Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1082 Small Town Dentistry with Scott Brookshire: Dentistry Uncensored with Howard Farran

1082 Small Town Dentistry with Scott Brookshire: Dentistry Uncensored with Howard Farran

9/10/2018 1:40:53 PM   |   Comments: 0   |   Views: 224
Dr. Scott Brookshire is raising a family and practicing in one of North America’s most beautiful places, the Tongass National Forest of Southeast Alaska.  Nestled amongst the fjords and misty coastline of Prince of Wales Island, is the small fishing community of Craig.  Dr Brookshire has had to finely hone the art of running a small town practice. With an island-wide population of only 5,559 (based on 2010 census), there is no room for error.  Most everyone is related, so small things can become big problems. By knowing your customer, and having a relationship-based philosophy, great things are possible. When not cutting teeth, Dr. Brookshire enjoys stream fishing the many salmon rivers  or hunting deer in the rain forest.

VIDEO-DUwHF #1082 Scott Brookshire

AUDIO-DUwHF #1082  Scott Brookshire

Howard: It's just a huge honor for me today to be podcast their name doctor Scott Brookshire, thank you so much for coming by. I've been a big fan of your posts on dentaltown for gosh a decade, how long have you been a townie?

Scott: When did it start?

Howard: It started at actually this the 20 year anniversary is the St. Patrick's Day. It started on St. Patrick's Day which is March 17th 1999.

Scott: I'm going to say about 17 years then, I first heard about you it was it was in San Francisco was in a Denmat sales / continuing ed and the first half of it was you talking about a 30-day MBA that's how I found about found out about the tapes then started getting the dentaltown magazine got online and from then on I've been a regular townie.

Howard: That was with Bob Ibsen's Denmat.

Scott: Yes it was

Howard: and he would say yeah he was the proud initial only supporter of dentaltown. When we started our magazine and website everybody said well you're going to be you know what we'll see how it turns out in a year or two. I'm like okay this thing cost 90,000 a month to run I don't have a year or two. I plugged all my cases and all the companies were marketing directors and they all needed data and they said well you know but Bob Ibsen was a dentist and he just loved the whole concept and so we got a magazine Bob Ibsen who we did a podcast on he's no longer, we have several that have passed on Bob Ibsen podcast passed on one the best podcast ever Carl Micsh had four pass on but he bought the inside cover the back cover and the inside back cover and I said well how long do you want to do this and he said until you break even, what an amazing man.

Scott: That's special

Howard: Yeah he was an amazing guy.

Scott: He opened the door for you.

Howard: but when you said that you might be in San Francisco I thought it was gonna be

Scott: Well I didn't want to talk about the bar afterwards.

Howard: Are you sure it wasn't at that Chip and Dales gay bar I was dancing down the street?

Scott: Yeah no

Howard: That's how I put myself through dental school.

Scott: Although looking at you I see how you could make that.

Howard: Yeah, so let me read your bio. Dr. Scott Brookshire is raising a family and practicing in one of North America's most beautiful places the Tongass National Forest in Southeast Alaska nestled amongst the fjords and misty coastline the Prince of Wales Island, is a small fishing community of Craig. Dr. Brookshire has had to finelyhone to art of running a small town practice with an island-wide population of rolling 5,559, there is no room for error. Most everyone is related so small things can become big problems. By knowing your customer and having a relationship based philosophy great things are possible. When not cutting teeth Dr. Brookshire enjoys stream fishing in many salmon rivers or hunting deer in the rainforest. OKay I got a lot of things to say before I want to start talking that is number one, the Alaskan cruise is the greatest cruise in the world. People don't realize that Alaska's makes halfway down Canada you know halfway to the state of Washington and it's a tropical rainforest.

Scott: Well I think they call it a temperate rainforest but it's definitely a rainforest.

Howard: Okay a rainforest.

Scott: Yeah we will get about 140 inches a year.

Howard: Oh my god

Scott: and it rarely rains hard it's a constant steady drizzle and then you get a couple hours of sunlight and then you get seven days of a constant regular drizzle its the norm.

Howard: It is so beautiful.

Scott: It's green and lush and gorgeous.

Howard: So that I have four boys and the first time I did that Alaska cruise they were about oh I don't know four six eight nine something like that and well maybe a six eight ten twelve well anyway motorola just came out with there walkie talkies so I thought I want to hang out by the pool the bar you know and I'll just let my boys run wild but I'll have them on walkie talkies and it was the most fun cruise they ever did. So for seven days the cruise ship is about 14 floors and now they're just running the whole ship wild and it was so gorgeous and a lot of those talons that he pulled into there was no roads in that town to connect to Anchorage or Seattle.

Scott: No

Howard: That was it and you had an airport and you don't have anyone your on an island.

Scott: Yeah so what you just described is Ketchikan, so Ketchikan to population maybe 12,000 13,000 it has a road because maybe nine miles north and seven-miles south and that's it and that's the big city for us we give it a boat and travel with your in Ketchikanand you travel three hours west and you hit Prince of Wales Island what we call POW and then that's the population the bio said fifty five thousand five hundred actually that's probably the census during the summer when he had a lot of workers that they come there I'd say year round rate of residence is about 3500.

Howard: So are you the only dentist there?

Scott: I'm the only for-profit dentists there is a native health clinic there that is also a community health center kind of a melding of the two and so there is some competition but they're you know therefore their focus is different than mine so that there's absolutely competition but I think we're going after a different demographic.

Howard: Now when did when did the United States buy Alaska?

SCott: It was jet it was Seward's folly he was I think the interior secretary of the interior during the Lincoln administration, so it was post-civil war I'm gonna guess 68, 1868.


Scott: Yeah

Howard: and there were a lot of Russians living in Alaska.

Scott: Yes

Howard: They didn't really like their country so I remember the first time I went up my dad my brother Paul we went up flew into Anchorage went down to Kenai went salmon fishing went down to  fishing and we stopped in this one town as tourists and it was there was a Russian village.

Scott: Was it Kiske by any chance?

Howard: I don't know but they certainly didn't like tourists from the lower 40.

Scott: Yes

Howard: How could you say that more more acknowledged because if I say it they think well Howard maybe you, your dad and brother are a bunch of assholes but not...

Scott: So I've never been in the Kiske so I don't know if you know the story for that community but a lot of your tourists particularly from the cruise ships are there for you know six hours eight hours they come in they stand in the middle road because they see an eagle that they want to take a picture of.  Imagine you're in a town of 4000 two cruise ships come in and the population of the town just the more than doubled.

Howard: or tripled.

Scott: Yes and so it just doubled in terms of the guests on the but then you had the crew and it's you know it it's suffocating. Now the community either then we don't have that issue it's too small community for cruise ships don't want to come there but Katican, Sitka,  Huna, some of these smaller communities in the inside passage deal with that a lot and it's a you know there's a plus and a negative, there's a lot of money there's a lot of economic activity that occurs. These communities by and large really rely on the wallets of these individuals that are coming to see Alaska and they very much want to show off with their community has to offer.

Howard: Well I guess I start thinking about that when you said that another dentist works on their native.

Scott: Yeah

Howard: and the Native American Indians actually came across the Bering Strait so they're the last before they were native Indians they wereRussian.

Scott: Yes they've been there a long time.

Howard: Yeah but I did sense that the Russians really I mean you were an American and we sold to Germany the next thing you know that everything's done in Germany and I listened to their telling me the deal but I feel like they were... it's sold down a river.

Scott: Yeah if you're referring to what the Native Americans were there refers was Alaskan native people they absolutely have a legitimate gripe in legitimate resentment. So you have Russia settles to the US the US comes in they start these Indian schools to quote you know modernized civilize the natives and so they go into these villages that might have a population of ninety to two-hundred everybody's related everybody knows everybody they take the kids and they take them to you know the other side of the world essentially 200 miles away 800 way to an Indian school beat them if they don't if they speak their native language, educate them in you know also in American ways and then let them go back to their community and that happened for I'm guessing about three for generations. So you now have people who don't speak their language or very few people do some ederly still will they speak English but they have a very legitimate resentment that their culture was ripped away from them was beaten out of them that's how a lot of them see it. That doesn't mean they necessarily hate all the white people but you know if you looked historically they have a legitimate beef no that's just no way around it.

Howard: Well it's here's to me it's the same deal, somebody in Washington DC knows that they're smarter than somebody on your small insignificant island and why any people off those traps that's being exciting Ronald Reagan what do you say government is not the solution you know what is the problem it's like they say the government will come to an industry regulate tax it break them all up so you can't even afford it and then say well you better give me more tax money and then I'll help you pay for it.

Scott: The problem was we didn't text you enough, if we tax you more things would be better.

Howard: It's like they come at you with a baseball bat they break both of your knees then they tell you you need that they you need them to help you now.

Scott: Here's a wheelchair, let me push you around.

Howard: and how many of those native communities now or still believe in big government after their governments then well our worst nightmare for 50 years?

Scott: I'm politically active and I'm were conservative so I'm biased to this one of my is perspective but I do think that your average Native community is far more leans Democratic social safety net high taxes that type of thing.

Howard: So on your Island it really doesn't matter if you're part of Alaska or Canada or the state of Washington, so that Island there's basically a how many people?

Scott: I'm going to say three thousand five hundred year round.

Howard: So thirty-five here people year-round and your the only fee-for-service private down there?

Scott: There's a total of three dentists to at the native health clinic and myself

Howard: Okay and on the,  is insurance a big of those 3500 people how many of those have like third party dental insurance?

Scott: I'd say about 20 percent are cash about 40 percent or Medicaid and the rest have some sort of insurance. They work for the Forest Service police officers teachers that sort of thing.

Howard: So 20% cash, 40 percent Medicaid and 40%v private insurance.

Schott: Yeah I'd say that's about right. I've only practiced on Prince of Wales Island so dentaltown a lot of people will complain bitch and moan about Delta Dental and PPOs and how little they pay for services such as crowns and I've read on dentaltown you know $600 crowns, is that accurate?

Howard: Yeah

Scott: Six, seven, Medicaid in Alaska pays eight hundred and thirty dollars.

Howard: Right so let's address some concerns you just said. So when you say Delta Dental  I mean how many Delta Dentals are there I mean let me just google it

Scott: 40, 50?

Howard: No not that many... how many Delta dentals are in the United States. Okay so basically when you say McDonald's you know within a country like McDonald's (inaudible) obviously if you read Pulp Fiction you know when you go to India that they're Hindu so they're on either my big Macs there. In fact it was so cute to me is you know when I was little in Kansas if you're the bad boy in high school you'd sneak out and get a case of beer and maybe a bottle of Jack Daniels and the dentists are giggling because we're a McDonald's and they were telling me that when you're bad in New delhi you sneak out you eat fish sandwich because it's you're eating something with a face and the real rebels were eating fish sandwiches at McDonald's and but Delta Dentals not like that there's 39 different Delta Dental Delta Dental's anything from you'd be out of your flipping mind not to think it was amazing to it can be a really bad deal and it worse attention to spine man but what but you're getting eight thirty, Delta gave me one thousand for a crown 30 years ago and 30 years later I get 650. So you know they trend down but that's the same thing with the DVD player. I mean

Scott: Cell phones...

Howard: My first DVD player was $800 and it sucked now there are $35 and their perfect so everything gets better faster higher quality lower price and healthcare just they don't want to play by that game, they say I want my iPhone I want intel every two years come out with a processor that has twice as many chips on half the size but I'm in healthcare I'm the government so I just want to raise my prices to raise my taxes and it's not reality.

Scott: I'm not gonna argue with that at all, the point I was trying to make was on dentaltown there's complaints about the amount that PPOs pay and in alaska medicaid pays can certainly more than a lot of PPO's.

Howard: Well okay and so back to the PPO's, so are you a member of the Alaska Dental Association?

Scott: Yes after 20 years of not being a member of the ADA I finally decided to drink the kool-aid and trying to you know improve it from within.

Howard: Does Delta have an Alaska? Is their Delta Dental of Alaska?

Scott: There is it's managed I believe by Delta Dental of Oregon and it mostly deals with Alaska state employees and a believe Alaska state employees retired.

Howard: but my point is being this on so you go to like the CDA meeting and they have it every year in Anaheim and San Francisco.

Scott: I went to it and took my staff last year.

Howard: and here's Delta Dental just California knocking out a billion dollars of Dental insurance every year. You can't find one dumbass dentist in California that even knows the name of the delta dental director and then you look at their speakers list and their never asked to speak their never asked to do anything and then they hire speakers on there that you know like Bill Dickerson who go up their and teach the coure Delta or the devil. It's like are you guys so dysfunctional it reminds me of the israeli-palestinian issue or the Saudi Arabia Yemen issue or the Sypress. I mean until you can sit down and communicate, so these PPO's I mean you know in some of these more healthy environments like the dental insurance will say hey we're calling on this company that's manufacturing plant they have 400 people and there's only 9 dentists that say we're gonna go meet with this guy is you think may become a couple you guys to come along

Scott: and they say no.

Howard: and it's like screw you and say the insurance is a fixed actuarial risk analysis versus of moral hazard cheating and stealing and stay covered this much and the dentist are like well why don't they cover 100% of the crown, hey dumbass why don't you make one of your patients pay 100% of the crown. It's never the dentist's fault it's the patient's fault it's the insurance but if you live in a state that's like my first Delta Dental story?

Scott: No

Howard: So my dad had nine Sonic Drive ins and in our same church as the founder of Pizza Hut, Dan and Beverly Carney and Beverly passed away and I opened up right next to a pizza Hut in Phoenix and but anyway long story short my dad I got out of dental school you and I both have the same story we opened

Scott: Right out of school.

Howard: Yeah I graduated May 7th and had my open September or September 21st how about you?

Scott: Graduated late because I cut my finger wide open, I was in a cast for ten months. I think I finally got out finish my clinical requirements early October and saw my first patient December 16th or December 17th.

Howard: Nice so now the millennials are like that I think we'll just get a job at a DSO because that would be great okay it's really great and everybody in the class last year the year before the year before year before year before they all quit in a year and you plan on working and DSO left for five years and what he worked at five different ones so they have to just be jumping into kind of like that Nintendo game where you jump in the hot lava until they finally realize that they had to open up their own but old school boys we just did it day one Millennials have to dance around for five years.

Scott: So when you and I were down school and got out you either worked for a private practice there wasn't a DSO's didn't exist buying large, you had a couple in California and a beach on the Dr. Beach or something they had bad reps. I grew up always as a kid always had my own business I raised mice and sold them to pet shops I was a paperboy.

Howard: Raised what?

Scott: Mice I made good money yeah.

Howard: You raised mice.

Scott: Raised mice as pets or to feed to snakes and sold them to pet shops and so for a 15 year old kid back in and you know 82 to have 100 bucks in your pocket every 10 days or so was I was a big deal you know so but the point is I had my own business of one kind or another from about age 11 until I College and to work for somebody else was just something that I thought I'd had trouble doing and I had one job that where I was an actual employee I was I don't know how to describe it I was kennel boy at the puppy land pet hotel. So the only hourly job I had was just spraying the manure off of concrete floors and that was the only in that my boss she was kind of crazy she was about you know a pain and so I could have a boss and so just innately knowing who I am I knew that trying to get my on the show and making it into what I wanted was going to make me a happier individual that's why I took a risk and just jumped in to taking the keys from a defunct kind of failed practice in the middle of nowhere because it was an opportunity and the absolute worst thing that could happen is that I failed and I get back in my truck and then head south. So I wasn't married I had debt but you know I was a dentist so I'm gonna figure out a way to pay for it and so you just you take the rest and you go for it.

Howard: So when the seller sold it to you how long was the transition period?

Scott: Okay

Howard: Did he just take the money and fly out of town?

Scott: I actually got into the practice for no money down so the stories kind of odd as I described earlier isn't a cast senior year dental school part of the senior year graduated late the ortho first year ortho students just started and met up with a guy who was just starting ortho was looking to sell his practice in Alaska long story short he saw me as an opportunity he was very aggressive in trying to sell and I found out the reason he was so aggressive and the reason he couldn't sell it is because about six months prior he was in his office driven away and ten uniform state troopers came into his office seized all of his files took spent a week were interviewing patients essentially there was rampant they were accusing him of rampant Medicaid fraud and so no one wanted to touch the office no one to buy it he ended up leaving and applying to ortho school because he figured his practice was you know went down the tubes and that's how I found out about the practice I told...

Howard: Medicaid fraud you can go to jail for that.

Scott: Absolutely he did.

Howard: He went to jail?

Scott: He went to jail.

Howard: For how long?

Scott: This is embarrassing he went to jail for it was 34 days he was accused of stealing that they know of idea to show about 60 grand but that's because they didn't look at all of the files and it wasn't just medicaid it was insurance the federal government or the state informed the insurance companies and they really didn't care so...

Howard: Like say 60 grand, if a private insurance company thought it was worth 60 grand I mean what would my attorney bill be.

Scott: Right

Howard: What are the losses what are the turns south I said are you I was innocent and you harmed my reputation and sue them for a million and that's why people you don't understand that the private insurance the Delta the BlueCross and BlueShield is a signal up those are just business associations but when you start participating with the government you start taking Medicaid Medicare you're doing with the FBI the IRS I mean you're dealing with some bad boys who routinely. One of my very good friends guess where he's practicing now.

Scott: Where?

Howard:Mexico because

Scott: Did he practice here?

Howard: He had a practice his wife was doing the books and let's just say that she was gorgeous but not a really good accounting mind attention to detail and so she was just loose and sloppy with the code.

Scott: So your saying he married her for her mind.

Howard: Yeah he married her for her bookkeeping ability obviously but anyway by the time that they got investigated I mean I know this woman she obviously had no idea what's wrong and this man loved dentistry but didn't do any of the business none of that stuff.

Scott: That was for her to do.

Howard: So they hired and then they got the dumbest attorney I can be aware because it was a friend of a friend from church.

Scott: What could go wrong.

Howard: I mean you need to ask for they can pray next to you at church that's the lady that knows.

Scott: Well then they can just put you in jail.

Howard: Is that you who just graduated from law school so awesome he has no flipping experience and he's not sure anyway by the time they started realizing oh my god he can go to jail for a long time so he moved to Mexico City where you get your license with I just few Benjamins and now he's an American trained dentist from America and Mexico. So when you go down to resorts when you're in Cabo and Puerto Virda Cosmo when you in the nice place you see a dentist that looks like us and talks still there running I mean everyone I met had a legal problem I didn't meet anyone who said you know what I just don't want to live in the country they didn't have 911 and electricity there.

Scott: and the drug lords.

Howard: but the drug lords are actually fine because I talk to you about that stuff well when you're in American joint dentist who has all the money?

Scott: Drug lords.

Howard: Yeah so who do they want the guy who went to Loma Linda there you think they want the guy from Loma Linda or the guy from america?

Scott: My vote would be Loma Linda.

Howard: Yeah so they actually have a great life they just you know but anyway. So this guy sold it to you so he went to jail for 30 days.

Scott: So yeah he went to jail for 30 days and I was subpoenaed so I had a be there for his sentencing it was the reason I said it was embarrassing is the judge when he did the sentence mean said you know doctor emissions last name you're a chiseler you're a crook but you were stealing from well-heeled entities insurance companies which isn't all that bad that's what a judge said during the sentencing of this guy who was getting nailed for Medicaid fraud and so we gave him I think was 90 days but in the state of Alaska if you have if you don't give it a trouble boy around the slammer yeah two-thirds of it gets removed so he only did three Sundays it was in a in a halfway house so he could actually it was a it was a converted like motel six in Anchorage. So he could run around during the day and he had to be in his bed at what nine o'clock at night and then he could get out again at 8 in the morning. So it was a situation where I don't think he learned anything from it although he's now in the lower 48 and I think he's doing pretty well so hopefully he did change his ways but he was a good quality dentist but he absolutely loved money I think it was it was a greed I can figure out some way where I deserve this and this isn't really illegal because it's you know it's okay for this reason I think that's the kind of thing he was doing.

Howard: Yeah so on Google you know that algorithms for search.

Scott: Sure

Howard: Well Israel makes some of the greatest algorithms for dental insurance and so now that you know the Delta those 39 in companies and billions of dollars and they run algorithms too or I had another friend who thought well god Delta only pays half a crown so in the patient exam I'll charge two crowns they'll pay half the two and then the patient won't have to give me any money and then we're all good that's a great idea.

Scott: but he would only do one crown?

Howard: Yeah he would only do one crown and he would build the second one later. So an algorithm picks up okay Arizona ninety six and a half percent of all the Crown's would build one at a time and here's dr. dumbass and half of his crowns are two at a time. So they go in and they do an audit and here's what you got to realize that claims he's mailed from Phoenix to Delta in Glendale Arizona those are civil criminals fines whatever but the claims that crossed a state line now it's a federal crime.

Scott: Thats mail fraud.

Howard: and it's mail fraud he went to five years in prison for mail fraud  and what I can't stand the most about the dentist the dentist don't realize that they're one of the most entitled groups. They always talk about how bad and entitled people are dentists are the most entitled they if they expect someone else to pay for all their customers business services when I bought iPhone paid cash bought a car paid cash. I mean these Americans buy houses and cars through their own private measures all day long but when it comes down to a crown they expect the government to pay it the employer to pay it, why can't you just tell the customer to pay you why can't you just man up and have them own it.

Scott: Yeah that's I know exactly what you're saying about the mindset of the patient.

Howard: Yeah

Scott: and I hear all this time I'm sure other dentists do I can't afford that because I don't have insurance there's a money said that somebody else is supposed to pay for this but it's too expensive.

Howard: but I call bullshit on that because in what I love most about carecredit and I don't get any money like that they can tell you what every dentist is using in that area in fact not just dentists there the vets are doing the eye doctors doing all the surgeries cosmetics everything in every damn zip code there's the average selling new price on a car is thirty three thousand bucks and you know in 2008 a horrible year only like nine million cars sold, on a good yeah it's like 17 million cars but the average American will buy 13 new cars between sixty and seventy seven and in every zip code there's a dentist who will sell the case that big every month his entire career and the other 95% will never do it one time in their life because in the other offices are saying well your teeth are all horrible but your insurance your insurance only has a thousand and so you have 28 shitty teeth but the shittiest tooth is this molar so it works just wonder it's one crown and then they'll get on dentaltown and bitch about the insurance companies.

Scott: Right

Howard: and there's another guy sitting there saying dude this is what we're gonna do. I mean you're driving an F-1 Ford pickup truck cost you forty thousand dollars we did this what you do when you tab on the whole thing for me and then they don't say it's gonna be 15,000 or you don't say the whole thing is going to cost you $280 a month for 60 months and they go $280 a month

Scott: I can do that.

Howard: I'll do that and they're doing it in the middle of nowheres everywhere and then the other eight guys in the medical dental building don't believe it's even possible you know I do you not know the guy in your own building and then they tell toy yeah he's been there 15 years and never been to lunch with him have been dinner never into my house never in his house I mean in the last year okay 50 business owners in Ahwatukee in my house 50 they don't want to press the flesh now I want to work. Back to when I was talking about Delta Dental and the founder of pizza hut my dad came out and he looked at the deal they're looking at my revenue and I back on a pay board I go from September 21st never back to that quarter first a year to pay board and I'll never forget Dan Carney looking at the deal and he says who's Delta Dental AZ, I said that's Delta Dental Arizona that's your number one customer a they've already give me anything like four hundred grand they go who's the CEO, I said I don't know. He said dude if some guy gave me four hundred thousand dollars I dropped my knees and blow the sons of bitch and my god damn Howie doesn't even know who he is why dont you pick up that damn phone buy him lunch. So I'm calling down there and I told him I want to take him to lunch and he said why I said because I mean God had given me more money than anyone and I've only been open a few months and he thought something was weird because I'm a dentist

Scott: That doesn't happen.

Howard: Because it doesn't happen but anyway so his name was Ed Jones I have had a relationship with him and some other Delta CEOs over the years I liked the Irish drinking one in Minnesota the most that guy could drink me under a table and still tell better stories and they were really sad because you would give your church religion the ADA a thousand dollars a year they wouldn't sell $1 worth of insurance for you and then and then I'd give us an on Delta and say id give your practice $100,000 a year for 20 years and now they get one one letter looks like you horrible bastard delta is the devil you son of a bitch you didn't cover this you should go to hell your ruining Dentistry you're the scum of the earth so that's real nice.Here's a guy out there selling a billion dollars of insurance and you think your best idea is there make them feel bad and hate you .

Scott: Right

Howard: and it's perpetuated by I mean I have the chief economist on this podcast from the World Health Organization all this and I say well your in Chicago, you're at 211 thats where Delta is. They got Danny we're talking about how long does dentistry last I said you can get in an uber five minutes Delta has hundreds of millions of claims with all the actual data in the world they can answer any question so when some dumbass gets one dentaltown and says well composite lasts longer than amalgams, sure if you were decapitated in a guillotine and you don't have a brain you know but do you consider saying these composites last six and a half years, these amalgams last 15 to 30 but forget that what percent amalgams at 60 like if you did a root canal at 60 months 5% one in 20 done by endodontist are extracted. See we could debate on do root canals fail.

Scott: Right

Howard: but we're talking about just the data it's gone and then general dentist do it it's 10 percent but if you talk to every general dentist on dentaltown... how many of your root canals fail?

Scott: Mine never fail.

Howard: Well knock on wood. I have just a good chance getting that data, I mean no does and why because of this 50 years of dysfunctional hostile relation brought by the Country Club dentist who don't work Friday Saturday and Sunday and expect other entities like employers and government to pay for the stuff they make is they don't want to bother their customers by having them pay for so you know it's hard it's hard to be me because when they hire a practice management consultant they want to hear something say you're perfect and everybody else is bad and I'm the guy who says I won't even be a practice management consultant because you're an idiot and I don't know if you're fixable.

Scott: Yeah I've hired one of those and they have a lot to say and none of it was that I was perfect and I took it as a learning experience it was sandy Purdue class and she you know we were doing a lot of things kind of right but the difference in the end result in our production collections packing patients between kinda right and right is it's like the difference between good to great. It was just us changing a few things slightly and a fair number of things moderately you know quite a bit and using her systems and the help with the specific individual consultant we were working with which was Laurie Weaver and it was probably a 20% year 1 and 15 to 20 percent yea two. Work with them a little bit longer that we were supposed to be supposed to be a year but my only assistant quit four months into it and finding a new assistant attracting a hygienist not an assistant hygienist attracting a hygienist...

Howard: Laurie Weaver who works for Sandy Purdue.

Scott: Yeah but attracting a hygienist to move essentially to the middle of nowhere from San Diego or Salt Lake City or Portland that's tough I managed to do it but that was difficult and what I decided to do was to sell the sizzle and not the steak. I talked about the benefits of small-town life you know no alien patients, relationships all of that and attracted three very good candidates and made a choice and it was a home run.

Howard: Three candidates for

Scott: Hygiene, from the lower 48.

Howard: Thats hard.

Scott: It was very difficult I either was very good at doing it for the first time with no experience or I was damn lucky but I just looked at it I was trying to describe principles I guess you know lake will be gone in Alaska you know it was community it's knowing everybody and I didn't lie whatever I was saying was true yeah I didn't talk about driving to work seeing drunk people staggering down the street because they were at the bar.

Howard: and this is how deans have all these dental schools and hygiene schools have really ruined the rural America because what would they would do they do these small towns they say they want someone to come to my town they say ok we'll have an essay contest at your local high school find the ones that want to be a hygienists and then and then pays the damn scholarship. They have a deal two girls that write a letter it's okay I'll pay both of you to go to hygiene school there's five of them in the state and then they apply to the hygiene schools, they didn't have the grades to get accepted because what's more important is to get a 4.0 in trigonometry geometry then you're guaranteed not having a damn hygienist. Second thing I go to these some businesses in Arizona in small towns I've isolated and stuff and you talk to business owners there one business owner says it's complete limited growth is mechanical engineers but if you only accept you for mechanical engineering school if you have a 4.0 in algebra and all this shit and maybe someone from their town applies to engineering school they don't get accepted because ASU it's more important to accept the asian kid who got a 4.0 geometry than some hillbilly that lives in Salingman that's gonna work there. I mean if you're in Salingman you should ask all the people here you're accepting your accepting, are you going to work in Salingman, does this school take state money does the state have half the people living in rural and a half urban and in your town doesn't have a hygienist he's an engineer why is ASU accepting you on algebra because that happen to us. The only reason we became dentists is because we had A's in geometry in calculus and how much of that geometry and calculus would trig do you use?

Scott: Zero

Howard: Zero point zero. When I think about how many thousands of hours I stayed in the library learning calculus trig and geometry I'd like to take my number two pencil and go poke someone's eye out. I could have been out drinking beer.

Scott: I went to UC Santa Barbara a total party school and I heard the same recording of the library will close in ten minutes almost every night because I was damn well going to make sure I went to dental school. Well that was my goal I'm an oddity in the sense that I grew up in Southern California and I moved to a small town in Alaska if the dental schools medical schools nursing schools aren't finding people from these small communities, the likelihood of people going you know go into those small communities is very small.

Howard: I know.

Scott: South Dekota, all these little teeny towns that are not going to have the services because nobody wants to live there unless they're from there.

Howard: I know like the first states that now have dental therapists because since they won't accept dentists from the rural we need to create dental therapist because you know a dental therapist when she graduates first thing she's gonna go do is cute down a tree carve out a canoe go upstream the river live under a tree and work on the people and you know for free I mean the story just gets dumber and dumber.  You know they go to Scottsdale I work for whoever brings in the most money.

Scott: Im laughing because the second class of dental therapists that came out of Alaska Indian Health Service it's a class of three it was the first class that was actually taught in Alaska the first class it was taught in Newzealand where the program originated came to Prince of Wales Island and so i don't know how many other dentists have dealt with with that you know working not really a therapist but in the same vicinity as a therapist. I was I think the argument that Indian Health Service was giving for therapists and that is sending them to these remote remote remote communities for two weeks at a time a month at a time is a very arrogant because you're talking in the middle of the Arctic and this is a true story a dental team three go to this little village and the room they put them in was the best room they could find for them. It had no heat until they showed up so they have a day to warm up and have a dead Fox in it that they had to scrape off the floor and throw out the window and that was the best place that they could fined. So your average dentist isn't going to put up with that kind of garbage they're going to do it for a month and then they're gone and that happens a lot. So dental therapists in rural Alaska makes sense the dental therapists that I dealt with whose work I saw was in my opinion not ideal there they are trying to be diplomatic there were issues with the work removing all the decay, contacts that that would you know stop floss and this was a community so that the Indian Health Service put them they get right that already had two dentists you know myself and one of the leading health services than they had in the second one.

Howard: Where I want to add to your story is if you're a Native American Indian and you speak your language do you really want some grado crackered Indian Public Health Service who doesn't speak your language giving you free dentistry and it was Jack Dillonberg who said there said you know what they know what they don't want guys that look like Howard so he started doing I'm talking about he was the first guy said if you live on the Indian reservation and you apply to dental school were taking you because wed rather send back a Navaja to the Navajo and I Hopi to the Hopi then all this other stuff and it's so obvious and I go Jack his I mean I love him to death and I mean the people that don't see that wisdom and the people that I mean it's just crazy and it's the same thing across all these sectors every time I go to the town under ten thousand their problem is they don't get the resources from the schools education. I mean I'm not talking about they need more money it's just like but I think that when you're saying applying to a dental school and they said well you need two references well one of the references is the mayor of a town saying my town aint got a dentist and thus the only chance we got, same thing with hygenists I mean I just think that its just sad that two little girls from a town of 5,000 could have got a free ride to hygeine school the town does not have a hygienist and it still doesn't have a hygienist because he didn't get good enough grades in their stupid algebra skills. I mean come and it's even worse now because these people they're so worried about how they're going to rank on the US News and World Report top colleges and everything they game it, so they say well what are you looking at well the big highest of the highest SAT scores so then you come in with this great story they dont want to here that...

Scott: Its whats your SAT score.

Howard: Yeah what's your SAT score and they say well my village doesn't have a hygienist.

Scott: That's a disservice and if it's a private college church funded whatever that's their business - if it's a government school it's a state school they should look after all people in the state it's not just Phoenix you know you've got the smaller communities in the north in those communities what not same thing in Alaska. So I think these state schools are doing a disservice.

Howard: Yeah so basically half of America lives in 147 metros and the other half lives in nineteen thousand and eight towns and who's everybody focus on the half note.

Scott: Yeah

Howard: and they just don't even care about the rural and that's just like the last election a lot of people who don't like the current president and its like you know there was a lot of really upset people who didn't like the status quo you know. I want to go back to what I think would be the hardest thing with you and because I was from Wichita and my ex was from Maze and all the family was in Parsons and all these little towns.

Scott: What size are these towns?

Howard: You know maze was two thousand

Scott: Okay so similar.

Howard: and Colwhich was maybe you know 1500 and Parsons was a big town it was 14,000 but all my you gotta realize that I went to Catholic school in Wichita, a third of my friends all from farms some of you know thirty to forty minute drive out in the middle of nowhere but as you get smaller and smaller and smaller and you're on an island with three thousand the social complexity gets very tough because everybody knows everybody,

Scott: Everybody's related.

Howard: You can't go to the store in your underwear at midnight and buy a case of beer in a cigar.

Scott: Without...

Howard: and not have Mrs. Jones saying that's the guy who's doing my root canal tomorrow. How do you survive that?

Scott: Okay you could get a new clothes dryer and somebody hardly know will say hey how does the new clothes dryer because they just heard about it through conversation within three days later maybe when I first moved there so I grew up in Southern California move to this Island and used to the California social layer which is thin and narrow you know on clothes and everybody knows everybody so I mean how many people come up to me and ask me questions that they know about me I don't even know who the hell they are so it's very off-putting for the first three to four months until I finally kind of realize these are people that are trying to get to know me they're not sticking their nose in my business and now after 25 years it's extremely comforting to have a community with the type of depth and three-dimensional social nature as opposed to down here where you may know your neighbor you may know a couple people down the block but you don't know everybody you don't go to the store and know the guy that's putting meat behind the counter and he's a patient and you know who his son as you know you know the baseball coaches of his son it's really a neat you're smiling because you lived it, it's wonderful.

Howard: Here's the truth it's like when you live in Phoenix you could be invisible, say you were going to pick a super power what would it be alot of people will say I pick invisible. Dude if you live in a town of a million you can be invisible. I can drive around Phoenix for three days and not run into anyone I know but so that's a social lazy you don't have to be very socially adept to survive in Phoenix.

Scott: Not at all.

Howard: and I some of the greatest companies in the world were smart and we're starting at your environment I've never liked Sam Walton I mean he invented the return policy and its because they were Bentondale and only had five thousand people and Hellan went to church and was like I bought these shoes from your husband and the heel fell off the next day and Hellan said your going to take those back and he's like that ain't my responsibility, she goes well it is now because this is a town of five thousand and that whole family's never going to go back to your store. So he was the one and then when he took it back he was so mad when the guy who came to sell him his ten shoes he shoved that up the line and said I had to give her her money back so you give me another pair of shoes. So he's started pushing quality at the value chain and so my question to you is do you think you're just more socially adept and would be good at this and versus your classmates that you went to four years of college with how many could survive in that atmosphere?

Scott: I don't know how to answer that it was difficult for me for the first two or three years you know the office was growing I was becoming accepted in the community things really changed when I married my sweetheart who I had met at Loma Linda and she came up and started working the front desk.

Howard: She's Seventh-day Adventist who the longest-living earth of people in America yeah read the book the blue zone you're talking about the earlier the blue zone is a mathematical don't work they realize that the analogy ten zones have 10x the number of people living to be honored so this is anodite fad or anything crazy like that in the Loma Linda so you were in California hippie on this little Alaskin Island.

Scott: She's Filipina moved to the US with her family when she was 5 months old grew up in Virginia but she was...

Howard: Virginia to Loma Linda

Scott: To Alaskan

Howard: To Alaska.

Scott: Yes but she was extremely adept at remembering everybody's name who they were related to being very gregarious and our office our production that was doubled that year and it was all because her and her ability to simply have a much better relationship and in connection with the people of the community then I was able to do at that time now I think I'm much better at it but I'm also much smarter. I hire people to fill the voids that I'm not able to fill, so I want to I want to work on teeth but all the social stuff and the niceties I make sure I hire folks that that I want to spend went to around and they're teachable because none of them are going to be a dental assistants or answer a phone I had to train that but I have to be able to like them and I want to spend my time around them that be teachable and they have to be you know good with the community. They have to be my there any of the mommy set and it just makes things so much easier for the social aspect of small towns. Everybody is related to everybody you're talking families have been here you know if they're native thousands of years if there are commercial fishing logging to three generations they then are married and if you piss a patient off you usually just lost at least five patients minimum probably a lot more and when you have 3,500 people you can't do that too many times you know you've got to be so that's the type of thing taking care of little teeny problems before they become noticeable to the patient it's extremely important. We clear calls, dentists just fine marks don't do them they are absolutely necessary if you know if you're a dentist and you're out there and you're not doing we care calls you or your staff members just do it.

Howard: Does it matter if it's the dentist or the assistant or the receptionist?

Scott: It depends if it's you know wisdom teeth anything major I will try and make the call. We always have the staff a week later call as well. So the plan is they get contact and say a day later and then a week or so after that so they're usually surprised and were they happy the first time because it's kind of unexpected the second time there's been enough time for you know it hurts my bite down it's still throbbing whatever and then they're really appreciative because you know there's two flavors of ice cream to dental offices on this island there's myself and then there's the native health and I need to make sure that because I can't charge free okay I have to charge money I have to make sure that in every imaginable context that when there's comparison that we are superior that were better we're friendly or we answer phone faster you can get in sooner there's more compassion there's more care there's the appearance of more confident all though the dentists that work verifying we do everything we can to try and shine a little bit brighter than the competition and making sure that you taking care of little problems so they don't become big problems is absolutely crucial when you're on an island because you don't lose just one person you lose the whole family.

Howard: and it's the same thing in some of the areas in America like you man here not Amish town.

Scott: Sure

Howard: I mean we talk about you know they say only a dozen Native American Indians cross from Russia and the United States so there are avenues twelve people and then these Amish people on it that when they left Germany I mean I know they I mean you piss off one Amish guy yeah but so though that is amazing so Warren Buffet always talks about takes your whole life to build your reputation and five minutes of throwaway. I mean look at Anothony Weiner I always think that's the funniest one because if they would have never invented Twitter he'd be the mayor of New York and he's sitting in personally not only for tweeting pictures of himself but I mean just a random people I mean he didn't even know it wasn't like I was sending you a dirty joke there'd be like second someone a dirty joke you don't even know where it went it just went often to them in Crick people are freaking crazy.

Scott: Like very self-destructive terrible

Howard: I mean so you think there's behaviors that dentists do in the lower 48 than if you did you could destroy your practice?

Scott: Absolutely the stereotype so I went from dental school to running my own show so I've never worked for anybody else I've always spent you know Dave Alvin since super diver in Ketchikan I've been in his dental office I've been in a few other dental offices but not enough to where I have to look and feel an idea but I think if I were to try you know pinch the ass in the dental assistants asked out a patient's cuss and bitch out an employee and throw crap if I did that type of thing and I hear about that from people not all the time but you put your stories so I couldn't get the impression that that kind of stuff happens I do with people would be leave me in droves because I just pinched the ass oh there cousin okay you know I just asked out their married mom whatever. So you're going to there's definitely things that if you did in Phoenix people wouldn't hear about and that everybody hears about it.

Howard: That's my point so that when you move these great companies like WalMart that started in the town of 5000, they from the very beginning they put in these policies that made them the companies they are today and when you go to the dentist in like LA and Phoenix and Houston Chicago the big cities they have really horrible practices but they have a marketing machine because if they can get in 40 50 new patients a month they can piss them off because if you piss off 50 people a month in Phoenix well you could do that until the end of time but when you go down to the night under 3000 you can't piss off one person a month, two people. So they just have better policy and that's what marketing is a bad drug because I mean it's even in your league when you talk about that patient experience what do you mean the new basis for going taking the mask on the average dentist in his lifetime 11 out of 12 patients what so I mean the maximum to here...

Scott: What about the old patient experience that's what they should be focusing on.

Howard: Yeah how about every patient has a good experience but anyway

Scott: Well so we're talking about you know trying to keep patients from being upset there are some people I make mistakes my staff need to say some people are legitimately upset so you do everything you can to smooth things over generally that means calling them up knocking on their door having them come into the office having a need any conversation and looking it in the eye and saying I'm sorry if you do that, that goes so far I mean you will get patients that you know work they know that you did something wrong things that things didn't work out for whatever reason and if you just own it and you say you know this outcome wasn't my intention it wasn't what we were striving for it still happening I'm very sorry what can I do to make it right that phrase right there will get you out of a lot of trouble and wins you points because you're not tithing you're not you know going down the other isle in the grocery store to avoid them but it's important.

Howard: but the bottom line is I'll just say if your hygienist works 40 hours a week, 50 weeks a year that's 2,000 a year so she can only see a thousand people twice a year. Well 25 new patients a month what's a thousand divided by 25 that means every 40 months divide that by 12 that means every 3-4 years you'd add another hygienist. So you can look at that boy started his office when he's 25 now he's 65 you gave him 25 new patients a month his whole life so he should have added another hagas every three and a half year and 40 years later he has no new patients and he said what do you need I need new patients. Well you could do that business model in LA you can do it Phoenix you can't do an island.

Scott: No

Howard: and what I love most about you boys is you have to walk the talk because if you went out there and got drunk fishing and fell off your boat was found with mermaid how long would it take for the whole town to find out?

Scott: Half a day

Howard: Half a day

Scott: If that

Howard: So and here's something that in every major Metro is what they'll tell you while their drinking beer at the other bar will say you know you go to Scottsdale and you go to Beverly Hills and all the good things the dentist you read about they don't do good work they just do really get marketing. You know when you find the best cosmetic dentistry Glendale Chandler or Phoenix and let's see when you're the best cosmetic surgeon in Scottsdale you have a botched tummy tuck or a boob job every week once a month and until the lawyers come take your license away or whatever but man when you're innocent but as this town gets smaller and smaller and smaller and smaller everything becomes transparent and in Phoenix Arizona under that root canal any dentist done in no-class Glendale or Chandler the North Scottsdale where the main focus is building a million-dollar Taj Mahal all the movies all the billboards all the advertising in the top journals and while they're doing all of that what does that make their product lower cost?

Scott: Not at all

Howard: That makes our product twice expensive and that's the quandary in America so many rich people are paying twice as much money for high-end cosmetic boob jobs some execs veneers all that kind of stuff like that and they're paying twice as much for half the quality. I tell people that if you're a scottsdale go to Chandler to get your fancy dentistry time if you're Beverly Hills when I save some money go to Loma Linda or Redlands, I bet there's better dentists and Redlands than Beverly Hills.

Scott: There are some excellent in Redlands.

Howard: There just conservitive

Scott: Yeah but I'd like to say something you mentioned the Taj Mahal practice then you know I get these Burkhardt and Patterson magazines that even has some I'll say poor schmuck that when two million dollars in debt building this beautiful beautiful enviable practice, that's a huge amount of risk that I think they're taking the amount of debt you know it's something that I'm sure a certain percentage it works for them. I would love to find out how many of the people on the covers of those magazines five ten years later where they are financially do you have any idea?

Howard: I mean the last financial crisis was ten years ago so that should scare you cuz their usually about in ten years.

Scott: Sure

Howard: It was ten years ago 2009 Wednesday we lost about eighty-five practices to bankruptcy in the valley here and half of them were exactly what are we talking about high end Taj Mahal. in the class at million dollar two million dollar deals.

Scott: Yeah it's self induced financial tragedy is what it is and I think that you know if you're a young dentist fresh out of school, invest in yourself root canals and recognize implants and probably root canals, surgical extractions that is you're going to go into debt go to debt learning those. I think the big fancy office is unnecessary I think that debt can really it's a double-edged sword it can it can now leverage you into a very good position but it can leverage you know hole.

Howard: See I have totally different advice than you my advice is in dental school just married the Asian chick, She come out and work 10 hours a day six days a week. You know how many boys I know who look like me they're married the Asian chick in their dental office and now she does like six hundred thousand dollars here in dentistry take some 250 while they're basically losers on a golf course just...

Scott: but their winning. I married an Asian chick she's an occupational therapist.

Howard: Maybe you can lose some money in the million dollar taj mahal maybe you can lose some money in the million dollar divorce and what a lot of these dentists don't get is when you marry a girl who's looking for a rich dentist whatever and they spend tens I mean if you do the math, ten thousand a month times 12 months that's 120 thousand year times age 25 to 65 times forty years she got she five million bucks.

Scott: Oh no she cost you more than that.

Howard: Oh my god if would have just married the Asian chick in dental school she would have made you 5 million bucks that's a ten million dollars spread. When you're on a date and they bring the bill if she doesn't make an effort to pay that bill then she didn't even get your hand get the bill just run because when she expects you to pay the bill that's a 10 million dollar differential between I destroyed five million dollars in capital ten thousand a month for four years versus I made ten thousand dollars a month for others.

Scott: but you're not in your equation there you didn't include the cost of capital so you know she's spent ten thousand dollars a month you couldn't be invested. You are a hell of a lot more than 5 million.

Howard: Yeah

Scott: but that's you know if you're young dentist...

Howard: and the reason I keep saying that is because the bottom line is it's hard to get into dental school medical school or law school and so those guys always get predatory trapped by a girls thinking oh did you say you're a lawyer all I got to do I just found my meal ticket.

Scott: The doctor

Howard: and the lawyers and dentists and physicians fall for that more than the plumbers and electricians and the sheetrock workers and welders. Do you agree?

Scott: Absolutely

Howard: Well hey I'm a big fan of posts on Downton make you posted, I feel like I know you as a brother I can't believe you or nice enough to come by and talk.

Scott: Really enjoyed it just a lot of fun, I just want to say that I get for the last 17 years I've gotten so much out of dentaltown you know dentaltown I think the tagline is there dentist has to practice a lot when you're on an island in the middle of nowhere you're pretty much practicing alone and it opened my world to be able to talk to other dentists you know I just started doing a lot of posterior composites I'm having post-operative sensitivity what am I doing wrong, you're having guys have been doing it you know that are giving you real world advice that works.

Howard: What bonding agent are you using?

Scott: Right now I'm using vetopen which is seen but other times.

Howard: I think most people who have post operators sensitivity solve it with Clearfil Se.

Scott: I used Clearfil Se for 10 years

Howard: and you're going posterior...

Scott: No no no you know I went to Clearfil Se I see the post doc promise run away yeah but the issue I have with Clearfil Se is it has a thick coat thickness and I like using something that I can use the composites and veneers and something that's kind of universal and the FIFA 10 product works very well it's a single product.

Howard: Ultradent?

Scott: No it's not a to Ultradent I think it's curved it's a product my assistant would know she orders it.

Howard: You know I recommend for the bleaching bonding, just dimming the lights.

Scott: Works great.

Howard: but I get to one in one final story I'll just have to bring your chip over here I gotta tell my other island dentist story.

Scott: Go for it.

Howard: I was lectured in London and the dentists came may have a lot of items out and this dentist came and he was the island dentist, he was the only dentist and over the years the NHS pulled out so yours didn't he funded one day and on and well I'm sorry long story long story short he finally had was very tired of his office and couldn't sell his practice nobody died finally the guys are dying to self that I'm retiring. So he shut down his dental office every day some people are knocking on his door and he was walking back to his that thing out. So I met him so he retired tried to sell at 65 I think closer than over 68 I think when I had dinner with him he was like almost 80 and what he loved the most about dentaltown is that free classified ads I think it's the most overlooked thing on dentaltown. I mean there's like 40 million dollars worth of free stuff I mean why would you buy a laser for a hundred thousand if you could buy a used one for thirty, why would you buy a dental practice through a broker you know take six per seven tries to get the maximum price when here's some hillbilly guy who will sell it to you and when the owner carrie's he's got skin in the game like if I buy your practice though again if I bought a practice in Scottsdale and it was financed by a billion dollar bank you know they're all the same players and you gave me money and ran Im in Phoenix so I'll make the man if I bought your practice on an island and then you got to outside finance it and you took my $750,000 went and told everyone on the Island I was an idiot man you're in trouble and there's a small town right with the owner to carry now the owner says I want half down well then have the bank have the big billion dollar banks who are greedy and want the whole loan tell them to half but I want the seller to take skin in the game and when you're in a small town the owners got skin in the game and then you call him up and say yeah I just work on Paul he's madder than hell, I'll call paul.

Scott: I've known paul for 20 years, i'll talk to paul.

Howard: and then and you got a patient say it's sensitivity errors and people lose faith in you. I'm in a good practice for 30 years and I say we know about my buddy redo it for free or in office or even down the street in my best friend who's a dentist down the street I'll pay him to do it. I don't know to be against the bottom line is once he thinks the secret to success of algebra calculus and it's always the people skills. So I read about there's only three things people time and money and people's 80 percent of us and if you get an A on the people skills you can literally screw up almost everything else in life and so many fine.

Scott: and if you have trouble with people skills hire those who don't hire those who were black belts at the people skills.

Howard: Yeah that the dentist forever the library so he hires a bunch of intellectuals.

Scott: Like them yes

Howard: and the weak people like you see the books coming out about him you know we always worship on these CEOs like Steve Jobs or now it's Elon Musk who are just complete assholes and that you worship them because they're their job Steve Jobs gave you the Iphone who did horrible father I wouldn't want to be a boyfriend but anyway I mean the dentist's like to hire week injured people who won't call membership and the dentists who hire if you don't have anyone on your team that can say no no we're not doing that then you just you shot yourself. So if you're an introvert why we're in Greek geek hire the gorgeous extrovert Filipino gregarious woman who knows everybody's name but if you have a team that can't feel safe communicating with you, you lost.

Scott: I think hire people that are stronger strong personalities sometimes it's difficult because I'm more introverted the introverted geek but we've have a number of opinionated strong-minded women that are working at the office which is very helpful it makes staff meetings kind of difficult because most of our staff meetings turn in to the staff telling me i'm kind of screwing up somewhere okay so but it has been a real benefit to have people that are willing to tell me that they're willing to say that this policy right there it sucks and this is why and it's pissing people off or you're going to lose staff members and instead of having them just say yeah yeah yes doctor or whatever you say.

Howard: Final word is you know what the most proudest thing I did in my company there would be 20 years well they're not going to be into 20 years that they don't feel safe and they don't it'll say that they don't feel safe like they can call you on your only shit then you're never going to get good advice and then the best one for that was I mean Saddam Hussein these dictators. If anybody would have told him if you make away the Americans get over her and below the shed of you in a hundred hours they all told them that they win. So he always had misinformation because if you told them anything you didn't want to hear he killed so I called the Saddam Hussein scenario I mean everybody's gonna tell you what you want to hear or your business when you go nowhere but final question.

Scott: Yeah

Howard: Can I Drive my car from my house to your house?

Scott: No

Howard: How could I get to that island?

Scott: You could get to Prince Rupert Canada which you could then take a ferry to Ketchikan which is about eight hours ferry and they didn't have to take a three hour ferry from Ketchikan to Prince of Wales Island and then you have to drive across the island for an hour to get to my town.

Howard: Okay well I'm going to drive to your house.

Scott: Hey we will fish

Howard: Do you care?

Scott: No please, I hope you like salmon fishing.

Howard: I think hell yeah I think that would be the coolest damn vacation in the world can I seriously sometimes?

Scott: Absolutely

Howard: Just come to your house and go fishing.

Scott: Yeah I would love for you to see Kraig.

Howard: Okay I'm doing it. The other drive I forgot the city in Canada straight is at Edmonton, anyway it's like...

Scott: Calgary and Edmonton, Calgary it's in Alberta its in the north.

Howard: Yeah straight 11,000 miles up oh my god you leave Phoenix you go around the Grand Canyon you go through Utah;s canyon. I mean my god it is 1,200 miles of a 3,000 miles don't even think you're on earth. Alright thank you so much. 

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