Office Visit: Keeping Up with Dr. Dorfman Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

by Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine William Dorfman, DDS, well-known Los Angeles practicing dentist and co-founder of Discus Dental, has been a busy man the last few years. Since his stint as the go-to, life- and smile-changing dentist on ABC's Extreme Makeover, he runs a summer program called LEAP at UCLA to motivate high school and college students, he is one of the clinicians on the Emmy-winning informational talk show The Doctors, and he recently made it into the Guinness Book of World Records for the money he raised for charity by shaving his head! I had the opportunity to talk with him about how he splits his time between Discus and his own practice, while simultaneously keeping up on the lecture circuit and still having time for charity in his community.

Name: William Dorfman, DDS Graduate from: University of the Pacific, San Francisco Practice Name: Century City Aesthetic Dentistry Practice Location: Los Angeles, California Year when this office opened: 1985 Practice Size: 5,200 sq. ft. Web site: www.billdorfmandds.com

Discus has done a top-to-bottom redesign – what are your thoughts on the company you
co-founded 20 years ago?
Dorfman: We have basically revamped the whole company. We put out a new logo, a whole new look. We have a whole slew of exciting new products coming out. We bought Zap Laser. We retooled the Styla. It is now called the NV Microlaser. Our cordless prophy is coming out as we speak. It is a brand new cordless prophy angle for hygienists. It is powerful, cordless, beautifully designed and easy-to-use. It will allow a dentist to basically build a hygiene operatory without having to put in all the plumbing for handpieces. We have a whole new Transcendentist line of green, infection control products. We have just reformulated our whole restorative composite line, Nuance. There is a lot of new and exciting stuff coming out.

What year did you open your office?
Dorfman: I graduated from dental school in 1983. I did a two year residency in Lausanne, Switzerland. I worked for the Swiss government in a Swiss dental hospital, and then in 1985 I started practicing in Century City, California.

Were you starting from scratch or practicing with somebody?
Dorfman: I was practicing with an older dentist with the idea that he would sell me his practice and I would take it over. Ironically, the more I practiced the more excited he got about dentistry and didn't want to leave. So he said, "Why don't you just open up your own place; you have enough patients coming in." So I opened up right next door to him and we have stayed friends all these years.

How big is your physical practice? You mentioned it is two floors. How many square feet is it?
Dorfman: The upstairs office is about 3,200 square feet and the downstairs is just under 2,000 square feet. Altogether I have 13 operatories.

How many staff?
Dorfman: There are two dentists who just do ortho. I have a dentist who does a lot of Invisalign and I have an orthodontist who does lingual braces. In addition, I have two other full-time dentists and I have three part-time dentists. I have three full-time hygienists, four assistants who are dedicated just to the back office such as sterilization, X-rays, etc., and then I have eight additional chairside assistants. In the front office there are eight women. I also have one executive assistant who doesn't do anything dentistry-related – she does all my bookings for TV shows, speaking engagements, appearances, articles, anything other than dealing with my patients in the practice.

How did you come to cosmetic dentistry as a focus for your dental career? If you had been born and raised in Nebraska do you think you still would have focused on cosmetic dentistry?
Dorfman: It's funny, when I was in dental school I never felt like people got all excited when I fixed their teeth, but when I made them look better they really got excited. For me the bigger payoff was how appreciative the patients were. So I started drifting toward cosmetics when I got back home from my residency in Switzerland. I started practicing in LA and it was the place to be for cosmetics. If I were in Nebraska, would I still be doing it? Knowing what I know now, yes. Maybe when I started off I might not have been driven into it as much.

Do you subscribe to the philosophy of presenting treatment plans at the initial exam, or do you appoint the patient back after you have had a chance to review their records?
Dorfman: Every practice works differently. People in LA are kind of rush, rush, rush. If I came in and said to a patient, "Hey it's great to meet you, we're going to take some records and then you'll come back next week and then we'll sit down," they might not come back. I would say the majority of Invisalign cases that we start, we start same day. A patient comes in for a consultation, we look at them, we discuss Invisalign, I show them a video and we take impressions right then and there. It is an impulse buy.

What is the biggest pitfall for dentists who focus on cosmetic procedures? Is it failure to manage expectations?
Dorfman: I think that dentists who want to do cosmetic dentistry need to first and foremost listen to what the patient wants. Some of us get so stuck in a rut, in a cookie cutter approach, and we can't do that. A patient might really need Invisalign on her lower teeth but just doesn't care. She may just want four veneers on her upper teeth. Unless I think it is going to be doing a disservice to the patient, I always try and listen; I try to explain what I think would be the best treatment but ultimately I do what they want.

What advice do you have for dentists that aspire to do more cosmetic procedures?
Dorfman: I'll tell you a little secret. One of the things that sells cosmetic dentistry more than anything else in my office is a mock-up. What I mean is, if a patient comes in and they have some rotated teeth, chipped teeth, etc. I can mock-up the six anterior teeth literally in five minutes. That sells more cases than anything else in the world. You can take a camera and do imaging but it is not as tangible. I take a picture before and after the mock-up and I let them leave with it.

Regarding cosmetic vs. non-cosmetic patients, how do you handle procedures that are not part of your focus?
Dorfman: It's really easy; I just don't do them. I have been practicing for almost 30 years and I don't want to do fillings. I only do cosmetic cases. The other procedures are performed by my associates.

When patients do come in for other procedures, is there a method that you use to assign them to your associates?
Dorfman: Pretty much when new patients come in I see them and then I decide who in the practice I want to do the rest of their treatment.

I think there is a perception among dentists about somebody like you who is out lecturing and is on television shows, they think, "He can't possibly be practicing real dentistry."
Dorfman: I do more dentistry than people think. I work four-and-a-half days a week.

What is your typical schedule?
Dorfman: It is not uncommon for me to do 40 veneer preps in a day, two 20-unit cases. That happens a lot. DaVinci Dental is my lab and they always tell me I produce more units than any other dentist that they work with. I am a wet-fingers dentist. I am in my office every day. Two days a week I am at Discus for part of the day, but the rest of the time I am doing the same thing you guys are all doing.

When you are a famous cosmetic dentist, is it necessary to market your practice?
Dorfman: I'll tell you something, when I was on Extreme Makeover I was seeing 200 new patients a month without even trying. The halo effect lasted several years. Last year (2009) it really started waning and pretty much drying up. I still got two new patients today who both said they had seen me on Extreme Makeover, but the show hasn't been on the air for a few years. I started running radio spots on KIIS FM, on the show hosted by Ryan Seacrest and I thought that would go gangbusters. After spending $20,000 I haven't had a single patient book an appointment from that. And it is a great spot on a popular show! When I sat down and tried to analyze it with an advertising agency they said it was bad demographics. Their demographics are young girls ages 17 to 24. They don't want cosmetic dentistry. It was stupid. I did all the things wrong I used to lecture about in the old days. I haven't really had to advertise or do any of that for such a long time. I cut that ad and I am going to start doing some radio spots on stations that cater to patients that are 30 to 60, really focusing more on implants, sedation dentistry and things like that.

Everybody has been talking about the recession, especially the last couple of years. Cosmetic dentists in smaller markets have certainly felt the pinch. What have you seen in the Greater Los Angeles area?
Dorfman: 2008 was probably one of the biggest years I have had. 2009 was horrible. First of all I did one of the stupidest things ever. I totally took my eye off the ball. We had done so well in 2008 that I just assumed 2009 would be the same. About three or four months into 2009, my accountant called me up and said, "Doc, your numbers are off." I had never even looked at them. So starting in January I made some radical changes in my office. I cut overhead a lot. I cut staff down to just what we needed. I know it sounds like I have a large staff but this is kind of a bare bones compared to what I had. We started shopping around for dental materials and things like that. We started doing things I just never did before. It was a rude awakening for me. We have turned it around, and this year we are having a really good year.

What are your thoughts on Dentaltown.com and its impact on dentistry, or maybe its impact on you?
Dorfman: It is a great forum. It is a great adjunct for dentists. We tend to practice in a profession where we have a myopic view of the world and we are sitting in our little offices, in our little cubical, with our little instruments, working in these little mouths on these little teeth and you get stuck on that. Having a forum like Dentaltown really opens your eyes. It really enlightens you and it makes you feel like you are not alone. There is a lot of camaraderie. There is a lot of great education that comes out of the interaction with other dentists and leaders. I think it is a great thing.

Is there anything that you would like to add that we didn't discuss?
Dorfman: There is one thing I would like to end with. I would just like to thank you guys and all of your supporters for supporting me and Discus for so many years. We certainly appreciate it and there is no way we could have been as successful as we have been without the support. It is very much appreciated.