Podcast: Jennifer de St. George on business options for dentists

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: Welcome. You’re listening to Ascent Dental Radio. My name is Dr. Kevin Coughlin and I’d like to just give a notice of thanks to Mr. Doug Foresta. His company, Stand Out and Be Heard, has been producing and managing this podcast now for several months. I’m proud today to introduce to you Mrs. Jennifer de St. George. I’ve had the pleasure of chatting with Jennifer over the last several months, and in particular, a variety of subjects.

But mostly, the independence and the options that dentists now have. Perhaps one of the most significant changes is the advent of corporate dentistry, or what more properly would be referred to as managed service organizations and dental service organizations.

Anyone who has followed practice management, anyone who has been involved in the field of dentistry will be familiar with Jennifer de St. George’s background and accolades. She is one of the leading practice management speakers. And she is an authority in building teams and providing perhaps most importantly, education, team work and the development of a dental practice to suit the current goals and necessities that are available to today’s dental force.

Without any further ado, I’d like to introduce Jenny de St. George. And as always, these podcast are brought to provide the dental profession with the best in these areas and other areas. And I can’t thank you enough, Jenny, for taking the time to speak to me today about what’s new and what’s going on in the dental profession and how perhaps, between the both of us, we can shade some information to a variety of different topics. Jenny, thank you so much for joining me today.

Jenny: Kevin, it is absolutely my pleasure. I am going to, I’m afraid, date myself a little bit. When I first into dentistry almost four decades ago with my then current husband after he graduated from dental school, we opened our independent practice. And along with about 97 percent of graduating dentists at that time, which would be in the late 60s, about 97 percent of dentists graduating went into solo practice.

They took some money from the bank, in our case it was a whole whooping $25,000, to start four treatment rooms in 770 square feet. About three percent went to the military, postgraduate and once in a while, went into an associateship. So really the decisions that Edmond was making and the dentists at that time was not even a decision they had to make. It was a given.

When we went to crack a bank to get our loan to equip and open and finish the practice because the building was not completely finished, we had to do the last construction, the bank manager as he gave us $25,000 — and by the way, the only collateral we had, two wedding rings, a used VW that Edmond bought going through dental school and a DDS degree. And the bank manager looked at us and said, “We’ve never had a bankrupt dentist yet in the state of California, you will do nothing but succeed.”

Fast forward to today, 2017, and historically I think that has changed to maybe — and I’m going to exaggerate a little bit — perhaps 97 percent of graduating dentists are now looking for some sort of relationship where they don’t have to go out and start what we would call in England a scratch practice. And maybe three percent take that huge leap of faith, put their name on the door, open the door as we did, and just pray that somebody walks through the door.

I know it’s beginning to turn. I was at a meeting recently in San Francisco and I ran into a vendor from Wells Fargo who’s worked in dentistry for actually as long as I’ve been. He remembered me, I didn’t remember him. And we sat and chatted and he said that the market — and I can obviously only talk for California — he said is changing and he’s beginning to see more and more doctors graduating beginning to consider the potential of setting up an independent practice.

Either way, I think that Kevin your goal and my goal is to help in any way we can, the professional make an educated decision. So if they decide to join an organization or they make that commitment to go solo, they do it with, to the best of their ability, all the facts that they can get and not just make a blind emotional decision which I fear that many of them do.

Kevin: I can’t agree with you more, Jenny. I do teach at Tufts School of Dental Medicine in Boston, Massachusetts and the focus of my course is part of a practice management curriculum. Which now is mandated basically through almost all 60 dental schools in the United States to provide a business background and try to improve the business acumen of these young graduates so that they’ve been given the tools to make informed decisions about what works for their particular wants and needs.

So one of the reasons I was interested in bringing Jenny on to our podcast is dentists look for experts. They are looking for information and knowledge. Because unfortunately, most of us have a very strong science background, but we have a very weak background in business. And today, we’re surrounded by significant debt, significant challenges and it’s up to us to provide tools and information to guide these graduates or any particular part of your career whether you’re in mid career or in the twilight of your career, to make informed decisions.

Jenny, in your professional background, what would you consider would be the greatest opportunities, potentially the greatest threats to the profession as you see it? And you’ve traveled all over the world speaking and I believe you’ve been to five continents. What is your feedback from the people who are participating in your programs, reading your books, listening to your CDs? What do you see as their biggest opportunities and threats?

Jenny: I think it’s very important for your listeners to know I do not come from a clinical background. I came into dentistry through marrying Edmond, so I feel like I went through dental school. I feel I graduated as a dentist, but I did not.

When Edmond graduated out of the last year of what was known as P&S in San Francisco, College of Physicians and Surgeons, that was the last year before they moved the school and it became the University of the Pacific. Edmond and his class and the classes before him used to tell me that there was virtually nothing that would walk into their practice on the first day that they did not have the confidence to know how to handle.

Edmond told me he chose to be a GP because he liked the stimulation and the challenge of never knowing what kind of patient was walking through the door. He just didn’t want to go into a specialty practice where he was limited to a specific amount of procedures. So his confidence was so high that he could barely wait for the next patient to come through as an emergency.

Today, and this is just third party feedback, I am wondering if today’s graduating dentists have the same confidence and they have the same skills. I’m going into my memory bank, I think Edmond, I want to say, he made 35 dentures off the top of my head. I do know that when he delivered a new set of dentures, that the patient could not get it out. The fit was so good. He had so much confidence.

And so the most important it would seem to me to say as a non-clinician is to do whatever you need to do to get your clinical expertise to the level that you are confident and comfortable with yourself.

And I think as a number one, therefore, if you have that confidence, the second decision is where to take that confidence and expertise becomes a little easier. I sometimes wonder if the youngest dentists graduating lean towards going into a management service organization because they perceive that perhaps they still need to get more experience or more expertise.

Which in a way, he’s almost made the decisions for him or her. I don’t know how you feel about that comment because you and I have not discussed it and I appreciate I am a non-dentist making it, but it would seem to me that expertise is what the profession is all about.

Kevin: I can tell you that from my perspective, a number of factors are taking place today. One, many of the young graduates are limited in their exposure and in their clinical skills today, much different than it was 30 and 40 years ago and that’s because of the rise of specialization.

Today, that graduating student, that third or fourth year student is many times taking patients and these patients that require specific clinical care are referred to the post-grad departments, whether that’s endodontics, periodontics, pediatrics, oral and maxillofacial surgery, public health. The list goes on and on and the nine specific areas of specialization.

So unfortunately, and this is a generalization in my part based on 34 years of clinical experience, not only my own business but teaching, that many times these young men and women — and I shouldn’t use the term young, but recent graduates — may be lacking the experience that your husband had three and four decades ago.

I don’t see that changing and my feedback from my students are, “Dr. Coughlin, I just need a couple more years of working anywhere I can to get my skills and confidence levels up,” where your husband’s confidence levels are because of perhaps additional clinical training.

I always tell the students, and perhaps you can comment on this, I always say you would never marry someone just to be married. And I don’t think you should take a job just to take a job. I think you should take a job that you’re passionate about and a location with a support team that you’re enthusiastic about. And it’s up to you to get that additional training.

Because from a purely financial standpoint, since the bulk of our profession is still general dentist, I cannot emphasize what you mentioned earlier in this podcast, you have to get training in the nine areas of specialization.

And although you may not be a complete expert in all areas, with adequate training and mentoring, you should be able to do 80 or 90 percent of the treatment that walk through your doors to improve your bottom line, keep yourself technically and didactically stimulated, and also offer more services for your patients than just simply a radiograph and a referral path. What would be your comments on that, Jen?

Jenny: Number one, I could not agree more because if the graduating dentist does not follow your advice, they will end up by rather being like a traffic cop at an intersection. A patient comes into the GP practice and like the interns doing medical, they pass them on to somebody else. They’re just like the gatekeeper and I wouldn’t have thought most dentists would go to school to become a gatekeeper.

Kevin: I couldn’t agree more. One of the things, Jen, that I’ve actually seen and are part of my presentation, is it’s almost like a dating game. I have them fill out a series of 20 questions and those questions are basically personality questions that determine do you have the entrepreneurialship, do you have the drive and the desire to be a solo practitioner, to be in a group practice or to be guided towards corporate dentistry.

And it’s interesting over the last ten years, typically the groups that I’m speaking to are between 50 and 100 students. And more and more, each year, I see them gravitating towards corporate entities, sometimes because what we touched on is lack of clinical and business skills, but more and more, I see two incomes.

Many times one professional is marrying another professional and they say, “Dr. Coughlin, I’m looking for a different life balance. I’m interested in pursuing other aspirations and goals and I don’t know if I want the trials, the tribulations and the potential stresses of being a small business owner.”

And as I’ve said to you in private, I think our job as educators is not to necessarily put our views on people, but to explain to them the risks, the strengths, the opportunities, the threats and the decision-making process so that they don’t make a mistake.

Because personally, being independent, being in control of your clinical and business, to me is hugely important. But sometimes for other people, they’d rather have other people make those decisions and just focus on the clinical aspect. What would be your thoughts on that?

Jenny: Many years ago, I was interviewed and in fact, interviewed him, a psychologist on entrepreneurship and small businesses. He had worked in the dental field for quite some time and he told me that dentists’ group was the most individualistic of any of the professions. And in his opinion, there were dentists who were brilliant, they could have been heart surgeons or flown to the moon, whatever, but they choose to go into their own practice because they wanted to be in charge. But it takes a personality.

I think that what dentists today who have been practicing for many years, is they realize that 50 or 60 percent of the stress in their practice, maybe more, was not caused by their clinical area, it’s caused by staff and patients.

I joke when I speak from the stage, the ideal dentist if they could wave their magic wand, would let the patient drop off their teeth in the morning, pick up their teeth at the end of the day. The dentist at the dentistry never has to see the patient because it’s the patients and the money and the insurance and the staff that cause the stress, not the dentistry.

So I think that some of the dentists think that by going into a corporation that this stress, as I described it, will disappear, but that is absolutely not true.

And if there’s one practical suggestion I could share with you, Kevin, that I have said from the stage for years, when you are going to interview, whether it’s a DSO, an MSO, to be an associate in a private practice, whatever it is, call up and be a mystery shopper.

Call up and pretend to be a patient and make an appointment for an emergency. Get to the reception room two hours before the interview with the senior doctor or the manager of the group. Watch the staff, watch how they behave to each other, watch how they handle patients.

And if this is a mismanaged rude office where you will do nothing but learn how not to do it, I suggest you make your appointment five minutes and leave. You only want to go where you will be surrounded by the quality in management and communication.

Kevin: Jennifer, how do you feel, what’s the best way for the listeners of this podcast to improve that situation? What are some of the areas if a dentist listening to this podcast says, “You know what, I think I’m doing a good job, but really if I was to be critical of my team, myself, my office, I need improvement,” what would be the best way for them? How do they reach out to get better?

Jenny: The sad thing is we shouldn’t have to ask this question. The sad thing, Kevin, is that in dental schools, patient management, patient-doctor communication and human resources, how to hire and fire and manage, should be part of every program.

In England, a few years ago, they actually took the four-year dental program and made into five years so they could add all this stuff that was not being included in the four-year program.

When I talk to deans of dental schools as I have over the years and I got on my little soapbox about the kind of thing you and I are talking about, the deans tell me that the students are not ready for this kind of information. Yet when you go and talk to the students, they are more than ready and they want it. The deans will say there’s no time in the schedule, the students say you come in at 5:00 in the morning, we will come in.

At the moment, to answer your question, I don’t think there is a structured approach. It’s going to people like me going on to webinars, going to the conventions, but it’s not a systematical approach. I am hoping to get it finished this year, 2017, I would like to start a JdSG Learning Center online where I put up a very basic but the whole program. Because in my opinion, when you learn staff management or you learn how to communicate with patients or how to ask for money, you must always do it in the context of the whole program.

But dentists graduate from dental school and they maybe go to a convention and in theory they could have three speakers who actually say three opposing views on the very same subject. So it can be confusing. It should be part of the school curriculum and it’s not.

Kevin: I couldn’t have said it better myself. Hopefully, with experts in communication, in teaching, in education like yourself, we’ll see an improvement. And if I could give you a little prod, a little push, I will tell you get that program out running because our profession needs it. The better our business is, the better our communication skills are, the higher level of care and service we’ll perform. And I think understanding the independence and the luxury of being independent — I tell the students be careful what you wish for.

Nothing in this world is for nothing. And when someone tells you they’re going to take away all your stress and all your problems, sometimes you’re left with more stress and more problems.

Our goal out there in the practice management field, in the educational field is to provide data and information so that students, the seasoned practitioner, that practitioner getting ready to transition perhaps into a new area of their life, they need these tools and they need this information to make the most informed decision.

I  want to thank Jennifer de St. George so much for her expertise, her knowledge and her time. She’s been doing this for over two decades, actually over three decades, and it has been an actual honor and a privilege to have you on this podcast.

You’ve been listening to Dr. Kevin Coughlin, Ascent Radio, that’s Ascent Dental Radio. And again, my thanks to Mr. Doug Foresta for producing this podcast and it’s Stand Out and Be Heard. Doug, thank you so much for your expertise and I look forward to our next podcast. Thank you listeners very much.

Podcast: Bob Tremblay on dental practice trends

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: Good afternoon. You’re listening to Ascent Dental Solutions Radio. This podcast is brought to you by Mr. Doug Foresta. His company is Stand Out and Be Heard and without his expertise in podcasting and production, I would not be able to bring this podcast to you. The podcasts are made for business in general, but dentistry specifically. In this particular podcast, we’re fortunate and lucky to have Mr. Bob Tremblay, who’s been associated with the dental profession for over 35 years.

So often, we as dentists sometimes underestimate the knowledge and information that’s right at our finger tips. Mr. Tremblay has been involved as a growth specialist for Patterson Dental Supply, as I said, for over 35 years. He serves well over 100 dental offices and in my opinion, he’s an expert in the field of dentistry.

His expertise can make your practice grow, make your life better, and most importantly, provide the assets and information to provide the highest level of care and satisfaction to our patient base.

Bob has been featured in full-page articles of Proof, the industries trade magazine. He’s received numerous corporate and national awards for sales and sales training and has consistently been the growth driver of awards and has been in the top ten percent of his specialty with over 1,000 different colleagues for the last 15 years. I consider Mr. Tremblay an expert in the field of dental supplies, dental growth and the general business of dentistry and we’re fortunate to have him take time from his busy schedule to speak to us on a variety of topics that I believe can help your practice and provide some knowledge and insight that sometimes we often forget.

Mr. Tremblay, thank you so much for joining us. I can’t tell you what a privilege it is to speak to you this afternoon. Bob, what can you tell us about the dental profession today as you see it? Since you see hundreds of dental offices, what do you see as some of the trends in dentistry today?

Bob: I think dentistry today is probably the dentistry we’ve seen in quite some time. I think that dentistry is changing very, very rapidly with different procedures and easability of doing the procedures in the dental industry.

Kevin: Bob, sometimes what I found is that the materials, the techniques, change so rapidly. And as a practicing dentist for 35 years, sometimes I get set in my ways, I don’t want to change. I think what I’m doing and what I’m using is the best technique and best procedure.

But with your expertise, you’re able to come into an office, evaluate the supplies, the materials and techniques and you can really add insight to the dental profession because not only do you know these materials and their advantages and potential disadvantages, but you’re seeing them used in hundreds of practices. How do you go about the training and the education of a dental office? What does Patterson have to offer that sets your company apart from the other supply companies?

Bob: First of all, thank you. There is over 84,000 items in the dental industry of what doctors used. And like you say, you’ve used them for years and you become comfortable with what’s going on and what that product does for you. But the evolution of the changing products and what they can do and the strength of certain products, that changes quite frequently. I pride myself in learning and taking numerous classes all the time on the certain products.

But there’s a lot of products that have a lot of similarities and there’s a lot of dentists that enjoy that manufacturer of products or what it does and how it handles. Each office is different of products and I will always provide information on certain products and give them the tools and give them my understanding of what that product does and how it would work in their hands and what the final result is.

But the items out there, each doctor is different and each doctor looks at things different and handles things different.

So I certainly give them the tools to utilize, but it really depends on what they want to use at the end of the day and there are a lot of products out there that can accomplish the same thing. Because it’s comfortable in their hands and they’re using it, I won’t have them changing it unless I know that there’s another product out there that is just far better than what they’re using.

Kevin: Bob, sometimes when I open my closet, I believe I actually have all 84,000 items. I know that’s an exaggeration, but many times I find dentists fall into different categories. There are those dentists who don’t want to try anything, and then there’s that group of dentists who are willing to try almost anything.

And what I found a great asset of Patterson Dental is many times they’ll bring into the office a lunch and learn and allow the dentist and the team members to try different materials, work with those materials before we actually make the investment and time and finances to implement that into their practice. That’s something that I think is not only unique, but very special about Patterson. And what I found working with an excellent sales representative such as yourself, you allow those lunch and learns. Is that correct?

Bob: That is correct and that’s a great topic and something to talk about. That’s one of the things that separates us from the Catalogs and the Uniques out there. There are so many lectures that doctors go to that they tell you that this is a better product and why. So the doctor would go on the internet and try it out and they’ll have a very expensive kit on their hands that they don’t like the handling of it or something like that.

One of the things that gives us the advantage or the value of coming into your office is we have these lunch and learns. Even though the lectures will say that this best, it may not be, like I spoke earlier, it may not be their type of product that they like to use.

So what does that do? That does what many offices that sits in the storage shelf and it’s never used and it becomes outdated. But it’s very important to have the value of somebody like myself to come in to explain the product, for them to utilize the product and try it out even in hand.

And we certainly — I know I do and Patterson stands by this — we give you 100 percent guarantee. So if you use it and it’s not what you want or it’s not what you thought it would be, we certainly take it back and give you a full credit if it’s in a kit’s form. Because it’s something that we can’t guarantee that you like and it’s important that you utilize what you have.

Kevin: If I could just make an inside comment, my personal opinion is sometimes we as dentists we’ll only give something a try once or twice and then that’s it, we’ve given up on it. And like most things in this world, sometimes it takes a little additional training, some patience, to make sure that these products are used properly, not only by us, but the dental team that supports it.

If you were to comment on the restorative part of dentistry, which is still a large portion in dental health care. I noticed a phenomenal company like VOCO has the ceramic composite restorations. How are those products being represented and is the dental community and the patient base receptive to them and are you getting good to excellent feedback on the products such as those?

Bob: Yes, and VOCO does have a new ceramic-based resin composite and it seems to be really taking off quite well. There’s a lot of manufacturers out there, that name brand product: the 3Ms, the Dental Supply Cox of the world, that have that name or that brand, if you will, so doctors will utilize theirs before. VOCO is from Germany and they’ve really stepped up and have really come up with some great products. They’ve really come a long way with their resins and their ceramic resins and other products along the way.

But there’s many, many manufacturers; Ivoclar has some great ceramic products as well, but it really depends on how the doctors like it to feel. As Gordon Christensen says, there’s three things you really look at when you do; how it handles and what the end result is and obviously, the cost. We want to look at those three things. And if those three things work in a dental office, it’s worth utilizing.

Kevin: Bob, if you were to comment on the actual instrumentation. I know through personal experience Patterson has an excellent association with Hu-Friedy and the cassettes and the instrumentation that goes along with that. I’ve just been blown away by the incredible hands-on service to prepare these kits. These kits can sometimes have 20, 30 instruments in it and the organization and the implementation which is just phenomenal. That association with Hu-Friedy, how long has that been going on for?

Bob: That’s really a great statement there. Hu-Friedy is one of the finest instrument manufacturers in all of dentistry. You look at their dollars and so many people are so short-sighted looking at instruments because it’s very price difference from one instrument manufacturer to another. And it’s definitely a quality product and you can have instruments that are a very weak metal versus a strong metal. Plus the Hu-Friedy company really prides themselves in an organization of IMS cassettes. It’s not just instruments being put into a cassette, it’s a very well-built cassette, very organize-driven to make your job more efficient and better organized.

And that’s what helps the dental offices get better and grow, is the organization of their protocol and procedures and what they do. And Hu-Friedy certainly adds to that with their IMS cassettes. Their instruments are far better than any other instrument I know and I’ve dealt with. They’re constantly designing new instruments for different procedures. They never stop. They’ve really taken the time and every single…

Kevin: I can tell you when I had an instrument fractured, and in almost all cases, it’s because I was using that instrument improperly, I took it beyond what it should have been done, I’ve never had an issue with Hu-Friedy replacing that instrument free of charge.

But for those listening who may be just beginning their career or thinking about improving their overall practice, the ability to organize your cassettes for orthodontics, endodontics, periodontics, restorative, whether that be amalgams or composites, the whole gamut of the cassette organization and the instruments in those cassettes I cannot emphasize how incredibly effective and efficient it can be when you allow a company like Patterson and Hu-Friedy to set this up for your office. And again, that over the top service and care will pay you back in dividends.

I’d like to change topics and brag a little bit that I had the fortunate time to go to a Sirona meeting in the Connecticut area recently. I know the relationship with Patterson and Sirona is quite strong and I was just amazed at the new technology. And for someone who, I believe, keeps up-to-date and usually has the latest and greatest, what can you tell me about their 3D imaging that really stands out with Sirona?

Bob: I just want to say, Kevin, you’re absolutely right. Sirona is, yet again, another German company that Patterson is really connected to and has really worked well with. They have not only CAD/CAM, but their latest CT scan that really helps them and dentistry and actually has changed dentistry from where it was even two or three years ago where it is today.

Dentistry is changing and the technology that is out there. Sirona provides some huge high-end technology from CAD/CAM to CT scans to take better care of the patients, easier, faster, less trauma. With their 3D scans, it allows you to do implants without flaps. It gives you the tools that you need to pretty much do everything in the dental office that wasn’t able to be done two years ago.

Kevin: What particularly for me took me back at that wonderful weekend was the integration of CEREC with Galileo; the ability to have this technology, whether it’d be the intraoral cameras, that whole integration of the technology so that it’s user friendly. As an early CEREC user, I remember some of trials and tribulations, not only with the hardware, but the software.

And sure enough, a company like Patterson and Sirona team up and they understand some of the disadvantages that new technology can present and they proceed with research, technology and it’s just amazing how everything is married together today. Can you give us an example of what you see in the near future, what’s on the agenda that Patterson has that makes your company continue to stand apart from other companies?

Bob: I think that Sirona will always be a major part of what we do and what we have seen. You had mentioned the CAD/CAM and the capability of how they marry each other into the CT scan. And it really keeps everything into the general dental office where you can scan the mouth, do a CT scan that will allow you to do a surgical guide by milling it with the CEREC to place the implants.

Kevin: I can tell you, Mr. Tremblay, that I’ve been a practicing dentist for the last 35 years and in my opinion, like most businesses, most businesses revolve around relationships, what I call the BLT. You want to deal with people you believe in, you like and you trust.

And for the listeners out here, I cannot emphasize the importance of creating that relationship with your sales representative who’s actually a part of your team. Use them, use their knowledge, use their information, their technology and it may be one of the best relationships you’ll foster in your professional dental career. I’m so happy that you were able to take time and I can’t tell you enough how much I have been appreciative of your expertise and your company’s backing and just your ability to teach our team members and our office how to get better. Mr. Tremblay, thank you so much.

Ladies and gentlemen, you’ve been listening to Ascent-Dental-Solutions. It’s a company that focuses for dentists on dentists. I hope you’ve enjoyed today’s podcast. I want to give a shout out again to Stand Out and Be Heard, Mr. Doug Foresta, who’s produced over 40 of these podcasts for me over the last year and without his expertise, this couldn’t be done. Mr. Tremblay, thank you so much for your time and expertise and we’ll be talking soon.

Bob: Kevin, my pleasure. Thank you so much.

Podcast: What dentists need to know about sleep medicine

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Welcome. You’re listening to Ascent Radio. This is Dr. Kevin Coughlin. You can hear this podcast on Ascent-Dental-Solutions, where the focus is on knowledge, development, training and education. Today’s podcast is for dentists and for the lay public that is interested in learning more about sleep medicine. I want to first, before I get started, give a congratulations and a big thank you to Mr. Doug Foresta. His company, Stand Out and Be Heard, has produced over 30 of these dental podcasts for me and the production and the effort is tremendous. Thank you so much, Doug.

My name is Dr. Kevin Coughlin and this is Ascent Radio. Today, the topic is sleep medicine. Sleep medicine started back in 1895. So it is not new, but it is new to the dental profession. And it appears to me that each year sleep medicine is becoming more and more important, not only for the dental facilities to provide care and service in this area, but for the public to be informed.

Some statistics that may shock us; number one, sleep disorders are more common than asthma and diabetes combined. This means that it is affecting tens of millions of people. You may not be aware of it, but 20 percent of all motor vehicle accidents are associated because of sleep deprivation. The driver is tired, they’re not alert and there’s a motor vehicle accident.

Some notable issues that were associated with sleep deprivation were the Three Mile Island plant that almost blew up, the Challenger, which did blow up. All of these events and in particular motor vehicle and truck accidents, occur between the hours of 1:00 am and 7:00 am. And this is because tens of millions of people are not getting the proper amount of sleep.

Some systemic issues that are associated with sleep deprivation are hypertension or high blood pressure, stroke, dementia, loss of memory, loss of alertness, a decrease in memory, a decrease in alertness. All of these factors have an effect on our ability to perform at a high level and feel good about our overall health.

How does this relate to dentistry? First of all, the American Association of Sleep Medicine is considered the governing body. It provides guidelines and the standard of care for dentists and physicians to follow to provide the public with the highest level of education and with the proper processes and procedures to help our population address this chronic, severe problem of sleep deprivation.

In lay terms, most people consider going to a dentist for snoring. Their significant other is disturbed and irritated because the individual snores and that snoring creates a situation which is uncomfortable and embarrassing.

In reality, the proper process and procedures to provide excellent care in sleep medicine is the following; first and foremost, you should seek out a dentist that either has certification, designation or a minimum of 25 hours of training in the appropriate sleep medicine courses.

Many dentists provide sleep medicine care and treatment, but most do not have the designation, the certification or the minimum requirements and as a lay person, you may want to seek out those qualifications. This certainly doesn’t mean that a dentist that doesn’t have these qualifications can’t provide adequate care and service, but first and foremost, you may want to consider those three options in choosing a dentist to provide this care.

The next thing to look at is how is sleep dentistry provided today in the United States. Many times, there’s confusion and the lack of ideal care and service. Step one, according to the American Academy of Sleep Medicine is the patient must have what is called a PSG, or a polysomnogram. This is a level one sleep study done in an area hospital where the individual stays overnight and their eye movement, muscle movement and cardiac evaluation is constantly monitored along with their blood pressure, their inspiration, expiration and a combination of all these factors will determine whether the correct diagnosis of obstructive sleep apnea is present or not present.

By definition, obstructive sleep apnea is determined by the number of times an individual stops breathing during their nighttime sleep. As a general rule, between zero and five is considered normal, between five and 15 is considered mild obstructive sleep apnea, between 15 and 30 is considered moderate obstructive sleep apnea and above 30 to 60 episodes is considered severe. It’s critical that this proper diagnosis be made.

In most cases, this is going to be done by a physician in a sleep facility and in most cases, it will be covered by your medical insurance and in most cases, the gold standard of treatment at present time is called CPAP, which stands for Continuous Positive Airway Pressure. In 2017, the C has been dropped and now the correct verbiage would be PAP or Positive Airway Pressure because some of the newer CPAP machines do not provide continuous positive airway pressure, but it comes intermittently and some patients respond better.

It is critical for the lay and professional individuals to make a proper diagnosis of obstructive sleep apnea. If in actuality you do have this condition, this condition can be life-threatening. It can increase your chances of stroke, hypertension, diabetes, memory loss, physical activity, concentration and alertness along with a decrease in your autoimmune or your ability to fight diseases. I bring this up because many times we as dentists will simply treat the patient for a snoring disorder. In order to follow the appropriate guidelines by the American Association of Sleep Medicine, you shouldn’t be taking that course of action, in my opinion, and in many others in this field.

Step one is make sure the PSG study is done. Once you’ve been diagnosed, the gold standard, as discussed earlier, is the CPAP unit. However, 80 to 85 percent of the public are unable to tolerate the CPAP unit. They find it constrictive, some people feel claustrophobic, people find it difficult to sleep. Generally, most people have the most difficult time during their first seven to 14 days. If you can get by those seven to 14 days, usually, most people adapt and they’re quite comfortable with the CPAP unit. However, the vast majority of patients don’t make it those 14 days and are looking for alternatives. And those alternatives from a dental standpoint, in most cases, are what we call Intraoral Devices or Mandibular Advancement Devices. Mandible standing for the lower jaw.

There are an entire slew of perhaps 75 intraoral appliances and they all have advantages and disadvantages. But in sum and substance, the major driving force is the appliances should be comfortable. They should fit well. They should be able to advance your lower jaw in increments of one millimeter or more. They should be easily adapted and changed based on your particular needs.

I’m not going to waste time and energy going through each individual device, but suffice it to say that the intraoral appliance many times could act and provide as much success in obstructive sleep apnea as the CPAP unit when it comes to mild and moderate cases of obstructive sleep apnea.

For those individuals who have severe obstructive sleep apnea, the gold standard is still the CPAP unit. However, for those patients who can’t tolerate it or refuse to use it, they’re still much better off with an intraoral appliance. Keep in mind that these intraoral appliances should last at least three years or longer. In most cases, the fees will range anywhere from $800 to $2,200. The reason for the vast variety of fees depends on the type of appliance and whether the adjustment visits are associated with the overall cost of the appliance.

In most cases, the correct process and procedure is the dentist will deliver the intraoral appliance. It’s first constructed by impressions of the top and bottom jaw. Those impressions are done in the dental office and then a construction bite is taken with the lower jaw in a protrusive or forward position. Generally, the upper and lower teeth are separated between two and five millimeters. And generally within seven to 14 days, the appliance is fabricated either in the dental office or at a professional dental laboratory.

The device is then delivered to the patient, and in most cases, the patient should be seen within seven to ten days to make any additional adjustments to make sure that the patient is comfortable.

Common complaints with the intraoral appliance are that patients will state that their teeth are a little sore in the morning. Their temporomandibular joints may be a little uncomfortable from the protrusive force placed on by the appliances. Overall, the results tend to be good to excellent, but keep in mind the subjective findings are not good enough according to meet the standard of care.

After the adjustments to the appliance have been made and the patient feels more rested, more comfortable and their significant other states that they hear less snoring or no snoring at all, the correct process and procedure is to have a follow-up PSG examination so that we can look at the objective studies and determine ocular movement, which is an EOG, muscular movement which is an EMG, and brain waves and cardiac issues which are an ECG or an EKG. The reason for this is we’re looking for objective evaluations to determine that the intraoral appliance is providing the high level of care and service to improve your overall health.

Keep in mind that there’s nothing that will make you feel better than a good night sleep. We’ve been providing intraoral appliances for sleep disorders for many years now and it is amazing to me how much better patients state they feel, how much better and more alert they are after the use of an intraoral appliance or a CPAP unit.

Keep in mind that there are some specific things that can be done to reduce your need for each of these devices. Number one for a female, you should try to keep the diameter of your neck less than 14 inches. For a male, less than 17 inches. Your base body mass index should be less than 30.

Losing five to ten percent of your body weight will significantly improve or reduce the need for an intraoral device or an extra-oral device. These are things that really can not only improve your overall health, but reduce or eliminate the snoring.

Keep in mind that all patients that are diagnosed with obstructive sleep apnea they all snore, but all people who snore do not have obstructive sleep apnea. By definition, apnea simply means the sensation and lack of breathing for a duration of five to ten seconds or longer. They are significantly different than a snoring event and that’s why the correct diagnosis is imperative.

Keep in mind that this information, along with other information, will be brought to you in future podcasts. For those individuals that are suffering from snoring, in summary, get the proper diagnosis first and then if the CPAP is effective, go forward and if it is not, consider seeing your dentist who has certification, designation or a minimum requirement of 25 hours or more in continuing education devoted strictly to sleep medicine.

A simple trick for our listeners to determine whether an intraoral device would be effective at eliminating or reducing snoring is as follows; make the snore sound. Just sitting in your car right now or sitting at home, make that snore sound [snores] now take your lower jaw and move it forward as far as you can and attempt to make that same sound and you’ll find that if you can, then more than likely, the intraoral appliance is the root to go and you will have an effective and successful result and save yourself thousands of dollars and hours of time. I</span

t’s a simple trick that most of us can us at home. And the reason I explain it this way is sometimes snoring and sleep apnea is caused by an upper airway or nasal passage obstruction. When that’s the case, an intraoral appliance would be much less effective or not effective at all.

Another cause of sleep apnea or snoring is some kind of central nervous system disorder. And again, in most cases, an intraoral appliance will not be effective. However, overall, over 90 percent of all sleep apnea or obstructive sleep apnea is caused by occlusion of the oral cavity or back of the throat by the tongue. By bringing the lower jaw or mandible forward, the tongue is advanced forward and the airway is open.

I hope you’ve enjoyed today’s podcast. You’ve been listening to Dr. Kevin Coughlin and this is Ascent Radio and you could get more information on my website

And again, my thanks to Stand Out and Be Heard, Mr. Doug Foresta, who’s produced this podcast. Thanks again and I look forward to talking to you soon.

Podcast: Doug Foresta on how podcasting can help your dental practice

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: This is Dr. Kevin Coughlin, owner and creator of Ascent-Dental-Solutions, with a focus on education, development, training and coaching. I’m excited today to bring to you a guest, Mr. Doug Foresta, who specializes in podcasting for businesses.

In full disclosure, I created Ascent Dental Solutions sometime ago and noticed that it was spattering. And after meeting Mr. Foresta, he introduced me to the concept of podcasting and what it could do for my business. And I cannot explain how it has rocketed to a more successful level that I never dreamed possible. With no further ado, I’d like to introduce Mr. Doug Foresta. Doug, thanks so much for taking time with this podcast. Can you just give me a little background about yourself and the business, please?

Doug: Thank you so much, Kevin, and thanks for having me on. When I first started podcasting, I didn’t even know what podcasting was. I moved here to Massachusetts from New York in my late 20s and went back to school, became a therapist and I wanted to get the word out about what I was doing and the work I was doing and thought I would go into radio.

At the time, I was working with a business coach and I said, “Why don’t I go into radio?” And she said to me, “Do you know anything about radio?” And I said no. She said, “Do you have any connections in radio?” And I said no, and she said, “Why don’t you try podcasting?” And I said, “What is podcasting?”

I started off podcasting as a way to get my own messaging out and overtime people started asking me how do you do that, how do you do podcasting, can you help me with podcasting? I never thought when I started doing it that I would be helping anyone else. It was never my intention to do that. But as I found it to be very effective, other people wanted help with it and so here I am.

Kevin: We’re glad you’re here and we’re excited about not only what you’ve done for my business, but what you can do for other businesses. Could you briefly explain the diverse clients that you’re currently dealing with?

Doug: Sure. One of the nice things about podcasting is it works for such a wide range of people and organizations. I can tell you that I currently have a large portfolio of clients in government and nonprofit, probably because of my social work background. But I produce podcasts for the National Association of Workforce boards, California National Association, San Diego Metro Career Centers as well as lots of speakers and coaches and authors.

I’ve trained literally hundreds of speakers and coaches from all over the world to do podcasting. And I produce podcasts for people including speakers, including Jennifer Brown who is a inclusion and diversity expert and many other coaches, speakers, authors.

I think that the common thread between all of the different organizations and people that I help is a desire to create some type of positive change in the world. So that probably would be the common thread.

But that’s what’s so cool about podcasting is that whether you’re a nonprofit organization, a profit, I also produce podcasts for Insurance Licensing Services of America, so truly quite a wide range of people and organizations. But again, I think the common thread being a theme of creating positive change in the world and the desire to use podcasting as a way to get the message out in a larger way.

Kevin: I know most of our listeners are in the healthcare industry, and in particular with an emphasis on oral health and dentistry. But one of the things that I found that was so amazing with the podcast is the diversity of the listeners and the contacts that I’ve been able to make with your expertise and your knowledge.

Just briefly, I was able to do a podcast with Ms. Debra Rowe who has just a phenomenon background and expertise in communication and health care, along with several other individuals. In particular, I’m now talking to the Kellogg Foundation on oral health and how to improve it for children.

Recently, we did a podcast with Judith Brown who coaches, teaches and consults on inclusion in the office for Fortune 500 companies. All of this would not have occurred without the expertise of your business, your contacts and podcasting in particular. Is that common or have I just been exceptionally lucky?

Doug: One of the things that I think people don’t realize about podcasting, people ask me what’s the difference between podcasting and radio, I think one of the ways of looking at podcasting is absolutely it’s a broadcasting tool, but it’s also an amazing networking tool.

I’ll tell you when I realized this was, I remember I was sitting in Barnes & Noble — we live in western Massachusetts — I was in a Barnes & Noble in Holyoke, Massachusetts and I was reading a book called Imagination First by Scott Noppe-Brandon and this book was talking about the power of imagination and education and workforce. And I thought to myself boy, I’d love to get involved with the work that they’re doing and I thought I’d love to interview the author.

The thing is that the author of that book, Scott, was at the time the executive director of the Lincoln Center Institute for the Arts and I thought well, there’s no way that they’re going to come on my podcast. But I reached out and almost immediately I heard back from them. And it was really funny because I thought why would they do this?

We did the interview, it went really well and afterwards I thought I’d like to run one of these imagination conversations that they have. At the time, they were doing these conversations all across the United States in every state and so I reached out, they said, “Well, we already did one with the governor of Massachusetts.” And I thought, well I’m not the governor but I thought what about doing one in the western part of the state.

From that, I was able to facilitate an imagination conversation. From that, I was then invited to something called America’s Imagination Summit and there were all of these amazing people there. There were NASA astronauts, the people from IDEO, all these amazing companies and organizations, Deepak Chopra was there, Sir Ken Robinson whose TED Talk has been watched more than any other TED Talk.

When I went there, I said, “Hi, my name is Doug Foresta,” and they said, “Oh, we recognize you from your podcast,” and that’s when I realized the power that podcasting has in terms of being able to get the word out and connect with other people.

So yes, podcasting is a great broadcast tool, but it’s also a great way to get access and to meet people that you would just never meet otherwise. And for that reason alone, I think podcasting is such a powerful tool.

Kevin: I would say I’m 100 percent convinced of that analogy. I’ve seen it in my own business, Ascent Dental Solutions. Let me ask you another question, Doug. Is there particular metrics that someone new to podcasting like myself and people listening if they wanted to go in it, do you expect 50 people to listen to the podcast, 50 million people? Is there a way or a metric system to determine how powerful this is and is it working for you as an individual or a group?

Doug: That’s a really great question and I could tell you that the average number of downloads, according to Libsyn, which is a leading podcast hosting service, the average number of downloads for a podcast episode over 30 days is 160 downloads. So that gives you some kind of idea of a metric of if you’re doing better than that, you’re doing better than average. But it really is a good question because one of the first things that I ask clients to think about when they start a podcast is what does success mean for you.

For me when I first started with podcasting, I wasn’t really worried about making money from it. I wanted to get my message out in a bigger way, I wanted to build up thought leadership. But for other people, it might be podcasting is a way to get more opens for your email list, which might ultimately mean that you’re trying to sell more products and services, get more clients.

So it really depends. You have to decide for yourself. Some of the organizations that I work with that are nonprofits, definitely their goal isn’t necessarily the goal of making more money, but it might be getting more people to utilize their services or staying top of mind with clients.

So you really have to decide for yourself what does success look like for you. And actually my number one piece of advice before you start a podcast is to really think about it and make sure that you know what success looks like for you. Because otherwise, let’s say if you don’t know where you’re going, you’ll probably end up somewhere else.

So it’s really important to decide for yourself what that metric of success is, but certainly you can watch the downloads and see if you’re growing your listener base and audience base. That should certainly be at least one part of that metric of success.

Kevin: For some of the listeners here that may not be familiar with podcast, this podcast, how does the vast majority of people download it? What are the actual steps and systems to download a podcast so that the listeners have access?

Doug: That’s another great question, Kevin. What I can tell you is that iTunes is definitely the primary way. From what we know from watching the statistics is that iTunes is the king of podcasting. People are accessing iTunes via their iPhones and now we have, as well, iHeartRadio, Google Play, Stitcher Radio which are allowing people to listen from their android phones.

Podcasting is definitely mobile. I would say that that’s one of the nice things about podcasting is you can download it to your mobile device and listen to it on your tablet, your iPad, your iPhone or your android phone whenever you want.

Having said that, one of the things I hear people say is what if I have an audience that isn’t really mobile savvy? What I have found is that we can get people to listen to your podcast in a variety of ways. You can send it out as a link in an email, I definitely recommend doing this, putting it as a player on your website.

So even for people who, let’s say, aren’t that savvy with getting a podcast off of iTunes and don’t normally listen to podcast, if you put that podcast on your website, put that player there, that gives you an opportunity for people to very easily just click on a player and be able to listen to a podcast, even if they don’t go to iTunes. So really depending on your audience you can tailor the ways that people do listen to your podcast.

Kevin: That’s a nice segue because almost every dentist and health care provider that I’m aware of they have a website. So you strongly recommend that the podcast be downloaded to the website so that there’s access to it, not only along with iTunes and iHeart, but also on their particular website?

Doug: Absolutely. I definitely recommend putting the podcast on your website. Because again, some people are going to find you on iTunes and Google Play and these other ways, but if you’re getting traffic to your website, you’ve got a built-in audience of people that are already going to your website. Just make it clear, make it easy for them to find and click on and that’s a great way to just get a head-start in building that listener base.

Kevin: I suppose my business with 14 dental practices, practicing dentistry full time for the last 30 somewhat years, most of the dental offices that I’m associated with, we have some kind of marketing in the reception room.

We have flat screen TVs which promote products, services and care and we promote this podcast on those flat screen TVs so when people are sitting in the reception room, they have the ability to hear different topics. Would you recommend that also?

Doug: Right. The bottom line is go where people are. If you know that that’s where your audience is, go where they are. That’s just a great marketing principle in general. Absolutely.

Kevin: Some short facts about podcasting. I know when you were coaching me, introducing me into the strength of podcasting, generally you want to keep the podcast at what timeframe for an average listener?

Doug: What the data tells us from medicine research is that there’s a drop-off after about 22 minutes of podcast listenership which really correlates to the average American commute. My recommendation is good average podcast like this, 22 minutes. People can then subscribe on Stitcher Radio, soon to be an iHeartRadio, Google Play, et cetera. If people are listening and they want to go to do that.

Kevin: And we’re trying to expose the health care profession in general, but dentistry in particular, the power and the strength of promoting a message that’s interesting to the general public and to our peers. And I can tell you with 14 dental practices, 150 employees and practicing dentistry full time for the last 34 years, there’s very few things that I found that has created the reach and the power of podcasting.

And I have to give a plug and full disclosure. I could tell you until I met Mr. Foresta, I met Doug, he coached me, we talked about it, we came up with a strategy, it’s been a tremendous shot in the arm for my personal self-satisfaction and the business. And I have no one to thank, but you. And I say that publicly and I say it in private. How can people get in touch with you, Doug, if they need additional information or perhaps your expertise developing their podcast?

Doug: They can go to and if they go there, they can actually get a free gift there. So they can go to, again, They can also email me at

Kevin: I don’t want to put you on the spot, but as we get ready to close today’s podcast, can you give the listeners a general cost? What kind of investment would someone have to make to start this podcast and get things rolling? Do you mind answering that question?

Doug: I can tell you that you can certainly learn this yourself, but it is something that you have to think about your time and whether it’s worth it for you. If you’re a dentist and your job is your business, do you want to stop what you’re doing to learn podcasting? In the beginning, I used to teach people podcasting, but it was really clear that people didn’t want to learn how to do the technical aspects of podcasting. They just wanted it done. So primarily, now that’s how I work with people, is we handle all the backend, me and my team handle the backend of things so you don’t have to take time out of your business to learn podcasting.

The other thing I would tell you is, first of all, I tell people not to look at it as an additive cost, but rather to think of it as how could I switch over some of my marketing dollars from things that I’m doing in more traditional marketing to podcasting which has a longer shelf life than a flier or a brochure. And I could also tell you that it really is very cost-effective when you think about comparing it to having a professional video done.

You could literally have a year of podcasting for what it would cost you maybe to produce one or two professional videos. So very cost-effective. And like I said, one of the things that I do is help you so that, if you really decide podcasting is right for you, you don’t have to waste your time, which is money, learning podcasting, learning the technical aspects of podcasting.

Kevin: Just one last point I’d like to make; what I’ve personally learned is the frequency of the podcasts are also important. And as I’m doing my own research and getting more familiar with the podcast system, someone who does a podcast once every other year isn’t as effective and yet some people do ten podcasts a day, that also may not be effective. In your expertise, what’s perhaps the best rate to promote a podcast, the number of times it should be done in a week, a month or year?

Doug: I often say that podcasting is like exercise. If you go to the gym once, you say I tried that, it didn’t work. Podcasting is not one of those things that you can do once or twice and then walk away from it. The most important thing is consistency. I have organizations that do podcasting once a month, but they do it consistently and they do well with it. I would recommend at least once a month, ideally twice a month. And what I tell people is try it twice a month, see if you like it, and then you could move to weekly if you think that it’s something that you really want to do.

But even if you do it once a month, you’ve just got to be consistent about releasing it at the same time every month. And when you do, you’re definitely going to see more results with two podcasts a month than one podcast a month. So consistency and don’t overwhelm yourself, but give it some time and allow yourself to see what the results are.

Kevin: Doug, I want to thank you so much for your expertise. I want to thank you personally for what you’ve done for me and my company, Ascent-Dental-Solutions. I hope our listeners have enjoyed tonight’s podcast and I look forward to talking to you in the future.

If you have any questions or comments about how you can be helped by Ascent-Dental-Solutions, don’t hesitate to reach out to me and my contacts. Thank you again, Doug, for a wonderful evening and I appreciate your expertise.

Doug: Thank you so much.

Podcast: Kim Ades on the mindset secrets of successful dentists

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: Good afternoon. You’re listening to Ascent Radio. This is Ascent-Dental-Solutions with a focus on knowledge, consultation, development and training. My name is Dr. Kevin Coughlin and I’m excited to introduce you to our guest, Ms. Kim Ades. Kim is President and Founder of FOM, which stands for Frame of Mind Coaching.

Her focus is that she’s an author, a speaker, an entrepreneur, a coach and perhaps most important of all, a mother of five. Kim has been recognized as one of North American’s foremost experts on performance through thought mastery.

By using her unique process of integrating online journaling and her coaching, Kim will help the dental profession and health care profession in general improve not only their company, their personal lives, but their team members that support their company.

Kim, thank you so much for taking time out of your busy schedule to be with me. Can you tell us a little bit more about Frame of Mind and when you started it and why you started it?

Kim: I’ve been at this for about 11 years. I coach highly driven entrepreneurs, executives, professionals, that type of population, but I started it at the time because I found that there was a gap in the coaching industry.

I found that most coaching companies were focused on helping people achieve goals through the process of managing their behaviors or giving them a list of things to do or creating a strategic plan and then holding them accountable to that plan. And my feeling was that these professionals are pretty driven. They know what to do, but for some reason, something prevents them from doing the things they know that will help them achieve their goals.

And I realized that that has something to do with the way they think. Perhaps it has to do with their belief systems, their perspectives or their emotional resilience and I decided to create a company that focuses exclusively on helping people get past whatever it is that prevents them from achieving their goals. That’s where Frame of Mind Coaching started.

Kevin: I could tell you I would consider myself an expert in the field of dentistry. And as a wet thinker dentist myself, I could tell you that sometimes we’re so overwhelmed. We’re wearing so many hats; we’re businessmen and women, we’re health care providers, we’re psychologists with our staff, we’re emptying the trash. We’re doing a thousand things at one time and perhaps most difficult is running the business of dentistry, dealing with finances and insurance.

As I got more familiar with your company and with you, this mastery of your thought process, of using your mind and controlling your ambitions and your desires really struck a chord with me and I think it’s going to strike a chord with many of our listeners today. Can you explain a little bit about the importance of journaling and actually what does it mean and how does your company use it?

Kim: When we coach people, we start with a six-month process, but it’s the first ten weeks that are really paramount. Here’s what happens in the first ten weeks; there’s a call once a week and every call is recorded. We ask our clients to listen to the recording. The reason we do that is so that they can start to hear how they show up. The language they use, the speed at which they speak, the intonation, the stories they tell over and over again. And really they can start to become observers of their thinking and how their thinking sometimes holds them back and often times propels them forward.

So that’s part A, but part B is the journaling aspect which you asked me about. Every single day for those first ten weeks, we ask our clients to journal in an online journal. No days off, no weekends, no vacations. The reason we do that is because we want to see how our clients think across situations, across relationships, across environments.

Because the way you think in one place will transmit or transport to another place. And so we really want to examine how a person’s thinking affects them and their outcomes. And so we ask them to journal and share with us what’s going on for them. We ask specific questions and they respond. But they’re in contact with their coach — I have a team of coaches — every single day for those first ten weeks. So it’s profound.

What does journaling do? It allows us to get a big download of data that, for the coach, enables them to examine what are these patterns that get you tripped up, that cause problems for you. The philosophy is the way you think has more impact on everything that you touch, you see, you smell, on every outcome that you have than any other factor.

So if you want to change something about your life, before taking massive action, we want to examine the thinking that causes you to act and behave the way you do.

Kevin: Kim, I was particularly struck by Frame of Mind, I know you’re the president of the company, but the core values of your company. Could you just touch on what those core values are and what they mean to you as President and CEO of Frame of Mind?

Kim: Of course. We have five core values. We talk about them all the time with our team and they transmit into everything we do with our clients.

  1. Personal Growth: As coaches, we’re committed to our own personal growth, but as service providers, we’re committed to the personal growth of our clients. The philosophy there is that if we’re not growing as coaches, it’s very, very difficult to be of assistance to our clients. So personal growth is a huge value of ours. 
  2. Leadership Impact: Always, we look at it from two perspectives. We want to work with leaders who have a ripple effect on their communities, on their families, on their businesses, on their industry. So it’s who we work with that’s important, but as a coaching company, we want to play a very important role in the coaching world and provide a methodology, a philosophy that has a profound effect and really turns the coaching industry around. So we play in the role of leadership. 
  3. Innovation: We like to be at the leading edge of innovation in terms of our perspective of coaching, in terms of our approach to coaching and the technical platform we use. We want to be innovative and we want to explore ideas that haven’t been explored before and also put things on the table that for most people they feel are challenging. We want to challenge status quo. And so we’re very eager to do that in an innovative way. 
  4. Generosity: When I talk about generosity, it’s not only financial generosity, but we believe in generosity of time, generosity of spirit, and really as coaches, giving everything that we have to give to our clients. So if we have an expertise in something, let’s pretend it’s knitting, that we would share with our clients. But if our clients are in a desperate situation and they don’t have a call scheduled, we will give them our time generously. So that idea of generosity, give what we have to our clients. 
  5. Intimacy: I think in many ways, this is one of the most important values. The philosophy is this, is that the relationship that exists between coach and client is critical for client movement, development and achievement. And only when the client can really trust the coach that that could happen. And so that intimate relationship is crucial. That is why our coaches and our clients are in contact every single day, that’s why they go deep, that’s why it’s a two-way relationship as opposed to an arm’s length relationship and that’s why intimacy is so important for our clients. But even internally as a company, that it’s a company that is here designed where coaches support one another and we’re growing together.

Kevin: When you mention the intimacy, I’m struck by it because you’re really creating an atmosphere of trust. You want to believe in these people, like these people and trust these people. What I call the BLT. And you’re sharing some secrets, not only about your business, but your personal life.

In your experience over the last 11 years of being the President of Frame of Mind Coaching, what do you find is the single strongest event that’s preventing your clients from getting from point A to point B?

Kim: It’s interesting that you ask what is the single strongest event and I would say it’s not an event because an event for you may have a different impact as it might have for me and it may be the same event. So it’s not so much what event has the biggest impact, but what belief has the strongest impact or what type of thinking prevents clients from moving forward to the greatest extent.

So what we find is that people have a set of beliefs they have maybe inherited or picked up or absorbed along the way and those beliefs severely inhibit their progress. It could be something like I don’t know what I’m doing. I don’t have the expertise. I don’t have the education. I’m not good looking enough. Who would trust me or who would give me their money, or whatever it is, but it’s usually around the idea of self-doubt; I’m not good enough, I’m not enough and I don’t deserve it. It’s around that.

That’s the biggest one that shows up over and over and over again. What we see is extensions of that, but that’s the core issue that keeps popping up.

Kevin: What do you think the root cause of that is, Kim? Is it the way we’re brought up, is it the environment, is it the circumstances that we’ve gone through in our personal and business life? In your expertise, is there something you can share with the audience and maybe some of our listeners will strike a chord and connect and get over these…?

Kim: It’s all of that. It’s the way you were brought up, it’s the experiences you have, it’s the relationships you have, it’s the messages you’ve receive. And really what it is it’s the meaning you assign to the experiences you have. But one of the things that I find over and over again, you talked about how you were brought up. Do you have children, by the way?

Kevin: Yes. I have three young adults now.

Kim: Young adults. But when your children were young, and I see a lot of parents right now with young children, when our children are young and perhaps you can remember when you were young as well, our parents they take pride in their ability to raise you right. And what they do is they influence you, they impart their wisdom, you could say. And how do they impart their wisdom?

By telling you what to do; go brush your teeth, go to bed, you need to get good sleep otherwise you won’t be able to function in the morning, you better eat your dinner before you have dessert. And so what do parents do? And again, their intentions are 100 percent pure and good. That they want to influence you in a positive way to be healthy, successful and well-adjusted human beings, but what parents do, inadvertently, is they give instruction for pretty much everything.

And so what do we actually want for our children? We want them to grow up to be great decision makers, to be contributing citizens, to be confident, to be successful, to have wonderful relationships. But as parents, we interfere in the process of allowing their confidence to develop, of allowing them to make their own decisions.

I’ll give you an example. How many times do we tell our children don’t eat too much candy? You should only eat X amount, and we don’t give our children a method to self-regulate and that ends up affecting them long, long into life.

Kevin: I could tell you through personal experience. My mom and dad, who are both alive and in their 80s, for as long as I can remember, they always said, “I’ll trust your judgment. I’m sure you’ll make the right decision and if you don’t, you’ll make the corrections to make a better decision.”

Once I had my own family, my wife and I, it’s very difficult, at least for me in particular, to not impart what I think they should be doing. Why they should be doing it. And I never realized how difficult a task it was, but by luck or happenstance, my parents had always done that and I think it’s helped me and my brother dramatically.

Kim, as far as Frame of Mind and your coaching, your participants, your clients, do they stay with the same coach or do you mix coaches up depending on particular aspects of your client’s desires? How does that work in your company?

Kim: No, they stay with the same coach the whole time and only if after they finish a minimum of six months, many times people go on for years and years, but after they finish their first six months, some of them choose to learn how to coach.

We train people in the Frame of Mind Coaching method and really equip leaders and parents and outgaining coaches how to incorporate critical coaching skills in their business and personal lives. And so they come for training and in that case, I do the training. So usually, they have their coach and then if they’re ready for certification and learning how to coach, again, not everybody wants to do that, but for those who do, I do the coaching.

Kevin: For our listeners, what’s the best way for them to contact Frame of Mind Coaching? Your website, maybe you can spend a little bit of time and go through that.

Kim: Best way to contact us is One of the most interesting things on that website is there’s an assessment. It allows you to assess your thinking at this point in time.

One of the things that I explain to people is that if you want to make massive change, before you start engaging in a big plan or start taking massive action, it’s super important to understand where your starting point is, what direction are you facing.

And so that assessment allows you to stop for a minute and take a snapshot of where you are right now in order for you to understand where you want to go and how to get there. So that Frame of Mind Coaching assessment is a really great exploratory tool, great beginning place for anyone who wants to visit.

Kevin: You know what I noticed about your website and about company in particular, and maybe you could comment on this, is that so many times the CEO or the CFO or the leader or the president, we look to these kind of experts such as yourself to help us.

But I’m wondering isn’t it just as beneficial to that leaders, president or CEO’s team members, their employees, to get engaged to help them get the proper mindset and the proper direction and if everything works out appropriately that has to be good for your company and has to be good for your team members and employees? Am I on the right track or would you disagree with that?

Kim:  You’re 100 percent on the right track and I would even simplify it and kind of move it away from a business scenario; any person who really wants to live an extraordinary life, any person who wants to have great relationships, have great health and feel better and know that they are living passionately and in the right place, anyone like that is a candidate for Frame of Mind Coaching or coaching.

Smart CEOs understand that those people who come to work engaged and passionate and really turned on, those people are going to contribute a whole lot more. So smart CEOs say, “Yes, we need to get all our team engaged in all of this.”

Kevin: Kim, I can’t tell you how much I enjoyed communicating with you, learning about your business and how you can help people like me and companies like mine. And in the dental profession in particular where I think sometimes so many of us are wearing so many hats, we don’t take time to really understand where we’re going, why we’re going in that direction and how we can improve that journey. How do our listeners reach out? How do they get in touch? What’s your website, telephone number? How can people get in touch with you?

Kim: My email address is, the website is and phone number is 416-747-6900 and if you want to reach me, that’s extension 221. I want to say that there’s lots and lots of information about us on our website, blogs, videos, testimonials, all kinds of things and so I’m happy, happy to share with anyone who wants to learn more and even give you some journaling questions to think about so that you can start your own Frame of Mind exploration.

Kevin: Thank you so much. I’m sure our listeners are thoroughly enjoying your expertise and the information you shared with us. My name is Dr. Kevin Coughlin and you’re listening to Ascent Radio. This podcast along with others can be heard on

I also want to give a plug to my podcast expert Mr. Doug Foresta. Without his expertise, his training and his help, none of these podcast would be available. Doug’s business is Stand Out and Be Heard: Podcast Production and Consulting and he can be contacted at

Thank you very much for listening and I look forward to speaking to you on our next podcast. I hope you enjoyed the show.

My name is Dr. Kevin Coughlin.

Podcast: Creating a special practice

Podcast: Russell Trahan on how to use publicity to grown your dental practice

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: You’re listening to Ascent Dental Solutions and Ascent Radio. I’m proud to introduce to you our thought leader today, Russell Trahan, who is owner and CEO and President of the PR/PR public relation firm. For the last 20 years, he has used his expertise in marketing and publicity, and in particular, I believe he can help the medical profession and the dental community in particular to improve our practices, improve our awareness and just overall help our businesses grow and prosper. Welcome, Russell. Thank you so much for joining us this evening.

Russell: Thank you, Dr. Coughlin. It’s my pleasure to be here.

Kevin: I understand you have some additional experiences at Stanford University that is unique for helping your business, PR/PR, and our businesses of health care in particular. Is that correct?

Russell: I did my grad work there in organizational management. Truth be told, full disclosure, I’m always very careful because you want to have truth in advertising and truth in publicity, I did my grad work there but I did not complete it. So I’m always very careful not to say that I graduated from Sanford, but I attended Stanford.

Kevin: That’s quite an honor in itself.

Russell: Thank you.

Kevin: Give the listeners a little bit of background of some of the companies that you’ve dealt with in the past.

Russell: Sure. PR/PR specializes in content experts. The client best served with our media relations is one that’s looking to position their expertise, their unique position, their controversial stance in front of their target market. Many of our clients are thought leaders in their industry, be it dental, medical, be they lawyers or business leaders, authors, particularly non-fiction authors. So anybody that wants to get name recognition in front of their target market.

Kevin: What, in your opinion, is the most effective and efficient way for us to accomplish that?

Russell: These days, it’s definitely through use of social media coupled with print media. Everybody thinks it would be sweet and sexy and everybody thinks they’ll be famous if they can get on TV or if they can get on radio. But really for that residual return on your publicity effort, online coupled with print are still the most effective.

People save magazines, they rip out pages, they bookmark, they download, they email information to friends. So to get that really long term result, because people may see your message today but not be ready to respond to it tomorrow or even next week, but when you’re online or in-print, they can always come back to it when they are ready.

But in broadcast media, which like I say, it’s great for a blip and it’s great for a spike, but next month, next week, that message is gone. So still stating online and in print is the best way to reach your target market.

Kevin:  Russ, my market is health care but dentistry in particular. There’s approximately 150,000 active practicing dentists in the United States and the average practice has between six and eight employees, revenues of between 800 and a million dollars. Is that too small a company to consider a firm like yourself or a strategy that you’re discussing?

Russell: Not at all. Really the size of their practice isn’t relevant. When publicity serves you the best, when you’re ready to start a publicity campaign or a publicity strategy is when either you’re new to the market.

Whether you’ve got one employee or six or ten, if you’re new to a market, you want to establish that name recognition. You want to position yourself in front of your potential client. Or if you are introducing a new service or you are introducing a new product. Maybe you didn’t work in a certain area before and now you’re adding that to your practice and you want to let both your established clientele and a new market know about that new service or product that you’re offering.

And also the very well established dental practice. Whether you’ve been in business for two months or two years or 20 years, you could really benefit from a publicity strategy because there are all those new dentists coming out of school and starting up their practices. So you need to maintain your name awareness in front of your established clientele as well as try to capture some new markets on occasion.

Kevin: I’ll just digress a little bit, but a story that you just jogged my memory on is approximately 17, 18 years ago, Sports Illustrated contacted me and they were interested in me doing an article on dentistry. It was a full page and at that time I think it was about $5,000. And I hummed and I hawed, I just really struggled did I want to spend that kind of money, would there be any reach for it?

And the long and short of it is, it’s just as you stated. About 18 months later, a gentleman came in with that article and he said, “I’ve been saving my money. I think that you’re an expert. I sense that you’re an expert and I’d like you to restore, not just my mouth back to normal health and function, but my wife’s.”

That gentleman spent almost $90,000 over the next six months. It just amazed me that without any prior knowledge, you hit the nail right on the head. He actually had the magazine with the article that I wrote and obviously that was a terrific return on investment. And I have not stopped marketing for my practice which now has over 100,000 patient visits a year, 14 locations and it continues to grow. And it’s thanks to people like yourself that made me think outside of the box.

If I’m not putting you on the spot, what would be a typical budget for an average dental practice? And I know there’s no such thing as average. Would you put a dollar amount on? What would you recommend?

Russell: Certainly, and I would be happy to answer that in just a moment if I can segue back to what you just said though, because it brings up an excellent point that many, I’m sure, dentists are thinking about as they’re considering publicity is they would think why do I want national press?

What good will national exposure get me? My market is here within a 50 mile radius of my practice. But how impressive was it in the eyes of your clients to see you in a national magazine? For you to use that quote “as seen in Sports Illustrated” when you are marketing to your local community? So even though you may think I’m not ready for national press or I don’t need national press because my market is local, to get that national exposure and then be that big fish in your local market pond is a wonderful way to gain that name recognition.

To answer your question directly, a good publicity campaign you’re probably going to want to budget anywhere from on the low side probably $1,000 a month anywhere up to probably $3,000 a month, depending on what combination of avenues you want to pursue. Obviously, social media, very strong, people sit down and Google everything these days.

So for you to have an online campaign positioning your name and your expertise so that when they sit down and Google “hometown dentist” your name comes up above the scroll. In the old days with newspapers you always wanted to be above the fold, but these days with everything being online, you want to be above the scroll.

And then you obviously couple that with the print media, local magazines, neighborhood newspapers, local monthly magazines as well as that national exposure. But comfortably in the range of about $1,000, you shouldn’t have to spend any more than $3,000.

Kevin: What exactly does your firm PR/PR do? I know that I’ve used you, I’m a client and I know exactly what you’re doing for me and I’m just ecstatic about the results. I’m also incredibly impressed with the expertise and professionalism, but I’m sure it’s not cookie cutter. I’m sure you are tweaking it for individual needs. Could you expand on the social media, but in particular the print media? Are these articles less than 1,000 words, more than 1,000 and so on?

Russell: Certainly, I’d be happy to. We are ecstatic with your results as well so glad to hear that you’re happy with them. You give us great content to work with so we’re glad to be able to get those results for you. The typical article these days that editors are looking for is about the 800 to 1,000 word range, about two, two and a half pages. This is longer than your average blog post which is about 300 to 500 words, so you’ve got the chance to lengthen it there to really get your point across in the 800 to 1,000 word range for the article.

Also these articles, it’s very important editors are looking for content. The editor of your local neighborhood magazine, the editor of your community monthly magazines, they are looking for content. They want educational, informational articles. It’s very important that you make them bullet-pointed, that you make them benefit-oriented, that you make them action-stepped.

These types of magazines would love articles on the top five myths of children dentistry, the top seven things you can do to make your teeth last longer. These are just off the top of my head. If you’ve got something controversial or if you’ve got a unique stance on something, that’s even better.

But then because the articles themselves are non-advertorial, the article is content driven, at the end of the article is the resource box. This is where the promotion comes in. This is where it comes in about you, your practice, your education, your specialty. This is where the call to action comes in. For more information call this number. To learn more about it, click here and you put your website on it.

That’s where the promotion is going to come in. Because when the editor realizes that you’re offering content that is going to benefit their reader, they will be more than happy to place your article for you.

Kevin: How many publications would you say on average are going out on a monthly basis? Let’s say to some of our listeners who are not as savvy with marketing and are probably just thinking about it, would it go into 10, 20, 50, 100? On average, how many magazines are reached?

Russell: In your case, since we are placing your articles into the national trade and industry and association magazines, our average for other clients is 14 placements per article. Yours are actually doing a little bit better than that because I say you’ve been giving us great content and we truly appreciate that, but focusing on that type of market typically you can get about 14 placements per article.

The way we pitch them out on a non-exclusive basis, the insurance industry doesn’t care if the restaurant industry uses it and the real estate industry doesn’t care if the landscaping industry uses it. So we can get a typical article placed into a dozen or more different magazines. If your market is different, like you said it’s not a cookie cutter system customizing it for each of our clients, that number may go up or down according to the market you’re seeking to be positioned in front of.

Kevin: Again for our listeners, I am a client of PR/PR. I’ve been extraordinarily pleased with their care and service. But just for those listening, I actually write the article. I come up with the ideas, sometimes I get some coaching and some input, and then those articles can be cleared up by the editors at PR/PR and they’re giving me points that they think maybe could be polished up or perhaps I should go into more depth or less depth and that expertise has been very insightful for me.

I can just tell you a true story, last Friday, I got a phone call from a dentist in Florida. He was interested in having me coach. He’s got four practices. He’s interested in expanding his market. He listened to the podcast, he read some of my articles on leadership and that’s a direct impact from my association with PR/PR.

Russ, as we’re getting ready to close, is there a way for our listeners to reach out either through email, Twitter, LinkedIn? How’s the best way for our listeners to get in touch with your company?

Russell: Thank you. Again, I’m so pleased that you are pleased with your results. The best way would be to visit our website My employees joke with me that whenever I say that’s Papa Romeo Papa Romeo dot net, it makes it sound like an Italian restaurant, not a publicity agency. But we are And then on the website there is a contact request form. They can give me their name, their email address, their phone number, whatever their preferred method of contact is. And write me a little note. Let me know what it is they’re looking for. Do they want to set up a call, do they just want some preliminary information? But that would be the best way to get directly in front of me is through our website  

Kevin: You’ve been listening to Russell Trahan, owner and CEO or PR/PR. My name is Dr. Kevin Coughlin, owner and producer of Ascent Radio and you’re listening to Ascent-Dental-Solutions, with a focus on knowledge, consultation, training and development.

I also want to give special thanks to Mr. Doug Foresta who has produced these podcasts over the last several months. And great thanks Russell for taking the time this evening to speak with that. I appreciate your expertise and your help and good luck in the future.

Russell: Great. Thank you, Dr. Coughlin. It was my pleasure. Thank you.

Podcast: Chris Widener on how to build influence and grow your dental practice

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: Welcome. You’re listening to Ascent Dental Radio. This is Ascent Dental Solutions with a focus on knowledge, consultation, development and training.

Although we’ve done many podcasts, this podcast, in my opinion, is extremely special. Chris Widener is widely recognized as one of the top speakers in the world today. He’s spoken all over the world in places like Germany, Spain, Russia, China, Egypt, Singapore and Australia. Of course, he’s spoken all over the United States and Canada. Chris speaks to groups as small as 100 and as large as 25,000.

His focus is on coaching right now and he’s willing to take dentists, dental leaders, dental hygienists, assistants, small organizations and large managed service organizations and show them how through influence and leadership they can improve their bottom line and just overall, besides money, just make the practice, the service and care they provide better.

Chris has clients as large as General Electric, Cisco, Microsoft and Harvard Business. His mentors were Mr. Jim Rohn, considered as one of the most successful speakers in the last 50 years and Zig Ziglar, considered one of the greatest motivational, personal development and leadership experts of the 20th century.

Both of those leaders selected Chris and Chris has taken their programs, their information and knowledge and brought it to an even higher level.

Chris, welcome so much to Ascent Dental Radio. Thanks so much for taking your time. In regards to health care and dentistry in particular, can you explain in your experience how important influence and leadership is in building a business, small or large?

Chris: One of mentors was a guy named John Maxwell. Jim Rohn was also one of my mentors, but John always said that everything rises and falls on leadership. And I think that that’s a great quote because whether it’s a large business, a multinational corporation or a small mom and pop grocery store or, of course, a dental practice, I do believe that everything rises and falls on leadership. How you grow your business, how efficiently you run your business, the satisfaction of the employees that work there.

And so it’s been my focus for the last 20 years or so to focus on leadership and helping people, whether they are in a large corporation, or they’re running a small business, which most dental practice are a small business. They might make a lot of money, but it’s a relatively small group of people in a one location.

Obviously some have multi-locations, but helping people expand their business, make their businesses more efficient, make it more profitable and it always starts with the leader. It always starts and rises and falls with the person who’s setting the strategy, who’s casting the vision and who’s responsible for the execution of the game plan.

So it’s imperative that dentists become better leaders. Those who are running their practices can drastically improve their business by becoming better leaders.

Kevin: In your 20 years of experience in this particular area, are there specific traits that you’ve noticed that make some leaders more successful than other leaders?

Chris: Yeah, absolutely. In fact, one of the things that I teach on, in fact, it’s the primary thing that I teach one, comes from my book called The Art of Influence and it’s how to gain trust, respect, admiration and loyalty.

So those four things. How do you gain trust, respect, admiration and loyalty? Whether it’s from your employees or it’s from your patients if you can gain trust, respect, admiration and loyalty, you’re going to build a bigger business. People are going to be dedicated to coming back to that business. They’re going to refer other people to that business.

And those four things come from four traits and if you’d like, we can just talk about those four traits. How do you build trust, respect, admiration and loyalty?

I’ll start with the first one: Trust. Every relationship between a leader and a follower or a seller and a buyer is predicated upon trust. For example, does the person coming into your practice trust that you really need what it is that they’re saying that you need? Are you really charging them the going rate or do they trust that you are highly skilled in your practice?

And so it’s imperative for us to build trust with those who we’re either selling to or employing. And the way that you build trust is through integrity. And so I find that the number one, and I always say integrity is number one, you can put the rest in whatever order you want to put them in, but integrity is the foundation to building strong leadership that last over years.

You can’t see me because we’re on a podcast, but I always hold my palm out like I’m holding up a mirror and I always ask the people, my audiences, to just look in the mirror.

Am I the type of person that other people trust? Am I the type of person that operates out of a single set of morals, ethics and values or am I duplicitous? Do I operate out of a dual set or sometimes even three sets of morals, ethics and values? Those who operate out of a single set of morals, ethics and values, who operate out of integrity are going to have trust from those who they either lead or they sell to.

And so that’s the number one trait of a successful leader, is to be a person of integrity and to make sure that your practice is a practice of integrity.

Kevin: I can tell you that when I listen to you speak, I get actually a little chill. I can’t concur more. I’m sure I didn’t coin the phrase, but I heard it somewhere and it’s called BLT. You want your service and your product, you want people to Believe, Like and Trust in you.

So really this trust, actually in my opinion, and maybe you can help me with this, it’s really your core values. Those core values, in my opinion, are developed at a young age and they’re reinforced over time. Would you concur with that?

Chris: Parents can instill it in us or we can come to a conclusion later on in life that this is something that we have to adhere to.

Kevin: Your second point was admiration?

Chris: Yeah. Admire. To be admired by people. And that doesn’t mean celebrity status or anything like that, but it does mean and probably falls in that likeability that you talked about as well. But people who admire people who are optimists, who are friendly, who are happy people.

If you got to go to the dentist, I got to tell you, I’m 50 years old, never had a cavity. But if you got to go to the dentist, wouldn’t it be better to go to a friendly dentist who you like, somebody who’s optimistic and happy? If they’re going to stick a drill in your mouth and charge you hundreds of dollars, you ought to at least make them feel good. And the way that you make them feel good is by being an optimistic, positive, happy person.

People admire people like that. People want to be around people they like and they like people who are optimists and happy people.

Kevin: Terrific. Your third and fourth points?

Chris: Respect: respect comes from excellence. When somebody walks into your practice, do they see excellence? Do they see average? Do they see poor? What do they see?

I’m talking about the quality of the carpets, the artwork on the walls, the smell of the room, the people behind the counter, the way that they’re treated by the dentist. I’ll give you an example as it regards to excellence.

I went to a naturopath for a while and she was great. She was really great. In addition to doing naturopathic medicine, they sold things like weight loss plans and things like that.

I moved to Seattle down to Scottsdale, Arizona about five months ago. And my last meeting with this woman, who is my naturopath, who I really liked, I said, “Can I talk to you about something?” And she said yeah.

I said, “You sell lots of health products, you sell a lot of weight loss products,” they have a map at their front counter and all that. And I said, “I don’t mean to be a jerk, but everybody that works your front desk is really overweight, but you’re a health place. And look, I’m no skinny person, but I don’t know that that says what you want it to say about your practice.”

She said, “Oh yeah, I was just talking to my husband about that last night.” And she said, “I can’t hire people based on their weight.” And I said, “Yeah, I get that. But wouldn’t it be great if the people who were working your front desk actually were excelling at health?”

And so what do people think when they come into your office? Everything they look at, whether the first impression or their lasting impression, what are they thinking about as it relates to excellence?

Because when they’re going out and they’re sitting to have coffee with somebody and somebody says, “Hey, I’m looking for a dentist,” you want them to say, “Oh, you’ve got to go to my dentist. I totally trust him, he’s an amazing guy, he’s so happy, he makes me feel good all the time and you know what, every part of their practice is just topnotch.”

That’s what you want them to say. You don’t want to say, “I kind of like my dentist, but the office kind of smells a little bit.” So every single level you want to excel and to do the best that you can and that breeds respect from people.

Kevin: I couldn’t agree more. I can tell you our organization sees over 100,000 patients in a year and day in and day out, in my opinion, the general public doesn’t actually understand what the actual dental needs are. They’re really like a lamb waiting to be slaughtered.

And it’s easy to take advantage of our patients. And once they feel, whether it’s correct or incorrect, that that trust has been lost, that respect of admiration, they’re gone. And as I like to tell when I do my training, you never lose one patient or a client. You lose the husband and the wife, the kids, the neighbors, the friends, family and relatives.

Chris: Absolutely. Let me tell you a story. I moved from New Jersey in 1991 to Seattle and right before I moved to New Jersey, I went into a car mechanic and he said, “Oh, you need all new brakes.” I didn’t make much money at the time and I go, “Okay, I’m going to push this off until I move to Seattle.” I said, “Thanks a lot.”

Came to Seattle, moved to a little town called Issaquah, and I pulled my car into an auto mechanic and I gave him carte blanche, “I need new brakes. Just fix my brakes, call me when they’re done. He said, “Okay, will do.”

About 20, 30 minutes later, he called me up and he said, “You don’t need new brakes. Who told you you needed new brakes?” And I realized that some scrupulous guy in New Jersey had told me I needed new brakes and this guy said, “No, you got like probably 15,000, 20,000 miles left on these brakes.”

Guess who I went to for an auto mechanic for the next 25 years until I moved to Scottsdale. He showed me that he was trustworthy.

Kevin: And almost more importantly, how many people you referred to that auto mechanic.

Chris: Dozens.

Kevin: Dozens. I can tell you in my own small practice, we receive about 940 new patients a month and the number one reason they left the practice is that trust factor deteriorates. And we’re all at fault.

A day doesn’t go by that I don’t make a mistake, but for our listeners, hopefully through your coaching program, you can educate, inform, not just the doctors, but the team members that support that doctor in that organization the importance of trust, admiration and respect. And why don’t you talk about that fourth item now for a little bit.

Chris: The last one is loyalty. Loyalty is what you really want from customers, patients, in the dental world. You want loyalty. People that will come back and come back and come back and they’ll take their kids there and then when their kids graduate, they’ll keep going there.

And like you’ve mentioned a number of times already on the podcast, they tell their friends, they tell their brother, they tell their neighbors, “You got to go to this dentist.”

And the way that you do that is through service. The way I put it is, because everybody says, “We have customer service. We serve customers.” But I don’t just mean doing the actual cleaning of the teeth or doing the root canals, I’m talking about considering their interest more important than your own.

Zig Ziglar, I used to co-host a TV show with him. It was one of the great honors of my life. Zig had one of his most famous quotes. He said, “You can have anything you want in life if you just help enough other people get what they want out of life.”

What is it that people want when they come to the dentist? They want great service, they want many of them to have their fears calmed, and they want it done at a price that they can afford. And understanding their perspective when they come in and serving to that need that they have is going to make them loyal to you.

I come in, I’m always a little scared, somebody might say, “But you know what, the doctor is so great with me. He’s got great chairside manner. They always give me great service. It doesn’t hurt, it feels better afterwards. They always do the right thing.”

Making sure that their needs are met — Robert Schuler used to say, “The way to wealth is to find a need and fill it,” and that’s the key. That’s how you build loyalty, people that keep coming back again and again and again and referring other people to the practice.

Kevin: Well, Chris I know how busy you’ve been. I can’t tell you how much I appreciate you commenting on trust, admiration, respect and loyalty. Could you spend a few minutes and tell our listeners how they can reach out to your coaching program?

I also think that so many times in healthcare, we focus on the patients, the patients, the patients. But a huge part, the other part of the equation, is your team members, your employees, the people who are working day to day in the trenches.

They really have a huge affect not just on the care and service, but the overall decorum of your practice. And a coaching program such as yours I think could be invaluable, not just to the doctors, but the support team for those doctors. Could you tell us how we can get in touch with you?

Chris: Sure. You know the old saying “if mama ain’t happy, ain’t nobody happy” well, if your dental hygienist ain’t happy, ain’t nobody happy. So it’s so imperative to invest in our employees and especially our key employees and invest in ourselves so that we’re better leaders so that they enjoy working there.

Because if they’re not happy working there and it’s drudgery, then they’re going to give poorer service to the people who are your patients. So it’s not just patient focus, but making sure the employees are happy and growing and well compensated and positive work atmosphere and the like and then at the top, creating yourself as a great leader.

I do an annual coaching program that I only take ten clients at a time. It’s for the full year and work with them on becoming better leaders, growing their life, accomplishing their goals.

You can find out more about it at You can check that out and it gives some details there. You can fill out the form if you’d like some more information and I’ll give you a call and we can talk it through and see if we’d be a good fit for each other for 2017.

Kevin: I can tell you if we don’t take you up on it, it’s our mistake. Shame on us. I firmly believe people don’t want to work somewhere, they want to be part of something.

And when people are part of something, the trust, the loyalty, the admiration, the respect are all part of the practice. I can’t tell you how much I appreciate you taking time from your busy schedule. I know you have an additional engagement, an additional talk.

Chris, thank you so much for spending time with Ascent Radio.

We’ve been listening to Ascent Dental Solutions. The focus is on knowledge, consultation, development and training for health care, but dentistry in particular, and experts like Chris are out there to help us take advantage of it.

Chris, thank you so much. I really appreciate your help and expertise.

Chris: Dr. Coughlin, I appreciate you inviting me to join you and your listeners.

Kevin: Thanks so much.