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Howard Farran:
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It is just a huge honor for me today to be podcast interviewing Jonathan Abenaim all the way from Hawthorne, New Jersey. He's the owner of Jonathan Dental Spa and the Smile Syllabus institute in Hawthorne, New Jersey. Dr. Abenaim graduated from the University of Pennsylvania and did advanced implant prosthetic residency at Nova South Eastern University and Atlantic Coast Dental Research Clinic in Palm Beach, Florida. He is in the top five percent of elite cosmetic dentists in the United States to execute both surgical and cosmetic portions of dental implant dentistry. He's also a clinical instructor at NYU in the department of implant dentistry. He is passionate about staying current and progressive in modern dentistry. With his passion, skill and love of both learning and teaching, he opened the Smile Syllabus Institute in 2016 and is educating leaders in dentistry with continued education.
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Out of the office, he likes to spend most of his time with his four beautiful children and wonderful wife. We both have four children, so how old are your children? What ages?
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Dr. Jonathan A.:
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One of the things I have to say is it has to be four beautiful children and one beautiful wife 'cause I don't want to get in trouble too.
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Howard Farran:
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Okay well I can't say one beautiful wife. My boy's mother fired me after 20 years. My boys are 22, 24, 26, 28.
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Dr. Jonathan A.:
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Oh wow, mine is 11, 10, seven, four.
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Howard Farran:
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And mine are all boys. Did you get all the same or two of each?
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Dr. Jonathan A.:
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I'm good at controlling so girl, boy, girl, boy.
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Howard Farran:
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Well played. Ryan was supposed to be a girl, that's the only reason we tried to have a third one. He let me down right out of the gate, then his little brother Zack, he let me down so finally we threw in the towel.
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Hey I called you to be on this show, you didn't call me because you wrote this book "The Trust Factor, Empowering Your Team, Your Patients and Your Dental Practice." I always said, you know I've written books that ... Writing a book I mean it's like having a baby, it's a nine month process. What was going on in your life and your journey especially after having four children, that you decided you were gonna sit down and write a book?
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Dr. Jonathan A.:
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Actually the book was written not just by me but with my team members 'cause I really felt that I wanted to have a book that finally can be written and read by the whole team, in the persons point of view. My hygienist wrote some chapters, my treatment coordinator wrote some chapters, my assistant wrote some chapters and I wrote some chapters. I had a lot of great help to do that, but what I really wanted was ... The main reason I wrote the book is based on my journey and my evolution about how we do dentistry and how we speak to patients and how we do everything, we really felt that we wanted to be able to give that out to the world, but most importantly whenever we added a team member, the hardest thing was to teach them our culture. Now we basically have our book and it's like a manual. They read it, this is what we believe in, you believe in it, you work here you don't want to believe in it, next.
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You know ten years ago, I saw a great interview from an office in Arizona. They interviewed the team and the team said, "I was looking to work at today's dental and I couldn't believe that they were interviewing and I was so excited and I think it's an honor for me to work here." I'll never forget that. I saw that 10 or 11 years ago. I said that's what I need to build so thank you for that Howard.
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Howard Farran:
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Awe, thanks buddy. So you have two websites, what is the difference between Jonathandentalspa.com and smilesyllabus.com? And which one should my homies go to Jonathandentalspa.com or smilesyllabus.com? Which one of those would have your book for sale on it?
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Dr. Jonathan A.:
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My Jonathandentalspa is my practice website. If they want to be my patient, they can go there. If they want to learn about you know our digital syllabus, about our courses based off of the book, that's smilesyllabus.com. We have everything that we have there. In terms of buying the book, just go on Amazon, it's sold there. I would definitely urge them to follow me on Smile Syllabus Institute on Facebook, we update that every single day with, whether its digital dentistry, new workflows, whether its things that can do in the office. Every morning I actually do a 10 minute conversation in car on the way to work with another dentist and we call it dentist in cars. They can check that out also on iTunes.
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Howard Farran:
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It's on iTunes, so it's a podcast?
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Dr. Jonathan A.:
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I don't like to call it a podcast, I call it a conversation. It's 10 minutes or less.
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Howard Farran:
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Well you know the best marketing for podcast ... The only reason I started the podcast is 'cause we started Dentaltown in '98. Then I did an online CE course in 2004 and kicked off that but we started a podcast section and now there's 39 dentist uploading podcast or an audio file whatever, but look at the views on some of these. Like this guy started a podcast, how to open a dental office and he's at 674,684 views. I think if you started uploading that, what do you call it? Conversations in cars?
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Dr. Jonathan A.:
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We call it dentist in cars.
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Howard Farran:
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That is so cool, I love it. Dentist in cars. But yeah, I think everybody whose put their podcast on the Dentaltown, they said their iTunes exploded. That's where a lot of people found these shows. That'd be a huge honor if you started doing that. Back to your patient website, I just want to say congratulations on that because on the Jonathandentalspa, you know whenever a dentist emails me Howard@dentaltown.com, a lot of times I click their website to see who I'm talking to, you know just to look at it. I'll tell you 80% of the websites, it looks like they bought 'em at a convention five, 10, 20 years ago and they haven't done anything with it. What I like the most about yours and why I think it's the most effective is, you have YouTube videos on there.
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If I was a consumer and I was living in the great state of New Jersey, I just think it's really cool to be able to see the dentist himself talking and talking with patients and they get to see who it is. What percent of dental websites do you think actually have a YouTube video of the dentist talking like a human?
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Dr. Jonathan A.:
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Who even knows, I mean probably very, very little. I mean one of the things we've started doing is, which is tremendous and really cool is, we now Facebook live in the chair, with the patient, with the conversation to show the patient's emotion, the way the patient is experiencing, to see that its not that hard. The truth is people have been saying it for years, we don't treat teeth we treat people. Today it's more than ever so we don't even show teeth, we just show peoples reactions, the way people are treated, the way that people are spoken to and that's tremendous.
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I'm not showing about me creating an Osteotomy at 1400 rpm with saline flying in and making a hole in your mandible, nobody wants to see that. They want to see the vision of what we created for the patient and how they feel after that.
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Howard Farran:
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What does it mean when someone like yourself says "Welcome to smiles by Jonathan at Jonathan Dental Spa?" What really is a dental spa? What do you think a dental spa is? But more importantly what does the consumer think when they see a dental spa? What is that?
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Dr. Jonathan A.:
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When I started my practice 10 years ago, that was in the, I would say maybe the infancy or the pinnacle of a lot of people doing a lot of different things for their practice whether it's like aromatherapy, paraffin waxes, massage chairs, foot massage in the office, 3D glasses during dentistry, all that fun stuff. I came out of the gate, I got all this stuff and I landed in New Jersey and I'm ready to rock and roll and everybody says to me "No, no, no man I don't have time for that. No, no, no it's okay just get it done, just get it done, just get it done." What happens is that our practice evolved from Jonathan Dental Spa to really Smiles by Jonathan, which is what we create every single day, but the problem is I had built of the brand of Jonathan Dental Spa, I'd be killing myself if I just got rid of my name. What we do now is we added Smiles by Jonathan at the Jonathan Dental Spa about a year, a year and a half ago and slowly we're gonna actually transition out of dental spa.
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Howard Farran:
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You have something very interesting on your Jonathandentalspa.com website, you have an article "Pink by Jonathan, a break free technique, a scalpel free, suture free procedure for correcting gum recession. Involves laser bio stimulation, stem cells and gum rejuvenation, gingival recession also known as gum recession, can be corrected without cutting or stitching. The affected areas are treated using stem cells and collagen to help speed up healing and reduce infection. There is no cutting or stitching. Patients can expect minimal post operative symptoms of pain, swelling and bleeding. Patients at our dentist office are pleasantly surprised by the instant cosmetic improvement." When did you get into that? How do you do that? What's that all about?
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Dr. Jonathan A.:
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80% of my practice, its surgically oriented. I do the surgical portion of implant dentistry and the restorative portion. Based on my experience, we mill our own zirconia restorations, we use intraoral scanners to create all this fun stuff and because of my surgical experience, wound healing is wound healing. We all know that right there's a very, very hot course called pin hole surgical technique. I took a course with Dr. Chow, pin hole surgical technique. Dr. Chow's technique is unbelievable, it works really, really well but I knew that because of my surgical background, I could make that technique even better and more predictable.
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I was doing a lot of PRF in my practice for my surgical sites but whenever I was doing any flaps or anything like that so I said "You know what? I'm gonna put PRF inside that hole." I created what's called Pink by Jonathan, where we put, not only do we put the Bio-Gide, that's with the original technique, but then we go ahead and we put some stem cells to allow the flap to not move. Then on top of that, one of things I learned with my implant surgery is that I wanted my patients to heal better. Whenever we had an infection, we used to use a Nd:YAG laser with laser bio stimulation's. We put everything together, whether it's the PRF, the Bio-Gide and the laser bio stimulation and I call that Pink by Jonathan because I've never seen anybody especially on PST pin hole surgical technique forums that's ever done that. I was the first one that posted to do that so I put that together and called it Pink by Jonathan.
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Howard Farran:
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Very, very interesting of course my job is to guesstimate what all my homies ... 85% of these guys are commuting to work right now and I think podcast massively took off. We started two years ago. The first year was during the year long election, everybody got so sick of radio they didn't want to hear about it anymore. There all commuting to work and their listening to podcast instead of radio, but I know what they're thinking. They're saying well first of all ... Your implant training, where do you learn how to get implants? What system did you learn? We just had 6,000 kids graduate from dental school last week and they're all coming out saying Jonathan I didn't place one implant in dental school. How do I go from I've never placed one to one? How do I go from zero to one? Do I have to pick the implant first? Do I pick the training?
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Dr. Jonathan A.:
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It's a really wonderful question. A great friend of mine his name is Paul Goodman, he said to me, he said "Jonathan, a dental implant is a monster post and core." That being said, when a student will say to me ... You know I teach at the University so I teach implant surgery, and when they say "Well I've never placed an implant," I said "Well think of it this way, it's a big post and core with a bigger screw." The difference is that there's now a surgical component attached to it. If somebody wants to learn implant dentistry, we know that implant dentistry is a prosthetic discipline with a surgical component. The first thing I would say to them is, "Restore these cases, work with your lab, work with your surgeon, start restoring these cases. Once you mastered the restorations, then you go start taking teeth out, now when you take teeth out, start doing some bone grafts, don't charge so much. Get your suturing technique under control. Someone is not gonna teach you in nine months everything you know about implant dentistry."
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You know I just got my boards in the American Board of Oral Implantology and I hope they're not listening to this, they may be but I took the exam without ... I didn't even study for the test, I just went to it. I was glad I didn't study. I passed by the way, [inaudible 00:13:19] I was glad I didn't study for it because you cannot teach experience. You need to see these things, it's not in a book. It's all about the numbers, the more that you do the better you're gonna be. So start doing a lot of extractions, start doing a lot of bone grafts, then do the single implant. Learn how the system. Pick a system that you like, learn the parts. The same way that a salesman whose not a dentist knows exactly what speed to go out, how to hold the drill, what part goes into what part, that's okay. That you can learn, it's very easy but the prosthetics and the surgical components of treatment planning, that you have to go and spend some time. Find yourself a mentor, take a course, but it's a lifelong learning. You cannot stop.
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What I did 10 years ago, I do not do today. It's just completely different and probably what I do today, I won't do in six months just because, especially with the way that I do digital technology today, like today I took a full upper arch with a full intraoral scanner and we're designing the restoration right now in house. We're gonna put it in the machine tonight and it's gonna mill. By tomorrow we come in, we have a full arch bridge ready to give the patient.
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Howard Farran:
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Is that an all on four, a full arch bridge?
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Dr. Jonathan A.:
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Yeah, so for me we don't do all on four because if you lose one it's all on none. We place as many as we possibly can, we don't charge the patient. We charge per case fee. I talk a lot about this in my book about not penny pinching your patients, really treating them like people. Yeah The Trust Factor and really allowing them to be treated like people the same way that you would want to play. If a patient trusts you to do their reconstruction, you better make sure it works. If you think you can make it work with four implants, do it with four. I personally think I need as many as I can because people smoke, a lot of people are on antidepressants, there's a lot of osteoporotic drugs, there's a lot of rheumatoid arthritis drugs and those implants, we are gonna have an epidemic in 10 to 15 years of all the implants that were placed. Peri-implantitis is a real thing because of medical history. If you don't over engineer your case, you're gonna be in a lot of trouble in a couple of years.
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Howard Farran:
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That was some of my biggest regrets from 30 years ago. I'd place two implants and do a three and a bridge, and then 20 years later I'm in the nursing home standing at her chairside and my assistant, one of the implants failed and Jan and I are thinking, why didn't we just put three implants there? Then you coulda lost one of the implants and you'd still have the bridge. They're asking in their car, what scanner do you use? What miller do you use?
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Dr. Jonathan A.:
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Yeah so that's a wonderful question. In my course I give a two day digital dentistry course that goes over for milling, scanning, printing, everything, all the workflows that we created. People that don't do digital dentistry, that's what they ask because dentist are like that, they assume that they can buy a piece of equipment, bypass all the education, plug it in and make it work. Just like what bur? What loops? Digital dentistry is about learning, understanding the technology and then it doesn't matter what mill you have. It doesn't matter what scanner you have, there all the same as long as you understand the technology. In terms of the mill, we are all taught about the CEREC. We say we're a CAD/CAM dentist, but let me tell you people that use CEREC are not CAD/CAM dentist 'cause they don't do any CAM. It's hidden, Sirona it's closed. CAD it's minimal, there's so little they can do a single crown a bridge, that's it but in real digital dentistry you can do so many different things.
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Like I'm creating something called the Jonathan solution, which is for patients that can't afford full zirconia bridges, what we're doing is, we're now designing fiberglass bars with long term PMMA on top of that and we deliver that to the patient. The lab cost is tremendously low, the patient has a fixed restoration and there's no more dentures. Now they can pay for dentures and still get a fixed restoration. Not mini implants, real size implants, real long term, we use digital dentistry to help us do that. So what mill, what scan, I would say come to my course, let me teach it to you and then you'll know exactly what the right questions are to ask.
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Howard Farran:
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Your courses are at SmileSyllabus.com.
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Dr. Jonathan A.:
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Correct.
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Howard Farran:
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Your courses are generally, what are they generally two days? Talk about your course you have.
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Dr. Jonathan A.:
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My course is two days, its full 16 hours. The people that have said to me that when they left, even after day one, that they had a knowledge headache. They felt inspired, they now see what is possible. And tremendous, it inspires people to do more for their patients because there's so much they could do. Dentistry all of a sudden is so much more fun, like I can't believe it's 6:30 right now. I have not stopped all day and I don't feel tired because it feels amazing to do this. We give a two day course which really that two day course can be a two week course but we pack it all in because I want every single person that comes in, to get exactly what they wanted out of the course. I was tired of going to courses, getting people to sell me things and I never got what I wanted out of it. My commitment is, that when you come and you have a realistic expectation of what you're gonna learn, you will get it when you leave.
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Howard Farran:
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You would basically go get to Hawthorne you fly into Newark right?
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Dr. Jonathan A.:
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Yeah fly into Newark, there's a Hyatt hotel seven minutes away. Newark is 20 minutes from my office. It's a beautiful little town called Hawthorne. There's gorgeous restaurants around, it's 20 minutes from New York City. The courses are usually Thursday, Friday, people stay with the weekends with their family and it's gorgeous. We have food, we laugh, we really have a great time. We don't hold back. I'm not sponsored by anybody so I tell you the truth of what is going on. If I tell you something is broken and it doesn't work, you'll know it's broken. I'm not gonna lie, nobody censors my slides. Again, I get a lot of slack for it I have the big companies calling me and telling me to stop it, stop talking, stop doing this, but I'm an advocate for the dentist. I am there fighting for you guys so that nobody takes your money, nobody tells you to buy something you're never gonna need and that 100 pound paper weight will never be in the corner again based on what I'm gonna present to you to do.
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Howard Farran:
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You were born in Montreal, Canada right?
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Dr. Jonathan A.:
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Yeah, Montreal, Canada.
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Howard Farran:
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Do you ever give like a French version of the course? Do you ever have like a French only course?
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Dr. Jonathan A.:
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I actually don't get to go back too much.
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Howard Farran:
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You should go to Paris and give this lecture in French.
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Dr. Jonathan A.:
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I just came back from London and I think London is probably a little bit more dangerous than Paris, not because of what's been going on lately, but because of the way they drive. I think I almost got run over a couple times 'cause I didn't know to look right and left, I just looked one side and I was always going the wrong way.
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Howard Farran:
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I couldn't even imagine driving in any of those countries where they drive on the wrong side of the street.
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Dr. Jonathan A.:
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I wasn't even driving I just tried to cross the street and I had a hard time.
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Howard Farran:
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Right 'cause your instincts, you're looking the wrong way it's crazy. You don't need marketing but I think the best marketing that I've seen people do for this course is when they have a two day course, they put one hour online CE course on Dentaltown, because it's a big jump for my homies especially if they're young and have [inaudible 00:20:41] from a flyer to flying all the way to Newark. But man I've seen dentist ... Or they'll put ... Like the Pankey Institute does it, they'll put an hour course showing kind of a highlights of week one and then another course. They did four one hour courses, one hour course showing what each week was about. Of course, I just want to get some amazing guy like you to put an online CE course on Dentaltown. Also, I would love to get articles on this.
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I mean if you ever want to write an article for Dentaltown Magazine because this is what everybody's questioning, but you said something, I want to drill down on it farther, when someone says they're a CAD/CAM dentist are you kinda saying that the CEREC machine is just a small piece of it, mostly a single crown replacement and you're doing it more ... 'Cause you notice the labs, they don't mill one crown at time, they mill big disc. Is that what you're saying, that kind of CEREC CAD/CAM is kind of entry level, one tooth at a time and you're doing full roundhouse bridges and that's not really a solution you're gonna do with a CEREC machine?
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Dr. Jonathan A.:
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Well let's talk about that. Do you remember Easy-Bake ovens?
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Howard Farran:
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I had five sisters so yes, that was one of my favorite pieces of technology ever invented.
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Dr. Jonathan A.:
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All right so the Easy-Bake oven you know very well had a halogen light bulb correct?
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Howard Farran:
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Right.
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Dr. Jonathan A.:
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All right, it had one button and only one recipe to put in.
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Howard Farran:
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Chocolate.
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Dr. Jonathan A.:
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Right. Every time you flicked it, you knew exactly what you were gonna get correct?
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Howard Farran:
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Right.
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Dr. Jonathan A.:
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But you decided you wanted to make a fondue, you decided you wanted to make a croissant, you wanted to make all this gorgeous baked stuff, could you use a Easy-Bake oven?
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Howard Farran:
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No.
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Dr. Jonathan A.:
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No, you'd have to actually be a little bit more grown up, you agree?
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Howard Farran:
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Right.
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Dr. Jonathan A.:
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And have to use a real oven so for me CEREC is a single, one trick pony Emax single unit crown, that's it. When somebody says to me "I mill, I scan, I design, I'm a CAD/CAM dentist" it's actually a marketing lie that was told to them. You're not a CAD/CAM dentist because you don't understand CAM, you don't understand CAD and you don't understand acquisition because there's so much more to that. Now let's look at the new game, the new game in town is you can buy the scanner that's best there for you. You have the ability to buy design software that allows you to design night guards, allows you to design temporary's, allows you to design bars, allows you to design single unit crowns, allows you to design custom abutments and let's talk about the economics Howard.
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A puck, a zirconia puck costs anywhere between $100 and $160. Out of one puck, you can mill a minimum of 30 single unit crowns. This is the best zirconia in the world. Did you just do the math?
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Howard Farran:
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Yes.
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Dr. Jonathan A.:
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Insane. For somebody that says to me "Oh I'm a CEREC dentist," I'm like "Well enjoy paying $50 a block for a material that's sub par than zirconia." We have the ability ... Today, I'm doing testing in my office where we're doing Zirconia and I'm holding it side to side to ... Full contour, not layered, none of that stuff, full contour zirconia next to Emax, it is not a comparison. The zirconia blows it away by unbelievable in terms of aesthetics and we get triple the amount of strength so why not?
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Howard Farran:
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If you're driving to work, it's hard to take notes. I just went to Amazon.com and looked up his book The Trust Factor and then I forwarded it out on Twitter. If you follow me @HowardFarran, I just re-tweeted The Trust Factor: Empowering Your Team, Your Patients, and Your Dental Practice on Amazon. I know my homies Jonathan I really do, I know what they're saying, they're saying "Yeah but I don't think any of this applies to me 'cause I'm in Parsons, Kansas and you're talking about this big fancy dentistry." Or they're thinking, where the hell do you get these patients? Or is Hawthorne a miniature Beverly Hills? I'm in a blue collar middle class America, what island is Jonathan on? What would you say to all those self limiting beliefs?
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Dr. Jonathan A.:
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Look up Hawthorne, New Jersey, you will see that I practice in a old school Italian town, blue collar to the max. Unbelievably nice people that work for every penny they have. Again, I once watched this unbelievable DVD 10 years ago and this person said "You know dentists, they want to be high end dentist and they go for that two percent of the people. Who's taking care of the other 98%?" That resonated with me Howard 'cause that was you. All right, and you said, "I want to be the guy that takes care of the 98% of people."
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I don't take care of the top two percent. My patients work really hard, they all use financing, they all use Care Credit, a lot of them have co-signers. It's something that because of the methods that we talk about in the book, we really get into why they need this and we tell them, "There's a reason that you got in the car today to get this done." You know what, when a patient is waiting four months for his implant to heal ... I had a patient come in, we did a digital scan on him, no cost, no impressions. I designed the crown in under five minutes, I milled it in 15 minutes, it's sitting in the oven tonight, tomorrow when I wake up I'm gonna deliver my zirconia restoration and it's gonna cost me less than $20.
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If you practice in Kansas, why would you not want to do this? Because you're gonna be the guy who people give to, Remember you don't need that many patients. If you have 1500 patients and each patient only does two cleanings a year and maybe one filling, each patient is about $1000, that's $1.5 million practice. You don't even have to try. You don't have to go for that two percent. You don't have to be a full arch dentist but guess what? It's when I tell people that say to me, "Doctor, I'm 67 years old, I don't want to spend any money on my mouth." I always say to them, "If you were gonna live only two more years, would you want those years to be the best years of your life so that you have the ability to eat whatever you want? Smile as best as you want? But in two years the clock just takes off."
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That's what I tell to dentist, "If you're only gonna practice for five more years, would you want those five years to be the best five years of your life? Or would you want to suffer through packing cord, impressions that get lost on FedEx, labs that call you and tell you that your impression is poor or crowns that don't fit, why would you not want the rest of the time that you practice to be fun, predictable and amazing?"
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Howard Farran:
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You know that's amazing that you said Hawthorne, New Jersey was an Italian community because one of my best buddies and role models, Gary Esoldi we actually went to undergrad together at Creighton University and we were roommates at Creighton hall and Esoldi, I mean that's Italian, anything that ends in Esoldi right, anything that ends in I is probably Italian right?
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Dr. Jonathan A.:
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Yeah, yeah.
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Howard Farran:
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And man what a great guy. Gary I hope you're listening man, thanks for all the fun. If you go to smilesyllabus.com, there's a lot of information. You can order the book, you can register. What else are my homies gonna find on smilesyllabus.com?
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Dr. Jonathan A.:
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I think my favorite section on top of there is the videos, which is snip bits of my lecture. They could just see what its all about. You know we talked about the online, you could see all the people that have been there, all the people that have experienced it, you can listen to their ... I've hosted leaders from all over the world and these are not regular guys that come. I've had some regular people that come and they love it and then we have the experts that come and they can't believe that there's something that they don't know. It's for everyone because it makes dentistry super, super fun. I love the videos.
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Then the thing where I'm really super excited about is, in December we're gonna be having our first course for the whole team. It's limited to seven teams where you come the dentist, the hygienist, the assistant and the treatment coordinator and we're gonna have a two day course about how we do what we do, not in terms of dentistry but the way that we treat our patients, the way the forms are filled out, the way the new patient exam is, the way the hygienist speaks to the patient about something that they see. We have something in the book called the trust hand off, we have all these different things that we talk about and heres the thing, you may be the best dentist in the world but if people can't listen to you and they can't trust you, it doesn't matter who you are.
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Somebody once said to me "Jonathan you could be Michael Angelo but if you don't have a canvas, nobody will ever know." Your patient is your canvas and if they don't allow you to paint on them, its over.
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Howard Farran:
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You know I do, I love your videos. I watch all your patient testimonials on Jonathan Dental Spa but that was the one I ... I mean it really is, it's very amazing stuff. My question is, when I watch your videos, to me my first gut feeling was that you had a dental laboratory background, that you grew up in a lab 'cause it looks like you're really mastering the laboratory side of this. It's almost like, where did you learn all these skills? Did you work closely with the lab? How did you find and learn all this stuff?
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Dr. Jonathan A.:
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It's so easy Howard. It's dentistry, we're all dentist and CAD/CAM technology just makes it so much easier for us, so no ... Let me tell you something I did my first onlay in dental school, I had to do it 10 times on dentiform that I threw it across the room and I swore I would never walk into a lab again. But let me tell you something, when I mill a zirconia restoration, and I sit there right just for even 15 minutes, I can put my headphones on right, early in the morning or late at night or on my day off where I could just put on my headphones and sit and paint, it's zen Howard. My kids I take them to color me mine or pottery and I spend $150 for them to paint. I am now getting paid to paint, why would I not want to do that? It's so much fun. I'm not telling you to do a full arch reconstruction, the laboratory is so important but there's so much that we can do for our patients, that we can provide treatment that changed the way dentistry has always been thought of, that why wouldn't we? Why would be stuck in the way that we were before?
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My mission statement that I wrote when I was in dental school is, "I want to change the way people look at dentists."
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Howard Farran:
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That is a hell of a goal.
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Dr. Jonathan A.:
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Its not easy. I also want ... My new Smile Syllabus goal is I want to change the way that corporate companies treat dentist. I can't tell you how many times I'm sitting in a stall pissing listening to reps talk about dentist. The way they talk about us, there's no respect, zero and we work so hard for our money that they just "I'm gonna get this guy for this much. I'm gonna get this guy for that much. He can afford it, he has this car, he has that car." We all worked really really hard for what we have.
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Howard Farran:
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We're trying to focus on the 30 and under club. You've talked about implants, you gave a lot of advice on CAD/CAM. Another question they have is lasers, what are your thoughts on lasers?
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Dr. Jonathan A.:
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I was a Diode laser guy for I don't know, what am I 12 years in practice? 11 years. I have packed cord since I left dental school. That was one of the things that when I went into [inaudible 00:32:58] I was like there's no way I'm gonna go into [inaudible 00:33:00] if I have to pack cord 'cause imagine prepping 30 teeth and packing cord in each tooth, I would (explosion sound) it just wouldn't work for me you know. When the back one moved, I'm like Oh my God, that's like an extra 45 minute appointment. When I found a Diode laser to trough around the margins with no recession, it was like God send to me. I knew that there was something else with lasers out there that I'm like, these laser dentist they love it.
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I had a rep come into my office and I met with all the companies and one rep just resonated with me what he said and the fact that his laser was so powerful, I don't use a Diode laser anymore, which for me is just a hot paper clip after I use this type of laser. I use a laser that has a combination of Nd:YAG and a erbium laser so it's a hard tissue and a soft tissue laser and you could do so many things. You can do cosmetics with it, when I mean cosmetics I talk about lips. You can do sleep apnea in terms of getting rid of snoring, you can do biostimulation, you can do obviously the regular stuff that we talk about Perio, class one occlusal composites, troughing, troughing around teeth is so much fun now. I can actually feel the tissue. There's just so much that can be done with lasers. I actually happen to use a laser, I don't know if it's important to say ... Is it important to say the type of laser that I use?
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Howard Farran:
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Yeah absolutely, please say it.
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Dr. Jonathan A.:
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Yeah so I use a Fotona LightWalker which is a dermatological company that makes medical lasers. They made the exact same laser that gets used 24 hours a day by doctors, for dentist. Its unbelievable. It's a Fotona LightWalker, I love that laser. It's built like a rock, I kick it around, I throw it around, it just doesn't break. It's wonderful.
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Howard Farran:
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How much is Fotona LightWalker?
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Dr. Jonathan A.:
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I think it's anywhere between $50 and $70,000. I'm not really sure but one of my favorite things that I use my Fotona laser for is crown removals on bonded teeth, so cool. Without breaking the crown. I love that.
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Howard Farran:
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Really? Talk about how you do that.
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Dr. Jonathan A.:
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I once had a case, a patient that's one of my cases that I show in my digital dentistry course, patient came in, zirconia restoration, we put it in, the lab totally screwed me, I put it in and I started adjusting everything and the guy was so excited, he was so happy about it, I too some pictures and then I went home and I looked at the pictures, I'm like this is an embarrassment to society. I cannot have this person walk around. I sent the exact same case with the impressions and everything back to another lab and I got new crowns taken. Now the patient comes back for his two week post op and I have to tell him that his new crowns that the loves, I'm now gonna cut them off in zirconia. Can you imagine what a shit show that would be? I take out my laser, we go on a erbium setting and we shoot energy between the zirconia crown and the tooth and it debonds the cement without breaking the crown in case my new case wasn't gonna work. If you ever have a case where you need to reuse the crown, you have the ability to take the crown off without doing anything. Thank God I was able to put the new ones in but I didn't want to destroy the ones that he loved. I remember that it's great.
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Howard Farran:
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Now do you do endo also?
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Dr. Jonathan A.:
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Haven't done endo since dental school.
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Howard Farran:
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Help these young kids, I'm gonna throw a rant at ya and tell me what you think. In 1900 you just had a doctor, and they did the whole body head to toe. And health care's only one percent of the GDP, by the end of the century, 2000 there were 58 specialties and healthcare was 14% of GDP and dentist had nine specialties. Now at 2017, healthcare is 17% I guess the point I'm trying to say is this, some dentist try to almost want to go back to 1901 where they're gonna do everything. Do you think a kid can really do everything? Place implants? Do endo? Do sleep apnea? Do ortho? Do restorative? Be a cosmetic dentist? Or do you think that's not gonna happen? I mean there's so much to learn. Like in the United States, there are 40,000 journals each month that go to physicians, dentist, MD's I mean you can almost barely stay up on one thing.
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So when these kids come out of school, give them some parenting advice I mean 'cause sometimes the kids start talking to me and I think, well this is scary they name every single thing and they're gonna do it all and I'm like "Do you think this is 1917 or 2017?"
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Dr. Jonathan A.:
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I think that firstly the kids coming out of school today are as arrogant as ever. Okay, they think that they know everything. I mean I was arrogant when I got out of school but I see ... Maybe it's just because I'm getting older, but there as arrogant 'cause they do not understand that when you screw up this is not a class, this is real life. When I tell people, and it's not associated just with the GP, it's associated with a specialist too, I'll get back to the GP in a second but the specialist, I get a phone call from somebody, he's an orthodontist, he just graduated from residency and he's asking me about buying a ortho practice in Hawthorne, New Jersey. I said to him "That's great you just graduated Ortho?" He's like "Yeah I went to ortho school, I know how to do the cases." I said "Let me ask you a question, what do you know about running an orthodontic practice?" He's like "Well actually I don't know anything." I'm like "Do you know how to bill for it?" "Uh, no I don't really know how to bill for it." "Do you know how to hire people?" "Uh no, not really." Do you know where to buy a new chair?" He's like "No, I don't really."
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The questions about what we go through every single day, that we have to find the answers for was just no, I don't know. I said to him "Find a mentor, find somebody that's gonna teach you how to be a dentist 'cause guess what, just 'cause you have three letters after your name, you're so far from being a dentist you don't even know." Even if you're a specialist get somebody, learn even it's somebody that you don't look up to you'll learn what you don't want to do so you'll just do the totally opposite but if your lucky enough to find someone that does what you want to do, then you copy him.
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In terms of GP's yes its so open, it's amazing it really feeds the millennial ADD because you can do so many things in dentistry and there's more and more but for a GP when I tell them, I'm like "Sit down, buy yourself a macchiato, sit in Starbucks put some really nice music, take a blank piece of paper and write your vision for yourself in the next five years. Whether it's procedures, whether you want to be personally, where you want to be professionally, where do you want to live, how long do you want to work. Get those answers all down before you think your gonna do endo, sleep apnea, implant dentistry, restorative dentistry, oral surgery, bone grafting, periodontics, there's too much. Go slow because if you go head in first, you may really drown so fast because you'll never be able to enjoy the fruits of labor of dentistry, 'cause dentistry's so much fun today. It really is like I can't wait to get to work because it's not work. I get to change peoples lives. I work with unbelievable people every day. Its fun.
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It really is and the mistake that you can do is either A, be stuck in something that you never want to do because you don't have a vision. Stephen Covey said it a million years ago "Begin with the end in mind." Dentist are not immune to that. Begin with the end in mind because if you don't have a vision, you have nowhere to go. You don't know where to start.
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Howard Farran:
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I want to walk you into a dark area because of what you just said having fun. It is a very common thread on Dentaltown where dentist ... Especially in their '40s maybe '50s will say "You know I'm just gonna be honest, I'm burned out. I'm tired of this game but I got a family and I'm a dentist. It's not like you can go make this kind of money working at the waffle house." What would you say to a burned out dentist at '45 and said Jonathan I'm just fried? And you're saying it's fun and I'm fried. What would you say to that guy?
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Dr. Jonathan A.:
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One of the things I learned is that it starts from the top. If you yourself keep telling yourself I'm burnt out, I hate my job, I hate going there, you know what happens? Every single day you're surrounded by people that hate their job even more because they don't make the money you make. Imagine being in a toxic environment like that. First thing you have to do is change your mindset. If you want to be miserable the rest of your life, the only person that's ever gonna be able to help you is yourself. You need to make a change for yourself and I talked about it in my book. I kept losing patients left and right, employees left and right, I was being successful but it was not fun. Before I went on a vacation boom, I lost an employee. My vacation was destroyed. I said to myself, I always said it's the lab, its the employee, it's the dental chair, it's the hand piece, its the bur, last person I ever blamed myself was me so look deep inside of you and see what is wrong that you're doing that's not making you happy and change it. Don't keep going down that road that makes you unhappy.
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Guess what if dentistry, really dentistry does not make you happy, then don't do it anymore. Don't do it, go do something else. Go buy a hotdog cart, go do something that makes you fun, go be a consultant. I got an email from a DSO who wants me to be there clinical director $600,000 a year, $1.2 in equity, that doesn't make me happy. People that search for money for happiness, will never be happy. Success is not defined by how much money you have, success is by the way you effect people, the way that you make a difference in the world, do that. People that are multi billionaires, Bill Gates, Mark Zuckerberg they are giving away all there fortune 'cause they've realized that its so much better to give than to take. For me its just logical. If you want to be burnt out, you want to complain, you want to say your always tired, you want to say I can't, I can't, I can't, its never gonna change but if you really make a conscious effort to say I need to be better for myself, do something that you enjoy. Pick one thing that you enjoy, that you look forward to it.
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In the summer my wife goes away to upstate New York, I hated going to upstate New York but when I go to upstate New York my phone service sucks. It allows me to just be zen, to get away and that whole week that's what I look forward to doing. My family's away, I can't wait to see them on Thursday night. I'm dead tired, luckily I drive a Tesla, my car drives by itself, it gets me there right, but look forward to something that you love. Being burnt out is just an excuse. For me, I once heard somebody say, "An excuse is just a well planned lie."
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Howard Farran:
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Do you drive up to the Finger Lakes area up north, is that where you go?
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Dr. Jonathan A.:
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I go to Catskill Mountains. Monticello, New York.
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Howard Farran:
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Man I love the Finger Lakes out there but you know what you said, you said you blamed it on everybody but yourself, my favorite Michael Jackson song was always Man in the Mirror. You know it's the man in the mirror and I'm sure your favorite song, you're from New Jersey so I'm positive your favorite song is either from Bruce Springsteen or Bon Jovi, did I get it right?
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Dr. Jonathan A.:
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Close.
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Howard Farran:
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Which one of those two is number one if you had to pick between Bruce and Bon Jovi?
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Dr. Jonathan A.:
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Bon Jovi all day.
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Howard Farran:
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Bon Jovi all day but you know but seriously they're saying it's all been ruined already there's nothing I can do. The whole markets been taken over by PPO's and corporate dentistry. You don't understand times are different than it was 30 years ago. What would you say to a dentist who says I'm being threatened by PPO's and corporate dentistry?
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Dr. Jonathan A.:
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The only person that's threatening you is yourself. One of the theories that we have is that we live in abundance. When you live in scarcity, your patient sees it. When you are like "Oh my God I gotta grab this, I gotta grab that, when you have the mindset that there's one pizza pie, there's eight slices and when more people, more DSO's, more corporate comes in and makes my slice smaller and smaller and smaller, you live in scarcity. I don't believe that. I believe that there's millions and millions of pies. I went to symposium this weekend and the statistic is that by 2020, it's right around the corner, there's gonna be 61 million patients that will need full arch implant dentistry. So for you to tell me that corporate is taking off, is taking that away from me, you don't need all 61 million of them. Hell give me 100,000 of them. I'll be good to go. There's so many patients. People are being born every day, every single day. You didn't fix all their mouths. 50% of patients don't have a dentist.
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One of the things this weekend did for me is to realize there's so much opportunity, there's so many pizza pies out there, I just gotta find them. I don't need all of them. That's why my course, all this stuff that I do, my Trust Factor, my digital dentistry, I don't make money giving courses Howard, I make money doing a practice. I do this because I want to leave a legacy for myself and share with people. If I could inspire somebody to help another patient, that's part of my work. That makes me happy. When somebody text me it's like "Man I just did this case and I'm so excited because of what you taught me, thank you so much." That's the best feeling in the world. I can't charge enough to do that. I can't get paid enough.
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Change your mindset. Nobody's taking ... When you say corporate dentistry, I hear I'm scared about corporate dentistry because the guy who just graduated, who corporate dentistry hired is better than me. That's a joke. He or she can never be better than you. How old is this doctor 40, 50?
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Howard Farran:
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That's funny until you said the word joke I heard no Canadian accent out of your mouth but when you said joke, that was total Canadian. Yeah I'm on the centers for disease control website right now, CDC.gov and I mean they're saying right now that 27% of Americans between 20 and 44 have a cavity right now. So one in four Americans are walking around with a cavity. There's 325 million Americans, they're saying that 38% or Americans between 18 and 65 didn't even see a dentist one time last year. That's basically 40%. If one in four adults are walking around with a cavity and 40% didn't even go to the dentist last year, there's a lot of upside in every community from Kansas, to Hawthorne to L.A.
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Dr. Jonathan A.:
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It's unbelievable the opportunity is huge. Remember what I told you, you don't need to be a fancy dentist 1500 patients, $1000 each, $1.5 million a year. A cavity and two cleanings.
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Howard Farran:
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You've talked a lot about clinical dentistry, what about business. I want to switch to business for a minute. We've surveyed dentist on Dentaltown.com every month since 1998 and for 20 years if you lined up 100 dentist and said what stresses you out the most? What keeps you up at night the most? Its always staff. It's staff, staff, staff. What advice would you give to a dentist whose sitting there saying you know my assistant fights with my hygienist, I know that every time the earth goes around the sun they all come in the office and want another dollar raise, it's all based on the zodiac. My overhead goes up every year, I tell 'em that, they still want a raise. They just have the hardest time with HR. What advice would you give 'em with HR?
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Dr. Jonathan A.:
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First things first I'm all about the definitions. For me that staff is an infection. If you have staff working for you, get rid of them. First thing you gotta do is you have to have a team that works with you. If you have a team that works for you, they will always ask for more money. First things first, you have to set the definition and the culture in your practice. That's the first thing.
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Second thing is again, you have to look at yourself. Are you making a safe place to be? Are you making them realize that this is there place, they're not just spit suckers, they're not just gum gardeners but they have a bigger role in the way that the whole machine works, are you empowering them to realize that what they're doing is making a difference? People don't leave practices ... I've interviewed so many people and they never leave because of the money. They always leave because of the way they're not appreciated.
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In terms of the way that people are fighting together, when I gave my course in London last month, I met this unbelievable Romanian dentist. He practices in London but he's moving back to Romania. He has an office in Romania that's three floors. They have general dentistry or implant dentistry, pediatrics and on the top is a full dental lab. They're a medical tourism. They have Americans fly in and get their work done. He has 54 employees in one office. Okay not multiple, one office 54 employees. He said to me Jonathan, "I found the secret sauce" he says "In order for a practice to be successful, it's about the way the team gets together." I said "Yeah of course we know that if they're unhappy they won't do that." So he says "You know what I did?" He said "Once a month I created happy Wednesdays." "What the hell do you mean happy Wednesdays?" He says "Once a month I put 500 Euro together and they choose something that they do together. They create a bond together that they want to be there everyday. When they want to be there everyday, the office just works so much better because they want to help each other."
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I am actually excited, my first happy Wednesday is this Wednesday. We're doing the escape room, which I so recommend to anyone. Have you ever done that Howard?
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Howard Farran:
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An Escape room, no.
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Dr. Jonathan A.:
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The Escape room is so unbelievable, it's something that you get to ... You know how we think we understand our team members, oh well this is what this person does, this is what this person does, you need to see them in a situation. What it is is you're locked in a room and there are clues. You have 60 minutes to find the key and you see. One is you have to have a puzzle together so the person that has the analytic mind that likes to do things with their hands the way that they think, they're gonna take that task. The one whose great at reading between the lines, who would be like your treatment coordinator who understands what the patient is really saying to them when they're not saying it to them, you see her in action. You see them out of their element and all of a sudden you get to see what they really are all about. The only way to get out of that room is if you work together.
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We did that about two years ago, it was the most fun we've ever had. I saw things in my team members, some of them just sat in the corner because they didn't feel great in certain situations because of their personality. So you know ... Don't give them a task in the office that they don't enjoy doing, they don't like doing, or they're not good at doing it. That's one of the things, make your place safe, make it empower them, show them that they're making a difference and again change your mindset, change the culture. The culture should be for your patients.
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I have a chapter on the culture for the way your patients come in. They should know that its a privilege to be treated here. I mean I can go on for hours.
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Howard Farran:
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No, I wished you'd go on forever. I never heard of the escape room and I googled it while you were talking and there's three in Phoenix. There's one in Phoenix, Gilbert is this a new deal?
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Dr. Jonathan A.:
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It's like a franchise. They have them all over the place it's freaking awesome.
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Howard Farran:
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Another thing I want to ask you, I only get you for three more minutes and again this has just been so amazing and I'm salivating and drooling that you're gonna write us an article for Dentaltown Magazine or at least put some online CE up. A lot of them also, they almost think they'll solve all their problems with marketing. So they're always asking so I know what a good chunk of the are thinking, well how are you getting all these patients? Are you doing Facebook ads? Direct mail? You got a billboard? Because if I just had 10 more new patients a month who wanted all this expensive dentistry it'd solve all my problems. Do you think a big part of your success is because you're a very successful marketer and get a high new patient flow?
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Dr. Jonathan A.:
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No not at all. The phones ring, it's all about your team. Do they know how to answer the phone? Are they saying Jonathan Dental Spa please hold? Are they really dedication the time to listen to that new patient, that shopper? That everybody's oh he's just shopping around. Do they really spend time? 'Cause the patient that's gonna spend 30, to 70 to $100,000 in one day that's a special person. If you treat them like the Days Inn or Motel 6, they're not coming to you, but if you show them that your gonna be there for them, this is the place to be, it's safe, they see that your team members feel safe, they see that your team members are excited to be here, you have to do nothing. I don't do anything. I just do the dentistry. It took me years to realize that. Like today we did a great interview today with 3D Biocad about milling systems and chewing, we're gonna post that on the internet soon.
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I had my hygienist who came back and decided she wanted to be my personal assistant. She gave birth, she has a new baby, she couldn't work the full time here, she decided she's not gonna be a hygienist just so that she can be here. She took a pay cut and she's like my personal assistant now. She does whatever I do. I was looking at the video and she's editing, I'm like "Oh" she's like "Don't micro manage me, I could do this." I said "You're right, I need to walk away and let you do it." Innately as dentist we think that by being on top of people we're actually helping them but really we're blocking them. We're blocking them to do what they do great. She finished the video and I just haven't had a chance to post it because of everything I was doing today it was so much fun. I mean I printed this morning, I milled this morning, I took digital impressions this morning, I did a bunch of implant surgeries. It was so much fun. It was fun. I don't even know how much money I made, doesn't even matter. I'm trying to check my day sheet.
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Howard Farran:
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We'll wait we want to hear?
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Dr. Jonathan A.:
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I'm not gonna tell you how much I made. Are you insane?
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Howard Farran:
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Did you already check?
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Dr. Jonathan A.:
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I already checked.
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Howard Farran:
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Yeah but it seems like a lot more money to you because you were born and raised on Canadian dollars. Was that a good one?
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Dr. Jonathan A.:
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I took the loan for my practice in Canadian dollars and then I got crushed during the payback period when the Canadian dollar and the American dollar was equal. [inaudible 00:57:19].
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Howard Farran:
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Well seriously I can't believe we did an hour. That was an unbelievable fast hour but I want to tell you another thing. I am a huge fan. You have 2,670 post on Dentaltown I can't tell you how many times when I'm talking to townies and I'll say what do you like about Dentaltown? So many times people have called you out by name saying man the people that post on there, your post in particular I mean 2,670 post I mean you're like in the top five percent of posters because most dentist are afraid to say anything 'cause someone might disagree with them or say they're wrong and to show a case ... That's another question I've been asked about people like you who have posted several thousand times, they say "Well you much have really thick skin." 'Cause what if you post a case and someone says you should have done it this way or that way or done this or that so for you to post 2,670 on Dentaltown would you say you just have thick skin? And trollers are gonna be trollers? Or what is it about your psyche where you have the balls to post work in front of a quarter million dentist around the world?
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Dr. Jonathan A.:
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The number one reason that I would post my case whether its on my Facebook, whether its on Dentaltown is not so that I could get responses like "Hey John that was amazing, wow John that was great. John your a great dentist." It's for the troller to tell me "Asshole you should've done this this way." And it gets me thinking like maybe I should have done it better that way. Maybe there is a better way to do it. I was in dental school when I started on Dentaltown okay 2001 I started dental school, I was a dental student and I was on Dental school. I was probably the first dental student then and I remember, I even posted my dental school classes. You need to understand Dentaltown wasn't created ... I remember Howard saying "Its for the first time the solo practitioner is no more practicing on his own." Remember when you said that?
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Howard Farran:
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Yes.
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Dr. Jonathan A.:
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No more ever. That's the thing, if you want to be surrounded by yesers, you'll never be great. You need to be surrounded by people that push you whether its your team, whether its your family, whether its your friends. You don't want to be surrounded by people that are logs that just say yes, yes, yes, yes 'cause you'll never be great. You'll be stuck where you are. I want to be uncomfortable being comfortable because that makes me push to do even more. Never be comfortable being comfortable 'cause then you're gonna be plateaued and that's how you burn out. If you're comfortable being comfortable, you need to look in the mirror really quick because it's gonna go downhill so fast you're not gonna be able to stop it.
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Howard Farran:
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Well hey do me a favor, if you ever see my roommate from Creighton University Gary Esoldi tell him that his bald buddy Howard from Phoenix Arizona says hi. Man God I love listening to you I could listen to you for 40 days and 40 nights. Again I want to thank you for so much world class amazing content you've posted throughout the years on Dentaltown and just thank you for having the hunger and the work ethic and the hustle and the natural curiosity to go figure out the next level of CAD/CAM from the Easy-Bake oven to the chefs filet everything you're doing. I mean I think what you're doing is just world class and it was huge honor that you would come on the show today and talk to my homies. Do you think my homies can expect an hour long online course someday? The kind that summarizes what they would learn if they went to your two day courses?
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Dr. Jonathan A.:
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I've been waiting for that invitation for 10 years.
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Howard Farran:
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Okay. All right well thanks again. Thank you so much for all that you do for Dentaltown and dentistry.
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Dr. Jonathan A.:
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All right thank you so much Howard.
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