Marketing your Practice in the Age of Instagram

Dennis  00:00

Hello Dental Online Trainers. I'm Dr. Dennis Hartlieb, and welcome back to this episode of our Sharecast. I am thrilled to welcome a guy that I kind of know, kind of don't know; we've kind of met. I won't to tell you our little bit backstory on how I got to know Brian, but this is Brian Baliwas. Am I saying that right?

 

Brian  00:36

Yeah, yeah, Ba-li-was.

 

Dennis  00:38

All right, thank you for correcting me. I'm so bad with last names. When I taught a demo of this last one, he gave me permission not to have to ever say his last name again. So I just call him Adamo "Elvis" now.

 

Brian  00:49

I love it.

 

Dennis  00:50

So Brian, thank you for joining us today. For those of you who don't know Brian, Brian is also known as San Francisco Dental Nerd if you follow him on Instagram. If you don't follow him on Instagram, then you need to follow him on Instagram. We're going to talk about that in just a little bit. Brian, thank you for joining us. I have so many questions that I'm just going to sort of jump in and start asking you stuff. So, first of all, you're out in San Francisco. So that's part of your... we know that from your handle. I know a little bit of your background, but share your background with our listeners and viewers and and readers. You are not from a dental family as I understand it, right?

 

Brian  01:32

I'm not. No, my father was in the military. He was a Navy guy, and he came here from the Philippines in the 80s... actually late 70s, and kind of got his citizenship that way. Came over with not a lot of money in his pocket and some big dreams to hopefully bring his family over here and kind of create something, and so I was born in 1982. So you can do some math there of how old I am.  Born in the states or born in Philippines? Yeah, San Diego. Yeah, down at... my dad was stationed down in Balboa. Actually,

 

Dennis  02:06

Were you a surfer?

 

Brian  02:07

You know what? I surfed a little bit, but no, I wouldn't call myself a surfer. I'm more of like a snow skier snowboarder type. The water just kind of freaks me out a little bit.

 

Dennis  02:19

No, there's no sharks on the snow. So, I don't argue that. Well, tell me how you got into dentistry. Who influenced you? There must have been something. Something raised your interest?

 

Brian  02:31

No, what I've always wanted to be in the health field. So you know, I went through college, kind of knowing that I wanted to do something like that, thought about being a dentist. We've always joked around like, I should be a dentist.

 

Dennis  02:41

Why? Where'd that come from? I'm curious.

 

Brian  02:43

I don't know, actually. You know, and I could lie and say, "Oh, I liked being artistic..."  And there was just something about it. You know, my best friend growing up, his father was a dentist, and I'd always go to his place. And I'll be honest, there's a little bit of "Wow, they are living pretty comfortably!"

 

Dennis  03:00

No doubt, right?

 

Brian  03:01

Yeah, my family didn't really come from a lot. And there's a little bit of that appeal. And it's interesting, because going through college, I didn't have great grades and I tried applying to dental school -- didn't get in, and ended up having to go to a postback program where I really stepped up the grades and ended up going and get into dental school. So, it wasn't until I actually started getting serious about "Hey, like I should actually take my studies in school seriously," that I started volunteering at a couple clinics. I started shadowing, I was interning at a dental office and I said, "Oh wow, like this is... this goes beyond making a great living. This is actually -- you're touching people's lives. People are happy to see you. It's a happy profession."  I've always been going back to the generic answers you get about dentistry. It's like I have always liked working with my hands. I used to build models. I'm gonna date myself again, but back in the day you used to take these plastic part models, and you'd strip them off these trees, and you'd paint each of the individual pieces, and you'd glue them with a model cement. I don't know if that's a thing anymore.

 

Dennis  04:08

I doubt that very much. But yeah..

 

Brian  04:11

But it was fun. It was fun. And so you know, I could see myself enjoying something like being a surgeon, or like internal medicine. But there's something about the pressure and also the interactions you have with patients. You know, even if you have a successful heart surgery, you still have complications, it's not a happy place. Whereas this dentist, I was shadowing patients loved going to see him; they'd get cosmetic work done, they were happy afterwards. It was just a great vibe to the office, and that relationship with the patients is a little different than other health care professions.

 

Dennis  04:48

You know, I was talking to Donald about this, and I think there's like two paths in dentistry. Either (A) we come from a dental family or we were totally influenced by a dentist, you know, and could be a family member, could be a relationship with some sort, or I think more commonly is people like ourselves that come from a more blue collar background, and look at dentistry as an opportunity to be able to influence people and help people and serve people and be able to use our hands and be able to be part of the health professions. And I've always said that it's hard enough for me to tell people that they have a tooth that's dying. When I was thinking about going into medicine, I couldn't even think about having to tell someone that they were dying, or someone that I just worked on had just just, you know, passed on. So, I'm with you. And I think that I think that's not, you know, uncommon with all of us that are in dentistry. I think we follow a similar path that way. What's your surprise? Now that you're in dentistry? What's your biggest surprise?

 

Brian  05:46

My biggest surprise is that, you know, I always have thought that there were these destinations in life... you know, like, "Oh, man, once I get into dental school, things will be great. You know, once I graduate, this is gonna be awesome. Once I buy a practice, right? I'm going to be set." And milestones that I haven't reached yet, like, oh, once I get married, once I have kids, once I retire, and I'm realizing that life isn't some sort of destination. It's just like one thing after another. And so my biggest surprise is I thought that, you know, once I was a dentist, that was it, I'd be doing one thing over and over again, doing that. But I'm finding that every, you know, month, every event I go to every CE class I take... it just changes my dentistry and my viewpoint on dentistry just a little bit. And it's just ever evolving. And sometimes it's my dentistry that I'm stressed about. Sometimes it's the business aspect of it. Sometimes it's my patients, and sometimes it's my team. It's not what I expected. But I'm having fun with it. So...

 

Dennis  06:49

I want to talk more about that. And it's funny because it made me think when you're talking about how like these destinations... my best friend, when I moved to Chicago for I went to Michigan undergrad in dental school. And then I moved to Chicago. And my best buddy was working for Arthur Andersen our Price... one of the big ones, and he would come home with his clothes dry cleaned, and I would see him pick up his dry cleaning. And I thought, "I'll know I'll have made it when I can afford dry cleaning." That was like the ceiling. I thought that was it. And then turns out then there's the next thing and the next thing.  So when you're, I want to talk about your practice. And the reason that I really wanted to talk to you, Brian was two issues. First of all, I'm a big admirer of your Instagram tag. And I'm sure you hear that all the time, I want to talk more about that. And also about a practice that is dedicated to fee for service and overcoming some of the obstacles with insurance based practices and all. But before we get into that, I always like asking dentists, and this is easy for you, because you're so dang young.  And this is actually this is why I want to talk to you is because I've been doing this for a long time, over three decades. So for our young listeners, our young viewers, my perspective, it's... you know, while there are some some commonalities and some similarities from what I went through when I was a young dentist, the world has changed significantly. And so it's it's sort of like, oh, when I was a kid, this is how we used to do it. And that's, you know, and that, that's okay, but it's not the full story, because the full story is that the world is richer in many different ways. And the life experiences are so challenging, so different. And I'm eager to speak to you because I think you can bring a perspective for our young dentists, instead of listening to this old geezer tell them about oh, well, this is how I did it. I'm super curious, super curious about how you've managed to go through some of the challenges of the practice that you have.  But first, before I ask that, what was your first dental procedure that you did in dental school outside of a profi? Your first real dental procedure...

 

Brian  08:52

I remember this! It was a number two amalgam, a DO amalgam on number two. And I was going, you know, like, really? Alright, like, let's, let's do this!

 

Dennis  09:04

Who throws you into that? I mean, how does this work? Like, like in medicine, that'd be like, that'd be like in medicine, you're like, a fourth year med student, and they're saying, you know, why don't you go take her this bypass? It's like, well, I don't know, I think maybe I ought to learn a little bit more first, and maybe get into some easier stuff. But dentists... what is so screwy is they'll throw you into some of the most challenging procedures as your very first procedure. Makes no sense.

 

Brian  09:27

Oh, it was brutal. And I remember three distinct things about this procedure. For one, going in there and asking constantly, "Do you think I should go deeper?" Mind you, I'm still in amalgam. Right? See all that stuff. That's amalgam. You've got to get rid of it! So keep going. Meanwhile, me not being able to put on a tofflemire. And so like I'd put it on there, and I couldn't get it deep enough, and little did I know... and now I do this constantly, but you can push down a little deeper, and it will actually cut some tissue, and there it is. It's okay, but don't be afraid of blood.  And then it was checking... I'll never forget this. I still remember the feeling of when this happened like going, "Oh my gosh, I can't believe I just built this. Look how beautiful it is." And I said, "All right, go ahead and go ahead and tap, tap, tap."

 

Dennis  10:14

No! You did not ask them to bite down on it! You did not! That's a sin!

 

Brian  10:16

And this distal marginal ridge crumbles. And clinic time was running out. They had to jump in and help me out. It was brutal!

 

Dennis  10:31

I tell you. I hear people say that dentistry is easy. And people say that... I guess they don't do number 2 DO restorations. I've been doing it a long time. I still find dentistry to be really challenging. I mean, keeping things isolated, keeping things, you know, keeping the patient from talking while you're working on them, keeping a rubber dam on if you're using a rubber dam. So many, so many, you know, so many issues.  Alright, so, Brian, I was... I became aware of you because of my partner, Dr. Chris Ching.

 

Brian  11:01

I love Chris.

 

Dennis  11:03

Yeah. And I love him, too. And... see, we've got that in common. We both love Chris. So Chris showed me your Instagram page. And, like many people, I fell in love. And you have, at last I counted, you have a 250 million followers? Something like that, I think? I've lost track Something like that. You have a lot of followers.

 

Brian  11:23

I think it's around 30,000, which I'm honored that there'd be that many people who want to see my content.

 

Dennis  11:30

What I what I particularly like about your content... First of all, you're incredibly vulnerable, I'll just say, man. For me, from my perspective, you're not just vulnerable about your dentistry. You're vulnerable about who you are as a person. You put things out there that I think are... you could easily be criticized for your viewpoint. I think part of that's your generation. I have a daughter who's 25. And you know, she's not afraid to sort of put herself out there and say, "This is what I believe. This is my world. I inherited this crap world that my parents left for me. And I'm going to speak out on the stuff, the injustices that I see. And so maybe it's part of your generation, maybe it's just you guys are just individually created that way. But I have to tell you, I'm not nearly as vulnerable on my, in my social media stuff as you are. And I give you a lot of credit. Are you like that in person? Are you that vulnerable in person?

 

Brian  12:23

You know, I feel like I've gone through so many iterations of myself and social media alike. I mean, you could probably find an example of me not being so open and being very opinionated about something. In the past, you know, there was a time where I get on social media, and I'd be offended by things and comment. And I think it's just being on there so long, I've just kind of transitioned. And I've realized that, that, you know, there's so many different ways to do dentistry and to get things done and different opinions that everybody has. And recently, I've just been trying to take a step back and be more positive about things. And I really think that that's going to be a big thing for social media in general. Not just with dentistry, but in general, like when you read something, we really have to take a step back and not react right away. Right. And so how I portray myself on social media, I think is honest, it's who I am. But it hasn't always been like that. I've been that person who I've critiqued, who I critique now. Right now, the biggest thing is just about being ethical, you know, and doing the right thing and just trying to spread positivity when we can.

 

Dennis 13:38

Well, I think you're really creative, you're really funny. One of my favorites, and I don't have it in front of me, but essentially, it was like, this is a cost of products, if you order from your dental from your dental supplier. And I can't remember what it was -- like a thing of alcohol, like, you know, isopropanol alcohol. And then the price was like, you know, $380 if you order through your, through your dental supplier, and it's like $22 if you go to the hardware store. And that's the stuff that you provide content for, and I think there's some some real great reality. You have a great filter to see reality and see the distortion between sort of the world that we live in and what's going on in reality. You have a really good view of that. And I think, especially at your age, I think that's really impressive. It's really cool, at any age!

 

Brian  14:22

I think it starts a conversation about stuff, and it kind of brings things to light. And that actually started... I had so many people commenting about, you know, I like to give little tips and tricks on my page. You know, here's how you can save a little bit of money here in your practice by using this material. But then, you also have to know when you can do that and when you can't, you know, because then I get people who go well what kind of bonding agent you're using? I'm not commenting on that. You can do it with certain things and not others.

 

Dennis  14:55

Right. So you don't have to... you don't have to go to Costco to buy your dental bonding agent, but you can't go to Costco to get your paper towels, for instance.

 

Brian  15:03

There you go.

 

Dennis  15:04

Yeah. I think you and the @DentinalTubes are my two favorite groups to follow because you guys have such, you have great insights, you have great information, and you're just kind of

 

Brian  15:14

Nate is great. He's one of my favorites.

 

Dennis  15:17

Nate's doing a great job. He and his team are doing a great job down there. So that's that's how I got introduced to you. So my first question really as we get in to this. So Brian, I want to get into like how you started your practice. You graduated in 2014 if I remember from Portland, Oregan?

 

Brian  15:34

No, actually. So I graduated 2014 from UOP, Pacific. I went to U of O for my post bacc. Long story short, I got out of school and said, "All right, I need a job" like most people do. Most grads now are working at multiple practices. I didn't have a parent who was a dentist who I could go work for, I just had to kind of go out and try out different things. I almost went out to Texas to work for a DSO out there. And somebody said, "Hey, you know, you should really practice where you want to live.: And so I said, "Okay, well, let's try the city." It's close to my family. I like it out here. So I worked at a couple of different practices. But the one that really kind of started things for me was a practice where somebody had bought a big group practice downtown. And since they were renting space, so what they said was, Hey, you know, you can build a practice within this practice. I'm starting off. You don't have to pay me anything, but what you'll do is as we collect from your patients, we will pay you 30% of whatever we collect. So in a sense, I was running 70% overhead practice right off the bat, right?

 

Dennis  16:40

Yep. This was great. And this is this is, I think, so interesting, Brian, because I think this is... I work with a young dental study club, graduates of Marquette, and I have a lot of young dentists I talk to, and this is a big issue. How do I get started? And where, you know, if I'm going to get into a practice, how am I going to make it in this practice? So I'm glad you're starting right there, because that's what we need to understand.

 

Brian  17:07

That's exactly it. And so that's one aspect of it. And then I was at another practice where I was a true associate. They paid me 25% of my production. And all I was responsible for was doing the dentistry, writing my notes, and leaving. I had, I mean, I was literally a cog in the wheel.

 

Dennis  17:26

And what type of practice was that? Describe that practice.

 

Brian  17:29

It was a private practice still, but it was very insurance based, it was a lot busier. And it had a very different philosophy from my own practice that I was building within this other one. I had been taught to be fairly conservative. All my mentors have taught me well. And again, I think the hardest thing to learn in dentistry is how to be ethical. Not to say that this other place wasn't being ethical. It's just a different philosophy. It's a lot more cookie cutter, which again, sounds negative, but not necessarily. It's just more... less personalized care than I'm comfortable providing.

 

Dennis  18:02

Now the practice, the other practice that you were essentially, space sharing or renting space, and they were taking a cut from you. Were you then... you were building your own practice within that practice? Or were you doing in a separate practice collateral to that practice?

 

Brian  18:22

Yeah, so, no, that was it. It was just that. My Brian Baliwas, DDS, was part of this bigger group practice. And there's other dentists doing that. And we were in charge of marketing and trying to get our own patients in the door. We shared staff who shared materials, we did all that. But really, it was on us to kind of build that practice. Patients weren't being handed to me. Patients weren't calling the practice itself saying, hey, I'd like to get in, and then there was a, okay, well, let's give one patient to you, and the next patient goes to you, the next patient goes to you, because the practice itself wasn't marketing.  So it truly was a space. I always tell the story in my marketing lectures, but my first month, I made $500.

 

Dennis  19:06

Big time! Go to Vegas.

 

Brian  19:08

And I was gonna quit, I think I made a mistake. I should have gone to Texas, and I'm talking to my friends who went out there. And I'm like, how much did you make? And I'm thinking... I'm looking at my student loans. I'm looking at my rent, and I'm going, Oh, man, like, I've really gotta step it up. And I'm sure we'll talk about this in a little bit, but that's when I really started getting creative about how do I market myself? How do I brand myself? How do I get patients in the door? And unfortunately, one of the first steps I took was, Well, why don't I sign up for insurance plans?

 

Dennis  19:39

Let me ask you a question before we jump into that, because I do want to talk about that. That's so important. So, I want to know about the culture of the practice that you're in. So, you are one of several dentists that are in there. You're =building your own practice, and you are essentially borrowing assistants. You're borrowing front staff. So you are at the mercy of the other team members that are there. Correct?

 

Brian  19:58

Exactly it. True.

 

Dennis  20:00

And so what what was the culture like of that practice? Is this the practice that you're in now?

 

Brian  20:05

No, no. So I mean, I'm still there two days a week, it's been cut back. And the only reason I'm still there is I don't have room to bring those patients over here. I mean, I'm busy at this practice that I've finally bought with one of the other doctors that I was working with there. I'd say culture is one of the hardest things to establish.  No doubt. And I think that's the tough thing about working in that type of environment of a group practices is... I believe, and this is just what I think, I think there needs to be one person or a few people who set the tone for what that culture is.

 

Dennis  20:41

I could not agree with you more. And this is -- if I can interrupt for just for a second. So we're talking about Chris, my partner. And this is exactly what we're going through now in this transition. So Chris bought in about a year ago, two years ago now. And the practice now is his, even though we're equal, we're 50/50 partners, but he's the future of the practice. And so the voice of the practice has to come from Chris, not the old guy who sort of... you know, I got us to here, but you know, the reality is, is that at my point in my career, I can't bring it any further. I've already set all the goals, I've already realized all my dreams, realize my goals in this, in my practice. And now it's Chris's turn to now make his vision obvious in guidance for the team members. So that's interesting that you say that because one of the things I think is a big mistake in partnerships is that there can be two voices. There can be in, you know, in a typical case a senior dentist and the younger dentist, and the team is going to follow the senior dentist, unless the senior dentist will step back, and the the younger dentist will step forward and take that responsibility. But you need a clear defining voice.  It needs to be clear. And actually ours, I would say the culture was much worse in the sense that it was the senior owner doc who said, "Well, I'm leaving it up to each of the individual doctors to kind of set their own culture." Well, when you do that, that's fine when you have individual teams. But It's one thing for an assistant or a team member to adjust to different procedural or task-oriented things. It's another thing to ask somebody to adapt to different cultures with difficult philosophies.  It's impossible!  Yeah, you just can't do it. You know, one of my tenants that I've had from the very start is I'm never late to appointments. Never is a strong word. And and I really mean it. And if I have to pop out of an appointment to go out to the waiting room, or the reception area and say, you know, I'm so sorry, I'm still with the patient. I know we're supposed to start right now, but I'm going to need 10 more minutes. I've met with the patient, like I'm not late with that interaction. There is no, you know what I mean?  Oh, I do, for sure.

 

Brian  23:01

That has to be on time. And if not everybody is like that, it's just impossible to work as a cohesive unit.

 

Dennis  23:09

Absolutely, absolutely, I couldn't agree more. And if I can just add one thing on that for our young dental dental students and dentists that are listening, one thing that I do is I thank patients for their patience. Because I do run late. I ran late today, and I had a patient not happy about it. But I had to take a phone call from a surgeon for a patient, it was in the chair I had, you know, blah, blah, blah, the things that happen.  And I just walked in, and I immediately said, Thank you. Thank you for your patience. I'm very sorry. I truly am sorry. And that what are they gonna say? I mean, it's not like they you know... And all sudden, she's like, okay, and I said, I you know, things on things that I did not expect happened. And I'm really sorry, but we're going to take care of you. And everything was fine. But you have to acknowledge you're running late, you have to greet them, and say thank you for being patient. I'm really sorry, let's get... you know, but I acknowledge it. I need to acknowledge this.

 

Brian  24:01

And it can't be the norm. So from a cultural standpoint, it is set up that is it is an exception. This never happens, or I'm so sorry... Whereas there are some practices that just run habitually 10 to 15 minutes late, and that is the culture. An hour late! An hour and a half late! I'm not saying it's right or wrong. But you can't have those two mix. Just to kind of let people know there's this really good book called The Culture Code. This is a really, really good read. If you're a basketball fan, it brings up Gregg Popovich and why he's such a winning coach. It is an awesome read or listen, if you're a listener. It's really helped us establish culture at our practice now.

 

Dennis  24:41

When I talk about bonding, I say the contour is king, and I think in practice, I think culture is king. Yeah, I don't think can get beyond it. Yeah, so continue on. So you're in this... So you're in this practice, and you have to develop your own practice. One of the things Brian, I hear from a lot of young dentists... They get into associate position, and unless you have a situation where a senior dentist has retired, or passed on or whatever, it's unlikely you're going to have a full time practice to walk into, right? A senior dentist like me brings... I brought Chris in. I said, "Chris, we're gonna have to build your practice. I'll help you with this. But you have got to build a practice." And that's, that's one of the things I really want to get from you on what what you did.

 

Brian  25:21

Yeah, that that happens even with, with some of my classmates who had parents who were dentists. It's like, they were kind of going in expecting, oh, I'm going to work with my mom or my dad and not realizing that, look, unless they were running a 200%, they're not going to be hitting the ground running either. So yeah, little things I did was, you know, I just had to kind of think outside the box and say, you know what, am I really going to spend a lot of money on a website? Am I going to spend money on ads? Am I going to... I wanted to kind of build things organically, and so I just reached out. I kind of, there's this idea that I say is dated, but not really. I'll say back in the day, it was all about community building, right? Like you join a church group or you join a softball league, or you would, you know, create mouthpieces for the mouth guards for the little league team.

 

Dennis  26:14

I did all that.

 

Brian  26:15

And what that does is you're building a community, right? And that community now realizes, oh, this is the dentist in our community, and we're going to go to that person. So I just tried to do that, you know, whether it was me going to the gym, meeting people when I went out. My big thing was letting people know, hey, I am a dentist in the city. And and here's who I am. If you enjoy my presence, over a beer, or, you know, next to me on a spin bike, you know, maybe you'd enjoy me, you know, doing dentistry.

 

Dennis  26:50

And you're in downtown, you're in downtown San Francisco, so you... it's not like there's not other dentists for people to go to. You're in a highly competitive marketplace, just like Chicago. But you're doing old school techniques. So part of, you know, if you're looking at like a fork, one of your prongs is, is that you are just connecting with people in a face to face manner.

 

Brian  27:11

That's, I think that's the biggest thing. And again, there's no right or wrong. I think it's just, it just fit my style a little bit better. And also my style of dentistry, which is a little bit more personalized. One of the big mistakes I did, and I look back, you know, I'm glad I did it, because I know that I'll never do it again was I signed up for a bunch of insurance plans.

 

27:30

Let's talk about that because I get that question all the time. So when I started I, I made the decision, right? And I don't know why. And you know, the insurance back then. So I graduated in 88. I started practice, I did a residency for a year, and I really started practicing around 91. So we didn't have the same influences that are going on today, but there there definitely was influences. And I don't know what it was, but it just seemed absolutely ridiculous that I would give away 30 or 40, discount my fees by 30 or 40%. And I thought you know what, I'd rather just tough it out and charge what I need to charge to make a living than do that. But it's a lot different today. It's much different.

 

Brian  28:16

You're fortunate to have that perspective, though. So you have to realize, I got out of dental school. Here I am. I joined a group practice where doctors are in network for sure. For me, that's the baseline. So I'm going, okay...  That's the norm. Yeah, I sign up for these plans. Patients come to me and then we charge $800 for crowns. Is that right? Okay, great. I'm coming out of dental school where crowns are 600 bucks. Okay.  Yeah, how about that?  I was like, $200 more in private practice. That's fine. And it isn't until you start looking at Wait a minute, like, I want to use this lab. This lab is really doing good work for me. Oh, wait, how much is that lab bill? Okay, well, then if I'm doing that... and it just doesn't... You start to do the math and you go, Wait a minute, how are you guys making this work? And then you realize, wait a minute, you see our your your usual customary and reasonable fees, your fees that are for people who don't have insurance. They're not higher, to make up for the fact that you're charging a lower fee from insurance. I mean, that's you want to talk unethical. That just makes no sense. That fee is actually your fee. And you're discounting your work to be in network? And that was a big, I mean, that sounds so obvious now. You know, I'm making it sound like it was a big revelation, but you would not believe how many patients, how many doctors don't know that.

 

Dennis  29:40

Oh, absolutely.

 

Brian  29:41

Yeah, those fees are not normal. And they don't add up necessarily. What you're doing is you're discounting your work for an exchange in marketing. And in my opinion, it's not great marketing,

 

29:53

That's a great way to put that. Can you say that again? So go deeper into that because that's such a perfect way to say that.

 

Brian  29:59

I was just gonna say that that discount. You're paying for marketing, It's not a discount of your work. You're just taking that money, and you're putting it towards your marketing budget,

 

Dennis  30:09

Toward driving people into your practice.

 

Brian  30:11

And it's not great marketing. And what I mean by that is, if people come to you because of a reason, then they'll leave you for that same reason. And what I mean by that is, if somebody comes to you because you're in network, well, if you become out of network, then there's a chance you might lose that patient, because that's the reason they came to you, right? Or if they, if somebody comes to you because it's convenient, well, if something becomes more convenient then they... you might lose that patient. You've got to think about what that bond is, what that attraction is. And that's what I thought about. That's what drove me towards what we were talking about earlier, which is I want to build connections with my patients. And to this day, I still have patients who, you know, I'm sure they know that there's someone they can go to for better work, or for somebody that's closer to their location, or somebody who doesn't work in a building with a $30 parking fee, you know what I mean? But why did they come to me? It's because they, we've built some sort of connection. They know and trust my work. I'm transparent about it. You've got to build a solid foundation. And for me, I didn't realize this, but building a foundation of insurance-based patients just didn't fit my style. It's not a wrong thing to do. There are several practices that make it work. Sure, absolutely. But it's a very different style of practice. And you need to be aware of that.

 

Dennis  31:39

You have to decide what type of dentistry you want to do, and when you're in a PPO practice or a practice that's dependent on that, it's gonna limit the type of dentistry you can do. And if that's the dentistry you want to do, then that's awesome. And then you provide care for people who have a limited financial ability to pay for dentistry, and you can do some great things for people. But if you if you want to do more, more holistic or more comprehensive dentistry, more complete dentistry, in some respects, but say more comprehensive dentistry, it can be pretty challenging, I think, in running through those programs.

 

Brian  32:14

Yeah, the other analogy that I've used to kind of explain this to some of my students over at the dental school, or some of my patients even is, you know, it's like running a restaurant. If I come right out of culinary school, and I want to open a restaurant. You know, what, one of the ways that you can get patients in the door? We've all heard of Groupon. What does it do? You open up a burger place that says, hey, with your burger half off, and you get free fries? Well, the thing about Groupon is usually most of these Groupon save limit one use per customer. Why is that? Because if everybody bought the Groupon and got a burger at half off and got their fries for free, the restaurant is probably losing money on that. They're okay with it because it introduces everybody to their work. And hopefully you like the burger enough to stay and become a patron of that restaurant. The problem with insurance is it's not a, Hey, your first visit is covered at 100% along with the x-rays. It keeps discounting everything,

 

Dennis  33:15

Groupon forever!

 

Brian  33:16

It's a Groupon forever. And so what ends up happening is you can really kind of get upside down in this. And if, going back to that restaurant analogy, if all of a sudden, I'm trapped, and the only way people are coming to my restaurant is from Groupon coupons, and I'm realizing that I'm losing money, where do I start making compromises? Do I start, you know, cranking out burgers a little quicker? Do I start buying ingredients from places that are a little cheaper? Do I, you know... there has to be a compromise. And unless I'm willing to lose money, which most people aren't, because they won't be open in a few months.

 

Dennis  33:53

And as you said, people are going to seek you out based on what that denominator is. So if it's about price, if they can find it for cheaper, then they're likely to leave you because you haven't built that relationship, right? I think one of the biggest challenges in dentistry and what we've talked about with our team, countless times, is not allowing us to be a commodity.That when people go to the store, and they're buying toilet paper from Costco, it's the same toilet paper they'll pick up at their local grocery store. It's a commodity and you can look at it from a price point. And I think the biggest challenge for dentists is to make sure that you're not a commodity, that you're not the same as a dentist they can go to, and pay 1/3 or one half of what the are paying if you go to see you. And I think that's that's what we have to get over. And that's what we have to learn to be able to build these relationships, have conversations, and help people understand that.

 

Brian  34:45

I think that comes with with education. And it takes time to do that. And if you don't have the time to educate patients, or some sort of clever way to do it, you're going to lose. And for me, I use social media to educate patients. I do spend a lot of time at new patient appointments. Think about it like this, like, how about wine? Right? Somebody who's not into wine and knows nothing of wine, you can give them a really nice, you know, $400 bottle of cab, and you can go to Trader Joe's and get some, you know two buck Chuck. And to them it's a commodity. They're interchangeable.

 

Dennis  35:22

It's a bottle of wine.

 

Brian  35:23

It's a bottle of wine because they don't know. So how do you educate somebody? If you're, you know, trying to say, Well, you know, you should really buy this more expensive bottle, you have to let them know. You give them tasting notes. You give them the history of of the wineries. You teach them how to properly pour, store. All this stuff to educate them. And then what ends up happening is people appreciate the differences. And then they're willing to pay for it because they value it. We do the same thing with cell phones, right? I mean, you're not ripping my iPhone away from me. You can tell me how great Samsung is. And I'm so devoted to it because I've been educated around it. It's everywhere. I'm talking to you through a MacBook Pro, right now.

 

Dennis  36:03

As am I.

 

Brian  36:04

Yeah, I value it. And so I pay for it.

 

Dennis  36:08

Pay extra. So two things. I think you're absolutely right. But two comments on this, because I think this is super interesting. The first thing that comes to mind is Paul Homily did some work with us, with DOT. And the thing that I got from Paul that I had never really thought about, because I used to use the word educate also. And he said, "Dennis, you're not educating. Educating gets you so far. What you want to do is you want to influence." And that's what you're doing when you're spending time. And helping people understand the difference between say, being with a PPO or being fee for service, you're influencing them. Educating is sort of giving them the information, and then just sort of expecting them to sort of figure it out. What you do more and what you do with your social media stuff and, in getting to know you, you're influencing people, and that's why people will make a change. That's why people will make a decision. Because with education, people can very often just sort of be stumped, right? I had a conversation today with a patient whose child has fractured off a tooth at the osseous crest. He's 10 and a half years old, we went through the treatment options. So what they were there for was to be educated. What I was trying to do was sort of influence them.

 

Brian  37:23

Makes sense.

 

Dennis  37:24

Right? The other thing is, is that when we talk about this wine tasting, the reality is they is going to be a certain amount of people that just don't give a rat's ass. Excuse me. They don't care, right?

 

Brian  37:34

And that's okay in my mind.

 

Dennis  37:35

And that's what you got to be comfortable with, right?

 

Brian  37:39

Yeah, I'm not the dentist for everyone. And I tell patients this as well. You know, it's funny, you would think that if I get a patient who's like, Well, you know, this costs too much, and I don't really want to get this. I'm not the doctor who goes out to the office and goes, I can't believe that patient doesn't want to, you know, that they're valuing price. I tell patients all the time I go, look, you know... I had somebody the other day, I said, Look, you're 21. You just graduated from college. This is your first job. This copay that, you know, you're confused about, it's a lot of money to you right now. I get it. I'm not here to make you feel bad, but we have got to find you a better fit, though. And if we can find a dentist that meets the needs financially, from a philosophy standpoint, let's do that. Right? Like why try and keep and pressure patients who don't belong in your style of practice. It's just gonna give headaches or provide headaches to your staff to your team to you.

 

Dennis  38:37

I think the point where I, where my practice took off, was when I was at the point where I said, I am comfortable with a patient choosing the dentistry that's right for them. When I truly in my heart said I'm okay with this, I'm okay with them choosing not to do dentistry or choosing to do dentistry somewhere else, or choosing a different type of dentistry. When I became comfortable with that, all the sudden, it's like the practice just sort of blossomed. When I sort of stopped trying to control people, trying to control their decisions, trying to I think educate instead of influence. It made an enormous change in the growth of my practice and the success of my practice. When I finally just sort of let go and let... I heard someone say, "you know, it's, it's their teeth, it's their money, it's their decision." What we can do is give them guidance, we can influence them, right? We can educate, guide, and influence. But after that, we have to sort of sit back and allow us to understand allow them to understand, it's their teeth, their mouth, their money. And I say that all the time to patients: "It's your teeth, your mouth your money. You tell me what's best for you."

 

Brian  39:42

Yeah, I'm really stoked that I'm doing that now. And kind of, again, I wish I did it earlier, but sometimes you got to go through the ups and downs, and then you've got to explore insurance sometimes to see if it's a good fit for you.

 

Dennis  39:56

So for patients who have been heavily working in PPO practices, and you started out with that, how do you have conversations with patients to be able to separate yourself from the PPO into a fee for service practice? And again, this is not for everybody, but for those who want to be fee for service. Talk about those conversations.

 

Brian  40:16

I'm very open. I mean, you just talked about how, you know, I'm pretty honest on my page. I'm the same with patients, I tell them straight up, I go, look, I'd love to be able to provide you with this care at this lowered fee. But I can't do it. And sometimes I'll even break down the math point. I go, look, this is how much it is to be in San Francisco. I'm very honest about that. And I and I let them know that from an ethical standpoint, I don't think it's fair that some patients get charged a lower fee. I think everybody should pay the same fee. Because if I felt comfortable doing it for that lower fee for you, then I should feel comfortable doing it for that lower fee for everyone.

 

Dennis  40:57

How do you have this conversation? When you are... So let's say you're you're part of any number of plans, and you decide that I'm going to start dropping off plans. I'm going to start with this. This is the plan that has the worst, you know, percentage receivables for me, so I'm going to drop this plan. How do you have a conversation with those patients? Do you call them? Do you do meet with them in person?

 

Brian  41:18

Yeah.

 

Dennis  41:19

What would you recommend?

 

Brian  41:20

I did it through a six month, you know, kind of timing where I I kind of let people know. I was like, Hey, here's what's going on. I kind of gave them a heads up.

 

Dennis  41:30

That's great.

 

Brian  41:31

And that way, so at their next visit... and I made sure, like every visit, to make sure that their visit that day was kind of special and different. You know, here at our practice now, you know, somebody... Our doors are locked because of COVID. We'll try and undo that soon. But we see people; they kind of knock, and they get a text message or a call and it says hey, you know, we'll be out to get you shortly. Can we get you a bathroom key or a bottle of water? Right? And just little things like that they kind of differentiate you? What's interesting, people say, you know what, I've got to see somebody in network or they go elsewhere. We've had quite a few people come back and they said, You know, I went to a couple different practices. And it just wasn't the same. And I see now, why you practice the way you do. It feels good when that happens, you know, and this is why you should never be judgy or negative if somebody wants to leave. Let them find a better fit for them. You can't force people to be your patient. And the best part about that is if they are meant to be your patient, they'll come back, and it'll feel good. You'll say, "Oh my gosh, and I haven't seen you in a while. What happened?" "Oh, Dr. Harleybright, I left. And you know, I was really concerned about my insurance. But then I went, and I had this crown done. It didn't fit right. I was back and forth. And I remember all the crowns you did for me. And they've always been so wonderfully. I'm so sorry I ever left. Oh! Those make my day! You know what I mean?

 

Dennis  42:56

I think it's beyond how the crown fits. I think it's the influence in the practice. I think it's how you make that person feel when they're in the chair.

 

Brian  43:05

Absolutely.

 

Dennis  43:07

I think so often we we think about the dentistry, but we don't think about how is the patient feeling? What is their experience? How do we make them feel? That's challenging when you're running a practice, and the stresses of running a practice. You and I spoke off off camera about this a little bit, about the stresses: it can be from the dental work you do, and it can be from staffing. It can be from any number of different issues that are coming in from different directions. Ultimately, when the patient's in the chair, it's about the patient. And that's what we've really tried to work on in our practice over the years is just understanding and making sure that we know that the influences when they're in the chair, or when we're on the phone, and it's all about them. And even though we have maybe this all this stuff going on behind us, this chaos that's going on behind us, how do we make the patient feel like they're in a perfect calm? And that the storm that's around them is not related to them, that they don't even know that it's going on? How do we make that happen?

 

Brian  43:59

Yeah, I love that.

 

Dennis  43:59

And it's being present in the moment. And I think obviously those patients that have been influenced by you, that have sought you to come back, is because you've had this great influence on them and how dentistry can be. Not the dentistry that people talk about, Oh, I hate the dentist. I hate the dental environment. But you've created an environment where if they don't like that, they are still in a place where you make them feel that they're special, and they're unique. And this is the right spot for them. It's about finding that time. When you have these conversations and this -- see, I didn't have to go through the site find this so interesting, and I think this is so smart that you planned this out, and you said in six months, we're going to be dropping this plan. I need to start having these conversations now. How much pushback did you have from those patients? Was there a lot?

 

Brian  44:43

You don't what? Not a lot. I think I'm fortunate. I actually my retention rate for many of the insurances was well over 90.

 

Dennis  44:52

That's fantastic. That's incredible.

 

Brian  44:54

Thank you. One of the ones that was lower, I'd say maybe in the 70s was It starts with a D.

 

Dennis  45:02

We may be familiar with them,

 

Brian  45:06

It could be anything, but you...

 

Dennis  45:10

It rhymes with Smelta.

 

Brian  45:12

So it was tough, but they... and that was a different conversation with patients, and it was very much, hey, you know, they might inconvenience you to try and seek another dentist, you know. They don't reimburse me directly. They'll have to reimburse you or give you a check. And so you know, billing will be a little bit of a challenge. It is what it is. And again, who am I to... people are in different parts of their lives that sometimes they've got to find somebody who's in network. And I don't think all in-network dentists are insert whatever negative connotation you want to put there. It's just, for me, personally, this is a me issue. My, the way I was practicing, the way I had things structured, the timing of everything. It just did not work well with that.

 

Dennis  46:03

Now, having said that, how do you guys work with insurance now? So I don't know. Are you completely out of PPO programs and stuff? Are you waiting fee for service?

 

Brian  46:13

We are completely out of PPO programs. We still currently, as a courtesy, still bill for patients,

 

Dennis  46:20

We do the same.

 

Brian  46:22

Yeah. And we try to collect up front, and they get reimbursed on the back end, or you know, depending on again, everybody's in different parts of their lives, and they're in different situations. For some people, I'm okay with saying, look, that insurance will just come a little later.

 

46:37

But Brian, Brian, you can't do that. If you if you listen to people, you say you can not have a practice like that today, especially as a young dentist. So for the young dentists out there, you can't be doing this. How is this possible?

 

Brian  46:50

You know, again, it's just how... How about this? I think if we went back in time about 10 years, and 10 years ago, I'd say.

 

Dennis  47:01

I was still old back then!

 

Brian  47:02

No, I probably got my first cell phone back then. But now, it's probably been longer than that. But let's go back 20 years when you get your stuff when cell phones were a thing, right?

 

Dennis  47:12

Sure.

 

Brian  47:12

You remember when a new cell phone would come out? What would you do? You'd renew your plan, and they'd give you that new cell phone? It was kind of like a free upgrade is what they said. And people would always say, Oh, I'm due for my upgrade, right?

 

Dennis  47:24

Oh, you're right. Yeah.

 

Brian  47:25

If I took a little time machine back to that time and said, Hey, by the way, in 2021, you're going to shell out $1600 for a new phone.

 

Dennis  47:35

Can you imagine?

 

Brian  47:36

And in your plan is going to... you know, it's not even included in your plan, people are gonna go No, I'm not

 

Dennis  47:41

No way.

 

Brian  47:42

The thing is, people are educated about it right now. It's part of their, who they are and in what they understand. I'd like to say my patients are in the know; they value what goes on at this practice, and they value themselves enough to invest in this type of care and experience.

 

Dennis  48:04

Because you spent the time the time. You educated to influence. Right? You didn't just send them, you just didn't send them a letter. Hey, by the way, we're dropping your program. You spent the time, you or your team members spent the time, to help them understand why you're doing it, and why it's okay for them to continue on if that's what they want to do. But why you were not able to continue on? Am I correct? Is that is that right?

 

Brian  48:30

And not only that, but we almost... I don't want to say we encourage it, but we made it very easy for people to continue on. There are a lot of practices who, you know, if you're requesting records, it's like, well, we need to, we need you to sign this form. And it's going to be $25. And it'll be... We made it really easy. We said you know what? Have your office send us this form that we can send it off direct to them. Or, if you want, these are your records, you've paid for them, let me send them to you so you can give them direct to your doctor. We can bypass the permissions here. You know, until you find someone, here's our emergency number. Call us if you need anything. If you get behind, you know, it's been six months and you still haven't found a dentist, please come back, and we'll work something out. Maybe we you know...

 

Dennis  49:21

That's great!

 

Brian  49:23

And it's genuine. It's not a marketing scheme. When you're genuinely caring about your patients and giving them what they deserve, and the care that they need, I mean, it just... you can't top that.

 

Dennis  49:39

That's great!

 

Brian  49:40

And so I think you just have to be ethical about things. You know?

 

Dennis  49:44

I think this is a real challenge for... I know it's a real challenge for a lot of dentists and how they're going to separate themselves from their programs. As they do it, they start to realize with each one that they drop off -- as I've talked to dentists who have done it, it's like, "Oh my god, why have I been waiting so long to do this?" But I think it's so important that they have these conversations like what you're discussing. This is tough though, Brian. I don't think that... this is not for the meek. This is not for the...

 

Brian  50:11

It's not for everyone.

 

Dennis  50:12

 Hey, sitting there and having these challenging conversations about finances with patients is very difficult for any dentist, especially for a young dentist, to have to have these conversations. This is real challenging, I think.

 

Brian  50:23

I would say that... I might in trouble for saying this! But but it's also tough because you have a lot of big corporations and organizations who come into the dental schools, and they give Lunch and Learns. They get everybody to come for pizza. And they tell them that, "Hey, you've got a lot of student loans. And dentistry doesn't have to be so hard!" What I'm doing...

 

Dennis  50:45

They're hearing this all the time.

 

Brian  50:47

It wasn't easy; it was very hard. And they'll say, "It doesn't have to be this hard. Come join us, and we can really get you set up. We'll take care of everything. We'll just let you do the dentistry." And all of a sudden, you're kind of caught up. And you think that that's what it has to be and truth be told, it's tough. You probably don't hear from a lot of private practice dentists coming to dental schools to speak, because (1) there's no incentive, not to say that there always needs to be an incentive. But it's tough. And (2) We're busy, right? I'd love to be able to go to the dental school and speak every quarter about my experience as a private practice and how I'm not starving. And that, you know, that things are going well. But it's tough because I'm in charge of all of this. I mean, I'm in my in my wet lab right now, but we're in charge of ordering. We set up this board and this system. And we've got our invoices here. And we came up with this system to kind of get this taken care of. I mean, I look around this room, and it's all systems that we've built to make things run efficiently in order to divert our focus from these little things that cause general headaches and actually devote towards our patients.

 

Dennis  51:59

Right.

 

Brian  52:00

And when you do that, they value what's going on, and they want to come back and you build a practice that way. It's great.

 

Dennis  52:06

That's awesome. You talked about... when we were talking about building a practice, you're getting it out there, and you're letting people know that you're a dentist, and you want to treat them. I want to talk about your Instagram. This is, for someone like me and we do about social media with Dental Online Training, and to be completely candid, for all those who might be listening, watching or reading, I don't do that. I have someone who does that. Clare does that for me because that's just not in... I don't have a lot of time. My job is to develop the content. And then Clare helps by making it available for people. How much time do you spend doing your social media?

 

Brian  52:44

It's kind of funny. So let's, let's hope it's lower, but if I go through my actual social media lecture, it shows a screenshot of my time. Oh, that's not so bad. So today, I've got four hours of screen time. Okay.

 

Dennis  52:59

Holy Cripes!

 

Brian  53:01

Oh my gosh, well, that... The highest I've ever gotten on that is nine hours... nine and some change.  Brian. Is that healthy?  No, it's not actually and I talk a little bit about how that's unhealthy. There's actually papers that show that you know, when you take a break from social media that all sorts of good things happen psychologically to you.

 

Dennis  53:20

The world keeps on going without you in it.

 

Brian  53:22

Yeah, it's crazy. And Josh Austin, if you know him as a great lecture about mental health, Kyle Stanley's been talking about mental health a lot. It's really important to kind of separate yourself from this. I'll be honest, I spend a lot of time on this (1) because I enjoy doing it, but (2) it's also a transition. I told you about all the different variations of my social media page. There was a time where my main goal was how many likes and followers I could get, and let me come up with the next video that I could film so that I could go viral and things could be shared. And it was just so meaningless to me.

 

Dennis  53:57

But did that help you build your practice?

 

Brian  54:00

You know, what you could argue that that somehow contributed to that. I would argue that I could have done it without it, and I could have really focused that energy towards patients and done the same thing. I think it contributed to other things. It's built up my page, it's opened up other opportunities for me in terms of meeting dental companies and some of my mentors of mine. And it's interesting; it's kind of like a journey that I took that this is where I ended up. But looking back, I think I could have done it without. And really I could have... What I'm doing now is I'm taking that audience, and I've lost some followers for this and I've gained some as well, but I'm kind of transitioning into more positive information sharing. I mean, I'll still leak a few videos here and there, memes, and I try to keep things light hearted and funny. But I always want to have the intent behind my posts be something meaningful, rather than the intent being how many likes, follows, and shares can this get. I thought that was just so superficial of me to think like that. And now it's, you know, like even going on this podcast: Can we can been one new grad coming out of school to maybe explore working in private practice?

 

Dennis  55:15

Right, exactly.

 

Brian  55:17

And all it takes is one.

 

Dennis  55:19

That's all it takes is once, and I think that our role as people who are out in practice as a profession is to help influence others in their career path. And so people are going to figure out their path and they're going to find people of influence. And I got very fortunate on the people who I who I started following. It seems that you have as well. For the young young dentists... So say it's a recent graduate, someone coming out of school, who says, "Alright, I've got to get patients. I mean, here's the bottom line, I've got to pay my bills, I don't want to live, I can't live on $500 a month, (as you learned!)." Right? So how do I how do I go out? I know how I did it back 30 years ago; it's completely different today. So what advice do you have for the young dentist who is starting out their practice?

 

Brian  56:01

I would say that there's this term a phrase called a marketing funnel. I would look up what a marketing funnel is. And really, just for those who don't know, the first one is just like awareness,right? When you think marketing or advertising, you think about ads, and all that is is awareness. Hey, Brian Baliwas is a dentist in San Francisco. However creative way you can bring awareness to people, that's great. You know, explore those, whether it's meeting people, if you do want to do traditional things like print ads, websites, social media; whatever you want to do, it's awareness. But then people kind of focus too much on that, and you've got to remember, it's a funnel. And your goal is to widen that funnel as much as possible. The thing underneath awareness is consideration. Just because I say, "Hey, I'm Brian Baliwas, I'm a dentist." if I tap somebody on the shoulder and said that on the bus, you know, they'd go, "What the hell are you doing? Like, that's really creepy!" And there'd be zero consideration for that person to come to my practice. So you have to make it easy, and it's got to convince people to actually consider you.  Of those people who consider coming to you, you've got to have people who actually take action and call the office, and so for that, you've got to make it easy. You've got to have a phone number, your whatever you're using -- your website, your Yelp. You've got to have a link. Social media -- it has to have a link that allows people to call get directions, email you, DM, whatever. You've got to give them action. And then here's the best part of the funnel, my favorite part of the funnel is now that they've called you know, they've made it a point taken action, come to the office, then you have to get, you know, loyalty, right? Because now you want somebody to go, "You know what? Not only did I call but I'm... this is it! This is going to be my dentist, and I'm going to stay, I'm not going to shop around anymore. I don't care if I get awareness from others because I've found my home." And then from there, from loyalty, then you need people who will actually speak out and tell others.

 

Dennis  58:02

Build your tribe.

 

Brian  58:03

That's it. And the thing is, we get so caught up in how do I build my practice? Oh, we've got to build a website, we've got to do this, we've got to do that. That's all, all, all awareness. But what are you doing at the tail end. All it takes is one patient to give... Let's say you you start your practice, you get one patient in the door, and you give them a great experience. And that patient just happens to work at a startup two blocks away. And they had such a great experience that they go back and tell everyone, and they get on their Slack channels and say, "You know what, guys, I know, we just got new insurance. I had a really great time at this dentist. He's super informative, spent a lot of time with me."  All of a sudden, you just jumped that funnel, and you've got a wide base. All of a sudden, you get five or six patients from there, maybe more. You've got to trust the system, and you got to focus on the right part of the funnel, which is, you know, what are you doing at your office as well, you know? What are you doing to help people tell others about you? Are you on review sites? Are you giving out business cards? Whatever it is. I think it's worth looking into these marketing funnels and trying to widen what that is.

 

Dennis  59:14

I think that's a great point. Because what I've looked at that it's so much interesting. We get emails. All of us get these emails about how to create the funnel, right? But you're exactly right. It doesn't... You get this enormous funnel; you're getting people who are aware of you. But then what are you doing with those people once they are aware of you you, right? And then how do you create this loyalty?

 

Brian  59:34

And then I guess got to say, and I'm not trying to toot my own horn here, but it's just the reality of our practice. Right now, we're throttling things. I mean, we're trying to limit our new patients to two patient new patients a day. Like that is our limit. And the reason for that is we don't want to sacrifice the experience at the cost... You know, it's just like when a restaurant gets busy, and all of a sudden they get overwhelmed, and then you get 10 People who go, "Man, that food wasn't great, and the service sucked." And then that's the end of that!

 

Dennis  1:00:05

The problem, I think, Brian, and a lot of practices (and our practice has suffered this) is that you get so many people coming in, but you get that many people walking out the door, because you're not serving them at the level that you're supposed to serve them at. And they know that. They feel it.

 

Brian  1:00:16

Yeah. And again, it's a different practice model. Right now, with all of the CE I've taken, I'm sure you saw that I've been...

 

Dennis  1:00:26

You were just over at Kois!

 

Brian  1:00:27

I was at the Kois Center, and our CPA and our consultant, they gave us a lot of crap for how much money we spent on CE. But I'll be honest, my practice philosophy now is data driven. This isn't just a new patient appointment; I'm taking in data, I'm gathering it, and I'm putting it through our systems. And I'm looking at things comprehensively. So I'm looking at bigger treatment plans, you know, full mouth cases, trying to solve occlusal issues, versus what I thought I was doing at the start, which is trying to get as many patients in the door, and then we're just doing single tooth dentistry. It's very busy that way, it's daunting, some people love that. It works, but this, again, it doesn't fit the model that I was going towards.

 

Dennis  1:01:14

I think that's it exactly. I think you have to figure out as a young dentist, and this is hard, because you don't have a lot of experience... You have got to figure out what the model is that you want. Do you want to be doing a lot of single tooth dentistry, which is great. That's the model that my parents could afford. My parents could not afford to be a patient of mine, you know, likely. But once you figure out that model, then you have to stick to that. And you cannot serve both. You cannot have a high volume and high comprehensive practice at the same time.

 

Brian  1:01:40

You know what's interesting? This is kind of like a little aside here is I think it's easier to have this model of doing comprehensive full arch dentistry, and help trying to cater that towards the insurance-based patient than it is to have a practice that's just humming single tooth dentistry, and all of a sudden somebody comes to your door, and they want to do a big case. You know, Adam and I, we just heard a talk by Greg Kinser at Seattle Study Club Symposium. And he talked about like, Look, can you put people on some of these long term temporaries? And once you get them in this final position, you just go, "Look, your insurance covers a crown or two a year. Let's just start tackling this!" I hate to say it; now with the new shade matching techniques and the you know, the labs for or porcelain powders that they're using, I could comfortably say that we could probably get a pretty good case piecemealing it together, you know?

 

Dennis  1:02:34

That's part of our CPR for the worn dentition is, you know, we rebuild the bite, we take and manage all the occlusal issues, we have managed all the aesthetic issues in the transitional period or prototype period. And then we're able to do quadrant by quadrant, tooth by tooth, and we can fit into the patient's budget, whatever, whatever that is. Yeah, agree. Before we finish up, I did want to talk to you about Kois and how you got influenced into Kois. And we just talked Adamo last month, and I was influenced by Frank Spears as a young dentist, but John Kois also was a great influence to me. And I've seen John a number of times, and he's just outstanding. How'd you end up with working through Kois?

 

Brian  1:02:34

You know, a lot of people have been asking me that. They see me checking into the Kois Center or posting about it, and they say, well, you choose that over the other.  Spear, Dawson, Pinkie.  And I don't think that it's necessarily choosing them over the others. I think they're all great. I think if you're going to choose a continuum, choose it. Stick with it. You know, go through a series. For me, what really pushed me though, is, I think we all need to find mentors. And we need to find people who are doing the type of dentistry you want, who have practices, the way you'd want a practice to be set up or are living their lives in a similar... you know, like to have a lifestyle that you achieve, that you want to have. And so for me, I have a lot of mentors, I've been collecting them.

 

Dennis  1:04:00

How did you find them?

 

Brian  1:04:01

You know, a lot of it is just, for me, it's been social media. That's one of the things that I'm so fortunate to have is just people connecting with me through social media.

 

Dennis  1:04:10

Did you connect with your mentors? So for like a young dentist and stuff, so when you... so who did you reach out to? How did you end up in Kois? What was your big, who were your big mentors for that?

 

Brian  1:04:21

Adamo was a big push, as was Amanda Seay. They were like, you know, this is how you do this type of dentistry.

 

Dennis  1:04:29

Did you reach out to them through social media? Did you IG them, just do a message to them

 

Brian  1:04:33

I did. And that's the crazy thing about the world today is we're so hyper connected. You know, you can now send a message to almost anyone and say, "Hey, you know, I've got this case. I know you're busy. You think I could shoot you over four or five pictures, and just show you what... ask you?" I mean, it's so easy to connect with people. And again, there's no right or wrong, but if you have people who you look up to, who you follow, and you just say, "?Hey, how'd you get where you are?" And they say, "Hey, I did X, Y, and Z." Now that kind of gives you a pathway. And every mentor I have, they don't want me to just follow that path. They want me to follow the path and like go beyond.

 

Dennis  1:05:13

Right.

 

Brian  1:05:13

They want to push on. And so it's not just sticking with that. I explore all sorts of CEs. All these little adjuncts. And I've just been taking little pieces here and there and trying to build my own... my own little system, my own little practice.

 

Dennis  1:05:29

What advice do you have for... Well, so, I want to go back to social media for one second, because I'm curious about what advice you would give to like an old guy like me, or more senior or middle career dentist, and let's say they say they don't have any, they don't have any influence, but they keep hearing it. You've got to get on to social media. What would you What would you tell them about what social media really means as far as how it should impact your practice?

 

Brian  1:05:58

I don't know if you remember this, we actually had a conversation. I think it was at Chicago Midwinter at a party. And I remember saying, "Hey, I'm on this mission right now to try and get as many people like you," and I'm not gonna use the word old, because you're not old...  Look at this, this is gray! You're an experienced dentist, somebody who has had great success. You have been influential. You have done so much and contributed so much to dentistry. What's interesting is the only reason I know that is because I've had mentors who led me to understand the history of dentistry and how things progress and who the key players have been in the last 5 to 10 years, right? And I understand that. And so now with this platform I have, one of the goals I've had is how do I connect some of my younger followers to this, to some of these more experienced people who have so much to give.  And, again, I would say that my advice is to change your metric because a lot of people get on and they think, oh, man, like, Okay, I'm posting all this content, but I'm not getting a lot of likes, and  Sure! You hear that all the time,  And not a lot of followers... And it's not really... The one I always get is, "Well, I'm not getting much traction." And I'm going, it's not about traction. It's about you putting yourself out there, and then trying to build relationships, right? Because people are looking for these mentors, and feel free to use me. People do it all the time. Reach out and say, "Hey, you know, I've got this lecture coming up! It's on this." And I'll say, "Oh, my gosh, that's so great." And I'll post and connect you with some people. I've been trying to share as much CE as I can, because there's this... I'm trying to be the conduit between this experienced, more knowledgeable foundation... the people who aren't speaking at the dental schools, by the way, who are, who could be of value to some of these younger dentists, myself included.  And so my advice is put out content. Think about what message you want to give. And it could be anything. It could be like a tip that you do daily, or you know... And I'm coming from a KOL, key opinion leader, standpoint, if you have stuff to share there. But even if you're doing practice stuff, you know, it's helpful.

 

Dennis  1:08:10

So let's say you're just a mid-career dentist, and you're here. And I need to do this for my practice. And I've heard you talk about make it personal. So if you're someone who likes to spin, you're in a spin class... Is that the stuff that people should be posting in their dental practice Instagram? Or if they're trying to build a practice, should it be more about the team? Or is it a combination? How do you how do you balance that?

 

Brian  1:08:36

I think it (1) starts with what your culture is, and figuring out what you're trying to show and share with patients, what vibe you're trying to give. Then you post about that. You can audit things like, "Hey, when you are building rapport with new patients, what do you talk about?" And you can ask your dental team, you can just say, "Hey, you know, when I'm talking to new patients, what are the things I always talk about? Like, what do I bring up? Family? My hobbies?  Michigan. Michigan football. Michigan basketball that just lost last night. Ohio State, right? I'm sure you talk about that! No! We do NOT talk about that. Those words and not uttered in our office.  But that's my point. So if that's a big part of you, and it's important to you, why not share that with potential patients? I think the advice that I'll give, too, is when you're starting a page, know who your audience is. So here you are, you start a page for your practice, you should be connecting with potential patients. No need to connect with me. Or, you know, other doctors.

 

Dennis  1:09:34

Or any other influencers...

 

Brian  1:09:35

 Yeah. It's like, it's not about the numbers. Don't do that thinking, "Oh, well, I'm going to get more followers." It's not about followers. Remember the funnel. What we want are people who are actually going to call and click and make appointments and people who are going to speak and tag about you. That's what's important.  So rather than having 4000, if you get 40 that follow through, then you're much better than having this huge funnel, and you're only having five people or two people that follow through. Yeah, think about if you are posting about your spin, or about being a Michigan fan, let's say you get one patient who happens to be, you know, the athletic director of the program or whatever, right? That's it! You've won because now you've given that person a great experience. And it goes from there. It's not about this, this email blast of a page where it's like you constantly have to be posting.  Just connect with people. That's all it is. It's a community. We talked about building community and joining a church group, joining sports leagues. This is just one big community. It's a digital community. I've been fortunate to connect with a lot of the people in the dental community, dental professionals. I learn from them, I share tips, tricks, CE experiences. But if you're dealing with patients, then connect with them. Share who you are, share in their interests. You're just trying to connect with people. It's social media, so just go out and be social.

 

Dennis  1:11:01

Excellent. I could talk all night. That wouldn't be fair to you. I am super, super grateful. I do have a final question, and then I'll leave it to you. So the successes that you've had to this point in your career, what do you attribute your successes to?

 

Brian  1:11:17

Hmm, that's such a good question.

 

Dennis  1:11:20

Thank you.

 

Brian  1:11:20

You know what I would attribute it to just previous experience, my previous experiences, and being able to learn from them. I think I used to be scared of making mistakes. And now it's not so much that I'm scared of making mistakes. I welcome them, and I accept them. I still try to avoid them. But I accept them. And I learn from them. And so I'm not perfect. And you know, like I said, you can go back in time and probably find snapshots of my life or things I've posted or things I've said that I'm probably not proud of, right? But I've learned from them, and I've tried to be better. You know, we can always find cases that aren't... that we look back, and we go, OH. Absolutely.  But what are we doing about that? Like, are we using it to better ourselves today? And I think that's kind of been my big focus. And that's really been helping me (1) not get so down about things that I've done, or cases, or results, or end points. But it's also helped me grow because then now it helps me kind of springboard forward from those and just be a little better.  That's awesome. Yeah, people want to reach out to you, how do they find you?  Shoot me an email. It's baliwasDDS@gmail.com, or you can DM me on Instagram. Yeah, or, hopefully one of these days we'll be able to go to Chicago Midwinter or...

 

Dennis  1:12:50

Academy.

 

Brian  1:12:51

Yeah. Oh, hey, I love that place. I mean, that that is hands down my favorite meeting to go to, and I'm such a lit nerd that when I get that little USB in the mail, it goes straight into my computer. I review things, I reference notes that I took in my phone, and I just keep a little folder of it. It's great.

 

Dennis  1:13:11

It's a great two days. Brian, I can't thank you enough. This is so much to ask for people like you that join us after these long days at the office. And to share, and to share in the way that you do that... Again, I said earlier that you're so completely vulnerable and that for people like you that are willing to share, and allow others to learn from their experiences, I can't thank you enough. It's really, it's just awesome. I'm so appreciative. So thank you so much.

 

Brian  1:13:40

I'm honored you even asked me to be on here, so thank you.

 

Dennis  1:13:44

Dental Online Trainers, this is Dr. Dennis Hartlieb. Thank you so much for joining us. And we look forward to seeing you at our next Sharecast, and look for us, of course, on the Dental Online Training website. Check out our courses. We do, for those who are watching this, we have a course coming up in May, our six to tooth direct resin veneer course that we're going to be doing live virtually. So we look forward to seeing you all soon. And yours for better dentistry, I'm Dr. Dennis Hartlieb. Thanks.