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How I survived a startup when others around me failed

April 10, 2015
Six years ago at the beginning of America's second worst economic collapse, I opened a new general dental practice with a focus on cosmetic dentistry in Naperville, Illinois. Looking back, I don't think anyone realized just how bad the recession would be or how long it would last. As it turned out, Illinois became the second highest state in unemployment, dropped to the worst financial bond rating, and is still reported to be the third worst state for future predicted economic growth. Talk about a triple whammy. Had I known all of this was coming, I assure you I would have turned and run. But I didn't. So I put out my dental shingle at probably the worst time ever and got on the unexpected roller coaster ride of my life.
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Chiann Fan Gibson, DMD, AAACD

Pictured from left: Dr. Parihan Tamkin, DDS; Mary-Kay Barrett, RDH; Daisy Ramirez, admin. director; Henry Sharfaei, DDS; Raza Hussain, BDS, DMD; Chiann Fan Gibson, DMD, AAACD; Margaret Kowalczyk, DDS; Suzi Salerno, clinical director; and Tami Savage, accts. director

Six years ago at the beginning of America's second worst economic collapse, I opened a new general dental practice with a focus on cosmetic dentistry in Naperville, Illinois. Looking back, I don't think anyone realized just how bad the recession would be or how long it would last. As it turned out, Illinois became the second highest state in unemployment, dropped to the worst financial bond rating, and is still reported to be the third worst state for future predicted economic growth. Talk about a triple whammy. Had I known all of this was coming, I assure you I would have turned and run. But I didn't. So I put out my dental shingle at probably the worst time ever and got on the unexpected roller coaster ride of my life.

It's worth noting that two other Naperville dental offices with great locations and high profile drive-by visibility failed within 24 months. In contrast, our practice is located on the second floor of a nice office building with little foot traffic and zero visibility. The building doesn't even allow visible signage. As we settled in, we grasped the enormity of our challenge and asked, "What were we thinking? Can we get a do-over?"

With the odds stacked against us, how were we able to make it? I read that in 2008 only 5% of the population did an Internet/reputation search to find their dentist. Today it's closer to 90%. So we ask all new patients who were not directly referred to us how they found us. The majority say, "I found you on the Internet and read your reviews." So from my perspective, there is no more important social media channel than online review sites. Your website is obviously critical, but online reviews trump it.

Many programs and companies promote that they help businesses with the social media process. I won't tell you whom to choose, but I will say that as vice president of the American Academy of Cosmetic Dentistry (AACD), the AACD has invested its resources the past year to launch a new digital informative review initiative for all AACD members this spring. Through the AACD website, each member will receive the benefit of having their online presence include their academic information, credentials, videos, photos, and online accredited patient reviews. Patients trust patients, especially for cosmetics. We get that!

On a side note, being the only AACD-accredited female in my five-state region and one of only 12 in my state has not only been an excellent education, but a tremendous marketing plus for attracting cosmetic patients. It's not uncommon for new patients from other states to find me after reading my reviews and credentials online and then travel in for cosmetic services.

The next big marketing decision for a general cosmetic practitioner is whether to become a partial in-network PPO provider. I say "marketing" decision because marketing is the cost and return for getting new patients through your door. I could write a book on this, and we all have our opinions, some very strong. But in the highly competitive community of Naperville, I found that most dentists are in-network PPO providers to some degree. Many prominent, well-known, longstanding dentists I spoke with told me they became tired of watching their patients drift away to other outstanding dentists who are in-network. After some thought, I made the decision to become a partial PPO provider, and I currently have a balance that works very well.

I've learned that it's perfectly doable to provide excellent dentistry in a multi-disciplinary PPO setting if the staff and dentist work well together to streamline time management. This comes from hiring the right staff and providing them with the proper training. It's no different than how the medical insurance world transitioned 30 years ago. Things change, like it or not. As Cher said in the movie "Moonstruck," "Snap out of it!" Decision made! Now, how do you provide excellent dentistry, focused on cosmetics, with a profitable outcome?

As a general dentist PPO or FFS, I choose to not only treat patients, but also to educate them. Most of my PPO families have never considered any elective cosmetic dental care. So I don't sell dentistry, I educate patients, and they sell it to themselves. Sometimes that cosmetic decision happens on the first visit, and sometimes it happens after two years, but it often happens. We never push these decisions or pressure patients, and this works. Thankfully, our practice produces a significant amount of cosmetic dentistry.

Charitable opportunities in dentistry are also something I enjoy pursuing. My husband Jim and I have been involved in a number of charitable organizations. One that I like is the AACD Charitable Foundation's Give Back A Smile program for victims of domestic and sexual violence.. I also found another charitable opportunity through my son's school.

Our son is in first grade at a local Christian school. During a conversation with his teacher I realized the school is not able to offer dental insurance to employees. My husband and I talked about it and BANG! A light bulb went off. We met with the school administrator and put together an agreement whereby staff members and immediate family members can receive the same discounted fees as with a PPO fee schedule. This represented a significant savings to each family. We showed them our standard FFS fees, and then the school discounted fees. This offered a free membership, no yearly dues, and no risk to anyone.

Prior to our presentation to the school staff (100 staff families), I made individual custom plastic membership cards with each staff member's picture, name, and school logo. This tangible card makes the benefit real. When I handed the teachers their dental card, there were tears and hugs, and many said, "Thank you for helping me do what I wasn't able to do for my family." Within days, calls were coming into our office from the school staff to book dental exams, Invisalign, and even cosmetic veneer dentistry. I believe that tangible card is the cement that made this program real. It's been a win-win for everyone involved.

The school can now offer employees a discount dental plan "only" through their school affiliation. The employees love this because they can now receive affordable dental care. We win because we get new patients paying the same amounts as our PPO patients. We no longer fight insurance companies or the cost associated with the staff spending hours on the phone jumping through hoops for payment. Best of all, these school patients are FFS patients who pay at time of service, so no more accounts receivable headaches!

The practice will continue to balance the proper percentage of PPO, FFS, and discounted FFS patients as we consider other charitable organizations that might be interested in receiving the discounted dental card program that worked so well at my son's school.

In summary, we've grown into a thriving practice during a tough economy by focusing resources on three fundamentals: 1) we realize there is no more important social media channel than online review sites; 2) we became an in-network provider and developed a patient education process with a pathway to more cosmetic dentistry patients; and 3) we were innovative and worked within our community to create win-win relationships. If you create these relationships, you will carry your patients as much as they carry you to success.

Chiann Fan Gibson, DMD, AAACD, is a graduate of Tufts School of Dental Medicine, an accredited member, board of director, and current vice president of the American Academy of Cosmetic Dentistry (AACD), the president of the Chicago Midwest Academy of Cosmetic Dentistry (MWACD), a Fellow of the International Academy for Dental Facial Esthetics (IADFE), and an adjunct instructor at Tufts University Department of Prosthodontics and Operative Dentistry. Dr. Gibson is a published author, dental newspaper columnist, and featured speaker seen on network television. For more information viist www.smilesbygibsondmd.com.

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