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Howard:
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It is just a huge honor for me today to be podcast interviewing Keith English with localmed.com. Keith English is the CEO and founder of Local Med, founded in 2013 Local Med's mission is to provide accurate, realtime scheduling for dental patients. Local Med currently supports over 1700 offices in the US, scheduling 10s of thousands of patients a month. When not trying to help dental offices grow their practice and provide a better patient experience, Keith enjoys fishing, golfing and reading. His wife of 10 years, Josie, and their two children Bryce and Grace, split their time between Baton Rouge and Florida and we have a very common good friend, Sandy Pardue, and you told me that Sandy Pardue is the first person that heard your idea and didn't think you were crazy and the office, from her partner, uses it. I just think this is ... I called you to be on this show, you didn't call me, this isn't an advertisement but I just think this is amazing. So tell my homies what they're doing. Patients are actually scheduling their own appointment in a dental office, online?
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Keith:
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Yeah. So, absolutely, so it's the same sort of service and ... From an office you would expect to get from any other way that you deal with life in general, whether it be scheduling your appointment for pretty much any other service or get a hotel or a flight or any of that other stuff that you come to expect. It's the same concept applies. You basically go on and look at the open inventory at the office itself, make the selection that best fits your life, and fill out your information and that information is then transmitted directly back into the management system at the office.
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Howard:
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Wow. I mean, because so many people think ... I mean, it'd be like giving up ... That's their full time job is scheduling appointments and you're saying that now consumers are looking at your inventory of openings to come in and get their teeth cleaned. Is it just teeth cleanings or is it new patient exams or what kind of appointments are they scheduling?
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Keith:
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So the vast majority fall into teeth cleanings, new patient exams and emergency. The reason that a lot of them fall into that category though is that's also the most common thing that people open up online to have for scheduling. We don't dictate to offices what they have to have for online scheduling, we let them tell us what that they want to have availability online. So it's not our job to tell offices how to do business, we will work very hard to fit within their existing business flow.
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Howard:
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By the way, if you're listening to this on iTunes, you got to subscribe to our YouTube channel and watch this YouTube because he looks just like Leonardo DiCaprio. You've obviously been told that?
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Keith:
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I'd get that one particularly when I was younger and didn't have gray hair. I got that a little more often.
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Howard:
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Well how old are you?
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Keith:
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I'm 43.
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Howard:
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Well how old's Leonardo?
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Keith:
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I have no idea.
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Howard:
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Ryan find out, because I'm just looking at you like I'm seeing movie scenes right before ... "Catch Me if you Can." Yeah Leonardo's 42 so you're only one year older than Leonardo but I was thinking you looked, God, just like the later scenes of the movie, what was it, Aviator?
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Keith:
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Oh yeah. Yeah when he was going crazy? I don't really though want to hear that.
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Howard:
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Oh my gosh, you look like, man you look ... You got to check this guy, he does he looks just like him. So what or ... You know 17 dental offices are, 1700 dental offices are using this, what are most of them using it for?
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Keith:
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So most of them use it to help do two things. One is to attract new patients that otherwise might not schedule at their office. The other is for interoffice efficiency. So about 42% of the appointments that are scheduled on our platform are done so outside of office hours. So these are folks that literally had no other way of scheduling with the office. Everybody knows the problem of people not liking to leave voicemails, things come up over the course of weekends, life just gets in the way and they don't have the ability to schedule during normal office hours and we help alleviate that problem so that we open up scheduling to be 24 hour possibility at any office that we work with. And the other thing is it allows the interoffice staff to focus on the patients that are actually in the office right then and there to maximize that experience. If you have a few less fewer phone calls on a daily basis because the people are scheduling online, that means that your front office staff can focus more on those folks that are standing in front of them and provide better service as opposed to being on the phone.
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Howard:
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Wow, and you got top states on Local Med, I mean it's just all over the ... There's so many states on here.
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Keith:
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We don't have Maine and Vermont so we got to get those two, those are the last ones.
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Howard:
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All right, if any of my homies are from Maine and Vermont you got to get this going. Now how much is it?
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Keith:
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Depends on the size of the office and the organization. So maximum it's going to be is $249 a month, and it is a month to month contract but if you are a single provider office or part of a larger group, obviously those prices are going to go down.
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Howard:
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42% of these are scheduling outside of the office hours. I found it very weird because you know you always have personal biases against what you believe. Like young kids hate direct mail so they believe that Facebook ads work better than direct mail, which isn't always the case. I remember when they came out with ATM machines my dad used to think, "Well who the hell would use an ATM machine when you can walk inside and talk to the teller?" But it sounds like now Americans ... Do you think more people prefer to do like their banking and scheduling online than with a human or?
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Keith:
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Oh absolutely, absolutely. Not just from a timing perspective but we ask at the end of every appointment whose scheduled with us to help us improve our service, we ask why people utilized our service as opposed to calling the office. So I want to know, why did you choose to use us as opposed to the traditional method? Like you just mentioned. And they basically fall into several buckets. One is that the office was simply closed and they had no other alternative. The other bucket things fall into is that they tried to call the office and nobody answered.
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Howard:
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What was number one?
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Keith:
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They had no other alternative, the office itself was closed.
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Howard:
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Okay, after hours.
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Keith:
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After hours, weekends, things of that nature. Second bucket being they tried to call and nobody answered. And that's a known problem, not just in dental but in healthcare in general, is that busy times of the day, somebody doesn't show up to work for whatever reason, that you can have those calls not answered by a live person.
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The other big things that fell into it were people simply just didn't want to call the office and waste that 10 minutes of their life on hold or being shuffled from one person to the other. Or to get into the circumstance that I like to refer to as the old movie circumstance. As I said I'm 43 years old, when I grew up I used to have to call the movie theater and listen to the answering machine to see what movie I wanted to go see. They'd list off the times. The movie you always wanted to see they'd put last, you'd have to listen to all of it and you had to wait. It's the same thing that a lot of dental offices do right now is it turned into a negotiation for a time. Patient calls up says, "Do you have anything Tuesday in the afternoon?"
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"No but I've got Wednesday in the morning."
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"Well that doesn't work for me, how about Thursday in the afternoon?"
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"Oh there's nothing Thursday afternoon."
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So it turns into a situation where the patient can't see all of the inventory that's available to know what fits best with their schedule and a lot of patients really like that concept of being able to see what's available and then match that with their calendar.
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And the fourth bucket things fall into are people simply can't call at work. They don't have the ability to call while they're at their work environment, which are the types of people that you want to have as patients. They have jobs, they have the ability to pay for stuff, they just simply can't call between 8:30 and 4:30.
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Howard:
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Man, that's amazing. And have you ever seen, by the way, most of our listeners are probably 85% are commuting to work. They're commute's an hour, that's why we do the show for an hour but I always retweet my guest last Twitter so when they follow me @howardfarran I just retweeted you, you're @localmed. I just retweeted your last tweet from ... "Over 40% of appointments scheduled on our platform are while the office is closed. How many opportunities are you missing?" And have you ever seen any data on how many people have to call your office and get prompted for voicemail before someone leaves a voicemail?
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Keith:
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I have not personally because we deal strictly in the online environment we don't get a lot of that data, which would have to come from our offices. I have been given anecdotal information but nothing that I can say "Hey, I know this to be a fact."
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Howard:
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Well, what kind of anecdotal information have you heard?
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Keith:
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So we have heard that somewhere between 17 and 31% of phone calls go unanswered, depending on the practice.
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Howard:
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Yeah.
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Keith:
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And again, those are not my numbers, these are numbers I've been given by a variety of consultants and other folks that have been in this industry a lot longer than I have. And then as far as the number of hang ups or people that leave, it's in the single digits of a percentage of people that get the voicemails and end up leaving a voicemail.
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Howard:
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Yeah. And I know, my job is to guesstimate what questions my homies are asking, but they're probably thinking what dental practice management software does this work with best? What if she's a young kid and she's going to start her own office, she just graduated last week from dental school, what practice management software works the best with this or does it even matter?
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Keith:
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It does matter. Our connections are read write connections so we integrate with Open Dental, Eaglesoft, Dentrix, Softdent, Practice Web, Dentrix Enterprise, those are the basic ones that we ...
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Howard:
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Let's say them again: Open Dental, Eaglesoft, Dentrix ...
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Keith:
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Dentrix Core, Dentrix Enterprise, Practice Web. Those are the main ones right now.
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Howard:
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And what of your clients, like what percent have Dentrix versus Eaglesoft versus Open Dental?
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Keith:
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So as I'm sure you've seen across of all of your folks as well, not just related to us but Open Dental seems to be gaining and awful lot of traction. We started building this about ... Almost five years ago now. Open Dental was not nearly the percentage of the market that it is currently. We see an awful lot of our folks changing practice management systems, there are existing clients switching from one of the other systems to Open Dental. We see that very frequently.
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Howard:
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Yeah I'm doing it in my office this month. I've been on Softdent since 1987, my gosh, 30 years I've been on that system. Why do you think people on Dentrix and Eaglesoft are switching to Open Dental.
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Keith:
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Again, anecdotally, kind of what we're told is that they tend to play nicer with other services, which means that the offices can then get best in class at whatever outside service they're looking to work with. Whereas those other systems are trying to very tightly control things so it really limits the outside services that they could work with. You know, completely outside of what we do, but if somebody wants to work with a particular credit card process or accounting software or whatever else it seems that Open Dental tends to work with that a little better as well as it seems like the pricing mechanism that's set up with that is more conducive to what dental offices are looking for right now.
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Howard:
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And you know, the guy who started that was a dentist, Jordan Sparks, and that's exactly why he started. He got so mad that he couldn't export his patients name, addresses for a direct mail piece, when he found out that not only that he couldn't do it but they'd actually gone in there and did extra programming to make sure he couldn't, he was so pissed that he started his own software company. But I guess he's moved on and now his brother Nathan runs the show. So what, I'm not smart enough, this is all new to me ... I want you to review, what, where are humans doing this again? Doing this in other place? I mean if someone sit there and say this isn't common to dentistry, you said airline tickets? Give more examples of where American consumers are scheduling appointments online?
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Keith:
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Sure. So take something as basic as like a haircare appointment that takes very little ...
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Howard:
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Oh you had to say haircare knowing I'm bald.
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Keith:
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Yeah!
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Howard:
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And you're sitting there looking like Leonardo DiCaprio. Go ahead, passively ...
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Keith:
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I didn't bring it up, just so you know. But take salons any of that sort of stuff like that are very basic appointment types, over 60% of those are now booked online.
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Howard:
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Seriously?
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Keith:
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Yeah. Whereas six years ago, zero. But there are some very large companies like Mind, Body and Booker and those that don't have to be connected to any back-in system. They're actually the scheduling system and the online component because it's not like dentistry or healthcare where you have to have the full patient information in the background. You don't have to have that for haircare right, there's just no ... The history is not as important as it is when you go into somebody for a dental office so you have to, because they're not connecting to anything they can spread out a lot quicker. But you mentioned hotels, airlines, things of that nature. Over 80% of those are booked online.
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Howard:
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80% of hotels?
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Keith:
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80% of hotels and airline tickets are booked online.
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Howard:
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And what was that six years ago?
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Keith:
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I know 10 years ago it was in the single digits.
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Howard:
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Wow.
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Keith:
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And it's been estimated by several organizations: Pew, Intuit and Kaiser Healthcare, all say that in 20 that it will be over 50% for healthcare too.
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Howard:
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In 20 years it will be 50%?
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Keith:
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2020.
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Howard:
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Oh 2020? So in three years they say healthcare will be 0 to 50 by 2020?
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Keith:
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They're saying it's about 6% right now, so when you've got somebody like a Kaiser Permanente who's a closed system, they've invested a ton of money in building their own system. So they're already way ahead of the curve as far as that's concerned. But related to some of these others, they count online forms as online scheduling, even though it's really not, but they're including those numbers in there as well.
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Howard:
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Okay so tell my homie how this works, you said it's $249 a month, what do they do? They go to localmed.com?
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Keith:
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Yep, they can go there. So our ... I want to say one thing about the service that's very important to me to get out there on this is there is a process that some of the others use to drive people to their existing domains, right? So they're trying to collect all the traffic for themselves. And you think of some of the other companies that have tried to add or gate scheduling or lead generation through their platforms like a 1-800-Dentist or something like that and they did a very good job of bringing people to their properties and then distributing those out to their members. Our philosophy is very different in that we work in the places where patients are already looking. So as an example, we work on your website. So 30% of people that are new patients that come to your website will simply never call your office. They just won't do it, they will not pick up the phone but they will schedule online and show up. 18% of your existing patients that walk out the door will not call your office to reschedule but they will schedule online. So those are ways to recapture off of your existing marketing dollars and office website that you already have.
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As well, we have partnerships with insurance companies to allow people to schedule directly from those insurance company directories and appliance companies like Six Month Smiles. So if you're in network with the insurance companies or a member dentist of say Six Month Smiles, when people are searching on those directories to see who in their markets provide that service they'll be able to schedule directly from those directories, which helps bring new patients into your office.
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Howard:
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And of your 1700 dentists using this right now, in 48 states, because Maine and Vermont can't get their shit together and get their first user, how many patients a month are scheduling? Do you have any data on that?
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Keith:
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So we have some offices that have one or two, we have some offices that have several hundred. There's a variety of factors that it matters. One is the amount of open inventory you frankly have. If you don't have but one or two open appointments in a month, we can't do very much to help you schedule additional folks into that. If you have a variety of open appointments then yes, we have the ability to do so. If you don't have people coming to your web properties or you're not in network with our insurance partners, then that makes things a little bit more difficult. But I think the most we've ever had at a single office in one month is around 300.
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Howard:
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Wow. Wow, wow, wow. And what questions should I be asking but I'm not smart enough to be asking because you're dealing with dentists all the time, what questions are they asking you about this?
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Keith:
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So the biggest question we always get is something you started to allude to earlier, which was: I'm going to lose control of my schedule. How am I going to give up control of my schedule and you're going to put crowns in my 15 minute lunch break and screw up everything. The reality of the situation is, by being integrated into the practice management system we cannot book an appointment in the wrong place. So it's absolutely impossible for us to do so after you set things up. So when you tell us that a new patient appointment is one hour, then and it goes into chairs three, five and seven on Mondays and Fridays and chairs two and four on Thursdays, then that's where things go. So there's no losing control of the schedule because you're the one that tells us where the inventory needs to be displayed if available. So that is the biggest thing that is a misconception out there, is that we are telling you where things should be scheduled as opposed to reading your schedule to only show the accurate openings.
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Howard:
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And how does the staff like this?
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Keith:
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The staff, it depends. If we have a staff that recognizes that they have more responsibilities, that's just a part of their function is to answer the phone and do that, then they're receptive and they realize that this is going to help free them up to do the other things that are a big part of their job. We're not replacing anybody. So something you mentioned earlier was that this is people's whole jobs.
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I'll use an analogy, again, I'm dating myself a little bit on this but when I was really young is when the microwave became really popular. And I remember my mom got a microwave and everybody said that you're going to be able to throw your oven in the harbor and you can just do everything in the microwave. Reality of the situation is it turns out that the microwave has its set of uses and the oven and the stove have their set of uses and pretty much every single kitchen has both. And that's effectively what we have here is you have the traditional way of scheduling has its place, there are always going to be those questions that have to be answered, people are going to be walking out of the office they want to schedule. And online scheduling has its place for people fall into those buckets that I mentioned before. They don't want to call, they can't call, it's after hours, they're at work. So it really will take both pieces of that to effectively run an office.
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Howard:
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And another thing I want to say about scheduling is that dentists they ... The number one cost is a 42% reduction in their PPO fee, then it's 28% labor, it's 10% lab, it's 6% supplies and where is the constraint at chair? I mean, in operatory. They don't have enough ops. And then they're saying, "Well what happens if someone does this online and I get double booked" or whatever the hell. Then the next question they say is "How do you get rid of cancellations and no-shows?" I mean, the airlines always overbook. So to me I look at the worst case scenario, you double book, and one of them is not going to show anyway. No-shows and cancellations are huge and the airlines legally have the right to overbook 10% and if you don't like it they'll just beat you and drag you off the plane. So I think everybody should have this online scheduling deal. We're converting to Open Dental next month and I hope you ... I'm going to get it done in mine.
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Keith:
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Good, happy to have you.
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Howard:
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And Sandy Pardue is a legend on Dental Town. I don't think anyone's ever disagreed with her one time and she's been doing this for a long time, three decades, and she's just amazing and she just told me you were the real deal and a bag of chips. And so I was curious, what other things, since I haven't started doing this in my office yet, but I totally intend to on Sandy Pardue's recommendation and now meeting you, what other things should we talk about that the 1700 dentists ... What are their FA- ... What's your FAQs with dentists? You're so new on this you're going to have to interview your self on my show.
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Keith:
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So once we get past kind of the understanding and show them that the control issue is not really an issue, that they're telling us how they want their schedule to look, the reality is they start looking for opportunities to use it. We get a lot of questions about "Can I use this in my recall messages?" As an example. So things are sent out to ... People saying "Hey, you haven't scheduled in the last six months" and can I put a link to my schedule in that? Absolutely. Can they send it out on their postcards to drive people directly to that? Absolutely. So the dentists that see it and get past that initial part of it, then they really start to look for opportunities because they realize it can only help them. The whole goal of this is the same goal of this is the same goal that they have with every other thing that they do, which is to get butts in seats. Right? Butts in seats equals more top line, equals more bottom line. And that's what we're working with them to do as well is the more opportunities you give people to schedule the more they will schedule. It's amazing how those two things fit together.
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Howard:
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Yeah and the other thing is, there's 168 hours in a week and the average dental office is open 32 hours a week, which is only 19% of the week so 81% of all the hours in the week there's no one answering your phone.
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Keith:
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Absolutely.
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Howard:
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And you were saying, what you'd say it was ...
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Keith:
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42.
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Howard:
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42% outside of office hours. And then they'll have two receptionists, or front desk or whatever you want to call them, I don't like to call them front desk cause I don't think anyone should have a job named after a piece of furniture, but they'll both get to lunch at 12. So it's like well why got to lunch 12 to 1 and one go to lunch 1 to 2 but why, cause they're buddies and they love each other and they want to go to Taco Bell together. And then ...
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Keith:
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You're speaking to issues I don't want to step on there.
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Howard:
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And then even if they come in early, you know to get ready for the day, they still don't turn the phones over till exactly eight o'clock. So they might get there at 7:15 and getting ready for the day and all this stuff but they're so busy talking to each other and having fun and all that kind of stuff they don't even turn the phones on. So the phones are rolled over to voicemail and you're thinking, what are you thinking of 10 to 1, 10 calls would have to come in for one voicemail? You're thinking 20 to 1? 30 to 1? What are you thinking it'd be? In just your gut.
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Keith:
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Again, I would say between at least 15 to 20, before somebody's going to ...
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Howard:
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To one?
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Keith:
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To one, yeah. I mean, because it's kind of a fool's errand to leave a message because history has shown everybody that you just don't get a call back in a reasonable period time because if they're not going to ...
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Howard:
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That's called a fool's errand? Is that what you said?
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Keith:
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Yeah.
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Howard:
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I've never heard that before, a fool's errand?
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Keith:
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Yeah, sorry.
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Howard:
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Where'd you get that line?
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Keith:
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I'm from the south, we say some things that other people just haven't heard of every now and then.
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Howard:
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I think it's cool. I thought, wow that is really cool, I've never heard that before. A fool's errand because why leave a detailed voicemail when they're not going call you back in a timely manner. You're just wasting your time.
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Keith:
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And if they do you call back the reason you called at 7:15 is because you can't call at 9:30. You're taking your kids to school and you're on your way to work or whatever else has gotten in the way that's the rest of life that has nothing to do with dental that's a lot more important than you calling the dental office. The reason you're then is because that's when you have the time to do it and if they're not going to answer then the time that they are there is not going to be convenient for you.
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Howard:
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By the way, did you know that we live on the same street?
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Keith:
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Oh yeah?
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Howard:
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Yeah I-10. I'm right on the I-10 and you're on Baton Rouge, I can drive from my house to your house without making one turn.
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Keith:
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Yep and then if you get there ...
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Howard:
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Do you know that's the busiest interstate in America and the busiest train? Because 10 goes from LA, where's it, to Jacksonville, Florida right?
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Keith:
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Jacksonville, right. Straight, there's a sign in Jacksonville that literally says "2400 miles to LA."
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Howard:
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Is that right?
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Keith:
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Yeah.
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Howard:
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Wow I'd like to get a picture of that because there's another thing about I-10 with trucks and there's a ... It's the busiest train route too because if you dump off all ... You only have two options if you're a ship. If you're coming from China and you need to get East Coast you either got to sail all the way down and go through the Panama Canal and come back up, which is time and fuel. Or you come in to LA and put all those containers on trains and when I'm climbing these mountains out here in Arizona those trains, not only do they go by all the time, but they're so long it's almost incomprehensible how long they are, and they're stacked two on top of each other, two at a time, just chasing I-10. So how far, how long does it take you to drive to New Orleans from Baton Rouge?
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Keith:
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About 45 minutes, in fact that's where I fly out of most of the time. So they have direct flights out of New Orleans to most places where Baton Rouge has a direct flight to Atlanta.
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Howard:
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So do you have like your own condo on Bourbon Street or do you just pass out on the sidewalk like everyone else?
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Keith:
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No, I try and not get down that way too much, I just had my second child three weeks ago so I've been a little bit worried about that.
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Howard:
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Oh nice man, congratulations. So you got two now huh?
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Keith:
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That's it yep. An eight and a half year old boy and a three week old daughter.
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Howard:
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That is just amazing. So you'd recommend to these young kids, you've had 6000 kids graduate from dental school so you're basically saying if your own office you'd go with Open Dental and you'd go with this online localmed.com.
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Keith:
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I did ... Don't pin me to the Open Dental thing, you asked me what we see so I'm not ...
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Howard:
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Well if you go to Dental Town, I love it when you go to Dental Town and search because they research on dentists shows that 91% of dentists, when they're deciding whether or not to use a product or service in dentistry, their first response is "I want to hear from another dentist." Only 9% say, "I want to hear from the company." So I put that little search pad, you know there's five million posts on dental town, so I put that little search button and if you do a search for any practice management software system it just moaning, bitching, complaining, you know. And you do one for Open Dental and it's just all raving fans. It's right there, I can't make up five million posts. I only have one account. So of those five million posts I haven't even posted 30 thousand times, it's Dental Town not howardfarran.com. And then would you also put it on your voicemail that by the way, you can go to our company website. Like I'm todaysdental.com, if you'd like to schedule your own appointment go to todaysdental.com and book your own appointment online?
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Keith:
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Absolutely. So somebody does reach out because one interesting thing we have seen is people, patients right now are not used to scheduling online. They just don't even know that it's a possibility. So when they run into it on your website, they've come there for something else, the number I mentioned a bit ago of 42% of our patients through our system but we started, when we went live almost three years ago now, that number was about half that because people just didn't know that it was even an option. So they'd never went to dental websites outside of business hours because they didn't think there was anything they could do about it anyway. But as they are coming to expect that to be more available for them that number is starting to rise. So a lot of people are putting it on their voicemails, "Hey we're sorry you reached our voicemail, if this is during business hours we're very busy. Please go todaysdental.com to schedule an appointment or after hours. Our office hours are 9 to 5 Pacific Time. If you're calling outside of those hours please feel free to visit online to see, to schedule yourself and see our open inventory." So those are definitely ways that people utilize the system.
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Howard:
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And when did you launch this? What year?
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Keith:
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We went live outside of our data at the end of 2014.
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Howard:
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So how did your journey, how did you end up in dentistry? How come you didn't go into mani-pedi salons or stuff like that? How did you end up in dentistry?
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Keith:
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We didn't do any of the other ones frankly because other people were doing them, right? There was already people exploring how to do that. And so a little bit about my background, I owned a previous business that did lead generation for financial firms. So we did lead generation for auto companies, for short and long term loan, mortgages, credit cards and I built that company up and I sold it at the end of 2007 to a private equity firm and spent about four years fishing, goofing off, then decided I wanted to get back into being an operator. So met some folks through some mutual friends that had a concept, we kind of massaged that concept a little bit and we originally had a very broad medical focus for scheduling. But as we got into it we realized that dentists schedule very different than dermatologists, who schedule different than chiropractors and so forth so we realized we needed to kind of specialize to start with.
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So we did a bunch of research and came to dentistry as one that we could connect to the existing management systems in the offices and have enough market coverage that was ... Ability for us to go to live. So it took us almost two and a half years to build this system, with zero customers. Just development, sitting in the dark trying to figure out exactly how to make these things function the way that they needed to and then we went and sat and ... We were very fortunate to have a gentleman by the name of Dr. Robert Delaroso who was the president of the American General, the Pediatric Dental Association and we bugged his staff to death. We sat in there everyday, why do you do this? How does this work? Why is this, why did you answer the phone call that way? What questions were they asking? We sat there and just bugged them to pieces until we understood the process a little bit better. And then we spent two and a half years building out the code before we ever launched out to do anything. So it was basically born out of the fact that we knew this was something that didn't exist in the market place, we focused on dental because it had the largest number of appointments with the smallest number of practice management systems that we needed to connect to.
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Howard:
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Damn, you're a smart man. And if you do a search on Dental Town for Local Med you have legends saying ... This is what Lenny Tao says: "I know Local Med, I've spoken to them. Looking forward to hear more, it's going to be huge for dentistry." I mean everybody's just ranting and raving. But nice ... So by the way for my international viewers, are you in any other countries or is this a US play only?
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Keith:
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So we will be in the English speaking countries within the next 12 months. So Australia, New Zealand, Canada, UK, are all on our roadmap for the next 12 months. The biggest roadblocks, not roadblocks but the things we have to really work through there, each of those countries has its own data storage and transmission laws. So related to PHI, so figuring those out, figuring out the data storage, we're working directly with Amazon Web Services, AWS, to make sure that we're adhering to all of the local laws and that we are handling data properly.
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Howard:
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Hm, I always assumed that laws were just suggestions but you're taking it more serious huh?
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Keith:
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We are very sensitive to HIPAA in the US and then whatever the local data protection laws are, that's something that while we certainly are innovators and very creative in the way we do things, there is a place where you have to play 100% by the rules and that is related to data security.
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Howard:
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When will you be ready in Australia?
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Keith:
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So Australia really we have all the rules it's just a matter of launching. There's nothing data-wise down there, it's just a matter of putting some sales efforts in that market. That would be one of the easiest for us to get into.
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Howard:
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While I'm luxuring in Sydney, Australia July 29 and then the week after that in Melbourne so Ryan will you make sure I get a slide in my seminar for that. I'll put a slide in there. Yeah, I love Australia and New Zealand. Yeah I would think Canada, I would think the fastest growing English markets are Canada, Australia, New Zealand and the United Kingdom. The United Kingdom is interesting cause 30 years ago they all were pretty much employees for the NHS systems, fee schedule, and the fees got so low that they literally had to start going private practice. And so now, so that the practice management has exploded in the UK and I wonder if the PPO fees in America keep sliding down and down and down and down and down, I mean a lot of the Medicaid fees are about a third of the fee schedule, there comes to a point where the dentist can't afford to lose money on all these procedures so they have to be more competitive.
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And you know what, I'm proud of dentist because dentists and vets and chiropractics, chiropractors, are 10 times more practice management savvy than in healthcare. In healthcare it's like they're not even trying, I mean you know we always criticize dentists how they should be better and better and better and then every time you go to your physician, you go to these hospitals I mean it's just, it's like my god, there 20 years behind dentistry.
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Keith:
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You know, dentists are put in a unique position in that the traditional path has always been to hang out your own shingle, go your own route and it's just so many things they have to figure out by themselves. And not having been through dental school myself but I have a lot of dentist friends and their level of kind of what they're thrown out to the wolves with, to me, is pretty interesting. They're given all the technical capabilities but dealing with the things that require, are required to run a dental business are completely separate from the ability to work on somebody's mouth. And it's pretty interesting to me how many different things have to be covered in order to become a successful dental practice and I think one of the things that we work very hard it on our side is to fit within the personalities of that particular office without trying to impose our own will, is very important to us because those are small businesses. They're private businesses. They take on the shape and the form of the individual and it's our job to kind of fit into that as opposed to try and demand that they work in one way or another.
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Howard:
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And what percent of the dentists, you've dealt with 1700 of them, what percent of the dentists would you say are just batshit crazy?
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Keith:
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We have had some interesting circumstances where there was absolutely no chance of us ever satisfying all of the things that they wanted but by and large most of them are doing the same things that everybody else is, they're trying to utilize their skills in the best way they know how in order to grow their business. But there are some ones out there that make that pretty tough.
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Howard:
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Yeah but I bet you're dealing with the cream of the crop. I mean there's 150 thousand general dentists, there's 30 thousand specialists, if you want to get legal there's actually 211 thousand Americans who are legally board licensed to practice dentistry but it's about 150 thousand are doing your full time 32 hours a week or more, another 30 thousand specialists, and you got 17- ... So that's 180 thousand. So you get 1700 out of 180 thousand, you're dealing ... Right now you're dealing with the top one percent.
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Keith:
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Yep.
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Howard:
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At a business sophistication. Which is my next question, is this a general dentist play or are you seeing orthodontist, endodontist, periodontist, pediatric dentist ... How's specialty versus family practice?
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Keith:
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So the vast majority are general but we have a great number of pediatrics. If you think about the service this provides for a mother trying to schedule for her children, cause her children are screaming bloody murder at her through the course of the day, and this, when she finally gets some peace and quiet can schedule or she can look online to make sure that she can schedule for both or all three of her kids at the same time.
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Howard:
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And so what new product you roll now? You're doing something in the review space. What companies did you say were stand-alone dental review companies, currently?
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Keith:
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They're not necessarily stand-alone dental reviews but they're ones that are large in the dental space like Podium and Birdeye. They're the ones that have it.
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Howard:
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I've never even heard of them.
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Keith:
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I think they're the ones that have the most traction, or at least, let me rephrase that, they have the most visibility. The reason that people generate reviews, or the reason people read reviews, is because it gives social proof that other people like that practice. That they had a good experience at that practice. The whole reason for social proof is to give the next set of people the confidence to schedule at that practice. So we believe that linking those reviews into the scheduling process is the next logical step. If you have stand-alone reviews but can't do anything other than still call the office, people are looking online to get those reviews and then you're forcing them to call the office. Why would you not let them schedule directly from that same application? So we believe combining those two pieces will help offices to be able to fully realize the value of all of the reviews that they're creating.
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Howard:
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So you're saying that you're going to put peanut butter on the chocolate?
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Keith:
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We are doing both, yes sir.
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Howard:
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And Ryan how long did we find out yesterday, when did movies come out and when did they finally add sound? I thought that was ... What was it? I thought it was so bizarre that the human mind was watching soundless movies and listening to music on a phonograph for two decades before one monkey said "Hey, I'm going to put peanut butter on the ..." Do you remember that commercial where the guy tripped and fell with his chocolate bar into a jar?
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Keith:
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The two pieces?
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Howard:
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Yeah.
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Keith:
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Yeah.
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Howard:
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How many years was it? 37 years before a talking monkey thought they would add the record to the movie. That shows you how things that are so obvious today are just not always obvious and that's so neat that you're going to combine online scheduling, which I couldn't believe when Sandy Pardue was telling me about it, to the reviews. And you know I have a real bias against that because I've never read a review. I've never seen anybody use Yelp. Who are all these people that would give a shit what some stranger on the internet said about a business when all you have to do is go to your own Thanksgiving dinner and see that half your uncles and aunts are completely insane. I would figure that the people leaving these reviews nut jobs anyway. The only review that would make sense to me, I'd want it to be video. I want to see the person's eyes talking cause you can see if they got crazy eyes. Like when your batshit crazy aunt is rattling off about conspiracies and all that stuff you can just tell by looking at her that she's drunk and crazy. But you know, I'd want to see a review, I mean is it coming from someone's who's dressed like they know what they're talking about or is it a crazy person? So I don't know. But you think reviews area big deal for a big portion of the population?
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Keith:
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They are. I mean that's not my thought, it's what has been proven by a variety of different marketing companies.
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Howard:
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And what percent of Americans, 325 million people, do you think are reading reviews and acting on them?
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Keith:
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Now they say somewhere close to 68% of people read reviews before, not just booking a dental appointment, before making an online purchase, before making a decision about a product they will, up to 68 or 68% of people will read reviews on that product or service.
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Howard:
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So that's two thirds of the market. Now do you see any age ... Am I saying that because I'm a grandpa, I mean you got two new babies, I got two grand babies. Is that an age deal? Is it because I'm an old man? Or are old people with liver spots looking at reviews?
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Keith:
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I think it's all over the place. My mother looks at reviews. My father turned 70 this year, he looks at reviews. It's not that they seek it out but if it's something that's there that gives them the opportunity to know that what they're buying is not going to fall apart or the guy that they're going to see, or girl that they're going to go see for their teeth is not some person that's going to be rude to them or whatever else, that gives them a level of comfort to make that decision. And to me combining that with immediately the ability to schedule in front of their face, right then and there, without having to switch mediums or platforms seems to give them the best opportunity to capture that patient at the point at which they're trying to make that decision.
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Howard:
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I would get serious about the orthodontic practice. I've been in this game 30 years and right now there's no competition amongst oral surgeons, endodontists, pediatric dentists, but the orthodontists have just had to wake up to competition in the last five to ten years and it's really, really getting competitive. Especially in the urban markets. The only orthodontists who don't have to anything you're talking about are in the rural but man if you're downtown LA, San Fran, Phoenix, whatever it's a competitive market. And now you're seeing the orthodontists, you're either killing it on all the high tech, soft stuff, great staff and you're doing double the guy across the street who doesn't master all the soft sites. So I think you'll do very well in ortho. There's ... We mail Ortho Town magazine to 10 thousand orthodontists every month, if you cut Alaska in half each half would be bigger than Texas. And if you cut the number of orthodontists in half each half would be bigger than the two next biggest specialties of oral surgeons and periodontists. I mean there just, there's a ton of them and it's getting competitive. So I think you'll do real well there.
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Keith:
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That's certainly on our map because orthodontists have to basically eat what they kill too. They have a limited period of time in which to take, not take advantage, but to have that patient in their practice. A general dentist may have, or excuse me a family practice dentist, may have that person for 20 years. Whereas an orthodontist has got three years. So they have to take advantage of all of their opportunities as they present themselves.
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Howard:
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What did you say, they have to eat what they kill?
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Keith:
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Yes.
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Howard:
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Is that another southern term? What does that mean they have to eat what they kill? What does that mean in business?
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Keith:
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It means that if you don't bring it you don't get to benefit from it. It means if you don't kill it you don't get to eat.
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Howard:
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Wow. I love that. And by the way, speaking of eating, is there even one person on earth who knows what's in gumbo? Or do you just like clean out the entire refrigerator and throw everything in there?
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Keith:
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If you make good gumbo you don't make it the same way twice.
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Howard:
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Oh is that the deal?
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Keith:
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Yeah.
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Howard:
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I'll never forget my most favorite new food ever was I was down there lecturing and some boys took me out in the ... I was lecturing in Baton Rouge, and no it was in Lafayette Louisiana and we went out catching red fish in the bayou, it was about a two three hour drive south and it was crawfish. Or is that what you call it? Crawfish or crayfish?
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Keith:
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Mud bugs, yeah same thing.
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Howard:
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Oh my god, when they said they were going to do that I thought they were crazy I said "Well that, in Kansas that's fishing bait. You're not going to eat the fishing bait are you?" And they cooked that stuff up and my god that was so good. I love Louisiana, I really love New Orleans. I just think it's an amazing city. So anything else I should be smart enough to ask you or did you pretty much cover it all?
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Keith:
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We went through a lot of it. The big thing that has been super interesting to me, not coming from dental at all, is the reduced level of expectation of what dentists will expect from their software. So they anticipate that it's not going to do what they want it to, from a default. Instead of assuming or asking if it will do everything they want it to do, they have just had to deal with such subpar efforts for so long that they assume that things will not do what they want. So we're really hoping that we can be part of and have others follow what we're doing to raise the level of sophistication of things that dentists can expect from their software platforms.
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Howard:
|
So you mean they've been let down by Dentrix and Eaglesoft so many times that they just expect it to be a disaster?
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Keith:
|
I'm not naming names, you're not going to make me, I can't do it.
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Howard:
|
Oh my god. Well you know Microsoft started it, seriously when we were growing up whenever Microsoft rolled out like Windows and 95, what percentage of the time was it riddled with bugs?
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Keith:
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100.
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Howard:
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And when you hear Bill Gates talking about all of this, all these ideas he's doing, he's trying to be this elderly statesman, I think to myself "My whole relationship with you Bill Gates, I would buy the software, that was one tenth of the price. Then I'd have to pay 10 times that amount for IT people to come in my office and fix your shitty software." I mean when people say "You want to see the books that Bill Gates is reading?" It's like, no I actually don't want to read any of the books, I want to take the books and throw them at him because the whole country had to pay 10 times for any of the money they gave him just because they would release that stuff. And it's true wasn't it? It was riddled with bugs.
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Keith:
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Yep and they ... That was their rollout platform and it's not an uncommon rollout platform for software companies is to put out a minimum viable product and then let users find, they become your quality ... Your quality assurance is your consumers finding the issues. They report them back to you, then you know what to fix.
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Howard:
|
Okay now do the same analogy to Steve Jobs. When they would roll out Macintosh what percent of the software was riddled with bugs?
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Keith:
|
I can't answer that because I personally will never use a Mac and never have.
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Howard:
|
And why is that?
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Keith:
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I find it not intuitive.
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Howard:
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I know my four boys they told me all through college "Dad, dad, you're an old man, you're senile, you're crazy, you got to switch to Mac." So finally I heard this for so long I said "Okay I'm going to do it, I'm going to switch to Mac and I'm going to commit. I know it's going to be rough but for one month I'm going to use Mac." I almost jumped off the tallest building I could find in like three days. I found it ... Yeah I agree. I found ... But what's weird is I use an iPhone though. Wouldn't you go get ...
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Keith:
|
Ah, no. I don't, I can't do it. I just, my wife does. So we have a pretty interesting division in the office, so we're a product focused business right so we spend all this time developing stuff, that's our core of what we have. We didn't have a sales force until middle of last year. So we have a very stark division in this company though of those that use Mac and those that use Windows space machines and Windows/Linux space machines but it's, I mean half of the office won't use anything but Mac and the other half of the office won't touch a Mac with a ten foot pole.
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Howard:
|
So the programmers like Microsoft and the sales team likes Macintosh?
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Keith:
|
Half of our developers don't use Apple either so our creative side of things tend to use more Apple based products but our hardcore integration developers they can't use Mac.
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Howard:
|
Yeah we have the same thing. So the dental office is all ran on Microsoft and then Dental Town, all the accounting and business and programming is all on Macintosh but to create a magazine, oh my god, they would only use Mac. They wouldn't even consider Microsoft.
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Keith:
|
Yeah and my wife's a photographer so that's primarily why she does it as well is just the creative side of things tends to be much more developed on Microsoft, excuse me on Apple, whereas you know ...
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Howard:
|
Well I'll tell you what, I just sent you an email and I'll be your sales team and I'll tell you what I sent an email and my programmer that does my todaysdental.com is Jake. My office manager Robert is the one working with Nathan Sparks, did you ever get Nathan to come on? Did you ever find the time ... Is he scheduled? Okay. So Nathan's going to come on to the show but we'll do this and then we'll track it and if it actually works and everything I'll write a column on it, cause I've been writing a monthly column since 1994 called Howard Speaks and I know that ... Bottom line is I'm proud that ... You know I see the data online so I see the views and reads, it's well read column, since 19- ... What year was it? 1994? 1994 and what is it now, 2017? So 1994, so that's 3 ... How many years is that? 1994 to 2017 would be 3 ... That makes ...
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Keith:
|
23.
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Howard:
|
23 years. That is amazing, 23 years I've had a monthly column. So I'll do a whole column on this because I like to find the new stuff and I want to jump on this and like I say, you can't have any more of an intelligent, raving business fan than Sandy Pardue. And maybe I'll even ... So I say you email ...
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Keith:
|
Come on down.
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Howard:
|
What's that?
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Keith:
|
Yeah I said come on down, we'll find you some more mud bugs.
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Howard:
|
All right I will meet you at Bourbon Street and we'll go over the progress.
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Keith:
|
Sounds like a plan.
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Howard:
|
The other things that ... The only warning I have on Bourbon Street is I was sitting at one bar, I don't even know what I was drinking but it was yellow and it tasted like somewhere between kerosene and gasoline but it went down really nice. But my god I drank some yellow drinks one night, I don't know how many I had but wow. That was ...
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Keith:
|
Hand grenades.
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Howard:
|
They were 10 times stronger than a beer, but anyway ... Hey, thank you so much for returning my call and my email and coming on the show. I think it's really neat that ... I can't think of how many people will have heard of this first on Dentistry Uncensored all because you were kind enough to come on the show Keith. Thank you so much and seriously dude, I just thought I'd talked to Leonardo DiCaprio, if you're listening to this on iTunes, hang up, subscribe, go to youtube.com/dentaltownmagazine. I think we got 3500 subscribers to the podcast on YouTube and you got to check this guy out, he's definitely the Leonardo DiCaprio of dentistry. Thanks a lot Keith!
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Keith:
|
Thank you very much for having me, I appreciate it.
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