Knowledge is Power: Avoiding the Envelope of Law
Shaun Keating: Hey everybody, Shaun Keating here. Like to welcome you to this week's Dental Up podcast here at Keating Dental Arts in beautiful Irvine, California. Today, we're going to be talking with Dr. Lee Frost from Rutherford, New Jersey. Dr. Frost, what's up, baby?
Dr. Lee Frost: How are you, Shaun?
Shaun Keating: It's good to hear from you.
Dr. Lee Frost: Good talking to you.
Shaun Keating: Thank you so much for coming on this week, dude. I love you. God, you've been with me forever and one of my favorite guys.
Dr. Lee Frost: I've been there from day one. I probably have done 1 million units with Keating Dental. Incredible and most importantly, I have been there from the transition from PFMs to zirconium, probably the most important thing that's ever happened in crown and bridge in dentistry.
Shaun Keating: That's great, that's awesome, dude. Hey, tell me a little bit about, I know you're a big New York Giants fan. We like to start off with sports but you still believe in those guys or what? They're kind of letting you down a little bit, aren't they?
Dr. Lee Frost: Well number one, you know my practice is right next to MetLife Stadium so we work on a lot of football players, we work on a lot of staff. The Meadowlands is, to us, the mecca of the universe so we got the Jets, we got the Giants, and Shauny, tomorrow night and Thursday night, we got you, too. So there's a lot going on here in the Meadowlands.
Shaun Keating: I know. You could look out your office and just see it. I remember always Monday nights, Monday night football.
Dr. Lee Frost: We got a professional football game, home game, every Sunday of the season here. It is just tons of fun.
Shaun Keating: How neat is that, man. That's just awesome.
Dr. Lee Frost: Every single Sunday, we squish about 81,000 people into MetLife stadium.
Shaun Keating: No kidding.
Dr. Lee Frost: And that's a lot of teeth, so that's good.
Shaun Keating: Yeah, we got about 100,000 capacity in the Coliseum for the Rams, and we're lucky to get 20,000 people in every, I think they sold like 70,000 season tickets last year and after they started losing and losing and losing, they couldn't even fill 30 or 40,000 people in there. It's just kind of sad. You've got to have a winning team, man, to get people to come out here in L.A.
Dr. Lee Frost: Football's crazy here and, you know, with football comes, I'm not sure how big tailgating is in California, but tailgating is so huge in New York that we get there 8:30 for a 4:00 game. We just eat, eat, eat and party and drink all day long. There's nothing like New York football, nothing.
Shaun Keating: Oh, I bet. I bet it's a fricking exciting time. I did a few times because we haven't had football here for 20 years and we go down to San Diego to watch the Chargers, and I've done a few of those 8:30, 9:00 tailgate parties but by the time the game started, I'm ready to go to sleep almost. I remember one time, at halftime I was faded. I said, "Honey, let's go." And was just like, "Yeah." Kind of nuts.
Dr. Lee Frost: I get rougher Tuesday morning patients.
Shaun Keating: Oh bad, that's so awesome. You know, we got football to look forward to, I know a whole lot of nothing really going on. We've got basketball, the Lakers got some players. Heck, you've got the, is that New Jersey Nets? You took a couple of our guys off our squad. Are you a big Nets fan or no?
Dr. Lee Frost: Yeah, but we gave you Brook Lopez.
Shaun Keating: Oh yeah, and that dude's throwing up 20 points a game. For a big man, that's pretty unbelievable.
Dr. Lee Frost: That's a great deal for you guys.
Shaun Keating: Yeah, I think so.
Dr. Lee Frost: Yeah, Brooklyn's like the hottest new place now in the universe. It's all young kids, super intelligent, all working in social media and Apple and Google and Facebook and Amazon. Yeah, this is a happening part of the country right here.
Shaun Keating: Yeah, that's what I heard. Brooklyn took off. I mean back in the day, it was not even 20 years ago, it was pretty slummy in areas and stuff like that, but I've heard it's really taken off and a lot of the old units have been turned into condos or whatever you call them, and they're going for millions of dollars now. It's kind of crazy for the cost to live out there is pretty similar to California.
Dr. Lee Frost: New York is unbelievable. Unbelievably expensive, but, again, best place to live. I know California's [inaudible 00:04:31]. Shauny, you'll never beat New York City.
Shaun Keating: Ah dude, we blow you away. Fricking Orange County, L.A., nothing better. We've got the mountains, we've got the sea, we've got everything in between, the desert, it's beautiful. It's God's country out here. The government's a little messed up.
Dr. Lee Frost: You got Keating Dental Arts.
Shaun Keating: Keating Dental Arts. So, hey dude, let's Dental Up man. Tell me a little bit Frosty, how you got into dentistry. I know you worked with your pops forever, but you're second generation dentist. Tell me a little bit about how you got into dentistry, maybe where you went to college and what's it like to work with your dad and stuff?
Dr. Lee Frost: You know, I was completely exposed to dentistry for a long time. My brother decided to become a cardiac surgeon and I felt like dentistry was a great profession. You work for yourself, you're your own business owner, you make all your own decisions, all your job security is within yourself. You can design a great business model in dentistry, you really can. My dad taught me everything, I'm a dentist for 33 years, I'm very, very good at it. We are working on our fourth and fifth generation of patients right now. We love being healers, we love creating beautiful smiles and we love all the relationships and the friends that we've made. Our practice is 65 years old now, Shaun. We have a lot of depth there so it's fun. I really enjoy it, even 33 years later.
Shaun Keating: That's awesome dude. You know, I started 33 years also. That's weird how we're both the same time. '84, huh?
Dr. Lee Frost: Yeah and the technology in dentistry has just made this profession so much more fun to be a part of.
Shaun Keating: That is so cool. How's digital technology impacted your practice? Are you doing much with it yet or what do you think about the digital technology coming out with it?
Dr. Lee Frost: We're totally computerized, we're totally paperless. Digital radiography is incredible. Social media drives your new patients to your practice. Cone scan, putting in implants, guided surgery, digital impressions, yeah, you're crazy if you don't hop on board the digital.
Shaun Keating: No kidding.
Dr. Lee Frost: Remote access to your file servers, yeah. You don't even have to be in the office, really, to do a lot of the administrative part of running your business.
Shaun Keating: That's so cool, that's awesome. I'd like to ask you a few things about your social media. I know that's the new thing. We're kind of getting out of going to these dental conventions. We were doing one a month and it's $15, $20 plus grand for each show and it's kind of tough to get dentists. It's kind of like the swap meet. They walk by and you know, we don't really have nothing to sell. All we have is some information to give doctors but the whole social media thing, everything's going to your phone and what do you think? What are you using on that? You doing Facebook, how's that working in social media? Tell me a little about that.
Dr. Lee Frost: We have a very, very high end website, which is really your most important marketing tool. All of our marketing dollars go into our website and we position ourselves with our SCO, so that when people Google a dentist in my area, whether it's Rutherford, Burton County, New Jersey, implants, emergency, extractions, root canal, anything, we make sure our office is one of the first offices that pop up on your Google search. Your keywords are the most important thing. You should have as many keywords as possible and when any of our new patients come in, the first question we always ask them is what did you type in to search for our practice? We really look at those words and hone in on the most important words to strategize for our website design.
Shaun Keating: That's amazing, that's amazing. That's awesome. That's what I'm hearing from the most successful practices out there. They're really investing in their website and their social media presence because it's kind of where the people are going to now. It's not like the old school, the yellow pages and some guys that really go all out are doing some little TV ads or stuff like that or radio.
Dr. Lee Frost: Almost what you said about not going to dental conventions anymore, and I agree with that. You know, we don't do any print at all. We do all Facebook, we do Instagram and we do website. Those are the big three. Maybe a little blogging, but mostly the big three are Facebook, website and Instagram.
Shaun Keating: That's so cool. And you've got your same staff forever, man, and it's a pretty big staff. That's kind of good that you can keep the consistency with the same people around for years and years. What about your wife? She still in there manning the boards and all that? Is she still keeping an eye on things?
Dr. Lee Frost: She doesn't work within the practice, but she's a very, very smart businesswoman. She guides all the healthcare insurance, the disability, the malpractice, she negotiates with the credit cards, MasterCard, Visa, AMX, Discovery. She makes sure we get the lowest rates possible. We don't go to the bank anymore so everything's scanned now, makes it easier. No one has to leave the office. Nobody.
Shaun Keating: That really is kind of neat when you can have your wife. My wife comes in, does a few things here like with human resources, and just kind of keeps the happy face going around here. I mean, everyone's happy, but you know.
Dr. Lee Frost: Every relationship you have should be revisited all the time, at least once every couple months. You should renegotiate, renegotiate, renegotiate so you are getting the best deal, the best rates, the best prices that you possibly can.
Shaun Keating: I know. That's important to be diligent in that area. Some of us, with me, it seems with all my vendors it automatically, everything goes up three to five percent each year.
Dr. Lee Frost: But Shaun, it doesn't have to.
Shaun Keating: Yeah, I know, but when I've only got a few options where I can only buy E-Max from one company and I can only buy my gold from, there's only three companies in the US that you can buy cast gold. I see what you're saying. I have a CFO here that I don't really even, I sign checks and I always want to get the best deal from my vendors but I get at the end of the day it's volume. It's kind of like UPS. I use UPS and I try to use FedEx against them, but it's a matter of how many packages go out each day and there's a number to everything. Kind of like you get divorced in California. It doesn't matter what, they're going to put your income into a computer and it's going to tell you exactly what you're going to pay that little lady and it's kind of like our vendors. Shaun, well you do this much, this is what we can do and if you don't like it-
Dr. Lee Frost: There's always areas where you can negotiate and then from what you're saying, there's other areas where you are stuck.
Shaun Keating: Yeah, but it's something too, I get dentists, they negotiate everything like you're saying, then they try to come to me and say, "Shaun, can you do anything on my friends?" It's like dude, I'm lucky to make a nickel on every dollar I bill out. It's a tough field and with medical going up, my medical is going up 18% this year. I've always done medical-
Dr. Lee Frost: And every year, every year.
Shaun Keating: Yeah, it's so nuts. Well, you don't have a hundred and some-odd people to pay for and we pay 100% for everybody. It's kind of a perk for working here. I'm kind of proud of that though.
Dr. Lee Frost: That's why the employees have to kick in a certain percentage of benefits now, Shaun. They do. They cannot expect the employer to pay 100%.
Shaun Keating: You know, I know. I hear that every year when I'm in these meetings with our people that are shopping at me. We have the same people that do our insurance for years and every year it goes up a little bit. They say, "Shaun, you need to get the people to kick in." I don't know, I just, I love the people that work for me and I pay 100% of everything and I just think that's a good thing for me. I know yeah, I could charge them a couple hundred bucks each a month and it'll offset the $500 I pay for each person, but they're having a tough time. It's not easy.
Dr. Lee Frost: Okay.
Shaun Keating: That's just me, it is what it is. Yeah, I like to be able to offer that to them and I just hear all the country with all the insurance and all the hassles of people not having it, and I knew when I had two employees when I first started, I was going to pay for them. I kind of like it, the more people I've got, the more I pay and the bigger check. I think I pay over $600 grand a year just in premiums. The thing is, with my company, a lot of my employees, after all this, all the money I spend each month to write these checks, for the yearly nut on it, probably 90% of my people don't even use it. It's weird but let's get off that. Anyway, so tell me a little bit about your association with St. Mary's Hospital. You do a little work with those guys or you do some, talk to me a little bit about that.
Dr. Lee Frost: Well, we started a residency program there and we intern dentists coming out of dental school. We train them, it's like a GPR residency and it's like a mentoring program. We take them on for about a year. It's a great program and they are in a very underprivileged area so we help out people who can't afford dentistry. We do a lot of things for the community there, along with teaching new dentists the practice and the business of dentistry.
Shaun Keating: That's great. I love that. We have a St. Joseph's here, probably related, St. Joseph and sister, probably St. Mary you think, or no? I don't know how that works.
Dr. Lee Frost: I think they're brother and sister.
Shaun Keating: There you go. Tell me man, you do a lot of implants too. Tell me a little bit about the implants you use. I know you do minis, you do regulars. Tell me a little bit about, did you go to anyone in particular for learning your implants? Tell me a little bit about that.
Dr. Lee Frost: Yes, I took a year long residency in implant surgery with a bunch of other doctors, every single Wednesday for a year, and didactic and clinical, and they just really feed you, feed you, crush you with knowledge until they think you're ready to enter the surgical world. You just dive right in. Now with a cone beam and surgical stents, every new dentist should really incorporate first prosthetics and if you want to go into the surgical aspect, it's just a great venue to add to your practice.
Shaun Keating: It takes some balls though, to get in there and pull that flap, but after using the right tools, surgical stents and cone beam, it's pretty predictable but it's takes some cojones to get in there and do that in my book.
Dr. Lee Frost: It takes guts. You've got to be a little bit brave. You really, really have to know what you're doing. You really have to put a lot in your training before you bring it to your private practice because you really don't want to do anything wrong. Because if you do and you're a general practitioner, do something wrong, you're going to get the envelope. What you want in dentistry is you never want to get the envelope. If you get the envelope, Shaun, the envelope is usually from a lawyer. There's nothing good in the envelope so you really want to be well trained in any aspect of dentistry before you really start advancing it in your private practice.
Shaun Keating: Yeah, it really does but the only way you're going to get that experience is by doing it, so I think if you can get the knowledge and get trained well-
Dr. Lee Frost: And the only way you're going to really, really, really learn is if you make mistakes. Hopefully, the mistakes are not large or grave mistakes.
Shaun Keating: Oh, I remember learning as a dental technician at the bench, back in '84, man, we all just, we got those dies, we trimmed them ourself where we kind of thought the margins were and it was like, I can't tell you how many bevels I trimmed off of yours because you're like old school. You're like a shoulder bevel guy. You're still doing shoulder bevels, aren't you?
Dr. Lee Frost: I'm not. My dad taught me shoulder bevels, now it's optical scanning and digital milling. Everything is a sloping shoulder, everything.
Shaun Keating: Ah, beautiful. I got you back on the way back now that I remember. [inaudible 00:18:02] but yeah, man, I remember the bevels. It's like the size of a bevel should be the size of a metal margin but that was back when all we did was PFMs. It's amazing how we've advanced in not even 10 years now. It's kind of crazy but-
Dr. Lee Frost: You get a much healthier relationship between the gum and the crown when you do a shoulder than if you do a bevel. Because usually a bevel, you are impinging on your PDL and you could get a bleeding, red, purple gum forever.
Shaun Keating: Oh blanching the tissue, it's just hard to get that flat, emergence profile when I'm trying to bring two tenths of opaque, three tenths of metal, then I've got to bring a millimeter of ceramic. It's tough to bring all those materials down and then to knife edge it off a bevel so kind of crazy.
Dr. Lee Frost: There should be really no more knife edges. There really should.
Shaun Keating: Yeah. I still get a lot of guys doing slice preps that knife edge. It's kind of, it seals wherever it ends up but no, it's just bulky.
Dr. Lee Frost: You know, for zirconium, when you have a deep bevel, you're can miss something.
Shaun Keating: Yeah. Gold is always supposed to be beveled. I've do [inaudible 00:19:14] a lot of gold and I've still got a lot of guys just beveling it and you can flatten that metal. The malleability of the gold is so nice, kind of old Tucker style gold, that [inaudible 00:19:28]. I still do a ton of it. It's kind of a lost art with some of the newer dentists out there. Now what about with you, I know you like to do everything. You do endo, you do pretty much orthodontics. Do you refer out anything? Tell me about how you refer out. Is it your local buddies or guys you just have relationships, or do you try to do everything in office and be a McGuyver of all trades?
Dr. Lee Frost: The only thing I refer out actually is, right next to me I have two women orthodontists who are amazing. For a full wire and brackets, that's one thing I don't do and number two, I also have a pediadontist right next to me. That's a great referral base because I send him the kids, he sends me the adults or the parents. That's really nice. Other than that, everything else other than that I do. I have my own anesthesiologist, I have my own endodontist, I have my own periodontist. A lot of stuff we try to keep in-house but definitely full ortho cases we don't do and some pedo cases that might be better off in a specialist's office. We refer out.
Shaun Keating: That's awesome. That's great, dude. It really is and I think today, with this economy after the recession back in 2007, 2008, I think more and more dentists are finding that you know what, I need to work on these orthodontic cases a little bit more. I need it a little bit more and I need to be doing more perio-type surgery or not even perio surgery, just different things in their practice that you can keep the money there with you but it's all about educational courses too. Do you have any certain educational courses through the years that you've attended that you took more home with some than others?
Dr. Lee Frost: Number one, dentistry, you should learn something every single day, you should. You should constantly take courses. Technology changes so quickly, endo is so important. You should take endo courses. You should take cosmetic courses. You should learn about the new materials. You should learn about e.max. You should learn about zirconium. You should learn about the new preparations. Implant surgery. I've been taking implant surgery cases all over the country. Invisalign. Then even really important, practice management. Whether it's Scheduling Institute in Atlanta or [Roger Linn 00:22:14] in Baltimore, or Las Vegas LVI in Vegas, you should take all different types of courses, especially when you're a GP, to make sure you are well-rounded, not only practitioner but businessman.
Shaun Keating: I always say that, I always ask the dentist that do the podcasts with me, what advice do you have for the new dentist that are starting out? I think what you're saying right there, I mean those first 10 years, whatever you can do financially to do it, get as much education as you can. They're all great out there, really like you said. Lavine and there's so many different guys, west coast, east coast, that have it.
But you've been through college all that time and you probably don't want to do that but the best thing you do your first five, 10 years is just, and through your career but just those first five, 10 years, learn everything you can and just fill your head with it so you've got all these options to use in your practice. Then you pare it down and find what you do best and what you like best.
I think continuing education, even for our dental techs, we've got to keep up to be certified, a yearly thing just like dentists do but education is so important to be on the cutting edge and to get your skills, to get the theory is just so important to know all that in theory. But then to get hand skills and hands on, it's kind of neat to get into those courses. That's why I always say Speer or Coy's down here, and I know there's other guys back where you're at, east coast. That's the best investment you could ever do. Even if it's $50 grand, $70 grand, and it's a year course that you have to go and do, it's going to come back and pay tenfold on you. You're going to be able to practice so much more confident and I think it's important. That's awesome, dude.
Now tell me real quick, I know you go skiing all the time. You come out here. You're in Park City. You got a place or something? Tell me a little something about your fun and activities.
Dr. Lee Frost: Yeah, I live in Park City, which is one of the best snow in the world. I spend a lot of time there in the winter and in the summer. The summer's actually more fun than the winter. The restaurants, the whole social aspect of the town, so many things to do. The golf is incredible, the hiking, the mountain biking, there is just so much to do out there. And the people are very, very, very nice. And easy to get to, 30 minute drive from Salt Lake City. That's just one of the reasons we chose that.
Shaun Keating: Is that where you fly in, to Salt Lake City?
Dr. Lee Frost: Fly into Salt Lake City and I'm in my bed in 30 minutes.
Shaun Keating: Unbelievable. You've got that place a long time ago. How many years you been there now?
Dr. Lee Frost: 2000.
Shaun Keating: Really.
Dr. Lee Frost: Year 17 already.
Shaun Keating: Gosh, I bet that's went up a little bit in what you bought it for, huh? A nice little investment there.
Dr. Lee Frost: It was, it was a good investment.
Shaun Keating: That's so cool, dude. Well Frosty, man, I want to thank you so much. I really appreciate, how long have we been together? We've been together since the start of this and even before that. We've probably been together probably 30 years now I'm thinking.
Dr. Lee Frost: I was one of your first accounts when you opened KDA. I was one of the first. I have about a million KDA teeth walking around here in New York and New Jersey.
Shaun Keating: That's so beautiful. I love that. You are, you're a cutter. You're a fricking monster, man. You really get at it and you just really have a passion for it. What I love about you is you'll be texting me or calling me at night, Shaun, I've got a 12 unit coming in the morning to you. It's like every day, you're doing so much big work we're doing and I love the way you put us together, man, how, we just love it.
Dr. Lee Frost: I just sent you a 13 unit that just arrived yesterday in your lab. So good luck with that one.
Shaun Keating: Thank you Lord. Looks like I'm going to be able to go out and buy mama a new dress, new summer dress. Hey, look Frost, thank you so much and I'll talk to you real soon big guy.
Dr. Lee Frost: Good luck to you. Bye bye.
Shaun Keating: All right man, bye bye. Hey everybody, I want to thank you for tuning into this week's Dental Up podcast. If you could, go over to iTunes and leave a review.