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The Secret to a Scratch Practice by Dr. Howard Farran, DDS, MBA

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The Secret to a Scratch Practice  

A no-money-down approach that uses guerilla marketing to fill the schedule

by Dr. Howard Farran 

Almost 40 years ago, on September 21, 1987, I opened my own Today’s Dental office from scratch in Phoenix, Arizona. I graduated on May 11, 1987. It took 133 days to find a place to rent, build out a dental office, and open—just 28 days before the day so terrible it will forever be known as Black Monday. On October 19, 1987, the stock market collapsed 22.6%, the biggest one-day percentage loss in history.

My three new employees—an assistant, hygienist, and receptionist—all panicked and said, “What are we going to do?”

I laughed and said, “Are you kidding me? People will still have teeth and need a dentist a million years from now.”

Starting a dental office with little to no money down can be challenging, but here are some creative approaches and resources to help make it possible.


First up is demographics
Success in a dental practice is not just about your clinical skills—it’s about understanding where those skills are needed the most. I grew up in the Sonic Drive-In franchise days. Finding a new location was very important. My dad took me to several seminars on how to find the best location. So, while I was still in UMKC dental school, I got a six-foot by four-foot map of the Phoenix metro and glued it to a cardboard mat. I traced the 1,000-plus census tracts on the map and made a 5"x7" index card for each census tract. I got a list of all the dentists from the Arizona State Board of Dental Examiners—all through U.S. snail mail, I might add. There was no internet or personal computers at the time. In fact, at that time, the Dead Sea wasn’t even sick.

I placed a pin for each dental office: blue for oral surgeons, green for periodontists, orange for orthodontists, white for endodontists, and black for general dentists. For each census tract, I wrote down the average household income, figured out the dentist-to-population ratio, and noted the number of cars. Basically, I tracked everything they were monitoring in the 1980 census and the 1985 mini census.

I found the best zip code at the time. It was 85044. It was a nice upper-middle-class area in Phoenix, Arizona, that had the highest ratio of people to dentists. It was 1 to 6,000, with a $60,000 median household income. It was so amazing that I didn’t go back home to Wichita, Kansas, where I couldn’t find anything half that good. The growth was amazing, building over 90 new homes a month. I knew I couldn’t go wrong because a mature market had 1 dentist for every 2,000 people, and this was three times that ratio.

Next up, I called Caldwell Banker and asked what commercial property was available to lease. I did not want to go to a medical professional building because you have no visibility. If you couldn’t see it from your car window while driving by, how would you know there was a dentist there? Fast food franchises like Sonic Drive-In insisted you were on a major four-lane intersection. There was a 16-acre Safeway grocery store/Walgreens/Chase Bank/Pizza Hut center that had a thousand square feet of space I could rent. They wanted $15 a square foot for a three-year lease, which is worth $45,000. I said I would rent it for $20 a square foot for a five-year lease, which is worth $100,000, if they would do the build-out. They took the deal.

I went to the dental supply dealer Healthco Dental Supply Company, once a prominent dental equipment and supplies distributor with over 100 storefronts nationwide, including Phoenix, Arizona, which ceased operations in the early 1990s. Healthco designed the four-operatory dental office and filled it to the brim with all the latest technology of the time, supplies, and equipment on a five-year, 60-month lease-to-own. When I made the last payment, it was all mine.

Last but not least, I had a job working full-time at Sunshine Dental Office, which was open from 7:00 a.m. to 10:00 p.m., seven days a week. So, whenever my office was closed, I worked at Sunshine Dental, which was the brainchild of Dr. Ed Silker. He owned four locations at the time. He was a true dental pioneer.

So, there it is. Here are some other steps you might consider:
  • Secure a Small Business Loan - SBA Loan: The Small Business Administration (SBA) offers loan programs specifically for healthcare professionals with lower down payment requirements and favorable terms. Some banks also offer loans designed for new dentists.

  • Specialized Healthcare Lenders: Some lenders focus on healthcare and offer loans with 100% financing, which may cover both equipment and operational expenses.

  • Look for Free or Affordable Practice Space: Some dentists start by sharing space with another dental office to reduce overhead.

  • Utilize Community and State Grants: Certain areas, particularly rural or underserved communities, may offer grants or loan forgiveness programs for dental professionals who set up practices locally. I interviewed several dentists on my podcast who did this.

    •
  • Consider Business Credit Cards for Short-Term Expenses: Using business credit cards responsibly can cover initial expenses like supplies or office furnishings. Look for cards with introductory 0% APR offers to avoid immediate interest charges.


Reduce your initial setup costs
Start small with essential equipment and expand as revenue grows. Many dentists begin with just one or two operatories to keep initial costs down, adding more as they build their patient base.

Starting a dental practice with minimal capital requires careful financial planning, but with the right approach and partnerships, it’s feasible to build a successful practice over time.

Guerrilla marketing is an unconventional, low-cost marketing strategy aimed at creating maximum impact and attracting attention through creative, unexpected methods. Unlike traditional advertising, guerrilla marketing relies on surprise and spontaneity to engage the public in memorable, often interactive ways. It’s designed to be bold, surprising, and highly memorable to create a strong impression and drive word-of-mouth.

Guerrilla marketing is effective for brands with smaller budgets or those seeking to break through the noise with a fresh approach, especially when targeting younger or social-media-savvy audiences.

When I opened up my Today’s Dental practice in Ahwatukee (which is technically Phoenix, Arizona), I went door to door with my then-wife Judith, knocked on every single door, and introduced myself and my wife. We told them we had just opened our practice and were looking for new patients. About every third door said they needed a dentist. It took us about six months to knock on all 10,000 doors.

Here is the map we took with us as we crossed off every street we covered.
AhwatukeeMap


Ahwatukee has an Easter Parade every year, so we made a float. I led on my unicycle, throwing out toothbrushes to the crowd with our name and phone number on it, while the staff waved at all the people.

Whenever Ahwatukee has a parade, a fair, or whatever, we would have an outdoor clinic handing out brochures and answering all dental questions. Only my dental office and the local chiropractor ever participated. Not one physician would ever do it. We got so many new patients from this—it was crazy!

I still say to this day that the best marketing anyone can do is to have your own freestanding building on a major intersection. After my five-year lease expired, I bought the pad in front of my office and built a 3,800-square-foot building with eight operators.

Author Bio
Dr. Howard Farran  Howard Farran, DDS, MBA is the founder and owner of Dentaltown.com and Dentaltown magazine. Connect with him on the Dentaltown message boards or on social media.  Facebook.com/HowardFarran/
Instagram.com/howardfarran/
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Linkedin.com/in/howardfarran/
Youtube.com/howardfarran
 
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