Monday, May 12, 2008

Tier Dentistry (con't)

We have been talking about Tiers in dentistry.
If you are just joining us, we talked about different levels of dental offices.
Basically, I was taught there are 4 tiers. From the clinic setting (McDonald's) to the boutique practices (Ruth's Chris).

As a small business owner I think of my office constantly.
I think of my patients and what they want. I think of my staff and if we are giving the customer a product that they will pay for.

I would say my clientele is middle class to upper middle class, who appreciate good service and for the most part care about their teeth.
Now this is a pretty big box. I have families. I have singles. I have young married with no kids. I have empty nesters. I have elderly. I would say I have this great mix of people because that is who I like to treat. Black, white, Christian, Jewish, Muslim, American and non-American. So I try now to exclude anyone. If they can afford it they can come (and sometimes if they can't afford it they can come anyway).

But what I am trying to say is the lines of the tiers are getting crossed.
I have been thinking a lot about this. Ruth's Chris is the top tier restaurant (I know, I know I talk about Ruth's Chris a lot. It is my favorite restaurant. I go every chance I get. The sweet potato casserole is AMAZING. Steaks come out on a plate that is 500 degrees with butter melted on top of them. OH MY GOSH. I am getting sidetracked).
So if you are the manager of a Tier IV restaurant or dental practice you are trying to cater to the people that can afford what you offer.

But this is where the lines are getting crossed.
What do these people look like? For me, who is the middle to upper middle class? For the Tier IV guy, who is the upper class?
So a couple of months ago I went to Ruth's Chris with my periodontist. My wife and I got their a bit early and took a seat at the bar. I started to people watch. I noticed something strange about some of the clientele. They were every walk of life.
Lets back track. 10 years ago, who went to Ruth's Chris? The rich.
With the exception of the middle to upper middle class on a special occasion.
I would say this type of people are from 50-65.
They would dress a certain way.
They all kind of looked the same.

Now, rich is such a relative term. There are people that are rich that don't look it (ever read the Millionaire Next Door, it is a must read. But if you did read this book you would know that the vast majority of the rich do NOT eat at places like Ruth's Chris) and there are people that look rich that aren't.
They all dress different and they are all different ages.
Can you imagine 10 years ago walking into a Ruth's Chris being 25 years old wearing jeans and a t-shirt?
Well, this is what I saw while sitting there. These two plopped themselves next to us at the bar and ordered some red wine. Now when I was 25 the only bar I was plopping myself down at was the Purple Porpoise in Gainesville and I sure as hell wasn't ordering a MERLOT.
Now is this young person rich or is he using his parent's money? I guess Ruth's Chris doesn't care. I guess if it was my office I wouldn't care.
I read a statistic recently that said that 33% of all new Mercedes owners make less than $60,000 a year. WOW!!!
Lines are being crosses all over.
I have a neighbor that is days from bankruptcy, living in a real nice neighborhood (yes, if you are an avid reader, I have some screwed up neighbors. I fit right in don't you worry).
and she is driving a super sweet Lexus. Also the car is never unwashed. She is so upside down in everything she has. It is amazing how stupid people are.
I think about what a burden it is to drive an expensive car that you can't afford. Every time I see someone in an ESCALADE, my first thought is that car is that car nice. Then I think, man the person driving that car is cool. Then I think what it cost to drive that vehicle. I think that he or she could have two tricked out Expeditions for that price.
I am getting off the point.

Who is it that we are trying to get in our practice?

One quick story. There are a lot of professional golfers in Orlando. One of them was referred to my office. I had a patient that plays with this dude. My patient thought the two of us would get along because we were the same age, we are both diehard Gator fans.
He came in to get his teeth bleached. We talked like old pals, we had lots in common.
Now this guy at the time was in the top 10 on the money list. I think he made close to 5 million dollars that year.
I never saw him again. My friend told me a while later that he was a little chapped because I charged him.
$300 to a man that made $5,000,000.
On the flip side of this, I was seeing a man for a new patient exam. He was a huge grinder and he had ground his teeth down to bits. So I told him, "You need a lot of work and it is going to be very expensive (something like $40,000) to fix your teeth."
He said he would think about it and let me know. He drove away in his 12 year old Suburban.
I told myself, "Yeah, right".
He called in about 15 minutes and asked, "When can we start, I had to go home and find out how long it would take me to transfer money?"

Who are we trying to get to our office?
I have stopped trying to figure it out. I set up my practice in a way that I think people would like. I have set up my office in a way that if I was a patient I would like it.

I don't care if the people are rich. I don't care if they are well dressed. I don't care if they are 50-65 years old. I don't care who's money they use.
I just want them to appreciate what we are doing.
I want them to appreciate the staff.
I want them to want what we have to offer.
In the last week I have had two patients that were NOT rich getting work done. These are the kind of guys that are doing one filling a month because they can't afford to do the work all at once. But both of them on two separate occasions said to me, "I appreciate you."
Not "thank you" or "I appreciate it".
This is the stuff I work for, "I appreciate you" and they looked me in the eyes and shook my hand.
And I said,"It is my pleasure", because it really was.

Have a great day.
Talk to you on Wednesday,


Anonymous said...


So, so true about people. They say "Do not judge of book by its cover!" and it holds very true to us. The best approach is to diagnose the needs, understand their wants and do the best we can. Sometimes their wants overpower the needs, but we must hold true to why we are dentist in the first place...and AGD members.

As for the $5 million golfer, you have to understand that it must have been an HONOR or PRIVELGE for you to treat him! NOT!!!!!!!!!!!!!

When you see him on TV, drop him a note telling him how nice his smile looks!


Joanne said...

I have two things to say... Most USED Mercedes owners are too poor to buy a new Mercedes but because we want HIGH quality we buy them used BECAUSE they are quality cars. We cannot afford them new, but we want the quality! New Mercedes owners can always afford to waste alot of money on a new car. And most Professional golfers are NOTORIOUS for being CHEAP because they never know when they are going to "win" their next paycheck. Professional golfers are like professional gamblers...very unreliable financially. Both are notoriously BAD tippers! They have learned to be cheap simply because their career is so unreliable financially that they never know when they are going to be rich one day, or broke the next.

gatordmd said...

Someones is catching up on all the old blogs.
Welcome to the family. Thanks for commenting.

Ps this particular golfer made 10 million that year


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