A Diamond in the Rough

As a chemical engineering student at Ohio State University, Dr. Richard Keefe was leaning toward medical school. While working his job at a local gym, an astute customer suggested that dental school might be a better fit. Once Dr. Keefe realized that dentistry is engineering in the oral cavity and each case is a little project, he was captivated. After weighing all options, Dr. Keefe chose a residency program.

In 2013, Dr. Keefe graduated from dental school and began looking for a practice to purchase. He was in search of an existing practice with a skilled practitioner and a solid patient base. What he found was a diamond in the rough that gave him plenty of little projects—dental and otherwise.

“I knew the [previous] doctor. He had been trying to sell for a long time, but esthetically the practice was lacking. You’d walk in and the equipment was nice, but nice like a 1970s Mercedes. But the dentist’s reputation was one of the best and he was known for his meticulous crown and bridge work. His good-sized patient pool was loyal, and had been seeing him for a long time,” Dr. Keefe reflects. He purchased the practice, but declined to buy the building with the hope of growing the practice and moving to a larger space in five years. Working hard, he began to plan each facet of his practice, with surprising results.

Getting it Right

Dr. Keefe began each day with absolute determination, as a left-handed dentist in a practice built for a right-hander. “I did my morning stretches. The operatories were so small that you couldn’t turn the chair. If I turned the chair, my assistant was sitting on the counter-top of the old Executive unit. The unit was rear delivery with one air/water syringe, one HVE and one saliva ejector for my assistant and me to share. We called it dental gymnastics.”

With $600 a month rent, Dr. Keefe knew he had a good setup. But every day, he not only performed dental procedures, but frequent repair projects. “One day our vacuum motor went out, and the front desk asked if I wanted to cancel the afternoon patients. ‘No, no, no, I’ve got my wiring tools in the truck,’ I said, knowing that if I could just MacGyver it a bit longer, it could work while I put together my plans.”

What concerned Dr. Keefe most though, was the fact that his practice didn’t reflect the value of his dentistry. “When I walked in, things irritated me, like the old two layers of carpet, the inconvenient restroom layout, the tiny combo lab, and the extremely compact and outdated sterilization and storage area,” he recalls. Still, Dr. Keefe felt that each day he showed up and worked hard was a means to an end.

Changing Views

Dr. Keefe began clarifying the vision and strategy for his new practice even as his fledgling office was getting started. His attention to patient comfort and care added momentum to the growth. He made it his goal to change how people view the dentist. It worked.

“I was focused on doing things the right way. I treatment-planned big cases properly, and didn’t refer out root canals. The patients were happy with the resulting work, so that was instant growth,” recalls Dr. Keefe.

Planning for the Future

Dr. Keefe considered buying land and building from the ground up, but it didn’t fit his budget. With a little luck, he found a 2,500-square-foot medical office just one block away. “I liked being the only dentist within a two- to three-mile radius. It’s kind of like a small town. I really didn’t want to leave because most of my patients go to the same high school, middle school and the elementary school down the road. So, I really wanted to stay just where I was,” he says.

With the location set, Dr. Keefe then designed out the space himself. He wanted every room to have a window, so the staff didn’t feel boxed in. In phase one of the redesign, Dr. Keefe completely outfitted four new operatories with A-dec 411 chairs, 332 delivery systems and 545 assistant’s instrumentation on Preference Collection 5580 12 o’clock cabinets. He also added A-dec 572 LED dental lights in every room.

Designed for Brilliance

As a left-handed dentist, Dr. Keefe understood his practice would need to accommodate both left- and right-handed doctors in order to grow. “It’s just super-fast with the A-dec chair to switch from left to right,” he says. “You just swivel and pivot and in about 30 seconds, it’s a right-handed room. That was one of the selling points for A-dec: It was the easiest I found for converting left to right on the fly.” Dr. Keefe also appreciated buying only what he needed now. “That was the nice thing about the delivery system; you can keep adding to it pretty easily,” he says. “You don’t have to get a whole new unit.”

Dr. Keefe’s overall treatment room design was brilliant. “Now we have it all laid out on the counter-top. So, if you are with gloves you can handle everything on the counter-top without contaminating handles and drawers. From an infection control standpoint, it’s a lot easier. And the overhead light is just a lot faster. Having the yellow (cure safe) setting on the light, the assistant is not having to hold a shield, so they are able to do other things.

The operatories are ergonomic, efficient and more pleasant to work in. I don’t go to the operatory thinking ‘Well, how are we going to get this thing done?’ Instead, I’m going, ‘Yep, we’re just going to do dentistry.’”

Growing in Appreciation

“We’ve been here just over two years, and we’re still growing fast. We just finished phase two, equipping the three remaining treatment rooms. I’m hiring an associate who works on Fridays. Now, I have two-and-a-half hygienists, and we are booked out 3-1/2 weeks.” While the practice is approaching capacity even with the new expansion, the real gem is what patients are experiencing. “Since I am more efficient and not being rushed, I actually have a free chair that allows me to do a 20-minute consult, without eating into production. I now have consultation space so my office manager can sit with my patients and have the benefit of privacy to go over treatment plans,” says Dr. Keefe.

Patients and staff alike are enjoying the beautiful space, which Dr. Keefe feels better represents the value of his dentistry. “My office matches everything I want to do. I feel a big stress relief in the fact that my practice is representing the standard of care we want to give, how we want to treat our patients. That’s probably the most memorable part: having achieved that goal.”

Watch more stories about doctors realizing their practice potential.