How one dental practice transformed itself into a first-of-its-kind in the Midwest
By Dr. Rami Shinnawie and Kasia Dmoch, MBA
For years, patients have been associating visits to the dental office with pain or at least anticipation of a major discomfort. As recently as only a few decades ago, a majority of patients had limited education about preventive dental care and visited their dentists only when they started feeling pain. While patients now are more aware about the importance of frequent and correct brushing and flossing techniques as well as regular dental cleanings and checkups, there are people who dread the idea of picking up the phone and making their appointments. First as a patient, then as a dentist, I understand the reason some people may be less than enthusiastic scheduling and keeping their regular dental appointments. Nevertheless, I am also disappointed to see that when patient discomfort is minimized thanks to advances in dental technology and techniques, some people still neglect their oral health out of fear.
Don't get me wrong — I chose this profession realizing that I will be helping people stay out of pain by providing good dentistry and educating patients about their dental health. Still, as an enthusiast of art and esthetics and an active follower of progress in dental research and development, I also chose this field to create beautiful smiles and help people look and feel their best. I get full satisfaction from my work when my fillings, crowns, and bridges are not only technically good, but also look great in a patient's mouth. I strongly believe that, in addition to educating patients about dental hygiene, my responsibility as a dental professional also is to educate patients about the options they have in improving the esthetic appearances of their teeth and gums. Esthetics often determine how often people smile and how confident they feel about themselves.
Omaha Dental Spa is one of four practices owned by Dr. Rami Shinnawie and wife Kasia Dmoch. The couple launched the non-traditional dental spa after discovering clients' concerns about overall appearance and well-being.
Building a practice that concentrates on cosmetic dentistry was my goal since I started working with patients on the clinic floor of Creighton University's Dental School. I realized the importance of gaining more experience in general practice, patient psychology and business practices. I also placed importance on attending continuing-education courses that focus on building an esthetic practice and selecting the best techniques and technologies prior to fulfilling my dream. For the last five years, I worked long days and weekends just to get experience. Today with the help of my wife Kasia, who has her MBA, I own and manage three busy dental practices that may be described as traditional, and one not-so-traditional esthetic dental spa practice.
Omaha Dental Spa is the first of its kind in Nebraska aas well as neighboring states. During its conceptual phase, many people, including our bankers, did not fully understand what we were trying to accomplish. Nevertheless, having three busy practices, I thought my knowledge and business practices were solid enough to follow my slightly unconventional dreams. We researched what it takes to open a dental spa practice and found out that the concept is relatively new and there is really no definition or outline to follow. While some dental offices offer refreshments and paraffin hand dips to comfort their patients, others hire full-time massage therapists and offer complementary mini massages to relax patients.
We did our research across many industries, studying trends not only in cosmetic dentistry, but also in medical spas, fashion and beauty industries, and interior design. After attending dental conferences where the national speakers started endorsing "pampering and comforting amenities for the patients," my wife and I realized that there is a definite need and a well-grounded business case for spa dentistry. We also knew we were absolutely ready to build a dental spa where the patients' comfort, esthetics, and art of dentistry were the primary focus.
Thus, the dental spa design and business plan were based on our vision and emerging trends. Our research confirmed our hypothesis: people seek undivided attention, professionalism, and expert knowledge in all aspects of the service industry, including medical and dental care. Clients and patients are more and more concerned about their overall appearances and well-being. They want a youthful, healthy look and appreciate a comfortable and relaxing environment. As people work harder and have less time for themselves, they have a true need for small luxurious getaways. Another important finding — applicable to present times — is that when the economy is booming, consumers are less concerned about their spending. During a tight economy, consumers, including those not really affected by the economy, pay particular attention to the value. They are more sensitive to the details of their overall experiences; they want to justify expenses.
In addition to national trends, we decided to carefully examine our immediate environment. We interviewed friends, acquaintances, colleagues, and some existing patients to learn about their current attitudes toward dental visits, their likes and dislikes, as well as what would make them most comfortable and excited in a dental office. Again, some responses were quite familiar — patients' attitudes were influenced by their past experiences, perceived degrees of personal attention provided by other dental professionals and their staffs, and level of patient education regarding oral health, technology, and cosmetic techniques they were exposed to, as well as familiarity with dental insurance coverage.
Many of our respondents did not particularly enjoy visiting their dentists because of the smell, dark and antiquated waiting areas, small claustrophobic treatment rooms, and, of course, the fear of pain. A few of our respondents (including a medical doctor and a high-tech executive) avoid going to dentists because of their traumatic childhood experiences with dental offices. Some people prefer to give blood rather than receive a shot in a dental office. One patient said she'd rather give birth to another child than have her wisdom teeth pulled again. Some people also thought the dental equipment at their dental offices looked antiquated and scary. To our surprise, we also learned most everyone wants to have Hollywood smiles, but the general perception is that such smiles may be attained only by the rich and famous in Los Angeles or New York. Most people have an idea of what veneers are, but they are mostly unaware of the corrective advantages. Only a handful of people complained they are not given sufficient levels of personal attention or feel rushed in a dental office. Finally, quite a few respondents are disappointed their insurance companies do not cover cosmetic procedures, including white fillings in some instances.
At The Loft Dental Spa Office Design
Your ability to offer extended spa services depends on your office design. Of course, you can add them later. Keep in mind that pedicure stations and facial rooms all require plumbing and electrical access. Initially, we wanted to open the dental practice with complimentary services such as a cappuccino lounge, massage, and makeup application station, then open the day spa with additional for-fee services as a second phase of our project. Being new to the spa industry, we realized there was a definite learning curve ahead of us. Splitting the project into two phases allowed us to individually concentrate on dentistry and day spa operations. However, having built two new clinics and remodeled an existing practice, we also realized the costs of remodeling an existing practice can be twice as expensive, not to mention the lost revenue when the clinic closes for construction. Thus, we decided to combine the two phases into one.
The 6,600-square-foot dental spa is located on the second floor of a 1920s-era building originally built for fruit storage. The space is open with 14-foot ceilings, iron posts, and old pine floors. Owners Dr. Rami Shinnawie and his wife Kasia Dmochand salvaged what they could from the original building.
Having experience with building and remodeling, my wife and I took the roles of general contractors. This allowed us to better control the costs, timeline, and overall project quality. We did not want to sacrifice the design and quality, or to exceed the project budget either. We partnered with lnner Salon Design, a Nebraska company that designs and builds custom furniture for salons and spas nationwide. The 200-hour design process turned out to be challenging and educational for both parties. As mentioned before, we lacked day spa industry expertise, and Inner Salon had never designed a dental office space. We were looking for a relaxing, upscale, artistic, yet timeless look that neither resembled a typical day spa nor a typical dental office. Inner Salon's initial proposal looked too much like a trendy day spa or salon. At times, we were all frustrated that we were thinking in separate directions, but after hours of patient revisions and the active participation of Patterson Dental, we achieved this one-of-a-kind look and feel of a dental spa.
Our 6,600-square-foot office is located on the second floor of a 1920s-era building that originally was built for fruit storage. We fell in love with the vast amount of space, 14-foot ceilings, iron posts, and old pine floors. The space needed an almost complete refurbishment, but we decided to salvage what we could from the original building.
The dental and day spa areas are discretely tucked away behind the original brick and concrete wall that splits the space horizontally into two separate private lofts. When patients and clients first walk up the stairs, they do not see any dental or spa equipment. Instead they see a beautiful concierge area and modern art gallery that is also open to the general public. We decided to replace the traditional receptionist's desk and tiny lobby with a 1,200-square-foot waiting area (we refer to it as our concierge facility), with a long, elegant bar as the focus point, featuring fresh fruit, cookies and frothy cappuccinos or teas. This is where we invite patients to try our refreshments while filling out their health and insurance forms. To one side of the bar is the spacious gallery showcasing works native and foreign. To the other side are couches, oversized chairs, and an elegant spa retail area bathed in warm sunshine that streams through floor-to-ceiling windows. While some patients choose to relax in our chairs and look down below the main street of Omaha's Old Market, others like to stroll through the gallery and view the current art exhibit.
If our schedule permits, we offer tours of the entire facility to first-time gallery visitors. We briefly introduce the technologies we use in our dental area before describing the amenities our guests can expect in our day spa. Visitors usually are thrilled to have a sneak preview of our pedicure and manicure stations, skin care, and massage rooms.
The gallery, dental spa, and day spa share one common element: art is displayed throughout. Our Venetian-plastered walls also feature scattered light boxes filled with glass art that illuminates the corridors. The tour wraps around the gallery, back to the concierge. These tours help our prospective patients familiarize themselves with our facility, amenities, and staff, thus making their first appointment more familiar and less stressful.
Depending on the nature of the dental appointment, we offer a complimentary 10-minute chair massage before or after the procedure. The majority of our patients find this service extremely relaxing, with few patients declining the service. We understand that our patients and clients have various comfort levels, and we like to respect that.
The dental equipment is of the highest standards. Patients often comment that our plush dental chairs overlooking the trees and blue sky above historic Howard Street help them forget they actually are sitting in a dental office.
People are more likely to comprehend and accept visual presentations than they are to comprehend listening to spoken words alone. In addition to educational purposes, the same patient monitors are used for entertainment during longer procedures. Patients are offered a selection of DVDs to watch and wireless headsets to block out all noise. Many patients appreciate this kind of "distraction," as it helps them forget about other discomforts and "makes the time go faster."
Day spa complements
While dental patients are offered free-of-charge, relaxing spa amenities such as neck and shoulder massages, paraffin hand dips, and makeup applications and touch-ups for female patients, other services can be purchased at regular prices. We offer a full array of massages (including warm stone, reflexology stress break, and aromatherapy), facials, nail care, and hair removal services.
Dr. Rami Shinnawie's dental stations feature two monitors, one for the dentist and assistant and one in front of the patient. He says patients are more likely to accept treatment plans if they fully understand it. His team displays digital X-rays and intraoral camera images on a 17-inch monitor mounted on the dental chair.
Although the day spa and the dental spa are connected through a corridor that displays works of art and the patients and clients share the same concierge facility, the official entrances to the spa and dental office are on opposite sides. Our design also incorporates a sizable waterfall to defuse the sound of suction from the dental area. Although we have the same main incoming telephone line and the same concierge staff, we developed and applied two separate management, computer information systems, and cost/revenue structures for the spa and the dental office. Not all day spa clients are dental spa patients, and not all dental patients are spa clients. Currently, the crossover between the two entities is about 15 percent, and we hope to increase this ratio to 25 to 30 percent in the near future.
Dental spas for everyone?
Most of our patients are amazed a dental experience can be so pleasant. They often comment they are actually looking forward to return dental cleanings and checkups. Those who drink coffee find the complimentary cappuccinos and lattes as an act of great hospitality and comment they feel more relaxed sipping drinks in our concierge than their offices. Those who arrive tense leave our office relaxed if they choose to take advantage of our complimentary neck and shoulder massage. Even patients who decline our amenities are pleased to be treated with care in such a relaxing environment. More and more patients are aware that digital X-rays are producing less radiation, thus making them less harmful. Those who come to us for their smile makeovers choose us because of our experience, latest technology, and highest quality of supplies (including the lab cases) we use. These happy and satisfied patients are great sources of referrals for us. Often during weekends they bring their friends and family to show them around.
Once in a while, we have patients who are upset that we accept only selective insurance plans and we do not negotiate our fees. Although our dental fees are in line with many other modern dental offices in the area, some patients perceive that since their insurance does not want to cover 100 percent of their dental treatment, we must be expensive. In these cases, our office manager explains to patients they may visit our other offices where we accept almost all insurance and the dental fees are slightly lower, but so is our overhead. We do not, however, do major cosmetic restorations in our other locations.
Just as with other establishments, there will be patients and consumers who expect more and appreciate extras. Others are quite happy with what they receive. A small portion of patients and consumers will shop around in attempts to find better treatment, services, or products at better prices. My wife and I learned you can't be everything for everybody and you can't please all people all the time. You need to find your own niche and pursue it. And, if your heart is truly in it, your chances for success, satisfaction from your hard work, and possibility of self-actualization will be much better.
Omaha Dental Spa owners
Dr. Rami Shinnawie and his wife Kasia Dmoch partnered with lnner Salon Design, a Nebraska company that designs and builds custom furniture for salons and spas nationwide. The couple assumed general contractor roles during the 200-hour design process to better control costs, timeline, and overall project quality.
