Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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765 Learn to be a Manager with Genevieve Poppe : Dentistry Uncensored with Howard Farran

765 Learn to be a Manager with Genevieve Poppe : Dentistry Uncensored with Howard Farran

7/10/2017 6:06:33 PM   |   Comments: 0   |   Views: 301

765 Learn to be a Manager with Genevieve Poppe : Dentistry Uncensored with Howard Farran

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765 Learn to be a Manager with Genevieve Poppe : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #765 - Genevieve Poppe

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AUDIO - DUwHF 765 - Genevieve Poppe

Text Townie to 22828 to schedule a call with Genevieve today!

During her 20+ years in dentistry, Ms. Poppe (pron. Poppy) has worked in almost every position within a dental practice. From dental assistant to owning and managing 7 dental practices, her experience is broad and practical. 

Ms. Poppe has a unique understanding of what it takes to help dentists achieve their practice vision. She is committed to listening to, understanding, and finding solutions with her clients. Her insight for communication pitfalls and her ability to envision and implement practice growth truly set her apart.  Genevieve is a self-proclaimed customer service maniac and an enthusiastic change agent. From practice start up to practice transition, she has the skills and knowledge to implement the systems and communication skills essential to practice and team success. 

Howard Farran: It is just a huge honor for me today to be podcast interviewing Genevieve Poppe all the way from Madison, Wisconsin. During her 20 years in dentistry, Ms. Poppe has worked in almost every position within a dental practice. From dental assistant to owning and managing seven dental practices, her experience is broad and practical. Ms. Poppe has the unique understanding of what it takes to help dentists achieve their practice vision. 

She is committed to listening to, understanding, and finding solutions with her clients. Her insight for communication pitfalls and her ability to envision and implement practice growth truly sets her apart. Genevieve is a self-proclaimed customer service maniac, and an enthusiastic change agent. From practice startup to practice transition, she has the skills and knowledge to implement the systems and communication skills essential to practice and team success. Her website is

So, Poppe, I always try to get the best practice management people to come on the show because my homeys like to pull wisdom teeth. They like to learn about bone grafting. They love to learn. If they owned a restaurant, they'd just want to stay in the kitchen and cook. And every time they're miserable and burned out and fried, it's because they never focused on the business side.

Genevieve P: That's true.

Howard Farran: So, thanks for coming on the show on this Saturday morning, on your day off, to come and talk to my homeys. And if you're trying to find her, everybody listening to the show is commuting to work. So, what I do is, I always try to retweet your last tweet of my guest. So, you are at Jeni Poppe, J-E-N-I, P-O-P-P-E, Jeni Poppe.

Genevieve P: Geni with a "G."

Howard Farran: What's that?

Genevieve P: Geni with a "G."

Howard Farran: Geni with a "G." G-E-N-I. Are you, "I Dream of Jeannie," or Geni Poppe? Which one are you?

Genevieve P: Geni.

Howard Farran: What's that? Are you old enough to remember that show, "I Dream of Jeannie"?

Genevieve P: I do, yeah. I watched it all the time when I was little.

Howard Farran: And, what was her husband's name? Colonel, some Colonel?

Genevieve P: Colonel? I don't remember his name.

Howard Farran: Colonel [inaudible 00:02:14]. But you I just retweeted, it says in your last Tweet, "In the recent months I've been on the receiving end of some pretty terrible customer and patient services." They always think if they get a bunch of alphabet soup letters behind their name, if they get their F.A.G.D. and their M.A.G.D., people are gonna come from the next county. And then, they come from the next county and the receptionist doesn't greet them. They tell them to sign in. The new patient experience, it smells like a, it feels like a library when someone's burning a eugenol candle. 

I remember when I got my F.A.G.D. I was so excited, I put it on my card. I put it everywhere. And the first patient that mentioned it was an 80-year-old lady. She goes, "Oh, I see you're a," it was my F.A.G., my Fellowship in the Academy of General Dentistry. And an 80-year-old lady saw it and she goes, "Oh, I see you're a 'fagd'. I have a friend that's a fag, too." And I'm like, "Wow." That was the whole deal. I got my fellowship in the Academy of General Dentistry and now I'm a "fagd." When you go into offices, what do you like to go in there and fix to get them a return on investment?

Genevieve P: Really, I believe that the patient experience starts with the first phone call. So often, just like you're talking about, doctors spend a ton of time perfecting their craft in the kitchen, if you will. And there is no trace of that anywhere else in the patient experience. So, even if they're an amazing dentist doing amazing work, one, patients don't know, and two, they kind of, don't care if they don't like the very first person they talk to.

So, I think it starts right at the beginning of that patient's first encounter with the office. But, I think it goes all the way through. I mean, oftentimes the doctors who learn all these amazing technical skills never really learn to listen to their patients. So, they walk into rooms and build perfect textbook cases, and they never heard that the patient only wants their front six first. And they alienate people by leading with their competence instead of connecting and understanding first.

Howard Farran: Again, I don't want my homeys to think I'm always criticizing them. I always tell them I think that the dentists and the vets and the chiropractors do a 10 times better new patient experience than the M.D.'s. I think the M.D.'s make us look like Albert Einstein married Sir Isaac Newton. But, traveling around the world, I don't want to throw any countries under a bridge, so we'll start with Russia. I have Russian dentist friends who, if a patient asks them a question it's an insult. 

Genevieve P: Right.

Howard Farran: I am the doctor.

Genevieve P: Yes.

Howard Farran: "What did you just ask me?" I've seen it, and I'm just like, "Dude, dude. That's the customer. That's not a patient." A patient is, be patient with all my bullshit, because it's worth it. They're customers. 

Genevieve P: Exactly.

Howard Farran: Some cultures, and I think the Soviet Union, the dentists that overcome this cultural bias that, "I'm a doctor and you're not. How dare you ask me a question." And then they flip that around and become the "press the flesh," running for Mayor. They crush it in Moscow. 

Genevieve P: I meet people all the time that tell me, I'm from Wisconsin. We're notoriously nice, right? We're friendly.

Howard Farran: That's 'cause you're almost Canadian.

Genevieve P: Right, we are. I talk to people, especially my East Coast offices. And they say, "Look, you're nice, and that might be fine in Wisconsin. But people out here, they just want to know what they need to do." The reality is, is I've never, ever worked with a patient or a client in any location where they were like, "Hold on, I felt too cared for. I felt too listened to. I felt too understood." It's never a waste of time. And I think people who feel too busy or too rushed to take a second for their customer really hurt, they really lose out on a lot of opportunities in a major way. I mean, hundreds of thousands of dollars sometimes are lost, just not taking that moment to feel connected to people.

Howard Farran: So, let's walk through the new patient experience. The dentist, you know I have said on the show 1,000 times, 80% of all the dentists go to all the continuing education by themselves. And then 20% brings their whole damn office. And if you go pull the tax returns of who brings their office and who goes alone, it's about a 2 1/2 to 3 to 1 net income. Everybody making 3-, 350, 400, they have the whole row. Sometimes they have two rows, the whole staff. And, what the dentist don't understand is that, the lady answering the phone is probably answering two-thirds of all the dental questions. And if you don't get through her, and then, they don't even know. How many strangers have to call your office that are not in your practice management database before one gets converted to a butt in the chair? What do you think the conversion is [crosstalk 00:07:21]

Genevieve P: Honestly, I do a lot of this. The industry average is about one-third of phone calls getting through.

Howard Farran: So, you're saying 3 to 1. And I've heard others say it's as high as 4 to 1.

Genevieve P: Yeah.

Howard Farran: But, you're saying 3 to 1 is the conversion rate, what you're seeing.

Genevieve P: Mm-hmm. It depends on the office. And it depends on the insurance participation of an office. But yeah, 3 to 1 is if you're doing okay.

Howard Farran: So, we wouldn't have to take her to a CE. We wouldn't have to invest any time and money in that lady. Okay, so she runs off two-thirds [crosstalk 00:07:50]of all the new patients. What's that?

Genevieve P: She just answers the phone.

Howard Farran: And her career was named trade piece of furniture. 

Genevieve P: Yeah, the front desk, right?

Howard Farran: She's the front desk lady.

Genevieve P: The front desk [crosstalk 00:08:01]

Howard Farran: So, let's talk about that because, and this is why I tell people, the marketing consulting companies in dentistry, "Get out of dentistry." Because, when they do the marketing, the front desk lady, your front desk lady takes four people to one gets in the chair. Then they're gonna blame it all on you.

Genevieve P: Yeah. [crosstalk 00:08:21]

Howard Farran: I say, go get into an industry that's competitive, where they track the calls, where they record their phone calls. So they're not gonna blame all their failures on you. They're not even smart enough to know that it's not even the marketing. So, let's start with that 3 to 1. What do you think that's doable? That you consult it, I mean. Obviously, you can't get 3 for 3, but do you think if you start with an office that's 3 to 1, do you think you can get it 2 to 1?

Genevieve P: I think you can get it, yeah, 2 to 1, easily. I think, it depends on your insurance participation and your market. But, I have some offices that take it to, from a 30% conversion to a 70 to 80% conversion. And I'm pretty happy with that.

Howard Farran: Wow. I mean, what would be the return on investment of that versus the return on investment of learning how to bone graft? I'm gonna quit listening to this broadcast right now and go to YouTube and YouTube "Bone grafting, everything you wanted to know." So, how do you do that?

Genevieve P: Well, kind of, like I talked about, we know that the number one question that the front desk lady gets the second she picks up the phone is, "Do you take my insurance?" And we know that the answer predictably, is either, "Yes, we do," or, "We do, but," or, "We don't, but," and then they attempt to kind of, overcome it. And, there's never a moment that they take to try to reach past that question.  Because, some people asking that question want to know, "Hey, can I use my insurance with you?" And other people want to know, "Are you specifically, in network with my insurance?" 

So, I teach them to sort of, get past that question for just a moment, better understand the patient and why they're actually calling. Because a person that's calling for veneers, or who's been out for 15 years from the dental office, their insurance is gonna play a much smaller role in their path back to being fixed up than a mom with three kids who wants their teeth cleaned. And the way you answer that question is very different for those personality types. And if you never get to know the motivation of that caller, your chance of succeeding in overcoming that question is just, you're lucky to get 3 to 1.

So, to me, it starts with just one or two more questions to the perspective patient. And, a team that's motivated to get them in, that wants to get them in and believes that they should come to their doctor regardless of insurance. But there's such a lack of motivation in a lot of front desk people, I think a lot of times the person that ends up as sort of, the head of the front desk, or the office manager is two things, one, the person who's been there the longest, and two, they know a lot about insurance. Which is fantastic, but it doesn't do them any good on the phone. It actually, helps them talk patients into going somewhere else.

Howard Farran: Would you say the conversion is, takes three calls to get one in, that's 30%. The dentist always has two assistants, and then there's one poor lady up front. 

Genevieve P: Yes.

Howard Farran: What percent of the incoming calls just to go to voicemail?

Genevieve P: A painful number.

Howard Farran: What would you think it is?

Genevieve P: If it's a single front desk person I've seen it as high as 40%. [crosstalk 00:11:38] Just go to voicemail hangups.

Howard Farran: And what do you think the average dental office goes to voicemail in your 20-year experience?

Genevieve P: Honestly, I probably, think it's about a third.

Howard Farran: Yeah, a third. So, I agree completely. So, one out of three goes to voicemail. The dentist has no system to track how many of the voicemails are even listened to or returned.

Genevieve P: Right.

Howard Farran: So, if you go into the hygiene room and say, "Can I see the bite wings?" I mean, if the hygienist didn't take the bite wings, she couldn't show you the bite wings. Everyone else in the office that doctor's aware, anybody with wet hands, with gloves on, the doctor knows what they're doing. Everyone up front with dry hands, the doctor has no measurements, no systems. And I've talk to people that go into an office and say that one-third of all the calls went to voicemail, and of those, 80% were never even listened to, let alone returned [crosstalk 00:12:30]. It's crazy.

Genevieve P: Patient calls that go to voicemail hang up and they call the next person. They're done.

Howard Farran: In any other business other than healthcare, those girls up front would be sales and marketing. Incoming calls.

Genevieve P: Yes.

Howard Farran: They would have a motivator up there that has a thermometer, "We're gonna try to answer 800 calls today and we're gonna try to book $50,000 today." And then you go into dentistry and one-third goes to voicemail. And then, how many times do, if it doesn't go to voicemail, you just get this, "Uh, can you please hold?" And then they come back. And then they're trying to check someone out. That's their treatment plan, presentation, and financial arrangements. "Can you please hold? I gotta check you out real quick." You were diagnosed with three fillings and a crown, so, "real quick," I mean, it's just-

Genevieve P: "Real quick" is 20 minutes later. 

Howard Farran: So, let's talk more about staffing. Do you have a formula? If one-third of your calls are going to voicemail and you only have enough time to talk to an incoming call that, it takes three people to call in before one wants you so bad they convert, what do you do? If the dentist has two assistants and one girl up front, do you take one of the assistants away and move her up front? Because in four years of dental school, we didn't have any assistants. You can get an Isolite, so when you're doing the filling your assistant doesn't have to be standing, why is your assistant standing there the whole time retracting a tongue when an Isolite can do that with you suctioning-

Genevieve P: When your phone's ringing and you're losing opportunities, yeah. I think in a small office, if you can't pull the trigger on another person, definitely having your assistants cross-trained to pick up the phone is really important. But frankly, I just think a lot of front office teams run understaffed. Because there's one person who's been there who kind of, doesn't want anybody else in their territory, you see that as a really common behavior. They'll say, "I got it. I don't need anybody else. I would never keep anybody else busy." And then you look at it and they've got all sorts of stuff that's not getting done every day. And they kind of, don't care if the phone rings or-

Howard Farran: That's when there's one girl up front? 

Genevieve P: Yeah.

Howard Farran: You see a lot of "one girls up front" that don't want any help.

Genevieve P: I see it all the time.

Howard Farran: That's an embezzler.

Genevieve P: Yeah, I believe so. They're either an embezzler or they're letting so much slide, they're so behind in what they have to do, they don't anybody to realize how poorly they're managing their scenario. And so, I fight that battle with smaller single-doctor practices, especially doctors who thought that they could have this boutique practice with a lean and mean staff. And I think the place that they run the leanest and meanest is their front office. And I think it's a mistake in a lot of cases. One, because they're usually the same offices really trying to grow and their missing phone calls all day long. And they're not able to give the time to the phone calls because they have a person walking up front and sitting there. 

So, if you can't teach your assistants to answer the phone, at least teach them to check out their own patients, if you have just one person. So, that the person manning the phone can keep that as really, their primary function. All the EOBs, all the checks that they have to enter, those will still be there at the end of the day. They'll still be there tomorrow if they have to be. And yet, so often, when I listen to recorded phone calls, what I hear are front desk people who are really busy, and when they pick the phone it sounds like an interruption to what they were busy doing. It doesn't feel like a priority. It feels like [inaudible 00:16:00] they're getting through.

Howard Farran: I think you should check out your own patient and reschedule your own patient. Because, if an assistant has the front desk, schedule the next appointment, there's nothing the receptionist do to get it right. " Why did you schedule an hour for a crown setting? We could do that in 10 minutes." And then you schedule the next one 10 minutes, "Gosh darn, we have to numb that lady up and we have to put her on laughing gas. Why didn't you schedule that for an hour?" And the front office is psycho, Sybil, we have no idea. 

And then the hygienists have to check out, because then, the hygienists don't check out their patients, schedule the next patient, they're not performing on stage trying to close the sale at the end of the appointment. If I'm sitting there bitching about my husband all day and griping about politics and Trump and religion and all that stuff, and then you go check out front, and the lady says, "I call ya," then, you can go back to the hygienist and say, "Hey, today you cleaned eight people's teeth. And I have three hygienists. The first one, eight out of eight scheduled for a recall. The other one, seven out of eight. You were four out of eight." Imagine, I mean, some Broadway plays play, I mean, CATS played for 20 years. 

Genevieve P: Right.

Howard Farran: How come nobody wants to see your play again? Because you weren't performing. So, the hygienists gotta, the only way you can measure if they were performing on stage for an hour is, they have to schedule their next six-month, three-month, four-month, six-month recall.

Genevieve P: Right.

Howard Farran: What percent of offices do you think record phone calls?

Genevieve P: Not enough. I really don't know how many do or don't record. If I'm working with an office, that's one of the first things I do, is set up recording for them.

Howard Farran: Okay, and how do you do that? Who do you do it through?

Genevieve P: I love Golden Proportions. They had Periscope. Now they have Smartmarket. I think it's a great tool [crosstalk 00:17:51] 

Howard Farran: Golden Proportions.

Genevieve P: Yeah, you know Ms. Xana Winans Golden Proportions Marketing. They have two products that record.  One's called Periscope.  Their newer version is called Smartmarket. They both work really well, in terms of tracking where your calls are coming from, if you're converting them to new patients, and the value of those patients. So, it's a pretty smart little marketing dashboard. Mostly, I mean, I love the marketing data and I want doctors to put their money where it's working, but I also, you can tell a lot about the level of engagement a front desk team has to the practice by listening to their phone calls. 

And a lot of those, a lot of people in that position never, ever got training. Never. In how to pick up the phone. They were kind of, thrown into the front desk many years ago, or they were an assistant that moved up. And it's just a real obvious thing that they're just going through the motions and there isn't any dedication or tie in to wanting to earn each opportunity with a patient inquiry. So, it's a powerful tool to not only track your conversion, but to track just, the overall verbiage and impression your team is making from your office.

Howard Farran: So, that is And if you want to listen to that Howard Speaks podcast, that was episode 593. She says on her website,, "Our very own Xana Winans is featured in this special episode of the Dentistry Uncensored podcast. Xana and Howard take time to delve into the important aspects of marketing for dental practices." So, you like to record the phone calls. It seems like if you call any Fortune 500 company, it always the call starts with, "This call may be recorded." 

Genevieve P: Right.

Howard Farran: You call your physician, dentist, you call anybody like that, I've never heard that. I've never called a dental office and I've heard that. I've never [crosstalk 00:19:46]

Genevieve P: And there's not enough of them doing it. There are more and more marketing companies I think, doing it to sort of, just like you talked about at the beginning, just sort of, demonstrate that they are generating leads. And it's the team not converting them. So, I actually, as a coach, get a lot of my leads from marketing companies because of the exact loop that you're talking about. The doctors are calling them saying, "We need more patients." And they're saying, "Hey, we generated 78 phone calls off this campaign last month and you scheduled 20 people." 

It's an important thing to look at. It's pretty bad in almost every case. It's very rare that I start listening to the phone call to say, "Hey, you know what? This is pretty good." It's usually not.

Howard Farran: The next question to ask, with these recording phone calls, do you like interacting with any dental practice manager software? Do you like some practice management softwares better than the others?

Genevieve P: In terms of recording the phone calls?

Howard Farran: Well, just, I mean, you're a dental consultant. So, just as a dental consultant, which practice management software do you like?

Genevieve P: My personal favorite is actually, Curve. Curve Hero.

Howard Farran: Curve?

Genevieve P: Yeah.

Howard Farran: Huh. Interesting. Because first one you recommended was Golden Proportions. Now, you're into Curve. You're a very visual person.

Genevieve P: Yes.

Howard Farran: Golden Proportions, Curve. So, Curve's out of Utah. And they're the first one where it's all in the cloud, right?

Genevieve P: Yeah, they were the first truly, to the cloud. 

Howard Farran: So, it's kind of, like when you're on Google or Facebook or Twitter, it's not in your machine, you're just interacting with the cloud. [crosstalk 00:21:31]

Genevieve P: You don't need a server at all.

Howard Farran: So, you need no server.

Genevieve P: No server.

Howard Farran: So, why do you like Curve? Is that it, because you don't have the IT, you don't have to worry about all the hacking and-

Genevieve P: It's a big part of it. [crosstalk 00:21:49]

Howard Farran: ... ransomware.

Genevieve P: The hardware expense of the more traditional, I mean, you can literally go to Best Buy, by the PC that's on sale, hook it up to the Internet, and your own Curve. As long as you have a decent monitor, your images look good. And if you need to check in on your practice you can do it from Starbucks. If you have an emergency at home you can go view the films, and every time there's an upgrade, it's just automatically happens. You don't have to shut down your office and load in the disc and inevitably crash one of your machines. It's just a much slicker, much cooler, I think, way of the future.

And I think because they're not adapting from an old software trying to make it cloud-hosted, they just wrote it truly for the cloud, it just works a lot smoother than the others trying to make that move. I can function in any of them. I think they all have their strengths and weaknesses. But I think it's probably one of the more modern, sort of the Apple-style software of practice management softwares.

Howard Farran: Does this phone recording software need to interact with your practice management software, like you recommend Curve online? Is that part of it?

Genevieve P: Well, Curve Online doesn't have, I mean, those two don't necessarily speak. The Smartmarket tool that I talked about that Golden Proportions put out, that actually, does interact with practice management software. So it not only can tell you who's scheduled from the marketing campaigns, but also, how much those leads became, how much they were worth. So, it can sort of, show you, this one may have attracted more patients but they were low-quality patients, in terms of overall spend. This ad attracted this many patients but they were people more likely to spend money. So, there are starting to be integrations between those things. But, Smartmarket's the first one I know of that's a call recording software that also actually, working with the practice management software. 

Howard Farran: Nice. Everybody's driving to work now listening to you.

Genevieve P: Right.

Howard Farran: What are red flags that, because I admit it, when you're doing a molar root canal, for an hour, you're like Stevie Wonder picking a lock. You're not aware of space and time.

Genevieve P: Right.

Howard Farran: A lot of these dentists, they don't even know they have problems. What is the ideal client you'd like? What are red flags that my homey could be listening and thinking, "Yeah, that's probably happening in my office." What do you like to fix?

Genevieve P: Well, first of all, if they walk up front and they hear their team going into a lengthy phone conversation about insurance or pricing, and then they hear it hang up, that's one thing they can kind of, just watch for. A lot of doctors don't ever listen to the conversations being had at their front office. And they don't even realize how many opportunities are being lost or that their team doesn't even view those as an opportunity. I talk to teams all the time and they say, "We schedule every new patient who calls." And I say, "No, you don't." And they say, "Well, just wanted to know if we take their insurance." They don't see that as a new patient in their mind. 

So, taking a listen, just even from the one-sided of the conversation, you can tell if there's too much discussion of insurance within seconds of picking up the phone call, there's probably some opportunity. Also, I think that a lot of times, doctors don't listen to the closing portion of the visit, as well. So, you have that case presentation in the room. And you feel like you've nailed it. The patients are gonna be a go. And you check on it later with the front desk person and, "When are we getting started with Mary?" They say, "Oh, well, they wanted a pre-auth." 

Patients never look to the front and say, "I want a pre-auth." I don't know what the word "pre-auth," or a "pre-D." I hear people say,"They wanted a pre-D." Really? Did the patient walk up front and say they wanted a pre-D? That never actually, happens. We teach them to want that because [crosstalk 00:25:56]

Howard Farran: I just went to meet the dentist who always puts the knee on your chest when he's pulling your tooth. I mean, I've been told that 20 times in 30 years. I mean, "It was sore, he had his knee on my chest." [crosstalk 00:26:08] Okay, well, that's never happened once on earth, ever. But it happened to you.

Genevieve P: It happened to so many people.

Howard Farran: And when he was doing it, the tooth fairy- [crosstalk 00:26:19]

Genevieve P: Common memory.

Howard Farran: ... was sitting on his head, and he rode to work on a unicorn.

Genevieve P: I just think that a lot of times doctors don't know how their experience with the patient starts or ends. They're not aware of that whole loop. And, unfortunately, a lot of times, the front desk is so isolated and so out of the realm of the doctor's awareness that they would be the least surprised and probably disappointed in the level of, I want to say attachment to the outcome. A lot of times the teams, they just sort of, they're paid hourly, they present the treatment, the patient does or doesn't do it. "I'll send a pre-auth, okay, good-bye." They view that as the completion of their job. And their doctor doesn't really talk to them about case acceptance, or earning new patients or how to stay connected with people. And so, they just sort of, go through the motions and whatever happens, happens. So, I just think it's a very under-managed part of most doctors' dental practice.

Howard Farran: The problem is obvious. We both agree that, at the very best, three people are trying to get in for every one converted by the front desk lady. When we get that one person in, the insurance data is abundantly clear, you have to diagnose three cavities to do one. So, it takes three people calling for one to get in. Now we need three people to get in to do one cavity. So, if you just start fixing that, if three people have a cavity, and the United States is a 38% [inaudible 00:28:01]. And we're not talking veneers, bleaching, bonding, braces. We're not talking about any of that crap. We're talking about, you're a fireman and this is a house on fire. The tooth has a cavity. We're talking about simple, simple stuff.

Genevieve P: Right.

Howard Farran: How do you increase, instead of three people each having a cavity and only one person goes up and schedules for it, pays for it, and we drill, fill, and bill, and two walk out. What do you think it's possible, you work with a team. Do you think it's possible to get to two out of three?

Genevieve P: I do. I really do. I believe that just is, that difference. One more person. If one more person a day accepts some treatment it makes a really, really big treatment in the dental office, doesn't it?

Howard Farran: Well, yeah, because once you've paid all your fixed costs, your rent, mortgage, [inaudible 00:28:49] computers, once you've met your breakeven point of the day, what percent of the dental offices even know at 8 o'clock in the morning what they have to do today just to pay the bills?

Genevieve P: Very few. A lot of doctors have no idea what daily breakeven number is.

Howard Farran: And some people I think, in practice management, I think you're stressing everyone out when you start getting hourly production and scheduling for hourly production, because [crosstalk 00:29:11]. I don't give a shit if the last hour we all went under or whatever. It's a day-by-day thing, you know what I mean?

Genevieve P: Yeah.

Howard Farran: I don't want to sit there be thinking about it at 8 o'clock, 9. So, if you don't even know what your breakeven point is for the day, how do you, you solve your overhead problem one day at a time. So, if you gotta go in your office and do $3,000 just to pay the bills, because the average dental office is open 16 days a month, and you want 50% overhead, then go in and do 3,000 in the morning, go to lunch, come back and do 3,000 in the afternoon. 50% overhead. But they don't even know what their breakeven point is. 

And it really changes behavior because so many offices, if they have to do 3,000 breakeven, and they're at 3 o'clock and they haven't hit 3,000, well then, if someone calls and says,"I have a broke tooth," then don't start saying, "Well, you know, we got tomorrow at 2 or we got next week at 1." Dude, you just paid your bill. It's 4 o'clock. [crosstalk 00:30:08] It's like, "Have her come down right now." Why would you want to work from 8 to 4 and then go home at 5 when you could have stayed till six and you were in the profit zone and lower your overhead from 85% for that day all the way down to 50% because a person coming in had a toothache and you stayed and did a root canal, build-up and crown?

Genevieve P: You're right. It starts with knowing what that number is, and having your whole team be aware of it. And talking about your progress toward meeting it on a daily basis. If you just mention it once, once a month or at the beginning of the year what the goal is, and then you never visit it again and it doesn't matter. There's never any discussion whether you've hit it or you don't, teams take the path of least resistance. And they don't push hard. And you have the assistant who doesn't feel like prepping this broken tube because she wants to go home. You get that type of reaction. Whereas, if you have that whole team in the mindset of, "Hey, we just have passed today's minimum level and now we have the chance to beat our goal," they get a little bit more inspired to work things in and make things happen as a team.

Howard Farran: Well, here's the dentists' best idea, "At the end of every year at Christmas, we give her a Christmas bonus. That will motivate her all throughout the year." 

Genevieve P: Throughout the year.

Howard Farran: Then you go into the restaurant industry, and if you are crushing it and cranking it and your busboys are running to the bars and getting the drinks, and because the drink's all the profit margin, and one more round of drinks could take the bill from 600 to 800. And then, at the end of the night, what do they do? They tip them out. When my Jan stays with me late and we do a root canal, build-up, and crown, and I just threw on 2,000, or she worked through lunch, I'm gonna go to my wallet and I'm gonna pull out a Benjamin. I'm gonna tip them out. I'm not gonna wait till Christmas or give them a raise when-

Genevieve P: Right.

Howard Farran: And you know what? She doesn't want to work through lunch because she just missed her damned lunch while you did $1,000 crown. So, you had $1,000 impact and she didn't get to eat at Taco Bell. So, why don't you throw her a 50? Why don't you throw her, why don't you tip her? They do it at every fancy restaurant. And I actually, am not a fan of fancy restaurants. And I'm serious. My favorite restaurants always have pictures of the food menu. It's the IHOP, the Waffle House. Whenever I go to a restaurant and there's no pictures on the menu, I know it's good to be [crosstalk 00:32:39]really expensive and not taste very good. 

Back to that deal, we talked about three people called to convert one butt in the seat, and that's who's ever answering the phone, that girl named after a piece of furniture that you never take to a continuing education class, how do we work on, I have to have three people with a cavity to get one to drill, fill, and bill.

Genevieve P: Right.

Howard Farran: How do I get that to two out of three?

Genevieve P: Well, I think, just like on the phone, a lot of times, there's a real discomfort with anything that feels like a conflict in a dental office. And a lot of people in that seat are very uncomfortable with money, themselves. So, if you're not comfortable with money, and you're maybe, not super confident, because you've never been to CE training, and you're anticipating that this person might have an insurance or financial objection, I watch team members all the time actually, throw up the objections themselves so that they don't have to hear the patient tell them no. 

They'll lead with what insurance isn't gonna cover, and "This is how much it's gonna be. And, I'll do my best. And if you want, I can see how much insurance is gonna cover, exactly." They sort of, create a scenario where the patient feels like they should or want to wait to get started. Instead, if you just sort of, approach it assuming that everybody wants to get fixed up, most people do want to proceed with saving their teeth. Especially, just simple, like you talked about putting out fires, fillings, single tooth crowns. I think you just have to go in confident about the value of the treatment you're presenting, and ready with solutions in case there are objections. But not assuming that there will be, and preempting them by creating hurdles yourself.

A lot of it's verbiage skills. A lot of it is just saying it the right way. But, a bigger part of it is having the kind of core belief that people should do it and want to do it and will do it, and not being afraid that they might say no. A lot of it's a confidence thing.

Howard Farran: Social animals don't like confrontation. 

Genevieve P: Right.

Howard Farran: The only way we survived the last 2 billion years and the last 100 billion humans is, we all have to work together, and we gotta follow the 400-pound gorilla. And if we didn't work together and we didn't follow the leader, we wouldn't be here 2 million years later. So, I always wonder, are you born where, "I just don't want to sell"? Is that an innate thing at birth, or can you train around that? Because I know exactly what you're talking about where, there are dental offices where they will bring in a treatment plan presenter girl, she loves sales. I have four boys. I have four boys. Half of them hate sales. 

Genevieve P: Right.

Howard Farran: Half of them, they get off on it. They just love it. Even when they were a little kid, I remember one of my boys, he was 16 years old and he was working at Applebee's, and they just had this deal where, if you upgraded from a regular tea to a tropical tea or whatever, the regular tea was like, $1 and the tropical fruity one was $1.80 or whatever, they just kept score. I mean, he was upgrading everyone, just to win the score. [crosstalk 00:36:07] There wasn't even money involved, he just loved, he loves sales to this day. Do you think that when you go into a dental office and little Mariella hates sales and hates presenting treatment, and the doctors, what percent of doctors do you think love sales?

Genevieve P: One.

Howard Farran: Yeah, one.

Genevieve P: One percent.

Howard Farran: I can only think of a couple that I've ever met [crosstalk 00:36:30]

Genevieve P: There's a couple out there that are amazing, you know. But, it's just not-

Howard Farran: Larry Rosenthal in Manhattan loves it. Omar Reed Loves it. Some people love it. But 99% hate it. But, I just keep seeing the ones that find that girl who loves to sell the clothes and sign them up. That one girl can double the office.

Genevieve P: Absolutely. I have to tell you, I think that there is something about having the right person in that role, that you can train people so far, but if, in your very gut, if you're super introverted and talking about money feels really core uncomfortable for you, you can give them skills to make them better. But then there are people who flat-out enjoy it. They love being part of the process for the patient. They don't have any inhibition about somebody telling them no. They feel very tied to what the doctor is doing and they love the outcome. And I think the difference between those two people that you'll see is that one loves the tasks of a front desk role and the other loves the interaction with people.

Howard Farran: Which one loves the interaction with people, the salesperson?

Genevieve P: The sales one.

Howard Farran: Yeah, and you know, the dentists, they treat like a four letter word. It's like, "Dude, you're not a good dentist if you only fix one patient out of three."

Genevieve P: Right.

Howard Farran: And then, I can show you that you could bring in this little girl and she could get it to two out of three. So, if you were a fireman would you rather want to put out two out of three houses on fire or one out of three? And then, as far as upgrades, I mean, they have patients that are miserable with removable their whole life. And because no one had the courage to go in there and present, "Well, we could do one implant in the middle, a snap-on right in the middle and that's 3,000. Or, we could go one on each side. That's 5,000. Or, we could put six implants in there. And the teeth wouldn't even come out, and that's 20,000." 

I mean, how much is the car you're driving right now? "Well, I'm driving Honda Prius and it was 35,000." I mean, what do you think would be more cool? The car you're driving now, or to throw that lower denture away and your teeth would never come out just like you were when you were 21 years old. I mean, some people love that. And then you find these dentists who have done that a thousand times. And then you go talk to the next 100 dentists, "I don't like sales. I don't like that." Okay, you don't like it. [crosstalk 00:39:04] Bring it to someone else.

Genevieve P: I see them say that it's unethical. They would never push people. They feel like they're really crossing a line by helping people accept care. And I guess, I've always viewed it as having been in that role personally, being that girl in the office that could sell the bejesus out of treatment plans, I always felt like I was helping them to have a better life and a better smile with a dentist that I believed in doing the work. 

And so, it never, ever felt to me like I was pushing the lines of something uncomfortable or unethical. And, I know that dentists believe that about the work they're diagnosing, so why there's so much discomfort with finding the personality that's comfortable in that wingman role, you meet these great, I work with a lot of Pankey Dawson-type doctors. The work they're doing is exceptional, and yet, they don't get enough opportunity to do it because they don't have the right person to present the solution that they're providing, they're just talking about building a case. They're going over the 300 photos they took, instead of phrasing it very plainly like you did. 

"Hey, wouldn't this be cool to not suffer with this thing anymore?" Just asking people if they want to do stuff, half the time, I guess, I was in office manager and a front desk person in the 90s when we did dentistry for fun. Back when we took out every silver filling, we all wanted white teeth, and granted, that was a good time to be in that role. I find that we're kind of, psyching ourselves out about what people will or won't do. We assume that money's tight and people don't want to replace those ugly yellow composites on their front teeth. Not true. Doctors don't even ask. And they don't have a team member who feels comfortable asking.

I think there's a key person missing in a lot of offices, and it's this girl we're talking about or a guy, possibly, that likes the people more than the insurance, that likes people and the outcomes more than the dentistry, even, and is a connector more than an educator.

Howard Farran: I tell myself, look, the economic data is very clear. Americans spend about 101% of all the money they make to between 103% every year since the beginning of time. So, they're gonna spend all their money. They're gonna spend it all. Would you rather than spend it in healthcare or in travel or clothes or food? And they're gonna spend it all, and they're gonna max their credit card. Only 10% of cars are bought in cash. 90% are financed.

Genevieve P: Right.

Howard Farran: Their houses, I mean, they finance it at 30 years, where if you'd just make 13 payments a year instead of 12, you'd pay it off in 15. Are they gonna pay off their house 15 years early? No, because 90% of Americans are financially insane. So, if they're gonna spend all their money, why don't you max out their credit card on saving that molar or getting rid of gum disease so she doesn't have bacteria all throughout her gums? I'd rather max out her credit card on getting rid of her gum disease. I mean, when you have them disease, it's about the area of the skin of your palm is bleeding. Now, if she was walking around, and her hand was raw and bleeding, she'd go to the emergency room. But you can't sell her? You can't convince her, "edumacate" her. I don't give a shit what you call it, the woman has an area the size of her hand bleeding, and she just left your office.

And you say you're a doctor, and you say you're good because you got a bunch of alphabet soup shit behind your name. You're not good. Two out of three of your patients walk out with bleeding hands, and you're proud that you don't sell because ethical people don't sell. I mean, it's kind of crazy.

Genevieve P: On their ethical high horse. And their patients are often really, undertreated.

Howard Farran: And again, if you had to go from dentistry to a fire department and they said to you at the end of the year, "Genevieve, Ms. Poppe, we need to talk, you only put out one out of three house fires last year. And the whole West side is missing, now." Imagine if you were the sheriff, "Poppe, you only caught one out of three murderers. You only recovered one out of three stolen cars." I mean, nobody in the fire or the police department would settle for that score. But dentists will do that for 40 years and then say, "He was a distinguished dentist who served our community for 40 years. Meanwhile, the diseased missing, and filled teeth rate went up. They voted to take fluoride out of the water," and "Mr. Pretentious" is all proud of himself. This thing is a business and you got to get into sales.

So, talk specifically, about patient treatment plan presentation. Do you think the doc should do it, or do you think you should bring someone else to do it, or do you think-

Genevieve P: I think that a little depends on your doctor. There are doctors who are good at presenting the treatment itself, and then having somebody else sort of, close it out financially. There are other doctors, you have to be honest with yourself, doctor, or ask somebody you trust. If you struggle to keep eye contact with the patient, if you feel uncomfortable sitting knee to knee with them having a long discussion, and you feel like questions to you make you feel like there's a conflict or a confrontation, if it make you nervous to do it, then I would suggest developing somebody else who can deliver that for you. It's a little bit different, depending on the doctor. But ideally, I like the doctor to present the treatment plan in a way that shows he was listening to the patient and demonstrates solutions to their problems.

Hopefully, there's some pictures from the hygienist or the assistant, however their patient came through your chair. But beyond that, I watched so many doctors launch into their treatment planning session without ever talking to the patient. They walk in to a patient already laid back. They look at their films, they look at their teeth, and they start calling out a treatment plan. 

And it works, I guess, for some fillings or some people who are used to sort of, that large corporate practice-type experience. But if you have patients of any level of significant need and you're expecting to close a treatment plan without having any connection to them or making them feel like you get it or you understand their priorities or you understand their fears, I just think your chances of closing the deal are slim to none.

Howard Farran: So, you earlier mentioned that you like And what I like to do as they're driving to work, I like to retweet the last tweet. This is the first time this has ever happened to me on the show. If you go to @smartmktdental smartmarketdental, so, @smartmktdental, they always go to @HowardFarran and I retweet it. They don't have a tweet yet. They've never tweeted.

Genevieve P: Oh.

Howard Farran: They're following 61 people, they have six followers, but I can't retweet a tweet because they've never tweeted. Do you know the owner?

Genevieve P: Yeah, it's Xana Winans.

Howard Farran: Then, tell her to [crosstalk 00:46:48] tweet a damned tweet.

Genevieve P: It's very new. I will tell you it's new. They're more [crosstalk 00:46:56]

Howard Farran: So smart. But you also called her, she's also Golden Proportions.

Genevieve P: Yes.

Howard Farran: So, she has two names. So, she's branding two names?

Genevieve P: Right. So, Golden Proportions is her marketing company. And they have a call recording product called Periscope.

Howard Farran: But on her Golden Proportions, she doesn't have a twitter.[crosstalk 00:47:19] Is she just messing with me?

Genevieve P: I'll have to get on her.

Howard Farran: Yeah, get on. Because if she wants to brand Golden Proportions, she doesn't have a Twitter following. And anybody who discounts Twitter, I mean, hello, our President of the United States basically, would not be President. I'm not even kidding you.

Genevieve P: I agree.

Howard Farran: He had 5 million Twitter followers he could keep communicating to his customer was a voter. And the difference between Twitter and Facebook is, if you build up 1,000 followers on Facebook on your dental office, when you make a post, your 1,000 people who like your page are not gonna see it unless you give Facebook money and boost your post. Twitter, on the other hand, you build up 1,000 followers and you make a tweet, all 1,000 get it. One is a direct feed and one is, "Oh, well, now that you got all these people," I have 300,000 dentists following me on Facebook at @HowardFarran. But if I post this podcast on there, they won't even show it to 100. I have to give them a Benjamin, and then 100,000 people will see it. 

Genevieve P: Right.

Howard Farran: So, Twitter is the best bang for the buck. So, if she's trying to brand Golden Proportions, she needs a Twitter. And if she doesn't want to brand Smartdental practice, but anyway, she's either gotta make a tweet on Smartdental practice[crosstalk 00:48:41]

Genevieve P: Well, if guys just email me. If anybody wants to email me, I would be happy to[crosstalk 00:48:45]

Howard Farran: Your email is Genevieve, G-E-N-E-V-I-E-V-E, Genevieve@ Poppe, P-O-P-P-E, like the heroin poppy. No, heroin poppy is H-O-P-P-Y, right?

Genevieve P: Yeah, it's H-O-P-P-E, yeah. Not like the flower.

Howard Farran: How's the flower spelled?

Genevieve P: P-O-P-P-Y.

Howard Farran: P-O-P-P-Y. You're P-O-P-P-E That is, you said, French, Genevieve. You go by Genevieve, [crosstalk 00:49:18] but how do they say it [crosstalk 00:49:18] How do they say it in France?

Genevieve P: Genevieve.

Howard Farran: They say what?

Genevieve P: Genevieve.

Howard Farran: Oh, I like that better. [crosstalk 00:49:28] Genevieve? Is that how they say it in French?

Genevieve P: Yeah.

Howard Farran: I love Paris, man. We did three podcasts in Paris. That was so much fun. And I gotta say one thing to Americans, you're up there in Madison, Wisconsin. You probably think the Packers are the best fans in the world, right?

Genevieve P: Well, they are.

Howard Farran: Soccer fans in Europe are twice as insane as [crosstalk 00:49:54] Americans.

Genevieve P: Soccer fans, different level.

Howard Farran: Oh, my God. They're crazy. And they're drinking three times as much.

Genevieve P: Oh, yeah. It's a different, you can't even compare. [crosstalk 00:50:05] The Packer fans can drink quite a bit.

Howard Farran: But, look at the difference. Here's the difference between a Packers game, which I've been to, and I've lectured at that stadium a couple of times. Lord's Dental Studio brought me in a couple times.

Genevieve P: Nice.

Howard Farran: In Paris, when those soccer games are going and those drunks start getting so drunk and crazy, the N Nice policemen just come in and close down the street. Because they know if cars are going by someone's gonna get killed. So, they just close down the street. In America, they'd arrest you for being drunk in the middle of the street. And they'd be all this, but the police in France just say, "Okay, this soccer game's getting out of control. Let's call in two cars and close down this block here, because there's five bars, and they're six feet out into the street." It is crazy.

You talk about one of the things you're most passionate about is that there's an under-management epidemic in dentistry, and the mythical self-managed team. Talk about that, because I see this in a lot of offices that are doing 600, doc's taking home 150. He says, "Well, Megan's been up there. Megan's 65. She's been up there 35 years. I don't need to go tell a 65-year-old woman who's been working in this office for 30 years what to do." And then, she just sits up there alone and, how do you convince a doc, and here's the other weirdest thing, here's also, the weirdest thing, which flies into my next question. If I ask 100 dentists, "What bothers you the most about dentistry?" it's always staff. It's always dysfunction. It's always, "My assistant hates my hygienist."

But here's what I've noticed. He hates the staff dysfunction so much, that the fact that he loves this one person because at least she's not dysfunctional, at least she's nice, at least every day she shows up. I know who's gonna show up. It's not the, happy one day, mad at the other. Tells me she loves me on Tuesday and Wednesday she wants to quit, the drama. 

It's, you know what? I'm gonna put up with my assistant or my front desk because those are the two that never stress me like my batshit-crazy hygienist or the whatever. So, it's almost like if you're not dysfunctional, you don't even have to work, because that bothers the dentist more. So that was about 38 questions. How do you want to answer that? Do you want to answer that, "How do you deal with dysfunctional staff?" Or how do you convince the dentist that that lady up front who you love and adore is actually, really [crosstalk 00:52:49] below average.

Genevieve P: Your practice? It's hard. I mean, in an deal world I would tell them, 30 years ago, "Never let that happen." But, there is a way to start. You can start with a team that's been grossly under-managed and you can expect them not to like it at first. If you've been a doctor who, for the last 20 years, has never held her team accountable to a single request you've made and then you decide tomorrow that when you say, "Hey, hygienist, I don't want to do anymore bloody prophies this week." And they keep doing them, that they're gonna hear about it. 

So, I think what I find kind of, going back to the whole confrontation thing, is that doctors are so afraid of confrontation, they're so uncomfortable with it, that they let little things slide and then over years and years and years, they build this dysfunctional maze of egg shells that everybody walks in to keep things calm in the office. And oftentimes, I mean, the expense of being afraid of that confrontation, so the office is so big, it has limited their growth for so long in such a major way. And when doctors do decide they want to do something different, oftentimes, it result in a pretty big shakeup, where people either get really mad and then get over it or they get really mad and then move on. And the doctor has to sort of, start fresh.

I don't like to be a proponent of getting rid of people. But I do watch doctors hold onto team members that are not working for them for a really, really, really long time, oftentimes, decades too long. And they know it. And they just don't want to do anything about it. And so, to young doctors, I would tell them, learn to be a manager early. If you want to have this mythical self-managed team, that comes from once upon a time, having been a very clear manager who held people accountable, who set clear expectations, who helped people really understand what the goal was, what the values and visions were, what are the decision-making principles of our office. But if you don't lay that all out and talk about it regularly with the team, it just sort of, survives. It does okay. It's okay, patients are okay, the practice does okay, but is never really amazing.

Howard Farran: All the dentists are exactly the same. They're all the same, but they all want to call you because they have a unique situation. They use the same unique situation as 80% of all the dentists in America. What if someone wants to talk to you about their unique situation that's only unique to them because they're in Iowa and you don't understand? How do they talk to you?

Genevieve P: Well, they can email me. Actually, they can text me, too. They can text me the word "Townie" to 22828.

Howard Farran: Text Townie? T-O-W-N-I-E.

Genevieve P: Yep.

Howard Farran: To what?

Genevieve P: 22828.

Howard Farran: 22828?

Genevieve P: Yes.

Howard Farran: 22828.

Genevieve P: Yes.

Howard Farran: Text Townie, I've never had a guest say that on before. Text Townie-

Genevieve P: Just for you, Howard.

Howard Farran: Text Townie to 22828 and what, that'll go to your cell phone, then?

Genevieve P: It'll go to my cell phone. It'll ask for their email, and then I'll be in touch with them to schedule a call, or they can ask [crosstalk 00:56:25]

Howard Farran: And, how much does that cost, if they text Townie to 22828?

Genevieve P: It costs whatever their normal texts cost.

Howard Farran: No, no, I mean how much do they have to pay you to [crosstalk 00:56:38]

Genevieve P: First one's free.

Howard Farran: The first consultation's free?

Genevieve P: Absolutely.

Howard Farran: And then they can email you Genevieve, which is G-E-N-E, can I give your email? 

Genevieve P: Absolutely, yeah, please do.

Howard Farran: G-E-N-E-V-I-E-V-E@ Poppe P-O-P-P-E, Poppe with an "E" So, how much does this cost? This is dentistry uncensored. How much does it cost for you to come in to the office, and what is the program like? Do you go in there for a day and then see them once a month? Is it two days, you see them twice a year? How does [crosstalk 00:57:12]

Genevieve P: I know every coach says that they're not cookie-cutter, but I legitimately, don't have a binder and an exact process that I go through. I usually, start by talking to the doctor and understanding their unique situation, which is, of course, always unique. And, it is unique to them. It's their own challenge. And my heart really does go out. I understand that it's hard. And sometimes, they just need somebody to hold her hand as they draw a line in the sand and cross over it and sort of, set their backbone straight to have the conviction to have the practice that they set out to have. 

But, I work with teams in a lot of different ways. So, sometimes, it's just virtual coaching where I'll have one or two calls with them a month, kind of, like this. And I have packages that are, I have clients that I work with for under $1,000 a month, just really reasonable. And then, I have other much more engaged packages where I'm way more involved. I'm on-site more often. I'm helping them fix some things that have been maybe, really broken in the team or in their processor in the business. So, it's [crosstalk 00:58:20]

Howard Farran: Do you do in all the US, or are you more regional?

Genevieve P: I actually, work all over the US.

Howard Farran: What about Canada?

Genevieve P: I actually, have one client in Canada, yes.

Howard Farran: Nice. What do you think your average client, if they gave you $1,000, how much do you think they'd get back in there? If they give you $1,000 in the year 2017, in that year, what to do you think the chance is that they'd get that thousand back?

Genevieve P: Oh, 100%. [crosstalk 00:58:57] Well, if you do it. I mean, if you take the advice and implement it. I think if you invest, gosh, if you invest even a fraction of the percentage you invest in your own CE into your team CE, including your front office, most dental team members never, ever experience working with a coach. Yet, we know the most successful people in the world work with coaches and consultants. [crosstalk 00:59:30] CEOs.

Howard Farran: Every single one of my friends whose office is in the 2 to 4 million collection, it's not that, have they ever used a practice management coach, it's which one did they not use? They say, "I've been here 25 years. Yeah, I brought her in 10 to 15 years ago. That was really awesome. She helped me do this." And then, "Five years later I brought in this lady and she was really awesome and she helped me do," I mean, they've tried everyone. And they always tell you that if they bring in at the most expensive 50-, $60,000 for one year program, the next year's tax return is up 75-, 85-, $90,000. So, they've got it back before they even went to tax, it's the number one return on investment, is a dental office practice management consultant. I tell them that, "You got to get your house in order." 

And then if you get your house in order and your stress level comes down and your wallet thickens up and you want to go play with Dawson, Pankey, Coy Speer, buy a laser, who gives a shit? You might just want to go to a Third World country and do free dentistry on the Third World, I don't care. But I know my homeys, and when they're really, really busy and they can't pay their bills and this team's fighting and there's dysfunction, about 14% of them will just start drinking on the way to work. They'll stop spitting out the Listerine. They'll start writing scripts of Vicodin. They'll hate it. They'll burn out. They'll get on Dental Town and say, "Oh, God, my twin brother is so lucky. He didn't go to dental school. He's a plumber." It's like, "Dude, you'd rather switch to flushing shit out of a line than doing dentistry? What's wrong?" You know what I mean?

And then when they just sit there and say they work too hard, I always remind them, well, in the last 2 million years, 100 billion humans have come and gone. How many of them didn't like their job? How many of them didn't like living in a cave, living off eating mastodon shit all winter, while there was an Ice Age. Not liking your job is, either you have a very bad attitude or you're not solving the problem at hand. [crosstalk 01:01:42] And if a consultant can come in and just, that's all I'm gonna say, "Just get your damned house in order."

Genevieve P: Right.

Howard Farran: Get your house in order. And then when you get your house in order, it's fun again. 

Genevieve P: It is. [crosstalk 01:01:57]

Howard Farran: And, as far as the, all social animals don't want have uncomfortable conversations. That's why the most successful people are kind of, socially messed up, because they're comfortable having uncomfortable conversations. It's true. You read everything on Steve Jobs. That was a very weird dude. 

Genevieve P: Yeah, he was.

Howard Farran: A lot of these top performers are messed up in the social department. And whatever's messed up about them, it allows them to have uncomfortable conversations all day long. So, if you can't have an uncomfortable conversation, you need to get a consultant that can sit there and be your personal coach. When you see the Olympians standing there beside, the boxing match has a coach, the gymnast, a coach, the swimmer, a coach. Everybody has coaches. When you look at S&P 500 CEOs, they have personal coaches. They have exercise coaches. When you're running Apple or GM or Ford or things like that, you have a nutritionist, a physical therapist, a life coach, I mean, these are just for you. 

And so, I just think, I just can't say enough about practice management consultants. And another thing, this industry is so small, if you have a bad reputation in Kansas, everyone will know it in Nebraska and Oklahoma in an hour. So, when you see these practice management consultants like you, who have been in the biz for 20 years, 20 years, you're obviously helping someone. You know what I mean?

Genevieve P: I'm fortunate enough to feel very successful in the outcomes that I've had with my teams. I know that it's not easy to have uncomfortable conversations. And I'm not the type of coach that's saying, "Hey, get over it and just do it." I recognize that it's never gonna feel great to bring up something that you don't love talking about. But, if you can get good at normalizing discussions about outcomes, that's it, it's not personal. It starts to feel a lot less like a confrontation and you become a much more nimble, much more effective team. I say this to doctors all the time when they tell me this thing that's bothered them about their assistant for 15 years. And I say, "Well, does she know?" "Well, no. I could never say that to her." They can't even bring up these little things that for the person that they work head-to-head with all day.

I think if you can just sort of, give them tools that learn to make talking about how things are going in the office with the whole team on a regular basis, it becomes just, a lot more comfortable and it doesn't feel so much like a confrontation.

Howard Farran: Do you think society's changed? What about the dentist, the average you work with in their home? They got a bunch of dysfunction at work. They got a lot of dysfunction at home.

Genevieve P: Some of them, yeah.

Howard Farran: So, when your assistant, you can't talk to your assistant about that and you can't talk to your son about that. You can't talk to your receptionist. Can you talk to your daughter at home? I mean, how do you deal with, the point I'm trying to make is that, these soft skills, you need to learn them with dental consultants because they apply to your spouse, your kids, your grandkids, the neighbor across the street. I mean, the best, I would not have wanted to have been born on earth the only Homo sapien on earth. I'd have been very confused.  I don't care if you're in downtown Hawaii, if you're the only human on earth, you'd be walking around thinking, "What the hell?" The greatest thing about life is your friends and family. There's no doubt about it.

Genevieve P: Absolutely.

Howard Farran: And, double-edged sword, they're the worst thing about it. I mean, even the ones you love are the worst. I mean, how would you like to go home and have Thanksgiving dinner at my house where your two oldest sisters are Catholic nuns, and your little brother is Elton John? Nice, nice. So, the people you love are crazy. In fact, at 54 years old, I think, I really think I might be the only normal person on earth.

Genevieve P: I sometimes think that. We might be the only two.

Howard Farran: It's just you and me?

Genevieve P: Right. Yeah, I think so.

Howard Farran: We should start the Normal Persons of the World Committee.

Genevieve P: I like it.

Howard Farran: We should start the Normal Persons of the World Organization, and we'll be the only two members. 

Genevieve P: We will be the only two members.

Howard Farran: So, get a consultant before CAD/CAM, before Laser, before you learn to bone graft, before [crosstalk 01:06:18]

Genevieve P: Oh, my gosh.

Howard Farran: Just get your house in order. And if I see you on the street and you say to me, "Do you think I should learn sleep apnea?" I'm gonna say, "Well, first of all, is your house in order?" One last question I want to ask you. One last question.

Genevieve P: Thank you. 

Howard Farran: I'm only gonna ask you this question, it's an overtime question, because, a lot of people are saying that the dental school graduates today are different than the ones that came out 20 years ago, that they don't want to ever own their own business. That a lot of them just, want to be an employee. And then, I go look at all the dentists who have associates and all the corporate who hires all the dentists, I say, "What is the worst thing about all your associates whether in private practice, public practice?" and they'd say, "Oh, they all quit after a year or two." So, which is it? So, they're all quitting after a year or two. Is it because I wasn't a good employer-

Genevieve P: Little bit.

Howard Farran: ... or is it because deep-down inside they want to own their own business?

Genevieve P: I think that's kind of, a mixed question. Undoubtedly, I will say that there's a different, I don't want to say work ethic, but ideal about what it means to own a practice when I talk to younger dentists. They're sort of, preached to in school that they'll have this amazing work-life balance. And they do sort of, blindly come out of school expecting to sort of, have the responsibilities of an employee, working 8 to 5 sort of, clock-punching mentality. But they want to have sort of, all the power of the dentist. They want to be the boss. They want people to respect them. They have sort of, an interesting view of how it will be. I think there's a hard lesson for them to learn in those first five years out, that you can't work four days a week and make $500,000 when you're 27. That's not happening for most of them.

Howard Farran: Look at us. Look at us. We're working on a Saturday.

Genevieve P: Right.

Howard Farran: I must be pretty stupid, because I'm 54 and I still work seven days a week.

Genevieve P: I work all the time. I think we're both fortunate that we like working. We love to do what we do. But-

Howard Farran: Well, you know the difference between our generation and the millennials?

Genevieve P: What?

Howard Farran: We get great satisfaction out of production, out of work. They get great satisfaction out of consumption, buying clothes and shit and cars and fancy dinners.

Genevieve P: Right.

Howard Farran: We feel good when we produce. Millennials feel good when they consume. I mean, you go to any 70-year-old farmer in Kansas where I grew up and they work seven days a week. And at the end of the day, if a tree fell on the fence and a cow got out, you spent the whole day cutting up the tree and making the firewood, fixing the fence, get the dumb-ass cow off the highway. And you finally, come in when it's dark. You just feel good, because that was a damned productive day.

Genevieve P: Got a lot done today, yeah.

Howard Farran: You got the cow off the street, you fixed the fence, you cut down, I mean, you just feel good. [crosstalk 01:09:19] 

Genevieve P: Absolutely.

Howard Farran: I would feel good if I could go to the mall and buy a new hundred dollar pair of sneakers and a new CD of some rap artist.

Genevieve P: Right.

Howard Farran: So, our generation feels good from producing. They feel good from consuming.

Genevieve P: Right. I see a lot of them come around to see, and hopefully, they get paired up with a dentist who can help instill the value of work into their practice, but I would say the flip of that question that you asked is that, a lot of dentists are terrible bosses. They have this-

Howard Farran: Are you talking about Jennifer Aniston?

Genevieve P: Huh?

Howard Farran: Are you talking about Jennifer Aniston? Wasn't that the name of her movie? Terrible-

Genevieve P: Horrible Bosses, yeah.

Howard Farran: Horrible Bosses, and she was a dentist.

Genevieve P: Horrible Bosses, exactly. A lot of doctors think they're gonna be these amazing mentors, and they're really not. They didn't plan to bring in their associate, they have no game plan to help that person be successful, they're not oftentimes, all that successful themselves as a manager or sometimes even as a dentist. And then they bring in some young person without a whole lot of experience. And it tends to be pretty disastrous.

Howard Farran: Can I ask you another overtime question?

Genevieve P: Absolutely.

Howard Farran: You've seen a lot of offices in two decades. A lot of these millennials are in school and they're like, "Well, Julie's my best friend. She's my buddy. We're gonna be a partner. We're gonna do it together." So, when you're in a partnership, in marriage, a partnership means, we're gonna get naked, have sex, have children, travel. And that fails half the time. 

Genevieve P: Right.

Howard Farran: Now, you're gonna marry your best friend from dental school, or you're gonna marry another dentist. No children, none of the social glues that hold-

Genevieve P: Right.

Howard Farran: When you're out there consulting for two decades, do you see, is partnership a good thing more times than not? Or is it trouble more times than not? Or does it have no effect, solo versus group?

Genevieve P: I think that you can see any of these situations go awry. Partnerships need to have open and clear communication, and expectations of each other at the beginning. When I see young doctors trying to do their practices solo, I think they feel very isolated and they miss out on some camaraderie. And so, I think partnerships can be a really, really, really nice thing. And that can lead to more satisfaction for the doctors involved. But, just like every working relationship and partnership working, it has to be the right two people and it has to be set up the right way, and it has to be the right situation. But I do think what partnership brings to the table is just a sense that you're not in it alone. And you tend to, I see that people perform a little bit better when there's somebody else holding them accountable at that partnership level.

Howard Farran: I agree. That's why I started Dental Town. When I got out of dental school in '87, I hired an associate right out of the gate. If I would've had a brain, which I did not, at 24 years old, I would have hired a 54, 64, somebody who's been around the block forever.

Genevieve P: Right.

Howard Farran: What did I hire? The coolest 24-year-old kid, buddy, from Creighton, Bob Savage, because it was just, so damned fun. It was just so damned fun to have another young, dumb, green dentist like yourself. So, you're right, I hardly worked any time at all before I realized, "Wow, I'm the only dentist. I'm all by myself." And then when I saw the Internet came out, that's why I jumped on Dental Town in 1998, because your friends might only know something about three or four areas, but you can't have a friend that knows everything in clinical dentistry, business marketing. 

And when I saw the Internet came out in 1998, which was six years before Facebook, I dove on it. My tagline was, "With, no dentist would ever have to practice solo again." And, I just want to thank you so much, and on a Saturday, you got up, all hung over from out drinking and dancing until three in the morning.

Genevieve P: Yes.

Howard Farran: And talked to me so that my homeys, they're probably gonna listen to this on Monday morning on our commute to work. Thank you so much.

Genevieve P: Thank you, Howard.

Howard Farran: For coming on the show and talking to all these dentists.

Genevieve P: Oh, thank you so much. I really appreciate it.

Howard Farran: Okay, and remember, next month, you're gonna only root for the Arizona Cardinals. No more Green Bay Packers. That was the deal.

Genevieve P: I can't make any promises.

Howard Farran: That was the deal. Have a rocking hot day.

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