What follows is an interview with my dear friend of many years Dr. Miguel Stanley, who is also a very successful dentist and businessman, with many stories to share to inspire and give insight into improving your dentistry business and career.
This interview was originally taken from Coffee Break With Coachman, a series of interviews with the best dental brains and the best personalities, in short, the most influential people in our dental industry today. From business to marketing to clinical to research, academics, laboratory technology and digital, each of the interviews is a conversation with a thought leader in their field, sharing their knowledge and experiences.
CHRISTIAN: Miguel, you're a true international guy, you speak many languages, you have an international career. I've always admired your entrepreneurship, and your ambition, and how you take risks, and how you handle life, balancing work and family, now with a new baby. I want to understand: how is that going personally for you, how is that changing your life? I want to start with you telling me a little bit about your background, where you came from and why dentistry? What made you pick this profession?
MIGUEL: Well, my mother is British, a redhead from Manchester. She was born on the Moors just before the Second World War. My grandfather was a bricklayer, and he fought for six years in the Second World War against the Nazis. When the war finished in the '60s he went to Australia to build houses there, and my mother lived there till she was about 16. Then they moved to Durban, South Africa because the economy there was picking up, and my grandfather moved to South Africa again, with my mom and her sister, to build houses in South Africa.
My father is from Grândola in Portugal - he left Portugal when he was 16 to join the Navy, and he basically did his entire career in the Navy in Portugal. He was an adventurer, he went around the world twice in the Sagres, which is a huge training Navy ship. He passed away a few years ago, it was a huge loss, but he was a larger-than-life character that truly taught me what it means to be kind and good and not scared of adventure.
Anyway, he met my mom one day on leave, because he was fighting in the war in Mozambique, they fell in love, and here I am. I've got two brothers and a sister. We were all born in Durban, South Africa. I lived there till I was 10. That's why some people can hear a faint South African accent. We always spoke English at home. Even with my father I spoke English. When I was 10 years old, we sold everything in South Africa because we were very against Apartheid. We couldn't agree anymore with the way that the government was treating the largest part of the population. I'm very proud of him for that. He sold everything and we got on a little boat and we sailed from Durban to Brazil, to Salvador da Bahia, then across the Atlantic to Faial, Azores.
That trip took almost a year. I was 10, and that was a defining moment, because I remember-
CHRISTIAN: You spent a year in a boat?
MIGUEL: On a boat. We didn't have a refrigerator, we didn't have any antibiotics. I got Scurvy from lack of vitamins when we were crossing the Atlantic. The longest we went without seeing another human being was 33 days. We were followed by sharks and whales, and we had a fire on board, so I guess my sense of adventure, and my sense of not really being scared of stuff comes from that, from having this amazing, feisty, redheaded, hot-blooded British woman as a mom, and an adventurous South African-Portuguese father that taught me to never be scared of anything.
Then I arrived in Portugal when I was 10, and I've been living here most of my life. I'd lived a little bit in L.A., then in London, but mostly Portugal which is my home, out of choice. I love living in this country, it's a beautiful, beautiful part of the world. It's now one of the hottest tourist destinations, Portugal is my home, this is where my friends and my family have chosen to live. My wife is Russian-Ukrainian, she hates it when I say she's half-Russian, but genetically she's half Russian half Ukrainian, but she's Ukrainian and she lived in France for 15 years. She was a very successful model, and quite, probably traveled more than you and I in our time.
Now we have a little daughter, Luna, and she is one year old, and she's a combination of all of this global energy that we all have, and it's a wonderful, wonderful thing.
CHRISTIAN: That's the reason why we cannot even imagine things like this. Mixing is the best thing in the world. We see this in the World Cup, a beautiful event in Russia, the whole world together. That's the way we need to go, and we are both the representation of this mix.
MIGUEL: I think that's something that you, yourself have done in dentistry. I mean, first of all, as citizens of the world, you're one of the most global citizens I know, your heritage, you're sixth-generation dentist, your great-great-great-great-grandfather was a dentist in the Civil War in America, your wife as well comes from an Italian heritage background, and look at your kids, it's incredible.
I think that yourself as well having worked in Belgium and the U.S. with some of the best clinicians in the world, with some of the best teams in the world. The fact you're a dental technician and you're a dentist, and you're one of the most tech-savvy, digital guys on the planet, and you've done something quite unique, is using that to become an aggregator. People have rallied around you, Christian, and despite your fantastic good looks, people are not jealous of your success, they want to contribute to your success. I think that's incredible, you've really used your skills to get the best out of people, and I think that's so important in our profession, because dentistry is full of jealousy, it's full of fear, its full of loneliness. Our friend Carl Stanley was discussing this the other day.
He was talking about the stress in dentistry, and our profession as being very lonely, and one of the greatest things that's happened in recent times, is we're bringing the world together, we're bringing the world of dentistry together, and what you did is just fantastic.
CHRISTIAN: Thank you, Miguel. We will definitely have this topic back in one of the future interviews, maybe when I invite Carl Stanley, a very important topic about the loneliness of a dentist, the tough life of a dentist, the highest rate in suicides in our profession, is in dentistry, depression, and all these factors that we know are important and not really discussed properly, I believe. We know many people need help in that way.
Back to your journey, you were a kid going around the world and suddenly you woke up and decided you're going to be a dentist. How did that happen?
MIGUEL: I always felt that I fell into dentistry, but I've always been very connected to people. I have a lot of energy, but there's a lot of people that think they know me, but until you’ve actually been in the same room with me, you don't know me. Let's just put it that way. You might have an opinion about what you see on social media or television, but if you’ve not been in a room with me, or had a cup of coffee with me, you won't know me because I'm a very energetic person, and I share a lot of energy, and I think it's good energy, and I've instinctively wanted to heal people. I want to make people feel better. I've wanted that since I was a boy, and I wanted to be a healer, let's put it that way.
When I was 16 I had to make a decision: I wanted to be a heart surgeon, because that was the most amazing thing a doctor could be because Christiaan Barnard, the South African Heart Surgeon was the first guy to do a heart transplant. That's when I realized that, oh, my, god, that's going to be amazing, to hold somebody's life in their hands.
I wanted to become a doctor, and then back in the day it was six years of medicine and plus another three or four years of specialization, and my family couldn’t really afford a 12-year adventure in education. Back then it was very difficult, so I started my degree at a university here in Portugal, because the first two years were the same as medicine, and I did that pretty much because I didn’t get the one grade in physics or something like that, by one point or something. I thought, "Do you know what, I'll do my first year in Dentistry, and then I'll move to medicine. I'll adapt."
I'm a human being like everybody else, and in my first year I made friends, and I realized, there's a little thing nobody knows. I was a delivery boy for dental clinics, and I had a motorbike that my father had got me to go to university, and my best friend, who was my Dental Technician for 21 years now, he got a job in a lab mixing gypsum in a dental lab. He said, "Hey, do you want to make some extra cash? They need a guy to do delivery." Basically, my first year of dental school in which I was preparing to go to medical school, I was delivery bags of teeth to dental labs.
CHRISTIAN: You were the motor-guy for a dental lab?
MIGUEL: Yeah. For a dental lab. I had about 15 clients, and I saw some really bad clinics, and I saw some awesome clinics on the way. I was the worst in the chain of command, but what I got to do was to go inside these dental clinics and see the lifestyle of these dentists. I mean, we're talking 1992, that's a long time ago. I was fascinated by the culture that these guys were in charge of their own lives - they had nice cars, they had a nice lifestyle, and I'd had my friends at university, and I said, "Well, let's try another year, and boom, I became a dentist. That's pretty much how I fell into dentistry.”
I was a good student. I was good at it, and I didn’t know back in 1998 when I graduated the importance of a smile. When I told people I was a dentist, they'd go, "Ugh," and I hated that, so I spent the best part of 21 years changing people's perception about what a dentist means, much like yourself.
CHRISTIAN: When you graduated, you were just a general dentist and then your idea was to just own your own clinic? What was your initial idea when you graduated? Did you finish dental school and had a specialty?
MIGUEL: No. We're talking pre-internet, so there was nothing, there was no such thing as benchmarking, there was no knowledge, there was no information, it was a hidden profession. I had no clue. Besides the 15 clinics that I'd been into. I was a great student, I got really good grades, I graduated, and I thought, "Hey, do you know what, if I'm a good student I'll be rewarded." What I found out was that despite having great grades I had nobody in dentistry, I knew nobody. So I got no job offers, whereas students that had an average of 10, their parents had clinics and they got a job straight away. I was like, "Well, that's just life," and I remember I went to visit all of those 15 dentists, and I'd say, "Man, I will clean your floor, I will clean the toilet, I will wash your car. I will do whatever it takes, give me a job." I guess the economy back then wasn’t very good, there wasn’t room for that, so, for about six months, I was terrified. I answered an advert in a newspaper that needed me to go 300 kilometers south of Lisbon, to go work for a South African dentist who had German Endodontist and a British Implant Surgeon back then, and this is 1998.
I was hired to do general dentistry, they said, "Oh. Do you know how to do bridges?" "Of course I do. I've done one in university." I was good at dentistry, and I managed my own way, but I realized I didn’t know enough. I'll tell a little secret to you, Christian; because you're working in a lab, you'll understand this. I remember on my first week of the job, I got given a three-element bridge to do, a molar to a premolar. I remember I prepped the tooth, as I'd learnt in school, and I took an impression in impregum, and I sent that to the lab, and I remember my dental nurse, who had 25 years experience telling me, "That's not how you do it. That's not how you do it. That's not how you do it."
Learning a lot from my dental nurse, and then the dental lab calling me saying, this impression is terrible. I said, "Okay, please teach me how to do it," and the dental technician helping me, and remember the patients being so gracious. I said, "I need to learn more." I learnt a lot about endodontics from this German guy, and German dentistry as you know, of course you know are very methodic. So I'm really grateful to these guys for teaching me and being kind enough to teach me back in 1998.
I stayed there for two years, and in those two years I went to Madrid on weekends from 1998 to 1999, to study implant dentistry at CEOSA in Madrid, and it was the Branemark Center. My teachers were Mariana Sanz and Pepe Rabago,and others who were directly on the team of Branemark in Gutenberg. These guys were the pioneers in education, and Mariana Sanz is a global leader in perio, and Pepe is a leading dentist in Spain, and a teacher.
There were about 30 of us on this course. It was a 12-month course, and we'd go there for three days a month, and I did this at great expense. I remember saving my money, not buying anything so I could afford the course, and I think that was one of the most defining things that I did in my career. That led me on the path to implant dentistry which is one of my passions. Then later I did the course in cosmetic dentistry at CEOSA as well. This was before 2000.
In the Algarve, the money that I made from this first job I paid for education over the weekends. I'd work during the week, I'd study during the weekends, I had no life, and I did that for two years. I think a lot of the younger generations of dentists forget how hard it is to study. It's tough. Then basically, I think the defining thing, was every time like once a month I'd come up to Lisbon, and I'd go knock on the door of this clinic in a very nice area of Lisbon, and I'd try to get a job at this clinic, because I wanted to be closer to my family. He was like, "No, no, no, no, no." Anyway, after two years he finally conceded and said, "Do you want to buy the clinic?" Then I managed to get a loan from the bank with support from my family, and I opened my first clinic in January 2000.
CHRISTIAN: So you started your business career in January 2000, and I know a little bit about your career, and what is interesting, what I really like about the stories you told me when we met actually, is that you're not afraid of sharing your failures. As I mentioned, you have ambition, you're driven, you're a doer, you're an entrepreneur, you have this inside you. You have ideas, you're creative, you want to do something different. You're definitely in that group of people that are not comfortable just living life normally.
You started a very ambitious project, you became big, famous, and then everything went downhill, you went beyond a tough situation. I think that's great to share that when you were down after succeeding, right?
Because having a tough beginning, most of the people have that, and it's interesting, maybe you shared the same feeling. I had a very tough professional beginning as well, and when I tell the stories people don't believe them, because they think that I was just born with success like this, and we know it's not true. When you have a tough beginning you don't feel it, it's just normal. When we remember the tough beginning, we're like "Oh, my, God, I really went through this?"
Because when you're living that moment you don't feel it. The tough, much tougher than that is to succeed, experience absolute success, and then drop all the way down. I had a similar situation, my father had a very similar situation, but you had that contrast.
You kept your personality, your ethics, and you were able to come back. I want you to explain a little bit about your dreams, your ambition, your vanity, how that created the situation to bring you down, and then how you recovered?
MIGUEL: It's a great introduction to the issue, and I'm grateful for it. Well, in a nutshell, I'll explain this in a full loop. Dentistry saved my life. That's a really powerful statement, and because of dentistry, and the journey that you just described, I became a better person, and I created the part of a bigger game philosophy. I understood at my weakest hour, when all of my competition, because Portugal is a small country, it's not a big country like Brazil, and I was a very successful dentist, I was making a lot of money, my clinic was on TV, we were doing TV shows. I mean, I was doing full makeovers, full mouth rehabilitation 12 years ago. I mean full arch, and we've been doing that consistently, and we had a huge turnover, and I decided to go from my first clinic to a second clinic and do a big jump. It was a huge financial jump, millions of euros, but this was before the subprime, the money was cheap, everything was good. Let's do it. My advisors, my consultants, my team, all said let's do it.
Life was great, it was 2009, we were making millions, it was all great and, boom, I found out that my accountant of nine years had been stealing money, and he'd embezzled a lot of money. It took us a while to figure out how much. It was compounded, it was a perfect storm. We found out he had embezzled a few million of tax money. He later got a four-year jail sentence. A lot of people don't know that, but he got a four-year jail sentence, suspended sentence, we never saw any of the money.
Then the subprime hit, the market retracted, and we had some difficulties with opening the new clinic regarding construction, because again, we had people wanting us to bribe officials to get the licenses passed, because that's the way things go, because our construction was supposed to take six months, it ended up taking a year-and-a-half. It was these three different things. Again, I was a dentist, I wasn’t trained in these things.
CHRISTIAN: I'd like you to go a little bit deeper. I know you have the strength and the courage to talk about this topic. I always say that our biggest enemy is our ego, and the worst thing is to think that we don't have an ego. I see many big egos saying, "No. I'm humble." I say, "That's the problem. That's going to kill you."
MIGUEL: If what you're getting at is if that was an ego issue, I think I bit off more than I could chew back then. There's two things, as businessman, if I could go back in time, there's so many things I could change. As a dentist, there's so many things I would go back and change, but had I not have this story happen to me, I wouldn't have learnt how to eat shit, excuse my language, for a while. Come 2010, we were managing the issue privately and confidentially, we were resolving things, we were paying, we were doing everything, but one thing never changed. There's two aspects here: one is Miguel Stanley the Dentist, and the other was Miguel Stanley the entrepreneur. The dentist never stopped doing gold standard dentistry, and that's why when I started this explanation, I said: dentistry saved my life. Because you opened this by saying, "A lot of people have a tough time at the beginning." I started from nothing, built it, lost everything, and then did it again. That second time is a lot tougher, and the only reason why I managed that second time, was because of the gold standard, ethical dentistry that was consistent.
There was very dark moments in 2010, 2012, because when dentists in Portugal, the competition, let's call it, found out, they were just like, shocks in the water. It became public, and not just that, what I understood was that the suppliers who had been great business partners for over a decade, all of a sudden I became super toxic.
It's like everybody disappears. I had a TV show that was a primetime TV show, as this happened, Dr. White aired. It was on primetime national television, millions of people. Now I recall, in 2012 people still watched TV. Nowadays it's a lot different; people have Netflix and all of that. It was a big deal.
I realized that I could go one of two ways. I could sell myself short, and give up, pack it in, and just go get a job somewhere else. I was a famous dentist, I was good at my craft, I could have just said, "To hell with it. I've just got a job working for somebody else”. I could have just left the country done some … but that wasn’t the story I wanted my life to be. Now, I wasn’t a father then. I am now. We started by talking about fatherhood, and I'll tie that in.
I wanted to have some form of legacy, not because of ego, but this failure was partly my fault, but a lot wasn’t. I said, "Do you know what, I'm young." I was 36 years old when that happened. I said, "I've got 20 years more career, I can do this again." I wanted to challenge myself. I remember my brother, who is a very successful businessman in his own right, and being a counselor to me over the years. He sat with me and he said, "Listen, man. You're at base camp right now. You're at base camp. You’ve made it here, it's incredible, your base camp of Mount Everest. You’ve done it, man." It's like: the weather up there is a mess and it's dangerous, and you might fail, you might even die reaching it. Just the fact you're here at base camp is amazing.
You can go back down safely and have a great life for yourself, but it's up to you, and only you, if you're going to make it to Mount Everest, to the top of the peak. Not many people can do that. Some people are crazy, some people they have a feeling, and I didn’t know if I was going to succeed, I really didn’t.
I have a Roman Catholic education. I got taught that if you're good, if you're kind, you are rewarded. Maybe that's not entirely true, but not just that, a very important here, is a shout out to my team. I have dentists on my team that started this journey with me, some of them 17 years ago. My Orthodontist has been with me for 17 years, my Cosmetic Dentist has been with me for 11 going on 12; my Endodontist 11 going on 12; my Technician for 21 years, my Cleaning Lady for 19 years, my Tech Guy for 20 years. I had these people around me that they held my hand, they said, "We're with you through thick and thin” and we just decided to go again.
I knew it wouldn't be easy, and I knew that the only way to succeed was to be kind, to be honest, to be patient, and to recall the difficulties of the first time and realize that it's going to take twice as much, and be twice as hard, but if we did pull through, it would be incredible. I'm not saying we've already pulled through, but I take nothing for granted nowadays.
CHRISTIAN: Maybe I can summarize the success, you said that dentistry saved your life, professionally, your business was saved by your passion for dentistry? That support from the family. I know your Three of them and the team, because that's definitely true and then we can talk a little bit about that, because I think one of the key factors for succeeding is being a team builder. You are a team builder, I've worked with you in your office. I lived the experience of working under your umbrella, being there as a team member, interacting with your team members, and I know that they really are proud of being part of the team. They own it.
MIGUEL: I think, there's an old African saying, "Alone you go fast, together you go further." Again, listen, I'm really grateful for this chat, because I don't really get a chance, but I'm a true believer in humanity, I have faith that there's goodness in everybody, and if people follow me on social media, they say I write a lot of human posts, and I believe that nobody wakes up wanting to do damage to somebody else. They fall into it.
When you’ve got a team that's doing dentistry in what is such a mess of a profession, I mean, let's face it. They allow us to do from a simple root-scaling and planing, all the way up to full arch implant dentistry and bone reconstruction with the same dental license, I mean in most countries, in some countries you have to be a specialist, but in most countries, the array of things that you're allowed to do, and I just think that you can't survive in this profession without a team. I don't know if you’ve seen the White Clinic logo, but there's no "I" in white, and that was planned because there's no "I" in team, and it's a team effort. I install a sense of purpose into my team, that you’re never too good to get somebody a cup of coffee, or clean the toilet, or have that same energy that I started my profession in 1998, that burning desire to come to work every day and just do better, and improve every day, improve your game, improve the people's lives around you, because we are in the service industry, people come to us for help, and if you don't help yourself and the people around you, you can't help other people.
Again, we discussed earlier on about what happened to me, and that was something that most people don't recover from. We're talking about in Portugal, which is a poor country, with a small dental community, it was public. The subprime, the money was drying out, and to do that without family, and without a team would have been impossible. I'm really grateful to everybody, to the companies, to the people that believed in us, and the only thing we can do now is share that energy and make sure that other people don't give up.
CHRISTIAN: When it comes to building teams, we can read books, we have many posts, and it’s amazing how there's a lot of cheap philosophy on Instagram, magical sentences giving you the recipe for success. Everybody knows that team is important, you have recipes to build teams, etcetera, but not everybody can do that?
MIGUEL: The same way some people say, "I'll be faithful forever," and then are not. It's a question of emotional loyalty.
CHRISTIAN: And I think that the key is to really care. Meaning that you really care about your team, and you think about them before you think about yourself. In the tough moments. Let's say all the money in the world disappears, and you have 1,000 bucks left in your office there, and I know that at that moment you can sit with your team and share that 1,000 bucks with everybody. Or even give more to them than to yourself, or you can just take the 1,000 and run away, because you'll never see them again.
MIGUEL: Over the years, there have been a lot of offers to do other things. I have a lot of wealthy clients, as you know, I have a lot of celebrity clients, and everybody has a plan about what they should do. But I believe that the White Clinic brand in itself represents something. I'll share that with you. I wanted to create something that was the benchmark. For me, for my career the benchmark was always Team Atlanta, and I'd like to give a big shout out to Maurice Salama, Henry Salama, David Garber, Dr. Ronald Goldstein, and you know them very well because you worked there for four years. Maurice taught me synergy, he taught me to always be inclusive, never exclusive. Not just that, interdisciplinary dentistry, the first time I heard the word came out of his mouth. I owe a huge debt of gratitude to everyone at Team Atlanta, not just what they did before Dental XP, but what they’ve done on Dental XP. There's a lot of people that are only now figuring out what it is they do, but that kind of dentistry for me was the way it had to happen.
Now, I'm not saying that they had an easy road, but in the USA, the economy is a bit different than in Portugal, and I refuse, on average, 50% of the first-timers that come to White Clinic, on the premise that I never studied financial-based diagnosis. I never studied at any of the courses I've taken, or in the 20 years I've been a dentist, I've never heard anybody train me: if patient X has 300 bucks a month, this is what you should choose. That's when I created the "No Half Smiles" philosophy as the foundation for excellence at White Clinic. I've been lecturing for 15 years now, I have a following. I have messages every single day on social media, I'm sure you have too, of people asking for guidance. I just realized, look, there's a way to do this the right way. It's not something that's hugely scalable, I believe now with digital technology, and we can get into that, we could talk for hours on that, finally with the digital technology it is scalable, but I believe that, look, somebody has to show the way of doing it right.
If I'm going to be honest with you it's: in a country like Portugal, it's not hugely profitable. It's a lot of hard work, but I'm still only 45. I will figure out a way to make this profitable, but right now what I want it to be is cool, I've just come out of a massive difficulty only seven years ago. Right now I'm doing this for me, I'm doing this for dentistry, and I'm having fun doing this, and my team are, and my patients are grateful for the kind of work we're doing.
CHRISTIAN: Having gone through the journey is another huge message, and I learned that with my father, even on the darkest periods of bankruptcy, and my name was involved because the second company he built he used my name, and then it was a disaster, it's not that you like to suffer, but you need to enjoy the challenge, and deal with it in a positive way.
Have a smile on your face, and say, "If it's happening to me, it's because it's part of the journey-"
MIGUEL: Look at football right now. The World Cup. Brazil did such a great job, Portugal did such a great job, but sometimes you win, sometimes you lose. That's the challenge, and that's what you trained for.
If you think that you're going to always be successful in this game, you're wrong. Why? Because life is very much like dentistry, most cases you plan for success, but you'd better be prepared for failure every now and again.
CHRISTIAN: How much of business knowledge you had on your first project, and how much you have today?Where did you find this information, or do you have people helping you on that? Or do you run the whole show?
MIGUEL: I would say for the first eight years, nothing. We just were making so much money, that we could afford all of the crazy ideas I had. I mean, back in 2007, we were making half-a-million euros a month, 11 years ago. I don't know many clinics in the world that can do that today. Of course that's going to affect the ego as well, is to get back to the thing of a 34-year-old kid. I had no knowledge.
I then got some managers that helped me, but at the end of the day I think only yourself, you who built the practice, and that run it, and that manage it, and that deal with the people, you're the right person to deal with that job.
You can't delegate passion, you can't delegate passion, and I'm passionate about this project. I can hire people to do it.
CHRISTIAN: Do you have business people helping you now, today? Or you are the business CEO?
MIGUEL: I am right now. Currently I have a few advisors, I have my brother, he is a strong ally of mine, he doesn’t work for me, it's just every now and again, we sit and we consult. I have a few business associates that work for me, that help me with certain projects, but in the large scope of things, it's me. Again, how did I learn this Christian? By coming to work every day, and improving one thing every day. I don't care what it is. "Hey, let's get better toilet paper."
You might think that that's funny, but just getting better toilet paper, that's a business decision, you have to make a decision to choose which one, and you put that in your toilet, and your patients say, "Hey, the toilet paper has improved, I'm sure now business is better." Those little decisions, and if you go around the practice, I've got 550 square meters here, 30 people on my staff, we've got a bunch of technology, we've got patients coming in and out every day, there's room for improvement every single second. I would say that it's learning - training your brain to never, ever, ever give up improving, and I've been doing this for 21 years, that's a natural thing that you learn business over time.
CHRISTIAN: Let's talk a little bit about the existing clinic you have and the concepts that you have developed right now that you're using that I think are very cool. We can see that you have a natural talent or know-how, and again, it's not trained, it's not your ambition, your business feeling, but also marketing. You're good at creating your brands, or slogans, and that for me, is one of my passions - marketing and communication, and how to make people enjoy your message, enjoy what you're doing. One thing that I always tell people, and I like, because you did that, and you never talked about that, but you didn’t put the name of your name in your clinic. You created a brand, and the brand goes beyond yourself.
The beauty of having a brand instead of your name, it's not linked to you when it comes to working with your own hands. You can multiply yourself much easier. If you want to do something in the future with your brand, with your company it's much easier than if it's not White Clinic.
Great name by the way, and a great brand; and it's easier to make people work for a brand, a company and feel like they own it, than working for Miguel Stanley. Now, White Clinic, it's much more empowering than I don't care, because it's all for Miguel Stanley. You know?
MIGUEL: Ironically, life has a funny way of working out for itself because it was White Clinic. Being White Clinic for many years now, and you'd be surprised at how many people do exactly that as you say. It's not about the "I". Now, there's a lot of guys that feel the need to put their name on the brand, and it that's going to be their only clinic.
CHRISTIAN: I believe it's a tougher journey because you need to transform your name into a brand.
MIGUEL: Apple has done a fantastic job. Steve Jobs honestly is a case study that should be studied at Harvard, the guy was genius. Respect to him. But not many people can pull that off. I believe that White Clinic was part of something bigger, and I wanted people to come and work for something bigger than just me. A little something that I did in my Dr. White TV Show was that, and most people don't know this, I made a conscious decision to put my team on. They got more air time on the show than I did, so that when the public came to White Clinic they didn’t just want me, they were happy to have the other doctors.
CHRISTIAN: Dentists always complain, "No. I cannot grow, or I cannot take a vacation, I don't make money when I'm away, because people want me." I think that is definitely not an excuse, it's all about a strategy.
MIGUEL: By doing that I afforded myself time on my weekends, and last year, I did 22 days away from the clinic lecturing, and as you know more than anybody, it's a day to get there, a day to lecture, a day back, so you lose about four working days to go and lecture. I'm very passionate about sharing my information and my story, and had it been just Miguel Stanley, I don't think I could be away from the clinic. People respect the brand. There's actually, you can see it on, if you go on YouTube, and Google White Clinic, there's a bunch of videos that we do, and there's a video of what a first appointment looks like at White Clinic. It's a four-minute video, and pretty much, there's like, we call it the Bible, and the Bible pretty much runs you through a first appointment, and how we set up a No Half Smiles. The No Half Smiles philosophy is the foundation for White Clinic.
CHRISTIAN: How people can find that video?
MIGUEL: If you go to YouTube just punch in "White Clinic" and there's a White Clinic channel, it's got the logo: White Clinic, Leading Dental Centers of the World. On that, it's one of the main videos. Or if you go to our Facebook page, White Clinic, it's one of the first videos on there. It's a tour, it's a four-minute video, really well produced and it shows you a day in the life of White Clinic.
We have six chairs in the clinic, only. We only do dental. We have six chairs, we have almost 30 people working here. Like: why are there so many people? Well, when you come you find out. I wanted to put a four-seasons-twist on a trip to the dentist. You know as well as me, Christian, that most dentists try and take out as much money as they can from the business, because they realize it's a fast-burn-out industry. The truth of the matter is, is that the more you put back in, the bigger you can grow, and the better the brand becomes. Dentistry is about generosity. I have never read any book that says, "If you cut out five steps of the process you will have a good outcome." We know that gold standard dentistry equals longevity, more predictability, and better outcome.
You can't cut corners in science, and those things take time, those things take a team, they take technology, they take patience, and that's why we have such a big team of people to make sure that even if I'm not here, or there's a person missing in the chain of command, if a receptionist is missing, we never stop giving just quality, consistently.
CHRISTIAN: Let's go to the two slogans you developed. First, number one, "No Half Smiles," the second one, "Slow Dentistry,". Very well-thought slogans, great brands as well, but what do they mean? What is the meaning behind each one of them?
MIGUEL: Well, I'm going to start with "No Half Smiles," No Half Smiles was actually a top guy in advertising, a Portuguese guy. He's a top guy in advertising, and I hired him to help me in 2007, to give a title to my lectures. There's a reason behind this. You see, in 2006, my first TV show aired, and as a result of that we just had thousands of patients wanting to do with us what we were doing on the TV show.
When I had, let's say 20 patients come to the clinic, I had a limited amount of time. One patient wanted six front veneers for, let's say, EUR6,000, and the other one wanted, or needed a full mouth restoration for EUR40,000 - which one do you think I was going to pick, if I had limited time? If you're only seeing one patient a week, you do both, but I had 50, 60 of these cases to choose a month, so we chose the ones that only wanted full arch rehabilitation from a biological, functional and aesthetic perspective. Because we all know that patients don't want dentistry, they want beautiful smiles, but you can only achieve a long-lasting beautiful smile with great occlusion, full arch, vertical dimension, everything biologically driven, so on and so forth. Now, for a lot of people, that costs a lot of money, but if you want longevity in the business, and I had to protect the brand, White Clinic, I'm not going to do something that is just half dentistry. We came up with the brand, No Half Smiles, and what No Half Smiles literally does, is its gold standard dentistry. If you think about it, every single patient wants 14 upper, 14 lower, vertical dimension-driven, perfect occlusion, with nice soft tissue, and they want to chew without food getting stuck in between their teeth, they want facially integrated, beautiful smiles - DSD.
Now, regardless of the problem, what No Half Smiles says is, if they come in and say: “listen, can you just do the top arch, and you'll do the lower arch next year," you say, "Listen! But we need to raise the vertical. I can't do that just on the top arch." "But come on, Doc, listen. You're asking me 40 grand for the full mouth; let me give you 20 grand." They put 20 grand on the table, how many dentists do you know Christian, will walk away from EUR20,000 on the table? But I do. Because that's the way the business is set up. Because I know that if I took that 20 grand and did half a smile - five years, six years down the line, I'd have chipping of ceramics, and so on and so forth, and the only way you can have longevity in this industry, is by doing gold standard dentistry.
CHRISTIAN: Can I translate No Half Smile into: creating an ideal, comprehensive solution and sticking to it?
MIGUEL: 100%, and do not filter it financially. There's only two ways you can filter this financially, actually only one, is you take a hit. You, the dentist can do charity, you can do it for free. Imagine you have a patient that needs 12 ceramics on the top, the nearest crowns whatever, and is missing two back molars. Without those two back molars, you can't raise the vertical to support the interior, but they can't afford the implants. I will offer them the implants many times.
You think of it as an architect. Architects say, "Form follows function." Patients want the form, they want beautiful DSD Smile Design, beautiful smile. But you can't have that without the function. What we do is sometimes, most cases we'll say no, but some cases, we'll say, look we'll offer you this or that, to get that perfect occlusion: No Half smiles.
Again, if you think about it, just for Portugal, there's 10 million living in Portugal. I have one White Clinic in Portugal, for the demographic. What I'm trying to say is, 1% of the Portuguese population is 10,000 people. I can't treat 10,000 with No Half Smiles, so I can be patient, I can wait. Of course for a bigger country like the U.S., it could be a bunch more, but what I'm trying to say is, that this clinic was built for a certain demographic with big problems.
CHRISTIAN: What you did is very simple, it's known on the marketing industry as creating your bio persona, creating the character that you want to serve. It's very, very simple. Everybody should do that. You'll want to do what you do the best, you want to do what makes you comfortable, you'll want to treat the people that you can match emotionally, and if you have enough volume to do that, you don't have to do what you don't want to do as much.
MIGUEL: There's a few little things here. One, my dentists come happy to work every day, because they know they're doing gold standard dentistry every day, from the perio, to the prostho, to the ortho. We've been doing Invisalign for 15 years, and most of these cases are interdisciplinary with cosmetic dentistry, and endodontics. It's fantastic to see that there's a passion for dentistry. Again, I started this by saying, dentistry saved my life, so the thought process of doing gold standard, not cutting any corners, despite being difficult it's essential.
It's great for business because you cannot sell Fiat and Rolls Royce in the same stand. Fiat is a bigger brand than Rolls Royce because they sell more cars, but no disrespect to either brand. What I'm trying to say is, if you're doing partial dentistry, and full arch dentistry at the same time, your partial dentistry might create more problems and won't have the emotional aggregate that full arch dentistry does. We focus on gold standard full-arch dentistry, and it generates, over time, a lot more emotional response from the public that, "Hey, if you have that problem you need to go to White Clinic”.
CHRISTIAN: That's the message. You specialize your message and you get the type of clients that you do your best. Some people will do bleaching and aligners, there is no right or wrong, it's just that you need to define your business strategy, and what you know from the scientific clinical standpoint.
MIGUEL: Christian, we're having a chat. You know me, I’ve known you for many years now, but of course this is something that's hugely demographic. There are some countries where this philosophy just wouldn't work, because people have great teeth. You go to a country like Denmark that has a dental program, people don't miss teeth, they have great smiles, you understand, or if it's culturally not something that you want. I think that this philosophy is going to be useful in the years to come, because we know that there was a huge boom in full arch dentistry 10 years ago, and there's a lot of implant failures happening. There's going to be a huge need for gold standard full arch dentistry in the years to come, and that's why I'm sticking to my plan.
Regarding Slow Dentistry. Well, we only have a few minutes left, but Slow Dentistry is an idea, it's also a registered trademark, all my brands are registered, and Slow Dentistry came to me, and again, I just had the creation, and it's now being managed by another team, and you'll be hearing about this very soon.
What Slow Dentistry is, I was having a problem understanding how some clinics were making more profit than I was, in my difficult times. And that's why, the difficult times are a great time for you to grow, because you have to really rethink everything.
It hit me. I'll give you a quick example. People call my clinic and say, "How much is a cleaning?" Let's say, a root scale and planing, and let's just say we say EUR100, they go, "Oh. That's very expensive," and then hang up, and they’ll go somewhere else, or they come and will say, "Oh. I'll do my cleaning at another because it's only EUR25”. I'm scratching my head, and scratching my head, and then it hit me. "How long do they take?" "Ah, they take 10 minutes." That's fantastic, because 10- minutes is super fast, you take an hour and charge 100, it has to be worse.
Then it dawned on me, that the patient's perception of excellence in dentistry didn’t have the time factor aggregated to it. Time is a victor of excellence in dentistry. Now, it's a very tricky road if you start describing what techniques should be used, but I can assure you that not a dentist in the world would say that you shouldn’t take the adequate time to disinfect an operatory in between appointments to kill and disinfect HIV, Hepatitis, and so on and so forth, to avoid cross-contamination. That takes time. Studies showed that an average from 5 to 10 minutes to disinfect an operatory in between appointments. Around the world, I've visited 55 countries professionally, that top-notch clinics do that. If you're seeing eight patients a day, which is an hour per appointment, you're giving adequate time to disinfect the operatories in between appointments.
But if you're seeing 16 to 20 patients a day, that's 200 minutes, that's like three hours that the operatory is supposed to be stopped, and those clinics that are doing volume are charging less money, and they're only charging less money because they're seeing more patients. It's impossible to do that and not create a health hazard for your patients, and I'm not discussing what kind of dentistry you're practicing. If you're just doing bleaching, or fillings, I don't care, you still have to protect your patients, and you have to protect your team.
The second thing is adequate time for anesthetic. If you're doing speed dentistry, and you’ve got an inflamed tooth, a molar, whatever, you can't do that in 5 minutes, it takes … I mean, I've been doing this for 21 years, it sometimes takes me 20 minutes to get total anesthetic kicked in. A central incisor on a normal tooth takes you 3 minutes before you can start doing your filling, but some teeth take a lot longer, and I fear that a lot of clinics that are working on the clock, are doing things fast.
It’s about creating awareness for the patient, for the patient. Things that the patients can understand. The last one, Christian, there's one that's very simple. Valid Consent, signed Valid Consent, you have to explain the risks and rewards of every single procedure to your patient, and if you're doing things fast, if I'm going to explain to a patient that a bleaching, full arch bleaching, in-office bleaching, that she might have post-operative sensitivity, that some of the fillings might not take. That takes time.
CHRISTIAN: When I first visited your office five years ago, I had this vision of the first appointment with technology, and really spending time, again, time. Investing time on first appointment, investing time on documentation, investing time on face analysis, investing time on smile design, investing time on comprehensive diagnosis, investing time on interdisciplinary treatment planning, investing time on putting a presentation together for the patient, investing time on preparing your team to present. Investing time on sitting and explaining the plan. By the way, all this time, before you even sell the case, meaning that the patient may say no, and you invest the time from A to Z to create that project.
When I first visited your office, you were one of the first guys that were actually doing that for real, because I was teaching this concept of investing time and this experience, and you had it all set up on that. What I call today the DSD room with projection, with the PowerPoint, with a presentation to the patient, and you were presenting this because you were investing time.
That means that you need to create perceived value. When the patient says, but this is a lot of money, and you need to somehow be able to send a message, "Did you realize, patient, how much time I invested, just to diagnose your problem, and created the solution for your problem. It's a lot of time."
"Oh, but the other doctor offered me the same solution, for much less money." I said, "But how much time did he invest on that solution?" Because saying, I'm going to rehabilitate your smile is very easy." We know that behind rehabilitating your smile, there's so much. We need to be ready, prepare a treatment plan, there are so many decisions. For me, it's all about, "How much time do you invest in making better decisions for your patients?"
MIGUEL: What I'd like to say is, I'm sure that you could actually calculate that you will have more revenue as a clinic, the more time you spend with our patients just talking, and creating a connection. Now, I've been talking about this in my No Half Smiles Lecture for a decade now, Christian. Just the last but not least in the Slow Dentistry, there's no dentist in the world that has not learnt that the use of a rubber dam, when doing a root canal procedure and over 80% of direct restorations is the most important thing, part of the procedure.
It takes five to eight minutes to set one up. If you're doing appointments in 30 minutes, and you're cleaning the operatory correctly, you're giving the anesthetic correctly, you’ve signed the valid consent form, and you put up a rubber dam, that takes about 30 minutes, and I haven't even started the treatment. So guys! Dentists listening to this, do the right thing, you’ve learned gold standard dentistry, don't work for people that make you break the rules, because there are good guys out there, and somebody … "Look, man, I had success, I failed, and I came back because I do the right thing," and that for me is the most important thing.
CHRISTIAN: We can conclude that, of course it's obvious, when you spend more time to make a decision, you will make a better decision. When you spend more time doing something, you're going to probably do something better. We all know the relationship between time and quality. If you are investing the time to deliver better quality, or make better decisions, what is the challenge? The challenge is to make your patient value the time. Because otherwise they will take it for granted. They will compare the name of the procedure: full mouth rehabilitation, full mouth rehabilitation.
MIGUEL: The difference between cost and value,. Christian, I have to commend you before we leave, the Digital Smile Design concept, that you have so ardently fought for, and the concept of sending your planning, outsourcing that to Francis Coachman, and I'd like to thank him and his team in Madrid for the outstanding work they do. That outsourcing of the treatment planning for the younger generation of dentists, for the dentist that has difficulty in doing this interdisciplinary treatment, try it, test it, because what you get back - you’ve literally outsourced that treatment planning.
You get the ortho procedures, the prosthetic procedures, the endo … you’ve literally packaged interdisciplinary dentistry with that one simple step of outsourcing it. I commend you personally are changing the way dentistry is thought and perceived, you're helping millions of people around the world get better dentistry, and for that my friend, I thank you, and the world needs to thank you and your team for the work that you're doing.
CHRISTIAN: Thank you, Miguel. Having you test driving all our ideas, the goal is actually to facilitate better dentistry. As you said, we need to be efficient, but we need to understand, of course, that we're in the health care business, and above any kind of business perspective, we have the patient, we have ethics, we need to deliver great dentistry, but we deserve the value, we deserve the credits, if we're really following the rules, if we're delivering quality, we deserve the value, the patients. What we see is that we need to understand how to make patients become a big fan of ours, when we're doing a great job.
MIGUEL: That's by making them become a fan of your team, and for that to happen, your team have to love to come to work every day, and for that you have to create a safe, healthy work environment, and that is what we work for every single day, making sure that it's fun. Dentistry can be fun if you don't break the rules. That's what I'm all about.
CHRISTIAN: Amazing! Great message: No Half Smiles, Slow Dentistry, meaning no short-cuts, and getting your value for the time you spend on every decision. And being part of the bigger game, hashtag, I love that.
MIGUEL: Christian, I'd just like to leave a message to all the dentists around the world. Don't be scared, you're not alone, but remember to be kind to each other. Social media is a platform for sharing knowledge, don't be jealous. Not everybody's life is as beautiful as it seems online. Learn through the art of dentistry that you can improve your dentistry the same way you can improve your own soul.
Be kind to each other, be nice to each other, and just be good, be good human beings, because our patients come to us to help … to ask for help for their precious asset, their smile, so be good to it. Be good to it.
CHRISTIAN: That's definitely a good message, because dentistry is huge on social media, and then that brings a lot of great things, but we see a lot of aggressive behavior, and let's just keep the good positive energy online.
MIGUEL: Yes, and you're a leader in that, and I just thank you for your good energy, and just keeping me part of your universe, Christian. Never stop. I'm here to support you my friend. Thank you.
I hope you enjoyed this interview with Dr Miguel Stanley and were inspired, as I was, to continue to learn and grow as a dentist, despite the difficult times.
If you would like to know more about Digital Smile Design, the DSD Planning Center and the courses we offer, including our four day residency to take the first step to becoming a DSD Master, find out more here: