It may come as a shock, but the industry that private equity firms and other large investment companies called Dental Service Organizations, are going crazy for right now – is dentistry.

In some respects the wave started around 2009 in the recession, private equity firms noticed that healthcare was one of the only industries growing when most other industries were suffering.  When you look further into it – not only is dentistry the one healthcare professional we are supposed to visit at least twice a year, unlike physicians where only about 47% of them own their practices, 77% of dentists own their own practices.  So there was a clear acquisition target.

And it’s still early days.  Right now only 7.4%, or 14,421 dentists are in a group in the US, that number is probably going to grow.

The other big factor is that new dentists coming out of school have big debts in the hundreds of thousands of dollars and many of them are inclined to join an existing practice than start their own – which would at least for the foreseeable future – add to their debt pile. With that happening at a time when the ratio of dentists per 100,000 people in the US projected to grow from 60.9 to 65.7 in the next 20 years, this trend is likely to only continue.

So why are the existing dentists whose practices often have over $1 million per year in revenue (what they call production) selling some or all of the ownership of their practices to private equity firms or DSOs or other groups that own multiple practices? In many cases it’s because they are not great at, or not all that interested in,  running a business or choosing good technology or dealing with the increased need of their patients to explore new payment plans for treatments their insurance does not cover.  They want to be dentists and have a good lifestyle.

So once you have those facts,  it all make sense, and as a result a few things are likely to happen:

1-Being run more like businesses, and with a surplus of dentists, we should expect to see offices open nights and weekends.  This is great for the new dentists (though they might not like the schedule – they will be able to pay down their debts), it will be great for the practice owners because revenue will spike, and it will be great for patients to have the added schedule flexibility.

2-Some of the practices owned by private equity firms or bigger companies may be told what to do to be more profitable, which is no surprise, but that might make things less fun for the dentists, at least for a while.

3-For the first time ever, it will be possible to roll up all of the data from all of these practices and see best (and worst) practices, apply artificial intelligence and predictive analytics to every aspect of operations in ways that will improve patient health and business efficiency.  There’s a lot of talk about this over in medicine and cancer, but this is also going to happen very fast in dentistry.  There’s a company called CareCru – they are already very far down the path of helping both independent practices as well as some of the biggest groups out their rapidly get to better efficiency and growth.  CareCru has a product called Donna that’s powered by artificial intelligence, and while Donna automates a lot of things like reminders and appointments, and patient reviews and things you might expect – she also learns about each practice and within groups look across practices to learn and share information about best practices and things to watch out for – there’s really nothing like Donna out there and it’s exciting to watch.

So keep an eye on this space – some of the biggest advances come from places you least expect and right now dentistry is well positioned to take a giant leap forward with better patient health through big data analytics and artificial intelligence.

 

By now most of us have read, or know the story from Freakonomics, by Steven D. Levitt, and Stephen J. Dubner about what really caused the rapid decline in US crime starting in 1994.  While many took credit for it, and there were many plausible correlations, the simple cause was a 1973 US Supreme Court ruling.   It’s a story they tell well and if you want to learn more about it – there are lots of articles – even this YouTube video.

Online and with credit cards, fraud is something that has been growing for years and this article does a good job explaining why it’s happening and some things people can do to protect themselves.

What this article does not do is speak to the root cause of the fraud (the brilliant simplicity of Levitt and Dubner’s book is being clear about the difference between correlation and cause) – which is now something we can stop.  The cause of the fraud is that through our credit card (especially online transactions known as “card not present” transactions) – there is no step to ensure the person is who they say they are.  That’s because when people create an account, whether it’s at Starbucks, or Facebook, or Nordstrom – none of those organizations do what AuthenticID calls “first mile” authentication – verifying the person is who they say they are.  The first time any new account is established either in person or online – first mile authentication involves taking a photo of a government ID like a driver’s license or passport – verifying it is valid and has not been forged or tampered with – and that it’s not a picture of a picture, and then a photo of the person, can be a selfie if they are home, or a retail person can take the photo, which is then checked for liveness (not a picture of a picture) and matched with the government ID.  All of this happens in less than ten seconds – and once the identity has been confirmed – the user, or in some cases the organization/merchant, can choose their biometric preference be it a finger print, facial recognition, corneal scan, or voice for nearly instant authentication for future interactions.

First mile authentication does several things for both the users and the merchants:

1. No more remembering passwords.  Even though there are now tools to help us remember our passwords for all of our various accounts – we are still tired of it and having a way to get rid of all of that is a big relief to us.
2. No more mass hacks.  Because the authentication is a biometric instead of a password, hackers can n0 longer hack into a system as they did with Target a number of years ago and compromise everything.
3. Much faster transactions.  Merchants love first mile authentication because both in store and for the card-not-present transactions, they have dramatically higher trust in the interactions.
4. Fewer duplicate accounts.  A problem for merchants from Facebook to Wells Fargo is that people can create multiple accounts and identities online – and once someone’s account has been compromised, other accounts can be created in their name.  First mile authentication puts an end to all of that and the list of benefits to merchants, and consumers – AND advertisers is huge.
5. New revenue.  This is the biggest surprise of all, to many merchants, and the reason is simple.  It takes a long time to create a new account online or in an app – typing in name and address and credit card information – getting the verification e-mail or text and then going back to complete the registration – it’s a lot.  Which is why so many people “abandon” the enrollment process. First mile authentication takes less than ten seconds, and because that’s so fast, and the result can be so trusted, – enrollment times can shrink to a fraction of what they once were.  Slashing abandonment rates, means a spike in new customers – and that’s new revenue, plain and simple.

The list goes on, but those are the big ones.

So now that first mile authentication is easy, and it can be done faster and easier than the nonsense of passwords and IDs, this will cause fraud to drop very fast.  2018 is the year for it, almost 25 years after the last huge drop in crime Levitt and Dubner talked about.

 

These days – there is a lot of conversation about identity and facial recognition software and the importance of knowing your customer and their preferences.  That’s going to continue and accelerate.  The other side of that is when your customer wants to be anonymous – the fact that not only you can and should let them – but the amount of money that’s involved with that borders on shocking.  It is so shocking in fact, that if you sell direct to customers for anything from clothes to food to electronics – you will not only get a big lift from some purchases – you are likely to also get new customers.

The first, and most vivid, example of this came from Jack-in-the-Box.  They installed kiosks in their restaurants to help break up the line at busy times and give customers the option to order without as much pressure from the person behind them in line while they talked with the person at the point-of-sale system.  It accomplished that – but what also happened was double the average ticket amount from the kiosk compared with the point-of-sale.  Double.  After some investigation, it turned out that people ordered the more indulgent items on the menu when they were not facing someone else – someone they probably didn’t even know.  And when they got their order – it would simply be presented to them in a bag, so they could walk out with their indulgent anonymity intact.

 

Something very similar happened when Starbucks started offering their Mobile-Order-and-Pay service.  A mocha is a drink whose recipe includes whipped cream – but if you order one, people will usually decline.  It turned out that a lot of us decline it less because we don’t want it, but because we don’t want to sound indulgent to the point-of-sale person and the people around us.  As Mobile-Order-and-Pay rolled out and people created their orders, not so surprisingly, because there is no face-to-face admission of indulgence, the percentage of people wanting the whipped cream went up significantly.  Since whipped cream is already part of the recipe, there was no actual revenue lift there – but there are many other sauces and syrups offered that do cost extra – and Starbucks saw immediate increase in sales in those sauces and syrups.

 

Now this is obviously not absolute anonymity – this is switching from a face-to-face interaction to a non-face-to-face interaction.  But that is where the money is to be made.  If you have a product that could be seen as indulgent, or embarrassing for a person to purchase, then there’s a very good chance you are leaving money on the table if you are not offering your customer a way to buy that product in a non-face-to-face way.

Raising kids in the age of the internet, when we as parents had nothing like it, is hard.

There are so many things that are scary and dangerous that can make you blush, or nauseas, it’s hard to know where to draw the line, and having done some research, it’s surprisingly confusing when it comes to putting controls on how they use the internet.

But Charles Cosse has taken this conversation up a level – with NetDispenser, where kids have to earn their internet access, and not only that, the way they earn it is through learning new things.  Education becomes the currency they need to buy access to the internet.  This is so brilliant, that my belief is it will be applied to many other areas down the line.

NetDispenser is just getting rolling, but the idea is so good, that I believe it will prevail because the core ideas and ideals are so strong.

The link to learn more about it is here.

This is a huge relief and a big step forward for parents everywhere.

Most of us use LinkedIn these days.

I am often there two or three times a day, and whenever I met someone new, I will look them up and usually offer to connect right away.

Sometimes people will have really low numbers of connections, which is surprising, and other times people won’t have a photo – which can be a simple privacy thing.  But every so often a person won’t show up at all.

It’s jarring. Make sure I got the spelling right?  Maybe Matthew goes by Matt, but LinkedIn usually corrects for that.

Why on earth would an adult in the business world not have a LinkedIn profile?

It’s still weird, but there are some reasonable explanations for this.

1. Culture.  The best explanation is that it’s a company culture thing.  So when I find one person at a company not on LinkedIn, it’s not quite so jarring to learn that other people in the company don’t do it.
2. No interest in expanding their network.  Some people are totally happy doing their jobs and have no interest in meeting new people or possibly getting a better job.
3. Privacy.  Some people are extremely private, either because they were raised that way, or because they are extremely wealthy and don’t want people to find them out on LinkedIn.
4. Above it.  Not in a snooty way, but my guess is that someone like Elon Musk or Satya Nadella or Donna Karan doesn’t need to spend time on LinkedIn.
5. Extremely common name.   I have the luxury of having an uncommon spelling of a pretty common first name, and a not so common surname, so I am easy to find.  John Smith is another story – and I wouldn’t be surprised if people opt out – unless they want to add their middle name or something, just because they are hard to find.
6. They are Raymond Reddington.  If you are on the FBIs most wanted list or in the witness protection program, that’s also a good reason.

There may be more reasons, but having realized there are sane, plausible explanations for people not being on LinkedIn has helped take some of the edge off of learning they are not part of it.