The Story of Our Practice

A Start-up Journey

R. Christian Solem, DMD, MS

About five years ago, before the COVID epidemic rocked the world and four years out of orthodontic residency, I approached my wife with the naïve question: “What if I started my own small business and built an orthodontic office?”. Being an engineer, of the characteristic risk-adverse mindset, she advised me to work for a few more years as an associate and explore other, less risky ventures. I’m lucky to have a great job, a great boss and amazing coworkers. Why would a dentist risk this comfortable existence, leaving work at 5:30, sleeping well and not having to worry about all the responsibilities of being a small business owner? Personally, I’m of the type motivated by challenges. Overcoming obstacles and solving problems must release a reward of dopamine in my synapses. In fact, I think most dentists are like me. Simply working and helping our patients, while enjoyable, can become routine. Something motivated us to study hard, make it through dental school and then pass our board exams with the light of reward distant. Setting a goal, working hard, and achieving it many years later feels better than any steady paycheck.

Once I had the idea in my mind, I tried to learn as much as possible from those who had succeeded, and the lessons from their failures. Naturally, I turned to my co-residents from UCSF. Our class was uniquely entrepreneurial, out of the five of us four had launched successful start-ups in highly competitive California. In fact, I didn’t think I had the personality to be successful in business. I really enjoyed teaching, and spent the first three years out of school teaching at UCLA and UCSF. If you asked any of them, I was probably going to be a clinical professor at a dental school. To supplement my income from teaching, I was lucky to work as an associate for a few incredible orthodontists. I found that more than talking and lecturing about orthodontics, I most enjoyed doing the work itself. Inspired by the achievements of my classmates and the shining examples of my mentors, I acquired the confidence to practice on my own. I found that many of the qualities of good teachers overlap with those in a good boss, and a good doctor. For example, your ability to delegate a task depends on how well you can explain how to do it. Conflicts are less frequent when you can clearly explain and teach a patient about their treatment. I took notes on the things that my bosses and mentors did well to manage their teams, and on what attracted patients to them. Armed with this experience, I set out to find a location for my practice.

Finding a location for my practice was the most difficult decision. It took us about three years. My wife has been working with the same environmental engineering consulting company in Walnut Creek since she finished her Master’s thirteen years ago. Moving would’ve been a major career set-back for her, so we focused on areas within commuting distance of here. We moved into a house in Pleasant Hill right before the pandemic hit. Like many others, we became good friends with our neighbors during this time, and discovered that there were a lot of younger families like us moving into the area. The population of retired original owners was gradually turning over to younger families. I did the math, and determined that there was room for another orthodontist here based on the projected patient population. So I literally rode about on bike while I was unemployed during the pandemic and looked for places to lease. I found a great spot right across from the high school and middle school, but at 1100 sq. ft. it was too small for an orthodontic office. The landlord suggested that I could knock down the wall to the adjacent suite to make it 1600 sq. ft., which is about the ideal size for a medium-sized orthodontic practice. The previous tenant had terminated their lease early due to the pandemic, so I was able to negotiate a good price on the rent and tenant improvements. Interest rates seemed like they couldn’t go any lower, and I was able to get a very low interest rate on the practice loan. In short, I wasn’t likely to get a better deal than this, so I decided to go for it!

It took us about a year to plan and design the build-out. Without my engineer wife helping out, and the advice of our architect and orthodontist mentors, I would’ve never been able to do it. The aesthetics, functionality, and openness of the space never cease to amaze me. It is a pleasure to work and treat patients in our office. I now have two great employees, and we are starting to get new patients trickling in. While it’s slower than I’d like, I realize that it takes many years to build up a thriving practice, and with patience we will get there eventually.