A Conversation with Dr. Rick Workman: Founder of Heartland Dental

Episode Description

In the podcast interview with Dr. Rick Workman, the founder of Heartland Dental, he shares his remarkable journey in dentistry, starting with a small practice in Effingham, Illinois in 1980 and evolving into Heartland Dental, the nation’s largest DSO. Dr. Workman discusses dentistry in general, education, and Heartland Dental’s model. The conversation highlights his commitment to enhancing dental education through working with institutions like Concorde University and the Workman School of Dental Medicine at High Point University and the importance of equipping new graduates with practical skills. Dr. Workman details the adoption of advanced tools like Itero scanners and AI-driven software, defending these investments as essential for service quality. He concludes with advice for dentists on nurturing leadership qualities, enhancing team communication, and establishing systematic practices to achieve productivity with minimal stress.

🏥 Dr. Workman’s Journey

  • Started practice in 1980 with $32,500 loan
  • Worked 50 hours/week in practice, 25-30 hours/week on improving skills
  • Founded Heartland Dental to offer support to dentists
  • Dental education costs increased from 5,000 total to over 400,000 now
  • Aims to provide support for dentists at any level they want

💼 Heartland Dental’s Model

  • Offers better reimbursement rates and support for affiliated dentists
  • Invests in training for all employees, including doctors and hygienists
  • Proactively increased hygienist pay, improving retention from 75% to 82%
  • Hygiene growth up 10% on average across 1800 locations
  • Aims to solve workforce issues in dentistry

🎓 Dental Education and Support 

  • Partnered with Concorde University to start dental hygiene school in Florida
  • Supports dental schools across the country including the Workman School of Dentistry at High Point University
  • Offers resources to affiliate practices like industry leaders in Invisalign education
  • Believes in providing practical skills and knowledge to new graduates

🖥️ Embracing Technology 

  • Installed 1700 Itero 5D scanners in offices
  • Implemented AI-driven clinical software in every office
  • Introduced Curodont, an FDA-approved product for incipient decay
  • Emphasizes the importance of basic skills before advanced procedures
  • Justifies technology investments based on service engagement

🚀 Advice for Dentists

  • Commit to becoming better, both technically and in leadership
  • Focus on personality and leadership skills to grow practice
  • Emphasizes the importance of team communication and synergy
  • Advocates for a systematic approach to practice management
  • Believes the highest productivity comes with the lowest stress when systems are in place

Transcript

00:15
Hello and welcome back to the Simplify Dentistry podcast. I’m Dr. Mustafa Shah-Khan, and along with my brother and co-host Dr. Murtuza Shah-Khan, we would like to introduce today’s guest, Dr. Rick Workman. I’m. Dr. Mustafa Shah-Khan, we would like to introduce today’s guest, Dr. Workman is the founder and executive chairman of Heartland Dental, a world class dental support organization that provides support to over 2,700 dentists in 1700 offices. Dr. Workman has been a pioneer and has made significant impact upon our profession by introducing practitioners to potential opportunities of high quality non clinical administrative support to practice dentistry. Dr. Workman, thank you for being with us today.

00:51
Dr. Rick Workman
Enjoyed being here and looking forward to the conversation. Thank you.

00:55
Dr. Mustafa Shah-Khan
Dr. Workman, you’ve had a remarkable career and a remarkable journey and you’ve been very impactful on the profession. Tell us a little bit about your journey.

01:04
Dr. Rick Workman
Sometimes people want to know that first of all I did not set out to found Heartland Dental and I never dreamed it would be what it is. I started out like a lot of people do know. I grew up on a farm in a small town, went to a three room grade school at six in my class. But I started out, I was looking for a job right out of the old school in 1980. They’d pay me 25000 a year. Couldn’t find that job. I had heard of a place I could rent in Effingham, Illinois, which is near where I grew up. A big town of 12, 000 people. And I could rent the Golf for $125 a month, two chairs and I borrowed 32,500 from my parents and grandparents and set up a practice. And I didn’t know if I’d make it.

01:48
Dr. Rick Workman
I literally didn’t know if I’d make it. But I thought I could always work on the farm if dental didn’t work out. But dental worked out pretty good. And I, I love dentistry. I practiced, you know, compared to working on a farm, it was easier and more productive. And so I started out working 50 hours a week and then I spent about another 25, 30 hours a week.

02:10
Dr. Rick Workman
I don’t say forever, but the next 15, 20 years trying to figure out all the things you need to do to become a better dentist, a better leader, how to maybe buy supplies better, design offices better, and work on leadership and through stupidity, ignorance and just punching head, I got more experience at all of those and over Time began to figure out that as dentistry was changing, becoming much more diverse, cost of education was going up. My total tuition was $5,000. Total tuition. And, and now, and I thought, boy, when it gets to get to 25,000 a year, I don’t know how these people are going to make it. And, and so we got to offer them to find a place where they can come in and join. And today we know that 20% of all grads have over 500,000.

03:00
Dr. Rick Workman
Another 20% have over 400,000. So it’s just a different, it’s just been a journey and were just trying to solve problems such that dentists would choose to want to work with us and choose to want to stay with us. And, you know, we don’t think that’s. I’m sorry, I got lots to say.

03:16
Dr. Mustafa Shah-Khan
But our model, we want to hear from you.

03:18
Dr. Rick Workman
Yeah, well, our model only works so long as dentists want to work in a supported office. To the extent they want to work in their own solo practice, great. The extent they want to work in military, great. F, F, Q, H, C, or whatever, great. I just, I. My goal is pretty simple, is that any dentist should be able to practice at whatever level of support they want with no professional disparagement. Seems so simple.

03:50
Dr. Mustafa Shah-Khan
Yeah. It’s interesting, you say, you know, your cost of dental school was $5,000 when I graduated in 2002 and from chapel Hill, and they estimated our total cost was $35,000 for four years, which, you know, wasn’t a huge, crazy jump considering time.

04:12
Dr. Murtuza Shah-Khan
Then when you, when I graduated, it was, I remember, ours, mine. Basically, I graduated 12 years after he did and it had doubled. And then I looked at the data last week for the incoming class at University of North Carolina School of Dentistry. On average for in state, it’s planned on a hundred thousand dollars a year. A year. So they’re going to be walking out with 400 grand at least. You know, the out of state kids are going to be paying more.

04:38
Dr. Rick Workman
Yeah.

04:39
Dr. Murtuza Shah-Khan
You know, it used to be when I remember when I applied to NYU was the only one that had that kind of a number.

04:44
Dr. Rick Workman
Yeah.

04:45
Dr. Murtuza Shah-Khan
And now it’s just. Yeah, it’s just these kids walk out of school. I mean, I mean, I was one of those guys too. You walk out of school and you’re like, oh, I have $250,000 of debt. You know, I got 500.

04:56
Dr. Mustafa Shah-Khan
Like you’re talking now.

04:58
Dr. Murtuza Shah-Khan
Yeah. You get a job that’s not paying you a semblance of that number. You know, you have a family, all those other things. I mean it’s making it hard to justify the numbers for new grads and it’s a. You know, I think at some point our profession is going to have to figure that out a lot better than we have so far. And I think it’ll be something great that guys like you are involved to help.

05:21
Dr. Rick Workman
We. You know, again, I’m. By the way, I want to say My total tuition first year was 1200, second year 1500, 1300. Third year was 1800. So my total, I say total, I’m talking about to graduate with 5,000. Yeah. Because I only went three years my last class to go three years at SIU, thank God. And, but no, I, I know that the audience is well aware that not everybody in the world appreciates Heartland Dental. But, but on the other hand.

05:54
Dr. Mustafa Shah-Khan
I.

05:55
Dr. Rick Workman
Think we offer a tremendous opportunity for a lot of folks. And, and again what a lot of folks don’t get to do and one of the reasons I love doing it opportunity like this is that I’m, I want all dentists to be happy and joyous and successful. It’d be great for everybody. I just know that there’s a lot of folks who have concluded that they’d better off having somebody else help them with different aspects of their practice. And, and that’s what makes the world wonderful is we all get to make choices. And I think that’s all. That’s all. I’d say.

06:36
Dr. Mustafa Shah-Khan
Well, you know, you’re looking at as you mentioned earlier, graduates who have been in profession for 10 years or less, the majority are in a DSO now. And whether it’s economic forces or whether it’s wanting that, you know, non clinical support and administrative help or whatever it is, you know, you, but you are seeing a growing number one, you’re seeing a growing number of DSOs and two, you’re also seeing a growing number of practitioners not being solo docs. Obviously. You know, I’m a solo doc and I feel like I’m a dinosaur. I mean you come out and at one point in time you wanted to hang your shingle. Kind of like what you did from the get go and practice.

07:15
Dr. Mustafa Shah-Khan
It’s a hard thing to do now, one with cost of equipment, cost of supplies, cost of everything kind of, you know, what trends are you guys seeing going on? Are you seeing obviously the continued rise of the DSOs, the continued rise of docs affiliating. You know, I know you guys have A couple things. I’m asking a bunch of questions all at once. I know you guys have, I got lots of answers. I know you guys have a couple of different channels where there’s affiliations and there’s de novos. Are you seeing affiliations rise and de novos decrease? Are you seeing more de novos that you guys are doing? What, what, what’s going on with what you’re saying?

08:01
Dr. Rick Workman
Going to go, and if I miss a spot, trust me, I didn’t miss it. It’s, it’s a political season and they, you ask any question you want and they give any answer they want. They’re just not correlated. But we do de novos because we can predict our growth in that regard. And we go like this community, this growth rate in this area over the next 30 years. This is a good place for a dental office. And then we can count on, we do about 100 a year right now, which means we’re going to need to hire a couple hundred, 250 new doctors a year net just to staff those up on affiliations. We look at lots and lots of practices and have for decades. You know, what’s that mean?

08:52
Dr. Rick Workman
Well, it does mean that we do have a pretty good insight into what’s happening with revenue, cost pressures, declining margins. We have a very good idea what people are paying for supplies as a percentage of revenue, for labs as a percentage of revenue, labor as a percentage of revenue. We have a extraordinarily good idea at the end of the day what people are getting paid and reimbursed from insurance companies. And, and we sit here and just say, we shake our hand heads and say, I feel sorry for many solo practitioners who are out there beating their heads against the wall, working alone to maintain their independence. And I go, independence from what? So that you can continue to get ripped off by the insurance companies, by the supply vendors, by people that we work with and have good relationships with.

09:45
Dr. Rick Workman
But technology, you know, we were, we were looking at an affiliation once and go, I wanted to do, I got to be careful how I say things in the right way. I careful. I want to do clear aligner therapy. But the scanner is $58,000 and the cost is $1,800. And I’m going, well, we wouldn’t be doing it either if that’s what they think cost. But we’re probably going to do 50,000. Our doctor support doctors do 50,000 cases next year because the pricing is better. And what we’ve learned is that there Is a lot of training required to learn how to do that and communicate that and handle that. But that’s where you go. A community can help you learn how to set up better ways to treatment plan. There used to be the term called mid course corrections.

10:44
Dr. Rick Workman
But how do I handle this now? And compliance isn’t what we want. What do I do? If you’re on your own, the most prudent thing oftentimes would be to say I’m never going to start that journey.

10:53
Dr. Murtuza Shah-Khan
I’ll be gone.

10:55
Dr. Rick Workman
But if you had a community of hundreds of people who only cared for your success, wanted to help you in any way they could, you’d have more confidence to learn how to do that. And, and it’s hard to become an expert or have develop expertise if you don’t do the first 10 or 15 root canals or extractions or invisalign cases. And so there are more people of all. You know, historically when you’re 65, you sell your practice and you walk away. That’s classic. Well, that’s nice. We, we can’t do that because you know, we need a transition to, to us and so we just don’t do that. But we also tend to be able to pay more money than what a younger $500,000 in debt new graduate could do. Well, there’s trade offs to everything and I’m happy for whatever makes people happy.

11:58
Dr. Rick Workman
But in the long run, people who really investigate what I’ll say I can only talk about us, what we do. We’re not perfect, but our batting average is pretty good. And we, they come to realize that it doesn’t help us if it doesn’t work out good for them, if it doesn’t work out good for the doctor. Well, you’re here, but your friends won’t be. And our goal down the road is to be able to be available for whoever wants to come and join our network and be a part of our supported offices.

12:33
Dr. Mustafa Shah-Khan
You know, there’s a practice right down the street from where we are right now that’s a supported office of you guys in Charlotte. And I was talking to the doc’s former partner and he said, you know, one of the things that you know, he was scared of is his mentor couldn’t sell his practice and just had to walk away. He didn’t want that to be something that happened to him. And then he also had a facility that had more space than single doc could use, but he didn’t have the cash to invest at this point in his career to upfit that to look at bringing on an associate to growing the practice.

13:09
Dr. Mustafa Shah-Khan
And when he kind of came to you guys and you guys reached an affiliation agreement, he said one of the big things was that you guys were going to help with upfit cost, with help getting him an associate with help growing the practice, which kind of leads to all the growth opportunities that the practice will realize from being an affiliated practice versus him being just kind of on his own. Yeah, and I’m sure, you know, that’s a really positive thing that, you know, like you said, a lot of people think that, you know, Heartland is this and Heartland is that. Yeah, I think, as you said, Heartland is a good opportunity for a lot of people. Solo practice is a good opportunity for a lot of people.

13:52
Dr. Mustafa Shah-Khan
You can’t be everything to everybody, but you got to be, you know, you got to be what you think is kind of the right thing and kind of with that, you know. Why do you think it’s a better choice to affiliate than to just go it alone? Is it the community or what do you think?

14:11
Dr. Rick Workman
Well, you know, we all have our own personal. I’m trying to abilities, awareness of our abilities and the realities that we face and things that I hear a lot would be that. Well, now I’m a solo practitioner and I’m doing very well. So why would I sell? Because if I do, then I’m obviously going to make lesser money because the people who I sell the practice to are going to probably try to get paid for doing, for what they do or so forth. And, and they go, so why don’t I just wait till I’m 65 and sell it for the same amount of money and walk away. But I’m going. Now there’s a couple things here. First of all, nobody can predict whether they’re going to develop a healthcare issue. Most people can or cannot predict whether they’re going to get a divorce.

15:16
Dr. Rick Workman
Nobody can predict whether we’re going to have Covid or higher inflation or a hygiene shortage or all these things. And so at some point in our lives we start to calculate what are we doing and why are we doing it. And, and, and I could. All I can say is that we have again, you heard me say we’re not perfect. We said that. I think our affiliations that work out 90 plus percent of the time, which means we can go out there and find a lot that didn’t. But when they don’t, it’s not because Heartland benefited, because it didn’t go, well, you know, I was, were at a meeting a couple weeks ago and they go, what do you mean that the doctor sold and never showed up the next day? Oh, yeah, no, they did that.

16:03
Dr. Rick Workman
And, and they, why would they do that? Well, you have to ask them because they felt they could just inflict pain on Heartland. And we closed the practice and wrote off a million and a half bucks. And that was, we all had fun. And it was outstate New York and the wife was the practice. And we called third day and asked, hey, you know, how’s your husband doing? Is he going to show up, come back? You know, we just, we’ve never had a day work here. What are we doing? It’s like, I am not going to violate HIPAA and tell you about your employee. I go, that was about your husband. But that’s, she’s an employee that practice. And, and I’m not sure that’s how it went down. And so we wrote down a million bucks.

16:43
Dr. Rick Workman
Now, nobody wants to publish an article about that. But if somebody allegedly says that, somebody said we did something, hired, fired their team, everybody believe that was like, that’s, you just have to give us credit. We’re not that dumb. And so they work out 90% of the time. And what we find out over time is that a lot of times, you know, the money that you take off, if you put that in the stock market over the last five years or the last seven or last 10 or the last 20, is not worthless. And you’re not your money job, right. In the meantime, you’re surprising what you can make. And then they find out almost every time that they’re going, oh, my God, I, I would beginning reimbursed at a different rate for doing the same work.

17:32
Dr. Rick Workman
And I’m going, we’ll do a lot of work for you if you just give us contractual benefits that we’re going to provide for you. You’re in the same spot. No matter what we take out of this, you’re in the same spot. We’re just getting it from other sources. You’re just donating that money to somebody else. And they, they can’t necessarily believe that, but it’s, and again, it’s not always the case, but it’s that case quite a bit. And so the doctors oftentimes come to realize that their life gets better when 5 o’clock comes. And whatever challenges we’ve had with the hurricanes recently and things like that, they go, Heartland has a team Facilities team that handles that now, they may need them to come in and say, could you just make sure there’s not water on the floor or leaks or something like that.

18:22
Dr. Rick Workman
But when it comes to arranging all the contractors, our folks handle that when they come time to. For your annual, hopefully annual increase from your insurance company, Heartland handles that. You just all of a sudden get notified that, by the way, your rates are going up 3% this year. Hope you’re happy. And, and, and so again, while we’re not perfect, a lot of the things that they’re most worried about don’t come to Pat Long. In the old days, it was like Rick Workman did your treatment planning. I mean, think about that.

18:57
Dr. Mustafa Shah-Khan
Yeah.

18:58
Dr. Rick Workman
Three, we’re over 3,000 doctors now. Or, okay, your dental assistance doing your treatment planning. I go back to. And I just remember we’re a little zany and crazy on certain things, but we’re not as stupid as people think we might be. Because as a dentist, you know, I don’t know a lot of dentists who are looking for a dental assistant to tell them what to do clinically. You just have to give us the credit to realize that’d be stupid and fatal for us as a company. And so that’s not how it is. We’re not perfect, you know, and would, and if you routinely decided in the middle of the day, you know what, just cancel the rest of the patients, screw it, I’m going home. Well, that’s probably not a great work environment now. Solo practitioner can do that.

19:45
Dr. Murtuza Shah-Khan
Yeah.

19:45
Dr. Rick Workman
And that’s a wonderful thing about owning your own business. But if you owned your own business.

19:51
Dr. Mustafa Shah-Khan
You’D never do that.

19:53
Dr. Rick Workman
You wouldn’t have your employees closing your shop down on a whim for just no good reason without saying, was that a once in a lifetime deal, son who is sick at home and you had to go, we get that. But yeah, it’s a sunny day and we thought we’d just take the day off anyway. You get my point. There’s give and takes.

20:09
Dr. Mustafa Shah-Khan
You mentioned, you know, hygiene, staffing issues. Obviously, we all face it. You know, is there, Are you facing the same challenges that, like he will be facing that I’d be facing, or because you have the support system that you have, are you able to get hygienists easier and are you able to fill the need better than a solo do can?

20:32
Dr. Rick Workman
I would say, I don’t know that we get them easier because we invest. When we get any employee, we tend to invest a lot of money. In training them, doctors, hygienists and everybody and bas and so forth. And so then that have to figure out how to train them myself. So. But about a year or so ago, you know, there’s a national shortage in hygiene and by the way, we’ve partnered it, I think you can read this, but we partner with Concord University to start a dental hygiene school in Fort Myers, Florida.

21:13
Dr. Mustafa Shah-Khan
Oh, wow. I did not know that.

21:14
Dr. Rick Workman
Yeah, because we’re tired of being without hygienists down there. I think there’s going to be other companies that do these things because we can wait forever on our government to fix our problems or we can try.

21:27
Dr. Murtuza Shah-Khan
To fix them ourselves or we go away.

21:29
Dr. Rick Workman
Fix them ourselves.

21:30
Dr. Mustafa Shah-Khan
Yeah.

21:31
Dr. Rick Workman
You know, you take 1800 locations and have the hygiene department be on average up 10% over last year is pretty good.

21:39
Dr. Mustafa Shah-Khan
And we think that’s been fantastic to be able to have that, you know.

21:43
Dr. Rick Workman
And so they’re, they’re paying for themselves in our minds.

21:47
Dr. Murtuza Shah-Khan
And for me it was, you know, I’m a solo doc, you know, me too. Hygienist and assistant and front desk. And one of my hygienists, she’s young and wanted to live in New York City, which, you know, awesome experience to have at a young age. But she left me November 2nd of last year and it took me until October 14th of this year to find a full time replacement. Note, there are entities that help you get temporary and fill ins and I think we all know the pluses and minuses is about as nice as I can say about that experience. But yeah, I think it’s phenomenal what y’all are doing with helping that, you know, add to the number of hygienists that are coming out.

22:30
Dr. Murtuza Shah-Khan
You know, there’s some folks in North Carolina that are doing the same thing to try to increase enrollment stuff. But it’s, you know, it’s still, you know, you start tomorrow. That’s, that’s two years down the road that you’re getting a graduating class out.

22:42
Dr. Rick Workman
Yeah, this is where I think I just, I, I do wish that all of us in dentistry could work better together on workforce even. I will say that even some of what I call our haters realize that us putting a school in southwest Florida would simply fill the basket up and eventually everybody would have more hygienist available. And you know, we’re, we understand what supply demand means and to the extent we get higher supply, I’m happy for everybody to get paid Fairly and well and. And be good. Everything else but scarcity of health care, you can’t get in. You know, that’s no good for anybody.

23:28
Dr. Murtuza Shah-Khan
Yeah, yeah, I think it’s great. Like, you know, we’ve talked about all the stuff that you and Heartland are doing for folks, you know, out of school or earlier on in their career, later on in their career and things. But I think, you know, to a certain degree, what doesn’t get enough attention is all the things that you personally, you and Heartland are doing for different dental schools across the country to help, you know, impact dental school education and also, you know, the quality of graduates that come out. So if you wouldn’t mind sharing a little bit of what you’ve done on that end, I’d love to hear it.

24:03
Dr. Mustafa Shah-Khan
Like with Dr. Bell and things like that. Yeah.

24:05
Dr. Rick Workman
Dr. Bell teaches us hard, smart and together. You got to work hard, smart and together. Of course, you got to work hard, you got to work smart, but you got to work together. And having you and your team symbiotic makes everything work better. So that’s what we do internally with Dr. Bell and that we’ve obviously helped certain schools, we’re happy to help skill schools. We want a relationship with schools, but we also want to. We want to be able to tell the students and the schools what’s happening in their external environment, which is our world. Our world isn’t the entire dental world. But for students to graduate and have only been told in their school, whatever you don’t work for a dso.

25:00
Dr. Mustafa Shah-Khan
Sure.

25:00
Dr. Rick Workman
I think that’s. I don’t think it’s fair to the students because they’re going to get. You heard me say we’re not perfect, but we’re not as bad as they tell us, some would have us say. And for some students, it’s the right decision. They may not know what they want to do. They need. May need to do a year or two of residency and, you know, they may stay for a lifetime. They may leave after a year.

25:24
Dr. Mustafa Shah-Khan
You know, dental education, it’s like my view of the news. You know, I think the news should have to present both sides of things and let people make an educated choice from that. Well, we don’t see that dental education, the same thing. You see, you have to do it this way, at least when I was in school, and that’s the only way to do it. And you can’t do it this way. I don’t know what’s going on now with. Obviously, you know, 25% of people affiliating and things like that. So I think being able to have that perspective and teaching that perspective is important. I know you guys very generously have supported, you supported Chapel Hill, you supported a lot of dental schools. Right down the street at High Point we have the Workman School of Dental Medicine, which is fantastic.

26:11
Dr. Mustafa Shah-Khan
Is your goal to help influence the perspective in modern dental education or just provide support and you know, let the schools kind of just go on their paths or what, what is your take on that?

26:27
Dr. Rick Workman
Yeah, and if I don’t get all the right details, please follow up. You know, I’ve loved dentistry. I’ve been very blessed by dentistry. I tried for a very long time to influence some university to put a dental school in my adopted hometown of Orlando, Florida. Florida needs it. Three to three and a half million people a decade move here. Pretty much the same number of schools they’ve had for all these years. I’d like for other schools in the University of, in Florida didn’t say that to get bigger we need more dentists because there’s three and a half million people and, and so forth. When I met Dr. Scott Derosi, who was at the University of North Carolina, and I met him because of all of our interactions with Dr. Bell and you know, I contributed to the university.

27:18
Dr. Rick Workman
And so they now have the Bell leadership aspect at the University of North Carolina Dental School. And I met Dr. Derosi and he, he stepped down from dean during COVID and he left the university. He went to High Point University. I didn’t know that exactly. I never, I’d heard of High Point University, but I didn’t know. But, but he said, Rick, you need to, you need to come down here and meet Nito Quebec at High Point University. I think, I think you guys will like each other. I go, well okay, you say so I’ll come down there and I don’t know how many people know or have met NATO or how many have been on the campus of Five Point University.

27:54
Dr. Rick Workman
But you know, I’d say I’ve been a few places and been beaten up enough to where I’m have a reasonable amount of cynicism or skepticism. But, but my wife and I went there and were absolutely, positively blown away.

28:10
Dr. Mustafa Shah-Khan
It’s a beautiful place, beautiful campus university.

28:14
Dr. Rick Workman
By a difference in thinking. They, they have these innovators in residence. You know, you go down there and Steve Wozniacki will talk to the people. Yeah, when I talked to Scott early on, after I made the commitment, he’d asked me, he’s like, well, okay, so Rick, you’re spending, you hire hundreds of dentists every year for 20 years and you spend millions of dollars teaching them. Why do you teach them? Why do you do that? And I’m going, I’m not. You know, we don’t do this because we’re critical of dental education across America. We’re doing it because we know in a practical reality there’s a lot of kids coming out of school who’ve never done root canal. Very many, they haven’t done very many extractions, almost none of them done invisalign. Same for implants and so forth. And they don’t know what’s possible.

29:03
Dr. Rick Workman
And so our job in our minds is to show them what’s possible. Explain to them, you’re going to be a dentist for the next 40 years. Invest in yourself, invest in your skills. Learn how to work as a team, hard, smart and together with your bell. But put more tools in your toolbox because your patients need these things. It’s better comprehensive care. I’m a passionate believer in the super GP model. Dentists can do more than single unit crowns. And, and we do that. He goes, you tell me what they need to know and I’ll try to see if they can do that when they graduate. I said, look, I, like, I’ve never been asked that question before. And that’s not what they’re doing. Let’s be crystal clear. They’re all independent, so forth.

29:49
Dr. Rick Workman
But I said, I, I’ll be honest with you, I’ve never been asked that. And I go, well, who in America knows more about what new grads on average need to know? And I, and I said humbly, I, I really don’t know because who has hired more graduates and spent more dollars training them for more years? And it’s not a criticism, it’s just like, let’s try to make them better. They will better off if we get them what they need. And so we all need more dentists. North Carolina need more dentists. I’m not anti dentite, as Kramer says, Carolina, but you can’t look at that growth of that state and say they don’t need more dentists.

30:34
Dr. Rick Workman
Half of all the students who go there from out of state, so maybe 20% of the students will stay in state, but North Carolina is like Florida, it’s a booming state.

30:43
Dr. Mustafa Shah-Khan
One of the big things you guys did is you have the ability to bring in the industry leaders in educating Invisalign. So a affiliated doctor or de novo doctor for Heartland has that resource to be able to learn. I’ve just now felt where I’m comfortable invisalign because I’m doing like a Molis course. You know, to be able to really understand. I was like, oh wow. The reason why that lateral never was the right place because you have to actually over rotate it 6 degrees, you know, but it’s things that you don’t understand. So I do think, you know, that is a great piece that you guys are offering to the graduates. You know, it’d be nice if that could penetrate into the undergraduate education, you know, possible or the pre doctoral education.

31:28
Dr. Murtuza Shah-Khan
But it goes back to that community aspect too is that thing gives you. Gives. I mean were both doing that program and it gives you a community of docs, you know, kind of like you’re talking about. You’ll have that open threads for all your docs to kind of discuss things and figure that out. And this thing has been a game changer for us.

31:45
Dr. Rick Workman
Yeah, look what occurred. Like you’re right. We, we met the best Invisalign teacher and lo and behold they became a Heartland affiliated office. And 15 years later they are a full time teacher person who’s helping with treatment planning and full time consultant internal. What happens because of that? There’s hundreds of dentists who are doing Invisalign that wouldn’t have otherwise offering that service and, and therefore hundreds of communities who are being served that otherwise wouldn’t or as well and the doctors and so forth. And it’s just, you know, again, it’s not perfect. Nothing’s perfect. Invisalign is not perfect. I don’t think Bandit Ortho is not perfect either. The point is I think we elevate the batting average and to the extent that more adults get better occlusion, that’s going to better for Perio. It’s going to better for long term restorative.

32:58
Dr. Rick Workman
But, but if we didn’t do Invisalign they’d get what they’ve been getting, but they wouldn’t be getting better. And so it’s an incremental game in my mind. We all, it’s better standard of care.

33:10
Dr. Mustafa Shah-Khan
So. You know, one thing that I do read about, you know, with DSOs and Heartland in particular is embracing technology. Are you guys utilizing technology to make things more efficient? Are you. You and I have talked a little bit about the AI driven clinical software, whether it’s Pearl or Overjet or I can’t remember who it was that you guys are using a lot. Are you guys using more of that? Using more cone beams, using more. I know you’ve in the previous. I’ve said there’s not a lot of in office milling. Are you guys embracing that or kind of. Where are you guys going there?

33:45
Dr. Rick Workman
Yeah. So this year has been a crazy year for us. This year we installed 1700 the Invisible, the Itero 5D something so one in every office and, and manage the change. Change management of all that with in face visualization and the benefits of that. We installed AI the video brand in every office. So there’s a change management of all of that and integrating that into software. Your practice manager system. We, we, I’ll call Cured on a technology but we implemented Curidont early in the process and Curidont by the way, if people don’t know what Cured on is, it’s.

34:34
Dr. Mustafa Shah-Khan
Yeah. I don’t know what that is.

34:36
Dr. Rick Workman
Yeah. Okay. This is, this is good. It’s kind of a game changer. Curodont is the first FDA approved product that will take interproximal incipient decay and you know, fluoride will code it over I call it and harden it. But I’m going to be not accurate. So don’t hate me on the accuracy some of your members. But it’s kind of an amino acid structure that bonds to the scalloped out lesion. They go on a microscopic level and creates a lattice work that then sucks the minerals out of the saliva and about 35, 40% of the time actually remineralizes the incipient lesion and it’s 93% effective in preventing further erosion. So the question for your patients is look, we now have this technology and it’s peanut butter and jelly with AI because the AI will show you.

35:48
Dr. Murtuza Shah-Khan
Yeah.

35:49
Dr. Rick Workman
What an incipient lesion is and say now look, that may not go to a restoration or on into the dentin, but every single cavity in the history of the world that ever became a full cavity through into the Denton started like that, went through this phase.

36:06
Dr. Murtuza Shah-Khan
Right.

36:06
Dr. Rick Workman
And we have a product that we can rub on your tooth by the hygienist that’s 93% effective. It’s about $100. Do you want to do it or not? You’d be surprised between 40 and 60% of all the folks that our hygienist talk to and doctors talk to Say yes. And you can figure out how many times per day that might occur in a typical product.

36:32
Dr. Murtuza Shah-Khan
Oh, for sure.

36:33
Dr. Rick Workman
And so to do one or two of those a day is per hygienist is not unusual. But that’s where AI and a technology like Curidont is changing the world. And we kind of joke, but probably we go, in five or ten years, most dentists will have heard of this, and five or ten years they’ll be working on this. But I’m telling you, Hardin started January 1st when the FDA approval came through, and insurance and Medicaid are generally paying for it. And I. That’s this takeaway to all your people, yada. You ought to think highly about this.

37:08
Dr. Mustafa Shah-Khan
It makes sense. You know, dentistry is the only profession, like to joke, that actively tries to put itself out of business.

37:13
Dr. Murtuza Shah-Khan
Yeah.

37:14
Dr. Mustafa Shah-Khan
But progression like that and utilizing technology is a great thing. I mean, all three of us will sit here and say, the last thing I want to do is a DL on number 18.

37:24
Dr. Murtuza Shah-Khan
Yeah.

37:25
Dr. Mustafa Shah-Khan
You know, or do number 19.

37:26
Dr. Rick Workman
If I can figure out a way mo 118. Like, oh my God.

37:30
Dr. Murtuza Shah-Khan
Yeah.

37:30
Dr. Mustafa Shah-Khan
And never have to do that again. I would do it all day long.

37:33
Dr. Murtuza Shah-Khan
Yeah, exactly.

37:34
Dr. Rick Workman
And, and the biggest barrier is always the dentist thinking, attitude, process. Well, what about the 7% where it doesn’t work? And I’m going, I used to worry about that too, but I’m going, I don’t know. Do the filling. Just take that off. The filling? I mean, yeah, I mean, I don’t know. I mean, and there’s people who would criticize me for even saying that. Don’t you devalue what we do. They can’t guarantee they work. And I’m going, I’m just saying a long time ago. Took me a while because trust me, I wanted to be right. I still like to be right. But, but we trained to be right. But the point is they argue. They’re arguing with the patient over this. And I’m going, well, that’s just not a discussion. We’re going to argue it didn’t work out.

38:18
Dr. Rick Workman
And I don’t want to change the nature of our relationship over something like this. Yeah, let’s, you know, we’ll move on. And, and my point is, we’ve had very good adaptation, but it’s an example of one. You were talking about implants. A lot of dentists want to learn how to do them, but they don’t know how to do basic oral surgery and basic endo. And I’m saying I, I unders this as A dentist, I go, I understand the desire to learn how to do implants, but if you don’t have these.

38:46
Dr. Mustafa Shah-Khan
Skills, learn the basics, you’re going to.

38:48
Dr. Rick Workman
Use these skills a lot more than you’re going to use this skill. And if you don’t have enough confidence to do these skills, it’s not the easy ones that anybody can drill a hole and stick a thing in there.

38:59
Dr. Murtuza Shah-Khan
Sure.

39:00
Dr. Rick Workman
What about the complication that could occur in the process of placing that? You had better have some pretty good skills, better than basic oral surgery in case you are. When you inevitably have a complication with something like an implant. And so we have doctors who do all that and work through that. But, but there is a process by which you can earn the right by doctors deciding that your office is entitled to a cone beam because you actually would engage in services where often enough that it justified.

39:33
Dr. Mustafa Shah-Khan
Yeah, yeah.

39:34
Dr. Murtuza Shah-Khan
You got to walk before you run.

39:35
Dr. Rick Workman
And it seems to me like that.

39:39
Dr. Mustafa Shah-Khan
Well, Dr. Workman, thank you very much for your time and being with us. Kind of. My, my last question would be you. Are there any takeaways that you have takeaway messages for our audience? And is there anything that you can think of, any advice that you can give docs to make dentistry a little simpler?

39:58
Dr. Rick Workman
Yeah, well, you know, commit to becoming better. I mean that sincerely. It’s easier for dentists to commit to becoming better at a technical skill Dr. Bell teaches us. Of course, you got to have your technical skills. In the middle of the base of the pyramid is your work ethic, which is are you willing to work hard and long, but also are you willing to be present when you’re at work instead of at work on the phone, on TikTok and blah, blah. And then the third thing is, at the base level of your skill pyramid is your personality and leadership skills. And to, at the base level, you have what you have. But do understand that when you out of one of my practice, my first partner, he sent me a text earlier this morning. His practice hit a million dollars in October.

40:50
Dr. Rick Workman
That’s a nice month for a single practice. Wow. I said, who do I call and who do I name? Because I want to do that. And. But he doesn’t even practice anymore. But he’s working with everybody on the leadership skills. Because you have to, you just have to trust that to develop those leadership skills, the doctors in the practice have to be in sync with the hygienist, with all the folks who are then in sync with all the patients. And it’s, it’s that personality and leadership and communication skills that really ultimately changes the game. Learning how to cut a crown prep a little faster will make a 3 or 5% difference in your practice. But when you learn how to communicate, work hard, smart, together as a team, that’s when you double your practice and then they could triple your practice.

41:42
Dr. Rick Workman
And I would say to dentists that go, I couldn’t imagine three times the work, three times the stress. And I’m going, well, that right there is an example of where you have it. You haven’t thought this through because do you really think that they have three times the stress? They’re working on it. Where they’re, their teams are all doing, they’re highly trained and they’re doing what they’re supposed to do and use, like as the pilot running an autopilot are just there to make sure we’re still on track and it’s all doing well. And yeah, you got to sit down, you’ve got to do your drilling out, do your thing. But that’s. That, to me, is the.

42:20
Dr. Rick Workman
My 44 years now of experience tells me that’s something that most dentists still haven’t seen, that the highest level, lowest stress, highest level of productivity is when you, when the system is running the office, you design the system, you always are in control of the system, but you put that system in, the system runs the office, you run the system, and things just work. People show up, people say, yes, and you do your work. And that’s a message I’d love for every dentist in America to understand.

42:51
Dr. Murtuza Shah-Khan
That’s fantastic.

42:52
Dr. Mustafa Shah-Khan
Well, thank you again. We really appreciate it. Thank you for being part of this podcast and for everything that you’ve done for the profession. We kind of always say that dentistry is a hard profession. You know, together we can dare to make it a little more simple.