MEMBERSHIP
Quarterly FALL 2018
VOL 17 / ISSUE 2
inside...
The President’s Message Foundation Gala Save the Date What’s New for Dentist? 1111 Har vard Avenue Seattle, WA 98122-4205 206.448.6620 www.skcds.org 2018 SKCDS FALL QUARTERLY l 1
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Seattle-King County Dental Society Membership Quarterly Contributors: Ms. Cathy Dahlquist Ms. Mallory Gillin Publisher: Bill Newcomer, BNC Printing & Graphics, Vancouver, WA OFFICERS Dr. Kirk E. King, President Dr. Lisa Egbert, President-Elect Dr. Craig E. Neal,Past-President Dr. Rica Mackert, Secretary Dr. Eric Wagar, Treasurer EXECUTIVE COUNCIL Dr. Imahn Moin, Executive Council 2019 Dr. Shane T. Ness, Executive Council 2019 Dr. Noah E. Letwin, Executive Council 2020 Dr. Austin Baruffi, Executive Council 2020 Dr. Elizabeth A. Kutcipal, Executive Council 2021 Dr. Amanda Spivey, Executive Council 2021 Dr. Joe Vaughn, Executive Council 2021 Ms. Cathy Dahlquist, Executive Director Change of Address: To ensure continued receipt of issues, change of address must be reported to: SKCDS Central Office, 1111 Harvard Avenue Seattle, WA 98122-4205, as soon as possible -206.448.6620. Email: skcds@skcds.com The information in this publication is for the exclusive benefit of SeattleKing County Dental Society members. Neither the Society nor the publisher makes any express or implied warranties as to the information herein, including the contents of any advertising. Opinions in the Quarterly do not necessarily express the official policies of the Seattle-King County Dental Society, nor the opinions of the editor, unless so stated. Publications of advertising is not an endorsement, qualification, approval or guarantee of either advertisers or product. For advertising and publishing details, contact: Mr. Bill Newcomer, BNC Printing & Graphics, 503.318.5916, 360.573.1201, bill@bncprinting.com; www.bncprinting.com
FALL 2018 Volume 17, Issue 2
CONTENTS President’s Message with Dr. Kirk King ............................................................. 4 The Director’s Message ..................................................................................... 6 Representative Michelle Caldier ......................................................................7 Welcome New Members .................................................................................. 9 Announcement 2019-20 Elective Office Openings ..............................................10 New Member Profiles .................................................................................. 11 What’s New for New Dentists?.......................................................................... 12 The Annual Member Resource Guide ..................................................................13 Save the Date: 2019 Foundation Gala Masquerade Ball .....................................14 Dental Practice Employee Fraud ......................................................................15 CDE Courses and Membership Meetings ............................................................16 Looking Beyond Interest Rate ...................................................................19 Seattle-King County Clinic ............................................................................. 20 Dental Action Day 2019: Stronger Together .....................................................21 Planning for the New Year ...............................................................................22 Constantine Builders ........................................................................................2 THANK YOU TO OUR ADVERTISERS OMNI Group ..................................................................................................5 Garde Capital - Tony Baruffi, CFA ......................................................................8 Freight Architecture .........................................................................................8 Handpiece Rescue ..........................................................................................8 Katharine Christian DMD - Sleep Apnea and Snoring ................................................9 Ann Durham Attorney at Law ........................................................................... 12 AFTCO ..........................................................................................................12 Sleep Apnea and Facial Pain Center ..................................................................10 Keller ~ Rohrback Law Firm ..............................................................................13 WDIA ..........................................................................................................13 NORDIC ....................................................................................................... 17 Big Sky .......................................................................................................18 Home Owners Club ........................................................................................15 Dental Group LLC ...........................................................................................23 Nakanishi .....................................................................................................24
Cover Photos: Top: Left to right: Rod Johnson, Dr. Z Nguyen, and Cathy Dahlquist Members and sponsors enjoying SKCDS continuing education courses and social events. 2018 SKCDS FALL QUARTERLY l 3
The
President’s Message
This is also a great time to consider your involvement in the society. We are always looking for capable, intelligent people (AKA dentists!) who are willing to be involved and help shape the future of the society. One way to do so is to reach out to our Leadership Committee and express interest in an elected position. Another way is to explore committee service. Your Society has many committees which cover a wide range of interests. Did you know we have a Forensics Committee which works with the local authorities and has regular training in disaster identification? We also have a strong Access Committee which has been instrumental in providing seed ideas and support to many of the access initiatives that are working well today. Perhaps you would be interested in serving on the Peer Review Committee? This vital but often overlooked committee is a wonderful benefit for members, patients, and our community at large.
Dr. Kirk E. King
Membership, Benefits and Personal Development Dear Colleague, As we enter the new year, there is always the inevitable period of reflection of the year past, and planning for the year ahead. Your dental society is doing the same, and we continue to look for opportunities in which to serve our members and enrich your professional lives. This is a great time to peruse our re-vamped website and explore many of the great CE opportunities coming up. Remember, the membership meetings are included in your membership and can be a great resource for a few CE credits, as well as comradery with your fellow dentists. We have also had a few changes around the office staff. Abid and Sandra have moved on, but we have a new team member who is more than happy to assist you with any questions you have about your membership, benefits, or professional development. I would like to introduce you to Mallory, who will likely be the face behind the phone when you call in. Please take a minute to introduce yourself to her when you get the opportunity. 4 l 2018 SKCDS FALL QUARTERLY
If you have any interest in increasing your involvement, simply reach out to Cathy or Mallory at the office, or you can always reach out to me as well, or any member of your Executive Council. Thank you again for being a member and we look forward to continuing to serve you and our community.
Dr. Kirk E. King
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The
Director’s Message
Society’s finances, which now allows for complete transparency. The Physicians & Dentist Credit Bureau was sold and is now owned and operated by an outstanding group of medical collection professionals. The transition was seamless and the PDCB continues to be a Society sponsor and trusted partner for our members. Staffing at the Seattle-King County Dental Society has been reorganized. Mallory Gillin, is now the Operations/Communications Manager for the Society. She and I work together on communications, event coordination, membership, and the administrative duties of the office. As a UW graduate with a bachelor’s degree in communications and experience in outreach, event planning, sales, bookkeeping, and publicity, she is a perfect fit for the Society. We are lucky and thankful to welcome Mallory!
Ms. Cathy Dahlquist
Thanksgiving is my favorite holiday. Singling out a reason as to why I came to this decision is impossible. Is it the annual Turkey Bowl, where men and boys fight for the title of champion in our front yard? Is it the aroma of the feast that takes hours to prepare and minutes to consume that amazes me? Maybe it is the tradition of the days-gone-by journey up logging roads to cut down the best noble fir on the side of a mountain? Whether it’s the friends and family, the sights and the smells or the traditions that touches my heart, it is different every year. Each year brings new family members (we have a soon-to-be daughter-in-law) and new friends to gather around our table. Costco makes an absolutely beautiful fake noble fir that is already strung with hundreds of lights. The kids decided they want to add a new dish to the feast that smells and tastes wonderful. Although my memories are fond, I am grateful for change.
Part of leading an organization involves a commitment to continuous improvement. Improvement requires change. Change can be difficult because we fear the unknown; it can be challenging and at times and it’s unpopular. We invite you to move out of your comfort zone -- invite a non-member to a membership meeting, read an article from someone with a differing opinion, challenge your staff to continuous improvement and think the best intentions of those leading the change. Try the new dish at your next holiday meal. Be gracious and thank the individual that prepared it. You might find that what’s new is more delicious than you could’ve imagined!
You have probably noticed some changes at the Seattle-King County Dental Society. Our e-newsletter has been condensed and become more interactive. In order to understand what is important to members, we now have the ability to measure what We at the Seattle-King County Dental Society are grateful and has been viewed. By collecting quantitative data we can deliver thankful for you. improved member benefits by offering what you value. The website All the Best, has been updated and the member portal offers a vast array of information at your fingertips. We have moved to a virtual accounting platform along with an outside bookkeeper to better manage the
Cathy Dahlquist
6 l 2018 SKCDS FALL QUARTERLY
Representative
Michelle Caldier
House Bill 1316 would require dental insurance companies to establish a fair appeals process for claims, and would also prohibit insurers from penalizing dentists when they appeal claims on behalf of their patients. This bill passed the House 97-0 last year, but did not come to the floor of the Senate. House Bill 2500 would require all nonprofit insurance companies in the state to convene a panel of enrollees to determine the salaries of the CEO and board members. If this had previously been state law, the public would have been able to decide whether the pay of Delta Dental’s CEO should’ve jumped from $1.3 million to $2.75 million in two years.
House Bill 2502 would require the Office of the Insurance Commissioner (OIC) to set minimum standards for dental explanation of benefits (EOB) forms, and would also prohibit Ms. Michelle Caldier dental-only plans from using EOB forms not approved by the OIC. Wow! It is hard to believe that just five years ago, I was sitting This would increase transparency to your patients on their dental in the office of then-Representative (and current SKCDS Executive benefits. Director) Cathy Dahlquist talking about dental issues, and just days ago, I won reelection to serve a third consecutive term in the state The 2019 session begins Jan. 13, and is scheduled to run for 105 days. I am truly honored to serve in the Legislature and have Legislature. the support of so many dentists across our state. I look forward While election results are not yet certified, it looks as though there to working with the WSDA and the Seattle-King County Dental will be 22 new members in the House and five new members in Society to continue fighting for the integrity of our profession. the Senate when the 2019 legislative session begins in January. Democrats, who currently hold one-seat majorities in the House Sincerely, and Senate, picked up seats in both chambers to expand their majorities. Representative Michelle Caldier, DDS
Michelle Caldier
As the only dentist in the Legislature, I anticipate I will continue 26th Legislative District Washington State serving on the House Health Care and Wellness Committee. Working across the aisle, I have been able to play a key role in passing legislation to help fix our Medicaid system, as well as protecting patients from corporate dental practices that interfere with their care. There is much more work to do, however, to build on these successes. This session, I plan to re-introduce three bills from last year that address dental insurance practices.
2018 SKCDS FALL QUARTERLY l 7
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Please welcome our new members JULY Dr. Carson Calderwood Dr. Chen-Ying (Emily) Chen Dr. Gavin Convey Dr. Kyle Countryman Dr. Lori Ha Dr. Stephanie Kang Dr. Narges Lotfizadeh Dehkordi Dr. Evan Mitchell Dr. Alyssa Mueller Dr. Kanvar Panesar Dr. Kayla Russell Dr. Tarnjit Sangha Dr. Edward Wang Dr. Jessica Wieker
AUGUST Dr. Lalita Angkanawaraphan Dr. Sheena Gaur Dr. Diana Jin Dr. Theresa Malamel Dr. Andrew Mueller Dr. Nigel Saw Dr. Shameena Singh Dr. Elizabeth Taina
SEPTEMBER Dr. Gary Arnold Dr. Jing-Chu Cao Dr. Julia Chang Dr. Stephanie Chen Dr. Hakan Gem Dr. David Haralson Dr. Soo Hyun Kim Dr. Gregory Maggas Dr. Sumit Makker Dr. Avery Ruben Dr. Fadi Shaya Dr. Mayank Shorey Dr. Alexander Stanton Dr. Robert Tracy Dr. Huey-Wen Tso Dr. Andy Yu
OCTOBER Dr. Lorena Furca Dr. Donghyun Koo Dr. Dennis Kwon Dr. Yirae Ort Dr. Victoria Vainer
Members of SKCDS are encouraged to invite non-member dentists who are practicing in King County to join the Dental Society. A quick call to the WSDA Office at 206.973.5210 is all that is needed for them to apply for membership at all three levels: Seattle-King County Dental Society, Washington State Dental Association and the American Dental Association.
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Announcement 2019-20 Elective Office Openings In accordance with the Seattle-King County Dental Society Bylaws, the Leadership Committee will meet in early December 2018 to formulate a slate of officers for the 2019-20 Society year. Thank you to the amazing group of leaders that serve as representatives of the membership on all the Executive Council. We also thank all of our current volunteer committee members who give so freely of their time and talents on behalf of the Seattle-King County Dental Society. Your leadership is appreciated. The following leadership positions are open: • President-Elect The president-elect will automatically become president in the year following the year in this position. The president-elect will be a member of the Budget and Finance and Program Committees as well as the Executive Council. • Executive Council – Two (2) openings for three-year terms Executive Council members meet approximately 10 times a year in the evening with a meal provided. This is the governing body of the Dental Society, and it is an excellent way to participate in the organization. • Delegates to the WSDA—Up to eight (8) * openings for three-year terms This position represents the Seattle-King County Dental Society at the governing body of the Washington State Dental Association’s House of Delegates Delegates must attend at least one of two evening caucuses before each meeting of the House of Delegates. The delegates must also plan to attend the Washington State Dental Association’s House of Delegates meeting (usually held from Thursday evening to Saturday noon in September). Finally, they will be asked to participate in dental advocacy efforts in Olympia to remain visible in the State Legislature. *The number of Seattle-King County Dental Society Delegate seats for the WSDA House of Delegates is determined each year based on membership as of January 2019; therefore, we do not know at press time how many seats exactly, will be open. If you are interested in learning more about the duties of these positions or wish to be considered for one of the offices, please call Cathy Dahlquist at 206.448.6615.
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NEW MEMBER PROFILES Dr. Gary Arnold is a general dentist practicing in the Seattle area. He’s been a dentist for over 35 years and has more than 2,000 hours of CE in advanced, restorative and cosmetic dentistry, as well as Invisalign, team-building and behavioral management. Dr. Arnold says his goal for the past 20 years has been “to aid people in creating a healthy lifestyle through dentistry.” His hobbies include yoga, hiking and reading, and one item on his bucket list is to ski with his youngest grandson. One career aspiration he has is to provide locum tenens services to dentists in need of temporary coverage. If you have a short or long-term need at your practice because of illness, maternity leave, etc, you can contact us at skcds@skcds.com and we will connect you with Dr. Arnold
Dr. David Haralson is a dentist specializing in oral and maxillofacial surgery and currently owns a practice in Downtown Seattle. He decided to become a member of SKCDS for fellowship and educational opportunities. Dr. Haralson has aspirations to help provide dental care to disadvantaged kids in his community. His hobbies include snowboarding, motorcycling, boating, fishing, photography and playing guitar. One item on his bucket list to one day catch a 200+ pound marlin. Dr. Haralson is grateful for the opportunity to be of service to our community. If you would like to contact Dr. Haralson, you can email us at skcds@skcds.com.
Dr. Greg Maggas is a general dentist, currently working as an associate in the Seattle area. He was born in Arizona and went to ASU for his undergraduate degree. His grandmother was a dental hygienist and he was inspired by her to pursue a career in dentistry. He moved to Seattle and attended the UW School of Dentistry. He fell in love with dentistry and Seattle summers and decided to make Seattle his home. His hobbies include golfing, skiing, surfing, hiking, biking, swimming and traveling. One item on his bucket list is a trip to Antarctica. Dr. Maggas also has aspirations to one day own or co-own a practice. He joined SKCDS to connect with local dentists. Contact us at skcds@skcds.com if you’d like to connect with Dr. Maggas.
2018 SKCDS FALL QUARTERLY l 11
What’s New for New Dentists? Opportunities for Dentists under 40!
Happy Hour is also a great networking opportunity for all of our members – new and old! If you missed our September and November events, it is not too late to get in on the fun. The first drink is on us, and it is a great time for all students and young practitioners to gather casually.
For most young practitioners, a lot of learning happens after you graduate. In case you are wondering if you are a “new dentist”, this is our criteria: anyone who is under 40 years of age or who has been out of dental school for less than 10 years. New Dentists who are members of the Seattle-King County Dental Society have a plethora of activities to choose from, and we are here to keep you informed so that you do not miss a thing! Every year, from January through May, the Seattle-King County Dental Society offers a series of programs for young dentists that focus on the basics of starting your practice. This year we have speakers presenting on: billing insurance (January), cash flow management (February), and job search strategies (May). In March, we will host our sixth annual Boot Camp. We have an array of speakers and some
We know you are just starting out and are on a budget, so all of our New Dentist programming is free of charge. We do ask that you RSVP for all events so that we can plan our meals accordingly. Our New Dentist program offers pizza and beverages along with CDE credit and time to learn and socialize. Boot Camp is free and includes a boxed lunch, four CDE credits and lots of information to start your dental practice. That is where your local dental society can provide outstanding vendors who will be present to share a valuable link in your career. Organized dentistry information. This popular half-day workshop is about bringing members together to learn, features presentations by 6 of our local experts. socialize and grow professionally. You can find The focus is on practice management and what it more information on our website, www.skcds.org. takes to start in the business of dentistry.
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Practice Transitions
Employment Contracts
Business Formations & Dissolutions
Commercial Property Leases & Purchases
Estate Planning
Restrictive Covenants
The Annual Member Resource Guide Have you received your member Resource Guide yet? This comprehensive guide includes information that will be useful to you and your staff all year long. The Resource Guide contents include: • SKCDS member benefits and services • Our society and foundation leaders • Our schedule of continuing dental education courses • A Where to Call section including phone numbers for: • Dental assisting programs • Dental hygiene training programs • Dental administration programs • Other dental organizations like AGD and Pierre Fauchard Academy • State groups like the Office of the Insurance Commissioner and the Department of Ecology • List of low-cost community health clinics in King County by geographic area If you are looking for a comprehensive list of Seattle-King County Dental Society members, we encourage you to go to our website and use our online directory under the Member Resources section. We encourage you to support our advertisers. These are the vendors we trust and have vetted for you. The staff at the SKCDS is always happy to answer your questions and assist with inquiries and we strive to give you tools to make your practice run smoothly. Of course, most of this information is also available on our website.
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2018 SKCDS FALL QUARTERLY l 13
2019 Foundation Gala
Masquerade Ball! Join us for the Seattle-King County Dental Foundation’s 2019 Fundraiser Gala: The Masquerade Ball! Get out your masks and get ready for a night of fantastic food, friends, fun and fundraising. Mark your calendar for March 8th, 2019 at the Fairmont Olympic Hotel in downtown Seattle. We’ll have a raffle, a silent auction and a live auction hosted by the one and only, John Curley. Gather all of your friends and colleagues and purchase a table of 10 or bring a small group and purchase individual tickets. Tickets and tables are on sale now at www.accelevents.com/events/SKCDFmasquerade. Don’t miss out on the greatest social and giving event of the year in the dental community! Check the SKCDS website at www.skcds.org for more details. We hope to see you there!
YOUR WDIA TEAM:
Matthew French
Director of Insurance Services
Kerri Seims
The Obvious Choice for Washington Dentists 142019 l 2018 QUARTERLY PCDS SKCDS NewsletterFALL ad.indd 1
Assistant Director of Insurance Services
Ph: 206-441-6824 · 800-282-9342 Fax:206-269-1922 info@wdiains.com · wdiains.com 8/29/18 9:40 AM
Dental Practice Employee Fraud: How It Happens & How to Discourage It Authored by Kevin J. Bray & Brian F. Bray, Co-Founders Dental Accounting Pros According to an American Dental Association survey, one in three dental practices will experience some form of employee fraud or embezzlement during their lifetime. Dental office fraud occurs more often than it should, and it’s often the product of poor or non-existent internal office checks and balances, too much autonomy and authority given to a specific employee, lack of oversight by the practice owner, and failure to prescreen employees adequately.
Common Types of Employee Embezzlement:
Skimming Cash Petty cash or the occasional cash payment from a patient is often the first asset that a fraudulent employee targets to see if they can steal money without being detected. Fraudulent employees rationalize their misdeeds; i.e., “I am underpaid” or “the doctor makes more than enough money.” $10 turns into $100, and that turns into $1,000’s. It is not uncommon for a fraudster to increase the magnitude of their theft as time goes on. They get braver, bolder, and feel invincible.
Deleting or Altering Transactions Once a fraudulent employee perfects their scheme to steal money from the practice, they need to cover their tracks in the patient management system (PMS). In other words, they need to show
that a payment has been made in order to clear undetected. Without oversight or protocols that are the accounts receivable. This can be done by designed to monitor the practice’s financial affairs, adjusting or deleting activity in the PMS. a fraudulent employee can pay personal expenses and simply post those transactions like any other legitimate business expense. Modifying Patient Checks Patients typically pay their portion of fees on the day of service, either by credit card or by check. One fraud scheme involves a fraudulent employee telling the patient to leave the “pay to the order” section blank because they have a stamp. The stamp would be made out to the fraudsters own bank account using a “business-like name” that wouldn’t raise any suspicions from the patient. Without internal checks and balances that reconcile the PMS activity to actual bank deposits, this scheme goes undetected.
Refunding Patient Credits Offices typically estimate and collect the patient’s portion of fees on the day of service and, when the EOB clears, it is not uncommon for patients to have nominal credits in their account. This fraud scheme involves a fraudulent employee processing these nominal patient credits as refunds to their own credit card. Patients may not be aware that they have a nominal credit and never inquire about it. Without oversight, no one is the wiser and the fraudulent employee has successfully stolen money from the practice.
Unauthorized Expenditures Offices commonly give a key employee (office manager) a business credit card to pay practice expenses as they arise (dental supplies, lab bills, utilities, etc.). Some offices even give that employee signature authority on the business checking account. With the simplicity of online purchases and direct delivery to the employee’s home, unauthorized purchases are easily overlooked and
Best practices to help monitor and discourage employee fraud: 1. Monitor your detailed production and collection reports; compare posted services to the schedule (routing slips or day sheets) to insure billing information has been entered correctly 2. Prohibit the use of check payee stamps 3. Lock out the refund option on your credit/debit card machine 4. Do not give employees signature authority on bank accounts 5. Provide an admin staff person with a “convenience” credit card that has a modest credit limit 6. Reconcile payments posted in your patient management system to payments posted to your bank and QuickBooks 7. Routinely review your Adjustments Report and Deleted Services Report, and ask questions about transactions you may not recall or understand 8. Routinely review patient credits that your staff processes 9. Outsourcing your accounting duties will help monitor and discourage employee fraud by having another set of eyes on the “numbers” (accounting) side of the practice Want to Learn More? Contact Us Today at 425-739-0300 or info@dentalaccountingpros.com to Schedule a Consultation Regarding the Above Topics You can also fill out our Proposal Letter Survey link from our website, and we will follow up with a detailed service plan proposal.
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CDE Courses and Member Meetings Member Meeting Compliance Panel
Member Meeting Dr. Rebecca Bockow
CDE Course Karen Baker
Member Meeting Installation
Tues, Jan. 15, 2019 6:00-9:00 pm
Tues, Feb. 12, 2019 6:00-9:00 pm
Friday, March 1, 2019 8:30 am - 4:30 pm
Tues, April 23, 2019 6:00-9:00 pm
Washington National Golf Club
Hotel Sorrento
Lynnwood Convention Center Homecare, Herbals and the Prescription Opioid Crisis
Salty’s on Alki
Our panel of experts will cover everything you need to know to make sure your practice is in compliance with the State and the Department of Health.
Dr. Bockow will discuss how soft tissue and breathing patterns influence skeletal growth, and examine similar malocclusions in children and adults, and discuss how the treatment plans differ, depending on the age and Presenters: Dr. Karim Alibhai, Dr. skeletal maturation of the patient. Harinder Walia and Melissa Sanchez Presenters: Dr. Karim Alibhai, Dr. Harinder Walia and Melissa Sanchez
Help us honor our past officers and welcome those who will serve for Karen Baker is a clinical pharmacist the next year. We will also recognize with a master’s degree in clinical our lifetime members and welcome pharmacology and therapeutics and new members. The WSDA President is focused on patient-specific dental will speak about critical legislative activity and Association business drug therapy. affecting your profession.
Sign up for all classes by using the exclusive member portal at www.skcds.com
New Dentist CDE Programs (free for members) For members younger than 40 or out of dental school for fewer than 10 years
Insurance Billing
Cash Flow in a New Practice
Boot Camp
Branding Yourself
Wed, Jan. 23, 2019 6:00-9:00 pm
Wed, Feb. 20, 2019 6:00-9:00 pm
Sat, March 30, 2019 8:00 am - 1:00 pm
Wed, May 15, 2019 6:00-9:00 pm
SKCDS Conference Room
SKCDS Conference Room
First Baptist Church
UW South Campus Center, Room 316
Amy Mitchell (Practice Consultant, The Richardson Group) has worked in the dental industry for more than 20 years. She will address some strategies for staying ahead of the insurance companies and helping your patients with the coverage they need.
Cash flow is king when you are running your own practice Learn some tips and tricks for making sure you have your practice finances in order from our presenter: Dennis Marvel, Fortune Management Consulting Firm.
This is our eighth annual New Dentist Boot Camp. Join us for this half-day seminar where our panel of presenters will cover a range of topics including: practice financing and valuation, contracts, choosing the right space and location for your practice, contracts, and more.
Job search resources and deciding how to market yourself are vital when you’re fresh out of dental school. Our presenter, Sasha Bachtold, will talk about “branding” yourself and how marketing your skills and experience is the first step to finding your next job.
16 l 2018 SKCDS FALL QUARTERLY
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Looking Beyond Interest Rate Luke Kapper and CJ Williams When speaking to Doctors about financing, one of the most common questions asked by a prospective first-time borrower is simply: “What is your interest rate?” While this remains an important part of the discussion, it should be viewed as one piece of a complex puzzle as one evaluates a lending partner to help invest in the next phase of their professional career. Let’s consider a couple different scenarios and dig into some key questions many dentists learn the answer to the hard way:
STARTUP PRACTICES
Startup ventures, especially for a first-time owner, can be an exciting and scary venture. Most startups make it or fail in the first 18-24 months and that should not be taken lightly. Cash flow and flexibility should be the two most important pieces on a startup doctor’s mind. The goal should be to get into the new practice and grow it as quickly possible. Working capital should be used to get by for the first few months and then serve as an emergency fund. Hopefully it is not being used to invest in the growth of the practice, not make loan payments. Additionally, the faster a doctor can move out of an associate role and into a practice full time should be evaluated. Here are some great questions to ask your prospective lenders when selecting a startup: (1) How do you structure your loans? If your startup loan as the same payment the entire duration, that can set you up for failure right from the start. Look for loan payments that grow as your patient base grows. (2) What fees do you charge on your loan? Origination fees, documentation fees, etc. all add up. Ask for an upfront estimate in writing to help avoid sneaky fees when the loan closes. (3) How do I access my loan? Some lenders will allow you to access a loan gradually (similar to a line of credit), others may give you the full amount up front and let you manage your project. That can be a lot to ask if you have never started a dental practice before. (4) How often can I access my loan? Some loans may limit the number of payments you can pay out in a month. This approach can cause unnecessary delays and upset vendors. Look for lenders that allow you weekly access or better to your loan so that you can keep all of your vendors current. Project delays can cost you extra money and erase a good interest rate very quickly.
PRACTICE ACQUISITION
Many Doctors opt to purchase an existing practice versus starting from scratch. They like the idea of having a patient base from day one and feel that their odds of success might be better. While it depends on the dentist and their business/leadership skills, let’s explore some similar questions many fail to ask as they approach the financing component:
(1) What are the shortest and longest terms available for financing? Again, flexibility is the name of the game on an acquisition. Patient attrition, unforeseen staffing changes, etc. can undermine any doctor stepping into a new practice. Banks are usually very accommodating to shorten our loan if you ask, seldom will they extend your loan longer than the original term. It is almost always better to start with a low payment to optimize your overhead and attack your loan balance strategically once you have stabilized the transition. Typically, your interest rate will correlate directly with the length of the fixed rate period. In other words, a five-year fixed rate should be lower than a ten- or twelve-year fixed rate. (2) How soon can I qualify for additional credit should I need it and what criteria do you use before extending additional credit? Seldom does an acquisition have brand new equipment. Equipment breaks, gets outdated, and occasionally a new owner has to replace something sooner rather than later. Understanding how you can access additional credit down the road is critical in growing your practice. (3) When do I need to have my insurances in place? Insurance requirements can complicate the closing process of the loan. Unforeseen delays can lead to a less than optimal transition so knowing when insurances need to be in place can create less headache during the closing process. (4) What banking relationships are required and what is the cost associated with those products? Some financial institutions merely want to be your lending partner. Others may require a deeper banking relationship or mandatory account balances to qualify for an interest rate. These products and services rarely are free. Understanding the full picture is critical. (5) How do you lend to doctors looking to own multiple practices? There are a vast number of entrepreneurs that dream of owning multiple practices. If you have a growth plan, you may have early termination penalties and mandatory refinances that impact the health of your balance sheet. Understanding the criteria for multiple practices is too often taken too lightly and becomes a very expensive lesson down the road.
These questions bring to light an important lesson: an interest rate is only as good as your ability to make a payment. Having the right team of advisors (CPA, attorney, lender, financial planner, etc.) is a crucial step in avoiding missteps as you transition from associate to owner. Building the right team inside and outside your practice is imperative. 2018 SKCDS FALL QUARTERLY l 19
Seattle-King County Clinic The Seattle-King County Clinic is held annually at Key Arena in downtown Seattle. Every year healthcare organizations, civic agencies, non-profits, private businesses and volunteers from across Washington State come together to produce this giant, free clinic. The clinic runs for four days and provides free dental, vision and medical care to vulnerable populations in our area. We stopped by the first day of the clinic on September 20th to see our local healthcare volunteers in action. Doctors Jeff Parrish, William Peterson and Mike Karr (pictured bottom right) oversaw the dental floor and told us they expected to treat over 2,000 dental patients over the four days of the clinic. The dental floor covered the entire basketball court in Key Arena and had sections for hygiene, extractions, composites and more. While the final report for the clinic hasn’t been released yet, Dr. Parrish estimates that they treated more than 2,140 dental patients over the four-day period, at an approximate value of more than $1.6 million in dental services. All of this was made possible by the estimated 215 dentists and 680 dental volunteers. The official Seattle/King County Clinic report is projected to release in December.
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Set aside Thursday, January 31, 2019 to join other dentists from across Washington State at the 2019 Dental Action Day in Olympia. This annual event brings together general dentists, specialists and dental students to discuss WSDA’s legislative agenda. Whether you practice in a rural community or in the heart of downtown Seattle, make your voice heard with your colleagues in Olympia. The Washington State Dental Association coordinates this fun and impactful gathering, which is the Association’s largest legislative advocacy event each year. The day begins early with coffee and socializing. Attendees are grouped by legislative district and meet with their local representatives to share their concerns about dental legislation for the coming year. Since the event starts early, come down to Olympia the night before and enjoy some camaraderie at a member Happy Hour hosted by WSDA. For more information, visit the WSDA’s website and search for “Dental Action Day 2019.”
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Dental Action Day 2019: Stronger Together
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Amy Mitchell Practice Management Coach The Richardson Group Amy has been in the dental industry for over 20 years as a practicing hygienist, author, speaker, educator and practice management coach. TRG Coaching provides dental businesses with premier dental practice management coaching and consulting, enhancing the lives of dentists and their teams by simplifying the business of dentistry.
Planning for an Outstanding 2019
• New Year, New Codes • New Procedure Codes are available and will be in effect in January. Don’t get caught off guard. Purchase your 2019 Code Books and guides to insurance billing to eliminate denied claims, decrease wait time on reimbursement, and fully understand applicable codes to maximize revenue and compliance. • Address new employment laws and update employee handbook • Check with your state L&I, City and County for new employee laws. • Evaluate Fees and renegotiate contracts • Utilize resources through national registries or your accountant to evaluate where your current fee schedule falls among your neighboring peers. • Identify your top 15-20 codes to renegotiate reimbursement with current PPO contracts. • Set practice and personal goals • Future pace practice profitability and growth • Don’t get caught at the end of the year with an unexpected tax responsibility. Plan ahead with your accountant and financial advisor to make your increase in profitability work for you.
Hiring Shortage
Having trouble attracting and retaining competent, dedicated employees in this low unemployment market? With so many openings and opportunities, staff members can land a job and then change jobs on a whim. To keep your staffing at a peak level, you must hire the right people and create a team environment that is supportive, inspiring and rewards outstanding performance. It takes more than luck to build the team of your dreams. The following are nine key steps to attracting and retaining outstanding team members.
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1) Identify Desirable Personality Traits Hiring based on credentials and experience may not be enough. Identify which personality traits will complement your team and include these in your search advertisements. 2) Place Value on Hiring and Team Integration Commit sufficient time to thoroughly interview candidates. Learn their values and motivations, not just their technical experience. Involve your team in the process. When the team feels a sense of ownership over the decision of who to hire, they will be more invested in the outcome of their placement. 3) Be the Type of Person Who Attracts Outstanding Employees Identify the traits you are looking for in a team member and evaluate whether you are the type of person/practice who would attract that. Would they be proud to work for you? Do you demonstrate respect for them and their work? What is your code of conduct? Do you follow it? 4) Provide a Quality Environment Salary and signing bonuses alone will not attract outstanding team members. They demand an environment where they can thrive emotionally as well as financially. That environment must be inspiring, fun and where they believe they can contribute in more ways than just performing their job. Outstanding team members want to contribute to decision making in areas such as marketing, patient care and researching new products, techniques and equipment. 5) Constantly Improve, Develop and Adapt Create a practice in which curiosity and creativity flourish. This will prompt you and your team to constantly seek new ways to work better, bring patient care to the next level, and create new possibilities. 6) Praise Early, Praise Often and Hold Accountable Praise publicly, correct privately, make clear what is expected and who is accountable, and acknowledge contributions toward outcomes and goals met. 7) Create a Compelling Vision Leaders create visions that are big enough to excite and create a sense of purpose beyond the self. Collaborate with your team to create an inspiring vision that calls people to ideals beyond their daily routine. 8) Create Massive Certainty Be congruent and connected to who you are, what you do, and to whom you contribute. This will create certainty and trust with your team, and patients as well. 9) Renew Your Commitment If you are not obtaining what you really want, take a hard look at your level of commitment. Are you committed to your team? Your code of conduct? Your patients? Your contribution? As valuable and crucial as attracting and retaining outstanding team members is, the fact remains that there is also a smaller pool of employees from which to draw from. Solution-oriented individuals continue to problem solve this dilemma with ideas such as: • Loosening restrictions for out of state professionals seeking employment • Providing an increased level of licensure for on-the-job training • Opening, staffing, and funding more schools • Online training • Creating and utilizing better platforms to connect employers with employees By working to create an environment that attracts and retains outstanding team members and contributing alongside your peers to find ways to place more employees in the dental marketplace, you can help yourself and those around you solve the workforce dilemma that we are all facing.
DG Transitions LLC
DG Advisors
Dental Wealth Advisors LLC
LLC
5808 Lake Washington Blvd NE Suite 101 Kirkland, WA 98033 Main Office 425-216-1612 Rich 206-455-5401
We are your Transitions Specialist,CPA,& Wealth Advisor
We believe the greatest value for our clients is achieved through a comprehensive approach to practice and personal finances. The synergy achieved by dove-tailing practice cash flow and long-term funding goals integrated with advanced tax planning is profound for dentists and specialists who believe that planning, implementation and monitoring are crucial to long-term financial success and quality of life.
Transitions Done Right
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We bring all of our tools and expertise to bear to achieve your desired transition and through tax and other planning, leaving more of your hard earned value in your pocket.
The Dentist’s Advisor
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For dentists and specialists who believe that planning, implementation and monitoring are crucial to long-term financial success and quality of life.
The Dentist’s Wealth Advisor
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Comprehensive Financial Planning* Wealth Management Investment Management Retirement Plan—CFO Services
*Personal financial planning, Investment & Wealth Management Services provided by Dental Wealth Advisors, LLC a Registered Investment Advisory
sam@cpa4dds.com : mmb@cpa4dds.com : nate@wealth4dds.com : richseims@comcast.net : Jennifer@cpa4dds.com : karrie@cpa4dds.com
Call 425-216-1612 or mail@cpa4dds.com us today to see how we can best assist you!
DG Transitions LLC
The Dental Group
Comprehensive | Professional | Tax Efficient LLC A DENTAL GROUP COMPANY
2018 SKCDS FALL QUARTERLY l 23
PRSRT STD US POSTAGE PAID PORTLAND OR PERMIT NO. 243
1111 Harvard Avenue Seattle, WA 98122-4205
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NIGHTGUARDS
from Nakanishi Dental Laboratory
COLOR OPTIONS * Clear (default)
NAME
DESCRIPTION
“Ivocap”
All-hard nightguard (this is default if type is not specified on Rx)
Orange
“Impak”
All-soft nightguard
Purple
“Gelb”
All-hard nightguard with lingual bar
“Talon”
Dual hard/soft nightguard
Yellow Blue Red Pink Green
All of our nightguards are completely BPA free.
A protective case is included with each outgoing nightguard.
Black
Our most popular nightguard is the Talon nightguard. We will make the Doctor a personal one at no charge.
Please send us upper and lower digital or traditional impressions or models and a bite.
GLITTER OPTIONS
Each nightguard is sent out with patient care instructions for nightguard maintenance.
Free pick-up and delivery service between Federal Way to Marysville and Seattle to Issaquah.
Gold Silver * available for all nightguards except Impak (clear only)
team@nakanishidentallab.com 425-822-2245 | 800-735-7231 www.nakanishidentallab.com/talon 24 l 2018 SKCDS FALL QUARTERLY
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With our comfortable nightguards, patients won’t grind their dreams away at night. Try the new glittered and rainbow color selection to sparkle up the night and their smile. Sabina Diez Berger
Nightguard Department Manager
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