Jen (03:07.182)
Love it. Okay, we’re gonna dive right in because we’re no BS over here, right? What’s one thing dental practices are doing right now that you think is a complete waste of money?
Howard Farran (03:22.546)
Wow, that’s a really good question. I think it’s taking continued education to learn things that nobody’s asking you for. like if I go listen to Dorfman, who’s the world-class Hollywood movie star, full mouth and ears, I’ve observed in his office for days, love the guy. Does that really apply to Elway, Arizona? I’m not aware of any movie stars in Elway, Arizona.
If all your patients are asking for dentures and you’re referring them to, you know, a prosthodontist or denture world or whatever, whatever, and then you’re off learning full mouth equilibration at the pink institute when no one’s asked you for full mouth. I mean, like I’m in Phoenix and I practice in South Phoenix, know, guys up in North Scottsdale and Paradise Valley, they can do $50,000 rehabs on patients that just write a check and don’t blink. But if that’s not your clientele,
You know if everybody if people are coming into your office for a toothache dentistry starts with a toothache and when someone comes in with a toothache I mean that’s why I love dentistry I mean they come in there in pain they hurt they’re scared they’re cranky and you don’t look at this 60 year old man say he’s an asshole you say no that’s not a 60 year man he’s a six-year-old boy he’s scared he’s gonna get a shot he’s in pain I mean this isn’t how you act before you go into sonic drive-in.
and get a footlong chili cheese dog and tater tots and cherry limeade, or waiting in line to go into Disneyland. I mean, you’re going to a dentist and you got to be bigger than that. You got to have empathy, the caretaker. And if you can’t get them out of pain with a root canal, billet and crown, or you can extract the tooth and do bone grafting and implant, you’re not a doctor. If all you can do is bleaching, bonding veneers, and you refer at all endo and all that, but then you’re taking CE courses,
on movie star veneers and I say, okay, well, you went there for a week, you closed down your office, do 5,000 days, so you lost 25,000 revenue, you paid 5,000 for a course, blah, blah. How many veneer cases did you do last year? Well, I didn’t do any. That’s why I want to learn more about it. And it’s like, okay, well, you’re referring out five root canals a month at $1,000 each and your patients, they want to, I mean, can you imagine going to an emergency room?
Jen (05:33.592)
Yeah.
Howard Farran (05:44.149)
and an ambulance pulls you up there, you’re in a car wreck, you got a broken leg and Tria says, we don’t do legs. We refer you to the other emergency room on the, and it’s like, you’re in an emergency room, you suck it up, buttercup, you know, so quit wasting time solving problems you don’t have and your patients have problems and the only way you can see the future, like if you want to know, you know, the future.
You don’t need to be brilliant. You don’t need to be a genius. But for me to see around corners and to see years in advance, you close your eyes and you listen to your customers. I’ll give you an example. I was practicing for like four, three or four years. I’m 87, three or four years. And we always tracked getting to yes. And we had a little prescription back there before digital. And someone asked for something that we didn’t have, we’d fill out the deal.
Well, Jen Bogus called. She wanted to know if we’re open on Saturday. And I said, no, we’re not. She wanted nitrous oxide. We don’t have it. She wanted this. And then someone said, can you bleach my teeth? And I’m looking at the month-end report of getting DS, and I had to bleach the teeth. Now, that’s weird. It’s an anomaly. I’ve never seen it before. And next month, there was two. So it doubled it. It exploded. It grew 100%.
And then the next month, that was four, and that’s when I hung up the, you know, I looked at that report. I called Gordon Christian, and he was telling me about this, and I found that there was this new bleaching deal out of, think it was Gainesville, Arkansas, or somewhere in Arkansas. I forgot the actual name of it. It’s so long ago. And I called the rep, and turned out the rep lived in Awetugi. He actually lived two blocks from my house.
So he drove over to my house. He gave me a case. And I got into it. he told me he hadn’t started yet. I was the first case. I think it was Omni-Gel. Yeah, Omni-Gel. And he said I was the first case in Arizona. And he just started. But he came in the office. And he talked us all into bleaching our uppers with a tray but not our lowers. And then if someone said, what do you think about bleaching? We just smile. The uppers were all white. And the lowers were all normal.
Howard Farran (08:02.104)
And so it’s listening to your customers. know, customers want bleaching. Well, there’s an opportunity. Focus on that. Quit focusing on things because you think, well, I want to be a really good dentist and that means I should go to Panky or Spear or I should learn this or that or, you know, you’re in a small town and it’s the same thing where you set up. You know, if I fixed potholes for a living,
I’d have a hot truck asphalt. I’d drive down the street looking for potholes. Well, where are dentists needed? mean, I mean, many, many government agencies have online lists of government shortage areas for doctors, Medicaid providers, whatever. They’ve already done the work. I mean, there are entire counties that don’t have a dentist. Well, Sen, if you just go there, you don’t have to take any insurance. A lot of times in these small towns, I was talking to a guy in Iowa.
He called Delta Dental and he said you don’t even have a provider in this county there’s not even a dentist do you have any help for getting your first provider in this county in Iowa they gave him a hundred grand cash and then I told him I said go to the mayor don’t build a building I’ve been in a million downtown Kansas with population 500 to a thousand there’s empty buildings that have been boarded up for years go talk to the mayor they gave him a six thousand square foot brick building.
He got $100,000 from Delta. He had like $500,000 in student loans. First year, brought in a million dollars and netted $400,000 because he went where he was needed. So just listen to your customers and quit making it about you.
Jen (09:44.269)
Yes, no, everything you’re saying is making absolute sense, especially, you you brought up veneers and all this other stuff coming up, you know, becoming an expert in something that doesn’t make sense for your patient, you know, why are you doing that? I get the hype and everything, but everything you said exactly to a T spot on. Just care.
Howard Farran (10:07.476)
It’d be like having a Mercedes Benz dealership in Childress, Texas when everybody wants an F, an F truck, an F-150. And then when you get upper middle class, you get an F-250. And when you’re finally a baller, you’ll have an F-350. No one’s buying a Lamborghini. No one’s buying a Mercedes. I mean, this is Texas. know, when in Rome, do as the Romans do. And what do your patients need? That’s your opportunity.
Jen (10:14.222)
Right.
Jen (10:35.724)
Yes, no, exactly. That’s a perfect example. So what is the biggest lie dentists are being sold about marketing right now?
Howard Farran (10:48.882)
Well I hate to tell you the truth because you’re a dental marketing company and I feel guilty but I got it I got it I don’t lie to my homies I tell them I call my podcast Dentistry Uncensored because it’s not what everybody wants to hear but I said you’re like that too. First of all I think marketing is a drug. First of all if you get a hygienist can only work 40 hours a week 50 weeks a year max that’s 2,000 hours I mean she could see a thousand people
Jen (10:55.402)
That’s the truth.
Howard Farran (11:18.58)
twice a year for an hour cleaning recall exam right and if you’re getting 20 new patients a month you’d be adding a full-time hygienist every three and half years. If you’re getting 40 patients a month every two years you would have another full-time hygienist. So I go to a dentist and he’s 50 years old he’s had the same hygienist three days a week for 25 years and he gets 40 new patients a month from marketing.
It’s like, dude, they’re just, it’s like having a cup of coffee and just pouring coffee in it for 25 years and you don’t realize it’s all going on the side and on the floor. And then when I drive to Vegas from Phoenix, I see Hoover Dam where they didn’t let any water out on that Colorado River. And that lake, you can’t even swim across it. You can’t see across it. It goes on forever. So the first thing I want to do on marketing is when patients come in my office, you know,
they two years old is this the first time they’ve seen a dentist did they just move to Phoenix from New Jersey Jen you a new patient did you just move to Phoenix I know I lived here 10 years my god you haven’t been to the dentist in 10 years is that anxiety no I went to another okay okay great I need to know why did you not go back there what did you like the most about the last dentist yeah nitrous oxide what did you like the least well I had no evenings or Saturdays.
What would you never change in his office his assistant? I love this assistant, know just keep focused and you and if you can’t get the back door at least halfway shut then marketing is just a disease and this is why I think rural dentistry is better than urban because I can go into Phoenix and work with someone like you and get all the new patients I need for the rest of my life, but you never hit rock bottom. You never have to fix anything.
But my God, if you’re in Colwich, Kansas, and Mrs. Jones comes in and she says, I’m never coming back here. mean, blah, blah, blah, blah, blah. And you’re like, oh my God, this city’s only got 2000 people. And she hates me and she’s married. She has two kids and she has neighbors. That’s why I don’t turn anyone over to a collection agency. You really think I’m going to turn someone over to a collection agency that lives one mile from my office and I’m 24?
Howard Farran (13:32.649)
and I’m going to practice till I’m 64? I mean, it’s not happening. So what I do at Christmas, you know, it sucks, but I just get a stack of business cards. I zero out all their account statements, and I write, Dear Jen, the greatest, I’m so sorry you’re having a tough year. I see that you haven’t been able to make payments on your bill. And with the spirit of Christmas around, I’m zeroing out your bill. You don’t owe us a dime. All I ask in return is your continued love and support.
And the greatest gift a patient can give is a referral to their friend and loved one. I hope things get better. Sincerely, Howard. They’d come in crying. They’d make me an apple pie. And they’d tell me their husband lost a job and their world fell apart and their daughters got cancer and all this stuff like that. you know, so before marketing, you got to get your house in order. You got to get that back door shut. You got to quit being an asshole and you can get away. I mean,
The bigger the city, the bigger the assholes. Look at the biggest assholes you know in dentistry. They’re always in the biggest towns because you can be an asshole in New York City or LA or San Fran, but you can’t be an asshole in Eloy, Arizona because everyone will find out you’re an asshole. So I would get all of that fixed first, and then I would double down on marketing. And as far as marketing goes, what you mostly need to know about marketing is when I got out of school,
It was actually it was illegal in 1973. It was actually it was actually a case here in Arizona in Tucson where the state board of legal examiners told these two lawyers that they couldn’t have a yellow page ad. And of course, their lawyers, they took it all the way to the Supreme Court. The Supreme Court said it’s free speech. So when I got out in 87, no one hardly ever had a yellow page ad. I got a big page ad. It was a slot machine, things like that. People are coming in. But what I noticed is that, you know, half the dentists don’t even advertise.
yet I can send them a PPO plan so here’s all the dental procedures you do but we’re gonna pay you 40 % less and you’re like sign me up and you’re ready to sign you didn’t even rate you signed it and then I say hey hey you know a quarter of the people have no form of insurance Medicaid nothing and half of them got insurance but they don’t want to go back there dentist and why don’t you spend 1 % 2 % 3 % on marketing and here
Howard Farran (15:55.797)
You know, you got to remember I own Orthodontist too. I know these orthodontists. These orthodontists, know, 25 years ago, they were the first ones to hit 5%. Now, I routinely podcast interview orthodontists that are at 8 % because every new patient for them is a $6,500 case. Well, if I can get, if I can do $6,500 and I got 50 % overhead, so I’m going to net $3,000 off a case, I mean, I can spend a lot of money
getting a new face in my office and so all I would say is that and then they countered it the opposite of marketing. He’s like, I’ll ask a dentist, what’s your favorite procedure? And I’ll say crowns or Invisalign. I said, okay, well, it’s in the year. What do you do with your prices? And I said, well, I’m going to raise my crown $100. I’m going to raise Invisalign $200. I’m like, oh my god, I thought you said that’s your favorite procedure. Well, if you lower the price, you’ll do more.
You’re putting an economic, you know, the first price that I massively raised was a denture. I was charging like $4.25 an arch when I first got out. I hated dentures so bad. And they had Denture World up the street for me that do the full mouth for like $2.75. And I hated it. But I raised the fee to $1,000 an arch. And if you gave me $2,000, my attitude was clear. I got over a bad attitude. And I took it serious.
But I was only doing like one a month. But Denture World, all the dentists there are doing, you know, three or four or five starts a day in the labs and office. So I would raise prices on what you don’t want to do, and I would lower prices on what you want to do. And when you get your house in order, then I would start raising your marketing from zero to 1%, 2%, 3%. And like I say, when I see an office doing $5 million a year,
They’re spending 8 % on marketing. And it’s a cash cow. And that’s another big mistake that drives me crazy with dentists. They always think they want a second location. Okay, well, you got two chairs. Why don’t you just expand to four? Okay, you got four chairs. Why don’t you go to eight? I know dental offices that are 15 stories tall called hospital dentistry or dental hospital in Cambodia. I know practices in Bakersfield that, you know, do, I mean, just,
Howard Farran (18:21.256)
tens and tens of, you 20 million plus with 30 chairs. I know a pediatric dentist that has 30 chairs. there’s no reason. I mean, look at a hospital. You can’t even walk across the hospital in half an hour. They didn’t break into 15 locations. They just said, we’re the big hospital. We’re downtown. Here we are. So locations is absurd. you want two rents instead of one? You want to spend half your time in two places?
Jen (18:34.594)
Thanks.
Howard Farran (18:49.47)
Why don’t you spend all your time under one roof and just get her done? Locations isn’t the key to your success. It’s your patience going out the back door. You need to build a Hoover Dam. And if you build that Hoover Dam, your office could grow to 99 chairs and then your market could go up. So get your house in order and then get your mind in order and then market when and how is it not a return on investment if you’re marketing and keeping?
half of your patients five years. I mean, that’s just crazy successful.
Jen (19:21.774)
No, everything you’re saying and I love the Hoover Dam analogy We do get a lot of dental practice owners and doctors dentists You know getting on a firstly console call with us and they’re so nervous because they’ve been down the road with like shitty marketing agencies and all that stuff And we kind of talk about the analogy that you made like here’s a bucket But it has a bunch of holes in it and now we’re not gonna pour some more water into it. That doesn’t make sense, you
We reevaluate their front desk. We evaluate how they’re answering phones. We track their calls, making sure that their whole office has like effective communication. Before we go ahead and take that marketing bucket and dump it in there, you want to make sure your back door, all the holes are closed in that bucket. So everything you’re saying is making absolutely marketing. So I’m happy I asked that question to you.
Howard Farran (20:13.932)
And what great company have you ever called where you didn’t get a message, this call may be recorded for customer training or whatever, whatever, whatever, when a dentist tells me they don’t record their phone calls, it’s just like, and let me tell you how crazy that is because, you know, in business, I got an MBA from ASU. When you do case study, when you go to any business in America, like say that you are a machine shop and you make a side baler for Bails of Hay,
Jen (20:22.99)
Thanks.
Howard Farran (20:43.588)
a harvester tractor okay. The eight guys working the machine shop they’re all in overalls they bring a lunch pal and they’re all paid good but they’re not the highest wages. The highest wages is always goes to the owner so why would a dentist go to eight years of college to be somebody’s employee that makes no sense to me and number two whoever is answering the phones is a suit and tie the salesman the owner and the salesman are the only ones making six figures and you want and
Jen (20:53.87)
you
Howard Farran (21:12.852)
the dentist got eight years of college, assistant goes to dental assisting school, the hygienist goes to two to four years of school, some of them have their master’s degree, and the front office you just find somebody at the Waffle House and say hey you know the training’s just like yeah I answer the phone and when you do that your office is pretty much exactly about half because here’s you know if I had to explain this in an elevator
know you get three patients one of them is gonna do whatever you say because they do author searches and you’re a dentist so when I go to my my physician he says you know you’re at your age you should have a colonoscopy well he’s this is what he does I’m a dentist I’m at the other end of the body I’m not gonna say well I think it’s a scam or conspiracy you know it’s like when my dentist tells me I mean when my physician tells me something and I have a good officer so one in three are gonna do whatever you say because you’re a dentist and they’re not and they’re smart.
One out of three ain’t gonna do anything you write. They put out their cigarette on the way in. They had Oreos and Cheetos for breakfast. They’re great people. I love them. I just described half my family tree, okay? Love them. They’re not gonna do anything right. And furthermore, when I do that filling and the contact’s not quite perfect and I’m ready for my next patient and the dentist says, says, no, I want it perfect. It’s like, dude, look at the rest of his teeth. He’s got cigarettes. He hadn’t been in for five years. Quit.
Jen (22:20.75)
you
Howard Farran (22:38.092)
if you’re running behind because you’re treating his teeth better than he does and they’re his teeth they’re his they talk about skin in the game don’t ever run behind redoing something where you care ten times more about this than the patient and so they’re not gonna do anything and another one in three that’s the gold market that’s the ones that you need you need to close and so when they call up it’s the same thing when they call up
know you ask any receptionist what is your job description it better be my job is to put butts in the chair and every time they ask the question you try to close. says yeah are you open yes we are when would you like to come in are you would you like to come in like right now like what’s going on. Well I got a two-day my god where you at are you in Awetuckie or you downtown working where you at? Okay well you know where we’re at you know 48th and Elliott there’s a Chase Bank there’s a Pizza Hut there’s a Safeway at Walgreens.
We’re right there. yeah. Visually, I know where that is. Now, they don’t need a MapQuest because they live in Awachukwe. They know where that Safeway is. They know where the Pizza Hut is. They don’t need a MapQuest. And I’d say just come on down. Now, remember, a hospital has an emergency department. Well, they’re not scheduled with routine treatment. It’s an emergency room. If you don’t have an emergency room, which means no one’s ever scheduled to be in there, you get a walk-in, the front office is cross-trained, you’re cross-trained where you work.
You know, she can take you back and get a PA at my wing. And then if we don’t have any opening, it doesn’t matter. You just catch the fish. Like, I’ll go in there and I’ll look at that and I’ll say, well, oh my God, Jen, you got an infection that’s clearing your nerve. We either got to pull the tooth or do a root canal and a crown. Are you thinking about saving it or are you thinking about pulling it? And you talk about that and we talk about pulling it. I’ll do the FA. They can do the FA. I’ll come in numb. I can come back in, pull. If they need an hour and a half for a root canal, billet and crown,
Then you can sit there and lie through your teeth. I’m just kidding, but you can just there say well, you know what? I’d rather put you on antibiotics till about then you look at your next opening I need to put you on antibiotics till Thursday at 2 or whatever, know, whatever, you know, whatever you need to do But you catch the fish they know where you’re at. They’ve got an x-ray. They met you They’ve done the finance right there in process But these dental offices they call the front desk
Howard Farran (25:02.036)
and she can’t close because they say, you’ll call me and say, got it. I broke, I just broke my tooth. Can I come in? And she’s looking at her schedule. Okay, that’s an emergency. Well, and you just have to face it. Well, are you fine or is this an emergency? mean, does it matter when you come in? And if they say, well, hell yeah, it’s an emergency. I was eating Froot Loops and half my damn tooth fell out. I mean, if they say it’s an emergency, they don’t need to hear.
Jen talking about it, well, is your two cents and a hundred golds a wig? You have a niner. You take it out of your dollar. It does not look like an emergency to any endodontist. No, no. I don’t care what the endodontist says. Or you have an emergency. And if you have an emergency, I don’t need to look at a schedule. I have an emergency room. And you just come on down. And then you come on down. Then there’s entropy of random people that just no show. Or they cancel. Or, you know, they cancel their hygiene appointment.
30 minutes before well great that high just went to four years of school and I’ll tell you what here’s no trigger and I just I don’t hire hygienists they come out of high school and went straight to hygiene school I want them to be dental assistants first love it so much they go back to hygiene school same thing with MBAs I told the Dean I even went to the ASU Dean told him you take kids straight out of school with a four-year degree in business enroll them right through the MBA program and that’s criminal.
You need to send them out in the world, have them work three to five years and figure out their ass from second base, then let them come back and make it a night program. I got my MBA on Mondays and Wednesday nights from six to 10 year round for two years. You know, same thing with IGES because I’m banking on this emergency shows up that we might get a cancellation. And if we’re busy in the back, everyone up front can take a PA and a bike wing and get it all rolling.
And if we don’t have time, give them antibiotics, pain pills, you know, catch the fish, but get them out of there. And then when you tell me you don’t have room for another operatory, well, great, because last I checked, Superman worked out of a phone booth, so we’re going to turn your private office into a dental operatory. And I’ve never met one single rep from Bingo that couldn’t figure out how to get an operatory in Doc’s private office. I don’t care how small it is.
Howard Farran (27:21.044)
they’ll get it in there and if you’re truly overgrown you don’t need another location let’s get a plan to you know keep growing so when this lease expires pick up some land and building and used as better like get on a four-lane street look for some house that used to be on a four-lane straight convert that to a commercial or maybe it’s an old state farm building or whatever but get some land get a building and double your size go from four to eight but keep growing not in locations.
not in overhead, and then last but not least as far as the number one metric is you want to grow earnings. So if you did $1 last year and made a dime, well, you don’t need to do $2 next year. Do $1 and try to make 11 cents. And then next year, do $1 and try to, you know, try to do the same volume and raise your net. And if you just work on growing earnings, like, I would tell my staff, you know, here’s what I’d tell my staff. say,
I could sell this office today for a million bucks and buy a government 30-year bond at 5%. If I put it in the S &P 500, historically, it’ll give me 12%. So if I can’t make between 5 to 12 % net income without even showing up, then I’m just on a job program. I was born to create jobs for dental assistants and hygienists and receptionists and
do free dentistry like Medicare will say, we’ll sign up for Medicare and you know your break-even point and they say, we were so concerned about the poor, we want you, to lose half your money on every procedure. It’s like this is a community. The government can pay. The other people, they want this benefit for all the people. They can pay higher taxes. Quit giving all the billionaires tax breaks. I mean, this is all community. I’m not going to care more about the community than all the people, the voters, the government, you know.
and just try to grow earnings and know your numbers, know your breakeven point. Like I would start an office deal and say, Jen, I want you to that today’s dental, we need $5,000 just to pay the bills. So we’re going to hit the ground running and nobody’s got lunch on the books until we pay the bills. And because this is what happens in most offices, dentists are so entitled, they don’t even know they’re entitled. Just like most of the racist people I know,
Howard Farran (29:41.397)
they truly don’t believe they’re racist they don’t even know they’re racist and you have to spell it out to them they’re like oh I guess I can see your point and the bottom line is they’ll have a cancellation 11 everyone will stand around someone will call the front desk and say can I be seen today you have nothing opening the afternoon but you got lunch from 12 to 1 but that’s blocked for your little entitled lunch and everybody right now is in the break room and you haven’t even broke even. No lunches are earned.
and we break even first, and then we go, think of a fireman. They just can’t say, Jen, I know your house on fire, and you still got two cats and two dogs and three cats in there, but sorry, lady, it’s 12 o’clock. It’s lunchtime. And then they leave. Same thing in the ICU. Those doctors will be getting ready to leave their shift, and ambulance pulls up, and they’re in there for another four hours. I mean, you’re a doctor. You don’t sell wristwatches. You don’t sell bottled water.
don’t sell candy bars you’re a doctor and emergencies are going to be seen and then also what I did with the staff is I noticed if you’re if you had kids you got a very important life you got to pick people up you got to take them to sports whatever whatever but if you don’t have kids can you be reasonable enough that if you got to go long no kids you can go long at the end of the day and if you got kids you can you can skip a lunch not to mention the fact that call me a pig but
I can wolf down two tacos from Taco Bell or a tuna fish sandwich in what? Three minutes with one bottle of water? If you really need an hour to refuel, don’t ever do an Ironman because you got to refuel over an 18-hour course through two miles of swimming, a 180-mile bike ride, a marathon. You can, if you can refuel while you’re running the Arizona Marathon three years in a row with three other amazing dentists out here, Lewis Core, Brad Sandvik,
J. Resnick I mean you really need an hour and plus I don’t even like lunch you know why my body is such that if I go sit down and have a big meal I come back to work and I got a sleepy wave and then I’m back there looking for caffeine or coffee or diet coke or something to keep me up it’s like I’d rather jam all through lunch then and refuel I mean you can numb up the dude say I need to let this soak in 10 minutes and go back there in 10 minutes if you can’t eat dinner in 10 minutes or something wrong with you.
Jen (32:10.158)
No, you’re so funny, but it’s so true. You know, at the end of the day, you know, you are a doctor. You’re not working at the the wash shop where you could put things off, you know, know your position. But you’re so right. You know, I want to say over 50 % of our episodes are on just the front desk alone because that is your barrier to getting, you know, butts in the chair, as you said.
So catching the fish and then even like those cancellations knowing how to follow up know the communication know the system To get you know, those butts in the chairs. You are so right. So where do you think AI actually helps practices and where does it fall short now?
Howard Farran (32:53.47)
Well first all I want to go back to one thing you said last time where you have to record the phone calls because you can’t come in and coach if you don’t know what they’re saying and then plus I had all this long-term staff I couldn’t believe what they were saying on the phone like someone to call up and say do you do Invisalign and they say no we don’t. I said what the hell are you talking about you said Dr. Fran you said we don’t do Invisalign you do this other brand and I didn’t know the name of it because blah blah blah it’s like
Okay, well, they just mean it generically or yeah, we do clear aligners, but she just needed an answer instead of no to Invisalign. Yes, we do clear aligners. She didn’t say yes, we do, but that’s things they would say because everybody needs training. Everybody can be a better version of self. So you start doing that. So when three people call your office at a one button chair, now you got two. You just doubled your opportunities in the chair. And then when you present the treatment,
One’s always going to say yes, one’s always going to say no. And you learn case presentation, you can easily get that other one out of three. Now you just doubled your practice. Same staff, same building, same marketing, everything’s the same. And you’re no longer a practice doing 750,000 a year at 68 % overhead. Now you’re doing a million five and you’re at 54 % overhead. So you want to do that. And then your question, just remind me what it was real quick about the.
Jen (34:18.764)
No, you’re so true there with recording all your calls and everything and saying the right answer to get, you know, the the chair, as you said. Where do you think AI actually
Howard Farran (34:30.166)
yeah AI so I’m an old dog I’m not only old enough to be your dad probably your grandpa how old’s your grandpa?
Jen (34:38.542)
He would probably be 80s.
Howard Farran (34:41.332)
Oh good good yeah I feel good on okay so I’m your dad. I’ve been through this whole thing you know the internet you know it was going for decades they talked about AI freshman year of college at Creighton they were saying that IBM artificial intelligence and all this stuff they said it’d be around the corner it wasn’t. I remember when I graduated in dental school they said that all laboratories would be extinct by CAD CAM which started in Paris France and it came to the United States
Jen (34:44.302)
you
Howard Farran (35:10.804)
and in two or three years, all the labs will be CAD-CAM. Hell, 40 years later, I think CAD-CAM’s got like 15 % of the market. You know what mean? mean, 15. So everything takes a lot longer, but in AI, you got to remember, when the internet really became consumer-friendly, woke, when everybody woke up to the internet AOL from 94 to 2,000, the four big stocks were Intel making the chips. Today, it’s Nvidia.
It was Microsoft and the software. It was Oracle or Cisco for all the routers and stuff and Dell for the laptops. And right now, you could buy Intel for $90 billion. I mean, it just fell from grace because Intel wasn’t the internet. Intel was what the internet would be built on and then companies like Facebook and YouTube and Amazon would come way later and at 2000 when the internet bubble popped,
and Amazon dropped 95%, Facebook wouldn’t be around for four years. mean, everything that you use the internet for today still wasn’t even alive in 2000. So now, it’s hilarious. I’m just seeing the same thing over. We’re in the first inning of this. The price of the stocks are a bubble just like Y2K, the 94 to 2000, and the bubble, of course, is going to pop. It’s a rash. mean, some of those companies,
if they converted all their customers to subscription and got all the advertising that Meta currently gets, they’re still losing money. If they got 100 % subscribers and all the advertising in Meta, they’re still losing money. Of course, the math doesn’t add up, but that has nothing to do with AI. Just like when that Y2K crash, the internet was just getting going. It was probably in its second or third inning.
And then all these things come out on the internet that you weren’t even thinking about when the market crashed. So when you, when people tell me that Nvidia is the best AI play and it’s the most expensive company, I just giggle. And it’s like, because you ain’t seen AI yet. I mean, it’s a coming. And a lot of people, know, they’re all, shooting arrows at it. Well, don’t do this. Don’t do that. Hey, when Amazon came out, they can only sell books because the pipes are so small.
Howard Farran (37:33.205)
They couldn’t send an image to the internet and get it to you in under a five-minute download. So they just sold things they could sell. But as the pipes got bigger and they could add an image, they started going into shoes and clothes and things. And then it got so big, it got to streaming video. And by the way, you know why it got so big for streaming video work? Because when the internet came out, everybody knew that fiber optic was faster. So all these companies laid down like 50,000 miles of fiber optic and all that, and there was no demand for it.
and every one of them went bankrupt. I remember them all. And then they laid their dormant, but the fiber optic cable’s on the ground. So then when the new technology, MP3 streaming video caught up, you had the pipes. So you could have Spotify and you could download videos because the pipes are, so what I’m trying to make the point is the stock putting in the internet, you lost all your money. The stock, Intel, you lost
2000 it completely crashed and it never regained its hiatus. Same thing most likely will happen to the chipmakers because it’s not about the chipmakers about the companies and you haven’t seen them. Now where I think where it’s at I I think it’ll be bigger for dentistry than digital imaging was. I think access to information now
I think right now it currently does best in quantitative fields like math and geometry and PubMed and all that. It’s perfect. But you calling up the front and talking to a robot? Are you out of your flipping mind? mean, right now, three calls, they only convert one in the chair. So you want to offload that to Obi-Wan Kenobi? Are you shitting me? No.
I mean, I should have said Obi-Wan Kenobi. What was the little droid? R2-D2? Yeah, yeah, that guy. mean, yeah, humans are the most complex thing in the known universe. mean, rabbits, squirrels, donkeys, were so much… the dumbest first you know is 100 times smarter than a squirrel. A rabbit, a donkey, a horse, a dog, a cat. But my God, they’re so complex.
Jen (39:28.513)
detail.
Howard Farran (39:50.133)
They can think anything. They can believe anything. You don’t know their point of view. You don’t know where they’re from. You don’t know anything about them. And I would want a human intelligence taking that phone call. I would want it recorded. I would want a recording coach. Again, and all the business, your salesperson is $100,000 a year, wears a tie, has a briefcase, and that’s you offload to the receptionist at the bank where you said to her one day, know what? You’re the best receptionist.
How much you make an hour here? And she says, $14. You say, I’ll give you $18 if you switch out of my, you know, and then no training comes with that. I mean, you know, I would rather have an A on everybody answering the phone, an A on everybody presenting treatment, and I’ll take Cs on all the dentists and hygienists and doing the thing because if I know you’re getting A on the people, you’re going to get them back in. So if you did overhanging that filling, you’re going to find it in the next cleaning.
You did something wrong. You have time to fix it. mean, you got to get the people skills right. And the same thing with presenting treatment. You know, basically, in all my years, there’s only about six objections I have. Is it going to hurt? Does the insurance pay? How much is it? When can you do it? What is it going to look funny? And when you’re talking to them, you make eye contact and you make yourself smaller. You don’t you don’t walk up there,
and make yourself big like a blowfish. I’m the doctor. You’re not genuine. And when you do that, know, you leave them in the chair, you raise up their chair, they’re lower than you. They’re looking down at you like a monkey looking down out of a tree. They feel safe. And then you let your assistants and hygienists diagnose and treatment plan everything in the patient’s mind.
I know the buck stops to me, I make it legal, but we’re not talking about law, we’re talking about explaining to Jen the options. Like I’ll go in there and I’ll ask the hijos, how’s everything looking? She goes, well, I know number three is gonna have to need extracted. I don’t know if you can save the root canal. I told her you might be able to save it, but no, not, because I’m looking at the X right here and it looks like the decay. You always say if the decay goes to the bone, you know, gotta pull it. And I don’t think, and you know, but.
Howard Farran (42:07.764)
When you sit there and say that you know you’re a controlling freak and you can’t let her read an x-ray, I mean it’s a dot on an x-ray. Right now, Pearl AI can read the damn x-ray but your assistant and your hygienist and your receptionist can’t. I’m sorry doctor, do you have issues? Maybe you need to see a therapist. Maybe something went wrong in your childhood. I don’t know what it is but it doesn’t benefit the patient.
When flipping AI Pearl and Overjet can read an X-ray and your hygienist can’t, you’re messed up in the head. And plus, the hygienist is in there for an hour. And plus, they think the owner is the one making all the big bucks and has an ice car and lives on a house on a hill. I had this big old mansion on a hill overlooking the golf course, first house next to the clubhouse, and I’d always get patients saying, yeah, I golfing at the foothills, and my buddy said that.
That big old man step on the hill. That was your house. Is that really your house? Dr. Fran? Am I making a mortgage on your house this month? And I go, buddy, there’s no mortgage on that house. That was paid off years ago because no one flosses their teeth in Phoenix, Arizona. And you’re one of nobody ever who can own the crown. And I told you, had a small cavity there in 2018.
It’s 2026. Now, I don’t know if you know geometry or calculus or trig, but, you know, this could have been $150 filling a decade and a half ago, but now that $150 filling is $250, and you’re going to need a root canal billet and crown, or we can extract it. You know, it’s whatever you want to do. But I’ll tell you what, if you want to lower your dental bills, you should see the hygienist every six months. She’s a lot better looking. She’s nicer. She’s general. She’s just better A to Z.
but you don’t want to go see her so you get to see me and I’m gonna give you a shot and drill on your tooth and you tell me you have anxiety and you tell me you’re afraid of the dentist so that if you’re afraid of the dentist then your best friend’s a hygienist she can put fluoride treatments in fact you got a small cavity she’s we got this stuff now called silver diamine fluoride it’s like rat poison for decay you can just put that in there I mean trust me if you’re afraid of me.
Jen (44:01.741)
Yeah.
Howard Farran (44:23.432)
get married to the hygienist, know, seer, whatever she says, and I don’t care if you’re in, I don’t care what your insurance says, you know, she’s one C every three months, you say the insurance one C every six months. So what if you want a vasectomy and your insurance only pays for castration? You want to cut your balls off because that’s what the insurance says? The insurance, they’ll cut your balls off all day long. cheaper than vasectomy, but I think you want to keep your teeth and your balls. So I recommend paying for cash for vasectomy.
and those two extra three month cleanings. Otherwise, you’re going to be the 10 % of Americans who have zero, zero teeth at 65.
Jen (45:01.57)
Yeah, yeah, no,
Howard Farran (45:02.804)
And if 10 % have zero, 50 % are missing multiple T’s.
Jen (45:10.038)
Yeah, no, that’s also true. know, everything you were saying and you know, just, know, at Kickstart, we’re talking about AI all the time and everything. And it’s really something that we’ve seen in healthcare where it gets weird. Of course, when you order your pizza, it’s not that personal, like, just give me my pizza. It’s not that deep. But in healthcare, when you’re implementing AI, that is a very, very fine line. And especially from
patient experience, let alone in the office like you were saying a hygienist reading something opposed to Pearl the AI reading it.
Howard Farran (45:47.061)
So what do you think will affect the patient most? You you’re getting your teeth cleaned, the hygienist says to you, she’s whispering in your ear, you know, I just looked at your x-rays, you have three cavities and I noticed you’re right-handed and they’re all in between the teeth on the left side. So we call those flossing cavities because, you know, cavities never happen where the toothbrush goes because cavities can’t live in oxygen. So there’s no air in between your teeth. So all that floss does, it’s carrying out the food in black, yeah.
But more importantly, it’s carrying down oxygen and the oxygen immediately annihilates all the anaerobic bacteria. In fact, what you should have is spaces between your teeth because whenever you have space in between all your teeth, you don’t have any interproximal cavities in between your teeth. But everybody is sent to the orthodontist and the orthodontist says, well, you’re not going to grow any cavities with all them spaces. Let me close them all up so you can soak them in Dr. Pepper and grow cavities. And so she says,
So she believes that now. She doesn’t floss. So she’s linking to her behavior. They’re in between the teeth. They’re flossy cavities. I don’t floss. Sorry. I trust you because I see you every six months. So when you tell me that you want to buy Pearl or Overjet because AI can help not only does it diagnose the cavities, it helps sells it to the patient. I’m sorry. I’m sorry. The trust between my patient and the assistant, my trust between my patient and the hygienist,
