Ep. 66: How To Compete Without Selling Your Soul

Part 10:00

This is Beyond the Arches, where full-arch dentistry meets real talk. Let's get into it. Hello and welcome to Beyond the Arches. I'm your host, Dr. Daniel Noorthoek, and joined with me today is Nick Glick. Hello. Hello, Nick. And Erica Pullen. Hello. Hi, Erica. Hi. Welcome back, guys. Today, we're going to talk about the price race and how it's tempting to cut corners, how when you're dealing with this sort of high-level procedure, it can be tempting to lower the cost and join the price race to the bottom.

▶We're going to talk about how that affects patients, how it should affect the way that they look at clinics, how we've tried to combat it, and maybe a few examples along the way of different cost savings that we've kind of gone through, etc. So, without further ado, why don't we talk where it matters first, first, first, and this will be mostly with you, Erica. From a patient perspective, seeing that you see the consults probably more than me now, at what level do you find that patients really want to talk about price?

Is it number one, number two? I would say it's either one or two, depending on the patient. Yeah, for sure. It's definitely a priority when they start looking into full arch initially. And I know usually the way that we at least kind of roll out our consults, it's usually doctor introduction, introduction to like the procedure in the week. And then when I jump back in, it's definitely like, okay, what are we looking at? You know, kind of like a car dealership, like as, you know, as soon as you're done driving the car, you're like, okay, what's the price?

Yeah, it's probably your first question you get or the first thing that you have to talk about every time. Yeah. How have you seen it change from when you started to now? I don't feel like there's been a huge change on our end. I mean, we've always been fully transparent. Right now, in this particular moment in time, I'm kind of excited to talk about it because we are running a special so it's kind of cool that we have the ability to do that on our end and kind of, you know, Explore all of our our routes that we can take and offer to patients. So that kind of is nice. And we also have a couple of different financing companies that are new to us. So I feel like we are offering some newer options.

▶As we get into this, like, layer of the game is always changing. Full arch game is always changing. There's always new guys, and then there's some new guys that don't last. And then there's ones that come out with. 2550 centers right away. And you kind of they're out of nowhere. And then maybe they Peter out, maybe they don't. But there's always sort of external pressures that are coming from our particular space. As this has changed, it's interesting to watch how price fluctuates. And I'm curious to get more of your feedback in terms of like, when a patient comes and they and they speak to you.

So that they've, they've heard about us, they know about us. They've showed up for the consult, they've gotten through that. How often do you feel the pressure of whether or not we're running a special, but how often do you feel that price pressure from a patient looking and price shopping to another location? ▶Like in comparison, um, I think that again, we just have the ability to offer like a really good special just because of a couple of things.

That we do the conscious sedation, the owning our own lab, obviously, we have like flexibility in that area. But also, again, it's just full transparency from our website from the initial phone call with Alex or Robert, that it's always kind of there. It's not hidden. It's nothing is nothing is a secret. It's not, oh, you have to test drive this car before we tell you the price, like you're going to know exactly what it is online. Nothing is hidden.

Yeah, I think my biggest. Frustration with the industry as we've watched it develop is not so much that the price has gone down. You have to find different ways to still capture a good create a good quality product and deliver on your promises and stand behind it, etc. That's, that's part of running the business. And it's natural to have competition enter and exit. And it's natural to have external pressure. I'm not upset about that at all. My frustration.

It comes with. It's very hard to communicate to patients what they're purchasing versus the competition, because there's a lot of misleading information out there and a lot of lying straight to call it, call it out and be blunt. There's a lot of lying. And that line can get in your way of being successful. So all things considered, we can we can be competitive with the best of them. We have good margins. We've we've done a very good job, I would say, with due diligence and picking materials and picking things that work and exceed expectations and keeping volume up high enough where we can compensate our employees well, etc, etc.

▶Been intentional about our rents and all of the costs that go involved. But the thing that frustrates the most is the misleading advertising that happens. Out there. And that's what almost kind of hurts us the most. And there's really not a way to a good way to combat that. But yeah, what about you, Nick? What on the lab side? Let's talk a little bit about what it looks like to be looking at the numbers more since you're a little bit behind the scenes a little bit more. What does that look like from selecting as we select materials and implants and negotiate with dealers, if you will?

Yeah. So, you know, there's a lot of different kind of variables when you're talking, you know, full arch, you can be on, you know, full arch can be class classified as like an acrylic, it could be a PMA could be a zirconia, it could be so many different layers. And even as zirconia can have, you know, a different substructure behind it, you know, whether that's titanium, trilore, or even going just to a monolithic zirconia, which is what we offer. And when you're talking about like materials on that level, too, there's so many different, you know, kind of your strengths of materials that you have to look at your, you know, where the materials being sourced, you know, there's plenty of, you know, companies out there that are selling very, very cheap zirconia. But you know, you're getting that source without FDA clearance. And it's coming from a it's going to take three months to get here. And it's coming off a pallet off a ship. And it's one of those, it's like, okay, is that really what I would want? So, you know, for us, we've always been really keen on the fact of like, okay, well, we need to pick the best material, because obviously, we're going to need to pick the best material. And we're going to need to pick the best material. And we're going to need to pick the best material. And we're going to need to pick the best material. And we're going to need to pick the best material. And we're going to need to pick the best material. And we're going to that's what the patients are expecting but also like let's make sure that we're picking a uh you know a u.s based company something that is really good inventory all the different shade tones that a patient would want so if a patient wants you know the hollywood white or they want butter yellow we have the option to give them either one uh but again we're you know partnering with reliable and usa based companies is kind of a real paramount for us obviously in this process with offering specials off you know kind of just trying to be competitive out there on this you know kind of playing field you have to negotiate you have to find the best vendor so i can't say that the company that we were with nine years ago is the same one today but i like to think that through innovation of materials and through you know not only competition of clinics but also competition of material vendors they have gotten much stronger and much more competitive on that front so you know we're able to get a really uh strong material at a really good price point and that's what allows us to then turn around and offer type of discounts or deals or things like that and you know we are strong enough as a company that we're buying in bulk which that helps us out a lot so like your average location or dental lab that's kind of doing worn off so they're probably you know custom ordering every single case so like oh erica you need this full arch and you want hollywood white okay we're gonna have to wait three days to get that and then it's gonna mill and then we have to finish it and the whole nine we're at and then we're gonna have to wait three days to get that and then it's gonna mill and then we're gonna have to wait three days to get that and then we're gonna have to finish it and you know i've done in one if somebody wants something we we have it in the back it's inventory it's stocked and ready to go our lab team pulls it off done within a day or two and we're off to the races on that front so um you know pricing is is a massive piece of it because it all starts you know obviously you know as a foundational like rents and you know doctor payment staff payment all that nine keep the lights on but then it trickles into the lab and making sure that we can keep our costs down there as well so that we can pay for it and then we're all these savings on to patients and uh you know that's it's something that you never really think

Part 29:34

about as a patient of like what goes into that final you just look at the price point saying oh it's a nice rat ford car like i can get that anywhere but like it's not really that there's so many different levels of what a zirconia could be and so many different variations of what a zirconia could be from clinic a to clinic b yeah and it's so hard for a consumer to really vet that out and figure it out you know um it again going to hammer it in my biggest frustration has been that it's really hard to communicate what goes into that and what the difference is between clinics it's not all prices are the same it's also not that more expensive is also better you know that there are plenty of clinics that are on the on the reverse side that are charging a lot more than us and i i feel bad for them because they're not going to be able to pay for it and i feel bad for them because they're not going to get a appropriately high volume clinic that has that efficiency so you know maybe if they don't have a high volume they're buying a cheaper product at our price for the better product um yeah i mean to that point sorry to cut you off but no it's fine a lot of general dentistry clinics out there like your average one that you're probably your parents went to your family your co-workers whatever it may be they're probably only producing anywhere between 40 and 60 thousand dollars of production on a monthly basis if they're able to do one of these full arch cases for 30 or 40 000 that dentist is walking to the bank they're they're super excited they might have just bit off more than they chew they don't have a workflow they don't have a system but hey that's for another day that's for another you know kind of the patient doesn't need to know that they're just excited for it so you know there's so many players out there that do price themselves pretty high and then you know as a patient you're going to look at it and go oh dun and warren you know they're at their price point they're very transparent but why are they ten thousand dollars cheaper than joe schmo around the corner and like it doesn't always translate but same with the adverse like if you see a clinic that's only you know six thousand dollars in arch and it's twelve thousand for a total and a no warranty like okay there's probably some red flags there because at the end of the day like materials do cost a lot there is a lot of uh you know costs that go into your implant selections your your materials in the lab all that different jazz that like okay if we're gonna if it's such a race to the bottom where are they skimping at what corners are they cutting in regards to it all so like it's really really tough to be able to translate that and showcase it and then additional from that like a little bit of it's like hey Done In One's building this name and the brand and like this and i think that our reviews speak for itself on like what the product is and all that but you also don't want to be so overly transparent that you tell everybody right hey here's exactly where we are right here's exactly where we are right here's exactly where we are right here's exactly where we are order all of our materials this is how we do it this is and then like what that just so that then the guy around the corner can just copy our exact same playbook like it's really tough to be super transparent but also keep a little bit hidden so that you know you're not just strengthening your competition if that makes any sense i imagine that being super frustrating as a business owner as well because from the patient side i would my best guess would be that it's pretty 50 50 when patients are like oh this is a really good price i'm gonna go with them because the price is better versus the other 50 where it's like okay well great but why i feel like there's only a small amount of of patients that ask that why that you guys kind of just talked about it's really it's also really hard to hit that sweet spot where you're connecting with the public that hey we're really high quality but we're also really low price and you know as we get more and more in ai that's one thing that that ai absolutely hates is when we have a website that says you're a low cost but you're a high quality which one do you want to which one are you trying to tout because you're you're doing both which is a confusing thing and i think both are sort of still important you know but i get i get what it's trying to tell us it's saying your message is confusing one um as you're talking about transparency i was thinking about the uh transparency of zirconia which is very important that's part of what makes it lifelike and you know we years on different pro bono cases and through different high profile cases we've sort of gone through the gamut of lower cost zirconia all the way to the absolute highest um can you remember nick when we first started getting into this game and we were with um the suppliers or cons on and they came out with this brand new website and the zirconia that they had it was just the most beautiful looking and it was um back in the day my old business partner joel david he had um he would he would obsess over this picture about how good this zirconia was and we had to wait for it to ship from italy and the whole thing and when it came in it worked fine and the machines and such that we had and it was insanely expensive so one puck of it just for listeners one puck of it was five hundred dollars which is well over double what a decent quality puck will cost you and uh when it came in delivered fine looked beautiful and it was just but the stuff broke because it was so brittle because it had such good quality you know uh lifelike qualities the transparency and i remember how much of a disaster it was so that's a good example of just because you buy the absolute best doesn't mean that it's going to result in the best um i can't think of another example off the top of my head but there's many of them in say cooking there's there's salts that are made to be like finishing salt and then cooking with salt where you don't really want to spend as much salt and then you're like oh much money this can be that sort of similar scenario absolutely and you know it's everybody looks at the the nice bmw that's leased down the road and like okay that's maybe a similar price

Part 315:41

point to what the full arch procedure is but like you're not leasing your full arch you're buying this and you're expecting this a lifetime warranty and this is all you got so like you're not you want you know obviously a great looking material that when you're out in public you're smiling you're doing whatever it is like nobody has any idea that this is even a procedure that you had but in the same breath you don't want something that's going to break when you're out to dinner and all of a sudden you chew into something and then pop uh so it's really you know interesting in trying to find the the fine line of like what flex what strength you know kind of components of a zirconia do you want um and the next same bit goes into like the try-in phase like you know the try-in material that we use we went through a whole list of trying to figure out what really makes sense for our patient base makes sense for the lab for productivity you know we're having patients wear these try-ins anywhere from only four to five hours to 12 hours to 24 hours typically 48 hours is about as maximum than that you would be in our trying material um but you know there's so many different players out there and you know you can have materials that would cost you know an arm and a leg to get a bottle of their resin or you can get like a really super cheap one from again coming off a pallet unmarked box type of material and you can get like a really super cheap one from of things so it's trying to find identify exactly what works for not only the clinical side of things to make sure we're hitting all those landmarks but really for the patient so that when they do go home with their first try and therefore you know their second try and they can look at their loved one or look at themselves in the mirror and say wow i i look good these look great but also understanding that it's still a plastic resin material and it's not like this incredible piece so you're just i always try to identify the appropriate materials and this is tough game so let's let's continue on the resin uh because i think it's the best example of what we're talking about there are resins that are filled with kind of a ceramic a zirconia material they're sludgy they need special shakers they have to be treated a certain way uh and they are very expensive plus it's a lot more uh technique to clean the the vat of goop if you will and to clean it off etc etc it's very costly and involved why do you use it you use it so it lasts longer what do we need it for not to last long so we could use the highest quality resin that's out there the most expensive stuff but it's not going to look as good because it's filled with um partially filled with a ceramic it's way more expensive it puts a lot more stress on the system and that's a perfect example we use a very inexpensive expensive resin because we don't need it to to last us very long we don't we need it to look good but not perfect um but we don't want it to look terrible and give the the patient idea of like uh this isn't going to look that good so that's like a perfect example of where we can cut corners it's it's something like that so we've we've found a way or in our protocol it lends to spending less money on the resin but getting a better try-in phase for the patient because it looks better it's cleaner it's much more precise than using the more expensive stuff so it's not always about using the most expensive stuff yeah i think any clinic that you go to that's going to spend uh you know 20 minutes talking about how great their temporary material is or looks you should probably figure out how long you're going to be in that material because if you're in the highest material that it's you know different poly you know kind of filled resin and such like are you in that for you know 90 days is that what you're going to heal in because if so great like that you want to be in something that's strong and that you can kind of go through life in but why would you want to be in a try-in for 90 days that's not you know there is a shelf life of the fda approval on trying material there's that for a reason and we choose you know we still the material that we use is fda approved for way longer than we ever you know put patients in you know you're looking at multiple months um however we're putting patients in this for 12 hours so we're not going to be putting patients in 24 hours whatever it may be so you know it's really trying to identify what looks good for patients so that when they can you know go through the process also like this material we stock it in one material so it allows us to kind of really fine-tune our price point so some patients are like oh man i want it you know brighter or lighter well hey that's for the zirconia that's for the final product let's dial that in towards the end of our appointment time so like we can really get you where you want to be but allowing and kind of streamlining what that profile looks like is really great because then in each clinic if you go to tampa jackson will boca like you're getting the same process you're getting the same material you're getting the same outcome you're getting you kind of know what to expect from day one to day three of your trying process so like it's it's very simplified plus then from you know an operational standpoint like we can lower our cost we're not having to have somebody manage three different vats of resin on an operational basis we're not having to stock and inventory all that and those are all different manners that we put in place not out of latex but we're not having to stock and inventory all that but out of intentional pieces of trying to say hey we want to lower the cost for you this is going to allow us to offer a lower price point and in turn allow more patients to even have access to full arch yeah and we've we've been intentional about that from day one uh and always kind of thought that we're going to be able to compete in mostly any market because we've been intentional about it every day uh every day that we negotiate at least every day that we pick a material every day that we hire a new staff member um everything from start to finish in this protocol

Part 421:35

is meant to be lean mean and high quality um just as a as an example that's coming to mind um i would say and i'm gonna put words in your mouth erica but i would say that you probably with exception of a couple times a month you probably feel like we have plenty of room in meisner is that fair to say absolutely so our office is how many feet oh shoot it's like 1700 yeah like less than 2000 it's less than 2000 it's somewhere around 1700 so our rent costs we're in a very nice building extremely nice actually it's one of the best places in boca uh and because we're on the third floor because we need less than 2000 feet we're able to have a better office showpiece we're able to have better equipment better staff all of that built into it um but still don't have we don't have the overhead of the office we don't have the overhead of the office we don't have the overhead of the office just weighing us down because our protocol is meant for efficiency and for minimal chair time for the patient and for us uh be straightforward and because of that it never feels overwhelming and overly crowded um which is really cool because the the patient's experience is going to be less time in the chair but also going to be overall a little bit more positive because things are a little bit more polished they're getting more than what their perceived value is uh etc but that's just an example of like how deep the mindset is for we'll say cutting costs but but staying um responsible to ourselves in in a financial sense and being sorry erica but being responsible in those you know silos allows us to be innovative on other pieces so like if you go into any of our clinics we have the newest intraoral scanner that's way more advanced than what we necessarily need to use it for but it's great for us to be able to be able to use it for us to be able to because it can translate exactly what the clinicians you know trying to get across to the design team so like boom there's probably one less trying that you need because we have the cutting edge in the lab we have the top end printers i mean these are like printers that are used by uh riddell for nfl helmets the u.s uh air force for different airline parts like we do not need a printer of this capability but we use it because it brings such a precise product that allows us to again maybe limit one try in appointment and again that's not just a oh we want to limit a try-in appointment for a cost perspective that's limiting a try-in appointment for a real human being having to take an hour and a half two hours out of their work schedule their loved one work schedule getting to the office doing the whole nine like it's huge so every little aspect of like hey can we you know maybe make sure that we're in a really healthy lease environment or hey can we ensure that we're uh doing like this on the try-in material well that allows us to then expand you know have some r&d make sure that we're getting the best possible materials and and you know kind of equipment to make this process something incredible like we have centering ovens that allow us to produce zirconia in you know four or five hours so that allows us to say hey a patient calls in at 4 p.m or night and says i was chewing on rocks like i broke my my set of zirconia okay great we can turn around and have it for you the next day so like it's it allows us to to be on the cutting edge but also ensure that like we're doing our part and kind of upholding our end of the bargain to the patients through this process and a very little nuanced thing that i was just thinking about um let's talk about the warranty for a minute because the warranty is another aspect or product of our product line if you will that is difficult to communicate properly to the patient base because you want to communicate that it's low cost and that everything's taken care of and that it's not going to be a problem for you and care of and you're standing behind your work but you also need to protect the business that you're involved in when when we used to include even a five-year warranty the number one question from anyone that was looking at investing was always what happens when this gets out of hand well they mature out and this and that well it's still a big liability and there's a lot of costs that can get out of hand in full arch dentistry and it's almost like you want to get out of hand you want the business to charge you something that's going to cover the cost you know the warranty that we have is essentially the cost of a cleaning and it keeps the patient responsible to get the cleaning because it is included but it also in that cost if i run the numbers it's not a huge profit center but it covers it's almost like this insurance plan where you're kind of covering your neighbor and what i think about is the message that i want to try to get out is listen it's good that it costs you something because it means that you're helping protect the company that you're invested in to produce this service there's been absolutely countless countless full arch centers that have included some weird word asterix full you know lifetime warranty based on some implant manufacturer wording etc but what happens is a lot of those have gone under a lot of those don't exist anymore and where do you go when you have a lifetime warranty that is with somebody that doesn't have it and so you know it's very hard to communicate all of that to a patient right away and say like no it's good that it costs you something because those those costs there are problems that arise with full arch there are massive costs involved with it it is a big expense for us to to cover to cover things but it's taken care of in the fact that the neighbors take care of each other and it's not a big drain where we have to overproduce every single year to be able to make up for that difference there there's multiple levels to that it's like a in the very first piece when we offered a five-year warranty well what happens after the five-year warranty you're just now on your own and whatever cost that may occur like you're coming out of pocket and like they can be very pricey if you're you know having a something wrong with your implant or you have a failure of a zirconia arch because again you're chewing on rocks or something of that nature then you know the other side is like you a lot of these then you kind of hit it on the very beginning like other companies will advertise a lot of pieces like oh a lifetime warranty and they don't include any pricing on that well if you get in there and you sign up for it and you go through the process like well when you come back in and they they give you a you know a three thousand dollar bill you're gonna say why that's and they're like oh no that that's not a part of the lifetime warranty that's here and and now you're you're in the game and what are you going to do about it well in our lifetime warranty like yeah we're going to have a transparent on the pricing and we are transparent also what's included in that but as maybe a consumer you're going to look at that and go well they're giving it to me for free and you guys are charging for it well there's a big difference in layers and a lot of times unfortunately these other places they don't have like a true system in place for a lifetime warranty so they'll just lie to you or you know tell you what you want to hear through the process because a it gets the treatment coordinator a sale and they get to make a little commission that keeps the lights on at the office but also they probably don't even have an answer towards it or a real systematic approach and then what happens when you do have an issue because everything you know you can go buy a brand new car and it could give you you still have to you know have you could have different issues a belt issue you could have countless amount of things but nevertheless it's it's really tough to to your point be able to showcase what really is included in this lifetime warranty without a patient going well why do you charge everybody's going to charge it for something nothing in life is free yeah and if a company is giving everything out for free it's really hard to stay a company you know you we live in a life of social media and the big thing that i've seen sort of on my feed here and there is you know do this and book this way on this site and then use this point and this thing and then you get this plane ticket for free or whatever it may be and i always think to myself well if everyone is going to charge it for something nothing in life is free and if a company is someone does does that delta is going to go under like at the end of the day if delta is giving out free flights to everybody delta is going to go under what what kind of problems does that cause

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so um you know we feel like we're adequate and fair what i want to uh know from you erica is in in the light of the lifetime warranty what aspect of that is um what does that look like do most patients sort of have that understanding to begin with because the education is good enough to start with or do you feel like you have to educate them post that to kind of get them on the right page no i definitely feel like they come in with the right mindset of it okay that's good from the console it's definitely like it's usually a yes or no i would say that again the percentage of people who are uncertain of which direction they're going to go in is maybe like 15 to 20 usually most people once they hear what it is and what the fee is they're usually on board pretty quickly okay i don't know that i would have expected that i would have expected you to have to do most of the education it's not it's not difficult once they understand the coverage of it and also the cost of it because we have our other warranty program our basic warranty our two-year warranty once it once it's done once it lapses anything that you have done any services are e for service well and like you still have to all like no matter where you go if they don't pitch you on a high like a hygiene program it's a red flag like no matter what procedure you have you have to go in and get a regular cleaning most likely annual but some places make it you know more frequent than that but our price point on hey you don't want the warranty great still get the procedure you have to come in for the annual cleaning it's very similar to what our lifetime warranty is and that was intentional because we want patients to be in the lifetime warranty we want happy patients we want people that leave good reviews that refer others because heaven forbid something happens doesn't one wants to be able to be the good guys the friends the family here that will fix this for you and not just build our reputation on hey we're here for the first initial win within a week and then you're on your own like that's not what the foundation of of all this is so i think the you know once you can get that message across it's like okay well it's a no-brainer ultimately it's a no-brainer once they understand it i mean it is to their benefit but once you understand that okay if something happens down the line then i could very well be paying for another full arch procedure which nobody was going to want to do and you know the cool part about our lifetime like we have spent a lot of time building it prior to ever enroll you know rolling it out so like there's a lot of different cool pieces like a patient can pay annually or they can pay on a monthly basis so like it kind of fits whatever that individual's economic standpoint is through the process so like again it just makes it makes it easy for somebody so like hey i don't have the 700 today well okay well we can put you on a monthly kind of price point to it and it comes out to be the same amount and it just again it's one of those another subscription that everybody has that hits their bank accounts however it's something that gives people a peace of mind and it's not such a a crazy fee that like okay they they can stomach it either annually or monthly we've always i've always tried to create deals that are beneficial to both parties all the way along dentistry is already a very big touchy point with the pain and the embarrassment and the fear and the unknown and all the things that go involved with the psychology of dentistry and then you add money on top of that you've already kind of cleared those you're trying to clear those hurdles in the consult so we've always been very intentional to try and be very transparent with the problems that can arise and in creating the what warranty we were trying to also make it so that if and when something happened which it does happen there wasn't going to be any weirdness of you know you're already going to have a little bit of pain of replacing an implant or you're already going to have the embarrassment that the teeth chipped or something like that why why make it tougher and include money into the deal as well why not make a deal where you've done your part i'll do my part let's work as a team and get it fixed quickly because that's the way to the best solution is that both parties are there and present and ready to get it done but it's also that the cleaning is included under it so if you're not using it you're not going to be able to use it to render an implant replacement at least you know that you're rendering it once annually for a cleaning absolutely you know it's you're going to use it yeah what um as we enter into

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this weird time where people are uh starting to realize it used to be there were very few players that uh capitalized on a lot of digital process and so the the cheap ones were really sloppy because it was just figuring out cheaper and cheaper ways to do it the old inefficient way and i've always said the price is going to come down at some point because people are going to start to realize the same efficiencies we have and we're seeing that we're seeing a lot of external pressure but as we go through that i feel like we're pretty well prepared uh we knew this was was coming um but at the end of the day it's hard to see where that race to the bottom ends you know where does this where do you where have you pushed the doctors far enough in their compensation where have you pushed the material limits far enough where have you scared the patients away because it's too too inexpensive i don't know where that number lies yeah i mean you know from i think we prepared ourselves for what that comes and you know we were one of the first to be on the cutting edge of a lower price point you know when we first or at least when i first started with you nine years ago the most average clinics were 40 45 000 and we entered the world of being under 35 000 and there's a lot of people that kind of looked at us sideways like hey what are these guys doing but it was because we built the uh you know efficiencies into the process being able to cut down costs and like okay let's pass that on to the patient not fast forward nine years later you know we're running a special right now that we're just south of twenty seven thousand dollars and like that's a big cut that's a big drop but we're able to do that through the inefficient or excuse me the efficiency of the that we built and like being able to lower cost so as innovation continues to you know go over the next five to ten years i honestly look forward to it because a that means we're going to continue to innovate and ensure that we're you know being able to be on that front edge and continue to lower our price point as materials get cheaper workflows get better but ultimately that's going to drive the volume even higher because there's so many countless patients that do need full arch and but they just can't afford it due to finances so i think it's going to be a lot of work but i think it's going to be a lot of work but i think it's going to be a lot of work but i think it's going financing um you know right now it's a very tough time to finance the procedure so like there's unless you have a you know and you know great credit or you've built up a savings you're probably you know just kind of neglecting your broken teeth or you're going into dentures and like hey this is on the wish list whereas maybe you know five to ten years from now this price point will be closer to that twenty thousand dollar mark even maybe even you know south of that and i look forward to that due to the fact that that's going to be a lot of work but i think it's going to open up the brackets to say hey so many more patients can get a procedure that actually makes sense for them because you know anybody that is doing it at such a low low cost is they're skipping corners they're cheating the system whereas i think right now we you know like are we here to keep the lights on and pay staff a good living absolutely but this isn't like an exorbitant fees the three of us didn't pull up in our rolls royce today to do this podcast um so like you know we're never going to be that we're always going to be the clinic that does at the best possible price for the and the best possible procedure and the best possible material so like having those three layers kind of baked into it i'm excited personally to see where it does go because it's going to open the doors to this you know procedure to so many more patients that truly do need it and kind of take it away from being this like oh wow you have full arch wow must be nice because you know you go on tiktok right now somebody posts their you know kind of transformation countless people are commenting man i wish i could afford it and like breaks your heart a little bit because like man do you want to do pro bono cases and do you want to help people out yeah but you can't because at the end of the day this is a business and we have to keep it going but maybe at some point in life and maybe that's 15 years from now 20 years from now who knows but like there will become a time where this becomes a very reasonable procedure and there may becomes a time that it's also covered by insurance but that's maybe wishful thinking so i think we're i think we're very very close to getting to the compression point where it's there is no more race to the bottom i think we're very very close actually i don't think it goes much further south than what it is um mostly because we're about as a lean and efficient as we can be while still putting out a quality product and keeping the lights on and staying profitable and unless somebody is just really just dropping the ball in terms of quality etc.

i don't see how much further we could still compete lower uh no doubt um but looking at material costs and such i just don't see where that continues to be the the feature of the industry as a whole maybe there'll be a player or two that's got a lot of money and doesn't care about losing some and wants to grab market share here and there i think we're narrowing the band you know if you look at the a crown i don't know how much a crown used to cost in gold and such it's fluctuant on that cost but of gold but the the price of a crown pretty much stayed the same since it kind of got to a certain point the price of a denture it's pretty much the same price as it's been to take out a full set of teeth and put implant or um just plain dentures in i think we're kind of there was a heyday where it was new and then there was a heyday when we were doing digital so we found a little bit more of a profit margin and more efficiencies and were able to offer it to more affordable but as that becomes more mainstream i just i feel like i don't know what your what are your thoughts i feel like we're getting to a compression point i feel like so too unless we decide to switch our final to not zirconia or yeah maybe it's a printed pmma whatever it is i feel like that would it like you said it just it just wouldn't be as quality and but he like he so i think about that all the time if somebody gave us the implants for free and we were able to print out of thin air and essentially got the teeth for free and printed them without without as much man labor manpower how much am i going to get out more out of that another three thousand total you know it's it's it's near it's getting to a narrower compression bin where it used to be five thousand an arch was our cost times two that's ten ten grand now we're kind of in that point where even if you give it to me for free and i'm not gonna lower it that much it's not this like epic leap all the way down which now that we're on that we can talk about how we kind of actually have that available for people we do offer a pmma final at a lower cost for a you know longer duration of payments if that's need be by their lifestyle but i haven't seen to your point i haven't seen anybody make that flip to want to do that to you know voluntarily once they see okay this is pmma this is zirconia what's the cost difference oh this is so much better okay i'm headed in this way yeah that might actually i didn't think about it but that point maybe the number one kind of indicator that we're getting to a compression point because even at the absolute cheapest fee you can imagine just the one little difference of it being pmma and we'll keep you in it a brand new one every year we that's not even a big enough flip for the versus the the zirconia and that's on the patients that's not on us because we you know we have it available we do offer it and it's that's a decision they make they decide to go zirconia route it's been a very weird career watching it go from the big boys at 40 45 and then kind of it dropping and then all the different players that have dropped out um and a lot of the the ones that we've seen sort of drop out have been um people that weren't in super intentional about soup to nuts their protocol and soup to nuts what was what went into it we've tried to create a world in which we've tried to create a world in which we've tried to create a world in which we've tried to create a world the outcome is the focus what parts and pieces do we need to have that makes it the the perfect thing you know to belabor the point of the best isn't always the best you know i was thinking like let's say you have two hundred thousand dollars and so you go out and you and you are a construction worker you spend two hundred thousand dollars on a mercedes something right you show up to the work site you may not even be able to get it but you're able to get it and you're able to get it on because you spent 200 grand on a car yeah it's a 200 000 car but it cannot go on your construction site it's not going to make it you have to buy the right tool for the job more than the most expensive um and i think that we've done a good job selecting for patients you know when when i and nick and everyone that's involved with picking things out when we go through the exercise of picking out a new material or a new supplier for implants or whatever it is what we're thinking or what i'm always thinking about is where where does this stand for a patient because you have to also understand a big component of this in corner cutting if you're going to be a corner cutter of any sort you're going to have to stand behind and deal with the fallout of that yeah so you know it goes into everything hiring a new assistant or hiring a general dentist to oversee the the teeth or hiring a new surgeon that doesn't do the right job is going to create more problems in the in the future than they are even worth in the short term so it's all about medium to long-term wins rather than just that short-term cost cut yeah 100 and you see that all over the place i mean that in many ways that's how we ended up getting into the digital aspect it was so incredibly monetarily uh exhaustive to do it the traditional way

Part 744:58

at the price point that we were doing it that we had to find an alternative because it was just so overbearing on the system and the team and the people and that's how our team got to be so wonderful because we cut him out exactly um yeah so you know it's been a good good interesting uh discussion i picked this one because it's the right time point i was reading an article this morning that was talking all about how we're essentially in a situation where we're in a situation where we're in a situation where we're in a silent recession and so the indicators have warned us for a long time that we're in one that we're coming up on one that we're definitely a month away from a crash etc but even though those indicators haven't necessarily fired or crossed into recession territory it's still being felt everywhere and we're definitely in some sort of silent recession is what this article was calling it and i feel like we see that now where i would say the counterpoint is is if you look at our numbers of people that end up paying cash from 401ks or friends or family or whatever it still hovers around 67 70 percent or so 60 to 70 percent we'll say and financing really hasn't become a bigger thing and if we were truly in some sort of recession i feel like we would see that number grow which we haven't really which is very very odd yeah i it's interesting on how it's kind of fluctuated it was like wrapping up the just like brought up a whole another guy no i i think uh to that point though it's just as interest rates continue to rise it becomes even tougher on individuals that are you know maybe hey financing is the way to go like they don't want to put all this cash down well as interest rates continue to rise it becomes even tougher to kind of stomach okay i'm instead of shelling out xyz or you know taking away from my 401k i'm gonna now be looking at a hunt you know a thousand or fifteen hundred a month i will kind of a payment with interest baked into it over 60 to 72 months like is it still a procedure that's necessary and like you need to kind of take this on yes but like it's really kind of almost unfeasible because also you have cost of living going up your rent groceries whatever it may be so like there's so many different economic factors that i think kind of can get baked into that factor where like yeah our patients are still paying cash they're still paying credit cards but also i think our if we look at the cost of living going up your rent groceries whatever it may be so like if we look at our credit card usage that's probably going up because you're able to then you know transfer that over extend it where whereas hey if you join with you know one of our different lenders at a pretty high you know let's just say you don't have the greatest credit so you're getting hit with like a 13 or 14 yeah you're pretty locked in you're locked in there's no real you know kind of variable rate there or anything of that nature where like that can be very tough when you know you're starting a family you're on fixed income whatever it may be so it's it's interesting to me i think it's a it's a it's a it's a it's a it's a it's a it's a it's a to see as everywhere you know things get a little tightened on the economic kind of structure where how patients can react to it because ultimately in an insurance size this is an elective procedure but if you ask any of our patients that get this done there's not much elective like they are saying this is something desperate i'm in pain i need this i can't function with without getting a procedure of some sorts and there's a massive difference between what we do and what a denture clinic does so there will always be this need it's just how our patient's going to get to that need or be able to pay for it whether it's you know leveraging themselves in a non-traditional financing manner so it'll be interesting to see how it takes you know from today to the next year to three years so as ideally we fix some of these economic kind of barriers that we have and you know we we can get back to lower interest rates and because at the end of the you know when we were doing this in uh you know 2019 and even in 2021 like interest rates were pretty darn low so you know if you look at it it was a total variable like we almost had majority of patients choosing to do financing because it just was such a no-brainer option pete you know different companies were offering zero percent where whereas now there's it's tough to kind of really get there so that's a that's a whole different conversation that we can go down on the financing side of things but it's a it's just another kind of layer and baked in factor of like hey you know we're not going to be able to do this we're going to be able to do this we're going to be able to do this we're going to be able to do this done in one offering uh the price point that we are through our special allows it to be that much more attainable for somebody comparatively to when it was you know uh six seven thousand dollars more more expensive i completely agree yeah that's that's something that is a it it touches into this topic a little bit where you're talking about where it's not elective my mind immediately went to my surgery this morning if it was not a case in which i was not able to do it i was not able to it was a you know disgusting you know like teeth as somebody would think of as like oh that person needs your help kind of scenario these teeth were intact etc but her roots were probably a third as long as that they they should have been she had regular traditional dentistry there was no option what does a person have to do that has no option they have to go through something like this so there's that aspect there's that insulation on the silent if we're in a silent recession there is still going to be people that have these unfortunate scenarios where they're they're stuck with it for sure she was talking about that in the waiting room before she went back with her

Part 850:35

friend she was saying oh i put so much money into my mouth she has you know there was there were four implants she had a snap indenture on the lower that was done by some goofball i don't know they were not where they should have been and um yeah she she had fought the fight and brushed her teeth but there was just absolutely no chance that she was going to do anything other than this truly i it's the only real option for um as we wrap this up i guess i'll wrap it up with the thought of it's very tempting to cut corners and as a business owner and a business uh you know operator you have to cut some corners you have to stay in business but the main thing that i go to bed and i sleep it well every single night because although there is always going to be some level of disappointment or dissatisfaction it is the human body and it is the닭Thee team from the beginning and the us um from anything getting out of hand because uh if you run a business with any sort of integrity and you hire employees with any sort of integrity doing the right thing and picking the right stuff is something that you can take very very seriously and and we do and um i think that we all pretty much without fail pretty much sleep pretty well i don't hear a lot of people uh complaining about too many issues yeah i think uh to your point we do our best uh to not cut corners and if you are a video watcher of the beyond the arches we did not cut corners in our uniforms dr norfolk and i just uh decided to wear the same color shirt today so great minds think alike yeah i guess so eric is just angry that she didn't have the the coral one i don't have a coral shirt but you have a cool jumpsuit thanks all right everybody thank you for so much for listening if you enjoyed this content please like or subscribe we enjoy your um support and your comments and uh we look forward to another one thank you very much