Core of the Nest Egg by Rick Kushner DDS, Founder and CEO of Comfort Dental

My team wants me to do 15, 20 minutes. I want to do 15, 20 minutes and kind of refresh your memories as to what I expect, what I'm looking for. What we expect in our office of you as partners, Comfort Dental, ultimately. Frankly, overnight we just got too big for me to— like, I know a name and a face and a name and a face, but I'll be honest with you, I no longer can put all the names and the faces together. And it's just never going to happen again as much as I try. I mean, we can play golf together and I'll get that and I'll remember that, but I can't go out to dinner with all of you anymore. I know. It truly would be every night of the year, and that's just not going to happen. So you get a little bit of— So, kind of give the prospective partners an idea of what we think about on our end of the thing. And to introduce this, this is last month's, or 2 months ago, concept. And I just want you to be aware of the value of our group concept. And the marketing advantage is— will never be equaled in the profession. The 66 hours that we offer, regardless of the other things that we do, gives us a competitive advantage, and I hope you appreciate it. Again, it's a given that you understand you've got pretty darn nice facilities. They're not fancy facilities, but they're pretty darn nice. And for the most part, they're really, really modern because they're all so new. I mean, we've got some old stuff, and we're at a point in my history where we've relocated 2 of the— we relocated the 1989 practice 2 months ago, Westminster, and a 1991 practice 2 years ago, North Denver. So those facilities just got too old to continue to refurbish. But back to the point, these facilities are pretty darn nice. They're not high-tech. You could not afford in your own practices, if anybody opened their own practice anymore— does anybody do that? You're all capable of doing that, did you know that? No. You weren't, but now you are. You're too smart to do that. I left the topic. Uh, the shared cost of these items, particularly the facility, uh, you can't do it without our group concept. Uh, this is something where we've actually had to monitor. I think it's a very, very big, very big plus, but it's become a negative when We've had to step in and say, no, you're not going to refer to your father, you're not going to refer to your spouse, or to your girlfriend, or to your boy, or to your church member. No, we're going to refer in-house. And I always thought that was a positive. You keep it in the system, even in your marketing, even in your marketing team. Comfort Dental across the state, I mean, that's all pooled dollars, and I hope you appreciate that. You have never, most of you have never practiced in solo practice. I actually did in the late '70s for about a moment until Bruce came on board. But in that moment I practiced solo and I never did actually. This is all hypothetical. But had I actually taken time off, my office would have shut down, all dollars would have shut down. I'm sorry, I didn't hear you. And all expenses would have continued. And that does not happen at Comfort Dental. You take your 3 or 5— we hope it's a 3 or 5 day or long weekend. Many— we hope that it's many long weekends. That's another whole topic. Rather than a 2 and a half week trip to Europe, because that frankly doesn't fit at Comfort Dental. But if it's a 3 or 5 day or multiple long weekends, those dollars— Mm-hmm. Continue to flow even when you're gone. Professional camaraderie, internal second opinions. Eh. Yeah, that's really important. I hope you enjoy it. I think it's really important. I'm being a smartass as usual, but you have that built in at Comfort Dental. I hope you appreciate it. I hope you take advantage of those second opinions, referring back to Not referring out. Clearly, we could give you dozens of instances when not necessarily a young partner, but a lesser experienced partner, or just someone that just doesn't have a particular skill set to do exodontia or dentures. For example, he was fantastic at dentures and I was awful. Those dentures tended to flow in Roy's direction when he and I practiced together. And that happens in dozens of instances in comfort dental rather than out the door. I want you to— just to give you a fairly sophisticated thought on the symbiotic relationship. To me, the very, very best— and don't be shy, tell me if you get this— the very, very best situation is to be A nice B, second best collector in the office, with a strong A in the practice. You just kind of ride the horse's back, yet you get your own percentage. That's an unbelievable— and we've got instances of that. Of course, the very, very best is— and it's so hard with new patient counters, which is a negative connotation now, new patient counting. And time and time again over these years, we have learned that the biggest producer-collector sees the most? Fewest. Fewest new patients in the practice. So when somebody's a stickler about counting new patients, in other words, to us, all too frequently it's, I'm wasting so many of them, give me some more so I can waste some more So I can get my numbers up just a little more, when the best thing would have been to have those who can handle them handle them. So the very best, of course, is with this— I guess I get the credit for this, but it was a stumbling along thing in the late '70s and early '80s. The very best is everybody's better when everybody's better. We all get our percentage of that income. So you've got to resist that natural competitive— I'll tell you what to do. Compete with the Comfort Dental in the next territory. You gotta resist that urge to compete. In other words, the very, very best thing is I get the last $825 that comes in for that crown the last hour of the last day of the month in my column. That's the very, very best thing. The second best thing, and it's a very close second, is if Roy gets the last $825 that comes in the very last hour of the very last day. Do you see what I'm— Because I still get my 25% or my 32% or my 38% of his $825. The biggest thing is that it just came. I think this gets lost on many of us. We've already talked about this. We're victims of our own success. We have, frankly, way, way, way too many new patients. So that the very skilled of you, frankly, can cherry-pick and wait around all afternoon for the one patient that will write a check for $1,300, because actually that happens. But that's not what we're about. And then if we get into counting new patients, it really goes against our symbiotic relationship. The team history Yeah. Refers to, on our side of things, our observation over the years of— we thought it was a fact, and it was that young docs who participated— and in my day it was team sports, and now it can be team lots of things, you know, it can be band, it can be It could be debate team. You know, it could be team lots of stuff. But they function better in this kind of setting. And I always forget if it's Title— is it Title IX? Mm-hmm. When all the money went equal to men. Now the women are just— and we see it with women too, who were involved in team activities. Because in those early days, I think it's fair to say now, Our women are— they run the gamut. They're among our best, they're among our mediocre, and they're among our weakest, just like the men. But there was a day when a female partner was not a poor dentist or a poor practitioner, she was a poor partner in this team concept. Didn't— just didn't grasp that. That's that history. And again, this goes back decades, and that's all changed for the reasons I gave. We think. When I say we think, it's, you know, we look at this stuff from the perspective of the inside, and I know that you're overwhelmed with your aggravating patients and your aggravating staff and your aggravating insurance and your aggravating cap and your aggravating partners. And I know that you're overwhelmed with that, but every now and then give a thought to what goes on on this side of this deal. When we look at things, those are the types of issues we have to consider, that team history. What we expect of our new partners, you've heard me before, but again, we're going to try to package this so everybody gets, whether it's this presentation or some combination of all of this. I really believe in my heart, as old as I am, as long as I've been around, that this ought to be your job. Your whole career. I mean, there's no better way to practice. If you've never done it any other way, you probably would question that. I certainly would. But a bunch of us have done it all the other ways, and this is the— I did it all the other ways in about 2 years, and this is where we landed. But frankly, 10 years is a reasonable expectation, and that would satisfy me. But Maybe I should settle for 5 years. Maybe 5 years is not a horrible— so I think you've got, within this age of your younger colleagues graduating with $300,000, $400,000 debt and take jobs for, if it's a good one, $80,000 to $100,000 a year, that doesn't compute to me. And obviously it doesn't to you or you wouldn't have made the big step to to be with us. So 5 years, perhaps I should just calm down, Rick. They'll give you 5 years, just shut up about it. But I think it ought to be your whole career. I think you ought to carry my box in 35 years. It would be a lot of— it would be— It wouldn't weigh very much if you spread that out over 350 of you, would it? But maybe I ought to just cool it and say 5 years is okay. Of course we want you to embrace Lean and Mean, and this is what Roy and Bruce— this is what we keep hammering. And look, this was a hastily brought together presentation because I do this, you know, I can talk for 4 days and not prepare anything. But I happened to notice that new patient wasters has already come. I've been out here 12 minutes and this is the 4th time I've mentioned new patient I think it's a pretty big deal. Maybe I'm right about new patient wasting. So we know what initial interview is, and we know that it's— it's— there's a— one of our very, very best offices, I won't say does not do an initial interview, but doesn't formally do it in a special setting. And we know that happens, and that isn't for many of you. That's not for many of you to build correct habits. That's for these That's for these veterans who can pull this off. And when we say complete case, and I'll just make a quick comment because I have just, I have 6 or 8 other thoughts to get through and then get out of here, but we're losing some of our youngsters at complete case when they believe it means get all the data on the chart and present. $6,200, baby, take it or leave it. And that's not what we— that's not— it's— you're just skipping and leaving out so much. Now, to get the $6,200 all examined, all diagnosed, all placed on the chart, and even to inform the patient that— Sally, hey, I gotta be honest with you. $6,200. We can go through $6,200 here, you know, if money were no object or your insurance were that good. But frankly, based on the things you told me in initial interview and the limitations of your insurance and the time of the year in which we're working with your insurance, maybe just this and this and this, and we can do this around $1,200, and your portion will be $412 for that initial phase. That's a complete case to me. And we're losing some of our youngsters because when it's $6,200, baby, take it or leave it, you know, you're going to get that 1 out of— I think it's 79 times you're going to get that $6,200. But then there are 78 times when I want you to get the $1,200, and there's another bunch of them where I want you to just get $140 and make a friend, and there are another 27 times when I want you to get nothing. And make that person think you're their dentist. That's complete case. That's where we are. And maybe I'm preaching to the choir here because there's some veterans in here and some pretty darn good ones, but some of the youngsters, we're really, we're really losing them. And from our side of this, we're wondering how we reach them when there are 300-plus of you in 10 states. And of course, those same youngsters— and I use University of Colorado, and there has to be a University of Colorado grad in here, or more than one— you gotta let go of dental school. And what I've always said about dental school is it's in there. You don't have to call it up. You don't have to reach back after it. If you have to reach back with a thought about something they taught you in dental school, You're in trouble. That's already there. And I do use the university just because it's our local dental school. There are others. My school, Marquette, I happen to think they do the opposite end of the scale, a terrific job. Apparently this dental school here produces good scholastic grads and horrible earners. Just— now we've overcome a bunch of that here. Here? But if you gotta recall dental school, you're in trouble. So we do that here at Comfort Dental. Dental school is done. And again, you've all heard this stuff. We're overachievers here. Now, when I get a little smart-assy, as I do when I stand up in front of all of you, you know, I've said it. I don't think I've said it for 2 or 3 years, But I say that every year we look at that ranking, and those stats are posted, by the way, they were posted yesterday. And, you know, you get down at the bottom of 272 of you and you're the end, you know, we're gonna either figuratively or literally tap you on the shoulder and say, hey, we got a buyer for your partnership. Now, I say that, and that's happened like 2 or 3 times. Over the decades. It really doesn't happen that often. But it doesn't change the point that you're supposed to be here because we're a bunch of overachievers. And those are the 7 qualities that we've recognized and dissected and used industrial studies We've mostly rejected the results of those industrial studies. But what they came down to, just to conclude this, and you have heard most of this. Does anybody know, has anybody paid attention to me over the years to know which 2 we land on most often? Am I putting you on the spot? Computational tolerance? Honestly, no, Brad. I mean, it's— I think those are— I think they're all important or I wouldn't have them up there. You can give yourself— Clinical speed. Just to step aside, I get— I grade myself. I get a 10 on likability. I get a 10 on organizational skills. I get a 10 on a scale of 1 to 10 on clinical speed. I get a 4 on clinical quality. 'Cause frankly, I recognized early on that the standard of care was a range, not a point, but a range. And our patients are investing enough to get me into this range, and I probably wasn't capable of it anyway, frankly. Work ethic, I was a 10. Confrontational tolerance, I'm a 17. In leadership, I'm a 10. But I'm not a 10 on all of those things. And maybe as the leader of this whole thing, I should be, I don't know. But, but all of the studies we did, and some even before your time, landed in clinical speed and work ethic. And then we did some more, we did another couple hundred of you. What was the first one? And clinical speed dropped off and it landed in work ethic. That's where that— that's— those are the 2 big ones. So I think they're all important, and I can't— I'm not supposed to take too much time here. Embrace the core. I introduced with the core. The core of the nest egg is our group concept. Be sure you always appreciate However haywire any other thing might go, that is our fundamental that gives us a competitive edge and will forever. No one will ever touch it. No one will ever touch it. Nobody will. There will never be anyone— I could say there will never be another me or my team, but there could be because they call me all the time because they want to be. What they won't do is take the 38 years that I was willing to take to get here. Nobody will do that ever again. And that's what gave you that core. So always embrace that. Of course, loyalty is a huge thing for me. And I always say, and I think it goes in one of your ears and out the other, but I earned your loyalty. Some of you, I started earning your loyalty before you were born, and the rest of you I earned long before you got here. I mean, I've earned your loyalty. If I don't have it, you're the problem. If you can't see it, you're the problem. It's not me. But what that really boils down to— and you do this because you recognize even the personal value, but certainly the partnership value, and hopefully to the organization to promote this opportunity to your buddies, to your colleagues, to your classmates. Communication seems like a small thing, but I expect this out of you. When I saw Roy sent out, and this— I'm just rolling my eyes in my gym 2 hours ago. Sorry. I mean, and I feel bad that he has to do this. Recently, Roy spearheaded the movement to stop the lab from Contacting you about individual cases except via email. And I thought that was a wonderful idea. And obviously, and you correct me, he got a little pushback on it. And he said, I'm sorry, this is a handheld device. He said, those doctors that want to be contacted by phone or want their stuff, they're not carrying this. So they gave us some pushback. Well, I get on my computer, you know, on Saturday afternoon. Nope, nope, we want this on your person. You're the, you're the technology kids, come on. I want this on your person. I've said a thousand times, if it buzzes, and it might be me, it isn't very often, I don't want you to set your instruments down and pick it up and look at it. Of course not. But in between patients, a few times a day, I absolutely want you to do that. So that's what that's about, and you need to be on— and then I like to follow up, and many of you have heard this. If it's from me, I don't play on here. I don't send naked women, I don't send jokes, and I don't play. It's either something really fun— it's a ball game, it's a con, it's something I'm inviting you to, a golf tournament, it's something really fun— or it's important. I don't play on here. So if it's from me, I don't play. I would appreciate you taking a look at it, more than Saturday afternoon when you— and it's fun to say, oh, it's Jerry Edwards and Larry Nessel, these old dinosaurs. It's not only them, is it? It's not only them. We have a lot of young partners in the state in question here. The Communications Acceleration Technologist Is simply a— It's like when my kids were in Little League, the team mom had a call tree, and one mom would call 3 moms, and then those 3 moms would call 3 more moms, and then those 9 moms would call the rest of the moms, and we wouldn't have to have so many phone calls to tell them when practice was. That's all that is. That's all the communication Accelerate— I thought it up. Acceleration Technology. It's just a representative to help me make sure I reach all of you. So when one of these videos is mandatory— and we understand completely, uh, I've been eating bullshit for a living from dentists for going on 4 decades, so I get the point. You can log on and you satisfy my requirement. I would hope that you sit there a little longer than that, but I get that. But that's what that's for. You're not to be cops. I hope that eventually the CAT can exert a little influence and say, hey, come on, open up the thing so I can report that you signed in. That's all that is. Chain of command is, uh, this office gets a little bit excited when you pick up the phone and you call and say, uh, they didn't throw the ice melt down. This morning or whatever. Go to your partners, find out how that stuff works, especially if you're a newcomer. We care about that stuff and we charge you for that stuff and we don't want to unfairly charge you and we want to know about that kind of stuff. But there's a way to do it. And the other thing, and I see these, and this is absolutely driving us crazy. The The failure, the lack of understanding of how our statistics work with respect to computation of month-end pay splits. I mean, we just have— we're just spinning our wheels. We just have meeting after meeting after martini after martini. It just makes us insane. So how— whatever What these guys are doing to get this across to you and then have you get it across to your younger partners as you grow with these concepts. These are multi-million dollar businesses in these little 3,000 square foot boxes. Don't turn these multi-million dollar businesses over to high school graduates. That's just not, that's just not sound thinking. I think that's a great point. And then finally, and I already said this, and we struggle here too, on my side of this business, we— I have said that we are failing miserably at conveying the mentoring requirement. We're just— maybe that just has to be as large as we are. I can't get through to them. These guys can't read. I think that's a good point. We can't reach all of you, and we depended for so long on you to pass that on. And the breakdowns are monumental. So we'll continue the battle, and we need your help. But those mentoring results in those types of things there, and those additional streams of income that I've had to downplay because I think we went too far, pendulum swung too far. We need to come back a little bit. Now, Let's remember that we need to fix the teeth. That's really the main thing we do here at Comfort Dental is fix the teeth. But that stuff all results in those things which our veterans will tell you is, is a much easier way to progress through a dental career and end a dental career. Hey, I'm talking about passive income, as we call it. In addition to fee-for-service with your own two hands. That's the hardest way to make it go in dentistry, with your own two hands. That's my— the things we expect of you as Comfort Dental Partners in 15 minutes or less. It was probably more than that because it always is, right? Not much. Not much? I did okay? But I am willing to take comments. I'm a good guy, for those of you who don't know me. All bark and no bite. All bark and no bite. They don't believe me. Dr. Ira and I go back to age 12, 13, in Little League together. The only, the only speaking I do, and I gave 50, I gave I did 50 cities a year. I'm probably exaggerating, you know, the older I get, the better I was type of thing. But I did 50 cities a year for about 15 years around the country in Lean and Mean stuff, what became Comfort Dental stuff, these things. In those vintage audio, video, print and audio, video, that stuff. I did 50 cities a year for 15 years. These days, This is all I do with you guys in these little sessions, and I love it, but I don't get much feedback because I think there's some fear out there that I don't— I don't intend in any way whatsoever. This is all that I do now, except I personally do dental school, and it's hard. It's Miserable dental school lunch and learns. I have next week at Oregon, and then 2 weeks after that I have University of Nebraska at Lincoln, and there's some others coming up. And they are— I mean, we're on some common ground. I talk about these concepts and you at least know where— try talking to a dental student. And I can't be any other way but this way. It's I might as well, you know, be speaking Swahili. But that's the only other thing that I do as far as this kind of a format. Anything else for me? Okay, thanks. Thank you.