Orthodontists spend most of their working hours in their practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Orthotown magazine’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of their practice protocols.
In this issue, we introduce Dr. Zulma R. Castañeda-Medina, a former Colombian GP who went through dental school again once she moved to the U.S., then earned a master’s degree in health administration, obtained American Board of Orthodontics certification and opened her own practice in Cooper City, Florida. Her experience working in Colombia taught her how to work more with less and the importance of community involvement, and prepared her for the growing pains of a small practice on the cusp of expansion.
You completed your DMD at University of Pennsylvania and your orthodontics training at Jacksonville University, but there’s a lot more to your education than that. Before moving to the U.S., you were a practicing GP in Colombia. What was it like going through the dental school gauntlet a second time?
We had to do five years of dental school and, at the time, a mandatory year of social work was needed to earn a dental license in Colombia. I worked there as a general practitioner for 10 years before moving to America. I then repeated my dental school in the U.S. and was fortunate to finish at Penn Dental. I tutored orthodontics to the Advance Standing Students and finished with multiple awards.
I learned here that it was very important to build relationships between dental practitioners. I also learned about multidisciplinary management of cases and how involving different specialties in treating patients allows us to come up with the best outcome for them.
Having worked as a GP before becoming an orthodontist affords me the knowledge and experience regarding the coordination of care we often encounter as orthodontists—orthognathic surgical cases, full-mouth reconstructions, extractions and the like. It also keeps me focused on how orthodontic care is an integral part of the patient’s oral health.
You’re a second-generation dentist. What was it about spending time in your mother’s dental practice that inspired you to follow down a similar career path?
I started helping my mom when I was in middle school, and I knew early on that was the career I wanted for myself as well. I saw how she would care for and treat her patients, and their happiness when the treatment was finished. I also learned how the best oral care is delivered through developing a personal relationship with patients.
Also, because orthodontic treatment takes time and tooth movements follow physiologic standards, I learned from my mother that patience is key to achieving a successful outcome.
After spending some time working as an associate, you opened your own practice in January 2017. How has that process been?
It has been very challenging—but also a process that I’ve enjoyed because I was able to build the practice I’d always wanted. As is the case with most dentists, the time I spent working as an associate helped me define my own standards and expanded my knowledge of treatment options. I was able to set goals and work toward developing the practice I wanted to have as an orthodontist and the experience I want to deliver in my office for my own patients.
When you treated patients in Colombia, you didn’t have access to some newer materials or common conveniences that a lot of U.S. doctors probably couldn’t imagine practicing without. How does practicing here compare to what you were used to there?
In the rural areas of Colombia, I didn’t have all the materials or equipment that I have in my U.S. practice, so I learned to be innovative and resourceful—how to provide the best care with the limited resources that were available. I worked about five hours away from Bogotá, the capital, and I often joined “dental brigades” to bring dental services to the population of more underserved areas in the country, who wouldn’t otherwise have access to this care. This helps me appreciate how here in the U.S., patients are blessed by the availability of technology, which helps provide better diagnosis and treatment in even the most basic or standard of practices.
Your practice often participates in events, sponsors children’s sports teams and holds prize raffles. What made you decide to have such a community-centric marketing approach? Are you seeing any success?
Being involved in the community has a lot to do with success in this industry. I understand the importance of having a strong online presence and digital marketing in general, but it’s equally important to get direct recommendations from your patients through word of mouth. Being part of the community not only helps with marketing but also is my way of giving back to it.
The most recent events were at a local church carnival and Cooper City Founder’s Day. The turnout was excellent, and we had a great time giving back to the community. We’ve already had several patients who just started treatment, and several more who’ve scheduled initial consultations.
Walk us through an average day at your practice.
We start every day with a morning huddle, on time, to make sure we’re all on the same page and ready for the day. We have a schedule template: We offer early hours for select patients and afternoon appointments, mostly for students. Scheduled scripting and role-playing is big in our practice to better serve our patients.
What’s something you’d like to bring to your practice in the next five years?
I’d like to add a CBCT machine, full digital printing services and obviously to expand our practice.
Name a couple of things you feel like you couldn’t practice without.
My favorite piece of technology in the practice is a scanner: The iTero has simplified procedures for new patients, especially with appliance fabrication and delivery. It’s also been great for record keeping, and very useful since the advent and growing popularity of clear aligners.
For many doctors who open their own practice, the business side can be a challenge. Do you enjoy running the business aspects? Can you see yourself hiring someone to assist in that area, so you can focus on the clinical side?
It has been a challenge! It’s not a secret that when we go through dental school, we don’t receive many administrative or business tools to help us thrive in this industry. I enjoy most of the business aspects, but will be adding some help in the near future to support our growth.
I’ve earned a Master of Health Administration degree, which has helped me better understand the business side of the practice. I like attending different business management career development events, so I can continue to learn and improve in that area.
Tell us about your life outside of ortho.
When I’m not in the office, I enjoy spending time with my family—my husband, my son and, last but not least, my mother and brother. My son is doing karate, and we’ve decided to join him on his way to earning a black belt. Also, I love playing musical instruments, including the harp, which I learned in Colombia, and the guitar. In fact, I’m currently taking harp classes to resharpen my skills on the strings.