Office Visit: Dr. Mitchell Mactier by Kyle Patton

Office Visit: Dr. Mitchell Mactier 

This Townie recaps the biggest steps in launching a successful startup in one of Houston’s up-and-coming spots


by Kyle Patton
photography by Al Torres


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.

Dentistry often finds itself at the crossroads of old and new. Old values, new technologies. Old traditions, new methods. Dr. Mitchell Mactier’s Houston practice is a perfect example of joining the tried-and-true with the up-and-coming. Mactier, then only a handful of years out of school, broke ground on a scratch practice in a part of town also at a crossroads—a historic neighborhood experiencing a retro refit and a cultural renaissance. Tailored to fit and blend, Mactier’s practice is enjoying continued growth and the doc behind it has his eyes on expansion.

In our exclusive Q&A, Mactier talks about the milestones involved in starting an office, how to marry the old and the new to craft a quality brand, and how he—and other docs—can best plan for future successes.



Office Highlights
NAME:
Dr. Mitchell Mactier

GRADUATED FROM:
Boston University; 
The University of Texas School of Dentistry at Houston

PRACTICE:
Smyl Dentistry, Houston

PRACTICE SIZE:
2,300 square feet

TEAM SIZE:

How did you find your way into dentistry?

Growing up, I was always in and out of the dental chair. I had many problems with my teeth and I became very familiar with different aspects of the dental world at a young age. When I was 16, I broke most of my front teeth in a wakeboarding accident. My teeth were pieced back together using composite, but from that moment forward, I didn’t smile very much.

A couple of years later, I got a full-smile makeover. That changed my life, changed how I felt about myself and I saw from a firsthand experience how life-changing dentistry can be. It was at that point I knew I wanted to go to dental school with a heavy focus on cosmetics. I wanted to help change people’s lives in the way that my life was changed.

Tell us about your practice.

We opened in April 2021, right after the pandemic was coming to an end. We are located in a trendy and fun area of Houston called the Heights. It is a well-known area experiencing a resurgence. We are surrounded by tons of great restaurants, bars and local shops. We are in a development called MKT, which is a unique and custom-crafted space. Our practice nicely reflects the surrounding style. I love design, art and being creative, so opening in the Heights was a perfect fit for us to create our dream practice.

What were some of the more challenging decisions you had to make early on?

I’ve been out of school for almost five years and this will be my third year at my practice. One of the most challenging things was picking a location that would be the home of my startup—especially in Houston, where there are so many awesome areas. Investing a whole lot of money into a single area is daunting, but we felt peace in the Heights.

From there, it was hard picking out everything needed for a dental office, from supplies to office decor to systems. I had some helpful mentors guide me along that stage, but I suggest doctors pick systems and supplies that work for them and just go with them! You won’t be 100% ready first opening your doors, but you can be as prepared as possible. I remember waking up at 3 a.m. the night before our first patients and getting to the office to make sure everything was perfect. Now, the team is surprised if they even see me at a morning meeting.

Before opening Smyl Dentistry, you—like so many dentists—were working as an associate. How did you know when it was time to make the transition?

I knew it was time to transition out when COVID-19 hit and I didn’t work for about three or four weeks. It gave me time to think and plan for what I wanted my future to look like. It also gave me time to explore the area where I lived and find a space that would be perfect for me. Once that idea of starting a practice got ingrained in me, it was off to the races.

We picked a name, created a branding packet, designed a logo, did all the legal work to form the entity Smyl Dentistry and found our location. I continued as an associate until a month out from opening my office. My employer was very gracious and let me continue working even though I was on my way out.

Working as an associate for three to five years is wise before starting a practice. Make sure you actually like dentistry and find which area(s) you’re passionate about. Learn about the current office you’re in, ask questions about the systems they use and why, and then take that knowledge and apply it to how you would like to practice.

You had to decide between buying out an established practice and starting your own. What was that internal discussion like, and what was the final deciding factor?

In short, the deciding factor was I wanted to create and build my dream instead of buying someone else’s. That is always a tough decision because each comes with pros and cons. Buying an established practice means you already have a patient base, you have cash flow, you have a team. You just need to find a way to finance the practice acquisition. But with that comes buying something that’s been around awhile, which may mean systems are outdated or the team is stuck in their ways. Also, patients may not like the transition to a new doctor or any other problems the practice currently has.

With a startup, it’s a bit riskier because you’re starting with no patients and no cash flow. I wanted to create something from scratch, not buy into someone else’s creation. I wanted to take the chance that starting from scratch would, in the future, give me full autonomy over the practice. For the first six months, I did hygiene before adding the first hygienist. Now there are two and I’ll be looking for a third at the end of this year.

You especially love full-mouth makeovers/rehab cases. What tips do you have for docs who want to do more of these or want to feel more confident in getting patients to accept these kinds of treatments?

Find a good lab that you trust and communicate with them. Take courses from them and build good relationships. I have had a relationship with Arrowhead Dental Lab for five years and I have met technicians I like to work with. These technicians dial in the aesthetics I love and know exactly how my cases will turn out.

Learn about new materials and preparation designs to maximize veneer/crown retention while also prepping as minimally as possible.

Be passionate about why you like cosmetic dentistry. Have a story or a great patient story. Give patients the personal side of why you like doing smile makeovers. They’re about to spend a lot of money, and they’re comforted by having someone do the work who is very passionate about what he/she is doing.

Every case is different. There are times when I have seen dentists overpromise and underdeliver, and that’s when patients get upset. Also, it’s important to have a conversation with patients about everyone’s expectations and what steps can be taken to meet those expectations.

Speaking of … do you have a favorite patient story?

I do! My favorite patient is named Jay. A 57-year-old man, he came to us for a broken tooth that we fixed with a root canal and crown.

During the initial visit, we got to know him and found out his wife was slowly dying because of holes in her lungs. She was on a respirator 24/7 and Jay was responsible for taking care of her. They had been married for countless years and were best friends. One day, Jay looked at me and said, “After she passes, I just want to be able to smile again.” He had broken-down, worn teeth and was considering taking them all out and getting dentures. Instead, we created a plan in which we would restore all of his teeth and give him his smile back.

Jay’s wife passed away toward the end of 2022. We then proceeded to do 28 upper and lower zirconia crowns with an increase in his VDO by 2 mm. This was broken out into two phases— doing the upper teeth first and finishing with the lower teeth.

During this process, I told Jay, “When we get you smiling again, I want to take you out for beers.” We got to share some drinks a few months ago and it was the greatest feeling to see him smile again!

Jay will always be a patient I remember for a few reasons. Firstly because of how kind he was, secondly because of how complicated the case was and, last but not least, that first moment I saw him smile again.
Office Visit: Dr. Mitchell Mactier
Before
Office Visit: Dr. Mitchell Mactier
After


A long-term goal of yours is to expand to three practices. How do you plan on going about that?

I’m always keeping my eyes open for new locations in Houston or different areas I would like to go to. I think a good way to live is to always be ready. You never know when a good place will be open.

For me, “being ready” means maintaining a good relationship with my bank if I need funding and keeping my first practice growing so that when the time comes, it can run without my being there. For a second or third practice, I wouldn’t mind purchasing an old office and just rebranding it. Almost like flipping a house.

A strength of yours is using social media as your main marketing. What kind of posts or content translates to new patients?

I started with a personal page as a doctor that I used to build my name around Houston. It was more of a lifestyle page that showed cosmetic cases, funny reels and day-to-day life. When starting Smyl, I used that to get the word out that I was opening a practice. From there, I created Smyl’s own Instagram page, which is the one I use now to showcase our office, team, cosmetic cases and our practice culture in general..

I chose to switch the focus more to my practice’s page than my personal page because at the end of the day, it is the practice that I want to flourish and grow; I just want to be part of it. I want people to know Smyl and not just me. Build a culture and online presence that can function and be successful without you, the practice owner, having to be front and center.

Some other tips: Most Instagram users don’t like the technical/superdetailed posts about dentistry; they like seeing funny/relatable videos, snapshots of your practice culture and beautiful before-and-after photos. Posting a photo of your latest root canal that is perfectly 1 mm from the apex may not be the most engaging content on certain platforms. (Post that to Dentaltown, though!) But a smiling team photo or introducing your team online may be a better way to engage your audience through traditional social media platforms.

Top Products
MEDIT SCANNER
I like how easy it is to use. It is open software, meaning you can use it with basically any system. The company keeps updating the software and adding new elements. There is no monthly fee to own the scanner.

SPRINTRAY PRO S 3D PRINTER
A great way to make nightguards very profitable for your practice. After the initial investment, nightguards cost less than $10 to make after you design them on the Medit scanner and print them in your office.

NET 32
A great way to shop around and find the lowest prices on day-to-day disposable dental products. One of my philosophies is that items that are thrown away or don’t stay in a patient’s mouth should be sourced as cheaply as possible. Invest in quality products that stay with the patient (crowns, filling materials, bonding agents, implants, etc.).

ZYRIS ISOLITE
One of the items I can’t practice without. It makes dentistry so clean and efficient. Enhances the time needed to do certain procedures and lessens the amount that an assistant needs to do.

NEXHEALTH
Online scheduling is pivotal to my practice. NexHealth also provides Google review links and forms for patients to fill out. I like this company because it is always innovating and updating its systems to try to enhance its process. The software gives patients the ability to see our availability and schedule without having to call our office.
Technology is a big player in your practice. What are your must-haves and why?

Technology is big for me. My main must-have is by far my Medit scanner. As a startup, you want to find items that work well without breaking the bank. I also don’t like being tied into using a certain system where you have to pay a monthly fee just for owning the machine. I like open-technology items that enable you to work or integrate with many other systems. The Medit was perfect—works with any lab, no monthly fee, is easy to use and is fully customizable. Currently, I have two Medit scanners, one for hygiene and one for restorative.

Secondly, I love my 3D printer. We can print nightguards, surgical guides and models. Saving $100 on lab fees for every nightguard adds up quickly.

I also can’t practice without the Isolite. It makes dentistry so clean and streamlined—you don’t always need an assistant in the room suctioning.

A startup—or any practice, for that matter—should have those pieces of equipment for added efficiency and profitability.

Walk us through your investment philosophy when it comes to this part of your practice.

Sometimes less is more. I feel like dentists get into trouble when they get sold on buying all the new fancy toys that aren’t necessary. Find the things you truly want, things that will add value and efficiency to your office. Shop around. Use sites like Net32 or join a dental purchasing group to help save on costs. We run around 50% overhead, and that is largely because of savings on supplies, low-cost equipment and fast appointments. Also, ask your team what things are nonnegotiables and which items are wish-list items. Keep that list and at the end of the year, if you need tax savings, see which items can fit that list.

As you’re still relatively new in private practice, there must be some clinical toys you haven’t added yet. What do you think you’ll get next and why?

I would like to get into same-day crowns, but with a three- or four-day turnaround time on Bruxzir crowns from Glidewell, it’s not high on the list yet. But someday. I would like to wait until milling and printing times are faster for both Emax and zirconia. Technology has come a long way in the past five years, and I think it will just continue to grow and be optimized.

How do you hope the profession will evolve over the next 10 years?

I think we will continue to get more digital. Milling crowns in the office will become faster and more efficient, lessening chair time for patients. More DSOs will emerge and take over. Private practices will become more valued by patients for their customer service and patient care, instead of being a patient at a DSO where you see a new doctor every time and you don’t receive the quality of care that most private practices provide.

What has been the most valuable piece of advice you’ve received?

Don’t take dentistry personally. This job is hard, starting a brand-new practice is hard and managing a team is hard. Doing all those things at the same time is even that much harder. Try not to let dentistry define you; let it be your job and not who you are as a person. Dentistry can be very lonely, and I have been through seasons where it was very hard. Find colleagues who support you and find a great counselor to help walk through life with you.

Give us a snapshot of your life outside of dentistry.

By the time this article is published, I’ll have a month-old baby girl! I enjoy working out and trying out restaurants in the area where I live. I enjoy grilling steaks on my rooftop with a glass of wine and watching the sunset. So currently, I am just trying to be the best father and husband I can be while enjoying the simplicity that life can bring.


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