Google loves to see those local community type back links coming in. And so it really is a twofold strategy where you get more exposure in a local market, but you might as well help your Google rankings while you can.

Dr. Chad Johnson:

Yeah, I like that, because you’re not only getting the PR that you want, but then you’re self promoting, in a way. And that sounds negative, but it’s just, well, take it for what it is. You’re using the PR that comes out and you’re trying to basically stir it, so that way it shows up in your LinkedIn, in your YouTube, in your Instagram, in your Facebook, all that kind of stuff. Or even if you’re small enough, your local town paper, perhaps. But just something, so that way, you’re recycling it. So that way, people are saturated with knowing. The humility thing, that’s fine, but at the same time, you have to have someone doing that for you. So self promotion might too strong of a word, but that’s why someone like you could go in there and do the promotion, and then it doesn’t necessarily have to come across like you’re promoting yourself.

Chris Pistorius:

Right, yeah. You’ve got it. And I still know dentists, I live in Denver, but I still have clients here that go to a weekly leads meeting, like BNI, for instance. They still get a great stream of new patients from doing kind of just grassroots marketing stuff like that. Did you do any of that or do you do any of that now?

Dr. Chad Johnson:

No. I think part of the reason why is, I mean, because my quick answer was going to be, “I’m not really a fan of doing that,” but I think the reason why is because I’m so extroverted anyway, that I don’t need too much of a platform to do that kind of stuff. I do feel like that probably helps some people out that otherwise naturally wouldn’t be finding those venues, but I’m really that quintessential guy that actually goes up to you and shakes your hand at a wedding and says, “I feel like I should know you, but I don’t know why.” And I’ll just strum up a talk that way. So for me to put it down might be a little quick shooting from the hip when, in fact, it might just be that my personality affords me to naturally meet enough people the way that I do, so yeah.

Chris Pistorius:

Makes sense. Well, when I started this business, I was kind of like you, I’d quit a pretty good paying job and had two little kids at the time. And all of a sudden, I’ve got a piece of paper in front of me with no clients on it and no income. So I’m like, “All right, I need to kind of go do the Mark Cuban approach, and you just grind and work and do everything you can to get in front of people and talk to people.” And I know dental practices that do that, and they have a lot of success with it, but you’re right. I mean, you can’t fake it, because if you don’t to go network and talk to people and be outgoing, it’s not going to work for you.

Dr. Chad Johnson:

Yeah. And if it’s not for you, call it like it is, because that might actually hurt your business if you go to those things and you’re just kind of a bah-humbug little fly on the wall, people are going to be like, “I don’t know what’s wrong, but he doesn’t seem to like us,” so it could actually work against you. I don’t know if that’s the case with most dentists, but probably at least, I don’t know, let’s just say a third of us, that a third of us dentists probably would not benefit from that, because you’re so shy and stuff like that, that if you stayed with online presence, then you’re able to craft more of an intimate, introverted story, and that authenticity would come out too, in a good way.

Chris Pistorius:

Yeah. And I just want to put in there that you are not a client of ours. In fact, we just spoke for the first time ten minutes ago, right?

Dr. Chad Johnson:

Right.

Chris Pistorius:

So could you tell me and everybody that’s listening, current day, three locations, post COVID, are you doing Google stuff? It looks you’ve got an awesome website, but what’s your strategy now, and what do you see that’s working the best right now for you?

Dr. Chad Johnson:

Internal marketing is still and always the best. So what we do is we have plaques on the wall, and this would depend from state to state, that say, “We love getting referrals and we’d to thank you for your referrals.” We basically are implying that we’re giving out gift cards of thanks for those that refer people, and for the people that got referred here. And so we have a choice of three or four different small gift card ideas that are up in each operatory showing on the plaque what we offer. And we also hand out little cards that say, “Thank you for choosing us. If you had a great visit, we’d love if you referred someone,” and it’s actually perforated where they can keep one side and give the other side to someone else saying, “I loved coming to Veranda, and I’d love if you were to give them a call and schedule a visit as well.”

Dr. Chad Johnson:

So internal referring, I think, so when we count our dollars, we count our dollars for how much we spend on something, and then how much return a treatment plan completed that we do for that, so to calculate our ROI. And it’s over 90 to one on internal referrals, because that kind of stuff, there’s a little cost upfront. And by little, I’m just saying, those plaques might be, shoot, I don’t know. It’s been a while. I don’t know. Let’s just say $1,000 bucks. And then if we spend for printing those cards and others, and the printing of the cards is probably $200 bucks. And then the gift cards that go with it, $25 bucks per person, so that’s $50 bucks. And then times, let’s just say, 10 a month. So that’s $500 bucks.

Dr. Chad Johnson:

So you’re still under $2,000 at first, that first month. And then from every month thereafter, another $500 bucks, because you have everything printed. So at the end of the year, if you spent $6,000 bucks, but you got $60,000, or after a while, $600,000. We get a huge return, because if those cards last for four years, let’s say we did a print of 1,000 of them, and you’re handing them out little by little, and the next year and the next year and the next year, basically it’s just like fuel economy. After you filled up, and then if you’re coasting downhill from Denver down to wherever, going down the hill, you’re stacking your fuel economy, miles per gallon, in your advantage to where then when you review that.

Dr. Chad Johnson:

So internal referrals, that is our hugest return on investment, but you have to be proactive and willing and talking with your team, grooming them to understand the importance of it and how to talk about it and why to talk about it. They need to love your brand anyway. If they don’t like you as the boss and stuff like that, they’re not going to do that. So that would be another thing for you to figure out. Does your team love your brand? And by brand, I kind of mean you.

Dr. Chad Johnson:

And after internal referrals, another good return on investment for us is Google ads and SEO kind of stuff. I have to admit, I’m not the best at understanding the minutia differences between the two, because it seems like STO is a smidge different, but we kind of group those together and I think we get a 10 to one, and then I do radio. And I think our radio, and the reason why is I’ve got three offices that, in essence, if you did a 20 minute drive between each one, it creates this triangle in the Des Moines area. So they’re not necessarily close to one another. They’re, let’s say, 15 miles from each one.

Chris Pistorius:

But they’re not far apart either, right?

Dr. Chad Johnson:

What’s that now?

Chris Pistorius:

They’re not far apart either though.

Dr. Chad Johnson:

No, close enough that I can easily get to, so by spreading it out, when I do radio for one office, there’s a lot of people on another side of town that might not come over to see me. But when I have three locations, in essence, what I’m doing is I’m splitting the cost. So that’s where the economy of scale can help me out by doing three offices and doing radio. For example, if McDonald’s does a radio ad, every McDonald’s is going to have advantage of that. Now, if you have a ma pa hardware store, only maybe within 10 miles, is anyone going to go to your hardware store, so it’s kind of a waste of money for a ma pa hardware shop. Exactly. But McDonald’s, that’s why Wells Fargo and big companies that have a national presence go on TV, is because they’re taking advantage of, if I put something on TV, it’d be a waste of money, especially during the Super Bowl. Who in the world in New Jersey is going to come to Des Moines, Iowa, right?

Dr. Chad Johnson:

So it just doesn’t make sense for me to spend $1 million on an ad when it makes sense for Burger King to spend $1 million on an ad. So radio is about, I think, a four to one return on investment. We do mailers. I think that gets a three to one return on investment.

Chris Pistorius:

Right. I think what you’re detailing here is a strategy. It’s not a, “Let’s put all of our eggs in one basket and hopefully it hits,” right?

Dr. Chad Johnson:

And the coolness is, I didn’t come up with that, so that’s where having someone to manage that helps, where they’re looking over the strategy, because I’m not smart at this. I’m basically kind of parroting what I’ve learned along the way.

Chris Pistorius:

Right. Yeah. And it’s not about putting all your eggs in one basket, it’s creating six or seven different baskets and putting one egg in each, because there’s no magic bullet, right? You’ve got to have a strategy. For instance, with SEO, okay? You’re at Google’s mercy. You could rank number one on the page and be doing great, and then the next day, Google changes their algorithm on how people rank, and you might be on page three. And so if you’re relying just on that, you’re in trouble. So that’s exactly what we talk about when we talk with dentists, is let’s have an overall actual strategy. Let’s not just try this or try that. Let’s put a lot of different things into play and see what we can do. And something that’s very intriguing by me by looking at your website and just a little bit of your background, is that you actually do a podcast too, is that right?

Dr. Chad Johnson:

Yes. So I’m with a consulting group called Productive Dentist Academy. And Bruce Baird is the head dentist that runs that. And so when I first went to Productive Dentist Academy, it was amazing listening and learning under him, how he markets. He markets at 8%. And that blew me away, because at the time, I was like, “Well, I’m kind of proud of the fact that I do 0%.”

Chris Pistorius:

Right?

Dr. Chad Johnson:

I’m kind of one of those guys. And there’s a big camp of dentists that are proud of the fact that, “I don’t market. I just let my name speak for myself,” and stuff like that. And I used to be that way. And so the more I got into that, they, just in the last couple of years, asked if I would come on and talk. Our podcast is called Everyday Practices, where we don’t talk about the drill and fill stuff. We talk about the importance of family, of taking time for yourself. How do you make the best of when you’re in the office, so that way, when you’re not in the office, you can enjoy life too? So it’s kind of a bigger picture of dentistry.

Chris Pistorius:

Got you. Kind of that work-life balance type stuff.

Dr. Chad Johnson:

That’s right. That’s right.

Chris Pistorius:

I think everybody struggles with, so that’s great. That’s awesome. Okay. Well, I don’t want to take up too much of your time here. In fact, I’ll just ask you right now, maybe in a month or two, we could do this again, because there’s a lot of stuff that we can learn from you. And this is just a fraction of it. But one last topic I do want to hit though, is it seems a lot of our clients right now are having an issue with hiring. How to get people, how to keep people, especially. We have several clients that are in kind of this churn of hire, then they leave or they get fired, and you got to train somebody new, and they can’t get ahead because they’re constantly training. And it seems like there’s two schools of thought here. You either bring somebody in with a lot of experience, or you bring in off the street that has no dental experience and you train them. What do you think of all this? What have you done in the past to be able to hire and retain successfully?

Dr. Chad Johnson:

I’ll admit that I’m in the same boat as everyone else. In real time, I don’t know any better than anyone else the perfect answer to that. And the reason why is we’re not a national company that’s hiring hundreds or thousands, or tens of thousands of people, right? If you hire tens of thousands of people, then you learn pretty quick how to hit the percentile that you need. Dentists are hiring one person every five years, typically. So let’s say this COVID year that someone needed to hire five people, that’s five years of hiring one. Now, Wells Fargo might hire five people in one hour. They might hire 10,000 people in a year. I don’t know. But they’re on a different scale. They have an HR department.

Dr. Chad Johnson:

So this HR question then is tricky because when I admit that I don’t know, I’m just basically trying to identify with a lot of dentists. I think both camps have a good strategy in that if you run across a waitress that is quintessentially a people person, and perfect for the front desk, and they are willing to give it a shot, then go for it. But at the same time, I think hiring someone that has no experience, and let’s say everything else being equal, that someone that has no experience, but someone else that wants $2 more an hour and has 15 years of experience, and you like them, so that factor in there, then hire for experience for two bucks more. Now, if they want $20 an hour more, then you’re going, “Well…”

Dr. Chad Johnson:

So those things, listen, everyone has to weigh out. And I’m not in the A or B camp on that. I’ll tell you my creative way around it. You’ll have to look at the bigger picture on this, audience. But one of the things that I thought about in Iowa, Iowa is 49th in the nation in pay for nursing. So I told my office manager this last year, I said, “If we need another assistant, I want to try and get a nurse, an RN, to work as an assistant, because they would love our hours, love our job.” Now, if you’re in the state that’s number two in the nation for nursing pay, then you’re not going to want to hire a nurse for an assistant. But in Iowa, where we’re 49th in the nation and some nurses are starting the graveyard shift from 11:00 to 7:00 on weekend nights and stuff like that, if they’re getting started at $22 an hour, and then my assistants are in that same range, these nurses would love, the ones that’ll think outside the box, to take a job like what we have available.

Chris Pistorius:

Friday off, in a lot of cases.

Dr. Chad Johnson:

Absolutely. It’s a day clinic. In nursing terms, it’s a day clinic, and they would love the hours. They’re like, “Wait a second. So I don’t have to clean up any poop. I don’t have to…” Assisting would be cake. So think about that. Find out where you sit on that. But here’s the bigger picture. If nursing isn’t your thing in your state, find out what it is. Do you work right next to Disney, and you’re like, “Man, I wish I could hire people.” Well, Disney just laid off people and they’re wonderful on customer service. Hire a Disney person. So whatever it is.

Chris Pistorius:

Yeah. Yeah. I totally get that, because you can teach a lot, but you can’t necessarily teach customer service…

Dr. Chad Johnson:

Personality.

Chris Pistorius:

Yes. The personality. Yeah, exactly. Being an outgoing person that that has that voice of care. You can’t teach that, right?

Dr. Chad Johnson:

Right. And they’re at the coffee shop.

Chris Pistorius:

Yeah. [crosstalk 00:27:41].

Dr. Chad Johnson:

Yep.

Chris Pistorius:

Absolutely. Well, that’s exactly what I was thinking too, and it’s great to hear your thoughts on that as well. But Dr. Johnson, I just want to wrap up here. Thank you so much for your time. And again, I do want you to come back very soon and I want to kind of attack another topic or two, if you’re willing to do that, for sure.

Dr. Chad Johnson:

Why not? If someone’s willing to listen to me, I guess I’m willing to talk.

Chris Pistorius:

Well, hey, thanks again. And thanks everybody out there for tuning in this week. We’ll have another great guest for you next week, but if you have any questions for Dr. Johnson, I’ll leave some of his contact info here as well.

Dr. Chad Johnson:

Yeah, please do.

Chris Pistorius:

And I would appreciate any feedback that you guys have on this interview, just so that we can make our podcasts a little bit better. Thanks again, and we’ll talk to you all soon.

Bill Orth:	Hello everyone. This is Bill Orth with Kickstart Dental Marketing, and thank you for joining us on our consultant network. Today, we have Leslie Icenogle of Dental Implant Auxiliary Training, and also insurance billing outsourcing. Thank you very much for joining us today.
Leslie Icenogle:	Thank you Bill.
Bill Orth:   [00:00:30]	She brings over 25 years experience in the dental industry, having been an implant coordinator and a practice manager. And now you’re primarily working as a consultant and also a speaker to audience across the US on various topics regarding dental. You know what, before we get started today Leslie, why don’t you give us a few details on how you got started in your consulting business and the various aspects?
Leslie Icenogle:   [00:01:00]           [00:01:30]	Yes. Thank you. Actually, you mentioned [inaudible 00:00:48] than in oral surgery and implant coordinating for so many years and that’s back when implants first became popular in the United States in the mid eighties. And what I’ve found is that a lot of dental team members were not very comfortable with the implant process as a specialty practice, working with referrals. I noticed right off that if a hygienist had an implant or was comfortable with an implant, you would have more referrals of implant cases. So I realized right off that it was the lack of comfort with the auxiliary as to why patients were not getting referred for needed implant treatment. So that’s already had a huge impact on referring the patients out for an evaluation to see if they’re an implant candidate or not.
[00:02:00]	So basically I started my consulting business about six years ago. We do primarily work with specialty practices on the six month Step to Success program on growing the implant practice, which does help educate the restorative team so that they get that comfort level. And there’s not a little feeling in their stomach when they have that on the schedule, they’re more competent and talking to patients and educating patients about it. So I also work with the general dentist practice too, and educating them directly if they just want to increase their restorations, or maybe they want to do the placement and restoration themselves. So basically I saw the void of education in that area is why I started to consult.
Bill Orth:	Gotcha. And now why don’t you tell us a little bit about the insurance aspect too. And we’ll get into both of these in a little bit more detail.
[00:02:30] Leslie Icenogle:           [00:03:00]	Yes. And I’ll tell you, I have been speaking on medical insurance and the dental practice for years, and the most common response I would get is, oh I just wish you could do this for me. So about two years ago, I decided why not? Let’s just go ahead and start doing it for the dental practitioners and take that frustrating path off of them. Insurance companies are really becoming more of a challenge and more time consuming than they were in the past. So we do the verification of benefits on the patient, the practice’s specific form, if they would like. We post the explanation of benefits, make sure that the proper write-offs are being made. We also file and call on the accounts receivable. That is fun.
[00:03:30]	And [inaudible 00:03:13] you can really see somebody’s accounts receivable go down fast. And when a doctor gets their cashflow tripled, the next month they’re super excited and it feels really good to help eliminate the frustrating path from the front office and improve the doctor’s cashflow. So one of the added benefits that our clients are telling us is that they’ve actually seen an increase in case acceptance because their team is more available to build relationships and talk with the patient. And one of our goals is to help reduce the turnover because it’s so high in the front office. And usually when you ask a team member why, it’s because of insurance.
Bill Orth: [00:04:00]         [00:04:30]	Well, I mean, that’s a very unique opportunity that you have here. You’re actually working in two of the hottest trending aspects of dental right now. From a dental implant over the last several decades, it’s really trending towards the number one solution for tooth replacement. I know that when I was much younger, those weren’t the options. It was a bridge or dentures seemed to be the thing. And I know that implants, there’s been a lot more growth as far as expansion of insurance coverage and also just the longevity and the aesthetics of a dental implant rather than the other solutions seems to be more of the forefront. Even to the point where it’s actually a main focus in curriculum and dental education these days, which it wasn’t in the past.
[00:05:00]       [00:05:30]	I saw this unique thing a couple of months ago as one of my clients several of them who weren’t doing dental implants are now growing. It seems to be a very popular profit option and a very valuable solution to be offering for their clients or their patients. But I saw this interesting fact that over 70%, just over 70% of adults, by the time they reach 44 years old, have at least lost one permanent tooth via accident, gum disease, a failed root canal, or tooth decay. So I’ve seen this large growth in dental implants.
Leslie Icenogle:         [00:06:00]           [00:06:30]	Yes. And we’re just actually outliving our teeth. And so having a third set of teeth when you age with 50% of our population soon going to be over 65 years of age, it’s a very important service to offer the patient. And then also the education, I think that’s the best service that the auxiliary can offer their patients is the education, not only on the treatment but the consequences of non-treatment, which is extremely important as well. And I find that a lot of the auxiliary members have at least 28, if not 32 functional, beautiful teeth. And it’s hard for them to relate to the partially or the fully [inaudible 00:06:09] patients where I have seen it for 30 years and I see the problems that patients experience. So it’s really a great service that you can offer your patients, that they will never regret that they made that decision. So it’s very personally and professionally rewarding when you can transform someone’s life into functional. So yes, it’s a great service.
Bill Orth:         [00:07:00]	Well you know, I really liked your program too. We’ve talked about it a little bit. A six month program, coaching program and you’re going through a lot of aspects, but you keep highlighting one of the things that I think is very critical in this. When you get in their dental practice, the procedure itself, it’s all based on education and you really focus on taking that education to the actual patient when they’re making a decision on what’s the best option for my situation. I need to replace a tooth, what’s my best option doing this? And continuing that education, the benefits to it, so they can make a great decision for themselves.
[00:07:30]	And also what’s the best thing for them from a longevity standpoint and stuff like that. And I think that is something that is typically not a focal point from a dental practice standpoint. They’re just saying, this is what we recommend. And a lot of times there’s not the why we’re recommending this and stuff like that. So I think it’s a really good dynamic that that is a central focus of what you’re trying to do, not just with the dentist itself, but the associated team when going through procedures like this.
Leslie Icenogle:     [00:08:00]           [00:08:30]	Yes. And Bill, you really hit the nail on the head when you said that because the dentist, first of all, you have PPO networks and everybody really kind of straining them. They don’t have time to do the patient education. So being able to delegate that to a properly trained team member is not only better perceived by the patient, but also more cost effective because the dentist is getting paid to diagnose and treat, which is what they’re supposed to do. And also a lot of the dental teams are not aware that the congenitally missing teeth and the severely [inaudible 00:08:18] or the trauma cases are covered under the medical insurance. So you see a lot of coverage getting wasted, things that patients are entitled to that aren’t getting utilized. So that’s kind of important for the team to know as well.
Bill Orth:           [00:09:00]	That’s great. So when you look at your coaching program, I know that there’s some different variables, I wanted to sort of go over them a little bit. I know that you do some onsite work with the team. I’ve seen that you’ve done one and two day onsite, but you also do a lot of stuff via phone, tele-coaching as you’d call it, conference calls, continual monitoring and support. And you have a really great webinar series, for those of you we’ll share her website at the end, take a look at that. She covers really good topics in her webinar series, so we’ll talk a little bit about that. But typically, how is that from a proximity standpoint? I know that you speak across the country for your services and stuff like this. Is there a geographic boundary for the services, or can you work with practices throughout the US?
Leslie Icenogle:   [00:09:30]           [00:10:00]	I work with the practices throughout the US. I do have a full day program that come in and teach your team how to file medical insurance. Now the six month coaching does start out with two days onsite. Then I come back for a day onsite at three months and six months. Then there’s three hours of tele-coaching, the odd months, as well as monitoring. But you’re right, I do have a series of four webinars for those that do not feel they really need somebody on site, that goes over the roles of an implant coordinator, the financial discussion, the case presentation, scripting, and all of those wonderful things that will really make the team more confident to discuss the type of treatment with the patient and know the real risks of non-treatment. So yes, there’s a series of four webinars. You may find one of them convenient or you may want a series of all four, or the coaching typically does need some onsite just to see where people are. But of course, reviewing numbers and things ahead of time to see where we could be most beneficial to that since it’s in our team.
[00:10:30] Bill Orth:           [00:11:00]	Okay. For those of you listening, before we get into the insurance billing outsourcing, I want to highlight that if you want some more information regarding what Leslie’s offering, you can find her at www.teamimplants.com. Like I said, you’ll find all of the details regarding the coaching, her availability to speak at different events, and also the webinar series that we just mentioned. You’ll find it a very dynamic thing, very profitable. So if you are currently doing implants or wanting to add that to your solutions as a practice, I definitely recommend you checking out that website and getting some more information.
[00:11:30]	All right. So now let’s transition a little bit to a very common headache, AR. Just aspects of AR, specifically insurance, is always the big headache, and it doesn’t matter what type of practice it’s something that impacts every practice. How can you help me get paid faster, more efficiently, stop the headache and the churn of my front office? And so let’s talk a little bit about that.
Leslie Icenogle:         [00:12:00]	Yes, that is actually becoming very, very popular as far as outsourcing. And we do offer the medical and dental, but how we can help is the accounts receivable, you may have a team member that’s extremely dedicated and a great person come in in the morning and think, okay, I’m going to make 25 calls or get through this page of AR today. And then the day gets busy, they get emergencies and things happen and they go home without making those phone calls. So what’s unique about outsourcing is you have somebody, a specialist that’s on your team, that is making calls all day long without interruption. And so they can get more done. So you can see your 90 days disappear, your 60 days start to disappear very quickly because somebody is focusing on getting those results.
[00:12:30]           [00:13:00]	Another very time-consuming task for the team is the verification of benefits. Some dentists really like to know some specifics on codes, frequencies, and things like that. And we find that one verification can take up to 20 minutes per patient, depending on how much we tell the business at once. So the nice thing about outsourcing it is they’re not really paying a salary and all the taxes and stuff involved with that. It’s now become a business expense for your practice, so it’s less costly. So the medical field has been doing this for a while. You may have seen your own primary care physician go from having an insurance team to outsourcing it. They find it more cost efficient. So our goal, to get you paid faster, is to file the claims properly the first time, with the correct attachments, we know what code needs what for which insurance company, and we also follow up on those right away.
[00:13:30]             [00:14:00]	So we file up to four insurance companies, more if the patient has it. It’s typically two medical, two dental. We did have a recent client that does a lot of frenectomies, but didn’t realize those were covered under medical. She’s been with us for about five months now, and we’ve collected over $26,000 in medical benefits for her frenectomies. And I have a full list of procedures that are covered by medical carriers. If you want to contact me, I’d be happy to share that with you. So we get paid faster. We also utilize the medical insurance benefits and also really review those explanation of benefits. We don’t want a dentist tricked into taking a write-up that they don’t need to or an insurance company trying to down code a code. We really appeal that right away. And we actually work with an insurance collection agency. If the insurance companies are not doing what they are legally supposed to do, then we can send the insurance company to a collection agency.
Bill Orth:     [00:14:30]         [00:15:00]	Sure. Well, that’s awesome. You touched on a couple of points that I want to reiterate for our listeners out there. You know, you’re incurring an expense in this capacity as a practice anyway. The problem is, at least a lot of our clients, it’s a headache that they really don’t want to deal with. You know? So one of the unique things about your expertise, especially when it comes to AR, it’s the gaps in AR are the biggest crux to profitability, to a practice. I know that speaking with several people in the space, the dramatic drop-off from what happens after the 60 days. You get a very high pay rate in the first one through 30, and then it continues through 60. Once you get to that 60 to 90, you start to see a dramatic decline. And if you get out there towards the 120, it’s deemed in a lot of cases, not very likely that you’re going to actually get those receivables. And so-
Leslie Icenogle:	Yes, and-
Bill Orth:	Go ahead.
Leslie Icenogle: [00:15:30]           [00:16:00]	Oh, and one issue that we’re finding too, is that a lot of dentists are inheriting these problems. For instance, if you purchase a practice and you now have their accounts receivable, and a lot of it is 90, 120 days, like you were just explaining Bill, it’s really hard to recuperate, especially with insurance companies. A lot of them are starting to go to this 90 day, timely filing. So you really have to stay on top of it. And a lot of times the team members are really, their heart’s in the right place, and they’re treating the patient and being that first person that the patient sees when they arrive, they don’t need to be on hold with an insurance company, fighting.
Bill Orth:           [00:16:30]	That’s great. Well, like I said, for those listeners out there, if you’re having a problem in this area, or you’re not even actually sure how well you’re doing in this area, definitely reach out to Leslie and her team of experts that can give you an assessment on exactly what those gaps are, how they can improve it, and possibly even just take that role and responsibility away from you, freeing up more of your time and your resources for other aspects and just improve your overall receivables and the focus on that aspect of your practice. You can find out some more information there at www.insurancebillingoutsourcing.com. Leslie, thank you so much for your time today. It’s been great having you. A lot of great information that’s going to be useful to our listeners and those people who have practices or involved in their practices. I really appreciate having you on the call today and look forward to being able to work with you in the future.
[00:17:00] Leslie Icenogle:	Thank you. Thank you. And a shout out to Kickstart Dental Marketing. You guys do an awesome job, I get great feedback from clients. So thank you.
Bill Orth:	Thank you. Bye bye.
Leslie Icenogle:	Great.

 

Bill (00:03):

Hello everyone, this is Bill and I’m with KickStart Dental Marketing. Thank you for joining us on our consultant network. Today, we have David Cohen of Cohen Law Firm, who specializes in serving dentists and dentist specialists with various legal needs such as business formation, transition services, partnerships and sales. David serves dental practitioners nationwide and has also spoken to audiences across the country.

Bill (00:27):

So thank you for joining us on our show today, David. Welcome.

David Cohen (00:32):

Absolutely. Thanks for having me.

Bill (00:34):

Thank you. I know we’ve had some brief discussions. In getting a little bit more familiar with you and your practice, I quickly realized the critical role you play, or your services play, throughout a lifetime of a dental practice. From the initiating of the dental practice, events that happens throughout regarding partnerships and transitions and so on, all the way through to an exit, when they’re retiring, the selling of the practice, and so on and so forth.

Bill (01:04):

Before we start to cover some of these topics, why don’t you tell us a little bit about how you started and why you created a firm that specializes in the dental industry?

David Cohen (01:14):

Sure. I grew up in a dental family, my father’s a periodontist. I always grew up going to meetings and such. He actually, aside from being a periodontist, is the starter of a continuing education business, so I had grown up going to meetings with dentists, and I always loved interacting with them and they’ve become longtime friends.

David Cohen (01:37):

So when it came to graduating from law school, I wondered how I could get back to dentistry without being a dentist and how I could interact with them. So I began to work for the CEO of a firm who just happened to have many clients who were dentists, even though we weren’t doing dental related things. By doing that, I was able to see what their general needs were in their lives, and I took that and ran with it and decided to start my own law firm to focus on those needs. And those needs typically being business related, practice transition, partnerships, formations of businesses, employment situations, just to name a few.

David Cohen (02:24):

So in 2011, I started my own law firm that specialized in those areas in helping dentists and specialists. That’s where I stand today.

Bill (02:37):

That’s awesome. Great. Hey, I know that we’re talking and I know that you’re located primarily in Dallas. I did see a reference to the Seattle area. I know you have clients across the country. But, do you spend time in both locations?

David Cohen (02:51):

I do. You nailed it though, that my clients are all over the country. We do really most of our business on the phone and via email, so location hasn’t been an impediment so to speak. But yes, as far as physical locations are concerned, we have a location in Seattle, we have a location in Texas, and I do spend time in both places.

Bill (03:16):

That’s great. You know, I heard a conversation of yours a little while back, I think it was with Howard on Dental Town. You were talking about the three phases of a deal, and I’d really love that to be the conversation that we talk about today on our podcast. But, I’d like to break it up into two phases.

Bill (03:36):

The first being the startup or a new dentist, someone who is starting a new practice. And I guess, a lot of the focus on that section will be on phase one, which you call the beginning or the formation. And then, the second half of our time today, I want to talk about existing or established practices and how some of the events that happen to them regarding partnerships, or associates and stuff like that, can influence the parameters of those deals, phases one through three. And then, we’ll conclude today in letting everybody know how they can contact you best about your services. So how’s that sound?

David Cohen (04:15):

Sounds great.

Bill (04:17):

All right, so let’s begin with the dentists, they’re just starting out. There’s basically two options, when we remove the associate part. It’s really a startup, they have 300 to 500,000 in capital, whether it’s a loan or whatever. Or, their other option is acquisition, I can acquire another practice, take over a practice from somebody whose retiring, or so on and so forth.

Bill (04:43):

Let’s talk about that, from a startup standpoint. I noticed in looking at some of your information, you really focus on the forming of the practice but you also help them with possibly some of their real estate needs, and so on and so forth, equipment. How does that work?

David Cohen (04:59):

Yeah, that’s correct. When we work with clients who are doing startups, we work with them in a couple of capacities.

David Cohen (05:04):

Number one, as you mentioned, forming the appropriate business in the state that they’re in to own their practice with. Every state has different requirements and different options regarding what types of businesses doctors can have. So what we do is we give that client the options and we talk to them about what might be the best for their situation. And then, once we’ve done that there’s always a real estate component, whether that client is buying real estate or leasing. Whichever the case may be, we then help them review … Usually it’s a review, because the landlord or the seller is the one that drafts the documents. We help with the review of those documents.

Bill (05:52):

Okay, perfect. So then when you look at the other option, an acquisition, the terms are basically the same. You might be talking to a person who actually owns a building or they’re under an existing lease, and so on and so forth. There’s typically equipment involved.

Bill (06:08):

And then, I want you to touch base, too. I’m not as familiar, but I’ve heard terms in reference to how they’re purchasing a practice, whether it’s on a flat rate basis or a per chart basis. Maybe, if you could touch base on residual compensation, and some of the things that they might have to face in acquiring a new practice.

David Cohen (06:31):

Well, yeah. When a client is buying a practice, usually they’re buying assets and usually the assets that they buy consist of furniture, fixtures and equipment, supplies, goodwill. And sometimes, accounts receivable, it really depends on the situation in whether they’re buying those or not.

David Cohen (06:54):

Also, they acquire records. And every state has different requirements with regard of who owns records and if those can really be bought or acquired, or if just the rights are assigned. There are other things to consider, but as far as records are concerned, as you mentioned, from time to time I have doctors who are going to acquire somebody else’s patients and bring them over to their office, and not do the traditional method where they buy somebody else’s practice and actually establish themselves in that location.

Bill (07:30):

Gotcha.

David Cohen (07:30):

When that happens, when they’re only doing a transfer of records, there are different ways that I see clients operate as far as purchase price is concerned. I’ve seen routes where the CPAs come up with specific numbers and it’s just like any other sale, the buyer pays the purchase price in consideration for the interest in those records. And then, I’ve seen a hybrid model where a purchase price is paid, but it’s perhaps only a fraction of what maybe the total could be. And then, the remainder of the purchase price is based on a formula of per patient, that comes to actually be treated by the purchaser. And then, I’ve seen the other extreme where a purchaser buys records and the entire purchase price is based on how many patients actually come and visit that purchaser’s office for a treatment. For a dental practice, at least getting hygiene treatment and usually the baseline of that.

David Cohen (08:35):

So I’ve seen all three different ways. And, based on the situation, based on the practice, based on the numbers, that’s how it’s determined as to which route they go and what actual price they’re going to be putting on the records. The most difficult thing to do is records are not like equipment, where it’s difficult to come up with an exact number that a chart is worth. All the parties, the teams involved, particularly the financial people do the best that they can to come up with a fair and equitable number based upon that practice.

Bill (09:15):

Yeah, that makes total sense. You know, you can definitely see that it’s a revolving dynamic based on the circumstances of each deal. That’s very good.

Bill (09:24):

So moving from the startup or the acquisition, I want to start talking about this, I want to go into details more about what you call phase two and three in this segment, also. Although, phases two and three are also applicable to the startup and acquisition. We’ll cover them in this scenario a little bit better.

Bill (09:48):

When you talk about existing or established practices, here at KickStart Dental Marketing, we also specialize in helping dental practices grow. We just do it through digital marketing efforts for new patient acquisition so we talk to all of our clients about their growth strategies. In the majority of the cases, in addition to what we do for them, many of our clients have also handled growth in different capacities. As they’ve worked with us in the past, they’ll get new clients or their work threshold will increase to where they’re looking into adding an associate, and so on and so forth. We’ve also had clients who’ve added a strategic partner.

Bill (10:34):

One of my very first clients was a pediatric dentist here in Colorado, actually. She added an orthodontic specialist into her practice in making a more holistic solution for pediatric services.

Bill (10:52):

So when you’re doing that, now you have an existing practice, or two existing practices. I know that in the past, you’ve talked about adding an associate, a partner, a merger. This is where the buy-in option also comes into play. Let’s talk a little bit about how that dynamic now changes, from the beginning standpoint when it’s talking about a partnership from either a buy-in or a merger, or so on and so forth.

David Cohen (11:21):

Yeah. With a partnership, there’s really three ways into the deal. A merger, merging existing practices. Startup, which is partners starting up brand new together. And then, a purchase where one doctor buys into another doctor’s practice. The most common of those three is the purchase.

David Cohen (11:41):

There’s typically purchase documentation drafted to effectuate the buy-in. That purchase documentation typically consists of either a stock sale or an asset sale. Usually, it’s an asset sale. What that means is that the actual practice, the actually company that the seller owns is not being sold, but actually an interest in the assets that the seller owns is being sold. That’s not always the case. Sometimes, stock sales happen and purchasers buy interest in the actual company of the seller. The teams that are involved in the deal are often going to come together to find the best resolution.

David Cohen (12:30):

It’s typically better for a buyer to buy assets then to buy the stock. There’s tax reasons for that, and also buyers want to steer clear of all liabilities from prior. If they’re just buying assets, then they are not responsible for the liabilities of the seller’s corporation prior. The seller likes to sell stocks because they’re not worried about the buyer in protecting themselves for liabilities, they’re more worried about their taxes and they usually are better off from a tax standpoint if they sell stock instead of selling assets.

David Cohen (13:09):

Now, that’s the usual. That doesn’t mean that it’s that way in every single case. I always encourage people to consult their advisors to make sure that they are doing the right thing in their circumstance.

Bill (13:22):

Sure, sure. Now, before we move on to what you call phase two of the deal, what’s the most common thing that you’re seeing? I’ve seen studies and I’ve heard that there are more people opening dental practices, so starting in dentistry, than they are retiring. Are you seeing a lot more from a startup or acquisitional buy-in as independents, or are you seeing a lot more from partnership, association, merger aspect, in the dental field since you’ve been practicing over these years?

David Cohen (13:55):

I’m mostly seeing buy-ins. I certainly have clients that do startups and do mergers, mergers probably being the least common. It’s mostly that I see buy-ins happening.

David Cohen (14:08):

As far as more people buying than retiring is concerned, I don’t have data on that so I can’t confirm that with certainty. I will say that the numbers may be skewed a bit because some people may have existing practices that are looking to expand and buy multiple practices, and that might be considered acquisition. And if they buy three practices, then that may look like there’s three more acquisitions going than sales happening from a retiring doctor. But, I think that it wouldn’t surprise me if that was the case. You have a lot of people that are entrepreneurial now coming out of school that really want to own, they’re not interested in associating in practices, and so they’re hungry to own practices. I can see that being the case, where acquisitions might outweigh retirement.

Bill (15:04):

Sure. Yeah. We’ve had several clients who, like I had mentioned earlier, used one aspect or another of the situation as a growth strategy, whether it’s acquisition or partnership. Which is very interesting as we talk to phase two of the deal, when you have a dynamic like that. I think that you reference this as operational, or the time during the deal. You’ve established a deal and now you’re operating within this deal.

Bill (15:32):

What are the things that are evaluated during that? Costs, and so on and so forth.

David Cohen (15:40):

Yeah. When clients go to stage two, which is operations through the deal, they’re mainly going to focus on management decision making, and how the costs and the money are split. With regard to management decision making, it can be based on majority consent, which means that whoever owns more of the company makes the decisions. Or if there are multiple, more than two, I guess two would be multiple as well, but if there are more than two doctors in the practice, then majority would just consist of more than 50% voting on something to make it effective. And then, there are other practices where they base their management decision making based on unanimity.

David Cohen (16:24):

There are positives and negatives to both. If you base things on unanimity, then everybody has a say, which obviously everyone is happy with. But then, it could frustrate the progress of the practice because if not everyone can agree on something, then it doesn’t happen. On the flip end, majority consent typically makes things happen, makes things go. But then, often times you have a party who doesn’t agree with what is happening, and how material that decision is could obviously impact how upset somebody might be that it didn’t go their way. Obviously, if it’s a very material decision they may be very unhappy. If it’s something that’s not a big deal, then they may be less unhappy, so it varies. That’s how I see management decisions being made.

David Cohen (17:15):

And then, when we move on to how costs and the money are split, that’s where I always recommend that clients bring a team in on their deal, one of the teammates is a CPA or financial based person who knows numbers, and it’s always great to confer with them based upon the practice, what the best scenario as far as splitting the money and the costs are concerned. Typically, I see practices that are purchased or owned as investments, where the doctors aren’t actually practicing in those locations. They usually just split the money and the costs based on percentage ownership.

David Cohen (17:49):

In practices where the doctors are actually working, I seldomly see the doctors split the money and the costs based on ownership. The reason why is because you could then have a doctor that’s producing 70% of the work and one’s producing 30, and then getting paid equally. And then, that causes a problem because the 70% producer is not happy because they’re getting less than they’re producing. And the lower producer is obviously happy because they’re getting more than they’re producing, and they’re less incentivized to work hard because why work harder when you’re getting more anyway for doing less. Usually, I see doctors split money based on production, and even split costs based on production.

David Cohen (18:34):

But, I often see hybrid models too, where there maybe carve out of a certain amount of money, or a profit pool so to speak, that is known money that comes in based on percentage ownership, every say month, where the parties know exactly what they’re getting, they know they’ll have something to pay their expenses. Buyer and younger associates that are buying in can service their debt. But then, the majority is based on production.

David Cohen (19:01):

That’s usually what I see. Again, this can be done in any way and the parties have to do what’s best for them, under their circumstances. But, I’m just mainly speaking on what I typically see.

Bill (19:11):

Gotcha. Yeah, it could be very, very complex. You know, as with any deal, there’s always the exit. Whether it’s retirement, or a partner retires and some of the complexities of one person continuing in practice, one person leaving. I’ve heard circumstances regarding non-compete in those situations.

Bill (19:32):

Why don’t you talk to us a little bit about phase three, the exiting of the deal so to speak?

David Cohen (19:38):

Sure, I’d be happy to. Exiting a deal consists of five things. Retirement, death, disability, disagreement and default.

David Cohen (19:47):

And just going through those, starting with default. Default would be something that a member of the company conducts an action or fails to take action on something that could materially adversely affect the goodwill of the practice. That’s usually what it’s based on. So for instance, if a party loses their license, or if they commit a felony or something like that, those are typically reasons for kicking someone out of a company, and they’re called default. Usually, the non-defaulting partners have the option to buy that person out, usually at a discount, because the goodwill has been affected if there is a default, which also holds all the parties accountable.

Bill (20:33):

Sure.

David Cohen (20:34):

Moving on to disagreement. Disagreement is probably the toughest thing to govern in these deals because you can map it out however you want if the parties don’t get along, but by the time the parties don’t get along, whatever plan that was implemented for the beginning may not be realistic or reasonable anymore, or fair to everyone, which is the key. One example would be that if it’s a multi-location practice and the parties decide that, if they break up, they’re going to split the parties among all the different locations. That might be fair on day one, but on year five, maybe it’s not an equitable deal anymore.

David Cohen (21:16):

I typically encourage parties to come to the table and try to work out an equitable resolution. Of course, their partnership agreement will have provisions that govern what happens in a dispute, and usually a dispute resolution provision that says the parties will go to mediation first, and then arbitration, et cetera. Or, maybe it’ll just say that you go to arbitration. Whatever the case may be, they’ll typically have that implemented. The issue is all of the things I just mentioned usually cost time, money and headaches. And usually the parties, even when things are most contentious, are more prone to want to come to the table and work something out before they go that route because they do save time, money and headache.

David Cohen (21:59):

Moving on to death. Death is typically governed by life insurance. Usually, the parties get cross insurance policies on the lives of one another. In the event somebody dies, the estate of the descendant then is paid the proceeds of the policies from the other partners in exchange for the interest in the practice. That way, the estate doesn’t own the practice anymore, which in some states they can own it for say up to a year, which nobody really wants. And that way, the interest goes back to the other partners and the estate gets paid out, which is usually what they want, and they go their separate ways.

David Cohen (22:35):

Why is this effective? Because death is often times sudden, or unexpected, and when that happens it’s difficult to come up with the financing to buy a partner out. But if they’re just paying premiums on a policy, they can just take the proceeds from the premiums and buy out the estate, and just continue to move forward.

David Cohen (22:57):

Moving on to retirement, or just transferring interest, usually the parties conduct some sort of plan to have a notice, where one party has to give X amount of notice to the other party that they’re going to retire. This gives the other party the time to buy them out, or to find a replacement partner, et cetera. That notice is really key, and then the parties come up with a valuation methodology as to how a retiring doctor’s going to be bought out of the practice.

David Cohen (23:31):

I usually see the same methodology used for disability. If a party gets disabled, they usually get bought out under the same methodology as retirement. You may ask well, why don’t they just do a disability policy like they do for life insurance? The reason why is because it’s often cost prohibitive. It usually costs so much to pay premiums on a disability policy that it doesn’t make sense to do so. But, the doctor can obviously always look into that and see if that is a possibility.

David Cohen (24:02):

In a nutshell, that’s really the five ways out of the deal and how I see them usually administered. Again, as I’ve continued to say, the parties have the liberty to do and handle these areas however they want and whatever works best for them, and they don’t have to do the norm or what I typically see. But, one thing that I do recommend is that they govern each of these areas in their contract. It’s really important to A, have a contract and B, govern the key areas in their contract.

Bill (24:32):

Sure. Yeah, it’s very interesting. Hopefully, regarding all of the different opportunities that you just discussed there in phase three or exit, hopefully retirement is the situation that those people listening today will be pursuing.

Bill (24:49):

You know David, thank you so much for spending some time with us. I really wanted to cover the three phases of a deal, I think that’s going to be very good for those listening on the podcast. I know that you are known throughout the industry as the trusted dental law professional, so for those of you listening, if you have any questions or need any legal advice at all, definitely contact David. He can be found at cohenlawfirmpllc.com, his number and email are there.

Bill (25:21):

I know typically as a courtesy, you’ll chat with people regarding their circumstance and give them guidance on how to pursue different circumstances that they may be facing with their practice.

David Cohen (25:34):

Yeah, that’s right. I’d love to chat with people. And if they have any questions about their certain situations or want to just talk about their certain situations, always happy as a courtesy to talk about their situation and see if it’s something that I’m able to help with or not.

Bill (25:51):

[inaudible 00:25:51]. Well thanks again, David, for joining us on the show today. It’s been a pleasure having you, and thanks for sharing such great information. I know that a lot of our listeners will find it very useful. So you have a wonderful day, and we’ll be talking to you soon.

David Cohen (26:03):

Thanks so much for having me. Take care.

You are listening to Hooked On Startups, where every week, you’ll hear from some of the most talented, inspiring and successful entrepreneurs who share their real life stories, how they overcame challenges and failures and how they’ve mastered success. Get ready for some of the best business tips, tricks and tactics and some frank unscripted discussions. Here’s your host, Matthew Sullivan.

Matthew Sullivan:

On Hooked On Startups this week, we have none other than the illustrious Chris Pistorius. Chris, welcome to the show.

Chris Pistorius:

Thank you. Thanks for having me. And you got my name right the first time. So it’s always a good sign.

Matthew Sullivan:

Well, I tell you what, it’s such a, it sounds like victorious.

Chris Pistorius:

Yes, I like that.

Matthew Sullivan:

It’s a combination of luck. I actually did look it up because I’ve got so much time on my hands. Apparently is Latin, pistor is Latin for baker, I believe.

Chris Pistorius:

I’ve heard that. I’ve heard a couple of different versions between German and South African and Greek, I don’t know. It depends where you at.

Matthew Sullivan:

It’s latinized. And of course that was that famous, was it Oscar Pistorius?

Chris Pistorius:

Yes.

Matthew Sullivan:

The guy with the blades.

Chris Pistorius:

Yes. Blade Runner?.

Matthew Sullivan:

Absolutely. Well, welcome, and all of you, welcome.

Chris Pistorius:

Thank you.

Matthew Sullivan:

So I’ve got your mind cheat sheet here, which really, all it talks about is just skill in marketing, design, ads, digital marketing, digital strategies. As you can see from your hat, you’re CEO, and owner, founder, boss of Kickstart Dental Marketing. So first of all, what got you involved? What made you get started into dental marketing?

Chris Pistorius:

I’m asked that a lot, actually.

Matthew Sullivan:

Was it the love of the sound of drills? Did you watch Mountain Man over and over again thinking, I just have try and recover this.

Chris Pistorius:

No. What’s ironic is that I really hate being in a dental office at all, even when I go to visit my clients. It’s like, I’m not a dentist person. I mean, I go to the dentist, of course, but I don’t like it, okay. So it wasn’t because of my love of dentistry, let’s put it that way. But no, when I first started this agency, almost, I guess a little over 12 years ago now. I left Corporate America and i had a nice job. And it was pretty safe. And at the time, I had two little kids at home. And I decided to jump ship and start my own agency.

Matthew Sullivan:

Is that because you wanted your wife just to go, “Chris, what a brilliant idea.”

Chris Pistorius:

It was quite the opposite of that, actually, she thought I was nuts. It was just, I knew I wasn’t wired for Corporate America my whole life and the grind. And I just wanted more out of my career, really.

Matthew Sullivan:

Yes.

Chris Pistorius:

But what’s funny is that when I started the agency, and I took on anybody I could, anybody that would pay me and would be willing to let me learn.

Matthew Sullivan:

Sorry to interrupt, but when was this? When did when did you, now, of course, big question, did you make the leap or were you pushed? You don’t have to answer.

Chris Pistorius:

No, I wasn’t pushed at all, no, no. But I made the leap. I knew I was going to do it. It was 12 years ago, this month, actually, this is our 12th year anniversary, but I knew I was going to do it a few months prior. So I had some ducks in a row in terms of having clients at least ready to be on our platform, if you will, right.

Chris Pistorius:

But, it was a lot of winging it, and just trying to figure things out in the beginning, but that’s how I got into dentistry is that, we took on anybody that would pay us and every time we did another industry, we’d have to learn the industry, right? Like the lingo and what works, what doesn’t. And sometimes, unfortunately, by the time we figured it out, it was too late and the client wasn’t getting the results that they wanted. So I was like, “Look, we’ve got to niche this down and really be an expert in something, right?” Not just try to figure it out.

Matthew Sullivan:

How do you market dental offices? Do you have an ad that says, “I promise you it will hurt you more than me?” Just kidding.

Chris Pistorius:

I might use that, that’s pretty good, actually.

Matthew Sullivan:

In brackets, just kidding, come find out.

Chris Pistorius:

No, we’ve got a lot of cool strategies that we use. Everything that we do is digital marketing. So think of us as like the website, social media, review management, online presence kind of people. And we get pretty creative with that stuff. And we actually have clients in Canada as well.

Chris Pistorius:

And what’s interesting is that they have a set of laws in Canada that really restricts on how you can market a dental practice. You can’t do certain things like you can do here in the United States. Just learning nuances like that and legalities in the U.S. in terms of like HIPAA laws, things like that, is huge and specialized.

Matthew Sullivan:

It’s brilliant over here. Because I’ve been over here for seven or eight years now. And it’s great. The marketing, as a dental office, you can say, “Don’t go down to Dr. Schwartz. He’s awful. We’re much better, come to us.” And you got to say stuff like that. So you got much more flexibility, but 12 years ago, so that would have been what? 2007? Something, is that right? No, 2009.

Chris Pistorius:

2009, right.

Matthew Sullivan:

I was applying a different set of mathematical rules.

Chris Pistorius:

Right. I could tell, it’s advanced mathematics.

Matthew Sullivan:

Advanced mathematics, the world will catch up at some point. So that way, I’m just trying to think about who were the major players in terms of digital? Because this whole concept of digital advertising, then, probably would have been something like ad words, or because, I don’t think Facebook had any real defined platforms. So you started off with a new client base, you’ve got to think of new strategies, and you’ve got a completely open field in terms of what’s out there. So where did you start?

Chris Pistorius:

With a blank piece of paper for the most part, but no, I mean, I had been in marketing for years, I used to work for America Online, AOL, back in their heyday, that’s really where I got my start in digital marketing. And back then really, nobody knew what the heck to buy or sell online, they just knew they needed to be a part of the internet, right. And so we sold basically, back then it was just banner ads.

Matthew Sullivan:

That’s right, God, I remember.

Chris Pistorius:

So we just put them anywhere we could and hope for the best for our clients. And we track things like how many times somebody saw the ad, or how many times somebody clicked the ad, basic things like that. And everybody thought we were heroes, and we weren’t. In terms of dental marketing strategy, I’ve been working with local businesses pretty much all my career. So I understood that, it’s not so much about branding and building a brand. I mean, that’s important, even in local marketing, but really, it’s all results driven marketing and direct marketing, and getting people into your store, into your office, whatever it may be. And so I sat down and designed a set of strategies that I thought could do that. And it’s worked out very well thus far.

Matthew Sullivan:

And you stayed with dental marketing. I mean, obviously, it’s a very big, I’m not sure if you would describe it as a niche business. But are you not tempted to move into other verticals like doctors, dentist, obviously, there’s other types of health care providers where, I guess, their skill set is pretty much focused on drilling large holes in your teeth, as opposed to figuring out how to market themselves.

Chris Pistorius:

Well, that’s it, and you just hit the nail on the head. I’ve entertained ideas of broadening it, but I’ve never really seen a need for it. In fact, I was very close to doing a veterinary marketing business, because I’m very passionate about animals and an animal lover, and I’ve really wanted to try that, but I didn’t do it. But the thing is that these kids that go to dental school, they come out as dentists, right, they’re very good at that. The problem is that they learned very little about business or running a business.

Chris Pistorius:

And one of those things is marketing. And in the United States, that’s one of the biggest killer of small businesses is knowing how to be a technician in your business and doing the work really well, but not understanding how to grow and scale and hire and fire and all of that other stuff, marketing, certainly. And that’s why most businesses fail. So there was definitely a need for this in dentistry, because like other small businesses, maybe even more so, these dentists just want to be a dentist, they don’t want to figure out how to market themselves and spend money here or there or anywhere else. And that’s where we fit in nicely for them.

Matthew Sullivan:

And I think really, that’s true, because you’re absolutely right that running a dental practice is a business. Now, you can come in as an associate or as a partner, and in many cases, the practice that you join will probably have that infrastructure in place. But as you grow, and as you set up your own business, this whole concept of digital marketing. If we look at where we are today, where are the most effective strategies for this vertical? Because I would imagine if it works for something as narrow as dental practitioners, you could apply that same logic to others.

Matthew Sullivan:

And I’m sure that my listener, or my viewer, because I’m sure I have at least one on this show, will be absolutely fascinated to find out, is it AdWords? Is it Facebook? Is it a combination of online and offline? Is it Instagram, showing pictures of before and after? Where do you find the real impact and what’s most surprising? I’m going to continue with questions, I’m never going to let you answer. But what is the most surprising outcome of all of the work that you’ve done, the thing that really made you think, “I never expected that?”

Chris Pistorius:

The thing that really impacts me the most is, we have a motto here of leaving dentists better off than when we found them, in terms of their overall financial health, in terms of their business, and also personally, in terms of what are 10 more patients a month mean for you personally too, right? And so I think what really keeps me going and motivated are the folks that we pick up that are struggling with one practice, maybe. And we see over months and years if they stay with us, and they grow, and not only is that practice successful, but they buy other practices.

Chris Pistorius:

And so now they own two or three or even more practices. And in a very short amount of time, they’ve gone from struggling to that. And I know that we at least have a small part in that, and that is really cool. And that’s what really keeps me going every day is that, we have tons of stories like that. And it’s just cool. We’re a startup atmosphere, even though we’ve been here 12 years. We’re a boutique agency, we only take on so many new clients a year, and we try to keep it really close knit and done from scratch type marketing. But that’s the thing that really gets me going.

Matthew Sullivan:

And what is the difference, because I would have thought that referral marketing would be a very powerful, so that’s very offline. And how much of a role has referral marketing played, because digital marketing is where you’re casting your net very wide. And you’re trying to bring in people really using a different set of messages than you would do. So how much of your overall strategy is based on referral, as opposed to general digital marketing?

Chris Pistorius:

You’d be surprised at how much digital does blend into referral, though. And you’re right when you say that, especially with the dental practice, almost always, the majority of their new patients come from referrals, come from family members, friends, whatever may be, and that should be that way.

Chris Pistorius:

However, we’re in this digital age where everybody can see everything. So if Aunt Sally refers me to a dental practice, I’m not just going to take her word anymore, pick up the phone and call. You know what I’m going to do, is I’m going to go online, I’m going to check them out, I’m going to look at their website, I’m going to look at their online reviews, I’m going to look at all kinds of stuff before I even pick up the phone and call them.

Chris Pistorius:

So a lot of what we do not only attracts new patients, but it also tells a compelling story for people like referrals to us that, they’re not just found, but they’re also want to be chosen. So we help them build great online reviews from their patients. In fact, we’re about ready to launch a brand new way to get video reviews from patients, and just help tell their story to people. So there is a blend there of even digital marketing helping out with referral patients too.

Matthew Sullivan:

Excuse me. Do you think that people trust other referrals less now than they trust online reviews? So historically, you’d say, you knock on your neighbor’s door and say, “Do you know a good dentist?” If I’ve just moved to the area. Now, do I trust that person more or less than the Trustpilot reviews or the Google reviews?

Chris Pistorius:

That’s a good question. I think it depends on the person. But I also believe that it depends on the source. Google reviews are pretty legit. A few years ago, they had a little spam issue where people could go in and fraudulently put reviews, that’s become harder to do now. Yelp is really the leader in that, they’re so strict with their reviews, that sometimes a lot of actual real reviews get filtered out because they show them as spam.

Chris Pistorius:

But there’s other sources that aren’t as reliable, that still will allow those types of reviews. But I think on a trust factor, I think we’re in a pretty good landscape now where people are believing those reviews, and especially the video reviews where they can actually see somebody and feel the emotion and see what they went through. Video reviews help a ton.

Matthew Sullivan:

And those video reviews that you put together, and those are the ones that you feature on the… I mean, because all of these things that you’re talking about here are relevant to all sorts of other businesses, businesses where trust, I think is the primary driver. So you’ve got price driven decisions, you’ve got trust driven, you’ve got location, all sorts of people buy things for all sorts of reasons. But would you say that trust is a primary driver for your particular vertical?

Chris Pistorius:

No question, especially with COVID. People want to be able to see and feel where they’re about ready to take their family for a health related service, right? So video allows us to show them that, and we really do our best to get doctors to do a quick two minute video on their iPhone if they need to, just to introduce themselves to the practice. Because at the end of the day, people still buy from people. And I know dentistry you don’t feel like you’re buying something, but you really are. And if people do buy from people, and you really believe that, then you need to make your online presence as personable as possible and video is a huge way to be able to do that.

Matthew Sullivan:

So that’s amazing, because the traditional understanding of digital marketing is essentially distanced marketing or depersonalized marketing where you’re trying to game the system to a certain extent. And what I mean by that is that you’re using Google AdWords. So when someone types in the word dentist, you go, “Aha, here’s an ad.” So we’re saying, this has now evolved, so is almost gone full circle, where you’re just moving back to people dealing on a Mano-a-Mano basis, but through a digital medium.

Chris Pistorius:

That’s absolutely right. I mean, we do Google ads as well. And it’s a very complex beast, Google ads. And for us, just typing in the word, a dentist, and a city isn’t necessarily going to be a dental patient, right? It could be some kid writing a term paper. So we really try to take some strategy and bid on long term keywords like, how much is a root canal? Or how many days do I have to have Invisalign on? Long term search words like that. But yes, you’re right. And we try to make this whole strategy as personable as possible.

Chris Pistorius:

There’s 100 dentists in every city, right. And we don’t believe a dentist is a dentist, we believe each dentist has a unique selling proposition of why they’re different and why they’re better than their competition. And the more clear that story is, the easier it is to market that practice. So that’s where we really try to start. And then we market to whatever we can with that USP. And in some cases, we just signed on with a dentist who does at home dental care, they do house calls, which is unheard of. They do some special needs dentistry, things like that. So we really try to target that type of a market to help them stick out from the crowd a little bit.

Matthew Sullivan:

And how much of those decisions are driven by you and how many are driven by them? So in other words, how many dentists say, I think this is going to be my unique selling point. How many people that you come across are not familiar with that term, with that concept, with that need?

Chris Pistorius:

I would say 98.9% of people have no idea what I’m talking about when I say unique selling proposition, dentists, especially because again, they’re not in the mindset of selling a product or a service. And they shouldn’t be, they’re really not. What they are, though, is they’re selling a solution to a problem. Somebody has a toothache, somebody wants to have a better smile. That’s a solution to a problem.

Chris Pistorius:

And so sometimes I’ll pull analytical data and I say, Dr. Jones, there’s 112 dentists within a three mile radius of your office, what are we going to do to be able to compete with those people? And I get that deer in the headlights look and say, well, that’s what we have to figure out first. And that really is the first step of our process.

Matthew Sullivan:

And you’ve got a certain advantage as a dentist, because it is a person to person transaction. The transaction is do I trust this person with my dental care? Now, how do your programs work with the industries which don’t have that personal touch? So let’s take something like, I don’t know, like finance, for example, or something where there’s still that requirement for trust, but you haven’t got the benefit of actually having the ability to, maybe it works, do videos work just as well with someone who’s not going to be having that same close interaction with you?

Chris Pistorius:

I mean, studies show that it does. I mean, obviously, I haven’t done a marketing campaign outside of dentistry for a while. But I do know, I’m part of a group that’s a bunch of other agencies like mine, but they focus on different industries, and we get together every quarter and talk about trends and best practices and things that are working and things that aren’t.

Chris Pistorius:

And I can tell you that across the board, video is a big, big way. I mean, I know a guy that runs a marketing agency for Tax Pros, right? And they’re using videos. I think if a Tax Pro can use video and benefit themselves, just about anybody could.

Matthew Sullivan:

And do you think that’s a result just generally of people being saturated by ad after ad after ad, saying the same thing in whatever industry you care to mention?

Chris Pistorius:

Yeah, without question. I mean, the big news in marketing right now is the latest update to the iPhone, right, where people are able to opt out from Facebook, tracking your every move and serving you ads based on your behavior, right? And I think a lot of businesses that relied on that type of marketing, which we did not, are going to have a tough time at it, and they’re going to have to probably change their ways.

Chris Pistorius:

So I think what we’re seeing in the market is people are tired of going to a hotel’s website and then jumping onto Facebook, and all of a sudden you see ads from that hotel for the next few days. It’s creepy a little bit, but I just don’t think people like it. And I’m not sure that’s the best way to effectively market a local business.

Matthew Sullivan:

I mean, you should expand on that, because that’s actually a fundamental change in the way that Facebook has to operate. I mean, can you tell us a bit more? Because it is, I think it is. I mean, certainly, it’s the beginning or it’s the definition of the tension between those two huge companies, between Apple and Facebook. And this will impact millions of millions of advertisers who rely on, precisely that, the ability to serve ads based on cookies, based on you go into a site, picking up this cookie that says, “I looked at this hotel for ever more.” So explain what’s happening, because it’s only recently happened.

Chris Pistorius:

So what’s happening, you just said it. I mean, essentially, in the past with Facebook, especially, they can track where you go, what you do, and these cookies are put onto your local computer, if you will, in a sense, and they know what websites you’ve been to. And so then when you hit Facebook, it can read what products and services you’ve looked at or shopped for, and it can then serve ads to you personally, based on your search history.

Chris Pistorius:

Well, now with Apple’s most recent update, they can’t do that any longer, you have to physically opt in to allow that to happen. And most people don’t want that to happen, so they don’t let it happen. Now, the other side of Facebook, though, the way that we use it, for our market, is that when you sign up for Facebook, you pretty much tell them your life story when you sign up. They know how old you are, where you live, how many kids you have, all kinds of stuff because the brilliance behind it is because other people are going to see that, people that you haven’t seen for years, and you want to keep them up to date on what’s going on. So that information is very accurate.

Chris Pistorius:

So when we use Facebook ads for a dental practice, we target things like age, if they own their own home, where they live, if they’re brand new parents. And that’s the data that I believe anyway, really drives results. And that’s the way that we use it. We don’t really do remarketing in terms of where they’ve been and where they’ve shopped, we’re more interested in the fundamentals about their demographic profile.

Matthew Sullivan:

And on that note, you touched on two things. You talk about audience selection, and you talk about copy or there’s the message, what is more important?

Chris Pistorius:

Both.

Matthew Sullivan:

You can’t say that.

Chris Pistorius:

If it’s either pick one or the other, it would be the copy for sure.

Matthew Sullivan:

I think so. Because the question is that you still have to have that message. So even though you can target specific demographics based on age, geography, the fact that I like watching The Wives of Dental Officers in New York, there’s some new show, I wasn’t there. But it is the copy, the message. And what do you think is the message that resonates best with all of the ads that you run? Is there some magic or some clear strategy that works pretty much across the board for most now [crosstalk 00:23:54]?

Chris Pistorius:

There isn’t. There really isn’t. What works for one dental practice may not work for another. Each market is a little different. That’s one of the benefits of partnering with a company like mine. Shameless plug.

Matthew Sullivan:

Good stuff, dental marketing.

Chris Pistorius:

Yes, right. We’ve got 12 years of experience in running these types of campaigns, and in all kinds of different size markets from tier-1 cities to tier-3 cities. And we’ve got the history of those campaigns. And we can see what’s worked well, and what hasn’t worked well in the past for similar size markets. So that allows us to hit the ground running. We still test everything, and we make changes on the fly as we go. But we have a pretty good idea what’s going to work. It’s not always that simple, but it definitely helps.

Matthew Sullivan:

And you’re right. I mean, the key word there is testing. Because there’s a lot of assumption that goes into marketing. We assume, based on an audience of one, or a sample of one, in other words, me, that if I like this than everyone else, out there will like this. And so from your perspective, talking to dentists, how difficult is it to get across that? Or to get over that view that the dentist always knows best?

Chris Pistorius:

I’m surprised by it, because it doesn’t happen very often in dentistry, maybe we’re getting a little bit better at setting the expectations of, “Hey, we’re the experts, follow our lead here.” But when I was doing other industries, it was hard sometimes, like attorneys especially, is that, “Hey, this is a type of television ad that I like, this is the one that I want to run.” Well, it doesn’t matter what you like, it’s what the consensus of your potential customers like.

Chris Pistorius:

And sometimes that’s a tough conversation to have. And early on, I’d made the mistake of allowing that to happen, because guess what, I wanted to be paid, right? Well, now that we’ve got at least a little bit of success, we have those conversations of, look, you’re not going to run this show, you need to rely on us to do this for you, we will get better results. And if that’s not the way you want it to run, then maybe we’re not the best fit. So we have very candid conversations about strategy. And most of the time, we don’t have any feedback at all from that, they trust us, and we’ve been around for a long time. And I think that that helps, too.

Matthew Sullivan:

And again, that also touches on something else, just on a wider spectrum, just dealing with people where the tail doesn’t wag the dog. So in other words, you start off in any business where you just want the customers, you want the clients, so you’re willing to do what you think they want. But the problem, then is that the outcome, as you were saying, it doesn’t always work. So how hard is it? And what advice have you got for people who are in that stage where they’re building something, maybe it’s a business like yours, where they feel that the customer is tugging them in a direction that they don’t necessarily want to go?

Chris Pistorius:

My advice would be stick to your guns and be passionate about what you do and be nice to them. But let them know that you’re the expert and that’s why they’re hiring you, right? Is for that expertise. What I’ve found is that if you don’t do that, we’ve got clients that have been with us nine years, right? And we have clients that haven’t been with us nine years, and some of those people that have left us have been like that. And what I found is that the people that do push back and want to enforce their own strategies are the people that probably aren’t going to be with you long term.

Matthew Sullivan:

But do they come back? Ultimately, cap and gown.

Chris Pistorius:

I’ve had several come back, yes.

Matthew Sullivan:

Which is good, because that proves that you are an expert. And did you think, 12 years ago, that you would still be doing this 12 years later? In the same group of people? Or did you have visions of becoming an agency dealing with all sorts of different verticals?

Chris Pistorius:

Well, certainly in the beginning, I didn’t have any idea that I was going to niche down, that really wasn’t had anything to do with any of the business plan. And in fact, our first very business plan was just to be a social media company. And while that’s certainly an aspect of what we do is what we found out is that people don’t just want one service from one company and another marketing service from another company. They’re really looking for somebody who can handle most of their marketing in one place. And that’s where we made that adjustment. But I don’t know, I don’t think I was thinking 12 years ahead about anything. So I don’t think I am now. So it’s like I’m trying to get out of the month to month type thinking versus the hour to hour, I guess.

Matthew Sullivan:

Long term strategies like next month.

Chris Pistorius:

Right, exactly.

Matthew Sullivan:

I think what you’re doing, though, is something that is really admirable. In other words, being able to become a specialist in a particular field because it’s so easy to try and be all things to all people and I think the money is actually finding a niche, or a niche, I believe as it’s pronounced.

Chris Pistorius:

Either way.

Matthew Sullivan:

One of those two things, and just becoming an expert in that area, because ultimately you outlive everybody who’s tried all sorts of different things, and you develop so much expertise, and so much experience based on just real life feedback. And so ultimately, you then become unassailable. So no one is going to have the same amount of experience as you do, because they haven’t been doing it for as long. So that creates success. I’m going to stop talking now, sorry.

Chris Pistorius:

No, no, you’re right on, that’s absolutely correct. And my advice would be anybody that’s starting a marketing company like mine right now is find that niche as soon as possible and just go with it, make it work. Dentistry is one of the most competitive places to sell anything to, right? And it’s one of the most elusive because you can’t just walk in or call a dental practice and talk to the doctor, you’ve got like three or four gatekeepers that are trained to keep you out of there.

Chris Pistorius:

So it’s very competitive, it’s hard to sell to them. And there’s tons of people trying to do it. So I picked one of the hardest ones. But is it was a big deal when we niched down and we can really talk results about other dental practices in specific like there’s and it helps a ton. So my advice would be definitely pick a niche and go for it.

Matthew Sullivan:

Yes. And also, you can then see results. So the most important thing is that, as far as the dentist is concerned, when the results start coming in, presumably, you get that movement from being skeptical to like, “Oh, my God, please, here’s [crosstalk 00:30:49].”

Chris Pistorius:

Because we pick up a lot of clients that have unfortunately been burned by other companies, and they haven’t gotten the results that they wanted. So it’s like the sales process and those first couple of months, people are like this, right, in defense mode. And they’re like, “All right, I’ve been through this before, I’m not getting burned again.” Type thing. And we’ve got to work through that.

Chris Pistorius:

So we’re very transparent with what we do. We have strategies that work short term, and then while we’re also waiting for a longer term strategy to take effect. So we have the ability to help bring patients in quickly, while we’re working on a longer term strategy, which will probably be more cost effective down the road. And my client success managers, these are the people that take care of our clients. They’re awesome. They go over above and beyond, just answering questions and making sure they’re updated on what’s going on. And that’s been a huge, huge contribution to our success.

Matthew Sullivan:

Yes. You mentioned earlier that, obviously, dental surgeries are a business, you provide a particular service. Do you see yourself expanding within that dental framework to other areas, like tax? Just general business advice in terms of growth, acquisitions? Or do you think what you’ve got is something that’s going to keep you busy forevermore?

Chris Pistorius:

What we’ve got now is going to keep us pretty busy. But what I try to do is, I told you, I’ve got a podcast show as well, I do on a weekly basis. And what I try to do there is bring in people like you just mentioned, like dental brokers, they help dentists buy and sell practices, right? Or insurance people or other people in the industry that can provide great information to my base, and people are potentially going to hire me.

Chris Pistorius:

And so that’s how I try to tackle a lot of that. And so we do that weekly podcast show. And that helps a ton. But I like to be the innovator, right? I like to be the cool tech guy. And in fact, I was just working on this new software, I just mentioned a little bit of it, where we can actually just send a link to a potential new patient. And they can tap on the link, and they can use their phone and actually leave a video review for the doctor. And that’s cool, because we have the doctor shoot a quick little video saying, “Hey, thanks for doing this. Here’s the questions I’m going to ask.” And it takes them through step by step.

Chris Pistorius:

And that’s going to be the next cool thing. I think, not just in dental, but I think that’s something that can be applied to just about any business. So it’s things like that, where I think I’m going to see the growth within dentistry and just adding on and innovating what we have now. The other thing with that is that what we find is sometimes with dental practices is that their front desk are great people, but they’ve never really been professionally trained on how to deal with new patients that call them and don’t already know who they are. So they’re just finding them online, right. And so that’s a different conversation than when Aunt Betty calls in as a referral. Right?

Chris Pistorius:

So we also have developed an online training course for front desk professionals to go through and teach them on how to close, if you will, more new patients when they call in just asking general questions. So we’re trying to go full circle, as you, I believe you said from, I will help you generate more leads and get more patient conversations. But we’re also going to help you close those new patients too, and actually get their butts in your chair.

Matthew Sullivan:

And that’s, again, a hugely important part, because, as you mentioned earlier, the front desk, and it was almost like it’s a particular breed of person, like a sales prevention officer. So you’ve got to try and unravel decades of training that’s designed to fend people off rather than invite them in. So I suppose that’s probably the hardest challenge, isn’t it? Getting the front desk people to smile, or to?

Chris Pistorius:

Well, I’ll tell you we actually help sometimes with hiring, so we’ll run Facebook ads, trying to get front desk people or hygienists, whatever it may be, and they ask us our opinion on that. And with hygienists, obviously, you got to go to school for that or anything like that. But with front desk people, a lot of times we recommend hiring people with no experience. And they look at us like, “Are you crazy?”

Matthew Sullivan:

There’s no predefined view of this is how I should act.

Chris Pistorius:

You can get them cheaper, and then you can train them just the way that you want them. You got to spend a little bit more time and training. But what we found is that if you have somebody that comes in with 10 or 15 years of experience, it’s hard to mold them into the way that you want them and to teach them new tricks, if you will.

Matthew Sullivan:

Now, do you think that because of the intense personal relationship that the dentist has with the patient, at the time that they’re doing the surgery, and the amount of trust that’s involved, and the amount of cost that’s involved. I mean, these are potentially big ticket deals, these aren’t small purchases, 1000s and 1000s of dollars. So, do you think the marketing that you’re bringing to this group is actually at the cutting edge of digital marketing? In other words, your doing over the next few years will trickle down into other verticals that have that same trust requirement?

Chris Pistorius:

Without question. I think it already is. There’s a fine line between cutting edge and what works, right? Like for instance, we won’t actually deploy any strategy with one of our client’s money without knowing that it’s going to be effective. And right now, we’re testing on our own dime. TikTok and marketing, then. There is a segment of the population that it does very well for, and we’re still trying to figure that out. But we’re going to be one of the first dental marketing companies and there are others, that will go into TikTok and be able to produce results out of it. Most companies are unable to do that.

Matthew Sullivan:

And I get that, that’s what I mean. You’re spearheading all your, I know exactly what you mean. What you don’t want to do is have your clients be the guinea pigs because you’re all about results. But I just think just listening to what you’re saying that there’s so many ways that people market their services, and it’s stale, and what you’re doing is innovative, is delivering results. And it’s something that is very transferable to other types of businesses, where trust is important, where the ability to train people how to react, where your video concept. So, I think that’s really interesting. Well, I’m pleased to say actually, Chris, that we’ve now graduated to the final part of the interview, this is where I ask my quickfire questionnaire.

Chris Pistorius:

Oh, I’m in trouble. I didn’t study.

Matthew Sullivan:

No. These are one word answers.

Chris Pistorius:

All right.

Matthew Sullivan:

That’s fine. There are 10 questions. Don’t worry, it’s simple, though. And we have the power of the edit.

Chris Pistorius:

Perfect. That’s true. This isn’t live. I like that.

Matthew Sullivan:

No, that’s fine. Well, we can pretend it is live.

Chris Pistorius:

Oh, yes, it is live. That’s right.

Matthew Sullivan:

Exactly. But anyway, so my 10 questions. Just to wrap up what has been an incredibly interesting interview. Question number one. Chris Postorius, what is your favorite word?

Chris Pistorius:

Favorite word is innovation.

Matthew Sullivan:

Perfect. Number two, what is your least favorite word?

Chris Pistorius:

Anything negative. I just don’t like negative people and anything with a negative tone. Take you’re pick.

Matthew Sullivan:

Number three. What are you most excited about right now?

Chris Pistorius:

All this business. 12 years ago I started and hopped out of bed and couldn’t wait to get started and I still have that feeling.

Matthew Sullivan:

That’s great. Every day you still have that driving, that passion.

Chris Pistorius:

Absolutely.

Matthew Sullivan:

So number four, what turns you off right now?

Chris Pistorius:

Negativity. I hate social media. I’m in the business. The only reason I’m part of social media is because I have to be, but what I’ve experienced over the last few months with politics and COVID, and what I’ve seen and how other people act is just repulsive. And it’s horrible. And I think that’s probably my biggest thing there.

Matthew Sullivan:

Number five, what sound or noise do you love?

Chris Pistorius:

Whenever we bring on a new client, there’s a little noise that my contact management software makes and I always love to hear that.

Matthew Sullivan:

Ka-ching!

Chris Pistorius:

Well, it’s not bad, but it’s similar. I can’t describe it.

Matthew Sullivan:

Question number six, what noise or sound do you hate?

Chris Pistorius:

These guys that have these little, my apologies if you are one of these people, but these people that have these little cars that they souped up, and it sounds like a weed eater, like the rrrng nngg! And it’s a car that’s going by, I’m like, “What’s going on there?” So I don’t like that.

Matthew Sullivan:

I used to do that when I was a kid. I used to drill holes in my exhaust pipe. But you graduate from that when you’re about 16 or something.

Chris Pistorius:

Right. But that makes more of a like a manly girl sound. These new things with these little street racers, they sound like weed eaters, they really do.

Matthew Sullivan:

You’ll like this, number seven. What is your favorite curse word?

Chris Pistorius:

Wow.

Matthew Sullivan:

You can plead the fifth if you like.

Chris Pistorius:

That’s a toughy, because I can go deep there.

Matthew Sullivan:

No one listens to this anyways, so we’re fine.

Chris Pistorius:

I’m going to go with the S word. I use that a lot, it seems like.

Matthew Sullivan:

It’s good. I mean, these good, multifunctional words. Number eight, what profession other than your own would you like to attempt?

Chris Pistorius:

I’d like to be a manager of a professional baseball team. I help coach my son’s little league team now, and I know that’s nowhere near, but I played baseball in high school in college. I think that’s what I’d like to try.

Matthew Sullivan:

That’s fantastic. Number nine, what profession would you not like to attempt?

Chris Pistorius:

Geez, anything that’s just like a daily grind, I think. Anything in Corporate America, I’m pretty anti that. But specifically, probably like a management type job.

Matthew Sullivan:

I can imagine that, just hell on earth.

Chris Pistorius:

I don’t think I can do it.

Matthew Sullivan:

Now talking of that, question 10, the final question. If heaven exists, what would you like to hear God say when you arrive at the pearly gates, cut.

Chris Pistorius:

Welcome in, would be good, I guess, take care.

Matthew Sullivan:

Here’s a star.

Chris Pistorius:

Versus the wrong exit, you got to go the other way, I think.

Matthew Sullivan:

That’s pretty. Well, Chris, thank you so much for being such a brilliant guest. Final question, how do people get hold of you? What’s the best way of contacting you and kickstart and learning more about how you can benefit their practices and their businesses generally?

Chris Pistorius:

The best way is just go to the website, kickstartdental.com. There’s several opportunities there to schedule what we call a strategy session, that’s our first stop. And actually it’ll be with me personally, I talk to every new client in the very first conversation. And we’ll go over, I have some questions and just see where it goes and see if we might be a good fit for what you’re trying to accomplish. So kickstartdental.com.

Matthew Sullivan:

Fantastic, good. Thanks once again, it’s been an absolute pleasure having you on and I look forward to following your progress and staying in touch.

Chris Pistorius:

Thanks so much for having me.