An interview with Dr. Howard Farran

[site_admin]

Dear dentists,

Dr. Howard Farran is well known speaker on Dental practice management. Not only we all have a lot to learn from him but we also need to imbibe his passion for dentistry and dental practice management.

I posed many questions to Dr. Howard Farran and he was kind enough to take out time from his busy schedule and answered all of them .

So read on:

How would you describe yourself first: A dentist, a speaker on practice management, or an entrepreneur?

I am first and foremost a dentist. I decided to become a dentist at age 12 when I was in the sixth grade and never looked back. I became a speaker on practice management because I was so passionate about not only sharing what I know, but meeting other dentists to find out what they know. That naturally progressed into developing Dentaltown.com in 1998 because everyone was wired into the Internet. Now, on Dentaltown.com, you can create a platform where everyone can share.

Changes in American Dental Scene over the years
There are only three variables in macroeconomics: people, capital and technology. Obviously people haven’t changed in the last 15,000 years. Money is money, whether it’s gold or silver or paper dollars. But what’s massively changed throughout the history of man is technology. If you go back to the 1850s in England, the world really took off with the invention of the steam engine, which led to ship building, which led to canal building. Then it moved forward with the telegraph and the telephone and the television. In my lifetime, the biggest explosion was the Internet. When I got out of dental school in 1987, we hand-filed root canals with stainless-steel files and it took two or three one-hour appointments. Today we do this with 300RPM NiTi in five minutes. When I got out of school, we did orthodontics by bending stainless-steel wires and it was so hard. Now we use precast nickel-titanium archwires with memory. It’s so much easier! When I got out of school, placing an implant with a two-dimensional panograph was incredibly hard. You thought you had 3cm of bone but when you reflected the flap it was only thick as paper and by the time you smooth that down to get some bone that was 5 or 6mm wide, you lost half your site. Today with three-dimensional X-rays with cone beam technology, dentistry has become faster, easier, higher in quality and lower in cost.

The economic meltdown & its effects on dentistry
The economic meltdown started August 15, 2008 when Lehman Brothers declared bankruptcy. The recession actually ended two years ago. The biggest problem in dentistry today regarding macroeconomics is dentists are still in shock from that brutal recession. They’re still standing there with their eyes wide open, scared to death. They’re scared to get back in the game and re-invest and start to grow and expand. That was the 10th recession since World War II. I meet dentists in every city, every state and every country who are setting economic records every month in their personal practices. It’s time to lose the fear.

The medico-legal scene in USA especially as pertaining to Dentistry.
Farran: I never worry about wrecking my car because I have car insurance. If I wreck my car, hopefully everyone is OK and safe. Every dentist is going to get sued at some point and the only one who should worry about it is the medical dental malpractice. I treat patients like I would want to be treated and I don’t worry at all about the lawyers.

Managing patients requires soft skills, managing the business requires hard skills. How do you combine the both?
I think dentists should delegate, delegate, delegate. I call it the “Five D’s”: design your plan, drop everything that doesn’t matter, delay everything you can’t drop, delegate so that you can do. I personally think that dentists should be doing dentistry all day long. I think it’s the job of other people – the hygienist, the assistant, the receptionist – to explain the treatment, to tell patients how much it costs, and to answer all their questions. A lot of dentists don’t delegate and it’s horrible for their practices and for the patients.

 

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

[site_admin]

 Dea all,

We continue with the questions and I am sure that Dr. Howard Farrans insights will change the outlook of many a dentist:

So read on:

Your favorite lecturer on the dental lecture circuit.
I would definitely say Dr. Mike DiTolla. He is the dental director of the largest dental lab in the world called Glidewell Dental Labs and he is sitting on more knowledge and more data than anyone I know at this time. They did a quarter of a billion dollars of dentistry last year and Dr. DiTolla has the data to back up everything he says. There’s no reason to go with porcelain-infused gold when you can do BruxZir. It has the same fracture failure rate as gold. His knowledge is unbelievable. If you ever get a chance to listen or see Mike DiTolla, go for it. He does have a continuing education course on Dentaltown.com.

In how many cities of the globe have you lectured?
I have lectured between 30 to 45 times a year, every year since 1990.  I’ve lectured in probably 40 countries, many of them several times.

Do you refer patients to a specialist or you call specialists in your clinic?
I do not bring any specialists into my dental office. We refer to the specialists all the time. My rule for practicing specialties is, if you absolutely love to do the procedure, it’s fun and exciting and makes you get a speeding ticket on the way to work, then do it yourself. But if you absolutely hate doing a procedure, you’ll actually lose money if you don’t refer it out. If you don’t like it you won’t learn more about it so it’ll take you longer. It’ll take the smile off your face, and lead to burnout and depression. I had a dentist say to me one time that he’d rather be beaten with a belt than do a root canal. I told him that’s what endodontists are for, so refer to them. Refer out everything you don’t like and don’t ever do a procedure just for the money. Keep a smile on your face. Remember life is a marathon, not a sprint, and the happy dentists who have fun keep going and going and going until they’re in their 70s and 80s, so don’t burn out.

Is dentistry comprehensive enough to challenge you?
People know what they know, but they don’t know what they don’t know. I think dentistry is completely impossible to entirely understand. The smartest dentists in the world know that they only understand the tip of the iceberg. Doing this for 25 years, I would say every year I practice, I learn a little bit more on the learn list but the list of questions of what I don’t know grows twice as fast.

Most practices report that professional receipts stagnate after a few years of practice.
What can be done?
It all comes down to one simple rule. Once a patient calls you on the phone and says, “I have a dental problem and I want to come down and give you money” and you say, “No, you can’t come down and give me money; you have to stand in line and wait a day or two to give me money,” that’s the instant you have a plateau and you’ll have it the rest of your professional life. So you have two choices. You can either hit the gas (expand your capacity by adding more chairs. There’s 168 hours in a week, most dentists work 40 hours a week, so they’re only open one out of every four hours. They could use their facility the other three out of four hours with another dentist, extended hours, weekends, or you could get more associates.) Or you can hit the brake and raise your prices. If you go to the market and every item there sells for a dollar and there’s a long line outside your door, then you raise your prices to two dollars – now you’re collecting twice as much money, but most of your line disappeared and the people who do show up and wait in line are giving you twice as much money.

Why don’t you also speak & conduct hands on courses on clinical topics like endo, adhesive dentistry etc.?
There is so much information in dentistry that you have to be an expert to speak on anything. An endodontist knows endodontics. All he thinks about, 24 hours a day, seven days a week for decades and decades is endo. A general dentist like myself who might do one root canal then go to the next procedure and place a crown, and then do a filling on a child, cannot intellectually compete with someone like Dr. Steve Buchanan, an endodontist, who’s only done one thing his entire career. We see this in economics going back hundreds of years with specialization. I have a master’s in business administration from Arizona State University. I have spent the last 25 years of my life focusing on one aspect and that is the business of dentistry. There’s no way I could compete with all the other aspects of dentistry.

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

[site_admin]

 Dear all,

One thing whcih I admire of Dr. Howard Farran is his passion for punctuility and the ability to take quick decisions. I feel that has been one of his reasons fro success.

So read on and note that the interview is open for discussion. 

If you would not have become a dentist what would you have been?

I would say a journalist, or involved in media somehow. Actually, I’m already doing it. I have a huge interest in reporting what I see and sharing it with others. There’s a show on television hosted by Anthony Bourdain that reminds me a lot of what I’m doing. Bourdain travels around the world and shows all the different foods that people eat. I find it absolutely amazing. There are seven billion people around the world, and everyone is the same. They all need food, water, clothing and shelter. They all have religion, government, politics and sports. I love being able to share what I see in my own travels, regarding dentistry. Seeing all the slight differences in how they develop their dentistry under different constraints of money, whether they have insurance, whether the government subsidizes it, their access to capital. I love telling people about these things.
 
How do you take feedback from patients?
When I was 18 I thought that to become successful the hardest part would be learning math. Now that I am 50 years old, looking back, I realize that was the easiest part of life. The hardest part of life is dealing with humans. The human brain weighs about three pounds, has more than one trillion circuits, and it is affected by genetics, diet and chemicals. People are so complex. Remember, you’re not working at a restaurant where everyone is happy to see you. You work in a dental office. Your patients are scared and emotional. It’s going to cost a lot of money, and you’re going to hurt them. Try to be compassionate. Listen to them.

After the economic meltdown, did you downsize?
No. We followed what Michael Dell (founder, chairman and CEO of Dell, Inc.) did in previous recessions. Dell said that during a recession, you need to double or triple or quadruple your advertising to replace all your current customers who now don’t have money to buy anything. What my practice did during this economic downturn was double our marketing efforts. We did direct mail, a Facebook page, Twitter accounts and Google ads. We did everything we could because we knew it would eventually pass.

How to maintain quality while taking care of overheads?
About 50 percent of Americans only shop based on price. The other half is not as price sensitive and is willing to pay extra for something with more bells and whistles. Let’s use cars as an example – there is the low-cost Honda Accord and the higher cost Acura RL. About half of the population will go for the Accord. These are the people who shop on price. The other half of the population wants the Acura. These are the people who are not as concerned with price.

 

These same two markets exist in dentistry. But what I see dentists doing wrong is they have low-cost prices but are doing high-cost procedures. If I’m building an Acura but am only charging for an Accord, I’m going to have high overhead. Serve your market.

 

The low-cost market wants low-cost extractions, dentures, partials, silver fillings and removable. If your folks are willing to spend a higher cost, then you’re going to charge more, and your overhead will go down.

 

The second variable is time. We only manage three things: people, time and money and we routinely see dentists with 50 percent overhead scheduling 45 minutes to do a crown and dentists with the average (64 percent overhead) spending an hour and a half to do the exact same crown. You need to build the technology and the capital and take continuing education courses so you can do dentistry faster so it can cut down on your overhead.

Class practice or mass practice. What do you prefer?
The bottom line is demographics, demographics, demographics. I see dentists all the time go listen to some famous dentist lecture in New York City or New Delhi or the richest part of town, and then they try to go back to their small town practices and implement the same thing, and it just doesn’t work. Demographics don’t lie. If you’re in an area where the population is mostly in the bottom economic half, you need to focus on the bottom economic half. The biggest companies always are the ones that are tops in cost leadership; they have the lowest prices. Southwest Airlines is the lowest cost airline, they’re the biggest. Wal-Mart is the lowest cost distributor, they’re the biggest. Ikea is the lowest cost furniture producer around the world and is number-one in furniture. If you want to become a major success, I would aim toward the middle class.

Your comments on GDP’s doing orthodontics.
Farran: If you want to be a community dentist and treat your village, you need to learn how to do all kinds of specialties. Now if you’re in a major market that has 5,000 or more people, if you absolutely have an interest and love and want to do a specialty whether it be periodontal treatment, root canals or orthodontics, then do it. You’re going to practice for 40 years. Have fun. Do what you enjoy. If you want to do orthodontics, go for it. If you’re busy and you don’t need to do orthodontics, and there’s an orthodontist next door who you like, then refer. When my four boys were little, if I put them in the sand box with nothing in there they’d leave and go find something else to do, but if I put them in the sand box with shovels and Tonka trucks to play with, they’d stay in there forever. So just have fun and do what you enjoy.

 

 

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

[site_admin]

 Dear all,

We all know that only clinical skills are not sufficient for succes in practice. A dentist needs to inculcate many skills in himself for success in clinical practice.

So continue reading:

When should a GDP start implantology in his clinic?

 
We call the last 50 years the “Golden Age of Dentistry” because everyone was doing porcelain-to-gold crowns and when there was a tooth that needed to be replaced, it was a three-unit fixed bridge porcelain to gold. We are now well into the new era, the titanium era of dentistry. The skill level to place an implant has plummeted just like automatic endo, and precast orthodontic NiTi wires. With imaging using 3D CBCT and then making a surgical stent to snap in place for implant guidance, placing an implant has never been faster, easier, higher in quality or lower in cost. I would jump into implantology immediately. When you replace a missing tooth with a titanium implant it is so easy to floss, so easy to clean, and the Strep mutans that causes cavities can’t eat titanium. It’s absolutely the future and you’ve got to get into implant dentistry today.
 
Do you do advanced periodontal procedures like sub-epithetical connective tissue grafts?
No, I do not. I have a great periodonist who that does that for me.

Some dentists are too talkative; some are too reserved & speak very less with patients. Your suggestions.
I will say it again, you only manage three things: people, time and money, and you need to pick your hygienist, assistant and receptionist with the same skill that your local soccer team picks its players. I believe that the most productive dentists mainly do the dentistry and leave all the small talk – the explaining of treatment, the collecting of money, the confirming of patients, everything else – to the staff. If you have a warm and friendly, educated staff who’s been with you for years and years and years, you should be able to just focus on the dentistry.
 
Should patients become social friends & should social friends become patients?
That depends on the exact person and the exact dentist. People are so complicated. Sometimes, a patient becomes a very good friend, but that’s the exception not the rule. Business is business. You can’t have a black and white rule and say never. What if you became best friends with your next-door neighbor and he became one of your patients? I would say that a patient being a good friend is rare.
 
Do you charge dentists, medicos, social friends when they come for treatment & how often?
Yes. Absolutely. Business is business. If my friend wants to come see me, he needs to pay. If he wants to get it free, he’s not going to get it free anywhere else. Business is business. Friends are friends.
 
When and how often do you raise your professional charges?

When Henry Ford started his assembly line, the Model T cost $668. Ten years later and 10 million cars made, it was down to $228. I think it is absurd that all dentists around the world raise their prices every time the Earth makes one revolution around the sun. This is not how other companies do it. You keep one eye on what the patient needs, wants and desires, and you keep the other eye on your cost. Figure out how you can do dentistry faster, easier, higher in quality, and lower in cost. Every other industry in the world figures out how to give their customers more value for less money. Raising your professional charges should be a last resort.
 
If a fresh dental graduate is in debt his attitude towards clinical practice may become too commercial. He may overcharge, overtreat & overdiagnose.
Integrity can never be negotiated. People who don’t lie, cheat and steal when they’re poor don’t lie, cheat and steal when they’re rich. A good person is just as moral in poverty as they are when they’re rich. When you see a rich man who’s an arrogant jerk doing illegal things, he would have done them as a poor man, too. People are people. They’re extremely complex and you’re always going to have a rotten apple in any basket of apples. If you get 100 new patients, one of them is going to be the nicest person you’ve ever met in your life and one of them is going to be the worst.

Is quality dentistry commercially viable?
Absolutely, yes.
 
Any specific suggestions to promote implantology?
You need to get your staff entirely behind implants. On Dentaltown.com, we have a dozen online CE courses on implantology. Start doing them on your staff’s missing teeth. Get your staff to bring in their moms and dads who have dentures. They’ll tell others about the implants.

Any specific suggestions to promote orthodontics
Same as implantology.

 

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

[site_admin]

Dear all,  

There are many questions on all aspects of clinical practice and pls read the views of Dr. Howard Farran on each of them.

Not just read but also try and implement his suggestions in day to day practice. 

How you been ever sued by a patient?

I have never been sued by a patient. The main reason, if not the only reason I have never been sued by a patient, is because if they want their money back, I refund the money. A lot of dentists won’t refund the money because of their ego and pride and the patient feels the only way they’ll get it back is to go sue them. So give more refunds, you’ll have fewer lawsuits.
 
Do you do treatments & afterwards the patient could pay in installments?
No. I am not a bank. I am not a credit card company. I am a dentist. If you want to make payments, then use your credit card. If you want a loan, then go to a bank. I am not a banker.
 
When & how will you retire from dentistry?
About five seconds after I die.
 
Your plans after retiring from dentistry
Retire to what? I’m going to quit doing what I love so I can sit on the couch and watch TV? If I really wanted to travel the world, I should do it while I’m a dentist and still making money and meeting dentists around the world. I have no idea what I would retire to.
 
How should a dentist plan his retirement?
A dentist should seek professional advice. We have many courses on Dentaltown. Doug Carlsen is a great read. Doug Henderson is a great read. For every nickel you want to live off, you’re going to need a dollar. Every nickel per year is going to cost you a dollar. The average retirement plan is earning about five percent. So that means for every dollar that I want to retire off of, I have to have 20 dollars in the bank. So if the average dentist makes $100,000 a year, they’re going to need $2 million to make $100,000 per year. And I’ll tell you what, the best way to make that $100,000 a year? Stay healthy in mind, body, spirit and soul, and keep working.
 
Lab offshoring. Your comments
Competition is what is good for the consumer. When you need a car, you want a dozen different major car companies all trying to make you the best car for the lowest price. I’m old enough to remember before there were any foreign cars in the United States from Germany or Japan. Every weekend a third of the households were out on the driveway fixing up their cars. Then slowly these very small Volkswagen Beatles started coming in, and everybody laughed at them, but what did it do? GM lost half its market. Japan and Germany raised the quality of cars in the United States. I think offshore labs have brought a massive increase in competition in the United States as well.

 

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

[drsnehamaheshwari]

 Dear Dr.,

Please provide some useful tips for fresh graduates looking forward towards clinical practce.

 

        

[site_admin]

We continue with the interview of Dr. Howard Farran

•         How was the idea of DENTAL TOWN born?

 

In the late 90s, I turned my focus on running my practice as best as I could – and in doing so, I decided to obtain a Master of Business Administration degree at Arizona State University.

 

The only reason I got my MBA is because I learned all my business knowledge from my father. My father was a massively successful businessman but he did it all on pure instinct. I always wondered how much my dad taught me was reality vs. false. I always wondered if the lessons he taught me even had the right terminology. I was just wondering if I was running my practice the right way. I was a businessman, naturally, but I had no formal instruction. So I wanted to see if there were things I could formally learn that would augment what I’d already knew.

 

It was toward the end of my coursework when it came time for me to fulfill a final thesis assignment. The Internet was a relative infant but it caught my full attention. My chosen thesis topic was “How the Internet Would Affect Dentistry."

 

I really focused my thesis on commerce vs. community. What I saw on the commerce side was that dentists were pretty much all solo practicing individuals. They might practice in the same medical building as five other dentists and will have never gone to lunch with any of them in their whole lifetime. The moment a sales rep came into the office to sell something is when the shy introvert scientist dentist would ask, ‘What is my neighbor using?’ Those salespeople were actually a form of community. Back then, everyone saw the Internet affecting dentistry by merely selling supplies, but I was thinking, “OK, you’re the only dentist in a small town of 2,000, you have a six-year-old girl with a big abscess and you don’t know whether to do a root canal or pull the tooth or whether you should put in a space maintainer or start her on ortho, etc.” I thought “What if these dentists could all get into the same Web site and talk to each other?"

 

I worked very hard for 10 years as a dentist. I paid off my debt. I had saved up a ton of cash and I took all my money and borrowed everything I could on my practice and my house and I hired 19 programmers to program 40 hours a week, 50 weeks a year to get a wWebsite going with all the functionality that I wanted. And in March 1999, Dentaltown.com went live.

 

When I conceived this whole thing, I knew that it would serve a huge need for some. I was realizing how fun that was because everyone was just talking in the way humans like to talk – straight to the point, no punches held and I thought this is the way dentists need to get their information. This was the way dentists needed to talk.

 

•         The difficulties you faced in print edition of DENTAL TOWN.

 

There is still a cultural human reality that dentists like to get in their easy chairs and get a beverage and some popcorn and read magazines. I would get dental journal after dental journal after dental journal, and I was an extremely motivated dentist, but the articles just didn’t interest me. They were usually too fundamental in nature, like they’d talk about cancer in rats and weird diseases that you’d never see in your lifetime. I never really read a dental journal and changed the way I practiced dentistry. The message boards on Dentaltown.com had massive amounts of content that I thought we could break down and say, "This is really what you need to know about." You can go online and read any newspaper, magazine or book you wanted, but the human side of you wants to go out on your porch swing and read a book or a magazine.

 

At the same time I was pondering a print version of Dentaltown.com, I came across the history of Sesame Street. I was inspired by this group of grad students who wanted to develop an educational program for children, but kept getting shot down by supporters because "kids would rather watch Bugs Bunny."

 

These grad students went back and took classes of 25 five-year-olds and they started playing them the top five cartoons, and they were able to factually establish that at any given 30-second interval, only 30 percent of the children were actually paying attention to the TV while the other 70 percent were walking around or playing with their toys. They took that data back to the advertisers and said, "Do you buy into this data that only 30 percent of the kids are looking at any given 30-second interval?" and the advertisers agreed, “You’re right, we’re still going to advertise our cereals and toys and things we want these kids to tell their moms to buy.” So the grad students asked the advertisers for funding if they could get 30 percent of the kids to watch. And the advertisers said, “Yes.” The grad students wound up getting more than 70 percent of the kids to watch at any given 30-second interval.

 

I was so charged up by this notion of measured content that I started to seriously pursue development of a magazine. The book would take the content of 100,000 questions and answers in a month and publish the top three discussions that most dental colleagues are interested in. While other magazines relied on editors who weren’t dentists and who used their gut feelings in trying to figure out what dentists needed to be reading about, Dentaltown Magazine armed the editor with data from the message boards and showed, "This subject on CPR – no one cares about, but the subject on TMJ, everybody’s going nuts over!" For the first time in dental history, the editor was connected to his or her readers. Actual measured content opened up a whole new format. This publishing model has been a revolution in dentistry.

 

Dentaltown Magazine has grown leaps and bounds since we started publishing it. Its success has even led to spin-offs such as Orthotown Magazine, which uses the same publishing model as Dentaltown Magazine – but for orthodontic specialists.

 

 

•         The difficulties you faced in http://www.dentaltown.com.

 

Launching Dentaltown in 1999, looking back, was at least five5 years ahead of its time. When Dentaltown was launched, not even one percent of dentists could tell you their e–mail address. The hardest thing about Dentaltown was trying to get a new behavior into dentists, and that was getting them on the Internet. The answering service and the ATM machine were two of the biggest job destroyers in my lifetime. When the ATM machine came out would sit outside of a bank and do transactions, 168 hours in a week and not take breaks or need health care or lunches or whatever, a lot of bank tellers were let go. When the answering machine came out, literally hundreds of thousands of receptionists lost their job because now the CEO didn’t need someone answering his phone, someone could just  leave a message. Well dentists and physicians and lawyers still all have a receptionist because they are dealing with the public transaction. So back in 1999 when I started, there was almost nothing alluring to the Internet that a dentist’s receptionist didn’t already do. If the dentists needed a book, his assistant would get it. If he needed to go to a dental convention, his receptionist would make plane tickets and hotel reservations, he didn’t have to go onto Priceline.com. So for many dentists the only thing that made them eventually get on the Internet was to actually talk to other dentists about dentistry.

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

[site_admin]

 Questions to Dr. Howard Farran ….continued

•         Do you think dental trade dominates dental deliberations?

 

Absolutely. Dentistry is a profession where at least four out of five dentists or practice by themselves, and they need to know what their other two million dentists peers around the world are doing and thinking about dentistry. Ever since Gutenberg’s printing press, newspapers and magazines have been huge. The more dominant form now is the Internet. So the problem with a dental trade publication is that if you read an article on root canals and it didn’t answer your question, you are kind of stuck, and what are you supposed to do? Wait un‘til next month and see if they have another article on root canals that answers your question? I think the most exciting thing about dental trade publications now is a dental trade magazine now acts as an introduction to an interactive conversation via the Internet. So I view Dentaltown Magazine as something mailed out, more like an advertising piece, or an information piece, telling you what everyone is talking about on Dentaltown. About half the people read that and get what they need, and the other half see that article and log on to the website after each article and say, ‘Oh regarding that article, what about this and what about that?’ So I think the whole is greater than the sum of its parts. I think a magazine being mailed to a dental office for free is never going to die. A magazine mailed to a dental office for subscription only, that’s going to be a tough thing, there is just too much interactive information on the Iinternet for free to actually be paying for a one-way communication piece. So I think the magazine is mailed out to 125,000 U.S. dentists and that starts the conversation, and hopefully that answers all your questions, and I think about half the dentists, that’s just the beginning of the conversation and then they log onto Dentaltown for follow up.

 

•         How do you ward of spam & bad comments on http://www.dentaltown.com ?

 

First off we sat down and designed a set of rules that prevents this but is not overly restrictive. For instance, we do not allow spam in the body of the message but we allow everyone to put their contact information and “sales pitch” in their signature area. That way if one wants more information from the person, they can look at the signature area, and  ignore it if they do not want it. We are very strict on editing and deleting personal attacks. For those that refuse to comply and repeatedly ignore our requests to stop, their accounts are inactivated and they are banned from our message board. Dentaltown hired a message board manager to run all this and he appointed volunteer administrators and moderators to help him enforce these rules.

 

•         How was the idea of TOWNIE meeting born ?

 

Townie Meeting is steeped in tradition. It was founded by two long-time members of Dentaltown.com who saw my vision that no dentist should have to practice alone. They created a meeting that embodies what Dentaltown is all about: eEducation, eEntertainment and cCamaraderie. We plan to continue the traditions set forth while growing in size and attendance. This meeting is THE place to grow your knowledge and passion for dentistry. With it now in our control, we will be able to invite every dentist in the world to take part in it.

 

•         Your future plans for TOWNIE meetings

 

Every year Townie Meeting just gets better and better. We have some amazing plans for future Townie Meetings in the works – but we’re keeping them secret. We invite every dental professional on the planet to come to all of our future Townie Meetings to check out what we have in store for them.

 

•         Did your involvement in DENTAL TOWN compromise the care you provide to your patients ?

 

No. Actually my involvement in Dentaltown massively increased the quality of care I did because I only knew at I learned in school, but it was actually posting cases on Dentaltown and seeing other dentists post cases on Dentaltown that I would say that it absolutely made my dentistry faster, easier higher in quality, lower in cost.

 

•         How much time did it take for you to break even in  DENTAL TOWN print edition and http://www.dentaltown.com  ?

One year.

 

•         Your future plans for DENTAL TOWN and http://www.dentaltown.com

 

Right now Dentaltown and Dentaltown.com are both in their infancy. I started Dentaltown.com in the United States of America only because that’s where I was born and raised, but America only has 150,000 of the world’s two million dentists and I have now 160,000 members on Dentaltown.com. If f you count all the hygienists, receptionists, assistants, dental labs, manufacturers, consultants, probably close to 10 million people work in dentistry. So Dentaltown and the Internet are both in their infancy. What I’m most excited about is, as we are writing this in 2013 two of every seven earthlings are on the Internet and we’re adding another one out of seven Earthlings per year for the next four years as they quit making cell phones and only replace them with smartphones – smartphones being a cell phone with Internet connection. So I think Dentaltown is going to explode as the world’s two million dentists from Portugal to Pakistan can literally log on. So I to put an analogy on the Apollo space mission to the moon – I think Dentaltown is still on the Launchpad.

 

•         When you started DENTAL TOWN were you sure you would break even & make a profit?

 

I would say no. Risk equals reward. I  ask everyone when you make a business decision, can you live with your worst-case scenario? I put all my money in and borrowed a lot of money, but I was a very hardworking successful dentist and I could have paid the loan back that I borrowed. When I see people make a business decision and when it goes south they literally decompose, loose it, kill themselves, whatever – they should have never made a decision where they cannot live with the worst case scenario. So you always want to know what your break-even point is and you always want to know what your worst-case scenario is, and you always want to watch how much leverage you use, because things can always go south. A lot of times they can go south for nothing that you did wrong. It could have been an earthquake, a hurricane. Look what happened on 9/11 in Manhattan. Some of those businesses that had been in business for literally four or five decades simply didn’t have a line of credit or cash flow or savings to survive until Manhattan got back on its feet again. Some of my favorite restaurants are gone and they are simply gone because the owner never even had a savings account or an emergency line of credit. So I think a lot of people don’t have enough insurance and a lot of people don’t have enough savings, and a lot of people make decisions where they are not prepared to live with their worst-case scenario.

 

•         How many hours in a week you are not online?

 

I wake up usually at five and I work out until seven, and I log on at seven and I’m checking Dentaltown off and on all day, probably logging off every night between about 9 and 10 p.m.

 

•         How do you select moderators for http://www.dentaltown.com

 

In the past moderators were picked because they were knowledgeable about a particular subject. Now moderators are picked only after they have shown through years of posting that they are fair and not abusive. They all agree to uphold and enforce the rules bye either editing and deleting posts themselves or alerting the Message Board Manager about the offending post. We have private moderator forums where the moderators can discuss message board issues amongst themselves and with the Message Board Manager.

 

 
• Why have language specific editions of http://www.dentaltwon.com been initiated. English is the global language

While English may be the global language and dentists around the world learn dentistry in English, it’s so much easier, friendly and comfortable for people of the same native language to discuss dentistry in their native language. That is the primary reason for opening up separate native language Dentaltown.com forums.

 

 

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

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 Dr. Howard Farran on PRACTICE MANAGEMENT:

• Some tips to identify delinquent patients.

When you go to a McDonalds, you order the hamburger, then they ask you to pay two dollars for the hamburger, then they give you the hamburger. Businesses that extend credit are insane – that’s why we have banks and credit cards and finance companies. There is no banking skills taught to a dentist in dental school. With Visa, MasterCard, AMEX – why in the world would you need to identify a delinquent patient? You’re not a bank; you are a dentist. If a person needs dental services then they need to pay you cash, or they need to arrange their own credit and come in and do that. You are a dentist, not a banker. You have no training to identify delinquent patients and you shouldn’t be doing banking.

• Male dentist – female staff. Any particular hints to manage female staff.

I would say that in watching dental offices for 25 years, you see what doI’ve watched what the most successful dentists do more of, and what do the least successful dentists do less of.? For instance, dentists who advertise have much bigger practices than dentists who don’t. Dentists who utilize technology are much more successful than those who don’t. As far as management, I think that the dentist is the most expensive person in the office and they have the capability of producing the most revenue by doing dentistry, root canal, fillings and crowns. The most successful dental offices don’t manage any of their female staff; they get an office manager whose skills are excellent in HR, in job descriptions, in performance evaluations, and start every day with a team huddle, and then wire everyone up to Motorola office walkie-talkies, and then finish the day with a wind-up recap of the day. I just don’t see any reason in the world that the dentist should be doing any of that – the dentists should be in the operatory doing dentistry. So get an office manager.

• How do you scold female staff!!!

Scolding people is not effective. All relationships are built on love, trust and respect. I think that you have to have effective communications, you have job descriptions, you have regular, quarterly employee evaluations. Again, while you are obsessed about dentistry during a root canal or pulling four wisdom teeth for an hour, you should have an office manager who excels as a people person, as a leader. I would compare it to sports coaches. Yes there are some sports coaches who are known to scream and yell and to have a lot of drama, but those are usually male coaches with male staff. I think it would be incredibly unprofessional to have a male dentists doing this with female staff. Again I would get a female office manager, and if they are really, really good there should be no drama, no scolding, no yelling, screaming – your office should run like a Swiss clock.

• Common mistake made by new comers.

Newcomers are going to make a lot of mistakes and basically it takes about 10 years for the average dental student to have successful dental skills and a successful office. Dentists are book smart, they all went to college, they know how to read books. But the most successful dentists are a combination of book smart and street smart. Street smartStreet-smart people learn information a lot more cheaply. You see some dentists, and if they want to learn anything they need to go spend $5,000 at some weekend course half way around the country. Then you see the street- smart people just get online and pay 18 dollars and take an online CE course on Dentaltown and watch it with all of their staff. That’s a bargain. You are going to learn every lesson one way; you are either going to learn it the hard way or the easy way. All leaders are readers and getting on dentaltown.com when you get out of school, reading the most posts, taking the most online CE, doing all that stuff at the beginning, you’ll learn everything the easy way, which is by learning from other people’s mistakes. If you decide that you don’t have a time to take a lot of CE and spend a lot of time reading and talking to other dentists, then you will learn every lesson the hard way, which is also the expensive way, and might involve some lawsuits or more. All leaders are readers. Be street smart. Learn the most information for the lowest cost.

• What should be the profit margin in a general dental practice?

Most dentists don’t understand what a profit margin is. They include their wages in the profit margin, which is not generally true. For a true profit margin, to know what you are actually being, what you are earning from doing dentistry, you would be paid what other employee dentists in your area are. Like in Phoenix, Arizona, the average associate dentists who works as an employee earns 25 percent% of their production. So in my dental office, when I do dentistry I pay myself 25 percent% of production because that is the true value of a dentist in Arizona doing dentistry. Profit is owning a business from having money or capital employed in a dental business. And I would say the profit margin for a dental office, I see that the really healthy ones are running somewhere between a wide spectrum of eight and 16 percent%.

• What percentage of the professional receipts could be the auxiliary staff salary ?
•
Again, I see two markets. In the United States, there are 117 towns that have more than 100,000 people, and staff salaries are usually anywhere from 25-27 percent%. Now that is being the total cost of having that staff in there, whether that’s health insurance, 401K, uniforms, whatever – all the money it takes to pay those people to work in your office. It’s a much lower cost structure in the rural cities, so in the 19,033 towns in America under 100,000, that percentage of labor is 20 percent%. When you ask, how much to do you pay your hygienists to work there – in a very high cost setting like San Francisco or New York, that can be as high as $50 per hour, whereas in very small town rural cities in the south, that can be as little as $12-$14 per hour.Dr

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

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 • When should get an associate dentist for your practice ?

I would get an associate dentist for my practice on day one. It’s a failed ideology to say that I’m going to have a very non-available dental office that is barely open evenings and weekends, and when it really grows and becomes successful, I’ll make it a really nice office, open on evenings and weekends. The average American works 8 a.m. to 5 p.m. and for half of Americans it is frowned upon if they leave their small business between 8 and 5 in that time period to go to the dentist. So you need expanded hours, you need to be opening your office at six6 or seven7 in the morning for the people who want to come before work, you need to be staying open until six6 or seven7 in the evenings for people who want to come after work. You need some Saturday hours. There are 168 hours in a week, so once you paid your fixed cost of rent, mortgage, equipment, build out, computers, insurance, professional dues – if you are only open 40 hours a week, then you are closed 128 hours a week, it doesn’t make any sense. If you’ve already paid your rent, and you’ve already bought your equipment, the more hours you have it open of those 168 hours in a week, the more efficient you are going to be utilizing your fixed costs.

• Was there ever a need for you to sack an auxiliary staff/associate ?

Of course. People are extremely complex. People have very complex brains – , a 3.5 poundlb brain, they have with a trillion circuits. You don’t know how they were genetically made, you don’t understand their diet, their shaping, their parental deals, their situation changes… your attitude determines you altitude, not your aptitude. So yeah, humans are incredibly complex, and in 25 years, on the one hand, I’ve still got my first assistant I ever hired, Jan, who has been with me 25 years. Then I have a dozen employees that who have been with me a decade or longer, but yeah I’ve got new employees too. So absolutely.

• How much should be the growth on professional receipts & profit margin year after year ?

That’s a tough question. I would say that historically it tracks the economy. When you look at the economic data for dozens of countries, when the economy is contracting, so does healthcare, when the economy is expanding, so will healthcare. There are only so many dollars in the economy; you can’t suck blood up out of a turnip. So a lot of that is professional receipts and profit margin growth have to do with how is your economy growing. Number two, what about new competitors? I mean, I’ve seen dentists open up in a small town where they were the only dentist, and then one year four dental students move in there after graduation, so in your macro economics you go from one dentist in a small town to five dentists in a small town. So there are many, many factors, so there should not be any generalizations of how fast you should grow your receipts or profit margin.
• HELP!!! There are now 43 dentists in the locality.

I would tell those dentists that if the locality sees 43 dentists as all identical and sees no difference in them in price or services or hours or convenience, then that is going to be tough. But when we look at car companies, the world knows the difference between a Mercedes Benz and a Smart Car, even though they are owned by the same company. They see a difference between Honda and Toyota and Chevy and Chrysler. I think some of those dentists should be very high cost, very low volume and focus on a Mercedes-BMW business model. I think the majority of dentists should focus on a lower cost, higher volume business model, like a Chevy or a Smart Car. I think some should focus on cosmetics, some should focus on sleep medicine. I would just try to advertise in your locality and try to brand a unique selling proposition, and once your locality determines your USP (unique selling proposition), you should be successful.

• Does your practice run a newsletter for your patients ?

Yes. We’ve had newsletters from our practice patients since 1987, but they have moved from a printed, glossy paper mailing to now a digital e-mail happy gram through our website. So we e-mail it.

• Some tips to make a website for a dental clinic.

I think that, again back to the 43 dentists, I wrote a column on this called The SWOT Analysis, and what I think you should do on your website is first try to tell me who you think you are and what you do. Some people who tell me that they are really focused on cosmetic dentistry, and then I go to their website and I just didn’t get that feeling. What I would do, is I would spendt 15-20 minutes on every website of your competitors and I would develop a SWOT Analysis. And you might know these dentists and you might think one thing of them, but you are not a consumer who is meeting these dentists on the website. I’d do a SWOT Analysis – what are your strengths, weaknesses, opportunities and threats for your dental office compared to everyone you compete with in your locality versus how you feel about them over on their website. And a lot of dentists have strong conversations with me about everything they are about, I then log onto their website and you just don’t get that feeling at all. So your website should reflect who you are and your unique selling proposition.

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

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Dr. Howard Farran continues to answer questions on DENTAL PRACTICE MANAGEMENT 

• After how many years of practice should a strong retirement kit be ready ?

I am not an opponent of retirement plan, I think that right now, around the world, CDs are paying one or two percent interest, so if a dentist wants to live off of 100,000 dollars per year, he is going to have to have 10 million dollars of CDs to retire. What I see, every dentist who thought he was going to retire at 65 realized that if they just stayed on and worked two or three days a week, their paycheck would be a lot more money than their retirement account. I think it’s a healthier lifestyle, I think there is no reason you should throw in the towel and sit on the couch and be sedate and watch TV and play golf. I think it’s very, very healthy for you to have to get up and shower and eat breakfast and go to work and interact with people. So what I would focus on is that business is not a sprint, it’s a marathon. And I’d start asking yourself, why do you want to retire? Some dentists will tell me that they hate root canals so bad they cannot wait ‘til they retire to never have to do a root canal again. And I’m like, why don’t you just quit doing root canals? I mean there are endodontists. Or why don’t you take a bunch of courses on endo and buy some new technology and maybe it will be easier?. If it’s the stress, then figure out why your office is so stressful. Bring in an office manager, tell her that the reason you want to quit is because of the staff struggling or office drama or turmoil or whatever. But what I would focus on is to keep altering your dental office until you didn’t want to retire. And then set a goal that when you get older, you’ll work one hour less and make one dollar more. So let’s say you want to retire at 65 and you’re making $100,00 a year, why don’t next year you try to do it in 39 hours and make $101,000, the next year try to do it in 38 hours and $102,000. Just slowly, slowly taper off is my advice.

• Have you ever been duped by an employee/patient ?

Sure! People are complex. People are – Ssome people think 3% of people are sociopaths. People have depression. People make imperfect decisions. It reminds me of the poem Anyway by Mother Theresa: People are crazy, but treat them kind anyway. People lie, cheat and steal, but be nice to people anyway.

• What precautions you take before you hire an employee ?
•
I think one of the biggest precautions that we take is that, number one, people are so complex so we want to call references and background checksGoogle them to check on their background. Another thing that we do with employees thatwho handle money is we do a credit check. A lot of dentists have listened to me over the years and done this and I get e-mails where they will do a credit check and they are literally bankrupt, and desperate people do desperate things like steal your money, embezzle from you. So yeah, I would get references, I’d call their last employer and I’d if necessary do a financial background check because you certainly don’t want people desperate working for you, especially when they are around money.

• How can a dentist use social media to promote his practice ?

I think the biggest player is Facebook. And you have your Facebook personal page, but I think your dental office should have a Facebook personal fan page and a Twitter account and a Pinterest account and a LinkedIn account, and whenever something fun happens in your office – you havegot an exciting case, maybe one of your staff had a historic event like a marriage or had a baby – then I would post that. I think when you make a human emotional connection with someone it helps facilitate love, trust and respect, and they are more likely to trade with you.

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

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More questions to Dr. Howard Farran 

• How much increase you give your staff year after year ?

Again that depends on how the business does. If the business does better, then we give out more money. If the business doesn’t do better and we start making less money, we start getting rid of certain benefits. So I think if the doctor is going to make more money, so should the staff. And I think if the doctor is going to make less money, so should the staff. It’s what I call a team-based reward – you already give individuals their individual rewards based on their hourly income – but I think your business should have team-based rewards, where if you guys are all successful and play well together and make more money, they should split sdome of that.

• How do you train your staff ?

First of all, on training your staff, I prefer the question: How do you reduce staff turnover?. You know, Aa lot of dentist look at staff and say they are so expensive to train. Well they are expensive to train if your average staff only works with you for two2 or three3 years. You know I’ve had Jan who has been with me for 25 years, so I look back in the last quarter-century of all the classes and institutes I took her too, man what a return on investment! Because she’s been with me for 25 years doing all the stuff we learned. So I would train your staff online. Again, the biggest university in the world is not in New York City or LA or Berlin; the largest university in the world is University of Phoenix online, and they sign up 70,000 new students a month and you can teach your staff everything you need to know about marketing, root canals, fillings, crowns, practice management, business – all online for an incredibly low fee.

• What is to be done if staff is not punctual ?

Again, I’ll compare it to sports teams. Let’s say you own the most successful soccer team in India, are you really going to fire your star goalie because he came late to practice? HR is incredibly the hardest part about business and life. I think the greatest thing about being alive is the people and friends that I love, and I think the worst thing about life is some of the people around me that I just can’t stand. For every Gandhi and Mother Theresa, there’s an Adolf Hitler, a Pol Pot, and a Joseph Stalin . So there’s just no simple rules for HR; I mean humans are just so complex. Obviously if it’s your star goalie on your soccer team, the others might think he’s a prima donna because he gets away with coming in late. But you aren’t going to cut off your head to save your little toe. Like Jan, in 25 years, like anyone who has been married for 25 years – they’ll say, we had some great years, we had some tough years, we had some challenging years, but we made it. And interpersonal human relationships are the biggest complexity that I’m aware of in the universe.

• How should the front office staff present treatment plans to patients ?

I think they should treat it in their own words and they should use a combination of words, pictures with the digital X-rays printed out or intra-oral camera photos, and take notes. I think if all you do is talk in the patient’s ear, the research shows that in three months they won’t remember 5 percent%. If you print out pictures of the diagnostic X-rays and you explain it to them while they are looking at the X-ray, they might understand or remember a little bit, maybe a third of it. But if you print out X-rays or a photo and draw notes on the pictures on the words that they understand, then they do very well.

• How do you train the front office staff to present treatment plans to patients ?
I train them by having them watch online courses on Dentaltown.com.

• Features of a good practice management software

The best feature of a practice management software is when it hooks into your accounting software. So at the end of the day, your software can tell you what your percent of cost was from labor and lab and supplies and it can tell your office what time in the day you break even. But if you have half your data on Quicken and Peachtree and the other half on dental practice software, then you basically have a schizophrenic system with multiple personalities and at the end of the day you have no way of knowing what’s going on.

• Some tips for husband &wife dentists

Yes. For a husband and wife dental team, it is more important than ever that you get an office manager and stay out of the details. What I would do is work like your associate dentist during the day, and then at night you might want to talk about interesting clinical things you saw or an interesting case you had, but having a husband and wife manage five to5-10 women is very confusing. You know, we only have one pope in the Catholic church, not two. Every country I know only has one President, not two. So it’s very confusing for the staff when the husband is saying go left and the wife is saying go right. It’s very confusing. I think the two of you should only talk to one person and that is in private and that is with the office manager.

•Female dentist-male patient. What precautions need to be taken ?
None.
Do you give sodexo pass coupons to staff as a motivation ?
I’m not familiar with Sodexo pass coupons, but we do have a series of perks and bonuses that we give our staff. We think that staff – like all humans – crave recognition. I remember with my four boys, at least once an hour I would hear “look daddy, look daddy, look daddy!” Staff need to be recognized. They are not going to dive for the ball and work their butts off to not be noticed. I think there are 5 ways you can do it, according to research. Some like gifts, some like money, some like time spent – sometimes you take them to lunch. But you definitely want to motivate your staff any way you can.

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

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Dr. Howard Farran continues to answer questions ….

 • In spite of our best efforts the professional receipts may not increase

True. Absolutely. There are no guarantees in life. No body said life was going to be easy; they just said it can be very interesting, it can be very challenging. Again, if several new dentists move into your area, that can massively hurt. And how do you have a successful dental office when a tornado came through town and leveled your office? Natural disasters, death in the family – yeah, there’s no guarantees that your receipts will increase.

• Advantages of group practice

Advantages of a group practice areis professional the mostmostly. I mean Iit is so much fun to be able to walk back to your private office and show another dentist the X-ray and the study models. I just can’t tell you how much that would depress me if I weren’t working with two associates. I think Dentaltown.com has really provided a lot of solo practicing dentists a great service by letting them hook up with many other dentists.

• Advantages of solo practice

The advantage of a solo practice is that you only have one Pope, you have a dictator, you can do it your way. When you have a group practice, it’s just like a marriage. So I would say what is the advantage of being a single bachelor and what is the advantage of being married? Being married is nice, you have a friend you can show dentistry and you can talk about root canals, fillings and crowns, it’s great, you can brainstorm with your partner. So all of the complexities of being in a relationship are very nice. But the disadvantages are, sometimes there is drama with your partner. Sometimes there is a lot of bending and giving. It’s so easy as the only owner, you can have it your way, you can make this hamburger with our without the cheese – it’s your call. It’s always going to be tough when you always have to negotiate every decision you have to make with someone else.

• At times inspite of your best efforts you may not find the best staff. What is to be done?

I would say that in my 50 years of life, when has any sports team been done with their best staff? It seems like every body whoteam that wins the World Cup in soccer shows up next year with and a third of the new players are new. Everybody Every team that wins the Super bowl football team, there’s at least a 25 percent % turnover. So I just don’t know when you are ever going to have the best staff. And just when you thought your staff was perfect, someone can die, someone can move, someone can decide they want to go back to school. I think that staff is the hardest part about business, it’s the most important part. You only manage three3 things: people, time and money. And business only has three functions: you make something, sell something and watch the numbers. If you get an A on the right people, everything else will fall in line. If you get a C or D in the people, you are never going to catch up. So I would never put your guard down that you have the best people. In fact, I’m sitting here with my Editor Bend Lund right now and yesterday an editor from overseas sent me an e-mail and wanted to know if she could meet me. I don’t even have an opening for an editor, but I swear I sure as hell am going to meet her. I mean for all I know, Ben will be ran over by a car tomorrow, or our business will grow so much that he’ll raise his hand and say, “I need help.” So I think the best sports teams in the world usually have two or three or four full-time employees as scouts, looking at all the up and coming talent. And they want to know – I know in the most competitive industry I’ve ever seen, the NFL, those coaches hire enough stats to have their summary of every single person in college football that’s a starter. So when they decide they need a quarterback, they know every single one of them. And some scout has gone out there and looked and watched them play their game. So man, HR is the hardest – and I want to also tell you one thing: – I don’t even think I’m that good at it. The only thing I’m good at in HR is to know how important it is. But in my dental office, I have an office manager named Sandy Wilkinson and she is far better in tune and connected with those staff than when I did it my self, and the last decision I would ever make would be to fire my office manager and do that myself.

        

For one to one consultations on dental practice growth and practice management please contact : todaysmedicalmarketing@gmail.com

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