These Mistakes Are Holding YOUR Practice Back

[00:00:00] Welcome! You're listening to the Grow Ortho podcast presented by HIP. This podcast is dedicated to orthodontists who want to stand strong in their market and be leaders in their community.

[00:00:13] Now, on to today's show.

[00:00:16] What are some common challenges that orthodontists stuck in their practice space?

[00:00:22] One is people pick locations that are overly saturated.

[00:00:26] They go into it and they're like, but I want to practice right next to where I live.

[00:00:32] But at the same time, I can promise you that if I'd opened the practice that I have where I live in the center of Houston with no growing communities, my practice would be a fraction of what it is today.

[00:00:44] People will also, they think that the way that they're doing it is the right way.

[00:00:48] They're going to hire the marketing company and before you know it, they've gone through like three or four marketing companies.

[00:00:54] But the one common denominator is them and they don't look in the mirror and self-reflect.

[00:01:00] I decided I'm like, okay, they're the experts. I knew how to straighten teeth.

[00:01:04] If I knew how to do marketing, I wouldn't be hiring you.

[00:01:07] And I'm going to follow the guidelines and the steps that you're telling me to follow.

[00:01:12] If you implement the systems and the processes that you have, you will be successful.

[00:01:17] It's when you try to veer from that and think that you have a better way of doing it.

[00:01:22] I think maybe that's like, you know, the egotistical side of the orthodontist community.

[00:01:28] Dr. Kinect, thanks so much for coming on the Grow Ortho podcast.

[00:01:32] Of course. Thanks for having me.

[00:01:33] Definitely. So tell us just a little bit about your background and how you got started.

[00:01:39] I became interested in becoming an orthodontist kind of college.

[00:01:44] I always thought I wanted to go into medicine. I was pre-med.

[00:01:48] I thought I wanted to be a dermatologist and the guy that I was dating at the time,

[00:01:53] his dad was an orthodontist.

[00:01:56] And so I started spending time in his practice and I was like, wait a minute,

[00:01:59] this kind of balances like the aesthetic side.

[00:02:03] There's still like an art to it. I really love it.

[00:02:05] And so I switched from pre-med to pre-dinner.

[00:02:08] And where'd you go do dentistry?

[00:02:11] At LSU.

[00:02:12] LSU. Okay. Are you a LSU fan?

[00:02:14] I am an LSU fan.

[00:02:15] Okay. Football season, I think is starting Saturday.

[00:02:18] It is.

[00:02:19] Technically it started because there was, I guess it started last week,

[00:02:22] but the main games are the real games are this Saturday.

[00:02:26] So that's cool.

[00:02:28] My wife's like her whole family's like Alabama, Rolte.

[00:02:31] Oh man.

[00:02:32] And then my granddad went to Auburn before it was called Auburn.

[00:02:36] It was called some, I don't know, it was like a technical school.

[00:02:40] So my whole side of the family's Auburn and then my wife's side is Alabama,

[00:02:45] but I don't really care.

[00:02:46] I'm like, we'll just watch football and see who wins.

[00:02:49] So you went to LSU, then where'd you do your residency?

[00:02:52] I went to UConn for residency.

[00:02:55] Okay. What was that like?

[00:02:56] It was very cold, quite an abrupt change.

[00:02:59] It was very eye-opening to leave the South,

[00:03:02] but I felt like if I didn't leave and I stayed in Louisiana for my residency too,

[00:03:07] that I would never get out and experience the world.

[00:03:10] So at the end of residency, I'd gone through a divorce

[00:03:13] and I kind of had to figure out what my next step was

[00:03:17] and what my next move was.

[00:03:19] So that's how I ended up in Houston.

[00:03:20] How did you start in terms of working within orthodontics?

[00:03:25] Where did you start?

[00:03:25] So I started working for Pacific Dental, which is a DSO.

[00:03:29] They offered a great starting pay for somebody that was just coming out of school

[00:03:34] and I figured it would be great to not have to worry about any sort of overhead

[00:03:39] or running a practice.

[00:03:40] All I had to do was figure out how to do the ortho essentially.

[00:03:44] And I did that for about three years

[00:03:46] and then I was starting to feel like, okay, this is great,

[00:03:49] but I was making good money compared to being poor in residency

[00:03:52] and having zero income.

[00:03:54] But you start to plateau.

[00:03:57] You can only do so much.

[00:03:58] They limit the number of your chairs.

[00:04:00] You don't have any autonomy in terms of staffing

[00:04:03] and who your treatment coordinator is.

[00:04:05] And that would get really frustrating

[00:04:06] because I'd go to one office and crush it

[00:04:08] and it was related partly related to the treatment coordinator

[00:04:11] and then I'd go to another one

[00:04:13] and my production was terrible.

[00:04:15] So I started looking at other options

[00:04:18] and I was approached to do an associate ship,

[00:04:21] which only lasted six months

[00:04:23] because I realized that that wasn't the right fit either

[00:04:26] and I would just never be happy unless I opened my own.

[00:04:29] So we actually met, was it 2018 or was it 2019?

[00:04:33] It was at AAO.

[00:04:34] I think it was 2018.

[00:04:37] I think it was and that was LA.

[00:04:40] It was.

[00:04:41] Yeah, so I was walking around with Dr. Feldman

[00:04:44] and he's like, hey, I'm going to introduce you to some people

[00:04:47] and I think Thomas was there too.

[00:04:51] I'm sure he was.

[00:04:52] Every time I see you at some event, it's like you and Thomas.

[00:04:55] At that time, HIP was pretty small

[00:04:58] but we had already started our footprint within Orthodontics

[00:05:02] and I think you and I talked,

[00:05:04] but it wasn't until maybe several months later

[00:05:07] or maybe even almost a year

[00:05:09] where we actually started to work together

[00:05:11] and did your branding, that type of thing,

[00:05:14] branding website.

[00:05:16] And I don't think we actually started to work together

[00:05:18] in a marketing capacity until 2020 when COVID hit

[00:05:24] and that's when you were opening, right?

[00:05:27] Correct.

[00:05:27] So I opened my practice six weeks

[00:05:29] before the whole world shut down.

[00:05:32] Good timing.

[00:05:33] Yeah, great timing.

[00:05:34] At least it was right before.

[00:05:35] Honestly, looking back, it was great timing

[00:05:37] because I didn't have all these patients

[00:05:39] in treatment that I had to worry about

[00:05:41] but at the time when I just spent my life

[00:05:43] savings opening at practice,

[00:05:45] yeah, it didn't feel like a good time.

[00:05:47] Yeah, but it ended up becoming the best time for Ortho

[00:05:52] and so that was huge for you in terms of a launch pad

[00:05:54] to be able to open.

[00:05:56] Who would have known that that would have been the best time?

[00:05:58] But it ended up being the best time.

[00:06:00] So you started with us

[00:06:02] and that was in a capacity

[00:06:04] that we don't even have anymore at the bridge.

[00:06:06] Then it kind of rolled over to our full framework

[00:06:08] and what has life been like?

[00:06:11] Like going back to opening,

[00:06:13] what was it kind of like in the early days through COVID

[00:06:17] and the next year, year and a half,

[00:06:19] what did that look like for you?

[00:06:20] Yeah, so when I first opened, it was pretty painful

[00:06:23] coming from working at a busy DSO,

[00:06:26] even working as an associate where you show up

[00:06:28] and you have this really full schedule of patients

[00:06:30] and then I open my own

[00:06:32] and I'm literally sitting there waiting for the phone to ring.

[00:06:35] And of course you have staff.

[00:06:37] You've got to pay them and make sure that you keep them

[00:06:42] and the phone would barely ring.

[00:06:44] We had so much free time on our hands,

[00:06:47] it was honestly scary.

[00:06:49] And that's when I kind of decided

[00:06:52] I gave that a few months

[00:06:53] and that was pretty much all I could take.

[00:06:56] I don't know how people tough that out any longer, honestly.

[00:07:00] It's pretty scary, yeah.

[00:07:01] It is and so I just felt like

[00:07:04] the sooner that I could grow my practice

[00:07:05] then the quicker that I could get out of the DSO job that I had.

[00:07:09] So I was splitting my time 50-50 at the time

[00:07:12] and I knew that if I kind of went all in with the marketing

[00:07:16] then that would just help me grow my ortho,

[00:07:19] my private practice and go full time there.

[00:07:23] And I waited through the end of the summer.

[00:07:25] That was kind of my timeline

[00:07:26] because all my friends that had practices

[00:07:29] at the peak of the summer

[00:07:30] when things were opening back up

[00:07:32] they were really starting to do well again.

[00:07:34] So I was like, okay, let me see what...

[00:07:36] I don't really know what my baseline is

[00:07:38] because I opened for six weeks,

[00:07:40] I closed then I reopened

[00:07:42] and it was just such a weird time.

[00:07:44] But I couldn't even get General Dennis in the area

[00:07:47] to let me in their office.

[00:07:48] They would want to have a Zoom call

[00:07:51] because it was still like the height of COVID

[00:07:53] kind of and people were scared.

[00:07:55] They were like, you can't come in.

[00:07:55] Where your hazmat suit put on four masks.

[00:07:59] You can't come in and bring my office lunch

[00:08:01] but I'll schedule a Zoom call with you.

[00:08:03] And it's just hard when you can't get in front of people,

[00:08:06] you can't really get to know them or talk to them.

[00:08:10] Why are they going to refer to me

[00:08:11] versus the office that they were referring to for years?

[00:08:14] Right.

[00:08:15] And that's what...

[00:08:16] When I talk to people all the time

[00:08:18] that are asking me about marketing,

[00:08:20] even with a startup,

[00:08:21] that to me is key

[00:08:22] because you just need people to get in the door.

[00:08:25] You can then establish the relationships

[00:08:28] with the General Dennis

[00:08:29] by following up with their patient

[00:08:31] that came to you from an ad.

[00:08:33] And then say, hey, I want to talk to you

[00:08:35] about this treatment plan.

[00:08:36] I saw one of your patients

[00:08:38] and then the more you start to do that,

[00:08:40] the more they like your cases

[00:08:41] and then before you know it,

[00:08:42] they're referring to you instead of the other guy.

[00:08:45] Right.

[00:08:45] Yeah, that's a good point.

[00:08:47] I think a lot of people don't think about it that way.

[00:08:51] When you started,

[00:08:52] because a lot of people have this question,

[00:08:54] how many people do I need to hire?

[00:08:56] So what did that look like with you?

[00:08:58] When you started,

[00:08:58] how many team members did you first have?

[00:09:01] My situation was a little different.

[00:09:03] I had three,

[00:09:04] so I only had one that was full-time.

[00:09:06] That was Vanessa.

[00:09:07] So she was essentially my front office,

[00:09:10] TC office manager, insurance.

[00:09:12] She did everything at the front.

[00:09:14] And I had two assistants

[00:09:16] that I brought with me from my corporate job.

[00:09:19] So I pretty much told them

[00:09:20] that I will quit if you don't let these assistants

[00:09:24] just follow me wherever I go

[00:09:25] because that was what they were doing

[00:09:27] at Pacific Dental.

[00:09:29] So they ultimately worked only with me

[00:09:31] in whatever office I was working at.

[00:09:34] Okay.

[00:09:35] So that's maybe not the best thing to...

[00:09:38] You're not supposed to steal staff,

[00:09:40] but at the end of the day,

[00:09:41] they believed in me and wanted to work with me.

[00:09:43] Right.

[00:09:44] And from the corporate side,

[00:09:46] I produced a lot of money for them,

[00:09:48] and so it's cheaper for them to not have turnover.

[00:09:52] Right.

[00:09:52] And it's a lot easier for them

[00:09:53] to replace two ortho assistants

[00:09:54] than it is an orthodontist.

[00:09:56] Sure. Yeah, totally.

[00:09:57] So they just kind of looked the other way.

[00:09:59] Right.

[00:09:59] I'm not telling everyone to go and steal assistants.

[00:10:02] But maybe negotiate, you know, if you can.

[00:10:04] But it's definitely something to consider

[00:10:06] or I know people that have hired someone

[00:10:09] in their private practice

[00:10:10] and brought them with them

[00:10:12] to a DSO.

[00:10:14] And pretty much said like,

[00:10:16] this assistant works with me part-time.

[00:10:18] Can they follow me here?

[00:10:20] And then the DSO is paying them.

[00:10:22] Yeah.

[00:10:22] So I think that key piece is, you know,

[00:10:26] obviously you worked at a DSO for a while

[00:10:28] and so you had some reserve built up

[00:10:30] and then you continued to work at the DSO.

[00:10:33] So you didn't have to live off of what

[00:10:36] your practice was producing.

[00:10:37] You know, they're not necessarily a right or wrong,

[00:10:40] but you definitely went about it in a smart way

[00:10:43] where some people may come out of residency

[00:10:46] and want to just go private practice.

[00:10:48] Again, not necessarily a bad thing.

[00:10:50] I commend them for wanting to do that.

[00:10:51] In today's climate, it's really, really tough

[00:10:54] because everything just costs so much money.

[00:10:59] So if somebody just pays full price for everything,

[00:11:02] they could come out $800,000 in debt.

[00:11:05] I think that's like the highest, you know,

[00:11:08] and then it's like from there,

[00:11:09] let me go open and take out another loan

[00:11:12] and work with a different, you know,

[00:11:14] obviously you're not,

[00:11:15] that's not student loans anymore.

[00:11:17] So you're working with a bank

[00:11:18] and you may have to take out anywhere from $500,000

[00:11:22] to a million dollars depending on the building,

[00:11:25] the build out.

[00:11:25] If you want all the fancy bells and whistles

[00:11:27] to ITERRA scanners, you know, et cetera.

[00:11:31] I think that's really key because you want to set yourself

[00:11:33] up in a position where you can actually win

[00:11:36] and flourish and do well, you know.

[00:11:39] So that is really cool

[00:11:41] that you were able to go about it that way.

[00:11:45] What was it like in terms of your build out?

[00:11:49] You know, you don't have to get specific,

[00:11:50] but like cost and like how did you budget?

[00:11:53] You know, what was your budget?

[00:11:55] How did you think about that

[00:11:56] and who did you work with in regards to maybe finance,

[00:12:01] planning, interior design, location?

[00:12:04] What did that look like?

[00:12:06] So in terms of kind of the finance

[00:12:08] and planning everything out,

[00:12:09] honestly I did most of it myself.

[00:12:11] My dad was a business owner.

[00:12:12] So that helps.

[00:12:14] I definitely got a lot of great tips from him,

[00:12:17] but I figured out essentially

[00:12:20] what my practice loan was going to be.

[00:12:22] I knew that wasn't going to be enough.

[00:12:24] I had a certain amount saved

[00:12:26] and then I figured out some loopholes

[00:12:28] with extra equipment loans.

[00:12:31] So like for example, you could finance

[00:12:33] like your scanner, pan-sef sterilization

[00:12:36] from Benco.

[00:12:38] And then that was separate from my Bank of America loan.

[00:12:41] Got it.

[00:12:42] And I honestly, I found that out from like an equipment broker.

[00:12:45] So he kind of gave me some good tips on loopholes

[00:12:49] and how people would get extra funding.

[00:12:51] Because Bank of America usually gives you about $500,000.

[00:12:55] And my construction cost was $350,000

[00:12:59] and this was pre-COVID.

[00:13:00] So that was honestly cheap.

[00:13:02] Yeah, it's like double that.

[00:13:03] Yeah.

[00:13:04] And you get tenant improvement

[00:13:06] if you're leasing a space,

[00:13:07] but you don't get that money back until after you have the CO.

[00:13:12] So I got 75 grand back,

[00:13:14] but you have to have that money upfront.

[00:13:16] Yeah.

[00:13:16] You started obviously the practice still working at a DSO.

[00:13:22] And then was it, you mentioned this,

[00:13:24] but was it about a year or that you worked at the DSO

[00:13:29] still part-time in some capacity?

[00:13:31] Correct.

[00:13:32] Okay.

[00:13:32] I thought it was going to take me a lot.

[00:13:34] I budgeted when I had all my planning.

[00:13:36] I thought it was going to be a two to three year plan.

[00:13:39] Right.

[00:13:40] And that's where honestly I feel like without your partnership,

[00:13:43] it easily would have taken me three years.

[00:13:46] I think where I got to in a couple of years,

[00:13:48] I was predicting to take five years.

[00:13:51] When did you start to realize,

[00:13:53] okay, this could happen a lot sooner?

[00:13:55] Was it pretty early on once we kind of jumpstarted everything?

[00:14:00] Yeah.

[00:14:00] I think in the first month that we did the bridge,

[00:14:02] I went from doing 10 starts a month to 20.

[00:14:04] Yeah.

[00:14:05] So double basically production.

[00:14:07] Yeah, overnight pretty much.

[00:14:09] So you started to think, okay, the runway for this is going

[00:14:11] to be a lot shorter than I anticipated,

[00:14:13] which was a great thing.

[00:14:16] Then once you went all in, how did you continue to grow?

[00:14:20] Like what did that look like in terms of, okay,

[00:14:23] now we're a year in, I'm going to leave the DSO,

[00:14:26] go full-time.

[00:14:27] How did the team change and how did the growth change?

[00:14:30] Once I went all in, the growth was pretty quick.

[00:14:35] It was a pretty stark difference about once I was kind of

[00:14:38] devoting all of my time pretty much to my practice.

[00:14:42] And I just had more availability for consults instead

[00:14:45] of saying like, oh, Dr. Kinnitz only here on Monday

[00:14:48] and Wednesday.

[00:14:49] Now we were giving four days of options.

[00:14:53] Yeah.

[00:14:53] And then you got married obviously like a year ago.

[00:14:58] A year ago, right or a year ago.

[00:14:59] And so what did that look like also juggling all of that,

[00:15:04] being a business owner, how did that go?

[00:15:06] Honestly, it was a little hectic last year.

[00:15:08] But even despite taking off tons of time to like go

[00:15:12] and scope out the wedding venue, get married in Europe,

[00:15:15] I still was up from the year before.

[00:15:18] And I, last year I worked the least number of days

[00:15:21] since I'd ever started practicing.

[00:15:23] And it was my highest production yet.

[00:15:25] And I think I'm on the same trend.

[00:15:27] I'm definitely working less now.

[00:15:29] And my production's up 20% from last year.

[00:15:32] And then last year, what was it up in terms of percentage

[00:15:35] comparatively to 22?

[00:15:37] It was only up maybe 10%.

[00:15:40] But the climate, I mean, and ortho wasn't that great either.

[00:15:44] Like a lot of people were down 10%.

[00:15:45] Yeah.

[00:15:46] And still are even this year.

[00:15:49] We did a podcast with Gage recently.

[00:15:51] And I think they shared that large practices are down

[00:15:55] somewhere between three to 5%.

[00:15:56] And then smaller practices are down,

[00:16:01] or was it the opposite?

[00:16:02] I can't remember down like 10%.

[00:16:04] Yeah.

[00:16:04] Anywhere from that 3% to 10%.

[00:16:07] And then I think some are pretty much brought it back

[00:16:10] to break even, you know, but still most people

[00:16:13] are not growing, but you are.

[00:16:15] And there's a lot of factors.

[00:16:17] We can kind of break down some of those.

[00:16:19] Let's kind of dive into your approach to treatment

[00:16:23] because I think that's pretty fascinating.

[00:16:26] And a lot of things that you're starting to do,

[00:16:30] there is a buzz in the industry about.

[00:16:33] I don't see a lot of people doing it well.

[00:16:35] So I'm really curious on how you're treating patients.

[00:16:39] And I hardly get into this because I can only go so deep

[00:16:42] myself, you know, in the whole clinical realm.

[00:16:44] But for viewers, listeners, what does that look like?

[00:16:48] How do you approach orthodontics?

[00:16:50] So one of the biggest things that I've really started

[00:16:53] paying attention to is airway.

[00:16:55] And I know that's a controversial topic in place

[00:16:58] in ortho, but I've worked really hard to kind of develop

[00:17:02] a team.

[00:17:04] So I don't just approach, I approach ortho as just one piece.

[00:17:07] So when I'm explaining that to the patient,

[00:17:09] you know, I do a lot of phase one, a lot of expansion,

[00:17:12] but I'm still referring them to other healthcare

[00:17:15] providers as well to fully, you know, treat the patient.

[00:17:18] So I'm looking at it as treating the patient as a whole,

[00:17:21] not just treating their teeth essentially.

[00:17:26] Yeah.

[00:17:26] And then, you know, the other big piece that I've done

[00:17:28] is I've gone to indirect bonding and I use KLON's

[00:17:33] bracket system, which has been amazing because once you

[00:17:36] get to a certain level, it's hard to, everyone always

[00:17:39] says like, I don't want to bring on all this

[00:17:40] marketing and have all this growth.

[00:17:43] And then how do I maintain the quality of care?

[00:17:45] And I think that's fair.

[00:17:46] Like that was the thing that I was questioning too.

[00:17:49] And with indirect bonding, you're doing the plan on a

[00:17:53] computer and then the assistants are, you know,

[00:17:55] placing the indirect bonding trays so I can easily,

[00:17:59] you know, do multiple bondings at a time and know that

[00:18:02] the quality is not decreasing.

[00:18:03] If anything, it's more accurate because I did the

[00:18:06] setup on the computer.

[00:18:08] So it's allowed my practice to grow tremendously,

[00:18:11] but without sacrificing quality at all.

[00:18:14] I think if anything, my cases are looking better now

[00:18:16] than they were two years ago.

[00:18:18] That's amazing.

[00:18:19] And there's a lot of options out there now for

[00:18:22] indirect bonding.

[00:18:23] Why do you like KLON specifically so much?

[00:18:28] So there's several to me.

[00:18:29] It's really the only way to go in the indirect

[00:18:31] bonding world.

[00:18:32] So you have a semi custom bracket system,

[00:18:35] which I like.

[00:18:36] So that's the difference you can use,

[00:18:38] for example, like Dibs AI and you can put any

[00:18:41] bracket that you want, but it's not using a custom

[00:18:44] or semi custom bracket.

[00:18:46] So I like that KLON semi custom.

[00:18:49] And then if you compare that to Lightforce where I

[00:18:53] don't want all my patients in ceramic brackets,

[00:18:55] I don't like ceramic brackets and I don't know many

[00:18:58] orthodontists honestly that love working with them.

[00:19:01] So to me, KLON was the perfect in between.

[00:19:04] Like it's not fully custom like Lightforce.

[00:19:06] It's still semi custom.

[00:19:07] You have the benefit of the indirect bonding and you

[00:19:12] also have a back stock of brackets,

[00:19:14] which to me is the biggest issue with Lightforce.

[00:19:17] So if you don't reorder that bracket and a patient

[00:19:20] breaks it and your assistant forgot to reorder it,

[00:19:23] the patient might come back and you don't have

[00:19:25] a backup and that's not a very good look.

[00:19:28] And it's just not, you know, efficient.

[00:19:31] I care about efficiency.

[00:19:33] And so now we have way less brackets that we

[00:19:36] actually have to stock.

[00:19:37] It's like this little pill box and my lead assistant

[00:19:40] just checks that weekly and we order, you know, as needed,

[00:19:43] but we don't really have to keep more than five backup

[00:19:46] brackets and you know, it's still traditional metal,

[00:19:49] but they also have self ligating for someone that wants

[00:19:53] self ligating.

[00:19:54] They've got ceramic.

[00:19:55] So you have, to me, it covers all of the different

[00:19:59] bracket types, but then also the price point.

[00:20:02] So it's affordable.

[00:20:03] It's half the cost of Lightforce.

[00:20:06] And you know, I would argue that it's just as good.

[00:20:09] Right.

[00:20:10] You had sent me a book and I think this book was part

[00:20:14] of your journey with Airways and kind of tweaking

[00:20:17] how you're doing things.

[00:20:19] What was the book?

[00:20:20] So the book was Breath by James Nester.

[00:20:23] And his whole, you know, concept or like the intro

[00:20:27] into it is pretty much he does this experiment where

[00:20:31] he turns himself into a mouth breather.

[00:20:33] It's him and this other guy and they go through all

[00:20:36] this like rigorous testing and the effects that it has

[00:20:39] on their body are insane.

[00:20:41] And so imagine if you've got these young kids and patients

[00:20:44] coming in that are mouth breathing, you know, how much

[00:20:48] is that stunting their growth and development?

[00:20:50] And why aren't we paying attention to that?

[00:20:52] You know, as an orthodontist that focuses on the mouth

[00:20:55] and we see things honestly, we're looking inside the

[00:20:59] mouth.

[00:20:59] And that's I think what really triggered me.

[00:21:02] Pediatricians aren't looking at the oral cavity the way

[00:21:05] an orthodontist is.

[00:21:07] So why not try to recognize some of these things and have

[00:21:10] a difference that has a more profound effect on a patient's

[00:21:13] life than literally just straight teeth?

[00:21:16] Yeah.

[00:21:16] What does that look like practically?

[00:21:18] I mean, I'm assuming that you're treating people a lot

[00:21:22] younger.

[00:21:22] You're building a treatment plan for them, which may

[00:21:25] include a team of other providers.

[00:21:27] Yeah.

[00:21:28] So one of the biggest things is I upgraded my pansef to a

[00:21:32] CBCT.

[00:21:34] So that was a really nice thing about Votech, which was

[00:21:37] the company that I went with.

[00:21:40] They'll do a complete buyback.

[00:21:42] Oh, wow.

[00:21:42] So after three years and I got mine extended because

[00:21:46] I opened in COVID.

[00:21:47] I just told them I needed more time and they bought back

[00:21:52] my pansef for exactly what I paid for it.

[00:21:54] Wow.

[00:21:55] And then I just paid the difference.

[00:21:56] That's incredible.

[00:21:58] Yeah, it's pretty amazing.

[00:21:59] And you were even talking to me about like skulls and how

[00:22:02] the jaws change.

[00:22:03] I mean, I know that we hear this because I even hear

[00:22:06] this stuff, but how are orthodontists thinking

[00:22:09] about do they know all this stuff that you were

[00:22:12] telling me?

[00:22:13] Do they know what's going on and know how they can

[00:22:15] affect that within their practice?

[00:22:18] I definitely think yes and no.

[00:22:21] It's just not something that's taught in school.

[00:22:24] And that's, I never learned about any of this in

[00:22:28] residency.

[00:22:29] Oh, wow.

[00:22:29] And I don't think that it's in a lot of the residency

[00:22:32] curriculum now.

[00:22:34] I never knew what a myofunctional therapist was or

[00:22:38] they didn't talk to us about tongue tie releases or

[00:22:41] the importance of early treatment and how it can

[00:22:45] affect breathing and all of that.

[00:22:48] So it's stuff that I've had to really seek out.

[00:22:50] There are some really amazing, you know, orthodontists

[00:22:54] that are outspoken in the space, but there's still

[00:22:56] a ton of people that really don't like this.

[00:22:59] And they'll say, oh, we don't have enough evidence

[00:23:02] to support it.

[00:23:04] When the reality is there's tons of evidence around

[00:23:08] expansion and how expanding, you know, broadens

[00:23:11] the floor of the nose, which ultimately is going

[00:23:14] to help you breathe better.

[00:23:15] And you have a more profound effect if you're

[00:23:18] treating younger kids.

[00:23:19] Everything is more pliable.

[00:23:22] So why do we want to wait and watch until they're

[00:23:24] 12 when things are more fused together?

[00:23:27] For you, did you start to see other orthodontists

[00:23:30] doing this and you were doing your own research?

[00:23:32] Were you starting to see things in your practice

[00:23:34] and saying, okay, something's not right here?

[00:23:38] I'm sure it was a combination.

[00:23:40] Yeah, it was definitely a combination and it was

[00:23:42] more along the lines.

[00:23:44] Like I used to do a lot of expansion to help

[00:23:46] prevent the canines from getting stuck.

[00:23:49] And I was doing that younger and younger and

[00:23:52] noticing that when I did that, I didn't have to deal

[00:23:54] with canine impactions which are very cost...

[00:23:58] They're costly for a practice because you have

[00:24:00] to see that patient a ton.

[00:24:01] So there are never procedures that you make

[00:24:04] very much money on.

[00:24:06] So if I was seeing ways that would prevent that,

[00:24:08] I'm like, one, it's way better for the patient.

[00:24:11] But then two, it's just so much more efficient.

[00:24:14] And I was realizing that I was hardly having

[00:24:16] to expose and I was rarely ever extracting

[00:24:19] when I would really expand and expand early.

[00:24:23] And so that kind of...

[00:24:25] Once I started reviewing all of my cases,

[00:24:27] which could happen more once I was in my own

[00:24:29] private practice because when you work for a DSO

[00:24:32] you kind of move around.

[00:24:34] Like I would never stay in the same office

[00:24:36] for a long time.

[00:24:37] And I'm assuming you're kind of tied to their

[00:24:40] limitations in terms of how you can treat

[00:24:42] to some degree.

[00:24:43] To some degree.

[00:24:45] They definitely give you pretty full autonomy.

[00:24:48] And I don't think...

[00:24:50] Like they never dictated, said,

[00:24:52] you can't do phase one or do a lot of phase one.

[00:24:54] They let me treat however I wanted to treat.

[00:24:57] But it was more just that,

[00:24:58] one, I was still just learning how to

[00:25:01] do private practice.

[00:25:03] That's not really something that they prepare

[00:25:05] you for in school.

[00:25:06] All of a sudden they just turn you loose

[00:25:07] and like you're the one that has to make

[00:25:09] all the decisions.

[00:25:10] So I was kind of just sticking to

[00:25:12] exactly the way that I was taught and what

[00:25:14] I knew.

[00:25:15] And to me it took time before I could

[00:25:17] start to form my own opinions

[00:25:19] and look at things kind of more objectively

[00:25:21] and say, wait a minute,

[00:25:23] why am I saying just

[00:25:24] wait and watch?

[00:25:25] Like what if I could have an impact

[00:25:27] earlier on that would have a better effect

[00:25:29] on the total outcome.

[00:25:31] And that's when I kind of started diving into

[00:25:33] it with my own research.

[00:25:34] Going to see e-courses, taking online courses.

[00:25:38] I kind of want to send my kids to you.

[00:25:40] They fly to Houston.

[00:25:41] All right, we're going.

[00:25:43] I actually just had my tongue tie

[00:25:44] lasered with Dr. Carter in Mobile.

[00:25:47] That was interesting.

[00:25:48] Of course my wife is like into all this.

[00:25:50] She does all the research.

[00:25:52] And so my kids had their tongue

[00:25:54] tie lasered when they were a couple

[00:25:57] weeks old.

[00:25:57] My daughter had a tongue tie and

[00:25:59] lip tie and then my son just had a

[00:26:01] tongue tie but it's also I never had

[00:26:03] like tongue mobility.

[00:26:05] And to see my son, you know,

[00:26:07] before he was a year old, like flip

[00:26:09] his tongue and do all these things with.

[00:26:11] I'm like, how do you do it?

[00:26:12] Like that's crazy.

[00:26:13] But it shows you how

[00:26:15] things should function.

[00:26:17] You know, and obviously I'm not going

[00:26:19] to improve like a child would who

[00:26:21] had their tongue tied lasered.

[00:26:23] But I don't know.

[00:26:24] We'll see there.

[00:26:24] There are some interesting articles

[00:26:27] and there's some interesting studies

[00:26:28] about adults who have

[00:26:31] more relief in terms of neck pain,

[00:26:34] tightness, releases of fascia.

[00:26:36] So we'll see.

[00:26:37] Crossing my fingers.

[00:26:38] There's a ton of research on that.

[00:26:40] So the ENT that I work with does

[00:26:42] a lot of like buckle tie releases

[00:26:44] and he's developed this very

[00:26:46] interesting method where you can

[00:26:48] literally like press on the frenum

[00:26:49] and it's pretty wild if it needs to be

[00:26:51] released, if you like press it against

[00:26:53] the bone, turn your head certain

[00:26:55] directions, you'll notice that the

[00:26:57] tension's relieved.

[00:26:59] And so that's kind of like a

[00:27:00] diagnostic criteria that he's figured

[00:27:02] out on if he needs to release it

[00:27:03] or not because of all the fascial

[00:27:05] connections.

[00:27:06] It's really interesting.

[00:27:07] It is.

[00:27:08] And the more you start to look into it,

[00:27:10] it's really hard to just kind of turn

[00:27:12] the other way because it makes sense.

[00:27:15] So ultimately from like a

[00:27:16] growth and development standpoint,

[00:27:18] that's why releasing everything so young

[00:27:20] helps because the tongue helps

[00:27:22] to shape and form the palate.

[00:27:24] So if it's restricted, you always

[00:27:26] see this like narrow vaulted palate

[00:27:29] and that's how like I

[00:27:31] can look at the palate and almost see

[00:27:33] that the tongue's tied.

[00:27:35] Which is it's interesting like it all

[00:27:37] tells a story and it's, I always

[00:27:39] have said that ortho's like a puzzle

[00:27:40] like the teeth have to fit together a

[00:27:42] certain way.

[00:27:43] And there's this like ideal way that

[00:27:45] every case should finish.

[00:27:46] And I feel the same way about airway.

[00:27:49] Like once you start looking at all

[00:27:50] the pieces like they all fit

[00:27:52] and it makes a lot of sense.

[00:27:53] I kind of want to send you all my

[00:27:54] images and just see

[00:27:57] what you think.

[00:27:58] Get my thoughts.

[00:27:59] Yeah.

[00:27:59] It is fascinating in

[00:28:02] what's really cool about

[00:28:05] what this could do for orthodontics

[00:28:07] and specific orthodontists like yourself

[00:28:09] is you're looking at things

[00:28:12] holistically, like how they should be.

[00:28:14] And it's almost like functional health

[00:28:17] within orthodontics.

[00:28:19] So maybe they'll be

[00:28:20] and I don't want to get into

[00:28:22] like the bio dentist, you know,

[00:28:25] because there are some cool things

[00:28:27] that they're doing too.

[00:28:28] And a lot of what they're saying does

[00:28:29] make sense, but it can also kind of

[00:28:31] get into conspiracy theory land

[00:28:33] with certain things that they do.

[00:28:36] But I do commend them

[00:28:38] for trying to look at things in a more

[00:28:40] natural way than, oh,

[00:28:43] we have like a quick fix, you know?

[00:28:45] And I think all of healthcare

[00:28:46] should start to look at things that

[00:28:48] way because we've seen what happens

[00:28:51] when you just throw the bandaid at

[00:28:52] it, you know, and in medicine

[00:28:54] that's usually education and,

[00:28:56] you know, we'll just cut on you

[00:28:58] and, you know.

[00:28:59] That was part of my journey too

[00:29:01] is that's how I view medicine

[00:29:03] and I feel like we should be looking

[00:29:05] at like everything from a preventative

[00:29:07] standpoint.

[00:29:08] And that was the other like

[00:29:10] aha moment with some of the airway

[00:29:12] stuff for me is when I was reading

[00:29:13] the book Out Live and I was like,

[00:29:16] wait a minute, why?

[00:29:17] Like if I think about an extraction

[00:29:18] case, like it's not really addressing

[00:29:21] why we have crowding or what

[00:29:23] the root problem of the whole issue is.

[00:29:25] It's like let's just put a bandaid

[00:29:27] and fix it and make the teeth look pretty

[00:29:28] and you're not thinking about

[00:29:30] are there any repercussions for doing that

[00:29:32] and I'm not trying to like get into

[00:29:34] the extraction, non-extraction

[00:29:36] dilemma because I still believe that

[00:29:38] extractions are needed in cases.

[00:29:40] Like I'm not like that far off

[00:29:41] the rails with it but it's still

[00:29:43] there's things that we should be looking

[00:29:45] at more holistically or earlier on

[00:29:48] that, you know, have

[00:29:50] a more profound effect on

[00:29:51] the well-being of the patient.

[00:29:53] Yeah and you mentioned data

[00:29:55] and there's a lot of data if you go

[00:29:57] look for it. I think that's kind of like anything.

[00:29:59] Whatever you want to find, you can find

[00:30:01] depending on what side you're on

[00:30:04] but what are you

[00:30:05] seeing in your practice

[00:30:07] with patient outcomes since you've started

[00:30:09] this approach?

[00:30:10] It's honestly been a huge practice builder

[00:30:13] because I've had

[00:30:14] parents that are honestly reporting on

[00:30:16] behavioral changes and that

[00:30:18] they're, you know, kids are sleeping

[00:30:20] better so they're not acting out

[00:30:22] as much, they're not as wild

[00:30:24] and crazy anymore.

[00:30:26] And so those are the parents that are

[00:30:27] like talking and people are coming

[00:30:29] to me saying now, like, oh I

[00:30:31] heard that you pay attention to this.

[00:30:33] Like can you check my kid for, you know,

[00:30:35] potential airway issues?

[00:30:37] And I've had people driving

[00:30:39] an hour away because, you know,

[00:30:42] a dentist in a neighboring town was

[00:30:43] like she's the only one I know that's

[00:30:45] looking at this, like you need to go to her.

[00:30:47] I feel like two moms know

[00:30:49] when something is wrong with their kids.

[00:30:51] They're so in touch like

[00:30:52] my wife will be like did you notice that

[00:30:54] I'm like what are you talking about?

[00:30:57] They're just in tune with what's going on

[00:31:00] because they've always been connected

[00:31:01] to the child.

[00:31:03] And so they're looking for stuff

[00:31:05] like this, I feel like within

[00:31:07] the mom's community this stuff

[00:31:10] probably starts to catch like wildfire

[00:31:11] because for the moms noticing this

[00:31:14] like my kid is a mouth breather

[00:31:16] and I'm on the internet

[00:31:18] and I'm reading or I'm in this

[00:31:19] Facebook group and, you know, now

[00:31:21] I hear people talking about

[00:31:23] adenoids and tonsils and it seems

[00:31:25] like that was not

[00:31:27] the case definitely when I was a child.

[00:31:29] It wasn't and same thing

[00:31:31] for me, like my sister and I

[00:31:33] kind of grew and developed very differently

[00:31:36] and a hundred percent

[00:31:37] like she's been a mouth breather her whole

[00:31:39] life. She had large tonsils and

[00:31:41] adenoids. She had all of these symptoms

[00:31:43] and then into her adult life

[00:31:45] she's had constant like neck

[00:31:47] and shoulder tension which they say

[00:31:49] is like due to posturing because you're

[00:31:51] trying to open up your airway.

[00:31:53] Like all of these symptoms that I never had

[00:31:55] or never experienced and it's just wild

[00:31:57] to see that like my mom was always

[00:31:59] like we did the exact same thing with you.

[00:32:01] I don't know what happened.

[00:32:03] And I've seen it on

[00:32:05] patients and that's what's really eye

[00:32:07] opening. Like I can show you this one

[00:32:09] particular family that

[00:32:11] one girl had tonsils and adenoids

[00:32:13] taken out really young has like a

[00:32:15] beautiful profile developed very normally

[00:32:17] the other girl did not have

[00:32:19] the tonsils and adenoids taken out and had airway

[00:32:21] problems but they had moved

[00:32:23] and weren't able to bring her to the same

[00:32:25] ENT and her profile

[00:32:27] is profoundly different and she's

[00:32:29] constantly sick like there's

[00:32:31] definitely so much more going on

[00:32:33] and I'm not saying it's

[00:32:35] the only thing that caused it but it's

[00:32:37] definitely you know there's known

[00:32:39] links between and that's been

[00:32:41] well you know studied

[00:32:43] in the ortho literature that

[00:32:44] it's called adenoid

[00:32:46] facies and it's been well

[00:32:48] documented that the mandible kind of

[00:32:50] rotates down and back

[00:32:51] if you have large adenoids in your mouth

[00:32:53] breather and we've known this for

[00:32:57] years and years

[00:32:58] but yet we'll still just look at

[00:33:00] that patient and say like oh let's

[00:33:02] put you on a recall you don't have all your

[00:33:04] permanent teeth yet we'll see you back

[00:33:05] you know in 12 months. Well it makes

[00:33:08] so much sense and you know I'm in the biohacking

[00:33:10] but one of the biggest things they talk about

[00:33:12] is breath work and actually

[00:33:14] I was at a retreat in Miami

[00:33:16] this was 2019

[00:33:18] and it was with like 20 guys

[00:33:20] and they flew a guy in

[00:33:22] just to do breath work and it was for

[00:33:24] hour long you all laid down in the

[00:33:26] grass flat on the back

[00:33:28] close your eyes he played some songs

[00:33:30] it's sounding super woo-woo

[00:33:32] but he leads you through

[00:33:34] group breath work and just the

[00:33:36] breathing you know you're really trying

[00:33:38] to get that belly breathing like a child

[00:33:40] and it is fascinating that

[00:33:42] you can see a child breathe that way

[00:33:44] like just watching them sleep you know

[00:33:46] you can see that belly breathing

[00:33:47] and then also with a lot of musicians

[00:33:50] you're breathing from your diaphragm

[00:33:52] you know like look down here

[00:33:54] versus most of us breathe up here

[00:33:56] in our chest so anyways

[00:33:58] you know walking you through that

[00:34:00] and he may work with a certain person for

[00:34:02] a couple minutes or seconds

[00:34:04] and just

[00:34:05] due to the sensation of like

[00:34:07] oxygenating your body for a solid

[00:34:09] hour like that

[00:34:10] people started to like cry

[00:34:13] not that they wanted to cry it was just some

[00:34:15] type of

[00:34:17] result of almost like

[00:34:20] euphoria or

[00:34:21] feeling good because they were actually

[00:34:23] breathing properly

[00:34:25] you know so it makes a lot of sense

[00:34:27] with what you're saying but also in

[00:34:29] tandem with just how as a society

[00:34:32] and humans

[00:34:34] most of us

[00:34:35] aren't breathing like we used to because

[00:34:37] just like our jaw and structures

[00:34:39] changing because we're not ripping food apart

[00:34:41] we're not running or walking

[00:34:43] long distance you know we're not doing any

[00:34:45] of those things that would require

[00:34:47] that type of breathing so

[00:34:49] it is kind of fascinating just to look at

[00:34:51] breathing and breath work

[00:34:53] and what that does as a whole

[00:34:55] you know for health you really have to

[00:34:57] read this book breath I want to read

[00:34:59] he talks about he goes on like all sorts

[00:35:01] of breathing retreats like you're

[00:35:03] talking about and he kind of walks

[00:35:06] through this like journey and kind of

[00:35:07] when it started for him and he went to

[00:35:09] this like breath work class

[00:35:11] and he said that they tell him to close

[00:35:13] his eyes and once he opens at the end

[00:35:15] of the class he's literally like

[00:35:17] drenched and like dripping and sweat

[00:35:18] and he's like I just sat here and you know

[00:35:21] breathed for an hour like what the heck

[00:35:23] happened and so he goes on this whole journey

[00:35:25] of you know different

[00:35:27] techniques and how the

[00:35:29] mouth breathing affects you and all of that

[00:35:31] so it's very interesting

[00:35:32] okay switching gears for now

[00:35:34] we may come back to this

[00:35:36] what do you see

[00:35:39] within the industry

[00:35:40] where most private practice

[00:35:43] orthodontists maybe

[00:35:44] kind of go the wrong way

[00:35:47] or think about things

[00:35:49] the wrong way and

[00:35:51] the result of that would be

[00:35:52] their practice isn't growing do you see

[00:35:55] any kind of common links with that

[00:35:56] and where I'm going with this just to preface it

[00:35:58] is we see a lot of

[00:36:01] orthodontist and private practice

[00:36:03] who are stuck

[00:36:04] and of course it's frustrating

[00:36:06] it's painful

[00:36:09] and they can't seem to figure out

[00:36:11] how to get to the next level

[00:36:12] even sometimes with help

[00:36:14] so I'm just curious your perspective on that

[00:36:16] I think there's a couple things one

[00:36:18] is people pick

[00:36:20] locations that are overly saturated

[00:36:24] they go into it and they're like

[00:36:25] but I want to practice right next

[00:36:27] to where I live

[00:36:28] and that's great

[00:36:32] and that's great

[00:36:33] but at the same time

[00:36:35] I can promise you that if I'd opened

[00:36:37] the practice that I have

[00:36:38] in Montrose where I live

[00:36:41] in the center of Houston with no

[00:36:43] growing communities

[00:36:44] that you're landlocked like the only houses

[00:36:47] that are built or new houses that are built

[00:36:49] or tear downs of an old one

[00:36:51] my practice would be a fraction

[00:36:53] of what it is today

[00:36:54] you have to go to an area that has

[00:36:57] continuous growth

[00:36:58] and influx of families

[00:37:01] because I also live

[00:37:02] in an expensive area of Houston

[00:37:04] so people move out of that

[00:37:06] area when they have kids

[00:37:08] that's where they'll live maybe in their 30s

[00:37:10] and then they're like oh I want to have a couple of kids

[00:37:12] the schools are more expensive

[00:37:14] so let's move to the suburbs

[00:37:15] where we can send them to public school

[00:37:18] and have a house that's just

[00:37:20] as big and costs

[00:37:22] as half

[00:37:22] and so that was huge for me

[00:37:25] in choosing a location

[00:37:26] I went into it thinking

[00:37:28] yes I'll commute

[00:37:29] but I know where I want to get

[00:37:32] in terms of practice level

[00:37:33] so I was very strategic about the location

[00:37:36] and I think that's a mistake

[00:37:39] a lot of people make

[00:37:40] and they're like well I'm stuck

[00:37:41] I can't get past the million dollar mark

[00:37:44] well there's just only so many

[00:37:48] people

[00:37:48] and you're in a saturated area with

[00:37:50] practice on every other corner

[00:37:52] so think about it like this

[00:37:53] let's just say you want to go to New York City

[00:37:56] Fifth Avenue and open a orthodontic practice

[00:37:59] okay cool

[00:37:59] I lived in New York, cool city

[00:38:02] probably would never live there again

[00:38:04] but it's cool, you know, cool place

[00:38:08] how much

[00:38:09] advertising and marketing

[00:38:10] dollars are spent in New York

[00:38:12] compared to the outskirts

[00:38:14] of Houston, like a little community

[00:38:17] you know I just want people to think about this

[00:38:19] it's like

[00:38:20] a thousand times

[00:38:23] more, you know, you're competing

[00:38:24] with all the big brands

[00:38:27] everyone is trying to advertise

[00:38:28] within New York City

[00:38:30] and so

[00:38:31] there is a lot more noise

[00:38:33] and a lot more competition

[00:38:35] same thing with like LA

[00:38:37] or Austin, Texas has become the new LA

[00:38:39] and you really have to think

[00:38:42] over your desire

[00:38:44] to live in a specific place

[00:38:46] first and foremost

[00:38:48] I am now a business owner

[00:38:50] that's the first, if you decide to start a business

[00:38:52] I hate to break it to you

[00:38:55] you are a business owner

[00:38:56] and so a business owner should want

[00:38:58] their business to be profitable

[00:39:00] because if it's not

[00:39:01] then guess what, you're not in business

[00:39:04] all of this sounds so simple

[00:39:07] but I think a lot of

[00:39:10] orthodontists

[00:39:10] don't really think about it

[00:39:12] they think, you know

[00:39:14] obviously I'm super specialized

[00:39:16] I want to go into private practice

[00:39:19] I should be able

[00:39:20] to kind of open wherever and make it work

[00:39:24] and it sounds great

[00:39:26] it just

[00:39:28] doesn't actually work that way

[00:39:30] and so if you're thinking about the competition

[00:39:34] of where can I spend advertising dollars

[00:39:36] as a small business

[00:39:37] most of our partners are spending

[00:39:40] somewhere between 2-3k a month

[00:39:42] in ad spend

[00:39:44] think about that in LA

[00:39:46] like companies are spending

[00:39:49] 100k a month

[00:39:50] you know, a million dollars

[00:39:52] a month

[00:39:54] and how are you going to compete

[00:39:55] now there's exceptions

[00:39:58] to everything

[00:40:00] you know, we have

[00:40:02] people around LA that are successful

[00:40:04] but it was a different path

[00:40:06] and if you have options

[00:40:08] you should really think about this

[00:40:11] you know, so I do think that

[00:40:13] that, yeah

[00:40:14] it's not thought about enough in a strategic way

[00:40:17] right, I think people just

[00:40:19] they think like, okay if I build it

[00:40:21] they're going to come

[00:40:23] and I want to live here

[00:40:25] so I'm going to open my practice right next door

[00:40:27] and I think that

[00:40:29] everyone also has different

[00:40:31] goals and aspirations

[00:40:32] so like if your goal is to have

[00:40:34] a practice that you work at a few days a week

[00:40:36] and you want a family

[00:40:37] and you want to get to

[00:40:41] 1.5

[00:40:42] I think that's very doable

[00:40:44] and you can just like ride that wave

[00:40:46] and like you're perfectly happy doing that

[00:40:48] but if you want to have more growth than that

[00:40:50] you have to go to an area that's growing

[00:40:53] but you know, everyone doesn't want the same thing

[00:40:55] so some people want to just be

[00:40:56] an associate and that's fine too

[00:40:58] and there's also providers

[00:41:00] that don't want the same amount of growth

[00:41:03] that I want

[00:41:03] right, totally

[00:41:05] and it's all fair, it's also about

[00:41:07] being true to yourself and figuring out

[00:41:09] at the end of the day what's going to make you happy

[00:41:12] and

[00:41:12] if I was like struggling to continue

[00:41:15] to beat my previous months I wouldn't be happy

[00:41:17] I'm very competitive with myself

[00:41:19] essentially

[00:41:20] and I don't like to feel like I'm stagnant

[00:41:23] so that was

[00:41:25] I knew that going in so

[00:41:27] to me it was like okay I need to pick a suburb

[00:41:29] I'm gonna have to drive

[00:41:31] and I also like

[00:41:32] the idea of being a big fish in a little pond

[00:41:35] you know

[00:41:36] where I can go in and make a much bigger

[00:41:39] impact, you can get involved with the schools

[00:41:41] and you're like the one sponsoring

[00:41:43] everything and everyone knows

[00:41:45] you and you're a household name and everyone goes to you

[00:41:47] and I would much prefer

[00:41:48] to be that person and like the expert

[00:41:50] in that community that everyone goes to

[00:41:52] entrust then in the middle of Houston

[00:41:55] where you know

[00:41:56] nobody really knows who you are

[00:41:57] mm-hmm yeah it's just too

[00:41:59] noisy and really hard to stand out

[00:42:02] as a small brand

[00:42:04] um and for those listening

[00:42:05] who are like okay well where's the best place to go

[00:42:07] I mean

[00:42:08] what we're seeing is really everywhere

[00:42:11] from Texas with the exclusion

[00:42:13] of you know Austin

[00:42:15] I would probably not open a practice

[00:42:17] there if it were me

[00:42:18] I mean it's just become

[00:42:21] so saturated and so competitive

[00:42:24] which I'm sure

[00:42:25] is good for the city in a lot of ways

[00:42:27] but as a small business

[00:42:29] I just wouldn't do it but

[00:42:31] the Texas all the way over

[00:42:33] southeast and then once you

[00:42:35] get into the northeast it kind of changes

[00:42:37] again you know and then

[00:42:40] Midwest

[00:42:41] Utah Oklahoma

[00:42:43] those are some really great areas too

[00:42:45] what we're seeing is it definitely

[00:42:47] is like these communities

[00:42:49] over cities

[00:42:50] you know you can go in and it's just

[00:42:53] easier it's kind of like a hack

[00:42:55] you know so

[00:42:57] I always tell people hey

[00:42:59] if you want to live in a city and you live in a city

[00:43:01] yeah but like you said you didn't

[00:43:03] open a practice there

[00:43:05] so I think it can be pretty simple

[00:43:07] just working like that versus like oh yeah

[00:43:09] you need to avoid Houston

[00:43:11] all together like no you live there

[00:43:13] but you're strategic about where

[00:43:15] you open and I honestly I like

[00:43:17] having my personal and professional

[00:43:19] life separate yeah like I like

[00:43:21] going out and going to dinner

[00:43:23] with my husband and we're not running into

[00:43:25] like patients and parents

[00:43:27] and it's nice to just have

[00:43:29] like a separate life like here's

[00:43:31] my work life here's my personal life

[00:43:33] and they don't overlap I'm perfectly

[00:43:35] happy with that yeah that's good

[00:43:38] okay so location

[00:43:39] that's a good one what else what else

[00:43:41] do you see maybe like a false belief

[00:43:43] or something holding holding them back

[00:43:45] I think people will also

[00:43:47] they think that the way that they're doing it

[00:43:49] is the right way so

[00:43:51] they're gonna hire the marketing company

[00:43:53] because a lot of people say like I hired

[00:43:55] we were talking about this a little bit

[00:43:57] and before you know it they've gone through like

[00:43:58] three or four marketing companies

[00:44:00] but the one common denominator

[00:44:03] is them and they don't look

[00:44:05] in the mirror and self reflect

[00:44:07] and I mean I have to admit

[00:44:09] even when we were going through all of the training

[00:44:11] I was like you want me to have my team

[00:44:12] follow up with leads how many times

[00:44:15] this is insane I'm gonna drive them

[00:44:17] crazy right and

[00:44:19] it wasn't until

[00:44:21] you know but well I

[00:44:23] I'll backtrack I decided I'm like okay

[00:44:25] they're the experts I know how to straighten

[00:44:27] teeth if I knew how to do marketing

[00:44:29] I wouldn't be hiring you

[00:44:31] and I'm gonna follow

[00:44:32] the guidelines and the steps that you're telling me

[00:44:35] to follow and I think that so

[00:44:37] many people will hire you or they

[00:44:39] hire a different company but they're like but I

[00:44:41] still know how to do it the right way

[00:44:42] or we're gonna do it my way

[00:44:44] when in reality

[00:44:46] they should be following all of those steps

[00:44:48] and if you implement the systems

[00:44:50] and the processes that you have

[00:44:52] you will be successful

[00:44:53] it's when you try to veer from that

[00:44:56] and think that you have a better way of doing it

[00:44:58] I think maybe that's like

[00:44:59] you know the egotistical side of the orthodontist

[00:45:02] community

[00:45:04] but I think that that's

[00:45:06] a really big

[00:45:08] kind of pain point for people

[00:45:11] and I hear it all the time

[00:45:12] when I talk to people and they're calling me for

[00:45:14] you know oh hey I want to hear about your

[00:45:16] experience with hip and they all

[00:45:18] get so hung up on the offer

[00:45:20] and how many times they have to call

[00:45:22] they're like I don't want to be a sales person

[00:45:25] and you know

[00:45:27] I was telling them that

[00:45:28] there's it wasn't until I kind of

[00:45:30] it's not that I didn't buy into it at first

[00:45:32] I did once I really started to see the results

[00:45:34] but it wasn't like Harrison

[00:45:36] and I always laugh about this story and this is

[00:45:38] when I would I now tell this to my staff

[00:45:40] when I hire new staff and I'm like

[00:45:42] encouraging them to do this

[00:45:44] I was like I wanted an alarm system

[00:45:46] and I signed up and filled out this thing

[00:45:48] do you know how many times they had to call me before

[00:45:50] I find they got me on the phone and I purchased the

[00:45:52] alarm like five times

[00:45:54] because they would call me and I was busy

[00:45:56] but they it never bothered me

[00:45:58] I didn't listen to the voicemail because I knew

[00:46:00] the same voicemail they were leaving

[00:46:03] and so they happened to just

[00:46:04] call when I was free

[00:46:05] and then I was like oh yeah actually I need that alarm

[00:46:08] system and I have time and then

[00:46:10] you know I buy the $5,000

[00:46:12] alarm system

[00:46:14] but that's when and now I tell that to my

[00:46:16] staff and so I tell

[00:46:18] them like they clicked on that lead because

[00:46:20] they wanted orthodontic treatment

[00:46:22] the reason they haven't picked up is it's just

[00:46:24] not an opportune time it doesn't mean that

[00:46:26] they're not interested so you have

[00:46:28] to keep following up with them

[00:46:30] yep so this is

[00:46:32] this is so interesting because I talked to

[00:46:34] so many practices and

[00:46:36] they have the same false belief we're going to annoy

[00:46:38] the hell out of them we're not sales

[00:46:40] people we don't want to be pushy

[00:46:43] they're bad leads

[00:46:44] they didn't pick up they didn't return

[00:46:46] my call so and I always

[00:46:48] go yeah that's interesting

[00:46:50] that's how I behave too

[00:46:52] yeah and you know they

[00:46:54] kind of look at me and then I

[00:46:56] walk them through it have you ever clicked

[00:46:58] on anything

[00:47:00] where you really wanted it you had good intentions

[00:47:02] or you were curious maybe even

[00:47:04] you didn't know you wanted to buy the alarm system

[00:47:06] but you genuinely wanted to

[00:47:08] learn more

[00:47:10] and then life happens and then your phone's ringing

[00:47:12] and you don't know the number

[00:47:13] well I'm not picking up a number that's

[00:47:16] not saved in my phone in fact my phone doesn't

[00:47:18] even ring if the numbers not saved

[00:47:20] and I don't know how to change that setting

[00:47:22] it kind of drives me crazy because the other

[00:47:24] day I was sending a wire and the bank had to call

[00:47:26] me and like it locked my bank account

[00:47:28] because I didn't have the banks number saved

[00:47:30] anyway

[00:47:32] I don't check my voicemail

[00:47:33] my phone just told me yesterday it was

[00:47:35] 100% full I'm like

[00:47:37] you know delete 10 so

[00:47:39] somebody else can leave me a voicemail

[00:47:41] and then

[00:47:42] you know how many times does that cycle

[00:47:45] have to play out

[00:47:46] and then I've gotten texts from people

[00:47:49] and I'm like oh that's them

[00:47:51] okay

[00:47:52] but I'm busy I'm like driving

[00:47:54] or I'm about to get on a zoom call

[00:47:56] or and this sometimes

[00:47:58] has happened for a year

[00:48:00] where I don't buy the thing that I wanted

[00:48:03] because I'm not dying

[00:48:05] like I don't have to have it

[00:48:07] you know what I mean

[00:48:08] and so yeah there are some people who

[00:48:11] have to have care

[00:48:12] but there's a couple ways this plays out

[00:48:15] one you're in competition

[00:48:17] so what if they called

[00:48:19] or opted into the first three

[00:48:21] rankings

[00:48:22] and who's gonna win that patient is it

[00:48:24] number one in the ranking

[00:48:26] no it's whoever has the bus

[00:48:28] follow up and service

[00:48:29] because they could call somebody back

[00:48:32] and kind of not sound good on the phone

[00:48:34] and kind of tick the person off

[00:48:36] and then the one in the

[00:48:38] 10th ranking or 5th ranking could

[00:48:40] call and they have great service

[00:48:43] it's like oh well I want to go there

[00:48:44] you know so it's not just

[00:48:46] about even the follow up

[00:48:48] and what we have to do there

[00:48:49] is how do we have to sound on the phone

[00:48:52] and what's the service need to look like

[00:48:54] you know then how do we actually get them

[00:48:56] to show up because now they may forget

[00:48:58] about their appointment I've done that

[00:48:59] you know my chiropractor texts me

[00:49:02] you have an appointment in two hours

[00:49:04] and it's like this long text message

[00:49:06] I just like glaze over it

[00:49:07] and don't even see who sent it or what it is

[00:49:10] and then I get a text you missed your

[00:49:12] appointment click here to reschedule

[00:49:13] oh that was the text so there's

[00:49:15] all these things

[00:49:18] and people's attention spans

[00:49:20] I literally saw there's a study

[00:49:22] on the internet you can google this

[00:49:24] our attention spans in some

[00:49:26] cases are shorter than a goldfish

[00:49:29] you know

[00:49:30] and it's like the tick tock curse

[00:49:32] you know

[00:49:34] yeah on to the next yeah

[00:49:36] and it's tick tock instagram snapchat

[00:49:38] text messages emails

[00:49:40] and there's just so much noise

[00:49:42] so we have to think about that

[00:49:44] and we have to put

[00:49:46] ourselves in there that means

[00:49:48] empathy I have to empathize with you

[00:49:50] and go well

[00:49:52] I mean they did click on the ad

[00:49:54] they probably want straight

[00:49:56] teeth if they have teeth

[00:49:57] that's a whole different story you know

[00:50:00] and I'm just going to stay

[00:50:02] positive and keep following up with them to see

[00:50:04] because they probably

[00:50:06] want help and we can help them

[00:50:07] that's a whole different

[00:50:10] mindset than

[00:50:11] I called left of voicemail bad lead

[00:50:13] another internet lead

[00:50:15] you know these crappy leads and it's like

[00:50:18] yeah it's never going to be

[00:50:20] like your direct referrals

[00:50:23] um

[00:50:24] it just won't be you know

[00:50:25] but there are patterns

[00:50:27] and behaviors that most people have

[00:50:30] if we take the time to think about it

[00:50:32] we do it too we do the same thing

[00:50:35] so

[00:50:36] how do we have processes and systems

[00:50:38] um that are geared

[00:50:40] towards consumer behavior

[00:50:42] you know and I would challenge people

[00:50:44] to think about it that way

[00:50:45] and I don't know if you notice this

[00:50:47] but I definitely notice it in my

[00:50:49] practice and I do it too

[00:50:51] like if I clicked on something and I changed my mind

[00:50:53] and they send me like a second text

[00:50:55] I reply stop

[00:50:56] and that's what the patients like I feel like the ones

[00:50:59] that actually clicked on it and they're like

[00:51:00] okay really I'm not interested in

[00:51:02] they reply stop

[00:51:04] and then you stop reaching out

[00:51:07] because no one wants to be spammed

[00:51:09] with a bunch of you know calls or texts

[00:51:11] unless they actually there's like some

[00:51:13] inkling of interest

[00:51:14] but the ones that are like okay I

[00:51:16] that was an accident or I'm really not that interested

[00:51:19] now or maybe they want some who knows

[00:51:21] but they tell you no and then

[00:51:23] you just move on that doesn't mean

[00:51:26] to

[00:51:27] turn off all your automations

[00:51:28] turn off your or tell Sally

[00:51:31] not to text people that frequently

[00:51:33] because that person said stop

[00:51:35] simply means they were interested

[00:51:37] right just that one person

[00:51:39] and though I don't see

[00:51:41] those pop up that often

[00:51:43] but it does happen and I feel like

[00:51:45] those are the ones that

[00:51:46] you know decided they weren't interested anymore

[00:51:49] and that's fine then you move on from that lead

[00:51:51] but there's still hundreds of others

[00:51:53] that still are interested

[00:51:55] exactly

[00:51:57] and it's just a numbers game we deal with the same thing

[00:52:00] at hip

[00:52:01] obviously we're selling to orthodontist and dentist

[00:52:03] we get told

[00:52:05] nope wrong phone number that's not me

[00:52:07] but are you dr. Kristen

[00:52:09] yep click you know what I mean

[00:52:11] you know

[00:52:12] hip who

[00:52:15] they don't pick up

[00:52:17] one time I tracked this guy because

[00:52:18] they didn't want to follow our process

[00:52:21] and they were complaining about it in bad leads

[00:52:23] and I do this a lot of times

[00:52:25] I went back to him and said well

[00:52:27] if you remember

[00:52:29] and here's a video

[00:52:31] I'll show my video and scroll through it

[00:52:33] we had to call you and text you

[00:52:35] 52 times

[00:52:36] over four years to get you on a call

[00:52:40] oh

[00:52:41] yeah do you remember that

[00:52:44] I do remember some of it

[00:52:46] yeah I can't remember you know this person

[00:52:48] and then

[00:52:49] it paints that picture of

[00:52:51] again oh yeah I do that too

[00:52:54] you know so

[00:52:56] the thing to think about

[00:52:57] is you're building a pipeline

[00:53:00] of people like you just said

[00:53:02] there's gonna be people who are not interested

[00:53:04] there's gonna be people who are interested

[00:53:06] some of these people you may help

[00:53:08] years from now and that's why we do

[00:53:10] reactivation campaigns

[00:53:12] but it's really about having a

[00:53:14] positive mindset

[00:53:16] and in so many things we're just negative

[00:53:18] because our brains are trained to look at

[00:53:20] what's wrong versus think about

[00:53:22] what's possible and I think that's where

[00:53:24] people go wrong is like they hire you

[00:53:26] on and they don't get the

[00:53:28] team motivated

[00:53:30] the right way and explain

[00:53:32] like hey this is what we're gonna do

[00:53:34] we're gonna try this new process and we need to

[00:53:36] follow the steps that they tell us

[00:53:38] to do and

[00:53:40] you've got to call them back you've got to follow up

[00:53:42] with them and they just go about it

[00:53:44] in a different way and wonder why it doesn't

[00:53:46] work and then they want to

[00:53:48] get mad at you and go to the next

[00:53:50] the next one yeah it's just

[00:53:52] like a repeated cycle

[00:53:55] and ultimately

[00:53:56] I think that if you invest in good

[00:53:58] marketing and you follow the steps

[00:54:00] like it really is a recipe for success

[00:54:02] like I think my practice shows

[00:54:04] that I brought you on early

[00:54:06] on in the process so it's not like I have

[00:54:08] this crazy baseline to go

[00:54:10] off of but I do feel like

[00:54:12] for a practice that's four and a half years old

[00:54:14] like it's grown

[00:54:16] tremendously and

[00:54:18] I 100% attribute

[00:54:20] a huge part of that to the

[00:54:22] partnership that I have with you yeah

[00:54:24] thank you yeah it's been

[00:54:26] a good partnership it's super exciting to

[00:54:28] continue to see

[00:54:30] you grow and we've grown a lot together

[00:54:32] so it's pretty cool I know it's great

[00:54:34] to see I remember you were just walking around

[00:54:36] with a backpack in 2018 there was no

[00:54:38] booth yeah no booth there was

[00:54:40] couple team members no books

[00:54:42] yeah those were

[00:54:44] those were really exciting

[00:54:46] times you know because again you're

[00:54:48] you're building it and you're like man is this

[00:54:50] going to work out and it's cool to see

[00:54:52] the growth happen for sure so

[00:54:54] exciting and I kind of miss actually

[00:54:56] doing shows that way because

[00:54:58] I feel like you can connect

[00:55:00] with people better in a lot of ways

[00:55:03] versus having a booth you know

[00:55:05] so anyway may go back to

[00:55:06] that yeah see me at a

[00:55:08] A with the backpack just

[00:55:10] leaving the booth yeah or you can

[00:55:12] just venture out on your own and go talk to people

[00:55:14] true thank you so much for taking the time

[00:55:16] to come to Pensacola in

[00:55:18] studio and be on the podcast yeah it was great

[00:55:21] thanks for having me definitely thanks

[00:55:23] for listening if you'd like to learn

[00:55:24] more about hip

[00:55:26] or any of the topics in this episode

[00:55:29] send an email to hello at

[00:55:31] hipcreativeink.com

[00:55:33] that's hello at

[00:55:36] hipcreativeinc.com

[00:55:38] or jump over to our website

[00:55:40] at hip.agency