Full Arch Dentistry Case Acceptance and Industry Challenges

Welcome, everybody. Back to another episode of the Dental Boardroom podcast. It's your host, Wes Reed, CPA and certified financial planner and owner of practice cfo. And lately I've been doing a lot of sort of monologue podcasts where it's just me. Well, today I'm changing that up and I have Stacy Farley joining me on the call today. I'm really excited to tell you a little bit about what Stacy has done in her career and how she's produced some remarkable results within the practices that she has worked in. I've known her for a while because the practice that she was in was a client of practice CFO, a very successful doctor here in San Diego named Dr. Pfeffer. And Stacy actually happens to be Dr. Pfeffer's daughter. So, Stacy, welcome to the Dental Boardroom podcast.

Thank you, Wes. Thank you for having me. I'm so excited to be here.

Likewise. Just a little background. You have a business degree before you got into dental. So we'll go through the timeline to kick it off here. I want people to know a little bit how you got there, because what you had on your resume, so to speak, before you ever stepped into a dental practice for something other than getting your teeth worked on, you were in the business. You were in business. You got a business degree, you were in sales and didn't have anything really touching on dentistry until it sort of happened with your. With your dad. And so you bring a unique perspective in that you already had developed a certain skill set. And then when you stepped in with your dad in his practice and took it to a whole nother level, you applied a skill set that a lot of dentists, to no fault of their own, just don't have, which is a really solid business and sales background. So a lot of what we're going to talk about today on the, on the show is about sales. And I don't want you dentists to take that the wrong way. At the end of the day, we are all trying to convey the value of what we provide and to be properly compensated for conveying that value. There's nothing wrong with that. It's called sales. It is what it is. Now, there are a lot of salespeople out there who are trying to sell you something you probably don't need or having you pay way too much for it. This isn't the case here, and I assume, Stacy, you would agree with me that there's a lot of patients who walk out the door saying no to something that they probably should have or even Clinically speaking, absolutely. Need. Is that a safe statement?

Oh my gosh, yes. So it's actually interesting because when you learn to, you could call it sell, but it's really guiding the patient in the right, in the right direction. Right. And it's basically perception versus value. So it's all about asking different. It's a very, very, especially in full art, it's a very, very collaborative approach. Right. It's, you know, it's basically putting things into perspective by asking questions and educating the patients. Right. And one thing, you know, my, my dad was huge on was really understanding our true products. Like, what are our true products? Right. When we're talking about full out arch dentistry. And just to touch on that briefly, you know, you hear people all the time. We provide beautiful smiles. And it's like if you think about what our true products are and you think about when you start marketing to these type of people, these people literally cannot eat. They cannot chew, okay? There's, they've, some of them have suffered miserably trying to wear a lower denture that doesn't stay in their mouth. They walk around like this. They procrastinate for years and years and years and they're afraid, they're terrified. So when you think about what we truly provide, because if we're asking 40 to $50,000, we better understand what we're providing for people. And I've boiled it down to four things and even just pointing out one of them, if you think about it. So if you say, oh, we provide teeth or a beautiful smile, the way I look at it, we provide someone the ability to be comfortable. Not just like once a day or twice a day, every second of every day for the rest of their life. We provide someone comfort. Like, think about that for a second, right? When you're talking about. I boiled it down to four things. Confidence, right? This isn't just like mustering up the courage to go talk to someone at a party. I mean, I've literally had patients walk into my office and say, you're going to determine whether or not I attend my daughter's wedding in four weeks, okay? So confidence, like, these people can't look in the mirror. Health. They don't even realize that they have a hole the size of a quarter in their mandible because they can't feel anything. You know, so it's, it's educating them. Like, if, if you knew you had an infection on your arm like that right now, you'd be in the hospital taking care of that. You know, it's literally eating away at your bone.

And then so comfort and then function. Like again bringing up my dad, you know, he always used to say, you know, you could live without an arm, you could live without a leg. You got to have the lower half of your face working properly. That has to work. You can't live without that, right? Chewing properly is what our body uses to fight disease. So there's no middle ground. You either chew properly, you know, or you get sick. So it's putting things into perspective and understanding what we really get the opportunity to provide people. It's awesome.

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Awesome. Well, that is a. It's actually a a very thorough good segue into really what is the subject here which is case acceptance on Full Arch Dentistry. That is going to be the that'll be the title here in our podcast episode. And the reason why I've recruited you into this is because of how remarkably successful your dad's practice was and is under the new owner he sold a while back. But the remarkable success and almost there was a rise into that success because of the way you unfolded this case acceptance mindset and process within the practice. And as you know Stacey, I work with a lot of dentists and cash flow. It's always what we are trying to improve. In my relationship to my doctors, it's about their Their, their financial health. And so clinically speaking, when it comes to their money, a strong cash flow simply means you can pay for your overhead. Overhead. You can pay for your debt, you can pay for your DAC taxes, you can pay for yourself today and you can pay for yourself in the future. And you're breathing and you're okay and you're sleeping well at night because there's enough money in the bank account and you know that you are on a stable path toward financial independence. And when you're selling bigger cases, I can just tell you from looking at hundreds, if not thousands of financial statements and knowing what the doctor's treatments are behind those financial statements from full Arch dentistry. And some of these bigger cases are so make or break a lot of times for a really healthy financial situation. And again, I'm not saying to go and sell a patient something they don't need so you can have a healthy financial situation. There is a win, win here because of, gosh, just because of what America eats, you know what I mean? And their, their oral hygiene by default isn't that great. And so inevitably they come to a time where they need a lot of what, what you brought in the practice there. So let's go back to when you came in. You had, you were in the business world. Your dad recruits you. How long ago was this? And what were some of your first observations that triggered an understanding that there's an opportunity here in my dad's practice to do something really exciting and successful?

Yeah, yeah, it's, it's interesting that you say that because I graduated college in 96. Right. I'm, I'm 50 years old and, and I, you know, I grad, I graduated with a double major, business and communication from Arizona State University. Go Sun Devils. And basically just didn't really know what I wanted to do like most kids who graduate college. And so I went into sales. And I think anyone that's truly exceptional, that has the ability to just keep going and keep learning and growing until you become exceptional in sales will tell you that they failed a million times over to learn how to do it effectively. Right? And I was fascinated because I was always, I sold software, I sold advertising, I sold copy machines, I sold everything. It was very, you know, mediocre. I was new. I had to learn. That's how you get better, right? It's just like anything else. You put the work in and you get better. And then I worked, started working for a company you may have heard of called Nestle, who acquired a company called Jenny Craig. Right. They acquired a water company, they acquired Jenny Craig there. That was when health was. People were focusing more on health. And it was interesting. I started working for this company, and within like a year, I was like the top sales rep in the entire company. And there was like, I think There was like 660 locations in the field and also at corporate. And so I stayed with Jenny Craig for 10 years. But the reason I'm telling you this is because I went from sales to management to area market director to corporate sales trainer. The crazy thing about it, I didn't even realize till after I was in dentistry for like five years when I pulled out an award that I had gotten, like a Nestle Framework 4 award. It's literally the exact same type of sale as Full Arch. It's not selling weight loss. It's helping someone to take their own action, to make a commitment to change their life when they're terrified. Right? And if you think about it, the tagline for Jenny Craig. Jenny Craig spent millions of dollars in marketing. They spent millions of dollars, dollars learning how to convert a very emotionally based B2C sale business to consumer. Okay? They, we worked with Harvard psychology department, Disney sales trainers. And, you know, and the tagline for Jenny Craig was Jenny Craig, we change lives. Do you know what the tagline for clear choices.

Clear choice, changing lives. It's the exact same type of sale where these people are terrified to make that commitment. And finally, they procrastinate for years. They. They know in their head they ought to do it, right? But they're. They're scared. And then they go to Disneyland and they can't get on a ride with their grandkid and they hit rock bottom and see your ad and pick up the phone and you have a very short period of time to, you know, make an impression, build rapport, and you have to keep the momentum going, right? You have to book it within five days. And full arch is exactly the same. These people, like some of these patients would tell me they were shaking getting out of their car. It's the exact same thing where they procrastinate and they know their mouth is in bad shape most of the time. They. And then finally they go to a family barbecue and they see their innocent grandchild and they say, grandma, why are you missing so many teeth? And then they say, forget it. I'm making a commitment. And, you know, they see your ad, they pick up the phone and you have to handle this call, almost like a 911 call. And if you look at the statistics in Full Arch Dentistry, it's, it's. Our whole sales process is like broken, I think both in single practice and dso, because if it wasn't, we'd have higher conversion rates. So nationwide from lead to sale, I mean, from lead to. So from booked to show, right? So if, if you call my office, I'm ABC Dental, and you schedule an appointment, 25 of those people show nationwide. So if you talk to 10 people, less than 3 will even come to your office. That's because we're not trained on the lead call. So that's the first problem. There's all these holes in the sales funnel. Then once they show up, version from performed lead to sale is again 25 to 30%. Even with, you know, big DSOs that claim they have seasoned sales rep. How was I able to convert at 70%? I don't have some magic gift, but I learned the process on how to connect with these people. And like you said, I would never try to strong arm then if you're do. If you're doing that, if you're trying to, like, push them, that's. It's. If you ever watched me closing a full arch case, it's like doing a little dance until we come up with a, you know, a way to get them in a better situation. And the funny thing is, I've been, I've done speaking engagements and all that, and one, one time someone asked me, like, what case acceptance mindset, and it's like the one thing you shouldn't be thinking about when you're doing a sales presentation is case acceptance. That's like the last thing from your mind. The only thing I'm thinking about when I'm talking sitting across from a patient is how can I get this person in a better situation than they were before they came to see me, right? And right now it's a full arch frenzy out there. So it's like you have to be able to differentiate yourself. You have to use what's called a unique selling proposition. And it's the one thing that your practice does differently and preferably better than anybody else. And you have to own it and you have to use it on the lead call. And so, yeah, it's a whole process.

There's a lot of dentists trying to, I think, enter this space.

What advice would you give for a dentist who, let's say they're doing 1.3 million, top line, they're not doing any full arch work, but they, they want to get into these bigger cases now, people like, you know, like my mom, for example, she's going to see commercials about Clear choice. Or these big companies will spend millions and millions of dollars every month in order so that when people think about wanting to fix that health issue in their mouth and have that big treatment done to look better, the health benefits, the comfort, the confident, they're sort of going to go back to that billboard or they're going to go back to that commercial. And that's why those companies tend to do so much of that work, is they sort of dominate the space, kind of flood the zone, so to speak, with their marketing. So how do you compete that with that At a private As a private practice owner, are you looking to buy or sell a dental practice? If you're a seller, how do you find a strong list of potential buyers? There's no MLS or Zillow for dental practice sales. In such a fragmented market, with transaction costs so high, many dentists sell selling their practice feel discouraged. That's why I built practiceOrbit.com practice orbit is modernizing how dental practices are sold. It's an online marketplace platform and it brings together buyers, sellers and their teams to smoothly navigate a transition. When you list your practice for sale on Practice Orbit, you'll present a detailed and polished profile of your practice to a large pool of potential buyers. Think of it like a Zillow home profile, but for your practice. And importantly, that profile will remain anonymous, which means you can showcase your practice without worrying about the public or team members finding out. Only after an interested buyer signs an NDA will that buyer see your name, address and practice pictures. And at Practice Orbit, we have a team, deeply experienced, experienced in dental practice sales. Our broker and support team will hold your hand each step of the way. When you combine the power of marketplace technology with the highly qualified team at Practice Orbit, the result is a maximized sale price and a smooth transition timeline. And hey buyers, you can search for practices, submit NDAs and tender offer letters directly within the platform. You can even create saved searches and be auto notified when a new practice comes for sale in your market. If you're thinking about buying or selling a dental practice, create your free account today at www.practiceorbit.com.

Yeah, so what you do is you, you get help, right? Like you, you use resources, right? So, so first of all, you align yourself with partners that can help you, right? So there's certain marketing companies that are specific for full arch. Then you know, you get help in the sales department too, right? You find a reputable, a reputable person to help you in that field. You know that's one of the things that, and you know, one thing I want to talk about too is like, you also have to execute these cases. That's another thing. Like, it's crazy because you had asked about the numbers. So when my dad sold the practice, we were doing about and I, I, I, we never got to the point how I all start. I started out with my dad. The way that I started with him is I went to his office not to work there, to do a consulting project with him. And I was going to leave and go back into sales. And then he said, you know, I spend about 20,000amonth in marketing. He was doing TV marketing. And, and basically, you know, he, he was kind of one of the pioneers of the removable implant space. He started when the locator came out. It was awesome for him because he could finally effectively attach the implant to the denture. And anyways, so he said, you know, I spend about 20,000amonth in marketing. For every 20 patients that come in or 10 patients that come in, only two to three start treatment. Let me sit down with you for an hour a day and educate you. We'll look at the X rays, we'll look at the pano, and I'll educate you why these people can't afford not to do this case. And just call them up and, and whoever you schedule, I'll pay you a commission. And that's how that started. And then when he sold the practice, I was still just doing it kind of part time, working in the back end. And then when he sold the practice to the new owner, the new owner was like, you're going to be presenting these cases from the get go. And we started doing fixed full arch too. And basically we went from doing about 2.2 million to last year we hit almost 8 million with a 5% marketing spend. Right. So that's the key. A lot of these big players are using 20% of their gross collections in marketing spend. You should aim, you should be spending probably about 10% in marketing. That's like a good 8 to 10% in marketing. That would be a good goal to get to, but, you know. Yeah, so I would say just, just that's what I'm trying to do. I have an online, online course and now I'm, I left the practice that I was working in for 10 years and now I'm dedicating 100% of my time for helping doctors that are looking to understand the sales part of it too.

Yeah, let me ask you on that. And then I, in a Little bit. We'll get into what you're doing now and how you're helping. You're helping the doctors sort of implement a plan and you have a curriculum and a rollout strategy. I want to hear the details on that. But stepping back, going into the mindset of a private practice doctor is, is this one of those things where it takes money to make money, which means you gotta start outlaying that money for the marketing. So you start bringing people in like you're casting out a net. You're trying to bring enough people in so that after a, you know, a 20% acceptance rate, you have enough business to pay for that marketing, pay for your team, all of your overhead and ideally have some good profit also. So on this concept of does it take money to make money, the money you have to spend is on the marketing and then the money you have to spend is probably on a really good salesperson. Question for you, there is so two questions. One, do you have to start spending that money on marketing in order to get, kick this off, in order to rev it up towards actually starting to get movement, number one, and if so, how long of marketing efforts and spend do you think it would require before you start to see the traffic coming into the office? Then the second question is, do you have to have somebody like you, who's not the doctor but who is doing essentially the communication work, I will call it, or do you think the doctors can do that on their own?

Yes, that's a great question. So that's the two part question. So yes, you definitely. It's really interesting because full arch is a sales and marketing business. Like, you know, how general practice is a tactical business where you basically, you know, you, you want your patients coming back and, and you want, you know, residual, you know, they say as long as you always book another prophy, you're going to have, you know, that lifelong patient. So full arch is the opposite, right? You, you do want them coming back for biannual profis so you can, or at least partnering with someone to make sure the implants are good and so on and so forth. But full arch is a sales and marketing business. That, that's just how it works because so many people are trying to do it now, you know, even back now oral surgeons are taking a big hit because what used to be they were patients were referred, right from a GP and it was like already sold before it walked in the door, right? The trust was already there. Their dentist referred them to this oral surgeon. So it was very. Now they're Trying to compete and spend money in marketing. And a lot of them are calling me because it's so different. It's so much now you have to earn the trust and you know, and make them, you know, you know, choose you. So yes, you definitely.

It's not just about the feeder relationships from, from other dentists. Now you're going to go direct to market with some of these. You. It is the business, it is the marketing, it is the communication, it is the process flow of patients from finding them to getting them in to getting them educated to you know, getting them to accept the treatment plan and then of course delivering on that treatment. There's a whole pipeline there. And it isn't just your degree, dds, DMD that's going to get that pipeline effective. It's going to be actually be things completely unrelated to your clinical skill set to drive a sales and marketing style business like this 100%.

And your question in regards to should the doctor be selling the cases? So it's kind of an interesting question because if you can find someone that's coachable and trainable or like a sales professional that, you know, you invest a little more in talent, right? You pay this person, this is going to be your biggest asset, right? Because it's, you know, one thing actually my dad said is when he came in after.

After the practice owner that bought his practice, he came in just to kind of watch how we were doing things because he was fascinated with how we are growing it. And he watched the doctor do the clinical presentation, right? There's, there's like, there's there's basically four parts that you can, you can get better. So it's basically the lead call, the clinical presentation, right? Where the doctor meets with the sales presentation and then operations like the patient journey, right. So that's really important too. I mean it's easy stuff, but I feel like a lot of these DSOs are like putting the patient like with the treatment coordinator before it's even diagnosed to try to like qualify them. And it's so awkward and obvious. They're trying to see if the person has money. It's like cheesy. But, but anyways, yeah, so the, my dad came and watched doctor, the doctor doing the clinical presentation. And when we did the clinical presentation at the practice I used to work in, it was literally, we pull up the CT scan, we place the implants right in front of the patient and we say congratulations, you're a candidate for implants. And the doctor just educates. Everything needs to come out. Here's your options, you can either do dentures, right? You could do four implants on the top and the bottom. We can make you a denture that snaps in. We remove the palate, and, you know, it stays in and it's 10 times better than a traditional denture. Or we can take everything out. We do four to six implants on the top and the bottom, and we do a hybrid zirconia bridge that's screwed in. That's going to be most like your natural teeth. There's very little maintenance, you know, and you always assume people want the best, a fixed full arch, right? But you have another option in case, you know, they don't have $45,000 or they can't get financing for that, or they just really can't make that work for their lifestyle. And if a dentist. And that was it. And then he would say, you're going to meet with Stacy. She's. She's the expert in patient financing. And I would determine what we're doing. I could mix and match. I could drop in price. I would. I knew I had all the financing. I knew the product knowledge. It was like I knew these cases. Like, I would sit in on surgeries, I'd go to the labs. There wasn't a question they would ask me that I wouldn't be able to answer about a clinical part of the case. And so it's almost like one thing my dad said was it's almost like a conflict of interest when the doctor tries to recommend a double hybrid or a double all on four, because these cases are so much money, and the patient sees the doctor as the owner of the business. So it's kind of like the patient, see, sitting there thinking, you know, I really like to do this case, but I'm not interested in buying you a Porsche. You know what I mean? It's. It's so much money. Whereas if the doctor stays really neutral and then has a sales professional, right. If I recommend a double hybrid, they don't see me as the owner of the practice. This. So much of this has to do with psychology. So it's just. It's just better if you can find someone.

And, you know, find someone that's a sales professional and get them trained on how to effectively close these cases. And then. And then, yeah, and then we got to a point at that practice, he didn't even meet the patient until they were paid in full because he was doing 40 to 50 arches a month. So I. All the. Our associates that didn't even do the case were Doing the clinical presentation with me and then he was doing the work. Right. He didn't have time to do the clinical presentation. He would just meet them one time after they are paid in full for a pre surgery appointment before we did the case.

Is this the type of change up in a practice? The practice says, okay, I'm going to start doing this full, full arch work and I'm going to even put a little bit of money into marketing for this. Is this something where you've got to be all in and almost that becomes your brand, your theme? I am a, I am the full arch doctor in this part of town. And you pivot everything around that marketing message with your team process? Or is this something that a doctor can layer on as an additional. They do a couple, maybe one or two a month.

No, you can definitely, you can definitely layer it. You can definitely layer. You don't have to go all in. The thing is though, when you market for full arch, if you still, you're still going to get like that, those gp, right? The bigger GP cases too, because you have people that are afraid they're going to need all their teeth out and they come in and they just need like a twenty thousand dollar general practice, like you know, crown some implants. So you're going to get that. So, you know, it makes sense to market the implant dentistry and then you're. But you don't have to go like all in and change it. I mean, you know, I feel like this, it's a lot of these doctors and oral surgeons and periodontists that I talk to. It's like, it's such a meaningful thing to be able to provide for someone. Maybe that's, it's like everyone wants to do more until you get to be like my former boss who was like, ah, this is too much. You know, it just, it's a lot, you know, it's, it's one thing about Full Arts, it's, you know, it looks sexy on the outside. It's not so simple. You know, these people pay a lot, they deserve a lot and they expect a lot. And so that's why, you know, and if you, you know, now there's so much going on with digital workflows and things like that and it's amazing, like the technology that's available. But you have to be careful too because there's so many different ways to restore these cases that you could go out and spend a bunch of money on all these things and then you're in like a quarter of a million dollars and it's all the wrong stuff that you need, you know what I mean? Like, so it's, you just have to, you know, good clinical mentorships are good to have like for digital workflows and all that. So. But yeah, it's a, it's an awesome thing we get to provide. But you don't have to go all in if that answers. You can slowly. That's what I would recommend. Because you're not going to be able to, you have to think about the operation, the execution. You're not going to be able to go from doing like one arch a month to like ten arches a month. And because another thing too is like the one thing about sales conversion, the key is staying consistent. Because what happens is if you go one month and you close 10 arches and then you're not gonna, you're gonna collect the money that month. So I would collect the money one week after I initially saw the patient. I purposely did that. But then guess what? You're not gonna execute the case until next, the month after because you, you know, we, well, you know, maybe any, anywhere from two to four weeks after. Because sometimes you have to get a medical release. You have to do the pre surgery workup, pre surgery appointment. So guess what? Then you're paying out all that overhead and then that month you only do five arches and don't collect all that same. That's where people get, you know, because you, you get all the money up front and then you have to pay production and overhead and all this stuff. So where you're really, really effective in this game is if you are consistent. So you're like, you know, it's not every month is going to be great. But you don't want to have one month where you're doing two arches, then 10 arches, then three arches, then five arches, you know. So you want to stay consistent with your sales conversion.

Yeah, I want to go back a little bit to the amount of doctors revenue or collections that is allocated to marketing as a budget, as a budget item. And you said should work their way up to 10%. Here's my, here's always been my interpretation of marketing or my advice on marketing. If a doctor is fully, if they're, if they're, if all the chairs are full, so to speak. Like, like an airline industry. I always say your success is made or broken by getting people in the chair. Your chair should be full. If your chair is full, the airline is going to make some money. If it's not, the airline's probably going to be out of pocket money. And with, with dentists, if you've been around long enough, you have the brand, you have the reputation that your chairs are full, you may spend $0 on marketing, and that's totally okay. I think where this is different is that a lot of these patients may have never been in your office before. Right. It's not necessarily that they're a recurring recall patient now, they're going to get a full arch. If in this model you're attempting to go to market to bring in patients who are looking for full arch who may not know you, and therefore it takes a lot more money to market that type of patient. Am I understanding that correctly? Why you think it would require more marketing dollars as a percent of revenue in order to, to do full arch dentistry in your practice?

Oh, yeah, 100%. The, the cases that you're going to be doing are, it's like less than 5% will be like your existing patients. And listen, you can do internal marketing and if you're smart, you can look through your, your, you know, your database and, and you can target people that are wearing partials and explain to them how much better off they'll be if we do implants and this and that. But a lot of people get comfortable and set in their ways. No, you're going to be getting new patients. Like that's, it's all new patients. Like, that is how you're successful in full arch dentistry. It's new people that have never been to your office every single month. It's not your existing client. Yeah.

And I think that's an important distinction.

If like you have existing patients that are like their mouths are falling apart, you're probably not doing something right. You know, I mean, it's going to happen ultimately to some of your patients, but for the most part, they come every six months to keep their mouth together. Right.

So, yeah, yeah, we, we used to have a client who spent $200,000 a month on marketing. And I couldn't, I couldn't believe it. And then I saw that this doctor does 14 to 16 million dollars a year as a dental practice. And I thought, okay, that doctor is, let's say the doctor's profit margin was 15% compared to a million dollar practice at 40%. That 15% as a dollar is a lot higher on a $60 million practice than 40% of a million dollars.

Yes.

And so it's okay if you have to spend a lot more on marketing. A lot of this though, to be honest, it's, it's a little bit of a lifestyle decision as well. I mean, when you start to introduce business and you're trying to almost go a little bit, what I call enterprise, you're going from practice to being a business that's operating well as a business, think of like a factory with assembly lines. You're going from sort of making the shoe yourself, like, like a, like an.

Like a shoe artist, you know, and you're making your shoes, you're stitching it together and you're handing it. Now you're like creating a little bit of a, of a process with multiple people involved and almost like an assembly line. Now I don't mean to make that sound like you're, you're delivering widgets or you know, something simple. It's not. But my point there is, is that you have to start thinking about the business side of your, your practice. And for a lot of people that means that you have to do work on your non clinical day, a lot of work, and maybe you're working in the evenings and maybe you're meeting a lot with a marketing person or you're, you're meeting with your CPA to go over your cash flows to understand how much you can allocate to certain investments in order to really get this thing going. And all of that is the business side of dentistry. And if you basically want to come in, do the clinical and be, you know, be a nice employer with your team and then go do your thing at home, that's totally fine. I always say that's a personal decision, but I think if you're trying to kick off a full arch dentistry practice and get to this four or five, $6 million plus style practice, it's going to require some overtime work, especially in the beginning. And, and you actually may take home less money for a while as you spend time and money on getting this thing going. So it takes time and money perhaps and skill set to get that going. Because I think there's a lot of doctors who have tried to kick that off but never fully got lift on it and ultimately sort of abandoned that as a, as a new strategy in the practice.

Yeah, 100%. And you know, it's really interesting too because now with all this digital workflow, it's awesome because you can get a couple good RDA ef, which means RDA is Registered Dental Extended Functions. Right. And they literally can take, they can do like a lot of the restorative work before you get to the final prosthetic. So it's like you can remove the doctor and you know, now like at the former practice I worked in, you know, we had surgical assistants. They can put in the IVs. You know, you can do your own IV sedation. The anesthesia part of it is another huge expense. Unless you're an oral surgeon, you can use. If you're an oral surgeon, you can use CRNAs, but if not, you can't. In California, you can't use, you know, you can't use a crna. You have to have an anesthesia permit. So, so you have to use an anesthesiologist or you can do IV sedation. But we were doing four arches a day. And when you're doing four arches a day, you need general anesthesia, you know, that can run these patients. $4,000 a case. You know, it's significant. But yeah, it's. The better, the more efficient you become. And you'll learn that with time. You know, it's not like these cases are so profitable right off the bat. Cause you have to learn how to be really efficient with your time. That's, that's the key.

So if I have to. Going back to my two earlier questions about how much is needed to invest to get, get lift on this in the practice, number one and two, do you have to hire a dedicated salesperson for this?

It's difficult when a doctor has just enough cash flow to cover their overhead, debt and taxes and, and take home money to live and pay their bills.

And so I almost feel like in order to break ground here in this full arch space, you have to almost create some cash flow, breathing room or a little bit larger cash balance, something to, to sort of fund, so to speak, this a, a, a business plan around this now. So say, safe to say it takes a little bit of money to get lift. We sort of agreed on that. Right. In other words, it takes a bigger marketing budget in order to get lift. The second thing is, can the doctor do it? So you're saying that a doctor can do it, but almost. Preferably because of a, almost what's a sense of a conflict of interest between the patient and the doctor. It's better if somebody else can do it and do it effectively, is what you're saying.

Yeah, because I mean, look at like, I consider my father to be like, he used to tell me that he made so much more from his mouth than he did from his hands. He had such an amazing way of people making people feel important. And they were still converting at 30%. Right. So it's just, it's like the same reason you wouldn't try to sell your own house. It's like if, if someone came to buy your house and you're like, my house is great and this and that and the, the person buying is like, well of course they think that they own the house, they're going to make all the money off it. It's just like a psychological thing. If you can stay really, you know, non biased and just say, here's your option. Tell the pros and the cons. You know, if they ask the doctor, which option do you recommend? Of course you want to be honest, like if you are my brother, I would definitely recommend you do a double, you know, fixed prosthetic, a double hybrid. But yeah, if you can find someone that's really effective, it's going to, it's not the difference of hundreds of thousands of dollars, it's the difference of millions of dollars. And so that's the hard part though. Like, you know, it's hard to, you know, but you know, there's ways that there's, there's people that can help with that, you know, being able to as long as someone's coachable. Right. And then practice and, and they, they learn the product knowledge that's so key because people buy from people they trust. And you know that, that whole saying like confidence equals trust and trust equals sale. Confidence equals credibility, Credibility equals trust. Trust equals sales. So yeah, like I would never be sitting in a sales presentation and have someone ask me a question and be like, oh, let me go ask, you know, the doctor. Like I, I, I, you have to be an expert at what you're selling or you shouldn't be selling it. Like you have to know your stuff. Right?

So yeah, yeah, you know, when I, I do, I talk to a lot of prospective dentists who could become clients of practice cfo and I think what I'm about to say relates equally to a dentist. I always will tell a prospective client that in the very beginning there is there it, it goes without saying that you can opt out at any time to what I'm presenting to you, what I'm proposing to you, that clinically I believe you need so you're under no obligation and I want to just disarm them that concern right away that they're trying to sell me something and they're, they may corner me or press me and I don't and I want to avoid that. So I prefer not even to have a sales call, do my research online and make a decision behind the scenes. And usually if they're trying to make a decisions entirely behind the scenes, you're probably not going to get that, get that client or that, that patient. And so once they come in the door and I have the conversation, I just want them to know right away you can say no. And then what I want to focus on is the foundation of their financial health and really think about the why. And for a dentist, it's going to be the foundation of their, of their oral health. And you're not selling anything. It's just educating them on what it means to have good oral health, what it means to have good financial health. Because at the end of the day, that's what you're trying to do as a. Not you, but, but the doctor. What I'm trying to do with my clients is help them have good financial hygiene and oral health and become financially independent. If I can enroll them, though, in the vision of what they can become and what in financial health really looks like and help them simulate the feeling and the experience of what it would mean to unburden the financial stress that they're feeling. And the more I can help simulate that, then the easier it is to help them show the what we do. Here's what we do. It's like the Simon Sinek, excuse me, the Simon Sinek Golden Circle TED Talk, which is the number one TED Talk I still believe to this day. And he says, why is Apple successful? And Apple is successful because the marketing message is always about the why. First, that's the, that's the, the center of the circle, the center of the bullseye. Then once the why is felt and experienced, which in, I think in, in my case is helping doctors understand how financial health translates into a lot of other wellness in their life. It doesn't guarantee wellness in their relationships and in their hobbies and in their health. Physical it doesn't, but it translates into, into enabling health all around in their, in, in, in their life. And then you, as you go through that process, they hopefully will start to feel comfortable and share what they're experiencing about their financial stress or about their oral health. And then you unearth the need as they see it. You really unearth that need at some point. And once that need is unearthed and the patient starts to really open up about how they're, they're not conscious incompetent with their smile or they're constantly uncomfortable, or they just don't feel confident and they can't eat certain foods or whatever that is, then the case acceptance or then the commitment to the treatment plan to find that solution becomes a lot easier, more easily accomplished?

Yeah, yeah, 100%.

I don't mean to hijack what is a good sale, and I don't necessarily think I'm a good salesman either. But just in having hundreds of sales calls, I've just found that when I say, hey, my model may not be for you, my CFO model, you may want a bookkeeper down the street and pay him 250 bucks a month just to have your books done, fine. But my model is about financial wellness, holistically throughout your life. And if that model works for you, great. Let's have a conversation. What's on your mind? And we have that conversation.

Yeah, 100%. So it's like sell the problem, not your product, right? Like find the problem, find the pain point. It's like find the problem and then come up with a solution for them. Right? Like don't, don't make them. Like if I do a lot of research on. There's a guy, he's a best selling author named Daniel, Daniel Pink. He wrote the book to Sell as Human. He's a, he's a, an author and he's dedicated his entire career on studying persuasion and influence. And he talks about the irritator versus the agitator approach. And the irritator, if you have an irritator approach, it, it's trying to get someone to do something that you want them to do versus an agitator is trying to get someone to take their own action, to do something that they know they want to do and ultimately will do. So it's amazing. You know, they always say the best salespeople use their ears more than their mouth. But yeah, it's, and it's your ability to connect with people, right? Like it has so much more to do with like non verbal behavior. Like you know, like I treat, when I go in and do a sales presentation, I would treat you exactly the same if you look like you were homeless or the CEO of a company. And I would try to get on their level, like, you know, mirroring, you know, body image. You know, like if they look like more of like, you know, a blue collar person and I might like throw a cuss word out or whatever, you know, like just get me. That's how people feel comfortable. People feel comfortable. That's why you do that. Like you mirror their behavior, right? So you know, if someone's more serious, you sit up straight. If someone's more laid back, you sit back. So it's you, you try to get in their element, right? It's, it's, it's Interesting. But. And then you do those things subconsciously. When you get. When you do this so much, you know, you just know how to connect with people and make them feel important. That's what people want. And it's very easy to build rapport with people. You just ask them questions. Questions. Everybody loves to talk about themselves. That's why social media is so relevant. Right. It's the easiest way to do it is like, you know, just, oh, did you. You know, I used to always like, I'll go grab the patient from the. Bring them my office and be like, all right, now let's get down to the fun stuff. I'm sure you're so excited, like your favorite places to be at the dental office. Because everyone, you know, they know I'm going to be. So we laugh. And if you can make people laugh, it's great. Great. So, yeah, it. It is a really cool thing.

But I think it's interesting the industry has evolved in this regard because this is really prosthodontic. If you went back 20 years, who's doing this? These full arch cases, it's prosthodontist, Right. And an os. Right? Yeah, those are. The two have historically done it. And now I'm sure the prosthodontic space, which I. This could just be. This could be totally false. But it seems to me like there's fewer and fewer prosthodontists these days. I don't. I have a few prosthodontists for sure, but I don't see many. But again, I could be wrong on that, and I don't know if that's because a lot of general dentists are really moving into this space and so the market share isn't there to be referred to as as much. Oral surgeons continue to do really well financially. I don't see a too much erosion there, but I suspect that the OS and the prosthodontic space over the past 20 years has been a little bit discouraged by seeing a lot of what was traditionally their expertise is now moving into the. The domain of this. Of the. Of the gp, which has always been struck me as ironic that a specialist can't do GP work, but a GP can do specialty work. And at least that may be based on the state code. I don't know, but I always found that really interesting. Where am I going with this?

I was just gonna say that a lot of the prosthodontists that I work with, they just do implants now. So they. Yeah, so they'll do the Whole thing. So I. Yeah, so. So a lot of the. I actually met with a professor of advanced prosthodontics, Prosthodontics from ucla. I had breakfast with him last week. It was awesome. He's one of the, he's on the American Dental or cda, I think, or ada. But yeah, I think a lot of them are just finding creative ways to, to stay relevant, like doing surgery also instead of just doing the prosthesis part. Right.

I think that's where I wanted to go too, is. I mean, even since I've gotten into the dental space in 2009, there is definitely an economic erosion out of the profits of a, of a standard general practice because of the reasons we all know about lower reimbursements or at least not rising reimbursements. Delta Pro Premier, it's essentially gone. And now Delta PPO fee schedule, which is a lot lower for all the. The newer generation of dentists who have bought over the past 10 years or so are forced into Delta PPO reimbursements instead of the, the old Premier reimbursements. And all the while you got to pay a hygienist what feels like a million dollars a year just to keep them. I mean, they're making 70, $75 an hour now. When I came in, it was close to around $40 an hour. And even with inflation, it's just been astronomically on the rise. And labor costs in general have been on the rise. Rent has been on the rise. All of this has been on the rise. And so what used to be an industry where cash flow is more easily accessible, profits, I should say, were more easily accessible. Now you have to be more and more savvy as a, as an operator, as a communicator, as a leader, and as a business person in order to have the same results financially that you did 20 or 30 years ago. And so I think this is one of the reasons why is just the economic need for dentists who come out with 5, 6, $700,000 in student loans to have the income necessary to not only pay for those student loans and to pay for everything else, but also to justify having gone to school an extra four to six years even more sometimes than your average American. And they delayed all those years of making income. And so there's this real need to sort of play catch up in a way. If you're in your mid-30s, when most people started at 22, you know, and you're 33 and just getting started, what can I do to increase my income? Okay. Full arch. Wow. A $25,000 case, a $30,000 case that right there could pocket me $9,000 to help cover all of these things and sort of justify all this sacrifice I took to go to school and taking on the debt to buy the practice. Taking on the debt and risk of running a business and hiring people and all of that that I fight so aggressively for, which is my doctors deserve. And I, I want to be careful to not sort of over state this where it feels like there's an entitlement. But our, but my clients, dentists deserve something to be compensated for what they're producing in the world. And this is, and so I don't, I think it's understandable that they've sort of reached out and said, okay, these things were referred out in the past. I'm going to try to do these on my own. With the technology that's out there now and the training, there's certain things that they're able to do really effectively. On that note, a question for you is what level of clinical training do you think is needed? Both. Okay, so the clinical training on how to do this. Talk about, talk about that for a moment. And number two, what sales, specific sales training. Is there like a sales program? Is there a book? What do you do when you bring them on a new client to help them increase their sales? Those, those two things in terms of training.

Yeah. So the clinical training is definitely a must. Right. So some sort of clinical training, like a full arch course, you know, there, you know, depending on what implant system you're using, you know, biohorizons. Like I said, I speak at all their teeth express course courses. They do hands on life surgery courses, Neodent does courses. I have a, an awesome doctor that I have a doctor that I'm working with here in San Diego. He's a periodontist, his wife's an orthodontist. They just took me on, retained me as a, to help them with the sales. He's a periodontist that practices as a gp, but he, and he's always done single implants and now he's looking to go do full architecture. He tried guided surgery. So there's guided, then there's freehand. So but I have a really good friend, his name's Dr. Chef. I'll give him some shout out. He has an online course that you can learn how to do freehand if you already have. But yeah, definitely the clinical didactic training. And then like I have ways to get mentorship. Right. If you want to do a Few cases with like a mentor. So that, that's what I would recommend. You know, unless you, you want to just dive right in. Right. I remember I work with an oral surgeon, Dr. Sharafi, that told me, you know, it took him 3,000 arches before he knew how much bone to adequately, adequate, adequately remove. Because, you know, you're like literally, you know, thinking you're taking off the whole mandible, but you have to make sure you do enough bone reduction because you have to have enough restorative space. So the clinical, that's the key. You have to be trained clinically and then the sales training. Yeah. So I've dedicated my entire career now to make an impact on this. I have a company called Full ArchsalesExperts.com I have a learning management system. It's an online course that literally gives you my playbook. It's four modules on the, the lead call, the clinical presentation, the sales presentation, and then like an introduction to sales. If you have like a TC that's never had any formal sales training and it's 32 lessons, so each one is two to six minutes. And then I do on site training and remote training. I'm not going to talk about any of my competitors because I think a lot of these other people that are doing it, they've never really done full art sales, to be honest with you. That's why I'm really dedicating my time now to help. You know, there's a lot of marketing companies that claim they understand the full arch sales process, but they're marketing companies, they have never done the sales. So it's two completely different things. Like I would never try to tell someone, someone, you know, I could help with, I have marketing partners, but I'm not going to sit there and I could help with a little bit of internal marketing. But yeah, so there, there's definitely, you know, there's resources. It's just finding the right ones. And, and it's like you said, do you, should you hire someone that's good in sales? It's like any other business. Like sales is what drives your numbers. Right. So it's like, I just think it's like so new to dentistry. And like even like when my dad was practicing, you couldn't even do advertising. Like it was considered unethical. Right. Like one doctor could not own more than two practices because you had to spend 50% of your time at each practice back then, you know, and so. But I think also my dad had to find really creative ways to, you know, he Added this booming GP practice and HMO came out and he didn't want to mess with HMO and start, you know, having to use cheaper equipment and things like that. So he lost half his practice and that's where he really went and invested, you know, some money and learning like the business side of dentistry. But there's definitely resources if, if you want to make it, make an impact.

You know, I will say when it comes to the business of dentistry in general, I think that the education and government system around this is just really undeveloped. It has not stage doctors to come out in what is inevitably now a business oriented world in the space of dentistry. Because I'm, I'm telling you, when PE money gets involved and there's the DE, the DSOs have PE money. The PE money is not going to invest money in buying a doctor out or you know, investing in that space unless they know that they can grow that business. And the only way they're going to grow that business is through a well functioning, a high functioning sales team. So that's what doctors are, private doctors are competing with, is a really well marketing marketed company. And so there's no way, really, there's no way to avoid this unless you just have like that much natural charisma or your social circles are so strong that you just personally by will of personality can drive great traffic into your, into your practice and have a really successful business that way. Besides that it, I think you, I think if you really want to accelerate your financial progress, which is what I'm all about, I, I really want my doctors to hit financial independence in their early to mid-50s and it takes a lot of discipline to do that. You have to be good on the business side of dentistry. And I just don't think that dental schools for as great as they are clinically and we have some of the most amazing dental programs in the world here, no doubt. But when it comes to this other side of running a practice, not only I think are they behind in not providing enough education, they'll have like a club, you know, which may run a little course once a month on the evening and invite some dental banker or somebody like me to come in and talk, but it's not embedded in the curriculum. And you know what, maybe that's not their job and that's just totally fine. But the way that we're hardwired right now in the industry, the education, the doctors will by default not get the education and the experience needed to be successful in this, which means you have to be incredibly deliberate about carving out space and money in your, in your career plan to actually, actually make this work. Whether it's full art, whether it's doing cosmetic dentistry, you know, whether it's doing some bigger, other bigger treatments, whatever that is, you have to develop that. And I would say that if you're going to rely on a tc, a treatment coordinator or a salesperson, you cannot get that position wrong. And I think what's really hard for Dennis, as it's been really hard for me, is I hire people earlier on when, you know, I'm strapped for money and you, you can only pay so much for a position or whatever, and they come on board and you know, they're, they're a good B minus, They're a good B minus, and a B minus at some point, point in your careers, it's like, okay, this is, this is satisfying. What I need at a basic level, I'm good. But when it comes to the sales and that person communicating to the patient, if you have a person who can have a 50% acceptance rate and you're paying them twice as much as a person who has a 25% acceptance rate, you're going to be way better off paying the higher salary person because of that extra 23, 30, 40% acceptance rate, whatever that is, you can't get that wrong. And if they're not that person, if they cannot instill that confidence and that level of comfort and walk through that communication experience with the patient, you got to do the hard thing and either move them to another seat on the bus, as Jim Collins says in Good to Great, either move them to another seat on the bus, maybe they should be billing for you, I don't know. Or you got to move them out and let them be successful somewhere else. You got to love them out and let them be successful, successful somewhere else. You can't go wrong in that position is my thought. My last comment here, then we'll wrap up here in a moment. Is as a, as a dental office, as a private practice owner, you don't have outside investors. Generally speaking, if you have outside investors, it's because you've gone the route of DSO and you've essentially sold your practice, right? And maybe you retain 20% at the local level, what's called enterprise equity, whatever. But you've essentially sold your practice. So the only outside money you get is generally traditional lending from healthcare lenders like bank of America or provider Huntington and the like, pnc. And you get that money, but that's usually for a very limited thing. It's to buy a dental practice or to buy equipment. And so you generally don't have doctors going and taking out loans in order to hire a salesperson or to go and market. Now, I'm not saying they shouldn't. I'm just saying the industry has not worked that way. And it may be difficult to go get lending if you're already leveraged from an acquisition loan or other renovation loans or equipment loan. If you're already leveraged, meaning you have a lot of debt, there's not a lot of room for the banks to go and lend you more money. What I'm saying here is that in order to sometimes get something like this going, because you're at a disadvantage in that you don't have outside equity money, you have to live in a way. This is the personal financial planning, Wes, coming in here, you have to live well below your means personally in your life. If you can live well below your means and let your cash in your practice build up. And so you go from having $80,000 in the bank to having three or $400,000 in the bank over, you know, over a year period or whatever that is. But you build that up such that you have surplus 5%, 8%, 10% of cash flow in your practice because you're, you're living, you know, modestly outside of your practice. That allows you to essentially be an investor in a way. You, you yourself personally are investing money that you would have taken, taken home to spend on personal things, and you're reinvesting that back in the business, and you're using that reinvestment to hire a really good salesperson or transaction coordinator to go and market it to through some specialty marketing companies to get sales training and communication training, which I've emphasized this a lot over, over the, the year, Stacy, is go spend some money to learn how to communicate and sell really well. But very few people do it, even though I think those that do it become better leaders, better, better communicators, and they just overall are a lot more successful as a practice. The power of language and communication is, I can't put words on how powerful that is in our lives in general. But as it relates to case acceptance in the dental practice, I definitely think that applies there as well. So there's just, there's a lot of, I think, thought and planning that needs to go into how to get the capital, so to speak, to invest in these things, which will then have a return over time. If your practice is already cash flowing so well that you can go and do that without having to adjust your lifestyle budget, great, all the better. But some of you, you younger doctors, if you can keep living like a dental student for an extra three to five years after you buy your practice, it's going to create a lot of breathing room for you to invest, discover, make errors, learn, grow and then really get to a practice that's functioning exceptionally well as a business.

I agree 100%.

All right, that's my, that's my, that's my financial.

But your final thought was so good. There is, however, I don't know if you know this. Proceed Finance is one of the biggest patient financing company. They have loans available for doctors for continuing education and training and so on and so forth. They have interest free loans and things like that. So just so you know, they just came out with that. I work together with them on a lot of stuff. So there, I think there are some avenues. But your way, you know, anytime you could just live a little leaner and save it for. That's. You're, you're the accountant speaking. So.

Yes, but no, I'm not afraid of loans. Debt. I'm not afraid of debt when I have a high confidence level that that debt is going to convert into a return on that, that, that debt. What gets problematic is when you take on debt and you don't get a return on it, meaning it doesn't produce 300% of what your loan payment is. Even if it pays 100% of your loan payment, you still have to pay your team and taxes and other things related to the new income that that debt brought on. So you really need to get a 3, 4, 5, 6x return on whatever that debt that you took out is. So I'm not opposed to that. But I also don't want doctors to think that just because I took out debt and I'm investing in this thing that it's going to work. You take out debt, you put, you invested in that thing and then you, then you focus on a vigorous execution plan around that thing. In this case, we're talking rollout of full arch dentistry as a, as a, as a, as a line or a theme in the business. You execute that vigorously in order to make sure that that debt you took on actually increases your balance sheet, which is your assets, and doesn't ultimately only increase your, your liabilities and not increase your assets. All right, I'm talking a little bit too much like a CPA there. Hopefully people followed along. All right, give us a final plug for your company. Tell us the name again of your Company, what you do and how people can get in touch with you. Stacy.

Okay. The name of my company is full arch sales experts. And you can find me on full arch sales experts dot com. I do sales training. They. I do a couple things really well. I teach you how to make sure patients show up to your practice and once they're there, close more cases. I'm not trying to boil the ocean. I help with a lot of other areas. Right. A lot on the clinical operations. Because you like I was in an on site. I closed six arches yesterday at my client's office. So talk about an roi, Right? So I do on site. I do remote training. I do what's called virtual close, where if you have a practice in New York, your TC can zoom me in and I'll close the case virtually. So really creative things. And I'm just looking to help as many doctors as I can. Yeah. Full arch sales experts dot com. You can email me directly at stacey s t acquire@full arch sales experts dot com.

Do you help? I was writing something down, so I may have missed this if you said it, but do you help a doctor? Let's say I'm a doctor. I said, stacy, will you come in and not only will you help me roll this out, but will you help me recruit a treatment coordinator? Will you help me recruit somebody that you then make them a carbon copy of you?

That's a great question. Yeah, yeah.

It'll take a year or whatever. And then. And then you. And, you know, then that's our engagement. Then you move on to your next client, Whatever. Do you do that?

Yes, I do that. I'm doing that right now for an oral surgeon in Florida. So his office manager is basically gonna be bringing on like the 10 best people. They do the beginning part of the interviewing process, and then they're gonna afford me their top five and I'm gonna interview. And yeah, I do. I do that because I can recognize very quickly whether or not someone has, you know, the capacity to. To. It's very easy to understand. That's my language. Right. Just like you can recognize a P. L. Like, that's what I. I can see just by communicating and things like that. If someone has the ability to be really great in sales, well, I'm tempted.

To recruit you to practice CFO to become the first salesperson dedicated ad practice cfo. No. Thank you, Stacey Farley, for being on the program. Feel free to reach out everyone to her. How do they connect with you? Did you say just go to your website?

Yeah. So just Go to full arts. Full artsalesexperts.com or they can just email me directly S T A C Y atfullarchs experts.com and I'm also on LinkedIn under Stacy Fer Farley. I'm on Instagram, so you can find me. I'm out there. I'm, you know, I just transitioned from being in a practice like 80%. Like 90. 90, 10. Right. I was in the practice. We were doing 50 arches a month there. Now I'm doing this full time. So I'm kind of like putting everything together. My training, I've been training on the side for like seven years now. So that hasn't changed, but it's. I'm packed. So my website, so it's not all done, but you can get a hold of me, so. And my email is. Yeah, so.

And I'm a believer in boutique services. I think you're at that stage where you're transitioning, going from being sort of in the. In the practice to now outside of the practice, but helping other doctors implement it in their own practice, going from the clinician to the consultant in a way. So I'm really excited for you, Stacy. I think you definitely proved success because I looked at those financials, I've been looking at those financial statements for many years, and I'm like, wow, that is a phenomenally successful practice. And I'm looking at you right now, and I know you're, you're, you're one of the key reasons why that's been there. The current owner is awesome as well. He's a great doctor and it's a great team at Color Culture. But I know just how critical your role was in launching that whole new life or phase of that business to go from 2 million a year to 78 million a year. So congrats on that and good luck with your new venture and we'll have you on at a future point so you can tell more about your success and what you're doing for doctors.

Thank you so much. Thank you for having me. It was awesome.