Episode 79: Part 2: The Future of Dentistry and Billing with Dr. Howard Farran

Tired of bureaucratic inefficiencies and missed technological opportunities? Join us as we analyze the healthcare workforce, dissecting the tough reality of supply and demand in medical residencies, with a special focus on the rising field of pediatric dentistry. We'll reflect on personal encounters with government red tape and ponder how the tech boom of the 90s could have spurred a much-needed modernization of government systems. We'll even speculate on how influential figures like Bill Gates and Elon Musk could have further propelled these advancements.

Thinking about launching your dental career in an underserved area? Discover strategic insights on how to capitalize on dental care shortages by using data to pinpoint opportunities, and learn how buying out retiring dentists can set the stage for a prosperous practice. We also debate whether specialization in high-demand services like endodontics requires extensive schooling or if ambition and a good attitude can suffice. Expect candid discussions on the importance of self-care and reassessing your career path to ensure it brings you joy, much like evaluating the health of your personal relationships.

As technology continues to transform industries, we'll highlight why it's crucial to keep your skills sharp, whatever your field of expertise. From the evolution of dental billing practices and the indispensable role of consultants to the need for continuous education in today's rapidly changing world, our conversation covers it all. Enjoy a light-hearted wrap-up as we share personal family anecdotes that remind us of the importance of gratitude and the fun quirks of familial bonds. Prepare for an engaging episode that combines professional insights with personal charm.

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Chapters

• 0:00 Issues in Healthcare Workforce Supply
• 13:08 Strategies for Dental Practice Acquisition
• 19:11 Evolution of Dental Billing Practices
• 26:35 Adapting to Changing Industries
• 35:19 Family Height Banter and Gratitude

Transcript

Speaker 1: 0:48

or oral surgery or a lot of fancy stuff. They just get in there and for three years they pay them money to be pediatric dentists in training school and they're just. I mean, they've produced, you know, basically 5,000 extra pediatric dentists since I got out of school and it's a thriving profession. But you know lots of details, lots of nuances. Rome wasn't built overnight. How long will it take these countries to figure out that they have a supply and demand issue with their doctors? I mean, when you graduate from med school, you got a place for residency or specialty. I mean, it's the most stressful point of their life and it's real stressful because it's not a free flow. It's not just Erica just can't walk out of four years of college, then four years of medical school, and say, hey, I want to do a residency in oncology. It's like, oh well, thank you, erica, but first of all you got to apply and there might not be an opening in oncology. It's like, well, there's your supply and demand issue. If everyone who graduated med school want to do a residency in oncology, then I'm sure an oncologist would be working for $20 an hour. But we don't have those mechanisms. It's so altered by supply and demand, nationalism, economic barriers, like you have to redo your med school and our deal because we're in bed with the universities, and it's crazy. But here's what I'm excited about these and, uh, it's crazy, but here's what I'm excited about, um ai, and that is, I mean, my gosh. I mean I I talked to a man the other day and he's so mad because, like his child support, he can't pay, he can't mail a check-in and he, uh, they don't take checks, he's got to go down there. I mean it just like, like, like twice in the last five years my staff, they lost some or needed some.

Speaker 1: 2:33

I think one time it was a Social Security card where I had to go downtown, stand in line and then they thought I'm Howard Jean Fran II. They thought I was my dad. I said, do I look like I was born in 1938 and I'm dead. And then it was a different. They had to call Kansas because I was born in Kansas, but they couldn't send it to Kansas. I had to send them a letter. I mean it's like I have to send you a fucking letter, are you? I mean what is wrong with you? You're on the phone, we're all human. Just fucking send it. I mean the government, it's so inefficient. I mean the government, it's so inefficient.

Speaker 1: 3:11

And I blame all that on Clinton because, I'll never forget, from 94 to 96 was the biggest economic boom I'd ever seen. You had the four horseman stocks of Microsoft and Intel they called it Wintel back in the day Then you had Michael Dell whose dad was an orthodontist and Cisco and Free Enterprise. We had a deadline. It was Y2K. No one overthought it, no one thought about the implications of that, which means everybody would be done with their modernization programs on Y2K, because they had to be worked that Y2K.

Speaker 1: 3:44

Well, the stock market, the economic activity, I mean it was balls to the wall from 94 to 2000. And then when 2000 hit, nobody had any sales in January, nobody had any sales in February. And then they realized, oh my God, everybody did all their projects and the market just completely flip and tanked. And that is when Bill Clinton should have said hey, hey, free enterprise, good job, you guys get a job well done. Now let's take all the same companies, let's keep the whole momentum going and let's automate the entire US government, 50 states, let's get all our computers up to speed, which would have been so perfect for the AI revolution. But what did Clinton do? He decided he was going to sue Bill Gates for a monopoly the guy who led this entire revolution and then he was going to get 22 states to pile on, put Bill Gates in this massive depression. He canceled all his projects. He pulled out of everything and ruined everything and it's, like you know, for some little pissing match because of Bill Clinton. I mean just disgusting. And now, now you know, I had my hopes up with Elon Musk. I know he's crazy. That you know. Only the crazy ones change the world either.

Speaker 1: 4:59

The apple guy uh, jobs that was. That was a crazy, broken man too. He used to go to a. He was adopted and he used to go to the restaurant. He figured out where his real dad was and go to the restaurant and sit there and eat and just watch his dad, not even even introduce himself. I mean, he Doge, he was going to go in there and automate this whole government. He thought he could get rid of 2 million employees. I mean, obviously he could do it, but you know it's so crazy. He's so crazy. You know, can he do it? Will he do it?

Speaker 1: 5:26

Who knows what's going to get done, but for now, I think that you know the dentists. I want them to work for themselves. I think it's stupid to get on social media every day and just bitch about your DSO job. I mean, I mean you're. I mean, what are you doing? I mean you just want to get up every day and bitch on Facebook about how bad your DSO is Dude? Go open up your own office and if you can get, two hours away from where a Southwest airline takes off, you know, one thing the government does well is it has critical shortage areas of doctors and there's a bunch of websites that show doctor shortages in America. Well, they've already done the work for you. I mean, they'll show you every county in America that has 6,000 people that doesn't even have a dentist.

Speaker 1: 6:09

Everybody that goes that area usually they're Mormon because you're not going to go. It's pretty hard to go find a mate in a county with no dentist, okay. And but if you're already married and you already got a kid and one in the oven and one walking around and you have your whole self and family taken care of, they'll roll into an area like that. I'll tell them to go down to the city. We know the downtown's got half. The buildings are boarded up. Don't just go down to the city. We know the downtown's got half the buildings are boarded up. Don't just go down there. Talk to the mayor, say hey, you give me a building in downtown on the corner of first street in Maine and you co-sign me a loan for a hundred grand. A lot of times Delta Dental will give them a hundred grand.

Speaker 2: 6:46

Really.

Speaker 1: 6:47

Oh yeah, especially in Iowa, places like that and they'll go to some counties 6,000 people, no dentist. They'll do a million dollars their first year, no insurance. Everything you can tell is no insurance. It's like fillings are $250, crowns $1,000, dentures $1,000, wisdom teeth are $254 for $1,000. I mean all the math you can do in your head. You can add up every treatment plan in your own head and, my gosh, you go down there and you provide a job for $15, $20 an hour and you're the biggest employer in the whole city. I mean, everybody wants to work there. It's just great. But it's demographics.

Speaker 1: 7:27

Now, if you go into the big city, I would go on the corner between the four biggest DSOs because there's just a lot of people that love that DSO because they think, oh my God, I see their ads on TVs, this is where I can get dentistry done cheap. And it's really not cheap. I am, I'm just stunned at how many people go to these big ass DSOs and they'll have, like you know, like 15 broken down teeth and all they want is to pull them and all they want is an immediate denture. And then you look at the treatment plan. It's like it's like ten thousand dollars, like god dang, there's. There's no one in the state of arizona that would charge half that much. So so they, they got the the illusion of walmart going on, that everybody thinks they're walmart or their costco and they're going to save a bunch of money and they believe it and they're doing well. But it's the stat, it's, it's the selling, the invisible relationship turnover. Every DSO Kingpin, you know, you know that I ever talked to. I said you know that that that's your number one deal. I think. I think I think Rick Workman does the best. I think, tying them in to getting their FAGD or residency and implants or they got all these things where if you stay with me for two or three years, you'll get good at Invisalign or implants or get your FAGD or MAGD or something. But even Rick knows that. You know, even if you kept all your doctors on average for three years, well, I mean, walgreens is keeping them for 30 years.

Speaker 1: 8:53

I mean, so I think being publicly traded would be better. I mean, you know, when these guys say, well, yeah, I bought in, I'm a 25% partner, I said okay, so you have no rights and you have no liquidity. Who could you sell your 25% to? It'd have to be another dentist who also has no voting rights. And if someone has 51% of all the stock, they don't even care what your name is. You are nothing to no one, so a minority. But if it was publicly traded and I own 10,000 shares of this company I think it would be a psychological thing.

Speaker 1: 9:25

I think MB2, I'm predicting MB2 will be the first IPO in dentistry. I think they're going to do it, will be the first IPO in dentistry. I think they're going to do it. And you know the first is well, it's not the first in history. I mean, you know, you go back in the day and the first round of these things there was Monarch and there were, you know there were a couple of publicly traded, but they're pretty much all gone now, and so this will be what I call round two.

Speaker 2: 10:59

But, yeah, I think AI is going to be at least 15 years and what you have done and what you're doing with Dentaltown is revolutionizing dentistry yet again with the dental chat bot. We don't have that. We don't have anything remotely close to doing what I do, what my company does dental billing. You can't go to chat GPT and ask it how to build a crown because it'll give you the wrong way. It just rambles right now because it doesn't know dentistry. So this dental chatbot is going to be very revolutionizing. So, with that being said, howard, then as a new dentist, I want to go back to that part where you talked about a website they could go to go to and tell them no dentist, here there's 6 000 people but no dentist. Um, where do they go to find that information?

Speaker 1: 11:42

um, you just do a google search, um I I don't have off top my head, but I mean it's just uh, um, um health care shortages, um in america. I I I could find it for you and get it for you later. I've posted on social media so many times, so it's on one of my social media links. I'm at Howard Fran everywhere.

Speaker 2: 12:05

Yes, you can find them anywhere.

Speaker 2: 12:07

And you know, dentaltown it's been a when I needed answers, before the Facebook groups, before all of this information was out there on social media. I went to Dentaltown and the message boards always helped and I also participated in answering some of those questions pertaining to billing. But I mean I'm excited to see what's going to change in the upcoming years, that you're going to launch this new chat bot on Dentaltown. So that's really exciting. You have given us a lot of food for thought, and that is a very extensive answer to where do you think the future of dentistry is going. But I think, to sum it up, it's like ai right, it's just that's where it's headed. People that are not ready for it are gonna fall behind.

Speaker 1: 13:01

I found that website for you. It's datahrsagov. Uh, hrsa is health resources services administration, so it's just datahrsagov and um. You can just, you know, select counties, primary care, dental health, mental health. You find the county and um. So when this comes out, you know, I always check it out on arizona, like if I'm going to do a four or five, six hour drive across arizona to go to grand canyon or disneyland or whatever I would. You know, several times I've played on this website and I've gone to some of these towns and it's like good God, I mean some of these.

Speaker 1: 13:43

I mean, you know, just remember, when you go, when you go to a small town of 2000 people, usually the draw is the same size of the town. So if the town has 1000 people, 1000 people around it in the rural to that town, go in there. So if you need a dentist for every 2000 people, every town of a thousand without a dentist is your 2000 people. And there are towns with 2000 people without a dentist. And then if you find a town with like 5,000 people with five dentists, then that's actually where you get the biggest money, cause you go down to that town and you don't buy a practice and be the sixth dentist. You go in there and you buy out the oldest dentist and then you have them work for you for a percent, 25% or whatever, and then after three or four or five years he dies and you hire the next. You buy out the next retired dentist. When I meet a dentist and they're in one location doing like three million a year and they're taking home like 600,000, it's always that deal. They went into a small town of 5,000, there were five dentists and now you know, 25 years later he has the only dental office in town and he bought up every single retiring practicing dentist in that town over 25 years, every single retiring practicing dentist in that town over 25 years. And now he's got, you know, an office with you know 20 operatories and and he's got, I mean he's got everything. I mean it's just an amazing deal. So so that's called in wall street, that's called mergers and acquisitions.

Speaker 1: 15:13

You don't want to reinvent the wheel. I mean, if you go into a town and there's five good dental offices and you want to start a dental office, buy out the old guy and then start telling everybody your plan, and then they all start falling in line, and I mean some of the biggest kingpins I know in dentistry did that. And then another thing especially let's say you don't want to go to pediatric dentistry school, you don't want to go to endo school, just go to a small town, if you, if you find five, if you find a town of, uh say, uh, 5,000 people and there's no endodontist, and they got five general dentists there and they all hate endo. And you say, well, I'm not an endodontist, but I want to have a practice limited to endodontics. I will just do the endo. Uh, I will not keep the patient, get a hygienist, do the crown, blah, blah, blah. And I see people skipping pediatric dentistry school and endo school and just going to these small towns. I mean I mean, come on. I mean you know, and that's really a thing to what I've seen, that too, yeah, and you know. And when? You? When it really does impact the dental health of the community.

Speaker 1: 16:20

Because when you tell some guy, well, you know, either I'm going to do it or are you going to have to drive two hours into the big city to have it done, they're like, well, I'm not going to drive into San Antonio or Corpus or Houston If you can't. If you can't do it, we're going to just pull the damn tooth. And then the dentist is like oh my God, you know I got to pull this tooth because he doesn't want to drive to it. Well, they're humans, man, they're complicated. Life is tough. Life is very, very hard. It's very, very challenging. And telling someone to drive two hours to Houston to go drop $1,500 on a root canal, you know what. Sometimes it just doesn't sound fun. Sometimes just you pull it right now, we're done with it, sounds like a better deal. So find these shortages areas.

Speaker 1: 17:03

Remember, attitude is everything. Just have the best attitude and you know you're going to win this thing if you get up at you know, and it's all a function of taking care of yourself. You know, the first thing I do when I wake up is I put on my shoes and I go out the door. And you know, and that's the hardest step, I mean, and sometimes you're not in the mood to run, sometimes it's just a walk, sometimes it's so cold and you're so tired that you're just you're. I'm walking at the same pace I'd be walking with my 85 year old mother and her dog Lenny, and. And then sometimes, you know, sometimes after a mile walk you, you wake up, you feel good and you'll start jogging, sometimes you'll start running, but you know, just take care of yourself. And then, you know, make that your top priority, get your attitude in the right deal.

Speaker 1: 17:51

And then just you know, if you're bitching every day about your job, hey, I got an idea. Get rid of your job. I mean you did it with your girlfriend. I mean when she was driving you completely flipping insane. You didn't just say, well, I'm stuck with her for life. You know that's why it's called dating. And you know it's the same thing when you go do a job, I mean, god, dang it if you get a job. As soon as you find out this is a horrible idea. Cut your losses. Don't sit there and say, well, I don't want to look bad on my resume. I think I should work each place for a year.

Speaker 1: 18:22

It seems like every dentist I meet that's been out of school five years had five jobs and they're not happy. And then when I meet some guy who's been out of school five years and he's down here in Phoenix and he's taking Spear or he's taking some implant course or he's just just crushing it, um, he always opened up their own practice and um, you know and and some people, it really just gets rid of the bitching, because it's really easy to bitch about someone else. But man, now that you're the owner, oh my god. Now now you're bitching about your own shortcomings. So now you know, you used to work for a guy and he said you know, he, his supplies was, was bad and he's always running out of stuff. Well, now you're running out of stuff and you just said you know they can never get you into new patients. Well, now you don't have new patients.

Speaker 1: 19:05

And it's funny how, when it's somebody else's fault, it's real easy to get all negative and pile on. But now you decided you're going to do it and and that's why I started Dentaltown, and that's why I started Dentaltown and you have so many tools and I've referred so many people to you over the years, erica, and you've helped so many of them. Because how can you compete with Erica when she's done one thing for decades? I mean, she helped my office the first time. God, it was like 20 years ago.

Speaker 2: 19:34

I think all my boys still lived with me when you were helping.

Speaker 1: 19:38

And I had an MBA from Arizona State University. They didn't teach me one damn thing that you taught me and the team, and just getting it implemented. And that's another thing I just want to tell homies on the last deal, because I'm talking to Erica and I have no financial connection with her. I don't get any money from her. No, all I want to do is marry her. That's my only incentive in this whole deal, but, but, but, but.

Speaker 1: 20:02

The thing is, you know, whenever I would meet, every time I'd meet some dentists, you know, especially if they're taking home over half a million a year or 600, when I see a perfect practice I just start thinking what? What is the pattern? What do these guys all have in common? And one of the things they all have in common is every flipping year they hired one consultant and they would always tell me you know what you buy these back. In the day it was like 25 grand, today it's like 50 grand. He goes. You know what. You know, last year I did 1.9, but you know I'll pay 50,000 for a consultant and that 50,000 that I give that consultant I always get it back in a year If I'm at 1.9 and I want to do 2.1, I know if I hire a consultant for 50,000, I'll just get it done. I mean, I've hired one every year for 30 years. I was like, oh my God, these guys are so smart Because, like when I hired you the first time 20 years ago, it wasn't to tell me something on the phone or send me a man, it was to come to my office and find out what's going on, hands-on talk to my team and just get her done.

Speaker 1: 21:04

And what these dentists do is they just wear too many hats. They'll spend money on a car or a trip, a lot of these dental schools, these finishing schools. I'll see how much money I like I spent going to the Panky Institute for like five weeks and you'll sit there and say, well, how much have you dropped this spear or coice or Panky? I mean it's big money. Well, why can't you drop that kind of big money on a consultant that comes in here and fixes all this non-sexy stuff?

Speaker 1: 21:33

Yeah, you know, occlusion is fun and sexy and ortho and implants, and nothing gives me a rush than surgery. I mean when I walk into the bathroom after a surgery and I see blood on my bald head, I know it was a good day. I mean that's fun, fun shit. When you're in the shit and there's blood on your head, it's a good day. And then what do you want to do? Then you want to go do your aging reports and accounting. Really, you want to see if your insurance billing is. I mean, it's, it's just, I mean it's just so different deals and these dentists, they just dropped tens of thousands of dollars going to all these big sexy dental courses, spear and Coice and Panky and all this kind of stuff. And it's like my God man, you need to get the consultant center to get your house in order.

Speaker 2: 22:23

Yeah, if it makes you money, it costs you nothing.

Speaker 1: 22:26

Yeah, I mean I, I knew dental consultants and said, well, you know what these, these guys are, so stupid he goes. I've never, I've never even cost him. I still got dentist plan bitch. I'm like, well, I paid you 10,000. It's like, dude, I was in that office 10 days every day, just just just at the end day, just doing an audit on the charts. Oh, she took bite wings but it didn't get billed. Oh, we took a PA and a bite wing before they submitted the crown, it didn't get billed.

Speaker 1: 22:50

And they sit there and say every single day, I, I found five, six, seven $800 of dentistry that was done, that wasn't even entered and billed, the whole thing didn't even cost. Or they'll just sit there while they're waiting for the doctors, like, well, I need to have a meeting to go over this. And while they're waiting, they're just get on the over 90 account and seem to go hello. This is Howard from Dr Amy's office and your bill is overdue, so I need to get. Do you want to put that on your master charge or visa or discover card and how would you like to do it? And they'll just sit there and run down their over 90, you know, seven grand and their whole consulting service was five grand. I mean, dennis, you just got to spend money smarter, and your biggest biases, your biggest blinders, are always in things you don't like. I say I got an MBA but I don't think it's very sexy to do accounting and reconcile bank statements and do payroll. You could be placing an implant and getting some blood on your head.

Speaker 2: 23:50

Oh, I love that. I love that. Yeah, I think it is very important to have you know as a dentist you refer if you don't like endo, you're going to refer it out because it's not, it's not your deal. And same thing with billing it. You know, hand it over to the specialists, give it to people who actually enjoy our blood on our head is going after the money and making sure that insurance companies are being held accountable.

Speaker 2: 24:16

Clinical documentation it is so lacking right now I can't even like I have so much to say about it. But clinical documentation is where billing starts and we have some offices that need to improve on that, especially because, with billing going the way it's going, it's going to get absorbed by medical billing. Howard, honestly, like billers today don't realize that we need to start incorporating medical diagnosis codes on a dental claim form and that is so foreign to, I'd say, 90% of billers in the United States we're going to see an uptick of denials because they are so resistant to this change coming down the pike. It's already here. My billing company is already seeing denials because we're not using medical diagnosis codes on a dental claim form.

Speaker 2: 25:04

So as that continues to evolve, ai is gonna have to catch up with that as well, because dental billing is evolving rapidly and we're headed in the direction of following the medical billing steps and it's not going to surprise me if, in five to 10 years from now, we are just billing medical as the oral systemic connections continue to evolve. I think all insurance is going to be under one roof and we're going to be billing medical. So I think, if you know we want to keep on the up and up with all the changes happening, we're going to have to evolve. Same thing happening with dentistry. That's why I wanted your opinion on where. Where are we going, what do you see happening and what should dentists do to stay on the up and up, because everything's changing so quickly right now, especially with AI being involved. So I appreciate, I appreciate all the things that you talked about today. This is just like a standard conversation that we have.

Speaker 1: 26:07

We do. I always enjoy my conversations with you.

Speaker 2: 26:11

I know, I know I enjoy it too. I guess we'll close it out with that being said. I mean, I appreciate you being here and sharing all of that with everyone. When can we expect the new dental town to be released?

Speaker 1: 26:24

I really, really, really, really, really think it will be april. Um, you know, ryan came here and the first year, you know, he spent a year Trying to put lipstick on a pig. And then finally I said you know, it's too much, you need to get another one. So he hired the second AI programmer, brandon, and Brandon came in and he really thought he could help Ryan dress up this old pig and lipstick and he spent about two or three months on it and just one thing after that. And then we realized I mean you know it's really tough, erica, because this was really hard. And then we realized I mean you know it's really tough, erica, because this was really hard.

Speaker 1: 27:01

You know you're lucky, and I'm lucky because of the fields we're in. If you're a carpenter, a candlestick maker, you do dental billing or dentistry, after 10 years you're a lot better at it and you're worth more money. But it's not that way in electrical engineering or programming. So let's say it's 1980 and you go to college and everybody has a vinyl record and you heard about this new CD-ROM. And you go to college and you get an electrical engineering degree and you're a CD-ROMer and you come out and your company's thriving and you're making six figures and all the record companies are going out of business and they're all dying and losing their jobs and their pensions. And you're doing great and you think you're a baller and then 10 years later, someone walks up to you and says I'm sorry, erica, no one wants a CD-ROM, it's all going to MP3. And now you're like a vinyl record and now you're out of business.

Speaker 1: 27:53

And now you're going down and I had all these people on my team that have been with me for 25 years and they were all HTML, c++, microsoft SQL Server boys and they just missed the entire Python revolution. And it's really sad because now my whole team hell, I think the oldest person on my Python team is like 23. And when I started this you know the older programmers just like I mean. You know but, but you know, but that's why you got to keep up. I mean, my God, when I was in a dentist, you know, I went to Panky for five weeks. I got my FAGD, my MAGD. I went and got my fellowship in the MISS Institute. My, you know I got. You know you just keep getting all these continued education deals that you know I took Brock Rondeau's ortho. I took Jack Sheridan's ortho. I mean I took all the not not that I was going to be an orthodontist, but I I have to answer mom's questions. I mean, I think if you can't do, if you've never done 10 ortho cases, how can you answer an ortho question when you're? And it really changes Like, like, even when you don, and it really changes like, like, even when, um, you don't do the implant surgery. Well, if you haven't done 10, if you haven't placed 10 or 100, um, I don't even know if you can treat a planet. Because, because I saw with myself, um, you know, I mean you you start doing implants and you start realizing like, like, like, take it, this is all I'm trying to think of, something the craziest, most controversial I could say, but let's, let's say it was someone like you who was missing two lateral incisors. It's like, my God, you're a good looking woman to place two implants and have the gum tissue and the gingiva and all that stuff. Like that. I mean, my God, I know I could do two, three unit bridges and just make it look perfect. And I know I could do two implants. And there's about an 80% chance if you lift up your lip, everybody would know something was off. And then that's called the aesthetic health compromise and you have to ask Erica, what's? I'll never. I already know the answer to your question because I remember my grandma. I remember Grandma Mary. I walked into her room she's about 85 and she was straining and grunting and she was pulling herself into her girdle and I said to grandma I said, grandma, why? Why do you wear a girdle? And she snapped at me. She says, because I'd rather look good than feel good, and it's like all right. And uh, she would. She would pour her entire body into something about the size of a Christmas stocking, and you know. And so the bottom line is you know, you just got to keep up, you got to. And that's what I love about Dentaltown. We got 650 online CE courses, 150 of them are free.

Speaker 1: 30:37

Where you know you, I think that the one thing about COVID is it shot you. You know these dental meetings. They lost half their attendance since COVID. I mean COVID, you know those meetings were shut down. I mean, and some of the earliest meetings that were shut down, actually some people actually died from going to those meetings and it's really traumatic and they remember it and it was tough times and tough calls and I mean you just cancel the meeting. But now it's been five years, those meetings are only halfway back to attendance because everybody's burned.

Speaker 1: 31:07

That's so true. Well, yeah, I don't have to get on an airplane and fly to Chicago to listen to Erica Agliar speak for three hours. I don't need to do that. Guess, which is the only meeting in dentistry that has its pre-COVID attendance, and they sell out and you can't get a booth there at their next meeting, where Every other year the orthodontist and the pediatric dentist combine their meeting, and the next one is in St Louis and it is sold out, completely sold out. Can you imagine that? A major dental meeting, no booth space, no vendor space. If you want to go there and get a booth, you are out of luck. It is over. And that shows you the true. You know. I told you that dentists, you know that DSOs won't go to rural because when primates get out of dental school they're single and they want to find a mate and they're not going to go look under a rock in Eloy to find a mate. They want to go to the big cities.

Speaker 1: 32:06

And the same thing with spending money. When you tell grandpa oh, grandpa, I went to Spear and Panky and Coyce and would you like to, and you want to do a $50,000 rehab on grandpa and he's like, no, I'm going to. I'm going to take that money and send my kids to college. Orthodontics and pediatric dentistry is how families spend money. You go to the, you go to China, where they have one kid, one one. One kid, one family rule. So that kid has got a mom and dad and two grandmas and two grandpas. You have six adults earning money to so that kid has got a mom and dad and two grandmas and two grandpas. You have six adults earning money to spoil that kid.

Speaker 1: 32:44

And when you look at dentistry, for every girl who spends $10,000 on getting veneers for herself, 20 moms spend that money getting braces on their children. And you know I can't tell you how many married couples during Christmas they just the husband and wife say no, we're not getting anybody anything this year, because one daughter wants a damn iPhone for a thousand dollars and the other one has a tablet and that that's our whole budget. So mom and dad and grandma and grandpa always go without to feed boo-boo and boo-boos, go into a pediatric dentistry and is getting braces and and and. Then you got to ask the dentist. So why are you learning TMJ and occlusion and trying to do equilibrations on people that have more liver spots than teeth? I mean you're swimming against the run. You know what I mean. I mean, just go with the flow Baby gets. In fact, you know what the number one predictor of the housing community is. That I learned in MBA school.

Speaker 2: 33:44

What.

Speaker 1: 33:45

Well, when mom and dad get married and they have boo-boo that's a 30-year commitment to a house, an extra room, a child, a bed I mean you can count, you can figure out marriages and birth rates and predict exactly the housing rate. I mean, I mean these two kids grew up in this town, they met in high school, they're going to get married, they're going to live in the same town. Well, why are they going to buy a house? Because they got married. Well, why are they going to buy a house? Why don't they live under a bridge? Because they're going to have a kid and they need a baby room and a baby basket and a baby, all this baby stuff.

Speaker 1: 34:22

And so when those birth rates start falling, a good good chunk of your long-term investment capital is now in jeopardy. Because it was you know, think of all of them. My mom and I got married. They were Catholic, so they waited until they were 16. I think my mom's brother, pat, I think she was 16 and Aunt Sue was 14 or something like that. But I mean they got married real young, had seven kids, and I mean it's just big economic decisions follow a 30-year commitment to having kids.

Speaker 2: 34:51

Yeah, big time, and your mom and dad had a lot of them.

Speaker 1: 34:55

Yeah, seven. How many siblings were in your family?

Speaker 2: 34:57

I'm the oldest of five.

Speaker 1: 34:59

Oh my gosh. So so are you Catholic or Catholic?

Speaker 2: 35:02

I was raised Catholic.

Speaker 1: 35:04

Well, yeah, I mean, come on, come on. Hispanic with five kids, hispanic with five kids. What was my next answer? Supposed to be Amish.

Speaker 2: 35:16

Yep, yep, oldest of five and shortest of five. Funny, my, my sisters. I'm five feet tall, my sisters five, eight younger sisters and five eleven, my brother's six feet. And uh, I have one other younger sister. She's about as tall as I am, but I I'm the oldest of five, shortest of five. It's been fun with a big family.

Speaker 1: 35:39

Well, you won't always be five foot, because my mom would always say she was five foot and three quarters and she was. Now she's 84 and she is shorter than five foot and it really gulls her, oh I know. And she wants to go to a chiropractor and get back to five foot again and I keep telling her that might be past that.

Speaker 2: 36:07

I know I'm going gonna shrink. We all do that's so funny I forgot we were doing a podcast.

Speaker 1: 36:10

To be honest with you. Well, it's always, it's always great, it's always an honor to be on your uh show and uh, thank you for that yeah, I look forward to.

Speaker 2: 36:17

I look forward to hanging out with you soon. So, howard, thank you for being on the show and sharing your insights always a pleasure all right, thanks, erica.

Speaker 1: 36:25

You have a rockin hot day.