1309 Designing Your Optimal Facility with Pat & Jeff Carter : Dentistry Uncensored w/ Howard Farran


It is just a huge honor for me today. PODCAST interviewing Pat Carter. I which enter International Interior Design Association sitting next to that man with all that gorgeous hair is Dr Jeff Carter. DDS Eighty s pat attended clemson university and graduated with a degree in interior architecture from the University of Tennessee in seventy five practicing pissing as an interior designer. She started her career with hospital and hotel design project for several architectural firms TAT was VP of the design. Inc Thank for twenty years prior to form her own company. The practice design group. Would Dr Jeff Carter in two thousand two who I assume as her husband he is here still renewing his lease. Pat has written articles on dental office design in dental economics and other publications -cations and is a frequent speaker many national and state dental meetings including the ADA annual meeting Henman Texas Greater New York Chicago Midwinter South Western John Conference Pat was at the forefront of the evolution of dental office designed that utilize architecture interior design to elevate dental facilities from realm of generic office space since seventy nine. She has participated in the design construction of over three thousand dental facilities and is considered a leading expert on the provision of dental office design services. Nationwide The man sitting next to her. Frankie Valli Jeff Carter. DDS It's we're guys don't even think it's a real dodger Jeff Carter. DDS graduated from Colorado State University with a BS in biological sciences. And Seventy six in one thousand nine hundred eighty receivers. DDS degree from the University of Colorado School of Dentistry Were My radiology instructor. Denise Castenbaum is now the d a while Ah yeah she's just the most. She was the most amazing intense person from Young Casey that I remember in his ears as a proxy dentist. Jeff practice as a young associate. Dentist grew grew practitioner and enlarge clinic setting and as a solo practitioner zone. Practice in nineteen ninety-seven. Jeff was hired by Design Inc of Austin Texas during his thanks her at ten year at the designing Jeff implemented technology integration services a much-needed adjunct to the dental office designed services in two and thousand Jeff developed the workstation and pendulum mounts to effectively integrate dual monitor systems of the dental offer dory and other medical settings since nineteen ninety seven jeff has been involved in the designing construction of over five hundred dental facility. So He's about one sixth of his wife including dental school and has published Over seventy five articles on office design and equipment and technology integration. Jeff is also a frequent speaker teaming with PAT to present over three hundred courses verses on dental office design nationwide just multifaceted career also includes working as a series seven licence. Investment broker writer stuntman and B.. Movie actor and Two Thousand and two PAT and jeff form the practice design group in response to dentists seeking and more collaborative and innovative design design resource that was available Through the dental supply houses and other formula driven dental office designs. The reason I am so excited to get them on the show is because I for thirty two years I watched Dennis come out of school and some supplyhouse rappers say hey I can design your floor plan for Korea and go do some quick five dollar you know. What are the dimensions of your space? Oh Mine's forty wide and sixty. No problem I can do that in a minute. And then they don't realize that for twenty five to sixty five thirty your life. You're asleep a third of your life. You're at home. And thirdly life your dental office in this cramped condition that you don't like people and then the other thing that's just really bizarre. Is your dental offices the business and and when you rent a thousand square foot crappy location but you live in a three thousand foot home that you own the land and building and you WanNa leave your office fisk you want to go home and you're tired and you WanNa you know your dental rich people. Their business they own the land and building and it's bigger than their consumption attention but a lot of dentists have more debt in the consumption of their home. I mean patients come in. I'm across street from the Guadalupe Guadalupe Indian reservation for thirty thirty two years. You know some boil. Come out here and he'll want me want to take me outside. He showed me his new car. And it'll be some low rider hot thing and I'm look buddy. Look I said that is consumption assumption. I know you got it because the chicks are going to love it but you know what Maria really wants you to have a fancy low rider. She wants to have dental benefits. And you should've. You spent the money on this car to go to some tech school to get a good job at Intel Dab dental benefits. So what would you say to somebody who who lives in a three thousand square foot home and owns the land and building they rent and a thousand square foot. Dental officer burned out. There cramped up. They don't never break room if they don't feel good. They can't sit down anywhere they can't lay down and then they wonder why they want to leave their dental office. and Go home my my home. My my my home was my dental office was four thousand square feet and my home was slightly less than that so I've had enough. Wh what are your thoughts on. We'll we'll burn outs a big deal. What what is your thoughts on that? The actual dental office might be taking the smile off your face. Well let me let me give here. I didn't fly off in the middle of this description dates. So that's why we're in this and that's really are passionate about dental office design and you're absolutely right and we've had somebody experiences. BLAME IT on a spouse. You have a doctor. That's burned out tired. The cramped office. They're not happy. They drag home every night to this fabulous palatial mansion. And sometimes sometimes it's especially you don't need to spend on a dental office. It's like I said they're they're a third of their life a half their life so I tell Pat. Pat Doesn't know a lot of the kind of average dead who's out there you know through her career and Ashi Arthur. We've worked with a really kind of select group of doctors in Israel and people that are sensitive to the environment of the dental office. They they've perceived see that at some point in their career and I actually in retrospect perceive that in my career that I realized what the impact of facility was a lot of the things that discourage which may a lot of things that you know took my energy when stuff we're actually facility related. They had nothing to do with the dentistry and had everything to do with a poorly designed facility Zili where it was small. I was cramped CLAUSTROPHOBIC. People were on top of each other. There was no privacy and come home at the end of the day. And you're just like mush north capanna dentistry has really Har- united as I got into designer learn more and more about design principles of the thing called zoning and things like that but it could actually alleviate some of those the issues so we've been lucky we've worked with a lot of great practitioners look people with a vision for what dental office could be. I think what really separates those those people from people not sensitive to that as they're in tune with what the experience is in the facility. What does it feel like? What is experience I have ended up facility? Will they be focused on the clinical dentistry. But they're you know that's a big part of it. They're very sensitive that that'd be little sound sexist being. We've worked with a a lot of women female dentists. They're actually in a lot of respects more in tune with add. They're more in tune as sort of a nurturing supportive environment. Oh I wanted to be nice and comforting take welcoming. I want people to fill relax here. I don't want him to feel like gee there you know everybody hears every word they say they have an issue or something they can tell me in private in a private conversation sation at a nice consultation room or something like that so I would say you're absolutely right on that Naturally what motivates us to do what we do. And how you how you get a doctor is explain to them is an interesting challenge and arte part of what prompted. Our podcast was with you. Is You know mid Mark Mark announced. We're starting for two thousand twenty another. We're doing an packed Zion series for mid markets a C course dental office design but it gives us a chance to get in front of hundreds of doctors a year. Hundreds of doctors manufacturer Reps Dental Reps. And really just talk about the impact of the facility on their office and get people to open up. It's an interactive thing and it's just it's it's a real pleasure for us to feel like maybe we're and impacting people to give them a sense just like you said just you can't spend a third of your life in this thing that drags you down and makes you know makes you exhausted. Pat Jump I think to add to that. Yeah I think there's been a mindset for the longest time that you're you're prompting thought that I think it's changing if not already change. Is the dentist actually believing being that they deserve a good space to work in. I think the dental facility for the longest time has been in. I wouldn't say it's a blame of the Dow suppliers but the limited limited thought process put into what the environment is like how it works Your inches specific in what you need is far as clearances in that kind of thing. But there's also that added all album starbucks for that the expectation a patients for an experience the expectations of what the quality he is that they're gonNA receive by what they see. I hate to say that to Dennis. I I tell Jeff I know that hurt your feelings but the reality is patients. We can't fully appreciate the skill sets that you have to do what you do. As far as we're concerned here is good as the guy down the street. So the way we discern the quality of of your dentistry is often times going to be what that facility looks like how it works how it accommodates my needs how it accommodates my sense of quality. If if you will because I take those accused on what I see and I think that is a big shift. Hopefully that we're having an impact on Thera Arab. VP of the design. INC is that now called deserter. Go Desert Go. No we were. The design China's how we pronounce it stood for total health environment. And it is in no longer as I understand it shortly after we left our while after we left they close. Is there so sounds like you're the the the ingredient keeping it all together but my point was going to be for that has since You were with a total environmental longtime ago. You've been in this a longtime has it. Is it changing. I mean I yes yes I think it is. I mean I think the impact that we had through a gentleman by the name Dr Jim Pride that you may or may not recall inch guy I source into good news about him. He was kind of a love. Hey gentleman out there but one of the things that I will give him full. All credit for is creating the dentist and appreciation for the Ergonomics of the dental laboratory and is trained by him. You know this is before I married a dentist before I knew dentistry. So you better. You better not today to dentist but but I did anyway. That's a long story. But I WANNA I WANNA go back to the Jim. Probably what Because his dentistry uncensored I. I don't want to talk about anything everybody agrees with. You said Jim impre love hate Controversial why why what was controversial about Jim process controversial because he's simplified he exp- well did two things so I think he is simplified. The equipment is driving the dentistry and he expanded the view of the facility itself as accommodating equipment and and I think what was being missed their and that's his point in what he was looking at at the time with an architect partner. He said it doesn't work. It's not the equipment failing if acidity. That's failing he also felt that. Dare I say the dental suppliers were driving design and they weren't sensitive to the fact of clearances clearances of our economic of some of the things that we talk about fairly regularly today and Dennis appreciate today especially those that are impacting. Yourself yourself for many years you understand physical challenge of performing dentistry and so if you have a facility that's in your way or stands in the way of you being affective and efficient. It just adds to the stress and stress it adds to the stress so I can vouch that Jim Product. The first time I heard him was was right when I graduated in one thousand nine hundred seven. He was lecturing here at the Arizona. Dental society and the big hot thing was cameras and everybody was saying we had to have an insurance camera and he said you know what He goes when you talk to physicians. They don't talk about their equipment and their MRI and all this technology stuff It's it's a relationship ship and I'd I contact is shaking her hand and architecture and then when you went out to visit him what I couldn't figure I bet Jim Pride is I mean. He had a beautiful winery. It was like it was like like dentistry. Was this side Gig and winery in the. You know the whole because wine is all about marketing. It's all about branding. But yeah he was. He was an amazing raising a thinker. I right up there. Omar read another's but so so some people the diss towards everything. Jim Pride or you guys are doing doing is that. You can't build a million dollar Taj Mahal. I mean it's just too high overhead hall so million Anymore Howard. It's amount of million anymore. What is it two million now? Well it depends talk doing. Here's where we the Hudson so this is uncensored and we do this stuff. Nobody gets into well as I think. This is interesting so jim private as a trailblazer and so damn right but they created a lot of principles that actually hold whole today most of those principles in terms of flow and patient interactions are still really ballot. But what there was. There was sort of a schism I would say. So you talked about you. The GO-TO dental equipment supplier and I get five dollars floor. Plan them off run and then that's it well. There were the the dental design people there. Jim Pride Harry Demery Mike unthank- split off the designer novices name was actually part of. The design at one point. I showed up years later but all those people kind of went off on their separate ways and for many many years. They weren't odds with the dental. The dental distributors or dealers. So the shine of the ban. Costa Patterson's they were odds with them because they were selling Elliott against what the dealer was offering a design package and actually part of the way they were doing. It was within undercutting sort of equipment costs and cabinetry and custom designing dining things with knocking off things so it worked for many many years will around one technology showed up at tweak. A lot of things. So part of what pat and I in the last several years we we take a lot of I we I felt you know a lot of cry that we sort of formed a relationship. We work really hard to form a relationship with manufactured by mid mark at Healthman Crane. Leave were you know. We've had interactions all those people shine. And Patterson Ben Co Burkhart all the independence and we've actually come back towards them to try to combine good equipment. Integration you know good equipment support through the people that we're not sell equipment were designers but but to help support them enact but then mix merging with great design. Bring the two together to where we're not you know picking at each other not trying to undercut each other and really I think the the the main things were contentious were especially in the opera Tories so typical of G. Pr where you have at twelve o'clock dental cabinet uh-huh and the head of the chair and that in a typical kind of dual head entry concept. Well that thing is just a complete difficult. Won't cost on a podcast the way it's a very difficult thing to custom bill. It's really a hybrid cabinetry and equipment. So we love you know we love the mid market merging the aid Helming Crane version of twelve o'clock cabinet. That's fully integrated with Labor units. Nitrous oxide timers storage all of that stuff sterilization Shen. There's some great sterilization cabinetry systems. Mid Mart makes one atom Nadal. That's a tough thing to do. You get some crummy in custom mom and pop shop cabinetry battery a sterile. As the sterilization process will eat that in about a year. So we're very supportive of their of their interaction to project and their specific products. I I think because of the advancements technology are just essentials in a well-designed office so designer economics has their own little kind of delivery unit system. They may self self. My Gun Bank is somewhat gone away from that but pat and I are you know we take those grave design principles but we want to merge with state of the art good quality equipment Batman that has sold and installed and service and maintain by aiming our dealers are people that know how to you know how to take care of that stuff so I think I think we're actually we're actually better designers because we have a good collegial relationship with those people we learn every time we of course it's Fulla wraps everywhere. Doctors we learned something every darn project from that and the stuff of balls. I mean equipment evolves and so I would say anything's controversial. We've come that we've kind of come back back to the center with a lot of those people and like you said Harry the five dollar floor plan we try to go back and hey guys just. Don't throw this thing in a box. Let's help the doctor. Let's consult what. What are you doing with this? What is your vision for this thousand square foot space? You'RE GONNA CRAM and five ops and everybody's going to be miserable now let's take a step back and see you know how we can better assist the doctor advances visually as you said the three zero three Trailblazer Jim. You said Harry Demery Harry Dan. I the Demery D. A. R. E. E. and he trained me D. M. A. R. E.. And the other one you said was Eh David. hearn David hearn as the desire economics guy there in the northeast all right and then my gun. Thank was another T. G. so we're kind of wet slapped of the dental specialty people. Yeah and you mentioned. We lost We Lost Ken and his wife share. I still remember taking my four boys there for vacation and at one end Pallets of leather and plastic and metal beads or there was edey chairs cheers and Ken and Joyon took my four boy. I mean they were like four six eight and ten and they spent two hours with them. Walking down seventy nine nine. They were so amazing. But but again the You know I said the disc for this deal was I. Don't want to spend a million dollar charge all a lot. The people say well you know the patient can tell the difference in a deck chair and chair half the price of imported from who knows where Do what what would you say to a kid who's wants to save money on a chair. I mean I know what I would say. But what. What would you say to him? I think that condemning so the chairs the function of the charity. Earning domic's of the chair so catch the census uncensored. You know we've had all kinds. I've had that exact question posed by several class. So for example these names. They were com comparing atop the top tier amid marred. Eight eight Helton macrame top tier cheers. There's a whole middle tier citing. He got his little. Those top tier shares are channel. Two thousand dollars. Why wouldn't you know it? Looks the same to me. So he looked at a mid mid tier journals. O'Kane examine that share. You know. Tell me what you see. Well I go there expose bolts and nuts and stuff that rosser sharp things how well as at craft. It's like anything. Have you start breaking down. Well yeah it. Doesn't you know now that you said that doesn't quite. It doesn't quite look the same when I look at some of the the finer details details of. How high does it? Elevate does it have a headdress. Have Multi position so I would say some people can do fine with amid church with with a mid tier share other people. You know. They're just if they take the time to examine it. They see the bonuses. If it's like a it's like a high end car versus amid your car you get you get insomnia start okay. Well now I see this is more and I see why this is more. So I wouldn't say everybody's GonNa buy into that but a lot of people that would pursue pursue a kind of a more of a state of the art office that that's that's variant to without the patients. They're going to be sensitive to even the chair in a look. Look at that. You know that chaired looks better. Feels better. It's more comfortable has more options as better ergonomic positioning. Maybe it has a massage action and it looks cooler. You went through the eight attack thing. I mean they. They put a lot of care into that share. There's that thing where the chairs get beat up on the assembly line where they show you the cheer folds up and repositions like a thousand thousand times a day and it's still going after many many years of ending with midmarket and they're they're very proud of that plant tour. In the craftsmanship that goes into their products. So it's like the chairs is part. You know it's another piece of the puzzle of this of this office that either worse for Unit in works greater or it's you you know it's a detriment to the advancement of your career. I'll put another spin on it Howard and I guess I'll come from a design standpoint. One of the things I say over my career the air is really about design following dentistry dentistry. Following design. By that what I need is the procedures and modalities doughty's that you do and perform a dentist especially a season. Dentist nowadays is so far beyond what we were what was happening in industry. You know fifteen eighteen twenty years ago design was simple because dentistry was more simplified as. We've gotten more complicated. We've got more technology. We've got more requirement firemen for procedures. That are longer for patients sitting in that year longer periods of time with higher expectations. What that dentistry is going to that dentist will outcome? There's going to be the expectations that are going to be higher for the equipment so I think the equipment knee as a startup. Practitioner might be more simplified. Dare I say but as a seasoned practitioner more the practitioners that we work with that have been practicing for fifteen plus years. Their expectations are different. Level Oh and the expectation for the equipment is at a different level. The expectation of the facility is in a different level. As far as making a statement of quality. I would say that's the biggest thing on our side of the fence. As far as design to speak to that chasm that schism that Jeff was talking about that was in dentistry. Sorry the protein. I think that all suppliers were often taking whereas spending if they're spending money on the facility. They're not spending on equipment and that was not the equation. They were looking or and I think that's what Jim Prime was creating out there in the shake-up about balancing equipment with facility that there are needs the facility had had that were not being delivered to the dentist and away getting if you will the marketplace to how Denis should deserve and should benefit benefit from something that is very thoughtful and deliberate in design on the design side as well as the equipment side all kinds of conversations about equipment but no conversations nations about the design of the. Let's throw a chair in this room so I would say over time and has become more complicated the expectation acquitting does but I would also say that the the dental facility does as well and I would agree with you. There's a line that you can step over if you were to say Beverly Hills and we pattern experience in Beverly Hills facility expectations. How that's supposed to look they're shiny lots of blaming? and that's the expectation tation of that community of dentists. And so that's what designed delivers. But it's very different. I think in most other locations in the United States as far as what the facility will do to deliver to the dental expectations to the community expectations. That kind of thing but I think there definitely is a balanced Beyond which you don't go into design. There's I think there's a loss if you will be on your investment that you don't really Garner from the patient's this experience by spending all kinds of money beyond the need if I say that way so how are just look look at your set them staring at your set while pats talking pass I say Europe but right behind. His Barn road is at Barnard. PAT recycled way in a recycled wood looks. LS place. I'd go and have a beer be fairly comfortable last so you could be. You could be positioned in front of a stark white sheet rock wall but see you chose that shows that net has an impact on us. You know watching you how we perceive you so that was a conscious choice. Fight I think call or a backdrop I gotTA. I'd say one thing that you brought up a Harold L. Demery DDS. He passed away April twenty eight two thousand nine Just an an amazing man University of Nebraska College Dentistry graduating sixty one Born in sixty two. This guy was a while back but an amazing. I'm in my in my class. I you know we always. I always say that the smartest guy in my class was brian new worth. I mean he was just Just an amazingly brilliant I really am man. And when I visit his office and Hickory North Carolina. The first thing I noticed is the operator twice the size and some of them had couches and things that and he goes he goes. I knew I was going to be an oral surgeon in here for forty years. I don't want people coming in and stumbling over the edge of the chair and trying to sit in a chair to watch their daughter hold her hand while she gets her wisdom teeth pulled out or whatever he does so she could just walk in. Hang up your jacket in the story. Sit on a couch couch or SOFA or a chair I mean and I just thought Oh my God I mean so hit the average is about ten so he built his twenty by twenty. Ah Thinking through the experience of what it's like to have your wisdom teeth removed and be accompanied by an adult. So he didn't he didn't show up with that he said that the somebody and they they designed around it if you had a rationale if you have a rational how you want to do something designs your tool to deliver that and if it's well grounded in sort of you know in in clinical besieged and how we treat people. Usually it turns out fine. I don't want to waste a bunch of space. But you know he had. He had a specific reason. He's in purdue and that and if that's how he practices that supports him people people are. That's a reflection of how he perceives. A patient's it'd be more comfortable. I don't want I I want. I don't want like you said I don't want to trip over the J box at the toll of the cheer at the end of the procedure. MOMS in Oh get wrapped up in a billable. Corn can't get out the off-limits Admiral Apple. There's a lot of us so yeah that's a great example. Who really is your target market is? Is that the young kid coming out of school. That's been but an associate of for some data's or work at Aspen for five years start their own practice or is that really You know getting to first base the second year really more. The person who's been around the block a few times and is ready to expand into something bigger. I would say to that question Jecklin. Add to this which I'm sure he will but I would just say we seem to attract who we're attracting now are the practitioners that are more. Seasoned that are looking for actually building buildings near wanting to invest in that equity talked about that earlier on. Why dentist don't own? Oh narrow practice their facility when a lot of professionals do out there that I think is a shift. At least we're seeing and we seem to attract at dentists who who is wanting to no longer put out the lease payments and wants to invest equity into his own practice or their own practice. So that's the other side of the equation is group practices or multiple doctors building a single facility. That kind of thing but I will also say and I'm going to say to the benefit of those that have called and talked to Dr Dr Jeff Carter on the phone. We've had start up practitioners knowing nothing about design knowing nothing about the process where he'll talk to them for an hour or so on the phone. Tom Just coaching them. Whether we designed the office or not which oftentimes they're dollars are just not there for them to invest to the level that they will further into their career but just the council that we can offer someone about how to finance space what they're looking for in guidelines of square footage setting setting up at least the tone of what they are trying to do to balance what they are otherwise requiring an equipment obviously to start a practice and then what that facility will require Laron square footage to accommodate that. So I mean what would you would say that sure you can always start on. We have on the startup guy who is in his senior senior year residency Piatra resonates Ohio state at this guy had two or three little kids was finishing up his residency. And we were helping undecided opposite was moving to Texas that I got this guy has gotta be ten times smarter than heated Jiagelo one. He actually had a lot of good thoughts. I I just. It's it's a challenge for the startups because of the lending marriages you know Howard. So I don't know I know this is your show but what we liked it a little hypothetical because you said hey to build a million dollar Taj Mahal. Have you give us an opera Tori did so you said you were maybe in four thousand square feet. Let's say you're on how let's let's say you're you're thirty five. You're GONNA do your ultimate office dental opposite you've come to asking for advice. Just give give give us some like a hypothetical and start with how many ox walks. You want what I I. Actually I can do that. I WANNA spit it back the other way. you're go out to Ohio. I'd just lectured at the Ohio state dental meeting. That's where mid mark is John Q.. Bom Bom man is there you do a A really great if you go to their website and again this is not a commercial John Q.. Bomb and I've asked him to be on the show For years I don't think he knows I am. You GotTa return emails. So there's definitely not a commercial but he has a deal called. The mid market does dental design center. Impact design. And so. My question is You're a big hit out there who is showing up for these design seminars. And what are they asking. So that's the flip and coming from all over the country so even out of the country would what I what I like about. Ohio is a lot of times you know. Like I'm lecturing in Israel next week when when you go lecture and a lot of countries they think that New York New York City and Beverly Hills and key Biscayne. Those are Richfield. Ohio is just country Kansas in the middle. So you know things can work in Beverly Hills Key Biscayne in Manhattan. That do not work in Dayton Ohio. So when you see a bunch of soliciting international folks when they see see something working in the heartland they know they got a better shot at it in Cambodia and Vietnam and Indonesia than Than say Beverly Hills Calls Nine one one zero where your hair belongs on. Hold through the rest of this could blow it anytime our. ooh These people come in at first of all. How many shows do you do a year at mid mark? Well so we may average in Tanay worker ten to twelve so then how many people show up well it so it's a mix of doctors and APPS and we just did too. We had I think forty five and fifty one in Las Vegas seems to bring out people's enter one and Balaj you really you know. Sparks no opposite design interest and then one and actually Newport Rhode Island Great. So but they're they're it's an interesting process so their doctors are interested in design but they're brought there by their dealer sooner shine presentation Summer Patterson summer the in some of the independence. And then they're working partnership with mid Mark Reps but we over we've done this for seven or eight years. We have a reputation as we can help. Doctors that are stuck so doctors are pursuing soon new office but the dealer perception is they're stuck so maybe the dealer maybe Henry Shine has done fifteen floor plans and may get up you know. They can't get pass there and I don't know I just. I don't know what I'd look at the plan. I don't think that's GONNA work. I just I'm not sure that's what they want. I'm not sure that's what I want. So they come to. The course will the courses Berry interactive. So we literally will bring kind of like you try to do on this or are doing on this. We'll bring stop out of doctors in a in a group setting anymore. They'll they'll express their frustration. We had a guy all my current ops. I Hate I had my fate. You know one of my officers right by the front desk and he goes so I don't WanNa go back by the Rhonda's because Mrs Smith is checking I just had a top go around the off right. I want to run into so he'll go hide in the bathroom next to the front desk and wait for her to leave the front desk before he goes the odd. That's right next to the front density hates so no waste you know five ten minutes a twenty minutes a day hiding in the bathroom breath room by the front desk so the people at the front desk check out and get out of their students to run into him again. I mean what's that and Melanie and the guy that you know. This was like a forty five year old very successful. Missile Guy admitted in a group of like forty people that he was hiding in one of the bathrooms to dodge people at the front. We also have young people that are coming in. They're just just getting ready or they know in a year or two that they WANNA start a project but they don't know anything about design anything about the construction process and so they come to the course to learn more about about that just to get a handle on what it is about to venture into. Some of them are coming as associates. Some of them are coming having been an associate now ready to start their practice so I mean we cover range of individuals that come to that course usually there I can. I can spot kind of a designee Dr within a sentence or two. They asked up like well. I was envisioning. That's kind of warm and inviting. But I need some privacy but now has no no natural. I need more light I spill. It's claustrophobic they don't go. How much this costs you know what you know? What are you guys? Charge design off as they have a whole vision. And it's not everybody but it is a significant number of doctors. Have that sort of sensibility. So and say. It's it's driven by dealers out there the equipment specialised beschloss called the field. Sales consultants those kinds of people. On doctors do new opposite they start the normal process with the dealer but then they get stocker. It's more complicated complicated than a typical project right. So they come a lot of them. Are Ground up remodels get really tough. There's a lot of remodels where you're in the office and you add the ad on you. Add additional space. You don't have any space but you tear up the office while you're in there trying to practice. Those are very difficult as a very complicated very difficult. There's a thing called called phasing. How you kind of work through things like that but one of the things? We feel that we want to be able to do as you know. We do a handful of projects every year. Maybe ten to fifteen. There's so many doctors out there several pursuing things that they're actually never gonNA pull off because the parameters are so far off so you'll have people looking at property property thinking maybe their vision. I want to build a ground up ten arbitrary office so and they're pursuing a lot. That's maybe less than half an acre. They think suspend a million dollars. They have no chance of poll up but nobody will tell on that. Because they don't WanNa they don't have the troops an emmy Taco contract. You probably do yellowish Sablan. Someday when you get there they may have a commercial broker. Selma piece of property with big setbacks utility easement run across and not enough space as the site this building but they don't know they don't know the specifics of dental so we like to head off things we think. There's just no way you know you're not. You're whatever never busy you have is not going to fit on this piece of property and it's not gonNA fit within the budget you you have so that's just hypothetically there's there's rules of thumb weaken coach people in a few minutes. We have project specifics and at least give them a fighting chance of pulling off. Whatever it is? They're envisioning and not spending years to to get to the end of the road fat guy. I just spent one hundred thousand design in my building malt fit on this piece of property that I bought five years ago. I should've I should've done some due. You D legance. I should've had somebody with gentle. Specially design expertise. Look at that side lantern building layout parking show-me access from the street all that but all of those kinds blames the biggest thing is giving them tools to assess the best project for themselves Someti- and the reality is many of them. Don't have the Mayor Marty went. Why would they haven't built an office abir or are? They haven't built an office in many years. So we're there to provide updated information so that they am step into this project is wide wide wide open very informed about the project that they're doing and they have a realistic budget neighbor realistic concept for the product. They're endeavoring to do. And there's a lot of relief by payback. Comes to them about going to this course and feeling like okay on the right track or the track was on. Wasn't going to get me where I needed to go but now I know what I need to do to make this thing happened so do you. I I WANNA go back earlier. the last you know when you look at Franchises like McDonalds where they have forty thousand locations. They have a budget where they intentionally redesign all their locations every seven years so seven times twelve is what. What is that m eighty four? So they put away a little money every month and then at seven years they they redo it so when you walk into any McDonald's in the world it's anywhere from looking brand. Dan New the best to seven years to worse and you go into dental offices. Were some guy will put in this rock and hot dental offices in twenty years later. You're like dude the Japan and the fog light and the You know is not blend and for my office. I couldn't get everybody who had been with me ten twenty thirty years to agree so we actually flew out to San Diego to the Benko facility and having everybody in that room at the same in time. What was most important to me? which is that? We got the decision. Done you know three hours in that building where we were done whereas before you know it kept getting the decision couldn't get made because that's so getting your team all in one place you're doing it you know you're you're doing it in Ohio and Vegas all over the they vary just every year they pick different venues so about a third or and in actually for Sales Ohio and the others are out in the field and Canada. We've done we didn't want to New York. City is interesting that the northeast and sort of Atop Ako Las Vegas Casse just depend work with all the dealers Aiglon. Benko Patterson Shine Burkhart. So we've done not as much with Benko we've had over the years we've had interactions with everybody. We spent a lot of time with shot Konate Benko. He's actually been in the office right here on came and visited us so the the mid mark impact is mostly shine in some patterson on occasion of Burkhard. Yeah the independence that choice. As far as how they participate at to what degree participant actually the the former head of the dental division of mid market is now the president of Patterson Eric Shirley's he actually is. He's from Effingham isn't he. He's from Orange from Elsa Gun. No Manhattan Beach California. He started there and he it was a catcher in Long Beach Stadium. It's a catcher. Tony was at mid-march many years. He's had a lengthy Now be just within the last year it came on as president of Patterson so we're hoping to advance at relationship I love. I Love Chuck Chuck Cohen Had Been Co.. I mean he's he's He's been such a mentor die but my original mentor was Actually Pete for Shat Patterson because my older Lou sister Is She in her none. or She's a Catholic nun in Lake Elmo. So every time I go to visit her I need to do some business for four hours and one minute so I either either go to Patterson and next to P for shot or. I'd go to three. AM and So I'd buy them but man when I go to Patterson I'd walk other I say gotTa kill for one minute. He was good. Just just follow me around my meetings because it'll be good to have a young dentist perspective and these meetings just he he was. He was so such so incredible of a man but anyway so now Eric Shirley's down there and all I can say late Eric. Shirley is Ma'am with P.. For so you got some big shoes but anyway So what advice would you give right now to someone who's like Oh I hate my facility but I'm I take a lot of PPO's I mean you know what advice would you give them your ideal cut. Who's listening to you right now? On the hour commute to work I hope hope Garnier commuter hope you're not one of the guys on the treadmill or stairmaster But if you're on that stairmaster just just get off and go have a beer beer here. You're not going to live any longer. But who's listening to you right now. That needs to take a next. Who's your ideal dentists listening to right? Now what we hope. It's a dentist the vision to change the circumstances they're in their current facility. Something about facility doesn't work many things probably don't work for them Eh as driving and to do something else but they're not sure what to do so that that's really who we want you know so somebody that has had some experience you know. Maybe they're starting to build up a prakash because they're seeing the limitations of facility so we want to know what is that vision so like you said that. Maybe it's OK well. My production has plateaued at the end of the day. Were exhausted. Austin my productions plateaued but we can't bring in any more patients because we're maxed out. We got four chairs hygiene is booked eight or nine months out. People get there. There's a new A lot of times. What motivates? There's a new office down. The street is the kids right at school. makes our office look bad. We gotta do something to compete. It's actually a lot of times. It's that more than anything to peer pressure. Knowing that you're not keeping up just like you said how people will invest twenty years ago and a great dental office and not doc touch. It won't even flip the pillow around in the waiting room twenty years you know. I don't really understand that but I think that is definitely because I would say the number one thing we hear often is. It doesn't look like the dentistry. I'm doing today. My oth- doesn't look like the dentistry. I'm doing today. I go in there and I even challenged Dennis. They leave the course. I said. Go back the person you do. You walk up front door and put your patient hat on and you start looking at it if you've got clatter if it looks tired and all get rid of it or fix it because all of those things are accused about what you're doing a dentist whether you choose to believe that or not and then I would also just say we find that. We're a lot of dentists we think. Oh I can't do this. There's no way I can do this. I can't change. I can't remodel. I can't do a new building. I you you'd be surprised at the abilities. Thanks to the lending Environment and especially now be surprised. How many dentists are actually in in a position if they would take it up to do something about it was not encouraging? My pet peeve is you know I I don't and I'm only known for a few things one is I'm the only person on earth who listen to all thirteen hundred of the Howard. Dentistry uncensored podcast. No one else has done And I think I've had a I drink more beer with more dentists in Arizona than anyone I don't know who has shaw had more But the thing is every single time I've ever walked into a dental office. I mean is write it down and and I'm talking to my team. They're like okay. Tell me what happened. You got it there but every time you go to a dental office the dentist is in their private office waiting because surely is dismissing patient. Then she's got to clean up the room uh-huh and set the next and I'm like okay doc you know the ADA says average sixty five percent overhead. So you're thirty five percent of the cost what you're one third of the cost. What what are you doing? I'm waiting on a chair after after you. Thirty five percents. Labor's twenty twenty five labs eight to ten supplies Blaz four to six. I mean we don't even get down to opera Tories until we were after the electric bill and then like I don't have room for an arbitrary. Well where you're sitting is operatives Tori. I mean superman were out of the damn phone booth Whitey. You if you work in Superman leads a phone booth and I can put an auditory in. Your chair are the same way. I don't have room to expand. Oh yeah because you're renting so you're letting a landlords Key concerned trump your entire existence and purpose opus. Because you decided to be a renter for forty years in the same location as opposed to be an owner. Oh but you decide to own your own three thousand square foot home. I mean no. You don't leave your car even own your car but you write your nose so all I can say is when I look at the income that people make a lot of people Shortchange change the the specialist. They say oh well Orel surgeons and ended on us you know they. They get more money for their procedure. You know it's multi variant but we look at the fact that oral surgeons make the most money at four forty eight Perry non US exit three thirty ended on US next two three zero seven. The one thing they the specialist all have in common. Tom is about eighty percent of their referrals. Comes from about five offices and twenty percent of the referrals. Come from about another twenty offices and when they're one or five referrals calls up and says hey dude. I got a patient with a toothache. Can you squeeze them in. That ended. Honest is not going to say no because they don't want you to find another in an office because he knows you don't do any molar Endo's in their thousand bucks a piece so every Perry on US oral surgeon I know they all have one one or two extra opera tores that are never scheduled and then you go into any dental office and you say well what. What is your big problem on income? Well you know I've plateaued. I've been collecting the same amount of money every month last year. Yeah that's because if I call your office right now and say I broke my tooth. Can I come in. The first thing you do is is start looking for a chair. Share your constraint is a stupid chair and the specialist that's not the constraint that constraint is win can you come down here to catch the fish. I might not do the root canal now but I'll give you some antibiotics or pain or have you bike it in or just straight heroin or whatever it is you need and then and every dental office the dentist is sitting in their Pretoria all day long waiting on a chair. The receptionist can't get anybody to come in right now when people come in and say you know. I got a toothache. Well we're we're the corner. Forty Elliott right next to save way. When can you be here? We don't start looking for so so so you don't have an opera story. That was not empty. Never used at least every other day. Then you need another opportunity and if you think there's another constraint in your life that you need to go to the Pinky and soon learned tm J.. Or you need to buy a laser cad cam look. I'm on the phone tooth broke. I need a crown. And you're you're looking for a chair. You should never be looking for a chair. You should have so many damn chairs that have a homeless guy came by and say can I just live in that room. We say yeah. Because because I haven't had a patient in there a year so you add offertory until they're never used again they That that's my rant. So my whole whole deal is i. Don't care what the design is. I just WANNA come sit in a chair. I don't care if it's a lawn chair and and you're holding a law of the land you know and I need Tair. We would call that up LAXA. We want everybody to have an overflow flexible. So they're not just crazy trying to get people Ramaz. Must we and we challenged Dennis on the number of their count. If you will of Opera Tories what are you win now. What are you proposing to in this new chain whether it's remodel or new building there whatever and what's the rationale or because what we're looking for is exactly what you're talking about is that do you have women? Hurry that term. How how am I The same age you guys never heard of a flexible Tories. An Ohio word or is that really into this all the time. I don't know how do you thank you Texas. Yeah of all places. Just outside of Austin does that give us a little way right there. Four four out of five of my grandchildren learn living bevill Texas. We're beaver. Its downward by Texas bye bye. Mike Corpus Christi. We know where that three hours from here. And that way so you agree. Agree that if If that opera Tori is your constraint and that's going to blow out your overhead that's can bruhns efficiency of your staff. I mean sometimes the what I love is you know you work through launch a squeeze it emergency and it's at the end of the day and the whole office looks like a tornado just made out with a hurricane and I can go home. Everybody was seen. I mean I. I assume that dental assistants were there till midnight. Yeah Yeah we we got everything done so so if if someone goes to again I was super impressed by the the website mid Mark Dot Com dental design center impact design Zayn. They have design center. They have architectural resources designed tools impact designed seminar. So if someone's one's thinking about that next level can they go to the website and do that. Should they go to the horse. What would be the next step for them? You can go to the website and they. They have a registration capability. There you can register your interest in that You can talk to your dental supply partner. Assuming that you've got a partnership with a with with a donald supplier and just say. Hey I want to do this course. Tell me I need to get registered. So you're saying it was their dealer. Now you're saying it's our dental supply rap dealer delek dealer thing Shine Patterson Ben Goldberg Arnold those dealer from college the the new dental I the Las Vegas one what I wish you guys would do. Is we put up. Four hundred one hour online see Acorss Donald Town and they've been viewed a million times. I I wish you would make a course of an online course dental time because it's kind of a You know they saw you for an hour and met you and got your chemistry and all that that would make it easier to make the next move of going to Ohio or Las Vegas. It kind of deconstruct sells sells process. Because I really wanted to make a good decision and my my main purpose is that this is another bias. I've seen so my entire life. Whatever for a dentist designs five years later they all regret it not being bigger? I've never heard anyone say five years later. I wish I would have made it smaller. They always say say God. Instead of four officers on six six eight eight says twelve is that I wanna good high-quality decisions do do you. What would percent a dentist you think at sixty months after a new office regret that it's too small of course wrestling? We always have to the one with the ones that coming one anyway. Just the industry I would say typically ours. Don't aw but you know part of it Howard as you you know you give it your best shot so five years ago you give it your best shot number Bob size of Zili and it's really. They're all budget driven at some point. A number is going to determine a lot of what you can do so we actually just had some guys in Abilene three three years. They slapped on an additional four ox. Beginning we went from fourteen to eighteen because they started to get cash ready. Get in. They're going to be completely maxed out like a year so they had enough force also because there's three of negative for the budget aged lead going from fourteen to eighty hour. Say We've never specifically got got matt feedback and anybody. That was highly concerned. You know. Well you know this is a big. So here's here's a typical scenario single doctor. They want to build aid ops. They don't have an associate or a partner but they had been growing practice they had visions of bringing them on on. You know with them and they there and it's a struggle for like a single doctor presenting building up grabbed eight up ground up building. So maybe they'll they'll they'll will complete four or five ops dry box the other three. They won't complete part of the insight and now get all that up and running and then two or three years they may bring on an associate. Oh see that may go grain turn into a par then also they max out that aid off slowly so we have conversations about that. Somebody's highly concerned. That goes back to Picking a piece of property. So let's say the original opposite camps shooting for eight odds but who knows in on. I'm in my thirties. It's weakened tell we've worked with some great kind of high profile practitioners. We can usually tell who's going to build up a big booming practice based on their personality how they interact with revisionist while they're highly concerned. Let's let's get a little bit bigger piece of property. WE'RE GONNA Master Plan and ate up billy that if you ever outgrew it so we're going to be able to add on former odds it's GonNa flow right into conditional four obstacle ever get to that point knowing can project. Now you know make Kostas in five years. We don't know it's going to be more. Hypothetically you could could expand this facility from eight to twelve ops so he went sort of a safety valve fallback position. Sometimes you're just land lot. Sometimes it doctors on a piece of property for ten in years. Five years doesn't matter what we do. We're not gonNA ever get more than three thousand square foot building on there and we got to know that okay. You know. Three Thousand Scorpio. Maybe we can get a good six or seven in office. You're never going to go past you know. Is that going to work for you for the rest of your career and sometimes people have actually sold land and move somewhere else but you know that that is a good point. You've got you know what what what are you envision now but what is your. What is your ultimate vision future and many doctors? It's a single doctor. I love to have two or three associates at turn into partners were. I'm spending a course time managing this practice or maybe spin up another breath. I don't WanNA partner at all ars. It's not who I am. I don't WanNa be unroll or skates I mean. Tell the truth about who you are a dentist in it and I think that is a lot of immed- back to your question earlier on knowing who you are as a dentist telling yourself the truth and then telling the designer here's who I am as a dentist. This is how I like to practice. This is where I wanna take my career career. I need a facility that supports me. In that way you talked about that URL surgeon. There was a reason why what he knew what he wanted as an oral surgeon when he he wanted providers patients there was a rationale design should have a rationale and it should be backed by hopefully some level of experience and some level of truth telling I call all it is a dentist. Who are you? I mean we have no judgment here about who you need to be there Dennis. Sometimes I think it's unfortunate that feel like they have to have a certain number raw us or somehow they haven't accomplished what they need to accomplish or I have to be a part of a group or should be doing this or I should be doing as and why I I mean if you're really good and this is who you are and you can provide that service to patients beyond anybody else in the area. I think that's I think that's the way I just always always be true to yourself. I mean there's eight billion people on Earth. You weren't born to live someone else's life and to say that old when people who say described the average dentist yes well you can't describe the average as hell you says that my neighbor's house has a full grown rottweiler. And it's afraid of the cat. I mean I mean whoever emmy emme no one would ever say a rottweiler afraid of a cat I mean my gosh. Everyone's different just be true to yourself but I got two more specifics. Because I can't believe we. We already went over an hour but to other questions. What would you say to somebody? Says you know the only thing I'm really interested in is I want to fix this up for when I sell my practice to some day and another another people are saying well you know now that Dso's APP through mergers and acquisitions of snapped up about twelve percent of the dental office The the dicey on supplies. DSO's Irvine about eighteen percent of supplies at a twelve percent of the locations. A lot of people are hearing things that. DSO's aren't interested in your. They gotta be at least a certain size for their business model so two questions. What if what what would make me? What would help me fix up my office so I can sell it someday and number two? What do I have to make in size? The number of ops so that I have a liquidity did he play with. DSO's couple basis. We'd spiffing up your office so you can. You can salad. Alydar create some kind of transition strategy. So it's like you said earlier. Howard we see doctors will come to us? They've been in there up twenty thirty years. It looks like it's from the seventies or the eighties wood. paneling horrible old outdated. Well no really old outdated equipment making fun of the Brady Bunch. Seen No with the home and garden television they read. They redid the Brady Bunch House and he watched that took like toys. It's so it's so you know you have to okay. Who are you going to sell it to somebody? Right out of school is gonNA walk in there. There's no way in the world. They can ever envision themselves else in that space. I'm not going to spend eight hours forty hours a week in the space so you have to try to create something that has some appeal to actually the the new end user. The Person GonNA sell her transition too so that can look a lot of different ways. Sometimes it's equipment. Sometimes you got an update the equipment and you just have old outdated. What's interesting interesting is beginning to deliver units and stuff like that but the ergonomics of how people are trained in dental school now so almost all dental schools have what they call kind of splint delivery where the doctors module is in front of? You could be on a car could be on a swing arm. Attaches to the chair will some back in the seventies eighties. We did a lot of what they call dual function rear deliberate where the Doctors Ham pieces and the assistance module were directly behind you and some of the even older units there one hundred percent the X. You can't move around with their next to impossible if you're not used to work in that it's really difficult for you to adapt to that. So one is look at the equipment have any technology do I have any kind of technology overlay over an office. It was probably designed twenty or thirty years ago so it has to be some level technology. 'CAUSE people right out of school are very tech Tech Savvy. Sometimes it trans. You GotTa have a few monitors and a couple of computers laying around doing something to entice somebody and then what does it look like. You know like you said at retail every every seven years of McDonald's spiff up something that can be finishes paint. You know new new stuff on the exterior. You've got a spiff up the finishes it can't be so so dated looking than it just looks like you're moving in with their grandparents. You know you have to take it to level and it can be budget driven you can back. In or doctors to K- I WANNA transition transition. I WANNA sell this in the next five years and I'm willing to spend a hundred thousand dollars to spend two hundred thousand dollars. I wanted to spend thirty thousand dollars. Get realistic from what budget it makes sense for you and then you can back into what's possible at that you don't need somebody. Tell me Oh you need to do this and spend five hundred thousand dollars. You'll never sell it no you. You have. Every every right to make a budget determination what makes sense to you to invest an APP so to say you've got to be sensitive and are most older. Dennis have children or you know nieces or nappies. They understand kind of what a younger person has attracted to experience wise in a space and trying to translate that back to your office and at least bring it up to a level level where they can get in there some comfortable and then make it make it there in a year or two after they can make it. They're all making basser money. And but you gotta you gotTa have the bones or the the core of a decent functioning office that can be developed over time. You GotTa do you mostly do family practice general dental offices already already doing either specialist. You do everything we've done asking. We've got a lot of special just because sometimes it's hard the dealers that the dealer designed people they don't do as much as we'd done a lot of oral surgery two or a ton of orange. We don't do a lot of Endo for some reason and that at that they're Simpler offices but of all the special do a lot of pita pediatric is really interesting because of and well actually I when we're done with this driving deaths attacks us to do a site visit visit on a on a twelve year. Six Thousand Square with big smiles ranch is really gonna be something that's nationally but you know there's something I I would say when to your question that we're seeing the GP's bringing or possibility that will allow her neurosurgeon to come in or an orthodontist to come in or period honest to come in that may not otherwise be available in the area and now they get to the one-stop shop. I think it's sourced a little bit by a competition with the DSL. It might provide all services to you know everybody. This is their version of that and so when they come to US or Afghan okay. I'm going to be the the primary caregiver in this facility but I wanna have an oral surgeon come in once a month or twice a month what do I need to provide that all surgeon in this facility to to attract them to this facility so I think to say that is another thing. We're starting to see in the marketplace which makes a lot of sense to us amid expands your availability ability to the community expand the marketplace for the specialist. Who may not want to build a building in poughkeepsie Mississippi? But I'll go there because it's thirty miles else. Outside of where I live on oily drives Sata town. That's not I made that up but you get my drift so it is just to say that I think that's pretty smart for GP's as well. Well you said something extremely profound and that is you know the retail. The business is the model for over two centuries for all of America's existence as you go back to the early eighteen hundreds of New York City. You know you had this small little shop stop and everybody lived above it and the next generation. They rented two shops. Put them together and put the one shoppers out of business and kept getting bigger and bigger and bigger until it Max all all the way for Walgreens and Home Depot Kia. They're all these two hundred fifty thousand square foot centers. One Stop Shop before Walmart admitted they they got too big and now that was scaring people away so they served closing down facilities in their backing off from that size and that retails not GonNa Change You. Keep seeing in where I you had pediatric Denison orthodontist and then those two were like peanut butter and chocolate and they combined and now mom's like well. I'm going to go to this pediatric office. Because 'cause they have an orthodontist and the one stop shop is going to rule dentistry for the next one hundred years because it's ruled world retail we. We've seen it completely plan retail. I'm sold when I started lecturing down under in Sydney when I've gone down there every five years on the tour of Melbourne Sydney Adelaide Perth Gold Coast and jump over and do Auckland New Zealand on the way back but when I started doing Sydney in one thousand nine hundred ninety I mean here I am staying at a Dennis House and we had to go here for the meat at the butcher than here to the Bradman than here the Veggie shop and I'm like well. Where is your grocery she store that has all those departments of one place and at that time? They didn't even have hygienist our hygiene school. So you can literally go back in time came when I went down there in nineteen ninety. You were going back in time in retail now. Now it's all caught up and how they have to publicly traded. DSO's at America doesn't have but the bottom line is mom. And when I asked the dentist or you focus on the dentist. Is this all about your you. Dentists centric Customer Patient Nations Center. I'm I'm definitely patient centric. Oh really so. Your hours are Monday through Thursday. Eight to five and the Federal Reserve has thirty two hundred full-time impeached economists. And they say one third of America cannot see a healthcare provider. Monday through Friday eight to five so by intentional design. You just told one third of America. You're not when you have a question you always have to refer to another office. I'm so these. DSO's love him or hate him if they get the retail right if they get the one stop shop right So so I I tell us. I'm in on Saturday coming Ascoli at half a million dollars in student student loans because he went to a private dental school in a three year deal and then he married some woman who had the same thing so now combine there like one and a half million dollars dollars in debt you know combined and I said well why are you going to go buy land and building. Startup ended on his foreign. She'd go find the five biggest practices in town and go do all their endo and split it fifty fifty. You have no overhead. No no you know all that so so. When you're talking about this flexible I I do see the future? Being a specialty opera Tori were specialists rotate through to provide one-stop shop. Do you do you agree without is out. Exactly what we're saying but I'm GonNa just and this has been burning in me since we started talking about the off and adding the and one of the things I say and I mean in his very sincerely the way dental office has had failed as a facility is the notion that I can just give up. My doctor's office put in a chair. Give up my staff. Lange put in Pitcher in all of that works on the production side but what was not happening was any consideration of what was happening in the Waiting Area. The front desk area. And then you started hearing all these Upsets about the bottleneck at the front desk. So I have more patients coming in because I got more chairs more availability but I didn't accommodate eight that increase in production and the front areas of the office. So what we try to impress upon dentists and design is dull build such that the the production can increase increase without understanding. It's going to have an impact on the front part of the office. So to your point it is to say. Bringing in the end donnas raking in the period honest the oral surgeon urging whomever they have some uniqueness in even on the transaction side consultation rooms or exam with consultation that they may Bana fit from. And so what are those other aspects. Besides not count of cheers that will facilitate that ability to bring in those kinds of patients nations on those days or or even expand your hours in the facility so that you can allow for that as well so I I think I think the breaker it was so important. it's got to and our office had done something really neat. They play this game where they They named food or something. Like I'll go in there and I'll be eating a a ham sandwiches said Karen on it. I game a game. They play. I'm last one last question for you. Go when I got out of school and eighty seven the biggest guru in practice manuals Omar read and Jim you mentioned are but the more read. You always talk about front desk looseness. He wanted a the front desk. And you just said bottleneck at the front so I know I can hear his words thirty years ago there while you can have a front desk. So what would you say this only said. Hey what do you think about front desk closeness through that time and we would personal doctor. They're trying to get rid of the front desk. And then we talk through the rationale king. So how are we going to replace apprentice. We're going to do everything in the we're GONNA have a credit card. Swipe irs in the odds attached to the charity. Go you know and it always broke down and conversation. We Probably Fifteen twenty times based on Omah read saying that had a doctor's that went in into design and we started with no front desk and slowly over time. We just put it all back in. We just went right-back. Same kind of design principles today Harris. Well they're the hygienist agents second reappointing their own rooms they never do. They actually need to get out of there. So we they have hygiene assistant was a breakdown room. Clean it get another patient there. It's more efficient. The hygienist goes to a hygiene support me reappoints at patient versus maybe go to the front desk turnover the room but it's all part of the experience with now now we I mean we feel actually even more strongly about the front desk over time even with all the technology were still the thing. That's maybe change over time as we. We partition sort of checkout area. So there's more privacy so we would say in today's environment you can't. You can't introduce too much privacy now back maybe the seventies and eighties. Everything was open a wear jeans and everybody. Here's everything out genes with bell-bottoms. Everybody everything everybody says. Will you know people are just much more sensitive now and they. They expect some level of privacy but yet all of that that lasted for a while it just it never. It never took hold. I would then as you know. percent design follows dentistry dentistry. Procedures are much more expansive. It's not ten dollars at the front desk check for. I'm writing much bigger. Check some investing much. It's more dollar wise. I need to have a lot more education understanding of what you're doing because I've never had a root canal. I don't know what is what I don't know about been in years. I need to understand more about that. My Gosh I'm GonNa Spend Two thousand twenty five thousand dollars. I need an education experience. I need to be able to do it private. I need to tell you why I'm afraid whether there I can afford it or not etcetera etcetera so we have our patients commit to their dental health which we do and we have all these things that we can do beyond what we used is to be only do fifteen twenty years ago. There it'll be pleasing alka without a lot of pain. We need a facility that will accommodate those adjustments. Smits if you will and I. I just emphasize the Front area of the office helps feed production of those opportunities. So the Opera Tories our turnover if I can say I don't. I don't mean like McDonald's hamburger but there's a turnover ratio that we wanna see happening and those stories and we don't want patients sitting there occupying achier through a transaction process process or through a lengthy education process or a lengthy diagnostic process. There might be other spaces that can prove more beneficial to you. What are those and so I think what I hope you're hearing in this? It takes a lot of discussion with any practitioner. What is it that you do? How do you bring patients in? What are you providing being in service when he wish you were providing service? Do those patients let speak of. Let's create a facility. That's going to do that for you. And it's not about spending being money on Taj Mahal things it's about function and it's about delivering to the production ore to the procedures and to the community that you're trying to sir so I know there's one hundred ways to do everything and But you've done. I mean three thousand offices the big question is should. Did you have a treatment plan presentation room or should you do in the story where you have the Radi grass pulled up and all the stuff what would you you say At all your experience doing this for three thousand offices do they need treatment plan presentation room or is that just this is easily done chair side. Well the answer is yes and yes. So there's going to be obviously when we say we definitely recommend a consultation row of some some sort or treatment presentation room and then we have a conversation about what you need in a treatment presentation around how many people would be at any one time in that treatment presentation room and we you would design it as such but when we say that oftentimes Danis will go well. I- I present treatment in the story. Of course you do. That's where the opportunity presented sell. Obviously we're not eliminating that as anything that would go away because we have a consultation but I want my teeth straightened. I want my teeth white. I they have things that are beyond a conversation that I might have in my hygiene appointment today and I'm really serious about that was going to be involved with that. You need to educate we need to understand how I'M GONNA pay for but I want to have it done and those are the situations where we say treatment to opportunities that are for more expansive can be presented very well in a tweet. Myspace plan that way. The other thing that we're seeing in GP practices at Ruby uses intake. Area I'm a new My Best Friend Veronica says I need to go see Howard and here I am. I'm your new patient and I've had some kind of history that you I know nothing about but you can take me into that treatment area. Introduce yourself it could be the financial coordinator. Does this treatment coordinator does this to explain. This is is what we're committing to here in this practice to use a patient. What are your goals what you want to accomplish? What are the things that made you wanted to do that? You haven't had the interest ESPN or the opportunity to do. Let us see what we can do to facilitate those in your endeavor and treatment. Presentation Room can do that. Really go on record so so hard. So your highest producing per hour specialist is an oral surgeon. Correct yes or all oral surgeons have console rooms. They have exam console console awesome with a dental chair that they would never bring someone into there may surgical op and explain to them. What an implant extraction for wisdom teeth so many? GP's can take that as an example. You know your present complex. You know high costly tweet. Minutes talked to do an an opportunity. You know it's much better. It's much better and constellation of a different setting. Are One hour interview is now at a hour and a half but I just want to say that I still think. First Impressions are setting lead. They come in. They see your facility for thirty two years. I've had pee th. They don't know what a stat him. STERILIZER is. But you know many old ladies told. Yeah well you know. I mean. They're waiting room and they got dust all over their dust boards they lamey backing. There's water stains and I don't want to you know I don't even think that place was filthy and and then another thing is what we've always done is when they come in. It's their first impression. Will if if you guys don't do this but I know girls do. If a girl goes over to some other other girls house for the first time. That girl will always give them a tour of their house if I went over and visit Jeff I don't really WanNa see his closet and I really. Yeah but I know. It's no thing but every single new patient when they come in for the first time they give him the walk through the and so there's a hygienist us oh there's amy there's brandy there you know and our scenario and then they bring him in that new patient. Are The treatment plan presentation consultation room whatever and then I want to go on there and take and go in there and look at them standing up shake their hand and then sit down and that person per se so Jeff Pat. White White did did you. Did you just move to Phoenix. Congratulations to move for ten years. So you haven't been to the dentist for ten years or is that no I you know. I'm changing gene. And you you get that initial relationship and it's all about trust because if I tell you need four Modibo that they they don't know if you knew what Modem owed any of this stuff they have to see a team of facility and I also like name badges how long you've been here. Because when they see that the lady who shook their dawn has been at the front desk for two decades. And and and you know everybody's been there a decade plus than they searching trust and you're selling the invisible they need to see a facility. They need to see long-term staff. They need to see eye contact. I need the Dennis available and then I always give my card. It's got my office number my cell phone number my personal email number and say hey you know you ever have a problem. The BUCK STOPS CBS here. And you know there's myself number and only women never man will call me call that number while they're still in the office because because they they just know it's going to be you know some it's not going to be my cell phone and then all of a sudden you know your phone's ringing in your pocket and you pick it up and then you find out. Yeah yeah she's sitting right there really your cell phone number But Hey on that note. Thank you so much for all that you guys do for dentistry and to try to get. I'm trying to get the the John Q.. Bahman off the next summer. They're our kids. Liked the late podcast. They like an hour online. See and they don't Wanna fly across the country before they exhausted. Did you see at least seen what you're about on Youtube are on. I see but yeah doing online. See Course and get John on the show and I thank you so much for all that you do for dentistry coming on the show today thank you. We really appreciate you. Now you can go gloat the arrested about Clemson. We gotTA DRIVE DESA A I'll go out during it have a great day

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