Back to the roots

Dr. Sukant Shrivastava shares a powerful story of how he spread awareness about dentistry in his ancestral village in Madhya Pradesh and created a market for his skills

Tell us about your early days

I was born and brought up in Chhindwara, Madhya Pradesh. I completed my BDS from PMNM Dental College & Hospital, Bagalkot, Karnataka in the year 2012 (November).

When did you decide on opening your clinic?

After completion of my BDS, I was clear about establishing my own setup. I didn’t have much interest in post-graduation studies.

Immediately after BDS, were you confident enough to establish your clinic?

Immediately after BDS, we are exposed to very limited treatment modalities. We are taught majority of things theoretically. The exposure to practical aspects is very limited at the Bachelors’ level in most colleges. Thus, to gain confidence in various treatment modalities I joined district hospital in Chhindwara district and worked there from 2013-2014 without any pay.

How did you finance the clinic?

My dad helped me financially to establish the clinic.

How did you decide on the location?

While looking for a suitable area for the clinic, I realized that even in a small developing city like Chhindwara there were more than 30 clinics in established areas of the city. I was a little apprehensive about investing and setting up a clinic in a hugely competitive region at the start of my career. So, after exploring different areas, I felt setting up of clinic in my ancestral hometown near Jamai (Junnardeo is a tehsil in Chhindwara) would be a better option. It is a drive of about 50 kms from Chhindwara district.

Around 60-70% people in the area are into small scale business and farming and the rest 20-30% are working in western coal mines. Only 20% of people were concerned about their oral health and hygiene. But due to the unavailability of dental clinics in the area, they had to travel to nearby cities like Nagpur and Jabalpur.

Which factors went in your favor? What required more work?

The most favorable factor was the support of fellow doctors in the district hospital who helped me during my learning phase and in conducting camps. Another factor was the absence of a single dental clinic in the entire Tehsil (5 years back, when I started) and presence of my familial roots in the village.

There were several factors that had to be worked upon. People lacked awareness related to oral health and care required. They were also negligent, and reluctant toward dental treatments. There were also limited means of public transport to reach the place from Chhindwara.

What was the space you started with?

The place which I chose was a grocery store before. In the initial 2 years, I started with 250 square feet which included a single chair in the operatory with a waiting area. Now that we are doing well, I have extended the waiting area by including 70 square feet area of adjacent shop and have added another dental chair in the clinic.

How much time did it take from planning to starting operations?

It took around 6-8 months’ time to plan and implement.

How did you decide on the prices? Can you tell us the price of key services?

Many patients had a reluctant attitude toward oral health, and a few of them would not trust doctors enough to invest in consultation and treatment. So, for the initial 3 months, I did not charge them anything for the consultation. During this time, I used to talk to the patients, study their mindset, create awareness and analyse their paying capacities. Based on the analysis after interacting with people, I decided on the rates. My charges include: consultation: Rs. 100; RCT: Rs. 1200-1500; Ceramic crowns: Rs. 1200-1500; Extraction: Rs 300.

Did you make any compromises on the quality of materials, to compensate for the low cost of the treatment?

No, I didn’t. For the first two years, I didn’t make much profit. But practically I didn’t have much loss as well. Now that patient flow has picked up, the profits are much higher.

What did you do for marketing your clinic? How long did you do that?

I had to invest a lot of time in marketing my clinic as it was first of its kind in the entire Tehsil. I used to conduct a lot of camps, used to give small talks regarding oral health and its importance in various schools, colleges, and government offices. I distributed pamphlets and published flex for the initial 8 months. But creating awareness in the minds of people through RVG and models during the consultations, helped me a lot. Right now, I get patients mainly through word of mouth.

How has the patient flow picked up? Is there any seasonality you’ve observed?

It took about 16-18 months to see a peak in the patient flow. In the initial days, there were times when I didn’t see any patients. But right now, after 5 years of establishment and hard work, I see around 10-12 patients each day.

How are you managing the clinic? Do you also do other consultations/other jobs

While working in the clinic in Jamai, I felt saturated with my practice as I was unable to upgrade my skills and was unable to include various other advanced treatments in my practice due to the limited paying capacity of the people and higher costs of the treatment. To upgrade my skills, I started attending various CDE programs and learned various advanced treatment modalities and established another clinic in Chhindwara 2 years back. This clinic is a part of the multispecialty polyclinic. If a patient in the Jamai clinic is interested in undergoing advanced treatment, I refer them to my clinic in Chhindwara. I work from 11 am – 4 pm in Jamai clinic and around 6 pm – 9 pm in the Chhindwara clinic.

What are the overheads, working capital that you require per month?

Lab Charges: Rs. 50,000; Material charges: Rs. 10,000-15,000; Salaries to each assistant for part-time work: Rs. 5,000; Travel expenses: Rs. 10,000; Electricity: Rs. 3,000-4,000.

Looking back, what do you think have been your key learnings?

I feel perseverance is the most important thing that I have learned over time. I also learned to embrace my struggle with a positive attitude irrespective of the outcome. Initially, people had no interest in oral prophylaxis and preserving the tooth. Most of the patients demanded the extraction of teeth and paid no heed to oral hygiene maintenance. To change their mindset, I invested time and money in conducting camps, giving small talks in the different regions of tehsil and creating awareness amongst people regarding the conservation of tooth and oral hygiene through audio-visual aids & models. Right now, when I see people approaching me to preserve the tooth, I feel overwhelmed. Though the first two years were frustrating, I was able to cope up with the support of my family and senior doctors.

What were the challenges you faced?

There were a lot of challenges. I realized that few people had no idea about our profession and a few others were aware of extraction as the only treatment for which they trusted quacks more than the doctor. Eliminating such mental blocks were difficult.

Another major struggle was traveling a distance of around 100 km. each day (to and fro) with limited means of transport. For the first few years, I used to travel by local bus. There were times when I had to spend my nights in the clinic as there were no buses to travel back to the city after 6 pm.

How has been the experience for you so far?

The experience was truly a roller coaster ride. I feel I have just learned 10% of dentistry and 90% is yet to be learnt. To me, the sky is the limit to understand the field. I may not be world renowned or highly successful but I can appreciate progressive changes in my career when compared to the time and conditions I started with. I am just trying to change the attitude of people towards oral health at a small level.

About the author

Dr. Shilpy Bhandari is a Hyderabad-based Periodontist and the founder of Dentistry Insider. She has worked extensively across dental clinics of all sizes — from large corporate chains to small, independent setups.

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