SmileMD Breaking the Medical-Dental Barrier for Anesthesia

Getting dental work done doesn’t normally elicit excitement. Quite the opposite in fact…fear, anxiety, stress. A service that’s eliminating patient anxiety, making dentists more efficient and brining board-certified anesthesiologists into a dental practice, SmileMD is disrupting how anesthesia is administered in the dental world in Central Ohio.

When it comes to anesthesia, “The medical world and the dental world are very, very separate,” says Board Certified Anesthesiologist and SmileMD Co-Founder Navin Goyal.

Nothing made that more apparent than an insightful conversation Goyal had with a friend who is a dentist. The dentist told him they could use some anesthesiologists at their practice, which led him to ask how they currently do sedation. There are several answers, but none involve a traditional board-certified anesthesiologist.

The first option – some dental practices don’t really offer sedation.

They offer prescription valium or an anti-anxiety pill you can take the night before,” Goyal says, which can affect everyone differently. 

Or sometimes they are able to get a sedation license,” Goyal continues. The license is typically granted after a two-week course. Finally, there are some dental practitioners that complete a two-year anesthesia training residency who are then called upon by other dentists to perform their sedation.

“There is a huge need,” Goyal says. “There’s a lot of people that are anxious to go to the dentist.”SmileMD280

Goyal partnered with fellow anesthesiologists Tarun Bhalla and Ajay Satyapriya to launch the operation, each having a different speciality within the industry and a facet of the business in their charge.

“What SmileMD does is we go out and go to different practices and say, ‘Do you want a board-certified anesthesiologist to help with patient care?'” Goyal says. “Do you want any help with sedation? Do you want some solutions for offering sedation to your patients?”

The offer practically sells itself.

The full-service solution is available almost anytime with an average scheduling window of three to four days.

“Currently this is a fee-for-service model where patients are paying for it out of their pocket,” Goyal says. 

It was a model they were testing, but since their first case in May of 2014, has proven to be a service people are willing to pay for.

If a patient agrees to sedation services, the anesthesiologist handling the case will get in touch directly with the patient to gather a medical history and explain the process. The day of the procedure the anesthesiologist administers IV sedation (general anesthesia is available but generally too aggressive) and stays with the patient until the procedure is finished, rounding out the process with a next-day follow-up call.

Medical or dental sedation – it’s all of the same caliber to the anesthesiologists.

“These are things we are doing every day in the hospital and we are treating dental practices exactly the same,” Goyal says. 

In the last 10 months, SmileMD has cared for more than 250 patients at 25 different practices in Columbus and the surrounding area, and is adding clients at a rate of two or three a month.

“Many people say, ‘Wow, this is a great service,'” Goyal says. “Business are able to tell patients that they have board certified anesthesiologists coming. People feel very comfortable about that.”

Aside from calmer patients, SmileMD’s services have benefits for anesthesiologists and dental practices as well.

SmileMD has secured a team of about 15-20 board certified anesthesiologists that travel throughout the region. (The founders are unable to perform procedures themselves because of strict contractual obligations with their current employers.) Goyal says the anesthesiologists enjoy the team feel of a dental practice, and sedation is a little less stressful than administering general anesthesia.

Just as a surgeon handles the surgery and the anesthesiologist the anesthesia during a medical procedure, so can a dental practitioner focus on their specialty when SmileMD’s services are employed. One of the startup’s busiest clients told Goyal they are about 34 percent more efficient when SmileMD is there.

SmileMD’s portable equipment packs with monitors, medication and airway supplies mean, “We’re not dependent on anything at the dental practice,” Goyal says.

An office doesn’t need equipment to take advantage of the business’ services, and it actually improves safety as the anesthesiologists become familiar with the equipment and are consistently provided with the same set of tools.

Exciting opportunities are on the horizon for the healthcare startup.

“Our pediatric market has really picked up,” Goyal says. 

He finds children are missing out on needed dental care because many youngsters can’t tolerate a complex procedure without sedation. Or, a if a child is too young or the procedure too long, they have to go to the hospital for general anesthesia. Instead SmileMD can come to their dentist’s office and offer just IV sedation.

SmileMD is also gaining notoriety in the industry. The startup is in talks with a major insurance provider about expanding their service area and including SmileMD’s services under their insurance.

Expanding the service area under insurance or not is in the cards. SmileMD is initially looking to other cities in Ohio to expand the model, but “We really want to take this broadly,” Goyal says. “We don’t know of any other model like this.” 

The organic growth that SmileMD has seen through referrals alone has been rewarding for the first-time entrepreneurs.

It’s really gratifying because it’s the first company we’ve ever founded,” Goyal says. 

But now that they have been exposed to the world of entrepreneurship, the founders are not only set on providing superior service, but really changing an industry.

“We’re just trying to break down the medical-dental barrier,” Goyal says. 

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