Dr. John A. Wilde practiced dentistry for forty years in that midwest mecca of fine dentistry, Keokuk, IA. He is now blissfully retired. He has had six dental books and over 200 magazine articles published.


Hans Selye opined that to make a dream come true, one must first have a great dream. Most dentists labor for a long time. It was 40 years for me; and, for weal or woe, our careers, our life’s work, can define us. Little could be more foundational to happiness and well-being than functioning in an environment that facilitates attaining one’s ideal future. But a “great dream” must precede physical reality, as perfection can’t be created until it has been pristinely envisioned. So unfetter your imagination, and let’s begin to build your dental castle in the sky by comparing and contrasting three flourishing practices. No winners or losers exist here, but each manifests the views of thoughtful, foresightful leadership. Their broad diversity confirms that winning visions come in numerous sizes and shapes. The challenge is flawlessly identifying one’s own. Our first protagonist is a solo dentist who thrives in a midwestern community of 41,000. After serving as a prestigious national dental institute’s clinical director for years, he returned to his hometown and resumed practice. Acutely aware that there exists only one chance to make a first impression, his eye-catching 18thcentury mellow-cherry door bracketed by ornate lights reflects quality and beauty. The reception area reaffirms this impression as plants, carpet, furnishings and even magazine selection embody care, taste and purpose. Asked if he was concerned that the plush flooring and posh furniture might be damaged, my friend replied that people aren’t careless in such environments as “behavior conforms to surroundings.” He mentioned that a scheduled new patient would occasionally enter, peer about and then quietly depart. He felt this was for the best.

This dentist claimed the sweetest sound people hear is their name; and the five or six patients seen daily, mostly for TMJ and reconstructive care, are greeted with a warm smile and a personalized welcome by two lovely and gracious staff. Medical histories and other paperwork are completed in an interview format with the receptionist, lending a personal touch to the mundane. The office has two operatories, and prophylaxis and routine operative care are referred. An examination lasts a full hour during which the patient talks and the doctor listens. My friend advised, “During this interview if you must speak, ask a question.” Patients are seen 100 days a year, and the dentist is busier than he wishes to be. Unless requested, treatment plans aren’t itemized but presented as a single fee. Dental insurance is filed for patients but has minimal influence on most cases.

(All three dentists discussed introduce themselves by first names, sans title. Make of that what you will.) Our second dentist-hero excels in a municipality of over 100,000 souls. This one-owner, two-associate practice is located in a capacious, free-standing, repurposed building that had been a travel agency. The senior dentist was a successful pedodontist who retired for five years; then, inspired by a new dream at age 47, resumed his career as a general dentist.

A large, lighted sign and giant toothbrush announce the practice, and, though the door is nondescript, one steps into a buzz of activity and country & western tunes where 36 staff await. Five hygienists and three laboratory technicians work on premises. (Having enjoyed an in-house lab, let me assure all that consistent quality enhancement and massive improvements in communication more than justify its existence. Repairs are completed sameday; and, if need be… as when Fido destroys her master’s teeth… dentures can be fabricated in one day. Lab bills reduced to a fraction of prior levels don’t offend, either.)

There are 23 operatories, and over 200 new patients are seen monthly; many enrolled in entitlement programs. Calls are answered promptly and amiably, as the team works proficiently in a pleasant atmosphere. Not the abode of the 60-minute, newpatient interview, their ethos is one of swiftness and efficiency. Because much of their treatment is removable prosthodontics, the bulk of their advertising, such as the owner’s monthly dental health column published in a seniors’ newsletter, is tailored to a geriatric population.

The practice engages in an abundance of excellent, creatively unique marketing. For years this doctor has had prepared, entirely at his expense, a Thanksgiving banquet for any and all who wish to partake. When my family and I were privileged to attend, the dining experience included live music and roses presented to guests. Approximately four thousand meals are served. The host’s short message is that, especially during the holiday season, people need to be together. The only requirement to return next year is to bring a friend. Local newspaper and television coverage is extensive. More people volunteer to serve and deliver food than can be utilized. Such extraordinary philanthropy and deft promotion define the unusual spirit of caring embodied by the office. Our triumphant third office is also a one-owner, two-associate practice located in a riverine town of 13,000. The decor is pleasant but not opulent. The reception area resembles a middle-class living room and features a large play area sequestered behind a two-foot wall. The owner’s family photo is on display, and seeing his four little ones reassures parents who entrust their children’s wellbeing to him.

Eight staff members have been together for years and consider their loyal patients to be friends. The atmosphere is pleasant, affable and informal. Rather than waiting in the reception area, patients are quickly escorted to operatories. No intra-oral camera tours or educational videos are offered, but “meaningless” chitchat is encouraged.

Notable events, such as vacations, the birth of a child or grandchild or a new pet, are highlighted in patient records, making them easier to notice during future visits. Recalling these occasions helps patients feel recognized as individuals, not mere customers. This exhibition of concern is a highly effective marketing procedure that costs nothing, so its return is infinite. The 40-minute new-patient interview begins in the dentist’s private office and involves the doctor’s asking and listening. Fees are above average. Not by chance, the aggregate practitioners’ interests and skills include virtually every dental procedure, including TMJ, orthodontic and orthopedic care. Since evening and Saturday hours became available, new patient numbers have doubled.

The owner is adamant that dentists must understand success depends primarily on establishing positive, long-term patient relationships. He adds, “It’s not only profitable but enjoyable to work with and on your friends.”

Does one prototype resonate most, or are you attracted to portions of several? Our first victorious practice’s patients are primarily wealthy individuals who desired the best and gratefully pay to receive it. Complex state-of-the-art care (which not every dentist can deliver) is provided to an average of six patients a day. Concerted staff effort and lengthy appointments intensify relationships, and the office boasts virtually a 100-percent patient retention.

The second winning office focuses on ultra-efficient care at lower fees for mostly blue-collar clientele who want quality, affordable treatment in a friendly yet professional atmosphere. This volume practice treats over 100 patients daily. The owner is chairside more than 200 days a year and loves it.

Our third outstanding office combined five operatories, an experienced, committed, highly cross-trained staff and the convenience of evening and Saturday hours to become extremely profitable. Among their patients are wealthy and indigent, but the primary emphasis is providing friendly, efficient, quality family care. Due to the three dentists’ diverse combination of skills, referrals – which no patient likes – are seldom required and specialty revenue remains in-house. Relationship building is foundational to their success.

Many more examples exist within the wide, wide world of dentistry, each as unique as the visionary who developed it. Still, Henry Kissinger cautioned, “Perhaps the worst form of tragedy is wanting something badly, getting it and finding it empty.” To avoid such a devastating result, don’t set off willy-nilly, but develop a precise master outline before constructing your dream. I’d suggest initiating a “Future Office Notebook.” Perhaps retaining this treatise could mark the beginning of one’s quest. Visit successful offices and note what you admire. I’ve invited myself to see many without ever being refused as such attention is flattering, and I always buy lunch. Besides design concepts, I invariably acquire several clinical gems. Search for texts or courses that enlighten and inspire, then form two dream teams: one comprised of staff who will enthusiastically help create “our perfect office.” The other being you and your spouse, as a couple pursuing a common cause is a puissant force.

Be inspired on your journey by these words of McDonald’s founder Ray Kroc: “Nothing in the world can take the place of persistence. Talent will not. Nothing is more common than unsuccessful men with talent. Genius will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent.”

Or, as columnist Harvey MacKay put it, “The person who wants to do something finds a way, the person who doesn’t finds an excuse.” Godspeed, and enjoy your exciting passage to previously unimaginable success.