Dental Office Culture Is the Key to Growth at Sala Family Dentistry
In mid-May 2022, Sala Family Dentistry in Reno, NV had its biggest week in more than three decades in business.
Then, the 2022 Best of Reno Awards were announced at a ceremony at the Reno Sparks Convention Center. With more than 200,000 votes from community members cast, Sala Family Dentistry was named Top Dentist, Top Pediatric Dentist, and a Top Employer, cited for the company’s benefits program. A few days later, they were named the Best Medium-Sized Business to Work for by the Northern Nevada Human Resources Association. On the same day, the team produced over $150,000 in free dental care as part of their Smiles for FREEdom program, a non-profit organization dedicated to providing free dental care for veterans and active service members within the local community Sala Family Dentistry serves.
“It was quite a week,” says Dr. Jason Sala, DMD. “To be recognized as the best dentist, best pediatric dentist, best company benefits, and best place to work was awesome. Getting to that level of accomplishment gives recognition to the team for the work they have done.”
These results were the culmination of several initiatives put in place at Sala Family Dentistry over the past several years as they grew significantly from 20 employees to 60 and from a 4,200 square foot office to 17,000 square feet with 27 dental operatories.
Sala Family Dentistry was started by Dr. Mike Sala more than thirty years ago. At that time, Mike knew that to have a successful practice he needed more than great dentistry, he needed to form relationships. Mike said he wanted to make his patients his friends and treat them like family and these values were passed along to his two sons, Jason and Todd.
“We had some growing pains over the years,” says Dr. Todd A. Sala, DMD, and Jason’s brother. “We used to think that if we build a larger office, people will come and that was about as savvy as we were. There was a lot of hope. Then, as we matured, we realized that we needed to gain a deeper understanding of our business metrics, focus on efficiency, get better coaching, and develop an improved company culture.”
As the business grew, Todd and Jason wanted to maintain the attention to relationships that had been a hallmark of the practice for decades. “We want to know people for their entire lives,” Jason says. “Even though we are high volume, it’s very much a relationship-based practice. Besides general dentistry, we’ve got pediatrics and we’ve got braces, we really take care of the family.”
To help make the transition to the larger office, the staff at Sala Family Dentistry trained not just clinically, but also on efficiency and customer service. They model their customer service on a wide variety of companies that are known for excellent service like the Ritz-Carlton Hotel Company, The Walt Disney Company, Apple, and Amazon.com. In fact, Todd and Jason invest more resources into company culture than they do in external marketing to grow the practice, and the strategy is working. They now spend less on average to acquire a new patient than at any time in the past ten years because the company culture of great service drives positive reviews and referrals.
Jason and Todd didn’t just grow up with a father in dentistry, they also grew up working together. The brothers started a lawn care business while they were in elementary school in Reno. “We started mowing yards as third graders,” Jason says. “We grew the business over the years to more than 25 customers. We got used to working with each other and quickly learned that fighting in people’s front yards is a bad idea that doesn’t grow business very well. Chucking apples from somebody’s tree at each other and chasing each other down the driveway wasn’t good business! We realized that we needed to focus on our strengths.”
Jason and Todd decided that to succeed in the lawn business, each of the brothers needed to specialize. “The guy who’s working the edger needs more attention to detail, getting that line cut really well,” Jason says. “If the edger can trim a wider swath around a tree or around rocks, the person on the mower can execute what we called ‘rip and run’, work fast without any need to slow down. I was the edger, I did all the detail work around the corners, the nooks and crannies, and Todd was a guy who would fly up and down the yard back and forth, back and forth, and never have to go into a corner. We could mow 25 people’s yards in one day and never have to work the rest of the week. We were making more money than our friends working five days a week!”
The brothers brought the dynamic of specialization to their dental practice too. “We did an analysis and realized that I am best doing more in the chair,” Jason says. “And Todd needed to focus on running the business, taking on the CEO role. Todd needed to learn a new skill set, and we both need to be okay with the other doing their job. There’s a balance of trust and understanding that’s grown over our four decades of our lives and working together.”
“We complement each other well,” Todd says. “We let each other do what we’re really good at.”
The brothers’ ability to let go and trust others on the team proved important when they embarked on the largest effort in the company’s history—the 2015-2016 project to expand the office from 4,200 square feet and ten treatment rooms to 17,000 square feet with 27 treatment rooms. Design Ergonomics helped bring their vision to reality by developing a conceptual blocking diagram to outline the scale and flow of the new practice. After discussions with the Sala Family Dentistry team, Design Ergonomics created a comprehensive dental office floor plan as well as the interior design for the new office. The beautiful facility includes pre-plumbed operatories ready for use as the needs of the practice grew even further.
“The neatest part was we gave almost the entire project to one of our assistants and let her run with it,” Jason says. “We trusted that she would be able to answer the emails and work closely with the Design Ergonomics team and all the suppliers. She got 80 percent of the project done, leaving only 20 percent for Todd and me, mainly around financing the building.”
Jason is a mountain bike enthusiast who loves to go on long, challenging rides of 100 miles or more. “Training and staying in shape are important for mountain biking as well as in business,” he says. “Having coaches is hugely important and I think that navigating on your own is a mistake. In my life, I have a spiritual coach, I have financial coaches, I have a business coach, I have a cycling coach who sends me workouts, and Design Ergonomics helped us as our efficiency coach.”
As the project was in full swing, the team flew to the Design Ergonomics Massachusetts factory for an Over the Shoulder Event, visiting the Perfect Smiles Dentistry practice in Seekonk, MA to learn how efficient practices can be implemented in their new office. “Once we started seeing things, we realized it’s possible, we can do this,” Jason says. “We thought, oh, wow, this operatory is way more efficiently designed than anything I’ve ever been in before. If I use some of the other major companies to design offices, they’re selling you a whole bunch of stuff that isn’t necessarily needed. Design Ergonomics has cut all that out and makes it so we can have a well-run machine.”
The team understood as they grew that a beautiful building with a great facility that patients love plus a fantastic culture among staff would create the ideal strategy. “When we moved into our new facility, it was like opening a new restaurant,” Todd says. “You know there’s going to be potential, but the hardest part is getting the humans to work well within that space.”
Once the Sala Family Dentistry expansion project was completed, they opened their brand-new doors for business and started working with patients. “Then we shut the doors for two days of training with Design Ergonomics,” Jason says. The training conducted on-site at Sala Family Dentistry included dental training programs to optimize the flow and productivity of the practice. “We learned how to use our new equipment, how to set up our sterilization, how to make our supply area work and function efficiently. And Design Ergonomics trainers taught us lean principles, so we knew all the things that make our office run efficiently. We were trained on rate limiting steps. For example, the kill time of a spray in the operatory is four minutes, that’s our rate limiting step. And everything else is based upon those four minutes. Now, the whole turnover of the operatory is based on that number.”
Now, after having settled into the space over the past few years, things are running great for Sala Family Dentistry. Todd and Jason are happy that they invested time and money to significantly expand the practice. With a focus on efficiency and customer service, they’re winning awards as the best dentist in the area. They’ve even opened their own doors to dentists who are considering an expansion like theirs.
So, was all the effort worth it? Absolutely, the brothers say. They’re serving more patients, employing more people who are supporting families, and making more money. Better yet, the brothers have learned to delegate and are able to spend more time with their own families. They’re both raising teenagers and are active in their kids’ busy lives.
And because the business is running smoothly, Sala Family Dentistry has the time and resources to donate care to veterans through the Smiles for FREEdom program. It is important for Jason and Todd to give back to the community they’ve lived in their entire lives.
When other dentists visit, they advise making the move to a larger practice as soon as possible. “I tell my peers that it’s a little shameful if you have a smaller practice because you’re not serving as many patients,” Todd says. “More patients could use your care and extra space is what you need for them. Trust that historical data is predicting your future data and develop a culture to maximize your strengths.”
As we were finishing this story, we were saddened to learn of the June 2, 2022 death of Sala Family Dentistry founder Dr. Mike Sala. Everyone at Design Ergonomics is thinking of Jason and Todd and their families and colleagues during this difficult time.
If you have any questions or if you need help with your dental office design, please contact the Design Ergonomics team.