As a dentist, have you ever wondered what it would be like if you could start all over again and build your dream practice based upon all you have learned over the years? Well, that’s exactly what Robert “Bo” Turnage, DDS did... after 23 years in clinical practice. His story offers significance for newly minted dentists, established practitioners, and older dentists verging on retirement.
After graduating from Loma Linda in 1982, Dr. Turnage purchased a small practice in Palm Springs, where he and his family lived for the next 10 years. With his wife and 3 small children, he decided to forego California’s fast-paced lifestyle and relocated to Ellensburg, Washington, a rural community between Seattle and Spokane. Dr. Turnage bought an aging practice and spent the next 13 years building it into the largest dental practice in the area. “We were ‘crazy busy’,” recalls Dr. Turnage who, with a 12-person staff, saw from 35 to 50 patients a day. “We had 6 operatories and an in-house lab. But we also had old-fashioned equipment, including banana chairs, traditional radiography, and air-driven handpieces.”
Over the years, his rural practice grew to production of $120,000 per month. “Not bad,” said Dr. Turnage, but his high-volume practice generated tremendous overhead, which was hovering at 80% of revenue. “My philosophy was that pumping more patients through the system would lead to greater financial success. I had to work my tail off to keep the practice on track and profitable.” What kept him up at night; however, were dual “nagging thoughts.” His kids were nearing the end of high school, and his wife and he thought about relocating to their eventual retirement community, “somewhere we could truly enjoy natural beauty each and every day.” At the same time, the pace of work was very stressful, even in a rural setting. “There had to be a better way.”
Against the well-wishes of friends, they decided to up and move once again, to Friday Harbor, a community in the San Juan Islands north of Seattle. During repeated visits to Friday Harbor, they would ask locals where they went for dental care. “What we heard consistently was, “can you get back to Seattle?” The Turnages saw this as an opportunity to bring a unique presentation of dentistry to the community of 7,000 year-round residents that grows to 22,000 in summer. Starting from scratch, Dr. Turnage began to design a dental practice from the ground up.
They decided on an elegant harborview setting with Asian and European antique furniture, dramatic lighting and lots of art. “We wanted patients to feel like they had walked into a highend spa in Dallas or New York.” Next, they decided to make high technology the focus of their practice as well as the diff erentiator in the community. “We also wanted patients to feel that they could get the highest level of care without having to travel.” To accomplish this, they started by purchasing a laser. “
The Waterlase MDTM has become the cornerstone of our hightech patient care approach,” noted Dr. Turnage, who has also employed an additional BIOLASE LaserSmileTM diode laser, digital X-ray units and Pano, microscopes and ceiling-mounted flat-panel TV/monitors. “We took a risk, not knowing if and when patient acceptance would be there in a relatively small community. It was more expensive to start from scratch, but I wasn’t handicapped by outmoded equipment, systems, or bad habits built in to an existing practice.”
Indeed, the risk is paying off. With only a small sign outside their building and four “conservative” announcements, the practice is attracting both high-end and working class patients. “We have not only attracted ‘dot-com millionaires’, but also long-time residents who are in many of the service industries. We also kept our fees reasonable to create even more value to our high-tech approach.” They opened their doors in May 2005 and business has exceeded expectations. After 5 months, they are averaging 53 new patients per month. Production is at $632 per hour and growing steadily. In contrast to the high-volume rural practice, Dr. Turnage sees 8-10 patients per day utilizing a smaller and simpler structure that leverages technology. The lower overhead (now at 65%, which includes some equipment financing) has allowed more money to drop to his net income line with only two-thirds the production required by his old practice (Figures 1 & 2).
The reduction in overhead creates net income that far exceeds the lower volume of patients. The Waterlase MD technology has greatly contributed to this being possible. “The ability to practice dentistry with a laser is hugely different, better, and more fulfilling.” From bleeding control, to treatment options, to post-op pain control, to periodontal, endodontic, surgical, and restorative procedures, Dr. Turnage is doing things that previously often required referral to a specialist or simply were much less predictable. “Using the laser means fewer complications afterwards and much less post-op pain.” Both staff and patients enjoy the benefits of the laser. “My staff really appreciated that the ‘old dog’ was willing to learn something new. It motivates them to achieve a higher standard.”
And patients, who are hearing about this laser around town, quiz the staff before seeing the dentist to get the inside scoop. They ask questions like, “If the laser gets bumped while the doctor is working, will it cut off my tongue?” The reaction from other local dentists has been mixed: “Some embrace the laser and recognize its potential while others seem skeptical that it could be applicable to their style practice.” One informal metric has been the increasing frequency of the faxing of patient release forms to other dentists, which is occurring multiple times each day. “Patients are actively seeking this technology!” exclaimed Dr. Turnage, who likens his new practice to switching from driving a Cadillac to being in the seat of a Formula One race car. “Both are automobiles, and the new one took some time to learn, but it’s a lot more fun, it can do things I had never thought possible and I now make them part of my everyday practice.”
Dr. Turnage says his experience starting over, “where no one knows your name,” has helped debunk his previous belief that a successful practice depends heavily on longevity in one community. “I now have time to do the simple but important things,” which include developing a personal relationship with each patient, lunch with his wife, a phone call to his son at college, or extended staff meetings to review issues and opportunities. His advice to other dentists can be applied to new and established practitioners. “For the new dentist, you now have the opportunity to go ‘high-tech everything’ and you should do so. The improvements in efficiency and effectiveness are incredible. For others like me who have been in practice for 20-plus years, the laser gave me a new sense of pride in my profession as well as the ability to off er better patient care.” And he wants to serve as a role model for dentists contemplating retirement: “I am determined that when I retire, my practice will be technologically current for the new dentist.”
With a view of the harbor from both his home and his office, Bo Turnage has turned his dream into reality, with a five month old practice literally “in its infancy.” And he’s certainly proven to himself that the third time around is the charm!