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Howard F:
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It is beyond a huge honor to me to be podcasting, actually my first business of dentistry were role model-idol is all the way back in 1987, Greg Stanley of Whitehall Management. Do you remember, Robert Sundberg, Bob Sundberg?
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Greg S:
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Yes.
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Howard F:
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Let me tell you a story about Bob. I was on 48th Street in South Phoenix. He was two miles up the street. If I tried to pull a tooth and I could not get it out, I had an oral surgeon up the street. But if it's after 5, only me and Bob Sundberg were staying up until 7. About every month or two, I had to put a patient in a car, and drive to Bob's office and he would pull it out in one second, show me what I was doing wrong. Every time I ever talked to him he said, "Have you seen Greg Stanley yet?" He had his forms.
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It was broken up into five areas. It was first make payments and that he goes stopped taking on new debt. First was credit card debt. Second was longer-term debt. Three was I think longer-term debt. Four was savings. He had the formula where if he bought tax-free bonds, risk free, tax-free bonds that yield 5%, he kept telling me, "Every time you give a dollar to the government, for eternity they will give you a nickel a month. If you stop adding debt, get debt free, find out how many nickels you need a month to live off of and then you need a dollar for each one of those nickels and your retired. "Finally, he talked me into it and I went to that course and it was a revolution. You were the funniest guy. Thank you so much for that. It was just awesome. He started doing this in 1980, wow. 2020 you will be your 40th year anniversary of doing this.
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Greg S:
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It's scary to even say that, but yes.
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Howard F:
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How many dentists have you worked with in those 38 years?
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Greg S:
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At one time we calculated we had talked to personally 19% of the industry.
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Howard F:
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So, one in five dentists. Let me read your bio in case of there's somebody in Kathmandu that has never heard of you. Greg Stanley is president and founder of Whitehall Management. The website is WhitehallMgt.com and that was named after the Whitehall of London. Greg Stanley graduated from Arizona State University with a bachelor's degree in accounting in 1975. Since that time, Greg has spoken to over 50,000 health care professionals on the topics of practice, management and finance.
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In addition to producing over 200 monthly auto recordings, Greg has created 17 full length audio education programs on topics ranging from practice, overhead and control to teambuilding and marketing. Greg Stanley has been the key seminar presenter for Whitehall Management for the past 34 years and has spoken regularly in Canada, Australia and various European countries. In 2004 DentalTown.com voted Whitehall Management the best practice manager of the year from over 2200 write-in votes. The man has six kids, nine grandchildren. You are just an idol.
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Greg S:
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Howard, it's actually seven kids. One would be offended if they ever listened to this.
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Howard F:
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I actually remember that. I grew up with seven kids in the family. Actually I grew up with five sisters. My brother was not born until I was 18, so he was more like a first cousin. Greg, tell me this. You started in 1982 to 2016. That's 36 years. So many of the young kids say that when guys like me got out of school, it was the golden years and now it's not gold anymore. Do you think dentistry's best days were back in the 80s? Were those the Golden years of dentistry?
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Greg S:
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When I started, it was actually a bad time when I started. You came in later. It was a bad time.
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Howard F:
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In 1980 it was bad?
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Greg S:
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Yes, we would get calls from doctors, they got our mailer and they said, "What could you possibly say for $500 that would be worth my spending that money or taking that time? What could you say?" In other words, they were struggling. They were having it tough. Then we did come into some really good times. Insurance became a big deal. We have gone through different eras. To me, if you want to see a change in dentistry, 2008. It wiped some people out, especially high end guys.
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Howard F:
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Within 5 miles of this office. How many dentists do you think in the Phoenix metro lost …?
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Greg S:
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I know it doesn't sound like many, but I bet 100 of them became associates. High end dentists became associates somewhere and glad to have the work. But it did come back. In other words, it has gone through some upheavals. We have a time right now that's different and the people coming out of school have different ambitions. Somebody told me at a meeting some research was announced that more than half do not want their own practices. In other words, these are a new group with a different set of values or goals.
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Dentistry goes through all these changes. We are seeing as we have before, rising corporate dentistry. It comes and goes. I would say right now is a pretty good time. There was a time in dentistry we did not have enough dentists. I saw we searched done that showed 2% of the population is ready to go to their dentist in a month. A certain number of dentists is 2%. More dentists, it's the same 2% and you know what I'm saying. In other words, we are starting to feel the effects of competition and that's new. That's probably in the last five years, Howard. This is just our take on things.
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Howard F:
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I got to Phoenix in 1987, no fluoridated water in Phoenix and zero dental schools in Phoenix and our neighboring states of New Mexico, Utah and Nevada. Now Phoenix has two dental schools and fluoridated water, so does Las Vegas, so does Utah. These schools are pouring out 100 a month in one city and pretty much they all want to stay in Phoenix because that's where the Arizona Cardinals are.
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Greg S:
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You have seen it in your area. That's a change I have seen. I'm seeing right now, feeling the effects of competition. Another thing is so many doctors we talked to, 25-30 years in practice, they step back and have to look at what's happening to their lives, their practice. They are working harder in a lot of cases for a shrinking patient base. In other words, they are peddling harder and actually seeing the practice shrink. Going on old-school thinking, they won't discount. They won't be in insurance plans, those guys that literally are the Brontosauruses of our time. Then there is ending.
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Howard F:
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If a dentist is listening and says, "You know what? I am sick of all this insurance crap. I am just going to drop all my insurance and be a cash practice there." What would you tell that guy?
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Greg S:
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Well, if his thinking is, "I am sick of discounts," I would probably tell him to start looking for a job. I would talk to him about membership, having a membership program at his practice. About 40% of our patients at our offices are membership-based. They don't have to have insurance, but they had membership, but it is still a discount. 2008, for example, was so bad a third of the world's wealth disappeared in 30 days as the real estate bubble collapsed.
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Howard F:
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For just the United States or the planet?
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Greg S:
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No, the planet.
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Howard F:
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The planet lost a third of its wealth?
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Greg S:
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A third of its wealth disappeared in 30 days. We are still not …
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Howard F:
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That's not as bad as a divorce. That's half.
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Greg S:
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That's two divorces. That changed things. To give you an example, major department stores had incredible struggle, but out let's work growing like crazy. In other words, people became discount-oriented. I had heard complaints my whole life about the patients coming in saying, "All I want is what my insurance will pay for." After 2008, it seemed 90% of the people had that mentality. It was very difficult. Those are some changes going on.
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To give you an idea, too, of some old-school thinking, I had an orthodontist for the last five years his practice had shrunk 10% every year and with tears in his eyes he told me, "I am really good. I am worth it," but his practice kept going … In other words, it based that old thinking of if you do this incredible quality, you win the marketplace. Today you have to deliver value, which is quality and an attractive price. It's both. It's the day of value. If we see a real estate bubble take off or overnight everybody sees their house go up a couple hundred thousand dollars and it keeps going up, you will see people spend you could save foolishly or they are just not as bargain oriented, but right now, the bargain is king.
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It's a funny thing, Howard, because when I met you, you were way ahead on this. Man, if you have a big case, you would be willing to discount to get it done, "Sit down, let's get this done." Having had you said it, I felt emboldened to go to tell other people. They handed it to right back to me. It was not until 2008, the ones that got this idea survived and the rest struggled so some changes.
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Howard F:
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I came out of school in 1987 with $87,000 in student loans. My dad never gave me a penny. He said if he paid for my college, I would go up there and do drugs and chase women, but if I paid for it myself, I would be whatever. $87,000 in 1987 that's still a chunk of change in 2016.
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Greg S:
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Somebody told me it's $300,000 to get through dental school now. Is that true?
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Howard F:
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Oh yes, absolutely. What do you tell these kids in these two dental schools in our town? They are going to walk out of school with about $350,000 and if they are going to be 25 years old.
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Greg S:
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I will tell you the truth. The straight truth is it's still an amazingly profitable profession filled with opportunity, but it's unforgiving. In other words, there is a path that leads to opportunity. One wrong step and you probably are not going to do well.
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Howard F:
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Layout those steps, buddy.
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Greg S:
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Well, a good question. I'll tell you how we look at it. Rule number one and this will triumph in time. Make a practice that you would want to be a patient in. That's my number one rule. Everything I am going to say from this point on, you would want to listen and say, "Did he just contradict himself?" Make a practice you would want to be a patient in.
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For example, I have people doing just the opposite. I have people who get people in the chair, numb them up, open up a tooth and say, "Oh, we are going to have inter-proximal issues here, so we are going to do two teeth." You had them numb, partially treated. In other words, you would not want that done to you.
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The other side to that, you have guys that say, "There's always a danger of inter-proximal involvement, so let's plan on two teeth." Then they come out at the end and there's only one. You see what I am getting at? How would you want to be treated? Would you want to be left in the hygiene chair waiting 45 minutes for the dentist to come in and give you an exam? Do you want to be told it's two teeth? It turns out you treated three. You want to do a crown on me. I find out later, it would easily have been a feeling. You see what I am getting at? In other words, a practice you would want to be a patient.
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One of the things that happens, of course, the great thing is patients gravitate to integrity, but number two: staff have such pride in working for an office that treat people well. We are looking to recruit staff to create the ideal patient experience, which is just like … A staff person, imagine your mother was coming in here. How would you want her treated? If she can only afford one tooth, would you want us to pound the living dog out of her to buy five? That's number one rule. I sent that out first because a lot of people think it's all about what's the new trick? We are going to sell everybody Arestin or your hammer and everything is perio. No, you make a practice you would want to be a patient in. That you would want your friends and families to be a patient. That's number one.
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Number two: if you want this to be a fun, interesting, predictable business without a lot of negative drama because think of how many people tell you, Howard, my gosh, the strain of making payroll and staff always wanting more money, my rent goes up. You have all that drama. In the end, if you have enough what I call non-toxic hygiene, if you have enough, your life is a dream. 70% of all restorative dentistry is found in a regular hygiene visit.
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If you have a hygienist back there alienating the patients, we call that toxic hygiene, where you are trying to build a practice with marketing and consumerism. She is in the back room running patients off in droves, trying to sell them, hard sell them, spinning tooth brushes. She is selling them stuff because she is on commission and not all hygienists do that, of course, but we run into it often enough, it is definitely worth mentioning. Get a hygiene department that is trying to grow. Howard, are you a scuba diver? Have you ever been trained?
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Howard F:
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Yes, in fact I took Ryan. Do you remember that trip? Cosmo took all four of my boys, Cosmo.
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Greg S:
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Too bad we can't flash the camera on Ryan, but you guys will all remember what you got trained to create neutral buoyancy. When I did not know how to use a buoyancy control, I would shoot out of the water like an orca or I would bounce off the bottom at 160 feet. You have to learn how to hit this buoyancy. When we look at hygiene, where's the buoyancy? Is hygiene trying to grow or is it actually sinking? Or is it neutral and if it's been neutral, how long has it been that way? If it has been that way for nine years, is that a good thing or bad? Probably bad. If we see hygiene trying to grow, our job in the coaching business of filling the practice with restorative dentistry, it's a dream job. There's tons of hygiene. All we have to do is harvest it. If hygiene is being abused, it's tough. You just commented on my Donald Trump Doll.
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Howard F:
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Ryan, can you have that down? Actually, go ahead.
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Greg S:
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It's a good story.
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Howard F:
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Let's get it down. I think that's funny. I just saw that on there, Donald Trump.
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Greg S:
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Yes, he is a political figure now, but he was just a television … What do you call it? A reality TV guy. A hygienist sent this to me. If you touch a certain place, it says you are fired. We had a hygienist that was getting so many complaints from patients about how they were being treated and handled and so forth. We had to let her go. Boy, we don't take that lightly, removing a hygienist from practice. We usually have the bomb squad come to it. We had to let her go and she sent to me this doll, just her way of saying, "Hey, don't forget what you have done to me."
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That was a case where the doctor was spending all this money on marketing. He was probably spending 7% of his gross and he is just constantly schooling and his staff on how to inspire referrals. Yet in the back room, patients were being traumatized. You see what I am getting at? Man, the reason it's so tough, it's the last place doctors want to go because they get confused in their thinking. This hygienist is actually making money for the practice. Nobody in here but me is making money but her. She has a relationship with the patients. I don't want to traumatize her. She quits, maybe patients will follow her, which we have proven by the way, they don't by the way, just off the record. It's not a place a doctor likes to go.
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In fact, when we are working with somebody, it's not the first thing we do. We put it down the list to clean up hygiene, so that it's a great experience for patients. We have to get everybody else on board, then we will take a hard look at hygiene. Is it positive buoyancy? Is it negative? You have to ask yourself, "How long has it been since you added a day of hygiene?"
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Howard, you spent your career working with dentists, 28 years in practice with three days of hygiene. If you ask them why that had not grown, so often they will say, "I had not even thought about it." When the hygiene is positive, where it's trying to expand, a lot of guys say, "Well, should I build on three more ops or I can't do that here, so I will need a new building." They are looking at $1.8 million to add three more operatories. Our rule is you want enough hygiene to keep the restorative section full. After that, that's all you can do. Hygiene is secret number two. Make hygiene great and doctors who cannot sell …
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I always thought of you as being really good on the spot negotiator with the patients. Very quick to show them what they need and give them what they want. A lot of guys got into dentistry because they hate to sell. They don't want to sell anything. They find in dentistry, if they don't sell something, they cannot make payroll. Trust me, if you don't want to get in the sales business, fill up hygiene and everything takes care of itself. In the military, they talk about strategy, strategic bombing, divide a force and conquer. In dentistry, the strategy is to fill up hygiene and all the boats float. That's our experience. That's rule number two. Now you are thinking there is a third rule.
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Howard F:
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Yes, is there a third rule?
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Greg S:
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It would probably be to fill up hygiene.
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Howard F:
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What would be the magic formula? Should one dentist have one hygienist, two hygienists, three hygienists? Is there a business model?
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Greg S:
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Some states allow you to have three, some it's two. As you know, you can run ragged enough that you don't have time to do any dentistry. Our best guys, the dental athletes, they can check two hygienists and still do their dentistry. They are fast. They cut a crown prep in under ten minutes and they are not ashamed of that. They do good work. If they can check two hygienists, so that's usually where you draw the line.
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Howard F:
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You can cut your hygiene checks in half if you after you have done a new patient and they haven't done the work, you only need to examine them once a year anyway.
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Greg S:
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It depends on the state.
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Howard F:
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Oh, does it?
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Greg S:
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There are states if they come in for three month recall, you have to see them every time.
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Howard F:
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I have always thought that all laws were just suggestions? I am serious. I have never followed any of them to the letter of the law.
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Greg S:
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To tell you how crazy they are, there are states where if there is a dentist or a periodontist within 100 yards, the dentist does not have to be in the office to check the hygiene. He can be at home fishing and you can still do hygiene.
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Howard F:
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But he has to be 100 yards away?
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Greg S:
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No, another dentist has to be within a certain space.
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Howard F:
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So if you were in a medical-dental building and there's a guy practicing next door and you didn't know what, but if he is within 100 yards …
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Greg S:
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100 yards away, yes.
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Howard F:
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Really? Arizona is talking about just passed expanded function. The next step is to get somebody at a dental school to actually teach them to serve on, but we have passed that. That was almost why I did not come back to Phoenix and stayed home in Wichita, Kansas, because Kansas had expanded function duty.
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Greg S:
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I think you don't even have to be a hygienist to clean children's teeth in Kansas, do you or do you remember?
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Howard F:
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Yes, I think they could do super-gingerfull. The buzz, the marketing that the big companies, Sirona just merged with Dentsfly. You have these mega companies that were not there so much when I got out of school. All the kids walking in a school are $350,000 in debt and they believe if they want to be a rockstar, they are going to have to buy a $150,000 shag machine, a $100,000 3-D x-ray machine, a $75,000 laser machine. What do you say to that? When you look at 30 years of successful dentists, are they the ones with all the shiny toys or are they placing implants? Are they clinical gods or are they just restorative dentists?
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Greg S:
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There is actually a lot of schools of thought winning. We had a group in the Southwest doing all big cosmetic cases, huge cases calming spending $1 million a year in marketing. They would have a month with no paycheck, but at the end of the year, they were doing pretty darn good. That's an approach.
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I have a guy in South Carolina who does nothing but pull teeth and he makes more than the top paid cosmetic guys in the country. He has six chairs. He has his technique down. You can laugh at that and say, "I would never want to do that," but if you were living and practicing where he is, that's dentistry, man. Everybody wants an extraction and he will talk to them about a restoration, but in the end he will give them extraction and he is making more per hour … He is doing it in a place so economically depressed, you would not think it is humanly possible. He is giving people what they ask for. There is a lot of models for success.
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Strange thing is we talked about implant placement because we are talking to people all day about that. The thing that surprised me, you remember when they failed, half of them failed back in the old days? Then they were not failing, but let's face it. Even though you got sold on going to the meetings and learning to do with, people were not beating you are door down to come get them. Now we are seeing that. In other words, the bridge is just about done. We are on the real wave of acceptance of implants. So many guys they got a buddy, and they grew up together, went through school together. He became a periodontist or an oral surgeon and he is placing them at the dentist is restoring them. The dentist is not getting the best end of that, yes, he should go to learn or she should go learn to actually place them.
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Howard F:
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What about same-day crowns with cadcam? That's a $150,000 machine that Sarah has.
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Greg S:
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Same-day crowns, Oh, you mean grinding it? Yes, milling it, excuse me. I don't want to alienate any of your listeners or the supply companies that buys space in your magazine, but we have found they have their place. Up to 100 to maybe 125 new patients a month, which is far more than most dentists are going to do. It's fine. But when we get practices at 700 do patients a month, they will buy …
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Howard F:
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700?
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Greg S:
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Yes, they will buy three or four milling machines and still struggle to keep up. We are listening. By the way, I am sure you can talk for hours on how the technology has improved, but I'm just telling it from the heart. It has its place. It mega practices, we have not seen it work in yet, but in your normal practice it's fine.
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Howard F:
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In a mega practice, you have not seen it work?
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Greg S:
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Not yet, but I am sure that something will come along. The digital impression sent to a lab somewhere and they have 50 milling machines. It has its place. We are big supporters, but the truth is after a certain volume, it becomes a challenge, special challenge.
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Howard F:
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What would you say to someone who says they think their problem is they don't get enough new patients?
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Greg S:
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That's a good question. It's a bad problem. Yes, when it comes to new patients, if you are not getting enough new patients, you have to stop and look at things. Remember the Star Wars movie, where the Jedi tells us this kid to go home and rethink his life? When you don't have enough new patients, genuinely that's the problem, you have a couple of problems. If people are not impressed enough with what you are doing … I know your dentistry might be so good it brings tears to the eyes of Bill Dickinson, maybe, you have great chemistry, but yet your prices may not be in line with your neighborhood or something. Anyway, your offering is not meeting the market, so people are not referring.
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At the same time, we find a practice where people will not refer, statistically they will not stay either. You see what I am getting at? You have two problems. That means we cannot fix that problem by buying use some marketing patients because if we send … Marketing patients are less committed than referral patients. They are less likely to buy or refer. If we have gotten by you can marketing patients, you've just spent $2000-$3000, $200-$300 a call, to put them in a practice where they are not going to be happy because their marketing people, only half of them are going to buy dentistry and the other half are going to buy less than you are used to selling and they are not going to refer because your service is not inspiring. I would say it's say do-over. You have to rethink your life.
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I heard the term first used in dentistry "consumerism" was from you. You were talking about it and it probably did not like people up, but you were hot on it and you were ahead of your time. It's funny because sometimes dentist don't know whether they are part of the medical profession or something else? In medicine, you can abuse people. You can slap them. You can make them take ten tests that probably threaten their very lives and they will come back. They have to do it add their insurance pays for it. They don't have to deliver consumerism and they don't. Dentistry, we have to constantly think of new ways to make this comfortable, affordable, last longer. You were ahead of your time. I would officially on video like to acknowledge that we beat that drum pretty hard. You started it.
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Howard F:
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Thanks buddy. You were talking about extreme referrals. I thought that was very interesting. Tell them what …?
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Greg S:
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Good question, yes. A lot of people think the secret is to get referrals. You get people to refer. Actually, that does not do you much good. Somebody sees one of your patients and says, "Hey, you just went to the dentist. How was it?" "It was pretty good." In other words, you want people to stop and say, "If you have a minute, I will tell you about …" and they grab that person by the lapels and say, "You have to go to my dentist. It was incredible. They told me I needed two crowns. It turned out it was only one. They were affordable. They gave me drugs. It was like college. These beautiful assistants were fluttering around and fussing over me. You have to go to my guy." You say, "Are you happy with your dentist?" "Yes, dump them. You have to go to my guy."
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Remember, I said at the beginning. There are 2% of people going to go to a dentist. You want them to go to you. Yes, I always wonder if anybody ever stops to figure out if I am going to flood my practice with patients, the truth is I am draining three other practices and I am OK with it because in the end, we are giving people what they really want, a great dental experience." The old-school guys that want to talk about just the fact it is super quality and no, I don't do nitrous and no, this, know that, but I do quality, patients are not there yet anywhere. Don't get me started.
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Howard F:
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No, I want to get you started. I love great rants.
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Greg S:
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Where were we? We left the path.
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Howard F:
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We were talking about new patients.
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Greg S:
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Yes, if you don't have enough new patients?
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Howard F:
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Tell us?
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Greg S:
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A good story, a good question you have asked about new patients. You go to buy a patient. You cannot buy one. All you can buy is a phone call. Today that's $200-$300 actually, if you could buy patients particularly for $250, you should be thrilled. A typical dentist is making $1500-$3000 per case on the flow through the office. All you get is a phone call if you win, so you have to look at how the phone is being answered. I don't just mean they let it ring too many times. I mean they have to know how to answer the questions that perplexed people, "Do you take my insurance? How much is a cleaning?" You have to have your stuff wired super tight.
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For example, we are into free examine x-ray because if somebody calls and says, "Do you take my insurance?" No, but because we do a free examine x-ray, you are going to come out way ahead with your treatment. In other words, you have to have this all this wired tight or what you are doing is marketing, flooding your office with phone calls and one out of ten of them become the patient. Statistically right now in offices where we start with them, first we plug in the marketing. I can tell you today its online period. All the other methods are dying out fast. You plug that in. The phone starts ringing. Statistically half the callers don't schedule. In other words, you don't even get a schedule.
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If you paid $250 for that phone call, it actually costed you $500 to get somebody to walk through the door and that ups the risk. When they walked through the doors, unless you are really skilled, 50% of those don't buy anything. If you are going to look at you or by rate, it's up $750-$1000 to get somebody to buy some dentistry. The idea of consumerism, keeping people with you and you used a minute ago hyper referrals. You want people out across the back fence saying,
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"I don't care who your dentist in. I don't care if he is the governor. You have to come to this guy because everything there is just the best. I have been to five dentists and I am treated like family, like royalty." They will come up with the term. Now you are getting somewhere because number one, you get people to refer.
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A referral rate buys probably 90% plus. Nine out of ten of them come in ready to buy dentistry. The odds of a referral patient referring somebody else goes sky high and so you are starting now down a path not just of success, but of an enjoyable life. When you tell me you don't have enough new patients … This is a call that generated a lot of activity in our office. People call in saying, "My new patients are down. Should I do a newsletter? Should I advertise?" It's a tough question to answer because you almost need to say you have to clean up your practice and then advertise, yes. We tell people at the beginning of meetings after I do that, they you have to make a practice, you want to be a patient in.
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A huge problem is existing relationships with staff. These staff become our family. If you know about family, unless they are exceptional people, they don't want to work as hard as they would if they were not family. I have employed family, some good, some not as good as you say, "Family? Greg, I have my family working in Dental Town." No, I'm not saying that. I am saying anybody that we become close to his family. We become close to staff like family to the point when you bark, nobody jumps. You say, "Hey man, we are going to do this consumerism thing. I am all excited about it." They go, "Yes, I will write that down. Let's talk about that in a few weeks. I am busy now. Do you want me to collect this money or do your consumer thing?" and any change can be voided off. I am saying problem number three existing relationships.
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You know what's funny? What surprised us is how many staff like their life better when the office runs like a business instead of a dysfunctional family. They like it better. In fact, those who have worked in business and ended up in dentistry, long for their old life a lot of times where there was promotions and a structure. We have offices with staff that have been through three divorces with the doctor. They have been there for him, they have supported him emotionally and in return, they take a day off a time they want to, come in late if they feel like it. Some of them are abusive to other staff, refuse to help train people and because of this relationship where they have ceased to be employees and they have become people, we are paralyzed.
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When we come into an office we have this brief interlude where people see us come in and they go, "Am I going to get fired?" Then we explained to them, "No, you're not getting fired today, not today anyway, but we are going to up the ante here a little bit."
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Howard, when we go into an office it's typically for one reason. The doctor has, to the point based on age or maybe even some new consciousness, but they want an associate. We lost interest in the whole idea. Let's help you up your practice $20,000. We wanted a bigger challenge, so we do the, "Hey, you want to bring a doctor in here? First thing we have to clean this place up. Everybody, we are going to tell you what to say and this lady over here, you are new boss, your leader, she is going to make sure you are saying it. We have this checklist. Everybody have it? Pin it up in front of your work area. Every patient …" You see what I'm saying? We have a leader to enforce it.
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Before we had a doctor enforcing it, the owner-doctor would try to take these materials and tried to create a system, but they could not do it. They would say, "Ladies, we are all doing this today. We are going to do that," and before he could even finish his explanation somebody said, "Oh, your patient showed up early. You have a patient in room two." "OK," and he is over there treating and maybe buy lunch he comes out, "OK now, what were we saying?" "Doctor, you have a patient in three." He never gets the attraction or she never gets the attraction. We have to have somebody … In fact the vast majority of practices are grossly under-managed. In other words, it falls to an interesting level.
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I believe if an owner-doctor lost his mind, literally he is losing it, maybe he is old enough that he is slipping mentally, if he lost his mind and started saying things incoherently to patients, maybe even smacked one of them, the staff know to jump in and go, "Hey, he just does that because he likes you," where they would try to cover it up and save the situation because they want a pay check. In other words, they won't let you fall, but they also don't like the idea of you rising because if we rise, you are going to hire new staff and they are going to look like Barbie and I am not going to be the main person here anymore and so they don't put their hearts in it and they don't hold their heart out of it. In other words, if they want to practice in that neutral position.
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It's a phenomenon and so many guys out there and so many women out there practicing suffer from this and they can't break through it. They are hostages to this mediocrity. First thing we do is we have them get a leader, an ally. We call this HRT-Hostage Rescue Team. First thing we are going to do is get somebody on your side. She is your clinic administrator, your big boss. She then gets to choose three people. It's her choice, Howard, front desk, clinical and hygiene. She gets to choose people that are the leaders of those departments. We cannot choose them for her because if we choose them and it doesn't work out and her leadership does not pay, she can always point to them and say, "If you would not have made me take your sister-in-law here as the team leader at the front, we would be doing great." We get a leader. She picks her leaders. Now, we have four people on your side. They are thinking like management, instead of like labor. We start to see the wheels turning.
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Now we throw in the right incentives, the bonuses just right. I tell you, bonusing properly is a fine art. It needs a lot of maintenance because you cannot have across-the-board team bonuses because you start rolling, pretty soon you have an associate and three more staff to support them. All of a sudden we have 25 people and then we have 35 people and if there's no net. You don't get better pay check. You are just paying bonus. The bonuses have to be tied to what someone does, not the team. The whole team thing got very popular. Do remember when we could not call them of staff, it was a team? It's almost like if we called them a team, maybe we didn't have to pay them as much, you are team members.
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We get the leaders in place, get the incentives going. If things go well, we get a call from the dentist that's the economic indicator. He calls and says, "Greg now, I know I said I want these people motivated. I know I said that, so I get that, but I have not had lunch in six weeks. They don't let me out of here until 7:45 at night. How do I back up these people off?" I said, "That's your problem, buddy. You wanted to get them moving, you got them moving."
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Howard F:
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Greg, tell me if you have seen this or not? It seems to me that you are talking about these offices you are consulting him. They have hygiene departments and they have someone up at the front desk. It seems to me that all the people that collect the million dollars in the big offices, they have been using consultants their whole career. Then the people who would need them most, they just don't ever get a consultant. Who is your average client? What size of a practice? I am trying to describe to my homies out there, you are talking to several thousand dentists, how much do you cost? What is your program? What is your best client's scenario? Paint a picture of who calls you the most? How much do they give you? What do you do? What problems do you like to fix?
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Greg S:
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Like you said, Howard, we just fixed one problem. Typically, it's a doctor. He is across 50. He can see the end coming. He is successfully completed for marriages. His $6 million in real estate now is a negative. In other words, they realize, "I am going to have to work past the time I probably have the energy I do now," and they want to light the associate burner.
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I will tell you who is a prospect or was likely to succeed. It's somebody that is serious as a heart attack. They are dead serious, "You tell me what to do. I will do it." So many people join consultants and then start to argue with them as soon as they find up, but when you are 68 and you have $80,000 saved, $900,000 in debt and it's harder every day to put your shirt over your head, that's our dream client because he says, "You tell me to jump ... " Yes, the truth is in the consulting business, it's a little secret is there is a consulting circuit. People join a consultant, "I like him. It was good. I did better." Then they go join another one, then another one and another one. About five years, they are back with you and you will see them five years later. In other words, it's a circuit. I am fine with that. I love to be in the circuit.
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We find a lot of fulfillment working with these people who do not have a retirement. Maybe they have $500,000 saved, but they are getting 1% interest. We want to keep their income going into their retirement years. We seldom find a doctor under 70 who wants to quit. They want to slow down or way down and associates are the key to that. The associate is what we call "the perfect storm of dentistry." Remember that movie with George Clooney, "The Perfect Storm?" It was about …
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Howard F:
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Marky Mark, wasn't he in there?
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Greg S:
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The perfect storm came about as you measured the height of a wave or its potential on the planet Earth. A wave on the planet Earth can only reach 200 feet. It's determined by distance to the land, depth of the water and speed of the wind. The perfect storm is all of those combined to create a 200 foot wave, which is called "a ship killer." In dentistry we have the perfect storm. It's associate practice. We take a marketing patient who is predisposed to buy nothing, never see you again. We put him in front of an associate doctor out of school six months we still trying to figure out the difference between mesial and distal and I can't remember … Don't test me on it because I can't remember, either.
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The third thing is we do the hardest thing in the world is to present unexpected work. In other words, when a patient is not expecting something, that your toughest sale. We have a marketing patient whose commitment to the office is near zero. He looks at you like a television. He has a channel changer in your hand, no commitment. Put him with an associate doctor who does not even know your culture yet or your clinical style and then we send them into sale dentistry that the patient was not expecting. You will not survive that. It is on survivable. As it fails, you will try some desperate things like offering them partnerships or to buy-in to try to get them to behave better. Then even if it works, well now have to practice is gone, the secret to that is creating a killer team, staff that know how to build a practice.
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I don't just mean how to build a practice for an owner, for Daddy Disneyland, for the guy that in the end, he solves all the problems. I am talking about staff that can make it without the owner there. Leaders and it's a culture of excellence. I am talking like you have never heard this before. You have lived it. I have not lived it. You have lived it. Most offices, lucky to have one great employee. She can collect money from people that don't even hold you money. She is amazing and she is so great and we love her, but when you try to kick it up, put in an associate, she is not enough. Everybody has got to be great and because they are under-supervised, their greatness is never accessed. To solve the perfect storm, you have to have the perfect team. They have to be scripted, trained, motivated and determined.
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We just got a testimonial from a lady who runs a practice. This is going to be hard to believe, but I am going to stretch your belief here a second. They came to us and said, "We have an unusual request." It's a husband and wife dentist. One had become injured and the other was mentally so burned out they did not want to go to the office anymore. They said, "We want to be out of practice in three months." I said, "That's pushing it, isn't it?" They said, "No, but we want to do what. Are you in or not?" They really put it on us and maybe you should be interviewing the consultant here that managed it. They did it. They were out of practice in 30 days.
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They had a great leader. She whipped the team into shape and I just got a testimonial from her that said, "The day my owners left was the most exciting, exhilarating, empowering day of my life." They were doing pretty good. It's a funny thing. The owners were, they were taking home about $50,000 a month take home for a husband and wife, pretty good money, a couple of people making $300,000 each. They are making $50,000 a month and so they walked out of there.
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This lady takes over. She wraps it up and their income fell to $35,000 take-home because she has to pay these associates and the owners were not happy. They were unhappy with us, "Hey man, we were making $50,000 and now we're making $35,000." We had to run, "Hey, but you don't come to work at all." Now the practice of just crossed $500,000 a month. It's like a house on fire. It's funny. The doctors are so burned out, not only do they not come to the office, if they meet with the staff, they have to come to their house.
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If you ask me could everybody do that if they had the commitment, I believe they could. Howard, you used to talk about it. You were the first person talking about it. I got out there among the masses and I don't think people got it. When you said this place should be run like a business. Remember, you used to talk about McDonald's and the systems and so forth? They should have listened because now we have an industry if I could use the term "an aging industry" led by aging consultants and it's time to get serious and turn this into a business, instead of a dysfunctional family.
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Howard F:
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You started off this podcast saying the mindset of these younger dentists and we are in a new era. You said half of them don't want to own a business.
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Greg S:
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Right, they don't want to own a practice.
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Howard F:
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That's what's fueling of the big-box approach.
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Greg S:
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A lot of it is, yes.
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Howard F:
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Heartlands and Aspens and Pacifics …
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Greg S:
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I will tell you something though, most people that don't want to own a practice, I am not criticizing them. I hope I did not come across that way. There's a lot of offices we work with that hire associates. We have associates taking home $60,000 and $70,000 a month. They could do a lot worse.
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Howard F:
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Yes and how many times have I seen how in my own practice where you had some kid working for you and making $200,000 a year for 6-7 years, but they just have two own their own business and you are like, "You haven't shown any interest in the business," and then they go out and start their own deal, very headaches quadruple and they never make the money ever again that they were making in the your office.
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Greg S:
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I would be with you on that, except I have seen people who tell me since they became owners after the being associates, they are making half what they were making, but they would not go back. People are different that way. I would never see you as an associate ever. You are an entrepreneur and they gave you a general license somehow. Somebody wasn't looking and you got a dental license.
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Howard F:
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It seems like everybody is saying, "You should get a partner. You should get a partner," is usually selling the partnership. They are doing the legal work, the consulting work. You have seen partnerships. What do you think of partnerships? Is it getting married where half of them fail? Is that a good benchmark?
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Greg S:
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Well, it has not come yet to the Supreme Court, but maybe pretty soon we will be able to marry two people, so we can have three people in a marriage. It's coming. Everything is coming like that. People laugh at that, but that's what you are getting into because you have a marriage at home, where you have somebody not letting you do what you want to do once you get home. Then you go to work and you have a partner not letting you do what you want to do at work. You see what I am getting at? It's like having another, a three-way marriage.
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How often do we see partnerships successful? They make it. They pay bills, make a living, educate kids, but a lot of them feel very unfulfilled. There are so many things they want to do it they want to get rid of this person or they want to buy this equipment. I would think long and hard about it. When we talk about associates and we talk about it's like a good thing, we're not talking about potential partners. We are talking about making a dream environment for associates.
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Howard F:
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Imagine if the Catholic Church had two popes and they were always arguing? Imagine if the military had two commanders? I have heard this from one of the big boxes. I don't know if I should say their name because maybe Rick Court from Heartland Dental will not like me saying this, but he told me one time at dinner when he has an office and it's one doctor and two assistants, two hygienists, he says that the management required a manager is almost zilch. But when they sit there and go to two doctors, now the staff are confused because there is to dentist and they might be saying different things and they might believe different things about clinical dentistry. He says when you go from one doctor to two doctors, the trauma goes up 3-4 fold. I think employees, they just work better when this is the 400 pound gorilla. These are the two 200 pound gorillas. These are the 100 pound gorillas. You know what I mean? A hierarchy.
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Greg S:
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When there's two dentists, it has to become a business. You can have two owners of McDonald's because they have all been to burger school and everybody knows what they are doing.
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Howard F:
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So it can be done? Greg S: You bet it can. We like to see them on the same page, but I always want to know what you are getting out of it. If you are splitting the practice in half financially, how are you better off?
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Howard F:
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This is a Dentistry Uncensored. How much do your services cost?
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Greg S:
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Howard, it's $36,000 to work with Whitehall for a year. There's a discount if they pay up front. We have schools for the staff where they come and we literally try to create a culture how patients are treated. You know what I mean by culture? Where everybody is doing things the same way and when somebody comes from another dental office, a staff person is hired. They are migrating their culture and they come in here and go, "Gosh, I come from and where we just sell big cases and we have five patients a month. This is crazy. You guys are doing it wrong."
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In other words, we want to be so strong that our culture survives the addition of outsiders. We have cultural enforcers. They are like mob bosses. That's your leaders. We work to create a culture. We have a school may come to. They come right here to this office. The first thing we tell them is the reason we are here, the reason you are here is to deliver your doctor's vision and if you don't know what your doctor's vision is, get him on the cell phone at the break and find out and maybe he can call you back before the meeting is over. We are here to deliver what your doctor envisions for their future. We tell them that you have a good practice. You guys do it right. You are impressing people, but you have an owner-doctor. You don't have associates.
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When you explain to them if the difference between and this is not meant to insult anyone, it's the difference between the minor leagues and the major leagues. When you come into the major leagues of dentistry where you have associate doctors, there is not a great staff person and a bunch of drones. Everybody is super sharp. That's what we are working on. It isn't just me talking and making some suggestions. At the end of the meeting or at the end of the sections, they are tested harshly. Their doctors are emailed their score and how they ranked with the other people in the meeting and so it's pretty intense.
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We tell them it's like a boot camp in the military. They are always talking to you about what like it's going to be like in combat, "Yes, you are a good shot now, but when there are bombs landing around you and people shooting at you and your gun is jamming, you are not going to be so sharp." We explain to them when you have an office with two associates and the owner is gone, you are the one that has to fix stuff. You have to think ahead. In other words, it's that combat scenario. What's great is some of them that just love the challenge. They love a challenge. They feel better about themselves. Their self-esteem rises if they can make it in that environment. We tried to make a big deal out of them.
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That's what we do. Often, we talk to a leader in the practice once a week and help them work on projects. Our number one projects are typically getting them to change ratios like the one I told you about. Half of the people in that call don't schedule, we have to get back up to 90%. That's a lot of our work. Half of the people that come in don't buy dentistry. We have to get to that up to 90%. That's what we do.
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Howard, like I said, we have to take it serious and convey that seriousness because every doctor no matter who they are, they are aging. I don't know, Howard, you are 51. Do you remember when you got up in the morning the first time you could not sit up straight right away? I was in my 40s when I started to notice some stiffness in my joints and so forth. When we get people about 61 years old, they come to us and say, "OK, what do I do? Do I have to kill anybody? I will. What do I have to do?" and they are serious and they are fun to work with.
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Howard F:
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Tim Goodheart just sent me some mission statements and when you were talking about the team and enforcement, I was trying to find his mission statements. Do you think you were trying to get the team to enforce the doctor's mission?
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Greg S:
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His vision, yes. Let me give you an example of a vision that a doctor might put on us. I am working four days a week, nine hours a day. I want to work two days a week within two years or one year. After that, I want to go to two half days. That's the vision. We know that associates are going to come into the picture and so you have to fill in a whole bunch of blanks where that happens, all the things that have to happen. When we have a staff person that just won't respond, we have to get somebody that will respond to the doctor's vision. We are vision enforcers.
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Howard F:
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Greg, what if one of my homies wanted to talk to you? How would they reach you? Do they go to www.Whitehallmtg, so White-H-A-L-L-M-T-G.com?
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Greg S:
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Just put in Whitehall, Greg Stanley, yes.
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Howard F:
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Greg Stanley is S-T-A-N-L-E-Y, there is an E in there.
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Greg S:
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Can I just our phone number?
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Howard F:
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Yes, absolutely.
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Greg S:
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480-860-5700 and they can just call us.
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Howard F:
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Repeat it one more time.
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Greg S:
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Area code 480-860-5700.
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Howard F:
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Are you a big email guy or more a phone call guy?
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Greg S:
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Both, we do both. You would have to call the ladies out there. They answer the email. Any chance you can get one …
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Howard F:
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Just go to Whitehall Management and there's the contact …
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Greg S:
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Whitehall Management, sure.
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Howard F:
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God, I can't believe the hour is up. That was the fastest hour of my day. Seriously guy, 1987, I don't know how old I was. I was born in 1962. I went there. You lit up my world. You really lit up my world. You were an amazing man and I cannot tell you … If you are wondering about this guy, I cannot tell you how many of my close homie friends for 28 years have been your clients and you are a legend and you are a rock star.
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Greg S:
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Howard, one time you and I exchanged mailing lists and they were almost all the same people.
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Howard F:
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I remember that.
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Greg S:
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Woody Oaks.
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Howard F:
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I had the Fran Report and Woody Oaks had the Profitable Dentist and we said, "You know what? We should share each other's …?"
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Greg S:
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I think it was about 20,000 people. It made me think that's about super serious people are in the country.
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Howard F:
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You know what? We have also put up 350 courses. They have been viewed by 500,000 times. It would be an honor to put up one of those because at the end of the day what I want to do is I want to help these guys. I don't want one of my homies being burned out, depressed, going home and drinking Listerine and eating Vicodin and wishing he had become a plumber like his brother. I have heard that several times. I think your content is the real deal and it's been tested for decades and thousands of people's lives. Like I say, I will send my son Ryan up here to feel it or you can come down to Dental Town with two key and film it.
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Greg S:
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We would be honored.
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Howard F:
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It was an honor that you spent an hour with me today. Thank you so much.
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Greg S:
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Thank you, Howard.
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Howard F:
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My second son is named Greg.
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Greg S:
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I tell people you named him after me, Howard, by the way.
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Howard F:
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I did it.
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Greg S:
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Bye-bye.
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