Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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818 The Disillusioned Dentist with Dr. Zachary Kingsberg : Dentistry Uncensored with Howard Farran

818 The Disillusioned Dentist with Dr. Zachary Kingsberg : Dentistry Uncensored with Howard Farran

8/21/2017 6:06:44 PM   |   Comments: 0   |   Views: 273

818 The Disillusioned Dentist with Dr. Zachary Kingsberg : Dentistry Uncensored with Howard Farran

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818 The Disillusioned Dentist with Dr. Zachary Kingsberg : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #818 - Zachary Kingsberg

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AUDIO - DUwHF #818 - Zachary Kingsberg

Dr. Kingsberg graduated from Nova Southeastern University in sunny South Florida in 2015 and has been practicing dentistry in Dallas, Texas since graduation. Dr. Kingsberg or Dr. Z is host of a new podcast called The Disillusioned Dentist. The disillusioned dentist podcast is designed for new grads, current dental students and pre-dental students with the focus of getting young grads out of student debt and into practice ownership as soon as possible! Dr. Z is a new father and is currently opening up a scratch start practice with his wife (who is also a dentist) next month.

Howard: It is a huge honour for me today to be Podcast interviewing Zachary Kingsberg, all the way from Dallas, Texas. Dr Kingsberg graduated from Nova South Eastern University in sunny Florida in 2015 and has been practicing dentistry in Dallas, Texas since graduation. Dr. Kingsberg or Dr. Z is host of a new amazing podcast, which I love, called The Disillusioned Dentist. The Disillusioned Dentist Podcast is designed for new grads, current dental students and predental students with the focus of getting young grads out of student debt and into practice ownership as soon as possible! Dr. Z is a new father and is currently opening up a scratch start practice with his wife (who is also a dentist) next month. So where did she graduate from? Nova?

Dr. Z: Yeah. We graduated the same year, same class. Both Nova grads 2015.

Howard: So, the office opens next month?

Dr. Z: The office is opening next month, correct. We're still building it right now.

Howard: Right on. And how old is the baby?

Dr. Z: The baby is about 10 and a half weeks. We might hear him crying in the middle of the podcast. We'll have to check in on him soon maybe.

Howard: So, my God... And when did you get married? In dental school or after?

Dr. Z: After dental school. Memorial Day of last year.

Howard: You've had a busy time, I mean, to get married, get out of dental school, have a baby, start a practice.  My God, aren't you pulling your hair out? I'm surprized I'm the bald one in this conversation.

Dr. Z: I know. It's a lot going on. It's exciting. I like to multitask and stay busy. Keeps me focused.

Howard: Well, I think you're amusing. So, tell us about The Disillusioned Dentist Podcast, and I know you're keeping it real with Millennials, man. You're talking about the ups and downs, the goods, the bads. How's that journey going?

Dr. Z: The podcast started off pretty good, I pumped out a few episodes. The baby came, we had to pump the brakes a little bit but the whole goal, the podcast was just to get the word out there even with all the debt and corporate dental and saturation that young grads should still try and get practice ownership as soon as possible.  Kind of along the same lines as what you preached. So, basically, as I've been going through this process of looking at purchase of practice and now start a practice, I've just met a lot of contacts and built my networks and resources along the way and my peers and friends are always asking me questions about this and that. So, I kind of just decided to start a podcast and start interviewing the people that I've been talking to daily just to get the word out there.

Howard: I started a podcast simply because I wanted to start a section on Dentaltown for the podcast and I really have achieved my goal. There's forty of you guys now listening to a show.

Dr. Z: Yeah. I think there's even more on iTunes. Like every day I search for dentists, there's like one or two new podcasts by the week, it seems. So, yeah, they're blowing up and becoming very popular, very quickly.

Howard: Yeah. And what's weird is the podcast technology was available when the iPhone came out in 2008, and it started to take off and then it died and now it's back in spades, and I think a lot of it has to do with the commute and they just can’t listen to an hour of politics on the way to work. I mean, you just can’t listen to Trump and Putin and Hillary and Obama for an hour to and from work each day or you'd probably drive off a cliff, and what everybody's telling me is that they'll go on that Dentaltown app and scroll down, see what they’re in the mood for and every time they get to work, they've got one new idea, one pearl, something. Something productive that came out of it. So, I want to start out with this question... I'm fifty four, you're twenty eight. My oldest son is twenty seven. All the old timers like us, the baby boomers, we all keep hearing all this information that you Millennials are all different and as opposed to dentistry that you're not going to want to practice ownership. That you just want a 09h00 to 17h00 job, that you're not going to have five kids, you'll have one kid. You'll want to leave at five o'clock and be well rounded and all that kind of stuff. You think that's true or do you think that's a crock?

Dr. Z: I think it's mostly a crock. I would say most of my friends and peers want to get practice ownership but I would say the Millennials definitely want more balance and they want to be able to take their vacations and go their concerts and eat out at restaurants and do all those Millennial things, but I think that's even the more reason to get into practice ownership. So, you have that more freedom and flexibility to do everything that a Millennial wants to do. Yeah, I would say that's a bunch of crock but my friends and I definitely all want to get into private practice and practice ownership as soon as possible, for sure.

Howard: So, the people that own the DSO's, they claim half the dentists in America will be working for them in ten years and I just don’t see them maintaining dentists. I mean, it seems like they can’t keep their employees.  They can’t keep general dentists. What percent of your class in Nova went straight into corporate and what percent liked it and said, "man, this is awesome, I'm going to do this until I'm sixty five", and what percent have already quit? You've been out two years, right?

Dr. Z: I've been out two years. I'd say after graduation, not counting the kids that went to residency or GPR. The kids that went to work, I'd say eighty percent went into corporate dentistry and out of those eighty percent, how many liked it? Probably ten percent and most of the grads lasted at their first job probably not even a year. Maybe six months or even less. So, I agree with you. It seems like a very unsustainable model and I don’t really see the future growth of corporate dentistry, but it definitely serves it’s niche for new grads with a first job. Like you said, the turnover and the unsustainability, I don’t really see it. Fifty percent, no way, not a chance.

Howard: Why do you think they have so much turnover? If you were talking to a CEO of a DSO right now, what advice would give him or her to attract and retain and keep long-term employees? Or do you just think it's just people that go to school eight years and become a doctor aren't the ones that line up in a row?

Dr. Z: I mean, I think it definitely makes some small changes to keep dentists for longer than six months. Like it all starts at the top. They just don’t care about the dentists. They treat us like a commodity which I guess we kind of are these days but same thing with the assistants, the staff... Nobody's happy, just a bad attitude. New assistants all the time. That’s probably one of the things that pisses the doctors off the most, and we're constantly having to train a new assistant. Dentistry's hard enough with patients bitching all the time. We don’t have to worry about a new assistant who can’t suction, can’t do this, doesn’t know what's going on. Plus, most of the time they probably overload the schedule. Just a lot of lack in communication in the office and not everyone's on the same page. Plus, the hours they want you to work, nights and weekends. Like I guess a lot of Millennials don’t like to do that but I personally do. That's when I make my most money working nights and weekends. So, I don’t have a problem with that personally and I guess the pay, it's just really not that good. What is it?  $500.00, $600.00 guarantee?  That's kind of what these places offer.

Howard: $500.00 to $600.00 per day guaranteed?

Dr. Z: It's pretty much the norm basically, yeah.

Howard: Is that verse a percentage of production?

Dr. Z: Well, I don’t even have that daily guarantee or the percentage structure, about twenty eight percent, maybe thirty percent of adjusted production but it always seems to come out where the doc is just making his daily guarantee. So, they're not very flexible, and given the doctor, that actual percentage, there's always write-off’s and they're factoring overhead into the formula and come up with all these bullshit formulas to kind of screw the doctor out of actually making more than the guarantee, from what I've heard and seen.

Howard: Well, dentistry it's just a hard job. I mean, my dad owns Sonic Drive-ins. When people come to Sonic Drive-In, you can’t beat the smile off their face with a crowbar. They’re so excited to eat a cheeseburger and onion rings and tater-tots and then when you go into dentistry, people are scared and they hurt and they’re in pain and it's a tough job when you're doing it with your assistant that you’ve done it for, for thirty years and you’ve got all these long-term people that you are doing it with, but you just start doing things like taking out an amazing assistant who knows you. To, now it’s a stranger. It's just so easy to turn it into a food bar, as they said in that movie... what was that movie?  Saving Private Ryan. Food bar?

Dr. Z: No, food bar, no, I'm not a big movie person. I've got a very short attention span so...

Howard: It's blanked up beyond all recognition. Food Bar. It's a tough game. It's a very tough occupation when everything is going right but you just start adding a little bit of HR problems or scheduling problems.

Dr. Z: But I would say as far as the corporate dentistry goes, Heartland seem to keep their docs the longest. I have several friends who started there and some of them are still there two years later. So I’m not sure as Heartland does different than the other ones, but Heartland definitely seems to retain their associates longer than the other ones for sure.

Howard: And that's Rick Workman at Effingham and that's part of that culture there. He's a small-town boy, he grew up in a town of ten thousand, and he's doing the best, I think. Who would be the second best, you think?

Dr. Z: I don’t really think there is a second best, Pacific has a good name but a lot of docs that work there hate it. It's very spoon-fed for the specialists to produce a lot and the doctor owners but an associate there, you’re kind of just doing the HMO stuff and the free cleanings and the $20,00 fillings. I haven’t heard too much good stuff about any other chains besides Heartlands so I can’t really answer that.

Howard: Well, kudos to Rick Workman. He's been on the show. He is a class act guy, I mean, I do love the guy to death. He's a good guy. So, you say your students are asking you questions and things like that? I'm sure one of the biggest questions they have is their debt load.

Dr. Z: Oh, yeah.

Howard: For your class, I mean, we hear all these national numbers but for the people that you graduated with at Nova University which is a private school, they're a little bit more pricey than a public school. What was your classmate’s average debt load?

Dr. Z: I would say our average when we got out was probably around, North of $400,00.00. Close to $450,000.00 so, with interest now people are well over $500,000.00. That's probably an average.

Howard: So, half a million?

Dr. Z: That's from dental school. I'm not even talking about kids who had debt from a Master’s Program or undergrad. I'm talking just from dental school. You're looking at about $450,00.00 just for the four years at Nova.

Howard: And what percent of the class had no student loans because mom and dad paid for it all?

Dr. Z: Probably I'd say twenty five percent are debt free because they have rich parents. Twenty five percent. Maybe their rich parents paid for like their tuition and then they'd flick out some loan money to live off of and then I would say fifty percent are probably at that $450,000.00 plus mark at least.

Howard: Yeah, that's why I don’t like average numbers because when people's data, so many statistics, number one, they don’t talk about. They just assume that, it’s like, for their country or the world. So many of those data’s are incomplete and if twenty five percent have zero debt...

Dr. Z: (00:11:53 unclear).

Howard: Yeah, I mean, that really screws the medium average debt on so many studies that I'm reading and then maybe they did take it out and they just didn’t point that out.

Dr. Z: I mean, I know kids who are six, seven, eight, $900,00.00. Who had some debt before dental school, went on to do two or three-year specialty. Maybe an ortho programme for three years is going to become an $800,000.00, $900,000.00 in debt.

Howard: So, how many of these are having success refinancing them? You see some threads on Dentaltown where there's experts popping up that try to refinance all your student loans?

Dr. Z: I would say not too many people refinance you. I actually just refinanced a few weeks ago. I interviewed Travis Hornsby myself and after I secured the loan for the practice, I refinanced. So, hopefully they don’t hear this because I don’t think I was supposed to do that as part of the practice terms but that's all good. But yeah, most people don’t really refinance. Not sure why. I guess they’re scared of the high payments, and another reason if you do want to start a practice, I think the banks obviously don’t want to see that large payment every month. So, I think a lot of people haven't taken advantage of refinancing.

Howard: So, how long was your finance stretched out? I mean, was it a fifteen-year loan, a twenty-year loan?

Dr. Z: The refinance I just did?

Howard: Yeah.

Dr. Z: I just refinanced ten-year fix for four point five percent on $420,000.00. So, my monthly payment is going to be like $4,300.00.

Howard: Ten-year fix, four point five percent?

Dr. Z: Yep.

Howard: And what was it before you refinanced?

Dr. Z: Before I financed, I was around six point six percent, six point seven percent in average.

Howard: Man, that's huge.

Dr. Z: Yeah. My interest every day was like $100.00. It was wild.

Howard: And six point seven percent, was it also ten-year fixed?

Dr. Z: Six point seven percent, no. That was just on like the federal payment programme. I was on like re-payee so like, I was just, whatever. On a random programme trying to figure out what my next strategy was. So, that was probably like a twenty five, thirty year plan or something.

Howard: So, how old were you in 1980?

Dr. Z: 1980? I wasn't born yet.

Howard: What year were, you born in?

Dr. Z: In 1988.

Howard: Oh, my God. Thanks for ruining my day. So, the one point I just want to make on this is, if you've been around the sun twice as many times in 1980, you can’t have debt that's not fixed. The most important thing you just said is fixed because nobody sees any of these shocks coming, I mean, all these know-it-alls on TV. All these talking heads, they never told us the Berlin wall going to fall there, uprising, nothing! They don’t know anything. But in 1980, interest rates out of nowhere went to twenty one percent and people were losing their family farms just right and left. It was crazy, and we had a hell of a shock in 2008 but I think a lot of the people your age thinks interest rates, like you might think six point seven percent was high. When I bought my first house, my first house when I got out of dental school, the seller had it financed for fourteen percent and I thought I was just a genius because I had mine for twelve percent and six point seven percent is half of that. So, you could get into trouble really, really, really fast with floating debt. And banks love to do it... They love to say, "Yeah, we'll finance this".  Two hundred basis points over prime or whatever the hell. You have no idea where prime is going.

Dr. Z: Yeah, I would say most of my peers aren’t really concerned with the debt. They’re kind of on those twenty-five to thirty-year repayment options. They think it's going to get forgiven and they’re kind of just paying the minimums but I guess, yeah, most people don’t seem to be too concerned with it.

Howard: Do you think it's going to get forgiven?

Dr. Z: I do not think so. Why would they forgive and if they do, it's definitely not going to apply to dentists because we're supposedly the richest people in America. So, they’re definitely not going to help out the dentists at all.

Howard: So, what advice would you give to a dental student? When we talk about, I want to be fair about corporate. It seems like DSO's are the bad guy but when you look at associate problems, most of them go to private practice and those guys aren't their associates either. I mean, by the time you've been doing this thirty years, most of your friends who've had associates for thirty years say a really good one lasts seven to nine years before they go out. I'd say about seven years before they open up their own but a lot of associates in private practice also have really high turnover.  

Dr. Z: I've heard worse stories about private practice associateships than corporate. So, I would definitely recommend a first job, go straight to corporate. Try not to sign a contract for more than a year, and basically six months in, start looking for a practice. I don’t think you really need more than a year in a corporate setting. You could pretty much learn a lot in a year, pick up a lot of speed, make a lot of mistakes, doesn’t really matter because you've got that corporate umbrella there and after a year that's plenty of dentistry.

Howard: And that's a great point there, Rick Workman always makes. He says, he lives under a microscope and all these people are looking and trying to find anything they’re doing wrong and he's like, "God, you go into the dental office across the street and they might not even know their auto clean hasn’t worked for five years, I mean, they don’t even sport as". So, to be fair and balanced, what horror stories have you heard from associateships in private practice?

Dr. Z: I mean, nothing too crazy. Just more like not getting paid, not getting any patient flow. Senior doc obviously getting all the bigger cases and crowns. The associate just getting cleanings and huge fillings and crappy work that they don’t want to do. So, kind of just not really paying them and just not enough patients and they’re not making enough. Just very slow.

Howard: So, I agree. When you get out you need to learn if you're going to work out in the NFL someday, first you need to know a block, a tackle, a pass and a reception.  You've got to just start doing some volume of fillings, crowns, cleanings, root canals. When they decided they’re going to work for themselves, would you recommend buying an existing practice or doing a De Novo from scratch?

Dr. Z: My wife and I are always on, we never want to do a De Novo practice just because we practice in Dallas and it's a very saturated market. There's probably four dental offices in every intersection. So, we didn’t really want to be the fifth office on that corner but it's pretty hard to buy a practice. We look for about six to eight months. We went through the process of four different ones, they all fell through for four different reasons and at that point I said, "screw it, we're just going to do a scratch start because at this rate we're never going to buy a practice". A lot of them are overvalued. A lot of the practices that are on the market are pretty shady. I didn’t want to spend $500,000.00 or $300,000.00 or whatever the number is, and then have to put in all the time and effort into changing it. The equipment’s garbage and the floor has to be redone, repaint. Like, at that point I might as well just do a start-up even though I didn’t really want to. So, I mean, if you could find that golden, ideal practice out there then, yeah, I think buying an existing practice with existing patients, existing cash flow, some kind of systems are in order would be ideal but I didn’t really find that ideal scenario or even half an ideal scenario. So, we had to change our plan and doing the scratch start.

Howard: Well, the macros are completely reversed because all the guys selling graduated when America was pumping out four thousand in this year and now all the ones buying are coming out six thousand a year. So, the macros, it's certainly a sellers’ market. I want to ask you another question. So, you have your wife, you have your baby, you have your whole entertainment system going, why did you stay in saturated Dallas? Why didn’t you and your honey move two hours out in the middle of nowhere Texas where their fracking oil and be the only guy in town? No HMO's, no PPO's, no Medicaid and just make bank? Did you have a boy or a girl?

Dr. Z: We had a boy, little Asher.

Howard: Little Asher? And then he could go out in the backyard and shoot a twenty two pistol any direction. Why did you stay in saturated Dallas?

Dr. Z: We're city people, for sure. I'm from Fort Lauderdale, she's from Santa Barbara, California, so just coming to Dallas alone we thought it was kind of meet the Boondocks. I thought there was going to be people riding around on horses here. So, yeah, we've got good potential here. We have success early on with our first jobs. That's obviously why we’re getting to practice ownership. As soon as we did, and I think you can be successful anywhere. Probably not in Los Angeles, California but as saturated as Dallas is, there's still a lot of growth and potential. So, we like that three-hour flight to the East Coast to see my family. The three-hour flight to the West Coast to see her family and there's no Yelp in the middle of nowhere. So, we like to eat a lot. I don’t know if that will work out for us.

Howard: It's so true. If you're trying to fly at the corners like San Diego, Seattle, Boston or Miami, three quarters of the pie is nothing, it's, ocean and Dallas is the most strategic centre.

Dr. Z: Yeah.

Howard: You're basically American Airlines. You’re almost a two to three-hour flight from anywhere.

Dr. Z: That's five minutes from Dallas, Low field. That’s South West Airlines hub. So, we got the companion pass, we go buy one, get one free flights. So, we take advantage of that for sure.

Howard: Yeah. In Texas, right now is the number one performing state economy of all fifty states.

Dr. Z: Yeah, Texas is booming. The construction is out of control, Toyota is opening up their headquarters here any week now up in Frisco which is about twenty-five minutes North of Dallas.  So, it's definitely a booming economy, for sure.

Howard: So why didn’t you open up in Frisco?  It's only twenty-five minutes from your Yelp coffee shop?

Dr. Z: I don’t really like working on the upper class. I prefer the low to middle income population. My background is actually mostly in Medicaid so I go for low fees, high volume. I don’t like working on rich people that bitch a lot. That's not my thing, but my wife likes working on them but I don’t know, I

don’t really like working on those kinds of people.

Howard: Yeah, I would’ve never done Pedo and I would have never gone to Scottsdale and try to be a cosmetic dentist for the exact same reason. My favourite patient is someone in pain, someone who's scared, broken tooth, toothache. But when some lady comes in and sits down and has three pages of stuff written down about how she wants her smile changed. I just want to give out referral slip to a psychiatrist and say, "you don’t need a dentist, you need mental health".  So, it's not just not right or wrong, it's just what you want to do. Some physicians want to do cosmetic surgeries all day long and some want to do bypasses.

Dr. Z: Yeah, I go for the bread and butter dentistry, just filling, crowns, extractions and deep cleanings. I kind of keep it simple, high volume and just keep it burning and churning.

Howard: So, what if you were talking to a kid in your practice and he was in high school and he said, "hey, Zach, you think being a dentist is a good idea? If you had to do it all over again, would you have done it?"

Dr. Z: I mean, it's a little too early to tell, if he went to Bailer I would probably recommend it because I think Bailer is still affordable but I would definitely not advise him to go to a private school with five, six, $700,000.00 in debt.  

Howard: What's the difference in fee between going to dental school at Bailer vs. Nova?

Dr. Z: I think Bailer. I'd talk to those guys and those kids, even now, are coming out with like below $200,00.00 if they took out the whole four years.

Howard: Yeah. So, do you know the story on why education is so cheap in Texas?

Dr. Z: No, I don’t.

Howard: Way back in the very beginning, and Texas... To drive from Houston, Tela Passo is like a twelve-hour drive. In fact, a lot of people, a lot of the territory managers in Arizona also cover Al Passo because Al Passo is only six hours from Phoenix and it's twelve hours from Houston. Anyway, when they formed that state, it was just a monster state and they have all this land and they put huge tracks of land into the Department of Education and said, any money ever used in that could only be used in education, and sure enough, they find oil in there and so, I mean, that's why the largest library in the world is not the Federal Government's.  It's actually the Texas Library. The Texas Library I think has six million books. They just have tons of money and they can only spend it on education, so they don’t really need the tuition money.

Dr. Z: That's interesting. I didn’t know that but, yeah, to answer your question. Like I said, it's a little too early to tell but I would recommend if that person, their primary goal is to get into practice ownership as soon as possible and I think it’s definitely still worth it.  Even if you’re $500,00.00 in debt, you could, you can make that in half a year. Like one or two years down the road after building a practice. So, it's definitely still worth it if you’re going to buy a practice as soon as possible, yes. I think so. I hope so. I'll let you know next month.

Howard: And not to get too personal but what’s it like marrying another dentist? What have you guys learned? Are you going to work together the same hours? Are you going to work different days? So, for your son, would you like, not work a couple of days and stay home and be dad or will you work at the same time? What is your marriage strategy?

Dr. Z: We're still trying to figure that out but I think our son is going to be our mascot here. We already started taking pictures. I think the patients are going to love him.

Howard: Wow.

Dr. Z: We're still trying to figure out our plan. Like I said, like my wife, her background is more insurance and cash and working on adults. My background is more like, I like to work on kids. Kind of do the extractions and the root canals. So, we actually can do polar opposite dentistry. So, even if we work together, we don’t really like to see the same patients but until it picks up, I might keep my associateship a few days a week. But yeah, the goal is to both be here full-time as soon as possible, Monday to Saturday, six days a week.

Howard: Both of you working six days?

Dr. Z: Probably not both of us. Really, we just need extra capacity for that after school rush. Maybe from 16h00 to 19h00 but yeah, we don’t need two doctors there in the morning but yeah, I would say when we're busy just have two doctors there for a few hours would probably be good.

Howard: Isn’t the dental attorney David Cohen, isn’t he out in Dallas, too?

Dr. Z: Yeah, he reviewed my lease. Yeah, David Cohen.

Howard: Yeah, how's he doing?

Dr. Z: He's good.  He's a busy man. Every time I try to call him he's always travelling or somewhere, I don’t know. He's always a busy guy.

Howard: Yeah, that's awesome. So, wow, that’s a lot of...

Dr. Z: Yeah, we don’t really have a plan yet, that's the beauty though. We have all the flexibility with us both being dentists. We kind of adapt on the fly and see what works and what doesn’t work.

Howard: What percent of your class got married to a dentist in Nova?

Dr. Z: Well, there's a lot that are still dating. We actually just went to a wedding last weekend in Philadelphia. A girl from our class married a guy from the class below but I would say it's a pretty high percentage. Maybe twenty five – thirty percent.

Howard: And would you say they’re the smartest thirty percent?

Dr. Z: Yeah, definitely.

Howard: People think I’m kidding. The smartest thing you can do in dental school is find your spouse because if you find your spouse in dental school, you’ve just married a dentist. If you find her in the waffle house, it's just as easy to love the waitress at the waffle house as it is a dentist but one of them is going to make $10,000.00 a month until you drop dead, and the other one's going to spend $10,000.00 a month until you drop dead. Because the waffle house lady thinks she's marrying a rich dentist so she's already got her eyes on a Gucci purse, but the other thing I’m really excited about marrying a dentist is that, when a dentist marries a dentist, a lawyer a lawyer or an MD an MD. They have the lowest divorce rate in the entire country. So, you have more to talk about, to communicate. You understand each other, I mean, she obviously knows what your day's like because she did the same damn day, you know what I mean?

Dr. Z: Exactly.

Howard: Yeah, I just think that’s incredibly smart. I think those are the thirty five smartest percent in the class that married a classmate. And then I would say if you’re going to be a lawyer, same advice. Medical doctor, anything. Marry someone in your same specialty and you guys have got lots of understanding and communication right out of the place. So, what kind of marketing have you got planned? First of all, did you do a retail location? You’re opening next month so you’ve already got your location.

Dr. Z: Yeah, doing like a little strip centre. There’s probably fifteen shops in there. A sports bar, a liquor store, nail salon, pizza shop. We don’t have like a huge anchor store like a grocery store. I was actually looking at a lot of different areas. Our dental real estate broker probably sent us about twenty listings. I narrowed down to seven, I drove around to all seven just to kind of get the feel, check it out in person and we ended up going with the one that kind of is a more community dental office, I would say. Surrounded by houses and not as much that big box grocery store or Walmart because if you’re next to a Walmart, there's probably about fifteen to twenty dental offices within a mile of there. So, we are in a strip centre but it doesn’t have like a big box store. I guess we're going to be the big box in there.

Howard: And how many square feet did you have? How many offices are you going to go with?

Dr. Z: Two thousand four hundred and fifty, and we're getting seven ops in there.

Howard: Nice, seven ops and twenty hundred square feet. That's very nice. So, what is your marketing plan? It seems like the most underfunded things people do is they'll put in all the equipment, they'll put everything together and then they'll launch with no marketing plan.

Dr. Z: Well, we hire fire game. We splurge with our search and optimization. I’m not sure if you’ve heard of Fire game? They’re a dental marketing company. They’re setting up our website and doing our ongoing SDO every month so they are pretty pricey. Our website is supposed to launch tomorrow and we're also going to do the Facebook ads and pay per click ads through them. I guess that's an extra budget on top of the monthly fee. I actually listened to your podcast a few weeks ago at Postcard Mania. So, I hit them up last week and we're going to do a mail or drop with them. We're going to drop twelve thousand pieces for $4,500.00 within a two-mile radius. I know a lot of people say that postcards are dead but we're start up. We're just going to cover all the basis and kind of see what happens.

Howard: Well, the number one enemy of your entire life is always the man in the mirror. It's never the government. It's all that, and so people have so much bias. So Millennials, they're on Facebook so they want to do Facebook advertising and when they go to the mailbox and get direct mail, they think it's garbage, trash, some spotted owl lost its home cutting down a tree all of a sudden, yeah. When you look at the data, all the marketing experts that I know that can show me Excel spreadsheets and data, they say direct mail is still the crush net one and even though it might only be a one percent return, well, shit, if you email it to a hundred homes and you get a family, that’s bank.

Dr. Z: Yeah, they break even on our $4,500.00. Let's say we average, I don’t

know, $350.00 a patient. $4,500.00 divided by $350.00. We get twelve patients from twelve thousand drops, you already break even, so that's pretty low number to achieve.

Howard: But where did you get that $350.00 number?

Dr. Z: Just a rough average of production per patient.

Howard: Yeah, I don’t like when people say, "well, the lifetime value of a patient is $6,500 for an orthodontist or general dentist. And the orthodontist receives that over twenty-four months, the general dentist over sixty months".  It's like, "I don’t pay my bills over sixty months". 

Dr. Z: Right.

Howard: I look at a statement of cash flow. If I drop $4,500.00 on a flyer, I need that damn money back this month. I can’t average it in over the next sixty months. You said $350.00 and Delta says the average new patient billing is $418.00. I’ve seen some other insurance companies that push it closer to $460.00.

Dr. Z: New patients is definitely higher. I’m talking like if I do my production for a patient at the end of the month for Limited’s, walk-ins, people that don’t stay, treatment. Just my total production per, I guess appointment, I’m saying is $350.00.

Howard: And what practice management software did you go with?

Dr. Z: We're going with Open Dental. I haven’t used it yet but that's definitely the new trend in dentistry, so we're hopping on the trend.

Howard: Yeah, speaking of advertising. There are also, the only practice management software system that does not advertise anywhere because they are just explosive. Like Google didn’t advertise for a decade, they kept crashing their own servers. The last thing they we going to do was advertising. So, why did you go with Open Dental?

Dr. Z: Just because everyone says it's free and it's just as easy as Dentrix. I used Dentrix in probably ninety five percent in the offices I worked at but I have no problem with doing something for free. We need more money for marketing so I don’t care if the tooth is on the right side or the left side or the top or the bottom. As long as there's a tooth there, Open Dental should be fine.

Dr. Z: Seems like Dentaltown, if you do a search on Dentaltown for Open Dental, those are raving fan threads. Everybody seems to love it. What other advice would you give these kids starting a practice? Did you do demographic research? Did you have anybody do demographics?

Dr. Z: The only demographics we did was our dental realtor when he provided each location for us. It came with like demographics as far as immediate income, the population breakdown as far as race, ethnicity, age and stuff like that but we didn’t do anything more intense than that. We're kind of familiar with the market here, like I said, we drove around to all the areas and kind of just wanted to feel it out.

Howard: So, you didn’t get a formal demographics study?

Dr. Z: Not a formal one, no. We just use Dental Space Advisors. Evan Reynolds, he's a local guy here in Dallas which basically everyone uses. He negotiates the leases and provides a sample demographic report. It's like one or two pages. Not the full comprehensive one but it did have like the dentist population ratio. It had a lot of the metrics.

Howard: Who's the CEO of Dental Space Advisors?

Dr. Z: His name is Evan Reynolds.

Howard: Sharp man?

Dr. Z: Yeah, very sharp. Everyone uses him here in Dallas.

Howard: Can you email him and me, and introduce us?

Dr. Z: Yeah, absolutely.

Howard: Even though I hate everyone from Dallas who is a Cowboy’s fan, maybe he's one of the truly smart people who's not a Cowboy’s fan. Are you a big Cowboy’s fan?

Dr. Z: No, definitely not. I’m a Dolphins fan from Fort Lauderdale.

Howard: Man, they crushed it back in the day. That was so fun, who was that guy? Who was the quarterback for years there?

Dr. Z: Greasy?

Howard: No, I mean way back in the day.

Dr. Z: I don’t know. You want me to call my grandma and ask her?

Howard: Dolphins legend. Dan Marino.

Dr. Z: Oh, I thought you were talking about like in the seventies when they were winning super bowls. Yeah, Emer Greene was more of an 80's and 90's guy.

Howard: Yeah, he was a fun guy to watch man. Just a very fun guy to watch. So, what supplier did you go with? How are you going to buy your supplies? You going to do that online? Are you going to do it through typical distributors? What was your thinking there?

Dr. Z: I know this Darby guy. My dad goes to a business club meeting in South

Florida. He kind of hooked me up with him, so I've been talking to him.

Howard: Is your dad a dentist?

Dr. Z: No, he fights Insurance Companies when people need to make claims and he goes and gets them more money, and then gets reimbursed at twenty percent of what he gets the customer.

Howard: For personal injury or medical?

Dr. Z: No. Floods, fires, hurricanes, tornados, natural disasters, anything. He's very (00:36:05 unclear) basically.

Howard: And you said he hooked you up with a friend?

Dr. Z: Yeah. One of his guys from his business club meeting is a Darby Rep. So, I've been talking to him but I’m also going to cross reference his quotes with, I guess a lot of people use Safeco or Net32. A lot of the online players. So, I kind of got to play back and forth and obviously go with the cheapest rate.

Howard: So where do you buy all your dental equipment? Chairs, equipment and who installed it?

Dr. Z: We bought that from a local guy in Dallas, Scott Perry. His company is called South West Medical and Dental. He kind of comes on board early. Does a lot of the work beforehand as far as checking out all the electrical and plumbing and air-conditioning before I sign the lease. He also connects you with the engineer to get your drawings done. He's kind of like your project manager along the way. He's been checking it all at permitting and kind of just stays on top of everything but, yeah, he sells equipment. That's his main job.

Howard: Do you tell him that he can list, that he can list that equipment for free on the classified ads on Dentaltown? Have you seen the classifieds?

Dr. Z: Yeah, of course. I used to sell stuff on there after dental school. I bought all my classmate's used supplies and I flipped it on your classifieds section for double.

Howard: Nice. You seem to be a very sharp business man. You've got one eye on business and one eye on cost, and if you've got one eye on the customer and one eye on cost and too many people they just take their eye off cost, they just rationalise why they should buy all this expensive stuff and expensive overhead. They just think it will be all great and it's like, "dude, you’re not looking at the cost". You seem extremely cost focused.

Dr. Z: I mean, I don’t mind splurging on certain things if I think it's going to give me a good ROI, like personally I want to buy electric can pieces even though my wife's freaking out but I can’t really function without them, so we're kind of splurging on there. I like to splurge on certain things but at the end of the day, I definitely got to keep the eye on costs, for sure.

Howard: That's a cultural thing. You go to America, everybody uses air driven when all the patients hate the noise and then you go to other countries in Europe and it's all electric driven. Why do you think some of the smartest countries in the world that are smarter than us, like the Germans, Switzerland, Sweden? Why do you think they’re into electric and we're into air? Just cultural, always been that way?

Dr. Z: No, electrical is more efficient. It's cleaner, smoother, faster, it's just so much better. I don’t know. The bore doesn’t get caught. When I use the air driven thing, the bore hits the tooth and then it stops cutting. I think that's another problem with associateships. They don’t like to buy you new bores, so some of the bores I use are like 50 years old. It's kind of pathetic.

Howard: Well, the biggest problem these DSO's have is they say they just can’t get the dentist to agree on the same bore. So, you've got three dentists in a room and some of these dentists want fifteen different bores for a filling and a crown prep.

Dr. Z: I just use one bore and that's it.

Howard: For what?

Dr. Z: I can use one bore for anything, it doesn’t matter.

Howard: What bore is it?

Dr. Z: Just like a big diamond bore, like a three point thirty one diamond.

Howard: Yeah, and it's so tough for the assistants because if there's two or three dentists working in there and they all use different bores, you've got to get down to a bore block and I think if you can’t. What do you think is too hardcore of a limit on bores? Do you think the numbers five, do you think it's seven? At what number, if you were the master dentist of all the dental offices and it was your bore block, how many did you reduce that to for a filling, a crown and a root canal prop?

Dr Z: Filling, crown and root canal? Probably three.

Howard: Yeah, that's what I think. I think five is an easy number.

Dr. Z: Five is the max. I don’t use too many bores. You can do anything with any bore. I don’t know if people have it in their heads that they need thirty bores.

Howard: I know, and you should just have a round deal with those five bores and if your dental assistant, just tell your dentist to man up and here's your damn five bores. If you need any more than that you need to go see a shrink. I remember one of the most taken-out-of-concepts, thrown under a bridge statement ever made was by Homer Reed. The poor guy said clearly that most people, when they’re doing a crown prep, they drill, rinse, look, dry, drill, rinse, look, dry, drill... He said if you measure, which he did, of the actual time that your bore was actually on the tooth, it was only ninety seconds. So, prepping in ninety seconds, why does it take you half an hour to do a filling because you keep rinsing, drying, looking, so everybody said that.

Dr. Z:  Yeah, I can do full-mouth fillings in like an hour.

Howard: Wow. You’re a fast, efficient man. So, you didn’t mention the big ones. Shine is a quarter of the market, Patterson’s a quarter of the market. You've got Benko, Burchard. How come men in those companies aren’t in your business?

Dr. Z: I just started to stay away from them. I heard that they’re just too expensive, but I did hear some of my friends who are practice owners who work with the Shine reps who, I guess, Shine will match. Any price to try and earn your business but seems like they’re all lowering their prices to compete with each other. So, it seems like if you find a good rep at any of those companies, I think they’ll match a lot of the prices from wherever you find it.

Howard: But it is a game though. I mean, if I go into Walmart that's the price, and if you’re Rick Workman and I’m Howard Farran, we still buy the same gallon of chloride bleach for the same price. I just think it's very bizarre that the pricing is always a game. It's always like, "we'll match a price" well, it's like when I go into Fries they don’t say, "well, we'll match the price the same way, just here's your damn prices”. And everybody gets the same price.

Dr. Z: Yeah, I agree.

Howard: So, what about the high cost items? CADCAM, laser, CBCT... A lot of dental students, those are big ticket items. What is your thoughts on those big-ticket items?

Dr. Z: I don’t have any thoughts on those. I don’t do any of that. Like I said, maybe we'll adapt and grow over time and maybe add some of those things but none of my patients really ask or need any of that.

Howard: I know. I think the same day crown that everybody who's talking about this unicorn that comes into the office saying, "I want a same-day crown".  All my patients say, "I’m in pain and I'm afraid of how much it's going to cost". They all talk about pain and cost. And same-day comes up about once every ten years and everybody else" well, did you take my insurance? Can you get me in today?"

Dr. Z: I've never had a patient ask me about a same-day crown and I don’t think I ever will. So, not too worried about CADCAM.

Howard: Yeah, so pain and cost is where the money’s at. So, let’s talk about the cost first. Are you going to sign up for PPO's, Medicaid, Medicare, Delta? What’s your thoughts there?

Dr. Z: We're doing everything. We're getting credential with Medicaid. Like I said, it's my background. We hired Veritas, an insurance credentialing company. We're going in network with all the PPO's. Yeah, we're doing everything. Flexible cash patients, we're going to offer inhouse financing. We don’t want any barriers for treatment.

Howard: And where’s Veritas out of?

Dr. Z: That's a good question. I don’t know. Every time I call them there seems to be different numbers. There's like an Utah number, there’s an Arizona number. I'm not really sure. The guy's name is Ben Tumi.

Howard: Yeah, I know Ben.

Dr. Z: Benjamin Tumi. 

Howard: Yeah, you know why they have Arizona numbers and Utah numbers?

Dr. Z: Why's that? They have different offices?

Howard: Because Utah is half Mormon and half of those Mormon’s have some cousin, nephew, sister somewhere in Maisa or Gilbert, Arizona. It's a huge Mormon population down there. I don’t know one Mormon dentist who doesn’t have family in Utah.

Dr. Z: They actually sent me back a few scheduled today from Signa, so looks like they negotiated some decent fees.

Howard: Nice. Okay, here's another one, all the graduators are asking and they all come out of Nova or any dental school and say, "I didn’t place an implant, I didn’t do an Invisalign".  And there’s so much noise about what they should go do. What are you going to go focus on?  Are you going to learn how to place implants, sinus lftps, bone graft, are you going to learn Invisalign? Are you going to learn sleep Apnoea? There's so many things and there's so few hours in the day. What did you not learn at Nova that you think you might focus on?

Dr. Z: I don’t really focus on any of that fancy stuff. I'm a very simple bread and butter guy. I just kind of take the patient out of pain whether it's an extraction or root canal, throw a crown on, do a deep cleaning, some fillings. That's pretty much it. A lot of patients around here, they can’t really afford implants. Like I said, I’m in a more of a low to middle income area and I'd rather just learn how to run and pass and block before I kind of tackle any of that stuff.

Howard: So, did you grow up in a low to middle class neighbourhood? Is that your roots?

Dr. Z: No, not really. I kind of grew up middle class. Normal kid.

Howard: You just like working on those people better?

Dr. Z: Yeah, it kind of happened by accident. I was actually applying to PEDO when I was a fourth year at Nova and didn’t work out too well. I didn’t have a good rank. We partied too much down in Nova, so I was in the seventy five percent percentile. I guess for PEDO you need to be at least in the top third or half. So, I actually just found this job out in Dallas where you could work on kids as a general dentist and my wife always wanted to work at Pacific and she found a job here there in Dallas. So, we kind of just moved here randomly.

Howard: Wow, so you would’ve been a paediatric dentist?

Dr. Z: Yeah, that was originally my plan but it didn’t work out, so now I basically focus on PEDO as a general dentist and I love referring to PEDO.

Howard: Well, you’re in Texas and they just had the landmark decision that there aren’t specialties. Some dentist was calling himself a specialised implantology that the Texas Dental Association tried part of the ADA said, you can’t do that. The judge said, "who are you, you’re just a membership organization, not a government". And I know a lot of specialists. Some of the most famous endodontists in literature actually graduated, there wasn’t even such thing as an endo specialty. They just had practice limited endo and I know seven small-towns where there'd be like five, seven, eight, nine dentists, and one dentist one day went to all his buddies and says, "dude, I just want to do endo.

So, I’m just going to do practice limit endo, I won’t do the crown, I won’t have a hygienist". Same with paediatric dentists, there are kids going to these small towns where all the older grandpa dentists like me do not want to ever do a Pulpotomy. I'd rather just be taken out in the back yard and beaten with a stick.

Dr. Z: It's so easy.

Howard: Oh, my gosh. Anyway, back to the low income, I have to tell you. So, my practice is in Phoenix. Everybody in this area calls it Akatsuki but it’s actually Phoenix, but I’m across the street from the Guadalupe Indian Reservation. Five thousand Guadalupe Indians and another, estimated another five thousand illegal non-citizens, whatever.  In thirty years I've never had a problem with not any of those patients. They’re all dirt poor, they pay in cash, they’re always smiling. They’re the only ones who bring me food, tamales.

Nicest people in the world and then there’s this little pocket of rich people about three miles away from my office called the Equestrian centre, and my God, these are people who drive in with Mercedes Benz and don’t pay for their ten veneers. It's like all your money problems, they always come from the rich people because a fool and your money will soon be parted, and the rich people are rich for one reason. They don’t pay their bills, they don’t pay their taxes and they don’t pay their dentist.

Dr. Z: That's true. I haven’t had too many problems working on patients yet. They’re very grateful and appreciative and a lot of patients out here are obviously Mexicans. It's definitely easier to work on the Spanish people for sure.

Howard: So, are you going to get bilingual yourself? Or are you going to get bilingual assistants? How are you going to handle that?

Dr. Z: I speak Imap Keto Espanola, my wife speaks a little Spanish and all our staff is going to be bilingual so all the staff will speak Spanish and my wife speaks Spanish, too.

Howard: So, have you started hiring any staff yet?

Dr. Z: We're kind of working on that. We've been interviewing for a few weeks. We have some marketers that we've hired but we haven’t officially hired our assistants or front desk yet but we have a few people in mind.

Howard: I want to give you the tip of a lifetime on a start-up practice hiring staff, okay?

Dr. Z: Let's hear it.

Howard: So, these people that come into your office with ten years experience. Look at the experience they’re in, some dental office with high overhead, staff problems, all this stuff and you say, "well, man, you've got ten years experience." Every time that girl comes in to interview for the front office, say, "well, how many years have you been doing this?" She'll say, "I’ve been doing this ten years". "What computer system were you on?"  "Dentrix” “Really?  Just tell me one question, how many reports does Dentrix have?" "Fifty? a hundred? five hundred?"  She'll always blame it, not the man in the mirror. "well, Dr Zach, he never gave us any training and we should've got a $60,000.00 consultant to come in and teach us how to use it". "So, ten years. After one year on Facebook, you knew how all the buttons worked but you sat at that office for ten years and you don’t know any of your cost?" And here's my point, if you hire every multi-kazillionaire that I’m personal friends with, all say the same thing about HR. They say, "Bud, by the time I had my first five employees, two of them were bookkeepers and they started either a Pizza Hut or Sonic and Godfathers or construction companies. They always knew their cost and if you hire someone that comes in for a receptionist, if she has ten years experience in dentistry, she'll want twenty five-thirty five percent more than a bookkeeper.  

Dr. Z: We're looking at a $12 an hour, girl. Labour is pretty affordable out here in Dallas.

Howard: Yeah, but I’m telling you if you got a bookkeeper you can train with the damn dentistry but her mind is totally different. The reason that girl was on Dentrix for ten years and didn’t utilize any of the functions is because she has no interest in it. We all have the same brain, we just have different interests, and those bookkeepers have a total bookkeeping mind. For instance, most dental assistants couldn’t organise your dental supplies if you put a gun to their head because they want to work with their hands, or artists, they like making temporaries. They like patient care. They don’t want to set up systems of the supplies. You go in there with regular numbers and one month the supplies is four percent and next month it's eight percent. Like dude, that's a hundred percent variance, but if you hire a bookkeeper for $12 an hour and taught her how to suction and do all the dentistry stuff then all of your supplies are just a completely different mindset, and my last thirty years, the people I hired that came from bookkeeping or banking. I stole a few receptionists from Chase Bank over the years and, my God, they just have this complete detail oriented dot the i, cross the t mindset and you'll always know your cost.

Dr. Z: My dream's always been to go over to Chick-fil-A and just hire staff from there. I might head over there after this podcast and hire a few girls.

Howard: Why Chick-fil-A?

Dr. Z: Because all they say is "my pleasure" with a smile.

Howard: Oh, yeah.

Dr. Z: And respectful, and they’re always happy. I’ve never seen such a thing.

Howard: Well, they've got some very unique policies. Number one, they’re not corporate stores, they’re all franchisee owned. They only approve point zero four percent of their franchisees. They'll only let you have one store. They want you and your family committed to this one location, they don’t want you to buy half a dozen Subways and try to be a millionaire and not be working, you know what I mean? So, you only get one restaurant, they vet you to death, it's all about vetting franchisees. That was Burger King’s biggest mistake, is they would just sell a Burger King to anybody who showed up with a million bucks.

Dr. Z: Chick-fil-A did it. You go get a get a free chicken sandwich if you dress up like a cow.

Howard: Yeah, I get that free every day I go there.

Dr. Z: Questions for you about your practice here if we turn the tables a little bit.

Howard: Sure.

Dr. Z: Let’s do it. I know you always talk about Shark tank, it's one of your favourite shows. I wanted to ask you some Shark tank questions about your practice. First one is, what is your new acquisition cost?

Howard: I would say it averages about $150.00 ahead on today’s dental office and about the same on Dentaltown new registrant.

Dr. Z: And how do you guys market and how many of your patients come back for recalls, or what percentage?

Howard: We run the hygiene, they all get reappointed that day and the office manager, Bob Robert, doesn’t go home until all the hygiene, that’s the majority of the backdoor titian is you just... Our definition of an active patient is how many people right now are scheduled for a practice, an appointment. And if you’re not scheduled for anything then you’re not an active patient, and everybody knows the recall and they talk about the recall one, but they don’t realize the couple of other ones that they can do, which is the endodontist all want to see you back or a PA after one year to make sure that peri legion all healed up and all that and the oral surgeons, sixty months, five years, twenty percent of the implants have Periimplantitis and a lot of this can be discovered and treated in one year. Maybe there’s a piece of cement, something's wrong but it gives you one more follow-up schedule appointment because if I just say to you when you’re leaving, "Zach, by the way, I warned you this root canal but I have to see you in one year for a post-op", well that’s just another way to close

that back door and keep you active in my practice. 

Dr. Z: So how do you defy an active patient? So many that you've seen in the

last year and how many active patients do you have?

Howard: Anybody scheduled for an appointment.

Dr. Z: And how many active patients do you have?

Howard: I don’t know that number but we're switching over the 4th of July. We've been on SoftDent for thirty years and we're switching to Open Dental starting July 4th and I’m told that I’ll be able to pull up those numbers on my smartphone.

Dr. Z: Cool. What else here... I guess you always talk about a closing rate, that the average doc only sells one in three fillings. A great rate would be two in three, so how do you go about getting closer to that two and three acceptance rates? What do you do personally?

Howard: It's how you make people feel and I do all the vetting on the hungry, humble dentists who has a great chairside manner and likes people, and all the ones that are lazy or they’re not hungry. They make you feel bad, they don’t connect and I've given every eighty-year-old lady a bearhug when they come in, when they leave. Jan is the most warmest, friendliest dental assistant. I think far more the patients like Jan than they like me but I think that answers your question, this is what I think the reality is. The average dentist has a thirty eight percent close rate, so a third. A third of the people aren’t going to do anything they’re told. They wouldn’t even quit drinking when they’re on insulin but you can get that middle third. So, I think what is demonstrably doable that you can, see coast to coast in urban, rural, rich and poor is that two out of three accept

treatment but the average is going to be a one out of three.

Dr. Z: Do you talk dentistry with your patients or do you leave that to your


Howard: If you’re in there on a recall, my hygienist, if she sees something, she'll take an x-ray and she'll diagnose. You say, "well, that’s illegal." Well, that's just semantics. I let her talk, I let them all talk. So, if it's an emergency patient, I’m in there but if it’s a recall, everybody is talking and everybody pretty much uses the same verbiage and I think we have eight operatories, so we've got two to four with the central sterilization in the middle and over the years everybody talking. I hear a lot of hygienists say, "well, I don’t know what the doctors going to say". Well, how do you not know what the doctor's going to say. You should know that this is a cavity and he's going to want to do a filling. You should know when it's recurring decaying or a big old MOD and it's going to be a crown. You should be on the same page and the only way you can build long term loyalty is you've got to keep staff long-term. Like say, I think you should shoot for a seven year average on employees. Employees move, they get married, they get divorced, they retire, they turn into babysitters for their grandchildren but when I see a million-dollar practice, eighty percent of them just are doing cleanings, fillings, exams. They’re not placing implants, they’re not doing sleep Apnoea, they’re just a bread and butter. They've got two or three hygienists, two or three chairs but what they have is usually an average staff member, average of about seven years and the staff are all personal, warm and fuzzy and if everybody is making you secrete Dopamine and Oxytocin and Serotonin, and they stay there a long time, that’s it! Because you sell the invisible and when Zach looks at me and says, "dude, you have four cavities, give me $1,000.00" I'm a deer looking at headlights because I know every time the engine light comes on, if I take it to the oil change guy, he just says I need my oil changed. If I take it to Lexus they always tell me I need $1,000.00 for all this stuff, and you’re scheduled maintenance for this and that and you’re just standing there. Who do you believe? Who do you trust? I mean, even when my air-conditioner goes out in Phoenix when it's one hundred and eighteen degrees, I'll usually wait two or three days because there's only one guy that I trust. I mean he's like seventy years old and he's the only guy. I don’t care if I have to buy a new air-conditioner, I just don’t want to buy one for your commissioned pay cheque. I only want to buy one if I really need to buy one.

Dr. Z: Yeah, that makes sense. I just try to talk as little as dentistry with my patients. The more you talk, I feel, the more you convince them not to do

treatment sometimes.

Howard: Yep.

Dr. Z: Switching gears here, I’m a big Yelper, I’m looking at your Yelp page here. I know you’re not a big fan of Yelp so what's going on? What's your feelings on Yelp. My wife and I haven’t eaten at a restaurant that we haven’t Yelped in the last five years.

Howard: Yeah, that’s a Millennial deal. I’ve never seen one of my dentist friends, I’ve never seen anybody use Yelp. You’re the first dentist that held up Yelp and showed me Yelp. It's a Millennial thing.

Dr. Z: Yeah, I’m a big Yelper. I used to be Yelperee, I’ve written fifty six

reviews but I haven’t written one in over a year.

Howard: So, what do you Yelp for? Mostly restaurants?

Dr. Z: Pretty much anything and everything but, yeah, mostly restaurants. Like I said, we haven’t eaten at a restaurant in probably four or five years that we didn’t Yelp and at least look at the pictures, see what the best thing is on the menu. But yeah, I’ll Yelp an optometrist I went to a few weeks ago for an eye

exam. I Yelped, pretty much Yelped anything. Furniture, I mean, we bought some chairs a few weeks ago, we wanted to get them reupholstered, I looked it up on Yelp.

Howard: Well, talk more about Yelp because when you go onto Dentaltown and you do a search for Yelp. Every thread on Yelp on Dentaltown, it's not very warm and fuzzy. Wouldn’t you agree with that assessment or not?

Dr. Z: Yeah, I would agree but I think those people bitching about Yelp probably bitch about everything, so it's more probably their personality.

Howard: So, you would recommend that everybody old and young start adopting Yelp? Are you going to advertise on Yelp? Are you going to give them money?

Dr. Z: I don’t really know the logistics of that. I’ve never used Yelp from a business owner side but I think I’ll get enough review just through asking my patients that even if they filter out half of them, I should still have enough where hopefully I don’t have to pay them but, yeah, if I have pay them for them to show my good reviews then it’s probably a good ROI then I'll do it. It's not a big deal.

Howard: Maybe I'll do that. Maybe they can convince me. Maybe I’ll download Yelp someday. By the way, I just switched to the iPhone 7 from iPhone 6, but I only did it because I dropped my phone and cracked the screen, so I thought I'd just upgrade to the new one.  

Dr. Z: The new camera is great. You should go on the portrait feature and go take some pictures of your grandkids. It's awesome.

Howard: I haven’t noticed one changing feature with it yet but you say they're in there?

Dr. Z: The camera has a new feature with a portrait setting where it takes pretty good pictures but, yeah, besides that the iPhone pretty much seems to be the same phone every year.

Howard: Well, that was the fastest hour I've ever done it. So, we've hit three minutes over, we did an hour three. I could talk to you all day long. Good luck on your marriage, good luck on that little baby, good luck on that new practice, good luck on hiring your first employees. One more piece of advice on those employees. If she's adorable but her husband's in the army, he's going to be deployed every two or three years and they'll be gone. Another red flag with women is single women move to different cities with all these dreams and as soon as they get pregnant, they move right back to wherever mom lives and so you hire this great assistant and her mom and dad are in Houston and she's there in Dallas. So, getting the best long-term staff you can get is to have people that were born in that zip code or that city.

Dr. Z: That's the goal. Alright, well, thanks for having me on, it was a fun talk here.

Howard: Oh, man, Zach, thanks for doing your show, thanks for putting up on Dentaltown and thank you for all that you’re doing to help everyone’s journey in dentistry.

Dr. Z: Alright, have a nice day. Talk to you soon.


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