Home Interviews “In our larger cases as well, I’m definitely doing a lot less...

“In our larger cases as well, I’m definitely doing a lot less cutting of tooth structure to try and get the same result we used to get when we’d aggressively prep all the teeth.”

Dr. Michael Koczarski, Woodinville, WA


Q. You’ve always been an innovator in dental marketing.  What in your mind has worked for you and maybe what hasn’t?

A. Marketing is just number one, a moving target. It’s like what works today doesn’t work tomorrow and what didn’t work in the past may work tomorrow. I think the biggest thing about marketing is being patient, trying different ways to reach out.

And I think also the way people take in information has changed. I think I’ve also found that people have changed where they don’t want to be told what’s out there or what to do, they want to be given information.  Rather than saying you can bleach your teeth and make it three, four shades brighter.  I think the other way to look at it is now people want to hear if you want to bleach your teeth, here’s some things you ought to know.  Or we’re the resource to find out more information about that and give people connectivity to your office or your website to find out more information about different topics that interest them.

Q. I see on your website as an example you have a lot of videos. Has that been something recent?  Has that been effective for you?

A. That’s been more recent and it has been effective. But I find what’s let’s say less effective is the print ads in magazines, is direct mail. What I thought would work and has worked in the past doesn’t seem to work as much anymore.  So people are just a little more picky, a little more savvy, a little more skeptical.  And they want to find it on their own versus be told what to do.  And videos are nice

Q. You used to do a lot of smile makeovers, the cosmetic dentistry and so forth was a big part of your practice, isn’t that correct?

A. Yeah.

Q. So is it still?

A. It’s still but it’s changed. Like that book, Someone Moved My Cheese, our practice has been as high as 65% of what we do is elective dentistry, smile designs, full mouth rehabs, whitening and now it’s about 15% of what we do is elective dentistry.  And it got as low as I think 3 or 4% in 2009.  I haven’t seen days like I used to have like in 2000, 2001.  I think just coming back after the fall of the economy and after ’07 things crashing and coming back up, more competition, more people doing this kind of dentistry.  LVI, Aesthetic Advantage, Pac Live, all those programs have created a lot of great dentists who know how to do what I did.  Back in 1999 and 2000, I was one of few; now I’m one of many.

Q. Has your philosophy of dentistry changed because of this at all?

A. Yeah. I don’t chase the big fish as much as I used to.  I used to go after with my marketing the smile designs, the 15 to $25,000 cases and up and I used to market in airlines magazines and I used to draw from Alaska down to Arizona, San Diego, Hawaii, and have patients come in for their treatment.  But what I found is I became more and more dependent upon that kind of marketing to keep that ball rolling.  I kind of forgot about my 10 mile radius.  I forgot about my patient base I have as how well they can market for me and to reach out in that social media within the realm of just my patient base to keep things going.  So I became more dependent upon that kind of marketing to drive that kind of patient.  And then when the economy changes, that’s one of the first things that people give up on is spending that kind of money.

So I’ve gotten more back to relying on the bread and butter, _______ dentistry, direct fillings, crown and bridge.  That’s easy, less stressful, easier to market for, easy to keep it going.  That’s how you keep that ball rolling.  And I still market for larger cases but we do a lot more internal marketing, a lot more of word of mouth within our practice and asking for referrals.  Right now about 55% of all the patients that come to our practice are simply coming from a Care to Share program, just asking for referrals.  Another 15% is going to be your random word of mouth, someone just says something about us by another patient.  So really our marketing our doing is the last 30% is all the external marketing we’re doing with print ads or magazine or direct mailing or whatnot.

Q. On your referral basis, do you have a specific program you have in place for that?

A. We do. We have a thing called Care to Share and simply just asking patients at the end of their appointment how’d things go today.  If it went well, ask them to refer their friends in.

Q. Where does minimally invasive dentistry come into your philosophy these days?

A. It’s always something I’m doing, protective, preventative dentistry and sealants and things that we think commonly about minimally invasive. But in our larger cases as well – let’s say our smile designs – I’m doing more and more prep less cases through education through Dennis Wells and the program he’s doing with  Juan and Nelson Rego.  I’ve learned a lot more about how can I go through and create a smile and not prep teeth.  Or maybe it’s not a non prep for all 10 units, but definitely I’m prepping less than 10 teeth for a 10 unit smile.  Maybe I’m prepping only half the teeth.  Or I’m doing minimally prepped and just a little bit of contouring or reshaping of the teeth to allow the veneers to be placed.  So I’m definitely doing a lot more less invasive, less cutting of tooth structure to try and get the same result that we used to get in the past where we’d just go through and aggressively prep all the teeth.

Q. How does digital dentistry play into that?

A. Well, when it comes let’s say from a digital – that’s a broad term, I’ll break it into different parts. I’m a CEREC user and I use my Omnicam and I scan patients’ teeth and I communicate to my lab via digital information either from Invisalign in orthodontics to Rego Dental Lab for my smile designs and preplanning cases.

But another side of digital dentistry is just simply photography and using digital smile design processes. I’m going through and imaging people’s teeth and using PowerPoint and Keynote to design the case on the computer before I even get to the wax-up stage.  And then I use that information to allow my ceramist to then wax-up the case and/or use that information in creating the ceramics.

Q. Let’s talk a little bit about what occupies your time outside of the office.

A. Well, I have a 4 year-old little boy so my life has changed a bit. I have a 24 year-old, a 21 year-old, and a 4 year-old, three boys.  It’s fun being a dad a second time around in a way and I’m really enjoying it.  I’m at a different place in my life where I can just have more fun with it.  Then I’m into golf.  Golf is one of my passions.  I happen to live in Seattle where it rains a lot, especially October through May and it can get gray and just kind of gloomy.  So my wife and I made a change about three years ago.  We ended up buying a place in North Scottsdale.  So mid October to end of April, early May we leave every third weekend so we have something to look forward to and have a Wednesday through Sunday weekend or longer weekend and go someplace where it’s sunny and warm.  We love to play golf and play tennis.

Q. That’s a beautiful area. Some wonderful golf courses up there. What’s your handicap now?

A. I’m a 3.

Q. What do you recommend for the guy that wants to become a golfer?

A. Actually, Juan and Nelson turned me onto this and it’s called K-Vest, like a vest you wear. Of all the golf lessons I’ve taken over the past let’s say 7, 8 years, I’ve done this for the past two years and it’s made the biggest change in my game in the way I learn and the way I deal with my golf swing and with golfing.  It’s about kinetic sequencing.  It’s about learning how to snap a towel, how to crack a whip, or how to cast a fly rod and understanding where the energy comes from. It’s a really cool way of using motion, motion sensors and where things are in space to have a teacher look at a computer screen and get feedback that way about what your body’s doing and teach you from there.

Q. If you were going to recommend the best course you ever played on to the audience, what would it be?

A. I love Pebble Beach. I love the location.  I love the view, the scenery.  It’s a premium place.

Q. Are you involved with any other businesses Mike other than the practice at this point?

A. Yeah, actually I’ve gotten fed up with the stock market and trying to pick the right horse or right stock or right mutual fund and I’ve gotten more involved in apartments. We’ve gotten involved in trying to find 25 to 30 unit apartment complexes that make the right price, that make sense, and get involved with that and buy those and hang onto those. So I’ve been doing that kind of investing, in real estate.  I find that to be a lot more predictable.

Q. You’re quite the wine expert.

A. Well, I like wine.

Q. What kind of wines do you like?

A. If we’re talking brands, a good dental one is Pride. Jim Pride, rest his soul, he started a great winery and he was on that peak in the mountain that kind of divides Sonoma and Napa County and that’s a great winery to go visit.  I like Darioush, I like Quilceda.  I’m in the northwest, in Seattle.  Patients of mine, Jeannie and Paul Golitzin, they happen to own Quilceda Creek.  Quilceda Creek happens to be the only wine at this point that ever got a 100 point rated wine in the world.

But I would say from wines what I’ve learned, and a good friend to told me once, was think about how many bottles of wine you drink a year.  And wouldn’t it be nice if every time you opened a bottle of wine it was a 10 year-old bottle or plus of Cab?  So his suggestion to me was if you only drink 50 bottles of wine a year, then why not go ahead and buy those 50 bottles from wineries you like and store them and save them.  I took it to heart and did that.  And in Seattle we have – like you have public storage areas, we happen to have public wine storage that has lockers that can hold 20, 30, 40, 50 cases at the right temperature.  So I don’t have a big wine storage in my house, I happen to have a wine fridge from Costco that holds a couple hundred bottles of wine.  But I have lockers and I just started putting wine away back in 2000, actually 1999, and buying a case here, a case there, and storing it.  It’s out of sight, out of mind.  I can’t get to it, it’s a few miles away from home.  I don’t cheat and open it early.  So back in let’s say 2012, 2013, it’s time.  I know have 10 year-old bottles of Cab and I started pulling it out.  So now I just try to drink those 10 year-old bottles or more and enjoy by Cab that way or my wine that way.

Q. What makes a good Cab for you, a good Cabernet for you?

A. I just like a really smooth – actually, I would say my blends are my favorites. My favorite wine that I’ve had lately has been Insignia.  It’s a blend of a Cab-Franc.  I just

Q. What would surprise people that they don’t know about you?

A. I think nothing comes easy. I’ve had some success in my practice and success in lecturing and success in dentistry from that standpoint through the ACD or teaching, PAC Live, LVI.  I don’t know what people think they do or don’t know about, I would say at this point though I didn’t invent anything.  I didn’t create anything special but I’m really good at listening to other people and copying them.  I think it’s something like a Ron Jackson and build interest and people that have created something, Ed Rosenthal – innovators.  I’ve been successful at teaching because I copy people like those people.  I think I’ve got pretty good hand skills but what I’m really good at is paying attention and recognizing a good idea and saying I’m going to copy that and stick with it.

Like the Borg in Star Trek, I’ve kind of traveled around the country and picked up all these good ideas.  I think I’ve got a really good practice because I recognize good ideas and I stick with them and I implement them.

Q. Anything jump out at you as the thing that you copied or found that was most successful for you?

A. I would say the way I do an aesthetic case. The sequencing I do and the tools I use is very successful and very predictable.  I have a very simple way of going through and doing a ______________ case.  That’s helpful and makes it a real simple way to go through the process.  I think people can make it so challenging and it doesn’t need to be.  And I would say the other thing I’ve learned from people is monitoring what you do.  Using spreadsheets to track your practice or track certain parameters, certain numbers.  And then come back and compare a trend.

I don’t worry too much about what happened today, numbers-wise.  I note it but I care more about what happened for the past week, the past month, the past four months.  I look at trends.  There’s good days, there’s bad days.  But I want to see what’s happening for the past month or two.  How are things going that way, comparing it, how we did a year ago, how we have done it for the past five years.  Things like that.  So I try not to sweat the small stuff and the micro details.  I look at the bigger picture and trends.

Q. Do you track procedures as well?

A. Some I do but more so just the financial what are we doing. There’s two things I’ve tracked that people might find interesting. Track the number of crowns you prep a day and track the number of crowns you diagnose a day. The ones you prep may not be the ones you diagnose that day, sometimes it happens but rarely.  It’s just how many did I diagnose today and how many did I prep today and just keep that tally going.  You’ll find typically for every 10 crowns you diagnose, 7-8 will happen and 2-3 won’t because patients either have financial issues, they choose not to, they leave your practice, they move on, whatever reasons, it doesn’t happen.  And so if I know my practice needs to survive on doing let’s say 7 units of crown or bridge a day, I’ve gotta diagnose 10.  And I’m not going to make up a diagnosis but if I need more bodies, more exams to be done, I need more new patients, I’ve gotta keep that number where I at least have 10 shots at the goal and I hope I’ll score 7 times.  And if that gap widens, if I’m diagnosing 10 and I’m only prepping 4, you gotta wonder have these changed in the economy, have things changed in my case presentation skills.  What’s happening in my team, my dynamic that that number’s spread apart.  Ultimately what the bottom line is I want to be doing 7 units a day.

You can look the same way when it comes to smile designs.  Elective cases, 10 unit cases or more.  We track – actually 8 units or more that are elective dentistry.  And that’s a different dynamic.  I know for every 4 times a diagnose a case, 1 will happen and 3 do not. And I also know then if I want to do one smile design let’s say a week, I’ve gotta present 4 cases in that week and to present 4 cases, I maybe talk to 3 or 4 people before they say yes, they want to hear about a case presentation, a consult with them.  So it means that we’ve gotta talk to about 4 patients a day to boil down to 1 a day who wants to hear about it, to boil down to 4 in a week that heard about it, that boils down to 1 case that actually happens.

Q. So last question. If you knew then what you know now about life, what would you change?

A. I’d be more diligent about saving for tomorrow. I’d spend less time in the stock market and more time in real estate.  And I’d avoid things that get myself in big debt.  If you can’t float when the economy goes bad or income goes bad, then don’t buy it.  Debt is a bad thing.  Interest payments kill you.

Q. I do appreciate it. Thanks for your time.

A. Thank you.


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  1. I concur with most of the comments Mike makes about having a premier dental practice. It takes many years and a great deal of hard work to obtain a high end practice that is able to deliver exceptional dentistry. The emphasis on marketing cannot be over stated or ignored. A quality dentist MUST have a marketing budget that is significant and keeps your name out there in your geographic area.
    Gerald Benjamin, DDS
    Saratoga Springs, NY

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