Growth Potential by Dr. Daniel Grob

Dentaltown Magazine

Drs. Matthew and Courtney Dunn discuss how—and why— they quadrupled their practice locations in just over a decade


by Kyle Patton, associate editor, Dentaltown magazine


Drs. Matthew and Courtney Dunn are rapidly and methodically growing their community-oriented orthodontic practice across several demographic areas in and around Phoenix. Right now, the Townies balance their days between four practices and three children, while staying active in professional and community organizations. Courtney is also the founder of the national networking and study group Women in Orthodontics, while Matthew is the author of Brace Yourself: The Ultimate Guide to Braces, Invisalign and a Beautiful Smile.

The couple met at the University of Michigan School of Dentistry, where both earned DDS degrees as well as postdoctorate degrees in orthodontics. Courtney was born and raised in the Valley of the Sun, where the couple decided to move in 2006 to start practicing orthodontics. In a Q&A with Orthotown editorial director Dr.?Dan Grob, the Dunns discuss some of the challenges they face as busy clinicians and parents—increasing their presence in the Phoenix area, and shuttling between orthodontic practices and school athletic practices.

During the past several years, you’ve grown from a one-office, two-doctor practice to a three- soon-to-be four-office practice. What prompted you to do this?

When we moved to Arizona in 2006, our original plan was to run a two-doctor, single-location practice, so we opened a scratch practice in Litchfield Park, a fast-growing Phoenix suburb.

A year later, the plan started to change when a highly respected orthodontist in central Phoenix passed away unexpectedly. That orthodontist had a satellite practice in Wickenburg, a small town about an hour drive from our current office. We already had some patients coming from Wickenburg, so it seemed like a good fit. We reached out to the orthodontist’s family to ask about buying the satellite office, but they weren’t interested in splitting the practice; they wanted someone to purchase the entire business.

While we had some initial hesitancy, we’d already started to realize a year into our startup that it was probably going to take a long time to grow a single location to the point where it warrants having two doctors present. With that in mind, we bought both the central Phoenix and Wickenburg locations. Ironically, we ended up closing the Wickenburg office within a few years, while the central Phoenix office is now one of our largest offices.

After the closure of the Wickenburg office, we really focused on growing our two locations with no intentions of adding others. But once again, opportunity came knocking: an office space in just the “right” location with two fantastic general dentists as neighbors was available. That opportunity resulted a scratch-start third office in 2014.

In 2019, another opportunity presented itself: An office in Scottsdale came on the market. After looking at the practice, meeting with the owner and evaluating the area, it seemed like a good fit, so we took the leap again.

So, while our original plan was a two-doctor, single-location practice, over the past 13 years of practice ownership, we’ve learned that we need to remain flexible and willing to jump when the right opportunity comes along.

With only two doctors, you must need to spread yourself between the offices. How does that work?

We get that comment a lot but honestly, it’s really not a big deal. There are plenty of single-doctor orthodontic practices with two locations. We are two doctors with four locations; it’s essentially the same thing. We make sure that all offices have availability every day of the week, which means a lot of driving for us, but we’re willing to do whatever it takes to make it convenient for our patients. We have an alternating Week A and Week B schedule, so we do need to keep track of which week it is or we could end up in the wrong place. (It hasn’t happened yet!) It may sound complicated, but it works quite well, and our patients can get the appointment times they need.

Some would say that having multiple offices only adds to increased overhead and other issues. How do you manage this?

Well, the simple answer is, yes, expenses do increase with multiple locations. But going from one location to two locations does not double your expenses. Things like rent and utilities will definitely be higher, while other expenses such as accounting and website costs don’t really change … or at least don’t change very much. With cloud-based practice management software and VOIP phones, even our staff overhead hasn’t increased too much.

If you can reach your practice goals in a single location, that’s probably the easiest, most cost-effective route. Given the supersaturated orthodontic market in metro Phoenix, that was not realistic for us.

For you to be adding offices, you must have a game plan. Could you share with the readers why you decided to embark on this growth plan?

We love being orthodontists and we love running our business. We’re both stereotypical Type A, driven, first-born children with a little ADHD in the mix. We are both stimulated by the new challenge of adding offices and growing our existing ones, and we have come to embrace change. There is no such thing as the status quo with us. Thank goodness our team knows us and just adapts. We add and change things on a regular basis. We are both 43 years old and nowhere near retirement, so why not see what we can do? We will probably continue to grow as long as it remains fun.

Do you have a set of criteria for purchasing or adding new offices?

We do have kind of a mental checklist when evaluating potential new offices, and we have turned down many opportunities that didn’t fit us. One of the main things we evaluate is location. Do the demographics of the area fit with our practice model? Is the office space visible, or is it buried in an office complex? If an existing practice, is the office space “livable” as is? If not, how much will need to be spent on updates?

The next thing we consider is the reputation of the selling doctor. Is this someone we can generally trust? What is the overall quality of treatment being provided? Everyone is going to have cases that are overtreatment or not going as planned, but those should be the exceptions, not the rule.

Finally, we look at practice numbers. There are a lot of numbers to look at, but in broad terms: Is the practice growing or shrinking, and why? Is the practice price fair? Can the loan be serviced in a reasonable time and still provide income? Do we think we can grow the practice enough to make it worth our time?

I’m assuming that you treat patients together. Is there a system or standard that you’ve established to smooth things out to streamline patient care?

We both attended the University of Michigan (Go Blue!) for dental and orthodontic training. Our similar background probably makes it easier for us to share patients. We have the same treatment philosophy and are both “ortho nerds.” We’re always talking about how we can do things different and better, but try to stay on the same page. We have tried to standardize wire sequences and treatment mechanics as much as possible to provide consistent care for our patients, as well as make it easier on our team.

You are both young practitioners, with children and multiple offices. What is a typical day like?

Most mornings start at 4:30 a.m., driving at least one of our three children to morning swim practice. The other parent is usually preparing breakfast for our morning swimmer and then heading to the office, where the morning huddle starts promptly at 6:45 a.m. Meanwhile, the 4:30 a.m. parent is driving kids to school, then rushes to another office. Lunch is usually spent doing administrative tasks, treatment plans, ClinChecks, etc. Patients are typically seen until 5 p.m., occasionally 6 p.m., and then we head home. We have someone help us with picking the kids up from school and transporting them to afternoon swimming, Girl Scouts, Boy Scouts and taekwondo. Usually, the last kid doesn’t get home until 8 p.m. There’s a short bit of catching up with the family, and then the kids are off to do homework.

How do you find time for family, etc.?

We make a conscious effort to have focused family time on the weekends. During the week, we are busy with work and they are so busy with swimming, activities and school that we have limited time to catch up on events each day. We make sure to have meals together on the weekends and at the very least watch a movie together or play a game each weekend evening. We also make a conscious effort to “unplug” during vacation and we make sure to map out at least four weeks of vacation per year. This summer we’re headed to Iceland. We also seem to plan at least one Disney-related trip each year.

Can you share with the readers some pleasant experiences that you’ve had stepping into another practice?

When we purchased our central Phoenix office, it was like coming home for Courtney. She grew up in the area and went to the same high school as so many of the moms and the kids. It really was a tightknit group of people and it was so comforting to be welcomed back to the community. We both had tremendous pride when families who were “stuck” with us finishing their first child started their next child, and even started referring their friends to us.

On the other hand, could you share with readers some setbacks and issues that you didn’t anticipate that you’d need to resolve?

We had quite a unique situation because we stepped into an office where the patients and the team were grieving. The previous doctor had passed away suddenly and unexpectedly. We had to spend extra time with the patients because they needed to talk—they wanted to tell us about their experiences with the previous doctor and how special he was to them. We ended up taking on the role of grief counselor for the patients and the team, and that was a heavy burden for us because we wanted to honor the previous doctor, but we also realized that we needed to move forward in the practice and make it our own.

Making changes to the systems in that office was difficult because we didn’t want to “insult” the way the previous doctor did things and the team was emotionally connected to the way the office ran with the previous doctor. It was a long time before the practice really felt like ours and we gained the trust of the team to make changes and improvements to the existing systems.

Could you summarize your marketing game plan?

Community is very important to us; we really spend a lot of time and energy getting involved and giving back to the community. We are constantly at Little League games, soccer tournaments, school gatherings and charitable events. We understand that the local community support is why we exist, so we spend a lot of time giving back.

We love and appreciate our general dental referrals. It’s a lot of work to build and maintain good relationships with our dental colleagues, but it’s definitely worth it—not just for the referrals, but for the friendships that are developed. We’ve also had good success with digital marketing and social media.

Our internal marketing strategies are simple. Treat people well, keep them happy, produce great results and don’t forget to ask for referrals!

Do you have a budget for this?

We are fairly flexible with our marketing budget. While we try to stay around 6–8% of the previous year’s collections, if an opportunity that has good potential comes along, we’ll still jump on it.

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