“The Dr. Jo & Dr. Joe Show”
With special guests – Dr. Mitchell Josephs and Dr. Joanne Rief
Edited Transcript
David Madow:
Welcome to a special edition of the Madow Brothers audio series. I’m Dr.
David Madow. I’m here in the studio; we got a little bit of a strange
situation I want to tell you about. So I just finished up an interview with
Dr. Mitchell Josephs. He actually came in from Florida to do a very special
program on dental malpractice, and if you have not heard this yet, you
owe it to yourself to make sure you look through your audio series
because it went actually even longer than we thought; it’s packed with so
much information, it’s incredible. Dr. Josephs pretty much spilled his
guts. Coincidentally, I’ve got two superstars in the studio right in front of
me. This was not planned. Dr. Josephs was pretty much leaving the
studio; Dr. Joanne Rief, who has been on many shows, happens to be in
the studio with me as well. Don’t ask me how it happened; it just
happened. So I’ve got two of the most amazing dentists, friends,
marketing minds, just successful, great people in front of me here, and I
would not be doing the responsible thing if I didn’t try to get all of us on
here together to at least produce a little show for you. I think it’s going to
be very special. We’ve never done anything like this before, but I have an
idea, and my idea is this: Let me first bring them into the show. Dr.
Josephs, how you doing today? Welcome back.
Mitchell Josephs:
Great, thank you.
David Madow:
It’s great to have you here. Dr. Rief, it’s great to have you. Thanks so
much for being in the studio with us today.
Joanne Rief:
Thanks for including me.
David Madow:
You’re very welcome. Now, I got to tell you, the listener, I’m not talking
to Dr. Jo or... we got two Dr. Jos in front of us, so funny. Joanne told me
that in her old practice they used to refer to her as Dr. Jo, and Dr.
Mitchell Josephs, his nickname is Dr. Jo, so we’ve got two Dr. Jos here.
I’ve got to be honest with you, the listener, this was not prepared; they
don’t even know what I’m gonna say. But again, I want to try this. There’s
no scripting at all, there’s no subject, but I want to ask both of you,
you’ve both got very, very successful practices, you, Mitch, down in
Florida and Dr. Joanne, right here in Maryland. Let’s talk about
your success a little bit. Dr. Joanne, how long have you been practicing
dentistry?
Joanne Rief:
Twenty-nine years.
David Madow:
Twenty-nine years. Mitchell, how many?
Mitchell Josephs:
Twenty-seven.
David Madow:
So between the two people I have in the studio, we’ve got fifty-six years
of combined dental experience. You can see now why I did not want to
just let them out of here without talking to them, because we can do
something...
Mitchell Josephs:
Your honor, does that sentence run concurrently or consecutively? It
sounds like a prison sentence.
David Madow:
It sounds like you’ve been talking to too many lawyers, too many your
honors, too many judges.
Joanne Rief:
But wait a minute. I don’t want to outdo Dr. Josephs here, but I’ve been
in the dental field since I was 13 years old.
Mitchell Josephs:
Yeah, I was gonna say.
David Madow:
Well, your dad is a dentist.
Joanne Rief:
I worked in his office since I was 13 years old.
David Madow:
You were a hygienist before you were a dentist. I know the whole... so
we’ve got a tremendous amount of experience, and not just experience,
but I’m talking about real success in dentistry and in life as well. So let’s
do this with my two Dr. Jos here. We’ll just start talking informally, and
there’s nothing scripted; you can interrupt if you want, but I just want to
help our listeners become more successful in their lives, in their dental
practices, maybe financially. It could be anything, and we don’t have to
let this go real long; it can be a short episode. Again, it’s not all about the
amount of time you spend; it’s about the information. So, if we can,
maybe, I’ll start with Joanne. Joanne, what drives you? What do you think
makes you so successful in what you do? I’m the one playing you up...
Joanne Rief:
Okay, I know how to answer because I’ve mentioned this before, and this
will probably open a can of worms; it’s something that I don’t know if
someone said it to me or I made it up. I really don’t remember, but I work
on my practice, not in my practice.
David Madow:
And tell us what that means.
Mitchell Josephs:
That’s a nice way to put it.
Joanne Rief:
Well, and to elaborate, I mean, if you ask my children, if someone says to
me, how many days a week do you work, and I’m ready to say 4, 32
hours, and my children will say 24/7. Now, that to them is a bad
connotation, but honestly, to me it’s not a bad connotation. It doesn’t
mean that I’m sitting there waiting for the phone to ring 24/7, but I’m
available even if it’s not physically. I’m available by phone, by email, if
there is an emergency. Some way it’s gonna happen that I can help take
care of this person or answer a question. When I walk in the office, I’ve
said this before, when I turn on the lights, it’s not just the actually
physical bulb; I’m turning on my marketing light, because it’s all about
marketing as Fred Joyal would say, right? “Everything is marketing.”
David Madow:
Everything is marketing. Now, it’s funny, how I took that, when you said
you work on your practice 24/7. I took that a little differently. I wasn’t
thinking you’re available by phone; you’re gonna run in to see an
emergency patient. The way I took it was that 24/7, every single minute
you’re up and even sleeping, because you’re thinking about this
subconsciously, you are somehow thinking about your practice, how to
improve it, how to grow it, how to make it more successful, how to treat
the patients better, how to fill in gaps in your appointment book. In other
words, your mind just never goes to sleep. You don’t leave at 5pm and
turn it off and then turn it back on the next morning at 8:30 or 9; you’re
always thinking, because it’s your business, it’s your practice, and nobody
else is gonna think like you do. That’s the way I took it.
Joanne Rief:
Now, that’s not to say I’m not on vacation, not going places, because this
week I’ve been to a couple of meetings, different things, and not
necessarily dental meetings, and people say, “I love seeing all your
travels.” Well, yeah, I do go away sometimes; there are long weekends,
yeah, I’m not always in the office, that’s for sure, but, like, I was just in
Scottsdale, Arizona; it was for pleasure, but I went to visit Spear when I
was there because I might decide to go there. So again, I was on vacation,
I was hiking, but I remembered Spear’s there; I would like to go see if
Frank’s there or see the facility, which, by the way, wow, it’s like a
country club, it’s like a resort, it is unbelievable, that facility. I am
definitely anxious to learn more and get involved. But anyway, that’s on
the side. So it’s not like I’m just focused on dentistry. I am involved in
other organizations; again, I was at meetings this week. I’m on the board
of the F.I.D.F., the Friends of the Israeli Defense Force. I’ll be darned if
someone didn’t come up to me and say, “You know what? I’m in town
here more than I am where I live in D.C. I really need to get my dental
work done; do you have your card?” Last night I was at a G.E.M. event,
the Girls Empowerment Mission. There was a very high-powered woman
sitting two seats from me. She heard I was a dentist. “I really need to do
something about this dark tooth. What do you think?” I gave her my card.
So I really wasn’t there to market. I want to do other things in my life, and
I do, yes, I’m on vacation, yes, I’m on this board or this whatever, but you
know, you can combine it all. And it’s only helping my practice grow. I
now have an associate, so I really want this practice to grow. I want him
to be busy, and thank goodness he is busy. And that’s a whole other story
because I’ve added another dimension, because, unlike Dr. Josephs, I
don’t really want to place implants. I’m busy enough. I’ve got enough to
do. To me, like, he’s really comfortable with that. I’m not. I like to sleep at
night. I like to do what I know how to do. I know that the other dentist
that I bought my practice from, he did one case of Invisalign that didn’t
go well. He’s never doing it again. Now that’s something I learned to do. I
love to do it. So, you know, that’s what I like to do or whatever. I want to
grow the practice for this associate. He’s doing all this surgery that I don’t
want to do or that I just don’t feel comfortable doing, so it’s great. So
again, I want to keep this practice growing. I’d like to sell it to somebody
one day or make them a part, or whoever, whatever it might be. So that’s
why I keep going, and, I don’t know, do you want to interject the next
thing?
David Madow:
Wow.
Mitchell Josephs:
She’s just the better-looking version of me; it makes me feel good, like
I’m not a total weirdo.
David Madow:
Well, I wouldn’t go that far. How about you, so what drives you? What do
you attribute to your success, Mitchell?
Mitchell Josephs:
Well, you know, that’s true. My wife calls me a little ant because if I’m
not having my hands in someone’s mouth, I am always thinking of
something, and I love that expression, “I work on my practice, not in it.” I
guess a lot of dentists just work in their practice, they just kind of schlep
up the stairs to their office with a backpack, throwing it on the desk and
they’re, like, “Here I am. Who is in room 2?”
David Madow:
It’s like they are beaten down, it’s like life is...
Mitchell Josephs:
Yeah, they are not the CEO. They act like, they are just, like, a runt,
an employee in the factory, and yet it’s their business.
Joanne Rief:
And guess what their marketing budget is? Zero! I’ve had this discussion
with people. “What do you mean, marketing budget?”
Mitchell Josephs:
You know why their marketing budget is zero? I’ve said this in one of my
lectures I’ve done with you guys. Do you know how many times the top
dental lecturers that appear in every dental magazine, do you know how
much they recommend a dentist should spend, what percentage of their
revenue they should spend on marketing?
Joanne Rief:
3-5%.
Mitchell Josephs:
Yeah, that’s BS!
David Madow:
What do you think it should be, Mitchell?
Mitchell Josephs:
I think, like, that’s maybe for a dentist that’s 60 years old and has got it
made and has this critical mass of patients referring patients but...
Joanne Rief:
Does he realize we’re getting there; were almost getting to that, 60 years
old?
David Madow:
I’m there in six days.
Mitchell Josephs:
If I was a brand new dentist, and whether you bought a little, sleepy,
small practice like I did in ’92 and you need to grow it, or if you just built
an office with zero patients, I don’t think 5% on marketing is enough. If
you had to go to a bank and you’re gonna open up a car dealership and
you had to show the bank your business plan, and you’re gonna show
them how much money is gonna go towards the four walls, how much
money is gonna go to staff salaries, and they’re gonna say, “Well, how
much are you gonna spend on marketing?” I think, if you said, “Well,
we’re only going to spend 5% at our Chevy dealership on marketing,”
you’ll be laughed out of the bank; they wouldn’t loan you any money. So I
blame, I mean, can I mention the guys’ names on the...
David Madow:
Anything goes, but if you’re not saying anything bad about the person,
but...
Mitchell Josephs:
I don’t have to mention their names, just some of the top lecturers that
are in every dental journal, every single month, writing the big practice
management articles that say, “3-5% on marketing; don’t forget.” I think
that that’s a joke.
Joanne Rief:
Well, you also have to track, and I’m sure you do this, your return on
investment.
Mitchell Josephs:
We try, but I’ll tell you, with the internet, it gets more and more difficult,
because you say to someone, “Well, how did you find us?” and they go,
“Web.” I mean, can you narrow that down? No. I tried to ask them
questions, what search engine did you use, what did you put into the
search engine? They just go “Web.” It’s tough to track.
David Madow:
You know, not only that, Mitchell, it’s very tough to track. I’m not saying
don’t try and do your best, but these days, also, they may say web but
they are not telling you: well, they drove past your office for the past year
and saw your beautiful sign, they might not even say that, they may not
even...
Mitchell Josephs:
Dave, I had a radio show for 15 years, “Tooth Talk,” once a week. I was on
the radio for an hour. This was before there was satellite radio. It was the
number one source of new-patient income in my office. You know how
many times new patients would come in and we’d say, “How did you
hear about Dr. Josephs?” and they’d go, “TV.” I’ve never been on
television. “Not the radio show?” “No, no, I saw him on TV.” How do you
track it?
Joanne Rief:
Well...
Mitchell Josephs:
It’s not 100% accurate; we try.
Joanne Rief:
No, I didn’t say it was. We even have a category, pens, you know, pens,
like my husband’s... Yeah, we’ve had people say they got to me from my
pens, the sign outside the office…
Mitchell Josephs:
Where do you give your pens out?
Joanne Rief:
Everywhere, dry cleaners, restaurants, wherever my husband goes, he
drops them off.
David Madow:
See, Mitchell, you may not know this, but Joanne’s husband has a
business. I think he kind of invented this technique, but he has a business.
Is it okay if I mention the type of business?
Joanne Rief:
Sure.
David Madow:
It’s called “Big Boyz Bail Bonds.” Mitchell, I guarantee, if you had time
before I had to take you to the airport, I guarantee, if we were able to go
to a restaurant or coffee shop or something, and they brought us a pen
to sign the check, they somehow get their pens into every single business
in the Baltimore Metropolitan area. I’m not kidding. I’m not exaggerating.
It’s unbelievable marketing. So Joanne has, actually, I guess, your
husband has helped you with that on a smaller scale, but she gets her
pens out to so many people and businesses in the area, it’s unbelievable.
Mitchell Josephs:
How much per pen are you paying? Just curious, do you go for a fancier
pen or…?
Joanne Rief:
No, no, no, it’s from China. You have to remember, he gets, like, 500,000
at a time or something, of his, not mine. I’ll give you all a pen.
David Madow:
Doesn’t he actually have employees that’s...
Joanne Rief:
One.
David Madow:
And his only job is to drive around in that special car...
Joanne Rief:
It’s a good-looking woman.
David Madow:
Oh, it’s a good-looking woman.
Joanne Rief:
Yes, and every day they tell her what neighborhood to go to.
David Madow:
And all she does is drop off pens every day, full-time employment.
Joanne Rief:
For his business.
David Madow:
Yeah, for his, but it’s the same idea.
Joanne Rief:
So, like, my husband would go to a 7Eleven that’s in an office building
with a competitor dentist, and he drops them off there. I’m, like, I don’t
know if that’s such a good idea.
David Madow:
Why not?
Mitchell Josephs:
It’s a great idea. I think it’s needed; it’s necessary.
Joanne Rief:
And you know he’s done that before too. In fact, I’ve had dentists say to
me, like, up in Timonium, their office is in Timonium, they say, “I went to
Panera. Your pens are there.” What can I say? Timonium is, like, 20
minutes from my practice.
David Madow:
What are the common factors I’m seeing between you guys, and I’d like
to elaborate on this one even more, even get to different tangents; it’s
fine. But both of you are just immersed in you practice; you’re not
employees. You’re not coming in 9-5 and then leaving there, as you said,
just slamming the backpack or whatever. You guys are thinking, thinking,
thinking all the time about how to improve your practice. I think, with any
business, not just dentistry, but the people that own the businesses, that
it’s always on their mind, whether they are on vacation, wherever they
are. These are the people, the entrepreneurs and let’s face it, dentists are
entrepreneurs. These are the ones that get ahead, so you can’t just be
one of those people that’s treating it as like a 9-5 job, and then you go in
and do something else; you got to be thinking, immerse yourself in it.
Joanne Rief:
Agree, definitely. I think that the hard part for me, I want to see what you
think of it, because we had a staff meeting two days ago, it’s translating
that feeling to your staff; that is hard. For a while we had our staff on a
bonus system; we’ve lost some, a couple of them are still on bonus
system, which is tricky. But, how do you go to a staff meeting and the
next day, you’ve already seen that your schedule’s falling apart quite a bit
after you’ve been packed solid for months, and same with the
associate. I’m trying to translate to the staff, you know, the little puzzles
with the letters or numbers, you got to move it around. Well, that’s how I
try to translate to my dental staff of what a dental schedule is; that
you’ve got to move those pieces around. In other words, we’ve got a
patient coming in for quadrant root planing. I have an opening right after,
let’s say. Have you looked to see if they still have some restorations that
need to be done? Maybe they need to stay for a second quadrant, maybe
their spouse or sibling needs to come, whatever. And I’m constantly
showing them, if there’s a cancellation here, you move this one here, you
do... like that puzzle. And next thing you know, within an hour or so, the
entire schedule is filled the next day. It’s so hard to try to translate that to
your staff; that this is a business, that I want to pay you what you deserve
to be paid, but we have to keep busy. We have to keep productive. I
don’t know, do you have those issues?
Mitchell Josephs:
My initial answer to that, off the top of my head, is it’s the personnel. It’s
the people themselves. I’ve had my share of front desk people/office
manager kind of people, and every time I get the newest one, she’s
always a million times better than the one that was there before. And the
current one that I have, that I hired in last June, she makes that analogy
that you just said. She didn’t describe the puzzle to me, but she does look
at the schedule exactly like that, and I’ve never had someone like that
before. I’ve never had someone come up to me in the middle of the day
and say, “Hey, Dr. Josephs, tomorrow at 9 just opened up. Should I go
two weeks ahead and move such and such into that spot?” I’ve been a
dentist for 27 years; I’ve never had a staff member ever ask me that. I
just, like, looked at her like a deer in the headlight. “Oookay.” So my
initial answer is the right person will think that way. I’m not saying go
back Monday and fire someone, but it’s frustrating to try to get people to
think that way, who don’t normally think that way in their own life; they
don’t think of their husband’s business that way. It’s a matter of
personnel, and I’m fortunate enough that this new person I have since
last June thinks that way; she came up with it.
Joanne Rief:
The funny thing is, I said to them, I brought out the schedule, how it was
originally, and then how I, with a few phone calls, or get the staff to
change it, and I would have loved to have dollars and cents of what we
produced and collected this day, versus this day, but can’t do that. But I
showed them on paper, I printed it off and say, “This is how I move this
around and got this one...” Two totally different schedules. It was
incredible, and this is a business mind and getting this whole team on
board with this. And I do have good employees. I know what you mean,
we’ve lost some, it’s turned over very recently, and I do, I’m not saying
they are the best, but I do have good people. It’s still getting them in
the... I think it’s just the mindset; they have to get that mindset. But
that’s, we’re a little off the tangent, but this is how...
David Madow:
Anything goes on this show. Joanne, I know that if somebody calls your
office, let’s say after hours, or even before hours, let’s say your office is
not opening until 9, and then somebody calls at 7:30 or 8:00. From what I
understand, the call does not go to an answering service. Do you
personally pick up the call? Because I’ve had somebody that actually
called your office; they said Dr. Joanne actually picked up the call at 8:30
am, tell me about that.
Joanne Rief:
Yes, I transfer the calls to my cell phone, because I’m not 100% sure that,
I turn it to vibrate when I’m going to sleep, you know, because I’ve made
that mistake too, been woken up in the middle of the night, so it goes to
vibrate when I’m sleeping. But for the most part, when I leave in the
evening, I’m transferring the calls until I get… because you wouldn’t
believe how people want to call when they know that you’re not gonna
answer the phone to try to cancel or...
David Madow:
It’s called the coward call; been written about for ages in dentistry…
Joanne Rief:
Or there’s the new patient that if you don’t pick up, they’re calling the
next one. They’re not gonna wait for you to call them back. It’s happened
many, many, many times, and yes, I know you, Dave, have
recommended, you and Rich, to give the cell phone to an employee,
whatever, I’m still not sure that they will be as committed.
Mitchell Josephs:
I used to do that, and then I stopped about a year ago. Now I carry the
after-hours office cell phone.
David Madow:
So you carry it also. I didn’t know that, Mitchell. I know Joanne does. So
again, two highly successful dentists here in front of me, and they both
carry their own cell phone.
Mitchell Josephs:
Like Joanne, I don’t always pick it up, but all the contacts and the
patients’ names are in, so I see who’s calling, and it’s my voice on that
extra cell phone, and I’ll listen to every voicemail, 24/7, that they leave,
and I’ll decide if I should call them back or not. But I don’t trust the staff
member anymore, just wasn’t the same.
Joanne Rief:
With my phone system, if I didn’t do that, and they called the office and
did not leave a message, I wouldn’t know it. If they call the office and
leave a message, I get an email. So if they hang up, I know how many
missed calls there are that people hang up, and sometimes they listen to
the message but at least I see the number again. This way, if it’s
transferred, I see everything. Now, Fridays we’re typically closed. Several
weeks ago I was on the way to the Washington area with an aunt of mine
to go see a show, and I do usually have one or two staff members there
on Fridays, but they typically leave by 1 or 2:00. Most people know we’re
not always open, so we didn’t used to get a lot of calls on Fridays. That
has changed; we get calls on Fridays. I left the office at 2:00, had the calls
transferred. I’m in the car driving to Washington, my aunt must have
thought that I was the dentist of the rich and famous: 14 calls between 2
and 5:30 pm that day.
David Madow:
And you’re there fielding them all, wow.
Joanne Rief:
Yes.
David Madow:
And you wouldn’t have it any other way it sounds like.
Joanne Rief:
No.
David Madow:
Wow, very, very interesting.
Mitchell Josephs:
I learned from you guys years ago, one of your Love Dentistry shows, you
said make sure, because I never worked Fridays, we’ve always been
closed on Fridays, you said make sure someone’s at least answering the
phone on a Friday, even though you’re not there. So the next time I hired
a new front desk person, I’m not there on Fridays, there’s no patients
there, but she’s there on Fridays answering the phone from 9-1, and then
at 1:00, it gets forwarded to my second cell phone that I carry. For years,
if someone called my office Friday, they got nothing. I mean, there was
an answering machine but they would hang up.
David Madow:
Yeah, that’s unacceptable, totally unacceptable,
Joanne Rief:
Just think how the schedule can change from Thursday at 5:00 to Monday
morning; I mean, it could be disastrous.
Mitchell Josephs:
Oh, bingo, yeah, yeah, yeah.
Joanne Rief:
And I learned this when I went to LVI: if you don’t have a patient in the
dental chair, the whole staff is temporarily unemployed.
Mitchell Josephs:
That’s a good one.
David Madow:
Interesting.
Joanne Rief:
It’s another good one.
Mitchell Josephs:
I’m gonna say that Monday; it’s a good one.
Joanne Rief:
I’ve got a lot of good ones.
David Madow:
Mitchell, if you use that in a lecture, what’s your lecture called again?
Dentistry on Fire?
Joanne Rief and Mitchell Josephs:
Fast and Furious.
David Madow:
Fast and Furious, so you have to give Joanne total credit for that, Fast and
Furious, he’s got the whole speaker packet in front of him here.
Joanne Rief:
Wow.
David Madow:
Do you have any desire to become a dental speaker, Joanne?
Joanne Rief:
It’s funny, because I went on the Madow website this morning, looking
for something. I’m not going to tell you what, but I was looking, and I
happened to see that you’re, you know, you give that…
David Madow:
By the way, let me tell you, that whole website, within 30 days, it’s gonna
be completely redone; it’s gonna be so much better. But you’re on our
website this morning...
Joanne Rief:
I was looking for, like, I thought that there was a TBSE logo. I was looking
for a logo or something.
David Madow:
It’s on TBSE.com, there is…
Joanne Rief:
Okay, not the hats one, just, like, a general; I’ll find it. Anyway, so I saw, I
know you have been giving that...
David Madow:
Speakers course, which, by the way, Mitchell came to one last fall.
Joanne Rief:
September.
Mitchell Josephs:
It was great.
Joanne Rief:
Right, so I already checked out the date, so, yes, I will be taking that
course, and I’ve always wanted to be a dental speaker.
David Madow:
I didn’t know that, because I think that Mitchell was asking me some
other time, I thought you, I didn’t know if you really wanted to become,
like, a true dental speaker. I thought you were happy and busy in your
own practice and you didn’t want to.
Joanne Rief:
Well, I am now an empty nester, so I have different things in my life and
things I want to do and things I don’t want to do, less of, and like I said, I
have an associate now, and my life is more flexible, and I like that.
David Madow:
We can get you out on the road... you’ve been on this show for at least
six times, so you’ve got… the reason you’re on here is because you have
great ideas, so take that to the natural extension of becoming a speaker
on stage. I think you’d be great. Wow!
Joanne Rief:
Thank you. Are you having that competition in September, like you did
last year?
David Madow:
We’re still; you want to be in it?
Joanne Rief:
Not September, November.
David Madow:
November, November 13th-14th in Vegas. You’re gonna be there too, I
hope!
Joanne Rief:
Yes.
David Madow:
Everybody’s there, for sure.
Joanne Rief:
Yes. My whole family wants to come to hear Daymond John.
David Madow:
He’s gonna be fantastic.
Mitchell Josephs:
Oh, that’s the guy from Shark Tank.
Joanne Rief and David Madow:
Shark Tank!
David Madow:
If we had to like, kind of close this with one each of your absolute favorite
pearls, practice-building tips, whatever it may be, life tips, whatever it
may be, what makes you more successful, makes you happy? Mitchell,
have you, and this is totally unscripted, believe me, I’m putting these
people on the spot, so I want to hear what you say. What makes you
successful?
Mitchell Josephs:
Well, one thing that I learned, that I think is important, is if you’re
learning a new procedure, whether it’s Invisalign, Six Month Smiles,
dental implant surgery, make sure when you come back to your office
and you’re thinking of doing that new service or procedure, that it’s not
forcing something out of your schedule that was more profitable. I’ll give
an example. My dental assistant and I, a bunch of years ago, we flew to
Houston. We took the two-day Six Month Smiles ortho course and we
thought, we do so many veneers and so much cosmetic stuff, that would
be just a natural for our practice. I spent $4,000-$5,000 between the
course, $2,000 for the box of materials for the ortho, came back to my
office, and I never opened up that box. It is still there with the sticker
sealed on it. And I actually discussed this with Mike Goldstein from the
Dental Boot Kamp who was a practice consultant years ago, and when I
figured out how much you can charge for a Six Month Smiles case, and
the time involved in doing it, coupled with the fact that a bracket is gonna
come off here and there, and that’s gonna be an emergency I’m gonna
have to deal with coming in, it, to me, looked like it was going to replace
the more profitable things that I was already doing in time slots with
something less profitable. So just because it’s new and great and there is
a demand for it, okay, nightguards and snoring appliances, great, it’s
cheap, it’s easier to do, but do you want two back-to-back alginate
impressions for the Silent Night snoring appliance that’s going to replace
you placing two or three implants in that same hour? It’s $2,000 an
implant, and then, from those implants comes custom abutments and
crowns. So that’s my pearl, that’s my tip: Yeah, it’s great to learn all these
new things and continuing education, but make sure when you get back
to your office, it’s not pushing out something you’re already doing that’s
more of a profitable hour.
David Madow:
Interesting, very interesting. Joanne, what do you think?
Joanne Rief:
I’m still, like, listening to that.
David Madow:
Feel free to comment if you’d like to.
Joanne Rief:
I know what he is saying. Like, I don’t do the Six Month Smiles; I do
Invisalign, and you’re right. It may not be the most profitable; you use a
lot of appointments and this and that, but it’s fun and easy. I like fun and
easy, I do, and I like them mixed, like my associate doesn’t want to do
root planing. I am a hygienist; I feel like I have a good grasp on perio and
he probably thinks I’m crazy, because I don’t mind if I have a patient who
had a restoration done and wants her teeth cleaned or needs a quadrant
of root planing. I like to do things that I feel really comfortable with. In
the long run, to me, they are profitable because I’m there anyway or it’s
gonna lead to referrals or whatever. So, you really asked about what
makes us happy or whatever. I think, for me, it’s doing a combination of
things: treating the patient as a whole, just having a well-rounded
practice, working on your team; I think the team is really a hard part.
Mitchell Josephs:
Yeah, that’s what we have least control over, because our teams are
made up of people that have personal lives. And the number one reason
why someone has ever gotten fired by me has something to do with how
their personal life has started to affect their performance on the job, and
that’s the factor we don’t have a control over.
Joanne Rief:
Just this week we had an employee that we didn’t know, that we didn’t
think was really right, and we were trying to figure out what to do. Well,
this is the crazy thing, and this is the one that calls you for the
confirmation and didn’t call me Dr. Rief, she said some other name. This
is a crazy story.
David Madow:
Mitchell, so I’m a patient in Dr. Rief’s office, going in for my cleanings and
everything, and I got a confirmation call. It was, like, last month or so. I
didn’t even recognize the number, so they said, “I’m calling to confirm
your appointment with Dr…” It was, like, another doctor’s name; I did not
know what was going on. So I had it recorded, it was on my voice mail,
and I played it back for Joanne. To this day, I’m not sure...
Joanne Rief:
We couldn’t understand why he didn’t call to confirm; he always texts
back or whatever. We didn’t hear from him; he said he was at a team
meeting for the Madow Group and they had it recorded.
David Madow:
It was on my voicemail.
Joanne Rief:
I forgot what she called it.
Mitchell Josephs:
What doctor’s name did she use?
David Madow:
Maybe it was Dr. Josephs.
Mitchell Josephs:
Was it at least someone you knew?
Joanne Rief:
No.
David Madow:
Never heard of the person.
Joanne Rief:
And the other office that she came from, they didn’t let her answer the
phone, so anyway, so we kind of moved her away from that position
since you were there.
David Madow:
Oh, I got her in trouble.
Joanne Rief:
No, there were other things.
David Madow:
Okay, you sure it was not my fault?
Mitchell Josephs:
Dr. Doolittle will see you at noon.
Joanne Rief:
It was something crazy. Anyway, we decided to make her the hygiene
assistant; we need a hygiene assistant. And put someone else in her
place. So she comes to work Monday and my new associate was not
working Monday; he comes in to see an emergency patient; he says to
me, “Who writes those notes after a new patient comes in to say, like,
you recommend, you know, glad to have you in the practice, you gave us
all your confidence...?” Whatever the letter says, we have a whole... the
exact thing you told us to say. She sent it to a patient who didn’t even
have an appointment yet; the patient was coming in the next day.
David Madow:
Oh, this poor girl is doomed.
Joanne Rief:
Happened to be a friend of the associate, and he had taken a picture of it
so we would figure out whose handwriting it was; it was the same
woman. So I did not get a chance to approach the subject. I was trying to
figure out what to do; we knew this wasn’t working out. The next day she
doesn’t show up for work.
Mitchell Josephs:
Wow.
David Madow:
Oh.
Joanne Rief:
Doesn’t show up for work. Now, the day later, on Wednesday, this
happened.
Mitchell Josephs:
No call? Just no-show.
Joanne Rief:
Nothing, nothing, and in my practice manual, that’s, you know, she can
be dismissed at that point and it wasn’t working out. So Wednesday she
sends me this long text; she knows it wasn’t appropriate to let us know,
but her mother was killed in a car accident suddenly and lives out of town
and she needs to help. And I don’t, you know, this is what we deal with
staff. I feel terrible, is it true, did it happen?
David Madow:
Well, I don’t think you’d lie about that; that would be a horrible thing to
lie about.
Mitchell Josephs:
Well, that’s my point. It’s always due to a personal circumstance that
affects their job performance.
Joanne Rief:
You say that; however, she says to me in this text, “I will get the key and
my clinic jackets back to you. Do you need a letter of resignation?”
Mitchell Josephs:
Why would someone think of that if their mother has just died? Her
mother was just killed; that’s a little bizarre.
Joanne Rief:
Thank you! That’s what I think.
David Madow:
I would hate to think that somebody made up a story about her mom
being killed in a car accident; I would just hate to think that.
Mitchell Josephs:
You just don’t mention the words clinic jacket and my mother just died in
the same text; it’s bizarre.
Joanne Rief:
I said yes, I need a letter of resignation and the key and the jacket back.
Mitchell Josephs:
Yes, yes, yes, sorry.
Joanne Rief:
That’s basically what I said.
Mitchell Josephs:
Yes to question 1, yes to statement 2...
David Madow:
Sorry, I’m gonna ask one more question before we leave this show today.
Everybody sitting here in the studio is over 50, some are older than
others may know. But as you get 50 and over, you’ve got to be thinking
something about transitioning, whether you want to ultimately sell, just
retire, die with the handpiece in your hand. What are you guys doing to,
and you can start, Mitchell, what are you guys, like, to at least think
about transitioning, what’s gonna happen to your practice? What are you
doing?
Mitchell Josephs:
Well, I do read a lot of articles on practice transitions and Dental
Economics and the JADA, you know, just to keep abreast on how these
things take place, and a lot of different opinions on it, so that’s one thing
I’m doing is getting education about it. Other things, keeping my practice
growing, keeping the gross high, because they always tell you that
someone’s gonna put a price on your practice, and they’re gonna take
the gross of last three years, they’re gonna apply a percentage to it. So I
always read where it says, don’t slow down to where it’s not worth
anything anymore, so mostly just keeping abreast on the options that are
out there.
David Madow:
Keeping it growing.
Joanne Rief:
And the two of us, I don’t think we have anything to worry about, but
also, you have to keep the office technologically up there, and the decor
and all that stuff which...
Mitchell Josephs:
Paperless; that was another, like, good thing, like a good feather in the
hat, computerized, paperless, you know, digital X-rays, stuff like that.
Joanne Rief:
I mean, there’s always another; I mean, I don’t have an i-CAT in my office.
Mitchell Josephs:
Me neither.
Joanne Rief:
I don’t have the...
Mitchell Josephs:
I thought about it for one day.
Joanne Rief:
You know, all these things, I mean, there’s always more and more and
more and bigger and bigger and bigger, and who knows, we may go
another 10 years. So by then, who knows what there’s gonna be? But I
guess we have to keep thinking about these things, or I just expanded my
practice and I don’t have a CEREC or E4D yet. Now, my associate would
love it because he has done a ton of that, but I have a designed place in
the lab for it, if and when the time should come for it. So, things like that.
I use a dental CPA and...
Mitchell Josephs:
I have to ask you this question, because, other than that endodontist that
comes in my office every other Wednesday, in my office I don’t have any
associates. My question is, if you’re like me and you market yourself to
the public, if a patient calls up, a new patient, how do you get them to go
to the associate when they are really calling because they heard how
great you are or they saw you give a lecture on hi-tech dentistry at a
synagogue or at a country club and they really love what they saw about
you and they want to come to your practice. How do you get them to see
the associate instead of you?
Joanne Rief:
It’s a great question; this associate thing is very new for me. I mean, I had
someone for less than three months, didn’t work out, I decompressed for
a while, and this has only maybe been three months. Unlike you, I do take
some insurance, so some of these people are calling because we are
signed up with insurance.
Mitchell Josephs:
Right, so for sure they can go with the associate, okay.
Joanne Rief:
I’m probably very different than most dentists out there. Right now I
want him to be busy, so we are trying to give him almost all the new
patients. You know, that’s gonna have to stop after a little while; we’re
gonna split them up but...
Mitchell Josephs:
All the new patients, even the ones that are coming because they heard
how great you are?
Joanne Rief:
No, absolutely not. And also, mainly he’s going in for the hygiene checks,
so I’m giving him all the hygiene checks or whatever we decide every day.
So when he goes in there, and we’ve already made this mistake, I’m
assuming, he’s assuming that the patient, if they need a restoration, they
want to see him. And I found this out the other day, a patient says, “You
know, I am going to see you, aren’t I?” Because they happened to call up
during after-hours or whatever and I said, “Oh, my associate, Estevez,
you’re on his schedule.” “I really want to see you. I was referred to you.”
Fine. But I said to the hygienist, “This is what you have to do: Tooth
number 2 needs an occlusal composite; you have to say to the patient,
‘Dr. Stern saw that you needed a restoration on the tooth; I’m gonna
make the appointment on his schedule. Is that okay?’” They are not doing
that, and that’s what they have to do, they have to say that, because they
could come in and refuse to be seen by the dentist that day, and then
we’re really in trouble from scheduling, busy, so...
Mitchell Josephs:
What about saying, “with Dr. Stern,” but not asking the question. Is that
okay?
Joanne Rief:
Well, either way, we have to know; they can’t just assume because he
checked them off, because a couple patients assumed that they were
gonna see me, because they were my patients.
Mitchell Josephs:
Oh, for sure, I could see that happening, yeah, yeah.
Joanne Rief:
Right, but you have to build up the doctor just like you have to build up a
new hygienist. Yeah, you always said you called the hygienist “expert
hygienist,” or did I get that from somebody else? I have two expert
hygienists?
Mitchell Josephs:
Okay, then, how do you deal with this? What if one of your existing longtime patients knows they need a crown with you, and somehow, through
hanging out in the waiting room, they find out that the person they are
sitting next to in the waiting room has this insurance plan where they
only have to pay $200 bucks out of pocket for the crown, and the dentist
that’s going to work on them is in your office, in that operatory right next
to you. Is there a chance that any of your existing patients will say, “Well,
shoot, I want to get on that insurance plan and see Dr. Stern when I come
here and have my crowns done.”
Joanne Rief:
Well, we’re both on the same insurance plans. We both participate in a
network; we’re both on the same.
Mitchell Josephs:
I gotcha.
David Madow:
Let me tell you something else. Nobody ever waits in Dr. Rief’s waiting
room. It shouldn’t be called a waiting room; whenever I’ve gone in for an
appointment, they drag me right back there, there’s no sitting, they are
always right on time 100%.
Mitchell Josephs:
I teach that in my lecture. I say to my audience of dentists, “What’s the
ideal number of patients you should have in your waiting room if you
have a three-chair practice?” No one ever gets it right; the answer is zero.
Because, in my office, my waiting room is empty a lot, because a patient
comes in, we’re already ready for them, and then the exit door, a patient
already left.
Joanne Rief:
Sometimes they bring their spouse with them or one is right after the
other.
Mitchell Josephs:
So you’re on the same plan as the associate, I gotcha.
Joanne Rief:
But we did start our own in-office plan. You know about these in-office
plans?
Mitchell Josephs:
Just the term in-office plan; that’s all I know about it.
Joanne Rief:
I’ll share my brochure because we designed our own. I didn’t go with one
of these companies, and it took me six attorneys to find anyone who
would talk to me about it, because they don’t want to go up against an
insurance company. I found someone across the street from my office. I
knew of this guy and he says, “Oh my god, that’s what I do.” So we did
that, and I think we started it maybe seven months ago, I’m gonna guess,
and we have 42 patients signed up for it, and I think that’s pretty good.
They are saving a little money; it’s a lot better for us than an insurance
company.
Mitchell Josephs:
Is it like a VIP medical plan, where you pay an annual fee?
Joanne Rief:
Yes, it’s called a membership plan, like Sam’s Club. I think it’s $249 for
one person and there’s like spouse and family, and for that they get their
two prophies, if that’s what they get, and exams, emergency exam, and
PAs. Everything else is 20% off, except cosmetic procedures and perio
prophies is 20% off our URC and all that. But we went through it with a
fine-tooth comb. Like I said, to get an attorney to help me with it; I didn’t
want to pay one of these companies; you got to keep paying them.
There’s the companies out there, maybe you know about them, that do
this, but we did our own. It took a long time to come together, but I think
it came out nice, and we’ve been offering that to patients who may be
sitting in the waiting room talking to someone who has insurance.
David Madow:
You’re listening to Dental Talk, the only show out there that isn’t PR.
Joanne Rief:
This could probably go on for 10 hours.
David Madow:
I think we may be on to something, because how many times do we…
there’s no show out there you can hear, like, expert, successful dentists
talking about their daily lives, what they do, the little things going on with
the practice.
Mitchell Josephs:
The only problem is, there are only 150,000 practicing dentists in the
country and there are 400 million people, so it’s a tiny little niche.
David Madow:
No, no, I’m talking about just for our listeners. I’m not talking about
broadcasting this out on, like, national radio stations, but this is
something that, I mean, kind of sitting in on dentists that are successful
and brainstorming ideas. I like it, Mitchell, when you ask Joanne the
question; I mean, this is real-life, real dentistry, so we might be on to
something here. We’re gonna have to, I think, end it for today in a couple
seconds. But I may want the two of you to come back at another time;
that means you have to fly in to Baltimore, Mitchell.
Joanne Rief:
No, we’re going to Florida!
David Madow:
We can go to Florida; it doesn’t matter but... or it can be done online. You
asked me last night, “Can the quality be done online somehow, or by
phone?” We might be onto something, just kind of a dental discussion,
and what’s going on in the minds of dentists every day, and the questions
we all want to ask, and I think this can help a lot of people out there that
are listening.
Joanne Rief:
I don’t know if, Dave, I think you mentioned it, I was sitting in on the
interview with Dr. Josephs, which we just finished, and I’ve never sat with
my hands under my legs, not being able to say a word for those 70
minutes.
David Madow:
Joanne, you like to talk, you like to be in the discussion; I know, let’s face
it.
Joanne Rief:
I had a discussion. I had a scenario for everything that came out of his
mouth, and I’m disappointed because I think that we were all gonna get
together to discuss all that. We have to do it some other time afterwards,
but I have so many things that I wanted to say: the things that happened
to me that I’ve heard about, ideas I’ve had for Dr. Josephs, so many
things.
Mitchell Josephs:
I would have felt the same way if I was in that position.
Joanne Rief:
Exactly.
David Madow:
That just means we have to do this again.
Mitchell Josephs:
It’s called passion.
Joanne Rief:
Passion, that’s right.
David Madow:
We will; the three of us somehow will get together again, and we’ll talk
about stuff on mic, so our listeners can hear, because this is really
valuable stuff. I think we’ve helped a lot of people today. So I want to
thank Mitchell again. I want to thank you for taking your time to actually
fly in to Maryland from Florida. Joanne, from taking time from out of your
busy day. I know you’re off on Fridays, but you got a lot going on, so we
will do this again. But thanks so much for being here, and I’m Dr. David
Madow. Another episode of the Madow Brothers audio series, a little bit
of a different one, and again, I hope you liked it because it was not a
formal, I didn’t have a formal script. I didn’t have questions I was asking,
but as things came up, we talked about a lot of great stuff.
Joanne Rief:
Let it flow.
David Madow:
So I hope you liked it, and we will definitely see you next time. Take care.