PAC Podcast #9 with guest Jennifer de St. Georges

In this podcast Dr. Mike interviews Jennifer de St. Georges and discusses what practices need to do to create a referral practice and hire and retain good team members.

For more information contact the Pacific Aesthetic Continuum at https://thepac.org.

Transcript

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Mike 0:00

I'm really excited to have our guest today, Jennifer D. St. George. You know what? First of all, I consider you a great friend. So one of the things that honors me to have you on the program today, but I gotta do you right by letting our listeners know a little bit about you. Jennifer's hallmark, which I love is her hard hitting practical. Practice management. So practical practice management, I think, is the key part. Not a lot of fluff. It's things that you can take gems from any of her presentations or any of her writings and actually apply it. She's taught in North America and in over 25 other countries. So she is a global instructor. She's also published more than 300 articles in the U. S. and international journals. But I think that's a testament to the principles in which you, speak about because it translates globally. It's not just, what works best in the U. S., but it's really, I think, building upon human behavior, throughout the world. And so that's why this is so important. When appointed to the Dentistry Today editorial board, she was the first non dentist in that position, which just shows that, she holds her own against clinicians. So I think that's very, important. And then her teachings really focus on three different areas. First, Building a referral practice to enhance practice growth and financial stability, which is very, important to all of us today. Second, elevating the patient practice communications to educate the patients on the practice protocols and eliminate misunderstanding, which I think, is another very important point. And third, design a roadmap to hire match and maintain a quality team and enjoy a great working environment, which I think today we all find very challenging to do, especially, post COVID. It is my great honor and privilege and a delight to introduce, Jenny. And, I think you're going to enjoy her quick wit and just the delivery that she has. It's no nonsense. All right. So we'll jump right in.

Jenny 2:02

Hello. And thank you. It's an honor to be here. You and I go back many years and I'm going to age myself, because your father was A gentleman of every level professionally and personally. So I have been connected to the Miyazaki family now for more years than I have fingers on my hands. And I love the way you took my intro and my CV and you, you took the formality out of it and made it very practical and also focused on the global. I just got back from Dubai a few weeks ago. It's the third time Spoken in Dubai in 18 months. And I was on the largest dental meeting in the world, the AEDC. And I'm talking to them about stuff that I've been talking about for decades, particularly when I'm getting into HR, because in that part of the world, there is definitely a, I'm trying to, there's definitely a different way in how maybe male and females are handled and handle themselves and handle each other. And here I am giving a masterclass for four hours to basically male dentists in Dubai on my title of the program. And I know you have such good staff relationships within your practice. I called it, are you hiring staff or building a team? Because so many dentists I think are hiring stuff. But what, in my opinion, as a self employer, we should be building the team. And so, I'm sure that much of what I said was maybe very new to them, which I could see from the reviews. And it was fascinating, Michael, that it was a select group of 25 dentists in this master class for four hours, and yet one third of the attendees, male, were actually not doing clinical anymore. They were running the practice or in their case, the clinic, because many of them are large clinics. So we've got male dentists. running the business side of the clinic within which I would say 99. 9 percent of the staff are female. So, it was absolutely fascinating to me, but I didn't change my message. I don't care where I am. The message is the same. And I was so impressed at their openness of being perhaps exposed to a perspective from a woman, not from that region who maybe Had very different and perhaps to them radical, but they were so gracious. And you can see them sitting back and thinking and then asking some of the most intelligent questions. So the point of my story is when you said my material or anybody's material who has good material, it is global.

Mike 4:57

Yeah. I applaud you for doing that because I've lectured in Dubai and just knowing the cultural differences, that's a big, chasm to cross. It's just the way the culture is to have mostly males who own these businesses take your information delivered by a woman that's a big thing. So I give Both parties credit yourself and your audience in the masterclass, but that's wonderful. Those are some great changes that you're able to take and help them succeed and hopefully improve their employees lives because they understand better how to deal with them.

Jenny 5:29

And Michael, if I may, I want to give credit to the committee at the AEDC, because when I put this forward, they asked me for four programs, so I'm looking at the program I'd like to do it, and I thought they would not accept it, because I thought I was stepping over the line to, and they might think, Justifiably, what does she know about our culture? And we don't want to rabble rouser in in here. So the fact that they accepted, and I believe I'm correct in saying they've never had practice management on before. So when I went last year. I already caused a bit of a stir but within four weeks of returning last year, they invited me for this year. So I guess they were open for a rabble rouser.

Mike 6:13

Wow. That's great. Well, they, they had the best. So that's the reason why they carried it out, but I agree with you. For the AEDC, that's a big step for them. So I applaud them for taking that step. I know we've got to limit this to an hour, but we can probably go about a week. And then to go back really quick. I just want to say, you've, you've been a friend of the family for so long and, starting out with my father and my mother and, you were a dear friend to them. And maybe I should explain that you have. This information to deliver, but you're not just somebody who read a few books and became a practice management consultant. You were able to work in many different dental practices, side by side with the clinician and you had the insights as a spouse. And so you have much deeper insights than most others would have.

Jenny 7:01

Can I make a comment to that? And I don't want to correct you, but I just need to adjust it. Actually, I'm sort of not, because when I look at friends of mine who, you have a good friend of mine, Joanne Tanner in your area in Granite Bay. And Joanne and I for 10 years worked together. When I had consultants, she was my top number one consultant. Consultants like Joanne. And others, they are in practices, maybe since COVID not as much in, but doing it through zoom, when I'm asked how I came into dentistry, which not many dentists actually. ask me, I married into dentistry. I mean, I came from working on Fleet Street in London for a newspaper. I moved to New York and I was working for J. Walter Thompson, who at that time was the largest advertising agency in the world. Then I moved to San Francisco and I was working for Lomas and Nettleton. Who is a mortgage company, the oldest mortgage company in America and met Edmund going to what was then called PNS on 14th street in the mission while he was going through dental school and he graduated and, six months later, we opened our door. I mean, I guess if I'd married a plumber, I would be running a plumbing business. So. I came into dentistry and Edmund's opening comment on day one is we're looking at 700 square feet and we parked every penny we have and signed a loan for you ready for this 25, 000. We opened the practice and equipped two rooms and the rest. And we took out a loan from Mr. Maltzberger at Crocker Bank on Montgomery Street for 25, 000. And we did not sleep that night because we didn't know how to take on the responsibility of 25, 000. And we walk into the office on the first day and we've got an appointment book, which of course is empty. We didn't have computers then. And Emma turns to me and says, Well, dear, why don't you answer the phone for the first couple of weeks till I find somebody who actually knows what they're doing? Welcome to dentistry. And so everything I learned In dentistry, I can say it now, but I was scared to when Jim pride first, sort of brought me to the national stage is I didn't say I'd never worked in another dental office. I just by common sense and logic looked at how other people were doing it, which in many cases made no sense to me. Took some other programs, which usually made no sense to me. And so just through trial and error, I developed it. I don't want to sound as if I have no clinical expertise. I did assist once at the chair for about 10 seconds, saw all this blood running around, backed out and looked at him and said, fine, you have that department. I'll run the front desk and we'll meet at the end of the day. I never got into his side and he never got into my side ever.

Mike 9:55

That's a great story. So let's just put that in perspective. PNS is UOP or the Art Dugoni School of Dentistry in San Francisco. What was the year

Jenny 10:04

Edmund graduated in 56.

Mike 10:06

56. And then back then, just because some people might listen to this and go, wow, they had a so easy 25, 000 loan. But to put it in perspective, do you remember what a crown cost back then?

Jenny 10:17

Oh, gosh. Most probably I'm going to guess 399.

Mike 10:22

Was it 3.

Jenny 10:23

99? I don't know. I do remember when we took out the loan for, for maybe students listening. When we went in to see Mr. Malzberger at Crocker Bank, he said, what collateral do you have? And we looked at him and said, a used VW and two wedding rings. We were living in an apartment, And he looked at Edmonton and said, In the 30 years I've been in dentistry, we've never had a dentist in California go bankrupt. You are getting this loan on your signature, the school, and your DDS after your name. He said there is no way you're going to fail. Sign here. I think those days have gone.

Mike 11:09

No, you know, actually, it's still the same. When you get out of dental school as a new student, you could take out a loan. And same thing, you know, because the default rate of a dentist is so low, they basically take your degree, you sign off on it, secure it, and you're ready to go. And the reason I bring this up is before we get into all your great information is I'm always trying to encourage, the new graduates not to think that they can't get a practice going, but that they can, they can secure the, financing. Usually they can get anywhere from like 500 to a million dollars just on their, with the signature and, and open it up. But, you know, they, they feel like they're so saddled with debt, the student loans, everything like that, which we, we understand, but I, I just don't want those, early grads to think, oh, I have to go corporate or I have to, you know, be an associate. You could. Maybe with your information, we're going to give today. be successful. So, so maybe we do that. We jump into, and again, we, we have not scripted this out. We're just having a conversation, but you know, when I was going through those three areas that you focus on when you do your presentations, just building a referral practice to enhance practice growth and the financial stability. You know, if you've got patients coming in, you're probably going to survive. And if you don't have patients, even if you're the best clinician out there, you're probably not going to survive. What are some things that you're seeing today that maybe we can improve on? And I think one of the nice things about you is I know you keep up with the technology. So, you know, you're not just thinking the docs have, to have a great yellow page ad, but you know about social media marketing and everything like that. So if you had to give us a tip on how to build that referral practice, what would some of your advice be?

Jenny 12:50

Well, um, I'm going to tie it in with It's something you just said about the student loan. One of my problems, my brain is going, I mean, your questions and your points, my brain is just exploding. I think one of my issues today, Michael, is that you and I were brought up that this is a profession. And I'd say in the last two to three years, I'm beginning to feel it's become an industry. And that worries me. The next thing I'm beginning to think, and this has been going on maybe for four or five years, is I feel like in my work, in reaching out to dentists, like they're two completely different worlds. And when I say guys, men and women, dentists, perhaps over the age of 40, who remember life, perhaps when it was more of a profession, they appreciate maybe my more subtle approach that the importance of hiring good staff, the importance of correct communication skills, the importance of turning things around. So when you talk to the patients, it's always presented to the patients from their perspective to this new world. Of people who have graduated in the last few years that maybe come out of school and this is why your point was very interesting. When I came into dentistry, I would say that 97 percent of everybody graduating from dental school was assumed to go into private practice. They either open their own as we did in England, we call that starting a scratch practice. It literally says it all. So the majority of eminence class, when I look at them, they started to scratch practice. And then a few went to postgraduate couple, went to military, a couple that didn't have confidence yet, went to be an associate ship and then moved on to private practice. Today, I have a feeling and I have no steps to prove it. That may be 97%. Are automatically going into some sort of corporate DMO or an associate CIP and really don't have the, maybe the confidence, whatever, to open that scratch practice. I did meet, somebody from financial services about four years ago, and he and I go back decades as well, and he and I were talking about this, to your point, he said, Jenny, He said, I've noticed that it's swinging back and coming out of school now, at least they're considering private practice. He said, whereas before it was just like you said, they were out. Who could they join? He said, I'm beginning to see, and he said, the money's there. He said, the money is there. for the ones that want to take the leap. And the question is, Michael, why are they not taking the leap? Do they feel they need more clinical expertise? Do they feel the school's not giving them the management tools? Don't even start me on that. I've had heated rows with deans of dental schools who do not include, management. Why have they chosen this? Do they just want to be An employee turn up at nine, leave at five with no responsibility. So there are so many things that need to be considered before I ask you a question, what can they do? Because it really depends which hat they're wearing. Would you agree?

Mike 16:08

Absolutely. So those three points you bring up, it's all the above. You know, they don't get enough train where they feel confident. And, you know, I'm out lecturing, multiple locations every week. So I have a chance to talk to the doctors. And that's one of the reasons why we were doing these podcasts because these podcasts represent what the Pacific aesthetic continuum, what we believe, Vista Apex, which is a material company, we believe that. There's a couple things We have to provide the knowledge to help the, the clinicians feel like they can be independent if they want to be, and if they're gonna be in a corporate, they can be more successful. But I think we're trying to do is we're trying to help them actually implement it. So, just real quick, I haven't had a chance to talk to you about this, but this last year, we've launched a lot of, live patient treatment programs. Again, during Covid, they all kind of died because we couldn't be all in the same room together. But, we're doing a course here, just even in California, and it's going to be October November, where it's a two day lecture, then we work on patients, and then a month later we lecture, and then we work on patients again, deliver the cases. And, the course sold out before we even got the marketing out. The clinicians out there, I believe know where they need to improve their clinical knowledge And now again, after COVID, but three or four years out, they're starting to seek that again. So I think that's why it's so important to get your message out there again, because I just think you're right. You know, we went from everybody being private practice, and then. That pendulum swung way over the corporate and now corporate seeing that, well, you know, maybe somewhere in between is a better place for us all to live. And I think we're seeing that now. So I'm more excited today about trying to provide information to our clinical colleagues than I was two years ago.

Jenny 17:49

I don't know if you've, have you spoken in the UK at all?

Mike 17:53

Not recently.

Jenny 17:55

Okay, the reason I ask this, and I'll make this very brief, but it's to prove a point. Great Britain is sort of known as being NHS, National Health Service, and when I was there in 85, 86. I spoke to the, I'm going to, butcher the name, but basically it's the American Dental Association of the UK. They were British dentists who spent two years at an American dental school so they could have a DDS or a DMD after their name, which meant they went back to London, put the American degree in, double the fees. That's what it was all about. And then in the 80s. Margaret Thatcher, at the time, reduced the NHS fees to the dentists by about 25%. So dentists said, I'm sorry, and they started marching out. And, for some reason, they all started marching back again. And private practice, it seems, for the past few years has been a little like this. And now, and I took a, a webinar from London. In fact, I've taken the same program twice because it's fascinating. Now there is a total move in the UK to move dentists back into private practice. And it's like, I've just seen, they did this in the eighties and now suddenly they're doing it again for a new generation because the generation has, there's a generation that grew up only knowing NHS. not realizing that they have a choice. And so now there are programs on bite the bullet, take a deep breath. You can do it. You can go into private practice and they're giving them the checklist of how to do it. So I'm seeing it in both countries.

Mike 19:33

Yeah, that's great to hear. Hey, you and I have to work on that coming up. Just to give the clinicians a view of how dentistry could be, because you're absolutely right, a lot of them grew up in this environment. They didn't see what dentistry was maybe 30 years ago, 40 years ago. And those of us, have a glimpse of what dentistry was back then, and then it has slowly evolved. And so that, that vision that we had 40 years ago, kind of fades away and you forget. And then one day you wake up and go, I remember what dentistry was like and why I liked dentistry so much. And if we could get back there, you know, work to get back there a little bit closer to where we were, I think we'd all be having a lot more fun.

Jenny 20:10

I was watching American Idol last night and it was like saying, I'm going to sing a Beatles song and the young kids say, who's Ringo Starr? You sit there and you think, are we living on the same planet?

Mike 20:23

Yeah. Yeah. Well, you know what, just a quick story. I was working on a patient and I like to fly, so I like Top Gun and I was talking to a student that came in to watch us work this on the, On this day. So she was shadowing us and a song came on. I said, Oh, this is from top gun. And she goes from what I said, top gun. It was just so funny. Cause she, she didn't know anything about top top gun. I said, do you know Tom Cruise? She goes, no. I go, do you know mission impossible? And she said, no. And that's where I figured out I'm getting old.

Jenny 20:55

I know

Mike 20:56

yeah. Well, so what, what advice do you have? You know, if you are, let's set the stage, cause I know it's hard to answer it for DSOs and private practitioners, but if you're a private practitioner today, not a corporate, clinician, you are competing against the corporate dollars. You know, you see their commercials all over, you see them on billboards and everything like that. They get special pricing from various vendors and things like that. So we're up there competing against them. But what words of advice, if I'm trying to survive as that, soul practitioner, what do I do?

Jenny 21:34

I'm going to answer your question in a very roundabout way, but I cannot think of a clearer picture to paint. There is an app called Nextdoor, and you may or may not have heard of it, and I think it's global. I'm tuned in to getting quality messages and I do check in once a day just to see why there's a fire engine outside my door or whatever. But the biggest discussion on Nextdoor in Northern California where I'm involved is finding a vet that cares. The small family vet, including my vet of many years, I just learned he sold out last December and we won't mention the companies they're selling out to, but Wall Street with all its money. And the reason I'm mentioning vets, Michael, and not dentistry is because people are so emotional about their animals, they are voicing their unhappiness about vets on next door more than they're voicing their upset with dentists. They're speaking to the vet and they're saying, what happened to my family vet? I knew it changed when I walked in January and things were different. And literally, this is what they said. The girl at the front was a bitch and so forth. And I couldn't work out why it was so different. I've now learned that doctor so and so sold in December. And so the big conversation is where can I find a sole proprietor, somebody that isn't run by money that I'm happy to pay a fair fee for a fair service. And then now they're talking about, I took my cat in for an amputation. He was, the cat was there for three days, 15, 000. They're beginning to equate the money with what they perceive as poor service. So if I translate that into dentistry and I'm on file and you've heard me enough to know, I say this, I truly believe that patients only question the fee when they question the quality or the service as they perceive it. That they only question the feed when they are unhappy with whatever it is they feel they're unhappy about. Now, Michael, because no patient has ever gone to dental school. One of my sayings is that dentists are judged by everything but their quality of care. The dentist graduating from dental school may be so proud of their crown or their fixed bridge, whatever, but if the patient has no connection to the person who delivered, The wonderful bridge, the wonderful crown, whatever that perceived benefit to the patient is that actually we thought it was very high for what we received what they perhaps felt they didn't receive was a feeling of being welcomed, having questions answered, having the staff be attentive and all those. nebulous, I mean, you cannot really judge the category by which patients judge a dentist, though I do have, and perhaps you and I didn't talk about it. I have a wonderful article I wrote for dentistry today on what I perceive are the 20 things that the patient uses to choose or stay with a dentist. And I would be happy to make that available. And it was put into a very nice article and I send it, I sent it to Dubai, as a very good example, it's the 20 things, and I, I didn't use the word things, but it's the 20 things I perceive patients use, and number 20 is money, number 19 is location, and number 18 are hours. The three things that if a patient has bought into the dentist and their service, and how they're made to feel. Money, location, and hours are none issues. I don't know if that helps you a little.

Mike 25:43

Yeah, that's a great answer. I'm just writing it all down so I can remember it., That's great. Yeah, I'd love to get that article and then we can give it to people if they request it. I think you're absolutely right. There's, two things that I always try to tell patients when I'm When I see them, even it's just a hygiene check one. At the end of the visit, I was telling him, I'm always here for you. So if you ever need anything, be sure to let me know. And then the last thing is always say thank you for coming in today, because I think we have to have the gratitude that. They could go anywhere that they want to go. But the fact they chose us to render their care and then to pay us, we have to have a lot of gratitude for that. And I think that you're right. In a corporate saying, you don't always get that because, just the logistics of how they work. But I think those of us that are. In our own practices, we really have to make sure that our patients feel like they're cared for as a person first. And then you're absolutely right. Then we have to provide the care that they want and the quality care. But, that's great. Because, Yeah, money is the thing that we always worry about. Am I charging too much? And in your list, if we are doing a good job with everything else, money is probably one of the least factors that a patient uses to judge us. So that's great. If

Jenny 26:51

I may build on two things you just said. Number one, going into the corporate environment, and I see this more in the vet conversations going on, and that is when you go to these large clinics, The biggest complaint from the patient or the owner of the animal is that they never see the same person twice. So, oh, well, Dr. So and so is no longer with us. And so they just feel like they're a number in the system. They're just a tiny cog in this big wheel. And so they spend too much time having everything re diagnosed. And your comment about the asking for referrals. This is something I sorted out on my own. It was quite fascinating. We particularly did it with emergencies. Very important if we ever did an emergency on the evening or a weekend. Which does happen, but any emergency where we took a patient out of pain. And I asked him to do it and it was so successful. He would turn around before he released the patient and he would personally hand them six business cards and say, and I'm just paraphrasing, but basically he would say, we're glad that we were here for you today. If any of your family Or your friends have an emergency. We pride ourselves in looking after patients in pain. Here are six cards. And sometimes he would actually not charge, particularly if it was just maybe they had an infection and all he was doing was giving them a prescription. And so there was actually no fee, or maybe it was something minor, maybe it was, I don't know, a piece of popcorn between the teeth. But he would just say, my fee today for this emergency is this. Now, he gave the six cards, and Jenny being type A neurotic left brain, of course, tracked it. And I'd say our average emergency patient sent us 12 new patients.

Mike 28:42

That's good.

Jenny 28:43

And if you look at the average, what your average new patient exam is, You know, whether it's 1200 or 2000 or 10, 000, if you multiply that by 12, that's, that was the return on investment. So

Mike 28:59

it's a great investment. That's a great, way to deal with those patients who are grateful for you coming in and. When you would go in and see those patients, the, both of you would be very gracious to the patient. So I'm sure that they felt that now that I think those tips right there are great. If I go down to the third topic that you focus on a lot, and that's the hiring, managing, and maintain a health, a quality team, which after COVID just seems like it's really tough. And with the wage inflation going on, and in California now that. Our fast food minimum wage is up to 20 an hour, and with all the benefits of working for a large corporation, it is getting harder for us as a small businesses, non corporate, if we keep it non corporate today, to attract quality people and to keep them. So what are some tips you have there? Well,

Jenny 29:50

it's interesting. First of all, HR, is my favorite subject. If I was to give them half a day to talk about the subject that, that drives me the most, it's most probably staff, because I do see when you travel internationally, once in a while, you will find a single dentist with a single chair, literally without any staff. The first time I went to Belgium, And I spoke to 125 dentists for two days and I noticed it was not a single staff member there. And so I, I said, can you just reconfirm why I believe there are no staff here? He said, yes, because when we hire a staff member, we have a trial period or a probationary period. And after the 90 days, they become permanent employees and permanent in our country means till they retire. And. We are scared of making the wrong decision. And by the way, talking about Dubai, a new HR law went into place. It started in January of this year, that when you hire in Dubai now after the probationary period, which in my opinion is not long enough, it's 30 days, they have to sign a contract. For three years, so a dentist going into the marketplace to, let's say, how somebody administratively, which means they cannot actually look at them every second because they're doing dentistry of the 30 days. They have to sign a contract. Can they fire for cause? Yes, but you better have all your ducks lined up and have all the facts. So I hope that the states never comes that way. It's very scary. So I would say, If I look into dentists today, we talked about the two different markets, almost the old timers who've been around. I noticed through COVID and I talked to them today if I say, how long have your staff been with you? They say 20, 25 years, 30 years. And, if you talk to the younger people, they're not able to keep the staff because they've not been taught communication skills to keep the staff. And one of my pet peeves in life are, and I'm generalizing, so please don't send me an email and say I'm stereotyping, because I am. It's the HR attorneys. This is not dental. Because actually, I think the HR attorneys in dental. Do a pretty good job, but in the world, HR attorneys will have a huge audience and they tell employers what the rule or the law is on a certain thing, but they never tell the employer sitting in the audience. the communication skills or the approach to use to go back to the company to say the law has changed. So in dentistry years ago, we didn't have to keep time records. We arrived whenever we took a break, whenever we went for lunch, whenever, so forth. And then the law changed. And like every other business, one has to keep records. And I heard of dentists. Who literally went in on the Monday morning and called a staff meeting and said, the laws change and now we have to keep a record of how much you work. So there's a time card in as of nine o'clock today. The inference being that the dentist had been overpaying or the staff had been manipulating. When I put the time clock into our practice, I said, it's come to my attention that maybe I've been inaccurate with my timekeeping and I want to be sure that nobody is being shorted. So I'm putting a time card in because I don't trust my math. This way I can be sure I'm accurate. So I took all the blame and my staff said, Oh, Jenny, aren't you kind to think of us? Okay. Was it manipulation? Yes. But was it manipulation with love? Yes. Because what would it gain by upsetting everybody? And so the HR people giving advice to employers need to spend a little bit more time in couching how they pass on the law or how they pass on a new guideline. And I think some of the younger dentists have not yet acquired those skills. I know of a dentist, Actually, in the San Francisco Bay Area, who had a consultant come in and said, you know, Susie on the front desk is, she's sort of killing your practice. We need to do something about it. Would you consider it? And the doctor says, I will consider it over the weekend. Let's talk on Monday, nine o'clock Monday morning, the doctor walks to the front desk and says, the consultant so and so said, you are an absolute disaster, you're fired. And was sued for over a million dollars. So it's not just building the team, Michael, or doing the hiring. It is the manner in which one does it with what end in mind. So if I say to an audience, if you are looking to fill a position and you have a choice of an employee, excuse me, an applicant who can start on Monday, because you're desperate to have somebody answer the phone, or maybe finding somebody who can't start on Monday, which is your choice? I would say that the average dentist is, I want the person on Monday. In fact, 75 percent in this country, the last time I checked, 75 percent of employers hired the last applicant interviewed. It's like they run out of steam. They finally think, Oh, they've got two arms, two legs, and they can breathe and pick up a phone. I'll hire them. I, when I go to hire, I don't want the person looking for a job. I want the professional in a job. Who's unhappy with the job. And is thinking, where can I take my skills? I better make a better decision this time than when I allowed myself to be hired. So I write my ads to attract a professional sitting in a practice. Looking to make a move, but to do it with due diligence, not the desperate person who needs rent on Monday. And that's one of the messages I have to get through to the dentist. I would rather you close down a day a week or go fishing for a day or two and hire the right person than to hire the wrong person. And I, took a webinar the other day. I'm always taking HR webinars and I have always been told, and I've always quoted, That when we change staff in a small business, maybe it's in corporations, but I know in a small business, the cost to the employer of changing staff is one year's salary. So by the time you've gone to the marketplace, you've found somebody you've trained somebody, you may or may not have kept two people as they pass over the training mistakes are made, whatever it's one year's salary. And last year, Michael, I noticed that these. Experts in this field of HR are quoting most probably it's a year and a half salary.

Mike 36:45

Mm-Hmm.

Jenny 36:46

And maybe it's because the hiring is not good. The last time I checked with the a DAI should check again, but at one point the a DA was saying the average dental staff member in a practice in the States stayed 13 months. Now, I don't know about you, but I think it most probably takes somebody a year to feel really comfortable and blossom in a practice or in a small business. Takes about a year. Well, got four more weeks and then they're off again.

Mike 37:15

Yeah. Yeah. No, I, you know, we've gone through the same, a lot of team turnover, a lot of them for good reasons. They moved on to, pursue higher education. Yeah. And such. So they've moved on for good reasons, but you're right. When you're trying to find somebody to replace, a good employee and you go through 10 people, you're just at the end, you're just like, okay, if they can breathe and right, then, okay, we'll take them. Yeah, that's a good, you get, you throw your hands up, but you're absolutely right, the hiring the right person is key.

Jenny 37:49

Now, let me ask you a question, because I think that there are two different markets in this, administration and clinical. When Eamon and I started the practice, and it was in Milpitas, which at that time virtually nobody knew where Milpitas was, it was a community divided by a railroad. So when Ford were trucking their cars from one place to another, And there were cows in the field. We literally got caught at the railway crossing for 30 minutes while everything went up and down. And at that time, it was impossible to find a clinical system. We were out of San Jose, we were below Fremont. So Edmund went to the high school next door and, talked to the teachers there and we literally started taking them out of graduation and Edmund trained his first. clinical assistants himself. And I will tell you that when I look back, they stayed with us through marriages, divorces, births, the average stayed 20 to 30 years. And we used, I used to kid them, I said, now you can't work anywhere else outside Dr. D. St. George's office because, nobody does it his way. But I was talking to, Kevin Henry. I don't know if Kevin Henry, very big in, in that world. And he and I have been discussing some mutual interest in staffing. And he, and I told him the story with Edmund and he said, I'm beginning to see the same thing, Jenny. That dentists are now willing to invest to train, and I cannot tell you the loyalty that staff member has to a dentist who slows down in a busy practice to take the time and recognize quality and invest in it. They will never worry about that staff member. And I'm always asked what's the number one thing. What is the number one talent or characteristics that I look for when hiring. Never changes. Good attitude. It's the only thing I'm interested in.

Mike 39:50

No, that's correct. And going back into that, you're absolutely right. A lot of times when we hire somebody, like an assistant or front desk, it's like, okay, when can you start? You can start on Monday, show up at. And as soon as they show up, we don't have a training program. It's just watch somebody do your job. Right. And, you know, it's funny because every once in a while I will, look at the way we're doing things. I go, wow, we're not doing it the most efficient way. So I'll sit down with my assistant, usually the new assistant and say, well, who taught you how to do it that way? And they said, well, the other assistant did the one that's no longer there. Right. And I go, I wonder where she learned it. And so it goes back to the story about the, woman who's putting her ham into the oven and That's off two inches on both sides, right? And, you know, this woman takes her ham, she cuts off the ends and sticks it in the oven and one day her daughter looks at her and says, mom, why do you cut the ends of the ham off? And she goes, I do it because that's the way your grandmother used to always do it. And so she goes to the grandmother, her mother and says, why did we cut the ends of the ham off? And she says, because my grandmother, well, your grandmother, my mother did it that way. So finally she goes to her grandmother and says, why do we cut the ends of the ham off? And she goes, it has nothing to do with cooking the ham. It's just my oven. Was too small for the ham. And so I think, I tell my assistants the same thing I go, you know what, I think this is one of those things that got passed down from generation to generation of assistants where it was somebody's bad habit or something that they thought, but it's not really how we want to do it. So, it's funny the way that we in dental practices, again, if you're corporate, a lot of times there's a corporate trainer, so they hire somebody and then they put them through some type of training program. Those of us that are, so practitioners, we don't have the time to slow down. So it's like, okay, you show up on Monday at eight, okay, grab the section. Let's go do it. And so I think you're absolutely right. If we slowed down and spent a little bit of time training our new assistant or explain to the front desk, what our practice was about, then I think it would go a long way.

Jenny 41:42

That's why, actually, and I've been asked this for years and have not done it for various reasons, but I am going to start producing some on demand videos on these programs, because the point that you've made about corporate is exactly right. If you were hired by IBM, they would not put you on the phone on the first day. They would maybe either pay you to stay at home. Excuse me. Or go into a conference room and read all the manuals and watch the videos, but no, what do we do in dentistry? It's baptism by fire. And so they make the staff make the new staff member makes sometimes horrific mistakes. But it's not their fault. It's management's fault,

Mike 42:25

right? Yeah, you're absolutely right. I know we're coming up on close to an hour and, I think we can, get together again because I think there's so much more that you and I can go over. I think our, our beliefs and what we would like to see for the profession in the future. I think we're very well aligned with that. So I think we carry a very similar message. But one of the things I know you're working on a lot of new projects. And so for those that might listen to this. Is there a way they can learn more or their products that you have out there or, how do we keep in touch with you?

Jenny 43:00

Okay. And thank you for asking for those who followed me for years, I've always had um, it used to be audio cassettes, of course, today's listeners saying, what is an audio cassette? I still have boxes of them in my garage, but every time I did a program, I had my entire circle of. Information available. Then we went to CDs and they were always available on my website, which is j d s g dot com. And if you go to my website today, you will not see a single product because when you and I grew up, Michael, I would spend all day talking about scheduling by design. Well, I really needed eight hours, but I somehow squeezed it into about five and a half hours. And my product, was called take Jenny home. And it literally was five hours of me speaking, no editing. If I said, or I said an R or a questioner asked a stupid question, you got the whole bit. But today's market doesn't understand how to work in six hour segments. And in fairness to them, they want to be able to focus on their number one need. So the material hasn't changed, but the format has, Michael. So everything's been broken down into 20 minute segments. So if I talk about scheduling and you want to know how to schedule an emergency patient, you can actually go to the exact place. And listen to 20 minutes on how to schedule an emergency patient and just one more comment because you talk about things don't change. I recently have started to take all my handouts that I've had for years and years and I've had a couple of wonderful virtual assistants and I'm reformatting them. And as I go to reformatting them, I realized that the language and my philosophy is not changed. The only thing I'm changing is the beautiful layout and now it's got a photograph, it's got my bio and it looks, it's on a template and everything is nice. But what I'm saying is the same today as when I, started speaking. And, I was in Australia some years ago for the FDI. And the dentist, we had about 500 dentists in the room, no staff. And the dentist stands up on the back row. And as a speaker, you know, they're always on the back row when they take you on, they don't take you on in the front. No, they take you on the back. And he stands up and he says, this is G St. George. He said, I'm confused. He said, we've got dentists in this room from 45 countries. Why do you think that this is appropriate? For all of us, you know, that's such a sweeping, philosophy. And I didn't pause for breath. I just looked at him and spoke very slowly. And I said, common sense and logic has no international borders. I'll give you 10 percent for culture, 90 percent it works. He glared at me, I glared at him, he sat down and he came up at the end and gave me a hug and he said, I absolutely agree, but his first It doesn't apply to me. And I don't know if you see this clinically, but I see this in management. A specialist will come up to me and say, Well, I didn't take your session on scheduling because I'm an orthodontist and it doesn't apply to me. And I said, 95 percent applies to you. You have no shows, cancer, short notice, whatever. 5 percent is also schedules a little bit differently. And they look at you and they think, so what I would ask the listeners is to be really open minded that good knowledge. I've done six days to podiatry. I had a podiatrist in Sacramento, sent me a wonderful letter when people wrote letters saying, I took your podiatry course and he said in six months I doubled my podiatry practice. The only thing, Michael, I had a note at the top, don't talk about amalgams and trounds, just talk about bunions and varrucas. I did my dental scheduling seminar. Talking about marukas and bunions. I've talked to heart surgeons. I've talked to orthopedic surgeons. They all think I've been in their field for years.

Mike 47:11

I would say, I hope you don't get those lectures mixed up, or we'll be putting our foot in your mouth.

Jenny 47:17

No. Oh, oh, cute. Very good.

Mike 47:20

I had to go for that one.

Jenny 47:22

You had to go for that one. My email is info at I N F O info at Jdsg. com and my website is jdsg. com and if you would like to send in a request for the article with the 20 benefits that patients are looking for from their dentist or the 20 services or specific things. I will be happy to have that sent to you, but do send it to info at jdsg. com so my staff can handle it. And if you'd like to know about my upcoming Video programs, which we are now beginning to work on, will not happen till the fall. You know where to find me.

Mike 48:05

Oh, that's great. Well, just a real quick recap. I think, we talked about what's going to keep patients coming back to our practices and keep them within our practice. You know, people are looking for a fair fee, a good service and personal care, whether it be for their pets or for the mouse. I think, that's important. Just always remember, we can't make things to corporate. When I'm talking to Dentists I go just for medical care. I remember when we were referred to as a patient and now we're a subscriber and you know what happens in medicine is we used to have Our family doctor that we'd probably spend our whole life with and now whenever our insurance changes we change doctors And so things have really changed but dentistry is different. We're not going to be a million dollars or hopefully we're not going to give the patients a million dollar bill after services. So most of our services, they can find a way to, to pay for. And I think as long as we had that relationship, they're willing to, stay with us. I think, When we deliver messages to our team or even to our patients or to a spouse or a child, I think we should always remember how we deliver that makes the impact we can have the same message, but deliver it in a way that's more proceed to be beneficial to them, and there will be received better. So I think we should. Remember to do that. And then I think you're right. We have to make sure we hire the right people and then spend some time to actually train them so we don't just throw them into the fire and then get frustrated. And, in the US, at least we don't have to hire them for a lifetime, but it's no fun having somebody spend the time having them get to know. Our team, our patients, the way we do things and then have to let them go for some reason. And many times that reason is probably a shortcoming on our side because we didn't take the time to train them properly. So, I think there's a lot of great information in this interview. I thank you very much for your time. And I look forward to, getting together again and, sharing a little bit more information. Maybe we could do that as you get closer to launching your material.

Jenny 50:09

I would love that. And I'd just like to make one comment. And whether or not you mentioned the name, you sent me a podcast of somebody that you interviewed, which I found absolutely fascinating. And he made a comment that I almost fell off my chair. And I, if I'm misquoting him, I'm sure you'll correct me. But I think he basically said that private practice, as we currently know it, Will not become extinct, but is definitely going to be down to here. And I could not disagree more. And I think that it's become very clear to me in the last few months that I want to go after the market of dentists who wish to Remain in their own world with private dentistry and not go into that. So I don't know how you felt about the comment. I'd love you to comment on his comment, whether or not you mentioned his name. I don't have permission to do it.

Mike 51:03

Yeah. That was, it was a great interview. It was Dr. Jack Griffin that, we did the podcast with him and, going back to the perspective of, Dr. Griffin, Dr. Griffin, had a very successful fee for service practice, then bought some practices, bundled them up, sold them, and then went back into practice, bought some more practices, bundled up, and sold them again. So he's really, he's lived in both the, sole practitioner, kind of a high end practice, and a more corporate model. I think what his comment is well taken in that he sees the DSOs is growing, there might be a space for the sole practitioners, but I know he didn't make it sound like it was going to be a very small number. I think in actuality, he knows, it's more a little hyperbole in that statement. But I think we all realize that dentistry. I don't think we'll go to a hundred percent corporate. I think dentistry, because of our fee schedule, because of that relationship we have with our patients, at least in the next few decades, we'll probably be able to survive, those clinicians that choose to survive outside of the corporate, format, we'll be able to do that, but going back to the three points that you brought up before, I think many dentists don't feel well prepared, many dentists, don't want, and, We could generalize this to younger dentists, but when I talked to doctors, it's the old clinicians too. They don't want the headaches of managing a practice and then all the financial headaches that go along with it. So, that's why what we're seeing now is you see a lot of the young dentists, they go into a DSL corporate practice. You see a lot of the older docs that are maybe retiring, but they don't really want to hang their hat up yet. So at, in, in their fifties, they'll sell to a corporate. And then continue to work. But now all those administrative headaches kind of go away as it's the clinicians in the middle. They'll work for a DSO. They get their speed up. They save some money. Now they buy their own practice. And I think that I think you're absolutely right. That's the group that, we could really develop a good message for provide some training education for and really help that. Part of dentistry survive. And I think, by doing that, we'll see corporate will always be there, but I think we'll see a, a taming of that, which I think will, I don't want to say it in a bad way, but I think they'll save dentistry, at least in the view that we have of the way dentistry has been,

Jenny 53:18

I know you're trying to close, but every time you say something, you make a good point. So I write something else again. Let me just say the last thing I was talking to a good friend of mine over the weekend. And, this person has been in my life and in dentistry for as long as I've been around, but he works from product. He works from merchandising. He works from the other side and he's involved in the buying of practices and dentists who want to go into DSOs. And this is what he told me. And I find it fascinating. So for the young. Dentist listening to this heads up what he's finding now that the DSO is who going into the marketplace of discriminating and what they want to do is they want to buy the well established practices that are successful that are not going to bring a lot of baggage and Mishandling of situations, but who would like to relax a little bit and not be running the business side. So the standard of what they are now buying, he said, started about two years ago is really changed. And they're not just assuming, Oh, you've come out from school. You're welcome. It's, he said, it's really changed. And in some cases, which I thought was interesting, they're doing the sale, Michael, so that the patient doesn't know that there's been a sale. They're not changing the name on the front door, and I'm sure you've heard this. So the patient still thinks, unlike my vet, who sold in December, and boy, we knew in January. No, if the vet had handled it this way, the staff would have changed, everything would have, excuse me, the staff would not have changed, and the patient would have felt as if they were going to their current dentist. And, somebody said to me they thought it was immoral that the patient not know, but, I'm not sure about that. So, even in the DSO world, the standard is changing.

Mike 55:10

You're absolutely right. Yeah, I don't think it's immoral for a clinician to do that, but you're absolutely right, My practice could be purchased tomorrow, it'd still have my name on it, nobody would know that kind of the management of the practice has changed. And then you're absolutely right. What happened was the funding for the acquisition of practices began to change. And before what happened is you take a bunch of practices, you bundle them together, then you could roll them out and sell them off. When the money got a little tighter, what happened was, you weren't able to buy them and just, unload them very quickly. So you actually had to go in there and manage those practices to keep them growing. And that's why Today, what they're doing is they're actually trying to find quality practices and a lot of the corporate practices or the corporate businesses, if they have practices that are lagging behind, instead of trying to bring those up and keep it part of the package, they'll actually let those go and then make other purchases. So you're absolutely right. A couple of years ago, the way that all this was going changed dramatically.

Jenny 56:06

So I think at one point you said a little earlier that you're finding these times to be very exciting.

Mike 56:13

And,

Jenny 56:16

We're in charge of our own destiny. Absolutely.

Mike 56:19

And that's why, I mentioned before, but the Pacific Sec continuum, this apex and others I work with, we're really going to push a lot more education because we just feel like now's the time, you know, what's happened to is during COVID, there were a lot of new graduates that came out of dental school that were short changed. They either had their clinical time cut short, or, the whole dental experience was cut short. And so they were pushed out there, maybe not as well prepared as others. And so at that time, when that was happening, I looked at everybody around me. I said, you know what, there's going to be a day when people are going to come back and say, Hey, I need more education. And that's when we can help fill the void. So, I'm just out there today trying to figure out how do we help our community. Our colleagues, being the professionals that they are, it's no longer about how do I make money providing the education, but it's more, how do I get that education out? So a lot of the things I'm doing today are basically free to the clinicians where they had to pay 10 or 100, 000. 20 years ago. Yeah. And because we have these different models of delivering our information that makes it a little bit more efficient, we can reach higher, greater numbers. But I think it's just that point in our career where we want to give back to the profession. And I think like you mentioned my father before, and you know, that he really valued the educational side of dentistry. Spent a lot of years of his career trying to get out there and promote education, promoted speakers to help them get that education out there. And I think I'm just the next generation trying to carry that out.

Jenny 57:46

Well, I think it's wonderful and dentistry will have a bright future if the Michael Miyasakis of this world keep the priorities that you have and not get, and keep life somewhat in balance. I mean, it's great there are other services out there, but there needs to be some balance.

Mike 58:01

Yeah, there's room for all of us. No, but I appreciate that. And, I think you're going to be part of part of that part of my professional life that has always had a big impact on what I do today. And, and I really want to say thank you. And I appreciate that very much.

Jenny 58:16

And I appreciate your support. This has been an absolute pleasure. As you say, we could go on for another two hours, but we both have a life. And I do understand that because nothing is more fun than finding somebody that, that builds, you know, you make a point, I make a point and we build on each other's points. We don't have monologues. We have dialogues.

Mike 58:33

Yeah, absolutely. Thank you very much.

Jenny 58:37

Thank you, Michael.