Eric Vickery and Alex Nottingham JD MBA discussed the psychology of dental practices taking insurance. Alex discussed how his father, a Pankey-trained dentist, felt he had to start taking insurance towards the middle of his career due to pressure, and how that made him unhappy. Eric explained how eliminating insurance can provide freedom and noted they have helped over 100 offices to change their relationship with insurance companies. They both noted it is easier to be out of network when more dentists are in that position and it’s easier for everyone else to be in that position. Lastly, they discussed the fear around taking insurance and how it can be a successful marketing tool.
[00:10] Conversation on Insurance Freedom with Eric Vickery, President of Coaching at All Star Dental Academy
[02:00] Eric Vickery and Alex Nottingham JD MBA Discuss the Benefits of Removing Insurance from Dental Practices
[03:25] The Impact of Insurance on Dentistry and Personal Life
[05:33] Growing a Practice Through Referrals and Value-Added Services
[06:47] The Psychology of Insurance Freedom
[08:34] Overcoming Fear and Approval Addiction in Insurance-Based Practices
[10:23] Insurance Coverage and Effective Communication
[11:44] In-Network vs Out-of-Network Insurance Coverage for Medical Practices
[13:50] Exploring the Benefits of Membership Plans for Dentists
[15:55] Insurance Plans and Dental Practices
[17:02] Achieving Insurance Freedom in Dentistry
- [WEBINAR] Free Yourself from Dental Insurance Dependence
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About Eric Vickery
Eric holds a degree in business administration and brings a strong business and systems approach to his consulting. His initiation into the field of dentistry was in the area of office management. He managed dental practices for over ten years and has been consulting over 250 offices nationwide since 2001.
About Alex Nottingham JD MBA
Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.
Transcript performed by A.I. Please excuse the typos.
0:10:11 – 0:28:10 Alex Nottingham JD MBA
Welcome to Dental Allstars. Our topic for this podcast is Insurance Freedom. And our guest is Eric Vickery, the president of Coaching at All Star Dental Academy. He’s worked with hundreds of practices all around North America. He teaches and specializes on case acceptance and the topic today on how to get out of restrictive insurance plans. Please welcome Eric.
0:28:23 – 0:30:06 Eric Vickery
Alex thanks for having me again.
0:30:18 – 0:50:14 Alex Nottingham JD MBA
Again, I love having you. Yes, again. And again and again. And we’re talking about one of your favorite topics, how to get Dennis off restrictive insurance plans. And I’m not going to say straight up and I’m going to put it in the link in the resources. But we have a webinar called titled Insurance Freedom, and the URL is allstardentalacademy.com/freedom.
0:50:22 – 1:15:13 Alex Nottingham JD MBA
And in that webinar, Eric, our president of coaching, Larry Guzzardo, our lead consultant and head instructor. Together with me, we talk about how to get off insurance. And if you’re listening and you don’t take insurance, then it’s also good for you as well if you take insurance and like to get off. It’s wonderful to learn about this subject and we’re talk a little bit about it in the podcast, but we go into much more detail with case scenarios in the webinar and I’ll talk about it at the end.
1:15:24 – 1:21:27 Alex Nottingham JD MBA
So Eric, what I guess what got you? I mean, you’re so passionate about insurance. What, what got you into this?
1:22:04 – 1:38:20 Eric Vickery
So we got to go back 25 years. 1998 started in dentistry and working for my father in law. So I had a lot of job security. As long as I didn’t blow it at home, I was secure in my job. But here’s what we realized. There was this big insurance company will call it insurance plan. D was infiltrating our practice.
1:39:14 – 2:00:00 Eric Vickery
And what was happening was we realized we’re working to basically say, all right, this is the fair amount, $100, and you’re going to pay us $58 or $65 or whatever it was, 30 to 40% gap. And not only that, but recognizing about 65% of our practice didn’t have that meaning. They were paying the $400. Why was that fair to them?
2:00:07 – 2:23:04 Eric Vickery
Why aren’t they getting that same discount? And if I would just put it out there, if insurance is so great, why don’t we just charge $65 for everything? That’s such a great plan. Why are you charging your cash pay patients that high amount? Ouch. So we realized my father in law realized right away, he said, someday I want to be in a place where people desire to work with me so much based upon who I am as a practitioner, as a dentist, that they’re calling me, not because, hey, are you in my insurance plan?
2:23:07 – 2:37:21 Eric Vickery
But they’re calling me because have heard great things about you and I want you to be my dentist. And, oh, by the way, I have this insurance plan. D, will you see me? And we had to figure out on our own. This was in 2001 how to remove ourselves from that and navigate that process. And the vision happened.
2:37:21 – 2:55:04 Eric Vickery
And so I’d be watching that happen live and in front of me and, and going through that with him gave me the confidence to teach others how to do it. And it’s not for everybody. Everybody doesn’t need to be completely insurance free or at a network provider. But if you have that same sort of drive or vision or passion about being in that place, there’s a there’s an easy solution.
2:55:04 – 2:58:06 Eric Vickery
There’s a great solution that we can support you with. And so I think that’s where it started from.
2:59:08 – 3:25:23 Alex Nottingham JD MBA
Yeah. Like to add to that, my father as many of the listeners know, is a dentist. And when I was growing up, I mean, my father was a was still alive. He’s still practicing retired. But he does some work on the side and he is is an agency fellow Pankey trained dentist high quality and he towards the middle part of his career kind of when I was growing up he felt he had to start taking insurance because of the pressure and it really he was unhappy about that.
3:25:23 – 3:46:29 Alex Nottingham JD MBA
And he told me that dentistry wasn’t as promising. And so he told me, go be a lawyer or business person. They’re the ones who have the freedom, not dentistry. And so that was pretty sad. Now, fortunately, it was a happy ending. You know, I was able to like you work in his practice and we took it to a whole nother level where he wasn’t doing much insurance, it was more the associate and he was doing high quality self pays and doing the passion what he loved to do.
3:47:09 – 4:05:26 Alex Nottingham JD MBA
So it is what’s amazing is this a and I think a big part of it is the psychology being that you can do it, you can get off it, you don’t have to rely on insurance. And you also see that there’s an impact not just on your practice but on your personal life. I mean, I was impacted at home because of it.
4:05:26 – 4:24:17 Alex Nottingham JD MBA
I mean, my father didn’t feel as wealthy, even though he did well as a dentist, he didn’t feel as expansive as he would have been if he knew that I got paid for what I produced and all the work that I put into. So it’s kind of there’s a ripple effect when it comes to that. And so both of us share when it comes to the impact.
4:25:03 – 4:40:10 Eric Vickery
And I think the other thing that we’ve experienced over the last 20 years probably helped over 100 offices, changed the relationship with insurance companies. And we go over that in the webinar. We talk about what does that look like, the different levels. I won’t go into that here, but the freedom that that creates for you, that is what we’re talking about.
4:40:20 – 4:56:01 Eric Vickery
We have never had someone that’s come to us being an out-of-network provider and say, Hey, we really want your help in getting in network that right. It doesn’t happen that way. So why is it these dentists that are able to get Adam network really do it the right way. Never look back. If they can do it, why can’t you do it?
4:56:01 – 5:00:02 Eric Vickery
In fact, the more people that are in that position, the easier it is for everybody else to be in that position.
5:00:06 – 5:01:26 Alex Nottingham JD MBA
5:01:26 – 5:04:12 Eric Vickery
It’s easier and easier the more we all move that way.
5:04:26 – 5:33:07 Alex Nottingham JD MBA
Well, you know what’s interesting? It popped up, Eric, like I mentioned before, it’s the psychology, it’s the perspective that I like to actually. Let’s look at that, the perspective of it, because there is this viewpoint that I’m going to need it to be successful, that whether I’m getting in a dental school or I’m just struggling to get patients that I need it, or it’s a marketing tool that, you know, how do you how do you respond to that fear that that goes on?
5:33:20 – 5:50:08 Eric Vickery
I think just an understanding. I think you can you can reason with this. Right. You’re talking about there’s two ways to grow a practice. But in seats, we need people in the practice, you’ve got to have patients to grow it. This most people don’t know the second way to grow the practice so how do you referrals know that spots and seats they go over to hiring patients now that’s butts in seats unscheduled treatment that’s butts and seats.
5:50:13 – 6:08:00 Eric Vickery
How do you grow a practice? The second way is more dentistry per visit, more value per visit, getting people healthier, faster. That’s what this is all about. How do you get your patient from A to Z as fast as possible? Well, if you’re restrictive, insurance is dictating what they do. They’re in the crown of your club. Well, if they need eight crowns, we’ll see you.
6:08:00 – 6:27:10 Eric Vickery
You know, four, six root canals from years 3 to 8, and then we’ll do crowns. And so here’s how I would use this analogy. If you want just butts in seats, because that gives you mental peace of mind, the psychology of it. Here’s the analogy. Okay, so you’re going to see ten profiles a day, let’s say just imagine we worked and somehow we saw ten.
6:27:15 – 6:46:16 Eric Vickery
Okay, you’re going to get paid for five and a half of them. So you’re going to work 10 hours, get paid for five and a half hours. Okay. Or you could be an out-of-network provider and see eight patients. You get paid for eight of them. That’s the analogy that we have to understand. You could even see seven work, 7 hours get paid for seven of them.
6:47:11 – 7:05:23 Eric Vickery
You can do six. You can still be better off. The numbers never lie. Alex, if you’re writing off 40%, you can lose 40% of those patients and still break even. That never happens. We lose ten or 15% of the patients and the 35 of the 85% who stay pay 40% more. It always works out.
7:06:07 – 7:19:15 Alex Nottingham JD MBA
It’s interesting, we were thinking about because there’s so much to talk about on the podcast because we cover, I think it’s like an over an hour and 90 minutes on the webinar. So in-depth, like what do we talk about? How do we explain it? And they came to me the psychology of insurance, freedom. I like that. It’s going to be our podcast title.
7:19:15 – 7:20:04 Eric Vickery
Yeah, I love it.
7:20:15 – 7:40:11 Alex Nottingham JD MBA
It was interesting. One of our dentists, that’s a coaching client mastermind and he had years ago, he told a story in the group and he said that he was running. His father is or was a dentist and he was pediatrics. This is Dr. Mike. And he didn’t take insurance but Dr. Mike became a general dentist and he would take all the insurance and his father’s practice.
7:40:18 – 7:45:06 Alex Nottingham JD MBA
And eventually he built a successful insurance based practice. And then he had this vision.
7:45:09 – 7:45:28 Eric Vickery
7:45:28 – 8:02:19 Alex Nottingham JD MBA
Insurance. No, he was taking insurance. Okay. Yeah, okay. But then later he then built another he was so much work and stress, he built another side practice for himself that that vision was a fee for service but or insurance free or out of network. And that’s a whole nother we can talk about that. So that was Invision.
8:02:24 – 8:20:29 Alex Nottingham JD MBA
Now he shared openly he actually from all that stress of the insurance driven practice, he had a heart attack. Yeah. And he said, enough of this. Like that was his way of passing the psychology of the fear. He said, My life is on the line. He got rid of that insurance base practice focused on the and he did it at a time when it wasn’t as cool.
8:21:05 – 8:33:23 Alex Nottingham JD MBA
He didn’t have the coaching like he does now work with you, but he didn’t have the coaching back then. He does. It was it was a life or death matter and he made it happen. And he was explained to me that, gosh, if you look at it and he’s big when it comes to the idea, he knows what’s going on.
8:34:00 – 8:52:24 Alex Nottingham JD MBA
He’s very honest with it. And he says, look, the patient, if you break it down, they’re not paying that much more for maintenance treatment. The people that are making the money, the insurance company is taking, taking the money out of it. It’s just taking it from somebody. Somebody’s got to pay. But the insurance, the patient isn’t saving much on the situation and they’re getting less care.
8:52:25 – 9:09:28 Alex Nottingham JD MBA
It’s almost like somebody taking from the transaction out of it, like the insurance is getting to the middleman and it’s like doesn’t have to be that way. So that it just shows you that in some cases it is life and death. But from the psychological perspective, it’s worth it has to start. Is there hope? Can it be done right?
9:10:05 – 9:20:06 Alex Nottingham JD MBA
So talk more about that. What are what are some of the barriers, the fears? How do we get over it? And actually, as a lastly, are there practices that it does make sense to take insurance?
9:20:27 – 9:23:10 Eric Vickery
So you have to remind me of all those questions.
9:23:10 – 9:24:04 Alex Nottingham JD MBA
But I’ll start with.
9:24:13 – 9:43:21 Eric Vickery
Let’s start with the fear. So I speak to dental schools across the country, typically, virtually, virtually typically the seniors. And this one I was doing this sort of conversation. I was talking about case presentation formula, but I often get in my jabs when it comes to insurance, freedom being an out of network provider. And one of the seniors raised his hand and said, How can you even bill insurance if you’re an out of network provider?
9:44:01 – 01:10:05:15 Eric Vickery
This concept doesn’t understand that they don’t get the simple fact that your insurance company is going to pay you. There’s only two insurance companies that will not do this. Your insurance company is going to pay you as an ad, a network provider. So so pick any insurance company. Right. We can get into specifics with coaching clients, but you have to understand the first that the basis of this know that, hey, if I’m at a network, they’re going to pay me and they’re probably going to pay your UCR fee, your MSE.
10:06:01 – 10:23:11 Eric Vickery
As long as you’re not charging a lot, that’s the first thing that helps overcome the fear. The second thing is approval addiction. We talk about this a lot and the question becomes, how do I they’re afraid of how to handle the question on the phone. And this is where great call comes into play. Do you take insurance? I want to be able to answer that question.
10:23:16 – 10:33:15 Eric Vickery
Yes. Yes, we take insurance now. You have to define take. That’s the that’s the problem. When you don’t have good verbal skills, you can’t communicate. You’re only as effective as you can communicate.
10:33:23 – 10:56:19 Alex Nottingham JD MBA
And that that’s where we we are so big on when I say that if you take insurance or you don’t take insurance, you have to listen to this podcast. You have to come to the webinar because you nailed it right there that if and that’s a softball, you actually mention a case in the webinar will tease it but where there was right there of $40,000 case and the receptionist did not answer properly the insurance question and it’s gone.
10:56:25 – 11:09:07 Alex Nottingham JD MBA
But you’re saying to me that in most scenarios I can be out of network. I don’t I don’t participate with the insurance, but I can either get paid by the insurance or the reimbursement can happen or that patient, it’s the same situation.
11:09:18 – 11:28:26 Eric Vickery
Yeah, no difference said yeah, 90% of plans set set to big insurance companies aside. We’ll talk about those with our clients. But all the other insurance companies, 90% of their groups are purchased as mutual in network and out of network benefits. And those that do the research on the insurance background checks, they do there, hey, let’s get a breakdown of benefits.
11:29:01 – 11:44:01 Eric Vickery
They’ll see it 100% coverage in-network, hundred percent coverage out of network or 80% coverage out of network, whatever it is, that’s pretty rare. But 90% of them, you’re going to be able to go from your your ten pro fees a day, getting paid for five and a half to ten pro fees a day. You probably go to nine getting paid for nine is that 10% go out.
11:44:05 – 11:51:26 Eric Vickery
So why would you? The question really becomes why would you be in-network? And it boils down to two things. I’m worried that patients aren’t going to come in because my team isn’t trained on how to answer this question.
11:51:26 – 11:52:13 Alex Nottingham JD MBA
11:53:04 – 12:10:07 Eric Vickery
Or two. Marketing is marketing. When we do our marketing, when we do our KPIs, we break down. How do people hear about us? We’ll have insurance in one of the columns. I hardly see insurance as a reason where people found you. In fact, if that was a marketing company, you to fired them because you’re paying them 42% of what you write off.
12:10:07 – 12:24:23 Eric Vickery
There’s no way you’d pay marketing company 42% to do the results you get. So if you’re paying money to to market your SEO and your online and all that, you’re asking for referrals. That’s where we see new patients come from. They just want to confirm that you’re going to work with their insurance. Absolutely. And they pay us. We just ask that you pay for your copay.
12:24:29 – 12:30:06 Eric Vickery
And so we teach you the insulators that are required to overcome the psychological fears of moving forward with this process.
12:30:25 – 12:51:28 Alex Nottingham JD MBA
All right. Such a review. Wow. That that that definitely hit the spot. So, one, it’s a realization that you can get full compensation from missing churns companies without being in-network. You’re not giving up 40%. And one of the analysis that, Larry, Israel made in the webinar is he says that if you do the math in many situations, you’re losing money seeing the patient, you’re.
12:51:28 – 12:53:00 Eric Vickery
Paying the patient.
12:53:00 – 12:59:29 Alex Nottingham JD MBA
And then this your patient, you’re paying them to see you. Now, whereas an HMO, you joke sometimes you’re getting the money, the hope they don’t show up because then you limit.
13:00:06 – 13:00:12 Eric Vickery
13:00:12 – 13:19:11 Alex Nottingham JD MBA
Come in you actually make money from an HMO if they don’t show up. That’s right. Because you just get paid now. But that’s a whole different can of worms. And then with respect, second part is the marketing perspective. Oh, well, you’re getting marketing, like you said, paying 40% for marketing. We say you budget five maximum 10% if you’re if you’re aggressive with 5% for marketing, you’re going to do eight times that.
13:19:16 – 13:36:12 Alex Nottingham JD MBA
And when you look at the tracker, because in all of our coaching programs and the KPI growth coaching, we include trackers. And when you do the the marketing tracking, you see what you’re saying all across the board. Very few is coming from insurance actually. Yeah. So it’s all a perception, an issue that’s going on here. Yeah. It’s not reality.
13:36:22 – 13:50:07 Eric Vickery
Yeah. And wow, we, we get this competitive mentality. Well they’re all in network, all of them are a network. I need to be a network to take the patients know you to be, you know, be known for who you are as a clinician. If people are coming to you because they’re you’re in network with them, what are they really interested in about you?
13:50:16 – 14:09:27 Eric Vickery
Then the relationship you have with them is based upon money, it being cheap. Well, if you have a quality in mind, that’s, that doesn’t compute. That’s the Walmart budget Nordstrom service. It doesn’t it can’t work. The amount of dentistry they do to get healthy is typically minimal. They spend as little as possible. The patient who comes to you because what they heard about you, they’re referred by their friends and family.
14:10:10 – 14:26:24 Eric Vickery
They happen to have insurance. That’s the patient you’re looking for. They’re not driven by that. And and lastly, I will add this. Membership plans make a difference in this scenario, and that’s a whole nother part of our coaching. But I will say this people go to Costco or Sam’s Club and the expectation I save so much, but they end up spending a whole lot more.
14:26:24 – 14:38:25 Eric Vickery
They these full carts when people are in membership plans, the studies show they’re doing two and a half times the amount of dentistry that somebody who just has insurance. So we need to remember that as we go through this and walk through this, that’s another tactic. That’s a whole another part of our coaching hacks that we use in the system.
14:38:25 – 14:41:12 Eric Vickery
And so you have to know how to do that really well so that you’re safe.
14:41:25 – 14:43:18 Alex Nottingham JD MBA
I like this coaching hacks. That’s a coaching.
14:43:18 – 14:43:27 Eric Vickery
14:43:28 – 15:06:18 Alex Nottingham JD MBA
Yes. Yeah. Coaching hacks with Eric Vickery, president of Coaching the and we do a webinar, we have a few webinars on membership plans with a peer. Dr. David Period here. Yeah, it’s great. Now the, as I’m listening to you, I’m refining that last part that you forgot. I’ll ask the question, but if there are some dentists, I’ll tell you that insurance is appropriate and where it’s not, oh, this is my opinion.
15:06:18 – 15:23:04 Alex Nottingham JD MBA
I’ll tell you what my opinion is. And this listening to you is when I, I was kind of naive going into dentistry to, to do practice management and training because my background is with Tony Robbins lawyer MBA. I’m coaching big, big businesses. Right. But it was working for my father would open my eyes and I assumed that all dentists were like him, loving people.
15:23:04 – 15:38:25 Alex Nottingham JD MBA
They want to make good money because they worked hard. But it’s not just the money. It’s serving people. It’s doing good work. Like my father will go back into his models. It’s got to be perfect. The patient’s, like, happy with it, but he’s got to have a perfect. So there’s this attachment to that, to the quality of a product to do that, get paid appropriately, enjoy your life.
15:39:03 – 15:55:15 Alex Nottingham JD MBA
That’s what it’s all about. They’re not business people, most of them. And we’re helping them become better business. Now, those type of dentist and I think it’s 80%, 90% are out there. That’s who they are. And it’s, again, a naive assumption, but we’ve worked with thousands of dentists and I’ve seen everyone I speak to. They’re pretty much like that.
15:55:27 – 16:11:29 Alex Nottingham JD MBA
And that’s what we love serving them. And I think from Eric and myself, we feel like we’re helping family. When we’re helping all of you, you’re part of our family. You really are. Yeah. There are some dentists that really have no business being dentists. Their wealth is their business. People look under the it’s like a wolf in sheep’s clothing, but they’re really there to make money.
16:11:29 – 16:30:29 Alex Nottingham JD MBA
They’re not interested in the dentistry. And they may see a business model where they can build a practice to work with the insurance, where they can cut the costs and they can get lower labor. And they’re looking at the numbers to kind of work the system. So the most general practitioners and DSOs that are doing it right, they’re not going to participate much in the situation.
16:30:29 – 16:33:17 Alex Nottingham JD MBA
It’s not a great fit for them. That’s my opinion.
16:33:17 – 16:48:27 Eric Vickery
I agree. I agree. And I’ll will finish with this. Alex, I you mentioned Doctor Dave here. And and he’s I really admire him and what he did in his practices that he grew from scratch. I mean, he’s just really done it well. He said that this he’s out a network complete with all insurances. He had this very, very large insurance company.
16:49:02 – 17:02:23 Eric Vickery
There was nobody in network with this will call it insurance plan D and they called him and said, hey, look, if you’re in network, we’ll match your fee. If you if you join, we will. We’ll cover your fees. And he said, no. And I said, wait a second, why would you do that, Dr. Pierre? Why would you do that?
17:02:23 – 17:16:07 Eric Vickery
And he said, because if I go and network with them, that’s going to make the next dentists in line feel like they have to be a network and they’re not going to get the same deal I do. I’m doing this for dentistry, not for me. And if you have that sort of philosophy, you can make that change. That was his philosophy.
17:16:12 – 17:28:22 Eric Vickery
Some don’t see it that way. They see it from a different perspective, and that’s totally fine. We can figure out how to make that work for you if you want. We have we have clients who are have PPO, in-network plans. We make it work. We can show you how to do that. Eventually, I think you start going, Oh, my gosh, we’re we’re too busy.
17:28:22 – 17:40:12 Eric Vickery
We’re out of this. And that’s what people will say. Even marketing companies will say, Well, just sign up for everything and then you’ll get out eventually. Well, okay, so which is it? You know, you can’t serve two masters and you really need to be clear in your vision with this and we’ll help with that.
17:41:04 – 18:03:10 Alex Nottingham JD MBA
Just to summarize, so we wrap up this wonderful podcast about the psychology of insurance freedom. That, number one, is you’ve got to get your mindset right, your perspective. And I think what you showed is two aspects. One is there is a clear business model to be insurance free and you’re you’re not going to lose very much because that what you gain versus what you lose is minimal in the second, because it’s important to be a business model.
18:03:10 – 18:15:00 Alex Nottingham JD MBA
We’re not asking people to just be lemmings and jump off the mountain. There is a clear business model and if you do it right, very important. You got to see this webinar because if there are people who lost a lot of money who did not do it right, because once you get an insurance companies, you can’t get out very easily.
18:15:00 – 18:30:12 Alex Nottingham JD MBA
You got to be careful. We talk about this in the webinar. You have to do it right. You do it right. It’s a pretty much guaranteed success rate. And the second is, you get to feel good about yourself and you’re doing something good for you and your family. You’re doing something good for your friends. And dentistry is what Eric’s talking about, the good business model.
18:30:12 – 18:47:22 Alex Nottingham JD MBA
And you get to help others. And I know dentists like to feel good about themselves. They do. They want to do dentistry to make a difference in the world. So check out all star dental academy dot com slash freedom and I’ll put the link in the show notes. All Star Dental Academy dot com slash freedom. Eric Vicary president of coaching at Also Dental Academy thank you so much for being here and supporting everybody.
18:48:02 – 18:49:04 Eric Vickery
Thanks for having me again, Alex.
18:49:27 – 19:04:26 Alex Nottingham JD MBA
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