Everyone’s experiences over the last two years have been unique yet parallel due to the pandemic. Jeffery S. Kahler, DDS, decided to move and expand his practice not long before the shutdown, so he and his Patterson Dental team experienced all the setbacks that came with that. In addition, his wife Sheilah was diagnosed with ovarian cancer and went through four surgeries and chemo.
His office was later shut down again during organized protests in the neighborhood and another time for a couple of days when an armed man was being pursued through the area by the police. Patients and employees were affected by local brush fires. The container ship carrying some of his new office décor was delayed by the ship infamously stuck in the Suez Canal. But Kahler’s faith, motivation and determination kept him on the path he envisioned and, despite the challenges, phase one of his expansion is complete and the practice is so busy that he’s beginning to look for an associate. Or two.
Destined to be a dentist
Kahler decided to become a dentist when he was a sophomore in high school. Several people influenced him. “A lot of my friends’ parents were dentists, so that played a big part,” he recalled. “I excelled at sciences and my father was a physician. So, as I grew up, I just felt this was something that would utilize my skills and I’d be good at.” When he was younger, Kahler liked to build model airplanes, using a toothpick to paint the tiny instrument panels. “That still actually translates into what I do now,” he said. “Working in tight spaces without having to stretch out people’s mouths. I think that experience gives me a lot more finesse than somebody without that skill.”
Kahler grew up in Tracy, California, and had a good friend a couple of doors down. “His dad was a dentist and we ended up going to high school, college and dental school together,” he recalled. “We went to Loma Linda University. I graduated in ’92 with honors and then moved up here to Paso Robles where I associated with Dr. Jack Sloan. He had been practicing here for many years. I worked with him for about four years before I bought the practice from him. Then I continued to practice in the same little space for almost 28 years.”
Kahler said a lot of things pointed him toward making his career choice and that his reasons for staying in dentistry have evolved. “I feel like we provide a really good service for our patients,” he explained. “I’m making a difference in a lot of people’s lives. That’s kind of the bottom line right now. As I’ve matured, it’s gone well beyond making a good living, which is more fulfilling.”
Running out of room
Kahler’s practice grew substantially over the years. He was booked out several months because he could only do so much in just three operatories. “Although the practice grew, I had no room to grow, so we kind of stagnated for a number of years,” he recalled. “A lot of life happened in that time, which made my thoughts of expanding the practice a bit overwhelming.”
His wife Sheilah is a big part of his motivation. “When you surround yourself with the right people, it helps create a better version of yourself,” he said. “My wife brings out the best in me.” Realizing he had to address efficiency issues, he’d previously had consultants try to figure out how he could get more use out of his tiny space. “They would look at my patient base and say, ‘You have enough work here for three or four dentists.’”
While the Kahlers were trying to decide whether to move the practice and whether to rent or buy a building, another big challenge arose. Their landlord decided to sell the home they were living in and not renew the lease. Finding a new home became a top priority and a distraction from the project. Meanwhile, the lease was coming up for the office as well, and Kahler decided he didn’t want to renew it. They tried to buy the building, but that didn’t work out. They put offers down on other places that also fell through for one reason or another. A cousin of Kahler’s wife is a dentist who leases his office space in Miami. He advised Kahler that buying a place is not the only way to get it done. Kahler hadn’t thought about that as an option with his extensive plans for expansion. So, he started looking at larger places to lease and found one that was absolutely perfect. “Perfect location, perfect everything,” he said. “It’s at the end of a cul-de-sac in a medical community with a hospital down the street. There’s a great restaurant next door, plenty of parking … I could go on and on.”
Kahler chose to sign a long-term lease as opposed to purchasing. He decided it was the most practical option for him. He now has a flexible contract with an option to purchase later. “That really was the only way we could do what we did,” Kahler said. “I didn’t want to be bogged down with a huge loan to purchase a place and then not have anything left to do the buildout.”
So, leasing is what gave him the opportunity to create his dream practice. “We did the math. We did cash-flow studies, and it became clear it was something that would be very lucrative, not a waste at all. And who knows what the future holds here?” The new office is in Templeton, only about 10 minutes from the old one and Kahler believes, from all of the positive feedback he’s receiving, that it’s probably more convenient for many of his patients.
Working with Patterson Dental
Kahler said that the Patterson team was involved in building his dream from the beginning. “We had a relationship with Joel Buzard [their Patterson Dental sales representative] before we ever hatched this idea and I couldn’t have done it without him,” Kahler said. “Everything we did with regard to planning was right before the pandemic hit. They flew us out to tour the A-dec facility to see where all the equipment is made. That was huge for us.” Kahler didn’t really want to keep any of his old equipment, but to be practical, he felt he should take the three dental chairs. Then A-dec began offering a great deal after the pandemic started, which he took advantage of. “We were able to equip all seven ops with brand new equipment, which I wouldn’t have been able to do otherwise,” he recalled. “That opportunity would be one of the few advantages of the pandemic.”
Patterson Equipment Specialist Brendan Fitzpatrick helped design the floor plan and layout. “I’d say that some of the best money I spent was planning it all out so everything flows and taking it from him to the architect,” Kahler said. “We probably had 20 different versions in process before we nailed it down. We thought out just about every detail and now, six months in, I don’t regret any of it. It all flows seamlessly, from the design and location of the sterilization center, and then from the front office and into the consultation rooms and operatories. Brendan was a vital part of it. He worked out a lot of the problems.”
They were about three weeks away from submitting their plans to the county when everything shut down due to the pandemic, forcing them to submit their plans electronically. Kahler said that while the shutdown created some big delays, the architect was up to the task and was able to keep things moving.
Meanwhile, Kahler kept working on emergency and urgent cases and kept most staff on board. However, it was four months before his hygienists could return. Like many practices, they had barely enough PPE to keep going. “Eventually the county stepped in. They would get supplies and donate them to us so we could stay open and were compliant with everything. We even had patients donating N95 masks to help us keep running.”
Because of the pandemic, Kahler decided to scale back his original plans and do the buildout in two phases. “We met with the architect and came up with this plan to build out more than half the building, for maybe slightly more than half the cost. This will leave the other half of the buildout, which will add three additional operatories, for later.”
Because of life’s challenges, Kahler felt the practice had stagnated. “We felt we’d slipped behind a bit,” he explained. “The first decision we made when we knew we were going to move was switch our software. We liked what Patterson had to offer with Eaglesoft because it integrates seamlessly. We knew we needed all new equipment and to modernize everything.” They also changed their phone system and put more than $40,000 into computer equipment. “We felt the computer equipment and software were foundational to the project,” Kahler said. “The new tech rests on it and the investment was worth it. It’s an amazing system, and it’s working well for us.”
The biggest game-changer decision he made was getting the CEREC Primescan scanner. “We didn’t just take Joel’s word for it,” Kahler said. “Joel arranged an event where he brought in different manufacturers, and we got to look at several scanners. We went with the Primescan and within just a week, we wanted another one.”
Kahler said that as far as treatment goes, the scanner is allowing him to do more. “It’s freeing up so much of our time because it’s so accurate,” he explained. “We’re not adjusting crowns that much anymore. Even with removable appliances, temporary partials, partial dentures, there are practically no adjustments. We can predictably schedule that in to be more efficient. So, we’re doing things better and faster.” Primescan also has led him to doing some ortho with clear aligners. “We are just now tapping into what all it can do,” Kahler said.
Part of the phase two plan is creating a space for a cone beam computed tomography scanner and a milling machine, which Kahler hopes to accomplish in the next year or so.
Meanwhile, he keeps all of the operatories busy. “We actually use all seven with just one dentist,” he says. This is largely due to his two expanded-function dental assistants. “They’re RDAEF2 dental assistants. They allow me to be more productive. For example, they can place cord and take final impressions for crown and bridgework. They can also fit, adjust and seat final restorations. They’re highly trained. This allows me to fully use all seven operatories while we search for the right associates to add to the practice. I certainly don’t want to work this hard forever!”
One of the operatories is dedicated for one of those assistants. Another is dedicated for emergencies and diagnostic work. Three are dedicated to hygiene visits, and Kahler does his restorative treatments in the other two.
The wow factors
“I don’t ever get tired of hearing ‘Wow! This place is amazing!’” Kahler said. “And I even find that I’m pinching myself each time I go into the office.” He explained that years ago patients loved the view outside his operatory windows in his old practice, but it wasn’t long before a two-story building went up and completely blocked the view. In response, the Kahlers began creating a view, starting with some yard art his wife purchased, which was an elephant made of an exhaust tube, a bicycle seat and some railroad ties. They planted flowers in the “trunk” and patients loved it.
“I’d caught onto something, that this was a great distraction,” Kahler said. “We kept adding more and more yard art. And I thought, ‘What a great way to do dentistry if you can distract people enough.’ We’ve included in our value statement that if we can, for a moment, get them to forget where they are, I think we’ve done a service for people who have had bad experiences in dental offices. When we moved, we wanted to bring that whole experience indoors and it kind of evolved into putting our theme on steroids, so to speak.”
Both Kahler and his wife love the safari theme they’ve created, as do their patients. Kahler said it reflects his love for animals, “and of course my wife has amazing style sense.” Throughout her cancer treatment, Sheilah continued to provide support and advice. “We would take stuff to her or text pictures to her even while she was in the middle of chemo to ask, ‘What do you think about this? Does this look good with this?’ And she would text back, ‘Yeah, it looks great’ or ‘No, can you go with something else?’ And so she hung right in there through the whole thing.”
The exterior style of the office is reminiscent of a building one might see while on safari with its arched windows and terra-cotta tiled roof. The practice signage consists of the type of tree often seen on the African plains, featuring elephants and giraffes. The lobby has dark beamed ceilings with zebra print upholstery on the furniture. Hanging over the gas fireplace is a large, dramatic painting of an elephant painted by a personal friend. African wildlife art pieces such as giraffes, monkeys and leopards are stationed throughout the practice. In addition, the hallway features a unique ceiling fashioned from woven bamboo imported from Africa. The Kahlers collected some of the decorative pieces from eBay, estate sales and antique shops, while others were gifted by patients.
“I mean it when I say on the website that each piece of artwork has a story,” Kahler said. “We even have a crayon sketch of an elephant done by one of our little patients. We framed it by the reception desk where patients can see it.” The other message Kahler strives to project is total organization. “A dental instructor at Loma Linda used to say that if patients are moving away and ask, ‘How do you find a good dentist?,’ tell them, ‘You look in their sock drawer,’” Kahler recalled. “What he meant by that was, if all their socks are paired, lined up and organized, you’ve found a perfectionist and a good dentist. So that is what I’ve done with this practice, so to speak.”
“Patients don’t know about crown margins, right? They have to assess something else to know if they’re in the right place. So we decided to put the ‘sock drawer’ on display both figuratively and literally,” Kahler said. “In addition to paying attention to detail and being organized, I wear crazy socks. Word has apparently gotten out, because patients often check out my socks. Despite the leopard or zebra print, they actually match what I’m wearing. It communicates to my patients that the detail I put into my outfit choice is the same I give to their care. In addition, my team takes ownership and pride in what they do. They’re self-motivated and I can delegate to key leaders. I have an amazing office manager, someone dedicated to compliance, and another who runs the back office.” Kahler has added five new employees since moving and he said that being “ridiculously busy” has forced everyone to be more efficient. With the additional operatories, he has absolutely no time to waste. “The way the office is laid out, it minimizes wasted time and we’re so much more efficient.”
Kahler emphasized that the new office is the result of a lot of talented people working hard toward a common goal. “We’re so much more productive. I wanted to believe it, and now I’m living and believing it. It was just wild to get all this done. Again, if I didn’t have Patterson, no way this would ever have happened. They’ve been absolutely amazing.” This success allows the Kahlers to support more local charitable causes, such as animal rescues, their church and different ministries. They also have 10 dogs, five cats, two goats and 13 chickens to care for. Kahler thanks his architect (Warren Hamrick), contractor (Joe Gouin) and the Patterson team on his website. “We hope to have everyone back for phase two … stay tuned, it’s going to get even better.”
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This article originally appeared in the winter 2022 edition of Advantage magazine. Download the full publication (PDF).