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Office Visit: Dr. Fesaha Gebrehiwot by Kyle Patton, associate editor

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Categories: Practice Management, HR and Accounting;
Office Visit: Dr. Fesaha Gebrehiwot 

by Kyle Patton, associate editor
photography by Danny Fulgencio

Dentists 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. Dentaltown’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.

From a small village in East Africa suffering from war and drought to opening a thriving practice in east Texas, this Townie has had a remarkable journey. After being randomly selected in a diversity visa lottery at age 20, he immigrated to the United States from Eritrea, alone and knowing little English. He took a job as a food handler the same day he arrived at the Phoenix airport, and from there he went on to learn English at a local community college and pay his way through a four-year university program and become an engineer. Then, at 25, he went to the dentist for the first time in his life—a moment that would shift his trajectory into the world of dentistry.

Today, Dr. Fesaha Gebrehiwot runs a startup practice in Wylie, Texas. The city, just north of Dallas, is home to a community of his fellow Eritreans, as well as Ethiopians, and many others who’ve found their way to this Townie’s office because of its excellent care and quality.

In this month’s Office Visit Q&A, Gebrehiwot tells his remarkable story of growing up in Eritrea, leaving his family to try to forge a path in the U.S., how he eventually found a calling in the great profession of dentistry, and more.
Office Highlights

Name:
Dr. Fesaha Gebrehiwot

Education:
 University of Washington School of Dentistry

Practice:
Trusted Dental Care,
Wylie, Texas

Practice size:
3,000 square feet;
8 operatories

Staff size:
5, plus independent specialists

You have no shortage of stories, and they culminate in you finding dentistry as a career. Share the path you took to get there.

My story begins in a mountain village in the East African country of Eritrea, where I was one of nine children in my family. Early settlers set up the villages strategically on plateaus so they could see any enemies coming. This also reserved the fl at land for agriculture.

As my grandmother told the story, the villages were “a land of milk and honey.” She shared beautiful memories of life in the villages when farmers like my father grew legumes, vegetables and wheat and owned hundreds of cows and goats. By village standards, my grandparents were rich, with plenty of milk and meat to share.

Unfortunately, continuous drought began to rock East Africa. For decades, all the beautiful stories my grandmother told remained only memories. And on top of devastating climate change, Eritrea became immersed in a heavy war with Ethiopia for independence, and most of Eritrea became a battleground. Vegetation was cleared by the enemy soldiers for making trenches, while the rest was burned and destroyed to keep the enemy from hiding among it.

In the late 1980s, the war and drought escalated to their highest level. Farming and the traditional village lifestyle became almost impossible to sustain. I saw all the water streams dry up and the fruit-bearing trees be cleared. The wild cherry tomatoes we used to indulge in as kids disappeared within a few years. Clean drinking water was rare. We’d walk a few miles to bring back jerry cans full of water for the entire family.

During this time, my father decided to send my brother and me to school. Our older siblings didn’t get the opportunity because they were already helping with the farm. The nearest school was nine miles away, so our daily routine was to wake early, fetch water for the family and then head to school. After school, we were back doing farm work. In 1997, I caught a break and won a diversity visa lottery—a green card—to move to the United States. I knew little of the challenges ahead, but I was ecstatic to win the lottery. My older brother borrowed money from several people to pay for my airline ticket.

What was your best experience during your first few years in the U.S.?

Frankly, I don’t know that I can describe a “best experience.” I landed in Chicago because my sponsor was there, and I stayed there a few weeks until I received my green card. My sponsor took me to search for jobs—I applied at McDonald’s and some grocery stores, but didn’t speak English yet so I didn’t get any of those jobs.

The diversity visa process took almost a year from receiving the congratulations letter to arriving in the United States. During that time, I met someone who was the same age and in the same situation as I was, coming to the U.S. with no family. So after some frustrations in Chicago, I called him and he advised me to move to Phoenix, where he had ended up. My sponsor bought me a one-way ticket to Phoenix, and this new friend and I became roommates.

I remember arriving in Phoenix clearly: I landed at 10 a.m. and I told my friend to take me around the airport to apply for jobs. By 2 p.m. I had been hired by Sky Chefs as a food handler. I was employed and happy. I took ESL classes at a community college in the morning, then worked second shift. My friend and I bought and shared an old Toyota Tercel for $800.

The first year, I didn’t take a single day off. I worked 12-hour days, seven days a week, plus Christmas, Thanksgiving—you name it. My first year’s W-2 was for $28,900, all earned at the minimum wage. My goal was to save enough money so I could go to school full time. We rented a two-bedroom apartment in a not-so-nice part of town and had four people living there. I limited my expenses to the minimum. As a result, I saved almost half of my earnings. The next year, my focus was school.

What was the most difficult part of coming to the U.S.?

Being away from my family. I grew up in a village with eight siblings, uncles, aunties, cousins and so on. Our entire community was the village, and the village was kind of a second family. So coming to a place where I knew nobody was very difficult.

I couldn’t call home because my family didn’t live in the city or near a phone, so there were times when I didn’t talk to my family for more than a year. Some days, I wished my family was around to understand what I was going through, but I knew my family would be proud of who I was becoming. Another difficult thing was having no one to learn from—no role models or someone I could turn to for advice. I could’ve easily ended up in the wrong place at the wrong time at that age, but luckily my grandmother’s prayers were always my guardian angel.

I also didn’t have the luxury of eating the food I’d been accustomed to all my life. Food was probably the most challenging part! It took me several years to get used to the taste of it here. I was 130 pounds, and not really eating any kind of food for the first couple of years I lived in America, I became very skinny—unhealthily skinny.


By the time you went to Arizona State University, you were set on becoming an engineer. It wasn’t until you had your first experience at a dentist’s office that you began thinking of dentistry as a career. What happened during that first appointment?

After completing the basic sciences at community college, I found I did better in math, physics and chemistry—anything that required less English.

Communication and business were out of the question as majors because I had no confidence that my communication skills would get me anywhere. Engineering felt like a kind of safe hiding place; I thought, ‘“If I can do the job, I wouldn’t necessarily have to communicate well.” And my adviser agreed.

In 1999, the field of engineering was healthy, career-wise. Coming from nothing to make $50,000 a year as an engineer sounded like a dream, so I dove into engineering. I had all kinds of challenges: Coming face to face with a computer for the first time was frightening. Learning the language was hard enough. Then I had to learn Microsoft Office, how to use a keyboard, you name it. I didn’t take any summers off—I took whatever classes were available, and graduated in 2002, five years after I arrived in the United States.

After graduating, I began working for Motorola. It was an amazing feeling: To have a business card of my own that said “engineer” on it was such a joy. I used to hand my card to strangers because I was so damn proud of myself for what I had accomplished!

I also had health and dental insurance for the first time in my life, and this is where my dental journey started. I visited a dentist for the first time, and was overwhelmed by my oral health condition: I had chunks of calculus, bleeding, cavities … it was quite an experience. Luckily, I listened to the hygienist, whose name was Holly, who really cared and educated me on how if I didn’t do certain things, I would lose my teeth. It took a while for the information to sink in, but once it did, I followed through. I saw quite an improvement in my self-esteem and started to smile with confidence.

After a couple of years, engineering was going through big changes. Most manufacturing was being transferred to China and India, and there were many layoffs. A lot of senior engineers weren’t very happy, and they’d advise younger engineers to consider something else.

I considered dentistry, but just in the back of my mind—I’d never even taken a single biology class in my life before, so I almost ruled out the idea. But my curiosity about dentistry kept growing, so I decided to take some biology classes in the evenings just to test the waters. I found that I liked biology and decided to take all the prerequisites for dentistry. The rest is history: At age 32, I started dental school, where I was the oldest student in my class.

After working as an associate for a time, you moved to Dallas to open your own practice. What about that area was special to you?

I love the Phoenix area—I love the mountains, I love hiking—but before I built a practice, I wanted to explore where I should be opening a practice. I watched Dr. Howard Farran’s “30-Day Dental MBA”series and learned a lot from it. He approaches dentistry from the macroeconomic level and “Practice where you are needed” is what I took from it. I studied demographics, which led me to Texas. I knew there were some Eritrean communities in the Dallas area, and I wanted to be around one. That made my decision easier. I’m glad I did!

You’re a big fan of Howard and have taken some of his advice to heart. What advice would you pass on to others, now that you’ve seen the success of it?

A couple of years before I started my startup practice, I was hungry for every podcast out there, every book on psychology, business, marketing, etc. I turned my car into a library. In one of the episodes, I heard Howard say, “When you’re starting a practice, you have to run like you’re running for mayor.” That hit a nerve. Coming here to the Dallas area, not knowing anyone, was an opportunity to run for mayor, so to speak: I attended chamber meetings, upped my social media presence, met the Eritrean and Ethiopian communities, and did anything else I could think of.

Top Products

Daryou Dental intraoral camera
Best ROI! Better than any equipment, in my opinion. Seeing is believing and showing patients what we see is probably the best tool to have in the office.

iTero Element intraoral scanner
Great visual tool. At the same time, being able to scan instead of do traditional impressions cuts cost. Impression material is not cheap!.

Deka Dot fractional CO2 Laser
I don’t know how I ever practiced without it!

Planmeca CBCT
Great diagnostic tool that helps confirm the best treatment plan for patients.

Tell us about your current practice.

My practice is in Wylie, Texas, just north of Dallas with a population of about 50,000. We have patients who drive from the Dallas metroplex and our Eritrean and Ethiopian community drive several miles to see me.

I think it’s a great location—it’s visible from a high-traffic street, it has big, beautiful lighted signage, and it’s next to a gym and a hair and nail salon, with plenty of parking. The practice itself is 3,000 square feet, with room for eight spacious operatories and a consultation room.

With new patients, we take a full set of X-rays, intraoral pics showing full arch, and an iTero scan to make sure patients see what we see.

I have a great and compassionate periodontist who comes to my office. I also have someone who handles oral surgery services. The goal is to keep everything in-house, so my long-term goals include in-house orthodontic and endodontic options, too.

How do you leverage your history in helping relate to patients?

My personal journey helps me to not judge anyone but instead be compassionate. I have immigrant patients who walk into the practice with zero dental IQ. This gives me a lot of opportunities to affect someone just the way I was affected by good people. For this reason, we also have potential patients from across the country calling the practice, wanting to visit!

Which CE instructors, topics or courses have been especially useful for you?

I take anything related to implants or restorative dentistry. I completed Misch implant training, will be receiving my fellowship this summer, and will be traveling to the Dominican Republic for more implant surgery training with Misch soon. I completed the Dawson Academy miniresidency, and am starting a training at the Kois Center this summer to learn what’s available.

I took a course about facially generated treatment planning at Spear Education. I love Dr. Frank Spear’s teaching and delivery system—I did his online modules, more than 100 hours of CE. I’ve also done some laser training. I’m fortunate enough to be able to learn from all these amazing teachers.

I would probably recommend Spear online for new graduates who might not necessarily be able to travel so much for all the CE. Spear online opened my eyes to never look at a “single tooth.” The more I took CE, the more I realized there’s so much to learn for me to be a complete dentist.

What’s your favorite clinical tech under your roof, and what are you most excited to get into next?

 My practice is still a work in progress. I don’t have all the technology I’d love to have, but I have enough to treat my patients.

A good camera is definitely on top of my favorite tech. We also have a Planmeca CBCT machine, and a diode laser and a CO2 laser. I love the lasers, because most of my immigrant patients are perio patients and we’re seeing quite an improvement when we do scaling and root planing along with laser treatments.

I’m also excited about cosmetic dentistry and implant dentistry, and am at the beginning of my journey in both of those areas. Many patients in my practice will benefit from implant dentistry, because of the lack of access to care early on in their lives, and lots of young patients with tooth loss because of periodontal issues.

Describe your management style, office workflow and team lineup for us. What has been working for you?

I’ve found that staff management was probably the hardest part of dentistry to deal with, so far. My style is very laid back—I’m more of motivator than a manager. We do morning huddles not just about the schedule but also about how to live an impactful life. One of my favorite guides that I use for our morning huddles is a list that appeared in The Four Agreements by Don Miguel Ruiz:
1. Be impeccable with your word.
2. Don’t take anything personally.
3. Don’t make assumptions.
4. Always do your best.

In fact, we’re planning to laminate these and install them in a prominent spot on a glass wall in our office.

 What’s your favorite patient story?

I’m fortunate that I can relate to patients of all walks of life—it doesn’t matter their ethnicity, color, age or gender. When you’re kind to someone, people are kind to you. Frankly, I believe the best way to build a practice is to be kind, which can convert even unexpected people into patients. The building inspector who examined our practice became our patient; the UPS delivery guy who comes to the practice all day, every day became our patient; the guy who did our signage became our patient.

We always offered the mailman water or coffee but never pressured him to become a patient. And then one day, he told us, "I go to all of these dental offices to deliver packages, and they all ask me to become a patient because they know we have good insurance. Your office is the only one that never asked me to be a patient but always is kind to me, so I’d like to be a patient here." That’s a great compliment.
Stream Howard and Fesaha’s recent podcast!
Dentaltown founder Dr. Howard Farran invited Dr. Fesaha Gebrehiwot to be his guest on a new installment of Howard’s podcast, Dentistry Uncensored. Click here to stream the episode.
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