Howard: It is just a huge honor for me today to be podcast interviewing Doctor Daryl Holmes BDS OBE AICD. He’s the founder, owner of 1-300-SMILES in Australia. We both graduated the same year, in 1987. He’s from the University of Queensland in Brisbane. We both have four boys but he had a daughter then four boys. Ryan, you were supposed to be a girl, I want you to know that. Having obtained a Royal Australian Air Force undergraduate scholarship for his final two years of UQ Dental School. Doctor Daryl Holmes commenced his career as a dental officer in the RAAF in Adelaide, South Australia in 1988 and then was fortunate enough to work, not only in Australia, but in the United Kingdom until 1991.
Daryl started private practice in a partnership in 1991 in the small towns of Ayr and Home Hill, North Queensland, near Townsville. Before establishing Townsville Family Dentistry in 1999 with three practices throughout Townsville. After many practice acquisitions and mergers Townsville Family Dentist became 1-300-SMILES in 2004, before being listed on the Australian Stock Exchange in March 2005, with over twenty dentists across six practices in Townsville and one in Cairns. Today 1-300-SMILES has a total of twenty six practices, over a hundred dentists, three hundred plus staff, all along the Eastern Southern coast of Queensland, New South Wales, Adelaide and South Australia.
In 2010 Daryl and 1-300-SMILES became involved in YWAM Medical Ships, something he is still heavily involved in today, donating his time and expertise to voluntarily provide much needed dental care, training and mentoring of many Papua New Guinea dentists and healthcare workers in remote areas and villages. Daryl was recently awarded an Order of the British Empire, OBE, for his involvement and efforts with YWAM Medical Ships delivering dental care and training in PNG. I watched your YouTube videos of that. I want to tell the listeners that I know Daryl is humble and shy, and he’s in Australia, but I’m telling you, he was the first publically traded dental office, 1-300-SMILES, in Australia.
Today I’ve gone around the world so many times, lecturing in fifty countries, it’s basically only 1-300-SMILES, then later came in Australia Pacific Smiles, and then you have Q&M. We podcasted the Q&M guy, it was number 373, podcast 841 was the other guy, Pacific Smiles Group with the founder Dr Alex Abrahams. But man, Daryl, there is not one publically traded dental company in America, I don’t think any of them could go public. When you and I got out of school, Orthodontic Centers of America was the only one that ever made it to the New York Stock Exchange, and there was about a dozen on NASDAQ. They’ve all imploded, they’re all gone. Right now all these chains, when they want to (inaudible 03:19), they basically are private equity.
You are so well-ran that you can go publically traded and you were the first one. So, I mean, you are an amazing man. Tell us about your journey. How are you doing today?
Daryl: Great, Howard. Nice to be talking and listening to a bit of that history of things. It seems like a long time ago that a lot of this stuff was happening. The listing, and dental school and all those things, those early years. But look dentistry’s been a great journey for me. It was something that I always thought needed leverage, the one and two man dental dental practices of the past I believe are the past. They’re just too small, not efficient enough and they don’t cover illnesses, holidays, absences, lifestyle and family concerns adequately.
So the concept of having group practice and multiple group practices managed centrally, so that dentists and staff can focus on patient care and the delivery of quality, patient-centric dental care without the hassles of admin, IT, marketing, financial reporting, compliance and all that other stuff, apart from the obvious compliance, infection control and so on. You can centralize all the rest of it, allow the dentists and staff at practice level to meet, greet and treat the patients very well, to the best of their ability. We found that it’s a model that works well and we build in locums, toothaches, emergencies, time off, holidays and family time. So we found it’s worked well and our success today is obvious, measurable and quantifiable on all metrics.
Howard: Well you and I are about the same age, we’re in our early fifties. Do you think our generation that graduated in ’87, those Baby Boomers were hard-wired to want to own their own office which is, like you say, a lifestyle. When you own your own office it’s not a Monday through Friday, eight to five job. You wear so many hats, you got to be a leader, advertising, marketing, HR, legal, accounting, finance, managerial accounting, and they wore all those hats.
Do you think the Millennials that are graduating now, that were born after 1980, do you think they’re more likely to be a work-life balance, where they just want to work for you Monday through Friday and not have being a dentist a lifestyle where they just have to eat, live, breathe, die and sleep their business around the clock every day for the rest of their life?
Daryl: You said it. I think you described it perfectly, how things have changed. Millennials are a very different breed and a generation that we X-Gen Baby Boomers don’t quite understand as fully as we probably should. But, yeah, they have a lifestyle of need-it-now, they want to travel, they want to work and play, recreate and do whatever they want to do, and that many hats. Your courses, Howard, that I’ve done several times over the years, the One Day MBA, etcetera. It’s all about wearing those so many hats, and there are just almost too many hats to run your own business and do good things, keep your practice going, answer those after-hours calls, Mrs Smith's and little Johnny's, broken the teeth in the footy game, or in the swimming pool, or whatever.
You’re really on call 24/7 and you’ve got to wear so many hats. Dentists in general aren’t cut out to be good at all those other things. They’re great at dentistry in general and few other areas, but not all of them. So, yeah, I think it’s a model now for the newer generation, as well as some of the older dentists like us, and older who just get sick of all that admin and all that responsibility, and would rather just sit back and do the dentistry three, four days a week, x number of weeks a year, whatever they want to do. We’ve got a lot of lifestyle and sea-change dentists taking that option of just working in a back-end managed practice and just worrying about the front-end, the patients and the dentistry.
Howard: Well there’s so much evidence that what we’re both saying is true. Look at birth rates, my mom and dad had seven kids, I had four, you had five. Millennials are waiting almost a decade later than their parents to get married, and they think a third of Millennials will have no kids. A third will probably have one and a third might have two, whereas I had four boys in sixteen months and you had five. So it looks like they’re kinda cutting back on work, babies, all that stuff to do more travelling and work life balance, right?
Daryl: It certainly seems that way. I don’t think it’s finished yet, I think even the guys and girls who are in dental school nowadays and our new graduates coming out. We’ve seen every year we tend to take on six, eight, ten, twelve new graduates at least across our group and we’re aiming to take on more, because I think it’s great to learn more about these guys. It’s a moving feast, it’s a very dynamic generation and keeps evolving because there’s just more technology, more things to do, more areas of interest. They just seem to be focused and keen to do a lot more, to some extent, than we did in our day and some of our older folk. So, yeah, it’s exciting times but we’ve got to go with those times, and we’ve got to adapt to technology, and their needs and wants. I think they’re great. A lot of their attitudes are great for the three or four days a week, or the forty weeks a year that you can get them, or the whatever number of days of the week or hours of the week they want to work, and other times they’re just recreating and doing other things that wasn’t really in our DNA, but it’s certainly inbuilt and hard-wired into them.
Howard: I know, my boys tell me at least three times a week dad, you never have to work another day in your life. Why do you work twelve hours a day, seven days a week?’ It’s like ‘dude, that’s all I know’. What was the percent of girls in your class when you graduated in ’87 in Australia versus today in a graduating class?
Daryl: Sorry, that was number of girls, women?
Howard: What percent of your class in ’87 was women and what percent of the graduates…
Daryl: Yeah.
Howard: Are women today?
Daryl: I believe in most of the dental schools in Australia, it’s doubled the number of dental schools in the last five or six years, so there’s a lot more graduates. I believe the stats are just over fifty percent, somewhere between fifty, fifty-five, even approaching sixty percent, I think, in some of the university graduating classes. So back in my day.
Howard: Well, what was it?
Daryl: It was more like thirty-five to forty-five percent females and obviously…
Howard: So that’s not a big change.
Daryl: No.
Howard: That’s not a big change.
Daryl: It’s not dramatic. No.
Howard: Yeah, because the reason I was asking that is women dentists are always married to male dentists, physicians, lawyers, whereas male dentists always try to marry the prettiest girl in a pair of Levi’s. So the women dentists it’s always huge double income, whereas the male dentists, a lot of times their spouse doesn’t work. In America, the thirty-five corporate dental chains that have fifty or more locations, two out of every three of their dentist associates are women. Do you find that in 1-300-SMILES, that two out of three of your dentists are women?
Daryl: No, it’s not that high. Offhand I couldn’t tell you exactly, but I think it’s more like fifty-fifty. So I think it’s fairly even.
Howard: Okay, so that’s not a part of your secret sauce?
Daryl: No.
Howard: What is your secret sauce? If someone said ‘what is your business model that a publicly traded corporate 1-300-SMILES is doing, that the average mom-and-pop dental office isn’t doing? Is it more explained in hours, convenience, availability? Do all your offices have the same hours?
Daryl: No, it’s not as regimented as that. Broadly, we work on a triple A rating or policy. We talk about availability, accessibility and affordability of dental care, and we describe our model as owning, operating and optimizing dental practices. So there are our three Os and our three As, or triple A rating. So I suppose in essence we try and compare to a ma-and-pop, or two dentists, or a solo dentist operating, they’ve got to spend whatever number of hours wearing all those different hats on a weekly basis, daily and weekly basis, so if they don’t have to do that, someone else manages all of that and are specially trained.
They don’t have a hat for each person, accounting, HR, IT, marketing, financial reporting, compliance and so on. So if someone does all of that for them, ultimately they can either work some extra hours dentally earning more money, or choose to recreate, relax or family, friends and recreation, leisure activities. So I think that’s ultimately it, you choose whether you want to earn more money, or recreate and relax more, or play more sport, or whatever it might be versus doing it all yourself and having that ultimate control, which a lot of dentists are hard-wired to do and want to be in control and manage all those processes.
Howard: Yeah, most apes are controlling, that’s part of being homo sapien. But so when you talk about availability and accessibility, what is your corporate advantage? Are you more available in hours? Are you more accessible in the schedule? Are you more affordable? Are your prices lower? Go through your three A’s, and what is your unique selling proposition on those three A’s?
Daryl: Yeah, it’s not just those three A’s but they are certainly a core of our business and our model. Availability of hours and accessibility, there’s just many definitions of both those terms and words. We try and offer a range of hours, ideally we want to offer more than eight hours a day, more than the nine to five traditionally because, let’s face it, most people work or are at school or committed during those hours. So we work on trying to be able to offer more like 8am to 8pm type hours, if we can get that five or six days a week. Ideally we want to offer some weekend hours as well because again a lot of people work Monday to Friday so Saturday is free. Others have sport and other pursuits on a Saturday so if we can offer a six day, and in some cases, seven days a week opening hours and accessibility higher profile.
You, I know, talk about a higher profile busy street corner position for your practice in a shopping center precinct sort of thing. We want to be visible, we want people to know that a dental practice is at this location and there and here, so we work on big signage, big street frontage, all our shop fronts are labelled and branded, big graphic images of male, female, adults, kids and with some paraphernalia and some ‘come on in’ things and appeal. So knowing where your dentist is, if you keep top of mind, hopefully getting those reticent, hesitant and sometimes nervous patients that we know about. Getting them to know where your dentist is, hopefully come in and experience it, with good parking, easy access, wheelchair, disabled access, nice conditions, nice modern facilities.
Our model is five, six, seven chair facilities so that there’s always room for multiple dentists and particularly special interest dentists, maybe not specialists but dentists who want to do different types of dental work. So we provide all of that and affordability doesn’t mean cheap. We provide a lot of any and all health funds, insurers, veteran affairs, government outsourcing, public private partnership things, private health insurances and most of all affordability, we try and work over payment terms and payment plans, which we’re well-known for, over a period time. So people can either pay off their specific dental treatment plan over a period of months on a direct debit type arrangement, or they can acquire a one, two, three, four, five thousand dollar dental care voucher, which is again payable at fair budget level, forty-nine to ninety-nine dollars per week. So you can spread your dental payments and hence your dental care over a longer period of time.
Howard: I really like your video on your 1-300-SMILES.com.au that explains all this, it explains the ninety-nine dollar a week deal, what’s ninety nine dollars a week equal per year?
Daryl: Well fifty two weeks a year, basically it’s five grand. So for ninety-nine bucks a week, say a hundred bucks a week, for fifty weeks of the year. It’s five thousand dollars.
Howard: Yeah, but it just sounds so sweet.
Daryl: Is it?
Howard: It’s only ninety-nine dollars a week and it just makes it seem like, ‘well, I can do ninety nine dollars a week’. I mean, most people spend ninety-nine dollars a week just going out for dinner and drinks after work. Would you care if we insert that video at the end of this podcast?
Daryl: Happy to. Absolutely.
Howard: Okay, yeah. I want to put that in there because when I saw your video, my first gut was to have it transcribed and do the video word for word for my dental office. That’s how good it was. I said ‘I wonder what Daryl will think? I’m in America, he might not ever figure out that I did that’. But it was so well done, I think everybody should watch it. By the way, what is 1-300-SMILES? Is it thirteen hundred or one three hundred?
Daryl: We say one three hundred, basically it’s the same as your one eight hundred, isn’t it?
Howard: Yeah.
Daryl: Is it one eight hundred in America?
Howard: Yeah, that’s a free call.
Daryl: Yeah, so ours is the same. In Australia there is one eight hundred, but one three hundred is the next tranche or whatever. So it’s the same as that. It’s a free call, toll-free. It’s our name and our number is our tagline so to speak. So it’s 1-300-SMILES.
Howard: Nice.
Daryl: Think dental, think toothache, think smile, think white, think accident, think dental care. 1-300-SMILES and just dial the number.
Howard: I also noticed that probably about every five years going back to 1990, I flew from Phoenix to LA, then a sixteen hour flight and I would lecture in Brisbane, Sydney, Melbourne, Adelaide, Perth, jump over to New Zealand and do…
Daryl: Auckland.
Howard: Auckland, New Zealand.
Daryl: Yeah.
Howard: But you’re really far north of even Brisbane. I mean, you’re in Townsville, is that at the Great Barrier Reef?
Daryl: Absolutely. It’s one of our claims to fame. It’s Cairns, Townsville, Mackay. Yeah, that’s all the Great Barrier Reef. So right off our doorstep.
Howard: You have twenty six locations, right?
Daryl: Yeah.
Howard: But you’re not at any of the major towns. You’re not in Sydney or Melbourne, right?
Daryl: We are in Sydney. We’ve now just recently purchased two orthodontic practices in Sydney. We’ve got three other practices in Sydney. So there’s five practices of our twenty six in Sydney. One in Adelaide, which is the capital of South Australia. But no, we haven’t yet got into Melbourne. So yeah, Brisbane…
Howard: Adelaide is the most conservative part of Australia. Would you agree with that?
Daryl: It is. I spent my first three years out of university in Adelaide, on and off, in the air force, and it’s a city of churches, it’s a very English.
Howard: Yeah.
Daryl: Or English early settlers in Adelaide.
Howard: What.
Daryl: It’s a beautiful.
Howard: Yeah, when you lecture.
Daryl: Conservative city.
Howard: When you lecture in the United States and Australia a lot, you can get pretty out there funny in California and New York, but you can’t in Texas, Alabama, Mississippi. If anybody listens to this and you going to lecture in Australia, you can have a lot of fun and get crazy in Sydney and Melbourne, but not Adelaide. Adelaide, that’s a city of churches and this and most of my jokes aren’t funny in Adelaide. So it’s very conservative. But the question I was asking is, do demographics matter? You got your start more in a rural area. Did you find it less competitive and more lucrative to start out in Townsville and that? I mean, you went into Adelaide before you went into Melbourne, and Melbourne and Sydney are both the same size, they’re both about four and a half million people.
In fact Melbourne and Sydney alone is half the population of Australia, it’s about twenty million people, and it’s about four and a half million in Sydney, four and a half in Melbourne. So the question is, do demographics matter? Do your stores make better sense in rural areas where there’s less dentists, when you initially started back in the day?
Daryl: Yes, Howard, in short. You are a man of economics and so on. It’s simply the supply and demand curve, or the scales of justice where there’s supply and demand factors. In regional Queensland, in regional Australia in fact, there’s always been less dentists and hence more patient demand, so less supply of dentists, more demand of patients in anywhere outside of about an hour radius of a capital city, Brisbane city, Melbourne, Adelaide, Perth. So historically it’s balanced a bit more now due to more and more graduate dentists, doubling our dental schools, importing lots of overseas dentists and so on. So there’s now still though a maldistribution of dentists in the capital cities and within that, I call it the latte set or the chardonnay set, within a hour radius of a capital city and of GPO of a capital city.
So regionally, yes, historically there has been far more patient demand and the inability to attract or recruit dentists to those regional cities. Brisbane city and Melbourne are big cities on a world scale, but there’s a lot of regional cities and centers in Australia that are fifty to a hundred to two hundred, two fifty thousand people. Townsville’s only two hundred thousand people. But that’s where we’re mainly located along the Eastern seaboard, along the coast, and of course, Australia in the Outback, is hot and dry and very isolated. So we tend to base our model historically on the regional centers of fifty to a hundred thousand plus people with airports, good fishing, boating, recreational, tea, coffee cafés, theatre and an airport as I say, most importantly to be able to fly back to Brisbane city, Melbourne, or off overseas, for access.
So dentists obviously have to have a certain level of comfort and that’s how we were able to then try and supply, recruit and place dentists into lots of these regional centers where often the demand was six to eight weeks for waiting lists of patients to get in and see a dentist. So if we could obviously supply more dentists we could create a much better supply chain to meet the demand of the patients, and the dentistry that’s needed in a cost-effective manner, and multiple operators in one center in each of these regional cities, is one of our key and core USPs and secrets to success.
Howard: What is your mix of services? You say you bought two ortho practices in Sydney, three general dentists. Do all twenty six of your locations offer the same menu of services? Do you have specialists rotate? What is your mix of services that you provide?
Daryl: Yeah, look, it’s not McDonald’s. It’s not a franchise and it’s not the same fries, and the same Coke, and the same burger, and mixed and made and done the same way, because of course that’s just ridiculous in dentistry. All our dentists have clinical autonomy, they can do more or less of whatever it is that they have interest in. The best thing about multi-dentist practices and group practices, as you’re well aware, is if you want to do more of something you going to easily intra-office refer the other things you don’t want to do. I still practise half a day a week, but I haven’t done endodontics for fifteen odd years because I didn’t want to chase the fourth or the fifth root canal up in someone’s seventh or eighth tooth in the back of their mouth.
I just wasn’t ever particularly fond of it so I refer all of that out. Lots of our dentists do more or less oral surgery, some do implants, some do general dental orthodontics. We have bought now a couple of orthodontic practices. We haven’t yet got them travelling around all our different practices. It is a potential plan along the way. We do have a couple of implant specialists and periodontists travelling and visiting several other different practices and getting in-house referrals. So, yeah, there’s no one-size-fits-all. Lots of different practices have lots of different strengths and weaknesses, but if we’ve got several practices within a region or a city, we try and make sure we get the complete and full mix and full offering of all the different dental modalities.
Howard: Would you consider yourself a roll-up or roll-out? For my viewers a roll-up is when you’re publically traded, you got get a big line of credit and you go buy a lot of offices and roll them up. Then add your owning, operating, optimizing, versus a roll-out would be like, you have a franchise, like say McDonalds, and you do de novos, you buy the land, the building, you start them from scratch. So of your twenty six locations, how many of them were a roll-up, where you went out and acquired them, versus a roll-out, where you started de novos from scratch?
Daryl: Yeah. Exact numbers. We’ve acquired more recently, so we’re more a roll-up model in recent times. We used to do a lot more de novos and roll-outs. Pacific Smiles is, in Australia the other listed dental group, is a roll-out model, so they just build their own. They used to acquire many years ago, but now for quite some years they have just been rolling out, and de novos, green fields, which we have done quite a lot of, so I think probably about a half of our practices are de novo or were de novo, we haven’t done any in the last two or three or four years. We’ve had varying supply and demand and government funding and different changes, it’s been quite a dynamic dental industry in Australia in the last five or six years.
They took one particular scheme of a billion dollars a year in government dental funding out, cut it, chopped it with three months’ notice back at the end of 2012, which obviously for the dental industry at the time it was worth five to six billion dollars. When you chop a billion dollars out of it it suddenly changed the face of dentistry, a lot of dentists weren’t ready for it and didn’t realise that it would change dentistry pretty much forever. At the same time we had four or five new dental schools opening. So we’ve been through some very interesting, again supply and demand changes and dynamics in Australian dentistry. So we, at that stage, knew or foresaw and envisioned that there’d be a lot of practices for sale, particularly the ones that had hurriedly been built and rolled up, de novo-ed, during that last few years when the heyday of the billion dollar government spending was going on.
Some of those are just not worth owning, because if you haven’t got a database of patients now post that 2012/13 era, so the last four or five years, it’s been more challenging to build a patient base just because there’s so much competition from those hellitian days pre-2012 and the five or six or seven years leading up to that. So we went away from de novos and have basically focused more on acquiring and expanding the existing facilities we’ve got. We always build and create four, five, six, eight chair facilities and obviously initially you only end up filling two or three of those surgeries and then over time you have the scope to just add and double, almost triple the revenue and the services in some of those facilities.
Howard: Do you generally like to own the real estate or are you not in the real estate business and prefer to lease?
Daryl: We only lease. In a few situations which are disclosed in our annual reports, I or related parties or MDs, do own the real estate, but often it’s the vending dentist sells. 1-300-SMILES does not own any real estate, so we are absolutely lessees. We occupy premises. We want to be flexible enough to move if we need to or want to, but again we’d rather buy or set up in a good location which, again you talk about, because location, location, location is important in dentistry and real estate. So we rather get the right venue, the right location and then optimize it and run it well as a business, but not be a real estate player. So we’re a business player, not a real estate player.
Howard: My book ‘Uncomplicate Business: You Only Manage People, Time, and Money’, they don’t like to do numbers, they like to do dentistry, they don’t like to manage numbers, they don’t listen the demographics, they believe you build it they will come. You see when dentists graduate in America and they go two hours away from a major airport, they crush it and when they go downtown in these big, major cities it’s very hard. But within a country they don’t understand supply and demand. Brazil has the same number of dentists as America and America has a hundred million more people than Brazil, they have two hundred million people, we have over three hundred million people. When I lecture down in Brazil, half the dentists have a part-time job and I see that happening in India too with all these private schools. I mean, Malaysia, we were lecturing in Kuala Lumpur, they went from one to six dental schools in five years.
Australia doubled the number of dental schools in five years, while giving about a thousand license permits to Asian-trained dentists. It’s a perfect storm. I was down there a couple of weeks ago lecturing in Melbourne and Sydney, every dentist came up to me and said ‘my God, they doubled the number of dental schools, they let in a thousand foreign-trained dentists, and then we have corporate dentistry, expanded hours, better marketing, better location. It’s just like the perfect storm’. America’s doing the same thing, they’ve opened up six or seven new dental schools. It seems like every three to four months I see in a newspaper article where some other city or state is opening up a dental school.
Those supply and demand pressures is really going to have massive downward pressures on earnings. In 2010 dentists peaked out at two hundred, I forgot the number, but right now it’s gone down basically thirty-eight hundred a year on average for the last ten years. They’re down to one seventy-four. I think they max out at two fifteen and every year it’s average going down about thirty-eight hundred dollars a year. It’s now down to one seventy-four and I don’t see any changing in those downward pressures on dentists’ earnings. Do you see that the same or differently?
Daryl: Howard, I love what you say and yes, we are very aligned in a lot of our thinking and background there. I think one of the things we touched on with three A’s before was affordability. I think, that’s, I’m going on record now potentially globally, to say I think dentistry is far too expensive in this country and potentially the world. So unfortunately, statistically, sixty to seventy percent of the Australian population does not see a dentist on an annual basis. So if you talk about affordability, I don’t think it’s a government responsibility that a third, give or take a third, of our population has now got some sort of government health care card or entitlement card that supposedly allows them, if the government dental facilities could cope with the numbers, but it does entitle them to free or a certain amount of dental care per annum. This is adults, children and geriatrics as well, so the whole gamut. A third, they can’t cope with that.
So they did have some outsourcing programs and different things that we were fairly instrumental in implementing and getting going, certainly in the State of Queensland. Which was effective and reduced waiting lists for those government services from twelve months to up to seven years waiting lists, we’ve reduced them now down to under six months across the State of Queensland and most of Australia’s got this. But the average Australian, a third have government entitlement, at least a third have nothing they’re in the gap, in the mid-range where they can’t afford it supposedly. Then a third, yeah, a bit under a third have private health insurance and at least some way of affording at least basic care and a subsidy off most of their treatment.
But the concern I have is that seventy percent of the population don’t get to see a dentist annually and you and I know, we all know listening, that that’s not acceptable and that most people do need at least annual maintenance, preventative, scale and cleaning and often, perio or other care, and so how do we deliver that? If with the supply and demand situation you spoke of, I absolutely agree, but somehow or other we’ve got to try and make dentistry more affordable and accessible to the vast majority of the population who don’t go even on an annual basis.
Howard: You’re also very passionate about this YWAM Medical Ships. Is that part of your corporate culture? Do you think that’s a purpose-driven mission that helps pull your team together? How did get into that and what does that mean to you, the YWAM Medical Ships? I watched the video.
Daryl: What did you think?
Howard: I think it’s amazing. I mean, you guys are down there in Papua New Guinea. I want to give a big shout-out to Henry Schein, you said in that video.
Daryl: Yeah.
Howard: That the Henry Schein head of the Asian division…
Daryl: Gordon Anderson, yeah.
Howard: Yeah, Gordon Anderson. Yeah, Gordon Anderson. Can we put that video at the end of your podcast too?
Daryl: Absolutely, yeah.
Howard: Yeah. What is YWAM? Ya-yam? Or…?
Daryl: YWAM. It’s an acronym for Youth With A Mission. So it’s a global…
Howard: Youth with a Mission.
Daryl: Youth with a Mission. So in other words it’s a mission to basically go forth and help and do good throughout the world. It’s a totally voluntary organisation which just inspires me no end. One of our dear friends there has just been ten years as a full time volunteer here in Townsville with YWAM, and she does all sorts of things in PNG, a local Christian radio station, they help in the community, they do all sorts of things. So it’s a global organization, I think they’re in a hundred and sixty, a hundred and eighty six countries all over the world. It’s basically youth, but really youth is a very loose term. But in general it’s youth, somewhere around eighteen to thirty-odd years of age. I think it was founded originally in Hawaii and California but now it’s throughout, as I say, most of the world.
So it’s just young people with a Christian core to it, but you don’t have to be any particular faith or belief. It’s basically people who share common values, generally Biblical or Christian-type values, to basically want to go forth and do good and help others globally. Often they’re obviously in very third world countries, helping out and doing emergency aid or day-to-day care in schools, children, healthcare and all those sort of areas. So from my point of view it really struck a chord with me, when seven years ago when the first ship was donated from New Zealand in the South Pacific to YWAM in Townsville. It struck a chord to go out, it and other ships had been operating in the South Pacific, around New Zealand, Fiji, Tonga, Samoa and all those places.
The aim from Townsville then was to go up our nearest neighbour, it’s an hour and a half flight, actually nearer. Townsville New Guinea is nearer than Townsville Brisbane, and the ship basically is based in Townsville but then goes for six and nine month outreaches and trips up to Papua New Guinea. Our nearest neighbour and the island off the pointy tip of Australia, for some of your listeners who probably don’t even know where PNG is. It’s a very third world country, seven million people, there’s less than a hundred, or a couple of hundred dentists in the country. So the stats and supply demand curve there are just off the chart, and one of the biggest problems is it’s very hilly, it’s very jungle-y, it’s very wet, there’s highlands and lowlands, the jungle is seventy or eighty percent of the country, and basically there’s little or no roads and access to a lot of the rural and regional areas.
So the only access is by dugout canoes and little boats and outboard devices, so we have a big ship, a medical ship in effect. It’s just expanded its capacity and just left Townsville a week ago, after a final fundraiser where we raised a hundred odd thousand dollars to send it off again, equipped fully with a four-chair dental facility on board and then five to six Zodiac tender boats. The motor boats, outboards, go out from the ship when it moors up a river or off a coast somewhere off New Guinea and the many, many islands and provides medical, dental and optical care to the hundreds of thousands, and in fact millions of New Guinea locals in very hard to get at and remote areas. Some of the dental care is extraordinarily urgent, facial swellings, toothaches, abscesses. Stuff that is just not seen in a day-to-day American, or Australian, or whatever dental practice.
Howard: I follow you on Twitter. You’re @1-300-SMILES. You have two Ss in that. On Twitter you’re 1-300-SMILES. What’s the second S for? Oh, that’s 1-300-SMILES Stadium.
Daryl: Oh, yeah. Yeah.
Howard: I’ve notice all those posts at 1-300-SMILES Stadium and all the posts are about the Cowboys, is that a separate Twitter than your regular Twitter account? What is that about?
Daryl: Again we broke new ground five years ago, when we took the initiative and thought it would be a great marketing, and branding exercise to become the naming rights sponsor of one of the handful of national footy rugby league, like your American football stadiums. Here in Townsville we are very proud of our North Queensland Cowboys, which is the local team, not the Dallas Cowboys but the North Queensland Cowboys. We’re currently, tomorrow in fact, playing in the semi-finals to go into the grand final the following weekend. Two years ago we actually won the national competition, and beat all the Sydney and Melbourne teams, and some of the Brisbane teams.
We’re very much an outlier, but we have a very strong culture and a very strong community support. We are the naming rights sponsor of the stadium, the home ground of the Cowboys, it’s been a phenomenal five year ride. We’ve won the grand final, we’ve made the top eight in the final eight. Every year we’ve been a naming rights sponsor of the stadium, and our coverage and our reach and our brand has been off the charts from a success point of view. I’d rate it as my greatest achievement in business, to get dentistry, not just our company, but to get dentistry talked about around barbeques, around lounge rooms, around kitchens and in the paper and social media in this country. Part of my bid to try and get dentistry top of mind rather than other products and services.
Howard: It seems like when I got out of school it was Yellow Pages. Marketing has really gotten more difficult. What are you seeing today in marketing in 2017 that’s working better now than say five or ten years ago? What are you doing to feed twenty-six locations a steady flow of new patients? You talked about sponsoring your football team, 1-300-SMILES Stadium, has that been successful? Has that increased ever since you’ve done that, has that increased your new patient flow per location?
Daryl: Yeah, bear in mind it’s not the footy team. The footy team plays in their home ground, it’s that stadium. We sponsor the stadium, not a footy team. So sponsoring footy teams and sporting teams is a bit of a nebulous concept, but in terms of a naming rights sponsorship of that stadium that has concerts, like Elton John has played there in the past and various concerts, not enough mind you, but concerts, other activities and various sporting and other bits and pieces are on there. It was also a soccer home ground as well for part of that time. So that has been a major branding and awareness, top of mind awareness thing, but as much corporately as it was for dental patients coming in per se.
Rugby League is very much an East Coast of Australia, so top of Queensland right down to Melbourne, but Melbourne’s more Aussie Rules Football, as you know. So they don’t understand Rugby League down in Melbourne, but certainly Sydney, it’s the home ground, the headquarters of the National Rugby League. So it’s been great along the Eastern seaboard where a majority of our practices are. In fact, a major topic of marketing I agree, it’s become far more complicated, the digital world and social media is just a beast that we all got to keep on top of and try and obviously prevent negative comments and optimize positive comments and feedback. It obviously to some, to a large extent doesn’t apply to whatever age group, sixty plus year olds, because a lot of them aren’t on it and in it and involved in it, so you’ve got to keep more traditional mechanisms as well as the social media stuff.
I still can’t get past word-of-mouth. I think the best marketing advertising is still doing a good job, optimizing that relationship as we talk about referrals, recommendations and recall sort of stuff. Ongoing returning customer is the best one, and we try and work on a concept of one patient procuring five friends, family, friends or colleagues. A part of our model is, again, take away that back-end, the complication and all the other stuff, and let the dentist, the nurse and the receptionist focus absolutely on the patient, the optimum care and service and compassion, and hopefully get the referrals from a job well done. Looking after that patient so that they’re happy and they go and tell a friend.
Howard: What about practice management? In order to run twenty-six locations with a practice manager, managerial accounting, financial accounting, are you running twenty-six locations with a piece of dental software that any other dentist could buy or is this proprietary software that you’ve developed for yourself?
Daryl: No, unfortunately we’re at the mercy of a handful of practice management software programs that are out there. So no, all our corporates are using the mainstream-type software, it’s not as good as we’d like and it’s …
Howard: What are you using?
Daryl: A thing called ‘Dental4Windows’ by a company called Centaur and …
Howard: Does it have accounting inside?
Daryl: No. No.
Howard: Do you find that bizarre, that dentists are trying to run a business without accounting software in their practice management system?
Daryl: It is just ridiculous and it’s been that way all the way along and how many other business management systems do you have that doesn’t do accounts receivable, payable and P&L? Income and expense? Crazy.
Howard: You bought your supplies from Henry Schein, correct?
Daryl: Amongst others, but yes. Yeah.
Howard: Yeah. I argue a lot with the CEO about this. Stan Bergman, who we’re having on the show a couple of weeks and he listened to me. He’s a great guy.
Daryl: Yeah.
Howard: I love Stan Bergman. You like missionary dentistry. Twice in my life I’ve been in the middle of nowhere on a missionary dental trip, and all of a sudden stumbled upon a dental office in the middle of nowhere, and it was brought to you by Henry Schein. Anyway so he listened. He flew an MBA from Schein all the way to Phoenix, listened to me rant for several hours, filled out a survey, emailed it to a thousand of their customers to see is this something you want, and my own homies threw me under a bus and said ‘no’. Then they said ‘well what do you want?’ It was stuff like changing the fonts size of their notes, being able to change it from black to fuchsia. I was reading the feedback from dentists and I thought ‘oh my God, they don’t even know what they don’t know’. So yeah, that is a weak spot.
I want to ask you another thing, it’s been in the news so many times just recently about Facebook, Google and Uber, that basically the Baby Boomers they got a job at General Motors when they were sixteen and they retire when they’re sixty-five. My uncle got a job at Mobil Oil when he was sixteen, he retired when he was sixty-five. Same thing in Japan, Toyota, Honda. But the Millennials at Facebook, Google, these great companies to work for. Their average Millennial only stays with them two years, and when I look at the thirty five corporate dental offices in America that have fifty or more locations. Some of them only average a year and the average is about two years, and it’s not any better amongst private practice. These kids come out of school, they get a job, a year or two later they just, I mean, they flip jobs like we used to flip hamburgers. Do you see that in Australia too? You have a hundred dentists, what is your average turnover rate of dentists with a hundred dentists and twenty-six locations? How long do they average work for you before they’re off to their next best idea?
Daryl: Howard, I don’t know that stat offhand. It’s certainly not twelve months or two years in general. It’s generally longer. We’ve got a lot of five, ten, fifteen year dentists, but we’ve also got a lot of new Millennials who are only six, twelve, eighteen months out of university. I think most of those, apart from the regional problem I touched on before, a lot of them do come regional to get out of the capital cities to find work literally in this country, because in the capital cities it’s next to impossible to get anywhere near a full time job. Or they might work three or four day, day and a half jobs. So apart from ethnic and family drags and ties taking them back to the capital cities, where often their family, or their religious group, or their whatever live drag them back to the regions, to Brisbane, Sydney, Melbourne, that’s a bit of a problem.
But quite often now with practices in those cities and areas, we can just have an intra-company transfer and they can go from the regional area. We try and encourage to stay at least a year or two regionally, a lot of them stay longer, but then they can come back to the capital cities and hopefully get a position in one of our practices in Brisbane, or Sydney, or Melbourne, well not Melbourne yet, but Adelaide. So it’s really Brisbane or Sydney, the big east coast practices in the cities. So yeah, I think it’s certainly a new challenge and the concept of five, ten and twenty year dentists or staff. Yeah, we’re talking dentists, but the same goes for the staff, there’s not going to be a lot of loyalty or there’s going to be a lot of mobility in those seventeen to twenty-five year old dental assistants and receptionists and everything else too. So…
Howard: Well, a lot of people are making the observation, from many countries I’ve been to, that the Baby Boomers were loyal to their company and they were loyal to their doctor. You were talking about missionary dentistry, look at Christianity, the first three commandments are obey God, don’t take His Name in vain, honor the Sabbath. The fourth one’s honor your parents. A lot of loyalty to company, to the dentist, to God. The Millennials seem to be more loyal, instead of structural religion, they seem to be more spiritual and they seem to be more loyal to themselves, so…
Daryl: Or their phone.
Howard: Yeah. Plus they’re young so they haven’t had extensive root canals, extractions and implants, they’ve never seen all that stuff so they just assume ‘well all I ever get is cleanings, fillings, exams’. I’m sure 1-300-SMILES, a big brand, the dentistry is fine. So they don’t really care about the dentist turnover, they’re loyal to, it’s convenient, it’s accessible, it’s available, they have a payment plan. Look at these big dental offices in America that only keep their associate one or two years. They’re still growing like gangbusters, but the old paradigm ‘well, if you’re going to have a different dentist every two years no-one’s going to stay there’, then it’s like ‘that’s true if you’re a Baby Boomer.
Daryl: Yeah.
Howard: But that’s not true if you’re a Millennial. Do you see that observation in Australia?
Daryl: Absolutely. I think it’s being led, certainly in this country, by the medical profession. Like in the past, in our era of forty-five to sixty plus year olds, you had your doctor and that’s the doctor you saw and that’s your doctor you took your children to and so forth. Now again the suburban medical practice has, certainly in this city and pretty much this country, have all been gobbled up and rolled up into a five, ten, twenty, thirty doctor medical precinct with pathology, radiology, dietetics, physio, chiro and medical doctors galore and if you can see your own doctor, great. But the next available is Doctor Blogs and you’ll see them with little Johnny or little Mary’s cough, cold, sore finger or bumped head or laceration sort of thing.
So I think the medical profession is dragging us down that, your care and your health is very important, but need it now, which again is this philosophy. The next available, or the person you’re going to see now, or the next hour, or this day, or tomorrow is Doctor Blogs because your other doctor, your normal doctor, is booked out or away on holidays for the next few days or a week or two weeks. Hencely I think it’s even more personal than medically but I think the generation and this under thirty-five, fortyish vintage and era, I think are far more willing and accepting to, we believe, practice goodwill, location, service, reputation. If your personal family dentist isn’t available, I think they’re far more forgiving and understanding that they’ll see his associate or the other person, the other dentist or two, male or female, old or younger, hopefully we’ve got three, four, five options for them to be offered. They get to choose that person with the toothache, or the breakage, or the problem today if their own long term dentist isn’t available.
So that’s not our model per se but it is obviously what happens if Doctor Blogs is fully booked out or is away on holidays or is away on study leave or whatever. So, yes, I think it’s changing. Is it for the better? Debatable, but if we can give people ongoing longevity of care and service and their own dentist, that’s great. But I think, yeah, a lot of our younger generation are less worried about that as needing it now or getting it now. Do you agree?
Howard: Absolutely, I agree. I can’t believe we went over an hour, we’re at an hour and three minutes, and then we’re going to add two videos. I love your 1-300-SMILES intro video and I love the… what is it? Youth…
Daryl: With a Mission.
Howard: With a Mission. Y-W-A-M. You can follow them on Twitter @Y-W-A-M, Youth with a Mission, they have like nineteen thousand followers, that’s huge. But I want to ask you one final question, answer that, then it’ll be a wrap, then we’ll add these two videos. But you and I have done this for three decades, we have four children, five children, what advice would you give to the young dentists who just walked out of school and they just got out of dental kindergarten when we’re going into the dental nursing home. What advice would you give the next generation of sovereign professional colleague dentists that are twenty-five years old and just walked out of dental kindergarten all baby-fresh?
Daryl: Couple of tips, find a mentor or several mentors. At least one dentally or two, and one or two in life and other areas of interest, so have an interest and a mentor outside of dentistry. Look, listen and learn. Number two, look a lot, look at things, listen to others, take advice and learn. Don’t just think dental school taught you everything because it didn’t, don’t focus on the money, focus on doing a bit more and doing a better job, getting good referrals and building your business that way. If you don’t focus on the money, ultimately the money comes. If you focus on quality and service, the money will come.
One of our core values is treat others like you’d like to be treated yourself, again which is Biblical, from the commandments, do unto others as you would have them do unto you. Treat others just like you treat yourself, your mum, your dad or your wife or your girlfriend, or boyfriend. Set goals. We talk about clarity, focus and execution. I’ve got a great mentor out at Dallas, Texas, Tony Jeary, The RESULTS Guy, and it’s all about clarity. Be clear on where you’re going, what you want and set goals and be definitive about it. Focus in on what you want in life, not just dentistry but relationships, family, sport, recreation, health, wellbeing, and then execute it. The little word, the littlest word in the dictionary, Do. D-O. Then do it, and the rest will come.
Howard: My two older sisters went into the Catholic nunnery straight out of high school, and I was a disappointment to my mom because I didn’t join the priesthood. But you know what? When you said treat other people like you want to be treated, the reason they call that the Golden Rule, because when you study every major religion from Hinduism, Judaism, Buddhism, Confucius, Christianity, Islam. That is the only sentence that’s found in every major religion. There’s not another name of a person, a place, a city, there is nothing, there’s not even a name of a town that shows up in every major religion, and then in every religion it says ‘treat other people like you wanted to be treated’. That is why some of the nuns and priests in my school, thought that was why every major religion was praying to the same god, because they said that was so plagiarism, that was so exact that it was some divine intervention.
My older sisters believe that, my older sister believes that you just couldn’t make that up in seven different places, that many thousands of years ago. The fact that it would be considered plagiarism in every university, she thinks that means they’re all praying to the same god. But on that note I just want to say you are a pioneer, you are a role model, when I’m down there in Sydney and Melbourne, everybody was taking notes on what you did. They all assume ‘okay, this guy is running twenty-six offices, I’m running mine, I’m not going to reinvent the wheel, I’m going to study what this guy does in hours, in convenience, in marketing, in product mix, in pricing. I mean, my God, I don’t think I ever had dinner or lunch with one dentist where your name didn’t come up, and they profoundly respect you as a person, your integrity, you’re like Batman, Robin and Superman all rolled up into one in Australia.
I want to thank you so much for giving me the honor to come on this show. It’s Thursday night at six p.m. on November 21st, but it’s already Friday morning at eleven o’clock there. I want to give a shout out to my brother, Paul, who moved from America to Sydney and now he’s a full citizen there. It’s his birthday today, he’s thirty-eight years old. I’m fifty-five. He was in a Catholic family, they didn’t use birth control, so he was born when I was a senior in high school and, my God, Paul’s just an amazing man. But Happy Birthday to my brother, and thank you, Daryl, so much for all that you’ve done for dentistry, and for coming on this show today, and talking to dentists around the world and giving them a helluva lot to think about.
Daryl: My pleasure, Howard. Great to be part of it and thank you for your time also.
1-300-SMILES We care:
Daryl: Hi. I’m Doctor Daryl Holmes and I would like to welcome you to 1-300-SMILES.
Female: At 1-300-SMILES we care. We care about your oral health and the oral health of your whole family, which is why we ensure that our entire team have the skills and understanding to provide comprehensive dental care to all generations. We care about your convenience. Our practices are open extended hours and the locations carefully selected to provide easy access and parking.
Daryl: At 1-300-SMILES we care about your dental options, which is why we have selected dentists with the skills to diagnose and provide you with all your dental needs, from your regular check-up and clean to full mouth rehabilitation, enhancing your smile through cosmetic dental techniques, to straightening your teeth through orthodontics and Invisalign, and in later life replacing missing teeth with dental implants and implant retained dentures. Whatever your dental needs, our team will listen to your concerns, diagnose and assess your treatment needs and present you with all your options.
Female: Not only do we care about your oral health, but we care about your overall health. Did you know that periodontal disease, or gum disease as it’s often referred to, has been linked to heart disease? This is just one of many overall health issues that can be influenced by your oral health. Regular visits to your dentist at 1-300-SMILES, will not only help prevent avoidable dental treatments but can assist with your general health.
At 1-300-SMILES we understand the cost of dentistry can sometimes be a burden on you and your family, which is why not only do we work with all the major health funds, but we have also introduced our own payment programs. From just $1 a day, you can access regular dental visits, plus discounts on any dental treatment you may need. And, if you already require treatment, you can spread payments over time with our $99 a week program. These programs are part of our commitment to ensure that you and your family can access the dentistry you need when you need it.
Daryl: We deeply care about our patients and our team members, but more than this we are committed to our overall social responsibility, which is why we are a major supporter of the Youth with a Mission Medical Ship that provides dental, medical and optical assistance to remote areas of Papua New Guinea. We also provide thousands of Australians access to dentistry through our public private partnering, helping reduce government dental waiting lists. Our aim is to provide as many people as possible access to outstanding dental care. Great dental care should not be for the privileged few but for everyone.
Female: Thank you for taking the time to view this short introduction to our services. You will find additional videos about the treatments we provide, our flexible payment arrangements and our commitment to looking after your dental needs throughout this website. If you have any questions or would like to book an appointment, simply contact us now and we look forward to welcoming to 1-300-SMILES. Above all, we would like you to know at 1-300-SMILES we care about you.
YWAM MEDICAL SHIP VIDEO:
Victor: My name is Victor. I come from Papua New Guinea. I love my country. It is so beautiful and so diverse. We are known as the land of the unexpected, the least explored country on earth. We are made up of many different tribes, each with their own traditions. Me and my people live in villages. We live in high mountains, jungles, rivers and the coast. Though we have much beauty, we are facing very big healthcare challenges. Many of our women die in childbirth, we have one of the highest rates in the world. TB has been declared as a national emergency. Our children are dying of preventable and treatable diseases. Many of us will never see a dentist in our lifetime. Hundred of thousands of people have low vision or no vision at all.
Anna Scott: Makasi had been blind for ten years. Her and her family heard about the ship being in their area and paddled in their canoe for two weeks to see if there was anything that we could for her eyesight. After a forty-five minute operation, her sight was restored to perfect vision. She saw her three children for the very first time that day. She went from someone that was downcast, that had no hope in her face, to someone that had light in her eyes, someone that had hope and excitement for her future.
Jason Salawagan: It’s so amazing what happens when the ship first comes into a village. All the men, the women, the children, they all gather along the shores and they start singing, start dancing. The ship is more than bringing healthcare, it’s really bringing life and really giving them hope for the future.
Hannah Peart: On board the ship we have a day surgery unit, a laboratory, dental clinic and a lecture theaters, which allows us to bring really specialized care right there to the people in the community and the villages. A helicopter will be on board, which will allow us to do emergency transfers as well as to even reach further inland to some of those places that need specialist care.
Charles Abel: It is a partnership in the true sense, in that it is helping to assist and support and promote what is already contained in our national health plan, and working very much in collaboration with the existing health system.
Paison Dakulala: The training element of the medical ship is very, very important. What that does, especially our health workers working in remote settings and those difficult settings, it empowers them, it strengthens them, it gives them that someone does care.
Ken Mulligan: I’ve been involved now for over thirty years and it’s been an incredible journey. I am so grateful that we are able to align ourselves with the strategic plans of Papua New Guinea, working in not only public but private partnerships and together, as we strengthen this nation, we are seeing some really good outcomes.
Female: My dream. I want to be a nurse. I want to help my people in this district and country.
Sarah Dunn: One of things I love most about the work of the ship is seeing young Papua New Guineans engaged, seeing young, passionate Papua New Guineans from urban centers able to come out into the rural context and building their nation.
Male: When I think of the message I want to leave, it’s like ‘mi laikim laif’. I want life and for you and for me is to have life and live it to the fullest.
Sarah Dunn: We look despair in the eye and we say ‘you do not have the final word’. We’re people who have our fingerprints on a torch of hope, that’s Papua New Guinean fingerprints, Australian fingerprints, fingerprints from all around the world, that press forward because we want to live.
Male: So arise all the sons of this land, let us sing of our joys to be free. Papua New Guinea.