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5 Tips About Start-Up Practices

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Doctors Ken Nwankwo and Leslie Powell knew they wanted to settle down together in two ways: in a home, and in a practice. As husband and wife, they knew they were already great partners in one sense. They were sure to succeed as business partners, too.

Instead of acquiring a practice, Ken and Leslie decided to take the startup route. They wanted a business they could really call their own and form a culture reflective of their core values.  Having gone to dental school in the Dallas area, the two knew they wanted to stick around the same location. Specifically, they wanted to situate themselves in an area that could sustain them not only in the short-term, but also five or ten years down the line. Soon enough, they found a spot near communities where they had already established themselves. Here, the couple opened ConfiDent Smile Studio down the street from their beloved church.

Now, it’s smooth sailing for Ken and Leslie—but it wasn’t always that way. The pair had to go through a due process of trial and error before they were able to accomplish their dreams. And, during those ups and downs, they learned plenty. Now, they want to share five tips with you about starting up a dental practice.


If Ken and Leslie could go back in time, they would be more hands-on with their finances specifically TI. For those of you who don’t know, TI stands for “Tenant Improvement.” In simple terms, it’s an allowance that the landlord pays to help build out a space. When they were just starting out with their business, TI created a stressful situation for Ken mentally, emotionally, and spiritually. Leslie was his rock, reminding him that they were in God’s hands. Bills were delayed and, while they were eventually paid off, the experience gave Ken some humbling reminders.  They were paying out of pocket to fund their startup (with the help of loans from the bank), and getting wiggle room from their landlord was something they struggled with.

On that note, Ken and Leslie would advise anyone in a startup situation to interview their landlord. While your landlord might not be around all the time, they’re like a specter that hovers above you. At the first of every month they reappear— unless they’re using a management company and someone else shows up altogether. As for Ken and Leslie, they never got a chance to even meet their landlord, as he ran everything this way.  If Ken and Leslie had the ability to first discuss topics like rent, triple net income, etc. with their landlord, then they may have
ended up going with someone else. Either way, it would have provided them with peace of mind to be on the same page.  Like the TI situation, asking more questions would’ve reduced stress for both of them.


Six weeks before Ken and Leslie opened their doors, they put content on Instagram and Facebook telling people they’d love to help patients on what they call their “smile journey.”  By the time the first day rolled around, they had a list of about 100 people. Those 100 people were immediately able to start treatment from the moment ConfiDent Smile Studio opened for business.  On top of that, Ken and Leslie worked with seasoned doctors— like myself—to discuss business strategies and learn tips on how to create a greater impact. They contacted marketing agencies to bring awareness to their business. The point is, they were taking measures to further their business long before they were sitting patients down in their chairs.


In Leslie’s words, “your mind has to be willing and ready to walk through the trenches.” The startup grind won’t always look like sunshine and roses, and you can’t let that deflate or alter your posture. More importantly, you need to hop out of the mindset of comparisons. It doesn’t serve you to look at another practice and think about how shiny and beautiful it is—to think the grass is greener—and become frustrated about how your practice isn’t in the same state. When you’re jumping through hoops, signing stacks of documents, and meeting with tons of people it’s easy to ask, “Why do I have to do all of this?” But you need to strip away expectations and be willing and ready to just go for it. You signed up for this, after all, and it might not feel too great right now, but you need to realize that you’re investing in your future and all of this hard work will pay off.


Ken and Leslie would advise any aspiring dental entrepreneur— especially a new grad—to get some money under their belt before trying to start a practice. Most of us already have debt from dental school during our first years of getting out into the “real world.” If you’re still paying off loans rather than generating savings, then practice loans will just add onto that debt. So, Ken and Leslie believe it’s super important to save a good deal of cash so that you aren’t drowning in finances.


Often times people have no clear grip on their identity before they start the entrepreneur process, and it bites them in the butt. Ken and Leslie would advise you to have a long look in the mirror and refine your identity. Think about who you are, as well as who, where, and how you want to serve. Writing that out will make running a business so much easier because you’ll have a foundation to lean upon.

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