S09 E01: The Howard Farran Experience

[MUSIC] Okay, welcome everybody. It's the two reds podcast, myself, Ashley Later. Now, there are two things that we are incredibly excited about today. We're recording this on the 19th of January, 2026. The second thing that we're super excited about is our guest today, because we have, and I know he's going to roll his eyeballs and raise his eyebrows when I say this, we have a living legend as our guest on the podcast today. The first thing that we're excited about is the Manchester United game last Saturday, 2-0 defeat of Manchester City. Ashley, you were at the game. How did it feel to be in that stadium last Saturday? Words, bouncing Chris, absolutely bouncing. I think it's one of the best games we've seen at all traffic for several years. I'll be dining out on that one for a long, long time Chris. I'll be dining out on that one for a long time. It was amazing, an amazing day. No. It's just like-- Much as we would like to spend, much as we would spend the next 15 minutes talking about football, I am cognizant of the fact that it is 20 past five in the morning in Phoenix, Arizona, which is where we bring in the warm, the only Howard, Farron, Howard, good morning, how are you? Good, and I'll tell you what, the neatest thing about lecturing around the world is getting to be in a-- lecturing in a country that was in the World Cup. Their fans are 10x anything I've ever seen in America. Like right now we're in the playoffs for the Super Bowl, for our version of football, American football. I look at those fans and it's like, okay, they're so excited. They're jumping up down the screen. They have no idea what it's like to be at a soccer match when they're in the World Cup. The fans are losing their mind and Americans don't know anything about how they lose their mind at a football that is soccer in the World Cup. That's a very quick story. We had some Americans over. I talked them to a game last year and I talked them to a pub just next to the stadium about half past 11 in the morning and it was a three o'clock kickoff. And they were-- they came to me and we've got the tram into Manchester and they were saying, you know, Americans are very passionate about football with fanatical and stuff. And I just said, well, you know, come to a soccer match. Well, we call it a soccer match in England and see what you think after. And he said, it's got apps. It's absolutely at a different level. A different-- it's a different level. So yeah, so yeah, if you see-- Howard, if you see us both smiling today, think we'll be smiling for a long, long, long time. It was like the Derby. It's like the biggest game in Manchester. So we've city played United and we won. So yeah. But let's move on. Howard, it's an absolute joy to have you up with us as a guest today. I'm hugely grateful for your time. I know that you've got to stupid o'clock in order to be with us. And I really, really want to dive straight in because it's not often that you get to say that our guest today needs no introduction, but there is nobody on the planet who does not know who you are. And there is nobody on the planet that does not know the contribution that you've made to the world. A dentistry over decades now. And I've got one massive question that I want to ask you today. And it's so important. And that question is, how do you see the world of dentistry in 2026? How are you seeing the people that you work with adapting to the changes that we see in the landscape? I'd love Howard Farron's perspective on where we all are in the world today, please. Well, it's an honor to be on your program. You know, I've been big fans of both of you guys forever and a day. You know, dentistry, you know, I mean, you know, it's been around forever. I think it's not. I mean, they got dentistry documented, you know, 9,000 years ago. Ever since I got it at an old school, there's always been a boogie man, a bad guy. There was a capitation instead of a, you know, insurance and, you know, the HMOs, the insurance companies have changed a lot. You know, so I just want to say, first of all, that dentistry is not going anywhere. I mean, it's going to be here literally 10,000 years or now. In fact, it was about, and they now they've traced back the cause of a streptococcus immune tans back to 12,000 years ago. In the fertile crescent when streptococcus immune tans was transferred from a cat to a human, and they've genetically proven that. So if you're ever deciding whether you want to cat or a dog, you got to get a cat because if it wasn't for cats, we wouldn't even be talking today. So say hello to your kitty cat. But yeah, it's interesting. Corporate America has got into dentistry now in a big way, but still it's only 20% of dentistry, 80% no matter how many, how you measure whether it's in dental supplies, practitioners, four out of five are still single owner, operator, Dennis, and the DSOs, you know, they've come a long way, but you know, they still have a long way to go. I mean, I still am not comfortable with non dentists owning a dental office. I think having an MBA from Arizona State University, I mean, we've seen this in Boeing, where Boeing was the most reputable company in the world. And then out of nowhere, Wall Street decided that instead of having the greatest aeronautical engineers run the company where the aeronautical engineer would walk into the room, and all the young workers would be so excited that they're working with this guy, and they built the best products. And then they went to Wall Street, and they moved the headquarters from Seattle, Washington, where they make the planes to Washington, DC, where they're selling them to the, where all the money is in government contracts. And it only took three years, and their planes were falling out of their sky. Their stock is nose dive. Boeing is not even a reputable company anymore, and it's all because an MBA was running an aeronautical engineering company, and it's still, I can't believe that I see DSOs in your country, and around the world in America that are ran by people who aren't even dentists. I mean, so the dentists are finally getting woke to this deal. Like in the state at the state level, it's like 45 by the 50 states that pass laws that you can't own a dental office without being a dentist, but the lawyers, you know, they're lawyers and liars about half of them are actually truth, liberty, injustice, and half for liars, and we'll do anything to get whatever they want. But the lawyers and liars, you know, the dentists need to get the lawyers to check and balance the, the business DSO liars. And so, you know, it's a long way to go, but I think that, you know, in the insurance companies have gone backwards since I got a time. When I get out of dental school in '87, you take the biggest insurance company in Arizona, which would be Delta, dental, Arizona, everyone on that board was a doc, it was a dentist or a specialist, and they were all the best specialists. I mean, you would have sent your mom to anybody on that board, the Perry Donuts, the oral surgeon, the prosodontist. I mean, they were just the best. And then they decided, well, we need someone to represent the people. We need someone to represent the patients. So they got rid of all these stellar guys who would never sell out and replace them with a bunch of, you know, just lay people. And, you know, if you got a toothache and you want to go to a layperson, then, you know, knock yourself out, go to layperson dentistry and get a root canal. But, you know, so the government is just everything all about the price that he's saying now, Howard, because all these people have been replaced. Everything's about the price, price, price. Well, well, it's the insurance companies wanting to do, you know, again, the insurance companies aren't ran by dentists. It's about them wanting to go in a direction that a dentist would not sign off on. I mean, you know, just, you know, just, just, so, so it's got out of sync. But, you know, we, we still got, we still got a business where if you come out of school and you go where you're needed and you're an owner operator and you set up your practice, you know, you're, you're still doing good. There's a kid up the street for me who went in front of my and Bob Sunberg's old practice, and he's on a like baseline and 48th straight. I mean, he's literally two miles down the street. It's not a nice, it's, it's, it's a lower income area. And he set up his practice and, and he decided to not go any insurance. And he worked for some DSOs and he got some experience and some clinical time. And he's crushing it. He's just crushing it. I mean, I, I just think that, um, you know, there's, what, when it comes to, you know, if I was going to sell you a phone, I mean, he's going to the store, do you buy it out in? I mean, you could buy your iPhone out of a kiosk. But when you're going to a dentist, they're going to do surgery on you. I mean, the difference in dentists and physicians are very It's okay, simple. Only about 10 seconds. 10% of physicians are ever gonna operate or cut or do any form of surgery on you. And in dentistry, that's all we do. All of dentists are surgeons. We're dental surgeons. And then I gotta touch you. I gotta lean you back in a vulgar position where you're on your back, exposing your neck, which is the most stressful position for a human being 'cause humans always died for millions of years with a carnivore clamping down their neck. Cheetah and the jungle and operate on their tooth. It's a very serious relationship. - She questioned that. 'Cause I think this is a critical place to actually just pick up here. You've got one of your pals then, he's open his practice in Arizona. He's not doing any insurance. And all your patients will have their own insurance policies to cover them for dentistry. This guy's crushing it. What sort of things is he doing then in that practice to crush it? If you were to, 'cause that would be, that could be our client listening to this podcast today. - Yeah, he's just doing it his way. I mean, he's doing great marketing. He's doing even better financing when they come in. The first thing that he does is he's working with a finance company. So, you know, the insurance company, you know, they have their short list of procedures they're gonna cover for a small amount. And most people need far more dentistry than that. And they want the implants, not the crowns and bridges. They want it all. So he just says case dentistry where he presents the whole mouth and then makes it affordable. You know, look at the cars. I mean, the average car, the sublimine, the average car in the United States sells for over $50,000. And everybody you know, the average data shows that Americans in their lifetime will buy seven new cars in their lifetime. So here, your patients are gonna buy seven brand new cars in their lifetime from about $60 to when they die at $80,90 or $100. And yet, every dentist you talk to is never sold one treatment plan for the price of that car. And then in that same zip code and that same building, you got dentist that will take up an elderly lady with dentures and they don't fit and they're miserable and do a $50,000 all on four case with four implants on the lower, four on the upper, two fixed bridges. And the lady loves it just like she loves a new car. But if she goes to every dentist and manchester, none of them are gonna present the $50,000 all on four. And none of them are gonna have financing available. And none of them have sold a $50,000 case in a life because they live in this bubble of fear that, oh, they're only gonna do what the NHS says. They're only gonna do what the insurance company pays for. And even though she pulled up at a nice, Honda, nice Toyota, nice Volvo, they're never gonna, they want a nice house. They don't wanna live in a poor flat in the wrong part of town. They want a nicer house, they want a nicer car, they've got on cruises. How far have they traveled to go to a soccer game? I mean, but then when it comes to their body, they're like, well, I'm a victim. I can't spend any money on myself. If the government or my employer, and the other thing you have to realize is that we get in this bubble. When I gave my first lecture, I had no idea that someday that would mean I would get to lecture in 50 countries around the world and take my four boys. I think each one of my boys has been to 30 countries with me, lecturing. I'll never forget going to London for the first time because I was with Greg at that, I said, blue is mine. I mean, unbelievable. But you know what, there's 280 countries, only with 50 of them. And with, you know, out of those 280 countries, only 20 of them have dendling churns. And when you go, when I was lecturing in China, I was the keynote speaker in China. And these poor Chinese people were coming up to me, these Chinese does their sand. Okay, well, if you, if you buy Coca-Cola, and you eat chocolate, and you have cavities, why would your boss pay for your registry? Why would you expect your government to pay for your, no, that's just crazy. I mean, you can't even explain dental insurance in China. I mean, that was the number one question, why the hell is the government and your employer in charge of you deciding to buy Coca-Cola and Hershey's chocolate bars in Brazil. And they leave you like, really? So you don't brush and flush your teeth, and your boss has to pay for your root canal. How did this happen? And it happened because during World War II, the government said there were price freezes, and you couldn't raise, you couldn't wait, they froze wages during the war. So the unions got their lawyer liars, and they said, okay, we can't negotiate wages. So how about we just get them to cover dentistry? And that was the birth of dental insurance up in the Washington, Oregon area. And I mean, it took a World War to start dental insurance. And we gotta get this mindset that you gotta treat your body the same way you treat your car. You want a new car? You wanna take care of it? You wanna get oil changes? Look at all these people who have four world drive cars in America. They got these four world drive cars, and 95% of those people will never take their car, four wheel driving out in the desert. And you know why? 'Cause they don't wanna hurt their car. They don't wanna hurt the suspension. They don't wanna get it dirty or a dent. They bought it with their own money. I know my friends with kids. Buy your kid a bicycle, and when he comes home, he always leaves out in the front yard. He doesn't even put the kickstand down, and it's always getting stolen. But if you make that kid go on at 50/50, he's got skin in the game. He parks that bike in his bedroom. I mean, he's always wash it in, wax it, and you're trying to take the skin out of the game, the teeth out of the game with the human body, and it's insane. And you're seeing this big shift where people are getting woke to. And by the way, I was in Phoenix, Arizona, which had, you know, there's now 2,800 different. And then I wanna tell you something also about the corporate dentistry that people I think are missing, is there's 2,800 DSO corporate dentistry. But only like three of them have almost 1,000 offices. Those are big heartlin, your ass, and your Pacific dental services. The median size of corporate dentistry is four to nine locations, and most of them are about it four. And the reason we start at four is because, you get a guy with the brains and intelligence and ambition of you two guys and me. You have a successful office. You can start another office and muscle it. I mean, I opened up, when I opened up my office, I opened up my second one four months later and was just muscling both of them because you got the energy, you got the drive, the passion. But when you go to number three, that's the graveyard. That's where everyone goes to die because you can't do three and you don't have the systems and they all die at three. So if you survive three and you pop up at four, four means, oh my gosh, you have some systems in place. You actually have some systems. And that's what DSOs are buying. They're not buying dentists. They're buying dental practices that have systems. But they're really, really, they fall into this bad reputation of the big conglomerates that are trying to be coast to coast, like Walgreens or something like that. And it's because they're in a small town. Maybe they're in a town of like 25,000 or 100,000. And they're on the south side and they realize that if they had one on North, South, East and West, then they could bring in a professional management like they could bring in a marketing person. And that marketing person, I mean, look at the town. Like it's not cost-effective, really, for you to have a billboard on the main highway that goes to town. But if you got four locations, you should have one at both ends of the town, you know? Radio, radio and television is actually very, very cheap. It's very expensive to buy an ad on TV during the big soccer game. But 99% of the time, and we saw that with clear choice where they were doing these 30 minute infomercials. And they could run those, couldn't for like $50 for half an hour on all these odd channels in the middle of the night, and all this, like, well, people are doomed scrolling their TV. There's, and it stops. And it sees Dr. Chris Barrow taking a lady from dentures to implants. And his assistant Ashley Ladder is showing how he makes, Ashley Ladder makes the bridge in the own office. He's a ceramic. And they're just crushing it. And then you can bring in an accountant. You can actually go from calling up your CPA to ask him how much taxes you owe to actually an accountant in your own office. I mean, you know, when I hired my first accountant in my own office, it was actually a bookie where I couldn't afford a CPA the time. And I hired her and I said, OK, I just want to know one question. When I go into this room and I do a filling for $250, I need to know, did I make $50 and $12 after two days. that or did I lose $5 and I swear to God it took me and her. It took me and Lori probably a year or two to figure out all that accounting because you had, we had QuickBooks accounting on one computer and then we had our practice management software which was open dental and they're not connected. I mean, I mean dentistry is designed to have a bipolar schizophrenic metch- and management information system. And they both, they don't like each other, they don't connect, they never communicate. And so in fact, I had to go back to MBA school. I graduated in '87, I went back in '98 and he says, "Well, why the hell do you wanna get an MBA?" And I told him my problem and he goes, "Are you serious? They don't connect. Why wouldn't that be one system?" And I'm like, "Hello." So I had to go to MBA school for two years to learn how to connect those with Excel spreadsheets and all this crap which AI is gonna be solving. Probably I'm sure within a year, everybody's gonna have a dental AI management information system that goes into that. But anyway, but when I was practicing, I sold my clinical practice today as dental and Phoenix Arizona when I turned 60. And I only did it for one reason and that is, I admit it, I lost my hair. But I lost, I couldn't see good enough. I mean, I went from 2.5 lutes to 3.5, I finally bought a pair of tens and I had a headlobe and I was doing a molar ruckian down. And I realized, you know, the only thing every major religion has in common as far as the wording where it's almost plagiarism is the gold, rural treat other people like you wanna be treated. And I said to myself, I said, "Howard, would you want you to be doing a ruckian out on number two on you?" And I said, "Hell no." And I, and that's what I realized that if I had a tumor in my brain and I had to have a brain surgeon, I would want some kid who graduated last week and I would want some 63 year old man like me who needs readers to read his iPhone when he's got the font turned on large. But up until when I sold my practice, we had many DSOs and I loved them. You know why? Because dentistry is about connecting with the patient. It's about building trust, lean back, open wide. I'm gonna perform surgery on your mouth. And they would all tell me they go, "Well, I went to this and it'd be a DSO." And they said, "They told me I had five cavities, which I thought was weird because I had had a cavity in, you know, 10 years, 20 years." And then I went in to do them. He wanted to do three on the ride and come back to the show. I went in to three on the ride and he no longer works there. So then they gave me this new dentist. And he said, "I didn't have five cavities. I had four." So I said, "Okay." So he did two. And then I came back to do the other two. And then this other, he was busy with another patient. So they gave me this other dentist. And he said those two, you know, it's all about a relationship. And, you know, and so the main thing I would say to the DSOs is when you look at these DSOs, when you meet any kid that's been out of school for five years and you say, how many jobs have you had in your first five years? They always say five. If they've been out of school four, they say four. They've been out of school four. I mean, good God. If they can't learn to slow down the employee turnover, I mean, if a dental, and a lot of it's because the CEO is not a dentist and then the office manager is coming into you a doctor and saying, "Well, we looked at your X-rays today and on your recall system and you have eight patients and we see 14 crown opportunities." It's like, what the hell's a crown opportunity? And it's a big old M-O-D-Malgam and you got this office manager called them crown opportunities. I'm sorry, I miss lecture in dental school about crown opportunities. What the shit is a crown opportunity? And then it gets even worse. It gets even worse. So I'm going to tell you something succinct about these DSOs, these office managers. You go into the greatest franchises in American history. McDonald's and your Chick-fil-A. They only let the franchisees own one location. They want you to fully commit to one location. And then you look at the shitty franchises like Subway and Burger King. They routinely have people that own six, eight, nine Subways. Well, you can't manage six or eight, nine Subways with one person driving around all day long. And that's why there are food qualities and consistency. Their bathrooms are dirty. Their staff turnover is high. I mean, most of these McDonald's franchisees started working in the McDonald's when they were 16 years old. And they were there, you know, I mean, it's just an amazing difference. And you walk into these DSOs and you'll meet an office manager and she runs four locations. I mean, how do you run four locations? Are you, I mean, I've heard of bipolar skits. A friend of you have four personalities. Are you in four locations at one time? It's insane. So I tell these Dennis, they come out of school. And then another big part of it. Sorry, I'm running on, but another big part of it. Chris, it's short serve for the next question. Sorry. How my only concern is that I have to leave here in precisely 10 minutes. Okay. But I want to know the answer to a second question, which is, what are your optimistic and confident about in 2020, 16 Denses true? Oh, man, so many things. I think getting back on the right track. I think like buying a practice. I mean, when I got out of school in 1987, the dentist realized that, you know, this is my baby. I'm turning over all my patients and trusting someone's care. And they would carry the financing. They would sit there and say, I'm going to sell my practice for, you know, say, say $10. And I want you to, you to go get financing for five and all carry the other five. Well, then, then business got involved and said, oh, no, you don't carry money. We're going to roll that over to the big banks. So they just sell it to the highest bidder oftentimes a DSO. And the DSO comes and embies this thing and does what they do with it. And I think it's a returning to a roots. I think it's a returning to like, you need to come out of school and you need to work for a mentor. And you need to find many mentors because the doctor that you're working for should not be, I got to be, you're a root canal mentor. That should be an end of the honest, you're, you're implant. That should be a period on a sorrel surgeon. You know, it got, but he's your mentor and the fact that he's had this practice for 30 years. And his staff turned over. I mean, I mean, when I saw my practice, the new girl, the new hygienist that we just hired had been there eight years. Everybody knew her name and you know, all these relationships. And I think it's about a, and then I'm really optimistic about look at learning. When I opened up in Phoenix, Arizona, there were no dental schools. I had to get on an airplane and fly to learn anything about dentistry. When I wanted to learn implants, like I call a mesh, I had to fly from five. I had to fly from Phoenix to Pittsburgh. That's a five hour flight. I did it at seven times on three day weekends to learn about implants. Now you get online. I mean, dental down at 750 courses online where the price of that is less than the cab fare from the airport to your hotel. So I think the information is now zero cost. I think there's no cost and continued education words when I got out of school. It costs an arm and a leg. I think that the consultants, I mean, well, here, but. I could go on and on forever and today, but I'm optimistic that dentistry is not going away. People want to go where the doctor knows their name and they trust the doctor. The technology coming out in AI, I think AI is going to be a revolution and everybody's got the AI thing backwards. They think AI is going to replace their job. It's going to take their job away and the first one they aim that the right flat was oral and max low facial radiologist because these machines can read them better faster. And what happened to oral to to radiology in the medical world since they come out with AI. They now have actually hired more radiologists. Why? Because reading the image is a task. The purpose of reading the image is to treat the disease. Now the AI can read it instantly, put it on all these things. The radiologists can say, oh, that's just an, uh, uh, a blemish. That's an error. That's normal. And so, so now the prices come down when I, when you're, when you're at oral and max low facial radiologists and you can only read 10 X raise a day, your price is as high. Now that you can have AI and you can read 20 a day, the prices come down. So now more people are getting routine. They're getting more customers from around the world, uh, American, some of them are having them read in India and Pakistan and so because there's so much more oral radiologists doing so much more, so much more accurate for less money. And so, the oral radiologists are busier than they ever been and what's going to happen is before AI almost nobody had. ever had a dental x-ray or a panor or whatever read by an oral or a max so facial radiologist specialist. I mean I bet it was less than 1% and now I bet in 10 years it'll be it'll be routine and the consumer can get second opinions. I think what I'm most optimistic about is AI. I think that it's going to be you know like I look at my if you look at my phone the new iPhone 17 when you turn it off it doesn't go all the way dead it still has you know I can still see the time and there's my widget for chat gp and I talk to chat gp hello chat gp and and I think that they're going to talk to their practice managing information system they're going to say hey is my overhead high and instead of running a bunch of reports I think the AI is going to say well your overhead is 68% and the average genus is 64% and then you're going to say well I you know I hear that the insurance I'm losing money on insurance and it's going to say well you subscribe to 13 different insurance plans and you have four insurance plans where you definitely lose money on everyone if you just drop these four insurance plans you would stop losing money and then it could walk you out so and then you're going to get this information but here's the thing I know how to make a pizza okay I'm a doctor of dental surgery I know how to make a pizza but I don't want to make a pizza I want to go to your restaurant and have you make the pizza and sometimes I want you to deliver to my house it's going to be the same thing with dental consultants I remember when I hired my first dental consultant they they came in my office I had 5,000 charts it's like when she says well how often how many of your patients have been in in the last six months have their teeth clean and we looked at all those charts and we said well you want to go through all the charts you said no let's take one chart and then we'll take a ruler and we'll measure a foot and we'll take that chart and we'll just go through and we'll do a sampling survey so she took like 50 charts at a 50 feet of charts and I mean now everything's digital AI is going to tell you what the problem the solution is but I think dental consulting is going to explode because then we'll be able to instead of you having a a can presentation for every dentist that you talk to you'll be able to walk in there and just like an oral max low facial radiologist you'll be able to diagnose the practice they okay this is exactly what you have and let's go through this together let's join hands and let's go through this so I think amazing future thank you now I am having chest pains listening to you and the only reason for that is because I have another webinar which is starting in seven minutes from now and that's actually tragic because I could listen to you for another hour if not longer because what you've got to say is fascinating now unfortunately I have to go and I'm really upset about that Howard if I can have 10% of your enthusiasm 10% of your energy 10% of your experience I would be a very very happy man and thank you for sharing a hundred percent of it with us well we'll have to do it again someday it was an early program please may we go please may we go for part two please may we go for part two all right Howard thank you I know you've got a purly for this I really appreciate it I'm devastated that we did start a little bit late gotta go love what you've got to say you're an absolute inspiration thank you (gentle music)