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Office Visit: Next-Level Charity by Kyle Patton

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Office Visit: Next-Level Charity 

This Townie’s expansive network of practices centers around patients who might otherwise have fallen through the cracks

by Kyle Patton, managing editor
photography by Charles Harris

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.
Some might look at Dr. Larry J. Moray’s 14 practices and incorrectly assume that financial ambition drove him to create his orthodontic empire in North Carolina. However, a closer look—or just a few minutes of conversation with the doctor himself—reveals the orthodontist’s charity-driven mindset, which is consistently applied in each location.

Seventy percent of his practice’s patients are on Medicaid or use other forms of insurance that many private practices simply prefer not to accept. Moray believes too many patients fall through the cracks, so if his offices can help catch them and deliver treatment, he’ll happily continue to do so. In fact, it was Moray’s winning bid at a Smile for a Lifetime fundraiser auction that earned him the opportunity to be featured here.

In our exclusive Q&A, we showcase one of Moray’s practices and in the following interview, he discusses how and why he’s chosen to focus his practices predominantly on insurance patients, the systems he uses to help oversee a team of 160 people and much more.
 
OFFICE HIGHLIGHTS
NAME:
Dr. Larry J. Moray

GRADUATED FROM:
University of North Carolina at Chapel Hill Adams School of Dentistry and the Department of Orthodontics

PRACTICE NAME:
MyOrthodontist

PRACTICE SIZE:
(Chapel Hill Location)
3,000 square feet; 8 chairs

TEAM SIZE:
(Chapel Hill Location)
7
What are the first few steps for doctors embarking on opening a second office?

Back in the day, most ortho practices were single practitioners. If there were two locations, the team traveled back and forth and each office was open part time. That never made sense to me. The orthodontists who did this would tell me they weren’t busy enough in one location and thus needed two, which seemed misplaced. Having multiple offices allows you to serve more communities and patients while giving more folks a great work experience. Some of those new team members and patients may never have considered dentistry as a career, and now they have another option for their futures.

Consider need—don’t necessarily look where the action is at present, but where it will be in the future. My motivation has been serving Medicaid patients, so I’ve looked to see where that service is lacking and where we might be that allows easy access to our offices.

A reasonable stepping stone might be to open two locations—one might be fee-for-service and the other Medicaid or PPO—and split your time and staff and grow them both, then expand your staff and take on an associate when you feel you and your team are just about to be overextended!


Give us an overview of how your offices operate.

We follow the Entrepreneurial Operating System, which requires definitive systems and metrics, and also separates initiatives into “To-Do’s,” which should get done in a week, and “Rocks,” which are three-month tasks.

We have a fantastic leadership team that I resisted expanding for too long. They have been instrumental in creating protocols and procedures, putting them in place and documenting everything centrally. We now have a CEO, a director of operations, a director of finance, a director of HR, a director of admin and a senior marketing manager, some with teams of their own. I have a great assistant clinical director, and the ops team includes a compliance officer, two regional managers and our practice administrators.
You often joke that you have a difficult time saying no to people. For the sake of helping new and future orthodontists … what should they say no to?

I still advise that folks explore every opportunity before saying yea or nay. Too many “woulda, coulda, shouldas”! What I needed to do better was related to hiring folks who weren’t the best fits, and giving people raises simply because they asked. I like everyone and want everyone to be happy. Having a great leadership team now allows me to separate myself from a lot of the harder hiring and compensation decisions or at least bring others in to help with the decision process. It’s not to say I always listen, but the missteps have been significantly reduced and I continue to evolve as an entrepreneur, a leader and a businessperson.


70% of your patients are on Medicaid. What is that like from a business point of view?

The process has evolved over 25 years, both on our end and on the part of the North Carolina Department of Health and Human Services and the folks who administer the Medicaid contracts for the state. While the learning curve wasn’t that steep, where we are now is the culmination of years of hard work and diligence by our ops, billing and collections teams. There are still glitches that delay approvals or payments, but our protocols have us working as efficiently as the system allows!


What are the financial considerations of working with so many less-than-ideal reimbursements?

When I started, the party line was to not accept assignment of benefits, because that would require another team member and would also result in lower provider compensation. The question once again becomes one of why we practice: Are we driven by profit or by service? Accepting insurance allows us to further lower the barriers to entry into orthodontic care. Additionally, it has gotten way easier to submit insurance claims. Most if not all of the process has become electronic; though there are more steps and nuances, the benefits outweigh the costs for us.

My purpose in becoming a dentist and then an orthodontist was never about the money. I know so many of our patients would be without care were it not for us, and that knowledge is compensation enough for me and far more significant than any salary I might receive!

There are so many marginalized people in our country and we each, as individuals, can move the needle some. If we all did just a little, the cumulative sum would go a long way to improving the lives of so many.


You’ve set a good example that you can be successful without trying to pack an absurd number of patients into the day. What’s your message to doctors who put perhaps too much emphasis on volume?

As orthodontists, we have worked hard over the years to improve treatment efficiencies. We’ve gone from Tweed’s “eight patients a day” to practices seeing more than 150 patients a day. This has been a function of expanded auxiliary responsibilities as well as significant advances in technology, which continue to make our offices more efficient and the patient experience less arduous!

But at the same time, we’ve increased profitability—sometimes for the sake of profitability itself and without regard to service or our patients’ lives.

What has always driven me is the personal, human side of our profession: learning about others’ lives, their loves, passions and interests, and developing a bridge with patients and parents.
TOP PRODUCTS
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Ormco has been a big supporter of our mission and vision with great service and great products! We use Insignia PSL, LightForce and Brius Brava because we are always trying new technologies and looking to offer patients more options.

Spark Clear Aligners. We find them to be more efficient tooth movers than other aligners on the market. Spark and DentalMonitoring have also partnered in a technology that allows us to pull a Smart STL from the scan, which allows us to make refinements without bringing the patient into the office for an intraoral scan.

Synapse Dental Pain Eraser has taken the discomfort out of all procedures, as well as postadjustment sensitivity and debond discomfort— truly a change in the patient management paradigm.

Unique Dental Scheduling is a third-party call center that has greatly increased both our answer and scheduling rates. We answered around 65% of calls, which is the industry standard. Now, with Unique, we are answering around 85% of calls, which means way more new patients are scheduled!

Purchasing for a single office can be difficult enough. What goes into consideration when you’re looking at adding or upgrading technology across so many offices?

Early on, I would glom onto every new and exciting technology and roll it out across all offices. Change was constant as I tried to improve efficiency, outcomes and the patient experience—and it drove our teams nuts! Folks hate change, but I believe change is necessary to keep growing the company and touching more lives.

Today, we take a less drastic approach to new technologies and change: We look for an office or offices whose teams are open to trying something new, and then we pilot the technology, procedure or protocol in those locations. In that way, we can minimize disruption and better assess the impact of the change—be it good or bad—and adjust accordingly.


What mistake turned out to be the best teachable moment?

My advice to others is to be sure to thoroughly vet all new hires and vendors—even doing background checks and internet searches on new vendors.

One of our biggest missteps was hiring a software person our IT company recommended who turned out to be a fraud and a scammer. He gained access to our office networks and installed software on all our servers. We had paid him a significant retainer before we were alerted to his duplicity. Fortunately, we were able to shut down our network and servers before any patient data was compromised. Not only did he con us, but he conned our IT company!

And of course, there is the lesson learned from not creating too much change all at once but taking baby steps toward an eventual goal. It’s hard for me to sit on my hands sometimes, but it makes teams happier in the long run!


What was your last major investment? What will your next investment likely be?

There have been and will be lots of major investments in our offices from the standpoint of new and evolving technologies, as well as opening or acquiring new locations. Recent changes have been transitioning from our own in-house lab and aligner system to Spark, outsourcing our call center, and opening another new location. Plus, we have a great mentoring program for new doctors.

The future vision involves establishing locations in other areas of the state and eventually the Southeast, embracing new technologies as they become available and updating our current technologies to newer iterations. An example of this includes upgrading our scanners and 3D printers to keep pace with technology. Additionally, we are instituting new training programs to elevate our patient experience to the highest level possible!


Employees at all your practices do community service projects. Tell us about some recent ones.

Every location is charged with performing at least two community service projects a year. This also applies to our support team, of which I am a member. Recent support team activities include making dinner for residents and guests at SECU Family House, which provides housing for patients and loved ones who travel to UNC Hospitals for lifesaving treatments, and sorting and packaging groceries for TableNC, a community nonprofit that delivers healthy food and nutritional education to foodinsecure families in Orange County, North Carolina.

Furthermore, my wife, Dr. Jin Yi Kwon, and I formed a nonprofit called The Happy Tooth Foundation several years ago. Our mission has been to address inequities that leave low-income kids behind and not able to develop to their fullest potential.


What’s your favorite patient story?

Many, many patients have had a profound impact on me professionally and continue to drive me as an orthodontist. Most of the memories are small lessons of human nature, the good of giving and insights into orthodontic mechanics!

I’m reminded of Kevin (pictured below), one of our early in-house aligner patients on DentalMonitoring. We gave him his aligners and a ScanBox, sent him home and basically forgot about him! It was at a time when we were not coordinating the number of aligners in both arches. It wasn’t until he called and told us he was done with his lower aligners that we realized we hadn’t seen him for months and we hadn’t gotten any DentalMonitoring alerts, either!

Looking at his photos, it’s kind of obvious why his treatment was so successful, but this was a case that has stuck in my mind and has reinforced the concept of remote aligner treatment as an option for many patients.
Larry Moray Patient Story
Larry Moray Patient Story


What professional hill are you willing to die on?

I believe we drop the ball when it comes to serving our communities and often don’t grasp the enormous barriers to treatment. Some of this comes from not having experience living paycheck to paycheck or below the poverty line, whether personally or via acquaintances. Many of us don’t understand the financial challenges of most Americans or the unavailability and inadequacy of dental insurance.

I believe we all should be working to get care to more families and coming up with creative programs to do so. We also should be placing more emphasis on giving back to the communities we practice in.

Human beings tend to make assumptions based on personal experience and perspective, and orthodontists aren’t exempt from this. A dual standard often seems to exist—for example, someone might say that having a beautiful smile is key for improving self-esteem, which will allow one to go farther in life, yet in the same conversation wonder why Medicaid should pay for orthodontic treatment when those patients could “just” go to college, get a job with dental insurance and get braces as adults. There are so many misconceptions and false assumptions in that sentiment.


How did you find your way into orthodontics?

My dad was a general dentist, his brother was a periodontist and their dad had a dental lab. My cousin was a hygienist and my stepdad was a general dentist, so suffice it to say I not only grew up in a dental office but it is part of my DNA! Nonetheless, I have always been a Sinatra fan, so I’ve had to do it my way.

I was determined to follow my path and thought I’d be a PhD researcher. After a temporary position in the department of pharmacology at University of North Carolina at Chapel Hill ended, I applied to the university for a research assistant position and was interviewed and hired by Dr. William Profit in the department of orthodontics. He encouraged me to go to dental school, but I still had to follow my heart and entered the PhD program in neurobiology. I was still working part-time for Profit as needed and he was still grooming me to be an orthodontist!

After I realized that research was not for me, I worked for a short time managing a health club, and then met a perio resident who finally convinced me I should check out dental school.

I applied to UNC-Chapel Hill and graduated in May 1990, then completed a one year GPR at the VAMC in Hampton, Virginia, and was fortunate enough to land a position as assistant GPR director at what is now VCU Hospital in Richmond, Virgina.

I became close friends with several dental and hygiene students, one of whom was an aspiring orthodontist who encouraged me to apply to orthodontic residencies. Heeding her encouragement and missing Chapel Hill and the family I had built in the ortho department there, I applied at UNC and soon found myself back home and in school once again.


Give us a snapshot of your life outside of work.

My life is very full outside of orthodontics in the sense that there’s more to helping to run 14 offices than simply seeing patients. Outside of work responsibilities, my first and foremost commitment is my family—a wonderful wife and two wild and crazy boys ages 11 and 14! I used to be a very competitive triathlete and am planning to get back to racing soon, so I’m spending a fair amount of time running, biking, swimming and lifting weights.
Office Visit: Next-Level Charity

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September 2025
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