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Bringing Back the House Call Chelsea Patten, Staff Writer, Dentaltown Magazine

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by Chelsea Patten Staff Writer, Dentaltown Magazine
Amir Ghorbani and Lily Sarafan are married.

He is a dentist. She is the COO of an international senior care company.

Now, with a mix of forward and backward thinking, their professions are married too.

In 2009 Ghorbani and Sarafan founded Home Care Dentist (HCD), a mobile dental practice serving the San Francisco Bay Area.

Prior to HCD, Ghorbani, a USC graduate, owned his own dental practice. While he enjoyed working at his practice, he craved a more humanitarian approach to dentistry. The couple explored their options, considered Doctors Without Borders, but couldn't see themselves living abroad long term. They found their niche somewhere between their two professions.

"We never thought our two professions would collide," Sarafan, the Stanford graduate says. Working with elderly people, she knows many who receive in-home care for meals and bathing, among other services. The couple decided dentistry should be one of these available in-home services. "It's one thing to think of doctors in the 1950s with their black bags and stethoscopes going into people's homes. It's another thing to think about the very real and practical nature of the dentistry we're doing," says Sarafan. Ghorbani serves a wide range of clients by offering his in-home services. While the less mobile senior population serves as their primary clientele, the several additional markets that use their services initially surprised them. These include people with agoraphobia (fear of public or unfamiliar places), dental phobia, disabilities, and even busy professionals just seeking convenience.

Home Care Dentist operates with a philosophy of practicing minimally invasive dentistry. Sarafan mentioned a 102-year-old patient who, prior to seeing Ghorbani, was told she needed $35,000 worth of work. Sensitivity to the needs of their older patients, as well as gauging their ability to handle dental work are HCD's top priorities.

The couple lives in Los Gatos, California, but branches throughout the Bay Area. Although a portable practice, a typical day still plays out similar to a regular practice. Ghorbani takes calls from referral sources and prospective patients. He answers insurance questions. He converses with patients, does initial exams and treatments. A similar process, except he must get everything into his car.
Similar to the backpacking department at a sporting goods store,
all of Ghorbani's tools deflate, collapse or fold. Believe it or not, up until recently he operated his practice out of a Mini Cooper. Sarafan laughingly recalls one time he pulled up to a senior care facility and they thought it was a mistake. Ghorbani has since purchased a Dodge Magnum for comfort's sake.
Below: Dental equipment and supplies pack up
into a series of silver boxes, which fit into Home
Care Dentist's Mini Cooper.
Name: Amir Ghorbani, DDS
Graduate From: University of Southern California
School of Dentistry
Name: Lily Sarafan
Graduate From: Stanford University (Bachelors, Masters in Management Science and Engineering)
Practice Name: Home Care Dentist
Practice Started: 2008
Staff: Ghorbani-Full-time, Sarafan-Part-time, two assistants who rotate and one full-time patient coordinator
Web Site: www.homecaredentist.com
Ghorbani's portable tools pack up into a series of silver boxes. Sarafan compares the unloading process to the movie Transformers. The setup includes collapsible patient and doctor chairs, a small compressor, a suction and light that are actually embedded in the boxes into which they pack up. He uses a portable X-ray, comparable in size and shape to a glue gun. He can develop the X-rays manually with solution or can view them digitally on his laptop, both on-site. This sophisticated and functional setup certainly trumps the once popular little black bag used for house calls.

Ideally, Ghorbani needs a 10x10 foot area to set up his equipment comfortably. But he must exhibit flexibility since that 10x10 area might be a kitchen, a bedroom, or a living room – his environment constantly changes. Sanitation in his practice space remains under complete control since he brings all the equipment with him.

Ghorbani can perform anything in-house that he would be able to perform in his practice, with the exception of procedures requiring sedation.

The couple's service impacts many in their community. "We've definitely had people get teary eyed on the phone," Sarafan says. "They'll say 'you don't know how long we've been looking for a service like this. I thought, I don't know what I'm going to do about my mom. I am so glad there is something like this out there!'" Ghorbani and Sarafan are just as affected by those they are able to help.

Sarafan mentions patients or families of patients who have given up on the chance of dental care. "They're just living in pain. They can barely eat. Sometimes it's a matter of something simple like dentures not fitting and they just aren't enjoying food anymore. It's amazing how a couple of these visits can turn everything around." She says they often hear from people who have gone without dental care for nearly a decade because of their inability to leave home. Ghorbani finds it particularly rewarding to listen to patients' life stories, which patients offer comfortably due to their familiar environment.

Sarafan credits much of HCD's success to their comprehensive demographically-targeted marketing. She says about half of their new patients find them via the Internet – by press release, Yelp reviews, their blog, social media outlets, or their Web site. She names their Web site as a "mainstay" and an "integral part" of their practice. "It's a different world than it was 10 years ago," Sarafan says. "You need to have a Web site. You need to have an online presence." Fifty- to 60-year-olds are the fastest growing demographic on Facebook and since it is often the children of older parents who contact them, HCD markets with a Facebook page as well. The other half of new patients come from referral sources – particularly geriatric or senior centers.

As a visionary in both business and dentistry, Sarafan would like to see the perception of dentistry change in the next 10 years. "In this economy, dentistry is often put off. I'd like to see the perception of dentistry more in line with overall health rather than distinct." Poor dental hygiene is directly linked to heart disease, lung problems, and diabetes among other ailments. She would also like to see better consumer education for oral hygiene practice.

Sarafan notes Jeff Bezos, founder of Amazon.com, as a model for how she would like to see the profession of dentistry progress, as well as cites him as an inspiration for Home Care Dentist. Bezos said, "There are two ways to extend a business… Take inventory of what you're good at and extend out from your skills. Or determine what your customers need and work backward, even if it requires learning new skills." Ghorbani and Sarafan brought this business mentality to fruition. By figuring out their clients' needs – at-home dentistry with a minimally invasive approach – they landed their niche. Sarafan hopes dentistry progresses in a way that is patient-and community-oriented.

When the couple is not working, they enjoy traveling the world, as well as the food that accompanies the journey. Ghorbani enjoys working on classic cars, as well as going to shows and auctions. Sarafan compares her husband's love for classic cars to his ability to take the antique concept of a house call and turn it into a modern, accessible service. "My husband was able to be forward thinking by being backward thinking," she says crediting him with the idea of home care dentistry. How progressive!


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