How does someone emerge as a leading voice within a profession? For Phoenix-based orthodontist Courtney Dunn, DDS, MS, it took one 1,000-word blog post.
Last year, Dunn wrote a guest blog for Orthopundit and in the post asked the question: Does AAO membership matter? The post called on the organization to focus less on selling itself via its consumer awareness program (CAP) and more on member advocacy, whether that be better representing member interests when negotiating with insurance companies or addressing the student debt burden before future members find themselves underwater. It also called on the AAO to revise its leadership structure, placing an emphasis on increasing its age, gender, and ethnic diversity. Moreover, she made the argument that “It shouldn’t take you your entire career to become a major player in the AAO.”
Only 12 years into her career, Dunn took the AAO’s “My Life, My Smile” public relations campaign to task in the post, arguing that it was expensive and ineffective. Dunn pointed out that she had “yet to have one patient in my office from this campaign.” Moreover, in her words, the campaign had failed to educate consumers, even ones who should know better, on why they should seek out an orthodontist rather than a general dentist who also does orthodontics.
At the end of the post, Dunn conceded that she was keeping her AAO membership because she believed there still was a role for the organization to play in its members’ careers; however, she put the organization on notice that she would be watching to see how it proceeded and how it kept itself relevant to the needs of its members.
The Progressive Orthodontist picked up the post and Dunn soon heard from colleagues far and wide that she was not alone in wondering why she should continue her AAO membership.
In part, the post grew out of the economic reality facing young orthodontists like Courtney and her husband Matt Dunn, DDS, MS, in the aftermath of the Great Recession. They, like many of their peers, had fought their way through that period, emerging with battle scars that made them sensitive to how every dollar was spent.
When Dunn completed her residency at the University of Michigan in 2004—3 years before the recession hit—she and Matt, like many of her contemporaries, assumed career success was a given. The Dunns had laid out a plan to return to her native Phoenix and open a joint practice. As she remembers it, “The prevailing sentiment [at the time] was just open wherever you want to go and patients will come. There really was never a feeling that you shouldn’t go [to a market like Phoenix] because there were a zillion dentists and orthodontists. The attitude was: there’s always room for more.”
Still, Dunn had to wait another 2 years to execute the move as her husband Matt, who had worked as a general dentist during her residency, was taking his turn at completing his orthodontic residency at Michigan. In the meantime, Courtney worked at a Michigan-based dental service organization (DSO) to support her family, which then included the couple’s first two children. While her goal had been to find an associate position at a private practice, during which she would build the skills needed to open her own private practice in Phoenix, the reality was no one wanted an associate who would only commit to 2 years and who had every intention of leaving.
“As a resident, you don’t think about it from the owner’s perspective,” says Dunn, adding that residents would be well advised to consider a practice owner’s needs and wants along with their own.
Thus, the DSO’s offer of a 2-year initial contract fit perfectly with her timeframe. The DSO experience also offered Dunn an opportunity to build a different skill set than she likely would have built in a private practice setting. As she was tasked with seeing a larger volume of patients than she had ever seen in residency, her procedure speed improved significantly. In addition, she traveled within the company to a number of different offices, which exposed her to the good and the bad. In one office, she replaced an orthodontist who had been a poor clinician and had left many unhappy parents in his wake.
“I had to figure out how to smooth things over with parents. They would look at me and ask, ‘Why are you telling us, [our child] has another year of treatment?’” she recalls. “I honed my people skills because I had to deal with a lot of unhappy people.”
The Bubble Burst
Dunn believes that if she and Matt had been ready to open the doors of their Phoenix practice in 2004 they would have been better off come the recession in 2008. “Things were starting to slow down [when we opened in 2006], but the crash hadn’t happened yet. We were really naive to think it was going to be fine,” she says.
The fact is when they opened their doors in 2006, referrals weren’t streaming through the doors. Instead, the Dunns were met with the same refrain over and over from local dentists: “We refer to so and so. There’s a ton of orthodontists and we don’t need another one.”
“It was a shock to the system. You live in a bubble when you are in residency. You don’t really know. It was surprising; but it shouldn’t have been,” she says.
To survive, the Dunns, sure of their clinical skills, focused on building their business and marketing skills. As a result, they not only survived the recession when many other practices in Phoenix failed, but they built a successful three-office practice.
Despite the happy ending, Dunn hopes residents and newer orthodontists keep her whole experience in mind as they pin their hopes on finding success in overly saturated markets like Phoenix.
“It still blows me away how many people say I’ve narrowed it down to two areas—usually southern or northern California. I say, ‘Are you kidding me? Those are among the most saturated areas in the United States.’
“I would say if you are opening from scratch, you need to know what you are getting yourself into. Really research the area. If you have a lot of dentists saying we don’t need you here, it’s fine if you still want to open there, but know it’s going to be harder than you think. You are going to make more sacrifices than you think. It’s going to cost you more than you think. It’s going to take longer than you think. You will potentially make less money than other people. You will be working harder for every dollar you earn. If you are set on that area, just know that you will make more sacrifices than others,” she cautions.
Furthermore, she stresses the importance of focusing on the business aspects of the practice, as she and her husband did during those difficult early years. “It’s a business, and you have to work ON your business more than you work IN your business. You need to have a business plan. You need to have a marketing plan. You need to have your finger on the pulse of your business at all times. In the office, see patients; but when you are home, you need to be sure your business is running the way you planned it.”
As a result of the publicity surrounding the post, Dunn was invited to join a number of orthodontist-only Facebook groups to share her take on the issues confronting her peers and her business and marketing ideas. But it was at the suggestion of a colleague that she realized she should take her newfound voice and found her own group—one specifically for female orthodontists.
Dunn initially invited all her female orthodontist friends, who in turn invited their friends. From there it exploded and today the Women in Orthodontics Study Club has over 1,200 members. The group addresses the fact that women often have specific professional and personal concerns that their male counterparts don’t have.
“We talk about business, marketing, our children’s schools, what pants or shoes to wear, dinner delivery services, nannies. A lot of the women say they don’t feel comfortable posting in the other groups. You get attacked for asking what someone else says is a stupid question. There’s no ego in the women’s group. Anyone is free to ask anything. Instead of having someone judge you, you have a group of people there to support you,” Dunn says.
While clinical cases are also a topic of discussion in the group, work/life balance is huge.
“Husbands of this generation are probably the most involved in history, but women still feel the burden of managing everything in the house—kids, the meals, the activities—and the business. Right or wrong, we all get so stressed out,” says Dunn who is now the mother of three children.
A consequence of this burden, according to Dunn, is the fact that many women are too busy to devote the time to being a voice within the profession or a leader in the AAO.
“When Lance Miller started his [Elevate Orthodontics Podcasts], [my husband] said, ‘You’ll be interviewed.’ I said: ‘No. Male orthodontists don’t even know who I am. The only people who know me are women, and the men have no clue I exist.’ He just looked at me,” Dunn recalls, adding that Miller did eventually interview her.
The Women in Orthodontics Study Club is run through a closed Facebook group, but is open to all female orthodontists and residents. It is free to join. Potential members need to request membership via their personal, not practice, Facebook page. Dunn continues to run the group by herself, which means it can take her a while to verify membership requests.
Dunn admits that she is on Facebook a lot, often monitoring posts to make sure they are appropriate. In addition, she tries to blog once a week on the Women in Orthodontics website about a current issue facing her peers. And somewhere in all that, she carves out time to facilitate a Women in Orthodontics Mastermind Group as well.
Mastermind Groups are an outgrowth of Napoleon Hill’s book, Think and Grow Rich, and as the Women in Orthodontics’ website describes it, they are “designed as a place for personal support, idea generation, education, and accountability.” Dunn, who was trained as a Mastermind Group facilitator, leads a group of 12 female orthodontists that meet face-to-face every month to focus on growing their practices within a supportive community.
According to Dunn, the focus is definitely on business and marketing. Topics have included how to set up a schedule for an associate, to the process of hiring your first employee, as well as how to ensure your practice still has a good summer despite the fact that you are going on maternity leave.
“We talk about running the business and what we’re doing that works well for us. We have what we call a ‘hot seat’ to focus on the problems [an individual member] is having in her practice. We all work together to solve her problems,” Dunn says. “We have people starting from scratch, as well as people practicing for 10, 20 years.”
Through the Women in Orthodontics website, Dunn offers both an online Mastermind Group and Elite Mastermind Group. There is a membership fee to join the Mastermind Group, and the elite group is geographically exclusive, unlike the Women in Orthodontics Facebook group. In addition, members are required to sign a nondisclosure agreement stating that anything shared in the group is confidential. Dunn invites members of the Mastermind Group to come to her practice and see what she is doing. In addition, she spends part of the meeting teaching members about a particular business topic.
While the 2017 Mastermind Groups are full, there is a wait list open for 2018 on the Women in Orthodontics website.
Fast forward a year and a half, and Dunn now finds herself sitting on the AAO’s Council on Communications (COC) working to improve the very program she criticized in her blog post: the CAP. This summer she wrote another blog post about why she sought a seat on the COC, writing, “My platform was simple. I hate the current campaign, many agree with me, and things need to change. I didn’t sugarcoat my feelings, but I think my passion became clear, and for better or worse, the [Pacific Coast Society of Orthodontists] elected me to the position.”
Dunn wants to see more aggressive messaging from the AAO—and more importantly a shift away from the old messaging that focused on selling orthodontics and a great smile. Instead, she argues, the messaging should focus on the fact that orthodontists should be the ones providing that great smile.
Recently, the AAO ended its relationship with its advertising agency and brought in an in-house digital marketing expert. Going forward, the entire CAP will be digital—in other words, the cable TV ads are gone. This will include new content for consumers, email marketing, paid and unpaid social media, search engine marketing, and paid search ads. The goals, according to Dunn, are to build awareness among consumers about seeking out treatment with AAO orthodontists; to promote in-person orthodontic care; and to grow the AAO’s online presence to drive traffic to the member directory.
Dunn hopes members will have patience as the CAP evolves; and, in the meantime, she points out that the new approach has had an impact in just its first few months.
“Even with minor changes, right now, [we’ve seen] over 300% increase in traffic to the consumer website since [advertising] went digital, and over 800% more Facebook fans than [the AAO] had with the old campaign,” Dunn says.
Dunn was elected to a 6-year term and for now continues her AAO membership.
“They are still making an honest effort to help us on a national level—so for now, I remain a member. I became involved to make it better, but if I run into a wall and it doesn’t get better, if they’re not listening and I’m not being heard, then I will reevaluate.
“I’m not a diehard AAO person, but I feel they are trying to make an honest effort to save our profession and to fend off threats to it. I will give them my money to do that.” OP