Ep #5: Culture is Key to Success with Kirk Behrendt

Welcome to Practicing with the Masters for dentists with your host, Dr. Allison Watts. Allison believes that there are four pillars for a successful, fulfilling dental practice: clear leadership, sound business principles, well-developed communication skills, and clinical excellence. Allison enjoys helping dentists and teams excel in all of these areas. Each episode she brings you an inspiring conversation with another leading expert. If you desire to learn and grow and in the process take your practice to the next level, then this is the show for you. Now, here’s your host, Dr. Allison Watts.

Allison:       Welcome to Practicing with the Masters podcast. I’m your host, Allison Watts, and I’m dedicated to bringing you masters in the field of dentistry, leadership, and practice management to help you have a more fulfilling and successful practice and life.

Our speaker tonight obviously is Kirk Behrendt. I know a lot of you guys know Kirk. He is practice performance coach, an international speaker, and author. He has invested his entire professional life studying the elite practices in dentistry and the leadership that guides them.

As the founder and CEO of ACT Dental, his vision is driven by the commitment to provide highly personalized care to the dental profession. By creating a talented team of experts, Kirk and his team continue to positively impact the practice of dentistry, one practice at a time. His personal mission is to use up every ounce of his potential.

Kirk lectures all over the world to help individuals take control of their own lives. Dentistry Today recognized Kirk and ACT Dental as one of the leaders in dental consulting in 2011 and 2012. Dr. Pete Dawson called him “the best motivator I’ve ever seen or heard.”

Kirk has also competed internationally in four Iron Man Triathlons, nine Half-Iron Triathlons. He currently trains with some of the best triathletes competing in the world today. His feeling is that there’s no greater parallel to optimal business performance than optimal athletic performance. He loves cycling, basketball, stand-up comedy, and most of all spending time with his wife Sarah and his children Kinzie, Lily, Zoe, and Bo.

If you guys know Kirk, then you already know that this is going to be a real treat tonight and we’re all about to find out that. He’s going to share some of the great information that he has and I love listening to Kirk. I just think he’s one of the greatest presenters I’ve ever heard and I love your Jack Nicolson impression.

I really enjoyed … you came and spoke to us at the Fit meeting, and that was the first time I saw you in person and I was kind of hooked. I don’t know if you know, but I bought all your CD’s and DVD’s and started listening to you. Then you guys were sweet enough, you and Sherry, were sweet enough to invite me to come watch you do one of your launches.

I just love what you do, Kirk, and I appreciate you so much being here tonight and I’m looking so forward to you sharing with us a little bit about, the title of this is “Transformational Leadership” so I just let the speakers decide what that means to them. So we have kind of a broad, you know, whatever we want to talk about tonight. I just thought I’d kind of ask, Kirk, if you want to share a little bit about yourself and kind of tell us about some of the trends in dentistry. Get us started here.

Kirk:            Well first of all, Allison, I just feel blessed and honored to be on here. You know I’ve watched you grow too in this short period of time. I didn’t know who you were and now I realized who you are, you have great friends, all of your friends seem to be some of the same friends I have. I just feel honored you invited me to be on, so I appreciate this. You know, I need to say this out loud, I feel very blessed just to be in this profession and doing what I’m doing.

Many years ago, as I started our own consulting company, we started a little company called ACT Dental and started it from a studio apartment. I was dating my wife at the time and we were so broke, we were seat cushion broke. I don’t know if you know, seat cushion broke is when you start looking through your seat cushions to try to find enough money to get a sandwich for the day. You’re living on a prayer. Thank God my wife had a good job just to keep us afloat and as we’ve been moving along every year, we have learned from some great people. You know, every person that you meet adds a little bit more.

Some of my mentors early on always reminded me that you’re the average of the five people you hang around the most. I’m trying to keep that at the forefront of my mind and so Allison this group that you put together and the people that we collaborate with in the future just adds so much to our lives. Pete Dawson always reminded me, I met him at the age of 24, just getting ready to turn 25, and actually Deb Castillo was with me at that first meeting, it was a Pete Dawson Top Ten course.

I asked him, “What’s the one thing you would tell somebody getting into this profession?” He was so clear. He said, “The one thing I would say is that always stay curious, never tell yourself you have it all figured out because the first thing you are going to realize is that the people that have it all figured out anyway, there not that much fun to be around. When you stay curious, you keep yourself engaged, and you’re learning every day, even at my age. I’m learning constantly from the people around me.” It is just great to be on this journey and be around you guys.

Just a little bit about our company. Our company is ACTDental.com we’re a small practice management company. We pride ourselves in just working with a couple practices a year. I have no interest in being one of the biggest. I just love the intimacy that we have with our teams and trying to help them to be the best that they can. We’re having fun.

Like I said, every year that passes we’re learning new things, trying to stay on our learning edge. I’ve got a small team of coaches and that’s about it. That’s about it. In the last four years, five years, I’ve been doing a little bit more speaking and a little bit more and every time I learn. I’ve had some great coaches along the way. It’s just been a lot of fun for us. Check us out if you have any questions at ACTDental.com but I’m, like I said, I’m thrilled to be here.

Allison:       Well, cool. You and I talked a little bit in preparation for the call. I know that one of the things that you’re kind of finding interesting right now is some of the trends that are in dentistry.

Kirk:            Yeah.

Allison:       Yeah, you want to share with us a little bit about that?

Kirk:            Yeah, I just watch a lot of trends, a lot of homework, looking at what is happening in the market. This is a great question. Write this question down if you have a piece of paper in front of you. Some of you already use this question. But when you meet somebody that is successful in anything, whether it be parenting, fitness, finances, running a dental practice. The best question you can ask them is this, “What is your secret?” Like, what is your secret? I ask that question constantly. I’m asking it all week, even of our clients.

I get their numbers back every week and I can watch some of the big jumps that people have had from last year to this year. My question is always the same, “Okay, I’m looking at your numbers, what is your secret?” Like, what are you learning in this whole process? You’ll find that anyone that is good at anything, they want to tell you their secret because they work really hard at that.

I’ll give you a perfect example. There’s a mother who has four children at our church. These children are now teenagers, except well the youngest one is twelve. These kids are good kids, like they are really good kids. They come up and they shake your hand and they ask you questions and it freaks you out cause these kids are like teenagers. You know what I mean? They make eye contact, they actually listen to you, and I finally just said to the mom who I’ve known a long time. Her name is Marcy. I pulled her aside when we were getting coffee and I go, “Marcy come over here. What is your secret? I mean, you have four teenagers, how in the world are they such good kids, how did you do this?”

You know what she did? She said, “Have a seat with me, I’m not the perfect mom but I did use a couple things that really helped me.” And I was ready to write when she was talking. It is so cool because she gives you the magic to life or the secret to life a lot of times. She said, “You know, in my house everybody learns to get into the system. We don’t search for things in my house. I have four kids, I feel like it is my responsibility, the laundry, and when they’re age ten I take them to Target and I get them their birthday present.”

She said, “Kirk, you know what it is?” I said, “What?” She said, “A laundry basket. Because they can get any color. They can get green, they can get orange, they can get red, but in my house you get in the system.” So my daughter turned ten and I took her to Target and I said, “You can have any color.” And she was like, “You got to be kidding me.”

So, the important point is that you’re constantly in tune with people that are doing really well, and what the trends are. Now here are the two trends I’ve noticed and maybe you guys have seen a little bit different, but there are only two conditions in dentistry right now. There’s people that are absolutely motivated. I mean, they’re very motivated. I talk to several practices today, “I don’t know where to put these patients, I mean, we are booked solid, it’s been unbelievable.”

Then there’s paralyzed. Sometimes you can experience both of these conditions in the midst of a month but you go back and forth and back and forth and they can be pretty taxing sometimes. They go all over the place. I’ll be honest with you, sometimes we experience those conditions going back and forth.

But it’s more important now than ever to be on the motivated side because dentistry is the greatest profession ever. Ever. Now you can look at US News and World Report and there’s staggering statistics that they published in December, it’s the number one profession now. It really is. And the more and more I age and mature, it’s an unbelievable profession because not only do you get to affect people’s lives but you can create your own life by yourself if you’re really good at getting information and applying it and creating things like great cultures.

So those two conditions, motivated and paralyzed, are highly contingent on how much you learn, apply, reevaluate, and stay curious your whole entire life. So those are the two things that I am seeing. I’m seeing people have tremendous jumps but I will tell you that none of them would say, “Gosh it’s super easy.” They will tell you, “Look we’re working harder than ever but here are a couple things that we’ve learned.” So, I’ll share with you some of those things as we go about the call today.

The other trend I’ve noticed and some of you are very aware of this. There’s a very big difference between living in complexity and embracing simplicity. If you look at some of the best entrepreneur coaches in the world, people like, Dan Sullivan from Strategic Coach, which I highly encourage you all to be involved with strategic coaches, an entrepreneurial training program that has nothing to do with dentistry but has everything to do with what great businesses in the world are doing.

When you get outside of dentistry and get great education like this, they teach you that there’s what’s called the “ceiling of complexity.” Now, ceiling of complexity is when you can no longer get any further by working any harder. You now have to do one of two things. You have to change your thinking and you have to create a new set of unique team work. Which means you have to surround yourself with different people or rearrange your work environment.

What we learn in dentistry is that we reach several hundred ceilings of complexities in our lives, where you realize you can’t go any further. So you take a course, or you get a coach, or you take a long weekend and you rethink how you’re doing things. It actually works you through to the other side and you can start to embrace simplicity a little bit more. So I’m watching people as they get better in their lives embrace more simplicity.

So that’s the other trend we’re noticing. I’m watching people that are starting to do really, really well and the word that they keep using over and over and over again is simplicity. Simplicity is not easy it’s not impoverished and it’s one of those things that we have to constantly look at. The people that get into their sixties and early seventies that we still coach, they just have very simple, uncomplicated lives. They know where to give their best energy to. So that’s another trend that we’re noticing.

Then the other trend that’s really interesting and very curious to us, is that people are constantly looking for competitive advantages. You know, in their dental practices. Marketing, you know, you do a little a bit of the same thing all the time and it just gets diluted. There’s so much dental marketing out there, and even in our business, consulting or coaching, everyone is looking for a distinct competitive advantage. I think the more that you can bring creativity to that the more happy you are going to be, ultimately, and the farther that you’re going to go.

So those are the three trends. I see people paralyzed and motivated. I see people really embracing simplicity. I’m watching a lot of dentists really downsize their lives. It is powerful to see the effect on them. Then also people just coming up with very unique, creative, competitive advantages.

Allison:       Oh, I have a question for you, Kirk. I’m going to unmute.

Jen:            Hi, Kirk, I haven’t had an opportunity to spend a lot of time with you but I certainly have read a lot of great stuff about ACT Dental and what you’re doing. I am a management consultant. You had mentioned, it just kind of sparked my interest, when you said that weekly you look at your client’s numbers and when you started to talk about the competitive marketing and different things.

What are you looking at when you are looking at their numbers? Like are you looking at their practice numbers? Do you, in terms of helping them lead through that, do you have a checks and balances in terms of helping them make sure their numbers are clean so you can help them and do a good analysis?

Kirk:            Yeah, that’s a great …

Jen:            Because I’m finding that unless I get down to the nitty-gritty, what they think they have, and they feel really good and mindful about it, and then when I kind of go deeper that maybe those numbers aren’t as clean. That can really change the target of helping them to be successful.

Kirk:            Yeah, you’re asking a fantastic question. Yes, we use a program which is called the Easy Stats Dashboard. We gather more variables and numbers than you would even want to discuss in a phone call like this. But the metrics are very important.

People say, “Oh, you’re such an optimist.” Well, I don’t know, I mean I’m an optimist but I’m a paranoid optimist. Which is this, I need specific data. I want to know, how are you doing? How is it growing? Because I think the world doesn’t require perfection from us. The thing that we always say looking at dentists’ numbers is it’s not about perfection, it’s to see significant progress. It’s got to be measured. It’s really has to be measured.

So a couple of things I’m looking for. The biggest thing I’m looking for is this: life. I say it all the time. Life comes first. I don’t care how cool your practice is. I don’t care what you produce. Because really, these phone calls get initiated, I get calls every week from people saying, “Look, we do 1.2. If you can get us to 1.5 that will make me happy.”

As I learn more, you know, you ask enough questions, they start to tell you really important details of their lives. You talk to the spouse and you find out the dentist hasn’t been home for dinner in years. They have little kids. You only have sixteen summers with a child and then that’s about it, that’s all you get.

I had a dentist, this is really powerful, I had a dentist come up to me in Austin, Texas and he said, “You know the lies we tell ourselves are pretty heavy.” He says, “Your seminar today really shook me because for all these years I told myself that I was working late, evenings, weekends for my family. I would come home and I would tell them, ‘Look I’m doing this for you guys.’ And you know what? It’s a lie.” It’s just a lie. Because there is a better way to do it in dentistry.

The turning point for me was when my daughter was fourteen she approached my wife and she said, “Mom, is dad part of the family anymore?” It just killed me because what I thought I was doing and its affect, were two different things. So the thing that I always remind people when I’m looking at numbers, to answer your question, is I just want to make sure these guys and these women are really creating the lives that they want for themselves. Because dentistry is an amazing profession.

I mean, you can make enough money in dentistry working 32 clinical hours a week. You can. I always say this, if you can’t make enough money working 32 clinical hours a week, then there is something wrong with your practice, there is something wrong with your lifestyle. Because we do get dentists that have lifestyle problems. I mean, they think they’re just going to make infinite amounts of money and that’s just not true. There is only so much of you and that’s it.

Jen:            I guess what I was going to say is that I think everything you’re saying is true, but mine is even more fundamental. That when I start working with the dentists and stuff, it’s helping them realize even something so basic that I would think that everyone would know is, is a production adjustment, what they are really leaving on the table.

They really don’t even have their dental software package straightened out correctly. So they always feel poor. Then they’re working all these crazy hours and it’s because the information that their software is feeding them is inaccurate. So they don’t, it’s kind of like you said, it’s a house of lies, because they really don’t even have a really good starting point.

I was just curious to see if you run into that because I just had a client that left a half a million dollars on the table over a three year period because they didn’t know a particular report in their general software. What was it? Dentrix. Because there’s this report that you think of production adjustments but this is another report that you could bypass to get the information.

So it really changed the story when they could say I’m cash poor and they’ve tried to make all these leadership decisions about doing what’s best for their team and they’re like, “Oh my god, I didn’t realize that I was leaving that much on the table.” Because everyone says to run these particular reports but then there is another way to get around the system. How deep do you go in with your team to help them?

Kirk             Yeah, we go extreme.

Jen:            You do? Okay, perfect. I would be interested to learn about that.

Kirk:            Yeah, extremely deep. I would love to schedule another call and actually describe the metrics because there are very specific targets to hit in dentistry. There’s about 42 of them.

Jen:            I would love that to. I will find you.

Kirk:            Well there’s 42 targets in dentistry. If you hit all of them, you’re probably in really good shape. When I was talking with Allison she just said this is more of a leadership thing, so. So, yeah, I think you’re asking a great question. The answer is yes, we do go through those.

Allison:       Jen, since you don’t know him, I will just share with you real quick that Kirk is very open and very generous with his knowledge and time, I would just ask.

Jen:            Guess what? I’ll be calling you tomorrow, man.

Kirk:            Yeah, this is what I think.

Jen:            Anybody who has three girls and a boy.

Kirk:            I have three girls and a boy.

Jen:            God bless you, man.

Kirk:            My girls are twelve, ten, eight and then I have a little boy who is five. But here’s the thing …

Jen:            You got wife that still loves you.

Kirk:            Oh, she is awesome. Thank God, thank God for my wife. She’s a blessing. I married way up so I’m on credit right now.

So here’s the deal. When it comes to information too, Allison is completely right, I live by one thing. I didn’t come up with any of this. I’m a borrower of information. None of the stuff that I know, I created. I was just a kid with a yellow pad who was blessed to be around some great people. I did the same thing you guys would all do, I just took notes. What you see is that success really does leave clues. There’s trends everywhere. You can see specifically the metrics that make a practice work and you can see why. I mean, none of this is a secret.

You just have to constantly stay on your learning edge. It’s like trying to figure out how this person could be so healthy. How could this one dentist who’s fifty years old, have ten percent body fat, be so good as a dad, have a great practice, do great dentistry, and have it all? How can it be? Well, if you study close enough you’re going to see this person is incredibly disciplined and they found the formulas that worked for them. So it’s all good stuff.

Allison:       Well and it’s funny we’re talking about numbers but really you and I were talking about too, what are the most important competitive advantages that a dentist can have? I love that you don’t talk about, I don’t know … you do talk about money because that is part of the freedom of it all.

But I wish I had found you twenty years ago, Kirk, and you could teach me how to put life first. My son is about to graduate and I’m just going, wow, I did only have sixteen summers. I want you to talk a little bit about what the culture, and the stuff we talked about on the phone, the competitive advantages that dentists have and why it’s a great profession.

Kirk:            Absolutely. The number one competitive advantage any business can have in the world, and any dentist can have in the world, is one thing. It’s crazy simple. It’s called culture. It’s also the number one thing that would separate one family from the next. People say, “I want a great family.” Well that, you’re talking about the culture. You want a great business, you talk about the culture. I’m a huge fan of culture more now than ever because you see so many great examples of people that do this really well and then people that don’t do this really well.

I think that you need to have a good balance of culture, and profitability, predictability. But if you wanted to really define how you could excel in dentistry, you have to really embrace this concept. You have to want to embrace this concept. Let me explain. If you look the companies that do really well, let me just say the dental practices that do really well. You hear practice management speakers all the time say this this phrase, “The patient comes first.” The patient comes first, the patient comes first. That is absolutely not true. That is so far from the truth that it can get in the way and destroy our thinking.

Now I understand the concept, it’s a very nice concept, but it’s not true at all. The truth of it is, is that we have to make sure the patient comes second. I mean they truly do. Because when you put your team members first and you put the patient second, your team members can take care of your patient in a way that you could never take care of them.

The people that notice right away when you have a culture in which the people that work for you and with you come first, the patients are the first people to notice. They’ll come in and they’ll say “You love these women.” You know, or “You love these people.” And you say “Oh my gosh, I love these people.” And it’s an authentic love. It’s an authentic love that goes back and forth. These people will kill for you.

The problem is that we do put the patients first and we put the procedures first and all the other things that are pressing concerns for us. We don’t really take very good care of people. Now with that goes the organizational things that you have to think about. I’m watching dentists, now more than ever, change their hours from 8:00 to 5:00 with a lunch, to 7:00 to 3:00 straight through. I started watching this trend about six, seven years ago. I kept a little spreadsheet and I thought it was great. Then I threw the spreadsheet away because there was just too many practices doing it because these dentists were working straight through, no lunch, and they got to leave at 3:00.

And if you work primarily with females, what do females get to do when they leave at 3:00? They get do the things, pick up their kids, go shop, and all these other things. Now, there’s advantages to that but what you ultimately don’t understand is these people have amazing lives.

What happens is this: you create a culture in which people love who they are as a result of working for you. They love their lives. They would say to you, “I would never work in any other practice. This is an amazing practice.” Now there’s down sides to 7:00 to 3:00 straight through. The down side, hit your cues. People think, oh I just changed 7:00 to 3:00 and it changes my life. Yeah, that’s true but you’ve got to hit your cues.

Allison:       What do you mean by that? Hit your cues?

Kirk:            Well you can’t, there’s no room for error. You know, because a lot of times lunch, we call it lunch, but it’s really room for error.

Allison:       Okay, like if you run late, that kind of stuff.

Kirk:            Run late, squeeze a patient in there. It’s really, it doesn’t get used like it should. Now some people have a high respect for time but you’ve got to hit your cues. Patients have to be trained really well. They got to know when they come in, they have to be taught how to pay. You have to have very high levels of predictability in order for that to work or you are going to experience an entrepreneurial seizure when you do that.

But here’s what happens, people just love who they are as a result of working for you and in essence they’ll say to themselves and to you, “I would never work anywhere else.” And again it goes back to the self-lie. Because people say, “No, no, no, I work 8:00 to 5:00 and I really have a good life.” I’m in their practice and I’m like, I understand your hours are 8:00 to 5:00 but you don’t work 8:00 to 5:00. You guys get here at 7:00 and then you leave at 6:30. 8:00 to 5:00 is not 8:00 to 5:00. 8:00 to 5:00 is 7:00 to 6:30, and you go home wiped out. The human body just can’t endure that. So it’s important.

I’m not talking about working less. I’m just talking you’ve got to constantly rethink this all the time. How do we create a culture in which people come first? Then also finding the right people, you know Jim. I’m a big Jim Collins fan, it isn’t about having people as an asset. You have got to find the right people.

If you’re a dentist and you’re listening to this right now you know how much a chairside assistant, the right chairside assistant, she can change your whole life. Probably in twenty-four hours. It can change your whole life. Having the right hygienist, she can change the oxygen in your practice instantly. Having the right administrative person up front can change the financial landscape of your life in probably sixty days. So having the right people is incredibly important.

Then the other thing that goes with culture is this. If you have a pencil or a pen write this down. Because the thing I’m noticing is that we used to do really expensive hiring and procedure manuals for two weeks with a new employee. We got rid of that a couple years ago. What we started noticing, we started taking data from our highest preforming practices and I’d say, “What makes this work?” Like really work?

It really came down to three things. Here are the three things. All of these practices identified people that could do the three things that are most important in a dental practice. Number one, they had great attitudes. Number two, they could do the task at hand, whatever they were assigned to do. Number three, they were really good at promoting the doctor or promoting dentistry or promoting the rest of the practice.

So what we’ve done now is we’ve actually asked dentists to throw away all their reviews. You know, dentist hate doing team reviews. First of all, they don’t do them. Second of all, they hate doing them. Thirdly, it is never done timely or effectively. It’s basically a meeting to talk about whether or not we can get a raise, and the dentist in effect gives what’s called a “hush raise” to keep you from getting upset. I’m going to give you a hush raise, cost of living. Really it becomes a counterproductive appointment.

So here’s what’s really great. Now we just pass out a piece of paper that says three words on it. It says attitude, task, and promoting dentistry. Basically, the dentist scores the employee one through ten and the employee scores themselves one through ten. I can assure you if you are a dentist, again listen to this, if you have an employee that scores a nine, nine, nine, she’s probably one of the very best employees you’ve ever had in your life, ever. She probably makes you one of the happiest dentists on the planet.

But the problem is we’re not clear about what the expectations are in this environment. I’ll take anybody that’s got a great attitude and willing to promote us, because I can teach them tasks. We’ve been doing it for twenty years. So, it’s incredibly important that you’re clear with the people in the practice about what makes a good culture. Now here, a couple things about that. Number one, it is very important to differentiate between what attitude and moods are. That’s the thing I’ve learned as I start to age, is that attitudes and moods are two different things. Attitudes are external manifestations. Moods are internal.

Some practices, team members are just not emotionally competent enough to understand the difference. I work with primarily females at my office. I can’t come in and say, “Don’t be moody.” You know, that’s just not going to happen. I have pretty much all females in my house. I can’t come home and say, “Don’t be moody.” That’s not going to happen. I know when my team members are moody, but you know what? You wouldn’t. You would never know. Externally manifesting moods is completely unacceptable in a professional environment. It is not tolerated, whatsoever.

So it’s important as the leader, if we’re talking about leadership, it’s very important to help people understand the difference between attitude and mood. Creating a great culture, I think there’s a lot of people out there promoting culture and talking culture. We have a very specific system for creating culture and it’s really about a six-point checklist. If you hit it all of those, and one of the points is making sure that you’re clear about the three things that create a happy employee, happy dentist relationship, which are those three things. Then you’re going to see the whole thing change. You’ll see patients coming in for their own reasons because they love the energy that they get when they walk through those front doors.

Allison, I know I’m a little longwinded on this, but I got to say another thing too. I don’t mean to get political on this, but people say, “Well my practice is, you know, we listen to everybody, and we make really good decisions together, and it’s kind of like a democracy.” I just have to speak to that. Because democracy, while it was a great intention and a great concept, and it is a great concept that built this country, the way we practice politics right now is not really a democracy. It isn’t, it isn’t. It’s about people making decisions based on polls and what people want to hear.

Really when it comes down to it, I guess, this is what I’m trying to say: your practice is not a democracy. It’s just not. It’s a dictatorship with ears. I heard some great leaders say that and I thought, “Oh, I don’t even like the word dictatorship.” Like that’s a horrible word. But the truth of it is, is that somebody is going to make the … You know, my family is not a democracy. I don’t ask my kids, “What time do you want to go to bed? What works for you? What do you guys think?”

Nick Saban does not send out an email on Wednesdays before they play football on Saturdays to say “Which quarterback should I start? What do you guys think? Based on your polls, I’m going to start the appropriate quarterback.” That would last so long. Or what if in schools we asked people, “What would you like to see?” Then you made all your decisions on that.

I think it is important to listen. I really do. But when it comes to leadership, somebody has got to make really good decisions on the behalf of everybody involved. It requires making some tough decisions. You have to hire and fire all the time. These are tough decisions. And they have to be founded on your core beliefs and doing the right thing. Ultimately, if you’re clear about what makes a culture, you can make these tough decisions and you can watch the culture grow.

So that is a longwinded answer. I could talk days on this whole thing. But I am a huge fan of culture. Tony, oh gosh, I can’t remember his last name. The CEO of Zappos you guys know, if you guys have read the book, it’s fantastic. I studied those guys like crazy because I didn’t even know what Zappos was then I saw the boxes showing up at my house and I’m like, “What is this?” People love Zappos.

Tony, who’s the CEO, says this, “Look you can copy exactly what we do. You can copy my website. You can actually copy our whole business plan. But the one thing you can never copy is our culture. You’ll never catch our culture, because our culture is ours. It’s ours, it’s unique to us.”

You could actually copy what Southwest does. You could do everything. You could say what they say on their flights. But you’ll never capture the essence of their culture, because their culture is theirs. So I tell dentists all the time, your number one competitive advantage, as a family, as a dentist, as a practice is your culture. Does that make sense?

Allison:       Yeah, that’s awesome. Thank you. I guess I’ve never thought of the family that way. I don’t know. That’s cool. I like it very much.

Kirk:            Yeah, I’m not the greatest dad in the world, but you know what? I’m trying on it every day and I just want my kids to remember an incredible family culture. You know, our family was fun. Yeah, we had rules, but we really enjoyed a great childhood. I’m the steward of that culture and as a dentist you are the steward of the culture of your business.

You look at companies like Chick-fil-A, they’re very good stewards of their culture. Southwest is very careful about the stewardship of their culture.

Allison:       Yeah, awesome. I have a quick question for you. You started, and I don’t know if you intended to go through this, you did start to talk about your six-point checklist.

Kirk:            Yes.

Allison:       Where you going to share that with us?

Kirk:            I can, there’s a lot of pieces to it though. My fear is it will get longwinded.

Allison:       There’s probably too much to get into, okay [laughs].

Kirk:            Yeah. Actually, you know what I would love to do? I’ll come back and do another call and I’ll do the six-point checklist with you. Because that’s a whole hour, at least a whole hour on that.

Allison:       Okay, that’s a deal.

Kirk:            How about that?

Allison:       That’s a deal.

Kirk:            Absolutely.

Allison:       I love what you are saying. I’ve heard the word culture thrown around and I intentionally created a culture. But when you just said it, just now, like that’s the most important thing. I guess that was kind of like a big “aha” to me. Like it’s the number one advantage.

Kirk:            Yeah.

Allison:       I never really thought of it that way.

Kirk:            Absolutely. Now they’re very specific. I’ll just give you one little hint, one of them is actually being very clear about the attitude task, promoting dentistry. But another one too is constantly, every day, is hellos and goodbyes, every day. Because everything in the middle is context. In leadership we teach one thing. The two most important interactions of any communication, any communication, is your hello and your goodbye.

So as a dentist I think the greatest thing you can do on that checklist, one of those points, is that every single morning you come in and say hello. I always do that every morning. I will go in, make eye contact, and then ask your team member a question. Make it not about dentistry. Say, “Hey Tiffany, good morning. How was Nicholas’ baseball game last night? It was raining last night, did they finish the game?” What you do is you start to say, you start to show people that I care about you. I care about you being here because you are going to work your tail off, you know, all of us are, for the next six, seven, eight hours.

Then the best thing that you can do when it is all over is take off your mask, get away from your email. That’s another thing, I could go on for … email, we’re actually teaching dentists stay away from email. Like just stay away. My highest producers right now, you can’t get a hold of them by email. They’re teaching the world, look email is just not something I do.

Brian Gray, one of my favorite dentist in the world, everyone knows, his specialists, people that refer to him, you can’t, he’ll very rarely ever return emails. John Cranum, on average, is looking at two to three emails a day. He runs the Dawson Academy and a private practice. He just said, “Email is probably one of the primary disruptions in the twentieth century,” according to Tim Ferris and everybody else.

But at the end of the day, just get away from the email, pull off your mask, step out of your office, shake your team members’ hands, or however you want to do it, look them in the eye and just say, “Thank you. I really appreciate you.” You know in the South they say that all the time, “I appreciate ya, I appreciate ya.” I love that, you know. So we adopted that, we’re saying it all the time. “I appreciate ya. I appreciate who you are. I don’t know how you did it with that 2:00 patient but that was awesome.”

Because you know what? People can live on that. No matter how exhausted you are, you can go home and you can go, “You know what? At least I am appreciated.” The number one reason, you guys have seen these statistics, according to the US Department of Labor statistics, the number one reason why people quit jobs is they’re not appreciated. They just don’t feel appreciated.

I’ve interviewed thousands of team members, thousands. The number one thing team members say, consistently, for all these years, is this, “If you could get him or her to say thank you once and a while, it might not fix everything, but it would fix a lot. It would help a lot.”

So I think promoting a culture you’ve got to be very intentional. Now it’s a system because many dentists aren’t built with that infrastructure. You know, many males, it’s funny, even the younger males now, they don’t get that. They don’t understand it. So we actually have to program it as a system. Actually take a thirty-four year-old male dentist and say this is your system. You go in and you say hello.

“Do I have to?”

“Yes, you have to.”

Okay, and then at the end of the day, say, “I appreciate you.”

“Well that’s kind of corny.”

“No, it’s not. Do you want these people to work hard?

“Yes.”

Then you say, “I appreciate you.”

“Okay.”

You know what? It starts to become more of a natural thing. It’s crazy that the younger generations don’t understand that. So that’s just a little bit about that.

Allison:       Thank you for that.

Kirk:            Yeah. Other things we’ve seen, here are some other trends that are just really important. You watch what’s happened in the stock market, people are misinterpreting what’s happening. They think, gosh, the world is just coming out of the recession. It’s just going to be booming. I was at the ADA last fall and it’s an amazing conference, but you have people that are literally sitting and waiting for the recession to end.

Well I’ve got news for you. I’m no economist, I’m not a financial strategist, but all you have to do is drive around some neighborhoods in California and Arizona and realize this isn’t going to go away. It’s not like we’re just going to wash our hands of all this. Somebody has got to pay all these bills.

So if you watch really closely what has happened in the stock market, we’re seeing all these trends recently with companies saying the exact same …  they’re all saying the exact same thing. They’re doing more with less. They’re smarter at how they look at their labor and they’re working smarter, getting bigger gains, without the heavy labor cost.

Now I’m not saying it’s important to cut team members. That’s not at all what I’m saying. But we have to constantly rethink this. I have to rethink it all the time because you can hire yourself out of business. There’s a dentist in Virginia who had the perfect quote. He had a monster practice when we started working with him. He called me one day and he goes, “Kirk, big day today.” I said, “Why?” He said, “I realized today that I was just going to work just so other people can have jobs. I’m not doing it anymore.”

You know what he did? He ended up changing the culture, system structure of his practice. He went from about fourteen team members now down to four and he produces about the same. But his net is a lot higher and they’re a lot happier.

Now again, it’s not about getting rid of people but you’ve got to think differently. You’ve got to constantly bring the thought process to this whole thing. Because some of us are caught in patterns that are not sustainable, they are unsustainable patterns. Having that practice was an unsustainable pattern for him. He would have ultimately imploded. Maybe not gone and bankrupt, but maybe imploded personally. So, I think it’s important that you’re truly asking yourself, and I have to do this every year.

People go, “Well you have so much energy.” That’s not true. I mean, I have a limited amount of energy. I have energy and I’m excited, but I am constantly rethinking the puzzle. One of my favorite people in the world, he is a periodontist in Indiana, his name is Dave Alexander. Dave is sixty-seven and he looks fantastic. He looks better every time I see him. I go, “Dave, when are you going to quit?” He says, “Never.” He goes, “Because my friends, they’re all dead.” And he says, “You know, it’s true, you quit, you die.”

On average dentist die, it seems like, every, you know, twenty-two months after they retire, nationally. Now it’s important to keep going for whatever reasons that you have to be in the profession helping people. But here’s what Dave says to me. He says, “Kirk, I used to think that I was going to get there.” And he goes, “You realize as you get older, you never get there. What you have to do is rethink the puzzle every year.”

I’ve got a new situation. I’ve got some new hygienists. I’m trying to rethink the puzzle. So it’s important that every year you’re putting the puzzle together. And I do that all the time now as a result of his advice. We used to have a five-year plan and I just threw the whole five-year plan away. Now we only plan twelve months, because I can change my mind in twelve months. Which is kind of cool. But our whole goal is to stay committed for twelve months to a good plan. Then you can rethink because the energy thing is big.

So other trends I’m seeing as far as patients go. I know we’ve talked a lot about the practice and the team members and what is happening in the world. But I think that it is important to talk about the people that we serve, and I certainly don’t want to make it sound like they’re way, way in the distant. We have to take very good care of these people, but the patient trend that I’ve seen is this, and I think this is an important concept. If you have a pen, again, write this down. But we teach people how to treat us. We just do.

Every business in the world teaches their clientele how to behave. They do. And when you don’t believe that, then the inmates run the asylum. So it’s important that you teach people how to pay, how to show up, how to refer. I mean I have to teach, you know, I’m a practice management consultant. I teach other people how to refer. You have to teach your patients how to refer. You have to teach your patients how to pay.

One of those behavioral patterns that’s been very powerful in the last thirty-six months in the midst of recession is that dentists all over the country are teaching patients to pay in full or pay in full. There is only two ways to pay in dentistry. You can pay in full or you can pay in full. And people freak out and they go, “No, you can’t do that.” It’s true. The only way to pay for anything in the world now is to pay in full. If you’ve ever been on a cruise, they don’t say, “Hey, go on the boat, we’ll break up these payments over the next four months.” They don’t do that. In a discretionary purchase, everything is paid in full.

Here’s the important point. It comes down to two things. It’s not about the money. It’s about consistency and it’s also about people’s circumstances. Because as a dentist, the thing that you want more than anything in your life, is not more money. You just want high levels of consistency. The happiest dentists I’ve ever met in twenty years of doing this had very high levels of one thing that other people don’t have. It’s called predictability or consistency. Their dentistry is predictable, their days are predictable. Some of them go on the same spring breaks every year. Some of them eat the same thing for lunch every day.

I got a seventy-two-year-old dentist that eats … he works three days a week 7:00 to 1:00 and he opens a little Tupperware bowl, it’s the same Tupperware bowl. In the Tupperware bowl, there’s a little salad, a little diced up chicken, little balsamic dressing. I go, “Gary, you eat the same thing every day.” He goes, “I know, isn’t it cool?” He says, “I’m fueling the machine, man.” And you know what? I mean, he did an incredible job of raising his kids, but everything was predictable.

So, the important part of financing with patients is this: when people pay, the predictability skyrockets. It just sky rockets. The same thing happens in vacation homes. You know, or vacationing. You don’t pay in part because it would create havoc for the vacation industry. You pay in full before you go.

The second thing is circumstances. Because I think we’re in a place now as dental providers, we have to trust people. Trust is incredibly important in the dental profession. We can trust people but we are no longer in a place to trust their circumstances. Because your patients’ circumstances are beyond their control, many of them. Some of you have family members in which their financial circumstances are greatly beyond their control. As a dentist, when you mix patients’ circumstances with your schedule, that is formula for disaster. Because now you’re mixing their lack of predictability with your schedule and that is a nightmare.

And so you get older, you start to realize this. I’ve got a great periodontist in Louisiana and his receivables consistently run at negative ten thousand. He says, “I don’t even care about the money, it means nothing to me. What it does for me is that I owe people dentistry and then what happens is the predictability skyrockets and before I turned the age of fifty I was playing the front nine. Now I’m after the age of fifty and I’m officially playing what’s called the back nine, which means I don’t have that many holes left. So if you are going to get three hours of my time, I just need to know that you’re in. And that’s it.”

So he’s in a tough part of Louisiana and he says the same thing that everybody else says. “My patients don’t have any money. There’s people down here who don’t have money.” So if you are going to get my time, you got to find the money for the things that you value. And in essence, we have an agreement about what’s going to happen next. Does that make any sense?

Allison:       Yeah, very much so.

Kirk:            Yeah. It’s funny, the trend that we’ve seen the most is our practices in Atlanta. Practices in Atlanta have had to go to negative receivables. Let me tell you why. Because if any of you have ever driven in Atlanta, it’s the most miserable place in the world to drive. I love Atlanta. I love going there. I love the people. I love the city. But there’s no more miserable place to drive than Atlanta. I could think of a few, but Atlanta is probably on the top of the list. Right? And as a dentist you can’t survive with patients coming in the door using the whole Atlanta traffic thing.

What we found, this is really wild, I did not expect this. But as our practices that we coach went to negative receivables, they would all say the same thing. They go, “My patients don’t use that whole Atlanta traffic thing anymore. It’s wild. But when a patient pays in full before we actually prep, it’s funny, they’re here on time. I don’t get it. You know, this is a patient that could never get here on time. Now that she’s paid, she’s here.” I actually believe this. I believe when patients pay in full, your preps are even better. The procedures are better, everything just goes smoothly. It has nothing to do with the money, it has everything to do with trust.

Again, we just got back from spring break. You go to spring break anywhere and you rent a nice house, or anything, people want the whole fee up front. Because I’m not doing business with somebody I don’t know, unless you pay in advance. I got in a little fight with somebody last year when we went. I said, “Come on, you want the whole fee for the whole week?” And the woman was so great. She goes, “Mr. Behrendt, I know that’s unusual but here’s the deal, when people pay in full they show up.” I was like, “Oh.” She got me on that one.

Allison:       “Have you been listening to my talks? Have you been listening to my lectures?”

Kirk:            No, I haven’t, I haven’t. Great minds think alike though.

Allison:       No, I was saying, she has been listening to your lectures [laughs].

Kirk:            Oh, gosh. Hey, we all think alike.

Allison:       She’s using your line on you.

Kirk:            Hey, and I know we only have about nine minutes left, but I got to say one last thing. This is the biggest thing. I’ve noticed this happening a lot. Please, again, if you have a pen, read this book, Younger Next Year. I saw this book just coming out and I saw it in dental office after dental office. It’s just a fantastic read and if you don’t want to read the whole thing, at least read to page fifteen. Everybody can read to page fifteen.

But he actually shows you a methodology for actually making your body biologically younger every year. Now it’s important to a dentist’s life because of this: health is everything. There isn’t anybody on this phone call that ever accounted or prepared themselves mentally for how physically, emotionally, spiritually demanding dentistry was going to be. There’s not one person on this phone call that ever said dentistry was going be so easy. You never bargained for how stressful dentistry was going to be. It’s extra stressful for the people on this phone call.

Let me tell you why. Because the words shade, shape, translucency, margin, those mean completely different things to you than the average dentist going to the state dental meeting. You put a crown in, and if it’s not right, you could physically harm yourself emotionally. I used to think that the prepping of the dentistry was the most stressful thing and I’d watch all this and I go, “Wow, that is pretty stressful.”

But now I think the seating of the dentistry is way more stressful, because I want to strap a heartrate monitor around most of the dentists I coach when they’re seating a big case. Because I have to believe that their heartrate has got to be up to about 145 beats a minute. If it’s not right, you see the ears get red, the vein comes out of the neck, and so it’s just really important that you give stress compensation. Stress needs compensation. It has to have compensation and when you don’t give stress compensation, stress will just steal it from the cells of your body.

People say to me all the time, “Well I don’t have time to work out.” I’m like, “Are you nuts? Are you crazy?” If you don’t work out, you’re going to die. You know? And it’s true, I mean you have to compensate and for those of you that do this you know, exercise is not an option when you get good at dentistry. You have to physically take care of your body because your income as a dentist is directly tied to your ability to move and think, to move and think. That’s it.

I went to … this is really cool, if you guys ever get the chance to go to the Cooper Clinic. I’ve known about the Cooper Clinic forever, I’ve never been, never gone. Well, my wife and I went in January. So we made our appointment, it’s the most comprehensive exam you can have on the human body, supposedly, in North America. So I thought, “Let’s go.” My wife and I, we’ve got four kids, I want her to be healthy, and I want me to be healthy.

The physician that we had scheduled for the day, her son was sick, and they apologized up and down. So my wife and I were going to share the same physician for the day. One physician, whole day, right? It’s $4,100 per person so there’s no insurance, it’s all cash, blah, blah, blah. It’s amazing, it’s amazing. Now, they apologized up and down and they said, “Let me make an adjustment, I promise you we’re going to take very good care of you.”

Well they actually gave me Tyler Cooper, the son. I had Tyler and Ken Cooper all day long. I was their only patient. Now, my wife went to another MD and she loved her MD but it was probably one of the best days of my life because we started talking, and philosophically. I actually got nervous for them because they spent four hours just talking to me and asking me questions and you could tell they were listening.

They said this, “People from all over the world with unbelievable amounts of money come here and they always say, ‘Make me healthy, keep me in the game longer.’” And they want a pill. “And I say the same thing to all of them, ‘You want your pill? Here it is, exercise and eat right.’”

Seventy percent of all disease we see, seventy percent, has to do with what you put in your mouth and how you move your body and he looked at me and he said, “You’re in the dental profession.” He said, “You guys are the gateway.” I said, “What do you mean by that?” He said seventy percent of all disease happens right in the mouth area. He said there’s nobody better positioned in the world to change people’s lives than you guys.

I said, “Really? You’re an MD that spends a lot of time … “ He said, “I’m not really an MD. I’m a doctor in proactive health. I haven’t dealt with insurance ever. I don’t even know what insurance is. I couldn’t even tell you honestly what medical insurance is because it’s all cash here.” He said this, he said, “Nobody spends as much time with these people as you do. What an awesome opportunity to influence people’s lives. You guys are the gateway.” I believe that to be true. I think it’s very powerful. The same message applies to us in the dental community, you’ve got to be able to take really good care of yourself.

I want to finish on one last thought and it’s this: you’ve all embraced the greatest profession ever because you can be the architect to an awesome life. I won’t tell you that it’s easy to create a successful practice. From what I’ve seen, it’s actually quite hard. You’ve got to look, you’ve got to think, you’ve got to move, you’ve got to be really organized. You got to have great mentors, great coaches, all that kind of stuff. Good habits are really hard to create but very easy to live with. Bad habits are really easy to create but very hard to live with. You notice that in dentistry all the time.

The last thing I’m going to say when it comes to that is this. Retirement is an absolute mess. I’m forty-three and I tell anyone who’s even close to my age, “Don’t even think about retirement. Retirement is not an option.” It’s just not. Because the whole idea of saving enough money and then living another thirty years on the money you saved, is totally impossible.

Now, there’s people that would debunk that but I talk to people all the time that have retired. Bill Lockard, many of you know him. Pankey Grey, he retired over ten years ago, and I talk to him all the time and he says the same thing to me, “Keep these guys working.” He goes, “Because I never realized, I could have practiced quite a bit longer. There’s a good chance that I could live to ninety-five.”

He said, “I never realized how much money I spend when I don’t work.” He said, “Get out of bed on a Saturday, Kirk, and go have breakfast with a friend. Then go golf. Then go to Costco afterwards. Then pick up your wife’s medications and your medications, because you have a lot of medications when you get to be my age. Then go have dinner with your wife. That can be a $1,500 day.” And he goes, “My retirement plan didn’t incorporate all this stuff and I guess I could stop doing all those things but I got to keep moving.”

And so, I say this, retirement is an absolute mess. Set it up in a way that you can practice as long as you can and try to treat it in a way that you can contribute to people’s lives and you’ll look back at an amazing life in dentistry. It’s funny, all my dentists over the age of 70 all work the same hours, that are still practicing. They all work 7:00-1:00, three days a week. They all say the same thing, “I’ve got to keep moving.”

My mom works in a nursing home and she’s a nurse and she says, “The one thing I say all day long on my shifts, ‘Got to keep moving. Soon as you stop moving, you die. Let’s go. You want to move or you want to die, you choose.’” Some of these people need tough love and she says, “I care and love for all of them but the ones that stop moving, they die.” So keep moving, that’s one of my messages.

Allison:       Don’t you think too, Kirk, that part of that is that when we stop contributing to other people and stop helping other people that … I think that’s part of that too.

Kirk:            Absolutely.

Allison:       The dying of the spirit if we’re not helping other people and contributing to them.

Kirk:            Yeah. I guess the other big … Allison, you’re so on the money, is this, I tell people all the time when they come to the first day of training for us, with us. We always say the same thing. There’s two types of practices out there as far as vision goes, there are people that do dentistry and there are people that change other’s lives. You have to pick because once you embark on the course of changing people’s lives, it’s not the same business.

I could never say to myself as a practice management coach, “I’m going to do a lecture and gosh I hope I sign up a few people and I hope somebody …” You know, I could never say that because that is just a short road. I spoke in Dayton last week and I got off the plane and I went to bed. In the morning, I say my prayer and I say this, “I hope I get to change somebody’s life today. Just one. Just one.”

You know what? When you can do that, you believe it, it starts to happen and the effect on it is what’s called the ripple effect. It helps more people than you could possibly imagine and that’s what we all have the opportunity to do. It’s very fun. We’ve been blessed to be in this profession.

Allison:       Cool. Thank you so much. Oh, somebody raised their hand. Let me unmute you. What did I do? I think I … let me unmute you. Javia? Am I saying that right? From Atlanta, Georgia?

Linda:         No, it’s Linda.

Allison:       Oh, it’s Linda. Hi, Linda.

Linda:         Kirk, how are you?

Kirk:            Linda, I’m great. How are you doing?

Linda:         I am awesome. What was that book that you were talking about to get to page fifteen?

Kirk:            Oh, Younger Next Year. There’s two versions of it. Chris Crowley is the author. I’ve actually spoken to him on the phone several times, I’m trying to get him to speak to our mastery club. We’re going to get him here, shortly. But it’s Chris Crowley, C-R-O-W-L-E-Y, he’s awesome.

He wrote two versions of the book. One is the yellow version which is for males. Please get this book. There’s a second version. The second version is the pink version and that is written primarily for females. So you want to get that book for all the females in your life.

Linda:         Awesome.

Kirk:            Yeah, I gave that book to even my in-laws. My in-laws have been reading it and they’re losing weight and it’s awesome. He says you can actually reach your peak fitness at age fifty-seven and shows you how to do that, which is very cool. Now it’s a great book for dentists, dental teams. It’s also a fantastic book to give to patients because as patients, you know, you want patients to take care of themselves. “Why should I get this dentistry done now?” Because there’s a good chance you could live to ninety-five. Awesome reading.

Now, I will warn you, if you have a sensitivity meter, don’t read it because he’s very straight to the point. Some people can be offended. He talks about all the things that you don’t talk about after the age of seventy, like sex, and all that stuff and he’s very honest about it and it’s great reading. So please read it.

Allison:       I think Linda is okay, aren’t you, Linda? You don’t have to worry about the sensitivity meter?

Linda:         [Laughs] I actually think my husband has that book. So I think he just needs to read it. So yeah, it’s great to have both of you on the line. I love you both. Great energy tonight, I loved the call, so look forward to the next one.

Kirk:            Yeah.

Allison:       Thanks, Linda, I’m so happy you came on.

Kirk:            So much fun.

Allison:       Kirk, I appreciate you so much. This was great.

Kirk:            Hey, I appreciate you too, Allison. Thank you.

Thanks for listening to Practicing with the Masters for dentists, with your host, Dr. Allison Watts. For more about how Allison Watts and Transformational Practices can help you create a successful and fulfilling practice and life, visit transformationalpractices.com.