How Company Loyalty Helped Propel an Orthodontic Practice
Dr. Randy Kunik has a successful orthodontic practice built on high-quality results, stellar customer service, and sound business practices. But his loyalty to one medical device company has also been critical to getting him to the top of a competitive market - and keeping him there. In this episode, he explains business strategies for his practice, how he works with medical device companies and what is important in maintaining a long-term relationship, and a new technology he has implemented that makes orthodontic care more convenient for his patients, and better for his bottom line.
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Episode Transcript
This transcript was generated using an automated transcription service and is minimally edited. Please forgive the mistakes contained within it.
Patrick Kothe 00:31
Welcome. Many of us are familiar with orthodontics, we either had braces as kids or adults, or we have kids that have had them or are probably going to need them sometime in the future. Well, today's guest Dr. Randy krunic is an orthodontist, and he's going to share what it takes to build and grow a successful practice, from his patient care to how he runs his business. We also talk about the types of medical devices he uses, how he interacts with companies, and how brand loyalty has paid off for him. Big time. I've known Dr. Kooning for 25 years, and he has helped put beautiful smiles on all four of my kids. He's a master at customer service. You'll hear many reasons why in this interview. You'll also hear a lot about customer loyalty. And I'll have a few things to add about that after this interview. Here's my conversation with Dr. Cooney. Dr. Cooney to get everyone on the same level. What is orthodontics?
Randy Kunik, DDS 01:38
orthodontics is a specialty of dentistry which incorporates aesthetics and function in a way where we're looking at the big picture of getting both the teeth in an alignment that's obviously aesthetically driven, as well as getting a bite that fits nicer, hopefully improving the way people feel about themselves as well as improving their ability to chew and do important things like that.
Patrick Kothe 02:06
So you've treated 1000s of patients in your career, what does orthodontics do for patients?
Randy Kunik, DDS 02:15
Basically, the main thing I would say is the driver is give people sense of confidence. A lot of patients come in, that don't feel good about how they look and they're super interested in improving some element within their smile that that looks good. So I would say that's the number one. And then there's a smaller minority that are coming in because they don't they don't like something about how their teeth fit or they have some problem within their their bite causing TMJ type of skeletal problems. But that's not as common as people coming in for just the smile.
Patrick Kothe 02:58
So imagine helping people with their confidence is pretty satisfying for you.
Randy Kunik, DDS 03:02
It's keeps you going every day, never missed a day of work and it's a wonderful way to spend your life is having that kind of gratitude doing something that that I enjoy and people are so grateful that they got what they wanted and and it's a big deal.
Patrick Kothe 03:22
Can you describe your practice?
Randy Kunik, DDS 03:25
My orthodontic practice is a overall typical in terms of any orthodontic practice that you would go to in most western countries are electively driven? Mine is a 100% fee for service and not really anything other than that and doesn't pretend to be I, I sort of shy away from the word bowtique. It's it is a rather large orthodontic practice. But people are really surprised to know that way, way more than 50% of my practice are adults. And a lot of the adults are closer to middle age than even young adults. So the teenager that embraces is down to a quarter of my practice only and however they they make up the noise and that this practice is is all kids still even though I would say my practice is two thirds to three quarters adult driven.
Patrick Kothe 04:27
Has that changed over the years is that in general, what's what's going on across orthodontics? Or is that just your practice?
Randy Kunik, DDS 04:35
Probably truth to both one is yes, it's a trend thanks to the marketing and the benefit of being able to lie in your teeth without braces. So therefore the adult market has just grown enormously around the globe. And number two, my practice is also a bit of an X unicorn in terms of it's always been adult Driven because I kind of even in the 1990s, I used inside brackets called lingual braces to capture the adult market and I was very big on in the 90s on this ceramic market brace market to have a less distracting look compared to metal brackets. So I always tended to be on the high side of the adult practice compared to the market of the of the average orthodontist. But I would say in general, the overall orthodontics is much higher adult driven.
Patrick Kothe 05:35
So when did you establish your practice?
Randy Kunik, DDS 05:37
1991 1991?
Patrick Kothe 05:39
So was that a marketing strategy that you had to go after the adult adult market? Or is that kind of how it evolved?
Randy Kunik, DDS 05:48
I would say was, how it evolved, it's, I kind of have the feeling. A lot of people would want to have the adult, especially the clear, aligner adult practice I have. And a strategy would likely in my opinion, backfire. It's you have to earn your wings with your kids, the teenagers and the hard cases that you got to do in your career to get the adults and to get that you might call it the gravy, you have to you have to go through your 10,000 hours of those harder teenage brace cases and hard hard cases to get to the good ones. So I would say had, it wasn't 1991 to three, me saying I'm going to be adult, you got to be everything to everybody and just be a pleaser and not be selective or elitist. So I would just say evolution.
Patrick Kothe 06:45
So you move to move to Austin, you've established your practice. How did you do it? Initially? I mean, you just hang out a shingle, and here I am. But how do you build a practice?
Randy Kunik, DDS 06:57
It was definitely hang a shingle and on. And then the work began. It was all everyday I had lunch with a dentist. And basically, I never missed a meeting. I never missed an opportunity to throw a party. I I scored a 10 out of 10 and the 90s for energy with other colleagues to build a reputation. And that was the only strategy I used. I did not employ any direct marketing at all.
Patrick Kothe 07:33
Is that the way it is right now? I mean, is it still the referrals of dentists that drive the business? I imagine once you're established, you also have the referrals are coming from satisfied patients as well.
Randy Kunik, DDS 07:47
Okay, 100%, we call it word of mouth, who am I so we charge every new patient phone call. I know every patient that calls every day. And I'm looking at how they call and and these days, the referrals are very few. But the few I have I'm so grateful because they're high quantity of mainly from a half a dozen pediatric dentists and a half a dozen general dentists that really support me. But in the old days, it was more like onesies and twosies from 30 to 50 dentist. Now I might say it's it's three to five children to dentists and three to five really good cosmetic dentists that I works very, very close with. And the word of mouth that you alluded to of the community reputation is by and large, the, I'd say high majority of what drives my practice. And there's another element if you would like me to go into it, that I would call the word of mouth of the internet. And the internet word of mouth is not paid for my office, we spend very little dollars optimizing or buying AdWords space on Google or Yelp. However, we have the advantage of the history with having a website since the late 90s. And doing things right so that our website has a lot of traffic and above that is when people search the keyword Invisalign, Austin, Texas, I have a very large advantage on the organic sites where I pop up two or three times. And that's for free, organic, and the shoppers that are really interested in orthodontics, doing their homework are going to see me and find me and then the word of mouth that you alluded to in the online format of primarily Google reviews and Yelp reviews and then secondary after that. Things like next door will neighborhood apps Facebook, people kind of reference their word of mouth differently than they In the old days where they were going to church and carpooling, now, it's a neighborhood like where you live, and just people shout out, hey, I need a new work the dawn is and then if my name comes up more than the other significantly, they really feel like they're an idiot for not come into my office. And that's surprisingly, a strong referral.
Patrick Kothe 10:23
So you mentioned Invisalign, and Dr. clinic is the number one Invisalign orthodontist in Austin. And we're going to get a little bit further into Invisalign a little bit later. But you talked about the internal bracing and Invisalign, what is the what's the percentage of people who are using Invisalign versus standard bracing? Today?
Randy Kunik, DDS 10:48
That's a question for, I would say, very different from urban to rural, from one city or state to another, and for sure, from one country to the other. But without question, it's where all the growth is been for the last decade is in the clear, aligner space, and of that 98% is Invisalign, they've done a wonderful, a really strong job of cornering the market. And so I would say, the majority of cases are still around North America in the planning, I would still still braces driven, but the growth is all Invisalign driven. And it's, it won't be long till it's going to be easy to say braces are the minority of the driver, I i've never separated out like statistically, an Invisalign patient and a brace patient, I just kind of like to say, you're a patient, I have two tools, there's the same cost, we may start with one and switch to the other. I'm going to, I'm going to pick I hear you that you want to avoid braces, or if you're in and you want to be in them for the least amount of time. So I'm since I'm so aware of that, and I don't have people have to make a choice of one's more expensive than the other, I really get a real level playing field for a patient to say, Well, yeah, we want Invisalign. But you'd be surprised how many people still want braces, even given all the parameters of all things else being equal, a lot of seventh eighth ninth grade, kids just don't want to deal with something they have to take in and out and risk compliance. So it's not as a given that just because the fees the same, but I would say the trend every year goes more and more towards a Invisalign choice.
Patrick Kothe 12:42
So your practice has grown significantly over over the years, about how many patients do you think you've, you've helped,
Randy Kunik, DDS 12:50
for sure, over 20,000 patients, I've started and finished. And that's over 30 years, and it's a good number of patients that all feel very satisfied, I hope and you know, the proof is I'm treating their kids and their grandkids now type of thing. I've been here long enough to start seeing a lot every week, somebody who I treated in, you know, last 2015 to 30 years that are bringing their kids to me. And that's really rewarding. And I just think it's a larger number than I can fathom. And the only patients I really care about are the ones I meet on Monday morning, not the ones I've already treated.
Patrick Kothe 13:30
So the the number of active patients that you have at one at any one time, what would that number be?
Randy Kunik, DDS 13:35
About 1000 you're finishing, you're starting about the same.
Patrick Kothe 13:40
You talked about the demographics of the patients that you treat, moving towards the adult side of things, income wise, kind of what what kind of area Do you live in your what kind of practice demographics Do you see?
Randy Kunik, DDS 13:55
I would say that my I have two offices now that I work out of pet one one here, right here in where you know, and the other one up in the domain, which is sort of a younger, newer growing area. Both areas have I would say either wealthy a wealthy demographic, especially where my main office is, is is higher income and and driven by the school district. And so when I did open up the school district drive was a real obvious thing. And so I kind of said I'm going to be an A game player in this school district and do things in a way that's so customer service oriented. And that was a strategy and and then what happened was as you know, Austin, Texas has just taken off and so I could have gone wrong would that just be right place right time. And as things for this school district in area have gotten more demand because People are leaving states like California and the East Coast to move here or out of cold states to move down here, especially with the COVID. year, we really have experienced a stronger demand than ever.
Patrick Kothe 15:13
So you talk about school districts, is that how you segment things? And when Why do you segment by school district? Well, the
Randy Kunik, DDS 15:21
school district where I am, is is actually a driver. And so you have Austin, Texas, which has just been like the whole nation of the one of the most desirable year in year out to go live. And then inside of that, you have this pocket of a school district that just gets raving reputation. And so he said, Well, you I thought you said you treat adults, well, you gotta remember, the teenagers, I treat all have moms and dads that I treat. And that becomes how the adult markets really flourish without even trying. And so that that's, I would say the reason I would say a school district and the the income, it matters. Now, with that said, you'd be really surprised to know that some of the most expensive orthodontist are an areas that you would least expected and vice versa. So when you go out to some cities like Lubbock or San Angelo, or areas that you will not necessarily have Laredo, think, Oh, my God, it's gonna be a great price knows, what drives prices up and down often is how many orthodontists are competing for a certain space on fee. And so if you're the one star orthodontist, and one of those towns, you can drive your fee way high, and not lose out on your quantity. Whereas if you're in, I've been to cities, when I used to lecture all over Pittsburgh or South New Jersey, it was interesting when I would speak to those societies. And their fees were significantly lower than mine at the time. So it just doesn't it's not a because you're in a wealthier area, you drive a higher fee, that doesn't seem to be a correlation.
Patrick Kothe 17:14
I'd like to understand your business model a little bit, is it so you've provide services, but you also are using medical devices within those services? So I assume what you're doing is you are pricing the service? And including the medical devices in that, is that correct?
Randy Kunik, DDS 17:34
That's correct. Okay,
Patrick Kothe 17:37
so you use utilize your different different medical devices, you know, within within the practice. What do you buy them from? Do you buy them direct from companies? Are there distributors? what's the what's the sales process, like?
Randy Kunik, DDS 17:54
The three companies that are the major technical companies that have devices are directly through them. Invisalign is through a line and they have their own sales force. And then the braces I've used from day one are from three, there are three m unitech. And they have three m, sales force direct, and then the new one dental monitoring, they have grown sales force, the the supplies within an office are basically you use like a Henry Schein type of a vendor you and so that's the only other one I would say other than just the various here and there, but I guess to answer your question beats direct to through the company.
Patrick Kothe 18:36
So the shine is where you may get some instruments, you may get your peepee and dryer. You may That's
Randy Kunik, DDS 18:42
right. That's right. That's right shine or Patterson, I think we are the two that are the main players in that space. And you nailed it that all that kind of stuff, the bags for the sterilization, when your sterilizer goes out, you go there.
Patrick Kothe 18:58
Yeah, and and do you have an X ray machine at your office as well?
Randy Kunik, DDS 19:01
Yep. Yep. And that one is you you can do it through a provider, large provider like that, or you can go straight to the vendor.
Patrick Kothe 19:12
So you've got a lot of supplies that are in your office and your sole sole proprietor within there, do you just buy those supplies and pay for them within within 30 days? Or is there financing programs or consignment programs? How does it work?
Randy Kunik, DDS 19:28
I know those are all available but we typically would just buy it pay it out and do the deductions I believe in accelerated way and not it seems like in the past when it came up to do a lease, most the time it didn't work out so favorably that we would go that route, we would just go ahead and pay and then just do the accelerated depreciation I believe.
Patrick Kothe 19:54
So as a business, you've got your capital outlay for your your your chairs and in your office things, you've got your rent, you have these supplies consumables that you're using staff i think is probably another major component of your business.
Randy Kunik, DDS 20:12
20 20% is the extent the dental orthodontic standard. And I know at last, we just had a meeting. And I know we're high in that. And I believe that when you use high level technologies like we do, and we serve a very high end, very discerning crowd like we do, and the having staff, that is the high end makes is what you have to so we're, we're 24%, which should be least 20%, high for the industry average. And and I do believe that's what you got to do to really scale the way we scale the technologies. And if you can't cut corners on the people.
Patrick Kothe 21:02
So there's two things there. One is the quality that people and paying that paying them above market market rates, and then there's the number of people, are you saying that it's both or the quality,
Randy Kunik, DDS 21:15
quality? Very good, very good pickup, because I know orthodontic practices that do not do the volume of production I do that have significantly more people. And I have no clue what percent of the practice. However, I would say, it may be the same or less than mine, but they don't pay very well. So they have to make up for it with a higher number of people.
Patrick Kothe 21:43
So what type of people are there? I mean, how First of all, how many do you employ approximately, and what what are their positions
Randy Kunik, DDS 21:54
20 employees total. And we have, I would say one fourth of them are admin, back office and front admin and the rest are clinically driven with six of those employees being patient forward in a way where they they are the ones that patients interact with the most. And the rest are supporting the sterilizations, the records, taking the scanning, all the things that you would call in if you're on the inside, we will call it there there in the farm system to become one day a patient assistant. But they haven't earned their wings yet. And if you were to say what kind of people there, they're mostly people out of high school that got into dentistry and orthodontics, I don't remember what we called it in the Midwest, but I don't think it was deca, or where they did work, you know, work work from school and a lot of my employees started in high school. And this is what they are going to do. And it's their profession. And even if some may or may not have gone through some type of formal Dental Assisting program, but I would say by and large, most would consider training in my office, they're there on the job training
Patrick Kothe 23:11
to do what you want them to do at the clinic way.
Randy Kunik, DDS 23:13
That's right, that's right train, train them, right. Keep the bar always high and and let people go when they don't show that they care about the practice the patients the team. And that's sort of been the motto is don't don't hold somebody that might not have that. So we keep keep the people that care.
Patrick Kothe 23:36
So as as a as a business owner, we all have challenges. What are a couple of the challenges that you have as a business owner? Is it is it staffing. I mean, a lot of times it's what it boils down to.
Randy Kunik, DDS 23:48
It's typically over my career, I would say staffing, and with that, I would say sidebar, I've complained less than all my friends that are orthodontist. So I've been blessed, and that and but yet it's still a top five for sure. Top three staffing. But I would say the challenges are dealing with the fact that orthodontics and dentistry is not perfect in and you're dealing with a lot of science and art and the variables of the jobs and the growing and, and getting a situation where you're not going to get an A plus on a case. It's just the way nature works out. That's the biggest challenge I would say for any of us in our field is that we want to please we want to deliver a patient the best we can and sometimes the best we can on that person is not as good as they wanted or for sure was good as I wanted. And that's really the hard part of the challenge and then especially during the COVID year the biggest challenge has been Managing behaviors and personalities of the public. It's it's really been a and I can't imagine it's anything but worse with other medical professionals you speak with pet. But this year, what used to be a once a month is once a day with a patient coming in irrationally complaining, just I can't describe it, but it's just put it as a big challenge is dealing with
Patrick Kothe 25:30
the public. When you say irrationally complaining, are you talking about you're wearing peepee? Are you tired? You know,
Randy Kunik, DDS 25:38
just just dead, you would think so Pat, and that would be there, right? And I couldn't blame them. But the funny thing is, for how busy we've been, and we ramped back up to about 75 80%, of what we used to see pre COVID per day, we ramped up slowly to that starting after the shutdown. And you would think we would have had a lot less people coming in a lot more cancellations. We had so little, it's almost frightening as a community, why did not more people cancel? Why are they coming in for an elective service. And I didn't get that. But the people that the people did show up. And what I'm calling irrational is the patients are looking at themselves in zoom, and they're in there they are working from home. And I think there's a new kind of a bit of people, the public now doesn't have the interactions they had in an office. And so when they get to an orthodontic office, or probably anywhere, they just are not what they were before. COVID is all I can assess because it's just across the board. And not just me all my friends and I see it on Facebook orthodontic websites that I follow. And everyone's saying the same thing. It's just people are kind of hard to be with right now, as a professional service provider
Patrick Kothe 27:09
didn't realize that. One of the things that is always confused me, especially when you're dealing with dental things is insurance. I don't know how it works. I don't know why things are covered and why some things are not covered. How does insurance work? within your practice?
Randy Kunik, DDS 27:30
I share in your magical belief about the insurance, I know nothing about it, I need to ask my managers and I people that help with insurance. I do know basically an employee at a company has a benefit of debt and they usually have a dental benefit. And then they usually within their dental have a lifetime orthodontic benefit. And that is what they get typically 15 $100 or 2003 1000. real high. So a University of Texas employee that chooses to highest in Premium Package could actually get what I would say half their orthodontics covered by their insurance. If a typical case is $6,000, which is fairly average. They they're really set and pretty. So for you to understand, I would say normal is 1500 to 2000 and above 2000 be exceptionally high. And so that's how it works. It's basically a given that my team member when new patient calls already checked by time they get here what their benefit is. So the genies out of the bottle. Everybody knows where we are.
Patrick Kothe 28:46
Within the medical office.
Randy Kunik, DDS 28:49
You have
Patrick Kothe 28:50
teams of people that are dealing with insurance issues. Is it the same way with UDF? One person I mean, what do you what do you have
Randy Kunik, DDS 28:58
at least basically one person but it's not what it is at all for a medical because we have so few codes, Pat, you know, I'm an orthodontist, I do a couple things. I'm not like a dentist with two pages have codes for different procedures, I do orthodontics, and the benefit is the benefit. I don't think it's too mysterious. So we don't really have us but one or you know everyone in the front office and my trademark corners. They're all very well versed on it. So we really don't have additional teams just to handle insurance. And because we are fee for service. What I bet alludes to is most of the dental corporate chains. And a lot of Dentists have to work or not all of them but most choose to be part of plans and we're not part of any plans. So so we don't have to have a fee for one patient and different for another because we joined a plan and That's a nice place to be. And that would be a benefit of being where I am and Mike, how many years I've done this and where my practice is. So,
Patrick Kothe 30:12
you mentioned or we've been talking about Invisalign, and relationship that you've had with Invisalign over a number of years. Can you describe how you got involved with Invisalign, and kind of how it's evolved.
Randy Kunik, DDS 30:28
In 1998, the company was just starting with two entrepreneurs out of Stanford. It was Kelsey Werth and Xia, and Z and Kelsey, the two of them had the brain power of this company, and they were MBAs, but they backed into through software engineering, the idea of it the Zia lost his retainer founded question in his mouth, his teeth went back to the way they looked when he took his braces off. He has well that works we can do. There's how Invisalign, and he went through software engineering at Stanford, and worked his way into the profession. GE and then the literally their third hire was a guy that lives right between where you live, and I live in Rob Roy, and Joe breeland, was their VP sales. And he said new mega and he knew I was very 1998 and progressive and very adult driven and aesthetic driven. I met him at the Starbucks inside the Barnes and Noble. He showed me literally what had changed much of the IP. And, of course, I said, there's the naysayer, and you always comes out. It's easy to say no. But I was one of the very, very first people to jump on the minute ahead, FDA. I know my first case was three digits like case number 500. It was low. And and then within a year of, not even in 99 or 2000, I flew out to meet with Kelsey Xia and Amir Alba Fabi, who was their r&d Vp, and I said, Hey, you guys are trying to tell us what to do to make someone a candidate for Invisalign. That doesn't make sense. Everybody should be a candidate. And when we need to, we already have the braces to finish it. And they loved hearing that. And so I recommended a study where we do I take difficult bicuspid extraction cases, and treat them through Invisalign, and see how far we get down the road. And we created a steady working with their r&d, I mean, paid however, I let them use my office and my patients. And it was basically my idea, the study, and we provided the photography and the x rays for them. And we treat it I think, 40 cases, and a lot of their innovations of their attachments were made out of my office without me even knowing it, basically. But I was early on very involved with the company. And then my evolution really took off in oh six, when Zia actually splintered off and was I think, removed from the board and he created his own company. And when he did, because Austin had these roots with Joe and others with Zia, the the, he took those key people from Austin to the new company, and I stuck with Invisalign and I was very, very well rewarded by my loyalty. extremely well essentially Pat, someone oh seven, they gave me a URL with the word Invisalign in it five of them for his for being number one in Austin that's back in Oh, seven. And since then, that's why, one of the reasons I come up as Invisalign, Austin, because I am in his line, Austin calm. And and, and so when you talk about my history, it's been I've done some research with them. I've done presentations to them, but not for them. And so I've gone to their facilities in Costa Rica, I've lectured to them. And this is back in 2002. Back at their home base in the Bay Area. And meanwhile, I never worked for them as a speaker because I didn't like the feeling of doing stump work. It wasn't my calling. So I've been very loyal as a user, and but not as a promoter of them to the field. So I hope that helps you.
Patrick Kothe 34:38
Yeah. So it's primarily what you're interested in is the development of the product, helping the people develop the product, but not necessarily promoting the product. That's right.
Randy Kunik, DDS 34:48
That's right. And, and I would say the story to tell is, don't get you know, when when things go the wrong way which they have with me, but they I'll give a small Story less than two years ago, they opened a store called the Invisalign store to answer smile, direct clubs, launching of their stores. So smile direct club was a conscious consumer driven. No doctor company, so is a do it yourselfer. And it's done. It did very well out of the gates. And as you may have, you know, but the IPO was one of the worst IPOs of all time, I think. But whatever it is, Invisalign lost a lawsuit to smile, direct club, over the stores. But Invisalign did me wrong. As loyals I've been they open a store less than, oh, a quarter mile three, I'm in domain north side, they opened up in the domain, I mean, so literally the distance of five minute walk, they opened the store, and then took me to dinner and told me how it was to my advantage. And instead of ever losing my loyalty, I had dinner, I was not happy. And three months later, the store was closed down because they lost the lawsuit to smile direct club. And meanwhile, I kept The High Road with my, my sales team and their managers. And in in the long haul, I am the one that owes the company the big thank you, because they're the ones in general promoting the practice of orthodontics go see it's free marketing for the whole profession. They've made mistakes along the way, but so does every company. It's how I look at it.
Patrick Kothe 36:40
loyalty is really interesting, because you know, some people will will chase the the latest and greatest technology and other people will stay and wait for the company that you'll dance with who brung you to stay with stay with that company. While they're making those changes, and also being part of the the changes that are that are being contemplated and being developed. Right? Have you been working continuously with the company? Have you been providing feedback to them?
Randy Kunik, DDS 37:14
Always, we've always kept it where I literally have emails to the doctor, dentist orthodontist in Costa Rica that manages my technicians who prepare my cases with me daily. And when I've had issues in Mexico, where the facility is in what is Mexico where the facility they print, all the models that make the retainers all the robotics are there, when we've had issues, I have direct line to them. And that's very, very rare to have that kind of interaction with a company that's become so large, and because it's because my team and I always come at it from a place of let's figure it out, not complain. And so that's the difference. And I know you know that from where you had your career, there's just two ways to deal with it. And we've always sent photographs, documentation, nice emails, and we know this is hard for you know, we know this is a black hole for your company, just as it is for us, we all want the same thing to get the service to the patient. We're all part of the chain. Let's figure it out.
Patrick Kothe 38:29
Have you had any ideas that you've brought to different companies on your new ways of doing things or any things that are patented any new technologies that you've thought about?
Randy Kunik, DDS 38:43
I definitely in the 90s was writing my better music you would say in terms of my orthodontics, I got a patent back then I was real active with three m unit tech and, and trying to work with their technologies and their engineers were here and I was with them a lot. And I wouldn't say I ever had any breakthrough moments on any of the technologies but if anything, I stuck to the concept of not wanting to be the first one to do something or be part of an alpha or beta group they call them and that just wasn't what my patients were paying me to give them and wasn't that interested so I think I could have been more involved and more on the cutting edge but I wanted to be in that next tier, if you will, where I knew something already been through, dinged around a few times before I offered it to a patient and that's both wood and I've only been with two vendors my whole career three M and Invisalign as far as and devices go brackets from one and wires and adhesives for three M and then Invisalign for my clear aligners and not even sampled another company and I literally use the expression dance with who brung him. And it's served me. Well, but especially when you talk about the business side of this interview, the loyalty with Invisalign, it, it seems like it would be, it's gotten harder and harder for my colleagues to knock me off the king of the hill. So, if I was number one and 2006, or even, it would have seemed like, well, within five years, there's going to be a young pup that's going to knock me down just the way that the forces of nature, you know, but now it's 2021. And now it looks like it almost is impossible, because of the way the internet loves me. And because of how many patients I've treated, and for sure, I've know how many Invisalign patients I've treated as real close to 6000. Well, that's a lot of word of mouth, that's hard for a dent orthodontist or dentist who's not getting that kind of, I guess, love from the community that you've treated.
Patrick Kothe 41:09
So companies are made up of people. And the companies that you've, you've worked with, I'm sure have had stellar people, people that you've gotten along with tremendously, and some people that you haven't, and, you know, you've got an overall impression of the company, but you've got different people in there, how have you manage the relationships with all different types of people and still maintain the loyalty to the company?
Randy Kunik, DDS 41:34
Funny, you should ask, the first interaction with the new salesperson, their first week together was a deal breaker basically. So when you ask me how we interact, when things don't go, well, it's email very nicely letting them know, we need less attention, not more. If this person can't turn it around, we prefer almost to just have a remote salesperson, but still nice, but really kind of being clear that I my goal, my goal from your company is not to have my key employees complain. And, and we've had significant problems with a few coming up through Invisalign, there has been more sales reps and three over my 22 years with them. And a few times they've, they've had these marketing genius ideas have given me the stellar rep from another city, or that comes up to Austin and, and that person was not a fit at all for the teammates that we that they had to deal with. And we literally had to veto it. And they were and it worked out. So we work together for I guess you would say a common answer. So everyone continued to win win.
Patrick Kothe 42:55
So what what do you like about interactions with sales representatives or company representatives? What, what what works for you? And on the flip side, what is your what what are some, some don't Do's,
Randy Kunik, DDS 43:08
the for sure don't do is don't talk down to my team. Don't do not disrespect my team members. do treat them better than you would treat me don't. And that's that's probably number one, two, and three on the downside. And then on the also on the downside. It's don't overdo it. We're busy. We know what we're doing. We just need, we just need to work together to make sure we're efficient together. We want to use your sales don't so don't upsell, we have our systems in place. Don't come in here and teach us stuff that we've been doing, that we that my team's confident on. And so that's the don'ts the do is friendly, and and taking care of the team first but in a way, ask the team what they want. Don't Don't assume so a salesperson that starts out a new relationship with my staff should start out saying hey, I'm new here. And they've been with Dan for the last 12 years. And what do you like about what Dan did? What What can I do different? Or is there anything I can do different? That was all the new guy needed to do was take one minute to listen, ask the question and not come in with his guns loaded. Because he knows something he thinks we need to know what you maybe he's right. But it's not what he said. It's how he said it. That seems to be the answer.
Patrick Kothe 44:45
I think that's that's very sound advice to people in general is listen before you talk understand your customer base before you, you start to try and sell because selling without understanding is just
Randy Kunik, DDS 44:59
too Right. That's right. You're looking at me on the zoom. But there's that mirror on my shoulder right there. Well, I take new patient adults to the mirror, and I go, Hey, I know you found me on Google. Because literally, almost half do Pat, find me on Google. And I got when you were searching for an orthodontic experience to get into consultation. What things? Can you show me in that mirror? That would tell me what you're interested in. So instead of me telling them what I see, I first hear what they are interested in a lot of times, it's Wow, good thing I shut up and listened. Because I would have gone down the wrong track.
Patrick Kothe 45:42
those are those are great words. Dr. Koon. It goes are great words. So prior to COVID, you heard about another company. And and it was one that you mentioned a couple of minutes ago, a company called dental monitoring. Really, really interesting to hear how you got involved with that company and what they're all about. And how it's drastically I think, change things, post COVID,
Randy Kunik, DDS 46:09
the dental monitoring, it's a tool device that uses a smart phone, to easily conveniently communicate with a dental orthodontic tech team to minimize appointments. So on the doctor side, oh, scaling less appointments on the patient side, less traffic, less missing school. So you've got this. Now, I missed it, that I missed it. And it was forced on me. So he asked me how did I get learn about it or find it? backup five or six years ago, I read an article about this French technology that is so good using a smartphone that it could tell an Invisalign liner fit or not, or whether wire is active. And I read that with disbelief five years ago. And then the technology developed and I kind of lost track of it. And about two years ago, it was exactly two years ago is our anniversary trip in Paris. And before I left three people from different parts of the globe that when I used to lecture, I had a protege in the Gold Coast of Australia. And he and I keep up, he's been in my office, I've been the his his kids stayed with me, I saved my kids stayed with him on different things. And we're very close and proud of this guy, Dr. semaan. And he somehow became the number one user of dental monitoring on the planet about two and a half years ago. And he was saying you really gotta do it, you really got to do it. And then another friend of mine in Destin, Florida, that's another protege of mine was saying it's kit I is the best thing I've ever seen. I for some reason, was just not ready for some new technology. And then the final two straws were I was in Paris. And one of the VPS was from when I used to lecture unit tech was a three higher up person out of Australia and Southeast Asia. And I had a lot of respect for him. He is their global sales manager. He when I found out he was part of it. And then one of my all time favorite brilliant, brilliant regional sales managers from Invisalign out of Dallas. He joined the team when I found out so I had two orthodontists plus. And I had these two people from the industry that I had a lot of respect for all telling me when I was already in Paris, I need to go meet the CEO. So my wife and I walked a rainy day two years ago, exactly. Through Paris to their headquarters, understated building, walk up the escalator, the VP of this took me toward the CEO meant my wife and I gave us an hour long presentation. My wife who's not an orthodontist, was so blown away by the technology and what it can do for the public. And my mouth was just open with how passionate they were as a group. And so I was sold. My wife was so my office manager, Gina is my CTO and my office. I said Gina, they're having their annual session Las Vegas and a couple of months. They said that we could go I go, would you go for us and I want to see hear what you say. We were signed up she went, we signed up. And we spent the next six months getting on board with it with Invisalign plastic and then started to get the brace patients. So what what it looks like Pat is it's a subscription. So every sales team, every business loves things that are subscriptions, right? This is a subscription. So the device itself is is reasonably inexpensive. 25 bucks for this maybe all and 40 bucks. So the the upfront costs are small, the monthly
Patrick Kothe 50:04
and the device actually actually holds your smartphone. And that is Russian positions in that triangle right place.
Randy Kunik, DDS 50:11
That's right. And just coincidentally, that the cheek retractor part that fits in the patient's mouth was just coming out when we were joining up a year and a half ago, that summer of 19. And so all the hurt, everything converged on us falling in love at the right time, basically, because without that cheek retractors it was kind of hit or miss, I think for a patient. And so we joined in ramped up with my team over six months leading up to COVID, march of 20. And we'd already now started adding brace patient, and we're going to the level of all and right as COVID was hitting, I ordered enough of these for my entire practice. So when COVID shut down, I was able to keep up with all of my patients through the dental monitoring, and it just positioned us in a place where we didn't miss a beat. And we were able to come back in summer of 2020. And, shockingly, be working in producing at 101% of production right out of the gate. Because we didn't have to make up for the last patient appointments which are non productive, productive. Production of mine is only the day that a patient says we'll sign a contract with you. And otherwise, you're servicing the patient and you're taking care of business. But because we weren't so behind, we're able to take the demand of patients and what turned out to be patients working from home, aren't traveling, people decided they're bored and wanted to spend less money on their smile in their teeth, especially looking at themselves on zoom. And so ended up in a remarkable 10 months of production since June of 2020. And then the the real beauty in something any listener would really want to hear is we did that by working 30 40% less in the clinic. So I'm scaling more bending in the mouth with gloves on less. And so profitability is scaled in a way if you will.
Patrick Kothe 52:30
That that's a fantastic story. So what we're talking about is tell him telemedicine or tele dentistry at this point. And telemedicine is interesting because reimbursement had some hurdles to go through. And we saw with COVID, telemedicine became reimbursed at a higher level. And who knows what it's going to be going forward? teledentistry is a little bit different I would imagine because as as we said it's really not not an issue with insurance payments and things this gets packaged into the total program, I would assume.
Randy Kunik, DDS 53:06
Correct? And you said a few things that triggered in my mind interesting things. We have had virtual FaceTime consult on our website for five years plus, so we were but guess what? No one used it. It was funny. It just what? And then we were already doing what we call FaceTime consults before COVID. And during COVID, we would do a lot of FaceTime checkups or zoom checkups. Well, the beauty of the dental monitoring is it's more efficient to basically have the images loaded into a program, which is a really good program, have the laptops and old PCs in the office and email not it's not an email, you're communicating to the patient within the app on their phone, essentially. Well, that is so much more time efficient. And and what really happens with a FaceTime appointment is their pay once somebody's not around, or invariably the Wi Fi connectivity is an issue. And so this dm appointment for what you're calling the tele side is very efficient meant that that fast versus dialing and seeing if someone's going to answer have an appointment.
Patrick Kothe 54:24
From what I understand this company also has some products for the front end in in establishing the need for alignment as well.
Randy Kunik, DDS 54:34
That's right, we are not utilizing that as much as we will in the future. We actually though, gave a bunch of these scanners to our favorite children's dentists, pediatric dentists, and she just dispenses them to patients with instructions. And the patient then is able to communicate with us their future orthodontists and we can give them opinions. There's just through that. It's like So it's basically a way of a patient having a relationship with us with without them even having to call dial in, come meet us. And then we say, Oh, yeah, we'd like to do an X ray meet you summer 21.
Patrick Kothe 55:15
What is the future this technology look like is this you know what, what is what's going to happen once COVID is done,
Randy Kunik, DDS 55:22
people are going to be in the habit of wanting to avoid running into the dentists orthodontist, if they don't have to go in the germ phobia, the germ thing is never going to go away. It was it was already here. COVID really taught us about, you know, wearing masks and washing our hands. But those are things we probably could have been doing before. And so I think people are going to always think twice about going in when they don't have to go in. So I think it's fits under the category of value add
Patrick Kothe 55:58
doctor clinic, you know, that our listeners are medical device professionals, that are in all different types of functional areas from sales and marketing with which you know, well to the product development people quality people regulatory, is there anything that you'd like to say to people within the medical device industry?
Randy Kunik, DDS 56:22
The fine balance from where my colleagues and I sit is? How do we utilize a technology to better the lives of both the patient and our practice while it's profitable for the device company? And how do you strike a balance where the company is consistent is public publicizing themselves advertising straight to the consumer, and not commoditizing, both the device and the profession, and that will, that obviously, Big Pharma, and a doctor has to either do a deal with the devil to take advantage of all that or not. And so where we are with the incredible amount of marketing dollars, that companies that we've talked about tonight, not not so much dental monitoring, but smile, direct club, and the like, there's a bunch of them. And Invisalign, obviously, have a lot of money that goes straight to the consumer. And at what point do the listeners in the medical device world support the doctor side without commoditizing their service along with this attractive device and and that's the fine line. And if you err on the side of supporting the doctor, in terms of giving the patient just enough education, to say, you need to do this, such as in my world, you need at least go see a doctor to get an X ray. And then to get his opinion, before anything. And so that's the fine line, I would say to the medical device world is is How do you do? How do you do that with your whichever your device is? How do you how do you do both because the roads paved already that it's got to be direct consumer to really drive the doctor to to the device.
Patrick Kothe 58:40
So many good things to learn from Dr. krunic. I've got two big takeaways. First, dance with who brung you. Dr. Koon ik said he uses a saying often over talking about his loyalty. He's been loyal to Invisalign for years. And has he explained the relationship has made and kept him number one in a very competitive market. But how did Invisalign do it? First, they had a great product idea. Maybe it wasn't perfect yet. But Doctor clinic could see their vision. They listened to his to his ideas, including a clinical trial, which Dr. Koon performed. They establish relationships with him at multiple levels of the organization, and have kept them for years. They were flexible when he expressed his concerns, like when changing sales reps was not a good, good fit for him, or setting up a store five minutes away. I can imagine not all of Dr. Kooning's concerns were well received back at the office. Maybe he was wrong. Or maybe they just didn't fit with the strategy that Invisalign was trying to roll out. But as Dr. Kooning said, Everyone makes mistakes, and he and the company have focused On the big picture, this isn't easy to do, especially as a company grows. But the great companies do it. Congratulations Invisalign. The second thing is customer service. His story about bringing every new patient to the mirror and asking them to explain what they see. And what they want done was brilliant. Listen before you speak. Also, he knows his customers well, and said he's not an early adopter, because that's not what his customers want. He talked about the importance of his team and how he chooses managers and pays them to ensure they're the best, stellar stellar customer service always pays off. Now for your action item. What's your company doing to build long term loyalty? The simplest thing to do is build relationships at different levels. Think about your own experiences. The more people you know in a company, and the more you feel like you are heard and valued, the stronger your bond becomes. The sales rep usually coordinates most customer relationships and that's a good place for you to start. Give one rep a call and ask how you can help with one of their customers. A good rep will welcome the help. And the two of you can decide if a call a visit an email, or just a thank you note will strengthen the bond and ultimately, the loyalty. Thank you for listening. Please spread the word and tell a friend or to to listen to the mastering medical device podcast. As interviews like today's can help you become a more effective medical device leader. Work hard. Be kind
