Downtown or the suburbs? (Houston, Austin: middle-class, real estate, insurance)

[DoctorM]

I am looking to relocate to Texas and open a dental office.

I have a "road trip" planned in a few weeks to visit the Austin Metro and the Houston Metro. I have been to both communities as a tourist but was not looking at the area from a business perspective.

To make my trip more successful I have contacted a tenant broker in each community to show me possible commercial property options. I gave the broker specifics about size, signage, and budget but not knowing the Metro it was difficult to give an exact area to look for commercial property.

I have ex-classmates that have done well by targeting the business professional at work instead of families. However, these are offices in Chicago and New York City with a lot more options for public transportation and major employers are located in a very densely packed area. More or less being close to work verse home. Seeing patients on the way to work, during lunch, or at the end of the business day.

My ideal patient is 25 to 55, leads an active lifestyle, and is employed. I enjoy children, teens, and geriatric patients but don't want an office filled with them. I prefer the patient that wants quality care in a professional setting but can appreciate efficiency. The type of patient who wants to get in and out instead of making it a 90 min. visit for a simple cleaning.

When speaking to the brokers I keep getting told to stay away from downtown. Find a suburb that want to live and open a practice there. Once again, this leads to more family care verse my ideal patient. Thus, I am curious if those of you on this forum would suggest a more traditional dental practice of being where people live instead of where they work.

[FalconheadWest]

Many people work from home. Many people want one dentist for the family and kids aren't "working" downtown. You would be targeting the single people who live and work downtown, possibly. I don't see any issue with targeting a specific demographic. I know in my area, there are 2-3 dentists on every corner, seriously. There are too many around here...

If you want to target downtown, don't let them take you to the burbs.

[TexasHorseLady]

For your ideal patient, I'd, indeed, locate in or near downtown.

[Trainwreck20]

I am guessing the problem is that you will need to grow your business, and I suspect that many dentist do that by getting younger patients, then siblings, then maybe their parents, parents friends, etc. Most adults will be established with some dentist and will need a reason to change. Since you will have little to no track record here and no one to give you good referrals to start with, it will take a while to grow via a more adult oriented model.

Not that it can't work - there are kids downtown, as well, and you can get patients - it just will take longer and the real estate will be more expensive in the meantime. Just bring some cash and confidence.

[Idlewile]

Originally Posted by DoctorM

I am looking to relocate to Texas and open a dental office.

I have a "road trip" planned in a few weeks to visit the Austin Metro and the Houston Metro. I have been to both communities as a tourist but was not looking at the area from a business perspective.

To make my trip more successful I have contacted a tenant broker in each community to show me possible commercial property options. I gave the broker specifics about size, signage, and budget but not knowing the Metro it was difficult to give an exact area to look for commercial property.

I have ex-classmates that have done well by targeting the business professional at work instead of families. However, these are offices in Chicago and New York City with a lot more options for public transportation and major employers are located in a very densely packed area. More or less being close to work verse home. Seeing patients on the way to work, during lunch, or at the end of the business day.

My ideal patient is 25 to 55, leads an active lifestyle, and is employed. I enjoy children, teens, and geriatric patients but don't want an office filled with them. I prefer the patient that wants quality care in a professional setting but can appreciate efficiency. The type of patient who wants to get in and out instead of making it a 90 min. visit for a simple cleaning.

When speaking to the brokers I keep getting told to stay away from downtown. Find a suburb that want to live and open a practice there. Once again, this leads to more family care verse my ideal patient. Thus, I am curious if those of you on this forum would suggest a more traditional dental practice of being where people live instead of where they work.

I have a young family and interact with many families just like us. We live in NW Austin. All of our friends, including us, have their kids see a pediatric dentist. My dental office definitely takes and wants kids but they are not surprised when I tell them ours see a pediatric dentist who is amazing.

For the record, both of our dentists here (ours and the kids') not only hit it out the park, so to speak, they are the both the best practices of any kind of doctor or dentists we've ever seen. Gorgeous offices with every amenity you can imagine and more, especially in the pediatric office, staff that have clearly spent an inordinate amount of time learning what it means to provide the optimal patient experience and providers who consistently go above and beyond, in addition to seamless appointment scheduling and after-appointment follow up, even on routine visits. Oh, and no waiting.

I often wonder what is so different about dentistry that makes it possible for there to be so many stellar practices everywhere, practices that do everything right, while the rest of the primary care world is often everyone's worst nightmare. (I say this having worked at a nationally recognized hospital with access to primary care providers.)

I had the same kind of dentist where we lived previously -- they have all been rock stars, the practice on the whole, the doctor, everything. It seems, these days, anything less is not good enough in the dental world, so wherever you can accomplish this best is where you should be.

[scm53]

Originally Posted by Idlewile

I often wonder what is so different about dentistry that makes it possible for there to be so many stellar practices everywhere, practices that do everything right, while the rest of the primary care world is often everyone's worst nightmare. (I say this having worked at a nationally recognized hospital with access to primary care providers.)

I'm sure the differences in ratios of private pay/insurance/govt rates between dental and medical has NOTHING to do with what you've observed.

When I have to look for a new dentist, I refuse to go to one that takes Medicaid patients.

[Trainwreck20]

Yeah, that is kind of it....dental insurance is pretty unimpressive, so you can pretty much go anywhere and the insurance industry does not drive the show.

[Idlewile]

Originally Posted by scm53

I'm sure the differences in ratios of private pay/insurance/govt rates between dental and medical has NOTHING to do with what you've observed.

You're right, it's a consideration, but without getting into the nitty gritty, considerably less for private practice and more for hospitals. What I was more focused on in my comment was the contrast in customer experience which has little to do with money (reimbursemnt or otherwise). On the average, good dental practicas are VERY good an offer a Nordstrom-like customer experience, that is the exception rather than rule in other primary care practices even the ones who only take insurance and cater to the middle-class and higher. Of course, perhaps it's because all the dentists we know only have work 4 days a week.

[scm53]

Originally Posted by Idlewile

You're right, it's a consideration, but without getting into the nitty gritty, considerably less for private practice and more for hospitals. What I was more focused on in my comment was the contrast in customer experience which has little to do with money (reimbursemnt or otherwise). On the average, good dental practicas are VERY good an offer a Nordstrom-like customer experience, that is the exception rather than rule in other primary care practices even the ones who only take insurance and cater to the middle-class and higher. Of course, perhaps it's because all the dentists we know only have work 4 days a week.

You're right. I'm probably too focused on the hospital side, with a former CEO now turnaround consultant wife. But with the increasing number of employed physicians, look at that to change. The employed groups will look like hospitals. At the same time, the "concierge" practices will be even more differentiated.

The issue in dental is that while there are PPOs, there isn't nearly the level of managed care and impact on practice management that there is in medical. That's why there is a superior level of service - because a not insignificant number of people are spending their own money. Either from the get-go, or when they exceed their annual max.

[BatWing]

Burbs. as a Dentist, you wanna hit the ground runnnig with patients that will PAY UP immedately with cash and credit. Downtown, you might run into a lotta DMO recipients, slowing down your money.