Christian Coachman - Jun 6, 2019

Christian Coachman in conversation with Mr Kirk Behrendt

Leading dental consultant Kirk Behrendt


What follows is an interview with the guy who motivated me to start this series of interviews. It's interesting because we are swapping positions. I was interviewed by him many, many times. Kirk Behrendt, a great friend of mine and someone I have admired since I watched him many years ago for the first time on stage. Kirk is one of the number-one consultants in the dental field and has been helping dentists to succeed, but more than that, he's helping people to have a better life. That's the main goal - it's not only about numbers, but it's about balance, about being happy. Of course, making money, it's part of it, but it's not the whole thing.

This interview was originally taken from Coffee Break With Coachman, a series of interviews with the best brains and the best personalities, in short, the most influential people in our dental industry. 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: Kirk, as you're not a dentist, and you're not a dental technician, what the hell are you doing in this industry?


KIRK: I have no idea. I didn't even go to the dentist as a kid because my parents were broke. Well, they weren't broke, I mean, we were middle class. We were a good family. My parents always just told me to work hard, so I had three jobs working through college. I drove a forklift at night, and I worked at an Applebee's restaurant. I always joked that I was a three-time Employee of the Month at Applebee's, so whenever I drive by Applebee's, I say to the kids, "Three times," and they're like, "You're so weird," and I'm like, "Hey. You know, I loved it. I loved taking care of people”.  I also worked at a Champs sports bar - I just got a chance to work with people. I think it's a great opportunity for everybody.


CHRISTIAN: What's your educational background?


KIRK: My education was all in communication and business. When I was getting ready to graduate, I had a dental lab owner come in to the bar I was working in. His name was Dr. Bob Popp. He was awesome. He'd sit down at the end of the bar and he'd say, "Look, you'd be great in a dental office." I thought, "No, dentists are weird. I don't want anything to do with them!" But I was younger at that time, and he was an incredible entrepreneur, and so he said, "Come on in." I was 21 years old, and he taught me everything. He built a supply company on the back of a dental laboratory, and it was just great to watch him build processes. We had a simple list of products. We were servicing over 600 dentists, and I was young at the time. He built it to a $3 million company in no time. And it was just fun to watch him build that it lit my fire.

So, at the age of 24, I just decided to go on a journey and just check and see what was out there. I ended up landing in Scottsdale, and there's a lot of opportunity out there. I got to be a part of one of the biggest coaching companies and it was so much fun.

I landed in a great place called the Schuster Center. Dr. Mike Schuster was out there. I bounced around to a lot of different things. I went to a place called the Pankey Institute. I'd never heard of the Pankey Institute. I thought it was kind of a peculiar name, but I loved it. I had Irwin Becker as my C1 instructor. Then I went to the Dawson Academy. I actually went to a course at the age of 24, and I remember I had a mentor, and he said, "You know, you're going to go see a dentist talk for three days," and the dentist was 64. So I'm 24, and I'm like, "I'm not going to watch some 64-year-old dentist talk for three days." Because what I know now is that when you're in your 20s, you think you have it all figured out, and then you turn 30 and you think, "Man, there's a lot I don't know," and then at 40 you wonder if you know anything.

That doctor was named Dr. Peter Dawson, and I'll never forget, there were 400 people in the room, and I took so many notes. I actually still have the workbook from the first course, and I wrote him a handwritten note, and you know what he did? He wrote back. I was like, "No way." You know, and then Frank Spear had a course called The Practice of Excellence. I went through that thing eight times, and I was a kid, I didn't have any money, so Frank Spear would let me come for free, and I was like, "Oh, this is so cool." And, you know, you hang out in enough of these places and I got involved in the Seattle Study Club. You just meet the coolest people. That's how I met you, Seattle Study Club.


CHRISTIAN: I can tell you, that's an amazing start in dentistry. It's the dream of every young dentist. You know, you start from Pankey, Peter Dawson, Spear, and Seattle Study Club. That's a strong start. You can probably do some good dentistry yourself?


KIRK: No, people always ask me, "Would you be a dentist?" and I'm like, "No," because I hate this. But I love the teaching. I've always wanted to be a teacher, so now I get to teach. Then you introduced me to John Kois, and so we've had a chance to work. So, I say this: just hang out in the right neighborhood. I get to meet a lot of people just showing up with you at places. They have velvet ropes at rock star concerts. But I can just go in on your coat-tails, and I get to meet the coolest people. So, there's no magic to this, but I think if you love what you do, just be intentional about showing up at the right place.

Mr Kirk Behrendt Quote

Even Dr. John Cranham from the Dawson Academy, I'd heard about him, and in 2005, I sent him a series of emails. "Look, we're going to be friends. I like what you're talking about." And I showed up at a course, and I said, "We're going to be buddies," and he's like, "I'll decide that”. And to this day, he's still one of my greatest instructors, my greatest mentors. He teaches me so much stuff about great restorative dentistry and the mind of a dentist. I think what you can learn is infinite, don't you agree?


CHRISTIAN: At one point, probably, you understood that dentists needed help in anything or everything besides doing good dentistry, right?


KIRK: Yeah. Well, doesn't everybody need help, though? I've found that dentists love working on teeth. They go into it because they have a passion for the science, or the technical knowledge, and they often knew somebody in dentistry. Christian, you come from a long line of dentists. Are you the eighth generation of dentists?




KIRK: Sixth, okay. So you knew it was a good life before you got into it. But what dentists find out, which is probably no different than any profession, they're like, "Wow, I've got to manage people. I have to run a business now. I've got to figure this out. This is more than I bargained for." And it can often be challenging. But the other thing that people don't understand is dentists can make a lot of money, and they can also have a great life, if you get all the algorithms rightSo I love the algorithms. I love studying how great practices work, and I got a great team around me. It's a lot of fun. I just wake up every day, I pinch myself. My kids are like, "You love your job." I go, "I love it."


CHRISTIAN: I think dentistry is a very unique environment, because dentists have to control of so many things from the technical, clinical side. They have to learn so many aspects of what they do. I usually say that a dentist needs to be a little bit an artist, a psychologist, a scientist, a craftsman. We need to understand biology, function, structure, aesthetics, but also we need to understand technology. We need to be an engineer, a little bit an architect, everything in one profession.

With this new market ahead of us, we also need to learn how to manage a company, how to become a leader, how to influence people, be a marketeer, how to understand decision making, choices, body language, and be a salesman!  And all of these financial aspects, how to invest, how to structure your management strategies, how to create buying power, how to address companies, how to make good deals, how to plan an exit strategy, how to handle corporate world. It's impossible, right? So, I think more and more, we see the corporate world coming in, but we see dentists that still want their freedom, want to own their own business, and they need support from people like you. So I think it's probably a very interesting moment for a consultant to see this landscape, and see how you can help dentists to succeed on this crazy new environment for dentists?


KIRK: Yeah. Even in my business, I have to have a consultant, so I have a consultant or a coach. She just gets me straight, because often times I can be too emotional around the issue, I can't think straight. As human beings we're not designed, God didn't design us to reach our potential by ourselves. We need the help of other people. It's really hard to have a baby without anybody else. I mean, we could create an argument for that, but it's hard. In the same way, you can't create a dental practice on your own. You need the help of people around you. These people have been there before you.

Howard Farran says it all the time: “Do you want to feel better? Then hire a coach, physically, and if you want a better business, hire a consultant." They know what they're doing. I'm not saying it has to be us, but you got to find somebody who's like, "Don't do this, that's dumb," because you're going to save 30 years of your life trying to figure it out yourself. So, it's just a great time.

The other thing I would say too, is very few dentists ever go broke. One, I don't know what it's like in the rest of the world, but one half of 1% of dental lending notes fail in the United States, one half of 1%. That is crazy low. That means very few dentists ever go broke. I mean, you have to do something so dumb to go broke in dentistry, because you can still screw up and make a lot of money. I mean, it's a wonderful profession.


CHRISTIAN: That is changing. Don't you think that is changing? Because, you know, now the investment will increase because a modern office, to succeed, there's so much technology coming up. You know, you need to make much bigger investments.

The corporate world is owning clinics, and they are making the investments, so the consumer will compare, "You don't have this technology. You don't have this system to diagnose my problems. You don't work with this kind of sophisticated solution. I'm not going to come back to you." So the dentist needs to incorporate all these things. It's going to be hard to keep up. Running a dental office will become harder. The profits will drop. You said dentists don't go broke, and they didn't until yesterday. One of the reasons is, I usually say, because we sell the best product in the world, the smile. It sells by itself. Second, we have the best profit margins ever, you know?

My grandfather never had to worry about all these crazy strategies. He just needed to do his good dentistry, and he had a great life. But with all this pressure, profit margins will drop. Investments will raise to keep up with the standards. So, in my understanding, in the near future you're going to start to see dentists making bad decisions and disappearing from the market or going bankrupt. Or selling their offices with a much smaller amount of money than they expected, than they felt they deserved.

I think there will need more and more consultancy on how to pick the options, and how to prepare to be where they want to be.


KIRK: Two things, I totally agree with these. The ante to get into the game is bigger now. You just have to up the ante with more money to get in, and to get out into the real world. And the second thing is, when you talk about competition in this world, people are using data to beat everyone else. These large DSOs, you look at the insurance companies, they're looking at data tables all day long. Some of the best managers in DSOs that manage a thousand practices, are looking at hygiene reappointment percentages across the board and they're making adjustments, while other dentists are just saying, "Hey, did we collect enough? I'm going home."

They're beating them by a percent here, a percent there. So I think as a dentist, you're totally right, you can't stick your head in the sand anymore. You've got to know your business, no different than being a great dentist. You've got to have the digital workflow, you've got to have the technology now to be able to provide care at a very high level. And I think dentists are up for that. You know, I think they get it, and I think they're up for it. I would say that's for every business. You've got to know your numbers, you've got to know how to run your business, or else you won't be in business for long.


CHRISTIAN: I think it's all about choices. I usually say there's no right or wrong, you just need to know where you want to be, and then prepare yourself to be there. The options are very clear, or they should be clear. I don't think most dentists have that very clear vision of the options, but either you become a very high-end boutique office that I usually compare to a Michelin three-star restaurant, creating such a special experience and results that people just come.

The problems that this represents in my understanding, is Michelin restaurants are less than 1% of all the restaurants in the world, and the problem is the ego of the dentists, because every dentist I talk in the world, they believe they are part of that 1%. They say, "I don't have to worry, because I'm there, you know, but I worry about my friends and colleagues, because that's the future," and I say, "Okay." And then I talk to another one, and another one, and everybody's at the top. But there's not space for everybody there, and if you're not there, you have to really prepare yourself to become an entrepreneur and a businessman, or you need to do your homework, create value, and create a very cool exit strategy, to sell your office for good money, and maybe work for them without having the stress to run your business. In all these three options, of course you can go into academics or research, we're not talking about that, but on all these three major options, dentists need help. They need consultancy, they need strategy, they need to see the vision, and prepare themselves from today all the way to the next five years towards that direction.


KIRK: Absolutely, you said it really well. You’ve got the top, and you’ve got the bottom, but here's the cool part: It's not the top that's crowded, it's the bottom that's crowded. So, you're right, there are very few people up there, but there's so much opportunity in that, and there's plenty of room as you start to move up there. You've just got to be committed to the journey. And I always say this, there are people that fix teeth and there are people that change lives. It's not the same business. You've just got to be committed, no different than a Michelin restaurant never says, "Hey, look, we make food here." No, no, no. "We create experience. We make people's lives a little bit better. We give them a whole entire experience."

Mr Kirk Behrendt Dentistry Business Quote

I've heard you talk about that. That's really, when you get really good at selling the experience and understanding the variables of it, that's where you can really have a lot of fun with this, and my guess is, you know, the big thing for everybody is discovering why you became a dentist in the first place. If you just want to make money, that's not bad, at least you know who you are, but I'm guessing a lot of people went into dentistry for a different reason. They wanted to make an impact on people's lives, they wanted to do high-quality stuff, they wanted to feel significance in that whole process, and that requires a different journey. That's a journey of intention. You've got to reach out to people like you, you've got to find mentors, you've got to get involved with a process, you've got to get involved in education. It's unlimited. I look at this as it's blue sky or blue ocean, however you want to look at it. The possibilities are endless.


CHRISTIAN: Definitely. The more changes, the more crisis, the more opportunities. It's actually - nobody knows the perfect solution, the silver bullet. Even the corporations entering into dentistry, and all dentists are worried about corporations, and they should be worried because corporations will take over,  but even corporations are figuring out themselves. They’re making a lot of mistakes, not delivering the quality they expected, understanding, learning the hard way that dentistry is not one plus one is two. And there will be a learning curve on their side as well, and that means opportunity again.

I believe that a new profession will grow dramatically in dentistry, and that it is dentists with experience, with clinical experience, with the great business vision, or with a very organized thinking process, that will be hired by corporations to run their structure. Amazing job description, I believe, and a great opportunity, because they thought that just buying clinics was the solution. We know it's not, and we have so many dentists with experience that can help these corporations to create better structures.

These are things that I learned recently by meeting people. I was lucky to meet people like you, many people outside dentistry, with business vision, marketing business vision, management vision. I'm learning so much. It's so much fun to enter your world and start to understand why things happen in a certain way.


KIRK: Yeah. Well, Peter Dawson said this to me at the ripe old age of 24. I asked him the question, I said, "What's the one thing you would say to a kid like me? What's the one thing you've learned? You're 64." He's like, "That's a good question. One thing I've learned at age 64" — now he's 89, or he's turning 89 — "is I never told myself I had it all figured out." He said, "Kirk, if you're going to enjoy this profession, just always stay curious. Never say you have it all figured out, because number one, you never figure it all out; number two, when you enjoy that journey of constantly learning," he says, "I learn from my students all the time." And then lastly, he said, "The dentists that you meet that have it all figured out, they're no fun to hang around with. You don't even enjoy five minutes with them. Those are the people you're like, 'Stay away from that guy.”

I love the learning process, and you and I, we were together at the Seattle Study Club Symposium. I just like to be there because of the residue that comes off everyone else, by osmosis, you're just going to pick up on so many incredible things. I mean, all those processes are fun.


CHRISTIAN: So, going back a bit in time, you created ACT Dental, right? And that's the company that runs all the consultancy. Explain to me a little bit about how you started ACT Dental, and what ACT Dental does today.


KIRK: ACT Dental didn't start as that. We had a whole bunch of different names, and I don't know that the name stands for anything. It used to be Advanced Case Training. Everybody asks me that, but the domain was available. Basically what we do is, we're a consulting company for dentists, we do coaching. We really subscribe to coaching, because coaching gets you to think. Consultants tell you what to do, coaches get you to think, and I want our people thinking. Now, there are times where we just have to be consultants and tell people what to do, and that's fine, but I want them thinking. I want them making decisions on their own, because I don't want them to be dependent on us. Our goal is to grow leaders, not to make them dependent.

This is our 21st year of business, and our company is relatively small, and it's just growing. I'll tell you the secret, if you want our secret sauce, it's just this: it's the people. You find great people, and then you get out of their way, and you let them do what they do, and you go, "Yes." Because I suck at so many things, Christian, I'm terrible at a lot, but when you find great people that can do those things really well, you can create a great culture, and everything kind of takes care of itself for the most part.


CHRISTIAN: What are the things you do very well and the things that you suck at, as you said?


KIRK: I'm bad at follow-through. My wife would tell you that too. But I love the ideas, I love inspiring people, I love the movement. I can lead the charge. Give me a microphone and put me in front of a thousand people, it's my favorite thing in the world. Put me in front of a spreadsheet, and I'm miserable. Do you know what I mean? You know, I tell people all the time, people come up to me and they go, "You're terrible at email." I go, "I know." You're not going to get the best from me in that.

So, when it comes to building your business, you've got to look at it like this, "What am I really good at?" Dan Sullivan, who's a great coach that I have used in the past, he calls it your unique ability. You find out what you're really good at, and then you spend all of your time doing that, and you build systems and surround yourself with people that can do those other things.

Two things happen: Number one, you experience more joy, number two, your business is always more productive. So I try to spend as much time doing this kind of stuff, talking to people that I enjoy, and creating energy for what can happen in dentistry.

I think dentists have to have three things in order to be successful in the future. Number one, you've got to have a great mindset coming in; number two, you've got to have a process or a workflow that you're committed to; and number three, you've got to be able to execute. Any dentist that can really get everybody on the same page, thinking really well, that's half the journey.

There are so many people that are confused by working extended hours or expanding their capacity to grow their practice. You could work Saturdays, Sundays, weekends, and you can grow your practice, but your life falls apart. And really great dentists that think really well don't do that; they're like, "No, I only have so many hours." 32 clinical hours is all you can give, and we have more dentists in this country working 7:00 to 3:00 straight through without a lunch, and their production goes up every time. Every time they leave at 3:00 and they get to be with their families, they got eight hours after the day is done, and they go, "This is crazy." But they don't think like everybody else, and it's important that you've got to think that people come into your office, they want what you have, and that they'll pay for that.

And that's another challenge. I mean, half of our day is spent trying to get people to think the right way. Don't think that way. Haven't you seen that?


CHRISTIAN: Yeah. Actually, you mentioned this recipe, and I wanted to explore a little bit more, because I think one of the key factors of being a good teacher, a consultant, or a coach is to organize the thinking process, get it down into bullet points or steps or numbers. Because then you are able to make people understand the process, and help the dentist to become the teacher or the coach of their own staff. That's always a key factor. It's not only the dentist understanding the process, but it is convincing the team, convincing the staff, getting everybody on board. Because many times, I see dentists that don't have the communication skills, the leadership, and they hire a consultant, the consultant comes, and he is hired to train the team. That's hard because the leader, the dentist, the owner didn't change his own mindset. He didn't change himself to lead the continuation of the process. I believe you need to change first the leader, you need to become that leader to be able to enthuse your staff with this new vision of how to run a modern practice.


KIRK: Yeah. It's no different than if I was to come in and tell somebody how to be a parent, and the parent left. I'm talking to the kids, and I'm like, "You guys got to be good kids, and here's what I want you ..." If the parent isn’t involved in this process, it's not successful.

I have two dogs. I took them for dog training, I told the lady, "Fix my dogs." I was there for five minutes, I'm like, "Oh, this isn't about the dogs." She goes, "It has nothing to do with the dogs. You're the problem." So she fixed me, and I did what she said, and now I tell the dogs, "Go in the kennel" And they do it. I'm like, "That's crazy."

So, when you run a business, I don't know who mentioned this, but it's called The Law of the Lid. The business will never grow beyond the leader. The leader becomes the lid, and so the first step of any leader is to start moving in the right direction. You are going to have less tolerance for the way things used to be. You're also going to attract better team members. Most dentists sit and complain, "I can't find any great people. There's none out there." I go, "Well, it's not out there that's a problem. Nobody wants to work for you, buddy."

If I'm a good team member, and I'm good at dental assisting, I'm going to pick who I'm going to work for, and I'm going to enjoy this process that's heavily invested in me, and that's huge. My team and I, we talk all the time about how nothing trumps organizational health, except not having it. So, organizational health, you have great people, healthy people around the table. That's all you need to get started in this whole process. And when you talk about the process, I'll go a little bit deeper into mindset. The first step in mindset is just core values. I think one of the most valuable experiences or exercises you could do as a dentist is core values, just identifying who you are. There's usually four core values that drive you - they're your heart, they're your soul, they're behind your motivations. Any time you find a team member and their core values match up, it's magic. When core values don't match up, I don't care how good they are, it never works. No different than referring to an associate or anyone else, core values help you get really clear. It's called self-awareness.

When you can tell people who you are and why you do what you do, it attracts other people. If you're a dentist, your favorite patients are the ones that care about the same things that you care about. Your least favorite patients don't care about the things that you care about, and so you can spend your lifetime trying to convince these people, and they don't care. So spend your time with the people where, it doesn't have to be perfect, but for the most part, you care about the same things. You and I Christian, share a wonderful friend, Bill Robbins. Bill Robbins is one of my favorite people on the planet. You know why? His core values just make me smile, because he's a great human being who does it for the right reason. He cares and he attracts people that are like him, so it's not a difficult conversation.


CHRISTIAN: What are the critical steps to succeed? You said there are three.


KIRK: There's three. Nick Saban is the coach at Alabama. He's won six national championships from two different schools. People ask him the question all the time, "How did you do this?" He goes, "It's a three-step process." All CEOs use the same three-step. This is not a magic recipe, it's the same recipe.

Number one, mindset. you’ve got to get everybody in your organization thinking the same thing. You have to believe that what you do changes people's lives. You're not serving food here, you're changing people's lives, you're giving them a better experience.

Number two, you've got to have a process, you've got to have systems, you've got to have a workflow. You teach the digital workflow; everyone's got to be committed to the process and the systems. Even if you don't agree, you’re all doing the same thing. I've got teenage daughters. They don't always agree with what the system is, but they know they’re going to follow it while they're in this  house. You know what I mean? And so it makes everybody happy.

And then number three, the third step is you have to be able to execute, because you and I can sit here and talk about ideas all the time; the winners are the ones that execute. They put a plan in place, and they make it happen. Some dentists will sit there and watch 75 podcasts, but they won't do anything about it. The ones that execute always win, and I'll take done over perfect almost any day, because perfect is often hard to do. I don't want it to be bad, but I don't want it to be undone. When you can think and things get done, it creates a lot of confidence in your business.


CHRISTIAN: Perfect. Let's go a little bit deeper. Let’s pretend I'm your client, and I'm hiring you for this stuff.

Mindset, processes, and execution, I think it's a great way. We know it's easy to convince people, that's the key factor to succeed. Now, the mindset I see that dentists have is to spend a little bit more time with their employees, with their staff members, in terms of really understanding if they feel the same purpose, if they are proud of working for them. Many times, the owner of the office and the five, six or ten employees in that office will have a holiday party twice a year or something like that doesn't make that magic happen.

And when I ask dentists, I say, "What makes you special, why are clients choosing you?" That's a tough question by itself, but even if the dentist can answer that, what he thinks is special about himself, I realized that usually the staff doesn't understand that either. If I take the owner, the dentist, away from the room, and I ask the staff, I'll say, "What makes this office special, why are people choosing this office?" Most of the staff members have no clue. They say, "I don't know, I just work here, I do my job." But what is the purpose? Why choose this office?

That's when I see, very few offices you walk into, the whole staff would say, "I'm so proud of being here. The purpose is so clear." And whatever the dentist says that makes that office special, if you remove the owner and you ask the same question to the employees, they will all answer the same thing. "You know, what makes us special is this, this, and this," that is clear, the message goes through so well. So I think that we need help from people like you to create this connection, and create purpose, and mainly make owners spend more quality time with their staff.


KIRK: I think if you want to go really specific, because somebody might be thinking, "Okay, give me the recipe for how I create that." It's three things. Let me start at home first. If you want kids that don't do drugs, statistics show dinnertime prevents children doing drugs, because real families that are real communicators, that are committed to it, dinnertime's not an option. You're going to sit and eat with us, if you don't want to, you can go live with another family. Now, I don't mean that in a bad way, but, the other thing, if you want to stay married, you know how this is, we travel, we've got to go on date night, you've got to have committed time.

So if you're going to create a great team in any business, you have to have committed time to talk to them, to learn with them, to grow with them. In most of our highest-producing practices anywhere in the world, usually you do them on Tuesday or Wednesday mornings, because those are high-productive times, and they start at a very definitive time, and that time never gets disrupted. It's your best thing.

Your greatest asset to the business is how you think as a dentist. It's not your hands, because you're limited by this. Now when you've got a team of 10 or 15 people, it was easy when you had two or three, because you'd go, "Just do what you do, do your thing." You can't do that when you have eight, nine, ten, because you lose the intimacy, you lose the connection with them. And they need a leader that's invested, that says, "Hey, look, I care. Let's work together on this." So that's the first thing, is you've got to have dedicated time.

The second thing I would say is this. If we're going to get super specific on mindset, you've got to put your team members first. People say all the time, "Patients are first." They are not, patients are never first. It's a nice thought; it's never true. Great dental practices have team members that are first, and they make that super clear, "You come before any patients, because when I have your back … That's a different magic." There are so many dentists that put the patients first, and you can see what happens, no different than if I put my kids first. There's got to be an order to every process, and you've got to give your energy to the things that matter most, and I think as a dentist, you've got to tell them, "You come first. You team members, everybody comes first."

Let me add one more story. Howard Farran, who's crazy, and I love him. One of my favorite things he does, every year, he does this a couple times a year: Whenever a team member is violated by a patient, or a patient berates a team member, makes a scene. He goes, "Oh," he goes, "Get out of my office, I don't ever want to see your face ever again. Nobody treats my women that way." They all cry, because they're like, "That's why I love this guy." Because he makes a point: "You can't treat women that way." Everybody's looking for the secret. There's no secret. Put the things first that matter first, and everything else takes care of itself.


CHRISTIAN: This shouldn't be a strategy, it should be you, it should be a natural behavior, a team player, somebody that cares about people. That's another problem, I see there's so much technicality and courses about how to become a leader, how to become charismatic, how to influence people, how to create teams, and this and that. It’s almost like I do a course, I don't have the skills, there's not something genuine inside me, but I can learn a couple tricks. I see that happening in the US, because that's the country where you have more courses about these things, and people go to weekend courses, and they come out and say, "Okay, I learned how to become a leader, I'm going to apply these six rules, but I really don't care about people that much," or ... It's just very superficial, when you just answer, it's not about strategy, it's like, Howard is just the way he is. That's me, you know? It's a genuine care, it's really making people feel like you are a partner, you're not a boss, you're together, you really think that.


KIRK: I totally agree with that. You can't teach people to care. When you get stressed, you just have these things that happen that aren't natural. When you have a lot going on, and you have financial stresses, no different than I am, you just don't act like you should. You make a mistake, and I think the key is that we all need to be reminded of our actions every day. You know, I tell dentists all the time, "Look, you've got to remind yourself, I'm going to remind you, they come first." And you've got to keep that motion.

Also, when you have set time where you land the airplane and you fix it on the ground. That's a different motion than trying to fix an airplane in the air. It's chaos trying to fix an airplane in the air. That's why in a practice, you've got to land it and say, "Hey, we're not answering any phone calls. We're going to work together for the next two hours and improve our processes. I care about you guys, let's get better every week." And as a dentist, you don't need to be perfect. If you're making a little progress every week, you're so happy. I think this: As a dentist, you've just got to do a little better than last year. Your team has to be a little bit better, you have to be a little bit better. We expect it of our children. I've got a fourth-grader. How many times should a fourth-grader go through fourth grade? Once, right? They've got to get it done, and he's got to go on to fifth grade and sixth grade.


CHRISTIAN: Why do we have to always get better?


KIRK: Why? Because the human condition won't allow us to be the same. You can't do a crown your first day out and go, "Yup, just like 30 years ago, look at that, it's just the same."


CHRISTIAN: Technically speaking, but the problem is that you want to always be better as a human being; the problem is that people want to always do better financially.

So what I see that is very tough on the Western world is that every year, the number needs to be bigger, you know? And why this is a need? I had a great life last year, financially speaking. If this year is the same, why that is not good? Because there's just some space for the ultra-achievers, there's no space for everybody to be Tony Robbins, is there?

You go to these courses, and they give the feeling that you can do it, you can succeed, everybody can make it happen. And in people's minds, succeeding means making more money, becoming more well known. That means that next year needs to be better than this year, and that creates a crazy cycle that makes people very aggressive. Do you think that modern leaders will genuinely care more about people?


KIRK: Let me say a couple things about this. First of all, in dentistry, making money is the byproduct, because you see dentists all the time, money is their goal, so there's a big mess right here when money becomes your primary goal. When you do this right, you get great systems, great people and you already make more money than you ever dreamed of. You know, all of us do. We never dreamed we'd make this much money.

And the second thing I would say is there's a certain point in your life where no more money brings any more happiness. You're going to get to a certain point, everybody's got to find it, where the more money you add, it doesn't add to more happiness. So I would say the bottom line is this. Now, I'm older, I'm 48, so there's a possibility I'm playing the back nine, which is I may have less light in front of me than I do behind me, so money isn't the most important thing.

Like, it's important, don't get me wrong, but at the same token, it's not about, "Ooh, how much money can I make?" There's certain things that you want to accomplish in that whole process, so you've got to be thinking. I heard a speaker a long time ago, say, "The best definition of success, if you have children, is this: It's what your kids say when they describe you. 'My dad is,' blank." And then he said, "You get to influence what they put in that blank." Now, I think that's pretty powerful, because I don't know that anything would bring me any more joy than what they might say, and I'm hoping that they say good things. You know what I mean?

And money, Frank Spear taught me this years ago, he said, "You guys, don't think that you're going to do these big cases and everything's going to be wonderful. Big money, big expectations, very big expectations." There's no CEOs in the world that make, $10 million and say, "Yeah, my life's not that stressful. It's pretty cool, I go to work in flip-flops and shorts, I'm there for two hours, and I leave." No, no, no. There's crazy high expectations, no different than LeBron signing a contract in LA, or any of the great soccer players in the world. There's a lot of pressure on Messi and Ronaldo. They've got to win. So there's more money, more expectations. I think it's a good measure, and don't get me wrong, everybody wants it.

Now, one more thing I want to say about money: It isn't always top line. Even the stock market that drives the world is driven by one thing, its bottom line. It's actual profit. We never sit in the stock market and wait for reports that say "production reports." It's all about earning reports. I don't care how big a company is, I'm not investing in it unless it makes money.  I think it's no different than a dentist. It's not about producing more, because there's a certain point where you just can't produce any more. Now it's optimizing profit, which might mean adjusting your fees, taking a look at your schedule, getting better at what you do. So you've got to be looking at all those, because if you're a dentist producing 1.6 million and your only goal is to get to two, you're giving up something to get there, and my guess is it's probably not good. So you've got to be smart about what you go after, because you're going to give up something to go after what you want.


CHRISTIAN: It's a very tough balance. I wish we could all break even and make people around us happier. I wish we could have a stock market on happiness, you know, "Oh man, this year I made more people happier than last year, my stocks are going up," you know? "What about money?" "Oh, I'm doing the same money since the last 10 years, there's more than enough for me. I'm in the happy stock market, happiness market."


KIRK: I think you're totally right, and I think that's actually happening. The new economy now, I would actually say this, I think the new rich is time. People that have the ability to do what they want with their time, those are the wealthiest people in the world. The most unwealthy people we see, they don't have any time for anything. They're stressed, they're so busy. There are dentists that I met this summer that are working five and six days a week. I'm like, "It's the summer." "I know but I'm so busy." I'm like, "That sounds terrible."

I think time is critical. What money allows you to do is use your time right and it has a relationship, so the more that you can study the numbers and have somebody help you understand you don't need to work an extra day, get rid of that day, cut back your hours, get patients to come in the hours that you work, you're going to make more money, you'll get a greater result, you'll have happier team members. And dentists go, "Oh my gosh, that works." I'm like, "Yes, and tell that patient to pay." And they're like, "Well, nobody wants to pay." I'm like, "Focus." You know what I mean? What you do is valuable in people's lives. You have to believe that money spent in your office is some of the best money people could ever spend.

If you don't believe money spent in your office is a good investment, that is a deadly disease that works its way through your entire organization, and it's killing your practice. You've got to believe in what you do. It's crazy. What if I had a restaurant and I go, "Christian, nobody likes paying for this food here. They hate it." Do you know I mean? Like, no one would come. You've got to believe.


CHRISTIAN: So, step number two, process, because when we talk about process workflow, if you're an engineer, it's pretty clear you have in your genetics, in your DNA, you know, to build a bridge you need all the steps, and everything needs to be organized, and you learn in school how to to do that, you know?

If you're a businessman, you learn how to create a business plan, how to structure all the processes involved to get from A to Z.

As a dentist, we are supposed to do the same when we treatment plan but we know that that's already, in my opinion, the toughest part of dentistry, becoming a very good treatment planner, exactly because we are so trained to do things well, and not actually to see the big picture or to organize the processes to create efficiency. I don't see many dentists talking about, "Okay, I've been doing this for 20 years, 30 years the same way. How can I deliver the same exact thing with 0.2% more efficiency? With 5% more efficiency?" The same thing, you know? Efficiency on time, efficiency on materials, efficiency on number of appointments. There's so much that can be done, and usually I believe that dentists don't usually think about it, because we are in the comfort zone. That’s because historically we've been making good money without thinking about efficiency, without thinking outside the box, doing things the same way always. Or, usually dentists only change processes when they are convinced on the lecture for clinical reasons. You know, this surgery is better, so I do the surgery because it's more fancy, more sophisticated, or a better clinical result, not because of efficiency from the business standpoint, you know? Because I can do the same for less money, or I can do the same in less time, you know, thinking as a businessperson.

So, when you talk about processes to generate efficiency, it's beautiful to say, but for us dentists, it's just a huge question mark. What do you mean? Where do we start? If I'm delivering a single-molar crown in three appointments, and I need, I don't know, 12 hours, and I spend this amount of materials, how can I create a better process?


KIRK: Yeah, it's a great question. Now let's talk about why before we create a process, because we talked about making progress, that's important, but the other thing that dentists need is the other P word, and it's called predictability. The higher the level the predictability a dentist has during the day, it's just the happier they are. The lower the predictability, that's when the dentist's vein comes out of their neck.


CHRISTIAN: Just a parenthesis here, when you talk about predictability, great word, every dentist loves to talk about predictability.

But usually we are talking about predictability from the clinical standpoint. It has a better predictability. But what I like is to talk about predictability from the process standpoint.


KIRK: Process, okay, well let's pick one of the most difficult processes in the entire world, aviation, okay? Right now in the United States, so it's what, 6:00 by you, it's 5:00 by me, there are as many as 7,000 airplanes in the air, 7,000 commercial airplanes in the air over the United States.

John Kois said this: “What if you had a 1% failure rate? How many plane crashes would we experience per hour?” I mean, you would pick up your phone and go, "Wow, another plane crash, another plane crash, another plane crash." They have to subscribe in processes to a 0% failure rate, which means they find best practices, and they duplicate them over and over and over again to a 0% margin, and every pilot has to fill out what's called the checklist. Now you can do this two ways: You can do a written system, or you can do a checklist. A checklist is often easiest.

Now, take anything - financial arrangements, how you schedule, every patient that we're seeing in hygiene. I want these 10 things done for every patient, every time, all the time. Your digital workflow works with a checklist. You can't skip a box and go, "Nope, not today, not today," because you're going to see errors done. Your challenge as a dentist is to design your processes, best practices around your vision.

I'll give you the five questions. You can design the perfect system if you answer these questions. What are we doing, why, how, where, when, and who? If you answer these, you have the perfectly designed system. Any system that's not designed doesn't answer these questions, so you could literally just create a box and just fill them in. Who does this? When do we do them? How do we do them? The why is the most important, though. Take cleaning the room for the next patient.

Why do we need to do this? Because our vision states our experience has to be at a level where patients expect this level of service. This is why this has to be done.

Who does it? The assistant.

When? They do it immediately after the appointment.

What are the steps? They do step one, two, three. You never, ever skip a step. In heart surgery, cardiac surgery, there isn't one single cardiac surgeon in the United States that skips a step. They're not allowed to, because that's where infection happens, and people die when you skip a step. You can't. My sister works in a hospital, and they do what's called the surgical time-out, so when the patient goes under, she goes like this. No one's allowed to talk. Do you know what this first check on their checkbox is? Do you know what it is, when they're looking at an X-ray? I didn't know what it was either. When they're looking at a chest X-ray, and you're a cardiac surgeon, the first place you're looking at is name. I'm like, "That's brilliant,". I said to my sister, "Why do you have that?" She's like, "You don't even want to know why we have that system in place, because there are so many times we're looking at an X-ray and it's not the right patient." So they have their best-practices systems in place. And my wife was in the hospital a couple months ago, same thing. Every doctor came in and said, "What's your name?" I'm like, "Well, you should know her name," and they're like, "No, it's part of our system, because I've got to make sure I'm talking to the right patient." That's an example of you never skip a step, ever. You're not allowed to. It also allows you to free up bandwidth for the things that matter most.

When you have a small team, you don't need them. You go, "Yeah just charge her the thing and then get her back," but you can't do that anymore. Then, you know, as you get older, you've got to go like, "Oh, step one, step two, step three." My best treatment coordinators, my best assistants, they're checking boxes in every appointment, because they don't have to think. They can just connect with the patient, everything gets done, you open every chart. A great assistant that follows a checklist for photography even, you get that going, and now every patient, all the photos are taken. Not a couple, like some dentists do, and it's not hidden on a card in a closet in the camera, they're in the computer. So, the whole idea is to answer those questions and create a simple little checkbox list, and you're halfway there.

And I would say this: Do one or two, maybe one a week with your team. Say, "Look, we've got to design a system for this. All right, financial arrangements, who does them? How are they done? When do we do them? What are the steps?" And then you have everybody sign on the bottom, and you go, "Look, we all signed this."

I had mentors a long time ago that taught me this: If it isn't written down, it doesn't exist. So, if you have a system, it's got to be written.


CHRISTIAN: Don't you agree that it's a very intense paradigm shift for a dental office? Number one thing is that you need to be charismatic, you need to care, so the staff is on board, committed to all these things, otherwise it's impossible to transform a dental office into an airplane?


KIRK: Totally, yeah. So, does that answer your question? Like, all your processes. Now, you don't need 7,000 systems. In most dental practices, there's a maximum of 39 or 40 real core systems. You can create other systems, that's fine, but really, any dental practice, it's not a complex thing like aviation or heart surgery, it's really kind of a repetitive process. Heck, when I was working at Applebee's, we had to do the same thing every day, the same way. You never came in and said, "Hey, I want to do this." That's the only way you can scale a restaurant, and I'll tell you, Christian, that's also how the DSOs are beating the private care clinicians, because when they open up a practice, they do it the same way.


CHRISTIAN: They were born In this environment, so it's natural for them. Even though they're making mistakes now, they will fix those.  They will work out how to change things for the better, that's what I believe. We all know that the corporate is taking over dentistry because it's an open field, it's Nobody's Land in terms of management. And then, when you go to running 500 clinics, if you don't have systems, there's no way that can happen, you know?

But, as soon as they find a solution to manage 500 clinics very well, with very decent quality, with amazing systems, with good professionals, good managers, good marketing team, beautiful facilities, top-quality technology, that's the reason why we know they will take over. So, clinic owners, dental office owners have to able to keep the level, or if they're not on that 1% Michelin boutique that you're so good, and so famous, and so special that you don't need to do anything and people will come, this will go down to less than 1% at the top. Everybody else will have to compete with these amazing corporations, amazing systems, motivated staffs, top-quality marketing strategies, decent-quality clinical procedures, because they will use systems and technology to keep the level and predictability. And because of that, they will drop the prices. They will be able to live, survive with a smaller profit margin, and that's when dentists will have to join them, or to compete with them. And to compete with them, you need to change the model completely from where you are right now.


KIRK: Couple things I would say to that. Absolutely, and while a DSO can hire a process engineer, like an engineer that designs better systems, you don't have the budget if you're a private care clinician, but you can hire a great consultant that can come in and help you design great systems, and you'll be well ahead.


CHRISTIAN: You hire a consultant for a consultancy, they hired for good. Imagine a DSO that has somebody like you, full-time job. I'm hiring you for one day, a weekend, or whatever, few minutes a month from you. They hire you for good, every single day, implementing this all over, creating systems, you know? And the ideas will start to come out. For example, to create a system, to transform a patient into a fan. How to make a patient, how to feed your client that is happy, but only being happy doesn't mean they're going to talk about you and promote you at all, they're just happy, they are satisfied. Now, how to create a system to transform a satisfied patient into a promoter by doing one, two, three, four, five, ten steps that will make the patient say, "Aha, I can talk about this, I want to talk about this," you know?

You know, if I'm a company and I hire marketing, creative people, I'm going to have on my team for my 1,000 clinics that I own, people thinking only about that, you know? And then bringing to all my 1,000 clinics that solution, the perfect system to increase the numbers of conversion, of happy clients into promoters.


KIRK: Right, absolutely, and that's an incredible opportunity. First of all, I don't think private care dentistry is ever going to go away, because DSOs have their own challenges, but I think that's where the opportunity lies. There's a world of opportunity, and when you get good at the processes, create great mindsets, you'll always be in a great place to survive and do really well as a dentist.

And the other thing, again, we stated earlier, but the world is getting older by the minute, and so there's going to be an abundance of people, and they're going to need what you have to provide. You're also starting to see the trends in medicine where people are leaving the insurance realms and creating own concierge medicine, and they're doing extremely well. So I just think the possibilities are endless in dentistry.

I mean, I've got a bunch of thoughts on this. Dentistry is constantly run by fear, which I don't know, people have been saying dentistry's over for years and years and years, but I don't think it is. I heard 20-some years ago that PPOs were going to go away, and it was only going to be HMOs and cash, but that never happened, that just never happened. Actually, the world was supposed to end twice in 2012, that never happened. So people have been predicting the end for a long time, and it's just, I don't know, it's like, stop already.

We're just getting better. They've got to go to your courses and get inspired. They've got to watch that video. What was the video you made me watch? It was such a good video. What was it? The Power of a Smile? What is it? YouTube it. Tell us about that video. Like, I watched that, I'm like, "Game on." That's exactly the power behind being a dentist. Would you agree?


CHRISTIAN: That's also the reason why we usually stay in our comfort zone as dentists, because the smile's so powerful that people come to us even if we don't do much, and we can have the profit margins because the smile is so important. A healthy smile is so important, a confident smile is so important. So, we need to understand and appreciate that video, because it makes us proud of being dentists, because we transform people's lives.

Today there's this separation, there's this thing like the private practitioner against the DSOs. This is what needs to disappear. There's no two sides, you know? They're going to take over because dentistry needs them. We need to run better processes, and we need to treat so many more people. There's so many people without dental services. Why? Because there's not enough dentists, because the care is expensive, and this needs to be changed. And the only way is to scale up, is to make it more democratic, is to create systems that allow more dentists to do better for more people, is to multiply the processes and allow more patients to have decent care today.  You need to spend a lot of money. Good dentistry is super expensive. Everything that is not expensive in dentistry doesn't have quality, and that's not fair.


KIRK: Right. I love what you're saying, we're not talking about the elitist dentistry, we're talking about dentists that can go ... I think if dentists just provide better care, and they make it, I mean, they connect with their patients, I mean, you're always going to be fine. And, you know, if you're reading this, thinking, "Well, private care dentistry is going away," that's the equivalent of saying those Michelin restaurants that you enjoy, those are going to disappear too. People are always going to pay for that. I would die if I had to go to Denny's every day! I like paying a lot for food and experience because I value that, and your challenge as a dentist is to create an environment where people want to do that in your office.


CHRISTIAN: But you have Maggiano's with very decent quality all over the country, right? The restaurant chain is really good food, you know? And once in a while, you want to go to a Michelin, but the concept of having a high-quality chain will enter dentistry very, very soon.

And if we have a couple more minutes to finish, Kirk, just a final comment on the third process. So, you talked about the three things to succeed, the three steps: mindset, processes, and the third is execution. We talked about the challenges of changing the way you think, and bringing the staff on board. That is mindset. The challenges of being creative, and create processes and invest time with your staff to go over these processes, and create the processes together, and really create these new ways of making things more efficient. Now you need to execute.


KIRK: This is where it all comes together, because everything else is talk. In the great words of Yoda from Star Wars, “there is no try, there is only do, and there's do not”. I've graphed it, I've actually graphed it on a circle. There's do. There's no try. You either did it or you didn't do it, and if you know yourself well enough, like I'm in the category of the person who doesn't get things done if I let it go that way, so I've got to surround myself with people and hire coaches in which we just execute them. And if you know yourself well enough, you've just got to say, "Look-"


CHRISTIAN: Do we agree it's the toughest part?


KIRK: Oh, it's hands-down the hardest part.


CHRISTIAN: Because we see a lot of people very influential on changing the way people think, creating, consulting, and helping people to create processes, but you know, we have so many great ideas that just don't happen because we don't have enough doers, people that say, "Okay, give me this," it's done.


KIRK: Right. Now, some of you might be thinking, well, on the execution, building all these systems, but let's go to something simple on execution: being on time. Some dentists know, "I should always be on time," and they execute it. They realize that they're on time. They work hard at being on time. Others don't care, and it creates a huge ripple effect all the way through. I don't trust people that are not on time, and it's not that I don't trust them personally, I just don't build any credibility with them. When you're not on time, it screams, "I don't care." So if you're a dentist and you're five minutes late with every patient, you're screaming, "I don't care."

Doesn't matter what comes out of your mouth, it’s your behavior. That is a perfect example of people. People that execute really well, they know exactly what has to be done, they are on time, and they move on to the next thing, and they do that really well. No different than me telling my wife I'm going to meet her at 5:00, but I don't show up until 6:00. Is she happy? No, never. But if I show up at 4:55, she's like, "Oh my gosh, you're early." I'm like, "Yes I am."


CHRISTIAN: I've been working with some business people, and I met many, recently, doers, like business people that they like an idea, the next week it's done. It's like, it's done. It's not perfect, but it's already started, it's in action, it's happening. This is for me the most difficult part of any successful story, you know? We go through conferences and you see so many cool things, and we all come back super excited, and nothing happens.


KIRK: The single highest-producing dentist I've ever worked with practices in New York City, right off of Park Avenue, and his name is Steve, and Steve executes. I just saw him a couple weeks ago. When he goes to a course and they describe an articulator or anything, he doesn't even think about it, he orders it. When I was in a course with him a couple weeks ago introducing concepts, you could see him talking to his team, like, "We're doing that Monday." Do you know what I mean? Like, there's no discussion, "What do you guys think? Let's get a vote." Do you know what I mean? Like, he's just always executing.


CHRISTIAN: I love this execution attitude, like, "You're okay?" Meaning, "There's no way out. If you say yes right now ... If you don't agree, you'd better say now."


KIRK: They also build a high level of trust for him, because they're like, "Okay, what he says, he does, so game on, you guys, get ready, because he's going to execute it."

All of these processes all intermingle. A big part of execution is, if you go to a great course, you go to the Kois Center, or you go to Seattle Study Club, you've got to schedule a team meeting on the following Tuesday when you get back, so that when you land the airplane, you can start implementing what you learned. So it doesn't sit on a shelf for a while, and your team is like, "Just let him cool down for a couple days, because then his eyes will start getting back to where they were before he left for the course." 

Once you start to put these three together, every week it just gets a little bit better. You layer confidence, no different than layering porcelain. It gets stronger and stronger and stronger, and the team members start to believe in themselves, and they have what's called a new normal. They produce a little bit more, they have a different conversation, it becomes the new normal, and it's a wonderful thing to be a part of. The future's bright, my friend. And where you're headed, I want to go. I want to be hanging on to your velvet rope.


CHRISTIAN: It's a great honor to interview you, to learn even more from you, to have this positive energy. And I have to tell you, you know what? You have so many great skills and great qualities, but there's one that is even better than all the others, and it's your amazing smile. You have a smile to start with, you know, and that's your signature. And it just opens all the channels, it opens the doors, you know? The doors are wide open. People with such a smile, genuine, a smile that cares, you know, it's not the fake smile. So it just facilitates the process, it gives you extra minutes with people.


KIRK: I think you would agree that it's the best outfit you can wear. Like, of all the things you're going to wear today, wear a smile, because I went to the grocery store this morning, this woman, she was so sweet, she said, "Good morning," I couldn't help, I had to smile. I'm like ... I was like, "I love that, thank you." And it was like 7:00 this morning. So I think it's one of the best things that you can wear, and it's also one of the greatest things you can give people back, and so dentistry is the profession to do it.

I hope you enjoyed this interview with Kirk Behrendt and were inspired, as I was, to continue to learn and grow as a dentist. If you would like to know more about Digital Smile Design and the courses we offer, including our four day residency to take the first step to becoming a DSD Master, find out more here:

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Written by Christian Coachman

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