Office Visit: Dr. Irving Chao by Sam Mittelsteadt, editor & creative director

Office Visit: Young Blood 

by Sam Mittelsteadt
photography by Lori Eanes


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.

Dr. Irving Chao had been primed for success from an early age: His parents enrolled him in SAT tutoring while he was still a middle school student and (perhaps not so gently) nudged him toward a vocation in math or the sciences. But a career in front of a computer keyboard held no appeal for him, and Chao ultimately was able to parlay his interest in ceramics and glazing into a new medium: teeth.

After attending University of Pacific’s Pre-Dental Advantage Program—an accelerated program in which he earned his DDS in five years instead of the typical eight—Chao signed up to work at a DSO but quickly discovered he’d be working under an abusive manager, the first of his experiences in how not to run a dental practice. Eventually, however, the young dentist purchased his own practice in Salinas, California, where his clinical and practice management skills earned such a reputation that another local doctor hand-picked Chao to take the reins of the large practice she hoped to sell before she moved to Arizona.

Their relationship didn’t end there; she also taught Chao about buying investment properties, including medical/dental real estate buildings in the Phoenix metro area. One day, his real estate broker mentioned a Phoenix listing for a dental practice and its real estate, an opportunity that inspired Chao to consider owning practices in two different states. Imagine his surprise when he discovered the practice in question was Dr. Howard Farran’s Today’s Dental!

In our exclusive Q&A, Chao also explains how he identifies the right associates for his growing practices, what Gen Z team members are looking for from their employers, and more.

Office Highlights
NAME:
Dr. Irving Chao

GRADUATED FROM:
Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco

PRACTICES:
Salinas Valley Dental Care, Salinas, California

Today’s Dental, Phoenix

PRACTICE SIZES:
Salinas: 7,100 square feet,
15 operatories

Phoenix: 3,500 square feet,
8 operatories

STAFF:
Salinas: 6 doctors, 7 hygienists,
15 assistants, 12 members of business team

Phoenix: 2 doctors, 2 hygienists, 4 assistants, 4 members of business team

How did you first become interested in dentistry?

Coming from an Asian immigrant family, there is definitely a strong push toward math and the sciences—my father is an electrical engineer and my grandfather was a mechanical engineer. But I didn’t want to sit in front of a computer all day programming or designing computer chips, and I didn’t want to work in a hospital where I had to work all hours of the day. One thing I did enjoy was creating things with my hands: I took art courses in high school where I created porcelain cups, plates and bowls, and I was fascinated about characterizing ceramics with stains and glazes. I interned at a dental office during my summer breaks in high school and loved everything about it.


You attended an accelerated program in which you finished college and dental school in just five years—did you find that pace difficult, or did your parents’ prep work really help out there?

I was lucky to decide on dentistry early on, and the University of the Pacific’s accelerated program was going to get me there the fastest. I attended a math and science high school, which prepared me for the five-year program, but I had to grow up very quickly and learn people skills. Sure, I could take tests and prep a tooth, but it was more difficult for me to establish rapport, to be confident in presenting treatment plans and to manage difficult patients as a 20-year-old in clinic.


What was your first job after graduating?

I graduated during the housing market crash of 2008, so not a lot of places were hiring except big corporate chains. I was thrown into treatment on the first day, with no onboarding training.

The chain I worked for sponsored green cards for foreign-trained dentists and made them sign contracts that were several years long, with large penalties if broken. The regional director, who came by once a week, would find a reason to berate or fire someone and scared everyone into submission—he knew he could behave this way because the dentists had to stick around until they fulfilled their contracts or risked being sent back to their native countries.

I was promoted quickly to managing doctor not because I was more clinically skilled than other dentists, but because I spoke English without an accent. Even as a managing doctor, the director continued to harass me and even called me a “worthless piece of trash” who was lower in rank than the office janitor.


How could you stick around in that situation?

As a new-grad dentist, I didn’t know what I didn’t know! I wasn’t one to take risks or to try difficult procedures, and I had no one to show me the ropes so I was basically learning as I went. I left the corporate chain as soon as my two-year contract ended and found an associate position in a beautiful private practice in the suburbs of San Jose, California.

I thought I had won the lottery; it was the complete opposite of the corporate chain. No bulletproof glass separating patients from the receptionist. Beautiful granite countertops and plush leather chairs in the waiting room. The clinic area had new equipment and the owner doctor seemed friendly. I was excited to have someone teach me how to be a dentist in private practice.


And yet, you went from the proverbial frying pan into the fire.

Not long after I started the associate position, the office manager started pushing me to do more treatment. They set a goal for me to produce $4,000 per day. I was happy because I was consistently making a $650 base salary and the doctor gave me $50 for every Invisalign start. It seemed, though, that no matter what I did, it was never enough production.

The owner doctor didn’t mentor me; he didn’t give me guidance. When I had to redo a crown, he deducted the lab fee from my salary. I once had a patient complain and ask for a refund; the owner doctor refunded the UCR fee to the patient and subtracted the entire thing from my paycheck— almost three days’ worth of work!

My partner, Matthew, kept encouraging me to quit. He said, “We can do this on our own.” So when the office manager came to me again and told me I needed to produce even more and hit even higher goals, but didn’t offer an increase in my daily rate, I quit.


And then, relatively quickly, you ended up owning two practices in Salinas.

I bought my first practice in January 2014 from two retiring dentists who had been producing just over $1 million in six operatories. I was nervous about buying such a big practice, but Matthew and I took the challenge head-on together. We had a goal to be the opposite of big dental chains and the previous private practice I had worked for—we wanted to be the best place to work and create a great culture. Wow, was that a challenge! Staffing is always challenging, but we began honing our skills about identifying who would be a good fit and who wouldn’t.

After two years in that location, we quickly outgrew the space. We started thinking about where we could build an office, but there weren’t a lot of options. Then, one day out of the blue in the fall of 2016, we received a generic letter typed on nice ivory-colored résumé paper, describing a large dental practice in the area for sale. We thought, “We’re not ready to buy another practice” and tossed the letter in the trash.

Two days later, we received a phone call from Dr. Jennifer Wynn’s husband, asking us to come tour their “implant facility.” We had heard that Wynn Dental Care was beautifully built, so Matthew and I decided to meet with Dr. Wynn and tour her office to get ideas for a remodel.

We met Dr. Wynn and her husband on a Monday night after work. The building was huge—in fact, we later learned it was 7,100 square feet. Dr. Wynn took us on an hour-long tour of the space, showing us all the details she included and why she did so. We were in awe. Then, after we returned to the starting point of the tour, Dr. Wynn looked us straight in the eye and said, “I’m moving to Arizona, and I think you should buy my practice.” Unbeknownst to us, Dr. Wynn’s husband had sent that letter!

We shot back, “Sure—as long as you sell us the building, too.” She said, “Great. Let’s close on New Year’s.” We had a handshake agreement, and really did close the deal on Jan. 2.


This was your first experience having a more experienced dentist work as an associate in your practice. Was it difficult for you to be taken seriously, given you were still quite young?

In 2016, we had started to grow very quickly and started looking for an associate dentist who could help out a few days a week. A local dentist had lost his license and his associate needed a new dental home, and we thought she would be great because she’d been practicing locally for 17 years. We hired her assistants, too, and she started working three days a week.

Because she’d been practicing the way she preferred for so long, it seemed like she wasn’t interested in trying new materials, learning new technology and techniques, or changing the way she practiced to fit the model I was aiming for in this office. And the fact she was being mentored by a doctor who 20 years younger than she was probably didn’t help, either.

I thought, “This is not a good fit for the culture we’re crafting. We want someone who is moldable and eager to learn.” I hired my second associate right out of her residency at the local Veterans Affairs medical center. She implemented everything I taught her and didn’t question it, and all the staff loved her. The proof is in the pudding: Between them, our two practices have eight associates and 65 staff members, and production increased from $1 million to more than $9 million.


When a practice grows that large, how tightly do you hold the reins, and what do you think keeps associates around without the opportunity to buy into the practice?

As the practice continued to grow year over year, we established systems and a leadership team. We are a big proponent of hiring great people and letting them lead.

Shortly after purchasing Wynn Dental Care, we hired our first operations manager. He had been in the dental field for 15 years, is great with people and knows most of the moving parts of the dental office. We gave him a lot of freedom to make decisions and to coach and mentor the team.

As far as associates buying in, we’ve asked many times and none of them are interested. So we started profit-sharing with them. We wanted to reward them for their hard work and for taking care of the team and our patients.


TOP PRODUCTS
Dentsply Sirona CAD/CAM Primescan, Primemill and Speedfire oven. The scanner picks up full-arch scans in a matter of minutes, the design software makes delivering a sealed and strong restoration very simple, and the oven processes both zirconia and ceramics quickly.

Kuraray Noritake Clearfil Tri-S Bond Universal Quick Adhesive, Panavia SA Cement Universal and Clearfil AP-X ES-2 Universal Composite. All work very well together in making sure beautiful direct and indirect restorations last. I’m also able to cut down on inventory because the bond and cement work on all types of restorations and surfaces.

MouthWatch intraoral cameras. These are very cost-effective and take great close-up pictures to show patients during exams.

Dentsply Sirona Axeos CBCT. Both 2D and 3D images are clear and the acquisitions are fast. This software makes navigating complex root canals and planning implant surgery simple.

DryShield. When an assistant calls out sick, DryShield has saved our schedule by providing reliable suction and retraction during restorative procedures.
It sounds like you’re a big proponent of staff training and development.

We’ve worked with a handful of consultants over the years. Our first was a local retired dentist who helped with the transition. He told us what not to do as a new owner. We also worked with Jameson and, most recently, with Scheduling Institute. SI has been awesome for our team! The trainers are full of energy and so engaging.


Today, in addition to practice, you travel as a speaker about your best practices for hiring and managing employees, particularly members of Gen Z. What tips can you share with readers?

I spoke at two conferences in 2022 about how I hire and train new graduate dentists. We’ve tried different behavioral assessment tools over the years, including the DISC and the Drake P3, but the Kolbe A Index has been the biggest help. We can identify key traits in our doctors—how they deal with risk and uncertainty, how they gather and share information and how they follow systems. We look for doctors who are most like me: They don’t try risky procedures, they don’t try to change the systems and they follow directions. All our associates have similar Kolbe index scores.

I’ve also created a culture video we use on our hiring page on our website. It’s a short clip that shows who we are, what we value and how we give back to our community. It allows potential new members to see us in action and get a sense of who we are.

I’ve learned that the younger generation needs more communication. Our leadership team schedules regular check-ins with each team member to review the things they are doing well and to offer praise for their accomplishments. This is also a time to set goals and to give them feedback on how they can improve.


Your journey to buying a practice in another state started through one of your side gigs: commercial real estate.

After we met Dr. Wynn and her husband, Tony, they shared with us their investing strategy of buying medical and dental buildings in the Phoenix metro area. We followed in their footsteps and bought the real estate of two general dental offices in the Valley of the Sun.

In 2022, Matthew and I bought a townhouse in Phoenix ourselves, thinking we’d spend some of our free time there. Shortly thereafter, our real estate broker called and said, “I’ve got a deal for you: a beautiful, free-standing building on a busy street corner in the Ahwatukee Foothills neighborhood of Phoenix.” We drove down to see it the next day and when our broker mentioned that the practice was also for sale, we decided to buy both.

After signing an NDA, we were able to tour the practice and found out that it was Dr. Howard Farran’s famed Today’s Dental! We made an offer on both building and practice, and they were accepted.


Now you’re balancing businesses in two states. What’s your typical workweek like (if there is such a thing)?

I’ve stepped away from chairside dentistry. My typical day involves meetings with consultants and our marketing team. I’ve been focusing on ongoing training with the doctors at Today’s Dental and our treatment coordinators. California and Arizona are polar opposites when it comes to employment laws! On top of that, our regional manager, Timmi, works from home in Oregon. Thankfully, we have an awesome human resources company, Bent Eriksen & Associates, that keeps us compliant with the ever-changing rules in all three states.


You’re not quite one year into this new practice mix. What lessons have you learned along the way, and what’s on the horizon for you?

It was a challenge expanding into another state without having my core team of people with me. This first year has been focused on building that team of people in Phoenix.

We’re currently working to centralize some of the processes to support both offices. We recently hired a revenue cycle manager to make sure the entire accounts receivable process keeps on track. Our next goal is to continue to build out our training platform with more online videos and corresponding written workbooks and to teach it in a way that our team can easily learn. We want to build a strong foundation so we will be ready when the next practice comes along.

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Email: sally@farranmedia.com
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