Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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845 A Holistic Approach to Patient Care with Dr. Rachel Hall : Dentistry Uncensored with Howard Farran

845 A Holistic Approach to Patient Care with Dr. Rachel Hall : Dentistry Uncensored with Howard Farran

9/18/2017 3:02:41 PM   |   Comments: 0   |   Views: 254

845 A Holistic Approach to Patient Care with Dr. Rachel Hall : Dentistry Uncensored with Howard Farran

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845 A Holistic Approach to Patient Care with Dr. Rachel Hall : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #845 - Rachel Hall

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AUDIO - DUwHF #845 - Rachel Hall

Rachel Hall graduated form Leeds University in 1992 and worked as a NHS dentist in the UK for 8 years where she honed her skills to be very time efficient and productive. Suffering from boredom, burnout and the cold weather Rachel moved to Australia in 2000 and in 2005 opened her own holistic dental office called Evolve Dental Healing. Rachel provides safe amalgam removal, mercury free dentistry and has a special interest in dental sleep medicine – TMJ and sleep apnoea. Rachel is also a practitioner of Universal Medicine Therapies and likes to mediate and take care of her health and wellbeing. During her time in business Rachel has developed her skills as a dentist and a businesswoman and invested in coaches to support her growth and success. Now at age 48 Rachel has decided it is time to give back by becoming a business and life coach for dentists establishing Ascendancy Business Coaching for Dentists where she teaches dentists the processes and skills to master the ABCs of business for the dental office. Her coaching services, systems and insights into what it takes to make you and your dental office a success so you can live the life you want are highly sought after.

Rachel has won the Protrade Business Innovation Award 2016 and was nominated for Business of the Year 2016. This year sees her being nominated for The Outstanding Workplace and The Business of the year 2017 awards – which will be announced after this recording.

Rachel is a social media fanatic and a passionate industry leader who is a respected writer, presenter and speaker on the subjects of holistic dentistry and natural health. She is also a mother, dog lover and author as well as a driller of teeth. Dr Rachel is a self-confessed nerd and loves technology and is big on healthy lifestyle and wellbeing.

She plays guitar, and likes singing and dancing – much to her families’ amusement. She is a joker, a wordsmith and an avid consumer of Vietnamese food. Loves warm sunny weather, walking, fast cars, trips to the beach, café culture and living in Brisbane.

Check out Dr. Hall’s YouTube channels:

The 8 Biggest Mistakes Dentists Make that Will Leave You Poor & Burntout:

Howard: It is just a huge honour to be sitting here in Sydney, Australia with a mentor and role model, an idol of mine, Rachel Hall.

Rachel: Lovely to meet you.

Howard: I've been a big fan of you on Twitter for years.

Rachel: Yes. We've had some nice chats, and backs and forwards.

Howard: Yeah, and I've retweeted a lot of your stuff.

Rachel: Thank you. I do appreciate it.

Howard: Yeah, big fan of yours. So Rachel Hall graduated from Leeds University in 1992 and works as a NAH Dentist, that's National Health Service in England, right, in the UK for eight years where she honed her skills to be very time efficient and productive. Suffering from boredom, burnout in the cold weather, Rachel moved to Australia in 2000 and in 2005, opened her own holistic Dental office called Evolve Dental Healing. Rachel provides safe amalgam removal, mercury-free Dentistry and as a special interest in Dental sleep medicine, TMJ, and sleep apnoea. Rachel is also a practitioner of universal medicine therapies and likes to meditate and take care of her health and well-being. During her time in business, Rachel has developed her skills as a Dentist and a businesswoman and invested in coaches to support her growth and success. Now at age forty-eight, Rachel has decided it's time to give back by becoming a business and life coach for Dentists establishing Ascendancy Business Coaching for Dentists where she teaches Dentists the processes and skills, the masters, the ABC’s of business for Dental office. Her coaching services, systems, and insights into what it takes to make you and your Dental office a success so you can live the life you want or highly sought-after. Rachel has won the Pro-Trade Business Innovation Award 2016 and was nominated for Business of the Year 2016. This year sees her being nominated for the Outstanding Workplace and the Business of the Year 2017 awards which will be announced after this recording. Rachel is a social media fanatic and a passionate industry leader who is a respected writer, presenter, and speaker on the subjects of holistic Dentistry and Natural Health. She is also a mother, dog lover, and author as well as a Driller Teeth. Dr. Rachel is a self-confessed nerd and loves technology and is big on healthy lifestyle and well-being. The reason I wanted to get you on the show so fast is because in America, when you talk to Dentists, if you say holistic, they're just like, “Oh, my god. Quackery, no”. It’s crazy but then when you watch the Dentists, they're all holistic, like if you talk to your Dentist and his Doctor says, “Okay, I need to put you on a statin and I need to put you on some high blood pressure medication”. The Dentist won't do it. He'll say, “Okay,” and that's enough. I need to lose some weight, start exercising, join a gym. I look at Dentists, they always talk about how they feel sorry for their patients because they're on five, six, they call it polyfarma. They're on five different medications. So the Dentists are extremely holistic in nature yet they think that term is bad.

Rachel: Except when we’re out there but for me it's about taking Oral Systemic Health to a next level. So we all understand that if someone's got gum disease, that's going to increase risk for heart attacks, strokes, diabetes, cancers. There was even stuff in the press this week that if you're a menopausal woman you're much more likely to get several different types of cancer if you've got untreated gum disease. So we know that we're doing that but we've got to go beyond brush, floss, donate sugar. I've got to help our patients to make those lifestyle changes and to make sure that they understand that they've got a really big role and responsibility to play in their own health and well-being. I think we as Dentists have a great opportunity when we're looking inside somebody's mouth to pick up signs of inflammation and systemic disease.

Howard: Yeah, is definitely the future, isn't it?

Rachel: Yeah.

Howard: Yeah, and it seems to be that thirty years ago this technology would come out slow, like maybe every five years but now it just seems like there's just research coming out faster every day.

Rachel: Every day you open up, the thing with Google is you can do a search and there's just papers after papers after papers on this. I think as Dentists, if we're not keeping on top of that then we're doing a disservice to our patients.

Howard: Now I would think, especially in America and Australia. Australia is a very conservative country.

Rachel: It is, yes.

Howard: It reminds me a lot of the United States and the conservative. What percent of Dentists in Australia put on their website that they’re holistic?

Rachel: Oh, it's tiny.

Howard: Yeah.

Rachel: It's got to be probably not even one percent. Look, I work in Brisbane. There are six holistic Dentists in that whole city.

Howard: Do you see it as a marketing advantage?

Rachel: Oh, it's a huge marketing advantage for us because times are tough since the GFC.

Howard: What’s a GFC?

Rachel: The Global Financial Crisis.

Howard: Okay.

Rachel: Dentists are struggling –

Howard: I’ve never heard it called GFC. That’s 2008?

Rachel: Yeah. Australians will abbreviate everything given a chance.

Howard: So that was a gift from America.

Rachel: Yeah.

Howard: Did you send us a great thank you card?

Rachel: Yeah, we did. We did. We've got an oversupply of Dentists. New graduates are finding it hard to get work. We've got a lot of overseas Dentists coming in to get qualified here in this country. So having a niche allows you to target a market, as you know, but most Dental practices would find their patients will only travel about ten miles at the maximum to come and get treatment done. I get patients come from all over Australia and overseas for treatment because of the holistic work that we do, because people have a philosophy about their life where they want to live well, they want to take charge of what they're eating, products they're using, they’re organic, healthy living, clean eating, etc. They want their Dentists to have the same approach.

Howard: Yeah, and there's other approaches. I know a Dentist in San Francisco that just took his office off the grid and he advertised that he's an eco-friendly Dental office off the grid. He has people coming from the other side of San Francisco one hour just to come to his office because they want to reward somebody who shows their same values of not leaving a carbon footprint.

Rachel: That’s right. I think that there are many opportunities for us to tap into that, and as Dentists, we've got to be savvy, we've got to differentiate ourselves and we've got to position ourselves in a way that if there's twenty Dentists in your suburb, someone's going to look online who’re they going to pick. If you've all got similar reviews, who’re they going to pick? They're just going to go to random people. Call the phone. If your receptionist is nice, they’re probably book with you, but if you've got something that speaks to them and says, I understand you as a human being, they're in. They trust you and they want what you offer even before you've said hello and examine them.

Howard: The research is clear that the consumer has no idea what all the alphabet soup buying your name means.

Rachel: No.

Howard: They could be A, B, C, D, E, F, G, H, I, J, K, L, M, N, O, P. They don't know what any of that means.

Rachel: They don't care either. As far as they're concerned, you're a Dentist. You drill teeth. There are things like how much is it going to cost me? Are you going to hurt me and are you going to be nice to me?

Howard: Yeah. So holistic and environmental are huge. I know your city is wrestling with building the largest coal mine in the world.

Rachel: Yeah.

Howard: The environmental people were like, “No, that's not the way to go”. They’ll build the biggest solar farm in the world. So what do you already think of it? Do you think the coal mine will win or –

Rachel: I think the coal mine will win unfortunately, because it's going to generate more jobs, more resources, and structure.

Howard: So explain. You're talking to Dentists from Kansas to Kathmandu. What does it mean to you when you say you're a holistic Dentist? What does that actually mean?

Rachel: Well, it's a way of looking at a patient as a whole being and not just a tooth. So if I'm seeing someone who's got gum disease or tooth decay, gross wear on their teeth, they’re constantly fracturing fillings. I want to know why. I want to get to the underneath cause of that. So have they got some health condition? Is their diet really poor, are they not sleeping well, have they got a sleep breathing disorder? What are their stress levels like? What's their health like? Have they been exposed to toxins and is this something that we can do as a Dentist to then support them either to get healthier or to prevent them from getting worse.

Howard: You've got two websites. One is, your Dental office is

Rachel: Yes.

Howard: Then you started your Ascendancy Business Coaching at

Rachel: Yep.

Howard: So if my homies went to, what would they find there?

Rachel: Well, at the moment they'd find quite a small website that's starting to grow but it's about my journey as a Dentist. This is my twenty-fifth year. The first eight years I just was thrown in at the deep end, get on with it. You might keep –

Howard: That was in England?

Rachel: Yeah. You might get mistakes and you learn that then I moved over to so Australia and I work for a really lovely practice but they had no business acumen. I’m like, “Gee. This is how you run an office” and I don't want to bar it but they got divorced so I opened my own place. The first five years of being in business I was making it up as I went along. So I was learning the school of  hard knocks, heartache, headache, and picking yourself back up and going again. Then I realized that my answer, I mean, when I was raised with how it was, if you want to do well you got to work hard. So my mindset was I just got to work harder, I've got to work harder, I've got to work harder and eventually I'll be successful. I might be able to take some time off, spend time with my family but obviously that was just wearing me out. I was burning out and I thought, “No, this has got to change”. So I employed a business coach. We systemize the whole practice. We looked at finances, marketing, HR, all the avenues that you need to have and I took the business quite a long way with that. Then I went, “You know what? I need more. There's more potential here”. So I got a business consultant in Dentistry who was a Dentist himself and he then helped me hone systems and protocols and things within the practice, so that we could offset some of my workload and actually double my income, and that was five years ago. I thought, “Well, if I knew ten or fifteen years ago what I know now, I would have paid millions of dollars for that information because that's what it's been worth for, to me”. So part of me wants to help other Dentists not make all the mistakes I made. Fast-track their business so that they can actually make some money and not get to the end of the month and they're constantly living off their overdraft, and also to help them manage stress, anxiety, and all the things that come with Dentistry. It's a hard profession. It can be quite lonely and so I want to be someone who can be there in their corner for them.

Howard: Yeah. I don't think they figured it out yet but I remember when I was working in my dad's restaurant. Well, everybody's happy when they come into the restaurant. They're going to eat food.

Rachel: Yeah. They’re there for a good time.

Howard: But when you're in Dentistry, where you're really close to someone, you're touching them, doing surgery and they’re stressed and they’re grabbing the chair.

Rachel: All that's coming off them, that vibe.

Howard: And it affects you.

Rachel: It does. It affects you when - I mean, I don't know how many times I've heard this but a new patient, someone who doesn't know me will walk into the room. First thing they say to me is, I hate you. Oh, gee, that hurts, but we have to laugh it off and pretend it's okay but can you imagine if you were a young child and every day you got up and your parents said to you, I hate you, what that does to your psyche?

Howard: That's why Ryan's dead inside.

Rachel: Yeah, exactly. I’d heard that story. I’m going to have to watch it. We're human beings but because we're behind the Dental chair, that gets forgotten and then our team don't get what we go through. We're having to manage them, they're like having another family, have to deal with all their issues and ups and downs and personalities. At the end of the day there's no one for you to turn around to and offload and get some support. You go home to your partner and they kind of get what you go through but they're like, “Yeah, yeah, yeah. You told me that yesterday”. So you tend to just keep those things to yourself and to me that's really unhealthy.

Howard: When we were in school they told us that ninety percent of all TMJ, TMD patients were women. So a lot of the researchers started looking at it. Is that estrogen? Is that this or that? Then it took him twenty-five years epidemiology to figure out that men and women have the same incidents, it’s just that women will go get help.

Rachel: Yes.

Howard: Now it seems like, any consultant I talked to in America they say that as far as millennials, the women Dentists are the first ones to raise their hand and get a business consultant, and for something about the guys, I remember my mom and dad –

Rachel: Well, you want to stop and ask for directions, come on.

Howard: I know. They won't ask for directions. It's big ego.

Rachel: Yeah.

Howard: They're a Doctor, they’re the smartest one in the room so how the hell could someone else know more than me when I know everything on earth? It's sad because I see so many miserable male Dentists and they keep trying to solve their problems with technology. Chairside milling –

Rachel: They buy more stuff, they get more CE and they think that's the answer.

Howard: Is it the answer?

Rachel: It's not. All you're doing is you're buying bright, shiny things that are increasing your loans. You've got to work smart. We weren't taught business. I don't know about in America, I bet you don’t -

Howard: No.

Rachel: No. We got nothing. We weren’t even taught how to speak to someone and explain a treatment plan in plain simple language. So you've got them telling you, you hate them. You know, I hate you. I hate coming to Dentist. All that anxiety, then you're presenting treatment and you're getting rejected over and over. That for a man is terrible. I know it for men. Women it's about self-worth so you've got to feel valued, and I think men fear rejection more than women. So every time your patient says no, that's another knock on your psyche. So you go, “I'm going to get better educated. I'm going to get more letters after my name. I'm going to get more fancy equipment. That's going to make me a better Dentist, it's going to make me more than the money.” No, it doesn't. You've got to be able to communicate. You've got to be able to understand marketing. You've got to be able to understand finances and how to get your team behind you so that you can leverage them so they're doing more work for you so you can then be a better Dentist.

Howard: Well, if you lined up a hundred Dentists and you said, what keeps you up at night the most? What puts that pit in your stomach? What makes you not want to go to work? Ninety-nine times out of a hundred it’s the staff.

Rachel: Yeah.

Howard: When you ask the consultants in America when you go into an office, what usually is the number one problem? They said, “Well, it's always staff”. Why is that so hard for –

Rachel: I don't know but I was just going to make a comment on that is that the Dentist moans about the staff and the staff moan about the Dentist. So there's a common denominator going on here that there's this sort of isolation of the boss against the team. I think what's going on there is that, I don't know. For me, I was never like a team player. I liked individual sport. I like to be doing things on my own. I like to be in charge. I like to lead and like to do things my way. So then asking for help and support is quite difficult but when we were at Dental school, we didn't have an assistant helping you at the clinic with suctioning yourself or getting your patients to doing it. So you used to try to do it all on your own. So there's two things I see there. Ego, where it's nobody can do it better than I can which is bullshit, pardon my language. We have to let go of that and trust that we've got strengths and weaknesses. The other is a trust issue. We don't trust people. We think they're going to let us down. They've let us down before, they're going to make mistakes then I've got to pick it all up. So there’s those two things going on mentally. There's also a time issue. I want to be sat when I'm at work. I want to be with patients drilling teeth, making money. If I've got to stop and train my team two or three hours every week, I'm not making an income and why should I bother because they're going to leave anyway? They're going to let me down. If we don't train our people to do what we want to do then we're expecting them to be mind-readers. Could you imagine McDonald's with no systems? Everyone knows if you work at McDonald's you've got to ask, “You want fries with that?” But in Dentistry, it's a free-for-all. The only person I, as a Dentist, can watch is my DA. My assistant who's sitting next to me while I'm working. I can listen to every word and watch every movement she does but I've got to trust that my ladies out on the front desk who are booking patients in and hopefully taking their money, answering the phone. I've got to trust that they're doing what I want but if I don't tell them what that is and what it looks like, train them and then check in with them. How do I know? So if I don't tell them I'm going to bitch and moan about them because they're not doing what I want. I'm going to be stressed that they're not doing what I want, but the team, they now upset because all they hear from me is me telling them off but they're like, “But we don't know what to do. You haven't shown us”. So we've got to invest in our team.

Howard: Yeah. Well, you go get a job at Subway and those sixteen-year-old kids, before the day one they got to get on the Subway site, take eight one-hour courses and answer the questions afterwards but are you training that kid to go work at your front office – yes, you can just show up and you throw it on his desk.

Rachel: You’re like, “There's the file”. There’s the appointment book, book them in.

Howard: Yeah.

Rachel: I don't know. Often what happens here and same in the UK is you'll have a Dental nurse who's a little bit more extroverted and she gets put on the phone, but she doesn't want to be on the phone. She wants to be sat helping you and working with patients, that's why she went into Dental nursing. So now you've got someone in a role that they don't like and they're not suited for. So you can spend tons of money on advertising. You may have a hundred new patients ringing every month which would be phenomenal but you're only converting ten calls because you've got the wrong person out on the desk or they haven't been given the skills.

Howard: Yeah. It's crazy, when I started coming down here in the nineties, the average Dentist and you said, “Well, what is your main problem?” They said, “Well, when someone has an emergency because I don't have any openings for two or three months”. So that was 1990. Now fast forward to 2017. You live in a thousand foreign Dentists, you doubled your number of Dental schools, you have corporate Dentistry, you have medical insurance, companies like BOOP buying Dental offices. It's massively competitive now.

Rachel: It’s hugely competitive and look, these days you are lucky if you're eighty percent full. If you've got an eighty percent full appointment book, you are doing really well. Time’s tough so we've now got to start thinking more like business people and going, “what are the opportunities available to us?” In the sixties, I think it was something like seventy-eight percent Dentistry was restorative work. Now it's only forty percent. People are keeping their teeth longer and they're keeping their teeth healthier, but those people are having all those fillings in the sixties are still alive. Those fillings are failing so we've got a whole aging population that are going to need to be spending money on Dentistry. One of the biggest mistakes I see with my Dental clients is they under prescribe treatment. They are scared of telling a new patient you have all these cracked teeth and broken-down fillings. So they'll tell them, “Oh, I'll patch - repair these” and I'll maybe offer one crown in the hope that they say yes. So not only are we struggling because there's more competition in the market but we're shooting ourselves in the feet because we've had so much rejection when we put a big case forward. That we’re no longer even willing to say honestly to a patient, “Hey, you've had a lot of Dentistry done. You take the heavily filled starting to fail. We need to make a proper plan so that when you're seventy, you're not spending $50,000 on getting your teeth fixed.”

Howard: What percent of Australians in their lifetime do you think will buy a new car?

Rachel: Oh, eighty percent.

Howard: Yeah.

Rachel: Easily.

Howard: Same as America and the average price of a new selling car in America is thirty grand. Eighty percent of Americans in their lifetime will buy one or two or three of these new Honda Accords or Torch, whatever. Yet only five percent of Dentists have ever even sold one treatment plan one time for the price of an average new car of 30,000. What's amazing is you go into a medical Dental building. It would be like eight Dentists in there and seven Dentists are doing one tooth Dentistry and then this guy over here does a full mouth once or twice a month.

Rachel: Yeah.

Howard: So there is a lot of self-limiting beliefs.

Rachel: Absolutely, yep. I will say if I was a heart specialist and you came into me and your arteries are seventy percent blocked, am I going to not tell you? Am I going to just go, “Oh, I better not tell Howard he's got some problems with his heart because he's not going to like me, and he's going to go somewhere else and he's going to tell his friends that I'm a really horrible consultant, and it's going to damage my business”. So I’ll tell you what, “I'll be really nice to Howard and I'll tell him everything's fine but I was just going to watch a couple of things for him”. No. I got a duty of care to say to you, “Howard. I'm really bloody concerned here. Your arteries are blocking and I'm thinking you’re going to die soon if we don't do something”. So why is it in a subdivision of medicine called Dentistry that we're not upfront with our patients? Why are we always waiting for them to have an accident and an emergency situation before we're willing to do any treatment? We should be being proactive and preventing problems. I would rather someone go out of my office and not like me because I've told him the truth than halfway through our relationship I suddenly drop on them that they now need six crowns when I told them six months ago everything was fine. Where's the trust factor in this?

Howard: So what is your program like? If they went to Ascendancy, A-S-C-E-N-D-A-N-C-Y., what do you do? Do you go to the office, do you do it online?

Rachel: So we work one-on-one, we do calls through the month so we usually have two calls each month where we'll talk about what the challenges are, what that the goals are, what we're aiming towards. I would also do some training within that with that Dentist so if they're struggling on case presenting or treatment planning then we’ll help with that. As the program goes on I'll give them some marketing materials, I'll give them some worksheets to do so we can look at their mindset and their beliefs, and then they can do a VIP day with me so if they're here in Australia they can either come visit my practice and see how we work, and have those things that we talk about actually run through the day because my team does so much for me. That basically my day is saying, “Hey, how are you? This is what we're doing, blah, blah, blah, drill away. We're all finished”. That's my role. The team take care of pretty much everything else, most of the day-to-day running. I want to teach them just to do that. So if they're not in this country we can do like a half day VIP intensive training via Skype and so that can be on social media or whatever it is they want to do, and they have that four or five hours just picking my brains and all we can show them behind the scenes in the practice. So we've got a few programs and we like to be flexible because I think it needs to be a custom-made process. Not everybody's facing the same challenge or has the same sort of personality and belief systems that need to be overcome.

Howard: So how has your success been with the Dentistry?

Rachel: It's been really good. Look, it’s in its infancy so it's growing. The Dentists I've been working with have grown in self-esteem and confidence. They're seeing increased productivity, better case acceptance, and in one of the businesses they had five team players. Three left, two really stepped up and have started commanding the practice and really helping the Dentist and they've got three new girls in who have got great attitudes. He's starting a training program with them so every time he trains them, they video it, so this was off my advice, this is what we do on it now. Practice is every time we train, we videoed it or audio recorded it. So they've now got a library like we have where when you onboard a new team player, just like Subway, they can go online and they can watch those videos and take what's there.

Howard: What percent of the Dentists when you start working with them have a staff member that needs to go?

Rachel: All of them.

Howard: Yeah.

Rachel: They probably have more than one staff member that needs to go. There's things that I see there is that either the Dentist is very blinkered, and they don't realize they've got a cancerous team member or a toxic team member, or they know they have but they're so scared of firing them because that person knows how to do everything in their business and if they leave nothing's written down. Nobody knows how to do it so they're absolutely pooping their pants that if that person goes their business is going to collapse.

Howard: Yeah. I mean, I always think it's amazing. Sometimes I'll be at a seminar and you’re just talking to like a Dental assistant at the break, everything. I say, “Which one’s your Doctor?” She said, “That guy over there” and I'll say, “So how do you like working for that guy?” and she's like – It’s like, wow. You don't even know me and you just rolled your eyes at that Dentist there. I mean, how does that work when the Dentist leaves a room and the patient turns you and asks, I mean, it’s just like, okay, I don't even know that Doctor and I've already determined in one half of a millisecond that he's got a toxic, cancerous, Dental assistant. How do I know that? I can't even pick the doc out of a police line-up. How do they miss that?

Rachel: I think there's two things there. One, they don't want to see because it's hard hiring staff and onboarding them and getting them there. The other is that people can be very manipulative so they can tell you all the right things to your face and they can put on the happy smile and they can look like they're performing the role, but behind the scenes or in their head they’re thinking that guy's an idiot.

Howard: So when my dad tells me that I look like Brad Pitt, it might not be true. It might be.

Rachel: Yeah.

Howard: So how do you fix the funnel into the leaking bucket? So when I do the research on the funnel, ten people have to land on your website before it converts one to call.

Rachel: Yeah.

Howard: Three people have to call your front desk lady before she gets one to come in. Three people have to come in with just a cavity before one gets drill, fill, and bill. The average American is collecting seven fifty in revenue and taking home $180,000 a year and to do that $180,000 a year for that one filling, three had to come in. For three to come in, nine have to call. For nine to call, ninety had to leave on the website. See this whole funnel and then would you have this practice, it's a leaky bucket because by the time the average American gets to five thousand charts, four thousand have never came back.

Rachel: Yeah, it's true.

Howard: If you just fix any of that funnel and unplug any of those leaks, you double your practice.

Rachel: Absolutely, correct, and it’s which part of that funnel you should focus on. So is it customer service and making sure you're giving a wow experience, and that they're coming back because you care about them as a human being and you're doing something that's a bit out of the ordinary to another Dental practice? Is it being out there more with your marketing and trying to break the mould a little bit? I mean, we were talking about this before we started the show was that we have so much technology now at our fingertips that we can become our own movie stars. We can get YouTube channels. We can be on Facebook and Twitter. We can be out there and now with Facebook and Facebook live, and the way they're promoting that and getting that out to millions of people, you've got such an opportunity. What happens is it's something like seven to fourteen touch points before someone will buy with you, is what they reckon in psychology. So if you can be out there on a live video just showing who you are and a bit of your culture, showing that you're a human being and that there's something about you to that person because I like them. That is half the battle. When they do pick up the phone they already want to come in but you've got to have that front desk person trained so that they're saying the right things and they're giving them the same experience that they got watching you on social media, but then once you get them into practice you've got to match up to their expectation. So you can't come across on social media as being, “Oh, I'm awesome and I'm funny and I'm this and I'm that” if that's not who you are at work. You've got to be authentic and genuine. There are so many marketing agencies out there at the moment. They're going to promise you, “Oh, we can do Google AdWords. We can get your front page on Google, blah, blah, blah”. Yeah anyone can do that, it's just mixing algorithms and what-have-you. I think the key is you've got to give great customer service and then you've got to ask for reviews. Now here in Australia, we've got one arm tied behind our back with that. It is not legal for us to ask directly for a review like I could not email you and say, “Hey, Howard. We had a great appointment. Could you just go on Google and tell everyone how awesome we are?” Not allowed to do that. We're also not allowed to have testimonials on our web pages.

Howard: Really?

Rachel: Yep.

Howard: No patient testimonials?

Rachel: No, no patient testimonials because our legal governing body says that that's kind of trying to make out the one Dentist is better than the other and I'm like, “Come on. Let's get real. Dentists are better than each other. I am an average Dentist and I will be very honest about that, but I'm not average in the way I treat people, in the way I communicate with them, the way I want to know them, the way I care for them, the way I make them feel. So when they leave us they've had a great experience and they've had good Dentistry. It's not bad Dentistry but I wouldn't put myself up there with, oh, look at my awesome grand margins, even I do good Dentistry, but they don't care about that. They care about how you made them feel, so if you can get good, genuine reviews, that's going to make a big difference to your funnel. Now we're lucky both here in America, we've got options where we've got third parties that we can utilize to obtain those reviews, review processes for us. If I go online and I'm looking at a hotel, for example, I'm going to look where it is because that's my first thing. I need to know is it convenient for me to get to and is it going to be near all the attractions. The next thing I look at is the reviews. If it's got poor reviews or no reviews I don't trust them, I'm not going there. So if there's 20 Dentists in your area and you've got no reviews, they're not even going to look at you. They're not going to pick up the phone. The other thing that you talked about is that you've got to have a website. How many Dentists don't have a website?

Howard: Oh, yeah.

Rachel: You do not exist in this day and age if you don't have a website or social media presence. Your DNA does not count for anything. You have to be online. You've got to have a website. It's got to be user-friendly so that you can use it both on a laptop or on a MicroBot. It doesn't take much to get that set up, and then don't be vanilla. Don't say the same things everybody else does. Don't be all me, me, me. I'm this and I'm that and I've got this degree and I've been on this CE. Boring. What's in it for the patient? How can you help them? That's what I want to know if I'm reading your website. What can you do for me? I'm scared or anxious or whatever. Are you gentle, kind, caring? Everyone says they do that but there has to be something within us that, yes, we're all Dentists but we're all people, so we have a different personality and that needs to come through on the website. So if you don't have a website, you've got to get one.

Howard: Yeah, I love your website.

Rachel: Thank you.

Howard: And I also like, there's a lot of noise in the industry. I’ve always said being a Dentist for thirty years. If I told you you needed Dental work done, half of you are afraid of the pain, the shot, the drilling, can you knock me out, give me laughing gas. They don't have be afraid of the cost.

Rachel: Exactly.

Howard: The industry makes them think that what consumers want the most is same-day Dentistry. Do you hear that all the time?

Rachel: Well, I hear it all the time and look –

Howard: Do you think it’s true?

Rachel: I don’t think it is true.

Howard: On your website the first thing you talk about, are you afraid of the Dentist?

Rachel: Yeah.

Howard: Not, are you looking for same day Dentistry?

Rachel: Yeah.

Boo! Did I scare you? Why? Because I’m a Dentist. Hi, I’m Dr. Rachel Hall of Evolve Dental Healing.

Rachel: My hair's longer there.

Howard: I love that.

Rachel: Thank you, but straight away that's the point in difference. You're not expecting that and we didn't do it with a corny, “Oh, if we market it this way”, I'm like, we had the opportunity to do a video and I’m like, “How can we have a bit of fun with this? How can I get across who I am?” The scare mask, the scream mask and that that sort of was like a bit of an off-the-cuff.

Howard: That was awesome.

Rachel: Bit of a joke and I went, “You know what, we should run with that.”

Howard: How many people are afraid of the Dentistry versus what percent want the same day chair side milling?

Rachel: Look, they don't. They don’t want.

Howard: Well, what would you say? It's a hundred to one?

Rachel: Easily, and if someone's actually anxious, most of times they don't want it done there and then. They want to build a relationship with you, they want to see what you're like, they want to see how you speak to them, how you relate to them, do you understand their fear? Then when you're examining them, are you gentle? Are you considerate of them? Are you explaining what you're doing and what's about to happen and what they're going to expect? If you can do that in your new patient exam then they know when they come for the next appointment that that foundation has been set. I think for a lot of scared patients they need time to get their mind around what's going to happen and to psych themselves up for it. Look, there's going to be a small percentage that will be, look, I’m here now. It’s took me all this effort to get here, can we just get on with it? But that is a very small percentage.

Howard: So, Rachel, in America, I don't know how it is in Sydney but in America ninety-one percent of all health care appointments are made by women.

Rachel: Yes. Same in this country.

Howard: Whether it’s a hospital or an office. If a woman is at home and her air conditioner breaks down and she calls the AC repair man, he says, “You know, Rachel. I can't fix this, you need a whole new air conditioner”. A hundred percent of American women would be thinking, “I wonder if you’re just trying to sell me a new air conditioner”. I wonder if, my Uncle Eddie was an AC repairman, he'd fix it with duct tape and a shot of Freon. They get a coupon, take this and go get your oil changed for $20 and every time the man comes out, says, “Well, I think we should also change your transmission fluid and air,” and the women never believe it.

Rachel: Yeah.

Howard: So, then I come into your office and I have no problems. I want to get my teeth cleaned and you tell me I need four cavities and they're two fifty each. Every woman in America is thinking, “Oh, $1,000 I don't have any problems, I just want to get my teeth cleaned”. The only question I had is maybe, believe me, how do you sell the invisible? How do you project trust?

Rachel: Yeah.

Howard: To where I really believe you that I have four cavities and you're not trying to get $1,000 out of my wallet.

Rachel: That's a great thing because trust is not something you can magic out of thin air. It's the way you are with people, it's your body language, it's your communication, the words that you use. However, when I first started Dentistry, we didn't have intra-oral cameras. We had wet x-ray films, tiny little things that you're trying to hold up in front of the patient on a monitor and go, “You see that? That's a hole”. We have far, far greater opportunities now. We can photograph a tooth. We can get a digital x-ray, we can blow it up really big. So we can show them physically before their very eyes that there's something going on, so that's a really big help. The other is helping them understand that Dental disease is a chronic disease process. So like a heart attack, you don't know you're going to have one until you either drop dead with it or it's picked up in a screening, and that's why we do Dental checks, so we can pick things up. So I can say to him is, I think if you've got any elements of desperation, like I need to get this appointment booked, I have to have that money coming in. People smell that and they smell that fear factor as well and that's what they start to go, “Hang on. Something doesn't feel right”. I'm a bit nonchalant. I don't care whether they get the treatment done or not, it's their mouth. So I'll say to them, “You've got four areas of decay. We can treat that now while i’ts small and it's easy to deal with or if you want, you can leave it. It's going to get bigger. It's going to get close to your nerve and you're probably going to end up needing root canal and a crown and it's going to cost you $6,000 instead of 250. What would you like me to do?” I'll put it back on them and I make them take responsibility and ownership because they're the ones who are looking after their mouth or not, and they're the one who's going to make the decision. I think the fact that they can sense that, I don't care, either way whether they have their Dental work done with me or not somehow kind of flips the psychology where they're like, “Oh, it's my decision”. That for us change their case acceptance dramatically whereas when I was trying to be, “You have to have this done. You need to have some fillings. Oh, my gosh. You've got decay. We've got to get you booked in.” There was no “what’s in it for them”? They felt railroaded but I didn’t know any other way, Howard, because no one’s taught you. You just basically, I mean, this is terrible. When you used to do their exam, you'd be telling them why you've got your fingers in their mouth. Or you've got a hole here, you need to come back for a filling. None of this, stop and sit them up and have a conversation and show them and talk to them and ask them what their thoughts are, but I think if you engage them and ask them, “what do you think? Does that make sense? What do you want to do? Are you wanting to keep that tooth? Are you willing to risk that it's going to get worse?” I let them answer. I think that makes a big difference on the trust level.

Howard: I always tell the Dentists in Dental school, I said, if I can wave a magic wand and give you one gift in Dentistry, it'd be that you had a superior chairside manner. It’s more important than anything else.

Rachel: Anything, anything. Biggest mistakes, they take too long so they speak for twenty - thirty minutes. Sleep, checked out, disinterested, confused. They give them too many choices. “Oh, you can have this, this, this, this, this, this, this. Which one do you want?” Excuse me, who's got the degree? Who's the one looking in the mouth and having an understanding of what's going on and actually what's needed? Too many choices confuses them. You think you're being fair but you're actually making it hard for them and they're sitting there going, “Well, you're the one in the white coat, you tell me”. So that is a bit odd and the other thing that I see, and it is a huge mistake, is teaching Dentistry 101. So I say, you need a root canal. Well, what we're going to do is we're going to drill an access hole. We'll have a rubber dam. We’re going to have it on a slate. I'm going to use these little Reimers. I'm going to have them in this machine. I've got an apex locator. I've got a dip right it all. I've got to disinfect it then I got, blah, blah, and they're like, what? They just want to know how much is it going to cost. How long is it going to take and is it going to hurt me. So if we can keep it simple, that goes a long, long way but you've also got to then allow that person to have a discussion. Answer questions for them. Make them feel heard and understood. We go back to cars. If I'm in the car showroom, you've also got to get behind what their motivation is, what I call their reason to return. So if I'm going to buy a car and the dude in there goes, “Oh, well. She's a mother. I'm going to talk about safety features”. I ain’t buying that car, Howard. I don't give a damn about safety features. You know what I want to know? How fast does that car go. If that's what they work out I want and they'll say to me are, it's nought to sixty.  In this amount of seconds, it’s blah, blah. Let's get in the car. Let's take it for a test drive and if it's as fast as that, I'm buying it. So we've got to also get in their mind, why are you here? What's important to you? What’s your motivation? I just want it cleaned. Okay. I can see that you do need a clean but you want me to tell you that there's actually some other things going on here. Or do you want me to just ignore that you've got Dental disease. So you start having a dialogue.

Howard: You mention something, you said you're asking a patient what they wanna do and you said, you’re the one in the white coat. On Dentaltown, a lot of people, especially when they get out of school, they're like, the guys are saying. What is more trusting in authority? Should I wear a three-piece suit and a white lab coat over it or can I just wear scrubs? A lot of the girls are saying, should I walk in there in a dress and high heels, or the white lab coat, or can I wear scrubs? It seems to be a big question.

Rachel: Yeah.

Howard: The infection control is scrubs and tennis shoes but do you need to be in a dress and a tie, and a suit and tie?

Rachel: I think it depends on your practice. Scrubs to me look scruffy. They also don't convey an air of professionalism. If a whole team wears scrubs and the Doctor is wearing scrubs, too, who's the Doctor here? We have a very corporate image in our practice. We want to be high end. We want to look smart.  So our team, we want you to look like their hostesses. We want you to be very well turned out. We want you to look really smart and I think for me as the Dentist, that's important, too. So, I wear a nice tailored blouse and dress pants. Black shoes. I don't like heels because I just can't walk or do Dentistry in them but I think it comes down to what you're trying to market your brand as. What are you coming across as and to me, someone who looks like they've got a pair of pyjamas on, whilst that might work on the program like here. That for me doesn't cut it in a Dental office. If I'm trying to sell a $30,000, $40,000 treatment plan, I do not want to look like I'm wearing a pair of pyjamas. I want to look smart and as though I carry that air of authority ,so I would be recommending that it's a white jacket over the top of a nice dress suit.

Howard: And then another question is, who presents a $30,000 - $40,000 treatment?

Rachel: Very good question. I used to and my case conversion was appalling because as soon you got to the money conversation, I'd be going, oh, my god, this is so much money. I would be freaking out but also the patient sees it as when you tell him that figure, in their mind they think all that money is going in your pocket. They don't understand you've got overhead and wages and equipment and loans to pay forward. When you say thirty thousand to them, they go, well, that's their new car or their holidays or their kids’ private education. They’re not seeing it as a business. So I actually don't think as a Dentist it does ascend in benefit, so actually present the case. I think we should be presenting what's needed and, yes, we do to some degree need to touch upon money. So the way I handle that is I’ll say to them, you need twelve fillings. You got twelve areas of decay, you need twelve fillings, so if we ballpark that, a filling is $300, you're going to be there or thereabouts. They can then do a bit of the maths in their head themselves. They're smart enough. For me, I have a treatment coordinator and it's her role to present the cases and to actually break down, this is what the appointments are going to cost. This takes a step back because they don't see my front desk, my receptionist as having a vested interest in getting that $30,000 because it's not going in her pocket. She’s more on their side, so as that independent she can be talking to him about, oh, I had a filling done and da, da, da. I didn't get some work done. I ended up getting a root canal and now I've got a crown and I really regret it, and it takes that charge off it being a deal that we're trying to strike with them, so I personally think from trial and error and for what we've done in our practice is that it should be your treatment coordinator, but she's got to be trained and she's got to be sales oriented. So our treatment coordinator has a retail background, so she understands how to sell benefits and how to talk to people about money without her having any qualm with saying a figure. She will say exactly the same, whether it's $500 or $50,000.

Her demeanour does not change.

Howard: First of all, how many Dentists do you think are in Australia?

Rachel: That last reckoning, it was around twenty thousand I believe.

Howard: Twenty thousand? What percent of them have a hygienist doing all of these?

Rachel: Oh, not many.

Howard: Well, what percent would you guess?

Rachel: Well, I've worked in four practices over here and I only had one practice, I had a hygienist. When I had my own business, I didn't have one for eight years.

Howard: So what would your advice be? Do you think -

Rachel: Get one.

Howard: Get one.

Rachel: Seventy-eight to eight percent of Dental treatment now is preventive. So I worked it out with my Dental consultant when I was, didn't have a hygienist. What percentage of time I was spent cleaning teeth, and it added up to one week. One week every month that I was cleaning teeth. I’m like, “Okay, if I could free up one week of my book to do high production, what sort of revenue is that going to create for me?” Plus, my hygiene department are doing impressions for whitening, for night guards, they're doing preventive care, they’re doing periodontal gum therapy, and they're spending far more time with the patient than I could have ever done when I was trying to do it all myself. So that patient’s building a better relationship with the practice and they're getting proper treatment. They're not just getting a tickle over with an ultrasonic scaler. They're actually getting their disease treated which, going back full circle to oral systemic health and being holistic is the key to our business, we're all about. We do not want inflammation and bleeding in our patients mouths because that is setting them up for ill health.

Howard: Yeah, because bleeding gums, the surface area of the gums is the same size as your palms –

Rachel: Yes.

Howard: If someone was walking around with, their palm was just oozing and bleeding, they'd go to the Doctor.

Rachel: They sure would.

Howard: They walk around  with that in their mouth.

Rachel: Yeah, and they think it's normal to spit out blood.

Howard: I want to ask you some controversial questions.

Rachel: Yeah, go away. I knew you would. We’ve had our stash on Twitter occasionally, a bit of fun.

Howard: We know after AIDS –

Rachel: Yes.

Howard: That humans in a herd transmit diseases sexually and I think AIDS, burned that into every countries psyche –

Rachel: Yes.

Howard: But you still go into Dental offices and they've been treating grandma every three months for periodontal disease for ten years and they've never seen grandpa –

Rachel: Yep.

Howard: Then grandpa shows up with a broken tooth and he's got bombed out teeth, he’s got periodontal disease –

Rachel: Rampant.

Howard: Grandma kisses him every night, and they say a kiss transmits eighty million, the standard kiss, eighty million microorganisms, fungi, viruses, and parasites. A lot of Dentists say, “Well, I'm sorry, it's not like hepatitis or AIDS or HPV. It's not a communicable disease”.

Rachel: It is.

Howard: Do you buy that or not?

Rachel: I believe it is a communicable disease and that if you've got someone coming in and they're coming every three months for periodontal maintenance and they've still got active disease, they've got some systemic health issues and nutritional deficiencies that need addressing, or their partner needs to come in and get their mouth sorted out. We'll say to them, “Does your husband go and have regular hygiene treatments, have they got issues with their gums” and we’ll say to them, because every time you're intimate, he kisses you, he's reinfecting you. He's inoculating you with bacteria and that's why we can't get your condition under control.

Howard: Someone who said to me, lecture around the world. Which Dentists are the best around the world? I have to say it's a Lichtenstein and Austria. Those are the ones where they actually, the only two countries I've been to. Where they actually, if you come in pregnant they say, who is going to babysit? Who's going to be staying home?

Rachel: Who's going to be kissing this baby?

Howard: If it’s you and your husband and grandma’s going to sit and whatever. They want saliva tests on all them –

Rachel: Wow.

Howard: Then they will sit there and say, because they really believe in low notes. They say, okay, this baby is not going to be born with HPV, streptococcus mutans, P gingivalis, she's not going to be born with, just like she’s not going to be born pregnant with AIDS and gonorrhoea –

Rachel: Yeah.

Howard: And syphilis. She’s going to be a blank slate and they'll test them. They’ll get everybody’s mouth and condition and then they will coach the family of saying, we’re not going to kiss the baby on the mouth –

Rachel: Yeah.

Howard: You're not going to let –

Rachel: We’re not going to blow on their food and lick their spoon and lick their dummy.

Howard: Yeah, and you see, in family situations where your uncle Eddie is seventy and wears two partials and hasn’t had his teeth cleaned in twenty years, and he'll pick up the baby and kiss it right on the mouth, and they start coaching these things but what's interesting is they do testing for streptococcus mutans, and I've only heard Dentists say this in Austria, Liechtenstein will say, “Well, I have eighteen hundred and fifty patients, and six hundred of them are children under eighteen, and four hundred of those six hundred still do not test positive streptococcus mutans.”

Rachel: That's amazing.

Howard: I'm like, “Yeah. You need to go to America” and so then I looked at that the testing machine. I said, where's the machine? Williams Ava Claire. So I talked to Ava Claire. I said, “How come I haven’t heard of this machine?” He goes, “Because when we market that in America there was zero interest and the only interest about –”

Rachel: Yeah. Although their holistic practices want to do DNA pre-falling.

Howard: So my question is, when do you think earthlings will get religion about communicable disease in the mouth like they already do now with STDs?

Rachel: I think they are starting to understand it and the more that we can educate them, that if you've got Dental disease, it's shortening your lifespan. The more they're going to start getting that. Like I have a lady come in who's terrified and hadn't been to the Dentist in fifteen years, and her teeth were starting to move but that wasn't what concerned her. What concerned her who’s her friend had just had a heart attack. So she'd been researching about heart disease and she'd seen all the links about oral health and that is what got her to come and have her teeth sorted out.

Howard: Ryan, was the name of that the beating the heart attack gene?

Ryan: Yeah.

Howard: Have you seen beating the heart attack gene?

Rachel: No, I haven’t.

Howard: This guy is a cardiologist and I'm sitting here reading this book because I'm going to be fifty-five next month, and I don't know where chapters gum disease and that when you're doing these heart attack cultures when there's an infection in the pericardial sac.

Rachel: Yeah.

Howard: It's only one of four bacteria, the only place they've ever found these four bacteria is in gum disease.

Rachel: I think this is the thing is that there’s two avenues there, isn’t there. There's educating the Dentists and the Dental students, and actually teaching them this is they're coming through and in their CE and then there's also, we've got to teach the medical profession that the mouth is not just something you use to look down the back of the throat. I was talking to a GP friend of mine and she shared with me how much training they get on the oral cavity, zero. They don't even know what normal looks like. So you get somebody go in to the Doctor, because this happens a lot here. They'll go to their Doctor and they'll go, “I've got this lump in my mouth, doc”. The Doctor looks and they go, I don't know, and they prescribe him antibiotics and tell them they've got to come to the Dentist. They come to the Dentist and they go, “I've got this lump in my mouth” and they go, “Yeah, you've got one that side as well. That's normal”. So can you see how we're on a losing foundation already because medicine does not see Dentistry as part of the body, we’re this second rate, we're just tooth fixes but systemic disease from the mouth is massive and I think this is where we have an opportunity to educate every patient that comes in one on one. Educate through blogging, educate through getting on social media, using all those research papers that are coming out and just every day, have you seen this? Here's another article that proves that the health of your mouth affects the health of your body and that those bacteria are not limited to you. You share them every time you kiss somebody. You share them when you're blowing on food, like you wouldn't let your dog lick you in the mouth but you let your husband. Your husband's mouth is probably dirtier than the dogs if he hasn't been to the Dentist and have regular hygiene maintenance.

Howard: I thought the most interesting thing was when they started looking at streptococcus mutans and the data bank, they'd say, well, where did this come from? Because most herd diseases like every STD came from an animal –

Rachel: Yep.

Howard: There were permutations per thousand, per the whole nine yards. They're really great detectives. They say streptococcus mutans is picked up from a cat fifteen thousand years ago in the Fertile Crescent.

Rachel: Yeah.

Howard: So this entire disease came to us from a cat and it's been a parasite within your mouth.

Rachel: It's interesting because around that time we were starting to move slightly away from being hunter-gatherer type, so we started to get agriculture and that's been another big shift is that the way our diet has changed has meant that we can have that strep mutans, but if you don't feed it what it needs it won't over grow and be harmful because your healthy bacteria going to keep it in control. If we're eating a lot of cereal, processed foods, sugars, strep mutans, guys, that's it, party time, I'm going to breed, I'm going to take over, I'm going to give you gum disease and I'm going to give you tooth decay. So that double whammy because you could probably, I’ve got a very low decay. Right, I've only ever had one filling. My mom did not feed us sugar. We were the only kids in my, I grew up in a very poor area. We were the only kids who didn’t know what soft drink was.

Howard: Where in UK?

Rachel: So I'm from Birmingham originally.

Howard: Birmingham.

Rachel: Yeah.

Howard: I got to tell you my Birmingham story.

Rachel: Go for it.

Howard: First time I lectured in Birmingham, they want me to walk around. You can't even make this up. A flock of geese landed. These geese were so big.  Everyone. You know what I’m talking about? Those were the biggest, there had to be a thousand geese at that Dental convention hotel. So is that a common scene?

Rachel: Yes. I've got some video footage of when I was last over in England with my son and we're out with my brother in law feeding the geese bread, and one comes up behind him and bites him right on the backside. It's hilarious. Those things just don't care.

Howard: They're two feet tall, aren't they?

Rachel: Yeah. They are. They’re big. They quite scary.

Howard: They look like flying dogs.

Rachel: They’ll hiss like that. So we grew up, we didn't have a lot of sugar. We didn't have a soft drink. We had very sort of meat and two veg sort of diet. Lots of fresh produce. Now my mom and dad both had a lot of Dental work. My dad had periodontal disease and we were talking earlier. He died early of a heart attack so you go, got to figure but I don't have gum disease and I have very low decay rate but I would have the bacteria from my parents, but because those haven't been allowed to progress and grow because of the way I live and the way I feed myself. I am then a product of showing that if you systemically maintain the body, you're not going to get tooth decay.

Howard: So I’m wondering. Your website I often wonder when you're working with a client, how much of that work with the client do you almost feel like you're an armchair psychologist versus -

Rachel: A lot.

Howard: I know.

Rachel: I think on a six-month program I was kind of, you sit down and you work out where you want to take that person. What you want to offer them for that. To give them value for money and I was like, “Well, month one we’ll do this, month two we’ll do this”. We spend three, four months mindset. Mindset in communication and overcoming things I believe surround money. I had a client recently and I said, “Well, why are you discounting your work all the time?” She says, “Oh, because money is bad and da, da, da”. We did this whole program around money for her and we had to break that before she could then case present because she's all, I can tell them what treatment they need but I can't talk to him

about money –

Howard: Yeah.

Rachel: And she had no self-worth either so she didn't think she was worth charging what she should have been. So yeah, there's a lot of mindset stuff.

Howard: Yeah, I love that Chinese general who said that conquering another army is easy. Conquering the man in the mirror is the hardest thing you'll ever do.

Rachel: I'll share some of my journey is that when I hit thirty-four, I spent that whole year wondering what the hell life was about. What's my purpose? Is this all there is to it? Is there more? Is this what I've got to do for the rest of my life? I started to do some self-reflection and I realized that I wasn't very good at handling my emotions. I wasn't good at expressing what I wanted. What I needed to be happy. Even to just say, can I have five minutes on my own? There were no boundaries in place and so I started coaching as part of getting some self-development and some personal development because I'm leading a team, but if I can't do it without having a tan-t or losing my temper or getting upset then this is not healthy. So I worked on myself and through that I've become a better leader, a better business person. I've become a much better partner and friend. My relationships have blossomed and I feel really at ease with who I am. I'm comfortable in my own skin and I think if you can't hit that point in life, you're always going to be missing a part of the puzzle.

Howard: Well, Rachel, that's so profound. You said because so many times I'll be talking to like staff and I'll say,what bothers you the most about your doc? Well, I hate it when he throws instruments. I'm just like, “Throwing an instrument?” When you're throwing instrument, it's not about that you need a laser or you need a new bonding agent. So what would say to someone listening who's throwing instruments and blowing up on their staff?

Rachel: Well, look. I used to be an instrument thrower. I blow up at my staff. I occasionally will still go into that because I'm very driven and I'm passionate about us doing things well. I do get a touch of the Gordon Ramsay's from time to time. I'm like, come on, we've got a job to do, and I go, hang on. Who's running the show here? I think we have a perfectionism gene as Dentists and then that gets really honed down to the finest degree and so if something doesn't go well, we don't know how to handle it. We don't have the ability to step back and put it into perspective. So if you're throwing instruments, you've got to have a look at what's going on with you. What's really underneath that? It’s like when a couple argues that someone's put the toilet roll on the wrong way around. It's not really about the toilet roll. There's something that has led to that point. So there's been a trigger that has not been addressed and that is built and built and built and built and built until the toilet roll being the wrong way around is now World War III. I can have a Dental nurse, for example, who - I'll just borrow your phone. She’ll be holding the composite out here and I want it here, and so I spend the whole day in my head going, “For God's sake, will you bring that composite nearer?” But I don't ever say to it. “You know what? If you hold it here it really works for me”. So what happens is, it's now the hundredth time that the composites out here and I've got to stretch over for it and you lose it because you've been stewing on it and stewing on it. So for me it's about being candid, about being honest and about having those difficult and uncomfortable conversations and, you know what, when you do it, it's never as bad as you thought it was going to be. You've got a phone call to make and you put it off all day but all day long you've been thinking about, I've got to call that person. I've got to call that person and it builds up and builds up and then you call them and they're actually alright with you and you go, ah, I should have called him at 8 o'clock this morning and then I wouldn't have worried all day. So I think the advice I’d give is, if you have got something that's going on, it's bugging you or you're feeling under pressure, you've got to voice it, and what I learned as a leader is it's not about being the drill sergeant. It's not about having an iron fist. If you can be real and vulnerable with your team, they actually respect you a lot more. I don't mean having a breakdown and crying all over them. Although I have done that once in the past. We have dark days and sometimes you just, it all comes in on you, life’s been too much. Then the team are like, “My, god. What's up with Rachel?” They come in and make me a cup of tea and they brought me some flowers and we had a chat. I’m like, they're people. They care about me as much as I care about them, but we have to show that in our business. We've got to take time just to check in and go say to someone, “You know, when you do that it really bugs me or it doesn't help me with my job”.

Howard: Last question, because you've been very grateful, came by. We’ve gone over an hour. You practiced eight years in the UK and now a longer time.

Rachel: Yes, seventeen years now here in Australia.

Howard: Seventeen years in Australia. The UK, they're going through tough times, too, with the NHS.

Rachel: They are. Yeah, yeah, very.

Howard: What are your thoughts about? Are you glad? Would you rather be in Australia with everything going on here –

Rachel: Yes.

Howard:  Or going to be dealing with NHS?

Rachel: I shall be really brutally honest.

Howard: Please.

Rachel: If I had stayed as an NHS Dentist, I would have been one of those suicide statistics. I was so burnt out. I was so depressed. I would cry on my way to work the whole way there. I'd sit in the car. Clean my face up. Take a big breath. In we go. Get through the day. Go home and drink myself stupid because that was the only way I knew how to manage. I feel that the NHS is just completely ruining Doctors and Dentists. I had to see between thirty and forty patients a day. A day. I don't do that many in a week anymore, Howard. To try and make ends meet and to try and generate some business for our practice because we were getting paid something like ten dollars for a check-up. So it becomes a treadmill. There is no job satisfaction and there's no opportunity to build a relationship with your patient or with your team. You just go, go, go, and you'd numb someone. You'd kick them out. You’d get a check-up in, you get that numb patient back in and you'd be like, “Who was this again? What were we doing?” It's a horrible way to work and for very little cash return. I don't think that five, six years in Dental school and all that experience and expertise and skill level that we have, that we should be working on a factory fodder kind of output.

Howard: So if someone was listening you in England right now and felt exactly the same way, what advice would you tell them?

Rachel: Well, you've got the opportunity now more than I did to become a private practice, to set different fees. I don't know whether they still exist but the word schemes there where you've not called a damn plan, where you'd grade your patient’s Dental health and then they'd pay a premium each month and that would entitle them to x amount of Dentistry each year, and then if they needed a crown or a root canal. They'd pay for that on top. So I would be looking for ways to not be a hundred percent NHS is to have a mixture of private and capitation schemed patients. So you're not having to rely on that, and look, if you possibly could, and look, I became an NHS Dentist because I believe that everyone deserves to have good Dental care whether they can afford it or not. As altruistic as that was, it was very misguided because they're not getting good Dental care. They're getting compromised Dental care. They’re getting that'll-do-because-I've-run-out-of-time Dental care and that's soul destroying.

Howard: One of the things I don't like about the belief in free Dental care for everyone is that they have no incentive to quit drinking Coke and Pepsi -

Rachel: Correct. Yeah.

Howard: And eating potato chips all day instead of bottled water. So if you drink bottled water all day and brush and floss your teeth, and I drink Coca Cola all day and never brush, floss my teeth. There should be consequences for your behaviour.

Rachel: Correct. There needs to be an element of self-responsibility.

Howard: Yeah.

Rachel: Like we've talked about, Dental disease is not random. It doesn't just come and pick on an individual. You create an environment that allows you to have Dental disease. So if you're drinking, smoking, eating too much sugar, then you've got to realize that there's an out place like a child. If your child's naughty, they've got to understand there's a consequence for their behaviour. Otherwise they're just going to keep repeating the same thing and they'll become a juvenile, delinquent and end up in prison. So we've got to educate people that what you put in your body is going to have an outcome on your health. I think the World Health Organization statistics is that eighty percent of chronic health diseases are caused by lifestyle. So why are we investing loads of money in pharmaceuticals when we should be going, guys, healthy lifestyle. Stop drinking. Stop smoking. Get some exercise. Maintain your weight.

Howard: What's funny is America, they always try and distract like right now they are obsessed with opioid addiction –

Rachel: Yes.

Howard: They all, keeps on by the opioid addiction. I said, “Really? Opioid addiction?” How many Americans really know someone that had an opioid addiction, opioid addiction when the three most commonly abused drugs are free on every corner. Fast food, cigarettes and alcohol.

Rachel: Correct.

Howard: So they're talking about forty thousand died of opiate addiction. How many people died from fast food, smoking, and sugar which they still advertise. Budweiser sponsors every –

Rachel: Yeah, sports.

Howard: Sporting event known to man, yet I can look at every family that I've known and someone in that family is an alcoholic causing mayhem.

Rachel: Yeah.

Howard: So it's like, they let it focus on opioid. It's like, “Why don’t you focus on Coca-Cola, cigarettes, and Budweiser on every corner?”

Rachel: What isn’t focusing on opioids are really convenient smoke screen then. We can take the heat off this and put it over here and everyone can be up in arms about, oh, Doctors are prescribing drugs and they're getting people addicted and, ah, this is terrible, which it is, I don't want to trivialize it, but you make a very valid point. So the question is, where's this buy off then? There's a part of me that has to say, are we making a lot of money off keeping people sick? I think the answer is yes, we are.

Howard: Yeah.

Rachel: So you go we're taxing cigarettes, we're taxing alcohol, we've got people then having to go and buy lots of pharmaceuticals. It's propping up that whole industry. It’s keeping all the Doctors, and I've got a lot of Doctor friends so don't go booing and throwing things at the screen. It’s keeping a lot of Doctors employed. It’s keeping a lot of Dentists employed. I would rather go, “You know what? I've got to hang my journal up because there's nobody who needs me. Everyone’s so darn healthy. I don't need to treat them.” The only time we should treat someone these days is because they've smashed their teeth in because they've had a car crash or sporting injury, gone over the handlebars on their bike or something.

Howard: I think another telling thing about the case for holistic medicine is the top two drug advertisers in America are for erectile dysfunction, it's Viagra and Cialis. You talk to any researcher, they go, when this man cannot, you're an animal, you can't have sex, you don't want to take a pill. Why can’t you have sex? He’s got high blood pressure. He’s got diabetes. He smokes a pack a day. He's a hundred pounds overweight and you're seeing these people when they're so sick they can't reproduce damn offspring.

Rachel: Yeah.

Howard: Taking a pill and they're in one of the highest mortality rate people.

Rachel: Yeah.

Howard: When you are so sick as an animal that you can't reproduce that offspring. You don't need a blue pill. You need to go back and visit your fast food, your alcohol, your cigarettes, your lifestyle.

Rachel: There was a piece out maybe eighteen months ago that said ninety-five percent of the world's population is ill. So as a species we're not doing very well. If we were an animal species and we did not have medication, we are on the brink of extinction. We’d be picked off by the predators because we're not fast enough to run away and we would not be able to reproduce. We are setting ourselves up for mass extinction, yet we don't see it because medicine, and I am very, very pro-medicine, is helping people to live this illusion that I can smoke, I can drink, I can eat sugar, I can be a couch potato, and I can just take a pill and I don't have to change but medicine is supplying a demand. This is what I see too much of and it does upset me is that people will blame the Doctors and they'll blame the medical profession for prescribing and I go, “Well, hang on. Who's asking for those prescriptions?” We are. We’re the ones demanding. We’re the ones saying; yeah, I've had a heart attack but don't ask me to change. Give me a pill and fix me.

Howard: Yeah, and this is brutally rude, too, but when you do a general anaesthetic and you're under five or twelve and you're over eighty-five, it's very dangerous.

Rachel: Yes.

Howard: So in a big country like America with a third of a billion people. If you put tens of thousands of two-year-old’s under for Dental work, so every month or two someone doesn't come out of it and they die –

Rachel: Correct.

Howard: And the media, it's always the bad Doctor –

Rachel: Yes.

Howard: And the last one it was a paediatric Dentist. So a Dental degree –

Rachel: Yeah.

Howard: With a master's degree and was a board-certified anaesthesiologist and they never go in there and say, well, first of all, Rachel –

Rachel: Was it three-year-old child. Wasn’t it? Yeah.

Howard: Yeah. It’s like, “Why did your three-year-old need eight root canals?” No one will ever do it. It's always the bad Doctor, the bad anaesthesia and the family will probably get a million dollar reward –

Rachel: Yeah.

Howard: When the reality is, why did your child need eight root canals?

Rachel: Yeah. Why did they have to die for Dental procedures that could have been prevented?

Howard: Yeah.

Rachel: It's beyond comprehension, it breaks me off.

Howard: Well, I'll tell you what. I like your mind. I like the way you think.Whenever we disagree on something, whether it be water fluoridation or amalgam or whatever, it's like we both know what we know but we don't know what we don't know.

Rachel:  And we respect one another, and I've always said to anyone who wants to have an opinion, that's fine. Let’s not make it personal because when it starts to be personal, there's been a line that's being stepped over.

Howard: Yeah.

Rachel: We've gone and we've had very similar education. I was told just like you, amalgam saved water fluoridation works. However, I've then gone, things don't make sense to me, and I do not feel comfortable putting mercury into a human being’s body when we know mercury is toxic. So that's a personal choice for me. I think there are better ways to combat and prevent Dental disease than putting fluoride in the water and mass medicating everybody because again, Brisbane had fluoride added to the water in 2009 and I lost track of the amount of patients who said to me, “Oh, that means we can just eat as much sugar as we want”. And I’m like, “What? No. This is not what that’s for”.

Howard: You know what really opened my mind on the water fluoridation issue is I was looking at a Singapore and Tokyo. Singapore had water fluoridation and

Tokyo didn't, and they're right similar Asian people.

Rachel: Right.

Howard: Similar Asian diets and they're, both of their DAFTs have been descending –

Rachel: Like that.

Howard: For thirty years and it's two advanced civilizations. Tokyo and Singapore are very advanced.

Rachel: Yeah.

Howard: I mean, look at the epidemiologist, they said the water fluoridation is obviously not a factor. It was the, raising the Dental IQ of the population.

Rachel:  Exactly. Yeah, and that's been seen in other countries as well.

Howard: What killed me on amalgam which I – well, it's funny. So when you look at the ocean from 1950 to 2015, it's gone, the entire ocean. Seventy percent of the planet has gone from one part per million to four part million mercury and they say that's fifty percent from burning coal.

Rachel: Yeah.

Howard: From burning coal. When you burn coal, the smell goes there so (inaudible 1:17:47) but six percent of that is from cremating humans that have amalgams. My mission now is I'm trying to tell everybody, at least for now the first thing you have to do, if we stop placing amalgams today, we're going to be cremating humans for a century.

Rachel: Yeah. before it’s gone.

Howard: So at least for today everyone needs to run to their state and local society because how do you feel sorry for that that poor guy working in a Crematory because he's heating up those fillings –

Rachel: Yeah.

Howard: Till they disintegrate –

Rachel: Correct.

Howard: And when he opens that door, how much atmosphere? So it's like the mercury toxicity he's exposed to is a hundred times more than what we're exposed to, and we're Dentist drilling this stuff out. The least thing the humans could do is pass a law on every city and state that some Dentist has got to go into every single human before it's cremated, extract the teeth, and you wouldn't need anaesthetic.

Rachel: Yeah, and they wouldn't complain.

Howard: Might be, your favourite patient of the day was the dead man.

Rachel: I can remember them. This must be going back over ten years because my mom was still living in England, and she sent me a clipping out of the local paper where it was a bit of a spoof where they were calling that they done like a job advertisement for a Dentist to come and do that exact thing, but it was to highlight the problem of cremating all these people with their amalgam fillings, and they were calling to have mercury capture devices on the chimney stacks at the crematoria because they'd shown that there was a higher population incident of poor health around the crematoria, and they were linking it back to the mercury from the fillings. So it's been known for a very long time.

Howard: In Arizona, they just tried to do, one of the landfill's tried to bring in one

of those incinerators –

Rachel: Yeah.

Howard: I was looking at all the protesters, like when you just throw all these cars, batteries, and all this crap in a deal and incinerate it. That puts a lot of –

Rachel: Cadmium, all sniffing it.

Howard: Oh, my god. I was looking that and even though it's forty miles away from where we live in Phoenix, it was upwind.

Rachel: But we all know if, in the UK, they got sand storms in the Sahara Desert and then we got rain. It would rain sand from the Sahara Desert. It would be all over your cars and down the street. It'd just be orange everywhere. So we know it gets carried on the wind and within the weather, so forty miles away is too close but I think one of the problems is that Dentists go into this very blinkered mindset where it's like, but we've had it for two hundred years. We were told it was safe. It saved so many teeth. And I go, yes, but we had to carry a pigeon to get messages from A to B in smoke signals and that works but we now have the internet and text messaging and email and we have to move with the times. We've got to keep up with the modern materials and go, what's going to have the least impact on our patient's environment, our environment in the Dental practice, and the bigger picture.

Howard: Well, on that note, it was an honour for you to come by and come on the show. Thank you very much, Rachel.

Rachel: I’ve really enjoyed it, Howard. It's been an absolute pleasure. Thank you.

Howard: So go to her website. It’s

Rachel: Thank you.

Howard: Thank you, Rachel.

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