Many hands built the "Taj Mahal"

July 1, 2003
I read your April issue and just had to comment on the office of the month. Your magazine is one of the few that deal with the business of dentistry, so I read this feature

I read your April issue and just had to comment on the office of the month. Your magazine is one of the few that deal with the business of dentistry, so as I read this feature (and others over the years about the office of the month), all I could think of was what type of business decision led Dr. King to build this "Taj Mahal." I would love to see her net income — the overhead has to be extreme. What general dentist is going to build an 8,400 sq. ft. building and then equip to the hilt and have 25 staff members?!

You either have to come from wealth, do a lot of (in my opinion) unnecessary dental work, or be stressed out every month trying to pay the bills. Again, as a business/economic magazine, the consequences that this type of decision has on the bottom line are more important than an ego booster.

Paul Benjamin, DMD, MAGD
Miami, Fla.

Response from Dr. Debra Gray King

We understand that not only our building, but a number of other facets of our practice are not for everyone — dentists or consumers. But, then again, we're not trying to be all things to all people. It's the same as when Lexus makes a well-thought-out business decision to build a luxury automobile and sell it at a high-end dealership — they aren't going after 100 percent of the market either. On the other hand, even though we're not aware of a preexisting model for what we are doing in the dental world, there are a number of things we are doing that could be of great interest to other practices.

We understand that being a trendsetter can raise questions, and we welcome them. Of course, it would be nice if some of these questions were couched in terms that didn't assume the worst — ego project, unnecessary dental work, born rich, or stressed out every month paying the bills.

We run our practice like a serious business, not just for kicks. For the big picture on how our practice is doing financially, you are welcome to contact our outside CPA, Teresa Gast of Cain Watters in Dallas, which has hundreds of dental clients around the country, to confirm that the gross and the net income for this practice is in the top percentile of dental practices in the country.

Even though the practice is thriving in ways that most are not, the owners did not come from wealth, but rather from middle-class backgrounds. They had to learn what it takes to be successful on their own. For example, I worked as a cocktail waitress during college and dental school. Then, I started the practice from scratch, having less than 100 patients.

You suggested that we must have to do a lot of "unnecessary dental work." We decided many years ago to focus on cosmetic dentistry. When patients come in to the Atlanta Center for Cosmetic Dentistry, they know what we offer and they come specifically for those services. There isn't any "bait and switch" going on. As you are well aware, cosmetic dentistry is elective for the most part. So, although I don't think this is how you really meant it, I guess you're right — a lot of the dentistry we perform is "unnecessary" to the same extent that driving a Mercedes and staying at the Ritz-Carlton is unnecessary. But, the last time I checked, there were a lot of Mercedes on the road, and the Ritz-Carlton parking lot was pretty darn full.

The majority of the approximately 150,000 dentists in the country practice in solo or dual-practitioner offices that look and feel much the same. The small, boutique model of practice seems to be the rage. Many doctors seem to be almost lock-step in their thinking, blindly following their fellow dentists' cookie-cutter type of practice. Nonetheless, for the most part, dental offices are still routinely dreaded by many Americans. We decided on a more luxurious environment. Even aside from the look and feel, other aspects of the typical small dental office model have their pros and cons. What happens when the dentist needs to be out of the office? Is there a decrease in production? With a small office, how do you get the word out about your practice and separate yourself from the pack? Our vision was this: Build a practice that is, in essence, a combination of two or three cosmetic boutique practices under one roof. By doing so, we have a far bigger and nicer facility (ours is on a major street with approximately 100,000 cars per day passing by), our own in-house master ceramist, our own marketing department, etc.

Now, when I am out of the office, the practice keeps on chugging along. For example, when my partner and I were in Hawaii for two consecutive weeks in the same month, our office set an all-time production record for the time period.

How's that for economic consequences to the bottom line rather than ego? Are there challenges inherent in our business model? Yes. Are there risks? Yes. But achieving anything worthwhile in life involves risk.

Dr. Debra Gray King, FAACD
Atlanta, Ga

Dr. Blaes responds:
When I decided to feature Dr. King's office in the April issue, I knew that a number of dentists would be upset. I know that this office has a solid bottom line with which most of us would be very happy. I also knew that Dr. King did not come from a wealthy background. I featured the office because of its innovative ideas and design. I realize that very few of us will ever build an office like this, but you could steal some of her ideas and use them in your practice. I like to look for the positives when I read an article!
Joe Blaes, DDS
Editor, Dental Economics

A little testy?

This is in response to the letter by Michael Steinberg, DDS, in the April issue of Dental Economics (page 17). While I understand Dr. Steinberg's frustration with dental benefits and insurance, it's not a new topic. If we disqualify all experts who are not possessed of DDSs or DMDs, "doctors" will soon find they have no one to help them. This would suggest we must condescend to everyone — families, staff, patients, etc. It's not the path I would choose!

Since dental school at Emory, I have relied both on other dentists and Mr. Limoli to give me a real perspective on what's happening in terms of dental benefits. Perhaps because of their influence, I take a direct role in insurance appeals in my practice. Additionally, I use their services for coding clarification and fee schedule review. Like Dr. Steinberg, I wish dentistry were easier in every way. In the meantime, I try to be positive, work hard, and contribute to any improvements that I can.

Ken Gilbert, DDS
Decatur, Ga.

Celebrating life

What a joy to read your honoring of your mother. Thank you, Dr. Blaes, for reminding us of the things that truly matter in this life. It also is a joy to see you honoring your wife and being grateful for the wonderful gift of faith.

My son is a dentist here in Ireland, and he introduced me to your wonderful magazine. I read it on the Web! I also run a small dental supply company that I enjoy very much since I left the business world.

If you or members of your family are ever thinking of coming to Ireland, please let me know so that our family can show you some hospitality.

May the Lord meet all your needs at this time as he is now fulfilling all his promises to your mother — in person.
John Byrne, Ireland

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