Orthodontists work through the dynamics of being a business couple

Choosing a business partner wasn't hard for Sarah or Tanner Clark.

The husband-and-wife orthodontist team had gone through dental school together at the University of Iowa, had served as military dentists in Germany together and had trained for triathlons together.

And then they opened Clark Orthodontics, North Liberty's only orthodontic practice, on Feb. 20 at 650 W. Cherry St., Suite 5.

Of the many challenges they've faced together, opening the business would be near the top in difficulty, they admitted.

“It's a whole new world being a business owner,” said Tanner, 33. “It's almost like a second full-time job, and the learning curve is very steep.”

The technology required to open a orthodontic practice is costly. The couple had to develop a business plan and learn new areas such as financing the startup, new software systems, becoming an employer and leasing an office.

For the Clarks, it would have been easier to join existing orthodontic practices. But the prize they had in mind was clear - they had their first child, Drew, less than six months ago, and they didn't want to be tied down to separate practices.

It was a case of, “This is something we're going to do, and we're going to make it work,” said Sarah, 34.

“It gives us a little more flexibility,” Tanner said. “One of us can be at home with our son if we're not in the offices. It allows us to be our own bosses and to have the practice we want to have.”

Professional specialists such as the Clarks offer a distinct advantage over most couples starting out a business in that the earnings potential reduces the risk, said Al Beach of the Kirkwood Community College Small Business Development Center. Beach counsels business startups, including many husband-and-wife teams.

He usually recommends that one partner in a husband-and-wife startup keep that outside job, at least at first, to provide income security.

“Most small businesses don't generate a really good family income for three years,” Beach said, “especially restaurants.”

The Clarks used a division-of-labor approach to managing the startup. Tanner handled the financial details of getting the office up and running, while Sarah concentrated on office layout, design and procuring the equipment and furnishings.

Disagreements between the Clarks are minimized, Tanner said, revealing their secret with a chuckle: “Sarah's the boss at home, and Sarah's the boss at the office.”

Tanner clearly respects his partner as an equal, if not the boss. Their resumes are strikingly similar.

Both received their doctor of dental surgery degrees from the UI only one year apart, served as general dentists in the military, fulfilling scholarship obligations, and returned to Iowa City to complete orthodontic specialty training.

Tanner served as a member of the UI Department of Orthodontics clinical faculty for a year after completing his orthodontic residency, while Sarah practiced dentistry for a year in Cedar Rapids before entering the orthodontic residency at UI.

During his four years as a dentist in the U.S. Army, Tanner served three years as officer-in-charge of the Landstuhl Regional Medical Center Dental Clinic in Landstuhl, Germany. It was reasonably close to the Ramstein Air Force Base, where Sarah was based for four of her five years as a general dentist.

That allowed them to share a home in a German village.

Sarah and Tanner recall going to the operating room several times to treat patients with dental and facial trauma at the same time the general surgeons were treating other battle injuries.

“It gave us an appreciation for being in the military,” Tanner said. “Just the fact that we were seeing soldiers day in and day out gave us an appreciation for what they sacrificed.”

Tanner's patients included visiting U.S. embassy personnel from throughout Europe, and he served as visiting dentist at a North Atlantic Treaty Organization hospital in Brussels.

Sarah later spent four weeks on a humanitarian mission to the impoverished African nation of Mali, where extracting decayed and painful teeth from a long line of children could fill most of a day.

“You'd take out a couple of teeth, and they'd be so thankful for it - just to have the pain go away,” she said.

Orthodontia demand is growing. While the primary need is mostly among adolescents, a growing number of adults are seeking orthodontic care for appearance and health reasons.

The Clarks were attracted to North Liberty by its rapid growth and young population. They felt the community had ideal demographics for an orthodontic practice.

“Patients are really excited about having us in North Liberty,” Sarah said.

Because of the specialized nature of the business, the Clarks did not use a local business counselor. They attended practice management seminars for orthodontists in Florida and Chicago to learn about running an orthodontic practice.

They also consulted adjunct faculty at the UI College of Dentistry who have been in private practice.

Beach offered some advice for husband-and-wife business startups that may sound uncomfortable at first: He recommended couples accept they are going to be a de facto partnership and create an operating agreement.

“It's the equivalent of a business prenuptial (agreement)” Beach said. “Sit down and list 10 or 15 things they absolutely agree on in terms of how things are going to operate, and how the money will flow,” he said.

Beach advised that a couple download a template for an operating agreement from the Internet - available free from various websites - then turn it over to a lawyer to be finalized in a document they both sign.

Such agreements can reduce friction that could arise from debating the issues later, Beach said, and can prevent an expensive legal battle if a husband-and-wife business couple go through a painful split.

“It'll save you so many headaches down the road,” Beach said.

The ability to leave work problems and differences at the office is one of the most important survival skill for husband-and-wife business partners.

The question, Beach said, is, “when you leave work, can you turn it off?”

The Clarks say they sought out orthodontics as a specialty because it involves a blend of science and art.

Sarah said her first impressions of orthodontia came when she assisted in a orthodontic practice during high school. She was impressed by how the orthodontists patients related to him, and how excited they were by the changes in their appearance.

Obtaining military scholarships enabled the Clarks to enter practice without the overhang of debt with which many new practitioners must cope, Tanner said. In fact, they were able to save while serving in the military.