Podcast: Dr. Howard Farran From Dentaltown On How to Succeed As a Dentist

Kevin: Welcome. This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions with a focus on development, training, education and knowledge. Before we begin with our special guest, Dr. Howard Farran, I just like to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise, we would not be able to provide this podcast. We hope you enjoy today’s podcast. I can’t tell you how excited I am that Howard is taking the time from his incredibly busy schedule.

If you don’t know who Dr. Farran is, he not only is a dentist, he’s not only an MBA, but he’s also an international lecturer and he’s fast, easy and understands what’s important to our profession, not only clinically, but business wise. I’m a firm believer that the best clinicians in the world, if they don’t have an association and a knowledge of business, they’re in an uphill battle. And if you’re a great business person and you don’t attain basic clinical skills, then you’re also in an uphill battle.

Without any further ado, I’d like to introduce Dr. Howard Farran for today’s podcast. Howard, thanks so much for joining me today and thanks so much for everything you’ve done for the field of dentistry and all the aspects of dentistry. Thank you so much.

Howard: It is a huge honor to be on your show. I’m a big fan of your AD podcast and thanks for uploading on the Dental Town website and the Dental Town app. These kids have an hour commute to work every day and they just love listening to dental podcasts like yours and mine.

Kevin: Thanks so much. I thought what would be valuable to our listeners are basically three segments of the dental profession. I’d like to start off with that first segment, and that’s that new graduate. They’re in their senior year, they’re really focused on just basically getting the hell out of school, getting things started, but they really don’t have a roadmap. With your expertise, your background and all the information that you have coming into Dental Town, what would you say would be the three to five bullet points that you’d recommend for these young graduates just getting started in their career?

Howard: I had an extremely lucky childhood. My dad was dirt poor and when I was ten years old, he saved up his money and bought a SONIC Drive-In franchise. He went from making like $11,000 a year to $60,000 his first year, then he opened up another SONIC every year for nine years. We went from dirt poor and I didn’t even know what an air conditioner was — I didn’t even know that people had air conditioners in their house — to living in the wealthiest area of Wichita, Kansas in United States.

In that church that we were in was also the founders of Pizza Hut, Dan and Beverly Carney, who ended up with 2,800 Pizza Huts that they sold to PepsiCo, the Shah family that started Godfather’s. So when I was a little kid and went fishing, I would sit next to my dad who had nine restaurants, Roger Carpenter who had 100, Jim Williams had 1,000, Roger Carpenter had 2,800 and there was a lot of takeaways from growing up with these guys.

Number one, you would never know any of them had a dime. I mean, my God, they lived below their means. When Sam Walton died, everybody always says that Bill Gates was the richest man in the world it’s because they don’t know addition. When everybody said Bill Gates is the richest man in the world during my entire life, if you look at the Walton family and Sam and his wife Helen and his four kids were like number 17, 18, 19, 20, 21, 22. If you added them up, they were worth the 40 percent of the poorest Americans in that one family. And his desk was a door on two sawhorses and he drove a pickup truck.

Dan Carney, my God! You damn well would have thought he was homeless if you ever ran into the guy. He had these old corduroy pants. I think he only had about five different pants and shirts. They all lived below their means.

And then the second thing that the takeaway was is every one of those legends in the restaurant franchise business, by the time they had five employees, one of them was a fulltime bookkeeper. All they did was master their costs. These dentists would go in a room and they’ll do two MOD composites and I’ll say, “How much did you charge for that?” And they go, “Like 250 for an MOD composite.” And I’ll at them and say, “250! Dude, 90 percent of your practice is PPOs and this plan you got 125. How were you off a Benjamin on each one of these damn fillings? And what did that room cost you?” No idea.

I remember when I was ten years old and I was working at SONIC and I was making a number one cheese burger and I was dressing it and I put on four pickles, my dad picked up that hamburger and threw it at the wall as hard as he could and he said, “Howard, if you’re going to put four pickles on a hamburger, you might as well give it away for free.” And I was like, “Wow! How many pickles are supposed to be on a hamburger?” He says, “Three.” These guys all knew their cost. And by the time they had five employees, one of them was a bookkeeper. It was amazing.

I hired a bookkeeper when I started out. She’s now the president of my company and makes $200,000 a year. It’s all about cost. These dentists, they don’t know their cost. When you go in there and they have practice management information systems like Dentrix and Eaglesoft, they don’t even have an accounting software. So all your day you only manage people, time and money so all their costs were incurred in time, but they bill in units. The PPO price doesn’t even matter. The only thing that matters is what does that room cost for an hour and how much production do you do in that hour.

Southwest Airlines takes 100 percent of all their cost and reduces it to one airline seat flying through the sky for a mile. If that chair takes off where you’re at in Boston and flies to my house in Phoenix and no one’s sitting in it, it still has costs. That plane is not being flown by the tooth fairy, it’s not being pulled by magic fairy dust, it has costs. These dentists don’t even know what an operatory costs because Dentrix and Eaglesoft, those are the two worst things that ever happened to dentistry. They’re the WWI and WWII of dentistry.

The receptionist is out there, she books an hour for two fillings, she doesn’t even know what it is, then she books some lady to come in for a cleaning for an hour, she’s getting $55 for the cleaning and the hygienist is getting $40 and these dentists don’t even know they’re in quicksand. You have to hire a bookkeeper at every position you have.

I’ll go into a dental office and the supplies last month they were five percent, the next month they’re eight percent, the next month they’re seven percent, the next month they’re nine percent. It’s like how do your supply costs vary 100 percent from month to month? But if I hire a bookkeeper, she’s not in health care so she’s not used to inflated wages. Everybody in health care and government and unions are used to these overkill wages that are market reality so you hire outside of health care, outside of government, outside of unions. You bring in a bookkeeper, I can teach her how to be a dental assistant in a month. But then my supplies, if I say my supplies are 4.5 percent a month, then she’s totally organized, puts up all these bookkeeping accounting systems.

Same thing upfront. My gosh, you hire a girl that worked across the street in a dental office for ten years on Dentrix and I’ll ask during the interview how many reports does Dentrix have? Does it have five, ten, 20, 30? She has no idea. I’m like how did you sit on a software system for ten years and never even go up and click this icon? Mainly because what Dentrix and Eaglesoft does, instead of hooking it up to Quicken or Payroll or Peachtree or Microsoft Great Plains Accounting, they sit there and you send in all these wish list features so they’ve added so much bullshit that 85 percent of all the functions are not even used in any dental office.

Anybody go into anybody’s dental office, go to report generator, go to the utilization, none of it is utilized. But when you Marriott, it’s striped down. They only do like seven things to check you in, but they always do every one and you can’t go from four to five or five to six without doing it in order. When you go to return your rental car to Hertz Rental Car, they only do like five things to check you in. That’s why we switched to Open Dental. I have no connection with Open Dental, they don’t advertise in Dental Town. In fact, they don’t advertise anywhere because they’re the best damn software ever because they are open. So you can have your own programmer program right into it and make your own self a dashboard or whatever. But it’s the most open software for your data.

And if you get a bookkeeper in there — what we have to do is we have to dump everything out of Open Dental into Excel spreadsheets and then dump everything out of Peachtree Accounting into Excel and make all these damn reports because the receptionist, you call up and — if I sell bottled water, I make this bottled water for 90 cents and I sell it to 7-Eleven or Circle K for a dollar, I know it costs me 90 cents, I know I make a dime on every one and then they sell it for $1.15.

In dentistry, the average dentist is signed up for about 12 to 15 different PPO plans, he has no idea what he is charging for any procedure, he has no idea what his room costs and then the receptionist is scheduling your only cost, time — the Fortune 500, the SD500 average payroll is 53 percent. That’s what it is in dentistry. The dentist is making 35 percent on 65 percent overhead, the staff is making about 25 percent, lab bill 10, supply is 6, rent/mortgage/utility is 5 – 6, but that’s all spread out over time and the receptionist is just sitting there saying, “Well doctor, how much time do you like for an MOD composite?” I don’t care how much time you like for an MOD composite. What does that room cost and what are you getting? If that room costs $200 an hour and you put in $145 MOD, you just took a $50 bill grant and shredded it in a shredder.

Dentists also do weird things like they only do quadrant dentistry where they’ll say, “Let’s do the fillings on your right side and have you come back in two weeks to do your left side.” And then right next door to him is an oral surgeon that numbs up all four quadrants all day eight times a day, five days a week for 40 years. I just tell them, they’ll say, “I only want to do the right side today.” “Well, due to your insurance plan, it’s a heavily discounted plan. The only way this works is if I do all of them at the same time. I can only afford to do all these fillings that we do all at once. On this discounted PPO plan, I can’t schedule an hour four different times to do four different fillings. The way your plan works, I have to do them all at the same time or I can’t even do them.” And then it’s like, “Oh, okay,” and then they do it.

When you staff your assistants and your receptionist with bookkeepers, they get numbers, they get cost. Some dentists make 25,000 a month on 40 percent overhead, they only got to do $41,000 a month to make 25,000. At 50 percent overhead, obviously, all you have to do is 50,000. But at 65 percent overhead, which is the national average, you got to do $71,500 for the dentistry to make 25,000 a month. And 20 percent of dentists have 80 percent overhead, they got to do $125,000 of dentistry to make 25,000.

The other thing they do wrong is that they’re doing everything right in their mind, like they get out of school, they go to their church, they ask their pastor or the Rabbi, “Hey, I need a CPA. Do you recommend anyone?” And they’re like, “Sure, there’s a CPA in our church, in our mosque and he’s just a great guy. Go talk to Rick.” Rick doesn’t know anything about dentistry. I’m sure he’s a great guy.

But now we got the Academy of Dental CPAs at www.adcpa.org, they got 6,000 dentists on one database, they got the Institute of Dental CPAs at www.indcpa.org, they got another 2,000. But every dental office, every dentist I know that has switched to someone like Cain Watters and Associates, someone who only does dentists, then they’re sitting there because dentists know if all, they just know it all. They’re not a doctor of dental surgery, they’re a doctor of freaking everything. They don’t listen to anyone, so they’re not going to listen to their CPA.

But dentists listen to other dentists because they hang. They hang out with these dentists in dental school. They know everybody that got into dental school got A’s in calculus and physics and geometry, they know how many ATP come out of glucose on the Krebs cycle, they know their homies are smart. So when that American Academy of Dental CPAs or Institute of Dental CPA sits down and says, “Well, Dr. Kevin Coughlin, we have 6,000 dentists and their supplies range from 4 to 8 percent and the mean is 5.25 and yours are 7 percent. Can we talk about that?”

The dentists love numbers. Just kind of like when you’re in dental school and you’re taking a test and they went and posted the computer printout of everybody’s score and what the curve was, dentists are used to that herd mentality with their other doctor homies. So when they start seeing this data bank and they start realizing what’s going on…

The other thing is with PPOs. Let’s just say you’re in Wisconsin, that’s a very different PPO market than New Jersey, which is extremely different than Kansas. And so when you got a dental CPA who’s doing 150 dentists in Kansas, he can sit there and say, “I don’t know what’s correlation or what’s cause effect, but I do know everybody who’s on this PPO here, whether it’s Connecticut General or Blue Cross, whatever it is, everyone that’s on this PPO is running like 68 percent overhead. But we’ve had several doctors, we’ve had five that dropped these two plans and what we saw is that their gross production went from $1 million a year down to $900,000 a year. But their net went from 1.75 to 2.25, which shows you how much dentistry they were doing at a loss because now they do less dentistry and they net more money.”

And then the other thing is your hygienist comes in and your staff, the whole promotion system is based on astrology. They come in your office once a year and say, “Doctor, the earth has gone around the sun and past Uranus and it’s time to give me a dollar raise.” And you’re like, “A dollar raise? My God! I just talked to my dental CPA and I’m paying you $40 an hour to do $55 of cleaning and we’ve reduced all of our costs for operatory. Of course, we took out crown and bridges and applied that to the dentist, but your operatory is costing $90 an hour and you’re doing $80, I lose $10 every single time you do a cleaning. You take an hour. Is there any way you could schedule 50 minutes so I could break even? Or if you go to 45 minutes, I’ll give you a raise.”

But once you get the team on the same page and you build trust and integrity, if you have no trust and you have no integrity, if you lie, cheat and steal, you can’t lead a team, you’re not going to get repeat business, you lose everything in life. And then when everybody starts getting on the same page with the numbers, everybody starts making better decisions. The front office makes better decisions on how much time to schedule.

A lot of dentists are realizing that composites, I mean oil is trading this morning at $71 a barrel and CLEARFIL SE is trading at $1,250,000 a barrel. These dentists say these crazy whacko things like composites last longer than amalgams. When a dentist says that, you almost got to think his mom dropped him when he was a little kid. The average composite lasts six and a half years, it’s a neuroplastic, the [recut 00:16:45], decay and release composite is just much. You take out with a number four, number six, number eight round bar.

These amalgams are half mercury, you’ll never find mercury in multivitamin. The other half is silver, zinc, copper and tin. Every one of them is antibacterial tin, stannous fluoride, that’s tin. Silver diamine fluoride [detrinia 00:17:04], pediatric nursery, everything in an amalgam is toxic. And when you put in an amalgam, those things last 38 years but the thing is an amalgam doesn’t cost anything and they’re fast.

So when you sit there and you start realizing that this room cost you $200 an hour and you’re getting paid $100 for an MOD composite and you can barely do two of them in an hour, it makes you start thinking well maybe instead of putting in a six and a half year old inner plastic composite without an active ingredient, maybe I should just go back to amalgam. And a lot of these dentists are going back to amalgam because their patients prioritize PPOs and price over aesthetics. I can’t make a bottled water for 90 cents and sell it to you for 45 cents. These are what dentists are doing. They’re doing it all day, every day.

Gosh, at this point, I don’t even know what question you asked.

Kevin: I’m going to tell you this, Howard, first of all, the information is terrific. And if I was to paraphrase and summarize, I think what you’re trying to tell these new graduates is number one; live below your means. I know you want a new Porsche, I know you want a Mercedes, I know you want a Tesla. Hold on to it and save some money and spend below your means. Even though you think you deserve it, in the real world, my data says you’re going to be close to $300,000 in debt. And at a 6 percent interest over seven years, it’s going to cost you almost $4,000 a month to get out of debt. So the first $78,000 to $80,000 is going to go just to deal with school debt. So I believe what you’re trying to say is live below your means. Save some money.

Number two; know what the hell your costs are. When you sit there and look at your schedule, say how much time am I planned for and what am I going to generate for revenue? All that’s great, but if you don’t know what your overhead costs are for your business and your personal life, you’re just swimming in a circle going nowhere.

Last, if I was to say what I learned is remember, three pickles are just as good as four pickles and it’s going to put more money in your pocket and your old man taught you the right way.

Howard, I can’t tell you how much I appreciate this. If these young graduates, these people getting started in the profession they wanted to get more information on you, they wanted to learn more about you and how you’ve conducted your business and helped thousands of dentists throughout the country and the world, how do they reach you?

Howard: I would have them go to Barnes & Noble and buy my book in print or audio called Uncomplicate Business. You only manage three things; people, time and money. That book is my masterpiece. I was 50 years old, had an MBA, had been practicing 30 years and collecting a million dollars a month before I wrote that book. It’s my magnum opus. The secret to writing is rewriting. The first draft was 600 pages, second draft cut down to 400, the final draft, 200 pages. That book could tell you everything you ever need to know. And then it costs like ten bucks.

Kevin: Howard, I can’t tell you how much we appreciate that you’re doing this podcast. I know how busy you are. I personally want to thank you and I want to also say, thank you for what you’re doing for our profession. I hope that we can do a follow up podcast with a focus on those dentists who started off with a bang and a flurry, but for a variety of reasons that I think we both know, their practice is not going in the way they wanted to, they’re not accomplishing what they want and it’s sad. And with the proper processes and procedures, their lives could be turned around, not only clinically, but financially, and that’s better for them and their family.

And then that final podcast is how do we prepare that dentist for the ultimate exit strategy. For whatever reason; health, nerves, desire, they know that they’ve got to take this asset and they’ve got to, in most cases, sell that asset. And how do they get the most valuable return on investment for that asset? And I think with your knowledge and expertise, if you’re willing to spend the time with me, I’d love to follow up on those two additional podcasts.

Howard: Kevin, it would be an honor to come back two more times on your podcast. I’m a huge fan of your podcast. And again, thanks so much for putting it up on Dental Town because these dentists tell me they get in their car, they open up the app, they scrawl through the podcast, say what are they in the mood for. I’ve gotten so many great feedback and comments on your podcast on Dental Town. I think what you’re doing is just amazing.

Thank you so much for transferring your amazing knowledge from doing that for so many years and all the, hell you’re at 14 dental offices — to think that some dentist who’s done it for 30 years, who built 14 years telling these little kids that just walked out of dental kindergarten class everything you know is just a noble course. I’m so proud of you. Thank you for all that you’ve done for dentistry and Dental Town.

Kevin: Thanks so much and I look forward to our next podcast. This is Dr. Kevin Coughlin. You’ve been listening to Ascent Radio.

Podcast: How Dentists Can Add Laser Services to Increase Their Revenue with Eric Diffley

Kevin:       This is Dr. Kevin Coughlin. You’re listening to Ascent-Dental-Solutions and this is Ascent Radio. Ascent Dental Solutions has a focus on knowledge, education, development and training. Before we begin today’s podcast, I want to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his time and expertise, this podcast would not be available.

Today, we have another guest and his names is Eric Diffley. I have met Eric, and in full disclosure, he’s been associated with the company Cynosure which is considered the premier, and perhaps, one of the largest and best medical dental laser companies in the world. I can tell you that I was blown away by his knowledge, his expertise, but most importantly, his desire to suit the right products and services for me as a dentist and for other health care providers.

Eric, I thank you so much for taking time from your busy schedule to be on today’s podcast. Can you tell me a little bit about your company and the direction it’s going? I know there’s been a lot of exciting new things going on. And introduce yourself to our listeners.

Eric:           Absolutely. And again, thank you both Doug and Kevin for having me. It’s an absolute pleasure and honor to be here. Again, my name is Eric Diffley. I work for the company called Cynosure which is out of Westford, Massachusetts. Cynosure has been around for 26 years. It’s in over 138 countries so we have a global and a national presence.

Started off as a very blue collar mechanic-like company with one laser out of a workshop and it kind of blossomed into this overnight success with different types of technologies. And how we got there, really, was build out and start with just one core and good laser. Had great results, great outcomes. Business owners and doctors truly believed in it and it helped grow their businesses. That allowed us to grow into the second, third, fourth laser.

We got to a point where there were other competitors that were doing thing very well, things that we admired and we wanted to grow with them. So there were three different points in Cynosure’s career where they actually purchased different companies. Those companies are Palomar, ConBio and Ellman, leaders in the industry that are now under the Cynosure umbrella.

And very recently, in 2017, Cynosure partnered up with a company called Hologic, who is a woman’s health and mammography company out of Marlborough, Mass, which has allowed Cynosure to grow into this billion dollar company that it is today. So what that means for its customers and our customer’s customers is that endless support, whether it’s from our clinical side, whether it’s from our marketing side, whether it’s from our research and development side. We want to provide our customers with the topnotch support and give them the best products possible.

Kevin:       Eric, when I talk to dentists through my business consulting company, Ascent Dental Solutions, I was blown away by the continuing education courses that your company offered. You opened up a whole realm of possibilities and ideas to the dental profession that I really never thought about. I’ve been practicing for 35 years, I have 14 offices, about 160 employees and there’s almost no aspect of dentistry I don’t do. But for whatever reason, my own faults mostly, I never explored the extra-oral options that lasers could provide to the dental profession. I’ve been using intraoral lasers for well beyond 15 years and today, I’ve seen the ability of what your company and their products can do.

And for our dental listeners, please keep an open mind as we’re confronted over and over again with more PPO type of insurance plans, more paperwork, reduction in our financial returns on investment. For example, we do an amalgam, a composite, an extraction, whatever we’re doing intra-orally, there’s always an insurance plan that’s downgrading and making it more difficult to be profitable and putting more overhead on us. But in the field of aesthetics, what I’ve learned over the last two years, in particular with your company, is the incredible demand. Perhaps, you could talk about the aesthetic demand that your company has seen.

Eric:           Absolutely. A big time for the aesthetic industry came around 2008/2009 when Obama Care was implemented and reimbursement rates really dropped. So it’s now see more patients and make less money. It’s such a tough industry now in the medical field, as you were saying, Kevin, is that the reimbursement process is just a pain. It’s a pain in the medical industry. It’s not what it was in many aspects 10, 15 years ago. So I appreciate you telling all of the listeners to keep an open mind.

I understand there are plenty of companies and sales reps that do like to say that they can make them money, but it’s really a business opportunity here to have these types of discussions and add these types of revenue streams to your office and to your business. What this comes down to is this allows any type of practitioner, doesn’t matter which field they’re in, specialty; family medicine, dentistry, plastic surgery, to make that income and focus more on their specialty with greater care. Going home at night knowing that they’re able to feed their family and are able to live a comfortable life, however, they’re still focusing on what they currently chose to do.

Kevin:       That is exactly correct. From your market research and a company with your size and breadth of information, what would you say the largest demand is? Is it hair reduction and hair removal, is it tattoo removal, is it the reduction of fat cells or adipose tissue, a combination of all three? What would you say to our listeners that your company sees as the highest demand?

Eric:           That’s a great question and that also leads into why Cynosure has this whole rapporteur or arsenal of different types of devices. It’s not a one trick pony. We do everything and we do everything very well. So whether that is tattoo removal, skin tightening, photofacial, body contouring, invasive, noninvasive, hair reduction, even dipping into women’s health, we have it all.

To answer your question, I would say that the noninvasive body contouring market as well as photofacial market is extremely high right now. Two reasons being for body contouring is that while liposuction is still a sort out procedure and everyone has fat that they’re looking to get rid of, no one anymore wants to go under the knife. It’s a let’s do it and let’s do it now type of lifestyle that everyone’s living. So with this procedure that we have called sculpture, it’s 25 minutes and it’s noninvasive and there’s zero downtime.

How the science works — to keep it simple — the laser heats up the fat cells to a point of destruction, apoptosis; when a cell dies off. And over 6 to 8 weeks, the lymphatic system flushes those fat cells off contouring the body.

And then photofacials; everyone has them, whether it’s a sun spot, blood vessel, telangiectasia, Rosacure, acne scars, stretch marks, all things of that nature on our face which we can’t cover up. And in our society, those are things that all bother us and those are why we’re coming out with these options or solutions that people are seeking very heavily.

Kevin:       I can just tell the listeners that over a year ago, I had Cynosure come to my office. With no preparation, whatsoever, they just showed up and they brought their 1540, their MaxG, their MaxY and their MaxRed laser systems and IPL for Intense Pulsed Light systems into my office one afternoon and I had eight employees immediately ready to sit in a chair to have little nevuses or brown or red spots, what we call liver spots or sun damage for their face. I had others asking for hair reduction and hair removal. I had others wanting to have tattoos removed, and that go without any marketing, without any preparation. I was amazed of the number of employees that I had that were willing to just sit down immediately because they wanted the latest, the best and the most up-to-date technology to resolve their aesthetic wants and needs.

And perhaps me being a man, perhaps me not being abreast to the aesthetic demands that are out there, which is shame on me, the number of female participants that were interested in hair reduction rather than going through electrolysis, waxing, tweezing and sugaring and other aspects of the aesthetician background to reduce and remove hair, this was quick, it was exciting, it was fast, and it was extremely profitable.

Perhaps, Eric, if you were to say to the dental profession and they were considering getting into this field, what would be the first piece of equipment? Assuming they’ve had the appropriate training, they’ve got all the appropriate paperwork and things completed, what would you recommend for that dentist who’s interested in going down this exciting road?

Eric:           Absolutely, that’s another great question. And that’s the honest conversation that we both had. We shut down and we talked about where you’re looking to go and how you’re looking to grow your business. So keeping it inside the realm of dentistry and facial work, we didn’t jump right into the body contouring for you, we stuck within those walls. So for any dentist that is looking to stay within their practice or their scope somewhat, I would recommend IPL or photofacial.

And again, it’s keeping that open mind. A lot of dentists that I’ve spoken to over the years here is that they correct smiles but I ask them, “Doctor, have you ever thought about correcting the smile on the outside? You work on the teeth on the inside, but let’s focus on the out.” And once you start to look at the bigger picture, you realize that a large portion of your customer and client base have these issues or concerns, I should say, that can be treated with photofacial.

And like you said, you had eight of your colleagues or staff members ready to jump on the table to get treated and I would bet you that six out of the eight of them were already having treatment elsewhere. It’s the type of industry where the people if they don’t see it, they won’t ask about it, but once you have a type of solution, they start to come out with all these problems.

And again, like we spoke, Kevin, it’s the type of procedure where you can take care of a patient and say, “Do you mind if I just take care of that little stretch mark or scar on your face?” Once you take care of that as a complimentary service to that customer, they will come back to you, (1), in good faith, and, (2), to say, “Now that that’s gone, I realized that I have these freckles or these melasma over here. Can we start treating that?” And that’s how you really start these procedures that they focus on one thing and once that’s taken care of, they start to realize that there were a couple of other issues or problems that they want to take care of and resolve.

Kevin:       I think for many of our dental listeners, they are familiar with Ellman because they’ve been associated with the dental profession for quite some time. One of the things that Eric did for my personal dental practice was to introduce me to Ellman, which is radiofrequency, reduction of gingival tissues, coagulation of blood, the removal of fibromas, frenectomies, the list goes on and on, intra-orally. But I didn’t realize Ellman had attachments that would help with skin tightening, improving tone, texture, appearance. And it was quite interesting to me that I had the machine, I just didn’t have all the attachments. And with your company’s expertise, we were able to put them together and expand into facial photo improvements and texture tightness and appearance of the skin. And maybe you can discuss that in a little better detail.

Eric:           Absolutely. Again, Ellman was a company that Cynosure acquired in September 2014. Ellman was the leader in aesthetic and radiofrequency technology. So Cynosure kind of looked and said, “Hey listen, we could probably come out with something pretty good or pretty similar, but we have the cash flow right now, we have the stable company that will allow us to purchase them and make them part of the Cynosure family. Let’s not reinvent the wheel here.”

Again, as you mentioned with the coagulation and soft tissue cutting, there’s a separate attachment that is radiofrequency and it stimulates collagen and elastin. And how it does that is that you heat the skin to a certain temperature and it’s attracted to water in the skin. So the more hydrated you are, the better result you’re going to get. And then over a series of treatments in weeks and months, the skin starts to become more unified as that elastin and collagen is reproduced.

Kevin:       I can tell you through my own experience that the patients generally find it very, very relaxing and very comfortable. I won’t kill our listeners with didactic information, but basically, you’re using three or four different size heads, you’re placing a moisturizing cream or an ultrasonic type cream on the tissue and you’re heating it up to about 40 to 44 degrees centigrade, which is roughly between 102 and 105 degrees Fahrenheit. And for three to five minutes, you’re massaging areas of the face that your patient or client has concerns with.

It’s really like a souped-up on steroids facial that’s giving you long term much better results and much more cost-effective. Typically, your average facial makes you feel good and relaxed, but the long term success and improvements are minor, at best. Whereas when you start implementing radiofrequency, I can tell you first hand, you’re seeing a significant improvement in the tone, texture and appearance of the skin. And the clients have been extremely satisfied because they know the results are much longer lasting. And it’s just a very nice way to introduce your team members and your practice to the extra-oral aesthetic aspect of health care.

Eric:           Absolutely.

Kevin:       Eric, I want to say thank you to you and your company, not only personally, for providing guidance, training and education. But before we close, can you just provide a little bit of information? This Pellevé, this radiofrequency device, on average, what would you expect the dental profession to have to invest to incorporate that particular system into their practice?

Eric:           While our many different platforms range from different prices, it matters how you configure it as well, the Pellevé system will range somewhere within the 50, 60, 70 thousand dollar range, depending on how you get it configured as well. Because there’s facial attachment, there’s body attachment, and then there’s also a surgical component, that you mentioned, that you can add onto it as well. So there really is different configurations on pricing, but that is the ballpark.

Kevin:       If you were to expand into Intense Pulsed Light or IPL, what would you say, again, in a range for the dental profession to consider investing in those types of procedures and equipment?

Eric:           Again, it’s different configuration with our IPL device because there’s about five or six hand pieces so it definitely ranges. But you’re looking anywhere from $80,000 and it can get all the way up until $160,000, $170,000. But the point I like to make here is not that final price because there are a lot of times it’s a lease-to-buy situation. So what we break it down is a monthly cost, an ROI at that point. How many patients does it see to make that monthly payment? And generally, it’s anywhere from two to three to four patients a month, which seems pretty reasonable. Which bring it back to that perspective of it comes down to patients per month on how many you can treat, and then it’s a good business opportunity from there because they are cash-based procedures.

Kevin:       Eric, I want to thank you again. I want to thank your company, Cynosure. I want to thank you from employees and team members on the wonderful adjunct that you’ve provided. I’ve actually, for our listeners, started another company called Ascent Laser Aesthetics with a focus just on extra-oral treatment to improve the overall condition of the skin and the contours of the skin. And I can tell you, at age 59, it’s put another spark in me and I’m excited and it couldn’t have been done without your expertise and your company’s support.

You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin and my company is Ascent Dental Solutions, with a focus on education, training, development and knowledge. Our guest today was Eric Diffley and he is the sales manager and business consultant for Cynosure and I can tell you my response to this company has been over the top. Their support, their care, their service and their ability to support me through this new education and training has been outstanding. Eric, thank you so much.

In closing, I want to thank Mr. Doug Foresta and his company, Stand Out and Be Head. Without his expertise, this podcast would not be available. Thanks so much and I appreciate your time and expertise again, Eric.

Eric:           Thank you both very much. It’s been an honor.

Podcast: Digital Marketing For Dentists with Kellen Kautzman

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin:       Welcome. This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions and it’s brought to you by Ascent Radio. My special thanks are always to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise, the over 80 podcasts that we’ve produce would not be possible. I’d also like to give a plug to Short Circuit Media and the owner of that, Mr. Aidan Crawford. His marketing skills have brought my dental and dental consulting business to the next level.

Tonight, I’m pleased to announce that we have a special guest, Mr. Kellen Kautzman. Kellen owns the company Send it Rising. It’s an internet marketing and he’s a manager of a team of at least 20 internet marketing professionals. One of his claims to fame is his first book Everybody’s Doing It, which was the number one new release on the CEO category of www.amazon.com. He was also the keynote speaker at Planet Hollywood on the Las Vegas strip and he’s spoken at various universities. He’s also been part o the Lance Tamashiro podcast. Kellen holds a master’s degree in education and has taught for five years before transitioning his career as an internet marketer.

As a health care professional with a business degree and 14 locations and a fairly large dental practice, I can tell you that at least the dentist that I know, Kellen, certainly are remise and have a lack of education and knowledge when it comes to internet marketing. And an expert like you certainly should be a great adjunct to this podcast. Thank you so much for taking the time to join this podcast.

Can you tell us what you think the biggest mistakes that health care professionals make when they try to market themselves, their services and their company?

Kellen:     Sure. I would say that they forgot that they were once young. All of the amazing stuff that’s happening in internet marketing starts in that 16 to 20, 22-year-old demographic. That’s where Facebook started, that’s where Instagram is taking off now. And so all these things that will become dominant are now in the land of, “We don’t really have to worry about it.”

And so there’s this curious phenomenon that when we’re in junior high or high school and we’re asked to step in front of an audience, we can feel the perspiration and we can feel that anxiety. And the second, as adults for many of us, we have the opportunity to avoid those circumstances, we do. And so when it comes to YouTube, as a good example, this is now and aged platform on the internet, there is absolutely no excuse whatsoever as to why a dentist should not be making continuous content, video content, and placing it on at least YouTube.

Google, which the overarching company is called Alphabet Now which owns Google and YouTube, has artificial intelligence that is absolutely mind-bogglingly intelligent. It’s smarter than you and me combined and every other human on planet earth. It’s so smart, in fact, that it now speaks and understands English incredibly well. If you want an example of what this looks like, create a YouTube video, upload it and then click on the little CC icon, the little closed captions box that appears in the upper right hand corner once it’s uploaded. And what you’ll see is that within two minutes of the file being uploaded on YouTube, there is an automatic captions box that — with call it 98 percent accuracy — will tell you exactly what you just said.

And so for most dentists, as they attempt to get more patients through the door, they think I have to create blog content or I need to be posting more on Facebook. But the reality is that if you just stare into a camera and speak, all of those words are understood by the artificial intelligence and its job is to judge where your site appears in Google.

Google is still incredibly important in regards to getting patients through the door. If you rank for dentist, dentists, dental practice, tooth, whatever, you name the keyword, YouTube can get you there because in the description of the YouTube video, you can add a link back to your website. And for those of you that have studied any SEO at all, you know that a link is a vote and the more votes, the better.

Kevin:       Kellen, staying with the topic of YouTube, with your expertise and your company’s background, is there a specific length of time that is suggested for, let’s say, a beginner like myself that’s interested in uploading content into YouTube? Is it 30 seconds, is it four minutes? What does the data suggest?

Kellen:     That’s an excellent question and a good segue into YouTube advertising. If you’re not familiar with AdWords, look it up. Via AdWords, you’re able to create what’s called an in-stream video. In-stream videos are the yes, annoying videos that appear in YouTube prior to the video that you actually want to watch. Here’s the magic of in-stream videos; you’ve got six seconds before the patient, in this case, has the opportunity to hit the skip button. And so the great travesty is creating YouTube videos that in the first six seconds don’t say your name, don’t say your company name and don’t give your contact information. So if you move forward with YouTube videos, make sure that in those first six seconds, you’re putting out that information.

If you run these ads via YouTube, you don’t pay, and it’s bears repeating, you do not pay until the viewer gets to 30 seconds. Twenty nine seconds or less, it’s free. That is incredible. So when people are skipping those annoying ads, they’re actually doing you a favor because you’re walking away with free impressions. With the understanding that you will explore YouTube advertising which can be geo-targeted, so you can pick your area, you can pick your keywords, maybe it’s braises for kids, maybe it’s Invisalign, maybe it’s Fastbraces — that’s a new thing — whatever it happens to be, you’re getting them in via keyword and you’re getting them some good content.

That basically says don’t make videos that are less than 30 seconds. That will be a mistake. If you have 20 seconds and you’re throwing these ads outs, you’re paying when you get to 20 because the video is over. So at least 30 seconds and the rest of it, that’s art. Because I just released a book called Everybody’s Doing It and the video we just created is over 20 minutes, Kevin. Over 20, incredibly long. And as I was editing this video, I thought to myself, this is too long. I’ve never done something quite this long. I know it’s really good, I worked really hard on this, this is great content, I know it is, but it’s really long. Put it out there, so many people have told me that this is one of the best videos I’ve ever done. They watched the entire thing, they love it, it’s great, hurray!

So I can’t say definitively yes or no, but typically, our videos are in like the two to four minute range. Because if you even get close to kind of saying the same thing over and over again, people’s time is too valuable. Move on.

Kevin:       In your expertise, Kellen, and in your company’s expertise, I know that content is incredibly important but you touched based on the artistic aspect of it. Do you get a better response when there is a music, do you get a better response when you’re using certain audio/video special effects, or do you just focus in and get the content out there, don’t mess around and just make it straightforward to your viewers?

Kellen:     I think anything that prohibits you or stops you from moving the ball down the field should be avoided. So if you’re going to spend time trying to mess with this graphic and it’s been 45 minutes and you’re getting frustrated, forget the stupid graphic. What you’ll find is over time you will evolve incredibly. As an example, my first YouTube video, bad audio, lighting was rough, but now we’ve got the double lights, the condenser mic, the lapel, the double camera angles, the whole nine yards, it’s great. But you can’t get there just by — maybe you could do your research, but you get what I’m trying to tell you which is you have to grow into it.

There’s two pieces of the puzzle that folks should walk away with from the video production angle that are really sharp. If you’re unfamiliar with the vernacular picture in picture, think of a news anchor with a little box in the upper right hand corner where that just pops up, you can do that easily in almost any video editing software like iMovie. The other is a Kanban’s effect, which is the small pan into the video in or out or to any angle. With just those two things you can take a pretty boring video and make it interesting.

Kevin:       Great information. Thank you so much for that. I can tell you that at least in the health care providers that I know, and I interact with literally thousands of them, most of us did not get any of this training in our medical and dental education. So most of us need to reach out to an expert such as you and your company to get help, get information and knowledge in how to pursue this. You touched on this a little earlier. I know with the podcast it seems to me that if we can continue to do podcast weekly, the following increases. Is there a repeat with YouTube? Would you suggest or did you mention earlier in this podcast that you felt weekly by weekly, monthly? What’s your recommendation for content?

Kellen:     Consistent, that’s the hardest thing. It’s whatever pattern you want to establish, you want to stay on that. There’s a part of our brain that sounds like you’re going faster, it’s called the basal ganglia and it’s walnut-shaped right in the center, that old reptilian mind that fires when we’re on autopilot. There was an incredible study done where a gentleman had lost a part of his hippocampus due to a virus and so he had no short term memory at all and they put him in front of this board and they had him pick either A or B. And A, when he flipped it over, would be either green or red. If it was green, that was good, red was bad. Over the months, he just started picking the green ones. He had no idea why he was doing it and when they studied his brain, they found that this basal ganglia was firing.

And so when you start a new habit, know that whatever frequency you administer in the beginning is the frequency that will create that habit. You could drive yourself crazy and be like, “I’m going to do something every day,” and you could develop a habit. But guess what, other aspects of your life are going to make way for that habit. Succeeding could actually be detrimental to your practice. So just be very cognizant and assume you’re going to succeed. If I were to succeed creating, let’s say, a monthly podcast, would it be enough? Would it drive me crazy? Would I have too much on my plate? And so assume success and then get into that habit.

Kevin:       Kellen, could you take a few minutes and explain to the audience about link building and how we go about it, what your suggestions are to help the health care profession improve their ability to community with their clients, their patients, their team members, etc?

Kellen:     We can do a segue from YouTube links all the way into one of the pieces of a secret software which is Pinterest, believe it or not. In your YouTube videos, in the description you can add a hyperlink. It won’t turn blue and it won’t be a link if you don’t include the http://. If you forget that, you get no link. It’s very important to include that. So you can get a link from YouTube. There’s something called Google Search Console, it used to be called Google Webmaster Tools that if you have Google Analytics installed on your website you can easily install this. You’re literally about a minute away. So remember Google Search Console. In the backend of Google Search Console you can see how many links you’ve earned.

And this is important information, and there’s a bunch of other important information, but the reason I’m mentioning it is when I log into the backend for a couple of our websites, I see tens of thousands of back links from Pinterest. It’s almost as if Pinterest found me and not the other way around. So when I was looking at Google Search Console I went, “Whoa, what’s this?” And so I started digging into why this was happening.

What I found is that if you create an image that’s funny or interesting of shareable in any way, shape or form, for some reason, if you put that image on Facebook, you might get two shares, maybe. You put that same image on Pinterest, you might get 20,000. And every time — it’s called the Pin in Pinterest — every time this image, this pin is re-pinned, it duplicates the image and when you click on the image, it takes you to the website. So the image is the link, not your standard text link.

So start thinking about viral images. How could you poke fun of yourself as a dentist? What kind of stupid derail jokes, what kind of dumb dentist jokes could you throw out there? What interesting information could you talk about hygiene or the new tech that’s coming out or any of those things via images on Pinterest? A lot of people get confused here and they say, “Yeah, Kellen, but nobody’s going to come to my website from Pinterest.” I know that. I’m not under any impression that they will, but tens of thousands of links from a relevant social media platform will jump your Google rankings. And when those jump, the phone rings.

Kevin:       That is just an eye-opener. I can tell you, I believe I mentioned, this is probably the 80th podcast and the information you’re providing myself and our listeners is just fantastic. Can you take a little bit of time and explain how we can reach out to you? How do you help us? What does your business do? I don’t want to put you on the spot, but do you do a formal contract, is it a consulting agreement? How do our listeners reach out and you help them improve their communication, their business and ultimately, their bottom line?

Kellen:     As you mentioned at the top of the show, I used to be a teacher and so I come at this from a very different angle. We are as honest and transparent as it’s humanly possible and so we do month to month contracts. So if anyone’s interested in working with us, know that if it’s three months in and things are looking great, hurray! Wonderful! If they’re looking bad, we would be the first folks to tell you that they are. So no contract of any kind, none of that nonsense. We provide everything you’d expect: SEO paper click, social media, internet marketing, the whole line.

The book that I just wrote, that’s the easiest way to kind of start digesting our philosophy and what we’re all about. All you have to remember is Everybody’s Doing It. If you go to www.amazon.com and you punch in Everybody’s Doing It, I’m Kellen Kautzman, I’m the writer, hurray! It’s 15 bucks, no big deal. On Kindle it’s ten bucks. And then the audio book which, by the way Kevin, if you really, really just love hearing the sound of your own voice, let me recommend recording and editing your own audio book. It’s so much fun. Choirs of Angels, is just so much fun. That’s also out as well.

Kevin:       Terrific. Again, I don’t want to embarrass you or put you on the spot, but can you give a range? What would it cost our listeners to participate with your company? Give us a ballpark or a range of what our commitment is. I know you mentioned there’s no contract, you can do it basically at will, but can you give us a range so we know what our investment would be?

Kellen:     Absolutely. The smallest client we have is of $100 a month consulting, giving them direction, that’s great. Our median price is $700, our largest client is north of $4,000. So it just really depends. And these are wildly varying clients with wildly varying needs. That kind of gives you a sense. And then if anyone’s interested, the number is 702-263-0141. And I believe in transparency, I’ll give you my personal email address, just shoot me a mail. It’s Kellen@senditrising.com.

Kevin:       I want to say a special thanks to Mr. Kautzman. Kellen, you’ve been a terrific participant, a terrific guest. The information that you and your company are providing I think will provide unlimited amounts of return on investment.

You’ve been listening to Dr. Kevin Coughlin, Ascent Radio. The name of my consulting firm is Ascent Dental Solutions, with a focus on knowledge, consultation, development and training. I hope you enjoyed Kellen’s podcast. The information that he has I can’t emphasize enough how it can help our bottom line. Any time we can learn to improve communication with our team members and our patients, it’s a home run. His book, Everybody Is Doing It has already been ordered by me and I would strongly recommend the rest of you consider this book. Kellen, thank you so much for joining today’s podcast.

My special thanks to Mr. Doug Foresta, his company, Stand Out and Be Heard. Without his expertise, this podcast would not be possible. And special thanks to Mr. Aidan Crawford and his company Short Circuit Media.

Kellen, thanks so much for participating and we look forward to speaking to you in the very near future and you can expect a call from me and my organization in the next few days. Thanks so much.

Kellen:     Thank you.

Podcast: Quality Assurance and Quality Assessment In Your Dental Practice

Tonight’s podcast is one of many podcasts based on the business of dentistry. There’s always been a theme, as we approach our 75th podcast, in how do we relate the clinical aspects along with the business aspects of medicine and dentistry. I had mentioned in a previous podcast the importance of training, continuing education, knowledge, role playing. But one of the things that we had talked about in previous podcast were the use of audio and video in the office, not just for surveillance, not just to protect us from break-ins, but to use so team members can be trained. So you see how they operate, how they interact with patients and other staff members and then those video/audios can be reviewed, edited for training. Nothing is so powerful as seeing how you react in front of team members and your patients.

This podcast has a similar message and it’s something that I instituted at my company over 15 years ago and I refer to it as Quality Assurance and Quality Assessment. No matter what size your practice, no matter how many team members you have, I can tell you through firsthand experience that my company sees in excess of 116,000 patient visits in a 12-month period. That’s through 14 dental offices in western Massachusetts. And what I’m constantly looking for is something that’s repeatable, something that’s inexpensive, and something that, most important, is effective.

The quality assurance quality assessment forms can be done in many different ways. In today’s day and age, an electronic signing pad is a nice, efficient and effective way, but the most important thing are the questions associated with the quality assurance and quality assessment forms. Basically, question one is;

1. Was your patient happy with the care and service? Yes or No.
2. Was your provider on time for your care and service? Yes or No.
3. Did your provider discuss various options and fees associated with your care and treatment? Yes and No.
4. Would you refer a family member, friend or associate to this practice? Yes or No.

And then there’s a few lines for comments. I cannot tell you how effective and efficient this is to improve the quality of care and service in either your medical or dental practice.

In the beginning, we simply used small 4 by 3 tear off pads. At the end of each procedure, the patient was given this to fill out and the role playing would be something like this; Mr. or Mrs. Smith, I know you’re very busy, but if you wouldn’t mind filling out these four questions, we would greatly appreciate it. I would tell you that over 99 percent of the time the patient or client is willing to fill out the short quality assurance, quality assessment form.

The other option is to use an electronic pad and the patients fill out the same yes and no answers. The advantage of your electric pad is it’s immediately scanned and accessed into your patient chart if you’re computerized. When you do it on the tear off pad or paper situation, it is imperative that at the end of the day, those are scanned so that this information and data is in the computer.

I’d like you to think about the power of this. Again, with 116,000 visits plus each year, if we have a 95 percent success rate where patients are happy and satisfied, and five percent of our patients aren’t, that’s over 5,000 complaints in a 12-month period. That’s unacceptable, it will tear down your business and the results can be catastrophic if they’re not addressed. It is extremely difficult for Mr. or Mrs. Smith to bring you to litigation, to ask for money back, to bad-mouth you on social media when you can show that each time Mr. or Mrs. Smith came to your office they registered on the quality assurance and quality assessment pad that yes, we were on time, yes, they believe we solved their problem, yes, they would refer family and friends, and yes, we explained and introduced them to different options and fees. The power of that to protect you and your team members and to establish goodwill is critical.

If we look at it from the opposite end of the spectrum, when we do get a negative comment, and we certainly do in our business and I believe all businesses do, I can only tell you in my experience of a fulltime practicing dentist for 35 years and still practicing fulltime at this time, that the single biggest complaint that I have seen over my 35-year career is not being on time and keeping your client or patient waiting. Nothing is more frustrating and aggravating to not just your team members, but to your patients and clients than being kept waiting.

We all know in the health services that sometimes this can’t be helped, but my personal opinion is if you’re scheduling effectively and efficiently, and you manage your time effectively and efficiently, you can eliminate or significantly reduce this particular problem. When it can’t be helped, a simple straightforward, “Mr. or Mrs. Smith, I know your time is valuable. I’m so sorry I’m running behind. I will try my best to make it up to you. It just couldn’t be helped.” Acknowledge that you’re behind. Let the patient know that you’ll be with them. Don’t leave them in the exam room unattended. Don’t leave them so that they think that they’ve been forgotten. It’s a simple straightforward solution, just simply explain or have one of your team members explain the doctor is running behind, we’re so sorry and we will do our best to make it up to you.

The other issue that is critical is not only were we not on time, but the second biggest complaint that we get is no one discussed the fees. I cannot tell you when you’re seeing the volume of patient visits that we do, and quite honestly, it doesn’t matter what size your practice is, any problem that creates a negative review will have a negative influence on your overall bottom line, your personal stress level and a reflection on your team members and your organization.

When the patient says to you, “No one explained the fees or options,” that is a direct reflection on your organization that you have some serious communication issues. Many of the practitioners listening to this podcast will automatically assume that they being the doctors do not have to discuss fees. They will leave that to their front desk personnel. I cannot tell you that when you leave it to your front desk personnel, in many cases, the treatment and procedure has already been performed and at that point, it’s actually too late.

An example I use quite often during my training and coaching sessions is after the bottle of wine has been uncorked and you find out that that bottle was a couple hundred dollars, it’s really too late. You’d be much wiser, much better off, mostly likely not embarrassed and certainly, financially better off, if you knew before the bottle was uncorked that that wine was $200.

The analogy that I’m making here is what I see in office after office is procedures and treatments are completed and the fees are discussed afterwards. Never should that occur. In my opinion, it is a break of trust, it creates hardship and it creates problems for your team members and your organization. And in many times in my 35 years of experience of coaching and mentoring, in most cases, the owner doctor has no idea that this has actually even occurred.

The best way is ideally, Mr. or Mrs. Smith know before they’re scheduled what they’re coming for, how long it’s going to take, what the fees are associated with those services and procedures and the finances are taken care of before they’re ever appointed. However, in the real world, we all know as health care providers that things occur on an emergency basis. Things occur that we didn’t necessarily expect. We’re preparing a crown and we find out that the tooth needs a root canal in a buildup. We’re providing a root canal and we find out the tooth may be unrestorable and we’re doing an extraction, a bone graft and potentially, an immediate implant.

All of these potential clinical scenarios create financial hardship for patients and difficulties in the management of these financial arrangements because the services have already been started and in many cases, these services are irreversible, the patient is left with a bill that you may or may not know. But in most cases, they will be upset and unhappy because they weren’t aware of the overall cost and out of pocket expense to them. I strongly suggest that the individual, whether it would be a dental hygienist, a dental assistant, or preferably, in my opinion, the dentist or health care provider, simply explain to Mr. or Mrs. Smith the fees for these procedures are going to be X.

Again, in my own experience, looking at literally hundreds of different practices over 35 years, I don’t understand why providers don’t assess and give an estimate that’s higher. I have never, in my 35-year career, had a person complain that I quoted them one fee and I charged them something lower than that fee. However, almost on a day-to-day basis, I can find complaints in my own organization where someone was quoted at a fee of $105 and the bill came to $135 and the patient is aggravated and upset. And typically the response is, “If I knew it was going to be that much more money, I would have selected a different treatment or I wouldn’t have done the treatment at all.

For those individuals who are not doing quality assurance and quality assessment, I would strongly recommend that you check my website www.ascent-dental-solutions.com and take a look at some of these forms. Also you can find them in the three books that I’ve published along with my electronic books, this information is there. You can customize this to fit your own needs, but in my opinion, if it’s going to take Mr. or Mrs. Smith more than 30 seconds to a minute to fill it out, you may find that it may not be as effective. I can tell you with almost 99 percent assurance, our quality assurance and quality assessment forms get filled out. And I can tell you at the point of service to solve the dissatisfaction is absolutely imperative.

In some cases, because of time constraints, procedures that we’re doing, we can’t always, at the point of service, resolve Mr. or Mrs. Smith. But I can tell you, practicing 35 years, an evening does not go by where I don’t make a phone call to Mr. or Mrs. Smith and the phone call goes something like this, “This is Dr. Coughlin. I’m very sorry to bother you. I noticed your quality assurance and quality assessment form was less than ideal. I want to first say I’m sorry and I apologize for the dissatisfaction. If you have time now, I’d like to discuss it. If not, we can make a time or an arrangement later on during the week to address it. I want you to know you have my severe apologies and I will do everything in my power not to let it happen again.”

I hope you’ve enjoyed this podcast. You’ve been listening to Dr. Kevin Coughlin, my company, Ascent-Dental-Solutions, with a focus on education, knowledge, training and development. I look forward to speaking to you soon. And my special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard, for his expertise in creating this podcast, and Mr. Aidan Crawford and his company Short Circuit Media for making this material available on my website www.ascent-dental-solutions.com.

Thank you, again, for listening and I hope you have a pleasant evening.

Podcast: An Effective and Innovative Way to Train Your Dental Staff

This is Ascent Radio. You’re listening to Dr. Kevin Coughlin, owner and producer of Ascent-Dental-Solutions. I welcome you to this evening’s podcast. But before we begin, I want to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise and knowledge, this podcast would not be possible. So I want to say thank you to Mr. Foresta and his company, Stand Out and Be Heard.

Ascent Dental Solutions, provided by Ascent Radio, is focused on knowledge, development, training and education. Tonight’s topic is how do we make our organization better? All health care provides, and in my opinion, all businesses, have similar issues. How do we provide an outstanding amount of care and service while staying on time, staying under budget and providing the level of professionalism that is necessary in today’s competitive market?

I’d like to share with you something that I’ve implemented in our practices in western Massachusetts. It’s a combination of audio/video. It actually happened like most good ideas as more or less an accident. I was looking for the opportunity to protect our facilities from robbery and theft and break-ins and that morphed into the establishment of audio and video cameras in every one of our operatories, in our reception rooms, in our front desk areas and in our consultation areas. What this turned into is an excellent training facility.

But before you jump out and buy the latest and best, understand a couple of things. First and foremost, initially, the team members in our association were not comfortable being taped, audio and video. They felt it awkward and uncomfortable. Through training, knowledge, education and information, it became clear that these tools offered in a unique way to evaluate group practices and how we interact, not only amongst ourselves, but with direct patient relationships. I must tell you that the offices have signs that inform every patient that the facility does have audio and video tape running.

It’s also important to understand that these audio and video techniques provided extraordinary information and feedback to me and my partners as we evaluated how we collected money at our front desk. How those front desk individuals interacted with patients. How did they ask for financial arrangements? How did they schedule appointments? How did they create an optimal experience for the patients so that they became what I call raving fans?

We would then be able to clip on our computer system snippets of anywhere from 30 seconds to 46 minutes of various areas of front desk training, hygiene training, interaction among staff members during team meetings and how doctors interacted with patients. And it was quite interesting to see not only the verbal skill and communication and how drastically improvements were necessary, but the body language that occurred between clinical practitioners and the patient base. It was also very interesting to see how patients related to specific providers.

All in all, I would say it has been an extremely positive experience and I would recommend it strongly. I would tell you that it is critical not to force the audio/video situation on your team members. I would suggest you start with a meeting and explain the reasons for implementation. That you assume, and I believe assume correctly, that when people know that they are being video-taped and monitored, they generally tend to be on their best behavior. In my own personal experience with 14 dental offices, I found that less than a couple of weeks, most people completely forgot that they were being audio or video taped.

I could tell you that there are also subliminal advantages, underlying results that were brought to myself and our organization. And that was when patients behaved inappropriately, when patients said things that were inappropriate, it was to our advantage to have this information on audio and video tape. So many times in my 35-year career, I’ve had patients say, “No one ever explained this to me.” “No one ever told me about this.” “The doctor was unprofessional with me.” “The doctor did not explain things in its entirety or correctly.” And a view of the audio/video tapes, in most instances, not only show that the providers did a good job, they did an excellent job. What we found is that there were a variety, various, however that could be improved upon.

I strongly suggest that after reviewing hundreds, if not thousands of hours of audio and video tape, that practitioners made a better impression when they were eye-to-eye with their patients, rather than them standing and the patient sitting. I also found that patients seemed to interact better when there was a distance between the practitioner or team members and the patients. And generally, once you got more than two or three feet close to the patient, there was generally a sense of discomfort and an awkwardness. So I suggested that we maintain a safe zone of between three and six feet during discussions, treatment planning and education and training.

I can also explain to you that during staff meetings, we found that there was an enormous amount of wasted time. We found that certain individuals took up most of the valuable time during a team meeting and evaluations of the team meeting provided documented records of what needed to be addressed in the following team meeting and those areas that weren’t addressed completely in the previous team meetings. There were so many advantages and so few disadvantages.

In actuality, perhaps once every two weeks, a patient would explain that they were uncomfortable being audio/video taped while having procedures done or during communication with team members. In cases like that, we simply shut off the camera in that operatory.

I would also tell those interested in considering these training options to make sure on their medical history form that they place that the organization or office is monitoring audio and video so that all parties are aware and it’s written and signed in the patient chart or electronically signed in the computer.

I would tell you that there were some basic questions that have been asked over the last ten to twelve years of us doing this in our organization. And that is why is it necessary. And I hopefully have made it clear in this podcast that it’s necessary for the protection of your organization and to provide the highest level of care and service.

(2), as an owner, in most cases, you’re busy on a day to day basis. You don’t have the time to oversee all the little nuances that are occurring in your general practice or specialty practice. The ability to sit at the end of the day and review complaints, address complaints and also to provide positive reinforcement on things that you saw that were done in an exemplary manner provide tremendous positive background and tremendous positive feedback to your team members and that, in essence, provides an excellent outcome.

After 35 years of providing all sorts of general dental and specialty care in our 14 locations, I have experimented and implemented a variety of different office policies and procedures. In my opinion, the audio/video has been one of the best and most cost-effective of everything I’ve done.

I hope you’ve enjoyed today’s podcast. You’ve been listening to Dr. Kevin Coughlin and Ascent Dental Solutions sponsored by Ascent Radio. Special thanks to Mr. Doug Foresta and his podcast company, Stand Out and Be Heard. I hope you’ve enjoyed this evening’s podcast and for additional information, please check out the website www.ascent-dental-solutions.com.

Thanks so much for listening. I look forward to speaking to you in the near future.

Podcast: What NOT To Do (In Your Dental Practice)

You’re listening to Ascent Radio and my name is Dr. Kevin Coughlin. Today’s podcast is titled What Not to Do. You’re listening to Ascent-Dental-Solutions. My name is Dr. Kevin Coughlin and the focus of Ascent Dental Solutions is on development, training, knowledge, and a combination of teaching episodes to try to improve the health care along with the business of health care.

What Not to Do is something that I thought would be interesting to our listeners. I am a practicing dentist full time. I have 14 locations located in Massachusetts and I provide all levels of general dentistry, including IV sedation, hospital dentistry, laser care, iCat scanning, you name it and I would say we do it in our dental offices.

At this point in time, I have been providing expert help in the process and procedures of helping dentists in all phases of their career from the very beginning to the growth stage to the exit strategy. And it struck me interesting over the last couple of months, a couple of particular instances that happened that I thought I would share and open up. Although I consider myself an expert, I’m also human and the mistakes here will show an excellent example, in my opinion, of what not to do.

The first example is an individual who is periodically late for their appointments. When I say periodically late, I would say between 50 and 75 percent of the time, they are between 15 and 20 minutes late for an appointment. This is not a rare situation. I think most health care professionals deal with this.

What struck me interesting was how our company handled this particular episode. The first thing that happened is when the individual arrived at the office, they said they were sorry that they were late, they knew that they were late, but they were struck in traffic. A common excuse that we hear quite often, but it was an excuse and the individual owned up to it.

The receptionist or front desk coordinator or team member, however you’d like to refer to your employees, said to the individual, “You’re almost 20 minutes late and something like this cannot continue to happen.” And the individual turned around and walked out. I can assure you that within less than 45 minutes, I received an email saying how dissatisfied this patient was with our organization. How unhappy he was about the way he was treated. He heartfeltly tried his best to be on time for his appointment.

The results of that particular process and procedure, that in my opinion was a failure, means that we lost that individual as a patient who’s been a patient in our practice for over ten years. We also lost their wife and we lost their three children. The result of inappropriate process and procedures has a dramatic effect on your day-to-day bottom line and your reputation. At this point, I haven’t seen a social media post of this dissatisfaction, but I can assure you that will occur shortly.

The correct way that this should have been handle — and keep in mind I’m coming across as an expert in process and procedures, this is my own office and I’m someone who prides themselves on training and education. The correct way would be to first have the patient seated. Explain to the patient that their appointment was at such and such a time and that because they were running late, we would do our very best to coordinate and complete their care. In this particular case, it was a hygiene appointment. I think most up-to-date offices will have dental assistants, dental hygienists, front desk personal, doctors and associates that I think could handle a hygiene appointment, regardless of how late that patient is.

The point I would try to make in this example is the negativity should have occurred after the appointment was completed, not before or during. My personal opinion is if this was handled correctly, I think the average individual would accept the fact that they were late and they would understand that perhaps we may not be able to do as excellent a job as we would like. But in most cases, I think offices can handle this particular crisis. The result of not handling it properly was a financial hit to our company and to our reputation. And I’m sure if it’s happening to me, it’s happening to others.

So the take home point in this example is keep the negativity until after the appointment is completed and then have your treatment plan coordinator simply say to Mr. or Mrs. Smith, is there a time that is better for you so that you won’t be late? Is there a way that we can coordinate the appointment so it is easier for you and there’s less stress on you? That proper communication and relaying of that information could have created a much better outcome. In my opinion, we had the worst outcome that could possibly occur.

The second example is an individual who has 12 broken appointments over the course of two years. The patient has not been in the office for a period of two years. Out of a total of 28 teeth, 26 teeth have dental carries. Although it’s not critical, this particular patient was a Medicaid patient or MassHealth patient. And for those listeners outside the state of Massachusetts, it’s basically a government-assisted program for those individuals who are of the lower income bracket and need financial assistance.

This individual, in my opinion, was rude, they were abrupt. Their treatment plan, their radiographs, their diagnostic photos, their diagnostic impressions, everything was done. All I’s were dotted, all T’s were crossed. Her last appointment, two years ago, were to surgically remove tooth number 21 because of gross carries and inappropriate approach to endodontic or periodontal treatment, in my opinion, was valid. The tooth was deemed topless and needed to be removed.

For a variety of reasons that are not necessary to go into at this point, the patient scheduled appointments but never showed up for those appointments and on a recent visit, she arrived at the appointment on time demanding that the treatment be done. A complete and comprehensive exam had to be redone to bring her records up to date and an evaluation concurred that 21 needed to be removed.

In my opinion, this patient was a pain in the ass. This patient was miserable, rude and just someone you’d rather not treat. As a courtesy and in my opinion, I felt that because of the clinical situation, she was definitely uncomfortable, antibiotics, in my opinion, would be a short term approach and the tooth needed to be removed. I removed the tooth surgically by laying a flap vertical releasing incision, I packed the extraction site with a Collaplug and shuttered it, homecare instructions were given. A treatment plan letter was written up and signed.

What the patient really wanted was pain medication. So after I went to the entire length to do everything possible to get her comfortable, really what she wanted was narcotics. She wanted more pain medication and I refused. She then insisted and actually threatened if I did not give her a narcotic, she would go on social media and register a formal complaint and how bad a health care provider I was and how horrible our organization was.

I share this with you because how not to handle this problem, I handled it poorly. I simply said, “I’m not interested in your comments. Please remove yourself from my office and I would like to discontinue your care. Please find another health care provider. I have no interest in providing you care or service any longer.” This, of course, did nothing but infuriate the patient. And of course, she left the office demanding her records and also her final comments were, “I will put this on social media and I will make sure everyone knows how horrible you and your organization are.”

So here I am as an expert speaking to you podcast after podcast about process and procedures. The question that I pose and I assume most listeners have had this particular experience, is what do you do? Do you cave in and give the patient the narcotic just to get rid of them, do you toe the line and simply say the answer is no, accept two Tylenol and two Motrin over the counter every four to six hours for the next couple of days and if your signs and symptoms haven’t been relieved, we’ll see you again for a follow-up emergency? The way I handled it, in my opinion, was inappropriate. I took it personal. I was irritated and aggravated at the schedule, at her and a combination of other events. And in my opinion, the worst possible outcome occurred. She then went on social media and did exactly what she said.

I guess the proper process and procedure would be to be firm, be direct, don’t cave and give the narcotics because that, in the long term, is unhealthy for your patient, but to be professional, be above the fray and continue to maintain your cool no matter how difficult it is, and simply say, “I’m sorry, I can’t give you this particular medication. I believe that it will be detrimental to your health and wellbeing.” It hurts me to share these very personal stories because it’s a reflection in how, after 35 years in this profession, I still make mistakes day-to-day. But I thought, perhaps, our listeners could learn from these mistakes and try to do better than I did.

I hope you enjoyed this particular podcast titled What Not to Do. If it’s well received, which I expect it will be, you’ll hear others. Because unfortunately, these mistakes that I’m talking about occur more frequently than I’d like to admit and perhaps sometimes we learn more from the mistakes than what we do correct.

You’ve been listening to dental health matters and this podcast is Ascent-Dental-Solutions. My special thanks to Mr. Doug Foresta and his company Stand Out and Be Heard, who’s responsible for this professional podcast. I also would like to give special thanks to Mr. Aidan Crawford and his company Short Circuit Media for helping marketing this podcast and putting together these programs.

I hope you enjoyed this evening’s podcast and I look forward to speaking to you in the near future.

Podcast: Daniel Beers tells us how to target patients to maximize success

Dr. Kevin Coughlin: Good afternoon. This is Dr. Kevin Coughlin. You’re listening to Ascent Dental Solutions. This is Ascent Radio, where the focus is on knowledge, consultation, training and developing.

At this particular time, we are flattered to have a company on today’s podcast called eRelevance. One of the field and sales directors of North America is a Mr. Daniel Beers. Mr. Beers has reached out to me to try to help my organization and make suggestions in how he could improve, not just the sales, but also the service with a sort of, in my opinion, a very unique approach to target marketing, and I think it will be very valuable for our listeners to tune in.

Mr. Beers, thank you so much for taking time from your busy schedule to speak to me today. Why don’t you give me a little background about yourself and the company?

Daniel Beers:  Sure thing. My pleasure and I’m happy to be here. eRelevance was a company founded in 2013 in Austin, Texas. A seasoned team that has traded over 1.5 billion of shareholder value. Very well-funded company. We’ve seen triple digit growth three years in a row. Innovative pricing service levels and results. We serve the aesthetic industry, the dental industry with a high retention rate of over 1,000 customers delivering near-immediate ROI. We are a hi-tech-powered patient marketing service to generate more repeat business from existing customers.

Kevin:  Dan, if you don’t mind, I’m going to continue to refer to you as Daniel or Dan. But Mr. Beers, when you are talking about this targeting marketing, I’ve been marketing since 1983 and my personal opinion is many times that money has not been spent well because of my inability to really understand the marketing to really make sure that I am tracking properly. When you took time out of your busy schedule to sit down with me to see how you could help my company, basically, I know there is some proprietary information here. But in sub and substance, how do you direct and steer the appropriate clients that health care industry such as dentistry, whether it would be cosmetics, whether it would be lasers, implants, oral surgery, any of the nine specialty disciplines, how do you target that? How does it actually work?

Daniel: What we do is we are going after your existing customer database. Statistics say that 60 to 80 percent of your business comes from your existing customers. A lot of the times the doctors are going out there and they’re putting billboards and they are ramping up their website and doctors say to me, “This is how I’m marketing to my patients.”And I say, “You are not marketing directly to your patients.” And I say, “Doctor, can you tell me how many of your existing patients are driving by that billboard? How many of your patients are listening to your radio?” And they can’t tell me that?

So what we do is we monitor your patients’ behavior. We market directly to your existing patients. We monitor them through how they are clicking Google Ads, how they are going on Facebook, Instagram. Like I said, we are really monitoring what they are doing. There is two primary ways to doing patient marketing and one is to go out there and find new patients. It’s traditional and digital advertising. The problem is, what I just said is it’s hit or miss and it’s expensive and it’s hard to measure the results, and a very low conversion rate. What we do is we go after the existing patient. It is more repeat business through your existing patients.

A lot of people are saying maybe my billboards aren’t catching my patients, but my internal marketing is. And I say, “What are you doing?” Sometimes they refer to a company called Constant Contact. What they are doing with that is, technically, you’re spamming your patients. And doctors don’t like hearing that, but you are not targeting these patients. If you are going after a group of patients that would be suited for a certain laser or a certain treatment, not everybody is suited for that.

That is why we’re monitoring their behavior and we’re putting those emails directly towards those patients. We can tell you exactly what patient opened up what email, when they opened it, and what they googled and what they searched after they did that. So that allows us to be able to direct these e-blasts to those current patients. We are touching 95.7 percent of your patients through seven different marketing channels.

Kevin: Mr. Beers, when your company gathers this information, this profile on a particular group of patients that we as dentists want to attract, does that patient have the ability to, let’s just say, unsubscribe to it if they do not want to hear? How does that actually work if a Mr. or Mrs. Smith receives — I know several times a month I get a report and that report says to me so and so has unsubscribed. Which is telling me either they are getting too much information from me or the information they are getting they don’t find value in or they are just not interested anymore. Is this a similar program where someone can opt out when they choose to?

Daniel: They can opt out. We are doing three campaigns a month through seven different channels. For example, one of those channels will be text. They are going to receive that text and they can opt out of that text. If they do opt out, you do not lose that patient forever, you lose them on that one campaign. Keep in mind we are targeting these patients so we know what their interests are, we know what they’ve been researching. So we have a very low rate of people opting out or unsubscribing because we are emailing them stuff they’re already interested in, already stuff they’re looking for more information in, if that makes sense.

Kevin: Why don’t you take the listeners through the protocol that you’ve been working with me and my company on what the exact process and procedures are? Let’s say Dr. Jones or Dr. Smith is interested in contacting eRelevance, going through you or one of the other excellent sales representatives, how do they actually make the system work? Can you explain that to us?

Daniel: I would have a conversation with the doctor and what I would like to do is because I am covering all of northern America so for you I was lucky I got to drive down there, which I would rather do. But if I’m talking to a doctor somewhere in California or Ohio, we set up a demonstration over the computer. It’s a Join.me meeting and I walk them through about 22 PowerPoint slides and they’re able to ask questions and interact and I kind of go exactly what they’ll be receiving as being a customer of eRelevance.

What a practice would get is that, you get a tech-enabled service delivered by our experts. So you’ll have a client success manager that works directly for your practice. You get three targeted patient campaigns monthly. Those ten campaigns are engaged across seven different digital channels. It’s data driven and we are holding ourselves accountable because all the data is right in front of us, it’s also right in front of you.

The practice will be able to see who is clicking what, when they’re clicking it and when they’re booking the appointments. Also you’ll be able to see how they’re booking their appointments. Are they booking their appointments through text? Are they booking them through email? Are they booking them through a web landing page? So everything that we do is clearly right in front of the practice so they’re able to witness and they’ll be able to see exactly where everything is coming from.

Kevin: Is it correct to assume after a contract is signed between the organization and your company, you then provide them with your email list of patients, or does your company actually go into our computer and software systems and gather that information on their own?

Daniel: Once you go through the demonstration and you believe this is a solid fit for your practice, we’ll set you up with an on-boarding call. So you sign the contract, the contract is a year-long and then you’ll have your on-boarding call about a week later or whatever is suitable for you, and what we do is we pick your brain inside and out. It’s about a 45-minute call with your client success manager and you just tell them what your goals are, where you want to be. If you’re having an open house, we can do a campaign for that. If you’re having new doctors coming into the practice, we can send that to that.

Keep in mind that we are sending this to all of your patients, something like a Constant Contact, they’re only touching 16 to 20 percent of your current patient database. Like I said before, we’re touching 95.7. So if you’re having an open house and you have 5,000 in the database, wouldn’t you want to send it to those 5,000 instead of just having to touch 16 percent of them? That’s why these campaigns can be customized to you. Everything, like I said, is customized. We can use our before and after pictures, we can use your before and after pictures.

The way we get to your current patients is you provide us with your database. We are 100 percent HIPAA compliant so we take that database and we scrub it down. We scrub it down from people that have passed away, people that have moved, old numbers, nicknames, house numbers. We get all that out of there. So if you are telling me that you have 5,000 in the database, I can almost promise you that after we scrub that you’re probably going to have 4,500 to 4,000 in there because we’re removing all that bad data, so now we’re not wasting these emails sending them out to those people that it’s not active. So we’re getting no kickbacks because all the emails — after we scrub — are all clean so everybody will be receiving this.

Kevin: For somebody who is not as technologically savvy as yourself, how do you actually get into our database? Do we take a thumb drive and download the information or does your system actually go in there and retrieve it?

Daniel:You would send us your database. You could do it through a thumb drive, you could do it through however you thought was the safest way. The way they operate is obviously HIPAA compliant as well so there’s 100 percent safety behind all this where nobody’s information will be leaked out or anything like that.

Kevin: Okay.

Daniel:  You’re requesting the work, we’re providing the results. I want you to keep in mind that this is a service. We’re not just giving you the software and saying good luck, we’re doing all this work for you. We’re customizing everything, we’re scrubbing your database, and we’re doing every single campaign. The work on your end is we just need to get the thumbs-up on the campaign. So for a month you say, “Hey Danny, I want to do a campaign on Botox.” So we’re going to customize the campaign for your practice on Botox. We’re going to customize it, get it ready, we’ll send it to you, say it looks good, send it out.

Kevin: For real life examples, whether it’d be fillers, Dysport, Botox, laser for tattoo removals, hair reduction, the list can go on and on — facial rejuvenation, wrinkle removal or reduction. These targeted campaigns, your company has certain databases, certain criteria that knows that a Mr. or Mrs. Smith would be right for this particular brand of marketing for this particular service and that’s how you do the link. And then it’s up to them to follow up with their dentist to schedule the appointment. Is that a fair assessment?

Daniel: For the most part. Basically, as our first campaign we would probably do a general campaign where we would offer every single one of your treatments. And then from there, now we can monitor the patient’s behavior through their cell phone or through their email. So 90 percent of patients their email is tied to their Facebook or their Instagram or their cell phone number is tied to their Google so that’s how we’re able to monitor. It’s very similar to an Amazon approach. Because for such a long time, this software has been available but only for larger businesses like Amazon, like Google. We’re the first company to be able to provide this for small businesses.

Kevin: I don’t want to put you on the spot, Daniel, but I understand your company also has some very unique almost tier marketing opportunities for those individuals willing to try your company and see the success that they can get through this targeted marketing. Do you want to explain a little bit of that?

Daniel: Yeah. Just kind of break that down a little better for me here. The question you are asking is how we are able to provide this marketing service?

Kevin: My understanding is periodically, your company offers promotions. For example, I sign up today and then I refer Mr. Smith there is some benefit for us referring clients to your company. Am I correct in that?

Daniel: Correct. We have to do a whole vetting process on the practice to make sure they have a proper database. We can work with people under 1,000 in a database but we can’t guarantee our results as far as seeing five times ROI your first month, up to 14 times ROI after month three. So you have to be vetted and if you’re properly vetted through my CEO and Vice President of Sales, then we’re able to offer you a KOL program and that’s a Key Opinion Leader.

What we do then is anybody that you’re able to put in contact with myself or anybody at the company, if we can sign them up, the KOL will receive five percent annuity over a three year span monthly. For example, if you send me somebody right now that has 5,000 in their database, they pay their monthly fee, they pay their database fee, you’ll collect five percent of that annuity every month they make that payment for up to three years that they have our service. We’re seeing a 99.1 retention rate as far as people renewing our service after year one. We also would ask per testimonials. That kind of is up a handshake, we’re not holding your feet to the fire to do anything like that, but once the service speaks for itself, if you go on our website www.eRelevance.com you can see that we have several testimonies from several big doctors around the country.

Kevin: Without putting you on the spot, are you comfortable telling the listeners what the approximate investment would be for groups of let’s say between 1,000 and 5,000, between 5,000 and 10,000 and 10,000 and up? Is there a way that you can give a ballpark figure so that they know what their investment would be?

Daniel: Of course. We do have specials. There are certain times of the month they offer specials. The company is trying to hit a number as a whole. It is a startup company in year four so they try to generate MRR, Monthly Recurring Revenue, so if they’re behind in a month or ahead, they can sometimes tailor certain specials. But for the most part, our service ranges between $2,000 to $2,500 per month. That’s a monthly fee.

Typically, you have a onetime startup fee of $1,999. That’s the fee you pay if you sign up right now, $1,999. What that does is it allows us to get your database and scrub it down. It’s basically a database scrubbing fee. If you hired a third party company to go do some like that, these numbers would be tripled. So you have your one time startup fee of $1,999 then your monthly fee is somewhere between $1,999 and $2,499.

Then you pay $100 for every 1,000 patients in your database. So if you do have 5,000 patients in your database, that will be $500 added to your monthly. So if you’re paying $2,000 a month for the service, plus your $500 for your database fee, now you’re paying $2500 a month for that fee. Somebody that referred that business, they would collect five percent of that monthly. Granted we’ve worked with doctors like Dr. Grant Stevens who has almost a million patients in his database through 60 different practices. So if somebody could refer somebody like that they’d be sitting pretty for quite some time.

Kevin: I can tell you this, Mr. Beers, I’ve had personal contact with you and your company now several times, everyone has been a straight shooter, they’ve been professional and they’ve been upright. And I can tell the enthusiasm in your voice and in your actions that you want to continue to see this company prosper and provide the services that are so greatly needed and that is, in my opinion, targeted marketing.

Basically speaking, whatever our listeners are into, whether it’s cosmetics, whether it’s implant surgery, implant prosthesis, whether it’s periodontal care and treatment, you name it. It makes the most sense to target the customer or patient base that are best suited for our personalities and needs to see our practice grow. And at this point in time, eRelevance has really seen, I think, the future and has jumped on it and that’s why your revenues are high, your business is growing. Kudos to you and your company and I thank you so much.

As far as providing contact information, Dan, is there a way our listeners can reach out and get information? Could you just review the website, perhaps a telephone number or email so our listeners could follow up with your company?

Daniel: I would be happy to do that. The website is www.eRelevancecorp.com. My name is Daniel Beers. Call me Danny. But if you’re looking me up on LinkedIn or social media, it will be under Daniel. My cell phone number is 508-439-3614. I’m on the road a lot so I’m happy to text, I’m happy to call, whatever the best way to reach out to me. My email is dbeers@erelevancecorp.com.

Kevin: I can’t thank you enough for taking time and I thank your company for offering a service that is so greatly needed in health care but in dentistry in particular.

My name is Dr. Kevin Coughlin. You’ve been listening to Ascent Radio with a focus on knowledge, development, communication and training. I also want to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Without his expertise and his time and effort, this podcast could not be brought to you.

Thank you all very much for listening and I look forward to speaking to you in the near future. Enjoy the afternoon.

Podcast: Scott Dupont from Cynosure, discusses why dentists should consider laser tech

Dr. Kevin Coughlin:  Welcome! My name is Dr. Kevin Coughlin. You’re listening to Ascent Radio. This is Ascent-Dental-Solutions, with a focus on knowledge, consultation, development and training. As always, I’d like to give special recognition to Mr. Doug Foresta. Without his expertise and his company, Stand Out and Be Heard, this podcast could not be put on on a regular basis. His editing and professionalism have made it a huge success.

Today, our topic is Lasers. I want to emphasize to our listeners. This is lasers outside of the box. Or what I mean, outside of the mouth. We, as health care professionals, many times look right through the mouth and many times we miss some of the most subtle things that are most important to our patients and that’s the areas outside of the mouth.

In this particular case, I’m proud to represent and introduce Mr. Scott Dupont. Scott Dupont is a Sales Representative for Cynosure. Cynosure has been around for the last 25 years. They are located in Westford, Massachusetts and they have over 20 different platforms for lasers.

Scott, can you tell us a little bit about your company and how you see the market and the marketplace moving and the advances in lasers as you see it and your company sees it?

Scott Dupont: Thanks Kevin for the introduction. I appreciate it. We’re a locally company to western Massachusetts, world headquarters. We’ve been around for about 25 years, just celebrated our 25th anniversary. We have, as Kevin mentioned, over 20 different platforms, anything from tattoo removal, skin revitalization, wrinkle reduction, laser lipolysis, CO2 laser systems for external skin revitalization and much more.

The world that we’re in now, a lot of people are seeking aesthetic treatments, facial treatments but with zero downtime. Years passed, when the CO2 lasers came out for resurfacing, that was really the only device on the market that could produce real results. But along with real results came about seven to ten days of downtime.

Kevin, the way the market is shifting, people want treatments, they want wrinkle reduction, they want skin revitalization, they want to get rid of vascular lesions, pigmented lesions on their face, but they want zero downtime. That’s the way the market place is going. They want to look beautiful, feel great with absolutely zero downtime. So that’s the direction of the market currently.

Kevin: Let me tell the listeners an interesting story. I’m a general dentist that has been practicing cosmetics since 1983. I’ve been doing Botox and dermal fill, tooth whitening, implant surgery, temporomandibular joint treatment, almost all aspects of dentistry. Since I started implementing dermal fill and Botox over the last three years, it became enormously obvious to me that I was missing the boat.

As a clinician, I looked immediately inside the mouth, and I was amazed. I believe you can talk on the statistics that it’s estimated that about 30 million people just in the United States have tattoos on their body. And almost 85 percent of those individuals over the age of 40 are trying to remove the tattoos. We as wet finger dentists, clinicians, see tattoos around the head, the neck, the face, but actually throughout the whole body and individuals are trying to remove these tattoos.

Can you talk for a little bit about what your company has and the different wavelength s that are necessary to remove the black, the blues, the greens, and the purples, and the reds from these tattoos and the uniqueness of your company and their systems?

Scott: Yeah, that’s a great topic. Even furthermore, when you go see a tattoo artist, a lot of tattoo artists won’t tattoo over somebody else’s work. So what you are seeing now are tattoo parlors partnering up with an establishment like yourself, Kevin, where they are referring patients to you to receive tattoos removal. That way they have a blank canvas to do their work over. So it’s a pretty unique time.

We were the first company to come out with a picosecond laser technology, 755 nanometer wavelength that would effectively get rid of all colors: reds, greens, blacks. One wavelength, 755 nanometers, and that was FDA cleared to get through all colors. What is really cool about the picosecond technology versus the Q-switch technology, which has been around for 20 to 30 years, is picosecond technology will allow you to get rid of the tattoo in almost half the treatments. Before, where a person was going to get rid of the tattoo and it may take 20 treatments, PicoSure technology can pretty much cut that tattoo removal process in half.

The box has a 755 nanometer wavelength to treat all colors, particularly blacks. It also has a 532 nanometer wavelength in the box as well to help with the more aggressive reds, greens, yellows and oranges. That’s a little bit about the picosecond technology.

Kevin: Scott, not to just beat a dead horse here, but when we’re talking about Pico, for some of our listeners, can you explain the technology? What actually is a Pico? Am I correct that it’s one trillionth of a second or is it one billionth of a second, one millionth of a second? Just explain a little bit about the technology because most of us, dentists, are really in to the technology aspect of providing care and treatment?

Scott: Yeah, Kevin, it’s one trillionth of a second. It’s firing almost ten times on average faster than a standard typical Q-switch laser.

Kevin: I think for consumers, which we as dentists are looking for the best and the brightest, I do believe that your company is offering something that’s quite unique to the market. And as you alluded to without tooting your own horn, if you can take a Mr. or Mrs. Smith and remove or eliminate the colors of that tattoo in four to eight visits rather than 16 to 20 visits, you’re doing a great service, you’re saving a lot of time and a lot of potentially post-operative discomfort. Although it’s not enormously painful, it’s still something that does provide a little bit of a jerk. It’s almost like a little electric shock, am I correct? How would you describe it to the dentist thinking to get involved with tattoo removal?

Scott: I would probably describe it more like a rubber band snapping. If you were to take a rubber band and snap it against your skin, your forearm but really, really fast, that’s the kind of sensation of what a tattoo removal laser would feel like.

Kevin: Can you talk, again, a little bit again about the technology here? How do you and your company control the heat or the temperature? I believe some of your systems have a cooling system involved. Is that correct?

Scott: Yeah. Some of our systems have a cooler system built into the systems; PicoSure. What we would sell separately is a Zimmer system, it’s a Zimmer Chiller. Basically it’s a — I like to call it a mobile air conditioning system. So when you’re doing something like tattoo removal, you have a separate cooling system that sits beside the device. You turn it on and all it does is blow cool air. So as you’re doing the treatment, technically, there is a couple of different ways they do it. They’ll use the chiller to maybe flash in their face just to cool their overall body down and then after the treatment, they’ll take the chiller just to hit the spots that were treated, just to cool it down faster. So it is a separate chilling system, separate from the PicoSure technology.

Kevin: Scott, I’d like to move the topic to probably the biggest marketplace. Being a male, perhaps I’m just isolated, but with two daughters, and getting into the Botox and dermal fill, I was amazed at the number of females and also males that were interested in hair reduction to hair removal and the unwanted hair underneath the nose, around the lips, by the ears, underneath the chin area. Your systems have quite a unique, again, technology behind it. Can you talk a little bit about hair reduction and hair removal with the current systems that Cynosure offers?

Scott: Obviously, hair removal remains to be one of the top procedures requested by individuals in this marketplace. There’s two types of ways of getting hair removal. We have a couple of systems; one is called an Elite+. It has a 755 wavelength in it for skin types I, II and III. I also has a 1064 wavelength in it to treat skin types IV or V and VI. Basically, what the Elite is doing, is super fast hair removal, strictly doing hair removal, bigger spot sizes to do, bigger areas on the body. We’re talking chest, arms, legs, back and things like that.

On the face, a lot of people are tending to switch gears and using a Redscan piece on an Icon system that we have, which is an IPL system, an Intense Pulsed Light system. Smaller areas: upper lips, facial hair, ears, nose, forehead, areas that are really tiny to get a laser into, a lot of people are using the IPL system.

Then we have a Diode Laser system called the Vectus, another very high-speed hair removal system where you can do a man’s back in about ten minutes. The cool thing about the Vectus is it has proprietary technology in it called the Skintel. Skintel is a live melanin reader that will give you a live melanin index of the areas that you are treating on a body.

Say for summer months, you notice the patient you’re treating is skin type III but they’re tanned so you’re really not sure what kind of settings to use on the Vectus. You take three scans with our Skintel reader that scans the area that you’re treating and Bluetooth wirelessly sends those settings to the device based on the melanin index of that patient. Basically Skintel is an insurance policy. You think you know the skin type, you take a scan with Skintel, it will send the settings to the device based on the readings from that Skintel system, which is really cool.

Kevin: I think some of our listeners will have a different level of understanding, but basically with most lasers, you’re using the Fitzpatrick levels I, II, III, IV, V and VI, with IV, Vs and VI being mostly, let’s just say, your southern Europeans, your Hispanics, your African American’s darker pigment. The concept basically is the darker your skin is, the more the laser would get absorbed. So you’re classifying your client or patient as a I, II, III, IV, V or VI and the ability to improve and standardize those classifications will give you a better outcome. Am I correct on that?

Scott: That’s correct, yes.

Kevin: I think it’s critical again to discuss another area that I think we, as dentists, are uniquely qualified to treat, examine and discuss and that’s skin revitalization. We spend so much time trying to get the perfect shade of teeth, the perfect line for a smile, to broaden the smile, whiten the smile, close spaces, do cosmetic or orthodontic dental care. But in the end, the ability to see a better tightness, texture, and overall health of the skin is critical. And the younger that the patients start undergoing treatment, the better.

You touched a little bit about the Intense Pulsed Light or IPL. Perhaps you can discuss a little bit about skin rejuvenation and the improvements that are available, and how it certainly is a significant improvement over your conventional facials that you might get at some day spa that does not have a laser. Can you comment on that, Scott, a little bit?

Scott: I think the Icon system, the Icon which we have is the IPL system. If you’re looking for something to really address your patients’ needs and concerns — the truth be told, people have vessels on their face, they have them on their neck, on their chest, they have pigment on their upper chest area. Women, for example, have décolleté. On your nose you could have little telangiectasias, you could have sun damage. All these different types of things that really concern patients, you can control and handle with the one platform that we have, the IPL systems which is called the Icon.

Once you clear the vessels, clear the pigment, people also are going to discover we have wrinkles maybe around their eyes, or some laxity on their jaw area or chin. The fractionated laser technology which we have on the Icon, the 1540, will allow you to non-invasively stimulate collagen and create more uniform elastin. It also treats moderate wrinkles, acne scars it treats stretch marks if you wanted to do body procedures, it treats surgical scars, trauma scars, melasma, and it does skin resurfacing.

So it’s one system that you can start with the IPL, clear the vessels, close them out, take care of the sun damage, reds, browns, melasma, anything like that with the IPL, and then go over it right away with the 1540 fractionated laser resurfacing. So it’s a nice system where you can address all of your patient’s concerns.

Kevin: Scott, you touched on another point that I think we as dentists sometimes overlook. For someone like myself, I’m doing orthodontic care, bands, brackets removable, fixed and functional appliances. And in many cases, this orthodontic care is done on adolescence, somewhere between the ages of 13 and 15. And we’re focused on improving their teeth to improve their self esteem, but so many times these young men and women are suffering from facial acne. And rather than dope these young men and women up with drugs like Accutane, which have some significant effects long-term medically, the laser, quite honestly, can do a wonderful job, not just eliminating and reducing the scars from acne, but improving the overall skin condition and reducing the outbreaks of acne. Is that correct?

Scott: Yeah, that’s a 100 percent correct. When you have patients that have had severe acne issues and problems and you can treat it — after acne has been healed and diagnosed and you have scarring and irregularities over the tissue, you’d be surprised and amazed how powerful this 1540 is. It really changes those patients’ lives. A 13 , 14 year old, saying you can go several treatments with the 1540, it will completely restore their confidence back in that patient. So acne scarring, surgical scars with the 1540 will do an amazing job.

Kevin: The last topic I just like you to touch on is we hear so much about different competitors and different systems out there, but your company has also addressed the remodeling of adipose, the reduction and eliminating of adipose tissue or fatty tissues, on not only around the neck region, but throughout the body. Can you comment on what Cynosure is doing and how their system stacks up against some of the other systems on the market?

Scott: We really put one of our body contouring systems on the map in 2006 with our introduction to Smart Lipo. If anybody on the call knows Smart Lipo, it is a gold standard in laser lipolysis. The focus big areas of any patient, male or female, are abdomen and flanks. The system came out in 2006. We did a big direct consumer marketing campaign. And now when people search for Laser lipolysis, Smart Lipo comes up. It’s been branded and it’s very well-known in the industry.

What’s really cool about that, about two years ago, we launched a product called Sculp Sure. It’s our non-invasive body contouring system. It’s FDA approved for lipolysis, permanent fat destruction over the skin. So no topical, no anesthesia, no surgery. There are flat applicators that go over the skin and it’s using a 1060 Diode laser to go through the skin — any skin types I, II, III, IV, V and VI — and destroying the fat cells. Being non-invasive, your lymphatic system is naturally going to get rid of the fat cells over a 6 to 12-week process.

We have launched a direct to consumer marketing campaign for Sculp Sure so the people on the call now, if you haven’t seen it, you will probably start to see Sculp Sure billboards, Sculp Sure on transit systems, Sculp Sure in publications, Women’s Health, Men’s Health, People. So we’ve launched our non-invasive version of Smart Lipo, essentially called Sculp Sure, about two years ago and it’s our hottest product that we sell here at Cynosure.

Kevin:  Scott, once again, your expertise and your company, I can’t tell you how much I appreciate you doing this podcast to educate the healthcare professionals, but in particular, dentists. In full disclosure, I am an owner of Cynosure. I went to their continuing education courses. I was a true skeptic. I felt that there was no need for me to get involved with it. But Ascent Dental Solutions is a Radio Station and a podcast and an information forum to share ideas. And I could tell you, I was so impressed, not only with what these lasers could do, but with the way the company represented themselves, the way they taught me and trained me and educated my team.

I can just tell you, what we ultimately want to do? We want to produce the highest level of care and service for our patients. And in my opinion, anything around that head and neck, should be available to the dental profession and to our patients.

I also would tell you without any disregard or nervousness at all, these procedures are quick, they’re effective, and for the first time, I’m seeing people really say, “Thank you, Dr. Coughlin. I am so glad you were able to offer this. I had no idea you as a dentist could be doing this or would be offering it”.

So to our listeners, I would strongly recommend that you educate yourself in these areas. Each State has certainly different by-laws and regulations and perhaps we could discuss that in a little greater detail in a future podcast.

But Scott, I want to tell you at this point, your company has been outstanding. Everything that you have said that you would, do you have delivered on. And I’ve been more than impressed and that’s why I wanted you on this podcast.

Before we close, Scott, could you just give the listeners an idea of the cost structure in the various ideas of the systems that you would probably recommend for the dental community? Just so they come away with a little bit of information, and also the best way for them to reach out to have questions answered by you and your company and how they could contact your company.

Scott:  As far as cost structure, it’s kind of hard to put a number on it. I can give some parameters based on the different technologies that you’re looking to add to the practice. If it’s one technology, two technologies, three technologies, I could say a safe ballpark would be anywhere from — depending on the system — 65 to 75k thousand dollars to anywhere upwards of — depending on how many systems that you’re going to purchase, you could go to 300k, 400k, 500k. But I think every single situation is different and that’s where the salesmen at Cynosure become your consultants. So depending on what you’re looking to do and what you’re looking to treat, we can come up with a package for you.

Kevin, I really appreciate you taking the time to have me on here. If anybody needs to reach me, my name is Scott Dupont and my cell phone number is 603-231-2603. If you are not located in my immediate region, then I can definitely get you in front of the right person that would definitely take care of you, in whichever state you appear to be in.

Kevin: We’ve been listening to Cynosure, located in Westford, Massachusetts. My guest today was Mr. Scott Dupont.

Before we close, I want to share this story. We as dentists, day in and day out, for the vast majority of us, deal with insurance codes. What’s insurance going to cover or not cover, what’s the limitation of this plan? As I ventured into dermal fill, Botox, and laser treatment, there were no real insurance codes. These are fee for services procedures, they are elective procedures, and I can’t tell you how enjoyable it is to offer our patients something that they want and need, and we can provide without all the BS and the paperwork that’s associated with so much of health care today.

Scott, Mr. Dupont, I should say, thank you so much for your expertise.

You’ve been listening to Ascent-Dental-Solutions. The focus is on education knowledge, development and training. You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin. Thank you so much for listening.

In closing, I want to thank Mr. Doug Foresta and his expertise on producing this podcast, and his company, Stand Out and Be Heard.

Thank you everybody and I look forward to our next podcast very soon. And Mr. Dupont, thank you and your company for offering this information to the health care professionals and dentists in particular.

Podcast: Dr. Kevin Coughlin answers your questions

Dr. Kevin Coughlin:   Welcome. You’re listening to Ascent Dental Solutions. My name is Dr. Kevin Coughlin, owner and creator of Ascent Dental solutions. I want to give special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard . Without his expertise and guidance, this podcast would not be available.

Today, we have a little bit of self-promotion. As you know, Ascent Dental Solutions is focused on knowledge, training, development and education. But over the last year and a half, I have been inundated with phone calls, emails, requests about what exactly is Ascent Dental Solutions? Why did I started it? What its real mission statement?

I’ve had several questions. Let’s listen to some of these questions and see where these response take us to perhaps add some expertise and maybe some additional connections to make Ascent Dental Solutions more valuable to you.

Doug Foresta: Thank you so much, Dr. Coughlin. This is Doug Foresta, of course. I thought where we’d start is, one of questions they have is; Ascent Dental Solutions, is it a dental company or is it something else? Maybe you can talk about what that “something else” is.

Kevin: Sure. First, it’s a limited liability company. It is its own entity. Really, the crux of it is why do we even have it? Why did I create it? I created it because since 2006, I was asked by Tufts School of Dental Medicine if I could provide elective information in the evening to the dental students. It was really outside of Tufts School of Dental Medicine. I provided the lectures, the seminars and information generally to senior dental students and to graduate students who were preparing to get into what I’ll call “the real world”. The business of health care, and in particular, the business of dentistry.

It was clear that the dental school, like most of the 60 dental schools, did not have the time in their curriculum, or perhaps even the expertise to talk about the business of dentistry. How do you select your first job? What are the steps? How do you make sure that that first job or career is as successful as possible? What questions to ask? How to ask these questions? What information should you obtain and how do you dissect this information to make the best decisions?

Understand that many of these young men and women, or new graduates, have had zero business experience. They are still learning the craft and the profession of dentistry and in health care and in medicine, but really lacked the educational background in accounting, legal, in business, sales, marketing to make decisions that would be informed. That really was my start.

My own personal business had grown from 1983 to present from one dental office with four dental operatories to 14 distinct dental offices, all located in western Massachusetts. Each office is self-contained, but all the offices are linked through cloud. Prior to the cloud-based systems, we were using what were referred to as T1, T2, T3 lines. Today, these businesses are all linked so digital photographs, digital impressions, clinical notes, insurance data information are all linked together for evaluation and treatment planning, and to provide a continuity of care.

During these 35 years of practicing clinical dentistry, and the business of dentistry, I would say a day doesn’t go by where someone doesn’t contact me and ask very similar questions. They fall into a variety of topics, but one topic is a group of dentists that want to emulate or copy the processes and procedures to establish a bigger footprint. They have various reasons, some are purely economical. They want to build a practice so that they are more financially secure. Others want to build a larger footprint and practice to compete against MSOs and DSOs. And others just are short of bored. They are excited, they are entrepreneurs, and they want to see how far they can take their business and they want to know the steps and processes I used to accomplish that.

Other groups are not interested in growing their business at all. They are happy with the size of their practice. They just wish it ran more efficiently, more effectively. They are looking for processes and procedures that they’ve read in one of my three books that really go into the business; the nuts and bolts of running a successful dental practice. But really, the processes and procedures for a successful business practice are similar to any successful business. What are the steps? What are the processes and procedures?

As these questions continued to occur, I felt that it would be a very efficient and effective way to partner up. I partnered up with Mr. Doug Foresta who had been listening, hearing and watching my career develop. Basically, what he said is a very efficient cost-effective way to get your information and knowledge out and share it with your profession and other practitioners are through podcasting and webinar. It’s one of the best business decisions I made, and his company Stand Out and Be Heard, has been a tremendous inspiration and have allowed me to express my views and recommendations to a much larger range of individuals. Not only that, but allowed me to network with individuals that I would not have had the luxury to network. That’s really what this podcast is about.

I have another question. Doug, go right ahead.

Doug: Sure. Thank you, Kevin. One of the things that we‘ve been getting feedback from brands, businesses, dentists, saying how we can partner with you? We like what you’re doing, we know that dentistry is undergoing a change, the profession is undergoing a change. How can we partner with you? How can we be a part of Ascent Dental Solutions? Maybe we could tell listeners a little bit about some of the opportunities and ways that we’re looking to partner with brands and individuals.

Kevin: One of the things I’ve learned over the last 35 years is no one can do it by themselves. I always relate, when I am speaking to dentists, to the clinical aspect. It’s very difficult to be an implant surgeon, a prosthodontist, a periodontist, an orthodontist, a pediatric dentist. You need experts for support and you need experts to provide the highest level of care in service.

In business, the actual business of dentistry, the partnerships are incredibly important, whether it’d be for marketing, sales, hardware, software, supplies, leaderships roles, consultations. There is an entire network out there that are at our fingertips, but we don’t know how to connect. I’m hoping through Ascent Dental Solutions that these connections can be made.

For those individuals who would like to share the partners that we’ve created over the last 18 months with 50 or so podcasts, and several webinars, and different connections, I’m suggesting that you contact and reach out to www.ascent-dental-solutions.com. On that web, you will be able to connect with me personally. And if you’re interested in linking up with Ascent Dental Solutions, with an emphasis on education, training, development and knowledge, I would welcome your expertise. The more we network, the more we educate our peers, the greater our organization becomes.

There are numerous threats, opportunities available to our profession. And depending on what side of the fence you sit, what may be a threat to one group could be an opportunity to another group. As you know, competition with dental service organizations, managed service organizations, the constant marketing of large corporations sort of honing in, competing with the solo boutique practice is relatively new to the profession.

I think we all know that it’s very, very difficult for a small supermarket to compete with Costcos. It’s very, very difficult for a small hardware store to compete with Home Depots or Lowe’s. And it may become very difficult for the solo practitioner, whether they be a specialist or a generalist, to compete with these managed service organizations.

I’m not here to say one is better or worse, one is right or wrong. But I do feel that as a profession we have to understand how do we compete with these groups, how do we work with these groups, and how do we function with these groups? There are specific processes and procedures that I’ve learnt through my own clinical training, my own business training, that I think can be helpful.

I ask you to consider reaching out to www.ascent-dental-solutions.com and consider taking your ideas, your company and yourself and interacting with us so that we can provide better information, more information, to establish us as a think tank for our profession. We’re not here to give our bias, but we’re here to provide information and data so that you can make your own decisions that are best for you, your family and your company.

Doug: Let me just say a little bit about some of the ways that we’ve already been partnering, again, with individuals and brands. One thing is if you have a message that dentists need to hear, we’d love to have you as a guest on Ascent Dental Radio. We had recently topics including; you’ve heard Jerry Jones returning to the podcast and talking about patient retention. And you’ve heard about embezzlement and the problem of embezzlement in dentistry and what dentists can do. But we’ve also partnered with great brands like VOCO. They make dentist…

Kevin:       They provide some of the best dental supplies for dentists throughout the world. Patterson Dental, Henry Schein, we’ve had marketing experts, we’ve had seminar experts such as Jenny St. George. The list is really too numerous to repeat on this podcast, but what I have received is superior feedback saying that these connections are helping our listeners. It occurred to us that by just self-promoting Ascent Dental Solutions, and saying that we’re open to listening to your ideas and suggestions, and we’re open to having you join our conversations and provide knowledge, information, training to our listeners, I don’t think there could be an easier or better way.

I hope you’ve enjoyed this podcast. You’ve been listening to Dr. Kevin Coughlin and this is www.ascent-dental-solutions.com. My special thanks to Mr. Doug Foresta. Without his expertise in podcasting, in information sharing, this podcast would not be possible. Thank you again and we look forward to speaking to you in the very near future.

Podcast: Dr. David Preble on how the ADA supports dentists

Dr. Kevin Coughlin: Good afternoon. You’re listening to Ascent Radio. This is Ascent-Dental-Solutions, with a focus on knowledge, consultation, development and training. Today’s podcast is brought to you by Stand Up and Be Heard, and a special thanks to Mr. Doug Foresta and that company. Without his expertise and knowledge, this podcast could not be put on.

Today, we have a special guest. That special guest is Dr. David Preble, ADA Practice Institute partner.

Although this is close to our 60th podcast, I personally feel that dental associations, and in particular, the American Dental Association, has perhaps more value than ever right now with the changes that are going on in our profession. I’m hoping that Dr. Preble can provide insight and knowledge to our almost 7,000 listeners.

David, thank you so much for taking time from your busy schedule. I just wanted to say thanks so much for sharing your knowledge and expertise and also your help in working with the American Dental Association. One of the first things, Dave, I wanted to ask you is right now, can you give the listeners an idea of about the average percentage of dentists that are participating in the American Dental Association?

Dr. Preble: Sure, Kevin. We have about a 63 percent market share of dentists. And that’s basically representing more than a 161,000 licensed dentists from all 50 states, the District of Columbia and Puerto Rico.

Kevin: Obviously, we’d love to see 100 percent of the practicing dentists being members. Are there particular areas that you think we could improve that number from 63 percent to higher? Are there things that the American Dental Association is working on, you in particular, to perhaps expand that base that’s already present?

Dr. Preble: As you said, we certainly want to and we are trying very hard to do that. What we are doing is trying to figure out that real value proposition for dentists at all stages of their careers. So both the young dentists, the millennials that are actually becoming now 50 percent of the dentists in the country, as well as the dentists in their mid-career and later career all get something that they want from the American Dental Association. We don’t just figure it out on our own, we try to ask them what it is that you want from us, and try to deliver that.

The ADA provides a broad range of services from legislative and regulatory advocacy, practice-based advocacy with third-party payers and governmental agencies, continuing education, peer review, scientific research, the development of dentistry policies and standards, as well as, practice management tools and resources. And we feel that all of these things are part of what dentists expect from the American Dental Association, but each individual decides for themselves whether or not it’s enough for them to actually join.

Kevin: I can tell you with my experience in Ascent Dental Solutions that there is basically those three broad categories that you touched on that individual who is just starting practice, who is recently graduated, their wants and needs are in a particular direction. And the ADA, in my opinion, is a tremendous asset to provide basically free information and knowledge to guide those new graduates through some of the trials and tribulations of either starting a practice, joining a practice, and determining do they compete with managed service organizations, do they consider joining managed service organizations, do they even know the difference?

And then you have that second group which have been probably practicing for 8 to 15 to 20 years and they are dealing with the practice management issues, the regulation issues, the day-to-day issues that perhaps their practice isn’t growing and doing as well as they’d hoped for a variety of reasons. And once again, the ADA has an enormous amount of asset to help that group.

Finally, the last group are those individuals more in the twilight of their career. Are they in a position to retire financially? Is their clinical practice in a position to pass on to another individual or group? Again, the ADA is there with knowledge, information and expertise.

When we look at these different areas, I know through previous conversations with you, you mentioned that there were probably three main areas or topics or issues that you thought were important to the dental profession. Would you like to touch base on those areas?

Dr. Preble: Sure. But before I do that, I’d like to come back in on what you said, because you really put it very well, those three different kind of stages of a career. Following graduation, a new dentist can really benefit from the services like our Career Center, which we are building to be even better and better, that really helps dentists make more informed and better decisions about where they want to practice, how they want to practice. Networking opportunities offered through the local and state dental societies, which are an integral part of the ADA, and practice development resources, even licensure guidance, loan refinancing options. We have this wonderful student loan refinancing programs that’s better than anything else that’s on the market and it’s saving young dentists thousands and thousands of dollars. Plus, of course, volunteer opportunities, continuing education, etc.

Then those dentists in that mid-career part, they can have ADA tools and resources to answer these third-party payer questions, accessed online scientific resources, etc. Then as they get into the later part of their career, we have practice transition information, insurance and what’s management options, answers to financial questions and then lots of opportunities for mentoring even new dentists. So there really is something for everyone.

But back to your question about these major areas that we keep seeing dentists say, “This is what we need help with. How can you help us?” There is the third-party payer reimbursement issues, whether they be public programs or private programs. This is something that is constantly in the dentists’ mind because this is the lifeblood of how they make their living. Along with that, there are lots of increasing regulatory burdens that we are seeing happen from governmental agencies, and even in the third-party payer private world, more regulation and how easy it is to do business. Those are the two big ones.

Of course, practice management itself, the business of doing practice is a big part of what dentists look for from the ADA. Because in dental school, we learn a lot about the art and science of actually treating patients and caring for patients, we don’t learn a lot about running a business. And that’s information that they really need and look to the ADA to give them in the most cost effective way. They can get all sorts of information from high-priced consultants, but when you are an ADA member, you get all that information for free. So it really is, I think, a good benefit.

Kevin: I think it’s not only good, it’s a tremendous benefit. And for listeners out there, I’m not here just tooting an organization. I firmly believe there is no real skin in the game, per se, with the American Dental Association. If you hire a Kevin Coughlin, I may have alternative motives that are specific to your wants and needs. The ADA is representing the profession and I think the profession comes first many times over the individual and hopefully, there can be a nice marriage and both benefit from it.

We talked a little while back about managed service organizations and dental service organizations. For some of our long time listeners, I define the managed service organization as equity-backed, venture capital-backed. This doesn’t mean good or bad, it just means that there are outside parties investing large sums of money to get a return on their investment. Whereas a dental service organization is generally run and owned primarily by practicing dentists, who also have skin in the game to make a profit and a return on their investment, but ultimately, they are the clinicians providing day-to-day care, services and expertise.

Does the ADA see any particular trends? Do they see that these MSOs and DSOs, are growing? Because based on the Health Policy Institute and other research that I’ve been able to do for previous podcast, that seems to be on the rise.

Dr. Preble: It is on the rise. First and foremost, I wanted to make sure that the listeners understand that the ADA supports ADA members and dentists to have the freedom to choose whatever practice model they decide. We are not judging whether one practice model is better than the other.

But that being said, the ADA does feel very firmly both in its policy and what we tell others is we support this conviction that the health interests of patients are best protected when dental practices and the facilities for the delivery of dental care are not only owned, but controlled by a dentist. We think this is just the best interest of the public. So there aren’t those conflicts of interests between the making of money and the care and delivery of the patient.

We do understand that dentists, some choose to not want to do the management end of practice. They would prefer to just do the care part. And having DSOs or any other type of support organization that does the business part of them for that, if that is the way they choose to do that, that’s okay. But all of those dentists agree, whether they work in a DSO environment or not, that they should have control over patient care. That’s the bottom line. It’s not just ownership on paper, but its control over how patients are treated. That’s what’s important.

Kevin: And I would concur 100 percent with that, Dave. Is there programs out there that the ADA has that can educate those dentists that are interested in learning more about MSOs and DSOs? Are there programs out there that the ADA may be able to review potential contracts, working relationships to determine whether one group may be stepping out of bounds? Are there any programs like that that the ADA has to offer to its members?

Dr. Preble: I don’t think that we’re going into that specific a detail. We have resources on the Center for Professional Success that help dentists, again, whatever stage they are in their career. Although, the Health Policy Institute research has shown that the large rise in the dentists that work in DSOs is in the younger cohort. So those younger dentists, there are resources there for them to say, “These are the things that you should evaluate in your contract. Are these things that you are comfortable doing and not comfortable doing? Are these the things you are comfortable agreeing to and not agreeing to?”

We don’t get into very specifics of evaluating particular contracts for the dentists, they’d have to hire their own legal counsel to do that. We don’t have the resources to do that for every dentist here at the ADA. But we do give them the broad ideas of what you should be looking for, what you should make decisions on your own about, what you are comfortable with and what you are not comfortable with.

Kevin: David, I want to thank you so much for your time. I want to give another plug for the American Dental Association. Your representation of what the American Dental Association is, I really think that 100 percent of our members should be members. I know I personally have been a member since 1983. I’ve had my ups and downs, I’ve had some agreements and disagreements, but in the end, the mission statement to represent the dental profession and dentists, I think, goes without saying. Your expertise, your knowledge is greatly appreciated, and especially spending your valuable time on this podcast to educate our listeners I think is terrific.

For the thousands of listeners that have been paying attention to Ascent Dental Solutions, strongly think about the American Dental Association. As competition becomes greater, financial risks become greater, educational debt. The American Dental Association has programs and options all at almost no charge to its members, granted we do pay a membership fee. But I really think it’s one of the organizations that we should be promoting and can offer much needed information to us.

We’ve been listening to Dr. David Preble. David, for some of the listeners who might not be as familiar with the ADA, is there an 800 number, a website? Is there a way that questions could be answered or information could be ascertained?

Dr. Preble: Sure. The home source of cause if just www.ada.org. That’s the easiest way to get to the home base of all the information. If dentists are looking for a specifically practice management type information and information about third-party payers and things like that, we have the Center for Professional Success, which is www.success.ada.org. Those two sources should get anybody started on a host of information.

Kevin: Thank you again so much, and thank you to the listeners. You’ve been listening to Ascent-Dental-Solutions. My name is Dr. Kevin Coughlin, with a focus on development, knowledge, training and education. Our guest today was Dr. David Preble, the ADA Practice Institute Head since 2013. Thank you so much.

Dr. Preble: Thank you, Kevin.