Office Visit: Dr. Josh Gilbert by Kyle Patton

Office Visit: Dr. Josh Gilbert 

This Townie’s community involvement, tech investments and slow-and-steady approach keep him thriving in a massively competitive area

by Kyle Patton, associate editor
photography by Robin Subar

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.

Every year, Orthotown asks readers to vote for their favorite products and services in the Townie Choice Awards, then publishes the results in our January/February issue. Out of all the readers who completed their ballots, we draw one at random to win a special prize: $1,000 and the chance to appear in an Office Visit cover profile. This year’s winner, Dr. Josh Gilbert, jumped right from residency into private practice in 2016. In the heavily saturated Chicago-area market, this Townie opted not to enter the rat race of congested schedules and high-volume churn. “Success in a saturated market is not solely about the number of competitors, but also about how effectively you position yourself and engage with your community,” he says. In our exclusive Q&A, Gilbert shares his advice for thriving in any market, lays out his buyer’s guide on CBCT, shares an impressive charity case and more.

Office Visit: Dr. Josh Gilbert

Dr. Josh Gilbert

Marquette University School of Dentistry

Gilbert Orthodontics
Highland Park, Illinois

2,300 square feet; 5 chairs,
2 consult rooms

How did you find your way into orthodontics?
Growing up in a family with no medical or dental professionals, I never thought about becoming an orthodontist. But as the years passed and I started secondary education, I excelled in math and science, and I always enjoyed working with my hands. One thing led to another, and I found myself deciding between applying to medical or dental school. I chose dental school because it seemed to be the best fit: It encompassed my love for using my hands, science and wanting to own a business with a shorter time in school!

While in dental school at Boston University, I had the opportunity to do research in the orthodontic department during my first year. They needed dental students to hand out surveys pre- and post-ortho that assessed oral health-related quality of life. From this, I realized that orthodontists have the ability, more so than any other dental specialty, to dramatically change lives for the good. It is proven through research that people feel more confident, are judged as more intelligent by their peers and smile more after having orthodontic treatment. I also shadowed my childhood orthodontists, became more curious about the field, and eventually decided that this was the path for me.

Tell us about Highland Park and your practice.
Highland Park is about 20 miles north of Chicago, right along Lake Michigan. I grew up in Highland Park and knew that I wanted to live in the general area once I finished my training. While in my final year of residency at Marquette, I was searching high and low for associate or partner opportunities in the northern suburbs. Through one of my instructors, I connected with a husband-and-wife team in my hometown. It was an amazing opportunity because they built a strong practice that had been around for almost 25 years. When I met Drs. Kurt and Robyn Silberstein, they said they were ready to move into their next stage of life. Rather than starting as an associate, I decided to jump right into practice ownership out of residency in 2016, and I haven’t looked back since.

Highland Park holds a special place in my heart as not only the location of my practice but also my hometown. From childhood friends to new acquaintances, it has been a joy to be back in my hometown making more people smile. I enjoy working in the town that I am from and now live in. I enjoy seeing patients and families out and about, and thankfully I remember their names most of the time!

Your approach is counter to the seemingly popular but stressful model of packing patients into the schedule. How does your practice operate and how did you accomplish this model?
Indeed, my practice operates on a patient-centric model that prioritizes quality of care over patient volume. While the traditional approach may involve packing the schedule to maximize appointments, I’ve found that a more personalized and less stressful approach ultimately yields better results for both patients and the practice.

Our scheduling philosophy revolves around providing each patient with the time and attention they deserve during appointments. This not only ensures a more thorough and comfortable experience for the patient but also allows my team to focus on delivering high-quality care without feeling rushed.

Communication with patients is key. By setting clear expectations regarding treatment plans, progress, and the importance of scheduled appointments, we foster a sense of trust and cooperation. Patients appreciate personalized attention and the opportunity to actively participate in their orthodontic journey.

While it might seem counterintuitive to some, our patient-centric approach has resulted in increased satisfaction, positive word-of-mouth referrals and long-term patient loyalty. By prioritizing quality over quantity, we’ve created a practice that values the individual needs of each patient, contributing to both their well-being and the overall success of my practice.

You’re in a relatively saturated area but so far this hasn’t affected you negatively. What tips do you have for doctors who are struggling in such an area?
In navigating a saturated orthodontic market, I’ve found that community engagement and differentiating my practice from others are key to thriving amid the many options in my market. Firstly, emphasize what sets your practice apart—whether it’s a unique treatment approach, cutting-edge technology or a personalized patient experience. Highlight these aspects in your marketing efforts to distinguish your practice from others in the area.

Another aspect of my practice that may be different has been my collaboration with local businesses and community events, which serves to strengthen my ties within the area. I am the president of our local chamber of commerce and sponsor countless other events in the area. I strongly believe name recognition serves to enhance your visibility and build trust within the community.

My demographic also favors the practice model I was just speaking about. We are not a high-volume practice, so instead of focusing on maximizing the total number of patients, I want to focus on giving the most value to each of my patients.

Success in a saturated market is not solely about the number of competitors but also about how effectively you position yourself and engage with your community. Focusing on differentiation and community involvement and being aware of how you’re positioning your practice allows one to not only survive but thrive in competitive environments.

Overall, you’ve shown a dramatic increase in your practice in the seven years you’ve been in this specific location. What practical things did you do or implement that were critical to that growth?
I’ve done a lot of things in my business over the past seven years, so it’s hard to focus on just one. I also know I don’t have all the answers, and running a small business is very rewarding but also quite humbling at times. I have taken my fair share of swings and misses; however, falling back on my core values when making tough decisions has served me well in my short time as a business owner.

One area I found to be helpful with my practice growth was simplifying the new-patient exam process, making it easier for patients to start treatment. We reduced our consultation process to a one-step system, rather than two appointments. I’ve been using orthodocsPro for contract signing because it offers patients and parents the opportunity to use the slider and sign contracts from their homes. Additionally, we give latitude regarding the sliders so people can choose their down payment and monthly payments.

I have increased production in my practice by now producing in-office aligners, as well as offering a lifetime retainer program. Furthermore, we have expanded our hours to accommodate more before- and after-school appointments, as well as adding one Saturday appointment per month. The most important part of my—and frankly any—office is the quality of your team members. I am fortunate to be surrounded by a great team that cares about providing value for our patients and the community.

While your main goal isn’t necessarily to promote your practice, that certainly could happen. What kind of involvement has been most rewarding for you personally and professionally?
Engaging with local schools and the local chamber of commerce and sponsoring events, in general, has positioned my practice as a trusted resource. While the primary goal is community well-being, the positive impact on individuals’ lives has been gratifying. This involvement naturally promotes our practice as a positive force in the community, fostering goodwill and a positive brand image. Overall, community engagement has proven to be a mutually enriching endeavor, benefiting both the practice and the lives of those we serve.

Josh Gilbert Patient
Initial pano
Josh Gilbert Patient
Josh Gilbert Patient
Josh Gilbert Patient
Josh Gilbert Patient
You volunteer with Smiles Change Lives. How is it working with them?
I have loved my involvement with Smiles Change Lives (SCL). I spoke earlier about how orthodontic treatment can change someone’s quality of life, and when it comes to SCL patients, I feel as though that impact is even greater. One of my first patients with SCL was someone from the town I practiced in, and the family unfortunately fell on some tough times financially and medically. I met a quiet and self-conscious 13-year-old girl who did not like to smile. On her records, you can see bilaterally impacted maxillary canines and an impacted lower right canine. After primary extractions and open exposure for her U3s, I started treatment with fixed appliances. At many of the appointments, the patient and her mother brought in cards expressing their appreciation and I saw her confidence growing.

After 24 months, she was finished with her treatment but her gingival display was still excessive, so three months after debond, I performed a soft-tissue gingivectomy using a Picasso laser. Her final photos show a beaming and confident young woman who can accomplish so much in life! This is one of the highlights of my short career where I know that I truly affected someone’s life—she even sent us a picture showing off her smile now that she is in college!

One of your strengths is getting the team to buy into your practice’s mission. What sort of things do you expect from your team?
Having a cohesive and motivated team is essential for the success of any practice. To ensure alignment with our practice’s mission, I expect several key attributes and contributions from my team.

The most important of them is to recognize my vision of a commitment to the patient-centric model. I emphasize the importance of putting patients first and I expect team members to share in this commitment by providing compassionate and personalized care. Some examples include taking a little extra time with a patient who is having a tough day or making care calls after long appointments.

This also extends to how we present treatment plans to patients and how my treatment coordinator follows up with the pending list. In the exam room, I will walk through why treatment is or is not recommended, and I feel as though patients recognize the authenticity of my delivery. We also use visuals within the consultation such as intraoral scans, CBCT volume rendering, patient photos and Ortho2 imaging to demonstrate our commitment to technology and get buy-in from our patients. It is amazing when the patients are telling me why they need treatment, rather than me trying to “sell” something. My treatment coordinator understands we do not need to resort to high-leverage tactics within the new patient process, and patients appreciate it as well.

Top products
Office Visit: Dr. Josh Gilbert-Medit-iTero
Intraoral scanning is essential to my digital office and patients love that we have eliminated all physical impressions. With either scanner, we take the data to help develop treatment plans and make appliances like aligners and retainers.

SprintRay has been a workhorse 3D printer over the past three years. We primarily use the SprintRay to print models for in-house aligners.

We transitioned to Edge for a cloudbased practice management system in 2017 and have ditched the server and IT costs since then. We use their imaging, reminders, scheduling and billing services at my office.

I use uLab Systems to design just about all my aligner cases (which we have named “GO Smile” aligners). We will either print in-house or send out to have uSmile aligners made.

I recently upgraded to the newest Dexis CBCT scanner. I am in the early stages of my 3D journey, but I love having more information at my fingertips to aid in my diagnosis and treatment planning.
Technology is a big player in your practice. What are your must-haves?
I was fortunate to walk into a practice that had embraced technology already. The practice was mostly paperless and was doing a fair amount of Invisalign using an iTero scanner. Since that time, the biggest change I want to highlight is the power of 3D printing in the office.

I was hesitant to jump into the unknown at first, because of a combination of logistics and cost of entry, so I dipped my toe in to start. I purchased a Anycubic Photon as a hobby printer for a couple hundred dollars and learned how to crop the STL files with Meshmixer, a free software. We then were able to print models to fabricate retainers from.

There was basically zero cost to entry for me; however, there was a learning curve. After a few months, I purchased another Photon for backup. The thing with hobby printers is that they work great … until they don’t! There are issues with hobby printers, such as punctured FEP resin films, manual recalibration and undiagnosed print failures.

I also taught my assistants how to crop models in Meshmixer so they were a part of the process. After printing with these for around a year, I purchased a SprintRay Pro and took Dr. Jason Cope’s course on in-office 3D printing. It was amazing to learn from his systems and I scaled my printing very quickly. This also coincided with the launch of uLab Systems and the two went together incredibly well. It was liberating to start treating limited cases such as relapse within the office. I wasn’t confined to certain aligner numbers for cases, long turnaround times or larger lab fees with using large aligner companies. I continued to scale up my 3D printing over a couple of years, and now treat just about every aligner case using uLab aligners (dubbed “GO Smile Aligners”), with a combination of in-house aligners or ordering from their facility with larger case numbers.

This has been a big win for my practice, because I am confident in treating most aligner cases with uLab. I now feel more in control of my cases and the cost per case is significantly lower. We have passed these savings along to our patients, and in turn have experienced increased word-of-mouth referrals.

What’s next on the tech menu?
I recently decided to upgrade from my 2D pan/ceph machine to CBCT.

One of my criteria when buying a new piece of equipment is: How is this going to positively affect the treatment I provide at my office? I believed I was sometimes making treatment plans without all the information I needed. I was also becoming increasingly frustrated when sending out for CBCTs because of patients nonscheduling, having to wait to schedule or complaining about the cost of imaging.

When I was making my purchase, I looked at multiple machines. There are a lot of high-quality options to choose from, and some of the criteria I was looking for were: a full field of view (FOV) in a quick single scan, with no stitching required; intuitive software; low radiation dosage; a good warranty from a reputable company; and competitive pricing. I was also deciding between new versus used.

The iCat FLX seems to dominate the orthodontic marketplace, so I started my search there. I soon came to learn their parent company, Dexis, just launched a new machine, the OP 3D LX, which was brought to market in September 2023. Both machines checked a lot of boxes. The FLX has a shorter scan time, but the OP 3D LX image quality is better.

Another new machine, the Vatech Green X 12, was a strong contender for me. The image quality is great with all Vatech machines, but this one has a limited field of vision so I needed a second exposure for a ceph. The radiation exposure was also slightly higher compared to its competitors. There are conflicting accounts among orthodontists; however, the VaTech rep did not recommend their full-FOV machine to me.

Lastly, I was considering the Planmeca Viso. The Viso is a full-FOV machine with low radiation dosage, and Planmeca’s U.S. headquarters are an hour from me. The downside was that the Viso was not priced competitively.

After going through the options, I decided to purchase the OP 3D LX from Dexis. Because it was only recently introduced to the market, I am one of the first orthodontists in the country to implement this machine, and I’m curious to see if it becomes more widely adopted in orthodontics in the next few years. (If any readers are interested in talking more about CBCT, I would be happy to, because I am very new to the 3D world!)

What’s your philosophy on deciding how and when to invest in technology? What should doctors factor into decision-making before making a sizeable investment?
There’s a lot of great technology out there, and it’s hard to decide what to add and when to do it. Being interconnected in platforms such as Orthotown and Facebook has so many benefits, but there are also some pitfalls. When I see another doc posting a case with something I don’t do or have, it’s tough to fight the fear of missing out. Don’t we want all the toys?

I have tried to slow down purchasing and be somewhat methodical before making large purchases. I ask myself: Would this particular piece of technology make my treatment outcome better? Is it going to simplify my personal and professional life? Is it going to increase or decrease my overhead? And can I get similar outcomes without having the technology?

My practice is smaller than many others out there, so I want to be intentional about what I’m adding and what I’m holding out on. Being mindful of how purchases affect your overhead percentage needs to come into play when you make buying decisions. It’s a tough balance to strike between always investing in the latest and greatest and holding back on certain technologies that may be beneficial.

Your wife is a pediatric dentist. What knowledge have you gleaned from her that carries over into how you operate your practice?
Erica and I met in dental school at Boston University. We have always discussed patients and cases throughout our relationship—in dental school, during residencies and in private practice. She’s my go-to resource on all things trauma-related.

Besides being a lucky man for marrying Erica, I’m in the fortunate position of having my spouse be a referring pediatric dentist! We considered doing a startup together after training, but I am happy we both have our own autonomous offices. Erica operates a multidoctor and multilocation practice in which there are four pediatric dentists between two locations. She has an amazing legacy practice, and I think one of the strongest aspects of what has allowed her practice to be successful over the years is the longevity of many of their employees. I strive for that cohesiveness at my business now, and do my best to reduce staff turnover by empowering them and getting buy-in to my office culture and values.

How do you hope the orthodontic profession will evolve over the next 10 years?
I am deeply invested in preserving the significance of the private practice orthodontist in the face of the rising prevalence of the OSO/DSO practice model. The trend of midcareer orthodontists selling their practices to corporations is concerning, because it may lead to a cycle of turnover and restructuring that ultimately harms patient care. When corporate entities seek new practitioners to replace those who’ve completed their tenure, or when locations are dissolved because of staffing challenges, patients are the ones who suffer. I hope that patients continue to recognize the value of in-person orthodontic expertise and avoid being enticed solely by low-cost options offered by corporate entities that may compromise on quality.

The recent failure of Smile Direct Club underscores the importance of the doctor-patient relationship. It highlights the potential pitfalls of relying solely on AI-driven algorithms for remote orthodontic care. This failure serves as a reminder that, despite technological advances, the human touch and expertise of orthodontists are integral to delivering high-quality treatment.

I am committed to advocating for the recognition of the vital role orthodontists play in ensuring the best possible outcomes for patients and to emphasizing the enduring importance of the doctor-patient relationship in orthodontic care.

Give us a snapshot of your life outside of orthodontics.
I live about two miles from my practice in Highland Park with my wife, our 3-year-old son, Ari, and our dog, Logan. I also have a large family that lives close by, and we get together often to watch Chicago Bears games and for various holidays and pool parties. In my free time, I enjoy staying physically active by working out, running, golfing and chasing my son around.

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