In 1999, I graduated with a Doctor of Dental Medicine degree from the University of Kentucky. Straight out of dental school, I did what most new dentists do and went into traditional private practice. After graduation, I spent a year working at three different dental practices by day and performed emergency services at a correctional facility at night. Working at the correctional facility was the only job that paid an hourly rate, which I appreciated since the other positions paid based on a percentage of collections.
After a year, I grew tired of working between four jobs and found an opportunity to acquire a practice. That first year of experience was unbelievably valuable in showing me the variations in each practice’s systems and processes. From each of these experiences, I took what I thought were the best aspects of each and acquired my first practice at the age of 27. Acquiring a practice where I was initially an associate allowed me to hit the ground running, as I had already determined what processes worked well and what needed modification. The keys to our success in this practice were centered around not overhauling the entire operations overnight, respecting the fact that change is uncomfortable to a staff accustomed to operating a certain way, and respecting the previous owner by allowing a degree of autonomy. In fact, many patients never knew ownership had changed hands because the focus was on increasing profits rather than who was the boss. The practice experienced exponential growth over the next three years, and I used this success to leverage the next opportunity into commercial real estate.
We moved the practice and expanded the number of operatories from six to eight. In our new multi-unit commercial development, I took on other entrepreneurial projects… most notably becoming a franchisee for a sandwich franchise. Margins were good in the dental practice; year-over-year growth was consistently achieved, even with the relocation of the practice and the 25% increase in practice capacity.
I find that most people’s strengths can also be weaknesses if not managed. In retrospect, I believe most entrepreneurs have a difficult time knowing when to be content and when success has been achieved. I challenge the readers of this article to make such an assessment. By truly defining your 1-year, 5-year and 10-year goals, with the proper contingency plans for unforeseen challenges and obstacles, you set your own bar for success.
In my entrepreneurial journey in practice acquisition and growth, I believe achieving success early on made me adherently more bullish on the continued acquisition of more practices and more businesses. I see this a lot in the current age of DSOs where these extremely aggressive entrepreneurs leverage their assets to continuously acquire practices to scale, with the goal of being acquired by larger groups at greater multiples of the single practice owner. The age of dental practice consolidation and the recession of 2007, unbeknown to me at the time, was not a great time to launch my second dental practice. I went big! Investing over a million dollars in a new venture for a more upscale pratice. I added another business partner and an associate, and I was sure that I would realize the same meteoric growth I achieved seven years earlier.
The practice did modestly well, but the tightening economy and the large initial investment made margins a lot slimmer. The inability to grow at the pace projected and a partnership where goals and objectives were not aligned made my second endeavor not as enjoyable as the first acquisition. It is important for a business to be able to pivot, so once economic circumstances improved, I decided to sell my denovo practice. In 2008, restructuring deals were not easily achieved, which was dissimilar to today where the banks are very accommodating with working with business owners during the pandemic. The experience taught me many things. For one, I learned that timing is just as important as location, budgeting and establishing the right team to achieve success. Timing and time are the most difficult variables to plan for and gauge when launching a dental practice. After exiting my denovo location, I refocused my efforts on my original practice location with a newfound appreciation of what I had and a lot less of a desire to be so quick to take a big leap into a large investment opportunity. As previously mentioned, the variable of time had caused my practice, that had consistently achieved considerable growth, to face new challenges from larger dental chains that entered the market to disrupt and capture market share. The recession had affected many businesses in the area, and margins that were once robust began to tighten in the second decade of ownership of my original practice.
Around 2016 my business partner, from whom I had originally purchased my first practice 16 years earlier, was ready to call it quits and transition to academia. Attempts to transition a younger associate to acquire a minority ownership had proven unsuccessful, so I chose to be acquired by a national organization focused on practice ownership in a nonprofit format. I was excited about the opportunity to once again reinvent myself and learn a new way to provide oral health care to those who so desperately needed it.
In 2017, I began to tinker in the tech space by creating a mobile app that connects patients to dentists for same-day treatment. The application was created to connect patients and dentists based on location of the patient, doctor availability within 1.5 hours of the requested appointment time, patient insurance and provider acceptance. Additionally, provider skillset was matched with the procedure type being requested to ensure that the patient was matched with a dentist with the ability to help the patient. The app takes all the patient’s pertinent information in advance to reduce wait times. Basically, the software was built to provide a contactless encounter, similar to how several software applications are attempting to implement within the current pandemic.
I shopped the application for a year seeking a partner with whom to collaborate in the insurance space to market and promote the technology as a solution for the third of the country that is underinsured, uninsured or faces difficulties finding a dental provider. Without a market for the software and with a huge investment made in creating the software, I strategized on a way to make people use my software. The idea came to me to provide a service that would make people want to use the application because the service I was rendering was so valuable you would try anything to get it. That is when comprehensive concierge mobile dental service was born. We built our first van from a used Ford E350 ourselves and embarked on performing all the services one would receive in a dental practice in the comfort of the patient’s driveway at home. It has been a huge success! The patient demand, improved outcomes and greater per-patient profitability this model provides made me focus on using the twenty-one years of experience to create a model for the dentist and hygienist to regain the autonomy so many yearn for, while also promoting practice ownership and increasing access for comprehensive services with a fraction of the cost to start your mobile practice. In essence, the inability to find a buyer for my software turned into my biggest opportunity to create impact. Around the time of the launch of my application, I lost my father to cancer. Losing your mentor and friend changes your purpose and motivation. Kare Mobile for me is the opportunity to allow others to be able to afford to do good within their communities by reducing the overhead cost to provide dental services. Doing good for others was instilled in me by my father at an early age, and through Kare Mobile we honor his legacy.
Fast forward to 2020, without any large marketing campaign, a few thousand people have organically made appointments through the Kare App and are now patients enjoying the benefits of mobile comprehensive concierge dental care. Due to the explosive growth in provider interest in the model, I developed a more high-tech model that utilizes invertor power sources as well as UVC lighting and an air filtration system to mitigate airborne health risks. Our alliances with top-tier industry leaders, such as Twice as Nice Uniforms, Dental Whale, and Virtual Support Solutions, supply the additional expertise and resources needed to scale my vision of licensing single operatory mobile dental units to dentists, dental therapists and hygienists across the country.
The revolution has begun; and by the end of first quarter 2021, you will see our expansion into 10% of the states in the country. We are a company focused on inclusion and increasing oral health equity in our communities. We want dreamers who are focused on thinking outside the box on new and inventive ways to change lives for patients and for the providers who now spend several hundred thousand on their dental education. We believe our model is the safest way for these providers to provide dental care in our current pandemic. We thrive on listening first to our customers – the dentists, hygienists and dental therapists – and tailoring a program with flexibility to meet their goals and objectives. We believe mobility is the only way to circumvent the variable of time that at some point will cause inherent challenges in fixed locations. We believe for outcomes to change we must take the time to change with time and adjust with the use of technology as a catalyst.