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Office Visit: Dr. Tom Novak by Kyle Patton, associate editor

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Categories: Practice Management, HR and Accounting;
Office Visit: Dr. Tom Novak 
by Kyle Patton, associate editor
photography by Kathy Tran
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.
After spending a quarter-century in the same office, Texas Townie Dr. Tom Novak began planning the practice of his dreams. After numerous delays and a global pandemic, his new 12-operatory facility in Weatherford, Texas, is the culmination of decades of experience, paired with an elegant simplicity that starts at Beacon Dentistry’s front door and permeates every square foot of space.

In our exclusive Q&A, Novak discusses how his love of digital scanning and zirconium has made dentistry more fun than ever, how he once found himself taking part in a wiretap for the FBI to expose a scam targeting fellow dentists, and more.


Office Highlights

Name:
Dr. Tom Novak

Graduated from:
University of Illinois

Practice name:
Beacon Dentistry
Weatherford, Texas

Practice size:
12 treatment rooms

Team size:
2 dentists, 14 team members

How’d you get into the profession?

My brother, 20 years my senior, was a dentist. The profession provided his family with a lifestyle that was very appealing to me. I had that realization when I was a kid. I never felt compelled to save the world from tooth decay or serve humanity; I just wanted to have a reasonable income on a four-day workweek. None of what motivated me would be fit for a dental school application. I had no idea of the incredible personal growth that the profession would provide.


What drives you now?

A dental practice is nothing more than a predictable series of required tasks. The series begins when a person gets a recommendation or lands on a home page. If you’re lucky, that series never ends because that patient remains with you for your career. Each of those tasks, however, can be done elegantly and efficiently or poorly and slowly. The former are sources of pride for me and the team, while the latter are sources of anxiety and fatigue.

No matter what your job is in life, if you’re exceptionally good at it, the world is aware. Whether you change tires, bus tables or fix teeth, the way you approach and perform your work is on display for everyone to see. What drives me are efficiency and velocity—the greatest work per unit time pointed in the right direction.

In 30 years, I’ve never had a patient say, “I feel cheated. I wish that took longer or hurt more.” Sure, you want to make treatment time faster. What about scheduling time, inventory time, checkout time, confirmation time, room turnover time, lab case check-in time, referral time, postop call time? I could go on and on. Efficiency and velocity, coupled with cultivating a team that chants that mantra, matter most to me.


What did you take away from your time serving in the U.S. Navy?

My five years in the Navy were among the best of my career. My wife and I had three of our four kids then.

In dental school, you’re taught to do things one way by a small group of instructors, many of whom have been prisoners of academia their whole careers. In a naval clinic as a young lieutenant, you might be struggling with a procedure and a colleague will stroll by and say, “What are you using that for?” You gain insights from experienced operators and from techniques taught at different schools. You get a full book of patients and you learn to go fast. You get to live modestly but comfortably. You get 30 days of annual vacation and 10 federal holidays. You’ll live in places you never thought you’d visit. If you couple those benefits with loan forgiveness, you quickly understand why it’s a tough deal to pass up.

 So, level with us … are you wearing a wire right now for the FBI? We heard that once upon a time, you did.

The con was directed at dentists via a variety of continuing education opportunities. I went to a seminar that should’ve been $500 but was $95, so I knew there was going to be a pitch. At lunch, a guy stood at the podium and started talking about debentures. Because dentists are always the smartest people in the room, everyone was in command of the subject matter and no questions were asked. The returns on the investment were out of control and my greed gland started to secrete.

I was told I’d be flown out to Salt Lake City, put in a charming hotel and get to see the opportunity in question on the next day. Oh, and my wife could come for free, too! We met the saleswoman for breakfast at a restaurant that happened to be a previous debenture offering from the same genius, then visited the investment facilities. The woman told me the parent company was under investigation by the SEC—but she was cute and the return was great, so I figured, who cares about a little government curiosity?

Later that day, I met with the genius, the CFO and the contractor in charge of building the facilities. After a rundown of my finances, the genius told me the investment was such a fantastic opportunity, I should invest at least $250,000 and whatever else I could spare. A two-inch thick stack of documents was provided for my review and I knew I wasn’t going to read them, but I knew I was moving forward.

That evening, my wife and I went to dinner with another company executive; we had a wonderful time and talked about everything other than the deal. When the check hit the table, he reminded me this was supposed to have been a business dinner, so he thought he should tell me everything he’d want to know as a potential investor. I told him to go ahead, expecting corroboration with everything I had heard that day.

He told me three things: The SEC was investigating the genius and this investment opportunity, the CFO I’d met earlier had been previously jailed for investor fraud, and the contractor had recently filed for personal bankruptcy to the tune of $2 million. Those three facts saved me $250,000.

A week later, an FBI investigator called me. I searched his name and saw him all over the internet, busting con artists and exposing Ponzi schemes. The investigator said he was calling me because as far as the FBI knew, I had been the only person who had visited Salt Lake but not gone through with the investment. He asked if I would have any chance of speaking to the genius again, and, if so, would I do it on a recorded line for the FBI. Of course I would!

I was instructed to contact the genius and let him talk. Narcissistic con men love to talk (true!), so all I needed to do was get him to tell me the rate of return on the investment. (In fact, it had never made a dime.)

I called the genius, feigning renewed curiosity in the investment. He talked for 52 minutes but danced around that fateful number like a prima ballerina; in the end, I didn’t get any damning evidence. So, that genius is still out there, bilking a different population for a different scam. I believe the scam I was lucky enough to avoid screwed dentists of more than $120 million, but resulted in only a $150,000 fine for the genius.


Your new practice involved a lot of planning and prep. Walk us through what went into it.

My thoughts about efficiency led me to David Ahearn and Design Ergonomics. I’ve been a conscientious student of theirs for a long time. They’ve got almost everything figured out as far as efficient workflow goes. Once they put together a floor plan, I built an operatory mock-up in my garage.

COVID-19 hit and plans were put on hold, but that gave me more time to play with variables in the treatment rooms—computer positions, different types of tubing, locations and numbers of outlets, and which of the four monitors display what at any given time. I spent a lot of time designing the twelve o’clock cabinetry and assistant work surfaces.

The treatment rooms are fast, universal and cost effective. Nobody in our office—and I mean nobody—claims a treatment room as his or her very own; there are no diplomas or family pictures in any of them. Any provider can do any procedure at any time for any patient in any room. I’m super pleased with the result, but we’re still working out some kinks. (Then again, I’ve spent my entire career working out kinks!)


Which aesthetic elements are you most proud of?

Paint is cheap, but I love the colors we’ve chosen. We refer to the blue as “Beacon Blue” and it supports the brand throughout the space. We’ve cleverly used some large decals once again to support the brand. We have a nice gurgling boulder fountain outside that patients ask about incessantly.

I think an office can be pretty without installing some 20-foot waterfall in the reception room. I’ve spent no money on elaborate ornamentation. Google reviews often includes words like clean and nice. After all, it’s a tooth-repair facility and not really much more.


It’s not just about form, though—you’ve built in just as many functions. Tell us about the layout and design of the practice.

Space can work with you or against you. We worked well with Design Ergonomics to eliminate—or at least minimize—the bottlenecks.

So, the hallways are wide enough to allow team members to walk alongside the patients rather than in front. The UPS delivery door can be opened from the front desk or by key fob, key code or from my phone. Sterilization is a single-counter workflow. There are three checkout stations, but all treatment rooms are swipe-equipped and we take about 70% of patient payments in the room immediately upon completion of treatment.


What’s your favorite patient story?

I’ve got hundreds, and like anyone who’s been practicing a while will tell you, I should have written them down. They rarely involve dentistry and are usually best told over cocktails!

I did have a patient in the chair for a crown prep a few weeks ago. As I tipped him back to begin, I said what I always say: “I’ve got some vibration and cool water coming at you; if it’s anything more than that, just let me know.” He responded, “OK, I’ll arch my back and clench my buttocks.” I almost fell out of the chair laughing.


Let’s get clinical. What advancements over the years impress you the most?

Scanning and zirconium.

Years ago, you choked a patient with PVS, paid $250 for a PFM that looked only OK, and then waited three weeks to get something from someone working in a hole you’d never want a patient to see. Now I scan and click, and five days later I have a beautiful, virtually indestructible crown for $120.

Although there are a million other advantages to scanning, I think faster, more predictable zirconium crowns should be reason enough to buy.


What’s a must-have treatment option you can’t imagine practicing without?

We don’t place many dental implants but we restore a bunch. I spent too much of my career doing “herodontics”—doing root canals and crowns on teeth that were never going to make it to the 10-year mark. Now it’s extract, implant, crown. The process has become so predictable and durable, it’s changed the way I diagnose and treat.


You utilize video well for treatment planning. How do you do it?

When treatment gets too complex for me during the new-patient visit or if there are aligners involved, we typically make a video. I record the video while I review X-rays and photos—I essentially think out loud and present the treatment just as I would if I were sitting with the patient. I break down fees and provide contact info for our treatment coordinator to answer scheduling or finance questions and for an assistant to answer any clinical questions. I send the Vimeo video to the patient and the treatment coordinator.

This avoids a return visit for the patient and chairtime for me. If patients want to move forward, all they have to do is call. It works very well and patients are typically impressed with the process. For aligner cases, the next visit is to deliver the first aligner. And if a patient waits a year or so to start, I can review the video to remind myself what I planned 12 months ago.
Top Products

Medit i700 intraoral scanner. A fast, high-quality scanner. We have two, and graphics desktops in each treatment room, so all that moves from room to room is one of the i700s and its cable. We love it because the updates are frequent and robust while having no subscription or software licensing fee. The scanner is the gateway to eliminating stone, model trimmers and shipping boxes, while allowing entry into 3D printing, aligner therapy and digital planning of all types.

Nu-Bird suction mirror. It’s a super light surgical tube that terminates in an aluminum female end. Into that end, you plug a mirror that has suction holes in it. The hygienists can’t live without it. I have one in every room permanently. You can also put an adapter or a valve that will accommodate a surgical aspirator or an HVE.

ZeroWater. A $35 Brita-type pitcher that makes “distilled” water for the autoclaves. Pour tap water in and get “distilled” water out after five minutes. We order a five-stage filter from Amazon quarterly for $15. I’ve used this for 15 years in my Midmark M-11s and they still work flawlessly. No distillers, reverse osmosis systems, trips to the store or mountains of inventory.

ZenSupplies. A supply aggregator that puts all your supplies from all your vendors—and I mean all your vendors—on a single page with any associated discounts you might receive from various membership groups and provides the best pricing across vendors. We’ve got supply costs under 4% and now the supply system, with the help of a remarkably talented dental assistant, runs itself.

You were in your old space for 25 years! What were some things you couldn’t wait to do differently with a new build?

Same-day dentistry! In the old office, I had seven rooms and three hygienists, so I had four rooms for myself and it allowed a lot of same-day services.

In 2018, Dr. Garrett Johannsen joined me as an associate and things started to really grow. Upon his arrival, my room availability was cut in half, and as the growth continued, we needed an additional hygienist, which made four rooms of hygiene while Garrett and I split the remaining three. We were stepping all over each other, and no matter what we found on a recall exam, there was no room to do it the same day.

Now we’ve got 12 identical rooms and five hygienists. Most single restorations, we’ll do same day in the same room where it was diagnosed. Before, I didn’t even want to diagnose something easy or quick because it would be inconvenient for the patient to drive 30 minutes for a five-minute filling. It was also incredibly wasteful to have to set up an entire room for a buccal pit. Capacity is king and, for now, we have it in the new office.


Tell us more about your associate.

Sometimes you just get lucky! I made a call to a broker on just the right day and got Garrett’s name. He came out for a talk, driving a rust-colored Ford Edge that had 200,000 miles on it and he was hoping to get 200,000 more. He came across as capable and humble and was immediately loved by the patients and adored by the team. He’s proven to be a great dentist, an excellent communicator and a culture champion. We share an office in the new building and whenever we cross paths in there, something good, funny or insightful happens. It’s a pleasure to work with such a nice guy. (He really should have been at the top of my “must have” list!)


Some docs shy away from the business side of dentistry. Not you. Why do you love it?

I lean into the beauty of business, not the processes. Over time, the team has established lots of best practices, and I won’t fool with them without the team’s permission. There are metrics, however, that describe the effectiveness of any particular business process. I know, for example, opportunities for same-day dentistry are converted 56% of the time. I know monthly visits have increased from about 550 a month in 2020 to about 800 a month now.

Command of the numbers allows for data-driven decisions. It assures you it’s time to add rooms, increase the size of the team or purchase equipment. As a dentist sitting in an office bummed because your work isn’t like what you see on StyleItaliano, or because the dentist down the street just got a new Rivian, the numbers tell you where you are—and, more importantly, where you’re going. They don’t lie. You can hate the numbers you post every month, but you can also change the numbers you post every month. The only requirement is that you know the numbers you post.


Tell us about the office culture you’ve created.

Nothing is more important than the team. I have this posted on the walls in the staff room and above the door of the doctors’ office. Sure, I care about the patients, but not nearly as much as I care about the team.

First, I think everyone wants to play for a winner. Pro athletes will take giant pay cuts and move anywhere in the country to play for a team that wins. Our teams are no different. They want to be paid well, of course, but they also want to feel like they’re a part of something bigger than themselves. They want to feel valuable and they want to feel safe.

It’s like I have 14 sisters. Most of the time, I love them; some of the time, I could kill them; and they feel the same way about me. They do know, however, there’s not much I wouldn’t do to support them. Even better, if I can’t support them, they’ve got 13 teammates who are ready, willing and able to provide whatever they need.

Culture is more important than equipment or office design. It’s more visible to patients than paint colors or parking spaces. It relieves more stress than consultants or bourbon. All you have to do is care for them and remember there’s nothing more important than the team.


What are the keys to hiring well?

Attitude and motivation. I never want to introduce anyone who doesn’t fit the culture, no matter how skilled he or she might be. When someone knows how to play nicely with others, support and trust come naturally. If they don’t fit, things start to rub and chafe very quickly.

When someone once asked Vince Lombardi how he motivated his players, he replied, “It’s not my job to motivate the players on the field. It’s my job to put the most motivated players on the field.” I couldn’t agree more.


How does your team compare now to when you started?

I began with a single assistant and a receptionist in 1996. The assistant had worked at the practice for 18 years before I arrived, and remains with us to this day. I try hard to get the team together outside the office as much as is reasonably possible. The team is different outside the office—they wear makeup, they dress in something other than scrubs, and they actually have a life outside of dentistry! Happy hours and distant CE opportunities cultivate conversations among the team that bond them in a way the practice itself cannot. I love it when I hear some of them got together over the weekend or they’re sharing hand-me-downs between their children. I support anything that builds friendship and understanding among the team.


Give us a snapshot of your life outside of dentistry.

My wife of 33 years and I have four kids and two dogs. When I’m not in the office, we spend a lot of time visiting the kids and tending to the affairs of the youngest, a high school senior. We’re beginning to travel a lot more as our nest empties. We do a lot of work in our backyard and manage to stay engaged in town with civic and church volunteer positions. We also help at an inner-city dental clinic where we take out teeth twice monthly. If we’re not doing any of that, you can find us on the back porch with glasses of wine.

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