FORT SMITH PEDIATRIC DENTAL GROUP FORT SMITH, ARKANSAS

How do you create a timeless setting for pediatric dentistry that also makes smart long-term business sense? We found a blueprint where the new South meets the old West.

DRS. MATTHEW BITTLE and Jared Acosta are no strangers to working under pressure. Together, they see about 200 kids a day—“completely normal,” according to them. They’re the only two doctors at Fort Smith Pediatric Dental Group, their single-location, roughly 30-employee practice, which lately has been adding up to 140 new patients each month. As you’d imagine, they’re booked far in advance. And parents routinely ferry their kids more than 100 miles round-trip to see them.

They had outgrown their previous space in more ways than square footage alone. Bottlenecks were cropping up not only in terms of patient flow but supplies and sterilization as well. Their location was a little out of the way, too. The knee-jerk reaction would be simply to hurry up and get into a bigger space, pronto. But taking a smart, long-term view of their clinical and business needs helped them create one of the more unique pediatric practices we’ve seen, one that will stand the test of time.

WISE GUYS
At first, the two longtime friends come across more like wisecracking partners in a buddy cop movie than pediatric dentists. They have an easy rapport, practically finish each other’s sentences and seem perpetually unfazed by challenges. However, they quickly reveal themselves as careful and studious, possessing an especially keen business sense. Over the years, they’ve become students of precisely what works in a busy pediatric practice and what doesn’t. Theirs isn’t a typical dental practice success story.

Fort Smith, Arkansas, is on the Oklahoma border between the population centers of Little Rock and Tulsa. Dr. Bittle is a fourth- generation Fort Smith resident who graduated from the University of Arkansas and the University of Tennessee College of Dentistry; he did his residency at Oklahoma Children’s Hospital. Dr. Acosta is a West Coast kid who attended Northern California’s Dugoni School of Dentistry at the University of the Pacific. An unlikely partnership? You bet. “I would’ve never come down to Arkansas on my own,” Dr. Acosta says.

The two first crossed paths while applying for their pediatric residencies at UNLV. Dr. Acosta later spotted Dr. Bittle standing outside the school, looking more than a little like a fish out of water. When he pulled over his car to offer a ride, Dr. Bittle said he’d wait for a cab. “You better hop in,” Dr. Acosta re-plied. “There aren’t any cabs in this part of town.” And so they struck up a friendship: two talented guys, young, single, figuring out what comes next.

LESS COMPETITION,
MORE OPPORTUNITY
“He told me about his hometown of Fort Smith, how he saw lots of potential there,” Dr. Acosta recalls. In the movies, it’s usually the other way around—the big-city guy urging his pal to break out of his small town. Though initially reluctant, Dr. Acosta paid a visit and said Fort Smith revealed itself as not only charming but also “a rare situation, a genuine diamond in the rough.” From there, the two were on a path to settling down as family men and business owners.

Dr. Bittle was already working as an associate in the busy pediatric office of Dr. Vent Murphy, by that time a beloved fixture in the community. Dr. Acosta signed on soon after and, by 2014, the two bought out Dr. Murphy. He retired in 2015, leaving them with a quickly expanding and much-needed health care resource in a large area short on pediatric dentists. More importantly, he imparted a career’s worth of experience for the partners to build on. They took it and ran with it, until the operation started bursting at the seams.

DOWN TO BUSINESS
The doctors mulled over various options and finally arrived at a plan for a larger mixed-use medical facility that would allow for shar-ing space—and costs—with other practices. “We had to ask ourselves, ‘wouldn’t it be better not to bite it all off on our own?’ ” Dr. Acosta says. They formed an LLC with two synergistic business partners, an ortho office and an oral surgery practice, with all parties owning shares.

All three practices are equal partners in the deal. However, since the other partners commute to Fort Smith, Drs. Bittle and Acosta also volunteer as de facto decision makers for the purpose of practicality, and Dr. Bittle was voted operating manager. Their deal gives them right of first refusal if either of their partners decides to close up shop or sell. “It took a lot of time and negotiation to put it together,” Dr. Bittle says. The pandemic also erected obstacles, from construction delays to rising materials costs and interest rates, but nothing catastrophic.

FINALLY, SOME FUN
With ample space set aside to do whatever they wanted in a gleamingly modern structure of their own, the two set to work over-seeing the interior design. “We wanted some-thing contemporary but timeless. There was no way we were going to invest this much time, energy and money into something we’d need to renovate in just 10 years,” Dr. Acosta says. Their solution: a cabin vibe. “Cabins looked the same 300 years ago as they do to-day. Kids think they’re a playhouse, but adults like them too.”

Since their part of Arkansas is home to many resorts and vacation communities, drawing inspiration was easy. However, the doctors were cognizant about not going too far upscale. “We told the architects, ‘we don’t want a Taj Mahal. We want to welcome everybody. Every-body should feel at home,’ ” Dr. Bittle says.

Taylor Haight and Emily Pieshefski, their inter ior designers from Benco Dental, “did a phe-nomenal job of taking our verbal descriptions and turning them into something tangible,” Dr. Bittle says, adding that the process became even more satisfying as construction began. “It’s one thing to see your ideas come to life on paper; it’s another to see them come to fruition in the real world.”

LESSONS LEARNED
Despite the new practice’s larger overall dimensions, the doctors actually insisted on a smaller reception area. “There’s a method to the madness,” Dr. Bittle says. “We’re more efficient in the new space, and this continually forces us to improve.” Efficiency is the name of the game throughout, in fact. There are no fixed computers; everyone uses Surface Pros. There are no fixed X-ray heads either, only Dexis Nomads. Redundancy is built into every protocol to prevent downtime, from everyday systems to the practice’s two panos.

About 1,800 of the 10,000 total square feet are dedicated to hallway—“an investment most practices would be reluctant to make,” Dr. Acosta admits, “but having an outside path for patients really pays off.” Equipment rooms are on the outside, so there’s almost no disruption from people servicing the mechanical room. “We had a nitrous delivery guy we called Mr. Whistles, for obvious reasons,” Dr. Bittle says. “He still delivers our nitrous, but we don’t hear him anymore.”

They also left some of the fun stuff from their old practice behind, like model trains and a large fish tank, going for a fresh start more focused on creating a cohesive feel. “We had bright colors and a jumble of toys and stuff that excited kids, but it made them more hyper,” Dr. Bittle says. “They’re calmer and more relaxed with our current palette, which is a lot more muted.” An arcade area now contains the kid-friendly stuff that previously sprawled throughout, though each treatment room is equipped with video games as well.

We’re more efficient in the new space, and this continually forces us to improve.”
—DR. MATTHEW BITTLE

All in all, “it came together pretty naturally,” Dr. Bittle says. “Disagreements can break partnerships, but aside from talking through a few things, we mostly saw eye to eye.”

The doctors also invested in branding, with the understanding that a strong brand—combined with referral-worthy patient experiences—is all the marketing some practices need. “We go to seminars and they say, ‘raise your hands if you do no marketing.’ We’re always one of the few to raise our hands. It blows their minds,” Dr. Acosta says.

To ensure things stay that way, they hired Benco’s Build Your Brand team, led by brand design specialist Allison Simenkiewicz, to refresh their logo and visual identity and sync them with the new interior. “Our old brand wasn’t a brand in the modern sense, so we gave Allison free rein. About all we said is, ‘we want it to look rustic.’ We spoke very generally to her about galvanized barns and woods,” Dr. Bittle says. “It was amazing to see it come to life and put our own special touch on it, playing with fonts.”

A CONFIDENT FUTURE
While the doctors are still swamped, they’re down from a peak six-month wait for new patients at their old location to around half that. They work five days a week, one in the hospital, but now at least manage to take every other Monday off. Their patient base also includes contracts with large Native American reservations and special-needs care facilities. Yet the practice’s built-in efficiencies and focus on continuous improvement keeps things manageable. “Don’t underestimate how much you can get done,” Dr. Bittle says. “We feel better at the end of the day even though we’re tired. We’d much rather be seeing patients than sitting in our offices.”

California native Dr. Acosta, meanwhile, has fully embraced the benefits of a small-town practice—and encourages other young practice owners to consider the same. “There’s an abun-dance of patients here. It’s friendly. We’re not really competing [with other practices], either—we’re working together to make sure the community gets the best treatment.” Dr. Bittle’s advice:

“The real competition these days is corporate dentistry. They draw workers to areas doctors probably would never buy or build practices in. The fact that not everyone wants to own a practice these days is an opportunity for those who do. Don’t count out the little guy or the little town. It works for us. We love it.”

The fab three: (From left) Benco Dental’s Allison Simenkiewicz, Taylor Haight and Emily Pieshefski

The Design Team
Photography: Aerophoto America
Interior Design: Taylor Haight, Emily Pieshefski, Benco Dental
Brand Design: Allison Simenkiewicz, Benco Dental
Equipment Specialist: Scott Fritz
Friendly Benco Rep: Austin Thomas
Online: fspdg.com