Podcast appearances and mentions of gary well

Gary Kilpatrick is an expert witness who has extensive experience with automotive accident reconstruction. He has a degree in engineering paired with a lifetime of knowledge of industrial mechanics. Gary joins us for Episode #57 of the Personal Injury Marketing Minute! Visit Gary's website, The Kilpatrick Group, PA, here: https://thekilpatrickgrouppa.com/about/ or call 336-841-6354. See all episodes or subscribe to the Personal Injury Marketing Minute here: https://optimizemyfirm.com/podcasts/. Transcription: Introduction: Welcome to the Personal Injury Marketing Minute, where we quickly cover the hot topics in the legal marketing world. I'm your host, Lindsey Busfield. In the personal injury world, the majority of your cases will be settled out of court, but there are some of those complex cases that will require mediation or court proceedings. In those cases, you have already invested long hours and countless resources to build the best case possible, hoping that there will be a big payoff at the end. Part of building that case might include the involvement of an expert witness. If it does, you want to make sure that you are leveraging that asset to its full potential. We are going to talk about how to do just that. Gary Kilpatrick is an expert witness who has extensive experience with automotive accident reconstruction. He has a degree in engineering paired with a lifetime of knowledge of industrial mechanics. Thank you so much for joining us today. Gary: Yeah, it's good to be here. Why Did You Become an Expert Witness? Lindsey: Well, tell us briefly why you decided to become an expert witness. Gary: Well, back about 2000, 2001, I read an ad in our local newspaper where University of North Carolina at Charlotte, UNCC, was hosting a presentation on the introduction to forensic engineering, and so I signed up. I was curious, so I signed up, and it was an eight-hour presentation. Dr. Young, who is a civil engineer, may or may not be there anymore, but he's got a PhD in civil engineering and is a licensed professional engineer, and his presentation was mainly for the civil world, but I could see how it would be applicable to other areas. And so at the end, he gave us a book, and I've still got that book today. At the end of the book, there are a couple of pages of references, one of which had different professional societies that we could go to for more information, one of which was the National Academy of Forensic Engineers. And so I contacted them and I spoke to the founder of that organization, Marvin Specter, and we talked for a bit and he encouraged me to join and become at that time a correspondent, and they were really the mentors behind how I got really more involved in this profession. Lindsey: What types of accidents are you routinely providing expert witness services for? Gary: Well, being a mechanical design engineer, it allows me to work in different areas. One is going to be motor vehicle crash recon, because as the engineers and the engineering dynamics and all the coursework we take, that goes front and center right down the list of everything that they talk about, and they get into the conservation of laws of linear momentum, work dealing with things sliding across a surface, kinetic energy and so forth and so on, and all those concepts are used to calculate the impact speeds of two vehicles coming together. I'm also heavily involved in industrial accidents, because I've got 20 years plus of experience working in the industry, one of which was where I worked for Clark Equipment, who invented the forklift and the front-end loader, and they were a major competitor to Caterpillar back during that day. So, I'm heavily involved in industrial accidents, dealing with OSHA regulation, machine guarding, forklift accidents, crane accidents, and amusement park ride accidents, because they are machines. And let's see if I missed anything. Mobile elevating work platforms,

John Burns co-authored Big Shifts Ahead: Demographic Clarity for Businesses, a book written to help make demographic trends easier to understand, quantify, and anticipate. Before founding John Burns Real Estate Consulting in 2001, John worked for 10 years at KPMG Peat Marwick—2 as a CPA and 8 in their Real Estate Consulting practice. John Burns founded the company to help business executives make informed housing industry investment decisions. The company's research subscribers receive the most accurate analysis possible to inform their macro investment decisions, the company's consulting clients receive specific property and portfolio investment advice designed to maximize profits. Gary Beasley is CEO and Co-Founder of Roofstock, the leading online marketplace for buying, selling and owning single-family rental investment homes. Recognized as a leader in the future of real estate, Roofstock was featured on Forbes' 2019 Fintech 50 list. Gary has spent most of his career building businesses in the real estate, hospitality and tech sectors. After earning his BA in economics from Northwestern, Gary ventured west to earn his MBA from Stanford, where he caught the entrepreneurial bug and still serves as a regular guest lecturer. Immediately before starting Roofstock, Gary led one of the largest single-family rental platforms in the U.S. through its IPO as co-CEO of Starwood Waypoint Residential Trust, now part of Colony Starwood Homes. In this episode, we discuss the current state of the real estate market and the economy more broadly. Gary and John share their thoughts on what has been happening year over year in the housing market; what 40-year highs of inflation, rising interest rates, and geopolitical unrest mean for real estate investors; and highlight some of the risks that investors are faced with today.    Episode Links: https://www.realestateconsulting.com/ https://www.linkedin.com/company/john-burns-real-estate-consulting/ https://www.linkedin.com/in/gary-beasley-956647/ https://www.roofstock.com/ --- Transcript Before we jump into the episode, here's a quick disclaimer about our content. The Remote Real Estate Investor podcast is for informational purposes only, and is not intended as investment advice. The views, opinions and strategies of both the hosts and the guests are their own and should not be considered as guidance from Roofstock. Make sure to always run your own numbers, make your own independent decisions and seek investment advice from licensed professionals.   Michael: Hey, everyone, welcome to another episode of the Remote Real Estate Investor. I'm Michael Albaum and today with me I have two very heavy hitters in the real estate space. John Burns, CEO of John Burn's real estate consulting, and Gary Beasley, co-founder and CEO of Roofstock. So without further ado, let's jump into hearing their thoughts and opinions around what's been going on in today's real estate market.   John Burns and Gary Beasley so happy and excited to have you both back on the podcast. Thank you for taking the time to hang out with me today.   John: You bet.   Gary: Hey, Michael, great to see you.   Michael: So I of course, know a little bit about both of your backgrounds and who you are. But for those of our listeners that might not be familiar with who you both are, if you could give us a quick two minute, two second intro of who you are, where you come from, and what it is you're doing in real estate and John, if you want to go ahead and start, that'd be great.   John: Okay, I'm the CEO of John Burn's real estate consulting, I founded it back in 2001, to figure out what's going on the housing market for a lot of people, mostly big companies and that's what we do.   Michael: Love it and Gary?   Gary: Sure, I am Gary Beasley, I'm the co-founder and CEO of Roofstock and we've been at this for about six and a half years now. Building out really the complete ecosystem for single family rental investors and I've known John now, I think, John, since about when you started the company, it feels like we've known each other for a while we when we I think when we met we we both had dark hair. Remember that?   John: It's been a very long time.   Michael: That's great. Well, I wanted to chat with you both around a lot of things that I've been getting questions about, and I'm sure that the two of you have as well and that's just kind of what's been going on with the housing, market and economy over the last couple years since the pandemic started. So I would love to just jump into things get into the meat and potatoes and get both of your thoughts on really year over year, what's been going on at the macro level in the housing market.   John: Well, I guess I go first, if you let me go back maybe three years, so but pre the pandemic because I think it's relevant. The housing market was extremely hot. We have a different view than a lot of people on on how undersupplied the market was, we don't think it was I just applied at all actually until about 2019, then it started to be under supplied and with interest rates. So damn low everywhere in the world, people had figured out that single family rental housing was a great investment just to get some yield and we were seeing a lot of investors come in to the market, then COVID hit so you know investors are very volatile. They stopped for a few months, and then they came back very strong and probably the biggest difference in the last year is the fear of inflation has piled in on top of the need for yield and it's double the reason to invest in rental homes. So we're seeing money from all over the world focused on housing in America.   Gary: I would agree that clearly the residential market has been booming and I would say despite a number of factors that you would have thought might have slowed it down. We went through a global pandemic, and housing chugged right on through and we could talk later perhaps about why some of those things happen. But the reality is really kind of across price points and geographies. You've seen robust demand for housing and if you look at price increases year over year, John, I know you track the SFR space really closely and it kind of mirrors what's been going on even if you look at owner occupied sales, but home prices have been going up call it 15 plus percent, year over year, pretty consistently. That's a big number, when you think about historically, it's been about 4%. If you go back 40 years on a compounded basis. That's how it had been up until fairly recently.   So a lot of you know in rents have lagged that a bit but you've seen high single digit to low double digit rent increases as well in a lot of these markets and so in oftentimes, I feel rents are a little bit of a lagging metric because especially a lot of the mom and pop owners don't raise rents every year don't raise them, really even to market so we're seeing a lot of homes come to market today that have rents that are 10 or 20%, below where the markets are today. So, so you've got just a lot of demand for the product and, you know, we're at an interesting time now, and I'm sure we'll talk about, you know, some of the current dynamics in the market, interest rates have moved up quite a bit in the last, you know, month to six weeks, we've got a lot of interesting things going on geopolitically, we're not yet seeing that impact, demand or pricing. One would think that those factors should that have an impact over time. But for now, I think just the supply demand dynamics very, very much in the favor of demand over supply.   Michael: Okay. Interesting and I'm curious to get both of your opinions on this, I mean, we are at such a unique time, kind of in history and curious to know your guys's thoughts on do you think that real estate investing fundamentals have it all shifted because of where we find ourselves today? John, I'll let you go first on this one.   John: I don't know if the fundamentals have shifted, because I've seen this game before. But what is different is that by investing in rental homes has become a very easy thing to do, thanks to Roofstock and others. I mean, prior to 2012, you couldn't get on your computer and figure out exactly how much a home was worth and how much it could rent it for in about five minutes, you can now there's all sorts of vehicles where you can invest in funds and completely passively invest in housing and I think it's become an asset class that really was very illiquid, and pretty lumpy before that now has become more liquid and I think that is a permanent change in the market, doesn't mean things can't go down. But I think it's actually had a permanent positive increase permanently on home prices.   Gary: I would agree with John, I don't think the fundamentals, I don't think the fundamentals of real estate investing have changed. But I would say perhaps some of our maybe preconceptions or assumptions about how it would perform is I kind of mentioned earlier, or maybe a little bit challenged, and that there's just so much demand for the product and in the pandemic. You know, it was almost counterintuitive that home prices would go up and rents would go up. But when you think about the fact that people really demanded shelter, safe shelter, and there was an exodus of from a lot of the coastal cities to secondary and tertiary markets drove a lot of that demand. So but I think still, the fundamentals of real estate are very much about location and supply and demand. Those things, those fundamentals I think are true. I think one of the things we're seeing though is perhaps there are different things get that can drive, demand and pricing for different types of real estate assets. So if you look at for example, housing, and industrial, which have done quite well, throughout the throughout the pandemic and the aftermath, and then you had some real estate asset classes that really suffered, because you look at office and retail and and REIT in hotels, things like that. So it's it. I think real estate broadly can be influenced by different things. The fundamentals of each have to be examined, but certainly for housing. It's been it's been very strong, despite what might you might have considered some some headwinds.   Michael: Okay, interesting and you both touched on inflation in the conversation thus far and so I'm curious to know, how much of the demand do you think is being really driven by inflation? And do you think that folks are right or wrong to be considering real estate investing as a hedge or as a defense against inflation?   John: People's expenses are going up and your investments should beat inflation and nothing in the treasury market does it in fact, nothing in the high yield bond market pretty much does it now too, I don't know how you earn returns. But this was going on pre COVID and that's why I mean that there was a surge of money coming into the market pre COVID. We at our conference at the end of 2019, we had Bruce flat, the CEO of Brookfield asset management, who at the time manage more than $500 billion was fundraising all over the world and he literally said that this is the most significant thing he seen in the last 15 years, is everything that produces cash is gonna go up in value, and that was pre COVID and so that this this has just got even more accelerated because inflation wasn't even part of the equation. Now if you're now if you need to beat inflation in your return and inflation is right now the latest print is seven 8% where you're going to get seven or 8%? And so housing, if wages go up which they are, you can raise rents, if the cost of the structure going up is going up, which it definitely is, every single component in the house has gone up, their cost of construction has gone up at least 10% in the last year. That's an inflation hedge too, because nobody's gonna replicate what you own for the same amount of money. It's very much an inflation hedge.   Gary: Everything points toward continued inflation, in my view in the housing market. Now, that being said, interest rates going up, you would think should moderate that. That's an offsetting influence, but the cost of the inputs, the labor and the materials, clearly upward pressure, everything that's going on in the world, disrupting the global supply chain, and the cost of transport and all that putting upward pressure, Pete wage inflation to keep people in their seats, and to hire people. That's allowing people to have more and more money to spend on housing that's also pulling pricing up. It's hard to see how much that's going to, in an absolute basis reduce the price of housing, I do think that we will see some moderating of the rate of inflation of homes over the upcoming quarters and years, I think that 15% is gonna come down naturally. But I don't see, I don't see it coming down to the point where it actually reverses and you see absolute price declines, like we saw in that really unusual time in the Great Recession, which was, arguably a once in a generation adjustment to housing prices there. I think, a lot of fundamental differences between what we're seeing today and and what we saw back then this is not a credit bubble.   John: So I agree with everything you said until this is not a credit bubble. I mean, maybe you meant a credit bubble on housing, because I agree with you.   Gary: That's what I mean, I mean that there's a lot of embedded equity, as opposed to people, you know, having 3% or less equity in their homes, they've got 20 plus percent equity. Now, you can talk about the I wasn't speaking to the global kind of free money, credit bubble, but…   John: Well, that's a I think there's a credit bubble going on in the world on pretty much everything else. I mean, Dodd Frank, made it impossible to do it on a mortgage going through a bank. But people are lending against crypto, it's the highest borrowing and stock prices ever. We're seeing deals even in single family rental that well, I would say are being done with pretty much no due diligence, because it's a mess piece. So there's a little bit of equity in front of me and what I worry about is a recession caused by a credit bubble outside of the housing market, which impacts housing demand and you know, that's when housing was struggle, but I think everything else in the world would struggle at the same time, maybe even more, so. So I'm not, I'm not saying get into stocks or bonds, because it's just that, that that's what caused the great financial crisis, and it was housing last time. I think it's other stuff this time. We were seeing flip flipper loans are being securitized on Wall Street. I mean, there's, you know, I see that in my business, one of my clients is lending against crypto balances. You know, I think another famous person just came out and said, if you've got if you can put up crypto, I'll give you the value of your crypto to make a down payment for a house, that there's some different stuff going on. That concerns me but not on buying rental homes or Roofstock more concerning on the economy.   Michael: Okay and so curious, John, just, you know, personal thoughts. What's a good defense?   John: You know, normally it would be cash, but holding on to cash it goes down 7% in a year. So I think Howard Marks who's a famous investors calls this an everything bubble. We're in an everything bubble right now and how do you invest in an everything bubble? I have no idea. That's why I run it…   Gary: Maybe maybe negative interest rate German bonds don't seem so crazy.   Michael: Yeah.   John: Well, no, exactly. So, so if you're, if you know, in the coming world, losing 3% is probably a good deal relative to everybody else if that's if that's how that plays out.   Michael: All right, well, keep both you keeping your eyes and ears peeled and let me know if you hear something great for hedge against the everything bubble, I'd appreciate it.   John: Well, it's it's still specific. I mean, that that's what the smart people aren't doing. They're just, they aren't going to do just a sector. They're looking at everything carefully and in this industry, if you don't have a lot of competition going around where you're making investments, that's a far safer place to be if there's some great job growth in your conference. In a job growth because those employers are profitable and making money and going to be there all the time, that's a different story than the job growth being in a sector that's currently losing money, for example.   Michael: That makes total sense, that makes total sense. I'm curious if we could take a step back and understanding that neither of you work for the Federal Reserve, but I'm curious to know your thoughts and kind of get some insight into? I mean, you talked about the wage growth going up, and then the cost of goods and services going up? How do we not get into this upward death spiral? And I know, Gary, you mentioned, you know, raising interest rates could curtail that, but it seems like there's just so much money out there how to, how do we kind of ease down from this?   Gary: Yeah, well, I think there's it I don't know, if there's been a tougher, it's never easy being involved with setting Fed policy, but you have a lot of things to balance here. This is a tightrope act. So you want to slow the economy here, enough to curtail inflation, yet, not necessarily throw it into a big recession, you've got a lot of things going on overseas, that should you could argue are already going to cause things maybe to slow a bit because of what's going on over there. So do they need to pump the brakes as much here. So maybe that means that the Fed doesn't raise as aggressively here and what that may mean is, you know, rates grow a little bit more slowly and maybe the economy tends to overheat despite the global weakness. So it's a really, really challenging balancing act, I think that the Fed is under enormous pressure to curtail inflation and so I think, despite that, we'll probably err on the side of pumping the brakes a little bit heavier, even though that may mean we're risking recession. That would be I'd be curious, John, if you have a view. But if I had to, like on the continuum of what they're more worried about right now, normally, they're, you know, I would say that they've been historically more worried about not wanting to put us in the recession. But we've never, in a long time had these sort of inflationary pressures and in particular, where I think people feel it, it seems to be at the gas pump, right? We're always talking about fuel prices people feel that very deeply and there's a lot of political pressure, even though the feds, in theory, a political, political pressures tend to work their way into those decisions.   John: Yeah and my 30 plus years of paying attention to this, I've never seen the Fed more politically tied than they are right now. They frankly, they seem to me to be puppets of elected officials. I mean, the fact that Powell had to announce for months and months and months, they were going to raise rates, but never raised them once until he got reappointed will tell you something. So I mean, I always honestly think it seems to me like elected officials are calling the shots right now and I think the ultimate fear is a recession or we want to get inflation down, because inflation isn't good either and then, you know, the way I think about this, too, is there's, if you really talk about people's true costs, there's a huge variation in inflation. So if you're a homeowner who owns your car, you know, your your housing costs haven't gone up at all, maybe you got a little bit of a property tax reassessment, you haven't had to go back and purchase a car or release a car and if you are close to work or working from home, frankly, your cost of living might be down over the last year or two.   If you're somebody who's commuting to work, Rance had to you know, really your lease was up had to get another car. I mean, your cost of living can be up to 15 to 20% and the Fed seems to be focused on those people, rightly or wrongly. But that that's how I'm thinking about this is it's a huge difference in what's actually happening depending on what you are, and then the wage growth. You know, if you're in the hospitality sector, you haven't seen anything. But if you're a construction worker or a truck driver, your wages are up dramatically. So and those are the ones I that we're seeing that are buying homes, renting homes, people that are affluent, able to work from home, hey, I can I can now go out to the suburbs and rent a really nice house and my housing costs are gonna go down, not up because my boss says I only need to come into work twice a week. So it's it's very complicated story on picture painting here, but that's exactly I think how the Fed is looking at it.   Gary: Yeah. And then you also have, obviously those who own assets versus not I mean, this is similar to what John was talking about, but not only can you have the cost of living impacted a lot, a lot less if you own your assets. But in fact, John, you may know this figure I read it, I think last week, some fairly sizable percentage of the US population made more off of their homes this year than they did from their jobs. The power, the power in an inflationary environment of owning assets, it's kind of hard to overstate it. That I think one of the reasons, I think we're seeing more and more kind of first timers wanting to own their first investment property, even if they aren't in a position to own the home they're living in right now. Going to some of these lower price markets, and getting on the ownership bandwagon and just writing that asset appreciation. It's, you know, it's a powerful force.   Michael: Yeah, absolutely.   John: I think you were going to say, it's a powerful drug.   Gary: Well, some people do become addicted to it…   John: We're starting to see that. So people are taking the $200,000 in price appreciation of their house with a refi out of their investment, and then using it to buy three or four more homes, right, that that's what's going on right now. So it is it is addictive.   Michael: Yeah. That makes total sense.   Gary: Yeah. Well, it's been it's been a, a tried and true, a tried and true way for real estate investors to make money, right is to buy that first property, refinance it, take that money, buy more properties and build. But I think, John, to your point, what's happening is, a lot of people are doing that with their primary home equity to get started, as opposed to being more of the intentional investor who just started to do that, I think more and more people are doing it with, you know, equity in their homes, which I think in many ways makes a lot of sense from a diversification standpoint, rather than having so much of your wealth, personally tied up in a single property address, where you happen to live, where you're really subject to the vagaries of your local real estate market, local job market, all that kind of stuff, because that's where you tend to work to diversify into other markets and other assets, I think does make a lot of sense.   Michael: John, would you agree?   John: Yeah, no, diversification makes a lot of sense. I just, I also think it makes a lot of sense to watch how much leverage you've got and to make sure you've got the cash flow, you know, just in case something bad goes wrong. And I think people that are investing like that, and doing exactly what you're saying, are going to be great. But last time, what we saw was, people just were ignoring that and then you lose your job, and then you lose your tenant, and you're your host. So you got you got to be careful here and I think the more I'm a generalized a little bit here, but the more mature people that have seen this before doing that, and I'm sensing the younger people only think home prices only go up and I are more willing to take more risk than I would recommend.   Michael: John, kind of to that point. I'm curious to get both your guys' thoughts if someone is taking out equity their home, because interest rates are so low, and they've seen the value go through the roof and they're going to go buy investment properties. What's the harm? What's the risk there? I mean, and how does someone know if they are over leveraged? If their cash flow is covering their mortgage payments? I mean, if the value dips, nothing really changes for them from a payment standpoint. So how should people think be thinking about being over leveraged or how much risk is too much?   John: I mean, that's a very personal decision for folks. You know, confidence in your employment situation is probably the most important thing and depends on what you do.   Gary: Yeah, I think, Michael, I mean, to your point, as long as they think it is an important point, in a rental home portfolio. Yeah, even if prices drop of that home and you've got a fixed mortgage, your payments don't change, right and unless rents come down, which they traditionally have not, they tend to be more sticky in single family rentals than say in apartments. We followed a lot of that data over time. So you should be okay. Even if on paper, the value of your home, your rental home has gone down. But I think in the primary residence, which is where John I think was going is if you let's say you have you know, 60% equity in your home and you lever it up to 90 through various means, then all of a sudden, you may be at a point where if you lose your job, and you don't have the reserves, you may be in a little bit of a tougher spot because you don't have that home equity to tap, which historically has just been a really nice thing to have as as a safety net and so when that if that were to happen you might have to sell some of your other properties or you have your equity elsewhere and it's not like you can't necessarily get at it.   But I do think in times where you do have some uncertainty, some global uncertainty and some things like that, having some reserves, make sense, not being over levered, make sense, play the long game, I think that's one of the things that we talk to people a lot about is, this is not a, you know, get rich, quick fix and flip, you know, strategy when you're buying investment properties?   Michael: Are you serious?     Gary: So over the long run, Michael, you're going to do just fine. But you have to be patient. So no, but there's plenty of there's plenty of ways you could make bats to win quickly win or lose quickly. But that's generally not what people are doing with us and I think there's times when people are more risk on is a lot of confidence to maybe lever up and things like that, I think this is a time to be more a little bit more thoughtful about all about leverage ratios and so yes, you give up some levered return, potentially. But if you're in a, I would argue if you're in a place where home prices are going up at such an extraordinary rate, you don't need as much leverage to get a phenomenal return. Even if you're only 50% levered, and your home's going up seven or 8% a year, that asset level, you know, obviously, you're doing much better than that, and the return on equity level, so I would say just don't get greedy. It's a long game and you know, make sure you're, you're around to, you know, fight another day, in case there's any sort of corrections.   Michael: To play the end of the game.   John: I mean, that that's the perfect, that's how I see it, too, is cut the long game. And that's how everybody who's been doing this for decades will all tell you that that's exactly the way to play it. I am I am seeing and hearing and running into 20 somethings who aren't listening to Gary's advice and I have no idea if that's 1% of the market or 40. But they're out there and fortunately, they're not getting loans from banks that 90% LTV, at least that I can find, so that's, that's good.   Gary: I mean, Michael, you talk to a lot of people all the time, what is what is your assessment are people do you think people are thoughtful about this? Do you think that is? Do you agree with John, that people who might not have seen a down cycle might be overly optimistic or do you think that they're better informed?   Michael: Yeah, you know, I think it's really a mix of the two, I think that there are two big camps. One camp says this is going to go on forever and that tends to be the folks that haven't seen a recession before and then there's the folks that say, you know, we're it's got to come down at some point and so let's just kind of see what happens and those tend to be the more seasoned folks. So I'm curious, I'm curious to get your guys's thoughts on for those two camps and someone who's just trying to get started trying to get their foot in the door? How should they be thinking about that, is this something that they can kind of catch on the upswing or is do they really need to be a bit more timid and reserved and say things are maybe a little bit too hot right, now let me let me just take a seat on the sidelines and see how this all plays out?   John: So we've been calling this the high risk high reward the part of the cycle now for 13 months. So I would have told you 13 months ago to be cautious and the person who would have taken a lot of risk what I made far more money than the person who listened to me so but that's how these things play out at the end at the end of the cycle. When you take a lot of risk you should make a lot of reward right? But you know, you also need to know when to take some chips off the table you know, unless you believe we're never going to have a recession again which I don't believe that and then also what Gary said has been very true for single family rental rents. The rents have been very stable over time compared to apartments because there's basically been very little construction of rental homes forever and there's always been a ton of construction in apartments and that's when you get hurt killed is when you know three huge apartment complexes open up down the store down the street totally empty and have to lease up 500 units you're done that even though billed for rent is growing pretty significantly in Phoenix right now it's still a lot smaller level of supply than apartments. So this is a more stable investment than comparative some other rental classes for sure.   Gary: Yeah, it's it's really we like to say it's a lot easier to go up then sideways because if you could you go vertical with apartments and it takes a lot more land and it's typically much more difficult to add the single family rental supply and then over time, you also have more than one on exit on the on the rental homes because you could you could exit to a yield investor or ultimately, an owner occupant. So that's I think one of the things that I've always liked about single family rentals is you've got built in optionality. It's very rare in a real estate investment, to have two very distinct buyer sets on the back end, right. You have an office building, you're going to sell it to an office investor. Same with a hotel, they would, but so this is, you know, I think a unique aspect of single family rentals, which gives, you know, it kind of gives investors a bit of a of a hedge.   Michael: Yeah, that makes total sense. Curious, what do you tell investors who come to you and say, John, Gary, you know, I can't seem to break in, all my offers are getting outbid by all cash offers that are 10 to 15% above asking, I can't go that hi, how can I get my foot in the door? What should I be doing? What tactics should I be using?   John: I mean, I might be the wrong person to ask because my clients tend to be very large companies, and this is for their capital partners, this is less than 10%, or maybe of what they're investing in the spectrum of certainly less than 20%. So they may be all in in this industry. But it's it's not, what you're alluding to, is maybe somebody with 100% of their net worth or 80% of their net worth getting in. That's, I don't advise on that, I mean, people are building rental homes, with the appropriate amount of leverage in good locations. That's where we're coaching people to go, there's also people building rental homes, with a lot of leverage in tertiary locations, right, where there's a lot of other construction going on and that that would be to me a higher risk scenario. I think I think there's room for 100 unit rental community, brand new built in every city in America of size, because you can pull it there's 1000s of people that rent ratty old homes with lousy landlords, and there's a percentage of them that would really love to rent something new. Well, and what's your biggest fear is the tenant that said, they're going to sell the house you live in it, you're gonna have to move out? Well, you know, if you're in a rental community that's owned by a public REIT, they're not selling the house, you know that that fear is gone. They may charge you a little more, because it comes with better service and other things. But I think that's a tremendous long term opportunities to build rental homes.   Michael: Interesting perspective, Gary?   Gary: Yeah, well, I would say, people should do their research, and be patient, be opportunistic, but but not be afraid to act with conviction when they find things that make sense for them and so I think, what we find is, on Roofstock, a lot of times people will come and they will look at properties for months and months and months and talk to people and kind of develop their strategy and eventually, something is going to hit your radar, that's going to check most of the boxes and in this market when that happens, as long as you've done enough work to kind of know this, then be ready to act, you know, I wouldn't recommend somebody come and buy the first home they see because then you're not you just don't have enough data. But when you see where these things are trading and all that, and so that's why I say you know, be disciplined, but also act with conviction, when you find something that does work if you do want to get exposure.   Otherwise, you could sit back and just sort of watch things. But you can also wait a lot of times with stock market, also people want to buy on a dip and just wait, maybe there is a little bit of a correction and that could be a time for people to want to wade back in. The challenge with waiting for a dip is, as John pointed out, there just hasn't been even throughout COVID there's been no dip, it's just, you know, been up into the right and, and so, you know, I don't recommend people just, you just buy because of the momentum, right? You want to, again, you want to feel good about the markets you're buying in and the home that you're buying. But also, it's really hard to time a market. It's just it's almost impossible. So heard that that's why overtime, we recommend people not, you know, even if you're only in a position to buy a home now once but, you know, have a design to own a portfolio of them over time and buy them at different points in the cycle and over time you get that market exposure. It's just, it's hard to time your ins and outs perfectly.   Michael: Yeah, yeah. Okay, cool. Well, I'm curious now to get your guys' thoughts and opinions looking forward, which I know is always a dangerous thing to do, but I'm going to ask you both take out your crystal ball and in talking, John, you mentioned about new newly built homes built to rent communities and so I'm curious to hear your opinions around, if the housing starts that we're seeing, since COVID, are going to have an impact, you know, several years down the road 8-10, you know, 5-10, eight years down the road, kind of like we're seeing now, as a result from the 2008, lack of home starts.   John: Yeah, we've done more research on that than anybody else. There's a couple people with some very simple analysis that says we're short, about five to 6 million homes. I think we're short about 1,000,007, which is still a lot of homes and that's not the same shortage in Buffalo as it is in Dallas. So you know, this is we've got the numbers by market. But at a high level, if we're short, 1,000,007 homes, there's 1,000,007 homes that have brand new homes that have paid for our permit that haven't been finished yet. So we've got all of that under construction and it's taking about nine weeks longer to build a house for the best production builders in the country. So this is taking a very long time, so it's going to be at least a year before we satisfy that, because there will be some growth along the way, too. So I'm not what is different about this cycle is the lack of construction. But what I want to point out is there's this notion that the low level of supply just means that this is almost a sure thing and I think the most important thing for housing has always been job growth always, even rates can go up dramatically. But if everybody's got their job, okay, we're, you know, maybe prices will be flat for a while, but we'll be fine. It's when you see massive job losses that we cycle down hard.   So that's why I was I was bringing up earlier the whole credit cycle issues. You know, know, if we if we knew exactly how much debt every company had in every industry had and how much they could cover their cash flow, I think I'd have more certainty. Some analysis I've seen is there's quite a few publicly traded companies that aren't currently generating enough cash to pay their debt service. That makes me concern they're not in the housing industry. In fact, the homebuilders have never been better capitalized like, they're amazing. They have the lowest debt levels ever and the bonds that oh, yeah, and the bonds they borrowed, they don't mature for like four or five or six years. So I mean, the homebuilt talk about a safe play, in terms of going through the cycle, I think it's the builders. I'm not recommending stocks, because I don't do that for a living, because I think all of this is priced in. But I'm telling you, publicly traded home builders are very, very strong, right now.   Gary: Yeah. You know, it's interesting, because John does such good research. So I have no reason to doubt the million seven. But I have seen, you know, estimates between four and 6 million homes deficit in in. So I don't know what the right number is and I'm sure that the method, there's methodologies that but but it's still, it's a couple of at least a couple million homes. The question is what, you know, what does that mean, going forward? Do we catch up as quickly? Can we catch up in a year or two?   That's, I think, optimistic. I think it'll be interesting to see if we do. One of the things that John mentioned was job growth, and that historically has been a real driver. What I think is so interesting now is jobs are so distributed and because companies are adding jobs doesn't mean the jobs are going to be where the companies are located and that kind of makes everyone's head explode. If you're trying to forecast, what's the impact of job growth, it really comes down, arguably, more to population growth. So local jobs are one thing and some things have to be localized, right? If you're going to work at a hotel, the hotel is in a particular place, if you're going to be a software engineer, working for Apple, you know, maybe you could be anywhere or any of these other places and so it's a it's a different calculus than I think it was 10 years ago of treatment, trying to forecast job growth from companies and then okay, well, people are going to need to live within a 30 minute commute or 45 minute commute it that's all upside down. So I think it does bode well for some of these secondary and tertiary places that have seen disproportionate growth. But then you also have these places like in Austin that continue to explode and arguably housings no longer very affordable but they keep building more houses and people keep buying them and keep renting them and there's plenty of land in a place like Austin and so I think almost looking at where taxes are low, and people can still get relatively affordable housing almost seems to be more powerful than local job growth. But I'd be curious about, you know, John's view of that.     John: No, he's right. There's a there's a large sector of the economy where you can live wherever you want and I mean, we, we've been doing this since before COVID, as I was never, never believed that all the best people to hire on the world, we're always within commuting distance in my office. So we've been hiring in good locations, and but you got to get the right person who can do that and companies have figured that out now. So your it is about a great location, it is about where I can get a lot of house for my money if I'm a tenant, or if I'm a homebuyer or I can pay lower income taxes, or I can have better weather. So it's really the same place as people were moving pre COVID. It's just more people have been given the permission to move. So you're right, the job growth. It's pretty correlated to the metro area. But I would say the more outlying areas should see more price appreciation, and they are seeing more price appreciation right now, because more people are being allowed to go there.   Michael: Okay.   Gary: Yeah and it's almost interesting. It's a little bit like the job, the jobs are almost coming with the people. So you think of a place like Boise, Idaho, where people move there not for jobs, necessarily, but because they could bring their jobs with them and they all had all this embedded equity in their homes for more expensive markets. So now you have all these people moving into a market like Boise, and you get incredible growth in the prices of homes in Boise. But now people are working from Boise. So are those jobs created in Boise are there jobs that now exist in Boise because it was inexpensive, and it's a nice place to live?   Michael: Yeah, I was gonna ask John, does that make it kind of squirrely to nail down that job growth metric because of this new phenomenon?   John: Yes and no, so there's two jobs surveys, there's one where they call the employer and said, how many people did you hire this month? That's based on where the employer is located. But the one where they call people and say, are you looking for work or not, that comes up with the unemployment number, that's where you live. So actually, we always triangulate the two. So I'll use my example. So we perfect example, I'm in Orange County, California, we hired somebody in Boise, but she could live anywhere. She's showing up on my here in Orange County on one survey, and she's showing up in Boise and the other, so you just you need to look at both the sample size on where the company's located is higher and better and the unemployment number at the Metro levels more volatile. So you got to look at a trend over time and not just overreact to a month or two.   Michael: That's super interesting. Okay, and great to know, too. So, the last question I have for you both, and I think I already know the answer. But for everyone listening, I'm gonna ask on their behalf and your guys' opinions, have there been asset classes that have become more valuable and less valuable as a result of the pandemic and if so, what, in your opinion, are they?   John: You can handle crypto, Gary. I am not going to touch that one.   Gary: Why don't you start then?   John: As I as I said earlier, I think new technology which was not around prior to 2012, has allowed the single family rental business to just blossom permanently And it's, it's now gonna be a permanent part of people's portfolio passively investing in real estate And that has already pushed up prices more than it would have been going forward. Whatever price appreciation would have been otherwise, it'll probably push it up a little bit more. The only thing you have to concern to certain yourself where there is, you know, the government doesn't like that And they tend to be pro homeownership. So you gotta watch regulation. I am seeing a lot of our clients tend to avoid California because they're afraid of rent control. So and there was just a Bloomberg article that 12 Different states have had rent control proposed because of all of this. So you just got to keep your antenna up on on that side. But the rent control is being proposed seems to be more reasonable. It's at the rate of inflation or maybe 1% higher than that, that you can raise rents. It's not, you know, zero or something ridiculous.   Michael: Okay and what in your opinion has been devalued or become less valuable, if anything?   John: Um, I can't think of anything that's become a …Cash!   Gary: It's it makes sense, right? I mean, you're you're losing. I mean, John, John mentioned, if you're literally if you have money sitting in your checking account, right now it's point 001% and we've got 678 percent inflation, that's how much you're losing by sitting in cash and so that does create a risk incentive to put it somewhere. And you know, I would say, Michael, I mentioned this earlier, but I think housing and industrial, which is driven a lot by distribution for E commerce, a lot of those have been really darlings of, of, for investors, they've become very much in favor and I do think you're still seeing some challenges with in some questions about office space demand and you know, not that there aren't always office investors, and there are always going to be people in offices, but there's probably structurally some percentage of less space that companies are going to utilize and so that puts maybe some uncertainty into the minds of investors, if there's another I think, I think a lens people investors are looking at today is okay, there's going to be another pandemic someday, what are the likely implications of this and, you know, office, retail, traditional retail was hurt by the pandemic, but it was also being crushed just by Amazon, right, and so you, so that's, I think, got its own challenges. And then hospitalities is very cyclical anyway, if people stopped traveling, you know, they didn't travel for a while.   So those those I think are, you know, maybe a little slightly more challenged than housing, which is, which has proven to be much more resilient than, than I think most people thought and, as a consequence, you have a lot of a lot of investors, not just, you know, traditional or not just individual investors or institutions from here. But yet people from all over the world saying, well, US housing looks pretty interesting, relative to other places that they could invest.   Michael: Yeah.   John: There's something we take for granted here called Title laws that don't exist in other countries. I mean, people in other countries don't want to buy real estate there, because the government could take it away from them. You know, and I hear that from foreign investors. That's one of the things that they love about investing in America.   Michael: Pretty scary notion if you had to be overseas   John: …Or get I should have mentioned everything that Gary said to I mean, there's a lot of huge funds, pension funds, who like to put a percentage of their assets a 10% in real estate all the time, and it would traditionally go into retail and office and hotel. Do you think they're ever going to go back to the same percentage of retail hotel and office? Probably not, it's going to be far more in this business. Because retail is now industrial. I mean, it's a warehouse and in line, you know, the best retail centers are all going to be fine in the best locations, but they're in line space is dead. So, so you're right, that's gonna push more money into our business.   Michael: Okay, well, guys, this was super informative. I know I had a lot of fun. Hopefully our listeners did, too. If people want to learn a little bit more about each of you, where's the best place for them to do that?   John: Oh, we've got a website https://www.realestateconsulting.com/ I post pretty regularly on LinkedIn. So you can look up John Burns on LinkedIn and get some free stuff every day.   Gary: I love the free hoodie that you got right there, Michael. John, I know you've got a Roofstock hoodie as well. I don't know if you ever wear it.   John: I do, I should have bought it today, I'm sorry about that I should.       Gary: So yeah, I think I would just encourage people, if they want to learn more about what we're doing at Roofstock just come to https://www.roofstock.com/ you could also follow me or hit me up on LinkedIn, I post pretty regularly there as well. But yeah, and keep checking out the podcast I know Michael's been doing a great job along with Pierre and the rest of the team here trying to get they couldn't get any interesting guests this this time so they got John and me but I know they've been otherwise doing getting some pretty interesting folks and doing a great job.   John: Well I saw that you're then the one of the top 1% of podcasters in the world. Hopefully we didn't push it down to 2%.   Michael: A filler episode though this this was great you guys. Thank you so much for taking the time and I very much looking forward to chatting again as we continue along this crazy trajectory that we're on.   Alright, everyone that was our episode, a big thank you to John and Gary for taking the time out of their extremely busy schedules to hang out with me and chat about what's been going on in the real estate market and where we might be headed going forward. As always, if you liked the episode, feel free to leave us a rating or review wherever it is you get your podcast, and we look forward to seeing on the next one. Happy investing…

Typically dentists are victors! This is because the process of becoming a dentist is challenging, and you truly have to be a victor to become a dentist. After becoming a dentist, have you ever wondered about whether or not you are still a victor? You may be surrounded by dentists who tell you that you cannot survive as a PPO-free practice because they have a victim mindset. As a listener of this podcast, it is evident that YOU are still a victor among the naysayers! Listen to this episode as Gary Takacs helps you embrace the victor mindset to take action.  00:00:59 > Intro to today’s topic 00:01:08 > Quick announcement 00:03:40 > Who needs who? 00:05:10 > You can be a victor! 00:12:02 > Visit the show notes to get inspired 00:15:12 > Freedom of choice 00:18:06 > Get RID of PPOs' Resources REGISTER TO THE FIRST MASTERCLASS HOW LINCOLN PARKER DMD STARTED A PRACTICE FROM SCRATCH HOW DR. BRIAN BALIWAS ATTRACTED 1000+ NEW PATIENTS INSANE SUCCESS WITH DR. PEYMAN RAISSI LEARN MORE ABOUT COACHING GET RID OF PPO PLANS! Transcript Naren: Hello everyone welcome, to another amazing episode of the less insurance dependence podcast show. This is Naren your co-host. The topic today is victim or victor, the choice is yours, victim or victor the choice is yours. Before we jump in, I have a quick announcement. The last master class that Gary did was sold out it was amazing. We got so many people saying wonderful things great reviews. The next one is on the 12th of May of Wednesday from 7 to 10 pm, 3 hours of CE and the topic is, grow your practice 10 percent or more every year grow your practice 10 or more every year. We're going to include a link it's thrivingdentist.com forward slash masterclass if there are seats left, we are we are positive because the last two have sold out this is also going to sell out if there are seats left quickly sign up and reserve your spot. Now let me start talking about this topic today victim of victor the choice is yours. You know one of the reasons I think both Gary and I were attracted to dentistry was you know these people who end up becoming dentists are typically at the top of their class. They're in the top you know five percent of their class. I think you know both Gary and me kind of like to you know do whatever we do really well and you know succeed at it, so I guess this kind of made a lot of sense now we were thinking you know even though that's how they start their career you know as victors PPO and many other things perhaps make at least some of the victims, you know they just give up and they just accept that 44 write off so we wanted to have a conversation around it carry over to you  Gary: Yeah, Naren I think this topic is one that's very pertinent for our audience here in the less insurance dependence podcast. Let's tie it into the topic of our podcast victim or victor. You know on the victim side it's you know sadly when you adopt the mindset of a victim and you feel like you're a victim, the number one reason for that is that you feel like you don't have any control, that you have lost control and as a result, you experience the negative consequences of being victimized and the context here is that many dentists feel like they have absolutely no choice other than to sign up for PPO plans and that's because of what, what, what, I think you know the terrible mindset that the insurance companies try to set among dentists, that the only way they're going to be successful is they sign up for these plans and you know I’ve said before, who needs who if there are two entities here there are the insurance companies and the dentists who needs who. Does the insurance company need the dentist or does the dentist need the insurance company? Well, if you can step back and look at this objectively, at a very core level, the insurance companies need your doctor because if no dentists sign up as participating providers, they have nothing to sell. They literally have no plan to sell if they don't have any providers and that's at a very core level. However, they've done a masterful marketing job, Naren you know marketing better than anyone I know on the planet the insurance companies have done a masterful marketing job of flipping the switch turning it upside down and convincing dentists that the dentist needs the PPO plan, when in fact the opposite is the truth. It's like you know when it's light outside we know it's the day, it's daytime, you know when the sunlight's out it is daytime when it's dark we know it's not it's like they flipped it they said no, no, at night-time this is the day, it's the day, and they flipped it and they've tricked dentists. This has been going on you know since the 1970s. So, this is not a new trick on their part but it's been a trick they've been pulling for many, many, many, years and I wanted this episode to ring loud and clear about, if you currently feel like you're in a victim status regarding whether you need to accept insurance or not, I want to share with you that you absolutely do not need to be a victim, you can be a victor and here's the first point that I want to make Naren, this happened somewhere around 2016 2017. So, this isn't new I don't have the exact date this will make sense in just a minute, I don't have the exact date but it was somewhere between 2016 and 2017 and the inflection point that I’m going to share with you is something that you need to embrace and that is whenever that inflection point was sometime between 2016 2017, there were more adults in the united states that didn't have dental insurance than adults that did have dental insurance. That was a switch that happened. Naren: so you're saying now the majority of the people in the united states do not subscribe to a dental insurance plan Gary: the majority of adults in the united states do not have dental insurance now prior to that inflection point the opposite was true slightly more had it but it's been going down ever since and it's dropping precipitously, I’m talking about what's dropping is the percentage of adults that have dental insurance is dropping precipitously and that number is radically shifting in favor of those that don't have dental insurance. So, there's one piece of information that if you embrace this as it is you say wait a minute, I know I don't need to there are more people that don't have it. Let me go find them; they are better when I say better, I’m not talking about a better human being. I’d like to think that they're all good human beings but if you're going to build your practice on patients that would choose you as for other than you have their insurance Naren: then you take their example insurance Gary: make sense Naren? Naren: more than half the jobs in the United States are created by small businesses. I bet small businesses many of those small businesses don't have identical insurance, you know all the freelancers the ETSY owners the Airbnb owners you know the what are you called eBay sellers the uber drivers, I mean the idea of being an entrepreneur working for yourself is has like taken off you know in the last you know 20 years or 30 years. It just exploded. So of course, what that means is not too many corporations that have ten thousand employees or a thousand employees and a dental insurance plan. Gary: exactly and let me list another group that's growing you know based on lifespan and healthspan and that's retirees. You know, it used to be if we go back a generation when people retired their benefits stayed with them the rest of their life. That's no longer true because those retirement benefits became a massive liability for big corporations and so they changed it and they said, hey once you retire, we'll provide a short period of benefits but once you hit the end of that you're on your own and so a massive group of people retirees doesn't have dental insurance and just another group you know in that. So, I want to share some great information, you know going back to-our listeners know that I enjoy everything about running and track and field and Roger Bannister that's a name that if you follow track and field everyone recognizes, he was the first person to ever break the four-minute mile barrier. He did that in 1954 he was an English runner, a runner from England, and before then there were scientists that actually publish scientific papers that said it could not be done because there wasn't enough oxygen content the oxygen couldn't flow enough to the legs and to the other you know parts of the body to allow someone to run less than four minutes and Roger Bannister did it in 1954 it was 359.89 three minutes 59 seconds 0.89 hundredths. He beat it by 11 100ths. And all of a sudden that completely upended the scientific community because they were proven wrong and interestingly enough Naren, remember this had never been done within three months three other people broke the four-minute barrier. Now in science, you can't tell me the cellular development in those three months is what made the difference. So, in other words, the human race you know when you look at three months’ time, it's a grain of sand on the beach you know in terms of the scientific measurement of time. So, you can't say that the body adapted in those three months to make humans that much faster. What happened what was the one thing that happened, someone did it and they figured hey if roger did it, I can do it right? Naren: yeah absolutely and I love that experiment the elevator experiment if you google elevator experiment on you'll find it it's like there's an elevator and there are three people facing the back of the elevator and these are hired you know actors and then everyone who entered the elevator from that moment on they all turned around and faced the back you know human beings really take a lot of cue as to what's possible what can be done from other human beings. Unfortunately, right now 95 percent of the practices are insurance dependent I think you said it might be even 98 percent right  Gary Yeah Naren: because only two percent are service so what do you see around you it's everything that's you know unfortunately but I think what you are doing Gary and I commend you for this I mean your coaching work your coaching clients not only have you and your expertise but they have peers who are doing it with them and they all meet every week or every month and they share ideas with each other and they learn from each other and then, of course, the RITA project I know you're going to talk about it more but the reducing insurance dependence academy I think a huge coup for the insurance companies because they had billions of dollars and you know to throw at it they did an amazing job making you believe that facing the back of the elevator because that's what 95 percent Gary: Well, let me be blunt. They did an amazing job of playing a dirty trick on dentists Naren: they did yeah Gary: they did an amazing job of pulling the wool over your eyes, convincing you that when it's dark you now think it's daytime ‘ Naren: Yeah Gary: And that's what they did now here's what we're going to do because you need Roger Bannisters in your life as a listener to less insurance dependence you need Roger Bannisters in your life three links in the show notes you can get the show notes from lessinsurancedependence.com just scroll down. These three links are three dentists who successfully started a fee-for-service practice from scratch. I’m going to name these dentists and these were interviews that we did on the thriving dentist show. The other podcast, my, flagship podcast Lincoln Parker dentist who opened a scratch fee first in orange county California. Brian Baliwas opened ace and successfully I want to make the statement that all three of these did it successfully Brian Baliwas opened a scratch fee for service practice in downtown San Francisco and then Paymen Raisy opened a scratch fee for service practice in 2018 in Nashville Tennessee and I want you to hear their stories and I want you to hear what they did but one thing you need to understand Naren as these doctors as Lincoln and Brian and Paymen talk to their colleagues you know, hey Doctor so I’m, I’m, thinking of opening up a fee for service practice in orange county is something Lincoln Parker would have said guess what everyone told him what do you think everyone told him Naren: it's not possible  Gary: you can't do this. His banker told them you can't do this. His accountant told him he couldn't do this the attorney told him he couldn't do this. The same thing happened, with Brian Baliwas was the same thing happened, with Paymen Raising well they were the scientists the naysayers were the scientists that told the world that nobody could run less than a four-minute mile  Naren: right  Gary: and it took it only took one person to prove that you know and that one person proved it proved the scientists wrong well in the analogy of our, of our profession these three dentists are simply three of many who they were you know they actually reacted differently. So, think about it Naren let's go back to the title victim or victor so what could have they assumed? It would have been logical to assume the position of a victim oh well I guess it was a bad idea you know I mean I really want to do it but everyone's telling me I can't do it I guess that's just a bad idea I guess I got no choice other than to be a fee for you know to be a PPO dentist but they didn't do that they actually said two words all three of them said two words watch me and what's that is that victim or victor perspective  Naren: victor  Gary: that's a victor Naren: it's the same kid who said watch me and got into dental school right so I guess that  Gary: you're all victor because statistically, you didn't have a chance of getting in you had a snowball's chance in hell getting into the dental school you know you're Vic you're victors you're, victors and you just have to flip that switch because you do have a choice. You know one of the coolest things about you know being in the united states is we have freedom of choice you can choose your path. There are no rules or laws, there are no regulations that say you cannot reduce insurance dependence in your practice. You can absolutely do that. So think about it doctor do you want to be a victim or do you want to be a victor. You know intuitively what the answer is to that I know intuitively you've got it in you to be a victor because you've already been that you've already been there done that you've done it throughout your career. You got into dental school, you survived dental school, you passed the boards you got to a position where you own your practice that's even getting into the elite of the elite Naren,  Naren: yes  Gary: you know just being a dentist you're in that top four or five percent intellectually but now only a practice it elevates you even further you are innately victors and I want to share that message I strongly encourage you go to the link the links that we're sharing the interviews with Lincoln Parker Brian Baliwas and Paymen Raisy and just drink in their stories and have those stories you know kind of filed away in the back your mind you know coming back to when roger bannister broke the four minute mile here we are today Naren less than 60 years from the time he broke it broke the four-minute barrier by the way the record the world record in the mile today is 3 43, 3 minutes and 43 seconds and world class high school athletes routinely break the four-minute barrier so and again human evolution in that 60-year period of time is a grain of sand on the beach there's nothing about human evolution, that's made our lung capacity or our ability to transport oxygen to the to our limbs it's none of that it's the fact that there were pioneers paving the way that proved it could be done and here's three Lincoln Parker Brian Ballywas and Paymen Raisy. Naren fun conversation I hope it's inspiring and motivating for our listeners because sometimes we need that you know we need that guidance we need that vision of what's possible and I really want you to ask yourself, doctors, this question am I a victim or am I a victor and ask yourself that question and I think the only answer to that is you are a victor now start behaving like one and take the steps to take those steps. Hey Naren as we come to the finish line for this particular episode, I want to provide another resource for our listeners. You and I have partnered together to recently create a wonderful resource, the reducing insurance dependence academy this is the very first digital all digital association in dentistry and its association of people and resources to help you successfully reduce insurance dependence. We have just launched this; we're excited about this project and again it's dentists team members and resources that are members of the RIDA reducing insurance dependence academy and it's all about providing you all the tools and resources you need to successfully drop PPO plans. We playfully like the acronym R-I-D-A but we also like the way it rolls off your tongue I want to get rid of PPOs if you want to get rid of PPOs and we're doing something very cool at least for now there is no membership fee at least for the first year we reserve the right to change our mind down the road but as of right now there are no membership fees you can join for free and if you'd like to do that come join us at www dot rid dot academy and again that's www dot rid dot academy. Come join us the water's warm and you'll be surrounded by victors like yourself thanks for joining us on this less insurance dependence podcast. Thanks so much for listening we appreciate each and every one of you. 

1. Ride-along 警民共乘 本集的名称ride-along是这样的。芝加哥警界有这样一个传统：普通市民可以坐在警察巡逻车的副驾驶座上，观察警员的日常工作，这个过程被称作「共乘」ride-along. Ross和Chandler随菲比的警察男友巡逻就是Ride-alongKevin Hart有一部喜剧片就叫做Ride Along讲的就是共乘的市民和警察误打误撞办案的故事。 Phoebe: (entering, with Gary) Hey!Gary: Hello!Monica: Hey!Gary: How are you?Phoebe: Monica, I'm sorry I didn't come by last night. I was out with Gary; he let me ride around with him in his cop car. We saw and prevented crimes.Joey: You got to go on a ride along?!Phoebe: Uh-huh!Joey: I want to go on a ride along!Ross: Me too!Gary: Okay!Chandler: Yeah, yeah! Me too!Gary: Really?! You?Chandler: Yeah.Gary: Well, it's kinda dangerous.Chandler: Well, I like danger.Gary: Okay, you guys free tonight?Joey and Ross: Yeah!!Chandler: Tonight? You-you didn't say it was going to be at nighttime.2. Rachel把Monica的照片给弄乱了，所以说oops, sorry. Oops! 感叹词 表示惊讶、狼狈、谢罪等的叫声,相当于，哎哟! 小甜甜布莱尼当年一曲Oops! I did it again 红遍全球。Rachel: Ohh, it's me and La Poo! Wow! I miss that dog.Monica: You can also find him under umm, dog and dead.Rachel: Great! Thanks!Monica: All right, hand me that other box of photos; that's the very last one.Rachel: Okay.Rachel:Oops. Sorry! Well, good thing you number all of them, huh?Monica: I hadn't! Photo 152 was a prototype.3. lean on 依靠，逼迫 Chandler夸奖Gary制服嫌疑人用了lean on. Lean on 除了依靠以外，还有逼迫，给某人施加压力的意思。Ross: (to Gary) That was so cool man, the way you leaned on that guy.Chandler: It is starting to get dark out there.Ross: (to Gary) He told you everything! I mean you totally cracked him!Gary: Yeah well, being that he was the victim, they're usually pretty talkative.Chandler: (laughing) Okay. (Deadpan) But it is officially nighttime4. out of the blue 突然的 Ross的前妻Emily又要结婚了，忽然想打电话给Ross看看是不是还有挽回的余地。她给Ross打电话也是心血来潮，所以用了out of the blueout of the blue 突然地，毫无预兆的Emily: (on answering machine) Hello Ross? It's Emily. (Rachel runs back into the room with the tequila.) I know this is out of the blue but uh, I'm getting married tomorrow. Well, maybe I am. I keep thinking about you and I'm wondering if-if we made a mistake giving up so fast. Are you thinking about me? Of course you're not, but if you are, call me tonight. Okay, bye.Rachel: Oh. Oh! (Takes a slug of tequila.)5. squeeze one's shoes 给某人施加压力 三个老友在跟Gary出警时，Joey问Gary是不是要squeeze the perps shoes.Squeeze sb's shoes = break sb's shoes 给某人施加点压力Ross: So where are we going next?Gary: This witness won't return my calls so we're gonna see if we can surprise him coming home.Chandler: Sur-surprise him? We're not, we're not gonna make anybody mad are we?Joey: Come on man! (To Gary) Listen so uh, are you gonna squeeze the perps shoes a little bit before he lawyers up?Gary: It's a witness not a perp. And no one talks like that!Ross: Yeah, no one talks like that!Joey: Oh what? Like your Mr. Cop!Ross: Hey, I'm more cop than you two!Chandler: How do you figure that?Ross: Hello! I'm in the front seat, okay? I'm Gary's partner!Chandler: Y'know, when you say partner it doesn't sound cop. It, it sounds gay.6. live every day to the fullest 每天要活得精彩 Ross离婚以后精神不够振作，所以自己给自己打电话留言给自己鼓励。有这么一句话说的很不错，Live every day to the fullest. 每天都要活的精彩。Rachel: Oh, maybe that's Emily calling back to leave the exact same message.Ross: (on the machine) Hey Ross! It's you! I just want you to remember this feeling. You are lucky to be alive! So live everyday to the fullest. Love yourself, okay? Okay. Oh, and also get stamps. Bye! (He hangs up.)Monica: Wow! Play that message for Emily and this whole problem goes away!Rachel: Right?7. join the forces 参军，加入警队 Joey在警车上勇敢保护Ross的行为让大家对他刮目相看，Gary问他是否考虑过加入警察队伍。join the forces 参军或加入警队8. ramble about sth 唠叨 Chandler不想听Ross叨叨，所以就回屋了。Ramble about sth 唠叨，絮叨Ramble about 也有闲逛瞎逛的意思。Ross: Okay, okay, so we're in the car. Right? And bang! A shot was fired. And Joey with no regard for his own safety throws himself on me!Phoebe: My God, Joey!Chandler: (pouting) It was a car backfire!Ross: Yeah, but-but he didn't know that!Joey: Yeah, I didn't know that.Ross: And it could've just as easily have been a bullet.Gary: Hey Joe, you ever think about joining the force? We could use a guy like you.Chandler: Who jumps at loud noises!Ross: Wow! I could've died tonight.Chandler: Yeah! If the car that backfired had run over you! Y'know what, I think I'll go home before Ross starts rambling about his newfound respect for life. (He gets up and starts for the door.)Ross: I do have a newfound respect for life.9. out of the picture 彻底消失 Chandler对于Joey在发生所谓的危险时先救Ross感到耿耿于怀，跟Joey理论起来，Joey误认为Chanlder想要Ross out of the picture. Out of the picture 某人或某事从生活中彻底消失Joey: Dude! How come you took off?Chandler: Oh, I just went for a walk, around the living room. Whatever…Joey: Is something wrong?Chandler: No. No I'm just tired. Y'know, from-from the walk.Joey: Okay.Chandler: You dove in front of Ross! Ross!Joey: That's what this is about! Oh my God, you hate Ross!Chandler: I do not hate Ross!Joey: Of course you do! I saved him! You're mad at me! It all adds up! You want Rossout of the picture.Chandler: What picture?Joey: I don't know, but I don't like what I'm hearing!10. a drop in the bucket 沧海一粟 Rachel在Ross家跟Ross说了这样一句话this is just a drop in the bucket mister! 意思说我不请自来到你家跟你不请自来到我家比起来根本不算什么。a drop in the bucket 沧海一粟，九牛一毛，小巫见大巫Rachel: Hey! Hi!Ross: Rach, what uh, what are you doing here?Rachel: Hey! Y'know what? You are in our apartment all the time! Okay? This is, this is just a drop in the bucket mister!Ross: Y'know, it-it doesn't matter. The important thing is that you're here. You're my friend, and you're here. 11. number is up 气数已尽 在描述自己晚上的奇遇时，Ross说认为自己number is up. number is up 死期到了，气数已尽例句：But this time I think his number is up -a he has a smart young man running against him with a lot of new ideas.但是这次我想他是大难临头了—一个干练又富有创新思想的年轻人成了他的竞争对手。Ross: The most amazing thing happened tonight. I thought my number was up. I had an actual near death experience!Rachel: What?! What? What happened?!Ross: Okay, okay, we were on the ride along with Gary, right?Rachel: Yeah!Ross: And somebody took a shot at me!Rachel: (gasps) Really?!Ross: No, a car backfired, but (Rachel suddenly calms down) I thought somebody was taking a shot at me. 12. close call 侥幸脱险 Ross 觉得这一天过得特别惊险，自己险些没命，所以说这是close call day.close call 侥幸脱险，幸免于难，千钧一发我们最常见的用法 That was a close call 好险！Rachel: I mean, look-look today you escaped (Pause) (Not believing it) death, y'know? And maybe this is a chance for you to escape getting back together with Emily?Ross: That does make sense. Because I do wanna seize some opportunity, but I-I really don't wanna see or talk to her.Rachel: Well, there you go!Ross: Yeah. Maybe today is just, close call day.Rachel: (laughing) Close call day.Ross: Hey, thanks Rach. (They hug.)

The changes Delta makes to contracted fees have a major effect on your practice’s profitability. In this episode, Gary examines the impact when Delta changed it’s contracted fees recently and the likelihood of that happening again.  Listen to this episode to find out how you can deal with this eventuality and what you can do to regain control of your practice.  Intro to today’s topic > 01:58 State of Washington incident > 03:25 High overhead > 08:50 Breakthrough > 20:17 Schedule your coaching program > 24:58 Resources LEARN MORE TALK TO GARY CALCULATE INSURANCE ADJUSTMENTS LEARN MORE Transcript Naren: This is the Less insurance dependence show with my good friend Garry Takacs and myself Naren Arulrajah. Gary: We appreciate your listenership, your time, and most of all we appreciate your intention to reduce insurance dependence in your practice. Our goal is to provide you information that will successfully reduce insurance dependence and convert your practice into a thriving and profitable dental practice that provides you with personal professional and financial satisfaction. Naren: Hello everyone welcome to another episode of the less insurance dependence podcast show. We have an amazing episode for you and the topic of today’s episode is: Is Delta Planning to Lower Your Contracted Fees? The reason we picked this topic is a few years back I remember Garry sharing the story of how Delta first tried this in the state of Washington. Since then, this has become a cascade and I want to kind of talk about it, and then we are going to figure out as a practicing dentist how do you respond to this trend. Gary: Naren you have introduced this topic brilliantly. You know we know that Delta is the gorilla in the dental insurance profession, absolutely because of the fact that they are the largest dental insurance company and for most dentists, Delta has the largest number of patients within a practice – that is almost always the case. Occasionally we will see another big insurance company be number one in a practice, but 95 times out of a hundred when we ask you know what plan do you have the most number of patients, 95 out of a hundred the answer is Dental dental – so it is literally you know the gorilla in the room and if I may Naren I would like to share the story of what happened in the state of Washington a number of years ago and why it is so important for all of our listeners to know this. May I share that story Naren? Naren: yes, please Gary: So this goes back to 2012. And on June 1st, 2012 the Delta provider in the state of Washington then known as WDS Washington dental service sent out a certified letter to all member dentists – so these were all dentists that accepted delta in the state of Washington and they said basically what the letter said was effective June 15th fifteen days later we are cutting your fees 15 percent. 15 percent – and then you know introduced it by saying in an increasingly competitive world our clients are asking for more competitive plans and as a result of that we are forced to cut your fees by 15 percent – reluctantly we are forced to cut your fee. So the language on it was very important because who is the client? Who is the client of Delta in the state of Washington – it is not the dentist Naren: Yeah it is not the patient it is the employer Gary: Then it is not the patient, it is the employer! So it is the employer that is forcing us to cut your fees – and heads up on June 15th we will be cutting your fees by 15 percent. Now you might look at that Naren and on the surface now you will not be a good person to use as an example as you know your math so well. But you know someone that was not so savvy about math might look at this and say – 15 percent that is not good but I can probably live with that right? You know dentists might ask that – I can try to live with that. Naren: But think about it - imagine you saying this to your employee or you say this to your associate – ah you know what? I have a lot of expenses starting Monday instead of making 5 grand you will make four thousand two hundred and fifty bucks – I am just making this up. Gary: Well let me amplify this on your first example – imagine a team member, how is this going to go? Naren: Right Gary: Hey Susie you are making 20 dollars an hour now – Naren: Right Gary: However with the increase, you know my costs going up I cannot pay 20 dollars an hour so imagine we are having this conversation on Friday Naren: Yeah Gary: On Monday you are going to be making 17 dollars an hour Naren: Yeah Gary: By the way how do you think that conversation is going to go? Naren: She would not stick around! I mean forget about the conversation she will be out of there like she will not just because she has not found the next job yet but Gary: Say what? Naren: Ha-ha Gary: When Delta did this in the state of Washington I truly believe that they did their research because you know multi-, multi-million Dollar Company Naren: Yeah Gary: They did their research and I believe they thought that it would go well for them. Or they would not have done it. I believe they thought we kind of got these guys over a barrel we kind of got the dentists over a barrel, they don’t really have a choice we are going to lose some as members but the ones that we retain will be paying them so much less we are going to be way better off – but in their mind, they had to do some cost-benefit analysis and say ok – imagine that board, imagine that board meeting. I would have loved to have been at that board meeting in that house in that board meeting listening to their rationale – hey guys we are going to lose people, we are going to lose some members – but we will retain many more than we will lose. Let’s roll the dice and let’s do it. Ok so now this goes out on June 15th and oh let me back up and say what the effect of a 15 percent fee reduction is? Watch this Naren – if your overhead is 70 percent and I am deliberately choosing numbers to make my math – to demonstrate a point here Naren: Yeah so let’s say I make a hundred grand I take 30 grand – a million bucks I take 300, three hundred thousand out after my overhead Gary: Right Naren: So now I am going to lose and let’s say all of that money is coming from Delta must for argument sake Gary: We have to make an assumption for the purpose of the analysis that all of your patients come from Delta which will never be true Naren: Right Gary: But if that is the case if your overhead is 70 percent Naren: Yeah Gary: Which by the way is a good number to use because even the ADAs says the average dentist overhead is 74 percent Naren: Right Gary: And doctor let me just state it right here – if your overhead is 74 percent you are working too hard too little and the number one reason why your overhead is that high is because you are writing off too much money doing insurance adjustments. But if your overhead is 70 percent and they cut your fees 15 percent Naren: Yeah Gary: It has the effect of cutting your income 50 percent. Five zero Naren: Yes Gary: So now imagine that conversation with the team member. You know hey Susie I know your income now is 20 dollars an hour but on Monday it is going to be 10 dollars an hour – it is just how this I sorry Naren: Because I only get to keep half so I am going to give you half so Gary: Right, but did everyone follow the math on that? Naren: Yeah Gary: Because the math on that is if your overhead is 70 percent your net is 30 – your fees are cut 15 percent – it is half of your 30 percent Naren: Profit Gary: And so literally your – you took a fifty percent hair cut on the fees Naren: Yeah Gary: Now here is where the story gets rich, I was not part of that meeting of course I wish I was a mouse on the wall – they had to be thinking we are going to lose some – four thousand members at the time, four thousand a very close number to 4000 almost around three thousand nine hundred and ninety-eight I believe. Naren do you know how many dentists resigned? When they sent that letter out? Do you know how many resigned? The actual answer was 3. That is it. I do not know what their projections were but I guarantee they thought they would lose a lot more than that Naren: Hmmm Gary: I guarantee they thought more. Naren: Hmmm yeah Gary: I do not know what they thought they would lose Naren: Let me ask you this Naren: 3 are as a function of four thousand it is less than one-tenth of one percent. These guys had to be dancing in the aisles. Can you imagine the celebration after everything shut down – yep can you imagine whoever presented that to the board and said remember when I told you, you were going to lose people? Well, guess what? We lose 3! Ha ha ha! These knucklehead dentists – 3! And here is the interesting part this is a fun little sidebar – two of them were clients of mine –two of the three and we were already getting ready to gloat and the network with delta was the last one – and this became the start that broke the camel’s back. I never knew who the third one was – I never knew. Until about a year ago – I was teaching at Pankey and I was telling them this story and one of the instructors at the back who’s eyes got really big – like big as saucers and she could not wait to come up to me – one of the instructors at Pankey came up to me after the class and said Garry meet number 3. I was the third one Naren: Ha ha Gary: So I now know who it was. But three out of four thousand now some of you will be thinking I am sure as heck I am not in Washington. I am not in the state of Washington. Those poor fools there - but this has emboldened every other delta organization. There are not 50 delta organizations because some of the states they combine there is actually 37 Delta, but what do you think the executives of the other 36 are doing when they saw the success of Washington, can you would you agree Naren that this is an unmitigated success story if you are Delta dental Naren: Oh yeah I mean when you lose 3 out of four thousand there is one in a thousand – I mean it is it is a home run, it is like a grand slam! Gary: Grand slam! Gary: Yeah and so what has happened now is and we are seeing it all over WDS – Washington dental services considered to be a certified innovator in the world of delta and so the other delta organizations are looking at them and are looking at what happened there and they are being embolden by those results and we are seeing this happen all over the country. So I am going to answer the question that our headline asks – is Delta planning to lower your contracted fees? Absolutely yes, absolutely yes. They will not be raising it and the only way to tell Naren: You have seen this in state after state after state right and this is not the only one, may many may states Gary: It happened in December in Arizona Naren: Right Gary: The state of Arizona delta set the letter out and the same thing and it is happening all over because of the success if you look at the economics of this you know – they cut your fees that you are paying out – 15 percent look at the profitability inside delta – you know of which the executive team and the board benefits from. It is amazing so I am going to answer that question very directly. Is Delta planning to lower your contracted fees? The answer is yes. So doctors if you think it is bad now their fees you look at that fees schedule you now and it causes you grief to look at it – it is only going to get worse. It is only going to get worse. So you know that is the lesson there – think about it. Naren think 3 dentists resigned! Naren: Absolutely, Garry talking about the 3 dentists who resigned Garry, I know we share mutual clients and I can think of three dentists – one is a lady doctor A and two men doctor b and doctor d and I mean of course for confidentiality reasons I am not going to mention their names Gary: Those actually are their first name initials! Naren: Yes Gary: We will keep the rest of it confidential for hipo reasons – doctor A doctor B and doctor D Naren: Right and they are literally I remember being in a kind of being a fly in the wall in a conversation you were having in a group meeting – they are kind of working with you as we speak to actually resign from Delta Gary: Well to use a dental term Naren – they are literally right on the cusp of Naren: Cusp ha ha Gary: Of resigning. And we have done all the- these are coaching clients – and we have done all the necessary prep work, we have checked everything off the checklist you know I am pretty careful about this because none of this is done irrationally or emotionally it is done analytically – there are readiness factors that have to be in place before we- before we send that resignation letter and all 3 of these clients have systematically checked off each one of the readiness factors and they are ready and that strikes me as kind of amusing as I have 3 right now in my client base which would equal the entire state of Washington Naren: Ha ha Gary: Provider list in 2012 and they are so excited about breaking free from the shackles of Delta and it is one of in our coaching, it is one of our most prideful you know sources of our work is to help dentists successfully break free so they are, there are so many positive things happening in their practice after they have done that. And so really the message I would like to continue with in this podcast episode is doctors it is – do not stick your head in the sand. Pull your head out of the sand and realize that it is only going to get worse and if your discounts today are 42 to 44 percent which is what they are and it gets worse than that – would it make any sense to remain a participating provider under delta dental and I am going to say absolutely not. Naren: Garry can I Gary: Now is the time Naren: Can I make an observation – two of the three clients in you know back in the day who resigned from Washington was your client’s right? That is 66 percent and just in the last couple of weeks – you know you are literally working with 3 clients who are doing the same – so the thing that kind of was sitting in the back of my head is, on one hand you have almost 60 I mean a hundred percent success rate in resigning with your client, even delta including the other plans, on the other hand you have one in a thousand – that is zero point one percent – what is the difference? I am thinking again I am just sharing my thoughts and I want your fed back on it – perhaps it is fear. And perhaps what you are doing is you are giving people clarity and confidence. Clarity meaning here are the steps one by one this is not rocket science this is what you need to do – and of course not just a list of steps but the details of how to do them precisely and then helping them to do those steps and then confidence – you have done this hundreds and hundreds of times and you have done it personally it is like Gary: And Naren let me emphasize in every practice physical environment Naren: Mhmm Gary: Urban areas, big cities, large towns, medium sized towns, small towns, were all practices and so we have been successful everywhere with this now you know it takes some work. And it takes some effort and you know there are occasions on the coaching side where a doctor wants to go out of network and I have to deliver the bad news to say that you are not ready for it – it is not that you could not do it sometime, but you are not ready for it now Naren: Well I am going to out you n the spot Garry – have you ever started the process of reducing insurance dependence meaning you said ready and failed? Gary: Yeah not once. Not once have we gone down made the decision and had – now there is a fall back, there is a fall back and I want every dentist to know this you have a plan B. we had it in place when we went out of network and the plan B was if it was no working you can always sign back up for the plan – I mean Naren: Ha ha Gary: Essentially Naren: But you did not have to do that with your clients but you are saying that option was there? Gary: No no not any of our clients but you do have that I mean Naren: It is like you are jumping from the plane but you have a parachute – I mean you have ha ha ha you want to enjoy that feeling of flying and jumping off a lane but you are not going to – you know you have a plan B Gary: Truly there is no risk. Naren: Yeah Gary: You can always sign back up – now you would never want to do that – that would effectively be like flying the surrender flag Naren: Yeah Gary: You know you never want to do that – but what I noticed which is the break through which often moves doctors off of the indecision path. You know there is a turn that we hear quite a bit about optics – you hear that term on social media and in the media it is all about the optics – it is all about those things, and I believe that that comes in to play in this discussion because how many times have we heard Naren in our common clients Garry I do not know if we can do this because 80 percent of my patients have insurance, plug in whatever number you want – 80 percent of my patients have insurance, 85 percent to my patients have insurance, 90 percent of my patients have insurance – so their optics and they are real Naren: Yeah Gary: Or they can’t see a way forward because of what they currently have and in our own practices it was 80 percent, but what I was sharing with them was that your future does not have to be your past the truth is your past you brought people in because you took their insurance. So reason only one out of thousand resigned was because in your case, you know every one resigned is because they were not afraid they were not afraid of this optic – you give them the confidence and the plan that they could execute from and I notice the break through Naren Naren: Mhmm Gary: Now certainly there could be individual reasons why you want to go out of network of any dentist you could have your own set of reasons but what I noticed most commonly is that when I explained to them that those insurance adjustments are a marketing expense and they are spending say four hundred thousand dollars a year – you know on marketing or let me use five hundred thousand dollars which would be more common – they are spending forty one thousand six hundred and sixty six dollars a month on marketing when I show them that, that is when many dentist realize oh my gosh there has got to be a much better way – there is a much better way to do this Naren: Right Gary: because you could spend a fraction of that like you know our clients are sending around 2 percent of their revenue on meeting – so what would you rather spend doctor forty four percent which is the average adjustment from delta – or two percent? Take as long as you like – you know while we playfully have those discussions Naren: And I love that exercise you did where this one particular client Garry, they were doing one point five, I mean they were collection 1 million 80 percent insurance dependence average write off of forty forty two percent – they were giving up five hundred and thirsty seven thousand dollars a year and what you did with these particular client was you had them realize in the next 10 years he is going to give the insurance firms 5.37 million Gary: Yeah Naren: The next 20 years he is going to give ten point seven million dollar Gary: Early mid careers – he is in his early 40s Naren: Mhmm Gary: So to say he is going to practice another 10 years is pretty obvious Naren: Yeah Gary: And that is not much 0 Naren: 5.37 Gary: 5.37 million in 10 years – and he is the one that said it is going to be more like 20 so do the math Naren: 10. 7 million in 20 years Gary: 10. 7 million dollars difference over a 20 years career Naren: It is mind blowing Gary: and I pointed out he was spending over forty one thousand dollar  month on marketing he was like no man I am absolutely going to choose a different path forward – well Naren I wanted to answer that question so in terms of answering the question – is delta on planning to lower your contracted fees – the answer is yes Naren: yes Gary: the question doctors that you need to answer is what are you going to do about it? What are you going to do about it? And I would, I have always like this analogy – we all know the parable of the frog in the boiling water – if we drop a frog in a pot of boiling water it jumps back up Naren: Mhmm Gary: It is a life saving measure – it jumps out but if you if you put a frog in a pan of Luke warm water and then turn the you know turn the burner up Naren: Yeah Gary: Turn the heat up what will eventually happen is that the frog will boil itself to death – doctors you are the frog in the pot. Because that is what they are going to you know inch by inch they are going to be turning up the heat and they are turning up the heat by dropping your fees. And it is time for you to regain control of your practice it is time for you to discover a new way of marketing instead of just signing up for the plan – lets attract people who are choosing you for reasons other than you are on their insurance – the end result of doing so you will spend 2 percent instead of 44 percent and if you can just take a leap of faith in me – the result if you will truly have a legacy quality practice that provides you with  personal professional and financial satisfaction Naren: I am going to invite our listeners to take a couple of next steps – the reason I am doing that is because every single one who has listened to the hundred and one episodes here is committed to reducing insurance dependence and by the way we are having a record month in October – so thank you so much for that – this is the best month ever and this is 2 percent better than the last best month ever so thank you for that Gary: Thank you for sharing the pod and Naren is listening to our listenership on the less insurance dependency podcast – so thank you from the bottom of my heart and thank you for sharing this with your friends and colleagues you are committed to reducing insurance dependence that is why you are listening that is why you are sharing this podcast – Naren: one of these next steps I would recommend is go to thrivingdentist.com forward slash coaching and check out the coaching program, in a nutshell, it is you know virtual coaching, personalized virtual coaching with practice management support – what that means is you have a Garry supporting you meaning working with your champions making sure they are doing their part – setting goals – achieving those goals, so you have Garry support kind of the same kind of support Life smiles enjoys – and while life smiles are within the one-fourth percent – plus there is an entire array of coaching calendar events – verbal skills, case acceptance you name it there are many many many hours of content that helps you become a better clinician helps your team become better at you to know influencing people and getting people to you know to say yes to the treatment that they deserve. So check it out it is fifteen hundred dollars and Garry wanted to make to affordable because he was thinking of the next phase of his career and he wanted a program that everyone can afford and everyone can say yes to – Gary: Yeah Naren we have structured that there are no onboarding fees there are no upfront fees there are no travel expenses it is 1500 dollars a month there is a 12-month agreement – we want to be of much value to you that you would never want to practice without us but we simply do that in 12-month increments and we would love to work with you – our primary focus for the majority of our clients is successfully reducing insurance dependence and if that is you and if you want to do something proactively ahead of time before delta delivers that letter to you then I would politely suggest that our coaching would be a good decision. Naren: Yeah the other thing is there is a coaching strategy meeting and if you are interested just go to thriving dentists. com again the coaching page and you can book it, or just type in the URL thriving dentist. Com slash CSM and you can you know talk to Garry and you know Garry here has turned several people down because for whatever reason he felt that they were not a good fit for Gary: Yeah you know what I do with that call – it is with me – what I do with that call I get to know a bit about your practice and the purpose of the call is to determine if our coaching would be a good fit for you and if so we would love the opportunity to work with you but I am also not shy about being very candid and direct if it is not a good fit. Well on that note – and Naren we will just put those links, we will put a link about our coaching in the show notes, we will also put a link to schedule that coaching strategy meeting if they like and on that note thanks again to all of our listeners, thank you for sharing this with your friends and colleagues – thank you for helping us enjoy our strongest month ever in terms of downloads we appreciate each and every one of you – thank you for the privilege of your time today.

“Life is gray. It's not black and white. It's possible to admit that the FBI made mistakes and at the same time recognize the ultimate responsibility of Koresh to have led his people out peacefully, as we encouraged him to do every single day.” Gary Noesner Gary Noesner, author of the book Stalling for Time: My Life as an FBI Hostage Negotiator, retired from the FBI in 2003 following a 30-year career. During this career, Gary was named the first chief of the FBI Crisis Negotiation Unit. As a negotiator, he was personally involved in numerous high-profile crises, cases, and seizures, including the Branch Davidians in Waco, recently dramatized by the Netflix series. I had the pleasure of speaking with Gary about the gray nature of life, what distinguishes wants vs needs, and the game-changing power of making adjustments at half-time. Listen in to find out how Gary’s discomfort with conflict in his youth led to his career as a hostage negotiator for the FBI.   Show Highlights [7:29] The fatal mistake of assuming that high rank equals expertise [14:07] The realization that life is gray [19:00] Saving the most lives possible [22:29] Making adjustments at half-time [26:40] Distinguishing between wants and needs   Links | Resources Gary on LinkedIn Stalling for Time: My Life as an FBI Hostage Negotiator   About the Guest Gary Noesner, author of the book Stalling for Time: My Life as an FBI Hostage Negotiator, retired from the FBI in 2003 following a 30-year career. During this career, Gary was named the first chief of the FBI Crisis Negotiation Unit. As a negotiator, he was personally involved in numerous high-profile crises, cases, and seizures, including the Branch Davidians in Waco, recently dramatized by the Netflix series.   About Voltage Control Voltage Control is a facilitation agency that helps teams work better together with custom-designed meetings and workshops, both in-person and virtual. Our master facilitators offer trusted guidance and custom coaching to companies who want to transform ineffective meetings, reignite stalled projects, and cut through assumptions. Based in Austin, Voltage Control designs and leads public and private workshops that range from small meetings to large conference-style gatherings.  Share An Episode of Control The Room Apple Podcasts Spotify Android Stitcher Engage Control The Room Voltage Control on the Web Contact Voltage Control   Intro: Welcome to the Control the Room Podcast, a series devoted to the exploration of meeting culture and uncovering cures for the common meeting. Some meetings have tight control, and others are loose. To control the room means achieving outcomes while striking a balance between imposing and removing structure, asserting and distributing power, leaning in and leaning out, all in the service of having a truly magical meeting. Douglas: Today I’m with Gary Noesner. Gary retired from the FBI in 2003 following a 30-year career, during which he was named the first chief of the FBI Crisis Negotiation Unit. As a negotiator, he was personally involved in numerous high-profile crises, cases, and seizures, including the Branch Davidians in Waco, recently dramatized by the Netflix series. He's also author of the book Stalling for Time: My Life as an FBI Hostage Negotiator.  Welcome to the show, Gary. Gary: Thanks. It's a pleasure to be with you. Douglas: So, Gary, I'm always fascinated to hear how people got their start, especially in the world of facilitation. And I’m sure negotiators are no different. While there’s certainly a course at Quantico, there’s not readily degree programs, like, “Oh, I’m going to go become a negotiator or become a facilitator.” It's a quite circuitous path a lot of people take. And I'm curious. All the way back to the Lakeland High School, you know, talking about some of those early situations you found yourself in, at what point did you really start to realize that you had this gift of kind of working with people? Gary: Well, I think as an early age, I was always uncomfortable around conflict and always sort of stepped up to the plate to de-escalate confrontations and arguments, whether it's between friends or others. It just seemed like a natural and appropriate thing to do for me. So when I got into the FBI, after wanting to do that since I was young, I had no sense that anything about negotiation existed because it didn't when I joined. But when I first got in the early part of my career, the FBI had sort of taken on this hostage-negotiation concept that had been started by NYPD. And there's something about it that really attracted me, and I thought it fit my personality and skill set. So I got the early training, and it was an auxiliary function for me for many, many years. And eventually I became a full-time negotiator and chief of the Crisis Negotiation Unit for the last 10 years of my career. But it was very challenging, and, yeah, there's a lot of similarities with mediation, facilitation. It's all about building relationships and influencing people in a positive way.  Douglas: And it must have been kind of—it's like coming full circle as you were one of the first to take the course, and then you ended up taking the program over. What did that feel like when you remember it? Like, what was that like? Gary: Well, in those days, when I first got involved, the FBI, perhaps more so than today, played a pretty significant role in training police departments. Police departments didn't have a lot of money for training back then, so part of the FBI's mission was to provide it at no charge. And one of the areas, of course, was negotiation. It eventually became the thing we taught more than anything else, except for maybe firearms. And it gave me an opportunity to really interface with a lot of police officers in ways that I might not have had a chance otherwise. And that was a really valuable piece of my learning as an agent, as a human being. And, you know, I certainly got as much from those officers as I gave. It became apparent to me very quickly that the skills and the approaches we were teaching had a real impact. It wasn't theoretical. It allowed officers to exercise some specific skills to prevent violence and come home alive to their families. So immediately I recognized it as rewarding and meaningful and certainly something I always enjoyed. Douglas: Something that really caught my eye—and I kind of can parallel it back to even the theme of the show, which is control, and how much control do we lean into, and how much do we back away from? And I really struck a chord with this notion of maintaining balance. And you were talking about managing yourself and the people around you. And in fact, I think there is a quote that really caught my eye, which was, if you cannot control your own emotions, how can you expect to influence those of others? Gary: That's literally the first line that comes out of my mouth when I teach negotiations, because it's so true. I mean, if you want to influence others and yet you yourself are emotionally charged or dealing not in a logical, thoughtful, empathic way, then you're probably not going to be as successful as you would otherwise. So self-control is terribly important. And you tend to see people that perform at the highest levels in certainly law-enforcement negotiations are typically people who have a lot of self-control.  And one of the chapters in my book, Stalling for Time, I start each chapter with a quote. And a quote I always like, it's a partial quote from Rudyard Kipling about if you can keep your head about you when all else are losing theirs.  And I think that says a lot to me about the kind of person that makes a good negotiator and what is required. It's somebody that can think clearly in the midst of a situation where others might be so overcome with various forms of reaction that they're not optimally performing. You know, it's kind of like—I always do the comparison of a trauma surgeon. You know, when mass casualties are brought into an emergency room, the trauma surgeon, it's not that they're not human and don't see the damage that some people have suffered or perhaps been deceased, but they focus immediately on what has to be done, which is to save as many lives and determine which ones need their most immediate care. So they put those emotions aside so that they can function at an optimal level or highest level they can. And I think negotiations is very akin to that. Douglas: Yeah. It reminds me of the, never confusing getting even with what you want. Gary: Yeah. And it's a good phrase we used to use for our commanders because even law enforcement, somebody can be a fairly high rank and have a lot of different experiences in an agency. It doesn't mean that they've had a lot of experience managing with these kinds of crises.  And law-enforcement officers are human beings, and when a perpetrator, particularly one that is maybe not a model citizen or somebody that may not have any attributes that we would find commendable, when they refuse to do what we want and they don't cooperate and they back out of promises, they engage in any number of problematic behaviors, you really got to maintain your self-control because if you respond and react to that, you may get even with them, but are you really accomplishing what your goal is, which is to get your way? And “to get our way” in the context of negotiation means we get people to peacefully surrender, to comply, to do what we think is not only in our best interest, but in their best interest. We don't want anybody to get hurt. So I found a lot of my career time was helping on-scene commanders and decision makers, chiefs of police, sheriffs, understand that concept.  There's always an assumption that people of a high rank know how to do everything. And of course, that's a fatal mistake you can make, because they don't necessarily understand, especially—someone might be a great internist as a doctor, but can they perform brain surgery? Probably not. So, you know, just because you have the MD in front of your name doesn’t mean you can do everything there is that could possibly come before you. So we have to know our limitations, and we have to understand that there are people who have more expertise that we probably would be wise to listen to. Douglas: Yeah. It reminds me of your points in the book around just the crises within the crises and these other negotiations that have to happen. So you're managing quite a lot at the same time. Gary: Yeah. I mean, and of course, I know we'll be talking about Waco shortly, but I got asked this on a recent interview, and I never really thought about it from that complexity point of view that while out there, I had three very distinct roles. I had to manage the negotiation team, maybe 15 or 20 people, and ensure that it was functioning properly and proceeding in a strategic way, the way I wanted it to. And at the same time, I had to convey what we wanted to the bosses and convince them to support the strategic approach we were taking, and that could often be a challenge. And then, last but not least, is dealing with David Koresh and all the unique issues and problems that he brought to the table. So, you know, you find yourself sometimes being the ringleader in a three-ring circus, you know, and trying to keep everybody functioning in the right way so we can achieve the outcome we want. Douglas: Yeah. And speaking of Waco, let's talk about that for a moment. I was really curious to hear your thoughts on how well it portrayed the negotiation process, because from a storyline perspective, when I compare your book to the show, there's definitely some sensationalism on the Branch Davidian side. My depiction was that it demonstrated the conflict with the kind of more forceful approach and also just the kind of slow, intentional approach ya’ll were taking. But I’m just kind of curious as far as, like, anything about the negotiation process that you felt was maybe skewed in the presentation. Gary: It's a big question, and there's a lot of variables. Obviously, they bought my book to show the FBI side of the story and what perspective we had from outside looking in. And then they bought David Thibodeau’s book—he was a surviving Branch Davidian—to get the perspective of someone inside looking out. And I liked that approach, to look at it from both angles. But specifically addressing the negotiation part, they got a lot of parts of the negotiation very right. What was the Hollywood dramatization part is they had my character doing all these things on his own, when in reality I'm leading the team, and there's eight, nine negotiators per shift. It's quite a complex and many-moving-part operation. So obviously, Hollywood doesn't want to pay those additional actors and introduce their characters and get the audience to know them. It's a whole different level of challenge, that they wanted to showcase Michael Shannon, who was one of the two main stars of the TV show who played me.  Douglas: I got to say, if I'm ever played by anyone, I would say Michael Shannon wouldn't be a bad—that’s not a bad deal to get. Gary: I had seen Michael Shannon in Boardwalk Empire, that TV show.  Douglas: Mm-hmm. Gary: I was very impressed with him in that show, and I didn't even know his name, to be honest with you. And they came out and said, “This Michael Shannon's been hired to play you.” And I looked him up right away. I said, “Oh, it’s that guy.” Well, he is just an incredible actor and human being. And, you know, during my time on the set, we had an opportunity to become quite friendly and had basically drinks and dinner every night while I was out there. And what an incredible actor. And he certainly was not trying to imitate me, but he captured the tenor of my philosophy, which goes back to your earlier question. I think those issues that came up, including the conflict between the tactical side of the FBI that wanted to take a different approach, I think that's very accurately reflected. Again, not so much in the exact form, but certainly in terms of substance. And he had it down very, very well and, I think, did an incredible job. And let me add another thing, Douglas. You know, what I found is I felt that part of the reason I wrote my book was to educate current and future FBI leaders. And one of the things they need to be educated on is to understand not only the mistakes that the FBI made there, but the good things we did. And there were far more of those than not. But if someone doesn't write that down and record it, those things fall through the cracks and they're forgotten, and sometimes mistakes are repeated, and good behaviors are not appreciated or replicated. So I wanted to write it for that reason. And I also feel that in the FBI, we serve the American people. If we do something wrong, we should step up to the plate, admit what we did, demonstrate that we are making changes and corrections, and I think we owe it to the American people that we serve to do those things. So for all those reasons, I wrote that book and stand by the portrayal of the FBI overall.  What I'm not quite as happy about is I think the portrayal on the other side of David Koresh came up a bit short for me because in reality, David Koresh was a far more dark and sinister, manipulative guy than was portrayed. The other great actor there—there were several of them—but Taylor Kitsch, who played Koresh, was just phenomenal. And he's such a nice guy in real life that I think that came through. And the producer, directors wanted to show the charismatic side of Koresh, what allowed him to attract followers and gain their total allegiance. And they did that, but I just don't think they showed sufficiently. They showed some dark things from him but not enough to my satisfaction. And I talked to them about that and tried to change that. But what you find out is when you sell your book to Hollywood or somebody else, you have some influence, but you don't have control. Douglas: Yep. I think that echoes my read on it as well. It’s a little sensationalized on the, like, kind of making people want to have a little more sympathy than maybe you would have if you were watching it go down from the sidelines. Gary: You know, you’re into facilitation, and I think the biggest takeaway for facilitators, if you want to use Waco as sort of an example, is the realization that life is gray. It's not black and white. It's possible to admit that the FBI made mistakes and at the same time recognize the ultimate responsibility of Koresh to have led his people out peacefully, as we encouraged him to do every single day. So you don't have to say, “Oh, these guys were all good, and these guys were all bad. The big old bad government came in and just wanted to kill people.” I mean, it's actually intellectually lazy to take on those extreme views and not very realistic. There were good people in there who were practicing their faith, and there were highly dedicated FBI agents who wanted nothing but everybody to come out alive. So to make those general derogatory statements, I think, is just showing you haven't done your research, and you haven't read about what really happened, and you don’t understand. Douglas: Coming back to your goals for the book around really cementing the positive impact so they're not lost, it also jumped out to me when you were talking about these post-incident reviews and applying these lessons learned, it was interesting because it seemed like the popularity of the techniques within the FBI began to grow as you started to celebrate some of these wins. But the irony of it all was, maybe one of the ones that I was the most tickled by and I thought that you guys did such an amazing move was the steaks and gravy and cakes for the prisoners. So they're all having a Thanksgiving coma while the tactical thing went in, and clearly, not much credit was given after the fact for that. Gary: Yeah. You know, it's funny. A lot of people in law enforcement are really not well versed on what negotiators do and why we do it. It's sort of a soft science, and you know there’s more to taking action than here's a bad guy. We're going to do this to suppress them, arrest them, whatever we have to do. And, you know, when you do negotiate people out, which we do, in the 90 percentile, people say, “Well, it must not have been so hard. That guy must not have been that dangerous anyway.” And they sort of make some excuses for it. Of course, I always want to say, “Well, you try doing it when somebody's life is on the line.” But it's a hard thing to define.  But just as in facilitation, we're building relationships, and people expect in these situations law enforcement to show up and be very confrontational, very demanding, very dictatorial. You will do this and you better do that, or we're going to do x, y, z. And instead they get somebody like me show up and say, “Hey, David. This is Gary. What's going on in there? I'm here to help. I don't want to see anybody get hurt.” It's something they don't expect, and it gives us an opportunity to listen to them and to better understand what their motivation is, what their feelings are, how they interpret what has happened. It allows us slowly and steadily to lower the tension, to de-conflict and de-confrontate. And it allows us to begin eventually to have some influence over their behavior. And, you know, you typically will get to a point where a guy like David Koresh, which you didn't hear, he said, “You know, I just don't know what I can do. I don't know what to get out of, how to get out of what I got into.” And you say, “Well, you know, here's some ideas for you, and here's something you might want to think about. And come out to jail and tell the world your side of the story. It needs to be heard.” You know, those are things we did, and with some effect, we got 35 people out during the first half when I was there, including 21 children. That’s a fact that many people forget. And it was not an easy task, and I'm very proud of it. I’m no less disappointed that we didn't get more out or everybody out. But you got to recognize that human emotion is a really challenging thing. And when there's been loss of life, like it was at Waco before we even arrived as the FBI, I mean, we were already in a deep ditch, and we got to dig out of that. It's pretty tough. Douglas: You know, as you were speaking, it reminded me of some notes I wrote down around there's a lot of similarities between facilitation and negotiation, but there's some clear differences as well. We’re not dealing with—life and death is usually not at stake. And the fundamental contradiction that you mentioned, which I thought was really fascinating, we don't really struggle with that so much, right? Like, we're all about building trust, but we never, ever have to bend the truth, or we never have to potentially send them into harm's way. And when I think about that story, was it in West Virginia, where Cheryl's husband, her and her child. And there was a lot of interesting dynamics there from the perspective of opening up options and demonstrating a future when you know that that future may not exist. So I’m kind of curious how that unfolds, just as you're kind of regulating your emotions. Gary: Well, it's a tough case. And, you know, my book is about the importance of negotiation and how it is a tool that law enforcement should even use more, and then I start off the first chapter of my book with a situation where we have to use deadly force to resolve it. But it was a very dramatic case. It showed how even in those cases where the behaviors, the actions of the perpetrator are so extreme that our chance of getting them to comply and resolve it peacefully are pretty slim and, thereby, someone else is going to die. So then the negotiator has to segue into a role that allows you to become more supportive of the only option we have left, and that's using force.  In Sperryville, I talked him into coming out to a helicopter, where a marksman ended his life. In the Talladega prison, that you alluded to earlier, we knew hostages were going to die, so we gave in and gave them a very sumptuous meal for the first time in eight days to sort of, excuse the expression, fatten them up and to lure them into a sense of victory and empowerment. And they took the bait and gorged on the food and basically went into sweet slumber that allowed the Hostage Rescue team to make a really terrific, well-executed entry and save everybody's lives.  So there are times where negotiators have to recognize reality, that while we will be successful most of the time, there's nothing in what we do that guarantees success and certainly not 100 percent of the time. So we have to be adaptable and flexible. And the bottom line is, how do we save the most lives possible? Douglas: Yes. That was the thing that was going through my mind in both of those scenarios because Sperryville, you saved a woman and her child; and then the prison example, I mean, how much more carnage would have happened if they would have been bracing for it? Gary: That’s right. I mean, if we had continued to deny them food until they released the hostages, I mean, I think we stood a good chance of having them kill one of the hostages to try to force us to do what they wanted, and that's one less human being alive today to survive that. So we have to take all that into consideration. And you make the best decisions you can, and you have to weigh all the facts. That's why we function—in Waco, I get a lot of credit operating by myself, but in reality, we're leveraging a team of very skilled and talented negotiators that bring a lot to the table from their training and their personal experience. We said, “What do you think? What are your ideas? Did you hear something I didn't hear?” And we really use that to full advantage to try to come up with the best approach that we think will achieve what we want in this particular incident. Douglas: That brings to mind something else I wanted to bring up, which was the comment of you write good notes. And it really resonated with me because I often love to facilitate with a co-facilitator, and I find that when, especially when we're exploring really tough issues that, like, a team is really struggling, like, they can't seem to get past some personal issues, or they're just stuck on some things, when you’re there working directly, it’s sometimes hard to see the big picture because you’re in the content, you're in the moment. But if you're on the sideline kind of just observing, you can see interesting things. So I was just wondering, is that similar in the negotiation world? When you're observing and writing these notes, do you find that you see things you wouldn't have seen if you were just on the phone, in the moment with them, like, watching every word, that kind of thing? Gary: Yeah, absolutely. I think it's akin, Douglas, if you want to do a comparison, you think of a college or a professional football game. You ever notice how sometimes—not all the time—the second half is dramatically different from the first half? I mean, dramatically different? And you say, “Boy, what happened? That must've been a hell of a speech that the coach gave.” Well, what it really was is the coaches up in the booth, they’re studying what happened. They're making adjustments at halftime. It's coaching. It's not being personally involved in playing that position out on the field, but watching it and seeing where changes or improvements can be made to get the outcome we wanted.  So negotiations is no different. If I’m the negotiation coordinator, or the coach, it allows me to listen to the interplay between the primary negotiator on the phone and the perpetrator, and then either in between calls or through passing a short, cryptic note, help nudge them to something I've seen that I think they may not have fully appreciated.  The quote you're talking about is in Waco. This mother was very angry that her son was by himself. He had been released in the Child Protective Services, and we sent a video in of all the children. And she was very angry at us for his forlorn status. And, you know, rather than just trying to defend ourselves, I passed a note to John Dolan, our primary negotiator at the time, and he read it, and he smiled. And it just said, “You know, Kathy, what little Brian needs now is a hug from his mommy.” And you could almost hear the arrow strike her heart. And, I mean, it was the one phrase that kind of brought it home to her that she was the missing piece. It wasn't us that was causing trauma to her child. It was the fact that she sent him out, and she stayed in to fight for Koresh, that it was her maternal responsibility to do this. And I think that shot hit home, and she came out the next day, and she was the first, essentially the first, adult that came out. And that was a very meaningful goal that we’d achieved. Douglas: It really struck home for me when I read that because sometimes people aren't even necessarily self-aware or why they're upset. And if they're lashing out to you, and you can—it's almost like judo, which is redirect their energy, kind of become more aware of where the center is. Gary: Yeah. You know, when you look at negotiations broadly—I'm not talking specifically Waco here—really, very few of them are actually hostage-taking events, where someone's being held to force somebody else to do something. Probably 90 percent of what police do around the country are dealing with highly emotionally charged situations. Often the jilted lovers, romantic situation gone bad; somebody holding an employer who fired them; an argument with a neighbor. There are people who are expressing anger, rage, and frustration who don't even have a clear goal of what they're trying to achieve. In other words, they've gotten themselves into something they have no idea how to get out of. And that's the role that the negotiator could play to try to understand those emotions and those drivers of their behavior, and to try to deal with those and diffuse those. That's what makes us successful. It's an approach that people don't expect from law enforcement. We certainly got that from the mental-health counseling community. And it's very effective in getting people to, for the first time, hear themselves what is driving them, and they may not appreciate, you know? Douglas: Yeah. It reminds me of another note that I had taken around you had talked about the role of the negotiator was to help people express their fears, so allowing them to open up. And it was interesting because as I read it, it was definitely similar to things that we're trying to do in the workplace, because often people have these unstated fears. It's just they're not vulnerable enough to say it out loud because they're worried someone's going to judge them or maybe they haven't even figured it out yet. And so simply stating what might be clear to you but not to them and allowing them to acknowledge it or even just to say yes, I thought that was pretty interesting.  Gary: You know, we used to talk about helping people understand the difference between wants and needs. So somebody involved in one of these situations may say, I want this and I want that, but it's our job to find out what they really need. Do they really need their job back? Or is it the loss of respect and the embarrassment of having to go home and tell your wife you haven't got a job anymore? I mean, you know, we don't always get that right. But that's kind of our goal, you know? And when we're communicating with them, and we say, “It sounds like you're really embarrassed by what happened,” and if he hasn't articulated that and that, in fact, is what he feels, then we've just really scored some big points because he said, “Yes, that's exactly right. I’m embarrassed by having been fired.” Well, that’s important for us to know if we're going to deal with how he's viewing what happened to him. Douglas: So, I had this—it was one of the last kind of sentences in your book. And I wrote it down because I thought it was pretty spot on. So I'm just going to read it, and then I'd love to just hear your thoughts today on this. But, “The happiest and most successful people are the ones that can remain calm in difficult times and put aside emotions like pride and anger that stop them from finding common ground. We need to be good listeners and understand the problems and needs of the other side.” Gary: Yeah. I guess it's never been more true than it is today in our very acrimonious political climate. And I'll bring up some recent events: the protests around the country. When people go out on the street and they carry signs and they're yelling and singing songs, whatever they're doing, what they're basically saying is, “We want somebody to hear us.” Douglas: Mm-hmm. Gary: And if instead of finding ways to creatively listen to them, we simply attack them, we're probably not going to be successful. I suspect if you had 100 people in a room and 50 were pro-life and 50 were pro-choice, you could even have great meaningful discussion all night long, and at the end of the evening, you'd probably still have 50-50. But that's okay as long as we've avoided name calling and shouts and threats and violence and so forth. That's the major goal. It's a slow, steady process to try to create an atmosphere where we can listen to others and appreciate their point of view, even if it's different. And I just hate to see that today, particularly in our political environment, we seem to be going in the wrong direction. Douglas: Yeah. I think that there's a real beauty—I had underscored the statement you made at the end of one of the early chapters, which was, “Listening is the cheapest concession we can make.” Gary: Yeah. It is. It costs you nothing. And, you know, you can acknowledge someone's point of view, “Let me make sure I understand. You're angry at your boss because he fired you. You don't think he appreciated your work, and you felt as though he mistreated you,” and so forth and so on. I'm not saying to him, “Yes, I think you should kill your boss.” I'm saying to him, “I understand how you feel about what happened.” I mean, that's a powerful thing. If you think about it, the whole evolution of communication between human beings, and we're social animals, we want other people to understand what we're saying and how we feel about it. And if you do that as a facilitator, as a negotiator, you're going to be successful. Douglas: Gary, it's been so great having you on the show today, and fun chatting and hearing about just the riveting life and career you’ve had in negotiation. Would you like to leave the listeners with any final words? Gary: Well, I would suggest that people really work on listening. Listening is such an important tool. So when you go out, not so much these days with COVID, but when you have an opportunity to have a social interaction, pick out somebody you don’t know very well or somebody that's a little quiet over in the corner or whatever, and go and talk to them and find out about their life and ask good questions. “Can you tell me more about that? That sounds very interesting. I'd like to hear about that hobby that you have or that trip that you took.” And you'll find that people are far more interesting than you might have realized, that people have done and seen things that you had no idea, and you will learn a lot. And they, in turn, will appreciate the fact that you have taken the time and demonstrated the interest in learning more about them. It is a very, very powerful tool.  And you know, what we all want to achieve is cooperation with other human beings, and we get that through being likable, plain old likable. Just be a person that strives to be likable and to automatically not think the worst of others and blame others, but seek to understand. Even the business guru Stephen Covey says, first seek to understand, then to be understood. So I’m not sure if that helps, but I would urge people to really make an effort at that.  Douglas: Well, thanks again for being on the show. It's been great.  Gary: My pleasure. Outro: Thanks for joining me for another episode of Control the Room. Don't forget to subscribe to receive updates when new episodes are released. If you want more, head over to our blog, where I post weekly articles and resources about working better together, voltagecontrol.com.

Oftentimes patients have a better relationship with their hygienists as they spend more time interacting with them. In today’s episode, Gary examines the role of the hygienist in increasing your case acceptance. Gary highlights the importance of measuring your case acceptance rates as well as acceptable benchmarks dentists should strive to attain when it comes to case acceptance. This episode is full of tips to help increase case-acceptance rates for your ideal treatment plan significantly.  Intro to topic > 01:30 Benchmarks > 03:56 How to get there > 08:02 Tips to make hygienists your partner > 10:35 Raising the bar > 21:50 About the last MBA of 2020 > 23:30 Resources LEARN MORE REGISTER LEARN MORE Transcript Naren: This is the Less Insurance Dependence podcast show with my good friend, Gary Takacs and myself, Naren Arulrajah. (Gary’s voice): We appreciate your listenership, your time and most of all, we appreciate your intention to reduce insurance dependence in your practice. Our goal is to provide information that will help you successfully reduce insurance dependence and convert your practice into a thriving and profitable dental practice that provides you with personal, professional, and financial satisfaction. [Music] Naren: Hello, everyone, welcome to another awesome episode of the Less Insurance Dependence podcast show. This is Naren, your co-host. Today, we are going to be talking about something interesting. This came because Gary and I were having a conversation the other day about some of our common clients. And one of the things that I asked Gary about is, "Hey Gary, what's the secret for the common clients, meaning the coaching clients who also happen to be, you know, our Ekwa clients, doing so well in case acceptance and specifically some of the comments I heard about, you know, them working as a team towards case acceptance". So Gary said, "You know what, let's make it a podcast episode", and here we are. The topic today is ‘Hygienist as your partner in case acceptance'. So this comes from Gary's experience, working with 2200 practices, you know, fine-tuning LifeSmiles and the client practices. So let's jump in. Gary, how are you this afternoon? Gary: Naren, I'm doing great. And I love this topic, you know, and I'm so glad you noticed in our common clients, some really great results with our clients. And I'm talking specifically is our case acceptance percentage. We measure that. You know, we measure that. You've heard me say, Naren, that data never lies. People do. When I say that, I don't mean that cynically. But let me, let me get very specific about what I mean on case acceptance. If you do not measure your case acceptance percentage, you may have a very different perception of what's going on in your practice than what's really going on, because you're likely to remember it anecdotally. Let me explain what I mean. If I talk to a doctor and I say, "Doctor, tell me how your case acceptance is and others when you present dentistry, how are you doing with patients accepting that," If they don't measure it, they might say something like this: "Well, Gary, I think I'm doing pretty well because yesterday we had two new patients. Both of them needed treatment. I presented the treatment and they scheduled. So I think I'm doing pretty good." You know, remember what their memory time is, it's yesterday, you know, and it's their most recent experience. Conversely, if they don't measure it, the doctor might say, "I don't know, Gary. Yesterday, I had two new patients. Both of them needed treatment and neither one of them scheduled. I think I suck at that". And neither one of them is accurate because it doesn't have a  ... it's not scientific. It doesn't have a long enough, you know, range of measurement. But when we start measuring it, it actually gives you information out. Naren, you know, I'm going to quote Stephen Covey and, you know, I'm going to quote the second habit. You know, Stephen Covey, the epic author of Seven Habits of Highly Effective People. And the second habit was 'Begin with the end in mind'. So is it okay if we start there? What should (00:03:52 – 00:03:53) case acceptance be? Naren: Great. Let's start there, Gary. Gary: Okay, so these are the benchmarks we use with our clients. At emergency dentistry, in other words, the patient came in on an emergency, they've been awake the last two nights, haven't been able to sleep with a toothache, and you present what should be done. What should our case acceptance be on emergency dentistry, Naren? Naren: I think it should be close to 100 percent, maybe 90 percent. Gary: Well, I'm gonna correct you, say 100 percent, one hundred percent. If it's a true emergency, you know, the patient hasn't slept in two nights and we can help them. Can we agree that that should be 100 percent? Naren: Absolutely. Gary: Yeah. So now but let's talk about the, what would be likely more common. Let's talk about necessary dentistry, where the situation is asymptomatic, where it's asymptomatic. No, it doesn't hurt. And a great example of that would be old amalgam fillings that are clearly breaking down. And you can see every different way you measure, you can see it through radiographic evidence, you can see it through photographic evidence, you can see it through visual inspection. And then you even ask the patient, "How long ago were those placed?" And they'll say, "Geez, I don't even know. Gosh, it has to be 25, 30 years ago". You know, we often hear that, right? So for general dentistry, that's asymptomatic, that it doesn't hurt. Our goal is 70 percent case acceptance. And notice I didn't say 100. And the reason I didn't say 100 is, we always like to set our goals realistically. Realistically, there will be some people with those asymptomatic old amalgam fillings that need replacement, "Oh, doc, I'm just going to wait till it hurts", which is not a wise decision, but that's what their thinking is. But our goal for general dentistry, that's asymptomatic, we should for 70 percent case acceptance. Now, let's go a little deeper for optimal dentistry. In some cases, you're going to think of elective treatment. They don't need to have it done. Optimal treatment, ideal treatment, comprehensive care. We look for a case acceptance somewhere between 30 and 40 percent, 30 and 40 percent. And the way I like to share why we benchmark it there, Naren, I happen to enjoy baseball. I grew up in a baseball family. And on a professional baseball, a player, Major League baseball player, if a Major League baseball player has a career batting average of, say 350, Naren, I know I'm going to ask you this question and I know I might be taking you slightly off-field /afield (00:06:38 – 00:06:40) because you're in Canada and you probably think more about hockey than you do baseball. But I'm going to take a chance and ask you that question. What would we call this Major League baseball player that had a career batting average of 350? What would we call that person?   Naren: Hall of Famer? Gary: OK, you got it right. I was a little worried there for a minute. If I asked you a hockey statistic, I'm sure you'd get it right, but you got it right. We'd call that person a Hall of Famer and let's break that down. What does that mean? That person got a hit 35 percent of the time, 35, and yet they're a Hall of Famer. That means they didn't get it 65 percent of the time. So let's translate that to case acceptance for ideal care. Then we're going to look for somewhere between 30 and 40 percent, somewhere in there. Even 30 percent on the low end of our goal is pretty awesome. You know, if a career Major League baseball player had a career batting average of 300, yeah, that person had a very, very, very good career. So that's how we benchmark that, 100 percent for emergency dentistry, 70 percent for asymptomatic general dentistry, and somewhere between 30 and 40 percent for ideal care, comprehensive care, elective care, the care that we like to say things to consider, you know, things to consider. Now that we have the measurement, we begin with your mind (00:08:00 – 00:08:05), let's talk about how to get there, right? And I love thinking about your hygienist in particular as your partner doctor in case acceptance, your partner in case acceptance. And think about it for just a minute. Sometimes, sometimes doctors don't want to recognize it, but I think we need to recognize it, sometimes the hygienists have a closer relationship with the patients than the doctor. Would you agree? Naren: Hundred percent, that's the case for me, you know, like because I see the hygienist for a longer period of time and I see the hygienist more consistently, especially if you have the same hygienist. Definitely, I kind of look forward to seeing her because, you know, I know her. I know her kids. I know, you know, and we have similar kids in similar ages. So we chat, you know, because when I'm sitting there, you know, I have to do some thing, so I chat, yeah. Gary: Well, there's another dynamic here. You know, a patient might have a little bit of a cynical perspective if a doctor is recommending treatment, you know, they might be saying, "Well, of course, you're going to recommend that, doctor, it’s your practice. You know, you have a lot to gain from that". Now, I don't think everybody looks through that lens, but some people might. But they view the tier team members as more independent and they view your team members as they're likely, think about your patient base. Your patients are likely to identify more socioeconomically with your team members than they are you. That makes sense? Naren: That makes total sense. I think, I have even overheard some people say, "Hey, you know, doctor said this. Do you think I really need this?" Gary: We hear that routinely, as approachable as Dr. Paul and Dr. Tim are, you know, they'll ask the patient, "You know, do you have any questions?" And the patient will shake their head, "No". And they'll leave the room and then they'll practically tackle the dental assistant or the hygienist and say "I don't know, what do you think?" You know, I don't, I wouldn't take that personally. I don't think that has anything to do with Dr. Paul. or Dr. Tim's demeanour or the presentation. I think they're looking for validation for, subconsciously they're looking for validation from someone that seems more similar to them. Naren: Yeah, this is Dr. Cialdini's principle called 'Similar others'. So, you know, "Hey, I can relate to this hygienist. I'm kind of like her, you know, socioeconomically, family, you know, etc., etc... So, hey, I want her opinion. What does she think?" Gary: Yeah, yeah. Okay, so let's talk about some techniques and some tips for a hygienist to be partners with your doctor. And one of the things I want to encourage our hygienist to do is to prepare for your appointments, to look ahead. We get this in the morning huddle, but you can do it on your own, you can do it in the morning huddle. But look at the patients that are on your schedule today. Look in their treatment plans and see if there is any unscheduled part of their treatment plan. In other words, treatment that's been recommended but hasn't been scheduled. Now, your practice should have a good system for noting that in your digital records, somehow. Pretty much every practice has, they have a system for checking off what's been done and what remains to be completed in the treatment plan. And let's go back to that example that we used earlier about the asymptomatic old amalgam fillings that need to be replaced. So let's say, I'm the patient and I have some fillings on the upper left that have been recommended by the doctor to be replaced. But I haven't scheduled that yet. The hygienist can bring that up in a very educational way. You know, she can say, "Gary, I noticed the doctor recommended some fillings for that area on your upper left. You know, the one thing, the reason why the fillings were recommended is there's very likely to be decay underneath those existing amalgam fillings that you have. Very, very likely." And you might be thinking, "Well, I'll just wait till it hurts." But if you wait, decay never fixes itself. It can't scientifically fix itself. Decay only gets worse. And if we wait till it hurts, what now could be treated with fillings, in other words, replace it with new filling material, might be more comprehensive treatment like a root canal and crown. Now, that'd be good for us, but not good for you. “I'm going to have doctor take a look at that when Dr. Paul comes in to do the exam today. I'm going to have Dr. Paul take a look at that. Just give you a status report, so you can, you know, you can kind of decide what to do from here”. And that's it, you know, just a heads up, I've noticed that, so now you're earning favor with your patients because you're paying attention. "Gary, I noticed that doctor recommended fillings on the upper left that remain to be completed. I'd like doctor to take a look at those today and kind of give us a status report." And then when doctor comes in the room, make a verbal pass off, you know, in front of the patient. That's called the 'overhear' (00:13:05 – 00:13:07)technique. And it might sound something like this. "Dr. Paul, would you do me a favor and take a look in the upper left for Gary? I noticed that he has some old amalgam fillings that you've recommended replacing, that remain to be completed. Would you do me a favor and look at those and give Gary a status report on those? I'm concerned about that area." Notice what I just said. "I'm concerned about that area". Naren: Right. Gary: Now, Naren, put yourself in the position of being in the chair as a patient. If the hygienist says "I'm concerned", what just happened to your ears? Naren: They're gonna perk up. Gary: You just perked up. Naren: Yeah. Gary: Right Naren: Yeah. I mean, I think the people who go to hygiene visits regularly, they want their teeth to be maintained. So that's the mindset they already bought into. So when the person who's responsible for that, the hygienist says, "I'm concerned", I'm concerned too, meaning, me, the patient is concerned too. Gary: Right. Now, and that conversation can be held with any patient that has recommended treatment that remains, remains to be completed. And of course the doctors listen to this. Doctors, I want to help you with verbal skills as well. When the hygienist, you know, does the verbal transfer of information to the overhear technique, I want you to say, don't script this, but in your own way, "Kelly, thanks so much for pointing that out. I'll absolutely take a look at that. Thanks so much for pointing that out to me." And it's just the patient's going to feel like "I'm being taken care of by a team of professionals. They are on top of it, they've got my best interests at heart. Right? But now let's talk about how the hygienist can actually be, you know, kind of a scout, an advanced scout for elective treatment for what we call a high value treatment. And this is so powerful and it's something that you're seeing it now in our clients. Now we're talking about that 30 to 40 percent of ideal care. You know, the ideal care, the elective care, the comprehensive care, the things to consider. So imagine you do adult orthodontics. i just like this (00:15:24 – 00:15:26), I'm going to role play with some information. Imagine your office provides adult orthodontics. And imagine that the hygienist notices that the patient has some crowding in his lower arch. His lower teeth are crowded. Okay? She can say something like this. "Gary, let me ask you a question. If there was a way to correct the crowding in your lower teeth, relatively quickly, would you have any interest in that?" "Oh, yeah, yeah, I really would, you know, I just, I don't want to look like I'm back in middle school again, you know, and have it take two years and, you know, but if it could be done quickly, yeah, I'm interested in that." Well, we offer adult orthodontic treatment for our patients today. And one of the really cool things about the advances in orthodontics, things can be done much quicker than they were in the past. "I'm gonna have doctor, when doctor comes in and does his exam today, I'm going to ask him to take a look and see if you're a candidate for adult orthodontics today". And then when doctor comes in, make the pass off and the pass off might sound like this. "Dr. Tim, Gary's interested in learning if he... in the crowding in his lower arch, he's interested in learning if he could be a candidate for adult orthodontics, would you do me a favor and take a look at that?" And hopefully it's good news. "Great news, Gary. Absolutely. You're like the perfect candidate for Six Month Smiles, for Invisalign, whatever it is you do". But notice the role and notice how it was done, Naren. If I say, "I'm going to ask Doctor to take a look and see if you're a candidate for that", how does the patient feel? The patient is anticipating, right? "Okay, I hope I am." You know, hope I am. And most of the time, you know, I'd say 95 plus percent of the time, they're absolutely a candidate for it. And one of the things you can do, doctors, is you could run an in-service training for one of your team meetings and just educate your team members about who are candidates for some of the procedures that you do. You know what? Who are perfect candidates and just let them understand that. But notice the questions she asked. "If there was a way to correct the crowding in your lower teeth, would you have any interest, and relatively quickly?" Or if there were, "I noticed there are spaces in your lower teeth, if there was a way to correct those spaces relatively quickly with adult orthodontics, would you have any interest?" Very simple. We're not looking for occlusion, we're not looking for posterior occlusion, we're not looking for canine guidance, what is it I’m just looking for, crowding or spaces? Naren: Right. Gary: Is that within the bounds of a hygienist to identify crowding and spacing? Naren: Absolutely. Gary: Absolutely, it is. Naren: Absolutely. Gary: In fact, if it's crowding, she can even say, “One of the concerns that I see there, Gary, it's hard to keep that area clean when you have crowding. It's hard for you to do your home care with that,” and so it's a right within her authority to identify that. Now, interestingly enough, as I presented this to hygienists over the years, most hygienists get really excited, "Oh, yeah, I, of course, I can identify crowding and spaces." I had a hygienist ask me one time. Said, and she had a good question, she said, "Are patients ever offended if I say they have crowding or if they have spaces?" And I answered it as I'm going to answer you in this podcast, Naren, "I've never heard the patient respond with any offense. They know their teeth are crowded. They know they have spaces. It's not, it's not like news flash. But now you're, you are viewed and, this is what I want a hygienist to take away, you are viewed as one of their providers in this practice. They respect you. They respect your wisdom. And I, up to date, now maybe that will change in the future, but I have never heard a patient respond in being offended by the fact that the hygienist said crowding or spaces. Naren: Gary, is it okay if I share something that I noticed about what you do with your coaching clients real quick, Gary? Gary: Please. Naren: See, many of these things are not like one time you learn about it and we are done, right? These are things that are ongoing. And the thing I love about your approach to all of this is you look at it like, you know, let's say you have a BMW car and you are with a BMW dealership. They treat you like a VIP. They do things for you. They pick you up, they drop you off. They'll tell you when things need to be taken care of. And the damn car is solid. So it usually doesn't break and they just take care of things, so you don't have to worry about it. So I think, you have kind of built that model, in even though we are using the word coaching, it's really practice management support where, you know, you have verbal skills training, you have team training, you have book clubs where you did a book club on, you know, case acceptance. So, you're constantly reinforcing these ideas. And then, of course, your practice management support team just, you know, checks in with people to make sure all these things are happening consistently. And of course, you check the numbers, you and your team look at the numbers and say, "Hey, is it working or is it not? If it is, then great, good job. Keep doing it. If it's not, let's troubleshoot. Let's figure it out." So, I think you have figured out something Gary, that is, is like a game-changer. And you are doing this virtually, so the cost is also like really, really low. Gary: You know, it's an empowering exercise, Naren, when you have good team members. They want to contribute to the success not only of your practice, but they want to contribute to happier, healthier patients. And let me go back to this adult ortho. I can't, you know, adult ortho's a big part of our practice. We love helping adults have beautiful, healthy smiles. And I can't tell you how many times the patient, you know, has come back as, "I am so happy I did this. You know, I am so happy. I mean, I've never felt better about the appearance of my teeth." And that's heart-warming for patients. You know, it's very much patient-centered. I think maybe that's where we can close today's episode. This is about really raising the bar on how patient-centered you are. Are you really patient-centered? If you see something that needs attention or that could benefit the patient and you don't bring it up. I mean, I think we let our patients down. Now you're not intentionally letting them down, but I think we let them down if we don't share, you know, information with them. What we want to do is we want to share information with them so they can make great decisions. Hey, if the patient says, "I don't care one bit about the spaces in my teeth”, make a note in the, you know, in your digital records and don't bring it up again. Don't pound a square peg in a round hole. You can respect that decision. But most people, and I'm talking about way, way, way above 90 percent, are going to respond with interest. They want to improve that. So think about it in the context of really being of service to your patients and truly being patient-centered. It's like you have this information, and you keep it to yourself, that's not helping them. Let's share it with them, share it with compassion. Let's listen. And like I said, if the patient doesn't have any interest, no harm. And on the rare times where a patient doesn't have any interest, they don't feel offended that you brought it up. They're thankful, but they may be, for whatever reason, they don't have any interest. Gary: Well, Naren, as we wrap this up, I think this episode will be a good one for our Less Insurance Dependence listeners and remember those benchmarks. I want you to shoot for those goals on your case acceptance. A last reminder, as you're listening to this, very soon after, we have our very last Thriving Dentist MBA livestream workshop. That is Saturday, December 5th. That's the last one of 2020. It's coming up on Saturday. December 5th, it's eight hours. I go through the 10 elements of a thriving practice. I want to encourage you to attend that one because you will have all kinds of information to allow you to set goals for 2021 that will, in fact, result in 2021 being your best year yet. Come join us. It's all done livestream. It's eight hours of CE. (00:24:04 – 00:24:06) We do it in a workshop format. We go through 11 different exercises so you can apply this information to your practice. And at the risk of sounding proud, this will be one of those CE events that you will look back on in your career 20 years later and say, "I am so glad I took that MBA livestream workshop because it literally set me on a course that changed the direction and results of my practice. Come join us. I'll put a link in the show notes. You can register for that. They do sell out. I would encourage you to go to lessinsurancedependence.com/mba. And if there are spots available, I would encourage you to sign up. You'll notice that the tuition is very affordable because of the livestream format. We strive to make that as affordable as possible. On that note, let me thank you for the privilege of your time today. Hope I get to see you at that Thriving Dentist MBA workshop.

In this episode, Gary and Naren discuss the dreaded last-minute cancellations and appointment no shows. Gary goes into detail on how to create an ASAP list that will help you reduce these last-minute cancellations and no shows in your practice. Highlights: Introduction to today’s topic > 01:00 Learn about the upcoming MBA > 01:27 How to handle patients who are always canceling or not showing up > 05:19 Learn more about the ASAP list > 13:28 Learn more about the VIP list > 14:15 How to building your ASAP list > 16:15 Come join the I love Dentistry community > 20:06 Resources: REGISTER NOW JOIN THE TRIBE Podcast Transcript Naren: Hello everyone. Welcome to another awesome episode of the less insurance dependence podcast show. This is Naren, your co-host. Today we have an amazing exciting topic for you. This was something that many, many, people wrote in and asked Gary about. We called it your ASAP list. Gary has spent a lot of time over the last 40 years in his coaching work as well as in his life smiles dental care practice figuring out how to handle patients who have a pattern of cancellations and no-shows. So, this is going to be a treat. Before I get into the podcast, I have an announcement. We have MBA coming up on July 17th and 24th, 4 p.m. To 8 p.m. Eastern. I wanted to first talk to Gary about what happened with the MBA he just got done yesterday. So, Gary good evening. How are you this evening? Gary: Hey Naren, I'm doing great. As we're recording this, I'm sort of feeling the afterglow of having just finished our June one-day thriving dentist MBA. Now this we needed to retitle the name because we didn't do it in one day. We actually took three evenings. We want to try to present different formats to try to be accommodating to folks’ schedules and so we did it. A nine-hour program. We did three hours on Tuesday night, three hours on Wednesday night, and three hours on Thursday night. And man, that was fun we had so much engagement by our attendees. One of the things we do in that thriving dentist MBA workshop, the workshop is all about the ten elements of a thriving practice. We actually turn the workshop into a coaching experience and we do that two ways. We do it through exercises. So, each one of the elements, each one of them has an exercise. A simple exercise but it's something for our doctors and office managers to do in the workshop that will allow them to take the information and apply it to their practice and the second thing we do is throughout the entire course they're invited to submit questions and then we have specific time to have Q and A sessions to answer their questions and I know you were there the entire time there and helping me moderate it but man the engagement level was amazing and I feel like we are turning out ambassadors to go out and apply these ten elements in their practice and I felt really good about it and it was such a great experience. I can't wait till the one in July. Now July is a little bit different. Again, we're experimenting with formats. Same content but we're going to do it in two sessions and two four-hour sessions. So, four hours on Friday the 17th of July and then the following Friday we're going to complete the one-day workshop and that should be convenient for some and I just want to consider this an invitation to come join. If one of the elements of course is becoming less insurance dependent. So, if you listen to this podcast, you're going to absolutely treasure that one-day MBA because a big part of it is all about successfully reducing insurance dependence. Naren: Thank you so much Gary for that and I do think you're also doing a big service because you're not only offering this to people who don't know anything about the 24 elements and sort of 10 elements in the 24 systems but you extended it to your coaching clients. So, they now can train every one of their team members especially the office managers with these fundamental principles of how to run thriving practice. So, kudos to you for doing that and I really appreciate it, Gary! Gary: Man, it was fun and July we'll have a blast with that. So, if you like attending CE where you get lots of content and you also have a great time, I think you're going to love this. So, come join us and the pricing, because we're doing these live streams, we don't have airline expenses, we don't have hotel expenses, we don't have catering expenses and so we have cut the price to the bone and it's very affordable. I think it's probably the most affordable way to get six hours of CE that you could possibly take. So come join us. Naren: Let's jump in Gary. This is a question that I’ve seen maybe tens and tens of times maybe even a hundred times. How to handle patients who have a pattern of cancellations and no-shows? Gary: Naren, I would love to tell you that I don't know what you're talking about. We don't have cancellations and no-shows in life smiles and I would not be telling the truth if I said that. So, hey every prize, so if you feel like, oh my gosh we're just getting deluge with cancellation no-shows and that might not be true right now, right now, in the COVID era where you've been shut down for 7 10 12 weeks. We're not experiencing a high percentage of cancellation and no-shows and if we do, we've got a call list as long as our arm. So to get people in, but think back to February maybe beginning of March and if you are pulling your hair out because of cancellation and no-shows just know you've got a whole lot of company. I mean every practice has that, and I wanted to come up with some strategy to deal with it because it's a pattern that keeps happening and it's like what you do and we came up with something that  has worked brilliantly in our practice. It works brilliantly in our client base. Every time I share this with their clients their eyes get as big as saucers, they're like oh my gosh why did I not think of that, why did not I think of that. So Naren, is it okay if I dive right in? Naren: Yes please Gary: So, let's begin by recognizing that you have to start looking for patterns. If you have a patient that has routinely shown up for their appointments, I mean their pattern is that they're routinely showing up and then they have an aberration and they call you in the morning for a hygiene appointment and say, Carly, I'm  so sorry I have an afternoon appointment with Kelly this afternoon for hygiene and I'm not going to be able to make it. I just got called into an emergency meeting at work. I am so sorry I know I'm supposed to give you 48 hours’ notice and I just I didn't know until now. If I don't go to that meeting, I'm losing my job, now Naren can we recognize that that's different than a pattern of cancellation and no-shows? Naren: Absolutely Gary, yes! Gary: That's different and I think common sense for all of our listeners prevails in a situation like that. Say of course, thank you for the courtesy of the call we understand and then we're going to scramble to fill it, but now what do we do with George and I'm going to make it a male patient because it's more likely to be a male patient Naren: Yeah Gary: I hate to say it but it is, and I am going to make this example, George, and when we look at George’s record, he shows up maybe 20% of the time that we've made appointments for him. If you look at it in Reverse Naren: can I share, I'm going to put myself on the line here and Gary: Okay George, go ahead George Naren: so, we all have mindsets, right? We run our lives based on our mindsets, the way we think. In my mind if I have to choose between a meeting with Gary and my dental appointment, I am choosing my meeting with Gary. I'm being honest, right? Gary: I will take that as a compliment, Naren. Unless you were a life smiles patient and then oh man I get it Naren: So my problem is they typically ask me to book 6 months in advance. I don't know when I'm going to have these meetings that I really want to have because I have fun in it, I enjoy it. So usually what I tell my dental office is please call me a couple of weeks before. That way I can definitely make sure that I find a time when and I don't tell this to them when I don't have those fun meetings like the meetings I have with Gary, so that way it's easier for me because a week or two ahead of time all my meetings with you and now the other stuff that I enjoy is already in my calendar. Six months ago, if I asked you Gary when are we going to talk six months from now you won't be able to tell me. So, I'm one of those patients Gary who won't show up if you book an appointment with me six months in advance. I'm being honest. Gary: Well let's go back to fundamentals, Naren. Here's the fundamental on that one Naren: Yeah Gary: and I want to raise my hand and say Mia culpa I’ve been part of the problem on this and let me explain what I mean. In 1982, my goodness thirty-eight years ago, I was the guy that stood up and said nobody should leave your office without making their next hygiene appoint, their next hygiene appointment, and I started teaching that in 1980 and I said they're right in front of you and back then we didn't have in computers and so we had to get the book out the big book the big appointment  book where the scheduling team I would have to flip the pages six months out and she'd make you an appointment and I was the guy who said nobody leaves your office without making their next appointment and I taught that from 1982 to 2007, okay? Do the math on that pretty quickly. I believe that's 25 years. Naren: Right Gary: 1982 to 2007 and then I experienced in my own practice the mistake of that and how I discovered it was, I have to tell the story because it is imprinted on my mind. My office manager Stacy, we had a seven o'clock appointment and the seven o'clock appointment was Charlie Raggle. I know I'm violating HIPAA but Charlie won't be listening to this, so I think it's okay. Charlie's a football coach for Chaparral High School and he was there at seven o'clock in hygiene, and I was excited I happened to be in the office that day and I was excited that Charlie was coming in because I wanted to talk to him about setting up our are coming mouthguard project that we're going to be doing for the team and anyway 7 o'clock rolls around. No Charlie 7.05 rolls around no Charlie. 7:10 no Charlie and I walk up front and in my most emotionally intelligent manner I say Stacy, where's Charlie? She said Gary, I knew he wasn't coming. I said well Stacy if you knew he wasn't coming how come you made the appointment and without missing a beat she said because you told me to and I like aha I did guilty as charged because I told Stacy nobody leaves our office without making their next appointment. She said Gary Charlie, single guy, football coach. What does he care about? He cares about football. Naren: It's like me like I have other things that I have fun with I would rather go to the other stuff if I have a choice Gary: So, she said Gary I knew he wasn't coming and right then I said this is a teachable moment for Gary. Hey Stacy let's look at our digital schedule. Let's look later in the week. This was a Monday. Who else isn't coming? And she went right through the list and she identified about 10 hygiene patients that were highly likely of not coming, okay? Naren: And knew who these people are Gary: She knew it like I mean her instincts were amazing. So right then I made a shift I said quit reappointing everybody and what we learned after the fact that about 90% of the patients in any practice, you can appoint in advance whether it be three months, four months, for six months. But about 10% again that could vary your practice it could be 92% you for your point it could be 85 but it's in that range, it's in that range. In the 90% rate but for those 10% don't pound a square peg in a round hole. Don't pound a square peg in a round hole. Don't try to fit near in with your noted priorities and I'm not going to try to pound you and you, I’ll call you the square peg. I'm not going to pound the square peg in the round hole Naren: Right! Gary: Now that's one but now let's go to this ASAP list. Now let's play Naren and you're the guy that historically 20% of the time, you've shown up. So, here's what we do with you. We say Carly will say to you, hey Naren and this is after you've broken another appointment. We've no showdown another one, Carly will say Naren, I can't make appointments for you anymore because when I make appointments you don't show up. Now Carly has the best temperament tone of voice style to do this and nobody has ever felt insulted. They always say oh I know Carly I'm such a knucklehead, I know I know and then Carly says I get it, Naren, here's what we're to do. I'm going to put you on my VIP list. Now just I’ll come off the role playing for a minute. It's actually not the VIP list it's actually the what list and I won't say it because we want to keep our clean lyrics rating on iTunes but it's the other list that starts with a four-letter word list. But we are not going to tell you, we're going to say Naren, I'm going to put you, we care about you and we know if we see on a regular basis, we accomplish two things. We keep you as healthy as possible and reduce your future dental expenses. So, here's what I'm going to do. I'm going to put you on my VIP list. Here's what that means: let me make sure I have your current cell number. Oh, yep that's it, okay. Now I'm going to shoot you a text now and again. It'll be the text message, it'll be a text message, it'll be the same day. It might be an hour from now, it might be two hours, it might be five hours from now. But I'm going to send you a text message and the text message is basically going to say hey we can see you for a hygiene appointment at two o'clock. If you want it, text me back. Now understand I’ve got a few other VIPs. Now they're not quite as good a VIP as you Naren, but I’ve got a few other VIPs. So, if you want it to respond back quickly and so now, I want to knock on wood, Naren. So, my desk is made out of wood. I’m knocking on wood because I don't want to curse myself here. As of this very moment that we're recording this since we started doing that if we have at least an hour advan10ce notice at least an hour advance notice, we are 100% at filling that opening appointment later in the day. Now someday we will be able to say and notice I said at least no no's because this doesn't work for a no-show and here's why because by the time we know you're not coming and get the message out you don't have time to get there for the hygiene appointment, got it? Naren: Yep Gary: But this applies for the patients that will give you a courtesy of a call and many will. Then we can use the ASAP list. Now here's how you build your ASAP list. I want to be firm about this. It should have no more than 12 people on the list, 12, because if you send it to too many it will be overwhelming and if you send it to too few you might not be successful with it so 12 is the number, we tested it. 12 is the number. Half of those people, maybe six of them, will be people that would like to be seen sooner. They told you oh if someone was up call me, let me know. The other half are these chronic cancels or no showers. Now when we started this I had no idea if this was going to work but i've been surprised pleasantly at how often the people that fill those appointments are look at out of the chronic counsellors a no-shows because they're like you they're good people they just are not organized enough where their priorities aren't sorted enough to be able to keep an appointment three four six months in advance but meanwhile you're sitting, now this would be you, Naren because you're busy but maybe this guy George is sitting at Starbucks. He gets a text message from Carly, Hey George turns out we can see this afternoon or two. Let me know if you want it. Hey this works George text’s back and we found, I can't say a hundred percent but most of the time they are really loyal about keeping that appointment later in the day because it works for them Naren: Yeah Gary: That's how we've been able to fill those short notice cancellations, very simple. It's done with a group text that goes out and it goes out to those twelve people and it simply says hey we can see you this afternoon or if we know the hydrogen hey Kelly can see you this afternoon at two o'clock thought of you if you want this appointment text me back. Now, many times will two or three people want the appointment? We'll go to the first one but we get two or three and then we respond back to the other two or three and say too slow next time be quicker with fingers, okay? I will keep you in my list and it's a great way to handle those short notice cancellations. Now Naren: I have a quick question, Gary. See I hate people when they cancel on me and I hate to not show for appointments. So, I ain't on me. I'm very outspoken. So I literally fess up and say what, let's mark something six months in advance but knowing me can you do me a favor can you call me a couple of weeks I had just because I know when I booked something couple of weeks ahead I am rock-solid but it's just a little too advanced for me to kind of like for example there might be an even that I want to go a lot of things can happen in six months right. So, I don't know if I'm breaking the system. Is this kind of one of those crazy buckets that? Gary: You might be an exception to that because really, I want this to be the same day. Naren: Same day, okay! Gary: So you are probably not the right situation for this but I'm surprised at how many of our what we're calling VIP list patients Naren: Show up Gary: sure love this system. They respond back and it just so happens to work for them and because we've got 12, it is going to 12 people. Naren: Right Gary: You have got a 100 percent chance in finding one, all I need is one. Naren: one exactly Gary: Now again some details on this. You want to send out by text. You want to send it to 12 people and the message is just a simple straightforward message that says, it turns out Kelly can see us this afternoon at 3:00 thought of you, text me back if you want it, and that has quite literally solved our short notice cancellation problem in hygiene. It's quite literally solved it. Hey as we're kind of coming to the finish line here, Naren I want to share something with their listeners but I want to share with our listeners. We have an I love dentistry community, Facebook community. If you're listening to this and you're not part of the I Love dentistry Facebook community, let me invite you to come join us. It's a private Facebook group. It's doctors and office managers and team members. Come join us and you can go to I Love Dentistry on Facebook and you have to request admittance it's a closed group just say you're a listener to the less insurance dependence podcast show. We will let you in. We will give you a secret key and will let you in and we'd love to have you join us. It's a group. It's all about what the name says it's people that absolutely love dentistry and we're there as a supportive community, lift one another up to share information and it's a place to go to recharge your batteries when you need that and to connect with an amazing group of people that'll be your new best friends but recently one of our community members posted something very cool. Naren you'll remember that she said hey Gary, hey Naren I just over the weekend binge listened to a whole bunch of less insurance dependence podcasts and I can't wait to apply this in my practice and so she discovered and I don't know if she's a new podcast listener or something but she discovered that she could download all of the episodes. As this one's coming out, I think this one might be episode 91. 91 or 92 something like that, but all of those episodes can be downloaded and she kind of did like a Netflix binge listening exercise and she had all kinds of cool information she's going to plan her practice. So if you haven't done this, know that you can download all of the episodes, they're free, and it's our way to help you successfully reduce insurance dependents. We're creating a grassroots movement. I'm all about preserving private practice dentistry and we want you to be part of that and please, if you haven't done it already download any of the episodes, they're all free and maybe you could be one of those binge listeners as well. Well listen. Thank you, guys thanks for, joining us we appreciate each and every one of our listeners here on the less insurance dependence podcast. Thanks so much. If you haven't done so, there are three things you can do to support our work here. You can share less insurance dependence with your friends. Maybe some of your friends don't know about this. Share it with them. Secondly you can jump on iTunes under less insurance dependence and write us a review. That'll help more dentists find us. By the way, for those of you that have written recent reviews, thank you so much and then the third thing you can do is you can hit subscribe. If you hit subscribe you can do that on iTunes or Google Play. That means that every Thursday when we upload a new episode, it'll be automatically uploaded for your listening device, for your listening convenience. Thank you so i'll add note let me simply say thanks we consider your time to be precious and I hope we've shared some useful information with you today.

What's Dan got against Gary? Well, he lists a few things... Check out this week's Questions, Clarifications, and Crap they got wrong with our friend, Dan Lowman.

Welcome To The Mike Dillard podcast, where entrepreneurs like you get the knowledge and skills you need to bring your dreams to life. Well gang, welcome to the new format and the inaugural episode of the Mike Dillard Podcast. Wait a minute… What? Where did Self Made Man go? If you’re wondering what in the world is going on, and why I’ve changed the name of the show, head over to my YouTube Channel and please watch the video that I just posted this week which will give you all of the details. Make sure you hit the subscribe button as well because I’m going to start posting videos there on a regular basis. With that being said, I can tell you this… Part of the reason for the name change is a result of the personal work I’ve done over the past year, that you’re about to discover here today. We’re joined by Gary John Bishop, and this interview is one of the single most profound discussions that we've ever had on this podcast over the past four years. So who is Gary? Well, for the most part, he was just a regular guy meandering through life, when he found himself attending a personal development conference many years ago on a whim. He wasn’t necessarily searching for answers at the time, but he decided to go on the recommendation of a friend, and what he learned during the next few days would completely transform his life. Now you’re clearly into personal development, which is why you’re listening to this podcast right now. But here’s a question for you… Why aren’t the lives of everyone who dives into the personal development process, radically changed? How many people do you know, and maybe you’re one of them, have read all the books, listened to all of the podcasts, and attended all of the events… And yet they still struggle? Well, that’s what you’re going to discover here today. Resources: GaryJohnBishop.com Follow Gary on Twitter | Facebook | Instagram Unfu*k Yourself: Get Out of Your Head and into Your Life Stop Doing That Sh*t: End Self-Sabotage and Demand Your Life Back Music: Music by: Star Party Song: Legends Licensed under a Creative Commons License  

Are you a last minute shopper? Never know what to get your secretary Agnes? What about your preacher Gary? Well move over Oprah because there’s a new, hot, gift list in town! This week Muñoz & Marie take you through favorite (and not so favorite) […] The post IN YO MOUTH (https://www.in-yo-mouth.com) .

Sheldon: Hello my audience, welcome to today's Campus Interview from VOE Foreign Language Radio. I'm your old friend Sheldon.Latisha: Hi 大家好，欢迎翻开今天的校园访谈录，我是你们的老朋友费丹力。今天来到我们演播室的是又一位来自美国的朋友，他将和我们谈谈在中国六个月里的所闻所感。Sheldon: Hello Sir! Welcome to China! And may I have your name?Gary: Sure, my name is Gary Wright.Sheldon: And where do you come from? Gary: I came from Missouri in the United States, which is central of United States.Latisha: 哦~原来你的家乡在密苏里州啊。那最初是什么原因让你来到中国的呢？And What brought you to China in the first place?Gary: Well, I came to China for many reasons. Umm…mostly because I want to familiar eyes myself with Chinese culture Chinese history and most importantly is the Chinese people. Latisha: Oh it's nice. 说到中国文化你对它了解多少呢？ Gary: Unfortunately very little. I've been here about 6 months and my friends do enjoy educating me. Regarding Chinese culture, but unfortunately I have not really learned as much as I would like yet.Sheldon: Oh it's doesn't matter. We Chinese people are willing to share the culture with you. And could you tell us which part of China culture do you like best and you want to learn? The literature the art the food or the martial art… （文学、艺术、食物、武术）oh you know there are many areas.（嗯，还有很多） Gary: All of it! It's not possible to really to say this is what I want to learn or that is what I want to learn. That's not possible because there are so many areas that are fascinating. I can't just limited one or two. I want to learn as much as I can learn in the time that I'm here. Umm…because of that I planned to stay in China for a long time.Latisha: Wow, 希望你在中国能度过一段美好的时光! (Thank you) And live in China, you must have eaten some Chinese food, so do you like it?Gary: Ah…I'm extremely picky eater. I don't eat vegetables so it is incredibly difficult for me to find food that I really enjoy here. But I've found some unfortunately. But to be honesty I typically tend to what more eat western food because of that.Latisha: 这样啊，我听说许多外国人都很喜欢中国菜的啊… Gary: Yes! My entire family love Chinese food. I'm the only one who doesn't like vegetables.Sheldon: OK… What sort of food do you like? Gary: Red meat. Red meat, yes, like steak beef pork… chicken duck lamb. I enjoy most meat or bases meat foods. Latisha: How about fruit? Gary: I love fruit! Sheldon: OK, another question, how many cities have you been to in China? Gary: I so far have only been to two cities, here obviously and Dandong it's very close train ride but beautiful place. I really enjoyed it. Umm… I didn't its as much as I enjoy Shenyang than though. This is… I love the city.Sheldon: And what is the reason that you like the city? Gary: Part of is the sights. I love the good sights city. Part of is also the people. Since I been here I have encountered countless very friendly very easy-going people who really take the time to help me out. Umm… educate me and become my friend.Latisha: 嗯，那你一定交到不少中国朋友吧？Do you have any close Chinese friends? Gary: Yes, I have several close Chinese friends. As matter fact I would say I have more Chinese friends than I do foreign friends.Latisha: Wow虽然我知道探听别人的隐私不好但是我还是很好奇诶~在你的several close Chinese friends 中是不是有一个女生已经变成了你的girlfriend? You've found a Chinese girlfriend yeah? Gary: YES! YES, I did.Sheldon: Oh cool! And could you tell us how you met each other? Gary: We met at a pizza restaurant but I can't remember the name… Oh Green Mile. We met at Green Mile.Latisha: 哦！原来是在沈阳和平区的那个绿里酒吧啊！ Gary: Yes in Shenyang. And we started to talking and really well. So we start to seeing each other.Latisha: Wow那你有没有和你的女朋友讨论有关英语学习的问题啊？今天也和听众朋友们一起分享一下学习英语的好方法吧~ Gary: Well, I honestly say the most important thing to practice speaking it. Umm.., many students try to get better just by watching television or listening to music and that dose work? But nothing work better than just getting together with your friends and speaking English to each other. That is the best way to learn. Even if you don't have any native English speakers around. It doesn't matter. Just get one of your friends who also speak little English and speak to each other. You will get better quickly.Sheldon: So practice makes perfect? Gary: Yes much better than more passive approaches which is like I said watching shows or movies or listening to music.Sheldon: So do you mean speaking is more significant than reading writing and listening? Gary: Well listening is obviously huge of importance whenever you are speaking. Without listening ,there is no speaking. As far as what's more important? That's depend on what your goal is. If you want to develop friendships with using English prominently. Then speaking and listening are more important. If you are wanting to develop yourself academically then reading and writing is more important.Latisha: 的确，在不同的目标下听说读写有着不同的重要性。那你觉得通过听外语广播来学习英语的这个方法怎么样呢？ Gary: I think it is a good way. Especially practicing the listening ability, broadcasting gives more students opportunity to listen to English been spoken, which is a huge of importance. As matter facts, today this week we've been practicing our listening skills in class and broadcasting plays an important part on that. Sheldon: Oh, that's great! In addition, you know nowadays in China more and more students choose to study abroad. So do you want to say something to the students who are going to study to America? Gary: Well I think the most important advice I could give is forget what you think you know about Americans. Everything you think you know is probably wrong. Just like my thoughts regarding China was completely wrong. For the most part have fun! Go to America study and learn but don't forget to make friendships don't forget to have fun because without those things it's not all about hard work about rewarding friendships and have a good time.Latisha: 没错，出国留学，不能让学习成为你的全部，广交挚友也是必不可少的一部分。Well that's almost today's questions. Thank you very much. Gary: Thank you.Sheldon: Bye节目监制：刘子含编辑：刘子含播音：刘子含 费丹力制作：刘子含记者：周 熠 杨理程 刘子含