Heat Advisory by Dr. Christos Papadopoulos

Heat Advisory

6 tips to help ensure your startup practice success even before it opens


by Dr. Christos Papadopoulos


“Well, team, it looks like the first day of PapadopSmiles Orthodontics will have to be tomorrow, unfortunately, and not today,” I said one cold January morning last year. That day was supposed to be our first day in my newly built clinic.

Our startup team was excited to meet each other. I was ready to lead. We had been counting down the days until we could open our doors in my hometown of Saint John, New Brunswick. However, even though my startup is in Canada, an office temperature of 45 degrees was still too cold for us to be working! The heat in my newly built practice wouldn’t turn on, so my team members went back home and I stayed at the clinic, waiting for the contractor.

I had received some great advice from mentors and colleagues about the ups and downs of practice ownership, but I certainly didn’t anticipate encountering this issue on our first day. Fastforward a year later and I’m happy to say I can look back on that day and laugh … but you can imagine the disappointment I felt at the time.

Becoming an orthodontist and opening a practice in my hometown had been a dream of mine ever since I received orthodontic treatment as a teenager. After five years of associating at an orthodontic service organization, where I gained tremendous experience both clinically and from a practice management perspective, I finally made the move to turn that dream into reality. Shortly before I made this decision, I was advised by one of my friends and mentors, who said, “You will never feel truly ready, and if you wait until you feel 100% ready, you will never do it.”

I am grateful for that advice and a subsequent nudge that helped me make the decision to go forward. I started my practice in 2022.

My goal for this article is to provide insight, encouragement and advice to those considering a scratch practice, although the information can easily be applied to existing practices too.

Although I’m still learning, 18 or so months into my startup journey, I can share many pearls with my colleagues both north and south of the Canadian border—the least of which is to ensure the heat is working the night before your opening day.


Be prepared to adjust your sails
Failing to plan is planning to fail. I’ve carried that piece of advice with me since high school, and it certainly applies to starting a practice from scratch. Although it’s important to make a detailed and methodical plan when opening a new practice, it is of paramount importance that you remain flexible along the way.

You need to be ready to correct the course of your ship at a moment’s notice. The changing winds and challenges of entrepreneurship can be suddenly strong or persistently subtle, but you need to be ready for them and adjust your sails accordingly.

For example, I had interviewed candidates in the summer of 2021 to begin work later that fall, but because of construction delays, we could not open our doors until January 2022. This changed the timing of my hires, my marketing strategy and purchasing office equipment, among many other things. Adaptability is your greatest ability, especially in a startup.


Make a list and check it twice … and then check it again
The difference between something good and something great is attention to detail. Paying attention to the little things will produce the big things necessary for a startup to succeed.
  • If you build a website for your practice and check it off your to-do list once it’s complete without thoroughly evaluating it multiple times, is it really complete?
  • Did you also check off “Visit dentists in the community” if you spent time at their offkice but forgot to bring referral pads?
  • Did you complete “Announce office opening on social media” if you didn’t include a link on how patients can self-refer?
These are examples of how little things can inhibit your practice growth without you even realizing it. Make a list of each item that needs to be done, but make a subsequent list under each item of what is necessary for it to be considered done well.

When I decided to do a new build-out for my startup, the list seemed endless and exhausting. However, it only seemed exhausting because of the amount of time and level of detail I put into it. The list was getting longer even as time went on and progress was made, but it was because I was constantly adding more little things to it as they came to mind. Focus and become fixated on adding more little things to your list.


Build your brand before you open
In 2019, I was fortunate to be invited by the Northeastern Society of Orthodontists to a leadership event for emerging leaders at the Disney Institute in Orlando, Florida. One of the most impactful lessons I learned from that course was how important the little things can be to building a brand.

What makes Disney’s brand so unique and iconic lies in its ability to create an exceptional experience and produce quality products and results, and how it differentiates itself from others in the marketplace.

Opening an orthodontic practice I remember getting a coffee in the banquet room during the course, and as I looked to add sugar to my coffee, I saw the sugar cubes were in the shape of Mickey Mouse’s head. It put a smile on my face and made me appreciate just how much emphasis Disney placed on incorporating its brand into even the smallest aspects of my experience there. Do the same for your startup.

Before I opened PapadopSmiles, I had visited every dental clinic in the city to meet with dentists and their teams, did a continuing education presentation for the dental hygienists and assistants in the province, sponsored community events and maintained a strong social media presence. There is no reason to wait until your clinic doors are open before you start telling your community who you are and what your new clinic is all about.


Hire the right people at the right time
Perhaps one of the most difficult aspects of doing a startup is deciding on who and what types of team members you require. This can be difficult to gauge, because you have no idea just how busy you will be from the onset. Rather than providing advice on how many people you should hire and their positions within the office, my advice is that you need to hire the right people at the right time.

I began my practice by hiring an administrative lead, who would also serve as my treatment coordinator, and an orthodontic assistant and a dental assistant who both worked in reception and also helped in the clinic.

I certainly did not need to start with three new hires, but I’m very happy I did. As the practice grew, I didn’t have to scramble and could time my additional hires with patience. This allowed me to make additional hires well in advance of when I felt the office truly required them, and as such allowed my team to integrate them into our office systems slowly and steadily. Hire in preparation for growth, not in reaction to growth.

Although one could argue not to overhire initially, a critical benefit was that it allowed me to cross-train my team. All my team members were trained on how to handle incoming patient phone calls, schedule consultations, do sterilization, open and close the office, etc. This has proven to be invaluable. Now, any new hires can be trained well by several team members instead of just one or two.

The other aspect of hiring is hiring the right people and not just the right skill. Hire go-getters who are also learners and you’ll see how your practice grows as a byproduct of their individual growth. Knowledge is an asset that compounds over time. Good habits will rub off on your other employees and produce a fundamentally sound team. You will then start to see how this becomes representative of your practice as a whole. Those who keep learning will keep rising. And if your team members are rising, so will your new practice.


Office culture begins on Day One
Establishing an office culture is critical for growth. Culture is another term that’s thrown around many ways and can have many different meanings; for me, office culture encompasses a wide array of practice attributes that need to consistently be upheld by every member of your team. These include team collegiality, spirit, proficiency with office systems and practice forms, open communication with one another, and dedication to the patient experience.

This requires an exceptional amount of work and time from you before Day One, so it can be successfully implemented then. Create internal office systems and clearly defined roles and expectations for each team member, with a plan to regularly review these aspects before your new hires show up on their first day. Without this structure clearly defined and in place before you begin your startup journey, individual team members will not grow in the same direction toward the same practice goals. Direction, consistent review and endless communication are required during the early phases of growth.

It’s also important for you to be a leading example of the office culture you want to cultivate. Your team will watch what you do, not just listen to what you say.

In my office, we recently hired an orthodontic assistant who had many years of experience. In the middle of her first day with us, a patient came in with very muddy boots and brought a lot of dirt into the clinic. As she was sweeping up the dirt, I grabbed the dustpan and helped her clean it. I could tell she was a bit taken aback that I had decided to help her. I later found out that she later commented, “I’ve never seen a dentist or orthodontist help sweep the floor.” Be an example to your team.


Patience, as well as patients

When you open a practice from scratch, it goes without saying that much of the advice you seek will be on how to bring more patients to your practice. Although patients are critical for practice growth, it’s also important to remember that patience is essential during a startup.

During times that your practice is not as busy as you would like, look to be generous. Be generous with your team, your peers, your community and your profession: Treat your team to lunch, organize a continuing education event for your peers, give back to your local community through sponsorships, and give back to your profession through volunteering your time with the American (or Canadian!) Association of Orthodontists.

The most rewarding aspects of practice ownership have come through my ability to build strong relationships with my team, my patients, my community and my profession. Remember that in addition to envisioning practice growth with your startup, you should also strive for personal growth as well.

Opening a startup practice will present many challenges, but it also presents many opportunities for both personal and professional growth and satisfaction.

Although my journey is new and has been undoubtedly unpredictable, it has also been undoubtedly rewarding. If you feel a strong internal desire to start your practice, do your due diligence, create an action plan, seek the advice of mentors and colleagues whom you trust and go for it.

You will never feel 100% ready, but if you believe in yourself and are prepared to work extremely hard, you can’t go wrong. Bet on yourself.

Author Bio
Dr. Christos Papadopoulos Dr. Christos Papadopoulos earned a Bachelor of Science degree with honors at the University of New Brunswick, a DDS at Dalhousie University and completed his orthodontic residency at Western University. He also did a one-year pediatric internship at British Columbia’s Children’s Hospital before his orthodontic residency. He opened his startup practice, PapadopSmiles, in his hometown of Saint John, New Brunswick, in 2022.



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