Dr. Steven Spitz: “Managing being a provider and business owner is a constant balancing act”

Managing being a provider and business owner is a constant balancing act. In private practice, the most important fundamental job is taking care of patients. That said, you can’t run a business by yourself, so it is essential to have great professionals around me who know what they are doing and that I can trust. As […]

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Managing being a provider and business owner is a constant balancing act. In private practice, the most important fundamental job is taking care of patients. That said, you can’t run a business by yourself, so it is essential to have great professionals around me who know what they are doing and that I can trust.


As a part of our interview series with prominent medical professionals called “5 Things You Need to Know to Create a Highly Successful Private Practice”, I had the pleasure of interviewing Dr. Steven Spitz.

Steven D. Spitz, DMD, is a prosthodontist, a dentist who is a specialist in treating complex dental and facial issues, including the restoration and replacement of missing or damaged teeth. Prosthodontists are highly trained in dental implants, crowns, bridges, dentures, jaw disorders, bite occlusion, and more. Following his training at Tufts University School of Dental Medicine and Harvard School of Dental Medicine, Dr. Spitz discovered a passion for technology in dentistry and maintains a highly progressive, technologically advanced practice. Dr. Spitz was the first prosthodontist in the country to surgically place dental implants a using Erbium dental laser and, it is documented, he is the only prosthodontist in the world who is Advanced Certified in Pinhole™ Surgical Treatment (as of the printing of this article). Dr. Spitz is the founder of Smileboston Cosmetic and Implant Dentistry, on record with the Academy of Sports Dentistry as the dentist for the Boston Red Sox, and the dentist on call for the animals (yes, the animals) at Zoo New England’s Stone and Franklin Park zoos.


Thank you so much for joining us in this interview series! Before we dive in, we would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?

I started my education with a plan to become a veterinarian as an animal science major and pre-veterinary undergrad at the University of Massachusetts Amherst. During my junior summer, I had the opportunity to work with my uncle, a dentist, and found that I enjoyed the detail of treatment planning and working with people in a medical profession where patients left happier than when they arrived. After earning my dental degree at Tufts, followed by a general practice residency at Jackson Memorial Hospital in Miami, I returned to Boston to attain my prosthodontic specialty through the Harvard University/VA program. Upon graduation, I started working in private practice and soon took over that practice in Boston, which is where I am today, almost 25 years later.

I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?

In the long run, everyone around you is a mentor if you listen and make a connection. However, if I have to choose, although a bit cliché, my dad is one of my primary mentors. During his career as an educator throughout the school system, private and public, he shared many thoughts that continue to resonate with me at every turn. One that really sticks with me, is to never let an opportunity to learn, pass. With that, I found that those opportunities were around every corner, if you looked for it. In looking, I stumbled into many situations that were not so obvious and connected with many people who became mentors and friends.

For example, I was once asked to pick up a speaker for an event at the airport and I was happy to oblige. The speaker, John Kois, was well-known in the dental world and an individual I revered. He was appreciative, the one-on-one time was priceless, and the conversation was easy. It was on this drive that I was given another piece of valuable advice: He said to never accept what someone states as fact, and to always question, until you can answer the ‘why’. My advice: no matter what industry you are in, offer to help, be the first to arrive and the last to leave, and never pass up the ability to pick up the special guest at the airport. You will not regret it.

What made you want to start your own practice? Can you tell us the story of how you started it?

As dental students in Massachusetts, we were able to work as dental hygienists in our third and fourth years. To earn and learn, I worked through a temporary placement agency and had the ability to experience many different types of practices. I experienced some that ran very well and took care of their patients, and I worked in some that seemed like a factory, (get ’em in and get ’em out). I realized that in order to practice the way I envisioned, I would need to run my own practice. It was eye-opening to begin to visualize how I wanted to practice in the future. During my tenure, I was placed in an office that was owned by a prosthodontist. I knew what a prosthodontist was, but not really. Over time, I found that it meant the art and creativity of restorative care. Very different from other prosthodontists, he added dental implants to his specialty as a concentration in this office. He was also very into treatment planning, from start to finish, and I knew that this is how I wanted to treat my patients.

Can you share the most interesting story that happened to you since you began your career?

I have been fortunate and actually have two fantastic stories, one with the Boston Red Sox and one with the animals at Zoo New England.

In 2005, my wife and business partner, Laurie, created a relationship with a marketing firm who put together a program for one dentist in each city where a Major league baseball team resided, who became the ‘sponsor’ of the team for Major League Baseball’s Pitch Hit and Run kids’ program. Part of the package was a touch of VIP treatment and a private tour of the ballpark. Being in Boston, the Red Sox were our team and a private tour of Fenway Park, one of the most historic ball parks in America, was thrilling. During our Sunday tour and the finals of the Pitch Hit and Run program, we were standing on the pitcher’s mound where Jim, the Medical Director, who seemed totally annoyed that we were there, answered a few questions. A coach from the visiting Florida Marlins walked up to Jim and said, believe it or not, “Who is your team dentist? One of our coaches is having an emergency”. He said he had to look it up and would find someone. My extremely outspoken wife chimed in and said, “you know, our office is right there (pointing to our office around the corner) and he’s a dentist (pointing to me). They all looked in amazement for two seconds, then Jim, realizing this was one less thing he had to deal with, said, “great”, and we were taken to the visiting team locker room. An hour later, we were in our office taking care of the emergency, along with setting the stage for a long-term relationship with Jim and, therefore, the team. I became the ‘unofficial’ team dentist, as I didn’t pay for the rights, and anytime a player had an issue, they were directed around the corner, to me. For five years, we were flown to Jet Blue Park in Fort Meyers, Florida for spring training to assess the coaches and minor

and major league players’ dental health so that they could preventatively care for any dental issues prior to the season. I have made countless mouthguards for players who swear that they help their game, worked with Terry Francona, without results, in trying to create a non-carcinogenic substitute

for chewing tobacco, and continue to this day, keeping healthy smiles on the faces of current, past, and retired players and their families. In addition, since that time, we continue to sponsor our hometown’s Pitch Hit and Run event for kids 7–14 years old.

I am also fortunate to be the dentist for the animals at Zoo New England’s Stone and Franklin Park Zoos. I believe in building relationships wherever I go, and dental school wasn’t any different. A professor of mine, Dr. David Russell, who knew about my love of animals and my animal science training, received a call from Tufts Veterinary school asking if he could work with the veterinarians performing root canals and placing crowns on a police dog injured in the line of duty. He invited me to accompany him, and it was one of the highlights of my dental school experience. Through the years, I thought about finding a way to perform animal dentistry, but never pursued it seriously, until one of my own dogs broke a tooth. I called the animal dental specialist I worked with when in dental school, Dr. Levann, but found that she had recently retired. She sold her practice to Dr. Bonnie Shoppe, also an animal dental specialist, who cared for our dog and later told me about the Peter Emily International Veterinary Dental Foundation, a non-profit organization that travels to zoos and sanctuaries around the country caring for large animals (jaguars, lions, tigers, bears, etc.) who are in serious need of dental care. Shortly after arriving home from my first mission, I created a photo book of my trip for my reception area. A patient of mine asked me about my trip and if I had ever considered doing dental work on the animals at the zoo. Interestingly enough, it was a dream of mine, but I hadn’t had the time to pursue it. I told him I was very interested, and he said, “Great. My next-door neighbor is the CEO of the zoo and I will let him know about you”. We actually spoke later that day and he immediately had an animal resident for me to evaluate. At this point, many years later, I have treated a potto, tamarin, jaguar, two hyaenas, wild dogs, lion, and others. What I realize from both of these stories, is that if you want something, keep talking about it because you never know who knows whom, or how, when, or where your dream can come to fruition.

Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?

I chose to go into the healthcare field as, whether animals or human, I wanted to make a difference in others’ lives. I chose dentistry because even though we all have teeth, they are truly unknown to the individual. For example, you can make personal adjustments in your life when you read about heart disease, having a general understanding of how the body works, causes and treatment, and how to do your best at prevention. When it comes to dental work, you can’t see it (other than in a mirror) and wouldn’t know what you were looking at even if you could. Every tooth in the mouth is different, has a different function, and the only way to know what you want or need, and if what you want is feasible, is to see a dental professional.

Early on, I realized that specializing as a prosthodontist would give me a greater understanding of the function, aesthetics, and rehabilitation of teeth and how they ultimately affect the entire body. With that, I attended three years of post-graduate training in the form of two residency programs. I am continually enamored with the technology that is available, for the comfort of patients and the advanced diagnosis for treatment.

Regarding monetization, I have a team who is paid, I own my location, use great labs, purchase goods, invest in technology, and that all costs money. Being honorable to my patients, my team, and myself, I have learned that it is reasonable to ask for compensation when what I am offering is valuable. When looking at a diamond ring, if you are not educated on diamonds, it is hard to tell if it’s flawless or a cubic zirconia. Same thing with a dental crown; you can’t fix what you don’t know. The more one is educated on the structure, alignment, cause of injury, etc., the more precise you can diagnosis and fix an issue for the long-term.

As a medical provider, I went into dentistry like most medical professionals to help people. The concept that medicine is also a business, is foreign to many. I was taught early on by one of my mentors, that there are many ways to run a dental practice. You can open 24/7 and be a resource for emergencies, or you can have a boutique practice that pampers their patients every need, including manicures and pedicures, during their dental visit, and everything in between.

While in dental school, I often read the professional journal, Dental Economics. This gave me a base of knowledge for how a dental practice runs and, in addition, I attended many continuing education programs focused on running a healthy practice. During my four years of dental school and three years of post-graduate studies, not one business course in the curriculum prepared us on the business of dentistry and how to run a practice. I knew that I could create the type of practice I wanted and hired good people around me to help me facilitate that experience. I carefully invested in the best, new technology, and had a great marketing strategy.

I was also taught early on, to never assume anything about anyone. I recall having a patient who walked in one day without an appointment and he asked to be seen. When he smiled, he was missing every other tooth, his hair was long and unruly, and his wrinkled clothes looked like he had just woken up. We sat down and I asked him the same questions I ask all my patients: “What do you like about your teeth and smile?”, “If you could snap your fingers and create your perfect smile, what would that be like?”, etc. He told me his thoughts and what would constitute his perfect smile, and when we were finished, he smiled, said thank you, handed me a credit card and put a deposit down on his future dental treatment plan. It turned out that he owned one of the largest construction companies in Boston and had always had a fear of the dentist. As we sat and talked, he felt at ease, liked the proposal, and was eager to begin.

Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?

Surround yourself with brilliant, positive, thinking people. It’s having good people around me who know more than I do about business ‘things’ that I have no formal knowledge. I have been partners with my wife, Laurie, in life coming up on 30 years this summer, and as a business partner for the years we have owned Smileboston. Her degree is in marketing and public relations and in addition, she manages all the out-of-the-office issues, so I don’t have to worry. My office team, who is spectacular and always adapting to new issues, keeps the internal office (AR, patient issues, technology, etc.) running.

In addition to my wife, I am fortunate that Smileboston is a family affair: I rely on my mother, who is an accountant and has worked for H&R Block for over 40 years, to assure we are on track with our books and our accounting firm, who we have worked with for 15 years, my father, an educator who has his PhD in finance, helps to track our 401k, and my father-in-law is our insurance guru. Having a good team around me allows me to work on the big picture of patient care and the business and make adjustments when necessary.

From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?

This is a tough one. As I mentioned, I worked often for a specific practice as a hygienist when I was a dental student. The dentist was a prosthodontist who took me under his guidance. He advised me about the importance of treatment planning, that I should consider being a prosthodontist, and to take extra time to learn surgery (which was not something prosthodontists did back then, as they left the surgery to the oral surgeon or periodontist), and he really did lead me on my path to where I am now. In my last year of my prosthodontic program at Harvard, we solidified our friendship and our professional relationship, and I planned to join his Boston practice upon graduation. In August of 1997, I joined as an associate, and soon after he let me know that he thought it would be better for me if I purchased and ran the practice and that he would transition and continue to mentor me as a clinician and as a business owner, but he wanted to pursue other aspects of life. Following the purchase, he told me that he was taking his family to Hawaii for vacation for two weeks in February. While he was gone, my wife and I were watching the news and there was an investigative news piece about a local dentist. We watched wondering if we would know this dentist and to our absolute horror, it was my friend, my mentor, my business associate. The news reporter was an undercover patient, exposing the dentist as he proclaimed that purely aesthetic treatment was unequivocally necessary. He ended up losing his license and, needless to say, we never saw or heard from him again.

I was totally devastated. Here we were, just out of school, six-figures in school debt, our first house, a two-year-old son, and less than a month away from our daughter being born. When you purchase a practice, part of what you are purchasing is pre-paid treatment. However, the next day, we were

refunding monies we didn’t have and drowning in bills. We felt that we had jumped head-first into an empty swimming pool that was being filled drop-by-drop-by-drop. With my wife’s marketing and PR

experience, she created a website before they were popular, as well as relationships with local magazines, newspapers, and television stations at a time that professionals who did any marketing or advertising were, ‘ambulance chasers’. My dental friends would joke that I was the, ‘famous dentist’, and now everyone is marketing. In addition, we did personal seminars on treatment in our office, we created elaborate financial plans for anyone who wanted me to treat them, I would watch the kids for the weekends while she figured out how to pay the bills, and we counted on family for so much.

In hindsight, it was a great lesson:

  1. Family is everything
  2. Know that no matter how much you plan, plans change
  3. Be positive, because the alternative gets you nowhere
  4. Don’t be afraid to show people how good you are, because you worked very hard to get there!

Know that there will be successful days and those days that make you feel like giving up. Just keep coming back to the why and the vision, and success, whatever that means to you, will come.

Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why?

  1. Surround yourself with great people who know more than you.

Managing being a provider and business owner is a constant balancing act. In private practice, the most important fundamental job is taking care of patients. That said, you can’t run a business by yourself, so it is essential to have great professionals around me who know what they are doing and that I can trust.

From the beginning, I realized that I needed to surround myself with brilliant, positive, thinking people. It’s having good people around me who know more than I do about business ‘things’ that I have no formal knowledge

Having a great team around me allows me to work on the big picture of the business and make adjustments when necessary. I typically spend 32 hours a week with patients, another six hours a week treatment planning and preparing for my patients, and 12 hours a week on the business. This allows me time to focus on my family, my health, and the things I enjoy outside of the office.

2. Keep learning. Technology, procedures, information, etc. evolves daily. You need to as well.

Technology is disrupting every industry, and, for me, dentistry is no different. Incorporating cutting-edge technology and breakthrough procedures is what sets me, and our office, apart. In my training, I learned dental implants were placed with a scalpel, a drill, and sutures. Now, I place most implants with a laser, and no need for sutures.

Early on in my practice, I learned from an associate about lasers and how they could work for placing implants. This specific laser was the first to cut through bone and not primarily soft tissue. I dove into classes, research, calling reps and other doctors who worked on the development of the laser and became the first prosthodontist in the country to place dental implants with the laser. I had the opportunity to travel throughout the world, teaching and lecturing on how to make the most of the technology. When Invisalign™ first came out in the market, I believed that their technology would help many of my cases and worked with them as the first prosthodontist, or non-orthodontist, to utilize their system. Bottom line, with today’s ability to Google and YouTube so many new procedures and equipment, it is easy to search and find what will keep taking dentistry to the next level.

3. Do good in your community.

Your community is where you live and where your work is reflected. Being in private practice gave me the ability to give my time and expertise. When my kids were young, I became involved with the Boys and Girls Club in our area and performed dental screening on kids, spent time at the dental clinic for local homeless veterans and, through Alpha Omega International Dental Society, I have had the honor of treating Holocaust survivors living below the poverty line. In Hebrew, there is saying, Tikkun Olam — to heal the world — and I believe that it is our responsibility to leave this world a little better than we found it. Giving back is extremely helpful for those you assist, and, in addition, it is good for your heart.

4. You don’t have to find a mentor, everyone around you can teach you something.

Life is all about creating relationships and asking questions. Everyday my goal is to get to know my patients, find out who they are, their goals, and their ‘why’.

I have been fortunate to have patients who are leaders in their fields, in education, sports, government, etc. As a prosthodontist, I make it a point to ask about their goals, dental and beyond, and appreciate finding their joy in life. I have made long-lasting relationships with patients and, as much as they can call me for dental advice, I have the pleasure to be able to call on them for their specific knowledge. These relationships and the trust that is built, is priceless.

5. Have a marketing plan and someone to drive it. It won’t help to be the best that no one knows.

Sometimes during my busy day, I feel that I don’t have the time or bandwidth for it, but I see the value. I do what my marketing director asks whether it’s a HARO request or an advertisement for a local magazine, and something good always comes from it. In reality, I am a medical professional, not a marketing professional. When I started my practice, if you were involved in any marketing, you were considered unethical. Now, you can’t have a successful business without it. As my goal is to help people, marketing allows me to share my experience and my knowledge, letting people know that there is hope and help for their healthcare needs.

As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?

Working on your practice is very hard if you do not actually schedule the time. I typically spend 32 hours a week with patients, another six hours a week treatment planning and preparing for my patients, and 12 hours a week on the business. This allows me time to focus on my family, my health, and the things I enjoy outside of the office. I often speak with friends and colleagues who tell me that they never have trouble with their practice. When I ask how much time they spend on the practice, they say that they are always in it, and don’t worry so much about working on the business. Right or wrong, I realized that ignorance is bliss.

The 12 hours I spend on the business, is time is spent with my management team discussing the current week and what’s coming up next week. I spend time getting reports from my marketing manager (my wife and life partner) planning where our efforts are going, to keep the constant patient flow in the office, I constantly look at the equipment we have and how we can better use and learn the technology for consistent treatment outcomes, and I give myself a few days off in September to plan my year and set goals for myself, personally and for the practice. I monitor those goals in a daily, weekly, and monthly timeline.

I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?

I created my core values for my office and, not surprisingly, it’s an extension of my home life. Just as in the office, I need to assure I am following them in my personal life: Make others smile, always keep learning, be positive, have an all-in attitude, and putting team, or family, first. If I keep this in mind and always in front of me, my stress is (mostly) controlled.

In order to keep my mind sharp and always be learning, I constantly read journals, watch webinars, learn about technology and communicate often with other dentists locally and around the world. This past year, I started a study club for dental students, as I find that teaching keeps me grounded and sharing the cases that we do on a daily basis, makes us humble because we can recognize where we hit the home run and where we could have improved.

As you noted, many healthcare workers including dental specialists, were taught in school to strive for perfection, and rightly so, for each case. However, this is not always possible due to a patient’s health issues, bone structure, financial limitations, or even their understanding of how their choices can affect their lives, and we need to learn to adapt to find the most favorable outcome with what we have in front of us. This can be very taxing mentally, when you know there is a person behind the teeth and you really do want to do all you can, as best you can, even if the resources are not optimal and not always possible.

With that, we all need an outlet. I like to be active during my time off or being near the water. I like to hike, play on two softball leagues, belong to a boating club and will always find time for fishing. I have a scheduled workout with a trainer twice a week and need that to keep me on track.

Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?

My favorite life quote is, “Never say ‘can’t’” — there is always a way to do something you truly want to do. Two years ago, my son asked me if I would join him to run a marathon at Disney. He knew that I could never say no to anything Disney. However, I had never run anywhere, at any distance, in my life, and I had always thought that people who run at all, like my son and my wife, were crazy. I did not like running and it was never even a thought — and a marathon at that! Well, I learned you never say no to your adult kids if it gives you opportunity to spend time with them… or to Disney, so I said that I would start with a 5k or 10k. But when he went to register, the shorter races were all sold out, so I committed to a half-marathon. 13.1 miles. I downloaded the couch to 5k app and started by walking, then jogging, then running. I did the walk/run method and learned to go farther and farther. That January, I ran my first half-marathon and when they resume, I have committed to doing it again, just a bit faster.

How can our readers further follow your work online?

I have been fortunate to take part and share in many professional and personal articles that can be found under my name, Steven Spitz, DMD, or Smileboston through Google and our website, www.smileboston.com.

Thank you for these great insights! We wish you continued success and good health!

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