156: The Culture of Convenience: Why Healthcare is Last in Line

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You have this natural talent, this unique ability. Hello everyone and welcome to another episode of DSO Secrets. I'm your fearless host, Emmett Scott. Today I'm here with Dr. Ryan Hungate who is an orthodontist and founder of Simplify. And we're going to take on this inflation recession and then it's combining with this culture of convenience. And frankly, healthcare is kind of the last in line being good at this stuff. So this is a topic that I've hit on many times around how much we have to look at retail, general retail, and say, okay, that's not just impacting them, it's impacting how the consumer thinks about this stuff. So Ryan, thrilled to have you on because you know, you're really there with dentistry technology. You've been driving this convenience thing. And I'll be honest, I think that it was a nice to have. It was like, oh, Emmett's being aspirational and yes, someday that would be cool. And of course everybody wants everything on their phone and they want convenience. And then Covid like took 10 year ideas and made them like 10 week requirements, right? And then inflation is just driving the margin down. So now we're saying, well, we can't use humans to do this. And by the way, we had a bunch of inefficiency with humans anyway and we were all kind of saying, well, I can't integrate some technology because Susie in the front is going to be nervous that she might lose her job. Well, Susie's moved to Frank, moved to John, moved to Henry, moved to, you know, back to Susie too. And so at this point we don't care. You know, it's like, how can we actually just get the job done? And frankly the new Susie's are like, yeah, could you integrate some of this technology? Because my job's too hard and I want my job easier and I need a $5 an hour raise on top of that. So the complexity of this, how fast it's moved, you know, I Was talking to some private equity investors and they're like, we're used to these kind of stuff, social changes, technology changes happening kind of in 10 year increments. Some of the technology stuff can really hit hard. But the social stuff, the mental change of what I expect out of my job and what I expect as a consumer has gotten dramatic. Because you know what's fascinating is as a consumer, I need you to be available 24 7, and as an employee, I need to not be available 24 7.

Yeah, there's a big mismatch. No. And I look at what Covid and what coming out of this pandemic did to people is actually a blessing for us. Now, let me get ahead of everybody going, what the hell are you talking about? Right? What I'm saying is, is that everybody wants more convenience, right? What Uber, what Amazon, what Doordash did to us during COVID is we go, look how easy this was. It forced Gener, who hadn't been forced to use that stuff, to now use it and like it and realize that it's easy. So for everybody that always walked up to me and goes, oh, Orion, that's, you know, the millennials and the Gen Zs that like that stuff, and the people that come in my practice and spend money are, you know, the boomers and the Gen Xers right now. And I go, nope, not anymore. Right? They want the convenience as well. And now they're okay at it, right? They're good at it and they expect that. I mean, think about it. The person that spends the most time on technology in all of my family is my grandma and grandpa. Meaning that they wake up in the morning, they grab their iPad, they look at it, they stay on it, they go to bed. That's just how it works, right? When they're at a concert, they're filming with the iPad.

I'll give you one piece. I'll give you one piece is QR codes.

Yeah.

That was such a brilliant idea. It had no traction. Like, you'd occasionally see it and my IT guys would drop it into stuff and like, wouldn't that be cool? Wouldn't that be cool? You'd see it in offices occasionally, but, like, you just did. You couldn't remember, like, was there a special app for that or do I use my camera? Like, it was just one of those things. Everyone knows how to use a QR code because they went out to eat, there was no menus. We all got trained. The QR code codes are cool. And then the super bowl, the highest performing ad was a QR code.

Yeah, the coinbase. The coinbase ad that didn't say anything, just QR code. I mean, that's a, that's a mic drop moment. And I completely agree with you. I think that what we should appreciate of that is that it moved the rest of the people forward with technology. So now it's uniform. Now we can apply this to a regular base that knows everything about this. So, and now what, what do we do with it? Now we go, oh, well, it's just another thing I have to put in my office. It's also the cure to all your illnesses. That's the best part about this, right. We were moving like a bullet train. And we still are again, by the way, the bullet train is moving again. So hopefully there's a lot of people that adopted this during COVID when the bullet train had stopped. There wasn't right. I was the guy applying all this stuff everywhere and we got a good amount. We had an insane adoption level, but a lot of people started it back up again. They hadn't gotten it done. Now these DSOs are left with going, oh my God, now I have inflation. Now I have all these things with other things working against me. Susie wants the $5 raise like you talked about. How do I fix this? Technology and automation is the only way to help you scale over this. And what's cool is you're going to come out on the other side in two to three years or whenever this thing's done. Maybe. Hopefully it's a flash in the pants, a fast one. Right. You're come out on the other side. Yeah, I agree. Hopefully you're going to come out on the other side and go, look, not only are my numbers fantastic during that recessionary period, but they're insanely good now. And I've adopted this mindset of saying one person can do the job of two and be a happier single person because they're not doing the job that they didn't want to do anyway. Right. The front desk is going to look at you and go, nobody wakes up stretches, gets excited in the morning to go, let's go schedule 100 people. Let's go verify this many insurances. Let's go call this many people back. Let's go send all these envelopes out. So nobody can ever pay me. Nobody does that stuff. Right. We get excited to interact with patients. That's why we're excited as doctors. That's why we're excited as assistants and hygienists and front desk people. We have to Remember that. That's why it's exciting to learn new things about people, ask about their families. That's why doctors get yelled at all the time to move on to the next patient. We like to talk a lot and just how it is. If you don't like to talk a lot as a doctor, I don't know, you're probably just not that good of a doctor.

Right.

But that's okay. Right? This is personality type. So I think that.

I think a big part you're calling out, though it is a huge blessing that the consumer base got trained. Trained on this. Because if we were trying to do this transition with what inflation is driving and the efficiency it's requiring, and we didn't have a consumer, but we were trying to teach them QR codes, if we were trying to teach them to online schedule and so forth. But now what I'm hearing from consumers is like, they'll go on Google, and if you can't online schedule, they'll go, look the same way that I look for something and then see if it's on Amazon. Online scheduling, it's. It's interesting because we like talking to people, but not in transactional moments. Like, I don't want to have to call. And if I do call, by the way, you better pick up because I'm not calling again, you know, instantaneous. So, yeah, you're right. There is good news in all of this. We have to adopt it. But the consumer actually wants what is. I think this is what you're saying. The consumer actually wants what is most efficient and profitable for our business.

Exactly. And their time. Their time is now way more valuable than anybody else's time. And I think we've known that for a while, but we've always said Dr. Time. So the way that I think about it and the way I compare it to people who are still like, I don't know, look, I'm getting a lot of patients. They're lined around the corner. Ryan, I don't, you know, I'm booked out for three months. Okay, that's great. First of all, you're not booked out for three months. Anybody that tells me that doesn't really understand their schedule, meaning, I go, did you have any cancellations last week? Right. That's immediately what I say, oh, yeah, I have triple cancellations now. So obviously you're not booked out. Right. That's where things like direct scheduling happen. One of the coolest things of direct scheduling that I'll tell you right now is it has a decreased amount of no Shows, Right. And people go, wait a second. Why would it be any different from my regular no show rate? Well, here's my question. When you go on OpenTable and you book a restaurant, do you show up to that reservation? Yeah, you always do. Why? Because you booked it for tonight or tomorrow or maybe the next day with dental appointments. The reason a lot of people know show is they booked it a month from now or two months from now. I don't know what I'm doing a month from now. Nobody does, you know, let alone a

little bit of personal commitment to. I don't like being a liar about my open table stuff, you know?

Yeah, yeah, exactly.

Anything I'm going to go on and make sure I cancel it. And you know, I kind of feel like they're walking around going, does anyone know Emmett, Emmett scheduled online. Does anyone know, you know, I don't want my name?

No. That's funny. Yeah. And then there's, there's other technologies too. Right. So the direct scheduling is one highly recommend, you know. And the other thing to think about is that if you are looking my

product, by the way. Yeah.

That's a simplified product. Yep. With, with direct scheduling we integrate in. We can do it like your front, by the way. So if you like things like side booking, non duplicating patients. It's one of the things that's unique to us. If you're a dso, we can actually see in your system if they've already been a patient. So we don't duplicate the charts. Everybody else duplicates charts. They just hope for your front desk to catch it. And if they don't, bad day for filing.

So you're able to see if it's a, if it's a current patient or a new patient.

Exactly. The other cool thing that we do, Emmett, is that we actually stamp each patient and we also tell you whether they showed up. That's one thing. And then the second piece is how much money they spent in your practice. We actually aggregate it over the next six months so you can actually see how much money they made for you. Now that might be like, okay, so I get it. That helps out. Simplify showing that they, you know, you paid for yourself. That's great. What we do is you can put your direct scheduling link not just on your website, put it on your Google my business results, put it in your Instagram ads that you're running and not getting any conversion from because you don't have a call to action. Right. Put it on your delta dental results. You can insert it Anywhere you want on Yelp. Now what's beautiful about that is let's say you're running a pay per click ad, right? We integrate with your Google Analytics. They click on the pay per click ad. We register that that came from that Google Ad. They show up to the practice, they spend money. We can now tie that spend back to the original click. It's true marketing attribution.

One of the things with Amber, our cmo, we were just yesterday, she's like, I can see what our click through rate is and appointments scheduled. I can't tie that yet to what is the actual return on investment. So I can tell you, Emmett, we're spending half a million dollars and pay per click. I can't tell you, you know, what the return is other than making some assumptions of a show rate and care per visit rate, you know, and that's why it's.

And it's always off, right? Because believe it or not, it's like the numbers, so much fun to look at. And what's interesting is it doesn't allow you to put your money where you need to. Because look, there are some marketing, you know, arenas that you shouldn't be in. People still shove Facebook down that, you know, that people's throats, people do that. It hasn't been doing well lately. Instagram's been killing it. Okay. You know, Instagram ads, if done correctly, do even better. So there's a lot of different things. And look, it might be, you know, one area of Colorado works and the other area, Utah doesn't work, right? This is how it works.

So this is where like zip codes, you know, depending on the competition, that pay per click can be high enough that it's just not, you know, you're just.

And you said QR codes, right? One thing I love now, I love going old school. When people are going new school, direct mailers throw a QR code that's unique. There's some really cool technologies out there like lob.com that you can actually make custom QR codes for each postcard so that when they click on that QR code, it registers to takes them directly to like a landing page. With the direct scheduling link we see that they book you tie your spend back to the original QR code click of the drive.

So now even Flyers get kind of that digital connection.

It's awesome.

Huge. Yeah, right?

It's gigantic. And look, those things are way more expensive, but they work, right? If you get a 3% result on those out of a neighborhood, you just killed it. So that's what we call that our matchback technology. It's very unique. To simplify, we integrate it into all of our stuff, even our live chat as well.

Can I hit on two those who have been killing it for the most part, what I'm noticing, it's the fee for service specialty groups. And one of the things that I want to call out is I think they're about to get hit. So just, you know, not to be Debbie Downer here, but a lot of our media right now is suppressed. You know, if I'm just being honest, we've got November 8th election. Neither side is very interested in saying how bad things are. So I like to dig into some of the numbers post Covid when everyone kind of got their money and handouts. We had $4 trillion in savings, 3.8 something. At the beginning of this year, we were down to 1.2. Right now I just saw that we're at 600 billion. So we have burned through our savings in cash, meaning the consumers in general debt is higher than it's ever been and we've got all this leverage within houses and so forth. So my point in all of that is people who've been getting approved for financing who've life's been easy to get them scheduled or whatnot, it's about to get harder on that end of the market too. So you really don't want to have unnatural friction points. Right. If you want to decide to weed someone out, great. But you don't want scheduling or something else to be weeding out because you're going to need every patient that has, you know, decent finance. And you're going to need some creative financing solutions too along the way. Right.

And it's interesting, I always say technology leads a lot of these things that are happening by, I would say, at least a year. It's weird. We can kind of see these macro trends a little early. Or maybe it's just that we make bets so that when these products, when the time hits, the products are almost ready. You think, oh, these engineers work so fast. They do not that fast. Right. What happens is there's some crazy son of a gun out there that made a bunch of bets and one of them hit. And that's how VC makes so much money, because they can make 100 bets and one of them plays out and they become a trillionaire. So you're seeing a lot of really cool financing products. One of the bets that we made talk about a culture of convenience is talking about text and email invoicing. We did this if you don't have, you know, we're talking about convenience here. One of my fun things I say all the time, that sounds so common sense. If you want to get paid, make it easy to pay. It sounds very simple, right? It sounds so simple. And everybody. Oh, they don't like to pay me. My accounts receivable are tough. Are you still sending out paper mailers? Yeah. You are. Cool. What do you do when you get a medical bill by paper? You probably sit it on the. I think I have one right in front of me right now. Like, it's just. It's ridiculous. So, like, this is just one of. It's for $16. 16. It's been here for a week and a half.

But if they texted you and said pay with Apple pay right here or

clicking your exactly right, you do it right away. So that's what we did. So what we. And we took it a step farther because there's a lot of great companies out there that are doing text email invoicing. A lot of people doing that. So one, I've realized that there's not a lot of integrated products out there. So one of the things that I believe that's holding dentistry back is right. And I'm going to make a cry out to. And they're not going to listen, right? But I'm going to make a cry out to all the electronic health records out there. Open your damn systems up.

Right.

It's not helping you grow your system. It's not making it be any more sticky by closing your system off. And by the way, they are closing.

Talking about the practice management software.

Yeah, the practice management software say the

payers need to do the same so that we can.

They do this the same thing. Yeah. They haven't changed their stuff forever. And you've got cool people out there that are starting to do better things like Tooth Fairy. I don't know if you've seen them. We don't name things. Well, in the dental software world, I have put an eye in my name, for Christ's sake. But like Tooth Fairy with t u th very. They've created a really cool API. Now they're making verification of benefits going to be a thing in the future, which is neat. But at the same time, you know what we did with text email invoicing, a lot of people had that, but we realized because it wasn't integrated, it caused a little bit more work for the front desk, which you and I both know is the devil. So what we do is we want

to call out One problem I see in dentistry right now is it used to be we just all go to open dental and have to build our own stuff because nobody was innovating. Yep, now we've got people innovating. But my front desk is in 10 different software portals trying to do everything from AI to two way texting to, you know, charting to everything else. So starting this integration piece, I think we've got to go from Microsoft to Apple on a lot of this stuff, right?

I agree. Yeah, I agree. So, you know, that's where we started to build integrations. Like, I'm a true believer that if you don't integrate it, it's probably, look, it's going to at least be a neutral change, if not a little bit positive if you don't integrate. That's why I really push integration. You know, we integrate with Dentrix, Eaglesoft, Open Dental, Dentrix Enterprise and a few others. Right. The big people out there. Now what's interesting is because of that, let's say the text email invoicing, we send that link, right? And they click on the link, they can pay via Apple Pay and Google Pay and a credit card that's saved on file, which is really cool, allows you, by the way, as practice even do things like payment assurance where you can tokenize a credit card and save it so that your policy is, oh, by the way, if it comes back 16 bucks short, you just call the patient, say I'm hitting it for 16 bucks, is it cool if I put it on the card? Ending in 5252. I'll see you later. We even build in really cool technology, Emmett, that like Netflix, right. Have you ever noticed that your Netflix credit card never expires for some reason?

Right.

Weird to think about, right? They have 300 million subscribers. If they have the same problem that you and I had with saving credit cards, it'd be a nonstarter.

Right. So we've got a lost or stolen credit card or I need to change it. It just magically changes in my Apple pay, my Netflix.

Yeah, right. They just, that's the technology that we have to have now as a practice. And a lot of these older systems, even integrated systems with some legacy softwares, they don't do that. So we have the front desk all day long calling and going after credit cards.

Mostly just have the dentist complaining that no one's paying their bill when the reality is they just change their credit card.

Exactly. You want an easy win as a deal. This is one of my favorite things to do. This is something that we do. We do with Guardian. Right. Guardian, Dell Group. So what we do is whenever we get a new practice, we'll go in there, look at the accounts receivable. We have them export the list. We will manually go into the new billing system, text and email, type all of them in and hit send. And then you wait 48 hours later. Usually you've got $90,000 that pours in. It's insane, right? It's just. And you want to get fast wins. I've always found when you're integrating a practice, there's only one real happy person that in that transaction, it's the doctor that got paid. Everybody else is worried, but if you show a quick win for that front desk of. Look what just happened. I got this avalanche of payments and did you have to do anything? Front desk? No. Oh, and I took all the work off your front desk. They are happy. Right. Maybe this is going to be okay.

Does your software work with payment plans? Like if I build a payment plan and open dental and then I've got to charge them every month or I got to send out.

Yeah, yeah, it does. Yeah, it does. It reads and writes back to the whole thing. Does it line item for the systems that are line item. It buckets it for the. For like the dentist of the world. So it's. Yeah, it's pretty cool. They can even change their own credit card. So let's say that one of them expires. They can actually literally go in there and they can fix their own credit cards. They don't have to bother your front desk. Similar to anything else online, right? Yeah. So. But this is the kind of stuff that we have to have right. In our practices for that.

That's a big change. It used to be like, that would be cool and yeah. Then I'd be like cutting edge and more modern. Now it's like, I need this or I'm going to die. I think it's going to get tough. I think we'll have a little bit of leveling off on the labor market. It'll be interesting to watch on that. I mean, we are still in a situation for two jobs for every one person. But I think with the number of layoffs I'm seeing again, I think a lot of this data is a little suppressed. But come December, maybe we'll get to see the truth of. Of what's happening. But I think we've got to get technology to leverage our.

Yeah.

Our margins here.

Because that's the thing with everything we just talked about what it did Is it really made everybody more efficient up front? And I always hate preaching efficiencies because, you know, people usually look at you well, we're plenty efficient, I get it. Right. But what you are is short staffed as well. So you can't be efficient and short staffed. It's not a thing. Right. It need one needs to be missing.

So I think you burn out people. You see this in the rest of healthcare happening. Like the nurses who stayed are like, this sucks. Right?

Silent quitters.

Right.

I promise you this. If you think that your front desk is overloaded and they're not saying anything, they are. Right? If you think that your back of house is overloaded and you think that, you know and they're not saying anything, they are. The problem is that all it takes them is one day to go on some website. I'm sure everybody's terrified for their hygienist right now or their assistants, their clinical more so than the front desk team. But I think the other thing that's interesting about automation and the front desk, how many times have you seen it where you lose a front desk team member and the knowledge drain is so great that they are up a creek without a paddle. Somebody has to relearn the whole process, figure out where all the bodies are buried and then do. Then start it all over again with automation and things like this. Not only is training a new integrated practice or firing up a brand new practice easier, right. A de novo. It's way, way, way easier. But the risk of you churning those employees in and out more and more. Right. You're gonna keep them for the culture reasons, which is why you should be keeping them anyways. But you're not terrified of it. That's the other piece of.

Hey, what other features and functions do you have at Simplify?

Yeah. So what we do in the other piece I'll talk about here, that I believe that people really need is live chat. Right? And I've been talking about live chat since Christ was a carpenter, but it's more paramount now.

You're looking good for your hair.

Thank you. Thank you. Right. It's died. Yeah. So I think that it's a bigger deal now than it ever has been. Right. And with real people. So anybody out there that's like, oh, a bot's doing just fine, it's not right. You just don't know it. Bots converted roughly 13%. We are converting. We hit last month, we hit close to 57%. I mean it's just, it's better than a front desk by almost 20%. And people go, well, how could that be? My front desk knows everything. I get it. Well, first of all, your front desk misses 30% of their phone calls if they're good at what they do. Because they're busy. Right? They're busy. And you were talking about the other day, we got to figure out how to make front desk, or whoever it might be, be available 24. 7 live chats available 24. 7. So if you just want to increase your bottom line by 40%, open up the phone, you know, open up the communication channels after hours and on the weekend.

But one thing, I'll scheduling everything in our life between 8 and 10pm While we're laying in bed.

That's when all the great thoughts pop in. Right?

That's the thing I really need to get into. I really need to see when they're open. I really. Yeah, so. And that's where if I put health care and they like, would chat with me, like while I'm, you know, before I go to bed. Wow, that'd be awesome.

And I'll tell you what, like, it's funny still today, I think that most practices will say win the moms. Right? Win the hearts and the minds of moms, especially if you're pediatric or you're ortho and. But I, I think it's every practice, if you win the hearts and the minds of the moms of the world, not just as patients. Right. But especially for the kids, you win. Talk about it after you implement it too. Say, hey, now that you are a patient at Hungate Dental, we also have a 24. 7 concierge.

Right.

People see that and they go, hmm, Right.

If you like your brand, I like your branding on that too, because.

Thank you.

Yeah, Chatbot's not nearly as cool as concierge.

Right.

And you have live people.

Yeah, real people. Real people. Absolutely. Real human beings, all front desk trained are all either current or front desk human beings. We speak eight languages, we answer within seven seconds every time. So for those people out there, like, oh, I'll just do it myself, you know, or some people, like put it into their call center, which is more efficient. But even then, the response time. So the average response time for a self man chat at your front desk is 42 minutes. Right. Versus us, which is seven seconds. That's a big difference. If you know and ask. I always tell people, go online after this. If you're listening to this podcast, go online after this and book an appointment at your office. If you think, wow, that was a great Experience, then you're good. Then leave it. All right. Still, you should be honest with yourself. People should be honest with themselves.

One time, Jody, when she was doing our ops, our ortho scheduling was bad, but the way she came to our executive meeting, she goes, just so you guys know, if you want an ortho appointment with us, you better really want an ortho appointment with us. I mean, we're very honest with each other. And. And it would just. It just needed to get cleaned up. Like, you know, bad answering and, you know, so it's kind of one of those things. Like, is it like, if you want an appointment, you better really want an appointment with you, or is it like, easy? I could do it at any time of day, right? Oh, man, did we freeze? All right, we froze with Ryan. I'm not sure if it's me or him. So we will. We'll be back. Man, this has been such a great conversation. I'm going to try to get Ryan back on, but good old technology. So here's a negative of technology, right? Sometimes it freezes. So if you haven't looked into Simplify, if you haven't talked to Ryan and team here, I'd encourage you to look it up. Listen, whether you want to go with Simplify or some other solution, just start learning what's happening in this marketplace. I think that's critical. So, anyway, we'll see if Ryan comes back on here in just a second. I do want to give him a second if he can jump back on and close out. I'm curious your all's thoughts for those who are here in the Facebook group. What are you seeing as far as the inflation and recession piece and what innovations are you doing? Are you dividing out to those two components? Because inflation's hitting us differently? That one I think's kind of the hardest one right now. I don't think we've seen a lot on the recession part. The way I think about it differently is inflation is the part where, you know, the cost is going up and it's squeezing the margin and we've got to figure out how to get the revenue up and get the costs down. The recession piece is going to hit where we have customers not wanting to come in or they can't get financing to come in. So anyway, we'll continue this conversation another time with Ryan, but hopefully this has been helpful, giving you some ideas if you want to come over. If you're listening to this on the podcast, you want to come over to our Facebook page, feel free. But until next time. Keep smiling.

Foreign.

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