Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
How to perform dentistry faster, easier, higher in quality and lower in cost.
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927 Advice for Students & New Grads with Brenden Smith : Dentistry Uncensored with Howard Farran

927 Advice for Students & New Grads with Brenden Smith : Dentistry Uncensored with Howard Farran

1/23/2018 12:09:28 PM   |   Comments: 0   |   Views: 342

927 Advice for Students & New Grads with Brenden Smith : Dentistry Uncensored with Howard Farran

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927 Advice for Students & New Grads with Brenden Smith : Dentistry Uncensored with Howard Farran

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VIDEO - DUwHF #927 - Brenden Smith

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AUDIO - DUwHF #927 - Brenden Smith

Brenden Smith is a Senior in Dental School at the University of Louisville in Kentucky and stopped by the studio to chat with Howard about corporate dentistry, the importance of demographics when opening a profitable dental office, how to engage with patients, and more.

Howard: It's just a huge honor today to be podcast interviewing Brenden Smith, who's a senior in dental school at the University of Louisville. I'm so excited to have you on because podcasters are usually thirty and under. I'm fifty-five. I'm a grandpa. Not one of my fifty-five-year-old grandpa friends that lives around the street here has ever seen any podcast. 

I always say, and please do this, e-mail me and tell me who you are, how old you are. I'd say 25% are in school. Shockingly, like 5% haven't even got to dental school yet; they're in undergrad. I'm just like, wow. How things have changed to be thinking about dentistry before you even went to dental school. But the other 75% just graduated to probably thirty years old and they get tired of hearing, like when I have Gordon Christensen on there, he's eighty-two years old. I'm fifty-five. They get tired of hearing fifty, sixty, seventy, eighty-year-old dinosaurs and flosseraptorus talk. 

I'm sure everybody wants to hear your journey. You're a senior in dental school. You were born in Alpine, Utah. I'm not saying what you are if you're Alpine, Utah, but when I tell him that in dental school you were married and had two kids. I think I just blew your LDS cover. 

Brenden: Yeah, I'm definitely Mormon. 

Howard: I don't think you can hide that after saying that. You graduate in just seven months. Tell me how has your journey been? 

Brenden: It's been fun. It's been challenging. I think any dental student can say that. But we moved out to Louisville, Kentucky. My wife was eight months pregnant with our first child. We hit dental school. We were in the gross anatomy, all of the tough stuff right at the beginning. It's been a long road, but it's been a lot of fun. 

Howard: Was that pretty hard on a marriage? Because you think if you're a newlywed and you've got a newborn baby, but if you've got to go to school and you've got to do your homework all night. Did you also have a part-time job? 

Brenden: No. I mean there was no way I could swallow more than that, being a new father and dental school. 

Howard: Did you ever get in a lot of trouble like you're not paying enough attention to me, all you think about is yourself doing dental school and homework, and what about me and the baby? Was that tough? 

Brenden: Yes, sometimes but she's been very supportive. But it's hard on any marriage. I mean you come home and you're expecting to have a little time with your spouse and you know that just to keep your head above water you have to go hit the books and study. But she's been great about it. 

Howard: I opened up my practice and my next best idea was to have four boys in sixty months. That's why I tell these kids, they get out of school and they say, "Well, I think I'm going to join the Navy or I'm going to do public health or I'm going to get some more experience under my belt." I always say, "You know what? Capitalism is risk." The older and smarter you get, the less risk adverse. 

I have a three-star general in my office. He says that the ultimate soldier is like sixteen to twenty-one. They don't like thirty-year-old men and they don't like women of any age. If there's a bunch of machine gun fire and people getting shot. If they tell a bunch of boys sixteen to twenty-five to go charge them, they'll all go charge them. You tell a bunch of thirty-year old man to go charge them, like, "I think that's a really bad idea." You tell women of any age to charge them, they're like, "I don't think that's a good idea." 

The crazy, insane risk of opening your own business and having four kids in six - there's never going to be a good time, so just do it before you think about it, get it out of the way, and then once it's over you kind of feel like you survived the hurricane. Yeah I survived Hurricane Erma, Eric, Greg, Ryan, and Zach and opening up my own business. 

Brenden: Well that's one of the things that I wanted to talk to you about is because in dental school we're so bombarded by these ideas that it's too hard, you can't make it by yourself, corporate dentistry is the only way to go. 

Howard: Where's that message coming from? 

Brenden: It's coming from a lot of corporate dental chains that come in and they're trying to recruit you. 

Howard: So corporate dental chains are going into dental schools and telling you guys that you can't do it alone? 

Brenden: Pretty much. I mean they're not saying directly you can't do it alone. They're saying, "You know what? It's going to be tough. Real tough." 

Howard: Oh my God. 

Brenden: What are your opinions on that? 

Howard: Well my opinion is it's Friday night and I'm glad I didn't eat dinner before you got here. I just would have thrown up. Yeah, I mean there's a lot of that sauce in the equation. The reason I never opened up a chain of dental offices, I actually did, but I did a different model. Here's what I did. Here's my dental office (00:05:05 inaudible). 

When I came here in '87, thirty years ago, the unique things I was doing back then, which was crazy, is I had a full page ad in the Yellow Pages, when all the older dentists - like your grandfather was a dentist. When I got out of dental school at twenty-four every fifty-year-old dentist thought I was immoral with a full page ad in the Yellow Pages. They'd say things like, "Well if you have cancer, would you pick an oncologist out of the Yellow Pages," and all this weird stuff. 

Then I also went into retail. Now everybody's in retail, but thirty years ago they were all going to medical/dental buildings. They had no visibility. No one knew they existed. 

Brenden: It was taboo to go into retail. 

Howard: Yeah, it was taboo. And I was doing white fillings, when amalgam and gold were permanent and I was this guy doing - and all mine were gold. I think amalgam is twice as good as composite, but the bottom line is no one wants it. 

But anyway so what I would do is I would go three or four miles down the street. My first one was an amazing (00:06:16 inaudible). I would go in there and I would find about a fifteen-hundred - two-thousand square foot (00:06:22 inaudible). Then I would go to the landlord and I'd say, "Well, how much is that?" He'd say, "That's a $10 a square foot a year for three years." I'd take the prints for that and I'd go to Benco, or Schein, or Patterson, or Burkhart. They would design the whole layout and give me the equipment bid. They'd design the whole thing. 

Then I would go to three bids in a construction company and they would all come back saying, it would be thirty-five, forty, forty-five-thousand to do the build out. Then I'd take that build out divided by five years and by the square foot. I'd go back to the builder and say, "Okay, instead of $10 a square foot for three years, I'll pay you $17 a square foot for six years and you do the build out." 

He's looking at my three bids. He built this whole twenty-acre center and I've got a contractor looking at some young twenty-four year old punk ass kid, dumb dentist doesn't know what he's talking about. He's looking at these builds, he goes, "Man, god, I can't believe they're going to charge you thirty-five or forty or forty-five." He said, "Shit, I can get the whole damn thing for ten." They'd do the deal because if you if you got the crew to build a Safeway, Walgreens, Chase Bank, Pizza Hut, a dental build out is like something you do on a weekend. 

Then they would build out. Then I'd go back to - back in the day it was Health Co. and I'd say, "So how much is all the equipment for that?" They'd say, "It's X dollars." I'd say, "Okay, well, I'm not going to give you a dime. You're going to put all that in there and we're going to do a five year lease." I had the lease five years and I had the equipment lease five years, so at the last payment I owned, so lease to own. I'd have no money in there. 

Then I had a dental office. These girls that work with you, it's tough because you like them as a human but they're not really your best player on the team. Then I would get rid of my weakest assistant, weakest hygienist, weakest front office, put them in there. 

Then I'd hire a dentist like yourself coming out of school and for whatever reason just wasn't getting it done, pulling the trigger. I'd say, "Okay, I'll put you in there and I'll be 25% of what the whole thing collects. Hygiene and all this thing collects $50,000 a month, you get 25% of that." I would just hire him for that. 

Then it would take about twenty-four months to really build that thing out and I'd have the numbers. I wouldn't do anything in there. Then after twenty-four months, I would take that to Darlene Winger, at the time it was Valley National Bank then I think it got bought up by Nations Bank. Now it's Chase bank. I'd say, "What do you think of this?" She'd say, "Doing good." I said, "I'm going to go in there with her paycheck on Friday. I'm going to say here's your paycheck, but if you sign here for $250,000 on a twenty-four year note at a" - what do you call those government loans? An SBA loan. "It's yours and you'll never see my ugly face again." They go, "Are you serious?" Because that payment, 250,000 over twenty years on an SBA loan with low interest. It was like just thousands. She was so excited. 

Then I went four miles down another way and did it. I did what I did - turnkeys. The reason I did turnkeys is because what corporate can provide, yeah, they can get better locations, they get better buys on supplies, they can get better website design or marketing. Those are almost nothing (00:10:07 inaudible). The product is the dentist. 

When you look at everyone who's an owner/operator they're freaking crushing it. When I go to a seminar, so you're the owner and you're sitting there in the far row, and you're taking notes, and you're asking questions. Your associate's over there on Facebook, Twitter, tweeting. After the break she's twenty minutes late back to her chair. Then she doesn't come back in the afternoon. 

It goes further. When you're an owner/operator, and by the way, they're some of the biggest chains out there, like Comfort Dental. Rick Kushner out of Colorado, he has three-hundred and fifty locations. He has no associates. Everybody's an owner because the owner looks at that second molar and goes, "You know what? I think I'm going to try that? I'm going to do that." An endodontist, he had to do this first second molar. 

It is like when I'm flying in an airplane nothing pisses me off more than when some man gets upset because some one-year-old is losing it and they're like, "Err." I always say, "Buddy, how old were you when you were born? Were you born at eighteen?" You're stressing the mom out. 

An endodontist had to do his first second molar and an owner/operator will attempt it. An associate working at a corporate dentist, will say, "Oh yeah, you need to go to an endodontist," which is crazy because a second molar isn't even functional. It's zero chewing on the third molar, one-sixth on the second, one-third on the first, one-third on the second bi, and one-sixth on the first bi. 

I pissed off more endodontists in my column "Suck it up Buttercup." I got hate mail. I don't even care. I'm not going back on my word because I've done this thirty years. When you pull a second molar, because they don't have the money for a root canal, and they come back to you and I'll say, "Well, do you miss chewing on that?" One person a decade will say, "Yeah, yeah I do." 

Brenden: I really miss that. Yeah. 

Howard: One person a decade. If you try that second molar and halfway through it, you have to pull it, the endodontists are just like, "Oh my god, you're immoral. You're satanic. You're Lucifer." It's like shut up. The only reason you want all second molars saved is because you get $1,500 and you're an endodontist and endodontists don't get referrals for incisors and canines, most of it's second molars. It's a non-functional tooth. 

Not let's go to oral surgery. The owner says, "Oh, you've got those four wis? Well, I'll pull those four wis." The associate at Heartland, "Are you out of your mind? You better see the oral surgeon." Now let's talk about the oral surgery thing that pisses all the oral surgeon. Dentists uncensored pisses off more dentists per day than you can count. 

Look at evidence based dentistry in Germany. Let's look around the world. When I was little, I lost my tonsils because when you were born in 1962 and you had a sore throat, guess how the ENTs made their money? Scooping out the tonsils and the androids. Me and my five sisters, we don't have that because it was an insurance code. Four wisdom teeth are extracted all day long because they exist. 

The Germans, and in my opinion the Germans, the Austrians, and Liechtenstein, their average dentist is a lot better than our average. If you want me to explain that closer think Mercedes, Volvo, Porsche and then Ford, Chevy, Chrysler. They're just better. Their laboratory technicians go to school as long as it is to become a dentist. 

Brenden: Yeah, that's amazing. 

Howard: Our laboratory technicians learned on the job. Their laboratory are like, "I'm an apprentice. I'm a master. I'm a sensei third degree black belt porcelain." It's out of this world. What are their oral surgeons saying? Their oral surgeons are saying thirty years, they were like Americans. They pulled all four wisdom teeth. Now they pull less than half of the wisdom teeth they just pulled ten years ago because they can't find any evidences. 

So again, let's say you have four wisdom teeth. You say, "Well, I can pull these upper two, but these lower two are so impacted I think I'm going to have to send you to an oral surgeon." I say, "Well, you know what? Why don't you pull the upper two and the lower two don't need to come out." If you show them to the oral surgeon he says, "Oh, they have to come out because I'm an oral surgeon and I'll get a $1,000 for each one." 

The bottom line is, what I'm trying to say is, you are the product. If you come out of that school, if you're married and a couple of kids, I don't know if you want to get personal, but how much student loans do you think you're going to have? 

Brenden: I asked that question a little while ago to financial aid. I'm going to be about three-sixty-five. 

Howard: Which I'll tell you what, three-sixty-five, for being married with two kids, you live within your means. 

Brenden: Yeah, we try to budget every day. 

Howard: I see single boys in this town that had an apartment in Scottsdale when they were going to dental school at (00:15:00 inaudible) still in Mesa or Midwestern Glendale, lived in Scottsdale the whole time and graduated $500,000 in student loans, a single bachelor and had a BMW. 

Brenden: Holy smokes. 

Howard: Yeah, and I should say his name on the radio or is this the ham radio, a podcast. You are the product and in dentistry you sell the invisible. Those associates - number one you're a Millennial. A Millennial is anyone born after 1980, right? 

Brenden: Mm-hm. 

Howard: When were you born? 

Brenden: '88. 

Howard: Oh my god. 

Brenden: Yeah, I'm right there. 

Howard: You're a Millennial. Did you read that book, "The Four Horsemen?" 

Brenden: No, I haven't. 

Howard: Just a great book. But basically "The Four Horsemen," let me see if I can get this right: Amazon, Apple, Google, Facebook. Two A's. Okay, two As, an F and G. Those are some of the most profitable companies in the world. They got more profit dollars. They make the greatest work environments and their average Millennial only stays with them two years. 

Because you're working at Amazon and you're on this project then Apple calls you up and says, "Hey what are you working on? We got this new project. You want to come work with us?" And they're like, "You know what? That sounds fun," and they quit. Then Uber calls them up, "Hey, you want to work on (00:16:15 inaudible)" 

But anyway, so nobody can keep their associates in private practice or in corporate America. In fact, Heartland keeps them the longest and that's like two year average. A lot of the other ones it's a year. So the bottom line is who's the only one that stays in the same location for thirty years? 

Brenden: The owner. 

Howard: Owner/operator. What do you think patients think if every time they go into a dental office, it's a different doctor? 

Brenden: They're just confused. 

Howard: Yeah. Then when you tell me I need four cavities, well, how do I know that? 

Brenden: Really, yeah. 

Howard: When I take my car in and I am thinking the battery is dead and they say you need a whole new alternator. 

Brenden: How can I trust you? Yeah. 

Howard: It's all trust. One of the biggest things I've seen in life from when I was your age at twenty-nine to my age at fifty-five is I think the greatest advancement of social media has been the destruction of trust. Fake news that wasn't even a word five years. 

Brenden: Right. 

Howard: Trust is like everybody's not telling the truth. Everybody's trying to sell you. When you take your car into the shop because your engine light comes on, then you see on social media, well, all the mechanics call the engine light the idiot light. That's going to get in there then they're going to sell you something you don't need. 

I think when you're married, too kids, handsome, adorable, wearing a tie, you're here with your family, they trust that. Then the other thing that really matters is demographics. It's supply and demand. In that last 2007 downturn, I had my MBA from Arizona State University and I guarantee you it is my opinion from memory, but about every two years there's at least a 10% correction in the market. But every six to eight years there's a 25% correction in the market. 

The last one was 2007 or Lehman day. When was Lehman's day? September 15, 2008. What is it now? November 3rd, 2017. We're about due for another 25% correction. There just seem to be patterns and then that pattern is based on imperfect humans make imperfect business decisions and they eventually get so high that they realize that they're imperfect. The cycle is because you don't have artificial intelligence making these decisions, you have humans. 

But, again, when that happened last time we had about eight-five dentists go bankrupt in this town and they were almost all in North Scottsdale. Demographics matter. 

Anyway, if you told me you were going to go to Four-fifty-five Downtown San Francisco, where they have that huge building with several hundred dentists in that building, I would tell you it would be better just to smoke crack under a bridge and sell fluorescent light bulbs or jewelry on the side of the road. In saying all that, what does it make you think? 

Brenden: It's encouraging. That was one of the reasons that I wanted to talk to you. I think dental students nowadays need to hear that ownership is still a great possibility, that it's the way to go and not be scared of it. 

Howard: Come on, a great possibility. Corporate America has about 14% of the dentists and they're doing 19% of the dentistry. If you've got 14% of the dentists, what's fourteen minus one-hundred, so 86% are not corporate. Again, trust. Fake news. It's fake news. 

Brenden: They want you to believe that though and most of the students, they're believing it. 

Howard: Because they want you to work for them. And what it tells my homies is you need to spend more time in those dental schools. And if you're busy, what I do with those dental schools, I used to be insane and say, "No, no, no, I'll do it for free." (00:20:29 inaudible). Pay my own plane ticket, fly clear across the country, sleep in a hotel, lecture for two hours, fly. There's not enough hours in the day. 

What I do now is I just Skype into him for free. I'll say, "No, I'm not going to fly there. I'm not going to fly to Louisville, but if you want me to Skype into your class, I'll do that." I don't even think you should Skype in that class because god dang, I've got one-thousand hours of YouTube videos. I don't know why you need a special one. My God, 86% percent of the dentists right now are private practice. 

But I'll tell you some things that corporate does better. They do their demographics. 

Brenden: Yeah, well, they've got stuff dialed in really well. I mean for what they do. 

Howard: So now you were born in Alpine, Utah. 

Brenden: I was born in California. 

Howard: Where in (00:21:16 inaudible). 

Brenden: I grew up in Alpine. Orange County. I think the city of Orange. I was only there for a year so I don't remember anything about it and then I lived in Utah the rest of my life. 

Howard: And now you are in Louisville, Kentucky? 

Brenden: Mm-hm. 

Howard: Compare living in Louisville to Alpine, Utah? Which one would make you happier? 

Brenden: Probably Alpine, for sure. 

Howard: Why is that? 

Brenden: Louisville's great. 

Howard: You even say it right. Louisville. 

Brenden: Yeah, you've got to slur it. 

Howard: I lived a summer there though. 

Brenden: Oh you did? 

Howard: Yeah. 

Brenden: Probably just the humidity. If it wasn't for that, I could do Louisville. 

Howard: They've got a great Iron Man in Louisville every year. 

Brenden: Yeah, they do. 

Howard: You know why everybody loves it? 

Brenden: Because they get to swim in the Ohio River. 

Howard: Yeah, but do you know why? 

Brenden: Uh-uh. 

Howard: Because the swim is with the current. 

Brenden: Oh, okay. I thought it was against the current, no? It's with the current. 

Howard: No, you're swimming downstream. 

Brenden: Okay. 

Howard: So that's a big lure and people say, "Let's go the other way." It's like, no, you want a lot of people to sign up for your race. It's a lot of tourism. So you don't like the humidity? 

Brenden: No. The summers are brutal. 

Howard: So where was your wife born/raised/reared/lived? 

Brenden: My wife, she was from kind of all over the place. She lived in Idaho growing up and then she moved to Montana, then back to Utah and that's where I met her was in Utah. 

Howard: Idaho, Montana, Utah. What's her favorite spot? 

Brenden: Probably I would say Idaho out of those but she likes Utah as well. 

Howard: Now, she has two kids and you're saying you might have three. 

Brenden: Yeah. 

Howard: Was she raising two kids without her family? Her mom, her sisters. 

Brenden: She was completely by herself. 

Howard: But did she like that or did she hate that or was she telling you the whole time, "We're going to graduate and go live in across the street from my mom." 

Brenden: No. 

Howard: Ryan, send me Doctor Demographics. 

Brenden: It's been hard but she's had a good support system because there's a lot of dental students out there that are kind of in the same situation. 

Howard: Same thing in the military. 

Brenden: Yeah, in the military or in dental school and they have kids as well, so they'll hang out while the husbands are doing the grind at school. But I think their job is probably harder than what we've got. 

Howard: Oh yeah, I mean my god, I used to come home - I used to work at my dental - I think the first year I was open like seven to seven because I was young. I had $87,000 in student loans. I had all these kids. I'd come home and I thought the most stressful part of the day is you'd put all four to bed, and every two hours someone would wake up. 

I remember sitting in the kitchen table feeding Ryan like Cheerios, looking at the clock like, oh my god it's three thirty and my first patient is at seven and Ryan's eating like one Cheerio at a time. That's a lot harder than work. I can guarantee it. 

But the person I'm trying to get at is demographics, demographics, demographics. The three rules of real estate location, location, location. Business in three words, supply and demand. Does your wife have hard feelings about where she wants to live? 

Brenden: She wants to be - so all of our families is in Utah. We're not tied to Utah but we want to be in a place that's at least you know a day's drive from there, so we don't have to put all the kids on a plane, so it leaves our options pretty open. 

Howard: Phoenix is only a day's drive. 

Brenden: Yeah. 

Howard: How far is it from Salt Lake to Phoenix? 

Brenden: It's about I would say eleven - twelve hours. You can leave in the morning and you can go- 

Howard: It's nineteen hours for me to drive home to Wichita, five and a half to Vegas, six to L.A., five to San Diego. But I'll tell you, I only drive anymore to Vegas or Utah, Salt Lake. You know why? 

Brenden: Why? 

Howard: That is the most gorgeous drive. If an atheist did that drive, you'd believe in God. I mean you leave the desert. You go up through the mountains, you go up to Flagstaff, you go around the Grand Canyon, all these national parks. I got turned on to that trip because Phoenix is about 10% Canadian and what's straight exactly a thousand miles north of here - is it? 

Ryan: Winnipeg? 

Howard: Is it Winnipeg? 

Ryan: Yeah. 

Howard: So, Winnipeg is exactly eleven hundred miles straight up from Phoenix. Those seniors will think, "Well, I'll get a separate car down here," but they'll drive an old one down and they'll fly back. But after they drive that drive, they think that's the greatest part of wintering in Phoenix is driving. I mean it's just the most beautiful. 

Howard: Then what I do, have you heard of Doctor Demographics. 

Brenden: Yeah, I've heard of it. Yeah. 

Howard: Did you watch that podcast I did? 

Brenden: No, I did not. 

Howard: It was number six-eighty-nine, Doctor - have you talked to him? 

Brenden: He had put a course on in Salt Lake a little while ago. While I was out there I was trying to go, but I couldn’t scrounge up the money to go. 

Howard: Well, "It is just a huge honor for me today to be podcast interviewing Scott McDonald. 

Brenden: Yeah, that's the guy. 

Howard: So the bottom line, here's the error. You've invested three-hundred and sixty-five thousand in your education and then they won't invest three-hundred and sixty-five dollars in their demographic report. What I would want to do if I were you is I would not want to make some early bad decisions. So the first best decision is going where you're needed. I know this guy, Scott McDonald. The other guy is Dave with REALscore. But the other guy is Scott McDonald out of Utah. Well, shit, if you're going to go to Utah, I would go with- 

Brenden: (00:26:57 inaudible). 

Howard: I would first go to where you're needed. 

Brenden: Okay. 

Howard: Okay. 

Brenden: (00:27:03 inaudible). 

Howard: Another way to get another benchmark is-. 

Ryan: David James. 

Howard: David James. 

Ryan: That was episode seven eighty-four. 

Howard: Episode seven eighty-four. Thanks Ryan and thanks Ryan for working on a god dang Friday night. Gosh darn, it's Friday night, you should be on a hot date. I was going to go on this hot date, but when I asked her out, she hung herself. 

But the thing is you can also go to your Henry Schein, Benco, Burkhart. I know Burkhart's big in Utah. Patterson. You go up to them and say, "Where is everybody expanding and adding operatories?" Then the opposite of that, "Where is everybody in your over thirty, sixty, ninety, one-hundred and twenty account receivables?" If you ask that question to all the dealers here in Arizona, they will say, "Okay, everybody that owes me money is in North Scottsdale." Then everybody who's panicking because they're trying to fit another operatory and the only thing you can do is lose your private office is in like Maricopa, and Florence, Eloy. 

Then another one and I posted this on Dentaltown, you know this big controversy on midlevel providers? 

Brenden: Mm-hm. Yeah. 

Howard: And that's done by Pew Trust, right? Well, you go to their website Pew Trust; they've got all fifty states as they're trying to sell legislators and congressmen of all these under-served areas. I'm looking at Arizona - I know Arizona like the back of my hand. I don't know Utah. I know my state and they just nailed it. I mean I've been doing this for thirty years and some idiot in Pew, who's not a dentist, probably never done a root canal, probably never even been to Arizona, nailed it. 

I would be talking to your suppliers, where you're needed. I'd look at those Pew Trust (00:28:49 inaudible) because I guarantee you - when I got out of school, Utah didn't have two dental schools and now you have one in Roseman in West Jordan, Utah and you have one in Salt Lake City at the University of Utah. Well, who was making the arguments that Utah would need two dental schools? 

Brenden: Yeah. You talk to any dentist there and they're like, "Why in the world do we have dental schools?" 

Howard: Yeah, but that's because they're dentists. If dentists had it their way, America would have one dentist. Each crown would be four million dollars. Of course they're going to say that. 

But who was the other side showing evidence that Utah needed - Roseman you said is graduating eighty a year and University of Utah in Salt Lake is graduating forty a year. Who was telling them they needed another one-hundred and twenty dentists? Probably Pew. Go to and look at mid-level providers. Look at that research. 

Now you say, "Okay, my honey bunny, Hannah, wants to be in Utah. A day's drive away from family." So you've got Utah. Then you go to Scott McDonald and say, "Well, where am I needed?" Then you look at Pew Trust and say, "Where are the under-serviced areas?" Then the only real decision you have to make is should I buy or should I build. 

If you buy, you've already used $365,000, a third of a million of other people's money. If you went to an under-served area where Scott McDonald said is good demographics and you found a practice for sell for seven-fifty, holy moly. You hit the ground on a jet ski. 

Here's what you'll do wrong. Here's what you did wrong, you'll say, "Well, I want to live in Scottsdale because that's where I shop at the mall. I'm going to be a cosmetic dentist. I'm not going to do any bloody stuff," because the average general dentist makes one-hundred and seventy-four thousand a year, but the average oral surgeon makes four-hundred and ten, "but I don't like exactions." The average endodontist makes three seventy-five. "I don't like root canals." The average pediatric dentist makes three-fifty, "I don't like working on children. I just want to do bleaching, bonding, veneers, and get into like sleep apnea and snore guards and Invisalign." 

I hope your dad paid for your school and I hope he put you up in a condo because - if you want to look at what procedures to learn, like what do you want to learn after CE? Well, look at the specialty income. The average dentist is making one seventy-five that tells you what fillings, crowns and the hygiene department is worth. The only people that say a hygiene department is profitable are the hygiene consultants. They're coming in your office trying to tell you how to make it profitable. There's no money in hygiene, fillings, x-rays, and exams. 

We make one seventy-five, oral surgeons are over four-hundred. Endodontists are damn near four-hundred. Pediatric dentists are three-fifty. I know you love your two daughters, but it's a special kind of love to love a three-year-old screaming. In my practice, I'm across the street from the Guadalupe (00:32:04 inaudible), so 25% of them don't even speak English, so when you're doing a pulpotomy on some baby and his mother is talking in Spanish and you're just looking to see what you can hang yourself off of. Can I hang myself off the overhead lamp? 

Find out where they need you from the Doctor Demographics, talk to all four of the vendors and then when you get to that area, I would talk to the (00:32:31 inaudible) brokers and say I'm going to eliminate all my risk. Because here's the deal. Okay so this is mostly going to be rural. Okay? 

Brenden: Okay. 

Howard: So half of America is urban and half is rural. It's about a fifty-fifty split. Two out of three dentists go to the urban in about a hundred and forty-seven metros. The other one out of three dentists go to nineteen-thousand towns where the other half live. Whenever I meet a dentist that comes out of school, the first year did a million dollars and took home three-fifty and paid off all his student loans in a couple of years, it's always rural. 

Doctor Demographics, Scott McDonald. It's probably going to be a town of five-thousand, seven-thousand, ten-thousand. Let's say you go to the town that's got five-thousand and there's five dentists. You open up a practice, now there's six. That guy who had it listed for seven-fifty and you didn't want to buy it, so you opened up six. Now he sells it to somebody young like you who is young and has vision, and has energy, and is feeding babies. You have no idea how much more energy you have at twenty-nine than I do at fifty-five. I remember when I was twenty-nine looking at guys my age and saying why are they so slow. 

This sixty-five year old guy selling his practice, you buy that. Now there's still only five practices. You open up your own, now there are six. But that sixty-five-year-old is going to sell it to a twenty-nine-year-old. Now when you're out there hustling and doing a great website, and SEO, and doing everything that you should be doing, you got some other highly energetic young twenty-nine-year-old dentist doing it. 

Brenden: Right next to you. Yeah. 

Howard: That would be my biggest words of wisdom.

Brenden: Well, thanks for that. I appreciate it. The other thing that I wanted to talk to you about, so I read your book. I thought it was awesome. 

Howard: "Uncomplicate Business." Buy it on Barnes and Noble, don't buy it on Amazon. 

Brenden: Yeah, I loved it. 

Howard: I'll tell you what, I'm an Amazon Prime member and I would like to meet - if you've ever received an Amazon package in two days, please e-mail me and tell me what the hell you ordered. My two-day Prime - it is so amazing that marketing. If you say (00:35:00 inaudible) time, everybody believes it. I've never gotten anything in two days from Amazon. 

My god, it's like there's two scoops of raisins in every box of Raisin Bran. Why do they say that? Because there's no raisins in there. But if they tell enough times, when you do find a raisin, you think there's a raisin. American cars always talk about a warranty because their cars suck. Japan, and Korea, and Germany never talk about bumper to bumper warranties because their cars don't break down. 

Brenden: Right. What would you say Howard about the importance of people skills in coming out and starting your own practice? I know you talked a little bit about it in your book: people, time, money. You spent a huge section about the importance of developing those, but for dental students who have been in school for four years and all their focusing on is teeth and they don't realize that there's a whole other component that is just as or if not more important than the clinical side of things. What would you tell them? 

Howard: I'd say that number one the United States of America is a very weird term. No one refers to Europe as the EU because you couldn't compare Germany to Greece or even Portugal to France. The "Think and Grow Rich" Napoleon Hill, the "How to Win Friends and Influence People," so very different people in Alabama than it is in Orange County and it may be very different from Provo to Alpine to Salt Lake City. 

What I would do is, again, when you buy a practice - let's say you had two practices for sell and they're both doing the same numbers, but one office had four employees. The average one had been there three years. The other one had four employees and the average one had been there twelve years. You know the twelve-year relationship has trust with the patients that you're buying that practice. 

What do the young boys do? They buy that practice and they say, "I'm going to get rid of all these old ladies and get some new ones." I pitched this idea and they didn't - they keep telling me, "Well, that is not how Dr. Cranston used to do it." After he hears Dr. Cranston three times, he fires them all. Then all the patients in that town say, "Wow. Man, Brenden - Dr. Smith only worked there for a year and everyone quit. Joyce and Jamal, they were the two of the greatest people in the world and they quit." So evaluating that staff. 

Then I always say the best thing to do is for people skills, I would tell everyone do the Toastmasters, where you have to learn how to talk to people. I think two of the greatest gifts that I did was I did - any art center has a comedy club and the comedy art teacher was Tony Vicich and the course was Monday, Wednesdays from like six to nine or something and then Friday was a stand up live. It was six weeks. Mondays and Wednesdays you had to work on your jokes and your lines and presentations. Then they give you five minutes (00:38:10 inaudible). What I love about standup is there's no props, there's no overhead. It's just you and a mic and you've only got like twenty seconds to win them over. 

The other class I took, which is even more fun, is improv, where they get five people out there then all of the sudden they say, "Okay, you're a dad and you just came home and your wife is sleeping with your neighbor," whatever and then boom you guys got to act it out. It's getting you just to relax and communicate. 

But you're handsome. I've been telling you the whole time, you make eye contact. You're wearing a tie. When you came in you gave me - look at that smile. I think you'll crush that. As far as trust, you're married. You've got two kids. 

And always remember about your reputation that you can destroy your lifetime reputation in five minutes. Look at Harvey Weinstein. That was one of the biggest movie moguls in the world and boom. I lived through - you're probably too young to remember Clinton when the Monica Lewinsky scandal came out. 

Brenden: I remember that. 

Howard: Do you remember that? 

Brenden: Yeah. 

Howard: You're twenty-nine and you remember that? Wow. 

Brenden: I was pretty young, but yeah. 

Howard: And now Kevin Spacey. What you've always got to remember - my Dad used to tell me - he was Catholic. He went to mass every single morning, seven days a week from birth until I left home. My dad always used to tell me - I used to hear him - he owned a Sonic Drive In and a lot of the other kids they weren't Catholics or they didn't believe in God or whatever. 

I remember he used to argue with this one guy, Gary Gibson, and Gary Gibson said, "I don't believe in that." He said, "Gary, if you don't believe the Bible just remember this. Do you want to see what you did last night on the front page of the Wichita Eagle and Beacon? If you don't believe there's a man up there, I don't give a shit. But there is a Wichita Eagle and Beacon newspaper and if you don't want to see your face on the front page of the paper tomorrow, don't do it." I always thought, man, that's the best morality in the world. 

You're in a town, so you'll have trust. You're selling the invisible. When you tell them you have four kids they're looking at you and they're thinking well if you buy, and that's what I recommend. 

I'll give one other advantage of buying. Let's say there's two different types of kids. Let's say there's a single kid, $200,000 of student loans and he's single. Then there's a married kid, say he's twice, so he's $400,000 of student loans and he's got a dependent wife and two dependent kids. Then there's two practices for sale. One is seven fifty and one's a million two. Well, you're buying a cash flow. If I said to you, "What would rock your world?" You said, "You know what? To make my student loan debts, and to give my wife the lifestyle she wants, and the kids," and whatever rocks your boat. 

He said, "You know what? I'd really love to make $25,000 take home a month." That's the easiest thing in the world to do. You can buy dental offices all day long and then have that cash flow. That's one of the reasons Heartland got so big. You know why Heartland got so big? Same reason Orthodontics of America did. 

If you go to sell a house in Salt Lake or Phoenix, if it's three bedroom and two bath, it's liquid. You can turn a three-bedroom, two-bath house into cash probably in a week in Phoenix. I can turn a stock or a bond into cash instantly. Three bedroom two bath. My house, this neighborhood, there's thirty-eight homes for sell in the Equestrian Center because once you're over one, two, three, four million dollars, they're illiquid assets. These basketball players, these Arizona Cardinals, these Suns, they'll come build some nine-car garage, fifteen-thousand square foot house. Then they'll get traded. Well, anybody who could buy a house that big, doesn't want your house. His little Miss Muffet sitting on a stool doesn't like the whatever - she builds her own. 

These bigger practices are illiquid assets. Like Bruce Beard, he had a four million dollar practice, well, what kid could come out of Louisville and buy Bruce Beard's practice in a small town for four million. I had another friend up there in Lake Havasu. For years and years and years and to this day if you have a $750,000 practice, it's pretty liquid in urban. In rural I can give you names of ten dentists last year, who after it was for sell for two years, health problems, getting older, just walked away and closed it down. I know several offices. There's threads on Dentaltown, in Illinois. There is an incredible practice in Illinois that he's probably just going to walk away from it because when he decided to sell he didn't know three years later he wouldn't have any buyers. 

If you decide that you're not going to have two kids, say you're going to have three or four. The wife's never going to work and she wants a Range Rover. Then you're in that small town. The single boy, he might only want the stress of a little $550,000 office. But if you're the alpha male and you've got to feed five cubs at home, you might want the one point two five million. But the bottom line is in dentistry you tell me how much money you can make I'll find you the dental office and sell it to you tonight. It's not a matter of if, it's there. 

Then what if the area is questionable demographics? Well, starting up a new practice, high risk galore but, again, you're buying an existing practice. If you're on the corner of Third Street and Maine, they say, "Don't go there dude. There's a dentist on every corner." That means don't go start a practice there. But if you already have Dr. Jamal, who's been in there with his assistant Shawanda for fifteen, twenty, thirty, forty years and they've got a million dollar machine, they've got employees that have been there six, seven, eight, ten years, they got their number, they get their client base. Then I'll tell you where it's gone downhill from when I got out from you is when I get out of school, the owners cared. 

Now let's say we go back to little Alpine. How many people live in Alpine? 

Brenden: Oh geez, probably only ten-thousand or so. 

Howard: By the way, the reason I'm doing so much talking is because he wanted to come over and ask me questions. He didn't want to come over and do a podcast. I just turned it into a podcast. Because my thinking is if he's got these questions, a thousand other kids do. 

Let's say you go to Alpine and thirty years go out and buy a practice from old man McGregor. He would carry it for seven years at 10%. Well that meant for seven years in Alpine, he was going to the LDS ward and saying, "Oh that gosh darn Brenden Smith, best dentist I've ever seen. Good thing I retired. I'm blind, can't see, my hand is shaking." 

Then you've got upset patients. Mrs. Granson called, she's all upset. She wants to turn me over to the board and sue me. And he, "Settle down. I've known her for twenty years." Do you know what I mean? He's your financier. So he has all the incentives for you to work. Do you know what they do now? Screw that. We'll have Bank of America; we'll have someone else do it. I'm going to sell you this whole load of shit, fly out of town tomorrow. 

Then it gets also bad where you don't have a mentor. All of the big money is in all the easy stuff, but the full mouth cases - you do three full mouth cases and one goes south, you're under water. But when you get in over your head, he can be there to help you or if something goes wrong, he's got the relationships with the oral surgeon, the periodontist, endodontist. 

Brenden: That's all great advice. 

Howard: Rural areas, I'm telling you, rural practices are illiquid assets. You know who I see go to rural areas? Married with children because you have your entertainment. But if I'm a bachelor, I mean I've certainly got to think my odds of finding a mate are better in Salt Lake and Phoenix than in Alpine or Maricopa. 

You know your odds your better of getting a date if you have an iPhone over a Samsung Droid. You're married, so you have a Droid. I'm single, so I have an iPhone. You have an Apple Watch, you're hotter than if you have a Swatch. If you're married with children, you've already got your (00:46:44 inaudible) when you come home, you don't want to go hit the clubs, you don't want to go hit the bars, you're not going to hang out and listen to music and all the annoying crap. You've got the party at home. 

Brenden: Yeah. If I can ask you real quick, I've got a buddy who's doing a startup right now. He started a practice straight out of dental school. He wanted me to ask you if there is a most effective way to market a startup. Any comments on that? 

Howard: Yeah. 

Brenden: He's in a rural town in Idaho. 

Howard: I did guerrilla marketing before it was a term. You heard of guerilla marketing? 

Brenden: Yeah. 

Howard: When I opened up my practice, I went to a visible location. I was in a twenty-acre center. I had a Safeway, a Walgreens, a Chase Bank, a Pizza Hut. 

Brenden: He's got a McDonald's, a grocery store, brand new, so it's a growing area. 

Howard: I always do the best guerilla marketing. What I did on Saturdays and Sundays, I took a backpack with gloves, mirrors, (00:47:52 inaudible), toothbrushes with my name and phone number. I went door to door to every single house in Ahwatukee, eight, five, oh, four. It was about twenty-three thousand people, I would go to a door and they'd go, "Eh." Well, you were you were a missionary, right? 

Brenden: Yeah. 

Howard: So you know what's going door to door. What was the rejection rate? What was get off my porch, out of town? 

Brenden: It was 99.9% see you later. 

Howard: If you're happy with the guy in the mirror, rejection is like whatever. My patients that sell the most cars, they say the reason no one can sell cars because it's twenty-five to fifty rejections to sell a car. But every time I get a rejection I always think, okay, that's number twelve, that's number sixteen. Because I need twenty-five. Every rejection is like, yeah, I'm closer to twenty-five. Then I'm going to sell a car. 

Two out of three houses just thought I was incredibly weird. "I've already got a dentist. I don't want a dentist come to my door." I was like whatever. I was twenty-four. Third house some fat, drunk would answer the door in his underwear and when I tell him I'm a dentist, he'd go, "Well you know what? (00:49:02 inaudible)." I'd like put down my backpack, and put on my gloves, and a mirror, and I had my flashlight, and we'd talk and bond in his white-beater shirt on his porch. I just loved it. I loved pressing the flesh. 

Every third house made an appointment and then I'd upsell that. I'd say, "Well, when you come in do you want to bring your wife and kids? Are you married? Do you have any kids?" I could upsell, like the moment telling me about - "Do you think she's going to need braces?" I'd look at her and say, "I don't think she needs braces, but I think she needs her teeth cleaned. When was the last time she had her teeth cleaned?" "Oh my God, I can't remember when she had her teeth cleaned." "Well you know, let's get her in," and all that kind of stuff. 

The other guerilla marketing I did, I did that every Saturday and Sunday. It took me I think six months to knock on every house in Ahwatukee. That is guerilla marketing. 

Number two, I'm a hustler. I just don't like lazy. You can't fix stupid and you can't fix lazy. That's why America needs to get rid of the Department of - the biggest dichotomy I have in America is you say, "Why is America the greatest country in the world?" "Well, it's all those immigrants that came from all those places." What is your ethnicity? 

Brenden: I'm White. 

Howard: But I mean what? German, French? 

Brenden: German, yeah. 

Howard: German. Germans. We're Irish. One million Irish washed up on the shore forty years before they had a Statue of Liberty. You said, "What made America great?" Was it the existing native population? No, it was millions and millions of people. 

Then in 1914 they started the Department of Immigration. They say, "Well don't you think we should tear that wall down and tear down and open up Ellis Island for the whole world?" Oh no. How does everybody know the right answer that what made this country was that it was immigration, free immigration for century over century over century? Now they don't realize that's why they're stagnant. 

In Arizona these strawberries rot in the field because they can't get any migrant workers because you scared them all back over the wall, but everybody in those small towns are on welfare and they've got free food stamps and welfare, so why the shit am I going to go work in a field. You get people that hustle because when I had an empty appointment or cancellation, I had a stack of flyers and I had my assistant you know we're in that Chase, Safeway, we're in a twenty-acre center and Arizona it would be one-hundred and nineteen degrees and there ain't no shade in the parking lot and she'd put a flier under every one of those (00:51:44 inaudible). Come see us. We'd go - in fact I just talked to that guy today. We'd go to his house and we'd take a staff photo of all of our pretty faces. He did fun stuff like, we'd be on a ladder or this or that and they'd see these beautiful faces. We're right here in the Safeway Plaza. We'd have a diagram of the Safeway Plaza because there's Elliot and there's Forty-Eight, so if you're over here on the Elliott side, they might not know that on the other corner of this deal is my freestanding dental office, Today's Dental. 

Another thing I used to do, unbelievable, I used to go over to the manager at Safeway and said, "Hey, you married, kids, need any dentistry?" He'd say, "Yeah, I need my teeth cleaned this and that" I said, "Tell you what come over here. I'll do all your dentistry for free.” Then I'd give him a box of my flyers. If you put them on each checkout stand, so every time they bag up the groceries they'll stick one flyer in with one customer. 

I had the dentist across the street from me, he was so damn funny. His name was Mark Woodland and loved the guy to death. He called me up one day he says, "How the hell did you get that flyer on my kitchen?” He goes, “I came home, there's a flyer in the kitchen. I don't know where it is. I don't know where it is. Didn't come in the mail. No envelope. I'm just curious, how the hell did your damn flyer get on my kitchen table?" That was like 1987. I told them what I did and he said he says, "You're so funny. You hustle so much." 

Another thing I did, every time I had a baby, I would take out - Ahwatukee had its own newspaper. I'd take out a full-page $500 ad back then, Dr. Howard Farran would like to announce his new patient of the month, Eric Wells Farran, born time, blah, blah, blah. It would be a picture of me and their mom holding the baby. 

Oh my god, that ad was five-hundred. I'd probably get like three car seats, a couple of wagons, a big wheel, a hundred Hallmark cards. In fact, what we'd do with each one of those, it was so cool, is you don't think about this but when you go buy a newborn baby boy card at Hallmark, there's only like four or five because we'd stack them up and it would almost be like four equal four-inch vials of the only four cards at Hallmark. 

But that's guerilla marketing, building trust. Well, he's a good guy. He's married, just had a kid. He's proud of his boy, his baby. In fact, Dr. Mark Woodland, when that full page ad came out, he actually tore it out of the Ahwatukee news, came all the way out - he was the practice across from me, came all the way across to me and he says, "Hey, that was the best dental marketing ever seen." He goes, "I tip my hat. That was the best I'd ever seen." 

(00:54:24 inaudible) go into all the beauty salons, bleaching came out. Now I don't want to say this and I don't want to get out because people are going to think, okay, this is bullshit, grandiose thinking. But just by luck where I live, the guy across the street was the Arizona rep for Omni Pharmaceuticals and they had fluoride treatments. Omni White was the first in-office bleaching tray. 

Well he lived across the street from me. We were buddies. The kit was $900. Nobody would buy it. He says, "You got to buy it." I said, "$900. I could buy a La-Z-Boy for $900. You could buy a new sofa for -I'm not buying that for $900." I think his name was Dave Keating. But anyways, so he (00:55:12 inaudible). 

What I did is I told (00:55:14 inaudible); I called Gordon Christensen because he's the god of dentistry. I called him up in Provo and he said, "Well, it's brand new. There's no research. Nobody knows anything about it." I said, "Well, what do you think?" He goes, "Well, it's a tooth. It's like an elephant's tusk. It's ivory. It's just carbamide peroxide, (00:55:32 inaudible) fixatrophic 10%. Then he said, "Why don't you try it on yourself?" 

So I took all the staff and I said - because they all want the (00:55:40 inaudible). So we all took impressions, made trays, and we all decided we were only going to do our upper. We all did our uppers and we wouldn't do our lowers. Oh my god, it was stunning. The uppers would be white and the lowers would be yellow/brown. Then we'd tease each other. We should make trays and soak our lower teeth in coffee, and mud, and Dr. Pepper. And just started selling the crap out of bleaching. 

Then I would go to the all the beauty salons and I would tell the girl "If you'll put your before and after picture, I'll do whatever you want. I don't care if it's bleach. I'll do a smile makeover. I don't care if it's bleaching, bonding, veneers. I don't give a shit what you need." 

These beauty salon girls, they're better than hygienists because hygienists, most of their customers come in because their insurance covers it 100%. But the cosmetologist is doing $200 hair treatments. I don't know if your wife bleaches or blondes or curls or permanents. If you're lucky, she'll just shave her head and wear a wig. There's a lot of girls in America that pay like $200 out of pocket every three months and they're very particular who they'll go to. I was going to each one of them and they'd all say, "Are you serious? You'll do a smile makeover" Some of them needed braces. 

I had gone to a Brock Rondeau. I had gone to - the best one is Richard Litt. He is the only board certified orthodontist. He used to be the clinical instructor at the University California San Francisco, then the University of Detroit, Michigan. His program was FORCE, Faculty, Orthodontic, Research Center of whatever, F-O-R-S-E, Faculty, Orthodontic, Research Center, something. Some of them need needed two years of braces, some got veneers, some got bleaching, bonding. But I think I had every parlor, their head mama was there and it was dentistry by Dr. Farran. 

You know like the most famous cosmetic dentist in the world is Dr. Rosenthal and Apa, but, shit, they're in New York and Dubai. They charge $50,000 for veneers. Well, what the shit does that have to do with Utah or Arizona? There is none of our patients - nobody in Ahwatukee is going to fly to New York/Dubai and give Dr. Rosenthal or Dr. Michael Apa fifty grand. But when they said that was done Dr. Farran right there in Today's Dental. That was amazing. 

Then another huge guerilla marketing thing I did was my two older sisters are nuns. I knew the dentist that did their dentistry free and the cloistered Carmelite monk was in Minneapolis, St. Paul. It was In Lake Elmo, a suburb of Minneapolis, St. Paul. The other one was the Immaculate Heart of Mary out of Wichita, Kansas and Dr. Pelzer would do their dentistry. 

I went and I wondered well, how many churches are in Ahwatukee. There were eighteen. There were two Catholics; there was a bunch of Lutherans, a bunch of non-denominationals. I told them that somebody is doing my nun sisters for free, so all I'll do the pastor free. That's why I like priests the most because they're not married. They don't have a bunch of kids. The Lutherans are horrible though. They might have five kids that you've got to fix up for free. That's a joke. 

The thing is it was amazing, this one Lutheran pastor, I don't want to say his name, it was actually two Lutheran pastors. It was the one down on - anyway, I did veneers on both of them. One was about seventy and the other one was about forty. Well, he's up there preaching every Sunday. What was amazing to me, you knew who it all sent in to get veneers done? All the grandmas. 

I'm sure your wife is young and beautiful and hot. The last thing she'd want to do is shape down her teeth. It was all these sixty, seventy, eighty-year-old grandmas looking at Pastor (00:59:47 inaudible), "Oh my God." They'd go, "What did you do to your teeth?" He says, "Right across the street from the church. I went over to Dr. Farran. He fixed them all up and everything." Next thing you know, these seventy-year-old ladies are in here saying, "He looks fifteen years younger. I want that." 

Again, I would say marketing should make you feel something. Why do people like rollercoasters? They feel something. Why is this big movie out that's going to do a hundred gazillion dollars, "It", they want to be scared. 

Brenden: Right. They want experience. 

Howard: They want to see a commercial that makes them cry or laugh. Like on your website. You go to a website and the dentist always got some image of himself that looks like his DUI mug shot at the police station. It should be a one minute YouTube video and you should be flanked with your wife and kids and borrow a dog, and, a cat and a bird. Get a bunch of people, so then they watch it and say - 

Because there's only two markets. They're afraid of you and they're afraid of the cost. "Hey, are you afraid of the dentist? Come on. Really? Come see me. I went to dental school because I used to be afraid of the dentist. My grandfather was a dentist. You raise your hand, I'll stop. We have laughing gas. Hell, we can put you to sleep, but I guarantee if you're afraid of the dentist, I should be your dentist. If you're afraid of the cost, I'll tell you this. We work with Care Credit, all these places, but I've never seen a mouth on earth that I couldn't fix up for $99 a week." They go, "$99 a week, shit." 

Where did I steal both of those from? The only three publicly traded dental offices on the planet, two of them are in Australia, 1300SMILES. The other one is Pacific Dental Group. They're both out of Australia. Then what is it? Q&M. 

Ryan: Q&M. 

Q&M out of Singapore. They found the sweet spot. Then Denture Centers of America, is that what they're called? American Denture Centers of America or Dentures of America? You know what their big marketing deal is? They go into an area and they call everybody and find out what it costs for a routine extraction and then they'll put that price in half because who the hell would ever need an extraction and not have a (01:02:04 inaudible) mouth. 

I mean if Margret comes in and says, "Well, my dentist Dr. Farran, he wants a $150 for an extraction and this place will do it for 99. I'm going to go there." Well you take an FMX of someone who needs an extraction, they've probably got four quadrants of perio, they probably need five extractions, root canals, crowns, bridges. That's like grocery stores, they sell their milk and bread at cost because they want you to buy frozen. Perishables, all the fruits and vegetables that you should be eating, that's a negative because there's at least a 25% waste pilferage deal. Canned goods. But frozen is where if you give them three bucks, they'll make their money. 

Brenden: I didn't think I would ever be sitting here doing a podcast interview with you. I'm really grateful for your time and you're an inspiration to tons and tons of people. You definitely have changed the way I think about things and reading your book was awesome, so I'd recommend it to any dental students who are listening and really grateful for the opportunity. 

Howard: Well, you know what? It's called paying it forward. I was a little bitty, okay so I grew up so damn poor in Wichita. From birth to ten, I didn't even know there were people that had air conditioners in their own house. My dad saved up his money and bought a Sonic Drive-In and boom he started making money. We moved out to the suburbs. I was blown away. 

He opened up one every year and after three or four he moved out to the nicest part of Wichita. My next door neighbor was Kenny Anderson, the dentist. I think I was in - I don't know how old I was. I'm thinking - how old are you in the sixth grade? I went over there and my dad was the love of my life because I grew up with five sisters. My little brother wasn't born until I was seventeen. I hated democracy because every "Monday Night Football" it was like, "Can we watch "Monday Night Football"?" "Well, let's vote? Okay who wants "The Big Valley" or "Bonanza" or whatever, who wants "Monday Night Football"?" it would be - I learned that democracy (01:04:12 inaudible) minorities. 

But dad was the love of my life. He was my everything, my hero, my everything. He made hamburgers and fries and Cokes. Then I'd go talking to my next door neighbor, I'm knocking on his door and he'd let me in, I'd sit on the couch. He'd talk to me for hours. Then I'd say, "Well, can I go to work with you tomorrow?" Because maybe school would be out or (01:04:32 inaudible). He'd always say sure. 

Then at lunch all of the dentists on the west side of Wichita, on West Street, they'd go eat at Westside bowling alley. Talk about camaraderie. That's why I like Dentaltown. Dentists should all get along. Your competition is big screen TVs and Disneyland. All the dentists on the west side of Wichita, they'd all go eat at that bowling alley. Kenny would always (01:04:54 inaudible) be his date. He'd buy me - I can remember getting the ham and bean soup and a sandwich and a BLT, because I only ate cheeseburgers, onion rings and French fries. My god that guy hounded me forever and I'm just paying for it. Thanks Kenny Anderson. By the way, he just celebrated his fiftieth anniversary in his practice. Still knocking them out. 

Brenden: Holy smokes. 

Howard: Right there in Wichita. Still lives on Hidden Lakes Estates. Thanks Kenny. 

Then I want to say one last thing to you. Thirty years of this, the kids that come and are knocking on your door, pressing the flesh in dental school, I've watched them; they float straight to the top. The fact that it's Friday night, it's dark, and you're down here pressing the flesh, running for mayor, I guarantee you there's no chance you're not going to crush it. 

Brenden: Well thanks. I appreciate it. I can't say enough. Thankful for the opportunity to come out and meet you. I wasn't expecting to be here, so appreciate it. 

Howard: And most importantly, good luck with those kids. 

Brenden: Yeah, I'm going to need it. 

Howard: All right buddy. 

Brenden: All right, take care. 

Howard: Ryan, thanks for doing a Friday night. 

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