Dental Entrepreneur Fall 2013

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CLASS OF 2014 | FALL ISSUE

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Business Beyond the Classroom

Ryan Dulde My Story Since Graduating Dental School Seven Mistakes to Avoid When Starting Out Are You Ready for the Dental Electronic Health Records Revolution?

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entrepreneur Fall 2013 VOLUME 16, ISSUE 1 Editor & Publisher Anne M. Duffy RDH Assistant Editor Michael Duffy Production Ruthie Gordon Publishers Press Inc. Director of Advertising A.Marie Linesch Editorial Board Dr. Gene Heller Dr. Harold Sturner Dr.Ryan Dulde Dr. Earl Douglas Rachel Teel Wall, RDH,BS. Dr. Tom Snyder Derek Champagne Layout and Design John O’Connor

Class of 2013 Contributors Dr. Ryan Dulde

Mike Uretz

Dr. Roger Levin

Theodore Passineau

Linda Drevenstedt

Earl Douglas

Trent Watrous

Kristin Nickells

Peggy Skirball & Jesssica Wilson

Charter Sponsors The Pride Institute The Snyder Group McKenzie Management Caesy Education Systems, Inc. Warner‑Lambert Co. Phillips Health Care Oxyfresh Worldwide

Oral‑B Laboratories Ultradent Products Inc. Procter & Gamble Wm. Wrigley Jr. Corp.

Glidewell Laboratories Benco Dental Co. Tess Corp.

Dental Care Alliance

Editorial Office 12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 ADuff2@aol.com Send materials to: Dental Entrepreneur Magazine 8334 Pineville Matthews Road Ste. 103-201 Charlotte, NC 28226 When you have finished enjoying this magazine pass it along to a friend and PLEASE RECYCLE Copyright 2013 Dental Entrepreneur, Charlotte, NC Material herein may not be reproduced, copied or reprinted without prior written consent of the publisher. Acceptance of advertising does not imply endorsement by the publisher.

Welcome to Dental Entrepreneur

CLASS OF 2014 FALL ISSUE

H

ello to all of the future dental school graduates entering the home stretch of their extensive studies in what can be a financially- and personally-rewarding field.

While it may seem that there is still a long way to go… well, there is. I hate to say it, but the finish line might be within sight, grasping the actual checkered flag can be a fleeting vision.

That’s not to say you won’t have a big jump-start when you finally hold your diploma triumphantly as a young and hungry dentist. In these times of the industry, you are a commodity, someone who can breathe new life into an existing practice, or someone who can bring a fresh practice into a needing and deserving area.

Whatever the case, I’m sure you feel confident in all the clinical studies you’ve completed.

The hands-on work already under your belt is crucial, as is everything you’ve devoured in each and every textbook.

But as we’ve seen over the years in not only working hand-in-hand with dental practitioners and students alike, one area that can be lacking in graduate programs is the business side of things.

Now, that “business” umbrella includes several different areas, but we here at Dental Entrepreneur: Business Beyond the Classroom believe we have pinpointed what areas need the most reinforcement.

As such, we have gathered together experts in a plethora of fields to provide additional guidance and help lead you on the path to success.

This will be our second issue with Ryan Dulde, the former president of the ASDA, on our editorial board (that’s him on the cover). Ryan contributed our opening article, “My Story Since Graduating Dental School,” in which he describes choosing a residency serving the Navajo Nation, working in a suburban private office and a multi-location corporate practice. And that’s just the start.

Not only does he inspire me, I am confident his tale will inspire you.

Linda Drevenstedt provides sage advice in her feature about the interview process.

She offers a highly-informative list of things that anyone should note when sitting down with a potential employer. To be honest, there are just some things that I never thought of as I have sat across the desk from an interviewer in the past.

What does Sterilization have to do with your bottom line? Peggy Skirball and Jessica Wilson, well known trainers in this arena, examine the systems and protocols from a business perspective, which gives a new appreciation of this tedious topic.

Mike Uretz is just one of our technical advisors with his tome on the advancement of electronic health records and what it means for dentists of the future.

“Whether you plan on starting your own practice or joining a dental group, you will be put in a position of having dental software vendors who WILL have the upper hand, beating down your doors trying to get your business,” he noted.

How to properly deal with that? You’ll have to read on.

This is just a sample of who has added their unique voice to this issue, not to mention the topics that we cover. But that is why I hope that you get as much out of our Fall 2013 edition as I did. I do encourage you to reach out to each resource – from our writers to those named in our contact lists located throughout the magazine.

As I’ve found, knowing what speed bumps could lie ahead will make the journey flow even smoother. With an eye placed towards your Spring graduation, I hope Dental Entrepreneur can be a fruitful pit stop along the way.

Good luck!

All the best,

Anne M. Duffy Publisher 2 Fall 2013 Dental Entrepreneur

www.dentalentrepreneur.com

CLASS OF 2014 FALL ISSUE VOLUME I

dental

entrepreneur’s

Contents

Business Beyond the Classroom

Prologue

4 My Story Since Graduating Dental School Ryan Dulde, DDS

Getting Started 6 Seven Mistakes to Avoid When Starting Out Roger P. Levin, DDS

10 Ace That Interview Linda Drevenstedt, MS

The Power To Succeed 32 Would You Like Floss With That?

Kristin Nickells, CEC, ACC

34 Be Ye Not Afraid, Ye Art a Dentist After All Earl Douglas, DDS, MBA, BVAL

14 Student Loan Debt: It’s Coming Sooner than You Think Trent Watrous, CPA, CFE, CVA

Business Fundamentals 20 Sterilization Systems and Your Bottom Line Peggy Skirball RDH, BS and Jessica Wilson, RDH, BS

24 Are You Ready for the Dental Electronic Health Records Revolution?

Mike Uretz

30 Transfer of Records When Buying or Selling a Practice Theodore Passineau, JD, HRM, RPLU, CPHRM, FASHRM

www.dentalentrepreneur.com

Dental Entrepreneur Fall 2013 3

Prologue RYAN DULDE, DDS

My Story Since Graduating Dental School

V

ariety is the spice of life, and I’d say my first two years in practice have been well-seasoned.

As the end of dental school drew near, I debated about applying for residency. Like many, I was eager to begin practicing.

Having been a student for the last seven years, I feared I was running low on the focus I would need to succeed as a resident. On the other hand, a residency program was the ideal environment for developing my skills and gaining some “polish” before entering a dental office. In the end, I chose a program that offered all of these advantages while looking and feeling completely different than dental school.

My residency experience can be summed up in one word: wild. I spent a year after dental school serving the Navajo Nation, operating three dental clinics in northern Arizona. I was drawn to the program for its uniqueRyan Dulde, DDS ness. Within the four walls of glorified trailers, our clinics offered incredible resources from orthodontics to CAD-CAM dentistry. I worked one-on-one each month with a variety of specialists. My residency challenged me to constantly leave my comfort zone with numerous opportunities for problem solving and practice learning every day.

My best recommendation when picking a residency is to decide in advance what skills you want to attain and pick programs based on alignment with these goals. There are many excellent programs, but likely just a few that can deliver the specific skill set you are looking for. Consider taking this time in your life to do something unconventional before your regular professional life begins.

4 Fall 2013 Dental Entrepreneur

With the residency program under my belt, I entered private practice with confidence and skill. The rigors of residency made the first few months of practice seem tame, but that didn’t last long. Private practice was a whole different challenge with a different set of rules. One skill to be mastered is the art of communication. There is a lot of great advice from gurus out there, but I have found it critical to find my own voice when talking with patients. I most admire dentists who can effectively listen, read the patient and ask the right questions. Along with communication, private practice has challenged me to advance my clinical skills to places I never knew existed. Dentistry is lucky to have so many highquality courses and resources at our fingertips for motivated dentists who never stop improving.

Some of my favorites include Spear Education, CEREC Doctors and Dental XP.

One skill to be mastered is the art of communication.

In the course of two years, I have worked in four very different environments: a start-up clinic for military personnel, a suburban private office, a multi-location corporate practice and a faculty position in dental school. While I would not recommend this many part-time positions as anyone’s first choice, the variety has been invaluable. Each has shaped my perspective on dentistry, helping me define the kind of professional I want to be. I have also learned to quickly identify the kind of people I would want on my team.

As I think about the future in dentistry, I find myself asking two main questions. First, what will the dental field will look like at the end of my career? With the ongoing changes to health care in our country and the shifts in medicine over

the decades, it’s difficult to know how to plan for the future. Is it wise for emerging dentists to buy what retiring dentists are selling? What effect do these uncertainties have on the choices new dentists make, and what is the impact on our patients and our profession?

Secondly, how can dentists share so much in common, and yet be so different? When looking for information on a clinical technique or a business task, I am perplexed by how many “right answers” I can find to my seemingly simple questions. Our practices do not look the same or function the same, and yet, it all seems to work. Our differences allow us to be responsive to the diverse needs of patients. Our differences fuel clinical advancements. Our differences give us the ability to fulfill our vision for successful business and optimum dental care.

As I move forward into the next phase of my career, I see dentistry’s ultimate goal as choosing to agree and converge on our very best systems for operation so we can be creative and diverge in how we deliver care. New grads, you are entering the profession at an exciting time! All the variety dentistry has to offer will surely keep things interesting! ■ Dr. Ryan Dulde is a general dentist in Milwaukee, WI. He graduated from Marquette University School of Dentistry with distinction for his accomplishments with the American Student Dental Association (ASDA). Ryan is passionate about leadership development for emerging dentists. He is a member of AGD’s New Dentist Committee, a co-founder of ASDA’s National Leadership Conference, and an editorial board member for Dental Entrepreneur. He presents and publishes on a variety of new dentist topics. His e-book for dental students is available in Fall 2013 at www.ThirtyTwoPearls.com.

www.dentalentrepreneur.com

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Getting Started ROGER P. LEVIN, DDS

Seven Mistakes

to Avoid

When Starting Out Introduction Hopes for great success are automatic for most dentists entering practice. Yet despite all of the opportunities, young dentists are facing challenges today that did not exist in the past.

As recent graduates are painfully aware, a dental school education entails significant debt. Unlike their predecessors, many graduating new dentists are discovering that banks are slower to lend money than they were in the Roger P. Levin, DDS past. Interest rates are starting to rise, too – not a good sign for dentists who are already saddled with a six-figure school loan upon graduation.

In the new dental economy, success cannot be guaranteed. Young dentists should be careful to avoid costly pitfalls that can interfere with practice growth. To achieve maximum success with minimal stress, new doctors must avoid the following seven mistakes: Mistake No. 1: Thinking it is wrong to view your practice as a business.

Obviously, all dentists strive to deliver excellent care to their patients. That is your whole purpose for becoming a dentist in the first place. However, a practice is a business and a good business is highly efficient. Not thinking of a practice as a 6 Fall 2013 Dental Entrepreneur

business has caused many dentists to experience grossly inefficient offices. Once this occurs, production declines are inevitable, forcing many dentists to practice years longer than they intended.

Inefficiency drags a practice down year after year, hindering your best efforts to be a great dentist. Fully understanding the business of dentistry has never been more important than now. Inefficiency compromises the practice’s ability to con-

sistently deliver outstanding patient care, which ultimately affects practice revenue.

A smart, efficient practice provides excellent clinical care and an excellent living for the dentist.

Mistake No. 2: Insisting that a practice brochure is all the marketing you really need.

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buy a luxury car based solely on a brochure you got in the mail or picked up at a showroom? Would you skip having a test drive or asking questions at the dealership?

For most patients, investing in dental procedures – especially elective procedures – is not something done quickly without considering the cost and the benefits. Case acceptance is the end result of an intricate process involving many factors – not just a nice brochure.

Remember that a brochure is one aspect of a marketing program. Other components include value creation scripting, a website, outreach campaign, etc. While you do want informative and interesting brochures that promote the practice and services you offer, you do not want to depend on them too heavily. Nothing can replace the value that the doctor and the team create during face-to-face interactions with patients.

ceived as a salesperson. However, to imagine that you are not selling to your patients is actually one of the biggest illusions that dentists can have. Every treatment is “sold” to patients. By the sheer act of presenting a treatment plan, you are, in effect, selling it.

There is no need to worry. Selling is not a negative. You are advocating treatment that you honestly believe will either improve patients’ oral health or help them achieve a better and brighter smile – that is what patients expect from their dentist.

Mistake No. 4: Not trusting your team to handle all non-clinical tasks.

Levin Group encounters many dentists who have lost their love of dentistry.

With few exceptions, these individuals avoid delegating non-clinical tasks to team members. In the course of a day, they perform far more operational and adminMistake No. 3: Believing that, as istrative practice functions than necessary. a dentist, you should not “sell” to Dentists tend to forget that the staff is your patients. there for a reason – to assist the doctor.

Certainly, no dentist wants to be perWhy allow your team to function with

one hand tied behind their backs? If you are hiring people you trust, trust them to do their jobs. If properly trained, your staff will always surprise you with how effectively they can perform the tasks you thought only you could do.

Mistake No. 5: Assuming a “full” schedule is the measure of success.

A full schedule indicates that you are busy. It is not an indication that you are doing well. How could this be the case?

For example, your schedule could be crowded with single-tooth treatment to the exclusion of nearly everything else.

In that case, you are working very, very hard for your income. When the schedule consists almost entirely of low-profit procedures, the practice is forced to see more and more patients for less and less money per patient.

A better situation is to expand the service mix to include elective and cosmetic services that add much-needed variety to each day. By increasing production per patient, the practice is in a position to become more profitable and less chaotic.

Mistake No. 6: Dismissing the importance of morning meetings.

Many established dentists give up on morning meetings, regarding them as unproductive. In truth, morning meetings – or, as Levin Group calls them, Daily Business Meetings™ – are one of the best things you can do for yourself and your staff. For some practices, however, these meetings are not an effective way to start the day but rather a “gripe” session. Remember, a little complaining is OK because people can let off steam. However, the meeting cannot end there. If it does, it serves no purpose.

On the other hand, a positive and solutions-oriented Daily Business Meeting™ can make all the difference in office morale. It sets the tone for the day. Keep in mind that the meeting is about mapping out the day’s events, identifying any pitfalls and creating solutions. The end of the meeting should always feel upbeat.

8 Fall 2013 Dental Entrepreneur

www.dentalentrepreneur.com

Mistake No. 7: Treating your team as if they were part of your family.

This is a nice idea – in theory. In reality, it does not work. Treating your team extremely well is certainly the right thing to do. An office is a small environment and you want it to be harmonious.

However, your practice is a business and there will be times in your career when you will have to let a team member go for any number of reasons.

You cannot allow yourself to be distracted by how you personally feel about the individual leaving the practice. In the end, you are a CEO, and CEOs have to make difficult decisions. Keep in mind that this person’s poor performance can have a very direct and negative impact on your personal income. Avoid blurring the line between your professional and perADS.south209

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A dentist just starting out will hear many words of wisdom from older dentists. sonal life. You will regret it sooner or later.

Conclusion A dentist just starting out will hear many words of wisdom from older dentists. Unfortunately, their firmly held convictions about how you should practice can be problematic. The old rules no longer apply. By dispensing with outdated business principles, you better position

your practice for greater success.

Levin Group has worked with many young dentists who had a vision of building an excellent practice and being financially independent within 20 years of practicing dentistry. While this is certainly challenging, some doctors have already achieved these goals and many are certainly on track to make this happen.

By using proven business systems, these young dentists are paving the way for extraordinary careers. ■ Dr. Roger Levin is a third-generation general dentist and the Chairman and CEO of the largest dental practice consulting firm in North America, Levin Group, Inc., which has served more than 22,000 dentists and specialists since 1985.

Page 1

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Dental Entrepreneur Fall 2013 9

Getting Started LINDA DREVENSTEDT, MS

Ace That Interview M

any dental school graduates will look for a job after graduation. Whether it is as a private practice associate or a position with one of the expanding corporate dental practices, getting the job is a critical step for you. Particularly with the corporate practices in highly desirable areas, you may be in competition for a well-paying posiLinda Drevenstedt, MS tion, which means that your ability to interview will be critical.

Interviewing like a pro in the business world of dentistry takes forethought and keeping the job takes savvy.

Here are some tips to help you in this challenging process:

Preparation 1. Have a professional resume.

Professional resume writers can be worth their fee to assist you with this important step. Your resume has to pass the stack the recruiter receives in order to be ASKED to interview.

Leave out items that are not pertinent to your position as a dentist, such as your hobbies, your religious status and your marital status. Put in any awards, professional affiliations and volunteer dental work while in dental school.

Keep the tone active and show your ability to do the job, for example, “Completed 15 crown preparations with perfect marks.” Your resume

10 Fall 2013 Dental Entrepreneur

should be to the point, not paragraphs of information.

2. Include a detailed cover letter specific to the entity you are applying to (see step 4). Communicate that you are motivated to be productive for them as well as open to learning. If you are comfortable with endo, oral surgery, children or CERAC®, say so in the letter.

Include letters of recommendation from any dentist who has mentored you along the way as well as your professors.

3. Clean up or delete your Facebook® page. You cannot be denied a job based on your Facebook® page with photos of you at a wild party, but it is public information and recruiters will likely scout your social media activity.

If your Facebook® page shows things about you that could lower your status, take it down.

4. Do your homework. If this is a corporate interview, look up the corporation and study their website. Ask your dental school alumni office if any of the former graduates work there. See www.dentalentrepreneur.com

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1. if you can arrange a walk-through to get the vibe of the place. Call ahead and ask permission from the Practice Administrator or office manager. If this is a private practice, look up their website and Facebook® page.

Interviewing tips: 1. Be on time and well rested.

2. Carry an extra copy of your resume in a professional portfolio with a pad so you can take notes. Be prepared to ask questions based on your homework.

3. Dress as a professional. How you look plays a BIG part in an interview.

Check out www.janicehurleytrailor. com for professional dental attire.

Men should think about being cleanshaven with a neat haircut, wearing a shirt and tie if not a suit, wear polished well-heeled shoes. For women, a great haircut or, if you have long hair, wear it up in a professional offthe-face manner. Wear business dress clothes, with no cleavage showing and no sandals, professional closed toes shoes and (please) wear makeup.

4. Don’t divulge information that they cannot ask, but can influence decisions once the information is on the table. Labor laws restrict interview questions in these areas: • Race, sexual orientation, religion, or handicap • Marital status, maiden name, spouse’s name, or spouse’s work • Don’t say that when your spouse graduates from law school in a year you are moving to Alaska. Smart interviewers will ask you something like this, and you will reveal that which they cannot ask, such as, “What are your plans within the next 3 years?”

You don’t have to lie, just don’t be too transparent.

• Birth year, weight, height • Number of children, ages of children, or childcare arrangements • Don’t let on that you soon plan to start your family. Or, that you have four children under the age of 4. Again, this can’t be directly asked, but you might 12 Fall 2013 Dental Entrepreneur

spill the beans without thinking that it matters to the interviewer.

Follow-up 1. Send a professional HANDWRITTEN note after the interview, not just a TEXT or email. Thank them for their time and show your interest. If there is something you particularly liked about the practice, share that. Even if you were not impressed and you don’t think you want the position, leave all options open by leaving a good impression.

Got the job - NOW, Real World 101

Paycheck = Production The lure to a particular corporate position may be the carrot of a nice paycheck.

Percentages vary but the norm in both corporate and private practice for associate dentists is 30-35 percent. All practices are in business to make a profit. To make $140,000, your production must be $420,000 for 200 working days per year, $2100 per day, or $262.50 per hour. This pay is based on collections, so the insurance reimbursements affects how much you’ll need to produce to net the paycheck you desire.

Production = Proficiency You may have a skill shortfall. Your bosses expect that you can deliver quality dentistry. However, if you have only done endo on an extracted tooth, and they expect you to take the endo patients, get thee to a multi-day hands-on workshop ASAP. It surprises dentists to find in the dental real-work world that they are not completely prepared. The best investment you will make initially is to get specific skill training. The larger corporates often plan a curriculum for you to learn missing skills, while private practices may not.

Find out if you need CERAC® training.

You can research their website to see if they are promoting “Crowns in a Day.” If this was not a part of your curriculum, then ask if you can come in on off hours to learn the skills.

Time is Money Time flexibility will be a part of your

future. Many corporate practices are open weekends, early mornings and evenings.

Some private practices are hiring you to expand their hours. Be prepared, as you begin your career, to work flexible hours.

In your interview, if you restrict your available work times, you may not get the job.

Learn, Learn, Learn Yes, you are a dentist. However, once you hit the “work floor” you are a student again. Be a good employee and learn from the seasoned dental assistants, hygienists and business staff. Their knowledge can be integral to your success. Enter with a dose of humility and leave any arrogance at the door. Yes, you may have learned some new techniques, but they know the “drill” of real-world work.

You can learn a GREAT deal while you are an employee, if you are willing. Staff can show you the ropes if you respect them. You’ll see what works and what does not. Learn all the systems. You never know when you might want your own practice. Don’t waste time just doing dentistry and checking out. This is your opportunity to learn the business side of being a successful dentist.

You have entered a great profession, and I hope you enjoy all aspects of it throughout your career. And above all, never stop learning. ■ Linda Drevenstedt, MS, President of Drevenstedt Consulting, LLC Linda is a wise and insightful consultant, author, webinar presenter, and speaker. Her “Steel Magnolia” approach is honest and straightforward with a spoonful of sugar. She has real “in the trenches” experience from dental hygiene, dental assisting and managing a multi-specialty dental group practice.

She is a well published author and national lecturer. She holds undergraduate degrees in Dental Hygiene and Business Management, and an M.S. degree in Health Care Administration. Dentistry Today has voted her a “Leader in Consulting and Speaking” for the past 14 years.

Linda’s monthly newsletter and webinars are considered “outstanding.”

Find her at www.drevenstedt.com, linda@drevenstedt.com or 800.242.7648. www.dentalentrepreneur.com

www.dentalentrepreneur.com

Dental Entrepreneur Fall 2013 13

Getting Started TRENTON D. WATROUS, CPA, CFE, CVA

Student Loan Debt:

It’s Coming Sooner Than You Think

A

fter finishing a presentation at a dental school “Lunch and Learn,” a line formed with students who had questions for me on various topics. One particular student sticks out in my memory. She waited in line patiently to pose her question.

I noticed she continued to let students go in front of her until she was the only student remaining. Before she spoke, I could sense something was bothering her.

Her question was very relevant.

With $350,000 in student loan debt, plus orthodontic residency debt yet to be incurred and a small car note, could she ever be in a position to start her own orthodontic practice? Before responding, I listened to all the details, sensing her deep concern.

When she ultimately said, “What do you think?”

I said, Trenton D. Watrous, CPA, CFE, CVA “Absolutely yes, you will—but the responsibility to prepare rests upon your shoulders and yours alone.”

Increasingly, dental students are raising questions about school debt and the impact it can have on starting a practice or buying a home. Denying the impact that debt has on your overall financial future is not accepting the reality of your situation.

Ignoring your credit obligations until a “more convenient” time is reckless to say the least. Instead, you should develop a 14 Fall 2013 Dental Entrepreneur

plan to repay your student loans so you can begin to take control of your finances.

decide not to complete your education, or you file personal bankruptcy (such as Chapter 7).

Three Essential Steps to Take Control of Your Financial Future

Repayment Payments made on student loans are paid to a “loan servicer” and must be done on a regular and timely basis. Each loan servicer has a specific process for repayment. As the borrower, you bear the sole responsibility for making timely payments – even if, for example, your address changes and you don’t receive the new payment coupon booklet. Some loan servicers may provide the option of automated loan payment withdrawals from your bank account in exchange for a slightly lower interest rate on the loan.

Follow these three steps to build and maintain a strong financial foundation moving forward: 1. Understand Repayment of Your Student Loans Student Loans are just like any other debt, they must be repaid over a period of time. You are responsible for repaying your student loans even if your personal financial situation becomes difficult, you

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ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association.

All financing is subject to credit approval. © 2013 Wells Fargo Bank, N.A. All rights reserved.Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A.

Consolidation Consolidating multiple loans into a single loan could significantly simplify your loan repayment process for two primary reasons. First, student loans may have varying interest rates which are above the current market rates. Consolidating all your loans together may reduce the combined interest rates on the outstanding indebtedness. Second, the potential exists to consolidate the loans into a single loan with a longer term—thus lowering the monthly payment.

Alternatively, reasons may exist for you to choose not to consolidate your loans, such as loss of loan cancellation benefits or loss of a fixed interest rate. Having all the pertinent facts available in the consolidation process is essential. You might also choose to seek advice from a Certified Public Accountant or Certified Financial Planner when making this decision.

Grace Period Another important feature of loan repayment you should be aware of is the grace period applicable to your loan.

The grace period is the amount of time after a borrower graduates or drops below half-time enrollment before payments are due. This period of time (which typically lasts six months) allows the borrower to become gainfully employed and prepare to start paying on the loans. Maximizing the grace period is critical – especially if you are considering opening a new practice.

Income-Based Repayment If payments on your student loans become difficult, you may be eligible for the Income-Based Repayment Plan (IBR).

This plan prevents your monthly payments from exceeding 15 percent of your discretionary income based upon qualifying factors. Although IBR may reduce your monthly payments, you will most likely incur more interest over the life of the loan and may incur income taxes on the forgiveness of debt after 25 years of repayment. Depending on your situation, use of the IBR can be a valuable tool in managing your cash resources.

2. Know Your Specific Debts 16 Fall 2013 Dental Entrepreneur

For students who dream of owning their own practice, managing debt effectively is key to future success.

It can be a little hard to stomach, but it’s important to know exactly how much you owe. Start by outlining all of your debts—including each of your student loans and any consumer debts, such as cars or credit cards. For each debt: Determine “when” payments will become due, calculate “what” the monthly payments will be, learn “where” the payments must be made, and explore “how” your specific debts could be amended (such as through debt consolidation).

I often work with younger clients who have little knowledge of their outstanding debt and who continue to create new obligations with zero awareness of how their current income can or cannot support the monthly payments. Continuing to remain unaware of your personal obligations is reckless. Beginning to understand your situation or seeking the advice of professionals is a foundation of financial wisdom.

For students who dream of owning their own practice, managing debt effectively is key to future success. Generally, opening a new practice or acquiring an existing practice will require you to borrow funds ranging from $400,000 to $600,000. Demonstrating to lenders, based on your credit record, that you are capable of handling the funds placed in your trust will move your dreams closer to reality. Protect your credit record from late payment or loan default comments by remaining proactive.

3. Create a Budget Let’s face it, we all have limitations in life. Understanding your unique financial resources and limitations is vital to your long-term financial health. Avoiding that

reality can have significant consequences. That’s why planning to allocate the resources you have toward your outstanding debts is essential. The best tool for managing your resources is a budget.

The two primary areas of a budget are cash inflows and cash outflows. Inflows represent cash collected as wages or interest income. Outflows could include rent, student loan debt payments, credit card payments, and basic necessities such as food and clothing. The difference between the total inflows and total outflows should be a positive number. If not, changes must be made to better allocate the resources and meet your obligations.

Why is creating a budget important now and in the future? Having a clear understanding of what outflows must be available to repay your student loan debts is essential to financial peace. Continuing to incur additional obligations, such as a new car note or consumer debt (i.e. credit cards), when your income will not support your obligations will create financial chaos. And that can limit your personal and professional options for years to come.

Manage Your Finances Today for Greater Success Tomorrow Just like maintaining strong oral health, having the facts makes a difference.

Knowing the terms of your student debt and how that student debt will impact your financial condition will ultimately empower you to a greater level of success.

Plan for debt repayment by creating a budget and confidently know how your resources will be allocated to help you achieve your dreams. ■ Trent Watrous leads the Dental Services Team at WSW CPAs. Offering a valuable combination of client service and expertise, Trent and WSW provide clients with industry specific knowledge, proven experience, and a willingness to work with young dental professionals. Discover the difference a dental specific CPA will make in your future success! Visit wswcpas.com to learn more and for a download of “From Dental Academics to Dental Professional: A Roadmap for the Journey”.

www.dentalentrepreneur.com

Home Mortgage

Physician Loans

BB&T has helped countless professionals in the dental industry to better manage and expand their businesses while improving their personal finances as well. We offer home financing options designed exclusively for physicians.1 For example, with a BB&T Physician loan, you can borrow 100% of your loan amount, up to $650,00, with no money down. Other features include: BB&T PHYSICIAN LOAN PROGRAM Maximum loan to value (LTV)

100% up to $650,000 / 95% up to $850,000

Maximum Loan Amount*

$850,000

Private Mortgage Insurance

Not required

Minimum FICO

LTV > 90% = 720

Student Loans

Excluded from ratios if deferred for 12 months

Escrow for Taxes & Insurance

Required

Occupancy

Primary residence only

Eligible Property Types

One-unit single family detached, warrantable condos and PUD's

Eligible Products

15- and 30- year fixed rates, 5/1, 7/1, and 10/1 LIBOR ARMs (fully amortizing)

LTV ≤ 90% = 700

*Consult your BB&T mortgage loan officer for details. Maximum loan amount subject to change without notice.

Added benefit from BB&T

Apply before September 6, 2013, and we’ll reduce certain lender fees up to $500.

2

To take advantage of this offer simply mention the promo code SMILE. To apply online or locate the mortgage loan officer nearest you please visit BBT.com/mortgage.

Please see our web site to find the states where BB&T operates.

BB&T, Member FDIC and an Equal Housing Lender.

Loans are subject to credit approval.

1 Offer available to the following medical interns, residents, fellows, and licensed physicians who have completed their residency, internship, or fellowship within the last 10 years: Medical doctors, doctor of osteopathy, doctor of dental surgery, doctor of dental medicine, doctor of optometry, and doctor of podiatric medicine.

For comparison purposes, a 10- year variable-rate mortgage of $850,000 with a 5% down payment at a variable APR of 3.697% with no points and no origination fee would result in 360 equal payments of $3,936.48. These payments do not include tax or insurance costs; the total payment obligation may be higher. This is a representative example based upon rates that were effective as of 7/18/12. Rates may change at any time. Rates may increase after consummation.

For comparison purposes, a 30- year conventional, fixed-rate mortgage of $650,000 with a 0% down payment at an APR of 4.57% with .375 points and no origination fee would result in 360 equal payments of $3,293.45. A 30 year conventional, fixed rate mortgage of $850,000 with a 5% down payment at an APR of 4.313% with .375 points and no origination fee would result in 360 equal payments of $4,181.49. These payments do not include tax or insurance costs; the total payment obligation may be higher. This is a representative example based upon rates that were effective as of 7/18/12. Rates may change at any time.

2 BB&T will pay up to $500 toward reducing certain lender fees (underwriting, origination, commitment, processing, courier/mail, doc prep or loan handling fees) you may be charged. Other fees may also be assessed, but are not eligible for this reduction.

Property, and if applicable, flood insurance must be in effect on property securing the loan. © 2013, Branch Banking and Trust Company. All rights reserved.

Business Beyond the Classroom ADS Dental Transition Specialists (888) ADS-4237 www.ADStransitions.com ADS is the nationwide leader in dental practice sales, associateships, buy-in/buy-outs, partnerships and appraisals. ADS is comprised of the industry’s most experienced professionals, including dentists, attorneys, and CPAs. We can help you with each step of your next transition. To view a complete list of practice opportunities available in your desired area, visit us at ADStransitions.com. Please see our ad on page 11.

ADS Dental Transition Specialists South 770-664-1982 www.adssouth.com ADS South is the premier dental transition organization in the Southeast. We provide associateship placement, dental practice sales, appraisals, and expert testimony services.

Our company was founded over 26 years ago by Earl M. Douglas, DDS, MBA, BVAL, and we continue to control the cutting edge of transition technology. Please see our ad on page 9.

RESOURCE GUIDE

Dental Dreams, LLC Dental Dreams, LLC provides families with high quality dental services in a modern technologically-advanced setting.

Because we understand the tremendous value of our associate dentists, we ensure that their compensation package is amongst the best. Our doctors take home an average of$230k/year plus benefits! See our ad on page 23.

Heartland Dental Care 217-540-5100 www.heartlanddentalcare.com Heartland Dental Care is one of the leading dental service organizations in the United States with more than 425 affiliated dental offices within 20 states. It supports over 700 affiliated dentists and 5,000 team members through continuing professional education and leadership training along with a variety of non-clinical administrative services.

See our ad page 13.

Henry Schein Nationwide Dental Opportunities 866-409-3001 www.dentalopportunities.com

Aspen Dental 877-330-1349 www.AspenDentalJobs.com

Henry Schein Nationwide Dental Opportunities is the perfect solution for your Dental Associate recruitment needs. Call 1-866-409-3001 today to learn more about improving your opportunities or success. See our ad on the back cover.

At Aspen Dental we recognize that our success is a direct result of empowering and supporting ambitious dental professionals. We provide a professional, fast-paced, entrepreneurial work environment based on a mutual respect that keeps our interests aligned together, we build and develop successful, patient focused dental practices. Please see our ad on page 5.

Henry Schein Professional Practice Transitions (PPT) 1-800-730-8883 ppt@henryschein.com www.henryschein.com/ppt

BB&T Visit BBT.com BB&T is one of the largest financial services holding companies in the U.S. with assets of more than $183.9 billion, more than 32,000 employees and approximately 1,800 locations in 12 states and Washington, D.C. A Fortune 500 company, BB&T is consistently recognized for outstanding client satisfaction by J.D. Power and Associates, the U.S. Small Business Administration, Greenwich Associates and others.

Please see our ad on page 17.

Comfort Dental www.comfortdental.com The Best of Both Worlds At Comfort Dental, we combine the old-style neighborhood dental practice with today’s modern group practice. Equity ownership, autonomy, management of your own business, and long- lasting relationships with your patients is combined with our economics of scale, prime locations, mass marketing, and overhead control. It truly is the best of both worlds.

See our ad on page 29.

18 Fall 2013 Dental Entrepreneur

Henry Schein Professional Practice Transitions (PPT) is the practice sales division of Henry Schein, Inc. Our affiliation with the largest dental supply company in the country—intent on servicing the practice buyer’s future supply, equipment and service needs―makes PPT the only company with a vested interest in the buyer and a career long trusted relationship with the seller. (Please see our ad on the inside back cover.)

Hu-Friedy 800-HU-FRIEDY www.hu-friedy.com Founded in Chicago in 1908, Hu-Friedy Manufacturing Company helps dental professionals perform at their best by producing dental instruments and products designed to function as an extension of each practitioner’s particular skill. Its products, hand-crafted by highly-skilled artisans, are known for their precision, performance, longevity, reliability and quality. See our ad on page 21.

www.dentalentrepreneur.com

Business Beyond the Classroom MacPractice, Inc (402) 420-2430 KellyKrueger@MacPractice.com MacPractice.com MacPractice provides a practice environment of comprehensive native Apple applications that harness the legendary simplicity and ease of use of Apple’s operating systems and devices. Multi-specialty MacPractice is the core Mac practice management and clinical software. Patient Check In, MacPractice Clipboard and MacPractice iEDR apps for iPad interoperate to eliminate data entry errors and redundancy, maximize staff time, improve patient registration experience, and eliminate paper. Dentists and staff can notate visits in iEDR and educate and motivate patients by showing them their x-rays and photos on an iPad. Register at www.

MacPractice.com to view demos or call (402) 420-2430 for information. Please see our ad on page 25.

Medical Protective 800-4MEDPRO www.medpro.com Since 1899 Medical Protective has been the nation’s leader in dental professional liability. As a member of the Bekshire Hathaway group of businesses, Medical Protective provides dentists and oral surgeons with four levels of unmatched protection - strength, defense, solutions, since 1899. For more information, visit www.edpro.com or call 800-4MEDPRO. Please see our ad on page 33.

Oxyfresh Worldwide Inc. 800-333-7374 ref# R23037601 aduff2@aol.com Since 1984 thousands of dental professionals have discovered Oxyfresh’s safe and effective oral health products for use in long-term care and maintenance of their patients. Retail sales, wholesale rebates and “free product” programs allow you to get paid appropriately for providing professional guidance and instruction to your patients.

PARAGON Dental Practice Transitions www.paragon.us.com 866-898-1867 Offices located Nationwide. PARAGON offers professional consultation and related services to healthcare professions with primary emphasis on the dental profession: comprehensive dental practice valuations (including a written valuation and analysis report); practice sales; pre-retirement sales; practice acquisitions; practice mergers; associateships; partnerships; practice consolidations and practice management. References available by request. Please see our ad on page 27.

www.dentalentrepreneur.com

RESOURCE GUIDE

Patterson Dental Supply Inc. 800 873-7683 www.pattersondental.com Patterson Dental Supply Inc. is a full-service distributor of a complete range of dental products and services to dentists, dental laboratories, institutions and other healthcare providers throughout North America. As one of the nation’s largest dental distributors, Patterson Dental sells consumable dental supplies, digital and other dental equipment and practice management software. Please see our advertisement on the inside of the front cover and page 1.

Patterson Advantage (800) 328-5536 www.pattersondental.com Patterson Dental, a leading distributor of dental products, equipment and technology in North America, is the largest business in the progressive, global Patterson Companies family of businesses. Dental professionals who partner with Patterson enjoy the convenience and assurance of relying on one trusted source for everything they need. Please see our ad on page 7.

Sirona Dental Systems, LLC 800-659-5977 http://www.cereconline.com CEREC AC from Sirona is the most advanced dental CAD/ CAM system available. With its Bluecam, capturing fast, precise digital impressions and then creating high quality esthetic restorations is a reality. CEREC AC delivers access to efficient, precise, scalable and affordable solutions, including CEREC Connect. Call 1-800-659-5977 or visit www.cereconline.com. Please see our ad on page 27.

Wells Fargo Practice Finance 1-888-937-2321 wellsfargo.com/dentists practicefinance@wellsfargo.com Wells Fargo Practice Finance provides customized financing supported by experienced specialists and practical planning resources to help dentists acquire, start and expand their practices. The only practice lender selected especially for ADA® members and endorsed by ADA Business ResourcesSM, we understand the business of growing successful practices and are here to help you achieve your goals.

Please see our ad on page 15.

Dental Entrepreneur Fall 2013 19

Business Fundamentals PEGGY SKIRBALL, RDH, BS AND JESSICA WILSON

Sterilization Systems and Your Bottom Line

O

pening your first practice can be both an exhilarating experience and exhausting process.

Along with the excitement of starting your own business, comes the checklist of tasks to do before your opening day. Practice design, equipment and merchandise choices, software options, business systems, marketing strategies… the list can seem endless. Because your practice is a healthcare facility where invasive procedures Peggy Skirball, RDH, BS will be performed, there are additional items that must be addressed before the first patient is seen. One of the themes that will be present throughout the life of your practice is compliance. The Centers Jessica Wilson for Disease Control and Prevention (CDC), who set the standards of care for patient and staff safety, recommend all dental practices have written protocols in place for specific Infection Prevention tasks (1). Without a plan, some sleepless nights are in your future.

In this article, we will examine these systems and protocols from a business perspective. What does it mean to the health of your business when the right systems are in place and what is the cost to you when they are not?

20 Fall 2013 Dental Entrepreneur

STERILIZATION AREA DESIGN The Sterilization Area is the heart of every dental practice. Almost everything used in direct patient care funnels through this area for reprocessing. It requires the highest infection control standards in the practice, as it has the highest potential for sharps injuries among staff and cross contamination to occur (2). This area should be a designated central processing area divided into four distinct sections for receiving; cleaning and decontamination; preparation and packaging; sterilization; and storage of these sterilized items (3).

The CDC has outlined this sterilization flow as a means of maintaining the chain of asepsis during instrument processing.

The one-way flow of instrument processing from contaminated to sterilized also encourages staff to remain in compliance by making the process easy and systematic. If this area and your instrument processing systems is not well-planned, ultimately, it will slow down the entire clinical treatment area. Minutes wasted add up to hours lost over the course of a week… precious time no office can afford.

Remember to consider your long-term practice goals and growth potential when purchasing sterilization equipment. For example, from a business perspective, it doesn’t make sense to purchase the smallest ultrasonic or autoclave available only to replace it with a larger one to accommodate your growing practice in a few years. Looking into the future and planning for practice growth is wise when making equipment choices.

INSTRUMENT MANAGEMENT Dentists receive little training on the complex steps involved in sterilizing con-

taminated instruments in private practice.

It is important to understand this process can be laborious and time-consuming for your staff. Because staff salaries will always be your largest expense, streamlining instrument processing to maximize efficiency is in your best interest. Any amount of time lost due to inefficient systems is production time and potential revenue that will never be recuperated and adds to your business operating costs. Renee Pfefferle, Practice Management Consultant and owner of Dental Evolutions in Raleigh, N.C., targets efficiency as the key to cutting practice overhead. She states that the lack of efficiency is the number one reason overhead is high in a dental practice and points to the sterilization process as one of the main culprits.

As the practice owner, having an established system for organizing instruments and their reprocessing will help you manage operating costs, reduce labor time and keep your eye on compliance. Staff safety has to be considered, as well with over 30 percent of all sharps injuries occurring in the transportation and processing of contaminated items. OSHA (Occupational Safety and Health Administration) directly addresses safely managing these items in their Bloodborne Pathogens Standard as a way to mitigate this high percentage (4,5). An instrument management system, like Hu-Friedy’s IMS system, is your answer to addressing all four of these concerns. Dr Louis Malcmacher states, “An Instrument Management System eliminates many manual steps, including dangerous hand scrubbing and sorting of instruments, while increasing chair-side efficiencies. An Instrument Managament www.dentalentrepreneur.com

PRACTICE MORE

CHAIRSIDE

CLEANING

STORAGE

INSTRUMENT MANAGEMENT

Hu-Friedy’s Instrument Management System (IMS®) is designed to keep your instruments organized and intact from cleaning to chairside, saving you 5 to 10 minutes per procedure so

...Chairside Efficiency

YOU CAN PRACTICE MORE:

...Safety Protocols

...Cost-Savings ...Revenue Generating Activities ...Organization & Productivity

Learn more at Hu-Friedy.com Call 1-800-Hu-Friedy or contact your authorized Hu-Friedy representative for more information. ©2013 Hu-Friedy Mfg. Co., LLC. All rights reserved.

STERILIZATION

be alert to what your existing patients see and observe (6). “When patients notice a breach in a dental practice, they are unforgiving,” says Pfefferle. Patients are more curious than ever before as to what you are doing and happy patients are your best referral source and marketing strategy.

The internal marketing value of an organized practice cannot be overstated with over 40 percent of doctor production coming from new patients (7). You need to attract more patients like you already have. Using your IMS as an internal marketing tool is only one of the benefits it affords your office. The medical-grade cassette that was presented to your patient before treatment begins gives them something positive to talk about when they speak of their experience with your practice. It gives them confidence in you and the treatment you provided!

Figure 1 is an example of a sterilization area that is set up in accordance with the CDC Guidelines.

System that stores procedural instrument set ups together through the use of stainless steel cassettes ensures that everything is where you need it when you need it.”

This system standardizes the transportation, cleaning, sterilization and storage of instruments used during patient care while protecting instrument integrity throughout the day. It allows your staff to begin reprocessing with a safe, organized and efficient system that can quickly and easily adapt to future practice growth.

In addition to these benefits, practices that use IMS consistently show a savings of between five to 10 minutes per patient in instrument processing time. In one day, this can save over one hour of valuable staff time that can be spent on more revenue enhancing activities for the practice. Time is money, and if your staff is available for face-to-face conversations with patients, they are much more likely to help increase treatment plan acceptance rather than having their hands in the patient’s mouth or stressing over instruments piling up in the sterilization area.

STANDARDIZED PROTOCOLS Recent media coverage of infection 22 Fall 2013 Dental Entrepreneur

control breaches has highlighted the need for the practice owner to have a pulse on compliance. Too often, staff is left uninterrupted to perform outdated processes without any oversight from the practice owner. As the doctor, you are the person ultimately held responsible for any bad patient outcomes or allegations. Sean Kurdys, an investigator with the North Carolina State Board of Dental Examiners says, “If it isn’t written down, it didn’t happen.” Without written standardized protocols, documentation of the tasks performed and calibrated staff training, your exposure to liability and risk are dramatically increased.

Basic Infection Prevention protocols to consider include Instrument Processing, Biological Monitoring, Hand Hygiene, Dental Unit Waterline Management and Patient Room Turnover.

Check with your state dental board to see if there are any additional state-approved plans with which to comply.

PATIENT PERCEPTION With 25 percent of patients leaving a practice due to some witnessed occurrence that they perceive to be in breach of basic sterilization standards, you have to

CONCLUSION The investment you make now in your practice design, equipment and organizational systems will ultimately pay large dividends for your practice. Business owners must have a strategic plan to decrease risk and liability, comply with standards of care and best practices and be certain staff is working as efficiently as possible while making the best impression on your patients every time you see them!

CDC and OSAP (Organization for Safety, Asepsis and Prevention) have websites that you can reference for translating these recommendations into protocols.

However, confusion and misinterpretation abound with these recommendations and sometimes just getting started is overwhelming! Luckily, you have dedicated dealer representatives and support professionals available to help you through all of the decisions. Asking for advice from experts will allow you to focus on your patients and do what you do best while being sure you are making smart business decisions! A successful practice is definitely in your future. ■ REFERENCES 1. Kohn, W.G., et al. Center for Disease Control and Prevention, Guide for Infection Control in Dental Health Settings, 2003. www.dentalentrepreneur.com

Review of Science Related to Dental Infection Control/ Education and Training.

2. Molinari, J.A., Harte, J.A. (2010). Practical Infection Control in Dentistry, third edition. Chapter 14: Asepsis Considerations of Office Design & Equipment Selection, Lippincott Williams & Wilkins.

3. Kohn, W.G., et al. Center for Disease Control and Prevention , Guide for Infection Control in Dental Health Settings, 2003. Instrument Processing Area.

4. Younai, F.S., Murphy, D.C., Kotelchuck, D., (2001). Occupational Exposures to Blood in A Dental Teaching Environment: Results of a Ten-Year Surveillance Study.

Journal of Dental Education. 65:5.

5. Occupational Safety and Health Administration (OSHA). Bloodborne Pathogens Standard, 1910.1030(c)(1)(i), and 1910.1030(f )(3) 6. Kelsch, N.B. A Patient’s Perspective.

RDH Magazine, Sept 2012.

7. Levin, R.P. Increase New Patient Production. Dental Economics, www. dentaleconomics.com/increase-new-patientprodcution.html. November 2003.

www.dentalentrepreneur.com

Peggy Skirball is a dental hygienist with over 23 year experience in private practice.

Graduating with honors from the University of North Carolina at Chapel Hill with a BS in Dental Hygiene., she has dedicated her professional sales career to raising awareness in the dental community about practice systems that affect office productivity and safety. Her passion is assisting Doctors in making good business decisions when setting up their new practice.

Peggy is an expert in sterilization system best practices and is intimately involved in planning dental practice clinical treatment area efficiencies and training staff on proper infection prevention protocols in the Mid Atlantic area. She is a frequent regional speaker at local dental societies, dental hygiene components and study clubs. Peggy is a member of the ADHA and North Carolina Dental Hygiene Association.

Jessica Wilson is a National speaker, trainer and educator focused on Infection Control.

As the Instrument Management Specialist for Hu-Friedy, Jessica is involved with

educating and training Dental professionals on current sterilization techniques in their day to day operations to ensure the safety of staff and patients. Jessica continues to stay on the cutting edge on Infection Control changes within the dental industry attending several continuing education courses throughout the year as well as continued professional development as an educator. Her passion for assisting dental professionals with time management practices, instrument maintenance, reduced staff stress and improved safety in the dental office comes through in her fun and interactive presentations.

Jessica is a graduate of the University of Rhode Island and certified in Dental Public Health from A.T. Still University in Mesa, AZ. She is a member of the ADHA, Atlanta Dental Hygiene Society, Georgia Dental Hygiene Association, Organization for Safety, Asepsis and Prevention, and the National Speakers Association Georgia chapter.

Dental Entrepreneur Fall 2013 23

Business Fundamentals MIKE URETZ

Are You Ready for the Dental Electronic Health Records Revolution?

“N

ext Generation” dental electronic health records (EHR) are quickly and dramatically changing the landscape for how dentistry is conducted. Patient care, communication, and clinical workflows are ever changing. Accountability and reimbursement models are looking markedly different because of the ability of this technology. And the growing concern over HIPAA and practice liability are coming to the forefront.

The federal government has EHR incentive programs that provide up to $63,750 per eligible dentist for implementing certified technology. And the state of Minnesota, as a precursor of things to come on a national level, has just introduced an EHR mandate backed by state legislation. After Mike Uretz having recently conducted the first dental EHR workshop for the Minnesota Dental Association, I was pleasantly surprised at the large turnout and numerous questions posed by dentists eager to learn more about how they will be impacted.

The question is “Are you prepared, as new dental graduates, to adopt next-generation EHRs with success or failure?” Most dental students and postgraduates don’t think about preparing to select, purchase and implement dental software until it’s too late. Whether you plan on starting your own practice or joining a dental group, you will be put in a position of having dental software vendors who WILL have the upper hand, beating down your 24 Fall 2013 Dental Entrepreneur

doors trying to get your business. And the frustrating part of all this is that with the explosion and exponential growth of dental software technology including electronic health records and imaging software, this is fast becoming the lifeblood of any practice. The proper evaluation, purchase and implementation can be a factor in a practice or dental group’s future competitiveness and profitability.

In terms of graduates who choose to join an existing group practice, from my experience after having helped practices

acquire and implement technology for over 12 years, I have seen numerous times when groups assume the new kid on the block, i.e. the recent graduate, being brought up in a tech-literate world, has the skills needed to lead evaluation and acquire and implement technology for over 12 years, I have seen numerous times when groups assume the new kid on the block, i.e. the recent graduate, being brought up in a tech-literate world, has the skills needed to lead evaluation and

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MacPractice integrates into your life and work.

Your practice management and clinical software should enable you to run your practice effectively and affordably with confidence. It should integrate with your lifestyle, your iPads, iPhones and Macs at home.

You wouldn’t buy a PC for your home, why would you want one in your practice? MacPractice has its finger on the pulse of dental software and technology. Our future-proof solution provides comprehensive functionality to manage your office and patient relationships.

An experienced, dedicated MacPractice Practice Consultant is ready to visit your office to demonstrate how MacPractice works – giving you confidence to choose the most capable and powerful dental technology designed specifically for Apple devices.

Macs-imize your practice with MacPractice.

www.macpractice.com/dds | (855) 679-0033 Clipboard

Patient Check In

iEDR

MacPractice Register at www.dentalentrepreneur.com macpractice.com TO VIEW DEMOS

Simplicity in practice

Dental Entrepreneur Fall 2013 25

selection of new software technology such as next-generation EHRs. When I talk to these folks, they very much feel that they are put between a rock and a hard place.

They’re expected to be the technology “go-to” resource in the practice, while at the same time having to deal with getting their feet wet in the world of patient care as a brand-new provider. And, do you want to be that new dentist who is partially responsible for making a bad software decision and costing the practice tens of thousands of dollars?

When it comes to dental software for your own practice, the skills needed to be successful become much more daunting.

Not only do you need to have the skills to evaluate and select the right software for your practice, but now you need to deal with purchase and acquisition, as well as implementation. And don’t kid yourself that your dental practice attorney will always have the skills to structure and negotiate a dental software contract.

Some will have that ability, but software contracts take very specialized experience that many healthcare attorneys don’t necessarily have. It’s your money in the ultimate success or failure is on you. So, the more you can understand about the contract you are about to sign, the better.

Or, how about having the skills to get a good deal, to get the best price, and not get taken advantage of by the vendor?

I remember speaking at a conference about how to evaluate, select, purchase and implement an EHR system.

Afterward one of the providers came up to me and proclaimed: “I went to school for years to learn how to provide quality clinical patient care. No one prepared me for having to deal with software vendors and technology companies. With everything to think about, and everything that can go wrong, sometimes this reminds me of my recent experience building a new house” Step 1 – Be in Control of the Evaluation and Selection Process You could do any number of things to help you choose the right EHR, including: • Spending hundreds of dollars at Starbuck’s on triple-shot espressos while 26 Fall 2013 Dental Entrepreneur

surfing the Internet, reading opinions, comments and testimonials hoping that one vendor will rise to the top.

• Buying your colleagues expensive lunches in exchange for their thoughts and opinions about EHR systems.

• Having each of the 50 vendors you’re considering buy you lunch and then get brain overload your brain with hundreds of competing features.

• Wasting hours sitting through unmanaged vendor demonstrations – with no clear end game or objectives – where the vendor shows you what he thinks is important, doesn’t answer the important questions and keeps trying to close the sale

• Communicate your needs, priorities and expectations • Provide for side-by-side, applesto-apples vendor comparisons • Document vendor commitments and promises from a legal standpoint Best of all, soliciting RFPs from various vendors doesn’t cost you anything, but a little “sweat equity.” Because RFPs require vendors to prepare customized proposals, the process gives you a good idea of which vendors are serious about working with you and which can best accommodate your needs. The RFP can cover a number of areas, and at a minimum should include:

When it comes to dental software for your own practice, the skills needed to be successful become much more daunting.

1. A vendor profile consisting of a laundry list of quantitative measures, such as financial information, customer base, staff breakdown (R&D, support, etc.), product maturity, etc 2. A list of your prioritized “must have” and “nice to have” EHR features. For example, electronic treatment plans and protocols based on diagnosis might be a high priority, but patient online access to their records may be low on your list.

What is the problem with these methods? You walk away more confused than ever with time ticking away, patients to see and a business to run. This usually leads to a poor EHR selection, one that’s based on sheer exhaustion and a need to “just get it done.” Worse yet, you just shut down, and you never make a decision.

I’ve had clients ask for help after looking at EHR systems for two or three years.

They laugh about the fact that they’ve become “professional EHR researchers.”

Of course, this is in addition to their day job as a clinician. The good news is there’s light at the end of the tunnel if you choose to follow a proven technology selection process.

Let the vendors do the heavy lifting and utilize a powerful evaluation tool known as the Request for Proposal (RFP).

RFPs are important because they:

3. The underlying technology (Is the technology standard or proprietary?

Will it grow with your practice? Can it interface with other systems?).

4. A description of implementation, training and support processes (this could be a big differentiator).

Once you analyze vendors based on their RFP responses, you can reduce the list to a short handful, leading to the next step: vendor demonstrations.

The biggest mistakes are often made with vendor demonstrations. Instead of exercising your control over the demonstration, the vendors are left to run the show, spending more time than necessary showing features that might not be your priority, and not showing features that are critical to your practice. This scenario www.dentalentrepreneur.com

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can be prevented by going into a vendor demo with clear objectives, a set timeframe, a list of the clinical encounter scenarios that you typically see, and precise knowledge of what’s important to you and what you want to see demonstrated.

In addition to addressing your issues and concerns, vendors should also exhibit certain “soft skills” such as the ability to understand your needs and demonstrate what you ask for, a desire to engage you by asking questions,and a willingness to think outside the box and deviate from their prepared script.

Conversely, be wary of those vendors who exhibit red-flag behaviors, such as one sided conversations, or discussion of solutions before they understand your needs. You’ll know this is happening if you feel that the vendor is exclusively in “sell mode.” The liberal use of technical jargon to impress or confuse is a red flag.

And, watch out for vendors who make promises about future features, as these might not materialize. If the vendor exhibits these behaviors, politely excuse yourself.

Where Do You Go From Here?

Congratulations. If you followed the above tips, hopefully you will have selected the best electronic health records system for your needs along with a suitable vendor partner. However, there are a number of steps along this journey in order to make sure you are successful.

Making sure you get the best price, negotiating a favorable contract and assuring a successful implementation are all necessary steps to get to your final goals.

These topics will be covered in follow-up articles, but in the meantime, with these tips, you are at least prepared to go forth and level the playing field with vendors by taking control of your dental electronic health records evaluation and selection.

Note - All tips described above are applicable not just to dental electronic health records selection, but also to dental software evaluation and selection in general. ■

28 Fall 2013 Dental Entrepreneur

Mike Uretz is a 30-year technology veteran and nationally-recognized Healthcare software and Electronic Health Records (EHR) expert. Mike has consulted with hundreds of practices and multi-clinic groups to help them properly evaluate and select their software solutions, structure and negotiate contracts, and provide management and oversight for their implementations.

In addition, Mike has been a member of the Certification Commission for Health Information Technology EHR vendor certification workgroup (CCHIT), and has helped a number of state programs acquire EHR technology. He has been involved with the federal EHR incentive program from inception and was a member of various regional extension center advisory committees. As co-chairman of the Best Practices advisory committee for EHR Contracts, Mike was instrumental in developing standards for structuring software contracts and pricing used nationwide. He is working with the ADA on dental software interoperability and clinical data exchange.

An accomplished author and columnist Mike writes on EHR and dental software topics regularly for industy publications and websites. Mike is the founder and editorial director of DentalSoftwareAdvisor.com a trusted, and objective online resource on all matters related to dental software. Mike is also the Founder of the LinkedIn group Dental software, Electronic Dental Records and Electronic Health Records. Mike can be contacted at MikeU@DentalSoftwareAdvisor.com

If you have any questions, comments, or responses to our magazine, please connect with us on Dental Entrepreneur Magazine — our official Facebook page!

Read us online www.dentalentrepreneur.com Send your questions or comments to aduff2@aol.com www.dentalentrepreneur.com

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Business Beyond the Classroom

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Business Fundamentals THEODORE PASSINEAU, JD, HRM, RPLU, CPHRM, FASHR

Transfer of Records When Buying or Selling a Practice

M

ost dentists are aware of the requirements to protect patients’ personal protected health information (PHI) as specified by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Yet, it is still common for dentists who are buying or selling a practice to not realize that they can’t simply receive or hand over patient records.

Many dentists are also not aware that individual states may have privacy regulations, some of which are more stringent than the national regulations.1 HIPAA allows for the exchange of PHI without a written authorization between current and prior practitioners or contemporaneously treating practitioners (including practitioners who are treating Theodore Passineau, the patient at the JD, HRM, RPLU, same time, such CPHRM, FASHR as consultants).

However, HIPAA does not permit a doctor who is selling a practice to transfer PHI to a purchasing practitioner without the patient’s written authorization.

Although handing over the records to the purchasing practitioner might seem like the most expedient solution, it just isn’t permissible under HIPAA. State statutes and administrative rules may further complicate the process. For instance, states can require practitioners to maintain patients’ records for specified periods, dating from the last date of treatment. Many states impose a seven-year or 30 Fall 2013 Dental Entrepreneur

longer record maintenance requirement, and many impose separate — and often more rigorous — requirements for the retention of pediatric records. HIPAA does not diminish the authority of these laws.2 To comply with these records retention requirements, most retiring practitioners choose one of two options. First, they may store the records themselves. Many dentists retiring today do not have their records in electronic formats. When this is the case, the dentist who sells a practice often assumes responsibility for storing the paper records. In addition to the space requirements, this approach can be problematic if the records have not been maintained in an ordered system and a former patient requests a copy of the records (to which they are entitled under HIPAA).3 A second document maintenance option is the contracted services of a

records storage company. While these companies’ fees may be substantial, they offer several advantages. First, they will pick up the records and store them in a climate-controlled facility, which can protect them from environmental damage (e.g., dampness, mold, vermin, etc.).

Second, these companies are usually bonded or insured, thereby reducing a dentist’s exposure if stored records are damaged, destroyed, or stolen while in the records storage company’s possession.

A third benefit to records storage services is their ability to respond to patients’ requests for records. Patients can be referred directly to the storage service, which then will locate and copy the records and collect the fee from the patient. HIPAA allows a reasonable fee to be charged for location and copying.

Finally, at the time of records transfer, a records storage company will execute a www.dentalentrepreneur.com

legal document called a Business Associate Agreement (BAA) with the storing practitioner. This HIPAA-required document obliges the storage company to protect the confidentiality of PHI contained in the patient records to the same standard that the dentist must protect it. Through the BAA, the dentist and the patient are assured that the PHI will be secure.

Experience has shown that when a practice is sold, many (but not all) patients stay with that practice and continue their care with the purchasing practitioner.

This potential for continuity is a convenience for patients and it also enhances the value of the practice. It would be ideal if patients’ records could be immediately accessible to the new dentist. One possible solution is for the purchasing dentist to become the custodian of the selling practitioner’s records through execution of a BAA. In this case, in addition to compliance with HIPAA Privacy and Security regulations, the BAA should specify that the custodian will provide the selling practitioner with access to the physical record upon reasonable notice (such as two business days), and that the custodian will not release or dispose of any original records without the seller’s written authorization.

As needed, patients who continue their relationship with the practice will be asked to provide written authorization to release the record from the seller to the purchaser. Once this release is authorized, the new dentist (who is in physical possession of the record) can utilize the record as they would with any other active patient. Records of patients who leave the practice would ultimately be placed in storage. This arrangement would be permissible under HIPAA.4 Although it may seem onerous, HIPAA has been valuable in providing uniformity in administration and enhanced protection of patients’ PHI — an important consideration in this age of medical identity theft. With proper planning, continuity of patient care and compliance with HIPAA can be accomplished when a dental practice changes ownership. ■

www.dentalentrepreneur.com

Ted Passineau is a senior risk management consultant for Medical Protective, the nation’s oldest professional liability insurance company dedicated to the healthcare professions. For additional information, please contact Ted at theodore.passineau@medpro. com or visit the Medical Protective website at http://www.medpro.com.

© The Medical Protective Company. 2013.

All rights reserved.

1 For example, many state privacy laws end their jurisdiction at the time of the patient’s death; however, HIPAA does not. Following the death of a patient, the only person who can authorize the release of the PHI is usually the executor or personal representative of the deceased’s estate. If an estate does not exist, a court order may be required to authorize the release of the information.

2 It is important for the practitioner to know exactly what the retention requirements are in his or her state of practice. This information can normally be acquired through the state dental society.

3 Under HIPAA, the practitioner’s responsibility to provide patients with copies of their records does not terminate with the practitioner’s retirement. As long as the practitioner still possesses the records, he or she must provide copies if patients request them.

4 This article focuses on the practitioner who is still using a paper record system. If the practitioner has transitioned to an electronic health record (EHR) prior to selling the practice, then PHI transfer is less complicated. In such cases, the retiring practitioner would transfer all records electronically to the purchaser (in an encrypted format and, again, after executing a BAA). The purchasing practitioner would then, with the patient’s written authorization, transfer individual records to active files when needed. The records of patients who do not remain with the practice would be stored as an inactive/archived record. The selling practitioner could also easily retain a copy of all patient records for his or her future use.

Please reach out to our authors and our advertisers. They care about you and keep us in print.

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Business Beyond the Classroom

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If you have any questions, comments, or responses to our magazine, please connect with us on Dental Entrepreneur Magazine — our official Facebook page!

Read us online www.dentalentrepreneur.com Send your questions or comments to aduff2@aol.com www.dentalentrepreneur.com

Dental Entrepreneur Fall 2013 31

Power To Succeed KRISTIN NICKELLS, CEC, ACC

Would You Like Floss With That?

How to practice smarter & easier using franchise business secrets

W

hat will it be like to be practicing right after you graduate?

You’ll be focussed on clinical skills and building confidence, and it’s also an opportunity for you to observe and learn about how to run a practice (or how not to!). Many dentists begin practice ownership without benefit of business training or experience. They often try to reinvent the wheel using trial and error and can end up with a semiorganized jigsaw puzzle of business Kristin Nickells, CEC, systems, proceACC dures and routines lacking vision or direction. There is a better way, and maybe I can save you a few steps.

One of the most efficient business models in existence is a fast-food franchise operation. They are exquisite in their simplicity and efficiency; the principles are bare, exposed and not dressed up with fancy jargon. This is because franchises are designed for people who are disciplined but do not have any business background. Thus, they have much to offer the dental industry.

Five principles in particular are readily applied to a dental practice; Customer Service, Consistency, Operating Systems, Staff Management and Profit by Design.

Customer Service: Patients are Customers!

Franchises revolve around customer service – their very existence depends on it.

Many dentists consider their practices to be patient-centric, but are they? Small things like waits, chair-side manner and floss-lectures, all serve to diminish patient experiences. Dr. Tim Orent (1000 Gems) says, “Imagine every patient is a guest in 32 Fall 2013 Dental Entrepreneur

your home.” One solution, taken from the franchise manual, is to make an “alwaysdo” list of the things that must happen with every patient interaction (saying their name, saying thank you). Doing this ensures a positive patient experience!

Consistency: People Want to Know What to Expect, and They Expect to Get It! Consistency is the holy grail of franchises (ask Ray Kroc of McDonalds), and there is good reason for it. When what we expect doesn’t happen, we react with stress and anxiety (think about how you feel when you’ve lost your keys). Dentist turned coach, Dr. Ron Arndt, advises “persistent consistency” – determine and repeat behaviours and routines that work, for everything from hygiene protocol to dentist-patient interaction, post-operative care, check-out process, scheduling, etc.

This creates calm for clients that comes from expectations met, which leads to more compliance, increased treatment plan acceptance and more referrals!

Systems Operations: Structure Doesn’t Freeze You, It Frees You! Franchises operate on a series of systems designed to produce quality results efficiently. A system is a structure, method, or routine designed to carry out a specific activity. For franchises, these activities range from building a cheeseburger to cleaning the bathrooms. The benefits of using operating systems in a dental practice are many; customer expectations get met, quality control is consistent, employee performance increases (the same jobs get completed faster), and waste and error are reduced (which increases profits).

Most importantly, less management time is required and is reduced to tweaking systems rather than reacting to problems.

Efficient systems can be created (for patient experience, sterilization protocol, op set up, hygiene protocol, processing patient billing and booking recall, for example) by crafting a detailed list of the steps required for everything done in a practice. This makes the inefficiencies pop out like red flags, enabling change.

Staff Management: To be PatientCentred, You Must First be Employee-Centred!

Franchisees put a tremendous amount of time and energy into training and motivating staff. I happen to think a root canal is more important than a cheeseburger, yet dentists don’t put nearly the same thought & effort into training! The solution is for dentists to select key employees to be trainers and train them how to train (there are many train-the-trainer programs available). These staff members would be responsible for training new employees and orienting them to practice culture, philosophy and mission. continued on page 35 www.dentalentrepreneur.com

The easiest Dental Exam you’ll ever take

DENTAL MALPRACTICE EXAM When selecting dental malpractice insurance, you should choose: The company with the strongest claims defense The most experienced company The dental malpractice company with the highest financial ratings Medical Protective is “All of the Above”

Before you see your first patient, you’re going to have to choose dental malpractice insurance coverage.

Some new dentists give it little thought and automatically settle for the first insurer they hear about or use their employer’s company. But it’s your career on the line, and there are significant differences in the quality and value of companies and coverage available. Choose the company that more dentists have trusted since 1899 to protect their reputations, practices and assets. Choose the strongest malpractice insurer — Medical Protective.

Ask about our malpractice protection specifically designed for new graduates. dental@medpro.com www.medpro.com 800-4MEDPRO ©2011 The Medical Protective Company®.

Trust the dental malpractice experts.

Power To Succeed EARL DOUGLAS, DDS, MBA, BVAL

Be Ye Not Afraid, Ye Are A Dentist After All Or Who Will Own The Dental Profession

O

nce upon a time, the medical profession actually belonged to physicians. Medicine was a cottage industry and most physicians managed their own practices, much like most dentists do today. Then something happened – the ownership of the medical profession shifted from physicians to big business. Physicians as a group evolved into working for corporate owners and not themselves.

U n f o r t u n a t e l y, many physicians became unhappy with this new Earl Douglas, DDS, arrangement of MBA, BVAL working for hospitals, insurance companies and medical PPO and HMO organizations. What caused this to happen? My guess is that physicians were lured by the prospect of not having to invest in buying or starting their own practice, or the arduous process of the day-to-day of management of a practice. While these were definitely risks and duties that most medical professionals were not trained in, suited for, or even rewarding, they are the price of practice ownership and the benefits that go with it.

So was it worth it? Medicine is now big business, much like major league sports. The purpose of business entities is to make a profit for the owners of the business. How is this done? The first strategy is to lower costs, and in any business, lowering salaries is the first cost

34 Fall 2013 Dental Entrepreneur

cutting measure to consider. Business owners had to learn how to get more results for less cost, and something had to give. In medicine, the giving was done by the participants in the game with no control – the physicians and the patients.

I am now seeing the process that changed the face of medicine beginning to make headway in dentistry.

I am now seeing the process that changed the face of medicine beginning to make headway in dentistry. A year ago, my assistant Rebecca Kyatt and myself went to a student encounter at a major dental school. We met most almost every student from all four classes and asked everyone we met what their plans were after graduating. To our great surprise, only one person intended to buy or start

their own practice. While a few students whose parents were dentists were joining them in practice, the remaining supermajority of dentists intended to become associates, working for other dentists.

This is a major shift from the era when I graduated, when the most of us fully intended to have our own practices.

I first noticed the emergence of corporate dental entities in the 1980s. Many of those original companies are no longer in existence and corporate dentistry seemed to fade away. But at the beginning of this decade, I began seeing more and more corporate companies and the companies were larger and better managed. We are now accustomed to seeing the large corporate entities building practices and buying practices and hiring dentists to staff those offices.

The question is, will dentistry evolve the same way medicine did, in which well-educated professionals who owned their own practices transition to work for big business, having little or no voice in the management of the practice? As of May of last year, there were an estimated 25 dental management companies employing an estimated 12,000 dentists, or 8 percent of the licensed dentists in the country. There is no doubt that dentistry is a target for entrepreneurs, and the entrepreneurs are no longer only dentists, but are now the businessmen who would make a living from the efforts of dentists.

There are many other corporate practices employing dentists. They are all not of the magnitude of the largest entities, but may be owned and managed by dentists who may or may not practice, or who www.dentalentrepreneur.com

are licensed and are the sole owner and manager. Considering these additional entities pushes the number of employed dentists to some very high levels.

So that’s all very interesting, but what is the point of all of this? It’s not meant to bash any group or any entity, or dental practice management style or structure, but to remind us of the advantages of owning our own practices that so many dentists have overlooked as they choose a more comfortable but less rewarding option of working for someone else.

The name of this magazine, Dental Entrepreneur, implies that it is directed to the dentist who is entrepreneurial in their approach to their career. While there is no question that not every dentist is best suited to own and manage their own practice, I note that the proportion of entrepreneurial dentists is lower than it has ever been and continuing to decrease.

I’m not purporting that there is any given percentage that the profession should maintain as owners, but to emphasize to students and dentists to look carefully at their choices.

We do acknowledge that there are benefits to practicing for someone else, including not having to manage and administer, not having to borrow money and be in debt, and the stress that goes with those items. For a dentist to take on those burdens, there must be some strong offsetting benefits.

First, there is the freedom to set your own course and philosophy of practice.

You can create a treatment plan by your own standards, not by those set by managers who may put time and motion studies before patient needs. Your conscience and that of your patients will benefit greatly by this advantage.

You will set your own fees, being as competitive or as independent as you please. You will decide which managed care plans, if any, that you choose to participate in and in the process set the tone of your career.

You will decide who works for you.

As an owner, you will hire the staff you feel is best qualified to assist you in your practice, train them to your style and your standards. If a staff member is not living

www.dentalentrepreneur.com

up to the standards of their job, you can return them to the community.

There are substantial tax benefits from starting or purchasing a practice. As an associate, there’s no opportunity for tax relief from depreciating and deducting expenses which someone who invests in their own practice can do.

You have the freedom to formulate and contribute to your own pension plan.

Your contributions can be larger than those of an employee, and you can decide on the best plan for your circumstances.

Practice owners also can enjoy many perks that are tax deductible, whereas employees do not have the flexibility of exercising these benefits.

Owners are able to choose insurance policies that best meet their own and their family’s needs. You choose the health, life, disability, long-term care and other policies that work best for you, and not the lowest cost, minimal benefit policies that may or may not be offered by your employer.

Some dentists feel there is a sense of security in working for big business, but the bottom line is, unless the employee is covering their overhead expense and making a profit for the employer, the employer will replace them with someone else. So my point is, if the dentist can make the employer’s practice and profit bigger, why wouldn’t they do that for themselves?

There is a satisfaction that can only come from knowing that you are a member of an esteemed and important profession, and not simply an employee of big business, whose job is to make the most profit for its owners. I guess I really do believe that the profession of Dentistry should belong not to the MBAs and the CPAs, but to the doctors who practice it. ■ Earl Douglas, DDS, MBA, BVAL, is the founding president of ADS, a company with independent practice brokers, appraisers, and consultants nationwide. His company, ADS South serves the Southeast and South Central US. He can be reached at 770-664-1982 or at douglas@adssouth.com. Visit the website at www.adssouth.com

continued from page 32

Another method that can borrowed from franchises are instructional audio/ video training materials (cheaply made and easily produced) which new employees must work through and be tested on (think of the time saving in this alone!).

The benefit of a well-organized training system for staff includes a shorter learning curve, stronger commitment to the practice and less need for dentist’s time – all of which means a healthier bottom line.

Profit by Design – Predicable Profit Provides Stability I have yet to meet a dentist who knows before year-end exactly how profitable they are, while a franchisee knows precisely how much profit is in everything on the menu.

This lack of necessity to monitor margins can lead to waste, sloppy financial habits, chaotic cash flow and possibly bankruptcy.

Dentists can avoid this by taking a mantra from fast-food franchises: monitor and control overhead! Payroll is a practice’s most significant cost and can be kept under control by 1) Creating a set scale for wages from starting wage up to increments earned by set achievements, and 2) Being prepared to prune excess hours, staff and non-productive employees.

Operating a dental practice by reinventing the wheel or learning by trial and error is counter-productive and unnecessary. As a new dentist, you can avoid that trap. Simply look across the street at a busy fast-food franchise and ask yourself, “What would they do?” The answers are as close as your next cheeseburger! ■ Kristin Nickells is a Certified Executive Coach working with dentists to make their practices better and easier to run. She makes learning business, communication and leadership skills fun. Her programs, Business Bootcamp for Dentists, Would You Like Floss With That? and Keep Your Staff Without Losing Your Mind are designed to help dentists and their teams stay sane in a crazy industry! Kristin speaks for dental groups and her articles have been published in leading dental journals. Contact Kristin at Nickellsilver Business Solutions Inc. (250) 248-1926; coachk@nickellsilver.ca www.nickellsilver.com Dental Entrepreneur Fall 2013 35

Dental Trade Shows 154th ADA Annual Session October 31 – November 3, 2013 New Orleans, LA Greater New York Dental Meeting November 29 – December 4, 2013 New York, NY 149th Chicago Mid Winter Meeting February 20 – 22, 2014 Chicago, IL 102nd Hinman Dental Meeting March 27 – 29, 2014 Atlanta, GA California Dental AssociationSpring Session May 15 – 17, 2014 Anaheim, CA 155th ADA Annual Session October 9 – 14, 2014 San Antonio, TX

ASDA’s National Leadership Conference The American Student Dental Association is hosting its second National Leadership Conference, Nov. 15-17, 2013 in Chicago.

For details visit www.ASDAnet.org/NLC. Registration is open through Oct. 1. The event will provide leadership and business training to dental students across all years. Other benefits of attending: • Experience training in people management, public speaking and presenting, personal finance, practice negotiations, mentoring others and more • Increase the understanding of key issues in dentistry and dental education • Network with students from 60+ U.S. dental schools • Build relationships with exhibitors to fulfill current and post graduation needs Dental Entrepreneur: Business Beyond the Classroom will be there to meet the leaders attending. Please look for us!

Annual Session 2014 Feb. 26-March 1, 2014 Disneyland Hotel in Anaheim, Calif.

ASDAnet.org/AnnualSession National Dental Student Lobby Day April 7-8, 2014 L’Enfant Plaza Hotel in Washington, D.C. ASDAnet.org/LobbyDay

Index of Advertisers ADS Dental Transitions South.......................................................................................................... 9 ADS Dental Transitions…………………………………………………………….................................... 11 Aspen Dental................................................................................................................................. 5 BB&T.......................................................................................................................................... 17 Comfort Dental............................................................................................................................ 29 Dental Dreams............................................................................................................................ 23 Heartland Dental......................................................................................................................... 13 Henry Schein ............................................................................................Inside back and back cover Hu-Friedy.................................................................................................................................... 21 MacPractice................................................................................................................................ 25 Medical Protective....................................................................................................................... 33 Paragon...................................................................................................................................... 27 Patterson Advantage...................................................................................................................... 7 Patterson Dental Inc. ..............................................................................Inside front cover and page 1 Patterson Dental Supply............................................................................................................... 27 Practice Image Builders................................................................................................................ 11 Sirona........................................................................................................................................ 27 Wells Fargo................................................................................................................................. 15 36 Fall 2013 Dental Entrepreneur

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Are you fully prepared for your professional journey?

Transitioning from school to a career takes planning.

Henry Schein Professional Practice Transitions (HS PPT) can help you now and throughout your career. Whether you are looking for an Associateship, partnership or to buy a practice, we can guide you with your best interests in mind.

HS PPT provides a full range of nationwide dental practice brokerage and transition planning services to help you achieve your professional goals. We will support you with practical advice and customized strategies that will ensure your success.

• Associateships • Partnerships • Practice Purchases • Business Consulting • Transition Planning

Speak with a Henry Schein Practice Transitions Consultant today!

1-800-730-8883 Henry Schein Financial Services is not a bank, does not represent itself as such, and does not conduct banking activities. © 2013 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

or e-mail: ppt@henryschein.com www.henryschein.com/ppt

The Perfect Solution for Finding Associateship Opportunities If you are looking for an Associate position, Henry Schein Nationwide Dental Opportunities (HS NDO) has positions in general dentistry and specialties nationwide, many with ownership or partnership potential. These positions are often exclusive listings, not available elsewhere.

Our unique relationships and experience with practitioners across the country enable us to help find Associate positions in private practices, clinics, and dental organizations.

Benefits Include: • NO FEE • Marketing expertise • Breadth of opportunities • Simplify the search • Practice profiles • Professional, supportive staff • Contract negotiations

We have hundreds of Dental Associate opportunities available!

Call or visit our website today!

• Consultation & follow-up

Get optimal results to support your professional goals!

Speak with a Henry Schein Nationwide Specialist today!

1-866-409-3001 © 2013 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

or e-mail: ndo@henryschein.com www.dentalopportunities.com