Rural Practice Shows Value of Going High-Tech

Main and Palmer Family Dentistry - Garden City, KS | Jay Main, DDS & Lance Palmer, DDS

Main and Palmer Family Dentistry is an example of how a state-of-the-art general dentistry practice can thrive outside of a densely populated city center by leaning into technology and thinking “big”. In fact, this 11,000 square-foot practice has always enjoyed a large patient load and a strong following in the community. With the new look and feel, it’s poised for even
greater success.

Main and Palmer Reception

Team photo

Left to Right: Lance Palmer, DDS; Victoria Guzman, DDS; Jay Main, DDS

Dr. E. Grant Larkin owned the solo practice in Garden City, a rural agricultural town in Kansas. Dr. Jay Main joined him as a partner in 2009, and they expanded and modernized the 11-operatory practice to better serve a dual-doctor practice. The gorgeous renovation modernized the 5,000 square-foot practice, but some structural obstacles could not be changed, even by a robust remodel. There was a shortage of parking spaces and treatment rooms needed to accommodate emergencies and a growing patient load. It became so tight, team members parked down the street to open up spots for patients! Overall, it was straining the delivery of the practice’s motto, “committed to comfortable care.”

Dr. Lance Palmer joined as an associate in 2011 and became a partner in 2012 after Dr. Larkin left. “It was difficult to see our growth potential constrained by the limited space inside, but it was more difficult to struggle with scheduling because of limited dental chairs and nowhere to add another provider,” Dr. Palmer said.

Henry Schein Equipment Sales Specialist, Adam Halabi, said the doctors added 3D imaging and same-day dentistry to the practice and converted some space into additional treatment rooms, trying to maximize their practice within the square foot limitations. Field Sales Consultant David Criger remembers how an unexpected conversation at Dentsply Sirona World, where they were viewing cone beam options, impacted the doctors’ next steps.

“On our first day there, we ran into Stanley Bergman [Chairman of the Board and CEO of Henry Schein, Inc.],” recalled Mr. Criger. “He chatted with us for ten minutes and said if he was a dentist at this time, he’d build the biggest practice he could! That impromptu chat became the foundation of our conversation about a new office.”

HallwayWhen a long-empty building, across the street from the Garden City High School was renovated into office space, they purchased half of it. They worked with Laura Seefeldt, Henry Schein Integrated Design Studio designer, on a basic floor plan that laid out optimal workflows and space configuration, and their architect took the design and fine-tuned it.

The office is immense, with an L-shaped hallway in the clinical area that leads to 19 operatories, with four more available for expansion. The goal of the build for the doctors was to make room for continued growth and the addition of an associate doctor, while maintaining a family-oriented, patient-centric practice, even in a large footprint. Their design choices echo that goal.

Warm and Welcoming Waiting Area

The waiting area is spacious, with a central stacked stone fireplace crackling on one end that matches the design of the front desk. Casual, comfortable seating in upholstered fabrics sit upon a cross-hatched patterned carpeting. Décor like lanterns, a rustic table and other accessories, including agricultural-themed photos taken by one of the doctors’ patients, create a homey environment. Tucked behind the fireplace, a cozy area, with a mural of mountain peaks and a real tent, attract younger patients. The doctors credit their wives, Amber and Courtney, for working with local photographers and coordinating the beautiful office décor.


Having more room to display their technology has given a boost to their same-day dentistry interest and acceptance. The CEREC mill is displayed openly, so patients can see restorations being made in real-time. The practice uses it so much, they plan to purchase a second mill.

“We wanted our patients to feel completely at home when they walk into our office,” said Dr. Main. “The spaces where patients will spend time outside of the operatory are extremely nice and comfortable. The large windows create a feeling of openness and space that is typical of western Kansas,” noted Dr. Palmer.

Turning left from the stunning reception area, an L-shaped hallway of treatment rooms greet patients. The doctors had A-dec equipment previously and were happy with its performance. Even so, the Henry Schein team arranged a trip to the A-dec facility in Oregon and tours of local practices to see different configurations.

“Being able to see how dental equipment is made and understanding the reasons and advantages for incorporating certain designs helped us to see the value in great equipment and how it can benefit our practice and patients,” said Dr. Palmer. “Seeing different designs and color schemes helped us visualize what we wanted for our space,” added Dr. Main. “Our reps also took us to several offices to see other designs and functionality.”

Drs. Main and Palmer did choose A-dec equipment again, moving some of the fixtures from their existing rooms and purchasing new equipment. They chose A-dec 511 chairs with continental delivery and Inspire cabinetry. “There is a mix of 25-year-old equipment and the latest cutting edge technology,” said Mr. Halabi. “It is a testament to purchasing quality equipment that lasts.”

More Clinical Space, Enhanced Workflows Offer Better Patient Experience

Treatment Room

The practice’s 19 operatories are bright and modern, and they are equipped with a mix of new and existing A-dec equipment from their previous location.

The large footprint and increased number of treatment rooms have resulted in a better experience for patients in a number of ways. First, they were able to add a new associate, Dr. Victoria Guzman, a recent dental school graduate who grew up in Garden City and returned home to practice.

“Dr. Guzman started working full time as soon as we moved into the new building,” Dr. Palmer commented. “With the addition of another doctor has come another hygienist and dental assistants. The waiting time to have dental treatment done or to become a new patient has decreased significantly!” The additional chairs have also helped to provide faster service to clients with emergency needs without interrupting the existing patient schedule. “A toothache, a denture adjustment, an impression can be easily accommodated in one of our extra chairs,” noted Dr. Palmer. “It is also beneficial when a procedure is taking longer than planned. The next patient can be seated in a dental chair and prepared for the procedure without wasting time waiting for the doctor to finish and have the room sterilized.”

COVID Check In

COVID has transformed the practice’s check-in protocols, with pre-screening calls and temperature checks upon arrival.

Finally, the office has embraced new technology and procedures to provide a safe visit during COVID-19. In addition to advance screening calls the day before and temperature readings once inside, all patients wear a mask and are asked to come alone unless they require a guardian. Surfaces are disinfected often, and the office has robust UV filtration and ozone air scrubbers. Inside the operatories, they’ve increased the use of high-volume suction and retraction tools like Mister Thirsty One-Step and DryShield. With more space available, supplies have been moved out of the operatories and into a central dispensary until needed.

Technology Attracts Attention from Patients

In addition to giving a better patient experience, the new office has provided niches to showcase the high-powered technology available to patients, a powerful conversation-starter. Mr. Halabi praised the CEREC mill display area, sharing that many patients had trouble grasping the idea of same-day restorations until they saw them being made. “With the display area and the additional treatment rooms, patients are able to see the mill working before [the restoration] is seated, and this has generated even more awareness of what their practice does for clinical excellence,” said Mr. Halabi.

CEREC Primescan

The practice uses the mill every day, and one of their plans for the near future is to purchase a second CEREC mill. Daily, the doctors use two intraoral scanners, Omnicam and Primescan; intraoral cameras; and the cone beam X-ray unit.

“We use 3D CBCT technology for patient evaluation and placement of dental implants,” said Dr. Palmer. “We occasionally use it for endodontic therapy.”

When asked if any piece of equipment is a game-changer, Dr. Palmer points to the intraoral camera as a driver of case acceptance.

“The intraoral cameras have allowed us to show the patients why they need treatment or to showcase what treatment was done,” said Dr. Palmer. “No longer is it necessary for the patient to imagine what the dentist or hygienist is talking about; we can show them. It portrays transparency and builds trust.”

Dr. Main also credits the CEREC scanner. “We use CEREC daily. Patients appreciate not having to mess with a temporary and having to come back.”

The office is large enough and ideally designed for four doctors, said Dr. Palmer, who added that having four clinicians working would enhance their cash flow and also give them all more flexibility in scheduling for work/life balance.

Sterilization Room

There had been some initial debate over whether a practice this large needed two sterilization centers. The doctors ultimately decided on one large galley-style center, positioned in the middle of the clinical space. With dual doors and plenty of room to ensure quick room turnover, it’s well designed to keep up with the demands of the busy office.

Now that they have been in the office for a few months, they are beginning to more fully recognize how the new office has improved their practice, workflows, and the overall satisfaction with the daily workspace.

“The increase in productivity is directly related to the increase of staff and operatories," concluded Dr. Main. "Our new patient flow has been steadily increasing, and the word-of-mouth is fantastic!”

“We knew we were crowded, but I don't think we fully understood until we moved into this new building,” admitted Dr. Palmer. “Everyone feels happy and proud to come to work in such a beautiful place. It's nice to know that everything has a place and is orderly. Even though the new office is larger and busier, many comment that it seems quieter and feels more relaxing.” ♦