The Ortho Empire

Atlanta orthodontist Robert N. Pickron, DDS, believes he has found a way to keep parents from flipping their lids when their kids lose their expensive retainers. He offers to provide a replacement at half the regular price—on the condition that the check is made payable to charity.

“I give parents their choice of charity from among five I’ve prescreened,” he says. “The charities they can pick from are those that help the homeless and the disenfranchised, that work to protect abused children, and that support breast cancer research. I felt those were the kinds of charities everyone could rally behind. The main thing is these are charities that let parents feel good when they have to write that check. And, as a bonus, they [the parents] qualify for a tax deduction.”

PRACTICE PROFILE
Name:	Pickron Orthodontic Care
Location:	Atlanta
Owner:	Robert N. Pickron, DDS
Specialty:	Orthodontics
Years in Practice:	41
Patients per day:	62
Starts per year:	4800
Days worked per week:	121 (each office 4 to 8 days per month)
Office square footage:	3,000 (average)

Pickron himself qualifies for a tax deduction because whatever amount the parents donate is matched with a check of his own to that same charity.

“I started doing this in October 2004, and since then the parents and I together have contributed more than $130,000 to these five organizations,” Pickron says.

Free Retainers

The idea to turn retainer-replacement angst into an opportunity for philanthropy dawned on Pickron after one particularly jarring encounter with an upset mom. “She complained that, after just having spent $4,000 on treatment, she was now going to have to spend an additional couple of hundred dollars to replace the retainer her child promptly lost,” he recalls. “She was so livid that she threatened to take her next two youngsters to a different orthodontist for treatment when their time for care came around.”

Not wanting to lose her future business, Pickron offered to make the replacement retainer at no charge. That placated the mother. However, Pickron quickly realized that this exercise in good customer relations might backfire. “I was afraid word would get around and soon every other parent would be demanding I replace lost retainers for free,” he says.

After much thought, Pickron came up with his concept of having parents give to charity. “I felt if a patient was irresponsible with his or her retainer, then there should be a consequence to that—but it should also be a consequence that lets everyone involved feel good about it afterward,” he says.

Pickron contends that this matching-gifts-to-charity policy is one that “any orthodontic practice can adopt and benefit from. It gets angry parents to think less about the cost of replacing the retainer and instead focus on doing good for the community. It’s a perfect way of taking some of the bite—pardon the pun—out of this problem.”

Lifetime Guarantee

To encourage patients to be careful with their appliances, Pickron guarantees for life the stability of his work as long as the patient faithfully wears a retainer every night, indefinitely.

“I wanted patients to know that if they did everything they were supposed to, then we would guarantee no relapse and they’d have a great smile,” Pickron explains. “More than anything else, the lifetime guarantee started as an education tool to develop the patient’s awareness of the importance of wearing that retainer.”

Today, the lifetime guarantee is a selling point for the practice. “It attracts quite a few people who want quality backed by a promise,” Pickron tells. “And this is a promise we give in writing, on a printed certificate.”

Patients gets the certificate at the end of treatment along with detailed instructions for use and care of the retainer and other information to help ensure that there is no unintended post-treatment shifting of the teeth.

Pickron stands behind his lifetime guarantee.

A Big Practice

Pickron estimates that less than 1% of his group’s patients have ever asked for retreatment by invoking the lifetime guarantee. That’s fortunate, because Pickron Orthodontic Care starts upward of 4,800 new patients in a typical year.

To serve that number of patients, Pickron employs 13 full- and part-time orthodontists supported by nearly 100 clinical and administrative specialists scattered across 23 offices in the Atlanta region. Each office is open 4 to 8 days per month and sees approximately 60 patients per day. “We handle about half the volume of the typical busy practice, and that’s by design,” Pickron says. “Our goal is to deliver quality care, to try to have all our appointments be on time, and to make sure parents are able to interact with us to the extent they desire.”

Each office is laid out as a six-chair, semiopen-bay operatory (chest-high partitions provide privacy for seated patients while allowing standing chairside staff to see everywhere in the room). “The floor plan, supplies locations, and workflow processes are for the most part the same in every office,” Pickron says. “We’ve set things up that way so that personnel can be moved from office to office as necessary and know where everything is the minute they arrive—no fumbling around, because they’re already familiar with the lay of the land.”

A Stepping Stone for Young Orthodontists

Orthodontists hired by Pickron tend to be young; almost invariably they contact him from various orthodontic programs a year before they graduate. “They come out of school with a debt of $100,000, maybe $200,000,” he says. “The best option for them is to come work in a practice like mine where they can in a supportive way build on what they’ve learned in school, develop their confidence, and make some money in the process.”

Pickron addresses members of his staff of nearly 100.

Each orthodontist that Pickron hires is assigned an office. “The management of that office is handled for the orthodontist, so that’s not something he or she will have to worry about,” Pickron says. “Each office comes with its own manager, clinical director, five or six assistants, and one treatment consultant. This permits the orthodontist to focus on each day’s clinical challenges and also engage in practice-building activities, such as visiting the offices of referring dentists.”

The young orthodontists stay on board an average of 3 to 5 years before starting practices of their own. Pickron sees this rate of turnover as a company strength. “I view my enterprise as a postgraduate training ground for young orthodontists just coming out of school. That’s a role I enjoy seeing us play,” he says. “Over the years, I’ve trained more than 50 orthodontists, showing them systems and ways to do things to start and build a practice. I hire them with no expectation that they will be staying. Then I am never disappointed but rather happy for them if they leave.” Not all are in a hurry to leave. At least two Pickron Orthodontic Care doctors have been with the group a decade or longer.

Following His Father Into the Field

Pickron empathizes with his young orthodontists, which is one of the reasons he so eagerly welcomes them into the fold. “It’s been a while,” he says, “but I remember only too well what it was like to be in their shoes, just starting out and all.”

Born the son of a dentist in Tampa, Fla, Pickron decided to follow in his father’s footsteps. He sailed through 2 years of undergraduate schooling at the University of Florida, then—at the tender age of 19—began dental school at Emory University in Atlanta, completing that program in 1964. He spent the next year working alongside his father.

Pickron then attended the orthodontics school at the University of Alabama. By 1967, he was ready to enter private practice in Atlanta. “I had friends in Atlanta from my years at Emory, and I knew it was a progressive city doing all the right things to position itself for growth,” he says.

In 1975, Pickron burnished his credentials as a quality-oriented practitioner by becoming a diplomate of the American Board of Orthodontics. He also got involved with the Georgia Dental Association, the ADA, and the AAO.

Pickron attracted many patients by dint of his service to the community—service that included positions as a Boy Scouts scoutmaster and a director on the board of Big Brothers-Big Sisters of Atlanta. He also was prominent with the Gwinnett Council on Child Abuse.

Dental Assurance Policy

Meanwhile, back at the office, Pickron sees very few patients himself these days. “I don’t have my own individual practice anymore,” he reveals. “I feel I can be more effective as a mentor of the doctors, teaching them. If a doctor wants an opinion about a patient’s case, he or she sends me the chart with updated notes and other most-recent records. I find that, usually, the doctor is already on the right track, so all I have to do is confirm that he or she overlooked nothing.”

More or less the same is true of parents and patients. When they ask Pickron for an opinion, their hope is to obtain assurance that treatment has been provided correctly. And if treatment has not worked as intended, patients stand ready to demand satisfaction under the terms of Pickron’s lifetime guarantee. Fair enough, says Pickron, who is fully prepared to deliver on that guarantee—but only if the patients first have done their part. Otherwise, he can collect and pass along a few more checks made out to charity. “Total patient satisfaction, not straight teeth, is our measure of success,” he says.

Rich Smith is a contributing writer for Orthodontic Products. For more information, contact