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AUDIO - HSP #233 - Vish Banthia
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VIDEO - HSP #233 - Vish Banthia
• helps providers solve the problem of having open appointments that they are unable to fill.
• matches cash-paying patients to practitioners who need to fill scheduling holes
• supplements business and helps providers bypass some of the challenges that insurance brings to the table.
Dr. Banthia is a double Board Certified surgeon and a graduate of Stanford, UCSF, and Columbia / Cornell University hospitals. Dr. Banthia and his Medical Advisory Team are responsible for the vision of ZendyHealth and the array of services and procedures that can be delivered to the consumer in safe and cost effective ways. Dr. Banthia has specialized expertise in minimally invasive procedures and has delivered lectures to plastic surgeons, facial plastic surgeons and dermatologists throughout the country as well as internationally. In 2006, 2008, and 2011, Dr. Banthia was recognized as a “Top Doctor” or “Top Surgeon” in Silicon Valley.
Dr. Silegy is a Board Certified Oral and Maxillofacial Surgeon practicing in Long Beach, California. He is a Fellow of the American College of Dentists, the International College of Dentists, the American Association of Oral and Maxillofacial Surgeons and the American College of Oral and Maxillofacial Surgeons. He is a Past-President of the Harbor Dental Society, a component of the California Dental Association. In addition to private full scope oral surgery practice, Dr. Silegy lectures internationally on Dental Implantology and was the featured oral surgeon on ABC's "Extreme Makeover."
Howard: It is a huge honor today to be interviewing Dr. Vish Banthia, who is a plastic surgeon. He's an MD, and a plastic surgeon in Beverly Hills. He's probably looking at me right now, my face, and saying, "I don't even know where to start on this guy." Would you just take me to a vet, and put me down, or would you actually try some type of [Eroge 00:00:25] procedure on my 53-year-old face? I was-
Dr. Banthia: Go ahead-
Howard: Go ahead.
Dr. Banthia: I won't answer that question.
Howard: You won't answer that question? You were referred to me by the editor of our magazine, Dr. Tom Giacobbi. He said, "Howard, you should interview Vish, Dr. Banthia, sorry, Dr. Vish Banthia." Tom says you have a really interesting new concept, and he thought my podcast was about interviewing doctors who have neat stories to tell. First of all tell us about yourself. You are a double-board certified surgeon, a graduate of Stanford. You're a plastic surgeon and a ENT. Tell us about yourself, and tell us how you got into ZendyHealth.com.
Dr. Banthia: Yeah, sure. Absolutely. I'm double-board certified, and I trained in head and neck surgery, ENT head and neck surgery, and also in facial, plastic, and reconstructive surgery. I've been in practice for a little over 10 years. Basically, I came up with the concept of ZendyHealth based on the issues, and pains that I saw from both the patients' side, as well as the provider side, and essentially came up with this concept that provides ... It's a win-win type of solution for both patients as well as doctors.
Howard: Which is a ... Is it kind of like a Priceline.com for elective medical procedures?
Dr. Banthia: Yeah. Essentially what we are doing is ... In my experiences, whether it's for cosmetic surgery like a face lift, or whether it's for something that's medically necessary, I see patients struggling to pay their medical bills all the time. Essentially, this is especially true when patients have a bill through their medical insurance because they don't know what the price tag is in the first place, and they get stuck with a bill that they can't understand 6 weeks later, or several months later, and they're negotiating their fees. Like the Priceline negotiator, ZendyHealth is a healthcare marketplace where patients can name their own price, or in our case pick their own price for standardized health and dental procedures, and get matched to top-quality providers near them.
Providers, we're seeing, are accepting these offers, these patient offers, because they have cancellations, last-minute cancellations all the time, and would prefer upfront cash, as opposed to dealing with the hassles of insurance billing. As a physician myself I'm on several insurance plans, and I have to pay my biller X-percentage for collections. Sometimes I get my reimbursement 6 months after the fact or sometimes I don't even get my reimbursement, and sometimes I get a check for 25 cents or zero. Sometimes it's actually favorable to just collect upfront cash, just like every other industry does and every other merchant does for the most part.
Howard: I think Milton Friedman said it the best. He said, "The most efficient way to spend money is when you spend your own money on yourself."
Dr. Banthia: That's correct.
Howard: Then it gets less efficient when you spend your money buying something for someone else. Then when you spend other people's money, or other people's stuff which is an insurance company. They are paying other people's money for other people's stuff. He says, "That's the worst economic payment mechanism on earth." That just explained the entire healthcare industry.
Dr. Banthia: That's correct. I think you're correct. I'm not a policy expert, but what I've seen from all the research, the healthcare cost kind of spiraled out of control everywhere since the third-party mechanism was implemented. That's a controversial area, and I'm not sure that-
Howard: In 1900, it was 1% of the GDP was healthcare. By 2000 it was 12%. It went from 1 to 12 in a century, and now it's past 17%. At the rate it's going, in another 30 years it will be a third of the entire economy, which is totally unsustainable. Are you doing this for plastic surgery in Beverly Hills?
Dr. Banthia: I started the concept ... First of all, I think it's one thing to say that people can name their own price and bid on hotel rooms, and then it's another to say that people would actually name their own price or pick their own price on health-related procedures. It's kind of a crazy type of concept. What I did was I actually implemented a model in my own real-life practice, a version of it, and saw some positive results, and then started a programmatic site, a watered-down site that's similar to what we have right now to some extent, with just a narrow customer segment which was just focusing on cosmetic procedures like Botox, and laser hair removal, or fillers. Lo and behold, we saw patients placing bids or offers for these types of routine procedures, and we saw providers actually registering and signing up with us, and accepting these offers.
It's interesting. We saw that the behavior of patients was changing to some extent in this field in terms of delivery of health-related services, and because of that finding, we expanded this to dental services as well as health-related procedures like MRI scans, CT scans, which can be very, very expensive. I think the patients are now feeling that pain because of the increase of out-of-pocket costs that we are experiencing with high deductibles and co-insurances, and what not.
Howard: Right now you're talking to 7,000 dentists, so all it's all dentists. Very few of them do Botox or dermal fills, maybe,-
Dr. Banthia: Sure.
Howard: ... but it started, maybe 1%. First of all, what dental procedures and in what states are dentists doing this currently?
Dr. Banthia: We have dentists from a variety of states, mostly in California right now. Keep in mind we have a strong team of medical and oral-surgery dental folks on the system where we did a lot of research in terms of talking to the right folks in different fields, and to get their input and their feedback on what we're doing, because obviously this somewhat considered as controversial, and clearly people are concerned about the quality of care. For the most part, knock on wood, we haven't had any complications, which is great. Basically, as I said, we have dentists in California and elsewhere. Some of the services are just essentially standardized services like teeth cleaning, laser-teeth whitening, Invisalign, and what else do we have? We have tooth extraction and dental implants.
Now, obviously, there's always variations with every kinds of procedures. What we did was basically ... we came up with a standardized way of creating content, and standardized ways of implementing procedural offerings. We know that with MRI scans or CT scans there's always some kind of variation that you can think of. Some patients might need the 3.0 Tesla, but about 90% of the time people will do just fine with the 1.5 Tesla MRI scanner, so there are ways to creating standardized ways to present procedures and content, and that's what we've tried to do here.
Howard: Now you're mostly a California play.
Dr. Banthia: We have providers in about 60 or 70 cities outside of California, and we're rapidly expanding at this point, given our media exposure and given the fact that people are finding us organically at this point.
Dr. Banthia: [Crosstalk 00:08:22] Yeah. I would say the highest concentration of our providers, though, from a dentistry perspective, is in California. That's correct.
Howard: Have any of them talked about it on Dentaltown?
Dr. Banthia: I haven't-
Howard: Or would they not want them to talk about it on Dentaltown? Is it one those deals where if they found something good they wouldn't anybody to know about it, or is it something they would ... help you out and get on the message boards and talk about it? What do you think?
Dr. Banthia: Yeah. I think they would. We could certainly identify-
Howard: Do you know if I know any of them? Do you know that?
Dr. Banthia: I'd have to ask and get their permission. I'm sure they'd be happy to ... We have doctors in a variety of specialties who are wanting to talk to the press and talk to the media on our behalf because they see it work for them. We actually have investors who are actual providers onto our system, so I don't see any issues for ... I can't imagine that dentists would think otherwise. We can certainly reach out and ask them to see if they feel comfortable coming on Dentaltown and certainly can pass on that information.
Howard: Yeah. What would do you want to tell these guys? You've got 7,000 dentists driving to work, commuting right now, listening to you. What do you want them to know?
Dr. Banthia: Sure. Yeah. What we do is essentially help fill the gaps and the holes in people's schedule. In my practice I had nurses, anestheticians, and whenever we had empty slots or openings in our schedule, that translates into a massive overhead [sum 00:09:53] costs. If you do the math, at least for me out in Los Angeles, every hour of empty space or empty slots translates into tens of thousands of dollars of overhead sum costs, which I find is incredibly unacceptable. The concept is pretty simple. Would you rather take 100% of nothing with an empty slot, or would you rather take 60% of something?
Howard: I might add, being a dentist, when I talk to people on the street one of the biggest problems they have is an emergency. They'll have an emergency and they can't get into a dental office.
Dr. Banthia: Yeah.
Howard: You're talking about, here's people that have an empty space, and here's people that have an emergency and they just want to be seen right now, and they'll drive clear across Phoenix to be seen today.
Dr. Banthia: That's interesting because we've had quite a few cash offers for tooth extraction, and for the most part the dentists feel they're very, very reasonable offers. These are $350 or $400 offerings for a single-tooth extraction, which most of the dentists out here in California find profitable.
Howard: Yeah. It's profitable, and in my 28 years of being a dentist in Phoenix, I can convert, by talking to them and meeting them, I can convert three our of four to changing their mind and saving it with a root canal and a crown. There's an up-sell, where you can get them in for a low-price extraction, and then if you've got the personality, and the charisma, and the leadership, you can say, "Come on, dude. You're only born with these teeth. You're not going to get another one. Let's-"
Dr. Banthia: The thing is, the whole premise of the site is, as I say, we're bringing in a very, very highly qualified lead. Somebody who actually wants and needs a service at a particular price point that they can afford, and what we're seeing is that every transaction has resulted in a profit. I'll give you an example on the cosmetic side. We've had patients request ultherapy, which is a nonsurgical facelift, and some of these guys in our system are able to convert those ultherapy consultations into face-lift consultation. Now all of a sudden they just got a lead for free, so the cost of acquisition of that patient was zero, and now all of a sudden they're turning that into a $12,000 facelift.
As a dentist, I'm sure people need more than just one teeth cleaning. They're probably come back to you. They might need some other things. A lot of people are interested in Invisalign and straightening their teeth out, or veneers, or whatnot. The reality is, just like any other business, the name of the game is to bring people in the door, have them become aware of your services and what your practice is about. That's essentially our concept.
Howard: You've done ENT and plastic surgery.
Dr. Banthia: That's right.
Howard: Which one do you like better, and why?
Dr. Banthia: Oh, boy. That's a tough question. When I was younger, in my training, I liked doing those big head and neck cases where I spent 6 to 12 hours in the operating room, but now that I'm getting a little older and just out of-
Howard: Older? You're one decade younger than me. I've got a full decade on you.
Dr. Banthia: It's getting harder to do those longer cases, but I enjoy operating. That's why I went to a surgical field, and so I like using my hands and working in an operating room. Although I can tell you that I'm not sure if it's as applicable to the dentists, but I think that the regulations as it relates to insurance companies and whatnot, it's becoming quite painful in terms of all the regulations that's being imposed on us as providers. I'm sure the dentists feel that, although I know that a lot of dentists out here just flat out even don't take any insurance, but I'm sure-
Howard: I know. That's why it's kind of surprising, because when Tom Giacobbi, Dr. Giacobbi, the head of Dentaltown Magazine, was telling me about your lead, I thought, "Well, why would Dr. Banthia here? He's out there in Beverly Hills where they have nothing but money." Is that a bad misconception? Or some people say that rich people, that, you know, a fool and their money will soon be parted, and one of the biggest problems with the rich people is, the reason they're rich, is they don't part with their money.
Dr. Banthia: I've worked in academic environments, HMO environments, and also in private practice, and I've worked in Silicon Valley and also in Beverly Hills. I have never come across anybody, whether they're rich or not so rich, where they weren't interested in being cost-effective with their healthcare dollars. I'm sure there's that 1% of the population where he doesn't care in terms of how much money they have to pay for an MRI scan or a particular procedure, but I think for the majority of us I think we're looking for ways to make smarter decisions with our finances. I know for a fact, if I went out and played squash or tennis and twisted my knee, and if I had to get an MRI, it would be tough to come up with $3,000 just right away. It's just not part of factoring it into my budget in the immediate term.
Howard: Right. Correct. What if a dentist wants to participate? You're only in California? What if they're in the other 49 states? Should they go to ZendyHealth.com and check it out, or should they-
Dr. Banthia: It's interesting, because we're getting organic patients in a variety of other states, including Arizona, Minnesota, Texas, and Florida, and a handful of other states as well, and people are finding us organically, so something is working in terms of our SEO strategy, apparently, and also we're signing some contracts with some larger organizations in the next month or so. I can't disclose the names of them, but we'll be adding hundreds of thousands of patients in the near term. Dentists can be from any state. They can come to our site and register online and submit an application, and we have our dental team, our medical advisory team review their applications. As long as they meet certain requirements, then they're good to go.
Howard: All right. I think I'm going to do this just for morbid curiosity and see how it does. Do you know if you have anybody in Phoenix?
Dr. Banthia: I'd have to check. I don't think we've ... I don't think so, but I would be happy to have you on board.
Howard: I'm going to be the first. I'll be the first. I love these new business models. I love these new things, and I think the trick with marketing, as I've always said, I do everything, then track it. I do everything, and if it doesn't work then I stop doing it. If I do it and it works, then I compare all my my different marketing strategies to how much money I'm paying per head. You have Yellow Pages, it costs 400 a head, and Google ads or Facebook ads cost 100 a head, or 1-800-DENTIST, you just move your money over.
Dr. Banthia: Absolutely. That's one of the reasons we made the system this way, because as a physician I pay X-hundreds of dollars for this marketing directory list or that marketing directory list, and I won't go into names, but the ROI is always questionable and it's very difficult to track all these things. What we want to do is really present a more provider-friendly platform where we can get leads and patients coming in and the cost of acquisition is zero, where people are not paying subscription fees. Yeah, it's not perfect, but at least you're not hemorrhaging out X-hundreds of dollars per month without any exact concept of ROI on those.
Howard: I'm sure everybody wants to know how the hell did you get into Stanford? That's the hardest university in America to get into, Stanford, or MIT, or Harvard. Was that pretty tough?
Dr. Banthia: It was intense. First, I went to a great high school out in Dallas, Texas, and it was a fantastic place. Saint Mark's School of Texas really prepared me and I learned how to think and write over there. I think education from an early level, I don't think that can be underestimated at all. As I look to my daughter growing up, I know that we're going to be heavily focused on education, but really it's just pure grit. I don't think that I'm smarter than anybody else, but it was just pure grit, and just getting things done, and just cruising through the books, and burning the midnight oil, so to speak.
Howard: Stanford told me the way I'd get in is with a ski mask and a gun. Before I let you go, though, so if the dentists would go to fill out an application, they'd go to ZendyHealth.com?
Dr. Banthia: Yeah. There's a section that's for providers. They can also alternatively go to www.MyZendy.com. That's, once again, www.MyZendy.com.
Howard: MyZendy.com is for the providers and ZendyHealth is for the consumers?
Dr. Banthia: Yeah. It's just to redirect to our page, and that's for the providers. Even if you go to ZendyHealth.com you can get to the-
Howard: If you're a dentist and you want more new patients and you want to fill some holes, you would go to www.MyZendy.com. Z-E-N-D-Y.
Dr. Banthia: MyZendy. Mm-hmm (affirmative).
Howard: Zen, when I think of Zen I think of one of the first books ... I went to Creighton, a Catholic school, and the first Jesuit I met said, "Oh, my God, you've got to read this book, "Zen and the Art of Motorcycle Maintenance."
Dr. Banthia: Yes.
Howard: Did you also read that book? Is that where the name Zen came from? Zendy?
Dr. Banthia: I've also heard of that book. I haven't read it, unfortunately. I should have. Zendy just came ... It's just a fun name. We had a lot of startups come out with ... where the first letter is "Z," Zillow, ZocDoc, Zeal, and it's something that's memorable. A lot of patients remember the name, and it's just a fun name. Yeah, we'd like to think that we put the zen back in healthcare.
Howard: Does it cost anything for the dentists to sign up?
Dr. Banthia: No. It's free.
Howard: What do my homies have to lose by checking this out?
Dr. Banthia: I don't know. It's not ... I hate to say a no-brainer. I don't like using the word no-brainer, but essentially there's no cost to the providers. What we'll do, though, after our initial period, we will likely have a subscription model for those people who register after our initial period, but for everybody who signs up in our early phase and our initial phases, they're grandfathered in into a complimentary service, where they can not only get some exposure with their websites by getting a direct relisting, but also getting access to our cash-paying patients in our marketplace.
Howard: Remember, homies, you heard it first on my podcast. Don't forget that. They have nothing to lose. They'll fill out an application. If they get accepted ... How do you weed out bad doctors, license taken away? How do you know it's a quality provider?
Dr. Banthia: Our dental/oral-surgery advisor actually reviews those applications. We've had to turn away some doctors. Some just don't have a license to practice, and ironically they're practicing, and some physicians that are on the medical side, the Mds that are not board-certified, so we don't ... unfortunately we can't accept those. There's also some folks ... we look at some consumer-rating sites, and those guys who have the worst horrible reviews, like one-star reviews across the board, it's going to be really tough to bring them on, but we-
Howard: What if they went to dental school, USC, or UCLA, which really isn't even accredited?
Dr. Banthia: Is that right?
Howard: No. I'm just trying to jab some of my buddies.
Dr. Banthia: Oh, got it. Got it.
Howard: If they're commuting to work, they probably just drove off the bridge. So they have nothing to lose. They'll go to MyZendy.com, they'll fill it out, and then what do they do? They put prices in for the 5 things you talked about, which is a cleaning, a whitening, Invisalign, an extraction, and an implant?
Dr. Banthia: They just mark ... First of all, just to clarify, they have to go to www.MyZendy.com.
Dr. Banthia: If they go to MyZendy.com it may not redirect properly. It's www.MyZendy.com, and they just register and they indicate the procedures they want to get notifications for, like teeth cleaning, teeth whitening, tooth extraction, dental implants, and whatnot. We've had some requests from dentists to add veneers and other types of procedures. Interestingly enough, we have other specialists, like GI specialists and colorectal surgeons wanting to add colonoscopies, and urologists wanting to add vasectomies. We've had to be really judicious and methodical about what we can add, and see what the patients are looking for, and how that-
Howard: Who's your head dentist? Do you have a head dentist?
Dr. Banthia: We do.
Howard: You said it's an oral surgeon?
Dr. Banthia: That's correct.
Howard: Can you say his name, or would you rather not?
Dr. Banthia: Yeah. No, I'm happy to. His name is Dr. Tim Silegy.
Howard: Tim Silegy. How do you spell Silegy?
Dr. Banthia: S-I-L-E-G-Y.
Dr. Banthia: Yeah.
Howard: My podcast is usually an hour, and you're a ENT plastic surgeon, and we're ... everybody in my audience is only dentistry, so now we've met the founder. You've talked about the concept, they know you're a smart guy. Then, Tim Silegy should come on and talk about specific ... How it's going in dental.
Dr. Banthia: Absolutely.
Howard: All right. I think that would be great. Like I say, when I talk to dentists and I say, if you kicked over a bottle and a genie popped out and you had three wishes, what would it be? One of them is that they could replace all their staff with droids, from the new Star Wars, and you'll never have to deal with overtime, and-
Dr. Banthia: That's not just for dentists. That's for, I think, every physician out there.
Howard: One, they'd replace all their staff with droids. Number 2, they'd want new patients, because new-patient flow is cash flow, and if you don't have any new patients walking in the door it's hard to pay the bills, the light, the mortgage, the rent. This was what got Tom Giacobbi excited.
Dr. Banthia: Sure. The interesting ... the dentists were really smart, because they actually did research into this, and they found out what the lifetime value of each patient was, whereas the plastic surgeons and the MDs didn't really do anything like this in terms of a cost analysis or a mathematical analysis, but for every patient that comes in, on average, you're talking at least $1,500 of LTB there. Most doctors, like plastic surgeons that I speak with, they don't really do that analysis, which is unfortunate.
Howard: While I still have you on the phone ... your credentials are amazing. I got out of dental school 28 years ago when ... if you're an ENT where, most all oral cancer was coming from smoking and drinking, and it was [crosstalk 00:24:54] history and it's mostly 60-year-old people, who when you met them you almost thought they were a chain-smoking alcoholic, but now we keep hearing about the human papillomavirus. Has that changed oral cancer from what you've seen in your field?
Dr. Banthia: Yeah. I think we have younger patients now, who are non-smokers, non-alcoholics developing a cancer. I think we're seeing an increased rate of that, and the behavior of these cancers is also different than the typical patient that you were describing.
Howard: How is the behavior of the cancer different?
Dr. Banthia: Studies show that the success rate for these types of treatments are actually quite good when it comes to HPV-positive cancers, so that's actually a favorable factor [inaudible 00:25:45] there.
Howard: Do you treat them the same? Are they both getting surgery and chemo?
Dr. Banthia: It depends. For the smaller cancers, for the smaller ones, then surgery might be an option, but clearly if there is [necktasis 00:25:59] then you have to consider other options and give options to the patient.
Howard: Hmmm. Very interesting. Anything else you want to add, doc?
Dr. Banthia: No. I'm very pleased and excited about being on the show, and I appreciate the opportunity.
Howard: Hey, you should be thanking Tom Giacobbi. He's the one who stirred up the lead for me. By the way, homies, if you have a lead of someone that you think would be a great podcast interview, email me, Howard@DentalTown.com. Dr. Vish Banthia, thank you so much for your time.
Dr. Banthia: Thank you. Another point is that if anybody wants to ... I'm happy to talk to anybody. They can call me personally on my cell phone and I can exchange that with you offline and I'd be happy to talk to anybody about any questions, and-
Howard: Do you want to say it online, or would you rather-
Dr. Banthia: Yeah. Sure. It's 917-721-
Dr. Banthia: ... 4306.
Howard: ... 4306. 917-721-4306.
Dr. Banthia: Yeah. We're trying to find solutions for providers regardless of their specialties, and I'd love to hear people's feedback to see how we can make the system better.
Howard: You're in such a famous Beverly Hills, California ... I actually know your zip code. 90210. Did I get it?
Dr. Banthia: 90211, actually.
Howard: Oh, I thought the show was 90210. 9021-, but it's 90211?
Dr. Banthia: 90211 is one of the zip codes there, but yeah, the more famous zip code is 90210.
Howard: Okay. Hey, doc, thank you so much for your time.
Dr. Banthia: Thank you.
Howard: All right. Have a great day.
Dr. Banthia: Okay. Take care.
Howard: It is a huge honor today to be podcast-interviewing an oral and maxillofacial surgeon, Dr. Tim Silegy. How are you doing, Tim?
Dr. Silegy: I'm doing fantastic, Howard, and I must say I'm quite impressed that you could completely pronounce the name of the specialty without stuttering or stammering.
Howard: The oral and maxillofacial surgery?
Dr. Silegy: Absolutely.
Howard: The Tom Silegy was the easy part. It's the OMFS. You guys are rare, and you guys are always busy. Trying to get an oral surgeon to do a podcast interview is like pulling teeth, no pun intended.
Dr. Silegy: It's not quite that difficult. Right?
Howard: No. It's very difficult. In fact, I haven't had that many oral surgeons. They're rare. They're very rare. Thank you so much for your time. I know you're a busy guy. This is something I haven't done before, where we did a 30-minute podcast with Dr. Vish Banthia, the founder of ZendyHealth, and then when he was telling me all about it, he was a plastic surgeon and he was telling me all about it, and I said, "Well, who's your dental guy? You got a dental ... a product champion?" He said, "Yeah. An oral and maxillofacial surgeon." I thought, "My God, I want to end this at a half hour and start with you." Tell us, how did you meet Vish Banthia, and what are you doing with this ZendyHealth?
Dr. Silegy: I met Vish through social circles. His wife and mine are very, very close, and a couple of years ago when he decided to try and move out of clinical practice and offer affordable healthcare for patients that tended to help them, and also provide a better living for himself and so on, I was really enamored with the concept of name-your-own-price dentistry. He had actually started it in the cosmetic industry, which was what he was familiar with, and I said, 'You know, Vish, I think you could be very, very successful if you take the same concept to dentists." He even asked me to come on board as his dental director, and that's where we are now.
Howard: Growing up in Kansas, everyone always told us, even your parents, your grandparents, your great-grandparents, that everything starts on the coast, and it will get to Kansas in about ten years. It doesn't surprise me that you guys are both right on the Pacific Ocean. Are you in Beverly Hills too?
Dr. Silegy: No. I'm down in Long Beach.
Howard: You're the poor pauper oral surgeon?
Dr. Silegy: Yeah. I'm where all the blue-bloods live, I suppose.
Howard: All the blue-, you know, when I came to Phoenix, I specifically stayed in Phoenix and I thought, "You're from Kansas. You're not even the right type of person to be up in Scottsdale and Paradise Valley, and that's not your tribe and you probably won't connect with them." I'm so glad. I love ... In fact, I'm across the street from the Guadalupe Indian Reservation, so 25% of my patients don't even speak English, and I actually have the most fun with them.
Dr. Silegy: I can imagine. It's funny. For a short period of time I had another office down in Newport Beach, and the difference just in the patient demographic was startling. You would think that the Newport Beach patient clientele would freely spend money on their oral health, and cosmetic procedures, and so on, and it really wasn't the case. Our no-show rate was about 30%. Last-minute cancellations. "Oh, my son has another thing they have to do today. Can we see you tomorrow?" It's strange, because you'd think that would be a very, very great place to have a practice in, and it is, but for me, I'm very, very happy here in Long Beach.
Howard: It always seem ... Albert Einstein said that intelligent people can't be happy, or geniuses can't be happy, or something to that effect. That the higher your IQ the more you suffer from depression and things like that, but I swear, my patients from Guadalupe laugh and giggle the most, and it seems like you go there, and they're very poor, and it seems like the patients who mainly come in from the rich part, the equestrian center, always seem to be the most stressed out of their mind.
Dr. Silegy: Mm-hmm (affirmative). It's true. I've done a fair amount of mission work in Latin America and I find the same to be true. You go to the top of a mountain and realize that people are born there and will probably never leave that mountain, and they're the happiest. They really are.
Howard: I keep saying I'm going to write a book called The Giggle Factor, and The Giggle Factor, because when you go to a country like the United States, and Germany, or Japan, or Korea, or Hong Kong, you just almost never see anyone giggling. Then you go to Tanzania, Ethiopia, Nepal, or Brazil, or way out in the "Third World," you just can't beat the smile off everyone's face. They're always giggling.
Dr. Silegy: It reminds me that the Joker and Batman, why so serious? It is fun. We like to have a good time with our patients here, and ascribe to that philosophy.
Howard: Name your own price. I bet a lot of people are cringing. They're thinking, "This is just ... it can't be a good idea," but you're an oral surgeon. Do you have patients naming their own price on pulling a set of wisdom teeth or getting a dental implant and a crown?
Dr. Silegy: Absolutely. Let me tell you the process. I do a lot of lecturing nationally and internationally on dental implants. With general dentists in particular, I go through a whole explanation of profitability. Profitability, as you know, is a factor of your fee minus your cost, and I usually end the seminar with that for a moment, and I say, "But there's one more variable." They all kind of look at themselves. I say, "It's time." I take that conversation with affordability, and profitability, and time, and put it all together for them so they realize that the worse thing, the biggest detractor of success in your office is open chair time.
What Zendy allows dentists to do is have another tool to make sure their chairs are always busy, because it makes a lot more sense to be doing a crown for $500, than having that chair open for an hour, where you don't get anything. That's the beauty of the system.
Howard: How long have you been doing ZendyHealth?
Dr. Silegy: We've been actively seeing dental patients for about 3 months.
Howard: 3 months? Are you an owner, or do you have any equity in this, or are you-
Dr. Silegy: I'm just ... I have stock options for the company, and I've decided to help Vish out with the project, and of course, reap the benefits of the patients that come my way as well.
Howard: Are you getting patients from this?
Dr. Silegy: Yeah. Definitely.
Howard: Once a month? Once a week? How is it ...
Dr. Silegy: It's-
Howard: Tell us your experience of how this is working, because I love changing business models. I just love it. Like this merger between Dentsply and Sirona. I've been thinking about that for 100 hours. I just love how technology is just game changers, and we saw this with Name Your Own Price with ... who's that? William Shatner and-
Dr. Silegy: Mm-hmm (affirmative). Priceline.com? Yeah.
Howard: Yeah. Is that kind of what this is modeled after?
Dr. Silegy: Definitely. Yes.
Howard: Definitely. We need to get William Shatner on here on a podcast-
Dr. Silegy: I think so. I think that the limitation now is it's still a very new concept, and we've made great progress in medicine in areas where patients have very, very high deductibles. So many people are excited about the Affordable Care Act because they now have insurance, but they don't realize that they have a pretty stiff deductible for a lot of different procedures, particularly in the diagnostic realm. You may be sent ... For instance, say you have sinusitis and you need a CT scan of your sinuses, you may be sent to a hospital-based imaging center and be hit with a fifteen-hundred dollar deductible for that.
ZendyHealth has imaging centers as part of its treatment team, and you can go there and, say, maybe pay $500, $600 for that CT scan or MRI, don't even have to deal with the deductible at that point in time. It's been very, very successful in that realm as well.
Howard: A lot of my complaints, when I was in college and I was laying around like, "What's wrong with America?" I'm so surprised at how some of the big game-changers have been changed. Like legalizing marijuana, for instance. I never thought they'd ever do that, and one of the other ones was, I always thought it was anti-American that I couldn't go into one of these blood labs and order ... have my own labs for cholesterol or whatever I'm measuring. I thought it was actually criminal that I had to go through the doctor's pay-station racketeering, and get a prescription for it.
Arizona just opened that up this year, and it's only been opened for a couple of months, and now there's all these television ads during the Royals' victory last night, during the Royals' game saying, "Come in here and we'll run something like 25 blood tests for $99, and then you can have 150 things tested for under $9.99 each." That's how it should be.
Dr. Silegy: Medicine, and dentistry for that matter, is becoming more and more consumer-driven, as the public becomes more informed about different procedures, and different illnesses, and different tests. That's, again, the beauty of Zendy because you know what you need. You now have the ability to use the free-market system to find a price that's affordable for you. As I said, it's also affordable for the imaging centers and the doctors who are participating in the program.
Howard: How long has the dental part of it been up?
Dr. Silegy: About 3 months.
Howard: Is it just specific things you can bid on, or can you bid ... Can someone just say anything, or is more just specific?
Dr. Silegy: Yeah. Right now it's not really bidding as much as it is offering your price, but we're still in development, and the model that we're following a lot is just with basic dental procedures. X-rays and cleanings, name your price for something like that, because as you know, one patient that comes into a general dental office has the potential, over the practice life of that patient, to be $2,000 or $3,000. We find that our dentists are much more willing to take a patient in at a very low fee for a basic cleaning and exam, because they know that the economic potential of that patient is very, very high.
A lot of dentists, I don't know how things are in your practice, but several of my colleagues spend thousands a month with postcard mailings to neighborhoods, direct-mail campaigns, email campaigns, constantly doing search-engine optimization for their websites and so on, all with the intention of bringing in new patients. This is something that a dentist can do passively, and if you're looking at your schedule on Monday and your Thursday fell apart, you get a couple of emails for patients that want cleanings, and exams, or crowns, or extractions, boom, all of a sudden you've filled that chair time and you have two distinct advantages. one, you're generating some income in that chair that would have otherwise been empty, and 2, you're bringing on 2, 3, 4 potential patients that will be with you for the life of your practice.
Howard: Yeah. I guess a lot of it depends on what type of dentist you are. If you come out of a large-competition PPO clinic where you're just kind of wham, bam, thank you ma'am, you've got to make each procedure because you don't have really the skillset of customers for life, but if you have strong skills in case presentation you might get someone in for a low-cost cleaning and X-ray, and then present them a large treatment plan of thousands of dollars worth of stuff, so it would really make sense. When I ask a dentist, "What is your cost to get a new patient in?" I can tell you mine are 300 a head for yellow Pages, 100 a head for 1-800-DENTIST, 75 or 80 a head from a Google-Plus ad, but most all dentists don't know that number.
Dr. Silegy: Mm-hmm (affirmative). No, that's true, and that's what I find when I lecture about implants. Very few know what their most profitable procedure is, and they don't even fully understand the concept of profit. It amazes me sometimes that they'll pay a $25 or $30-an hour assistant to sift through a catalog and try and find [locol 00:40:28] for a dollar less a box. It just doesn't make sense. Dentists aren't always the best businessmen. Again, I think for those who don't have the acumen to even have much of a marketing scheme in their practice, this is a very, very good opportunity for them.
Howard: What states ... My son Ryan just printed out a list of countries that subscribe to this, and you broke my heart. For the interview, I found out we only have one dentist listening to us in Khuzestan.
Dr. Silegy: Oh, no.
Howard: The good news is, I should be able to double that. If I just get one more dentist, I can double my Khuzestan inputs. How many states is this available in as of today, and today is the day after the Kansas City Royals won the World Series. I went to UMKC Dental School in Kansas City. I have to plug my Royals.
Dr. Silegy: That's great. I did my undergraduate work at Graceland University at Lamoni. In fact, last night ... I'm very good friends with the director of development there, and we were texting back and forth. I was definitely cheering for the Royals. The last time they won I think I was in college. If it's a-
Howard: I know. I was in dental school in Kansas City. I kept texting all my classmates, "Dude, can you believe that was 30 years ago that we were at the Royals' Parade?"
Dr. Silegy: Crazy. Right?
Howard: Oh, my God. I must be getting old, fat, and bald. I'm afraid to look in the mirror now.
Dr. Silegy: The only thing you can control is whether you're fat or not, so ...
Howard: If I lose weight I'll still be old and bald?
Dr. Silegy: Now, in terms of states, it's -
Howard: What states?
Dr. Silegy: It's an internet-based application, so you just go to ZendyHealth.com and see who's there. Again, it's a startup so we're still working on expanding the amount of practitioners and getting the word out to them. That's what I was going to mention earlier in terms of the demand that I see. Every time we have a podcast come out, or ... an article is coming out here very shortly in Inc. Magazine. Zendy was found to be the fourth-hottest startup company of the month by a different organization, 500 Startups. The more we get a little bit of the word out, we tend to see a spike in activity.
It's just a matter of time until the general public really sees what's available there, and we're concentrating our efforts right now on signing up as many dentists and healthcare providers that we can. I really think this is a fabulous way, especially now, during the startup period they're not charging dentists to become a partner. Not a partner, but to be on the site, so it's a great way to be prepared to expand your practice.
Howard: I try to stay focused only on dentistry and avoid sex, religion, and politics, and violence, because they're just such polarizing subjects, but the reason I was so interested in listening to you is because it's a new business model in the healthcare. It's high-tech, it's internet, because healthcare was 1% of the US GDP in 1900, and by 2000 it was 14%. Now it's only 2015, it's 17%. The healthcare expenditures of the 20 richest countries is just engulfing the whole economy, so things like this, these will have big play. Half of the Americans don't have any dental insurance, and healthcare is too much money for over 100 million people. In fact, it reminds me of these political debates.
When Obamacare ... did his Obamacare, all the Republicans were pooh-poohing it, and they're, "This is crazy," and blah, blah, blah, but the overwhelming millions and millions, and millions that signed up, they're kind of quiet about the issue. If anybody is saying, "Obamacare is a failure," when so many tens of millions of people signed up, because what it shows is not that Obamacare is right or wrong. What it shows is that people are drowning from healthcare debts, and it's the number-one cause of personal bankruptcy in the United States of America. When I saw this new business model, I thought "I want to jump on the story." I'm not endorsing it or un-endorsing it.
I'm just saying, anything that lowers costs in healthcare is going to get a lot of attention. That's probably why you got so much press attention in Inc. 500, because they're looking at, "Who cares about a game app on an iPhone?" Healthcare is 17 cents of every dollar, so you're in the real McCoy category. Do you know what I mean? Journalists will pick that up.
Dr. Silegy: It goes the same way. I don't know how it is when you talk to your colleagues, but speaking of my colleagues, everybody is ... their revenue has been down over the last several years and they're all looking for opportunities to see new patients. I'm a believer in a free-market capitalistic society, and that's really what ZendyHealth does. It gives people control of their own healthcare, and their own ability to pay for it, and it gives practitioners some of that control back, too, that insurance companies have taken away.
Howard: Did you read that article by my favorite economist called "Lawyers, Dentists, and Lattes?"
Dr. Silegy: No, I didn't. Am I missing out on it?
Howard: Yeah. The American Dental Association has their own full-time economist. They just do healthcare economics for dentistry, and he wrote a great piece called, "Lawyers, Dentists, and Lattes," and all the economists, he had had all kinds of citations in the literature, from the 2008 financial bust, the only 3 sectors that did not come back all the way were dentists, lawyers, and lattes. You're paying $5 for a cup of coffee. Yeah, so dentists have not fully recovered from the 2008 financial crisis, which is sad, because this is 20015. That's 7 years, and usually these economic cycles are usually about every 7 to 9 years. We haven't even recovered yet, and there's not an analyst in America that doesn't think we're probably around the corner from another correction.
Dr. Silegy: Right.
Howard: Dentists, lawyers, and lattes are saying, "Dude, we didn't recover from the last one, and we could be going into another one."
Dr. Silegy: Yeah. Exactly. You're still seeing-
Howard: In the last one, 2008, we had 100-plus dental offices in Phoenix go under. I mean in the Phoenix Valley, the Phoenix Metro.
Dr. Silegy: All new dental offices?
Howard: All dental offices. They were pretty much split in half. Half of them were just brand-new startups who thought they just do direct mail and get the cash flow, and the other half were highly specialized high-end cosmetic dentists, mostly in the Scottsdale Paradise Valley. It was the young dentists who thought, "Yeah, I'll just go into a retail center. I'll just set up, and I'll put up a website and do a couple of direct mails, and I'll be off running." That did not work in the year 2008. All the new startups right then were crunched, because direct mail quit working for several years. Then the high-end people who lost the ability to do a root canal, or do a partial, or treat a three-year-old were just doing high-end veneer cases, and cosmetics, $50,000-rehabs, those $50,000-rehabs dried up, so a lot of them went under.
Dr. Silegy: The thing that's kind of sad about dentistry and the fact that it hasn't fully come back yet is that new dentists getting out of school are burdened with a significant amount of debt, and then the concept of them trying to start a practice in today's economic environment, with the cost of construction or building out an office, or purchasing an office. I've seen a definite change. You see more and more dentists go into corporate dentistry. You see more and more dentists bringing in the specialists into their own office to capture a little bit more of their revenue, and it really has had a pretty startling effect on dentistry. I agree.
Howard: How many dentists do you have on this so far? Do you know?
Dr. Silegy: We have about 200 dentists in the Los Angeles area. That's where my focus has been. I know that there is certain other areas that we're planning on targeting, and are going to start launching some marketing for those here very soon.
Howard: What procedures are you listing on there? Or does it not work that way? Do they just see that you're a provider and email you a question and say, "Hey, Tim, you're an oral surgeon. How much is it to have all four of my sons' wisdom teeth pull out," or, "I need an implant."
Dr. Silegy: It's great because we have a lot of flexibility, and as the provider you have the ability to basically accept or not accept treatment. Typically what would happen is, you would go onto ZendyHealth and let's say you needed an implant. You would say ... For instance, you wanted to pay $1,200 for an implant, abutment, and crown. That, then ... that notification gets sent out to all the dentists who are in that region, based on the zip code, and whoever responds first and accepts that ad, sends the message back directly to the patient that, "Yes, I'll accept that ad. Call my office for," excuse me, that price. "Call my office for an appointment.
Obviously, I'm not going to be responding to tooth cleanings and basic exams, and in fact, in my profile I can filter those out. Depending on what your specialty is, or what your level of training or interest is, you can really fine-tune that with the software.
Howard: You, as an oral surgeon, can you do an implant or crown, or can you only do the implant?
Dr. Silegy: I can suddenly become the gatekeeper. Right now restorative dentists are the gatekeepers, and in some respect, if you're a specialist, because you're dependent on their referrals. Now I can go to the handful of my top guys and say, "Hey, I'm going to be placing the implant here. Can you do the crown for $400?" I know what the profit I want to make off of the implant procedure, and then I can pass the crown on to one of them for that, but I still am allowed to package it for that patient.
Howard: What type of a request are you usually getting?
Dr. Silegy: Most of them right now have been for basic extractions.
Howard: Extractions or wisdom teeth?
Dr. Silegy: If the patients are in pain, they may not be able to afford the extraction, or maybe the root canal, and they'll come through and say, "I'll do an extraction for $250," or what have you. That's the most frequent type that I'm seeing. We have seen some wisdom teeth bids. Most of those, here in California, the UCR, most oral surgeons for impacted wisdom teeth under general anesthetic is probably close to $2,000. Again, if I have an opening for some reason, I'm happy to do that case for $1,000, because in my practice there's not a lot of overhead associated with that procedure, and it's better than having an empty chair.
Howard: How long does the average oral surgeon tie up a room for a set of four wisdom teeth, for $2,000 for a general [inaudible 00:51:26]?
Dr. Silegy: I guess it depends on the time of year. In the summertime, when we're in demand, it's usually a case every half hour.
Dr. Silegy: Yeah. It gets pretty busy. This time of year it slows down a little bit around the holiday time. We're usually planning on one an hour.
Howard: I have to tell you. After 28 years of doing this, looking at the 9 specialties, if I had to go back and be a specialist, oral surgery has always been the most fun. I tie it to the instant gratification, whereas like crown, and bridge, and veneers are 2 appointments, and it just ... You get the tooth out and I think you just get a big dopamine-seratonin rush because when it's out, it's a victory. It's like passing a finish line. You set up for-
Dr. Silegy: Mm-hmm (affirmative). That definitely is a game that we always get to win.
Dr. Silegy: The truth is that we win. And [crosstalk 00:52:21].
Howard: I love that. Oral surgery is the game where ... what? What did you say? Oral surgery is the game that ... what?
Dr. Silegy: Where we always win. We always win and the tooth always loses. What's fun about oral and maxillofacial surgery, too, is ... I practice the full scope of surgery, so when you do trauma, when you do ... I do a lot of immediate implant placement, so someone could come in with a fractured central incisor, they'll walk out with an implant abutment and temporary. They can't believe that they've gone from having a missing tooth to a complete, beautiful smile in an hour. I totally get what you say about the instant gratification. It's wonderful.
Howard: How often do you get a patient sent to you where the dentists attempted an extraction and only got the crown out and had to refer them to you to finish the second half? Is that ...
Dr. Silegy: Probably more often than I'd like. I think that ... It's funny. Quite frequently I'll take out erupted third molars, and on occasion they'll be humbling for whatever particular reason. The tooth might be enclosed, it may not wiggle. You're there sweating, and I call these my GP wannabes. It's like a general dentist will say, "Hey, those are pretty easy wisdom teeth. I might as well take them out myself." That's usually when they get into trouble, because for whatever reason they may be a little bit more difficult to remove than they thought. That's mainly what I see.
Howard: Is there a profile for that? The dentist that happens to, is it someone who's been out of school 5 years and never someone that's been out 20 years? Or due to economic conditions are people trying to do things in over their head and it's across all spectrums of dentists?
Dr. Silegy: I think it's probably a little of all of those components, but I would say that economics has definitely factored into it. The same way they're bringing specialists into their office and giving them a percentage of production as their income. Everyone is trying to do well in dentistry, and it's a little bit more challenging right now, particularly in the congested areas. We have a lot of dentists in the Los Angeles area.
Howard: Actually, there is 202,000 total dentists, and 32,000 of them are in California. California has ... no one's even close to that, and you still have what? 5 dental schools?
Dr. Silegy: 5 or 6. There's the Southwestern Dental School that opened.
Howard: Then, of course, across the Pacific is Asia. That's the biggest, fastest growing ... India, and China alone, so many dentists are coming. Yeah, that's got to be the toughest area to compete, and then something like Kansas, or Iowa, or Vermont would be the easiest ones, so yeah, that's sink or swim out there in California.
Dr. Silegy: Yeah, it's interesting, because I do a lot of lecturing and I lecture for other oral surgeons, study clubs, etc., and I go out and I see their schedules, and so how much competition is there? Nobody for 100 miles in some of the more remote areas, and it's like, "Wow, they kind of have a captive audience of referring dentists and of patients."
Howard: Yeah, and they also remind me a lot of my pedigree and everything back in Kansas. About half my pedigree is dairy farmers, and if you don't know anything about dairy farmers, you've got to milk them sunrise and sunset, so a lot of those old men dairy farmers have never left their farm for a vacation for decades. You've got to have kids, uncles, cousins, and it stresses everyone out. A lot of these oral surgeons in small towns, they don't even feel like they can leave.
Dr. Silegy: Yeah.
Howard: It's not like they can go take a cruise for a week. They're like the only guy in a town of 5,000, and the draw is 25,000 and they don't even know what would happen if they left for a week.
Dr. Silegy: It's funny. I gave a lecture a couple of years ago in Jasper, Indiana. I had to take ... it was planes, trains, and automobiles to get there, and there's one oral surgery practice, two surgeons, and they are stuck there all the time, and the only way they take vacation is basically that ... One of the corporations has a little private jet and they'll try and fly out on that for a long weekend and then they've got to hurry back because they're so in demand.
Howard: Yeah, and those private jets are kind of like what you're talking about. Name your own price. Now that they have those private jet companies, the cost on those have just ... they've just plummeted. I can rent a jet for 5 grand and fly me back home. It's amazing, something that used to be only for multi-gazillionaires, now [inaudible 00:57:08] for 5 grand. I think it's 5 grand an hour, you can charter your own jet.
Dr. Silegy: Yeah, and if they have a capacity of maybe 8 to 10 people, some of these ... You team up with another family if they have a lot of kids, and it's probably a little more economical that way.
Howard: Yeah. That's amazing. We did Vish Banthia for a half an hour, and then we were going to use the other end of the half hour, but we're at 30 minutes, and I think you've explained ZendyHealth, and I've adored listening to you. I think you're a great guy, but the one thing I keep hearing is, you keep lecturing for other oral surgeons. We put up 350 online courses on Dentaltown, and they've been viewed over half a million times, because so many of these dentists in these economic times, they don't want to fly across the country to go to see ... they don't want to shut down their offices. How long is your lecture, that you-
Dr. Silegy: I have several different programs. We do all-day hands-on training. I talk about a lot of different components of-
Howard: Man, I would give anything to get your course on Dentaltown. It's so hard to find an oral surgeon at this time of year. Most all your oral surgeons, they go, "I don't have time, I don't have time, I don't have time." You're a rare dental unicorn, to be an oral and maxillofacial surgeon talking to me, but my God, if you put that on Dentaltown, the views on that from here to Katmandu, to Khuzestan. I don't think we've ever put up a course that hasn't been downloaded in 200 countries.
Dr. Silegy: Wow.
Howard: Do you think ... Any chance we could get you to do that? You could-
Dr. Silegy: Yeah. Let's ... maybe at another time discuss that, and go into the ins and outs of how it works. I have a whole series on all-on-four, on immediate provisionalization. Tons of stuff.
Howard: Oh, my God. We'd love that. If you ever want to come back and do another podcast, not on the other half as ZendyHealth, but if you just want to come back and talk about oral surgery, we can do that, too.
Dr. Silegy: I'd love to, Howard.
Howard: Yeah. Come back and we'll do a whole hour of just you on oral surgery, and then if you've got PowerPoint, slides, videos, or whatever, we can turn that into an online course real easily.
Dr. Silegy: Perfect. Great. That's very interesting. I'd love to-
Howard: I think you're awesome. Like I say, I called you guys. You guys did not call me. Anybody of my listeners, this isn't a paid advertisement or whatever. I saw this business model and I thought, "This is neat. I want to talk to the founder." He was actually a plastic surgeon, and it's hard to get a plastic surgeon to talk to me because they just want to put a sac over my head, but he said you were their dental guy, so I said, "I want to get him on for the other half." When they told me, "He's an oral surgeon," I said, "That's a snowball's chance in hell," and he actually did it. It was just good all around.
Dr. Silegy: My pleasure. We're really privileged to be dentists. Every day that goes by, I'm very thankful for having the ability to positively impact people's lives. That's what I tell people when I go out and lecture. It's like the power we have in our hands really, truly can change lives. Zendy is a little bit the same way. It gives patients the opportunity to get access to care that they may not otherwise be able to afford. I've had grown men ... I had a patient last year who came in that needed an implant for a central incisor, and I asked him how he lost the tooth, and it was reimplanted, and on, and on. He started crying, "If only my sister wouldn't have made me go down the slide backwards."
Here you have an adult man lamenting what he did as a child, and never knew that implants were possible replacements there. We really do have the ability to treat patients, and I think ZendyHealth is a great way to reach out to more of them, to market your practice, and actually serve humanity. Thank you. It's been a pleasure to be on with you.
Howard: You remind me of one story I've got to tell you. You know the only reason I joined the high school wrestling team and wrestled varsity all four years?
Dr. Silegy: No, I don't.
Howard: Do you know what my goal was?
Dr. Silegy: Tell me.
Howard: My goal was so that I could learn how to beat up my older sister, who then became a nun. Go figure that one out, hah? She beat the crap out of me for 15 years, so drove me to wrestling, but-
Dr. Silegy: That would make a hell of a Cage Man.
Howard: Okay. Thank you for your time. Like I say, I would love to have an online program from you, and if you want to come back and do an hour just on oral surgery, not on ZendyHealth, any time, let me know.
Dr. Silegy: Great. You have my contact information. Right?
Howard: Okay. My son ... So does my son, Ryan.
Dr. Silegy: All right. Take care now. Have a great week.
Howard: All right. Take care. Bye, bye.