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The dental practice of the future

June 1, 2011
An interview with the founders of McKinneyDentist.com...Marvin Berlin, DDS, Jeffrey Lynch, DDS, Matthew Markham, DDS, and Britt Bostick, DDS

An interview with the founders of McKinneyDentist.com ...Marvin Berlin, DDS, Jeffrey Lynch, DDS, Matthew Markham, DDS, and Britt Bostick, DDS

by Dr. Joe Blaes, Editor

This is a story of how four dentists decided on an uncommon way to practice, but how did you ever get four partners to agree?

All of us are 100% committed to the group practice concept. We’re all good friends as well, so that helps greatly. I’ve been best friends with Dr. Lynch since dental school, where we made an unwritten pact to someday work together. Before McKinneyDentist.com, Dr. Markham and I were in less than desirable partnership with some other dentists, as was Dr. Lynch elsewhere. So we all had our experience in how we didn’t want to practice. Since all three of us had similar goals, we joined forces and McKinneyDentist.com was officially conceived with the aspirations of creating a completely patient-focused practice. As we continued to grow, we soon needed a fourth doctor; ideally someone who we trusted and had the same practice ideals as us. Our unanimous selection was another good friend from dental school, Dr. Britt Bostick, who came on around 2007. I know they have my back, and I’ve got theirs. Our team mentality really pays off, as does our group decision making process – what’s best for our patients, then our team, then the partnership and finally us personally. With around 75 years of cumulative experience between us, we each trust each others judgment without a doubt. In a nutshell, the decision to be a group practice and to join Heartland Dental Care in 2008 came naturally to us because we all share this aligned vision. They fully supports our goals and continually allows us to grow professionally and personally. — Dr. Marvin Berlin

What are your hours of operation? How many hours per week do the doctors each work?

Our hours are 7 a.m. until 5 p.m. on Monday through Friday, and 8 a.m. until 2 p.m. on Saturday. Remaining open on Saturdays has been a great opportunity to serve patients. There’s not many practices in North Texas that are open on Saturday; this means we get to be the hero to a lot of patients in need. Even patients of other practices come see us on Saturdays because they simply don’t have time during the week or want to avoid using a vacation day to do so. Once they see the quality of work we provide and how available we are, many of them end up becoming lifetime patients as well. Each month we average 200 new patients and have 2,050 total patient visits. — Dr. Berlin

The new building opened in October 2010 but you must have been producing well in the old office to have produced so well in that year. What was the square footage? How many chairs? How many hygienists?

We actually had two locations. Our main office, which was opened around 1975, was about 4,800 square feet and our second location, opened to accommodate our growing patient base, was 2,400 square feet. The main office had six doctor operatories and four hygiene rooms, while our second office had three doctor operatories and three hygiene rooms. We’ve always had nine hygienists on staff. Heartland helped us to build a larger office to accommodate our entire patient base under one roof. — Dr. Berlin

What was the importance of Heartland? How did you all decide to join?

The support and tools they have given us have been invaluable. They allow us to be dentists, not businessmen. We don’t have to worry about payroll, HR, or administration issues, they take care of that for us. Instead, we can focus on our top priority — providing the best care to our patients. Many practices fear joining dental management companies because they don’t want to lose control or be told how to practice. That’s not the case with them though, they’ve never tried to steer our practice in a certain direction or push anything on us; they’ve simply given us the guidance and support to best run our practice. — Dr. Jeff Lynch

Instead of telling us how to practice, Heartland has worked with us to further our goals; they’re more of a business partner than owner. The decision to join first came about after meeting Dr. Workman at a dental conference in Palo Alto, Calif. After speaking with him after the event, it became clear that what he was trying to accomplish with his company was the same thing we wanted to accomplish at McKinneyDentist.com. After meeting Pat Bauer and the rest of their Executive Team, any worries we had were immediately erased. They were so in line with us, it was an easy decision to join. We got better after we joined them! In 2009, a rough year for dentistry, many other practices were going negative, but with this company on board, we saw a positive increase. — Dr. Berlin

How can what you are doing be modeled by other dentists?

For the McKinneyDentist.com team, it really boils down to three things:

1. Learn how to do all and be all for your patients. In the eyes of our patients, we offer them what they want and when they want it. McKinneyDentist.com provides all dental procedures and services, except full orthodontics, under one roof. Each of our doctors’ has a specific skill set beyond regular general dentistry. We’ve found that patients don’t like being sent somewhere else, to a “new dentist” to have procedures done that they would prefer to have done in the comfort and familiarity of “their” home office. Secondly, be open as often as you can to ensure your hours are patient-friendly. Remember, you are there to serve the patient and should be accommodating as possible. McKinneyDentist.com is open six days a week to make sure that we are meeting the needs of our patients. — Dr. Lynch

2. Do what you know – dentistry — and leave the rest to someone else. For many years my three partners and I spent an average of nearly two hours a day dealing with non-clinical issues such as ordering supplies, dealing with payroll and approving bills. That’s not why I got into the profession. As a member of the Heartland Dental Care team, those hassles are now gone, and I can spend more of my time treating my patients. — Dr. Berlin

3. Just say YES! Our profession is about building BLT (believability, likeability, and trust). The theory goes that if you get any two of them, then the third one comes naturally. At McKinneyDentist.com we build this motto into every conversation by immediately addressing the patients’ chief concern and providing an immediate resolution. We know that our team and the patient will receive greater success in the end if we build BLT by removing all of the barriers up front. — Dr. Lynch

How did you get to “YES” philosophy? Explain what YES means to your team and how it works.

The “Say Yes” concept originated back in 2005 when McKinneyDentist.com was founded. Whenever patients called the office, many would typically ask for teeth cleanings. We, as dentists, have been brainwashed into saying “No” since dental school, so we would say “no you must have an exam” or “no you must have X-rays.” These patients would then hang up and seek treatment elsewhere. We realized there had to be a better way. So instead of living by that old cliché “No first visit prophies,” we tried saying “Yes” for a change. Turns out, patients like hearing that word. They appreciate being able to get cleanings on their first visit, or have a painful tooth treated immediately, same-day. This is where our “Say Yes” philosophy was born, and where we discovered that listening to patients and addressing their immediate concerns works much better than bullying them into what we were taught they should do. — Dr. Berlin

A good example of our “Say YES” philosophy is the use of our E4D CAD/CAM system. It’s a great technology that lets us design and produce restorations in office — allowing us to say “yes” to one of the most important questions a patient can ask ... Can I get it today? YES! How about tomorrow? YES! By the weekend? YES! We picked the E4D System because of its ease of use, it doesn’t require powder, produces high quality results and best of all — most of the work in scanning, designing and milling is delegated to our team members, many of which are certified cad cam dental designers (CDD). This allows us the ability to maximize efficiency in the office, control the quality and completion time of the restorations — all the while exceeding our patients’ expectations. — Dr. Berlin

Who designed the new office? Who was the architect?

The architect and general contractor on the project was Russell Grimes of Grimes Construction. Dr. Workman’s input on the best ways to manage patient flow in the building, efficiently conduct our hygiene checks and where to generally set up everything has been a tremendous help. He also helped us with the waiting room design, which can be described as a combination of Starbucks, a Lexus showroom, and your living room. It features a coffee/juice bar, Wi-Fi connectivity, tables set up to work at, three flat screen televisions, and a children’s play area, so our patients definitely feel welcome in our practice. Heartland has been a great help in transitioning into this new office. They originally said it would be better to build new, and they were right. Not only was the building finished ahead of schedule, but we also stayed under budget as well. So without them, this amazing new building wouldn’t exist. — Dr. Berlin

How does your office run so smoothly?

Things just naturally run smoothly when everyone knows the vision, expects the same things and are working towards the same goal. We are a unified team, all working towards the main thing — saying YES to our patients. — Dr. Berlin

Expand on the flow patterns and efficiencies of your office.

Another huge advantage of affiliating with the Heartland team is access to their dedicated Development Team. Debbie Steppe works day in and day out on designing new offices, rebuilds and remodels. Debbie’s 20 years of service to this company and the dental industry is evident in the efficiencies that she creates with the office floor plan. She constantly evaluates and revaluates flow patterns in offices to better improve how they are designing and building their facilities. Most of their offices, ours included, have one common theme – ease of access:

1. First and foremost, the site for the office has to be an A+ location with A+ signage

2. Lab centrally located in the office with three entrances/exits

3. Operatories have two entrances/exits and minimal cabinetry. All supplies for necessary procedures are within arms length in the 12 o’clock cabinet.

4. Business Assistant office/reception desk is open with two entrances/exits

5. Doctor’s office is one large room with no walls to encourage collaboration

a. The McKinney doctors have personalized their office by painting each wall with their school colors. They thoroughly enjoy the open door policy their office has and the learning environment it has created. — Dr. Berlin

My personal experience has always been that change generally results in more production. Did that happen when you opened the new building?

The increased space and design of the new office has made everyone, doctors and team members, much more efficient, and increased efficiency equals increased production. The building grabs your attention visually as well, which has helped bring in more patients just from drive-bys and word of mouth. It’s really helped us establish a brand identity in the area; when people drive past our building — they know who we are. — Dr. Berlin

When I visited your office, it blew my mind when you told me you had $4,200 scheduled on that five-hour day and ended up with $11,000. Explain the “DO IT NOW” concept to me slowly.

That was simply a result of personal drive and having our team on the same page. Every morning, we review our schedules with our teams, seeking out areas to fit more patients in — schedule holes if you will. This is “opportunity time,” meaning we can work in additional treatments. When you say YES to patients and accommodate their schedules, it’s amazing how much work can be accomplished. We have a billboard that states, “How Soon Can You Get Here?” This perfectly sums up our ethic — there’s always room for patients here and doctors who are willing to take care of their needs. If you build relationships with your patients and listen instead of just pushing your way on them, it’s much easier to get people healthy. — Dr. Berlin

Is the solo practice dead?

Many of the concepts that we have designed and incorporated into our practice could be used by solo practitioners but I think the solo practice will continue to struggle to meet patient needs. Being a group of dentists allows offices like ours to function as a full-service oral health provider. Our patients can take advantage of the latest technology, expanded services, appointments six days a week and much, much more. It would be nearly impossible for a solo practice to accomplish these feats. Having an additional partner like Heartland just adds to our efficiency. — Dr. Berlin

Were your team and systems already in place in the old building before you moved? Did you use the same practice management software? What were the biggest problems when you moved?

Through the transition, our teams and systems remained relatively the same. In the spring of 2007, we switched to Dentrix Enterprise/Dexis, which we currently use in the new facility. For the new office, there was a significant need to increase the number of digital X-ray sensors and upgrade the server capacity. One benefit of moving into one office instead of two was the elimination of transferring data in multiple locations. This required three T1 lines which were costly, but the speed was inadequate as well. The biggest challenge we faced with the move was undoubtedly the phone line transfer. We were assured that the phone lines would be in place two weeks before our opening; however we weren’t fully operational until two weeks after. Heartland’s reinforcement definitely made the transition run smoother. With their support, we had many things taken off our plate that we would have originally had to worry about. — Dr. Matthew Markham

Did you need more people after you moved into the new building? How did you find these people and integrate them into the practice? What is your team structure?

We hired a part-time coordinator a few months before the move. With the increased volume of patients in one location and having everyone working in one group, we wanted a coordinator to organize and manage day-to-day activities in the practice to ensure everything runs smoothly. The rest of our team from the two previous offices still remained. — Dr. Markham

Each dentist has three dental assistants. In addition, we have nine hygienists that work out of seven rooms on a given day and two sterilization techs to keep things running efficiently. In our front office, we have a wonderful office manager and a business assistant, both are a tremendous help in maintaining front desk applications and keeping our team on track. We have five patient care coordinators that present and schedule treatments based on our diagnosis. Our three insurance specialists file insurance claims, verify benefits, submit narratives for reimbursements, and answer any benefit-related questions. In our house lab, we have a lab tech that prepares our crowns, bridges, stains, glazes, and removable repairs. He also has an assistant that pours models, creates night guards/retainers, and orders office supplies. — Dr. Markham

Please tell me more about the surgery area and what you do there?

In the surgery area, I perform procedures such as wisdom teeth extraction, hard/soft tissue grafting, and implant placement while patients are under either oral or IV sedation. The area is enclosed, with stainless steel, non-porus countertops giving it a much more sterile feel. You could say it’s a hybrid of a dental operatory room and a surgery room. — Dr. Lynch

Did Heartland influence your choice of dental equipment? How much did their buying power help? Why did you pick them?

Heartland’s research and experience with dental equipment allowed us to make quicker, more educated purchasing decisions. Without them, we would have had to have hundreds of meetings with vendors and do hours of research on our own to determine the right dental equipment for our office. — Dr. Berlin

With their negotiated vendor relationships and knowledge of market pricing for materials, we saved hundreds of thousands of dollars and finished a week ahead of schedule — this is absolutely unheard of in the construction industry. Frankly, their experience in the construction and project management is priceless when it comes to rebuilding or remodeling. — Dr. Lynch

Simply put, there is no close second. Our team is allowed autonomy, while professionally we have access to and benefit from the unlimited resources Heartland offers us to continually grow ourselves and our business. — Dr. Berlin

How do you make a difference?

Saying YES. Whether it’s being open on Saturdays, doing treatment same day, or hosting a free dentistry event, our team is committed to helping the residents of McKinney, Texas. Our team takes great satisfaction in knowing that our office gives back to our community by hosting free dentistry events. They are constantly being approached by residents thanking them for their generosity. It’s really two fold, our team and our community benefits. — Drs. Berlin, Lynch, Markham, and Britt Bostick

Equipment List
Apex Locator: J. Morita ROOT ZX
Autoclaves: SciCan Statim 500 & Midmark M11
Bleaching Systems: Discus Dental Zoom & Ultradent Opalescence
CAD/CAM: E4D Dentist™ System
Camera (Digital): Canon DS6031
Caries Detection: KaVo DIAGNOdent
Cavitron: DENTSPLY Cavitron Jet Plus
CBCT: Sirona Galileos, Galaxis Software
Chairs: Pelton & Crane
Cleaners, Ultrasonic: Maxisweep s3100, Coltene Whaledent Bio Sonic
Compressors, Air: Midmark Power Air
Computer Hardware: Dell (optiplex)
Computer Software: Dentrix Enterprise, Dexis Imaging & Intergrator, Smile Reminder
Digital X-ray (Intraoral): Sopro595, Gendex EZ1, SOPRO DEXcam
Digital X-ray (Panorex): Gendex 8500 dde
Digital Imaging Printer: Canon, Dell, and HP
Handpieces: KaVo Electrics gentle power Lux 20LP & gentle power Lux 25 LP
Handpiece Maintainance: KaVo QUATTROcare
Home Sleep Study: Watermark ARES™
Impression Material: Kerr Dental Take One
Laser: Biolase EZ Lase
Lights, Curing: Kerr Dental Demi
Lights, Operating: DentalEZ EverLight®
Loupes: Design For Vision
Oral Cancer Detection: Zila Vizilite
Patient Financing: CareCredit & ChaseHealthAdvance
Vacuum System: Midmark Power Vac
X-ray Units: Gendex expert DC

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