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Luring hygienists to a practice in rural Maine has proved challenging. Though there’s been a lot of interest in the ads they’ve posted, very few candidates are actually interested in the “downeast lifestyle” that Machias, Maine, offers.

Recruiting Hygienists from Across the State

So the Sparagas decided to try another hygienist recruitment strategy – and it’s proven to be surprisingly controversial. For $35, the State Bureau of Records gave them a mailing list of all licensed health care providers in the state of Maine.

Interestingly, roughly a third of the listed RDHs used their current office as their personal mailing address. As a result, the Sparagas received a few irate letters from dentists questioning the moral and ethical appropriateness of soliciting their hygienists. As one doctor wrote,

I feel compelled to write you today with a serious concern we have regarding a mailing each of our hygienists received from you (at our office address no less!) inviting them to join your team at Machias Dental.

Our reaction to this solicitation initially was to laugh at it, though as I thought more about it, my feelings went from amusement to outrage to bewilderment. This is not the way we “do things” in Maine, so where was this coming from? I know your reputation and the reputation of your practice is outstanding, so I’m confused as to why this type of mailing would make its way to our office. I can only assume this was an oversight mistake on your part. I suppose this can happen. But did hygienists at other dental offices in the state also receive this letter? I certainly hope not!

Please either respond to this email or call me to discuss this matter further. I would like to put my mind at ease that the collegial culture Maine dentists have traditionally enjoyed is not on the decline! I look forward to hearing from you soon.

The Doctor Defends His Strategy

Dr. Sparaga’s response was both diplomatic and sympathetic.

Thank you for your concerns about our recent mailing to all the hygienists in the state in our quest for a new hire. I’m sorry if you have taken this personally and it has offended you.

As we all know, it is most difficult to attract qualified personnel to live here, and we’ve resorted to a mass mailing to Maine RDH’s seeking someone looking for a change not only in jobs, but in lifestyle. With a practice in an underserved rural area, we do not have the luxury of putting an ad in the local paper, hoping to attract a provider, someone looking for a change.

The state considers the lists of practitioners, medical and dental, as public information, rather than personal. With the dental manpower shortage in the rural areas, the state bureau of records is most willing to give out the list of all their medical and dental personnel especially if it helps remedy the maldistribution of manpower toward these areas. I would suppose when considering the current access to care issue, it might be considered unethical to restrict such information. For whatever reason, it would appear that many of the RDH’s listed their dental office of employ as their contact address, instead of their personal residence. We could not tell whether these addresses were of their home or office. And of course, I assume that these healthcare professionals will judge for themselves whether our offer of new horizons is offensive to them. I would propose that the offer might mean more to them than a concern for collegiality amongst us dentists.

Thank you for understanding that a mass mailing was the only way we could reach out to Maine’s RDH’s and supply more healthcare manpower to this underserved area.

But in addition to the angry letters, they also received several excellent replies from remarkable candidates. The Sparagas are happily interviewing those RDHs now.

Jim Du Molin’s Two Cents

I am squarely on Dr. Sparaga’s side. There’s nothing wrong with a doctor who is looking to hire hygienist taking a state mailing list and sending out a letter. It is clear to me that there are no ethical issues here. The state mailing list is public information, and I’m not going to fault Dr. Sparaga for using all the resources available to him.

Registered dental hygienists are a scare resource. Given the realities of supply and demand, that means there will be competition for RDHs. If you’re a dentist and you need a hygienists, you will do whatever you can and pay whatever you need to in order to find a hygienist. It’s easier for dentists to raise their prices than function without a hygienist.

In addition, there are lots of reasons why RDHs (or anyone) might switch jobs. No matter how great a job is, sometimes people need a change of scenery. People are going to do what’s in their own self-interest. If you want loyalty, get a dog!

So to the doctor who complained, I would say, “If you’re taking care of your hygienists, then you have nothing to worry about.”

What do you think? Post your comments!

Dr. Jim Sparaga is constructing a new dental facility in rural Maine. He’s going to need some dental hygienists for his expanded practice, but finding them has proven more difficult than expected. He came up with a great recruiting strategy – but a few Maine dentists were less than thrilled.

Learn more by watching the video below. Or, if you prefer the written word, you can read Jim’s editorial about the difficulty of recruiting dental hygienists.

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Machias Dental’s new facility [click to enlarge]

It’s full speed ahead for Jim and Kathy Sparaga as they put the finishing touches on their brand-new dental practice facility in Machias, Maine.

At times, there are ten men working on the building’s interior at once. The basement is a maze of pipes and wires. The sheetrocking stormtroopers are making everyone nervous; will they close up the walls before the equipment gets installed? Inevitably, there will be a number of wall panels coming off to get the details installed before the process is over. Despite a well-reputed dental architectural firm and a good local architect, there have been many omissions and undiscovered conflicts of materials and placements.

Making sense of 33,800 feet of cable [click to enlarge]

“It takes 4 hours every day for Kathy to unravel the issues and do the research required by the general contractor,” sighs Jim. “I just do the dentistry.”

The move-in date looms. Several new hires are joining the practice. Their new associate is about to arrive. They’re wrestling with wallpaper and furniture. Their resident computer whiz is connecting 33,800 feet of cable. (Yes, that’s over six miles of cable.) And the Sparagas couldn’t be more excited.

Catch up on the dental practice construction story in Machias, Maine, and check back for further updates.

Laying the pavement [click to enlarge]

Earlier this year, I began to tell you the tale of Machias Dental. Owned by Dr. James Sparaga and his wife Kathy, it’s a successful practice in rural Maine. In fact, the practice was so successful it outgrew its building.

So the Sparagas embarked on an ambitious project to construct the dental practice of their dreams. They decided they would improve their working lives and pave the way for retirement by building a facility large enough to support an associate.

“The areal shot shows a parking lot full of cancellations,” jokes Dr. Sparaga. [click to enlarge]

Needless to say, building a dental facility from the ground up is no small task. Between the weather and contractors, the staffing issues and the equipment problems, they’ve had their hands full for many months.

However, their saga is finally drawing to a close! The building has been constructed and the pavement laid. Soon enough, the staff will move in, and the patients will begin to arrive…

Catch up on the dental practice construction story in Machias, Maine. And stay tuned for further updates!

Though construction is nearly complete, the financial work just goes on and on. Dr. Sparaga’s wife Kathy is continuously crunching numbers for the bank, for the governmental guaranteeing agencies (USDA), and for the insurance companies. “It seems endless,” explains the doctor, “and it’s constantly evolving with changes in equipment pricing and cost overruns in the project.”

It all comes down to this: the new facility [click to enlarge]

It’s unfortunate but not terribly surprising that the project has run over budget. Given that, the Sparagas are holding the line on items like trash compactors, garden pavers, and piezosurgery equipment.

However, they are increasing their marketing to create booking pressure sufficient to supply patients for two dentists. After analyzing their advertising budget, the Sparagas decided to change their strategy a little bit. For the moment, they will reallocate their television funds to additional radio and direct mail in extended geographic areas. (They intend to develop new TV ads within a year.)

I asked Dr. Sparaga about the reasons behind this marketing switch.

“We’ve found that the initial penetration of a geographic area is best served with radio, followed by direct mail and finally TV,” he told me. “Television is too expensive to introduce ourselves. However, when it’s applied after the initial invasion of other media, TV has worked to validate what the public has been hearing and reading about.

“The biggest cases we’ve done have been strongly influenced by TV validation,” he added.

Want to catch up on this story? Here’s what the Sparagas have been doing…

• Developing plans for a new dental facility.
• Undertaking a financial analysis.
• Laying the foundation.
• Putting up some walls.
• Constructing the skeleton.
• Raising the roof.
• Watching the design firm go out of business.
• Finding new design contractors.
• Buying some dental equipment.
• Searching for a new dental associate.
• Looking for a dental hygienist or two.
• Finding a compatible associate.

Dr. Sparaga is delighted to have found a quality dental associate who will mesh with his practice and enjoy its rural location.

“Our associate will be bringing a fresh set of skills to the office, as portrayed in his Caliper test,” said Dr. Sparaga. “Much of his personality profile matches mine (no wonder I liked him!), so we know we’ll see eye-to-eye on big-picture issues.”

What’s inside the walls makes all the difference [click to enlarge]

The new facility includes 33800 feet of category 6 computer cable [click to enlarge]

The Caliper test is a pre-employment personality test. It’s a quantitative way of measuring the compatibility of a candidate with a particular position at a particular company. Many employers who use the Caliper system swear by its results.

Dr Sparaga continued enthusiastically. “His high marks on empathetic interaction will balance my high ‘D’ developmental tendencies, and I welcome help in that crucial area. It appears we’ll have no shortage of enthusiasm over great new developments in dentistry as we concentrate on the personnel development that will be necessary to make our practice a success. It’s an exciting time for us.”

Want to catch up on this story? Here’s what the Sparagas have been doing…

• Developing plans for a new dental facility.
• Undertaking a financial analysis.
• Laying the foundation.
• Putting up some walls.
• Constructing the skeleton.
• Raising the roof.
• Watching the design firm go out of business.
• Finding new design contractors.
• Buying some dental equipment.
• Searching for a new dental associate.
• Looking for a dental hygienist or two.

As winter comes to end, so too does construction… [click to enlarge]

As construction of Machias Dental’s new facility moves into its final stages, personnel issues are coming to the forefront. Since an associate dentist will be joining the practice at its new location, it will be essential to have enough team members to adequately support both dentists.

In the meantime, one of Dr. Sparaga’s hygienists had to resign to take over hospice care for her mother, so the practice has incorporated assisted hygiene into the mix for the moment. And it’s working pretty well: with a seasoned assistant, one RDH is producing close to what two RDHs used to produce per day.

Sometimes the workers are happy.	Sometimes they are not enthused.

The Sparagas are currently advertising for two hygienists. The supply of hygienists seems to be more than adequate, as they have received multiple calls from their national search ads on the internet from candidates saying no one’s hiring. But the practice location in rural Maine has proved quite a challenge.

“We’ve learned that a well-paying job, a new facility, and a dynamic working environment is not enough to attract most young people,” sighed Dr. Sparaga. “They want lifestyle first. Since this lifestyle is not as glittery and vibrant as in more urban and affluent areas, it will take the exceptional individual to fill our needs.”

The doctor is also unwilling to settle for less than the best. “We’ve had a few hygienists try it for a few months who could not meet our minimum performance standards, so we asked them to move on. We know what’s possible, and we won’t settle for mediocre job skills.”

–

Work is nearly complete on Dr. Jim Sparaga’s new dental facility. His team is looking forward to moving in to their spacious new headquarters. But the doctor also knows that the new facility will require expanding his team…

The new facility is nearly complete! [click to enlarge]

Finding an associate is a common retirement strategy for dentists, and Dr. Sparaga was no exception. He was hoping to find an enthusiastic young associate who could help him recoup some of the construction expenses. And if he grooms his successor along the way, so much the better.

Dr. Sparaga and his wife wrote up an ad top attract the right sort of associate to their practice in rural Maine. They knew it wouldn’t be fore everybody, but they crossed their fingers. (See below for the text of their ad.)

They also had two “head-hunters” out there beating the bushes for an associate. Unfortunately, it didn’t work as well as they’d hoped. “All we got were dozens of inquiries from green-card seeking dentists in places like Bangalore and Sumatra,” sighed Dr. Sparaga.

Then the doctor got a call from a dental student who had happened across their ad on the internet. When Dr. Sparaga learned he went to Pitt, his heart swelled a little bit, because that’s his alma mater too.

Had the Sparagas found their new associate? His resume was in order, he seemed enthusiastic about Maine, and they got on well over the phone. So the Pitt student brought his wife and young children to Maine for a visit. They kayake and attended the local blueberry festival. The whole family loved the downeast lifestyle.

“We couldn’t be more pleased with him and his family,” enthused Dr. Sparaga. “Luck or Karma? Maybe it’s the new facility?”

Here’s the original ad for a dental associate:

ASSOCIATE OPPORTUNITY

Soar with eagles n the rugged coast of Maine with a dynamic team in a state-of-the-art facility. Instead of fighting traffic, take part in our adventure: providing complete dentistry to our neighbors in our rural coastal town. An unusual practice opportunity, practicing big-city dentistry in an historic village. Machias is the Shiretown, with the county court system, University of Maine, hospital, and airport (with a new one coming).

Help take our patients to the next level with excellent communication skills, while advancing your career with Implants, Cerec, Lasers, Invisalign, anti-infective perio management, conscious sedation, and on-site lab.

Take the leap and join us in our new office, currently under construction, overlooking the Machias River Falls.

Want to catch up on this story? Here’s what the Sparagas have been doing…

• Developing plans for a new dental facility.
• Undertaking a financial analysis.
• Laying the foundation.
• Putting up some walls.
• Constructing the skeleton.
• Raising the roof.
• Watching the design firm go out of business.
• Finding new design contractors.
• Buy some dental equipment.

Remember Dr. James Sparaga, a dentist who’s building a spacious new facility for his practice? Well, we’re back with another installment of the “Sparaga Saga.”

Even in the snow, work continues! [click to enlarge]

Catch up on what the Sparagas have been doing…

• Developing plans for a new dental facility.
• Undertaking a financial analysis.
• Laying the foundation.
• Putting up some walls.
• Constructing the skeleton.
• Raising the roof.
• Watching the design firm go out of business.
• Finding new design contractors.

Like most dentists, Dr. Sparaga was looking forward to purchasing new dental equipment. He was building the practice of his dreams, and he was going to stock it with his dream equipment.

The dentist was particularly excited about Cerec in-chair system. This would provide amazing computer-integration of the Cerec crown design and milling system with the patient dental chair. Dr. Sparaga couldn’t wait.

The interior takes shape… [click to enlarge]

But he heard reports from the field and from his dental supplier that the equipment was not functioning. He spoke with another dentist who’d purchased two units. This doctor tried for a year straight to get them operational for a year. At one stage, the dental repairman was in his office 80 hours straight! He finally shipped the equipment back to Germany for service. Though his units are now working, he advised Dr. Sparaga to dodge that bullet and not make the purchase.

To fill up their new facility, the Sparagas headed to Yankee Dental Congress in Boston. In 72 crazed hours, they selected all aspects of the dental operatories right down to the handpieces. “The sales reps were grinning from ear to ear every time Jim and I approached,” Kathy Sparaga commented. “It’s amazing how decisive you can be with a gun to your head!”

At long last, the Sparagas are in the final stages of completing their new dental facility. Stay tuned to see how it turns out!

We’ve been covering the story of Dr James Sparaga, a dentist in the middle of building a spacious new facility for his practice.

The team checks out their new home [click to enlarge]

Here are the steps the doctor has already taken:

• Develop plans for a new dental facility.
• Undertake a financial analysis.
• Lay the foundation.
• Put some walls up.
• Construct the skeleton.
• Raise the roof.
• Watch the design firm go out of business.

The work focus is shifting from the exterior of the building to the interior (the fun part of the building!). The Sparagas had found a millwork subcontractor to build the desk, cabinets and shelving. Unfortunately, he backed out just as the job was about to start. Small-town rumors flew about the reasons why, but all that Jim and Kathy Sparaga cared about was getting their woodwork done. They ended up ordering cabinetry from both Adec and a kitchen cabinet company, hiring a shelving company, and finding a carpenter to handle the reception desk and fine finish.

The interior takes shape [click to enlarge]

They didn’t want to skimp on the interior design, but the nearest designer was some 90 miles away. They decided to go with T.H.e. Design, thinking that a dental design company would be best equipped to verify and order wall covering, carpet, tile flooring and furniture, etc. But then, as previously mentioned, T.H.e. went out of business.

So now the search was on for an interior designer. It just so happened that the Sparagas were looking to make some adjustments to their home, so they called a residential design firm. Impressed with their service and out of sheer desperation, they asked if the design firm might be interested in a dental office project.

And what do you know? It was the design company’s slow season, and they were more than happy to take on the dental project. They have turned out to be the answer to the Sparagas’ dreams. They are re-sourcing all the needed items and improving upon the original selections.

Next it was time to select the dental equipment for the new facility. Like so many dentists, Dr. Sparaga was understandably enthusiastic about getting new toys.

But of course nothing is ever as easy as it seems… Check back next week to see what sort of snafus the doctor encounters in his search for dental equipment!