Special List #4: Your Dental Brand Is Not a Logo with Dr. Rob Ritter

Dr. Souyais (00:02):
You are listening to The Special Lists presented by Referral Lab, the podcast for dentists and dental specialists. On every episode, we bring you a special guest specialist featuring a special list. I'm Jason Souyais.

Dr. Seda (00:16):
I'm Michael Seda.

Cameron Full (00:18):
And I'm Cameron Full. And welcome to another episode of The Special Lists with my guy, my main dude, Rob Ritter.

Dr. Seda (00:27):
Oh yeah.

Cameron Full (00:28):
Before we get going, I Rob Ritter. So before we get going.

Dr. Souyais (00:31):
So nice to have you Rob.

Cameron Full (00:32):
I got to give this guy, this guy right here is a major reason that I am in the dental world. He believed in me real early, almost about a decade ago and gave me a shot and man, one of my closest friends these past 10 years, I watched the practice change and shift. I watched how they did dentistry shift down there, how they then ended up with the protocol and man, it's been a wild ride to be your friend Rob. Rob is a graduate MSC, college School of Dental Medicine, 1994. Practiced privately for 31 years at Ritter and Ramsey. Been lecturing since before time on cosmetic restorative implant and digital dentistry.

(01:23):
And actually when I started traveling more, I was thinking to my dude, he had to connect everywhere. So part of his whole lecture circuit was he had to connect all the time going home. I don't even know how he did. I was calling him. I'm like, dude, I am stuck here. How did you do this for 72, 72 years? His wife, Isabella, is a dentist and his daughter wants to become a dentist as well. Fellow of the American Academy of Aesthetic Dentistry, member of American Academy of Restorative Dentistry, spear Education and Co Center graduate. We welcome Rob Ritter.

Dr. Seda (01:59):
The legend.

Dr. Ritter (02:00):
Good to be here with you, my friends. Known all of you for a while and it's great to be here with you. I'm very excited for your journey on this pod and what you guys are doing with Referral Lab. It's pretty awesome, man. It's awesome.

Dr. Seda (02:11):
Good to see you, Dr. Rob. Glad to have you.

Cameron Full (02:13):
So when we were venturing every few episodes, we go off the specialist for the specialist and I said, can I bring my dude on? And the guys were like, let's bring Rit on. So for those that don't know, Rob is not a specialist, but he might as well be, incredible clinician. I've been in 150 practices in the last four years. His practice remains one of the best. So let's talk about Rob. Let's talk about this list, man. What's this thing now when you look back, what's one thing you wish you would've done a little sooner?

Dr. Ritter (02:48):
Well, it's interesting. First of all, again, it's great to be here with you. I had a chance to really think about this in the last couple of weeks, and if I was doing things over again, I think you always hit that fork in the road sort of thing in your life. Somebody would say, well, I wouldn't change a thing. I wouldn't be here with you guys, which is true, right? I mean, if I made one left turn instead of right? I mean based off that movie sliding doors, you wouldn't be here right now. So I fully understand that in the profession though, the profession has changed a great deal since I went to dental school in the very, very early nineties, right? It is changed a tremendous amount and by today's standards, the way that dentistry is performed and what is expected of general dentists now is a completely different world.

(03:38):
I hate to use the word the super dentist. I just think that there's so many opportunities now for general dentists to take continual education and not just a weekend course, but these continuums where you can add the ability to do extractions, hard tissue grafting, soft tissue grafting, orthodontics, endodontics, all of these different modalities that were not really available when I went to dental school, when you graduated. For me, it was about restorative dentistry, and so I focused on that. I drove those goals. My goal was to always be better the next day than I was today. Try to be the best dentist I could. Try to be the best dentist I could be in Northern Palm Beach County, Palm Beach Gardens and Jupiter, and I think I did that. If I was doing it now though, graduating, I have to be honest with you, I was graduating right now, I don't know if I would do that. I think I would take a lot of these different courses and be able to do all those different modalities that I'm basically incapable of doing, and you wouldn't want me doing those things on you right now. There's no way. Now if I wheel the clock back 30 years and I took all those courses, could I do an extraction with a hard tissue and a soft tissue graft? Yeah. After 30 years, I think I'd be probably pretty competent about it. But not now. Not now. So if I was doing it over again, that's what I would do. Because I think you know, Cameron and I think Mike and Jason, you probably know a hundred percent of my specialty work that's referred out to people like you to specialists. I don't do any of those things. I don't take out teeth, hard, soft tissue graft. I don't do endo. I don't even make dentures unless they're supported with at least six implants. So all of that gets referred out because it's just not what I chose to focus on. Today's a different story though. It really is. It's a different game.

Cameron Full (05:31):
Don't you think that that level of intention that you placed on the type of outcomes that you wanted, both aesthetically and non, made you as exceptional as you are?

Dr. Ritter (05:46):
Well, sure, because what do they say? A jack of all trades, master of none.

Cameron Full (05:50):
Correct.

Dr. Ritter (05:50):
The fact is that if you're going to do those five different things in your practice, there's no way you're going to truly excellent at all five. It's not the way humans are. It's not the way we're built.

Cameron Full (06:02):
Correct.

Dr. Ritter (06:03):
So right. So if I go back to what I did, did I focus on the one modality of just restorative dentistry and did I become unconsciously competent and some would say excellent. Yeah, I think I did that. In fact, I think I know I did that. Now I did put a lot of intention into it. It was very thoughtful, it was very purposeful. It was directed. I knew what my goal was. Even though the other thing about goals is they move the goalposts, they move, it always is changing. You got to kind of zig and zag a little bit. Yeah. Would I be as good of a restorative dentist right now if I took on those other modalities? Probably not. So am I happy with where I wound up? I am. I'm just saying if I was doing it today, if I was graduating in 2025 in May, I think I'd have a different intention.

Dr. Souyais (06:47):
Why do you think that is?

Dr. Ritter (06:49):
Well, we all know what the answers are. Number one, you're coming out of school with a half a million dollars in debt. You are subservient to about 30% of DSOs. It's more difficult to get into a traditional associateship job. It's difficult to practice what I call out of network dentistry. I like to spend a little bit of time out of network versus fee for service versus in-network. You put all those factors together, not many mentors are left people that want to actually truly mentor a young dentist. I mean, really mentor them, not just give 'em a job. And it becomes very challenging in today's environment and economies to do that sort of dentistry. It's very, very hard. It's everything wrapped up in one, right? It's not just the dentistry, it's the branding, it's the marketing. It's the pulling off of having a cohesive team, not staff.

(07:40):
It's having an office that looks the part and can give you the deliverables. It's running a small business, knowing your numbers. It's everything. That's what dentistry is, and people don't, I got to be honest with you, I didn't know that when I went to dental school. Nobody explained that to me. Nobody told me I'd be running my own small business. Nobody told me I'd be dealing with the challenges of disasters every day, with people walking in what I call disasters and being a problem solver. Nobody explained that to me when I went to dental school. They didn't tell me. It was a really big awakening for me, and you have to grasp it, embrace it, and say, okay, this is what we're going to do. We're going to make it happen.

Dr. Souyais (08:22):
Now, Rob, I know you're an amazing clinician today. I didn't know you back then when you first started, but I'm going to assume it took a while to learn and get to the level that you're at. What are the things that were instrumental in driving you and pushing you to become a master of your craft?

Dr. Ritter (08:44):
It's a great question, Jason. Let me start off by saying this. Some of what I acquired was not done, I don't want to say for the right reason, but it was because I was pushed to do it. So let me be very clear with everybody. I don't like blowing sunshine into people's asses and thinking it was all unicorns, rainbows, and candy, right? It's not like that.

Cameron Full (09:04):
And you're a pretty purposeful individual. So

Dr. Ritter (09:10):
The reality of that, the reality is I come to town, I knew what I wanted to become. I knew the type of practice I wanted and I knew the type of dentistry I wanted.

Dr. Seda (09:20):
Were you from the area, Rob? Were you from the area that you wanted to practice in?

Dr. Ritter (09:25):
I grew up south of here. I grew up probably about 25 minutes south of here of where I live in practice. I come from a small, very rural town. In fact, the quick story there is I grew up in a place called Green Acres, like the TV show.

Cameron Full (09:38):
Like the TV show.

Dr. Ritter (09:39):
When I applied to college, I was so embarrassed by that. I didn't put Green Acres down on the application. I put West Palm Beach. That's a true story.

Cameron Full (09:44):
Cue the Green Acres, cue. The green Acres.

Dr. Ritter (09:46):
Green Acres is the place for me, you guys. I come out, I get into this practice and I got shit on pretty bad. I took a lot of arrows in my back from the local dentist who were basically threatened by me, just let's call it young guy with a lot of energy, with potential. I'm not going to tell you I was super talented and they were threatened by me, and they shit on me and they slandered me. And so I said, okay, this is what it's going to be. Let me show them what I got. I had a rise above, which was tough. I'm not going to say it was easy. It was difficult.

(10:18):
I took Jason, tremendous amount of continuing education. Tremendous. In fact, I like to say I'm overeducated and restorative dentistry. I went through all of Dawson, I went through all of Spear. I went through all of Kois. I took a lot of courses from Mark Piper. I tried to put the whole package together and I just said, I'm going to work with better ceramics. I'm going to give better deliverables. I'm going to stand behind my work and I'm going to put in the long term of getting to where I want to be. Because as you know, everybody wants a shortcut to greatness. And there is no such thing. There is none.

Dr. Seda (10:49):
Yep.

Cameron Full (10:50):
Time. Time.

Dr. Souyais (10:52):
Not just time.

Dr. Ritter (10:52):
You would call it long tail, right? You got it.

Dr. Souyais (10:57):
It's not just time though. It's being able to, especially in a profession like ours where there's not only the mind portion of our profession, but there's the hand portion of our profession. It's unique in that way. And time alone does not do that. It's looking at our own work with critical eyes. How could I do that better? How could I do that different? What did I learn from each patient I treat? Don't you agree?

Dr. Ritter (11:23):
A hundred percent. I couldn't have said it better myself. And that's why they call it a practice, because every day you practice and you get better and better at your skillset, when you care, when you want to do the best, when your whole intention is. Lemme say it a different way. We all have egos. All of us have egos, and I don't want to get my ego bruised and I don't want to be embarrassed. I never want to embarrass myself, whether it be in practice or on a stage. I don't want to embarrass myself. Other people don't care, but I care. I don't like that. I don't want people to say anything about me. I want them to say, wow, he's really good at what he does. He's a great speaker. Wow, he runs a great practice. That's what I want to hear. I don't want to hear the other things. Which means you have to go into it and give it a hundred percent. Again, today's a lot of day of just coming clean. I was an average student in dental school when it came to bookwork. I want to make sure you understood. I would study, my wife's a dentist. We went to dental school together. Even though I didn't know her, I met her the first day we would study together. She always outscore me on every written exam every time.

Cameron Full (12:24):
That doesn't surprise me.

Dr. Ritter (12:25):
Doesn't surprise me either. Yet. I was at the top of the class and all the labs and working on patients, which to me was ultimately more important. Now, the dental schools back then, and we're going back 35 years, put more value on how well you did in biochemistry versus how well you did in operative dentistry, which was complete bullshit because you're not going to be doing biochemistry the day that you start practicing on a human being. So to me, they were completely farsighted in what was the most important thing. However, they did recognize my talent, my skill level. They took me under their wing. I kind of had an idea of what I wanted to do when I graduated. But did I graduate top of my class? No. Who gives a shit? I mean, I don't care. Nobody asked me where I graduated in dental school. And again, compared to the rest of my class, I think I did pretty good. Even though people scored way higher than me on their biochemistry exam. I don't care. Doesn't make a difference to me. They don't have a practice like I have.

Dr. Seda (13:15):
So let's fast forward now 35 years for those of our listeners that don't really, although I can't imagine there are many that don't know you in about you. For those that don't know, maybe you can just give us a little background on what you're doing now over there with the protocol and your practice.

Dr. Ritter (13:37):
So since we're doing this live, we can do, let's

Dr. Seda (13:40):
Show that chest.

Cameron Full (13:40):
You can shameless plug.

Dr. Seda (13:41):
Look at those pecs.

Dr. Souyais (13:45):
Plug it.

Dr. Seda (13:46):
So let me give you a brief rundown on the protocol. I got to puff it out. So what happened was

Cameron Full (13:55):
You gotta talk about when we named it though, Rob.

Dr. Seda (13:58):
He's getting there, he's getting there.

Dr. Ritter (13:58):
So I'll give you a quick second. I've been lecturing for 27 years. COVID hits the lectures, get shut down, and as Cameron said on the front end of this, everywhere I go is two flights there, a hotel room and two flights back. And back then my goal was to always be home on Friday night, even though I got home sometimes at two o'clock in the morning to be present with my young daughter. That was the game. Okay, COVID hits, shuts down, lecturing. I can't do it.

(14:24):
I said, when this happens, when it opens up back up again, remember the shift to online zoom and everybody loved it for the first three weeks. And then after that, everybody tapped out, said, I'm not doing it. I'm not getting back on the road after this. I'm done. No way. So I'm walking on the beach. I went to a beach illegally in Florida, which was the stupidest thing they could have done was to shut down the beaches. They literally had cops watching those beaches.

Dr. Seda (14:50):
A COVID breeding ground,

Dr. Ritter (14:52):
Right, they literally had cops blocking the entrances to the beaches. I mean, I think of some of the stupidest things we've done in this country. I'm walking on the beach, I'm having this conversation. I'm not going there. I don't want to say clean. I'm not going to go there. I'm walking on the phone, I'm talking to Cameron on the phone. Cameron, I'm not going to lecture again. I'd rather have people come to me. I want to show them how I took everything I learned from Dawson, Kois, Spear, which they don't teach you to go back to your office, fill in the blanks, have them actually wind up doing the dentistry that it seems like nobody is doing that they've been taught to do. Again, we've just set up these protocols where we take the temps off and we switch 'em out to PMAs and do color trials. And he goes, stop, stop, stop. You're talking so much. You're not even listening to what you're saying. He says, you just named your course. So what's that? He goes, I can't believe you, Rit. He goes, the name of the course is called The Protocol. So I go back to my house, I go to GoDaddy, type in protocol, register the domain name, and the second part of the story is I tell Ramsey this, my partner, and he says, okay. He goes what are you going to do?

(16:01):
I said, well, we're going to build a two day course where they're going to come here. And he says, yeah, what are you going to talk about? I said, dude, I can give you a couple things we can talk about. The truth is we'll probably have a hundred things we're going to talk about. He's like, yeah, I don't really see it. And I said, well, we got to try it. We got to do it. If we're not going to do it now, we're not going to do it. I said, I'm going to go on Instagram, I'm going to put it out there. Let's see what happens.

Cameron Full (16:25):
Yeah, we threw up a registration page.

Dr. Ritter (16:27):
Threw up a registration page that night.

Cameron Full (16:30):
We did. We did. You were banging on me. Cameron. I got to get this goddamn thing up.Hurry up.

Dr. Ritter (16:35):
I dunno what the hell I'm doing here. I have no idea what I'm doing. And I put it out there on Instagram and the next day I look down and it's sold out. So then I meet Ramsey and I meet him out for drinks and dinner and he's sitting at the bar, Ramsey, big guy, tough guy. It's like, yeah, he turns around with the, he's got

Cameron Full (16:57):
Sunglasses on inside.

Dr. Ritter (16:58):
Hey, what's going on? How many did you sell, three? And I go, no. He goes, I told you. I said, you're right. We sold 15 slots. Oh my God. He goes, oh my God. He gets all beet red and the face starts rubbing, he's

Cameron Full (17:13):
All red.

Dr. Ritter (17:14):
His tell when he's overwhelmed, we got to build a course. I said, no, shit, we got to build a course. I told you this was going to happen. Right? And then from there, this November will be the end of our first year.

Cameron Full (17:25):
Yeah. Five years later.

Dr. Ritter (17:26):
Five years later. Five years later.

Cameron Full (17:28):
So what you're effectively doing though, Rit is you're doing the special list for your students, for the people in that course, for the attendees. You're giving them that specialist every time. And I've been to the course continuously. I go twice a year. And for those that aren't familiar with it, in fact as specialists, something I've been telling Rit is like, man, you got to get these guys to come with their restorative partners for them to understand how you diagnose and treatment plan. The cases that you do is it's so helpful to be able to communicate like you guys do in the course.

Dr. Ritter (18:16):
Thank you. And a matter of fact, we just had an orthodontist come last session.

Cameron Full (18:19):
I'm telling you that's been something that getting these guys to come with one or two or whatever, how many of their restorative partners to work together through how you guys work on that protocol.

Dr. Ritter (18:33):
And again, our thing is that it's not, we're very pro specialists.

Cameron Full (18:39):
Yes, you are.

Dr. Ritter (18:40):
Huge. And I would love for them to come with their periodontist, their oral surgeon. This way they could see the mind of the treatment plan of what we have to go in. The one thing I would say about specialists, you guys have to understand.

Cameron Full (18:52):
Careful.

Dr. Ritter (18:52):
And you know that

Cameron Full (18:55):
Careful, careful, careful Rit.

Dr. Ritter (18:57):
A little bit.

Cameron Full (18:58):
Know your market.

Dr. Ritter (18:59):
Exactly. I know the room I'm reading the room, is that when we get a patient, we're fishing for these patients or marketing for these patients, acquiring these patients from other practices, and then we refer them to you. That's a very different, as you know, it's a very different referral. And when we say to them, listen, this is a problem that my specialist needs to see. It's important that you see my periodontist, my oral surgeon. They're the ones that are going to do the actual work and then we make the appointment for them. We don't just flip 'em a card, we make the appointment for them, we pre-frame them and then we send a little video to our specialist on WhatsApp pre-framing them. And then when the patient hears, it's like, wow, look at the level of service. Oh my gosh, they're really into this. They know what they're talking about. They're making the appointment for me, this is important. I don't know if I can say serious. It's important. I mean, you guys, I don't know how you could screw this up with all that. There's just no way you can screw this up. And if you do, I got no answers for you. And so if the specialist came with their restorative docs, they would see the process that we go through the pathway and it's a huge, huge learning experience and opportunity for both the restorative dentist and the specialist to come. That's my opinion.

Dr. Souyais (20:24):
So let's talk about that a little bit more detail. So since Rob, you're the first general practitioner we've had on our podcast here. Tell us a little bit about working with a specialist clinically from that perspective. What do you look for? What makes you pick your specialist? Tell me what that looks like in your mind and why you're picking the people to work with you're working with.

Dr. Ritter (20:50):
I'm thinking of two things right away. So if I forget this, please, let me go back to it about when we had the meeting for our specialists, the way this used to work, it's a great story. Remember the way this used to work years ago is that the specialist was the quarterback point guard of the teeth. They were the ones that directed the restorative dentist what to do. They told the restorative dentist what implants that were in replace, they told the dentist what teeth to restore, all those sorts of things. And for me and my partner, that's just not going to work. That's not going to work because the problem is, I'm going to tell it again, I think we're overeducated and we knew that we had to be the quarterback of the team. And I do think it is changing somewhat and I think the restorative dentist, because if it's going to land back in their lap and they're going to have to restore it, they need to take control.

(21:37):
They do. Now, I'm not going to tell you how to do what you do so well. That's not the way it works with me ever. I would never tell my orthodontist how to put the bracket on. I wouldn't tell you how to take the tooth out. I wouldn't tell you how to connective tissue graft. It is. That's not what I do. However, when I send a patient to you, I know that number one, you're going to place the implant correctly. I know it's going to get a connective tissue graft in the anterior. I know that you're going to use the implant system of my choice, which brings me to the next part. We have nine different restorative implant kits in our office. Nine because we have to get from everybody, not just in our area, but dentists from the northeast will send their patients down and I have to restore these cases. And it got to a point where I'm flailing.

(22:25):
I mean every day it's another piece and another part from another company. And I said, this is too much. It's getting ridiculous for us. And we were approached by somebody with a great implant system for us on the restorative side. Got to remember, I go back all the way to three i, three i is right down the street from me. I've been working with three i for 30 something years, and if I ever had a problem, I literally went over there or my assistant went there at lunchtime before the days of digital and we pick up pieces and parts, but those days are over, okay? There's a company called Neoss. Neoss comes to us like seven years ago, eight years ago. I look at the implant system, it's great. It's a strong implant. It's got one internal connection. It's got a couple of different things like the traditional transfer coping can be used both as a closed tray or an open tray that simplifies the system, or they have something called a custom aesthetic healing cap, have scan pegs on it.

(23:19):
The great for the digital dentist. It's just a great and so many restorative options. So me and my business partners said we're going to do something nobody's done in our area. We're going to throw a nighttime CE presentation together for all the specialists, orthodontists, periodontist, oral surgeon, endodontist. Whether you work with us or not, we're going to have you come, we're going to feed you. We're going to have an open bar and we're going to do a presentation. So 40 specialists show up, have a couple of drinks. We show them some of the cases that we do and how we do it and just how we do it and the intention of why we do it. Three scotches, well, three Irish whiskeys in. I said, okay, guys, girls, ladies, okay, you saw what we can do. Here's the truth. You ready? Here we go. And I hope I can say this on this podcast.

(24:09):
We need all of you and it's going to come to a head here in a second. We need you guys to cut the fucking shit. And everyone's jaws drop. We're like, what? And we said, okay, we got two problems going on right now. Number one, when somebody comes to me with a problem and they start asking me questions about what you guys do, my answer is great question. Wrong dentist. In other words, I tell them nothing. You have these questions, they're great questions. We're going to get you to the specialist and the specialist is going to tell you what they're going to do because they're going to do it. Not me. I'm not a specialist, not a periodontal, not an oral surgeon. The problem with you is you tell them when they ask you the question, well, what are they going to do for me after you're done, you because you think that you are more important or your ego jumps in, you start telling them, restoratively, what we're going to do, which is not right 50% of the time. You're not a restorative dentist and you're quoting them fees. You don't know my fees, so I need you to shut the fuck up. And I'm telling you, a dead silence comes across the room. Okay? You know they've never heard this before.

Dr. Souyais (25:14):
I would love to have been a fly on the wall at that presentation.

Cameron Full (25:17):
I think we're going to give Rob the spot as a host on this show.

Dr. Ritter (25:21):
Shoulda have video recorded it. Okay? Second thing, we told the periodontal oral surgeons, listen, we're going to work with Neoss moving forward. So you've got one or two choices. If you want to get the Neoss kit, the rep, we'll go ahead and sell you the kit, which is a surgical kit plus 10 plants. If you buy the kit, he will tell us who buys the kit. I will guarantee you, I will send you at least 10 patients. So you'll eat up the stock. It's not going to cost you anything for the restorative kit. Fair deal. You do it right, it's simple system for you. Simple system for me. You're not going to be out anything. If you don't want to buy the kit. I hope you enjoyed your dinner and your drinks because you're not getting another patient from me, because I'm done with this. It's a one-way channel of wealth out of my practice. You don't send me any patients, but you want my patients, you won't even use my implant system. Bye now. We're done.

Cameron Full (26:18):
The specialist.

Dr. Ritter (26:20):
Absolutely dead straight. We did it. We did it. And by the way, five specialists picked it up, three periodontists and two oral surgeons picked up the kit.

Dr. Seda (26:29):
Out of 40?

Dr. Ritter (26:30):
Now, not a lot of dentists would do that.

Dr. Seda (26:32):
Out of 40?

Dr. Ritter (26:33):
But I had it. Yeah, well, hold on. There were three or four endodontists, three or four orthodontists there as well. It was, I would say maybe closer to 35 people. Some of the people came, showed up for a drink and left. They knew they were going to get blasted and they weren't a part of it and I don't work with them. That's fine. I had no problem with that at all. I really didn't. I didn't have a problem at all. I wasn't going to do it anymore. I'm done. I'm done. You only make a change when your confrontational tolerance says you can't take anymore. Right? And that was it. I topped out. I had enough.

Dr. Seda (27:07):
So in terms of implant system, it sounds like that was one of the prerequisites to aligning with your specialist, right? Is we're using the same system, it works for us, et cetera. What other factors did you look at in terms of obviously clinical competence? Were there ways that you evaluated their systems of how they provide service to patients that kind of aligned with yours?

Dr. Ritter (27:30):
A hundred percent. I mean, we would poll our patients because I like to think of this as that the specialists, your independent contractors off of my office, your extensions of my office. So when I send somebody to your office, you have to treat them to the level that we treat them. Otherwise they're going to come back and say, I didn't have a good experience. The place is dirty. They run late, they're rude. People show up with sleeves of tats on their neck. I don't want that. I don't want that for my patients. I don't want it for me. I don't. I like tats, but I don't want to see it when you're in an operating room or a setting like that. I don't want to see it. My patients don't want to see that. They want to see a level of competence and a level of confidence that is on the level of what comes out of our practice.

(28:16):
So all of that plays into it. How do they answer the phone? How did they treat my patient when they showed up, how they treat them after the surgery was done? Did you call them? Did you follow up with them? Did you respond to me? Did you always send me a follow up letter or text or video to tell me how it went with the patient or tell me if there was a complication and things happen, I totally get that, but you need to keep me aware of what's going on. You can't turf the patient back to me and then say, okay, I'm done. You fix it. Uh-uh doesn't work like that. This is shared responsibility treating another human being, and that's the way it has to be.

Dr. Seda (28:50):
To that end also, communication is so important. So you've got clinical competence and alignment. You've got service that's on par with what you're providing your patients. And then the third thing for me in the trifectas communication between the team sending videos, that kind plan, what's going to be done? What are we going to see? What are you going to have when it's back in your office and actually looping the patient into that so that they can see the level of communication that's going on. I have found to be very powerful. Is that something that you find yourself doing with your specialists?

Dr. Ritter (29:30):
Absolutely. I show the pictures, by the way, the pictures get shown to the patient as well. The x-rays get shown to the patient. Now let me be clear about what we have and don't have. We don't have a cone beam. I don't have a cone beam because I don't do the surgery. I don't do that. So what do I need a cone beam for? I hope that you and I know you, all of you would do that. You would show them what's going on with the cone beam. You'd break it down for them in addition to the pictures, the videos, the x-rays that I send to the patient. They'll get a follow-up, follow-up letter. I want to make sure that they're involved in this. Now, I don't let objections get in the way of this either, which is a touchy subject amongst some of the dentists right now, which is I present the best treatment possible also to the patients, right?

(30:14):
Mike, whatever it is, I tell them the right way to do it the first time. Because my job is not to save the patient money. My job is to save their teeth for a lifetime of use. Now, what we have a problem with in dentistry, and what I don't like what I'm hearing from some of these places is you go through that entire process. You've gone through four years of college, four years of dental school, whatever post-grad training that you've taken, CE courses, running your practice. You present the best treatment possible, and then the first time the patient objects to the cost, you alter your treatment plan. It's a screeching halt. And you're like, okay, let me backpedal to something. No, no. That is not the right thing to do. So me and my partner have a little bit of a different opinion than what some other people would espouse, which is we do not modify our treatment plan. Now, there are ways that we can modify treatment outcomes or take longer to restore, but we're not going to change our treatment plans because that is not a good thing to do.

Cameron Full (31:17):
What I love about what he's been talking about is, and I know because my attendance of the protocol that everything that he talks about is his personal brand, and he exemplifies that through the imagery of the protocol as well as what is the final outcome at Ritter and Ramsey. But let's talk a little bit about what that means to you because there's that surface level brand, which is just the picture on the wall, and then there's the real brand, which is everything that falls underneath that.

Dr. Ritter (31:49):
Branding is more than a logo or an icon. It's everything that the community, the patient views you upon. So whether it be your website, the way that your marketing pieces go out, the way that you answer the phone, the way that the office looks, the way the office is dressed. Right now, we're all dressed in J Barber, which is phenomenal. J Barber clothing.

Cameron Full (32:14):
Plug. plug.

Dr. Ritter (32:15):
Yeah, it's plug. It's a plug. I was just with the owners. It's just the quality of their materials stand out. We went from shitty scrubs that look like geranimals to a level above with figs, but this is a level above figs. I mean, this is sleek. This is just the highest quality and everybody wearing the same sneakers. Believe it, or patients look at these things. They really, really do. And so it's a total package of branding. Plus I like to think of it as integrity marketing.

(32:48):
I know that the image I want portrayed of me outside of that practice. I know there's a level that I will accept and anything underneath it is completely unacceptable to me. I do not, what did I go back to the original conversation? I don't want to be embarrassed. So I don't want anything out there that's going to embarrass me, my name, my brand. All I have at the end of the day is my signature in a sense, it's who I am. So I'm not going to go ahead and compromise that at all. Matter of fact. Okay, one more. The protocol wristbands on the back of it, it says no compromise. There is no compromising on your brand. Once you start compromising on your brand, they're going to make sure that they're going to tear you down and they're going to ask you to compromise on everything else that you do in your practice. So there's no compromise on that. None. Zero, zilch. It's like anything else?

Cameron Full (33:37):
When did you get that? When did you get that though? When did you really get that?

Dr. Ritter (33:42):
These right here?

Cameron Full (33:43):
No, no, no. When did that switch change for you?

Dr. Ritter (33:50):
Probably about 10 or 12 years ago. I said that if we're going to continue to do this, I'm not going to be, here's another one. I can't heal all of Palm Beach Gardens. I'm not about to try. I know what I'm looking for and I know what I want to be able to do for patients, and that means that there are going to be some people I can't help, can't them for a myriad of reasons, I can't help them. And bottom line is they're probably not the right patient for our practice. And what dentists don't understand is that every patient that walks in that door is the perfect patient for your practice. Sometimes you ever hear the line, it's better to see the back of their head once and see the front of the head 50 times. Well, branding for me means that we're putting ourselves out there as the best office with the best quality outcomes.

(34:39):
So branding really began more so, I mean, we had the Ritter and Ramsey brand for 20 years, but we really ratcheted 10, 12 years ago when I saw a shift in the way that people were finding you based on the internet and then eventually all of the different social media outlets that we have. How did you want to be portrayed? Now I can't be so I can't be the guy that makes funny faces and goofs around because to me, first of all, that's not who I am. And second of all, I'm going to be authentic and genuine. And I said, this is what you got. And if that's who I am, I'm going to live up to that and I'm going to drive those goals. That's what I want to be. And I said, that's where we're going.

Dr. Souyais (35:20):
Were you like that in the beginning of your career or did it really?

Dr. Ritter (35:24):
No, hell no. Jason, of course not.

Dr. Souyais (35:26):
Of course.

Dr. Ritter (35:27):
I was the young dentist who tried to make everybody happy. I had huge practice note payment. I bought my practice from a gentleman who retired early who was a drill fill and bill dentist. I mean he did. And that's it. That's what he did in the practice. And I took over that practice and I transformed it into what was a very painful nine year journey. But I tried to make everybody happy. And along the way, I still lost patients and I was unhappy. And so I finally said, I'm not doing that anymore. I don't want to do that.

Dr. Souyais (35:58):
So what was the breaking point that made that change?

Dr. Ritter (36:01):
Well, I mean, I've got two different points. I mean, if I go back 10, 12 years ago, I started noticing that as the cases got bigger, more complex, I found myself less and less inclined to do some of the smaller dentistry because I really just didn't want to do it anymore. And if I was doing the big dentistry, I said, if we're going to wind up doing more big dentistry, then let's just focus on that and get rid of the things that we really don't want to do for the patients who probably don't even appreciate it. That was change number one. Change number two, we were out of network. So I'm going to work this in now. We were out of network for years. Then 2008 hit, the economy tanked. We picked up one or two I think maybe three different PPOs. And Jason, what happened was, the truth is we have these green sheets as new patient sheets.

(36:59):
And so when a new patient calls and the treatment coordinator picks up the phone and she's taking down the information to enter into computer, so you get good information in. If you walk up to talk to her, if you see the green sheet, that's a visual that she's on the phone taking a new patient, nothing's more important than the new patient, the lifeblood of the practice. That means don't interrupt them. But also that green sheet gets presented when we walk into the room, whether it be hygiene or restorative room. And I would look down and one of the major questions asked was, how did you find us? And when I walked in the room and I would ask the question to the patient, and I looked down on the green sheet and it said, insurance said I had to come here. I finally got to the point one day I went back to the private office, I just said slammed it, and I go, Ramsey, I'm sick of this shit, man. I can't do this anymore.

(37:46):
I don't want to go into a room because some shitty insurance says they have to come here on their PPO plan. I said, I'm done with it. I want people to come here because they trust and value us, knowing that whatever we're going to do for them is going to be better than everybody else. We need to drop this shit like a bad habit once and for all. And I'm going to tell you, he was hesitant. He was hesitant as hell. He really was not on board with this. So I had to find a way to do this the right way. And we talk about this in the protocol where we shed ourselves of all the garbage, we wound up losing maybe three to 4% of our patients, which is fine with me.

(38:22):
Some of them came back. All it did was create room for new patients that really trust and value us. And the truth is, after COVID, we all know everywhere you go, two things happened. Everything became hyperinflated in price. So everybody was used to spending money for everything and everything had a copay. Everywhere you go had a copay. So guess what, you got a copay with us now. That's it. And that's all there is to it. And you move on. So we're out of network, but I want to make sure you understand the difference of what we say. This is thrown around a lot and I don't like it. I don't like practice consultants or other dentists who are kind of flip with their answers. I don't like it because doesn't make sense to me. If you're participating in network in a PPO, that means that people have to find you on a list.

(39:03):
Then you have us who are OON out of network, which means we can accept almost every insurance. Not HMO, every insurance, but that means that the copay will be different from every different insurance provider. Fee for service to me means that when you go there, you pay for the entire treatment that day. If you're doing a $2,000 crown and the patient has insurance, you're collecting all $2,000 that day. Now the offices that I know of that participate like that in completely fee for service, they will fill out the insurance information and send it into the insurance, and then the patient gets cut back what the insurance would normally pay the dentist. To me, that's fee for service. I know one practice like that, one in our area, one, and it's a small practice. I mean, it's so small, it's nothing compared to our practice. We fill out, we'll still accept the money, but we don't take the full amount. We kind of know how much these insurances will pay. So they pay the difference and then we wait for the check back from the insurance company. But anybody can come see us. Actually, we call it, it's a bigger opportunity now because we can take almost every insurance that's available.

Dr. Souyais (40:17):
So how about for a young dentist coming out of school today, what would you tell them if they're like, okay, should I start out of network? Should I start participating? What would your advice be for someone who's just coming out with say maybe the first five to 10 years of their practice?

Dr. Ritter (40:34):
There's a lot of factors that go into that. I don't know if I could give one answer based upon that. I think there's a lot of different opportunities available to them. I think they have to do their research though. I think just walking into a practice these days, you need to know what you're getting into. You really do. You need to do some really thorough research before you jump into anything. And I think it's tough for young dentists. I'm not going to say it's not. I think it's very difficult, challenging environment. They're coming out of school with more debt than ever before, ever in their lives. They want to do dentistry. Some of 'em think that they're really good when they could leave dental school and then they get humbled. Some of 'em really are not even interested in the practice of dentistry. They're more interested in the business of dentistry. So I think a lot of different perspectives needs to be taken into account. When I give an answer like that, I wish I could give you a bigger answer than I am right now.

Dr. Souyais (41:27):
I understand that, Cam, it came back to a conversation you and I had once, is one of the potential ways of looking at insurance is it's a marketing lead. It's discounted leads. Discounted leads. So you're paying for marketing to fill your chairs.

Dr. Ritter (41:44):
That's exactly what it is, right? That's what the writeoff is. That's what it is. The problem, Jason, is that, look, we all have a friend who does that. He's ultra successful. He takes a 30% write off. You ask him, the funny part about this is you ask him what he produces, he gives you the top number, but he doesn't tell you the write off number. So it's not really true. And then I hear if somebody will come to the protocol and we ask them how much they're participating, and they say they only get $52 for a hygiene prophy. Meanwhile they're paying their hygienist $65 an hour. Whoa. I mean, it's almost like going to Toys R Us back in the day, the loss leader concept where you would go in to buy the diapers for inexpensive and hopefully on the way out, you're grabbing toys to make up the difference. That's a brutal way to practice dentistry. Brutal.

Dr. Souyais (42:33):
It's true. And that knot point, I think that comes for a lot of people once they hit a more stable financial situation. That freedom that I don't have to treat everybody, that freedom of, I don't have to see every patient that walks through my door. That comes with a degree of financial stability of when you're like, okay, my mortgage is paying, my loan is paid. I'm comfortable. Right in the beginning, I think we're all hungry.

Dr. Ritter (43:02):
You're absolutely correct. I took, in 1999, Frank Spear used to do hotel courses, and one of them was called The Practice of Excellence. And he talked about everything we're talking about right now, everything, the life cycle of a practice. And you're right, you finally hit the point where all those things, I'm not going to repeat 'em. You hit it, and then you start practicing usually better dentistry, more complicated dentistry, more expensive dentistry on patients who want it, and your level of satisfaction goes up, your stress level might not come down. You're dealing with bigger problems. All those things. I can tell you as a follow-up to that, I saw Frank, Frank's not doing well right now, but I saw Frank last year at our AED meeting. I said, Frank, I just want to let you know that your course in 1999 had such a huge impact on me.

(43:56):
And I pulled out the manual right before I saw him, and I looked at what he said to do, and almost everything he said to do we had done in our practice. I said, I just want to thank you because if I didn't have that mentorship, which is something we haven't even hit on, I wouldn't be standing here in front of you today. And all of my mentors along the way, and John Kois as well, who I was just literally sitting next to at the AED on Saturday morning, I wouldn't be sitting there without people like them because they're such a guiding light and everybody needs a mentor. I don't care what profession you're in, everybody needs a mentor. You need a mentor mentee relationship. You need to put your guard down. You need to put your ego aside. You need to learn from people who are willing to give. And finding great mentors is so important on the journey of dentistry. Don't you agree?

Dr. Seda (44:44):
Totally. A hundred percent. I mean, mentors have made the difference for me in terms of satisfaction of what I do, the exposure you get to how to do different things and then decide for yourself what's right for you. It's freedom. And to find people that are willing to give their time and energy to share what they've experienced, it's invaluable. And I know you do that for a lot of people. Souyais, Cameron and I share mentors in common, and it's so powerful. And then there's this point where it kind of flips and you go from being the mentee to the mentor, and then there's a different satisfaction that comes with that, right? And I'm sure that's kind of where you're at now.

Dr. Ritter (45:40):
Yeah. One of my earliest mentors told me, he told me two things and he said, number one, stay humble. And number two, he said, one day somebody's going to come to you. You came to me and you just need to do the same for them as you did for me. And I remember thinking, that's not going to happen. I don't think so. And now I'm more of a mentor than I ever thought I would be. And I enjoy it. I enjoy it because look, we're all at a point, it's not about us anymore. It's really not. You get to a certain point in your life, you want to help other people, and you get more out of helping other people, and you learn through that as well. You enjoy it more. And I can't tell you how many people, especially when I go to these big meetings now, the restorative academy, a they just, they're on you. They're like, oh, what would you do? How can you help me? Of course, hey, it's words of wisdom and encouragement versus when I started out, when people were just trying to break you down because they're probably either threatened by me or insecure. They had their own issues going on. So it's turned into something completely different. I love doing it. I want to do it on a bigger scale actually, I might be doing something like that.

Cameron Full (46:52):
We got a couple minutes left. Tell us about that. Yeah, yeah, we can go there. What's the plans with the protocol? I know what the answer is.

Dr. Ritter (46:59):
Cameron, I'm going to get up and show you.

Cameron Full (47:06):
Did you whiteboard it? You did.

Dr. Seda (47:06):
Oh yeah.

Cameron Full (47:07):
That a boy don't show everybody they don't need. Come on now. What's on the whiteboard, Rit?

Dr. Ritter (47:14):
Well, the protocol will continue. I consider that to be our flagship course. We're going to continue to do that. There's no reason to stop. It fills every time. Now, of course, we give it four times a year. It's small group learning. There's nothing better than that. We only have 15 people a time. So it's not like we're seeing 30 people a pop, right? It's not, I want to make sure we frame it correctly. The issue we have now is we're limited by space. We do it in our office. The truth is, again, I want everybody to know this was not some well planned out thought. Oh my gosh, this is my master plan. But it's morphed into something bigger than that. And what we get pimped about at the end of every course is, wow, when is you going to have a second course? When can we bring our team members?

(47:59):
And it was interesting, Cameron, I stood there at the end of the second day, and you can appreciate this, and I said, okay, everybody, I want to know how many people here would come back for a second course. All the hands go up. More importantly, would you come with team members? Absolutely. We would come. I said, okay. I said, Ramsey, it's time, man. We've had, by the time November's done in 2026, we have to add a bigger course. We have to give a two day seminar. It has to be at a hotel cuz we can't have it here. Where you can bring team members. And so we're going to do that, and we're probably going to do it next year in October. It's going to give me a little bit of runway to put this together the correct way and market correctly. And it'll be completely different than what we're doing at the small course.

(48:45):
It'll be completely different information. There'll be breakouts for team members, all the things that everybody's asked for the last four and a half, five years. And I think it'll be great. I really do. I'm really excited about doing it. It's a massive undertaking. It's a heavy lift. I know taking a little bit of a chance, but what am I waiting for? And the truth is, here's the other thing. Kois just finished his last symposium. He's not doing any more symposiums, the yearly symposium. There were over 600 people in that audience. Where are they supposed to go now for CE? Where? Because they're done with the continuum and he's not doing a symposium and something else just stopped as well. Smile, smile con, stopping. There's a lot of things that are stopping. So there's an opportunity, especially on the East Coast to host something like this and we're going to do it. It's time.

Dr. Seda (49:39):
Awesome. Who better to do it?

Cameron Full (49:40):
It's your duty?

Dr. Seda (49:42):
You're primed for this.

Cameron Full (49:43):
It's your duty, Rob.

Dr. Ritter (49:45):
We are primed. We are primed. So it's going to be a lot of work. And I'm okay with work as long as the vision is there, the interest level is there. And I want to make sure if we do this, not if when we do this that it comes off seamlessly. Like we've done it five times before that. It's fun, it's engaging, it's interactive, and it's purposeful to where you go back to your practice and you can implement the changes that you want to make.

Dr. Seda (50:16):
But Dr. Rob, the other point is, as the leader of the practice, sometimes it's nice to be able to sit back and let everyone else take the bull by the horns and move things forward. And we've, with Jason and Cameron put on courses for teams in the past. And really the experience I've had is the team gets energized and enthusiastic and then just runs with the baton even faster than you could have pulled them. And so it's just this kind of self-fulfilling cyclone that takes over and everyone's energized, enthusiastic, and ready to implement.

Dr. Ritter (50:57):
Well, it sounds great to me. I love that analogy. And I think that's exactly the idea behind this. Now it's the implementation, and most importantly, getting the dentist to bring their teams. We'll take as many dentists that want to come to this, but it would be a huge missed opportunity if they came by themselves.

Cameron Full (51:18):
It's a bigger conversation that we've had actually previous on previous episodes, was the reality is there's a clinical leader and then there's a business team leader. And when you're running a successful practice, the reality is that you're doing dentistry most of your day. You've got to have that support upfront. And I say upfront and air quotes, but you've got to have that support that's guiding traffic and doing the rest, directing the other parts of the show. You can't be good at all things. And so the more wonderful dentistry that you do, the less wonderful time you have to manage your wonderful team.

Dr. Ritter (51:57):
Cameron, you said it. It's not even about being great at everything. It's that you don't have the time to do that. In a busy practice you don't have the time. And a friend of mine used to say, if that bur is not in restorative industry, if that bur is not spending, you're not making money. And that's the truth. I mean, you've got to be cheer.

Cameron Full (52:12):
Did you say Bur?

Dr. Ritter (52:14):
I said bur.

Cameron Full (52:15):
Okay. There you go. Referral lab. There you go. Sorry.

Dr. Ritter (52:20):
Oh my gosh.

Dr. Souyais (52:21):
Cameron likes the sound effects.

Dr. Ritter (52:22):
Look at you with all the props. You got all the props. You've been waiting to drop that?

Dr. Souyais (52:26):
Yeah, he was waiting.

Cameron Full (52:26):
I was waiting for somebody to say bur or drill. Yeah.

Dr. Ritter (52:28):
Okay. There you go.

Dr. Seda (52:32):
Dr. Rob, Dr. Rob. Thank you. This has been fantastic.

Dr. Souyais (52:37):
I'm excited to see this next course. Rob, I mean I've known you for a while now and I know everything you do is insanely quality.

Cameron Full (52:46):
First class.

Dr. Souyais (52:46):
First class and I'm excited to hear what this develops into. I'm very excited to see this.

Cameron Full (52:52):
You come with me in November, Souyais, I'm going down there to the protocol in November.

Dr. Souyais (52:55):
I love that idea that we talked about. I'm totally bringing a couple of my restorative dentists.

Cameron Full (52:59):
There you go Rit.

Dr. Souyais (53:01):
It won't be this November because I'm already booked, but it will be soon. I love that idea. I think that's a wonderful way to do it because I mean building a comprehensive team of clinicians that can work together that way, there's nothing better than that.

Dr. Ritter (53:18):
I agree. I think that's where the game is right now, right? It's having that team shared responsibility. Everybody understanding what the ultimate goal is going to be, and let's just say this, the patient outcome, it's all about the patient at the end of the day. they have to leave having the best experience, having great outcomes, you can do that. That's how you build your brand year after year after year, patient after patient. It's going to take care of itself, right? I always used to say, if you just keep doing the right thing, the money will always follow. It's never the wrong time to do the right thing, right? You always do the right thing and ultimately if anything goes wrong, it's your fault. You just got to accept responsibility and say, it's my fault. Practice is not doing this, it's my fault. They're not doing that. It's my fault. We're not getting to the goals we want. It's my fault. And once you accept that, it's so much easier to move forward.

Dr. Souyais (54:13):
Amazing. Yeah, so true.

Cameron Full (54:14):
Wonderful.

Dr. Souyais (54:15):
Well said.

Cameron Full (54:16):
And on that note, Rob Ritter, my dear friend, thank you so much for joining us on The Special List, and I have no doubt we'll be bringing you back because we ran out of time, not content with Robert. Thanks brother.

Dr. Souyais (54:32):
Thanks for listening to The Special Lists presented by Referral Lab, the podcast for dentists and dental specialists featuring a special list from a specialist. Got a question for us? Send us a message at specialists.com with two Ls. Transform your referral workflow with Referral Lab, purpose-built platform for dental specialists to track, manage, and convert every referral. Request a demo at referrallab.io.