Dentistry Uncensored with Howard Farran

Dentists could learn a lot from Sol Price (1916-2009), the founder of Price Club in 1963, which became Costco, which pioneered the membership, absolute pricing authority, warehouse store retail model. The membership model is currently one of the hottest trends in retail. A store that tries to be all things to all people will end up being nothing to anyone. A retailer reflecting honesty, credibility, and a definite direction that can be understood by its customers and vendors will have a good chance to make it. Costco’s 3 Business Categories: Personnel, Product & Facilities. Costco’s 6 rules: Have the right kind, in the right place, at the right time, in the right quantity, in the right condition, at the right price. Costco counts on very significant productivity because they pay high wages and benefits. If you buy into the concept that Costco is the low-cost provider of goods and services and also pay the highest wages in retail and have the richest benefit plan, then we must be getting better productivity, because of every dollar that we spend on our business, $0.70 is on people. There’s a categorically false notion that the only business model in the service industry is the minimum-wage business model. Costco people work for years making great money plus health benefits. 87 million people have a Costco card because they have absolute pricing authority meaning if you see it at Costco, you’re sure it’s the best price you can find. Advertising is cost. The only secret to lower prices ins lower cost. So, if you spend 1-3% on advertising, you’ll raise your cost which will raise your prices. Advertising is like heroin, once you start doing it, it is very hard to stop. Word of mouth is the lowest cost most effective type of advertising. Costco saves 2% a year in costs by not advertising. In 2017 Amazon spent $6.3 billion in advertising, Target $1.4 billion, Walmart $2.9 billion. The average markup at Costco is just 11%, Walmart is 24%, Supermarkets 30%, Home Depot and Lowe's 35%.

In baseball and HR, three strikes and you’re out. So, if you fire someone and they’re surprised, you need to reexamine your ability to manage and lead your team. Sometimes no matter how many times you tell someone they’re not performing and meeting expectations, they just don't get it. However, more times than not, managers and leaders want to avoid confrontation and they don't ever address the issues with someone and instead avoid the person. That's being a horrible leader or manager. Let’s say you open at 7:00 am and your assistant rolls in at 7:05. Young dentists are mad but don’t say anything. The better managers, as soon as time permits will call the employee back into their private office and explain the problem, open up a word document and leave while the assistant types out in their own words what went wrong and explains why it won’t be a reoccurring problem. Many times, you comeback to learn that she does this because she always stays an hour after we close while the other assistant flies out the door and she doesn’t think it’s fair. This is what you need know so you can build a winning team as opposed to other more common method where the first time it made you mad and you didn’t say anything. The second time it made you madder and you still didn’t say anything. Then the third time you erupt like a volcano and fire them. This person had no idea this was going to happen, they have monthly bills they need to pay, and now they’re shocked, saddened, and unemployed, all because their coach never showed up for the game. Watch any professional game and watch how the coach is intimately involved during the entire game, standing at the sidelines calling in plays, time outs, etcetera. Now watch Doc go back to their private office in between every patient and shut the door. If this is you, then you need to delegate to an office manager that has the same authority to make plays that match their responsibility. You’re either the coach or a player, cuz you can’t be both. So, play ball... and okay to win.  

Getting to Yes by Tracking No means you better know your overhead and break even point for the day. The average net income for: Dental Specialists ($320,990) General Practitioners ($197,190) Dentists who owned their own practices ($244,980) Dentists who were employed at a practice ($147,950) Oral and maxillofacial surgeons $448,140 Periodontists: $330,690 Endodontists: $307,460 Pediatric Dentists: $304,280 Orthodontists: $289,190 Prosthodontists: $219,950

Does your dental team celebrate as much as your family? Do they spend more time discussing problems than celebrating victories? The whole team is greater than the sum of each team member. There’s no such thing as a self-made dentist. You’re only gonna reach your goals with the help of others - and that means having fun.

Is a bird in your hand really worth two in the bush? Is it really better to hold onto something you already have than risk it all for a double? Did capitalism die? Why didn’t you keep your fast-food job instead of spending years and student loans for something better? Saving money for retirement is about laying out a bird now to get two or more out of the bush. Do you really want to be an associate dentist? When you decided to be a dentist back in grammar school did you envision yourself as an employee dentist or the dentist owner of your own dental office, land, and building? Associate dentists are paid just enough money to kill all off all their dental self-mastery dreams. Don’t settle for a sure bird in your hand today if you have already proven that you have the internal self-discipline of delayed gratification to invest it in yourself in the hopes that someday it will be worth two birds. Dentists know this or they would have invested eight years of their life and half a million dollars to get a dental degree.

Transparency vs Opaque. I was wondering why successful dental leaders are transparent and not opaque until it became clear to me that if your not it’s clearly offensive. Does your dental office team know the daily breakeven point? Do they know the office overhead? Do they get to see the accounting reports for the balance sheet, statement of cashflow, and statement of income? Management transparency is the key to trust and the foundation for strong management-employee relationships to analyze and grasp how the practice is doing and where we’re going. Are collections meeting expectations in the 30/60/90 day periods? How’s are overhead looking and could we lower it? Are costs being managed? What’s helping us achieve our goals? What are our obstacles? Everyone in the entire company has complete visible transparency into the budget, how and what we’re spending, what our results are, and does everyone have a voice on how we can improve our performance. How often have you heard that people leave a job because of the manager not because of the company? It's true whether it’s a small family dental practice or a large dental group practice DSO. One of the common complaints you hear from disgruntled employees is they don’t trust their dentist or office manager who is not very transparent, and have no idea what they're thinking, what is happening, the performance of the office and don’t know what’s coming up in the future. If you can’t trust your opaque non-communicating dentist, office manager or team leader then your life and work become an exhausting challenge day in and day out. The late Herb Kelleher (1931-2019) co-founder & CEO of Southwest Airlines was the only airline CEO who was a member of his own pilots union because he knew how important that relationship was. His book was called Nuts!: Southwest Airlines' Crazy Recipe for Business and Personal Success. Maybe it’s time to go nuts and start trusting your employees to help you become successful.

Dentistry could learn a lot from Sanford I. Weill, the former CEO of Citigroup who tried to join the Air Force until his application was denied by a dentist after examining his teeth. His major break on Wall Street came with a mundane job doing g the paperwork behind the brokers trades. Sandys success with Citigroup came from mastering the back office mundane details of Wall Street trading, banking, insurance, and finance creating value from the knowledge and details of accounting, record keeping, and every other mundane task that was mostly unknown to all the major CEOs. How many dentists could do every task from scheduling an appointment to billing the dental insurer company. Sandy Weill fired Jamie Dimon when he was 66 years old because Jamie wanted to be CEO and then Sandy retired four years later, and in that time, the ship of Citi was wrecked. Young associates share this same issue working for older dentists who swear they are about to retire, it’s never in writing, the older dentists keep delaying their retirement, with nothing in writing, and eventually the relationship breaks down and the younger dentist moves on. Tearing Down the Walls: How Sandy Weill Fought His Way to the Top of the Financial World https://www.amazon.com/Tearing-Down-Walls-Financial-Journal/dp/0743247264/ref=asc_df_0743247264

Let’s get back to the pre-pandemic mindset. If you’re double vaccinated you know this pandemic is over. Let’s get back to fight mode in building a championship dental office. What do champion dentists do more of that their colleagues don’t?

Dentists could hit a Hank Aaron sized grand slam if they could just learn and implement any of the major business lessons that Denny’s have used in over 1,702 locations since Harold Butler and Richard Jezak founded the first Denny’s in 1953 in Lakewood, California. Denny’s are 24/7/365 explaining why in 1988 more than 700 of their 1,221 stores didn’t even have locks. During an economic contraction being poised for growth means you’re conveniently available, with low enough overheard, to perform profitable, high volume quality dental services with low prices. During an economic expansion… this strategy is even better. I’d rather own McDonalds (MCD) any day with a $177 Billion market cap than Ruth Chris (RUTH) with a $700 Million market cap.