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Office Visit: Dr. Jeffrey Heinz by Kyle Patton, associate editor

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Orthotown Magazine

by Kyle Patton, associate editor
photography by Ashley Wierenga

Orthodontists spend most of their working hours inside their own practices, so they usually don’t get many opportunities to see what it’s like inside another doctor’s office. Orthotown’s recurring Office Visit profile offers a chance for Townies to meet their peers, hear their stories and get a sense of how they practice.
Dr. Jeffrey Heinz is a testament to resilience. After a motocross accident in dental school left this Townie with limited mobility and behind in his studies, he kicked it up to a higher gear and finished in the top of his class. Heinz is one of the few orthodontist in the world who uses a wheelchair for mobility—and perhaps the only one crazy enough to launch a start-up practice in the middle of a pandemic!

 In this month’s Office Visit, we visit him and the team at work in his new Rockford, Michigan, practice and learn how he leveraged his time working with Dr. Jamie Reynolds to accelerate his practice’s climb to success. He also discusses what it’s like to sleep at his office for months, the most common mistakes he sees in clear aligner treatments and more.
Office Highlights

Name:
Dr. Jeffrey Heinz

Graduated from:
 University of Detroit Mercy School of Dentistry;
Indiana University (orthodontics residency)

Practice:
Heinz Orthodontics
Rockford, Michigan

Practice size:
 3,600 square feet;
6 operatories;
1 records room

Team size:
4

You’re one of only a few orthodontist in the world who uses a wheelchair for mobility, the result of an accident while you were in dental school. You stayed in school, but there must have been challenges.

It was hard—I mean really hard—but at that point I knew I had only two choices, one of which I could never live with and another that would be a treacherous road but could ultimately let me regain the “normal” that I longed for so badly. I couldn’t let my family down, I couldn’t let my friends down and I couldn’t let myself down, so after two months in the hospital— I made them let me out early!—I strapped on my back brace and headed back to Detroit Mercy dental school.

I made up the first semester of second year during the second semester of second year. It wasn’t easy, but it was my own version of therapy. I didn’t have time to feel bad for myself or to dwell on the past—I barely had time to breathe some days!—but I knew the only way through this thing would be forward. Whatever obstacles I would face, I would take in stride and do my damnedest to come out on top.

After that year, I was caught up and started clinicals with the rest of my class. I quickly found that I needed to be more prepared than my classmates, whether that meant studying more for exams or never forgetting something from the clinic dispensary so I didn’t have to make multiple trips back for equipment. I didn’t have time for inefficiencies, and was forced to become a better version of myself.

In fact, I hadn’t wanted to be an orthodontist until after my accident. During my recovery, I went from the middle of the pack in my class to the top 10. I fed off my successes and proving others wrong. After that, I knew general dentistry wasn’t enough for me. I had to do more—I had to be an orthodontist.

You then worked alongside Dr. Jamie Reynolds at Spillane & Reynolds for a few years.

 Jamie has been a big brother to me, both in and out of the clinic. I learned more over these three years than I could’ve ever imagined. He introduced me to some of the biggest names in our business, encouraged me to start lecturing with Ormco, and has coached me along the way with both clinical and business decisions. I’m continually impressed with the team and culture he has created, and I learn something every day we’re together. His focus and drive to continue doing bigger and better things inspires me to be a better orthodontist and businessman.

The transition into my own practice has definitely kept me busy! Initially, I worked in my private practice only three Fridays per month, my days off from Spillane & Reynolds, while continuing to practice full time as an associate. I didn’t know how long it would take for me to be needed more at the startup, so the flexibility I had by juggling both was great (but tiring). Over the past six months, we’ve moved from three days per month to six days per month, and I plan to be full time at the new office by Aug. 1 thanks to a second location we’re bringing on in August.

As I transition into my own practice full time, I feel sad to leave behind a legendary team and some incredible friends, but I’m also grateful to have created the relationships, skills and memories I have. Now that I have my own practice, it’s all on my shoulders to create something incredible. I’m up for the challenge and feel fortunate to have learned from one of the best in the business in the process.

You opened a startup practice in the middle of a pandemic?!

Sometimes I still can’t believe I pulled the trigger on this deal! It was—and continues to be—a crazy time in my life. I had been working at one of the greatest orthodontic practices and never imagined myself leaving, but when they decided to create a corporate model (albeit different and better than others), it never jibed with my long-term goals.

My grandfather was a business owner: He started out sweeping the floors at a kitchen and bath shop and eventually worked his way up to becoming a partner in the business. He probably doesn’t understand his influence on me, because he thinks he was just doing what he was supposed to do, but the love he had for small business and ownership never left me. So when the opportunity to do a startup presented itself, I hopped on it.

The location is two hours away from home, but it was the right opportunity at the right time. I’d leave work at Spillane & Reynolds on Thursday, drive the two hours to my practice, spend the night on a cot in the break room, then work all day Friday before driving home that night. I was essentially working seven days a week between the two practices (admin duties on the weekends).

As my private practice added days to the schedule, I was also spending more nights there, so I graduated to a twin bed inside one of our private treatment rooms. It’s been a lot, but being able to simultaneously keep a steady job and juggle the startup took most of the financial worries out of the equation. The extra work involved was worth it for my peace of mind. The distance from home and family has been rough, but with an incredible support system and my wife by my side, I feel invincible. I’ve never felt as happy at “work” as I do when I’m in my shop.

With a startup practice, you typically have the chance to control every detail. Were any alterations required to fit your mobility?

I actually didn’t get to design my practice! Another orthodontist went out of business seven months before my arrival, so I bought the equipment from the bank and signed the lease. Aside from adding some new chairs that I could maneuver underneath, adding hand controls for the drills and a few other cosmetic touch-ups, the practice is the same as it’s been since it was built. However, when we remodel, I have plenty of ideas to roll out!

What’s the office culture like in the new practice, and how are you achieving it?

Our mission statement is “changing lives through world-class service and smiles.” The only way we can deliver on that is if our entire team is 100% bought-in and feels like they’re a part of something. I want each of them to feel as if they are part-owners in our practice, not my practice. I try to lead by example, showing how hard I work and my dedication to them and our patients, not my paycheck.

When we started, I had only one team member, to answer the phones and be a smiling face at the front desk five days a week. She had zero dental experience but she was the right person, so she was an easy hire. She saw my dedication firsthand when I was answering calls one minute, doing sterile the next, treatment-coordinating after that, then putting on braces and tying wires all on my own when we were there. She learned quickly and has blossomed into my “rookie of the year.”

My second hire also didn’t have any experience, but she was the right person too. I ask applicants to make a video about themselves and why they’d make a great addition to our team. Most don’t make a video; of the few that do, you might find one or two who give you that feeling—you know they’re the right fit, the right personality, and I can teach the rest.

All team members are empowered to make decisions and bring new ideas to the table. If I hire the wrong person someday, I want the team to chew them up and spit them out! We are fiercely defensive of what we are creating, without exception. We’ve made two more hires, both of whom have been home runs too. I am nothing without my team—I love them, and I let them know that.

On “doctor days,” when the whole team is together, the stoke is high and the atmosphere is exactly what we want, but I was nervous about keeping that momentum with part-time team members. I try to stay engaged with them remotely throughout the week, so they have continual attention and motivation. It can still be challenging but I’ve found that when the doctor days go really well, we can ride that high until the next time I see everyone. Additionally, all of the team members are motivated, hard-working people, so we don’t struggle much with maintaining great work ethic. I task them with learning and other duties throughout the week and they always knock them out!

One of my technicians needed steadier income than I could provide at first, so I set her up with another orthodontist in the area for whom she could also work part time. Both she and the doctor understood it was a temporary fix to a mutual issue—he needed some help, too—and it worked out great. (She starts full time with us in August.)

What’s your average day in practice look like? What practice management techniques work for you?

The average day has 20–25 patients and growing. I like to empower the team to make decisions on their own, then use my guidance to adjust and learn as we go (similar to the principles in the book Turn the Ship Around! A True Story of Turning Followers Into Leaders by L. David Marquet).

My goal is to “multiply myself” as many times as possible, so I don’t end up having to be a bottleneck in the practice.

Yesterday actually was a huge day for us because our treatment coordinator completed the closest version of a doctorless consult to date. I stopped in for 30 seconds to introduce myself and ask if the patient had any questions, but they were already signing the contract. I was incredibly proud. It means our product—from initial phone call, walking in the door, office tour and treatment presentation—was all the patient needed to know that we were the right fit. They were purchasing an experience within our culture, not centered around me, which frees me up to take care of the clinic.

You mentioned earlier that you’re not afraid to do a bit of everything around the office. Do you think that’s just part of your personality, or is it a result of having to have your hand in each area of a start-up?

A bit of both! In the beginning, and even now when we get busy, I’ve had to be everywhere— initially because I was the only one who knew how to do everything, and later because we still needed the help. Now we have the help and they know what they’re doing, but you’ll still find me in sterile, cleaning up or taking phone calls if needed. I’m not above doing any task, and I like my team to see and feel how hard I work. The only way I can ask them to work as hard as they do is if I’m showing them the way.

I like to be very hands-on with our training process because I want to create “almost orthodontists” all around our office. The closer I am to replicating my knowledge in each team member, the less I need to be everywhere, which means my time is freed up to keep the other wheels on the bus spinning!

You lecture nationally on clear aligner therapies and have turned around some remarkable clinical results. What three common mistakes do you see from doctors who haven’t fully unlocked the potential in these treatments, and what are the solutions?

One common mistake I know I’ve made in the past is trying to expand molars in nongrowing patients. Unless they are significantly dumped lingually, I rarely program in any expansion; rather, I derotate the molars while expanding the premolars. The results are much more predictable, and I feel like we get to the finish line much sooner instead of fighting buccal root torque in refinements.

Secondly, as anyone with aligner experience knows, pure extrusion is extremely unpredictable. We must remember that aligners push well but do not pull well. To use this to my advantage, I have an “extrusion protocol” in my clinical preferences that my technician can follow when I call for it. Essentially, I procline the tooth forward (pushing), then extrude and simultaneously retract (still pushing) to complete the movement.

A final mistake that I see—and have struggled through myself—is thinking that aligners intrude posterior teeth and cause posterior open bites. Remember, posterior open bites are caused by anterior interferences! When presented with a posterior open bite, I think of four main things:
  • Do I have adequate torque in my incisors?
  • Do I need Class III elastics?
  • Is the bite opened far enough?
  • Do I need to address a Bolton discrepancy through IPR or cosmetic bonding?
What’s the trick to creating braces-like finishes with clear aligners?

Wow, do I wish there were just one trick! Aside from what I’ve already mentioned, I feel like aligner finishing starts with your initial setup—don’t shy away from big attachments!—and diagnosis. With braces, you can miss something but figure it out later at a progress appointment and make a quick correction. With aligners, that same miss may necessitate an extra refinement, which can lead to treatment times going over estimates.

Torque is one of those movements that you just can’t miss out on identifying early. There’s nothing worse than seeing improper torque on a lateral incisor, for example, near the end of treatment and realizing you’ll need another 15 trays to correct it. If you can proactively manage torque and start working on it from day one, it’s much easier to finish nicely—and, more importantly, on time.
Top Products

Spark Clear Aligners (Ormco). After using a different aligner for five years, and now Spark for the past 2½, I feel like I get better clinical results and my patients are happier with their experience in Spark. I love everything from the Approver software to the aligner delivery to finishes, and so does my team.

Damon System braces (Ormco).Before working at Spillane & Reynolds, I had no experience with Damon; I got nice results with twin brackets and was happy. But after using the system for the past three years, I feel confident that I have a more efficient practice and higher-quality finishes with Damon braces.

OrthoFi. I can’t imagine doing a startup practice without OrthoFi. I had to wear so many hats in the beginning—and still do—so being able to take all insurance verification, patient forms, collections, etc., off my plate was a life-saver.

OrthoBoneScrew (OBS) and Vector TADs. TADs treatment is a game-changer for our office. It’s incredible to be able to offer gummysmile treatment, closure of edentulous spaces, and solving complex biomechanical issues with TADs. I love the OBS product, especially its auxiliary wire slots, and founder Dr. Chris Chang’s work with TADs really opened my eyes to what we can accomplish without surgery. However, being part of an Ormco practice, and a consultant for the company for three-plus years, means I’ve used a ton of Vector TADs and we’ve always had great luck with them.

Orascoptic 2.5x loupes with LumaDent AirLux Wireless LED headlight. I prefer to direct-bond my brackets, and these allow me to be more accurate and precise. Also, posture is super important for me to be able to have a long career. I noticed myself slipping with poor posture without them, and now that I’ve been using them for a couple of years, I can’t imagine going back.

TADs have certainly gained traction in the past few years. What do TADs bring to your practice?

TADs bring a whole new level of care to our office. Treatment of gummy-smile cases is one of my favorite aspects of orthodontics. I’m still amazed when I look at the finishes and where we can get with cases that I used to send to surgery but now treat with TADs and braces or aligners.

What do you think will be the next “big thing” in orthodontics?

Unfortunately, I think we’re going to see more aligner companies going direct to consumers, with expanded treatments happening without doctor supervision. I think we will see attachments and IPR being done at home. I think we’re headed more toward the Wild West before we start to circle back around to doctor-centered care. I hope I’m wrong!

You offer hard- and soft-tissue laser options. What got you invested?

I’ve always been obsessed with aesthetics, but working with Drs. Spillane and Reynolds gave me the opportunity to treat a ton of patients with the best equipment and their expertise backing me each step of the way.

I used to reserve the laser for exposures and significant gingival overgrowth, but the more I was using it, the more I fell in love with the process. I am definitely an instant-gratification kind of person, and the difference we can make immediately through enameloplasty and laser gingivectomies is incredibly rewarding. (I’d be remiss if I didn’t give Drs. Stuart Frost and Trevor Nichols some major credit for inspiring me to be better, too. I love trying to keep up with those two!)

Give us a snapshot of your life outside of practice.

I’m a ski bum through and through! My favorite days are spent in the mountains on a sit-ski, then soaking in a hot tub with a beer afterward.

During the summer, I love fishing, waterskiing and keeping my dogs as tired as possible with a combination of bird hunting and Frisbee. I feel fortunate to live the life I live.

Some people ask me how I do what I do given my situation. I answer them with the question: “What other option do I have?” I know how miserable I would be if I weren’t doing all of this, and I wouldn’t do that to myself. I live a life that is a little more convoluted than many, but it’s also a lot better than most.

I feel incredibly fortunate to have an amazing team around me in both practices, a wonderful family, all the friends a guy could ask for and a beautiful wife who is way out of my league.
Orthotown Magazine
January/February 2023
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