Andy Goldsmith

DDS, DICOI, FIALD

Dr. Andrew Goldsmith

Become a FAST Manager!

AndyGoldsmith - 25/10/2017

Why should we motivate our employees?
They should be motivated by their paychecks and grateful that they have such a good job; or should they?
Unfortunately, there are many myths in the minds of managers everywhere. It is time that we recognize our staff for what they are; our team. The members of our teams need to be appreciated and motivated.
And a simplified cents, motivation maybe what prompts a person to perform a task. Therefore by motivating staff members we are increasingly productivity and patient care.

I recommend becoming a FAST manager©!

The FAST approach adds a twist to some leadership styles. The method is broken into four fundamental groups: feedback, appreciation, shared goal setting, and team. Further, the word itself, fast, represents a need in modern society for an efficient means of managing personnel.
FAST stands for Feedback, Appreciation, Shared Goal Setting, and Team.
and this video we are going to go through Feedback.

What follows are 23 rules to follow to help you build the DNA of your ideal Practice, part of the Process 23 teaching series that I am excited to share with you!

Feedback

Feeding back success builds positive self images, improves rapport, and more than anything else increases chances of similar positive behaviors occurring in the future. ~BF skinner

Feedback is in essential part of our lives. Fine motor skills are dependent upon feedback. In sports such as Golf, we rely upon instant feedback to determine how we can alter our swing. However, we cannot always see the effects of our behavior. Therefore feedback must be given from another source. Feedback from the dentist helps to preserve the harmony that is rudiment in the sensitive dental setting.
First of all, feedback does not have to have a negative connotation. Use opportunities to give people feedback when they do things well!
As a matter of fact try to balance your positive feedback with your constructive feedback.
*IF POSSIBLE: Set-up the moment preemptively as a teaching opportunity

Here are the 8 Process 23 Rules for Feedback:
Be solution oriented and positive
Don’t be a hater! do not approach the conversation in a mean spirited manner
Put Quality into the conversation: Research conducted by neuroscientists at Columbia University found that people only apply feedback 30% of the time, so take the time to apply feedback with quality.
Look for confirmation and understanding
Be specific – You can’t be ambiguous with people – e.g. you cant say you need to speak-up more often – instead say – Lisa, you are sharp! You have a lot to offer this team, you’ve had a wide range of experiences over 15 years and your opinion is very important to me, so, I am challenging you to contribute at least one thing during our team meetings.
Be FAST – Feedback is best received when it is immediate. The brain is hardwired for immediate feedback. If you wait weeks or months to tell somebody how they are doing, it will be confusing and creates misunderstanding.
BE firm and succinct but not mean.
Begin and end with praise – Try to sprinkle as much positive into the conversation as negative.

Appreciation

The need to belong and to socialize is a powerful motivator ~A.H. Maslow

Do you want a team that is more engaged?
Do you want your team to be more loyal to you and the practice?
Would you like it if your team was just more motivated or more productive?

 

I am often asked, how can I get my team to do more or to treat this like their practice?

This is the secret sauce and its called: appreciation.

The results are in and the fact is that most important factor related to job satisfaction is appreciation and not money. Research conducted with Harvard Medical School and Wharton School of Business found that people who received a message of gratitude were up to 50% more productive.
A Psychology Today article discusses which areas of the brain are affected by appreciation and gratefulness. The hypothalamus, which controls basic bodily functions such as eating and sleeping, and dopamine, the “reward neurotransmitter” are heavily affected from feelings of gratitude. Alex Korb Ph.D writes,

“Gratitude can have such a powerful impact on your life because it engages your brain in a virtuous cycle.”

Showing gratitude can increase a person’s wellness, increase better sleep habits, increase metabolism and lessen stress. This directly impacts work results and employee interaction. With employee appreciation, you’re not only boosting performance and engagement, but the employee’s well-being and health.
If your team feels genuine appreciation, they will serve the practice and more importantly your patients better.
Appreciation is best received when it is combined with specific feedback. When a person is observed performing a desirable task they should be reinforced.

Here are the 6 Process23 Rules for Appreciation:

Be Authentic
Praise the person
Praise the behavior
Be specific
Give them surprises – Have an extra long lunch for your team and get pedicures, invite a massage therapist to give everyone massages, buy them small gifts of appreciation or simply thank them out of the blue for all they do.
Let the Team reward and praise each other

Shared goal setting

Not failure, but low aim, is crime.

~James Russell Lowell

Do you want a team that has goals to be better, faster, more productive, more caring, more effective and eager to help you build the practice of your dreams?

 

Goals empower your employees and give them something to work toward. The manager can offer direction and feedback for the goal-setting process, thereby, meeting the needs of the staff member and the manager. The goals are custom.
They are specific to the individual and they are beneficial to the practice.

Employee goals can include earning a promotion, gaining more responsibilities, improving more skills, learning a new procedure, gaining more patients for the practice or earning a practice bonus. When a employee creates goals, YOU can show support by helping her develop an action plan, creating deadlines and celebrating each victory.
It is also ok for you to work on financial goals with your team too. If you let them know that you care about their long-term success and well being and help them formulate a plan, it will go a long way in enrolling them into being more of a team player.

The key of the manager is to think about what the employee really wants to accomplish in the context of work and life. Stewart D. Friedman, Practice Professor at the Wharton School says,

“If I account for the interests of the whole person, not just the work person, I’m going to get more value from them,”

Here are the 9 Process 23 Rules for Shared Goal Setting:

Be specific and realistic
Evaluate previous goals
Help them connect their goals to the goals of the Practice
Set long-term and short-term goals
Set goals into manageable goals and stretch goals
Establish a Strategy for meeting the new goals
Ask them if their behavior matches their goals
Conduct the meeting in a private area without interruptions
Set a specific date for the next meeting

“Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results.” –Andrew Carnegie

I am a practicing dentist too, so, I understand the rigors of each day and how it can be busy and hectic. I understand what it is like to own your own practice. As a matter fact at one point I owned a practice with a partner that collected over $3M a year and at one point had 25 employees. I have also worked with with a private equity company in helping to establish one of the largest dental groups in world with the chief focus of empowering independent practice dentists. I have also worked with manufacturers and dental suppliers on behalf of other dentists, so I understand the complexities of our profession and the impact that we make.

In my Process 23 teachings I go specifically through 23 ways to build the practice of your dreams. Process 23 is about helping you build the DNA of your business. So, every lesson is concise and to the point, there is very little fluff. The videos are short but power packed so that you can get back to caring for your patients. In addition to the videos, we have included spreadsheets, graphics and interviews with other experts for download.
As I said, my intention is to help dentists understand business better and to build practices that help them thrive.

Now, on to part four of FAST manager©!

Team

To this point workers have been identified as employees or staff. Change seasons!
These people are the integral members of your team. They are the engine in your car, and without them, the car simply doesn’t move.

To build a great team takes leadership. In general, there is a lack of leadership in dentistry. The reality is that it is hard work and often dentists are tapped-out

I recommend reading about leadership and great leaders. People like John Wooden who led the UCLA bruins to 10 NCAA championships in 12 years and created the Pyramid of Success. Or Jack Welch who’s leadership helped GE grow 4,000% during his tenure.

What you will learn is that you must be on the road to becoming a leader in order to build a great team. This starts with a higher level of self-awareness and a sense of truly knowing yourself which is of course, a journey.

Also, to build a team you will also need to get to know your team. The adage that they wont care how much you know until they know how much you care holds true here. – Get to know the members of your team.

Hire talent for each role. The chain is only as strong as its weakest link. Evaluate your team constantly and makes adjustments in roles if necessary. Develop your team and continue to provide Feedback, show Appreciation and engage in shared goal setting. This will help create an environment of mutual respect and comrade.

Having a great team will make or break your practice. But it is up to you to engage and be the leader for what you want to see.

I hope you have obtained value from this post.  If you are ready to transform your practice, sign-up for Process23 today. As I said, I am confident that it will more than pay for itself and it comes with a 7 Day money back guarantee so, theres no reason for you to delay getting started.

at Process 23 we help you build the DNA of your business.
Thanks and make today great!

 

What makes your Practice Unique??

AndyGoldsmith - 23/10/2017

Most companies, in seeking to differentiate themselves, focus their energy only on their products or services. In fact, a company has the opportunity to differentiate itself at every point where it comes in contact with its customers—from the moment customers realize that they need a product or service to the time when they no longer want it and decide to dispose of it

Brand Loyalty by benefiting the patient and keeping the patient

No Perceived Substitute – Creating a Unique Selling Proposition

“Your customers are only satisfied because their expectations are so low and because no one else is doing better. Just having satisfied customers isn’t good enough anymore. If you really want a booming business, you have to create Raving Fans.” – Ken Blanchard

The patient has an augmented perception of your services and with today’s market focus on information, the patient may push you in order to understand technical aspects, durability, market findings/ratings, techniques, therefore, the more you differentiate, the more you will need to justify your position

First: Map the Consumption Chain – Which is your Patient’s total experience of your services

Patient Calls the Office
Any Follow-up from the office prior to the first visit
Patient walks in the door
Patient walks to the front desk
Paperwork
Patient Waits
Patient brought back
Seated
X-rays
Exam
Treatment
Patient Walks to front desk
Patient Pays
Patient Leaves
Follow-up

Second, Analyze Your Patient’s Experience
Now work through your findings as a team and make the entire process exceedingly better

Sometimes you will need to add employees. E.g. We added a
Sterilization assistant in our office which freed-up our assistants to spend more time on the patient experience. We also added a Patient Concierge to focus solely on creating exceptional patient experiences.
You may be thinking, I can’t add additional overhead which is what I thought as well, but, the marginal benefit of adding labor exceeds the marginal cost which is the cost added by producing one additional unit of service.

1. Profitability is stimulated by loyal customers (Heskett et al. 1994)
**Heskett, J.L., T.O. Jones, G.W. Loveman, W.E. Jr Sasser, L.A. Schlesinger. 1994. Putting the service-profit chain to work. Harvard Business Review 72(2) 164.

Take the case of Blyth Industries, a candle manufacturer. By differentiating and redifferentiating its products, Blyth has been able to grow from a $2 million U.S. producer of candles used for religious purposes to a global candle and accessory business with nearly $500 million in sales and a market value of $1.2 billion.

Consider the problem of differentiating an everyday consumer product, such as a toothbrush. For many people, brushing is a ritual to which they pay relatively little attention. As a consequence, many brushes are used well past the point when their bristles are worn and are no longer effective. Toothbrush maker Oral-B discovered a way to capitalize on this widespread habit. The company, by introducing a patented blue dye in the center bristles of its toothbrushes, found a way to have the brush itself communicate to the customer. As the brush is used, the dye gradually fades. When the dye is gone, the brush is no longer effective and should be replaced. Customers are thus made aware of a need that previously had gone unrecognized. So far, the idea sounds like something out of Marketing 101. What gives it particular value is that the need can be filled only by Oral-B’s patented process. The company turned differentiation into a competitive advantage.

Ways:
24 hour phone lines
Offer your product in areas where others do not
Making the search process less complicated,
more convenient,
less expensive, and
more habitual are all ways in which companies can differentiate themselves.

Can you make the selection process more comfortable, less irritating, or more convenient? Look for the ideal situation, in which competitors’ procedures actually discourage people from selecting their products, while your procedures encourage people to come to you.

What is the customer really using your product for?
How is your product or service paid for?
What do customers need help with when they use your product?
What about returns or exchanges?
How is your product repaired or serviced?
Analyzing Your Customer’s Experience
Apply the 4w’s at each link of the consumption chain

CarMax and AutoNation “sell” cars by letting customers create their own selection process.

 

What makes you choose one company over another? Why would you use FedEx over the USPS? Why would you stay at a Four Seasons versus a Motel 6?
Why would your patients choose you over some other practice?
Go discover, Create and Differentiate!

Quality is Job 1!

AndyGoldsmith - 23/09/2017

In a recent article in Dentaltown titled 5 Reasons You Should Purchase Quality Hygiene Instruments, I articulated my thoughts on why you should not skimp when it comes to hygiene instruments or any other instruments for that matter.

First, let me say that I did not receive any compensation from anybody to write that article nor was I solicited to write the article.  It is simply my opinion that our number one responsibility is to perform quality work for our patients and frankly that should go without saying.  In my experience, quality tools and instruments help you to perform your job with consistent quality.

In my opinion, there are 5 reasons that you should purchase quality instruments for your hygienists and yourself: durability, reliability, feel, long-term use, and productivity.

Durability

In the 1950’s, W. Edwards Deming helped revitalize the Japanese economy with his enduring economic principles.   Deming’s teaching became the impetus for pulling Japan out of the ashes and making them the second largest economic power in a span of only ten years.  One of Deming’s primary beliefs was that:

higher quality, more durable products allow you to provide better service. 

Durability of instruments is important for the rigors of dentistry.  When we purchase cheap instruments, they have a tendency to break, dent, or bend.  How frustrating is it when your forceps tips no longer meet together or when a suture needle spins in the needle holder? What about when a 1/2 Gracey becomes an 11/12 because it now has a bend at the end or has lost its edge altogether? Durability is a very important asset that we should look at when buying quality instruments.

When I was tasked with finding the best deals for hundreds of dental practices, I searched the globe for the products that provided the best value.  About a year ago, I had the privilege of attending the AEEDC Dental show in Dubai.  While walking the exhibit hall, I was astonished at the number of dentists purchasing cheap instruments. When I asked dentists why they purchased cheaper generic instruments, I heard responses like, “it’s cheap so when it loses its edge I will just throw it away and get another one”, or, “I know they are not as good but I only use it to scrape calculus off the teeth”.  This reasoning appalled me.  I know first-hand that quality instruments cost more, but, the value of an instrument that breaks adds inefficiencies to the practice that cost time and money and may even cause harm to our patients.  Think about what a instrument goes through in its life-cycle, overuse, cleaning, handling, sharpening, sterilizing, etc. and when you pick-up that instrument, you want it to perform the same way it did the last time you used it. Durable instruments last longer and perform consistently throughout their life-cycle, especially if they are housed in a cassette.

Reliability

A well known telecommunications company created a digital test board that they installed millions of in the 1990’s.  Only 50% of the boards proved to be reliable and the company spent millions of dollars on diagnostics, service calls, repairs, and replacements. By the early 2000’s, the company was bankrupt.  Reliable products are crucial to the success of a business and it is an essential quality in the instruments we use to perform our trade.  Reliability with instruments is important because when you pick it up, you want to be sure it works for its intended purpose.  For example, If the instrument is a specialty instrument like a scaler, you must know that it will maintain its edge and remain sharp.  However, so often, hygienists spend their time sharpening an instrument with something like an Arkansas stone.  Do you pay your hygienist to treat patients or to sharpen instruments? What if your hygienist was elevated from the tedious and important task of sharpening instruments? I want my hygienist to be treating my patients and spending time with them building rapport.  In my ideal practice, my hygienist would never be taking time from our patients to sharpen instruments.

According to the research study, “The Effect of Multilayer Filtered Arc Coatings on Mechanical Properties, Corrosion Resistance and Performance of Periodontal Dental Instruments”, the authors wisely articulate, even if the sharpening procedure takes a few minutes per instrument tip, the labor cost will outweigh the replacement cost of the instrument after only a few sharpening sequences. This does not take into account the loss of productivity by the dentist or hygienist. The constant re-sharpening of instruments has another, possibly more sinister, side effect. Every stroke of the sharpening stone removes a small amount of metal from the instrument. With repeated sharpening, the thinner parts of the instrument can become sufficiently weak to cause breakage during function creating a danger of the piece of metal becoming imbedded in the surrounding tissue. Many instruments (especially scalers and curettes) are designed to be bulky in the beginning to minimize future fractures. In fact, I was curious about the effectiveness of sharpening and found a recent study by Lory Laughter, RDH, BS who found that only 6.5% of hygienist were able to maintain original angles on instruments after sharpening (RDH, April 14, 2015). I have become more concerned about providing the highest quality dentistry that I can.  In doing so, I also utilize the highest quality instruments.  In our practice we have embraced XP technology for our instruments.  This technology uses stratified cermet layers that are embedded in the metal substrate in different dental instruments using a metal-gas plasma arc known as  Large Area Filtered Arc Deposition making the instruments harder yet less brittle.  At the end of the day, our instruments are more reliable delivering a sharp edge every time we pick them up.  Persistent inflammation is not good for our patients and we need to do all that we can to remove it.  Research has proven that If 17-64% of calculus remains after scaling and root planing, persistent inflammation will remain next to the calculus2.  A reliable instrument will help us to effectively treat our patients.

Feel

I have a friend that spends his weekends in a meadow scratching, scrawling and stroking canvas with water colors to create beautiful interpretations of landscape and wildlife.  He is very particular about his paint brushes and swears that a brush remembers your stroke.  His explanation is that a good brush is all about feel and his brush of choice is a Kolinsky sable brush; the most expensive brush money can buy with a price per ounce higher than gold.  When I asked him if it was really necessary he said without hesitation yes.  His brushes are an extension of his fingers and his mind and when he is in his element, the brush just seems to know where to go. The tactile feedback of a good instrument provides a sensation that is difficult to explain so, we often simply say that it just “feels” right. When a surgeon holds in her hands an instrument with good feel, less force is required and the tactile sensation afforded the surgeon is that of a paintbrush in the hands of a painter.

For me, it is my composite instruments which must be reliable when I use feather strokes to smooth the composite.  I am very particular about what I use and strongly prefer lightweight instruments with thicker, ergonomic handles, and non-stick, treated tips. In our practice, we have given our hygienists the freedom to test multiple products and they most frequently choose higher quality instruments that maintain their sharpness.  When I find a quality instrument that has a great feel, I know that I will provide a great outcome for my patients.

Long-term

Our family has the funniest sayings and idioms.  For example, I had an uncle Bob that, “smoked like he was on fire and drank like he was trying to put it out” and he had a “cast iron stomach” because he could eat “everything but the kitchen sink”.  Several sayings frequented the top ten list and one was, “The bitterness of buying poor quality remains long after the sweetness of low price is forgotten”. This was one that has stuck with me and every time I buy something cheap, it echoes in my head.  Recently while reading a well known dental blog, a colleague shared that they had found curing lights for $79 on a website.  So, I of course purchased one as well.  It cured composite if you held it directly on a very thin layer and continuously cured the composite for a minute.  When our local dealer representative visited the office, I asked him to check the wavelength on the lights.  The verdict was that these lights were more like green lights coming in at about 500nm.  So, they ended-up in the lab for curing block-out resin and for oddball projects, but mostly, they rest in a drawer with other mistakes that we have made. If you purchase something that functions properly for a long time it provides greater long-term profitability.  When it comes to dental instruments we need to be purchasing instruments that will maintain their function for the long-term. When evaluating this concept, we performed a retroactive evaluation on instruments across 10 practices. We identified instruments using Easy ID Rings.  One color designated the month it was purchased one represented the year and one was used for the usual purpose of procedure type.  In our informal study, we found that instruments purchased through cheaper no-name sources, had a 63% shorter life span than the premium brand name instruments.  Coincidentally, we found that the instruments with XP technology (American Eagle Instruments) lasted the longest.  One obvious conclusion is that we need more formalized research around this subject. Having said that, If an instrument is half the cost and lasts a third as long, your business assumes a greater on-going expense with a lower ROI.

Productivity

Do you pay your hygienist to sharpen instruments?  In the United States, a Hygienist’s average hourly rate is about $42 an hour.  As a business owner, I breakdown each person’s role by determining their objectives, goals, strategies and tactics.  As far as a dental hygienist is concerned, I would not include sharpening instruments in any of those categories.  Some people have offered anemic arguments that sharpening is a tactic that allows a hygienist to provide periodontal care.  This is faulty logic since the instruments that they utilize should be adequate prior to performing their primary task.  Imagine if a carpenter had to sharpen all of his nails before building a house.  Therefore, a hygienist should be using tools that are either already sharp or maintain sharpness.  Let’s take it a step further.  If your hygienist spends 10 minutes a day or an hour a week sharpening instruments, they will have spent 48 hours over the course of a year sharpening instruments.  If your hygienist is paid $42 an hour then you will have spent an unnecessary $2,016 to sharpen instruments in your practice.  However, you also lost on potential earnings, at average $200/hour and you had a loss of earning potential of about $10,000 over the course of a year.  Now, these are only the hard numbers because you also have an anticipated ongoing ROI from diagnosed work that comes from hygiene as well as elective services, etc.  Bottom line is that you do not pay your hygienist to sharpen instruments and having her do so is a poor business decision because they have less time to perform tasks that align with their objectives, goals, strategies and measures.  Provide your hygienists with the proper tools so they can have greater efficiency with instruments that function properly.  Cheap instrumentation causes unnecessary workload. Focus on increased efficiency, quality dentistry and everybody wins.

If you do the right thing, the money will follow.  Which is why I believe that there are 5 reasons that you should purchase quality instruments for your hygienists and yourself: durability, reliability, feel, long-term use, and productivity.  Do quality dentistry and use the best instruments to perform your job and the money will follow.

Dental Therapists Rock

AndyGoldsmith - 23/08/2017

The debate over Dental Therapists still rages on, fueled by dentists who in my opinion have a scarcity viewpoint on the profession of dentistry.  I believe that there is plenty of dentistry in the United States with only half of the population visiting a dentist on a routine basis.  The issue is not wether therapists will affect your practice, it is wether the patients they serve are receiving adequate access to care and a majority of dentists live and practice in settings where there is not an issue with access to care.  If we want to truly battle this issue, then we need to discuss how to increase access to care and how to get dentists to serve underserved populations.  Otherwise, the debate will be one of, “since the dentists do not seem to want to serve these populations, how can we make this happen?”

In 2009 the State of Minnesota became the first state to fully recognize the position of Dental Therapist, Alaska notwithstanding.

Minnesota law defines specific educational, examination and practice requirements for licensed dental therapists and advanced dental therapists. One of the most distinctive is the provision that dental therapists practice in settings serving primarily low-income, uninsured and underserved 10 patients, or in areas designated as Health Professional Shortage Areas (HPSAs) for dental care.

In 2014 the State of Minnesota released a study on the workforce with an emphasis on the 5 year impact of the Dental Therapists as well as outcomes and recommendations here are some of the findings:

No disciplinary actions have been taken by the Board against dental therapists.

 

study sites also reported an increase in access to oral health services for those traditionally underserved.

A hospital site is using a dental therapist to provide oral health services to low-income pregnant women directly in its OB department. In the past, these patients were referred to the hospital’s emergency room. The dental staff explained these services are only possible because of the dental therapist; the grant-funded program could not afford to employ a dentist.

Several clinics noted that most of the new patients being seen since the dental therapist started are public program enrollees or are uninsured.

Combined with the overall reduction in wait times, the findings are an early indicator of the potential for dental therapists to reduce hospital emergency department use for dental pain.

Of those patients who had not visited the current dental clinic before, 24 percent experienced a reduction in the time it took to travel to the current dental appointment with the dental therapist.

estimated savings per dental therapist is estimated to be $35,000-$50,000 over the cost of a dentist.

While the reimbursement rates are the same regardless of services being provided by dentists or Dental Therapists, There are increased numbers of patients being seen because clinics can afford more dental therapists to provide greater amounts of care to more patients.

In general, it can be concluded that the dental therapy workforce is growing and appears to be fulfilling statutory intent by serving predominantly low-income, uninsured and underserved patients. Dental therapists appear to be practicing safely, and clinics report improved quality and high patient satisfaction with dental therapist services.  Clinics employing dental therapists are seeing more new patients than before the arrival of the dental therapists, and most of the patients are enrolled in public programs or otherwise underserved.  Dental therapists have made it possible for clinics to decrease travel time and wait times for some patients, increasing access Benefits attributable to dental therapists include direct costs savings, increased dental team productivity, improved patient satisfaction and lower appointment fail rates.  Savings from the lower costs of employing dental therapists are making it possible for clinics to expand capacity to see public programs and underserved patients. Dental therapists offer potential for reducing unnecessary ER visits for non-injury dental conditions.  The debate will continue to rage on but from the perspective of increasing access to care, dental therapists rock and since access to care is such a significant social responsibility, dental therapists are not going away.

The next iteration of the debate will be in limiting scope of practice and that will be where organized dentistry needs to bet the farm.  As a profession we will need to stand-up for clear definitions of scope of practice as well as how our profession can approach this subject head-on.

Comprehensive Dental Finance

AndyGoldsmith - 28/06/2017

According to FBI records, on February 15, 1933, “Slick Willie” Sutton and a confederate attempted to rob the Corn Exchange Bank and Trust Company in Philadelphia, Pennsylvania. Sutton, disguised as a mailman, entered the bank early in the morning. Unfortunately for Willie, the curiosity of a passerby caused the robbery attempt to be abandoned.

However, 11 months later, on January 15, 1934, Sutton entered the same bank with two companions through a skylight. When the watchman arrived, they forced him to admit the employees as usual. Each employee was handcuffed and crowded into a small room and Sutton made off with the loot.

Sutton was an accomplished bank robber. He usually carried a pistol or a Thompson submachine gun. “You can’t rob a bank on charm and personality,” he once observed. In an interview in the Reader’s Digest published shortly before his death, Sutton was asked if the guns that he used in robberies were loaded. He responded that he never carried a loaded gun because somebody might get hurt. He stole from the rich and kept it, though public opinion later turned him into a perverse type of Robin Hood figure. He allegedly never robbed a bank when a woman screamed or a baby cried. It is estimated that Willie Sutton stole perhaps $2 million in his career, and spent more than half his adult life in prison. When asked why he robbed banks, Sutton simply replied, “Because that’s where the money is.”

The bank is where the money is. We all use banks and continue to make deposits and withdrawals. The banking and finance industry has received a lot of attention lately. According to the International Banking Society, the public perception of commercial banks is that they are a failing industry.

The reality is that the banking system is much more complex than what we hear about on the evening news. In fact, banking and finance are among the best business models. Many individuals, families, and institutions have generated fortunes through banking. Take for example the Rothschild family. Currently, it is estimated that their net worth is somewhere between 100-300 trillion dollars, and it all started with a family bank.

This article will discuss reasons for establishing your own bank, ways to finance your future, and how to create a legacy for your family. It will provide you with only the basics that will enable you to do all three.

If the Rothschilds’ wealth is in fact in the realm of 100 trillion dollars or more, they would still not be the wealthiest family in the world (that would be the Waltons of Wal-Mart fame), but regardless, they are very wealthy. They have interest in, or own banks, railways, mines, finance companies, oil, diamonds (DeBeers), gold, wine, and the Federal Reserve Bank — yes — the U.S. Federal Reserve Bank. The Rothschilds’ wealth funded the Suez Canal purchase, the building of London’s “Tube,” and multiple wars including the defeat of Napoleon and the Vietnam conflict.

Interestingly, it all started with a meager beginning in a Frankfurt ghetto. The five Rothschild brothers established small banks in five different European cities. Gradually, they built a banking empire that now spans the entire globe. The Rothschild family continues to teach banking concepts to future generations. Training in banking, finance, and wealth preservation is required for family members in order to acquire an inheritance. Furthermore, the family has agreed to borrow money only from family banks. This family has effectively become their own best customers.

An important thing to remember is that in the banking system, there is only one source of money. Money circulates from banks to lenders, to borrowers, back to banks, and the cycle continues. The obvious objective is to inject you into the equation, not just as a borrower. Substitute your name in front of the bank, and create: “Your Bank.” So, how do you start a bank?

Starting your own bank or becoming a financier is actually quite simple. You have done it before. Whenever you make a purchase, regardless of whether you pay cash or borrow the money, you are financing a deal, and you are paying interest.

I know what you are thinking because I have had this conversation with many of you already. “I pay cash for everything so I don’t pay interest.” Well, Dr. Cash, you are either going to pay interest to somebody else or there is an opportunity lost on investments with that cash. So, what if you could do both, make the purchase and collect interest?

If you were to start financing through your own bank, you would need a safe holding tank for your cash. This holding tank, ideally, would generate its own interest in a tax-free environment and allow you to withdraw and deposit funds whenever you need to. The great news: Such holding tanks have existed for over 200 years and have been used by the Rothschild family, investment banks, and large corporations, and often are products provided by life insurance companies.

Life insurance companies are regulated to maintain cash reserves to cover potential claims. These companies are some of the largest, most profitable companies in the world. Also, very often, they will offer the policy owner a guaranteed rate of return, or a return of premium. Some newer products even include indexed accounts covering U.S. and/or foreign markets.

According to John Bogle, founder of the Vanguard Group, indexed funds are the only way to guarantee your fair share of the market gains. Also, in response to demand, companies now exist that provide a holding tank for your money and can assist you in the financing process.

Regardless of what type of account you use, your money will continue growing. Furthermore, money can move into and out of these accounts. In some instances, you continue to gain interest on the original balance even after you withdraw money. Accountants and attorneys can set up these accounts so that upon death, you can leave a large amount of wealth to help fund a bank for future generations, or a trust to fund a foundation or charity. The point to take home is this: Why generate more wealth for the bank when you can generate more wealth for yourself and your family using existing support systems?

John D. Rockefeller was famous for doing this. Considered the wealthiest American ever, Rockefeller displayed relentless self-discipline in financing. He would never give-up a potential 8% gain to another institution. Instead, he methodically self-financed multiple business deals to ensure that he not only profited from the actual investment but also from the financing as well. If self-financing worked for John D. Rockefeller, doesn’t it make sense that it could work for you?

But once again, I know what you are thinking because I have sat next to many of you at plenty of dental seminars. Remember the talk when the speaker said, “We are dentists and we should do dentistry, not financing”? My question is: What is holding you back? Ok, I get it; it’s the risk, right? Well, what if you could decrease the risk? If the odds were highly weighted in your favor, then I am sure it would be much more appealing.

I understand odds because I grew up in Nevada. Being a young adult in Nevada, I was exposed to all the offerings of the gambling industry. As I am sure you are aware, the odds are stacked against you at the casino. However, if you are going to engage in those activities, it is in your best interest to know the rules of the game and to play the game with the best odds. I found that craps was one of those games with the best odds, but, of course, you can still lose everything playing craps in a short amount of time.

So, imagine if your favorite casino introduced a game where you could gamble $350 and get a potential 40:1 return and, if you lose, they would just return your initial investment. Sounds too good to be true, and I would not expect any such game to appear in Las Vegas soon. But, a properly structured finance deal can be exactly what I described.

Imagine if you perform a service for somebody and you offer your own financing. What are you giving up besides your time and the cost of materials and labor? If the patient covered at least your costs, then you would only be out the time. After that, any other payments are icing on the cake, with interest.

Personally, my concern in dental finance was the collection side of financing. What dental speakers should really be saying to you at dental seminars is that you are a better dentist than collections agent. Fortunately, companies do exist that have the ability for you to outsource this service.

After some research, I found a company called Comprehensive Dental Finance that works exclusively with dentists and for dentists. They handle everything for you on the collection side from A to Z. Because this company handles the entire process, you can focus on dental treatment, and your only potential loss is your time. Providing financing to your patients can provide greater access to care for people everywhere. Also, by self-financing, you benefit from the gain in interest that companies like Chase and families like the Rothschilds and Rockefellers understand.

I started my own “bank” about nine years ago. After only five years, I had already used my family bank to fund the purchase of a car. I invested in my bank for five years and once it had sufficient value, I made a withdrawal, or loan from my bank. With the funds in hand, I paid cash for the vehicle, getting some additional discounts as well. Keep in mind, too, that you do not pay taxes on loans. Then, I put myself on a three-year repayment schedule at 6.9% interest to pay back my loan. Plus, the cash in my banking account continued to grow at a guaranteed rate of 4%, so the money in my bank ended up growing at a 9.9% total interest rate. That’s 9.9% in a bear market when most banks are offering 1% on money market accounts. That is when I started to really see the potential.

The goal of your bank is to raise capital. You could continue to be your own best customer of your bank, but what if you started to provide financing from your bank for your services? As I previously mentioned, the only risk is the loss of your time as long as you can get the patient to pay your costs. What I found is that with a company like Comprehensive Dental Finance, they will prequalify the patient, set up your bank, put your patient on auto-pay, and handle collections. In this scenario, the patient typically repays the loan.

Since we know the downside, what about the upside? Let’s say a patient finances $10,000 worth of treatment with you for periodontal surgery, assuming an overhead of $350. As long as the patient pays their first payment, which most do, your only risk is your time. As long as the patient continues to pay back the loan on a five-year note at 5.9% interest, you end up increasing your net worth by over $11,000 in a separate corporation. That is a great deal and one that a Nevada boy would take all day long.

With dentistry consistently listed in the top earning professions, there is no reason that dentists should ever retire without accumulating massive wealth. Certainly, there is absolutely no reason that any dentist should ever retire in debt. My wish for you is that you research this topic more.

The potential for you to amass a fortune still exists regardless of age or income. You don’t have to be like Willie Sutton and rob banks. Instead, build the bank. The reality is that building wealth through this strategy requires discipline. You have already displayed massive discipline to get where you are in life. So, I encourage you to build your own bank. Build it strong and build it to last.

What you do with your wealth could bless many lives during or after your lifetime. One of the greatest blessings of all is to live your life so that your legacy outlives your life. You already make a tremendous difference in the lives of your patients. Now you have a tool to make a difference in their lives even after you no longer hold a handpiece in your hand. Visit http://goldsmith.cdfinance.net/ and watch the instructional video and sign up for a free webinar to hear more about Comprehensive Dental Finance.