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Ransomware. PPO write-offs. A front desk that can't convert a phone call. The Wired Dentistry is where Dr Lorne Lavine, the Digital Dentist, and Naren Arulrajah of Ekwa Marketing work through what's quietly costing dental practices money — and what to do about it. Two decades each on the technology and marketing sides of dentistry, in conversations built for practice owners, not patients.
The Wired Dentistry — Episode 3: The Tech Decisions That Are Quietly Costing You Patients
Hosts: Naren Arulrajah and Dr. Lorne Lavine
[00:03] Two things keep dentists up at night. Am I getting new patients? And is my practice one click away from a technology disaster? This show is about both. I am Naren Arulrajah and one of the co-hosts of this show. And I'm Dr. Lorne Lavine, the other co-host of the show, and this is the Wired Dentistry podcast. Hello everyone. Today, I'm joined by Dr. Lorne Lavine, who's my co-host. And we're going to be talking about a very interesting topic. The topic we'll be discussing is the tech decisions that are quietly costing you patients. The tech decisions that are quietly costing you patients. And it's a really interesting topic. And many of you know Dr. Lavine, he's known as a digital dentist. He has not only practiced dentistry, but also spent at least two plus decades helping dent practice owners with everything technology, everything compliance. I'll let him introduce himself, Dr. Lavine, welcome. Share a few words about yourself. Thank you, Nair. So yeah, I think a lot of people kind of know who I am. I've been doing this for 25 years. I was a full-time practicing period scientist, and about 25 years ago, I decided to transition from helping patients to helping my colleagues when it came to technology decisions.
[01:35] And I really like this topic today of the tech decisions that are quietly costing you patients because people think that as a tech expert I know about computers or I know about sensors or cyber security, things like that, but not necessarily marketing or patient retention, patient attraction. And that's not the case. the whole purpose of technology is to improve your ability to practice at a higher level and to be able to use that technology in a way that is going to benefit the practice. So when people reach out to me, they're not saying to me, hey, Lorne, tell me what the best computer is or what the best sensor is. I mean, sometimes they do more. It's like, hey, we're struggling with new patient, we're struggling keeping people in there. How come our technology isn't working the way that it's supposed to? Why are we struggling with this? And that's where I come in. So I'm thrilled to be here because I think that there's a lot that people need to know about when it comes to detect decisions. And if you don't mind, I can just sort of give you a quick story here. This is a practice. We started working with recently, they asked me to do a bit of a consultation with them.
[03:00] And they were spending somewhere around $10,000 a month on their marketing program. It was a combination of different things. There was SEO and working with a marketing company and all the other things that go into the program. And what I noticed, for example, there was only one office manager, one person answering the phones. So when the time I was there, I think the phone probably rang five or six times. She only picked it up once. She was working with another patient that was rang in front of her. It was her lunch break. And I also said to them, you know, are you tracking these calls? Do we know where these calls are coming from? Because typically, as you know, as a marketing expert, you need to know where specifically that potential patient is coming from. And typically, as you know, you do that with separate phone numbers or different types of systems.
[03:56] They had no clue. Everything was coming into the same number. When the day was done, the day was done. There was no answering service. There was no way to get old of the practice. You know, you would leave a voicemail and the patient would pray that maybe they'd get a call back. And as you know, people aren't necessarily thinking about scheduling a dental visit between 8 a.m. and 5 p.m. Sometimes it's one in the morning and they want to be able to schedule that. And I know, you know, in my business, for example, it's the same deal that people are wanting to reach out and get a hold of us and get things scheduled. I have a live person who manages, it was actually a team of people that managed my website, it's a 24-hour chat box. This is not AI. It's real people that someone can log in at two in the morning and let's start looking at my website and they'll get a little pop up from one of the guys who's managing at the time to say, hey, you know, I'm not a bot. I'm a real person. Can I answer a question for you? Do you want to schedule some time with Dr. Lavine? How can we help you?
[05:10] Are you an existing client? Are you new? And they capture all the information and their phone Now I'm burning the best time to get all of them and they can even schedule them directly into my calendar And there's absolutely no reason that dental offices I don't spend a huge amount for that service on a monthly basis So there's no reason that dances if they're not gonna want to at least invest in a live person You know most of the better practice management software programs the better third-party software scheduling software programs out there Will allow patient to schedule or at the very least make a request for an appointment. But again, we're not seeing that with this particular practice. So I was in, they had none of that. So in my mind, and I said to them, listen, you guys are spending all this money really for nothing. Because patients, they're not gonna say, oh, I heard some good things about this practice. But they're not committed to you. They don't know anything about you.
[06:05] They call up, they can't get a live person. They don't get a call back for a day. They've already gone to Yelp or Google or Chachi. and found another practice and they're already booked. So I really think that people have to be smart about what they're doing and not waste money if you don't have the infrastructure in place to be able to deal. I mean, you work with Dell offices to increase their marketing efforts to bring in a fantastic flow of new patients. What a waste. If you're not closing them, if you're not scheduling them, they just get lost in the ether. They've spent all the time. And then they come back to you and say, oh, sorry, you're marketing's not working because we didn't get any new patients. And they didn't mention the fact, well, no one's answering the phone. And there's no way of scheduling.
[07:00] So it's kind of crazy what we see out there. Yeah, you are absolutely correct, Doctor. I totally concave it. In a lot of doctors are wasting, I think just in dentistry alone, probably a billion dollars is wasted on marketing. Because like you said, phones are not answered. They don't know what's converting, what's not. No after hours, no chatbot, especially a human chatbot. So so much money is being left on the table. I'm so glad you noticed it when you were working with this one particular client and you at least told them to do something about it. Let me ask you a quick follow-up question on what he just told me, Dr. Why do you think this happens? And I've seen it time and again. Why do you think a practice decides to spend so much money but then ends up wasting so much of it? You know, I think there's a number of things out there.
[07:57] And I think any office manager, dental assistant, is familiar with this scenario, where the dentist goes to a trade show on the weekend and they come back and hey guys, I just bought this fantastic new cone beam system. We're gonna be installing it in a week. Never any talk about well, can we support it? How is it gonna work with our workflow? But they're not buying the actual outcome that they're looking for, they're buying the thing for the product. And so eventually it's gonna arrive, it's gonna show about the practice. nobody's trained on and nobody knows what to do with it. And it just becomes basically expensive furniture. I remember when intro-roll cameras were all the rage back in the mid to late 90s, very expensive intro-roll cameras. And these were small companies that couldn't train the office people and they didn't know how to integrate into their workflows.
[08:57] And a lot of offices I would go into and that intro-roll camera was basically a coat hanger for their lab coat, which has thrown it over the camera, in between patients. It just became furniture. I think, secondarily, I think a lot of practices, and they treat this as a purchase, rather than it's a system. When you get technology for your practice, if you're not maintaining it and updating it and supporting it and training on it, whatever, It's not an asset to your practice. It's actually just a liability. You know, maybe it's got a warranty attached to it, but it's still a liability. It's just sitting there, taking up space, not doing anything. Another thing that we have found is that sales reps do a great job of convincing offices, you know, about how they're gonna be there to support you and how great their team is.
[09:59] They're not there for you. They're there to make the sale. once they've made that sale, the only thing that they really care about after that is upselling you, perhaps, on another sale or on some type of expensive warranty or maintenance plan or whatever, they're thinking about what's the next sale they're going to be. They're not thinking about your practice. They're not thinking, well, what can we do to make life easier for you to use our product? Because the sale's done. They've made their money on it. And I think the final thing that I think a lot of practices need to be aware of, and this is especially true when we start talking about cybersecurity, which we're going to talk about over a bunch of podcasts that you're not going to be doing over the next number of months, is that 20 years ago, a bad decision was just a financial loss. It was a minor. You bought stuff and it cost you $20,000. You didn't use it.
[10:54] You're out at $20,000. You got the tax right off. So maybe it wasn't that bad. Now it's costing you patients and patient records and data. And in my world, there is nothing more valuable than patient data. We'll be talking about ransomware, but a dental record is probably the most valuable item on the black market and not that I'm an expert in the black market, but when you think about what's in a typical patient record, patient's name, date of birth, phone number, address, Usually there's a credit card information, maybe a copy of their dry risk license. It's a gold mine to criminals. And if you're not protecting and securing that data correctly, and that's a little off topic to what we're talking about today, but losing patients to me is irreplaceable.
[11:50] You can recover from an expense that was something that didn't work out for your practice. But once a patient's gone, they're not coming back. Thank you so much. You have such a wealth of information because you are a specialist who practiced dentistry as a specialist for quite a few years before you started helping. So you know these problems firsthand and you know the mistakes you made and of course when you see your clients make those mistakes you help them. So when you audit a practice, what's the first thing you look at? This is so easy because I know a lot of practice management consultants and probably people like you, marketing companies do it, the first thing is, can you get a live person? It's so easy to test it. I can just call them up. I can pretend to be a patient and a lot of companies out there, you know, they're more sophisticated than me. They'll actually track and record the call and all that stuff. But that's the number one thing, you know, can a new patient actually get a hold of a live person? And I want to know that information before I start even getting into the, you know, tell me about your server tell me about all the other things here.
[13:00] Once we started looking at it from the standpoint, okay, do they at least have systems in place to be able to handle the new patients? Then we need to start doing more of a deeper dive at the actual technology. For me as a technologist, the number one thing that I worry about the most are backups. And we can spend hours just talking about backup. The key for most practices isn't, are they doing a backup? The truth is most of them have some type of backup. Maybe it's a local backup, maybe it's a cloud backup, maybe it's a combination. Most dental practices are doing a backup. That's not really the question to ask. The question to ask is, if your server went down for any reason, how long is it gonna take you to get backup and running again?
[13:55] And if that's measured in days, which is typically is, you don't have a good protocol in place, that's just unbelievable lost production that you're never gonna get back. And so that's one of the questions, because I can't see by looking at a server looking at a backup, but I have to ask them, when's the last time, if ever, because I have to put that qualifying, because that usually is never, then they've restored a backup. And how do you do that? And they just, people are not familiar with how to actually do the process. And you can't, even though I am what's called a managed service provider and IT provider, it's still something that most dental practices still have to be able to know how to do. You're IT being a weak strive to be there every minute of every working day. But it doesn't always work like that. We're not always available.
[14:51] It may take a while. you want to get up and running. Another thing which really falls a lot into HIPAA is what we call access controls. Who has access to the data? What did they do with it? When did they access it? That is a HIPAA law. And the fact is, is that most practices aren't tracking that, even though it's not that hard to set up. There's a lot of practices that have multiple employees over the years that have left. and that employees, username and password, is still there in the server credentials. If that person was managed to get either back into the office remotely, physically, they would have full access that they did when they were working for you. So you have to look at that. And then we really start going into the nitty gritty. You know, a lot of people are maybe familiar with their IT company, maybe reached out to them over the last few months. that every nine, 10 years or so, Microsoft ends support and security updates for their operating systems.
[15:53] Last year, it was Windows 10 that went to end of life. Coming up in January of 2027, it's gonna be server 2016. So we look at that, we look at it, and again, this is a HIPAA law. Are they doing everything to keep their software current enough to date, we call that patch management? Again, it's a lot. Is everything encrypted? There's zero reason not to encrypt your data. It's your get out of jail free card that it ever gets stolen or compromised. And it's free. It's built into every version of Windows since Windows 10, and every version of server since 2012, called BitLocker. So we check to see if they flipped that switch they put on encryption. How are they emailing the other offices, patients? That needs to be secure. Are they current in protecting from ransomware? Do they have a firewall? Are they trained this up? I mean, the list goes on and on.
[16:50] And it's a pretty comprehensive practice. And I would qualify when we first work with an office. We just want to get maybe just kind of an overview of where they're at. So we'll do what's called a technical audit, a security audit. It takes 20, 30 minutes. It covers all the things we talked about. but it's not looking at every single computer and doing a deep dive. We just want to get a feel for things. There is a HIPAA law called a risk management that you have to go through, it's called a risk assessment, and you have to have a management plan. Basically, any dentist would be familiar with this concept. You can't treatment plan until you diagnose first. So you have to do a cognitive risk assessment and come up with a plan. Those usually take more like about eight hours. We don't normally need the client with us more than five minutes just to get it logged on to the computers and answer a questionnaire. But it's pretty comprehensive. And one of my little pet peeves is that there's companies out there that said, hey, you know, because the HIPAA laws when it comes to doing a risk assessment, it's literally one set.
[17:53] It just says you have to do it. There's no guidance. And because of that, there's some companies that say, hey, you know, go on to our website and take a five-minute quiz and, you know, boom, you've done your risk assessment. And I think any HIPAA auditor would laugh at that because it's not comprehensive at all. Most people don't know how to check their IT systems. You really need to be an IT provider to be able to look at all the things that needs to be looked at. So I caution people that if you're going to do it, what you have to, because it is a love, you really need to start from the beginning, get an overview from where you're at, and then really start doing a deeper dive to figure out where are you not meeting best practices, laws, whatever, and then move forward from there. This is awesome. I learned so much. I mean, you know so much more than any other person I've ever spoken to on this topic.
[18:51] Dr. let me go back to what we originally started this conversation, right? Of course you have existing patients, you have new patients. So let me look at this from the perspective of new patient. and they're trying to reach a practice. Where does the technology or the systems usually break down in that process? Sure, and we touched on these a little bit, but number one, the first contact, which I think is, you never get a second chance to make a good first impression. Call comes in, the office manages at lunch, it goes to voicemail. Maybe they'll get a call back after lunch, maybe it's the next day, maybe it's the day after that. that the patients gone. You know, they didn't know you. They don't have people don't leave voicemails today. So again, exactly calling back. Yeah, they don't have skinned again. Maybe they were recommended to you by a friend or a colleague, whatever. But they could get a hold and they can go on to chat, she PT or Google and there's 47 other practices that are up within five miles of them. And, you know, they can see the one that has the most reviews and the best reviews. And you know, you've lost them at that point. Secondarily, we talked about a lot of people don't have a website form for scheduling, but maybe just even that information requests, I think a lot of practices will have that, but it's not sent to the regular inbox. It hasn't been set up properly, so it goes into some inbox, but no one's monitoring it. It could sit there for a day, three days, four days.
[20:22] And sometimes the employee leaves and it doesn't get forwarded to the new employee. So all of a sudden for two months these emails are lost. Right. Third, and we see this with all the busy practices that they don't carve out time for potential new patients. And what happens then is that the patient calls out and they're all excited and they're ready to enroll. And first appointment is three to four weeks out. That doesn't work for a lot of people. Yeah, that they're anxious to go. Maybe they've got a more immediate concern. And they have time to think about it. You don't want to get them four weeks to think about, oh, this is my practice. And what's going to happen for my next visit? I'm going to have to wait another four weeks if I need to get in. And what happens if I need something that's time sensitive? Are they not going to be able to squeeze me in? A lot of, another example, a lot of practices are using confirmations and reminders. They're built into their practice management software or third-party programs.
[21:22] And the problem is it's not really current, it's not accurate, so the reminder will go out to a number that the patient doesn't use anymore. So they're not getting it, they know show. And the practice is, oh, we have a problem with no shows. No, you don't. You have a problem with constremations and reminders that would never reach the place that it was going to go to. Same with recall. You know, the system, you know, technically has the patient in it, but no one's doing anything. It says, okay, you know, they're on our recall system, but no one's taking ownership of that. And, you know, it doesn't have to be a front office set. We work with a lot of practices where the hygienists have breaks in between patients, and they're responsible for recolds, they're patients, you know, so why not have them do that as well? And I think, you know, the final one, which is probably the most challenging to deal with, It's the invisible one.
[22:18] It's that if you're not measured, and I know you and I have talked about this as well, if you have no way of tracking at this, if you're not measuring these different systems and monitoring them, it's never gonna get fixed because you don't know that there's a problem in the first place. Yeah, thank you for that. And another one that just came to my mind is the doctor wants new patient, the team doesn't want new patients. So you hear it in the phone calls if you start recording them. They are not excited. They're not rolling the red carpet. Of course, they tell the doctor, of course, of course, we want new patients, but the way the phone is being handled, they don't want it because it's more work for them. They're not incentivized to get new patients. So there's a lot of, like you said, all these things have to go right for your marketing to work. For example, if you don't answer the call, like the example that Dr. Lavine shared, you know, let's say, even if you don't answer one out of four, that's 25% of our marketing dollars being wasted, right?
[23:15] Or your team is not enthusiastic and you're not tracking it and you don't know about it. That could be like another 25% gone because you're not booking all the new patients you could be booking. So I guess what I'm hearing from you is we just looked at new patients as an example, but this could happen with existing patients your entire practice. Systems are what makes your practice strong. Before I go to the next question, Dr. Can you maybe share an example of a practice that's amazing, your best practice? They're all the systems perfect and they're just crushing it. I don't know if you wanna share some numbers, some anecdotes just to kind of understand what does amazing look like? Yeah, it's a challenging question to answer because we haven't, I mean, when we start working with the practice and they start being with us for a while, we have a practice that we're working with right now. They've been with us for probably three, four years based out of Virginia.
[24:14] They're running on all cylinders. And I don't want to sound self-serving, but the practices that actually listen to our advice and follow what we suggest they do tend to do better than the ones that try to at the piece mill. One of the things that we offer for our clients is a comprehensive package of services It's basically everything, every cybersecurity service they can need, every backup, every, you know, all things related to an analysis of their marketing programs, of their spans, I mean, you know, free, unlimited IT support. And when the meter's not ticking and we can have full access to work with them, it's a partnership. And we tend to see those practices try where they tend to sometimes run into some trouble is when they try to do a piecemeal.
[25:10] And they say, well, that sounds great, but my budget's a little more limited. And again, they don't look at this as an investment, which I think it is. They look at it as an expenditure. So they'll say, well, we don't really want to spend that kind of money, but what if we just did X, Y, and Z? And I say, that's fine. We're happy to help you with that, but you're not going to really be able to sleep well at night Thinking that you've got all your bases covered because you're not you don't have everything you know under control here We would not be aware of any problems that that are cropping up We have no way of tracking you know what you're spending your money on and what the results are and you know We because a lot of times they just don't have the ability to work with the third party companies. We do So, you know, they're working. with a marketing company. If they're working with a company that handles recalls or reminders or whatever and they're not tracking that, we can work with those vendors to make it easier for the practice, to understand what dashboards they need to have in place and how to track it and how to delegate to the different staff people to do it. So I wish I could tell you, we have all these success stories out there, but for a lot of practice, and as you know, I mean the technology, the way you run a dental practice is changing rapidly.
[26:36] And it's not like the old days where you just, you know, hung up your shingle and the patients flocked in. You know, you have to everything from the, you know, from your end of it, which is to get patients into the front door. And then where we take over is, you know, what happens once they walk through that door, they've made that call, all of that has to be tightly integrated and there has to be systems in place that follows the patient through. You should always, you should be able to track where a patient is, you know, are they a prospect or are they someone who's already scheduled, you know, are they in the middle of treatment or are they on recall? Do you have systems to get them back in if they miss an appointment and cancel? Do you have a system to know that, hey, we need to call this person up and get them rescheduled. And the unfortunate truth is a lot of practices don't have those systems in place. Thank you, thank you.
[27:33] What's the most expensive technology mistake you see? And what does it typically cause to practice? Yeah, so there's two types of mistakes we see. The one that's kind of like the in-your-face and big, dramatic problem is I talked about this before, We've seen a few practices that went to a trade show. They were looking for a 3D imaging machine, Combi machine. This probably spent around $100,000. These were not, you know, there's no return policy on these things once it shows up. And you've opened up the box and installed it. You're kind of committed to it. And they didn't have the infrastructure supported at all. Their computers were seven, eight years old. They didn't have the horsepower in the processing. the CPU took a while, they didn't have enough memory, the server didn't have storage for the images, was compatible with their existing imaging software, they get new software. So not only did they spend on a thousand, which is a massive amount, they had to spend close to another 50,000 to get the infrastructure in place, but it's just an unexpected extent. We don't see those as often because now there's more options out there. A lot of times people will reach out to me first to say, hey, I'm thinking about getting this. What do you think? I say, hey, before you do that, let's go back and take a look at your network and make sure that you've got everything in place.
[28:59] I think the ones that we tend to see that are actually even more expensive are the small things that go unnoticed for a long time. Maybe you've invested with a company to help you with SEO, for example, and your website changed a few months ago, the URL changed or there was some change to the website. And now the SEO doesn't go to where it's supposed to go to. I mean, it's not sending people to where it needs to be. And you've spent thousands of dollars a month, every month thinking that you're getting great SEO and it's not working. And because you weren't tracking and monitoring it, you never knew. And that happens for six months, 12 months, 18 months. Now you've spent six figures plus on a service that was completely wasted because you just didn't know that it wasn't working in the first place.
[29:59] As you know, SEO is a moving target. A good SEO company, a reputable company is going to tell you, hey, Google's algorithms are changing constantly, and we need to monitor this and make tweaks probably every month or so, if not more frequent. Unfortunately, there's some companies out there that charge the fee, and they set it up and forget about it. And you just, because you're not monitoring it, you have no idea. You say, well, you see a little bump in new patients' companies. They'll, I guess, it's working. And that's it. So, you know, it's, like I said, it's kind of that. It falls into those two categories, either the major mistakes that are super expensive, but I think the ones that are more insidious are the small ones that just build up over time that you never knew that they were there in the first place. Absolutely. I think it's the things that they don't even realize that's happening or not happening that cost them the most. It's the unknown unknown, right? Things doctors don't realize. I mean, we talked about phones not getting answered. We talked about calls getting missed, $10,000 being spent, you know, marketing that's supposed to be working, but it's not working, but the doctor has no idea because there's no tracking, nobody's not defying him.
[31:12] You know, you gave me an idea for a product, which is like having a, you know, doctor to monitor the practice, so to speak, 24 hours a day, seven days a week to make sure that anything that can go wrong doesn't go wrong. You know, it's kind of an interesting, I think you're right. And sometimes these things that go wrong are not fixed for six months, nine months, 12 months. Even like an employee leaves, emails are going to the employee, those employees are getting you know, those emails are getting missed. Who's checking on it? Who's making sure all these systems are getting updated? Like you said, an employee leaves passwords are not changed. So you are now opening yourself up for security risks that could cost you tons of money, especially if that employee is upset and you know, he's not happy with your practice. Let me go to the next question. What are practices paying for right now that they should cancel? Things where you feel like they're wasting their money?
[32:07] Yeah, so I talked about SEO, and it's kind of a tricky thing for me. You're more of an expert than me. I just know myself that if I'm looking up a company or if I want to look for a service, whatever, I don't typically use Google anymore. I use chat GPT or another AI agent. So I think people need to be aware that the old way of doing things is changing, and they really should work with a company. I wouldn't necessarily work with an SEO only company, but a company like Epwap that can get them a full marketing overview of here's the different ways that people are looking for practices. And this is kind of, I think AI is kind of a double-edged sword. The challenge that I see with AI, well, there's a lot of challenges. First off, you have to make sure that it's HIPAA compliant and none of the public facing ones are HIPAA compliant. ChatGPT, Gemini, Grok, Claude, none of them, they do all kinds of things with the data.
[33:09] But from a dental standpoint, I think what's happening is that there's really no single pain of glass. It's a concept that we use where you have one dashboard for everything. happening is that each AI program, each AI system has their own dashboard. And what we're finding when we work with offices that are really trying to integrate AI is that when it comes to the staff, they're actually making it more difficult for them. They have more things. It was hard enough for them to manage their practice management software and the image software. Maybe they have a third party program for KPIs and another one for handling recalls. or now they've got four different AI dashboards out there. And I think it would be who most practices to really not necessarily cancel it, but to really try to figure out, what ones are we using, which ones, what can we do to make things more efficient?
[34:07] Another thing is we see a lot of practices that might have subscriptions of different software programs that kind of do the same things. A lot of people will buy third party programs to do recalls or patient reminders when their practice management software hasn't built in. And they never knew it because they never did the proper training with the PMS. But you're paying $200, $300 a month for a third party program that's already included for free with your existing software. Like I said, if you're paying licensing fees for products, for email, whatever, for team members that haven't been in the practice for two or three years. You know, that's, again, you should be paying for licenses that you don't need. A lot of times we're seeing that, especially when it comes to support contracts that people, you know, a lot of these vendors will sell you like a bundle, a contract that has bundled services, but maybe you're only using one thing and they marketed it to you as, hey, you know, yeah, each one of these services is 200 a month, but if you get all five, it'll be, you know, give it to you for 500 a month, you know, it's half off, but you're still paying the only using one of the services.
[35:19] So you're still paying more than double what you should because, you know, most people just, when I work with a practice and I look at how they use their practice management software as an example, it is rare for us to see a practice that uses more than 5 to 10% of what their software can do. 90% of it, they never touch it because they never got the training on it. is to time consuming, it's not a feature they want or need. So again, don't pay for modules. And the other thing I warn you about, we see some companies that do this, is that they try to get you to buy something, that's a subscription that you don't necessarily, this is one of my pet piece. So you go to a practice management, a cloud-based practice management software company, and they say, hey, you know, get our products, and you don't need a server, and you don't need workstations. And you know, you're going to save so much money on that. First off, that's not really the case, because even though a lot of your patient data is in the practice management software, there's dozens of other places where it is.
[36:20] So we have a ton of offices that are using cloud-based software. They still have a server. They still have workstation. But they're not saving any money at all, because when you have maybe a client-server-based practice management software, you're spending $100, $150 a month. The cloud ones are like 1,000 a month. So even there telling you, hey, you're going to save all this money on your hardware, you're going to spend more money on the yearly subscription than it would have ever cost you. And even if you replace the hardware on the schedule that we think you should be, which is about three to four years for workstations, six to seven years for server, you're going to spend way more on that cloud solution than you ever would have spent on the hardware. For multi-location practices, I think cloud has been tasked. Single location, if you're looking at it from a cost standpoint, it's really hard to justify cloud. Absolutely. This is amazing. I bet in your experience, do you see practices wasting at least 5,000 a month?
[37:22] Or is it more than that? Like if you really take a very close look. Five to 10,000, I think is a fairly accurate number. And that's any double part numbers to back that up. But that's pretty much part of the course. No, that's amazing, Dr. Thank you. Now the flip side, what are the things that they need to do that they are not doing that they end up regretting later on? So we're going to touch on a couple of these. Number one, a tested backup. Not a backup, a tested backup. If you haven't tested it, then it doesn't work. So let me ask you this. When you work with a client, do you actually do a test recovery to see how it works or how long it takes? Yeah, because I believe strongly in what's doing called an image-based backup, where you're backing up the entire server, not just the data, but the program files and networks saying we virtualize it, and within minutes we can just spin up a virtual copy of the server.
[38:19] So there's no reason not to test it. It's easy to do. We do it usually quarterly. And people will say, well, how do I know how I really test the backup? That's pretty easy. You have a server, unplug it, and start the timer. How long does it take you to get up and run? And if it's a few hours, something's wrong. So that would be number one. And if you run virtually, is it like the backup runs virtually to this computer store and worker? It runs on another computer. This different way is to set up. We find the easiest is just to put that virtual server on a souped up workstation that can run it down. as it basically becomes like an emergency server at that point. So it's got all the same stuff. Yeah, as far as the workstations are concerned, servers up and running, as soon as you store that backup. So way easier. Secondarily is, and we talked about this as well, making sure that there's someone who has an actual job to answer that phone when it rings, or multiple people.
[39:25] The phone should never go to voicemail. maybe after hours of course but you know so you always need to be able to to to to a live person and then the third one which is I which I think is probably you know the number one way that people get hit with ransomware and it's your data compromised is user error it's not that your firewall wasn't contributed you didn't have the property where it's someone clicked on an email that they shouldn't know they didn't have proper training and I think it's critical that any dental team really should be doing at least once a year, if not more, cyber security slash HIPAA training. There's a ton of online programs out there that are relatively expensive, but make sure you know how to recognize when something isn't right. Because all it takes is one click and it can be catastrophic for the practice. Thank you, Dr. Now, on AI, how do you tell what is good and what is just, you know, vaporware? Yeah, so, you know, I think if you're looking at if you're evaluating products, whether it's AI products or whether, you know, they're going to give you a demo. And I think there's certain questions that you have to ask. So one of them is ask what it does when it's wrong. A demo is not going to show you that. And AI, as we all know, it's not infallible. But what happens if it doesn't work? Is there an answer to how do you deal with that? You always want to get references from other people that are using this and ones that are more like you, you know, you don't want them if you're a solo practitioner, you don't want to say, hey, you know, and then they said, I'd like to speak to someone who's using it and they sent you to some massive DSO. I mean, it's been customized for them, you know, they get access to the technicians that you're not going to get. So, trying to find a practice that is similar to yours and production numbers, similar setup to see what their experience is.
[41:33] Get two or three references if you can. Critical, especially from a HIPAA standpoint. What happens to the data? Do they do training on it? And does it go to a third party servers? And what happens if you no longer use a product? Do they keep that data? Because if it's patient information, that's definitely a no-no. So you need to ask them what's happening. And who owns the data? And, yeah, I think, the thing with AI is, I think there's two areas. One, I think is a little more development others. AI, when it comes to clinical, I think is really where we want it to be, and it's really getting better. And you look at products like OverJet, and Pearl, whatever, and diagnostic tools. I think they're really good. And we're seeing new stuff coming out all the time. Where I think, like I said, it can get a little muddy is on using AI for more administrative things.
[42:29] Like I said, it's just so many different products out there and they're so very what they can do. And I think it's potentially a great tool. I know when I call up an office, yeah, and it's just, or not even a Dell office, just any business. If they have an AI bot on there, I just, I find it annoying. It's just maybe I'm different, but you know, they're getting better, but I can tell that it's not a live person and I don't get the answers that I want and I can't get through to a live person that I know the AI isn't going to be able to answer. So AI isn't the be all in the end. I think there's ways to integrate it into your practice to make it an effective assistant to your practice. But I think you don't want to go too far to the other side where AI is running the whole practice. And I think most patients are looking for that personal touch and they can still tell. Well, maybe we'll get to a point where you can't tell that it's not a live person but I don't think we're there quite yet. Absolutely. I agree with you. I think on the clinical side, I've seen some good products but on the admin side, I think it's hit or miss and you have to be careful because your clients can get mad because they know it's AI and it doesn't do what it's supposed to and it can irritate people. So instead of helping your business, it actually ends up hurting your business. Now, let's assume, you know, one of your new clients, somebody, a vendor is pitching them something. What advice would you give them? What are the three questions you think any dentist or practice owner should ask to make sure they're not for, you know, walking into a trap when it comes to technology or systems.
[44:17] So, three questions, one red flag. First question, what happens to data if I'm no longer your client? What do you do with that data? You do not want them keeping it under any circumstances. There has to be a written policy that says they're going to destroy it. And some are related to that like what happens that I'm just done with you guys. what's the cancellation policy, how do I get out? If you have a contract, you have a contact, but does it automatically renew? What happens with that? Secondly, this is where I think a lot of offices are gonna get tripped up. What is the actual total cost of ownership over say a three year period? You know, a lot of times they're gonna quote you the initial fee for the software, for the system, but what about the support? You know, what are three years of support gonna cost you in training and add-ons, And if they improve the product, you want the newest version, you wanna only get a realistic view of what's gonna actually cost over that period because the initial fee is never the whole story.
[45:25] Third is all about support. It's an early, it's seven o'clock on a Monday morning, it's down. What is it, we in IT, we have different types of contracts, We have service agreements where there's an agreement that says, like, you know, if a client reaches out within X period of time, usually it's a couple of hours, they're going to get a call back or someone's going to reach out or, you know, something that you need to see. Well, what is their agreement? What, how quickly do they promise that they're going to get back to you? And what are the consequences to them if they don't? You know, what are your recourse is to say, Hey, you promised me two hours of port and it took you two weeks. You know, why am I paying for this? And then I think the red flag is if it comes with a limited call to action. Oh, you know, this is our special pricing. It's only good until the end of the week or you're at a trade show. It's only good to the end of the show.
[46:20] And if you don't buy, then you're not going to be able to get... This is a decision that's going to affect you for years. You know, three years, five years, whatever the case is, you should never feel pressured. You know, take your time. And the other mistake I think a lot of practices make is that the dentist is making the sole decision for these purchases When it's the team that actually uses them day in and day up involve your staff in the process You know you maybe see something at a trade show you think it's gonna be a great addition great Have them come into the office have them do a demo or if they're different long distance fine do it over zoom Involve your team in it get everyone's input and based on all that make the decision Is this the right thing for what we want to do with our practice or do we need to keep looking? Dr. Lavine, as we bring this podcast to a close, I have one last question. You are an expert in technology and you have seen the bad, the ugly. And of course, you have seen successful people, very successful people and those who are struggling when they started with you.
[47:26] So if a practice does one thing this month, what is it? What would you recommend they do? So, if it's okay if you want to give you two, one in each category, one for technology and one from what we're talking about, you know, related to the topic of how it relates to patient retention. And I already mentioned this. Test your backup. It's the one advice I can give you is turn off your server, start the restore process, and see how long it takes. And if it, again, if it takes days, which you're probably not gonna stay down for days, you'll probably reboot the server right away after a few hours when you realize that you sell patients in the door, but you have to test it on a regular basis. The second thing I would recommend is this is more for the practice owners. If you don't believe us that people are calling and not getting return calls, hey, it's a Tuesday afternoon at 1230 call.
[48:24] Call your office number, see what happens. If you have to leave a message, see how long it takes your office manager to call you back. And you might be a little surprised with what happens because most, most practice owners have never done that. Thank you so much, Dr. Lavine. What I got out of this particular episode is that success is not exotic, success is not sexy. It's the things that a lot of people ignore. It's the phone, it's the follow up, it's the system, it's the backup, it's how long does it take you to restore your backup, the boring things, right? The training, the HIPAA compliance, making sure you keep everything updated, you're software updated, the boring things. But these boring things, if ignored, could be disastrous. And if these boring things, if you pay attention to them, and you have a firm like Dr. Lavine's, taking care of them could keep you, you know, let you sleep at night. So you don't have to, you know, be stressed all day long because somebody's watching over it, somebody is on top of it, somebody is taking care of it.
[49:24] Um, so two recommendations I have, if you have, um, technology that's costing you, uh, whether it's acquiring new patient side or, you know, keeping existing patients and building relationships and you have a gut feeling, something is costing you a lot of money. Or you have technology that is outdated. I strongly recommend if it's okay with you, Dr. Lavine, to book a call with you. I believe the link is thedigitaldentist.com slash call. Is that correct? Yeah. That's the easiest way to get ahold of me. It's just it's in my calendar and you can just schedule a call and your convenience. Yeah. One thing I want to highlight is the fact that Dr. Lavine was practicing and has spent years years training and working with dentists literally 25 years and the fact that you're not getting somebody else but him I think is worth its weight in gold because you're not going to get you know what somebody else thinks you are going to get what an insider thinks based on his 25 plus years of experience. So go to that link thedigitaldentist.com slash call use the calendar book book the call with Dr.
[50:29] Lavine and you can have a quick chat if you have something that's you know bothering something that's keeping you up at night. Hey, get a second opinion. And if you want help on marketing, go to a quadrondom slash wired and we would love to help you. It's a marketing strategy meeting, it's a one-hour meeting. We ask you some questions and once we do the research, we'll share our findings and our strategy on what we would do if it was our business. And I'm really, really looking forward to this. If you want to learn more about what we are doing, go to our website, wireddentistry.com, you know, subscribe to us on iTunes, Spotify, your favorite podcast platform, share this podcast with your friends or on social media. If you found this enjoyable or if you found some tips, and of course, don't forget to reach out with us with your questions, with the things you want us to see covered in this particular podcast.
[51:25] Have a wonderful rest of the week till we see you again with another episode of the while dentistry podcast show have a blessed week.