Dental Entrepreneur Winter 2016

Dental Entrepreneur

CLASS OF 2016 | WINTER ISSUE

DENTALENTREPRENEUR.COM

Business Beyond the Classroom

Maximizing Your (Huge) Investment Lessons Learned From Online Dating

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Dr. Adrienne Penley My Story

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Winter 2016

Welcome

My most favorite Saturday afternoon winter activity is to sit on my back porch watching college football, reading The Wall Street Journal, catching up with friends and family, scrolling my iPad, and reading a few favorite print magazines. I just love all the ways we can gain information and understanding of the world we live in. I bet you are wishing you had time to do that while you are in dental school!

VOLUME 18, ISSUE 2

Editor & Publisher Anne M. Duffy RDH Assistant Editor Michael Duffy Production Ruthie Gordon Publishers Press Inc. Editorial Board Dr. Dirk Fleischman Dr. Gene Heller Dr. Harold Sturner Dr. Ryan Dulde Dr. Earl Douglas Rachel Teel Wall, RDH, BS Dr. Tom Snyder Derek Champange Dr. David Rice Layout and Design John O’Connor

Class of 2016 Contributors Michelle Amiel Earl Douglas, DDS Tonya Lanthier, RDH Adrienne Penley, DDS David Rice, DDS

James Roos, DDS Roy Shelburne, DDS Anna Singh, DDS Rachel Wall, RDH, BS

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

Glidewell Laboratories Benco Dental Co. Tess Corp.

Dental Care Alliance

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

Editorial Office

12233 Pine Valley Club Drive Charlotte, NC 28277 704/953-0261 Fax 704/847-3315 anneduffyde@gmail.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 2016 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.

2 Winter 2016 Dental Entrepreneur

CLASS OF 2016 WINTER ISSUE VOLUME II

There is so much to learn and so many ways to learn it. How do you, with all the clinical skills you need to know, find time to balance it all? How will you prepare to join the dental profession?

That is where we come in. We try to fill the areas of business and leadership that you will need when actually practicing dentistry. We ask experts in the dental field to forecast what you might need to know that you don’t already. In fact, you might not even know where to get that information.

Our authors and advertisers are in the top of this field. Take a look at us online and get acquainted with our new website, which boasts archived articles and entrepreneurial ideas. Subscribe to our newsletter at dentalentrepreneur. com. You will find answers to the many questions you’ll undoubtedly face as you embark on this journey.

For instance, you will discover how Adrienne Penley became a practice owner.

You will learn how to find the fit, the right continuing education programs, the right broker and other dental partners, the right staff and the right attitude for you.

Who was Adrienne’s broker? That would be dental-transition expert Earl Douglas, who penned an in-depth guide on maximizing the massive investment it takes to finance a practice.

And speaking of attitude, we’ve also included a piece by Michelle Amiel, an Executive Coach with Fortune Management, that discusses the importance of culture in your practice.

In today’s day and age, it’s all about the information … and finding the right information. Let’s face it, there is a lot of noise out there. But trusting the wrong resource can lead you down a rough path.

Hopefully, you will use Dental Entrepreneur: Business Beyond the Classroom as a roadmap on your professional dental journey. We believe in our contributors, and we believe in you!

All the best,

Anne M. Duffy Publisher

First time ever, we left out part of Chad Widensky’s article, “Understanding Cash Flow,” from our fall issue. There is more to cash flow than you know, so check out his entire article on dentalentrepreneur.com.

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Contents Prologue

4 Where I Was, and Where I am Going Adrienne Penley, DDS

6 The Pursuit of Education and Mentorship Anna Singh, DMD

Getting Started 10 Lessons Learned from Online Dating: Using Data to Find the Right Fit for Your Dental Team Tonya Lanthier, RDH

14 Culture Eats Strategy for Breakfast Michelle Amiel

Business Fundamentals 20 Maximizing Your (Huge) Investment Earl Douglas, DDS

The Power To Succeed 34 How Rookie Dentists CRUSH it David Rice, DDS

24 It’s a Scary World Out There: What You Need to Know Roy Shelburne, DDS

Practice Builders 28 Dental Education Following Graduation: What to Consider James Roos, DDS

30 Making the Most of the Doctor-Hygiene Exam Rachel Wall, RDH, BS

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Dental Entrepreneur Winter 2016 3

Prologue

Where I Was, and Where I am Going Adrienne Penley, DDS

B

oarding the plane at 6 a.m. bound for Tokyo, I had no idea of the challenges yet to be faced and the doors of opportunity that were about to open.

It was 2002, I was recently married, and my husband was starting his career with the United States Navy in Yokosuka, Japan. While job searching, I discovered the American Red Cross Volunteer dental assisting program. Participating in this program, I gained excellent hands-on experience, and I was able to witness first-hand the results of a caring doctor-patient relationship. This unique opportunity reinforced my interest in the field of dentistry.

After four years in Japan and taking the DAT in Guam, I started dental school in 2006, at the University Of Mississippi Medical Center in Jackson, Miss. The following year, my husband fulfilled his commitment to the Navy and started a civilian career in Jackson. I graduated in 2010 and was finally ready to start my dream career in general dentistry.

I was fortunate to start my career back in my hometown of Picayune in a pediatric-focused Medicaid clinic. This was a great first job that allowed me to serve my community while gaining more confidence and efficiency. After two years, I wanted more out of my career and knew I would not be completely fulfilled until I was a practice owner. Also, during this time, my husband’s job did not transfer. Therefore, I moved back to Jackson.

While working at my new job at the Central Mississippi Correctional Facility and Affordable Dentures, I put my focus on researching practices for sale. I started my search on the Internet and contacted brokers according to their practice listings that caught my interest. The brokers were very helpful in sending me practice profiles, tax returns and profit and loss statements. They also helped me decipher the meaning of the practice numbers, taking out the seller’s personal expenses that

4 Winter 2016 Dental Entrepreneur

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were run through the business, looking at overall expense compared to total income.

Determining the most accurate number of active patients, number of new patients per month, production per patient and overall production vs. collection helped me compare multiple practices with their varying business and practice philosophies.

I also learned a great deal speaking with different banks. In my experience, local banks had no clue in how to evaluate dental practice sales. It paid off for me to get offers from several banks that deal with dental practice transitions. This taught me that there were many different options on financing a practice purchase. Don’t settle!

Because of all of my research, when I found the practice that matched what ADS.south209

2/25/09

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I was looking for, the closing process moved very quickly. Brokers attempt to be neutral, but I felt more confident going into negotiations with a financial advisor, attorney and bank on my support team.

In March of 2014, I became a very happy and proud practice owner. I know it was meant to be, because my husband’s job transferred locally shortly after the purchase. I was fortunate to have an opportunity to purchase an incredible practice, with an impeccable reputation back in my hometown of Picayune.

Looking back, I certainly did not have the most direct route to dental school and practice ownership. I am so thankful for having all of those experiences and mentors that got me exactly where I needed to be. I feel beyond blessed to be

able to serve my community from which I grew up. Growing corporate dentistry, I am so glad I have direct control over my practice. We focus on providing highquality dentistry and customer service in a relaxed, caring environment. This journey has been beyond my wildest dreams, and I am ready to see what opportunities the future holds.

Adrienne Penley graduated University of Mississippi Medical Center School of Dentistry 2010, Started working in a Medicaid clinic immediately following graduation Purchased current practice in March 2014 renamed to Penley Family Dentistry.

When she is not busy with home renovations, she enjoys exercising and spending time with family and friends.

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Practice Makes Perfect “Dr. Earl Douglas and the staff at ADS South have been real helpful in steering me in the right direction in the purchase of my first practice. Dr. Douglas’s experience, organization and detail-orientation, pointed out to me where improvement is needed and how to go about achieving it.”

Elizabeth H. Guerrero, DDS Get off to the perfect start. Call your ADS transition specialist for AL, GA, LA, MS, NC, SC, TN and VA today.

ADS South (770) 664-1982 ADSsouth.com DentalEntrepreneur.com

Dental Entrepreneur Winter 2016 5

Prologue

The Pursuit of Education and Mentorship Dr. Anna Singh, DMD

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H

ealthcare is one of the most rapidly evolving industries. It never stands still. This requires medical professionals of all ages and skill levels to participate in continuing education programs. Every day, these individuals are responsible for providing safety and comfort to others. In an environment that sees so much growth, it is not an option to assume that there is nothing left to learn.

The pursuit of education is increasingly important for new dentists, but not in the way you may think. Typically, the main focus for young dentists is on the development of technical skills. Besides finding a job, recent graduates are primarily interested in sharpening their clinical abilities. Undoubtedly, clinical education is important, but in today’s culture, dentists have to be more than just good dentists–they have to be good leaders too. Walking out of dental school, there is a void in your education that can be filled with leadership and communication training. Leadership education enhances dentists’ ability to lead their teams, effectively communicate with patients, delegate, plan and make important decisions. Technical skills are ineffective if you cannot connect with your patient. It is my experience that when patients trust their dentist, they are more inclined to understand and accept treatment.

Throughout my career, I have had the pleasure to work and interact with many successful members of the dental industry. Dr. Anne Marie Ross and I met at the start of her career and became instant companions. We share a similar passion for dentistry and an insight on how to help people. Dr. Ross is a general dentist at Dental Care of Spring Hill in Spring Hill, Tenn. Throughout the past five years of her dental career, her leadership skills have helped her to flourish both professionally and personally. After graduating from University of Louisville School of Dentistry, Dr. Ross entered into an office that needed to be revitalized. In less than

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five years, she was able to double the size of her team, double production and increase the original reputation of the office. She believes being a strong leader is contingent to having a successful practice.

“Clinical education is phenomenal. I learn something new every time I attend a class, even if it’s just a basic course. But

It is important to establish a mentor relationship with someone you can relate to and who has similar thought processes. in my opinion, the leadership classes are even more beneficial. You can clinically be a great dentist, but if you can’t relate to your team and your patients and you have a horrible atmosphere in your office, then it’s going to be a real struggle to be successful,” she said.

Leadership and communication skills are vital for patient interaction, but they are also important for team member interaction. A motivating leader will prompt a high-performance team, which ultimately creates a high-performance practice. I have a very large team at my office. There are 26 of us that work together to provide high-quality dental care to patients. For any team to function at a high level, there has to be a lot of respect and understanding among all of us. In the beginning, it was a challenge for me to step up as the head of my team. When I developed my leadership skills, however, my mindset shifted. I realized that while I can be one of them, I still have to be able to lead them in an effective way. My team and I attended classes together and learned about each other’s personalities, strengths

and weaknesses. By investing in leadership education, we were able to develop as a team and understand each other’s contribution to the big picture–enhancing patient care.

Patient experience and leadership education extend outside the office doors too. My team and I utilize our skills to give back to the community through Free Dentistry Day. Over the last few years, I have led multiple Free Dentistry Day events at my office. My and team and I provide free cleanings, extractions and fillings, and often team up with other medical professionals in the area to offer services like free eye exams. These events are especially important to those in the community who do not have the financial means to receive oral health care. We also actively participate in other community events and volunteer our services whenever possible. Community involvement gives my team and me the chance to bond in a unique way and allows us to form personal relationships with members of the community. We are able to grow as leaders, but in the end we gain something even more valuable.

In my opinion, the most successful dentists have a good mix of clinical and leadership education. For new dentists, it can be difficult to figure out how to properly implement those skills. This is where having a mentor becomes very valuable.

With a mentor teaching and guiding you, your education is boosted to a whole other level. Having a mentor at the very beginning of your career allows you to have an expanded viewpoint of what can be accomplished in the dental industry.

I currently mentor young dentists and encourage them to do the same after reaching a certain level. From the beginning of her career, I have mentored Dr. Ross. Before practicing in her own office, Dr. Ross spent a week observing me and the culture of my workplace. She was very dedicated and always figured out how to overcome a challenge. She looked at challenges as a way to find success. That was

Dental Entrepreneur Winter 2016 7

impressive to me. I knew instantly that I wanted to be her mentor and help guide her throughout her career.

As someone passionate about continuing education, especially leadership, Dr. Ross now serves as a mentor, too. She advises her peers on both clinical and leadership skills, offers advice and invites them into her office to observe her procedures. Dr. Ross says that just as her pupils learn from her, she learns from them. She believes that being able to teach and mentor others has made her a better dentist.

“I learn a lot from others, and I think it definitely makes you a better dentist when you have someone observing over your shoulder,” said Dr. Ross. “You have to be able to teach and explain your process in a unique way. You’re more aware of what you’re doing. Being a mentor really pushes you to be your best.”

It is important to establish a mentor relationship with someone you can relate to and who has similar thought processes.

Otherwise, it is hard to be honest and transparent. You want your mentor to be honest with you and vice-versa. Finding that person will allow you to advance your clinical skills and improve your quality of leadership and communication.

A mentor relationship is not temporary, it’s a long-term commitment. There is an exchange of information that takes place over an extended period of time that helps you build on those skills. Ask questions, take feedback, give details and share experiences and then apply everything you have learned into your own practice.

“I don’t think people understand the importance of having a mentor that you can feel completely comfortable with,” said Dr. Ross. “I was never afraid to call Dr. [Anna] Singh, and she always extended a helping hand and was available to support me.”

The key to it all is application. Gather all the knowledge from your leadership and clinical courses, incorporate that with

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the lessons you have learned from mentor relationships, and incorporate it all into your office. To implement these skills, start with your team first. Develop a strategy and set standards by developing a mission and vision statement. Be supportive of those around you and encourage feedback from all directions. Explore different types of training; not everyone learns the same. Continuously help others who can be mentored and share your knowledge with them. After developing confidence and morale within your team, apply this energetic attitude to patient interaction. Before suggesting treatment, get to know your patients on a personal

“I don’t think people understand the importance of having a mentor that you can feel completely comfortable with,” said Dr. Ross. level. Explain processes to them in a way that they can fully understand and be ready to answer their questions. They will be more inclined to accept recommended treatment, return for continued care and share their experience with family and friends. Overall, foster an environment that enables your staff and patients to feel comfortable in their surroundings.

Leadership is the perpetual companion to clinical excellence. The combination of these skills will allow you and your team to provide an unforgettable experience to every person who walks in the door. The most important lesson is to never stop learning. Always be curious about what is going on in the dental industry and be

willing to learn from others. The pursuit of education is a lifelong journey and the foundation to maintaining a successful office.

Anna Singh, DMD, graduated from the University of Pennsylvania School of Dentistry in 2000. During her career, she has completed over 1,400 continuing education hours.

Dr. Singh has received many professional awards and much recognition for her clinical accomplishments and excellence in leadership within the dental industry. Currently, she is a practicing dentist at Cane Ridge Dentist in Antioch, Tenn. and serves as the Vice President of Clinical Affairs at Heartland Dental. She is as a clinical mentor to supported dentists and advises in a variety of Heartland Dental continuing education programs. Dr. Singh is an active member of the American Academy of General Dentistry.

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

dentalentrepreneur.com DentalEntrepreneur.com

YOU DREAMT OF BEING A DENTIST NOT AN ACCOUNTANT, MARKETING GURU OR AN I.T. EXPERT Heartland Dental supported dentists focus on what matters most, THEIR PATIENTS. Along with our world-class administrative services, supported doctors are offered • Continuing Education • Location Flexibility • Network of 1,000+ Dentists • Guaranteed Salary • Work-Life Balance • Growth • Leadership • Access to the Newest Technology

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Getting Started

Lessons Learned from Online Dating: Using Data to Find the Right Fit for Your Dental Team Tonya Lanthier, RDH

W

hen is the last time you

went out on a blind date?

You remember the one where your best friend set you up and told you that this was your absolute perfect match. He was supposed to be your soul mate, hands down. You spent all day at the nail salon, getting a blow-out and even shaved your legs. Then it was time to meet him. You saw someone standing at the door of the restaurant, but hoped and prayed he wasn’t your soulmate. It was at this point on one of my many blind dates that I realized that my best friend must actually hate me.

The days of a traditional set-up have come a long way. Back then you only knew a few bits of information about the other person and the recommendation from a mutual friend that you might hit it off. Suddenly online dating hit the internet, and now even apps on your phone can supply you with a wealth of information about another person (admittedly, self-selected information). The evolution of blind dates continue as online dating turns in to a high-tech match making game thanks to the ability to evaluate potential mates based on a wide variety of data points.

Funny enough, many dental practices approach the hiring process much like a traditional blind date. You know just the basics about the candidate, like a resume, and on the surface it seems you might have the makings of a fit, so you go for the hire. But just as the days of a traditional blind date have evolved by using data to make better matches, so should the job search process.

What are some of the key takeaways from these successful online dating ventures for dental entrepreneurs looking to build their practice? Well, today’s leading online dating sites all use data to help make better matches. Popular sites like Match.com use the Myers-Briggs personality test, and eHarmony offers its own proprietary algorithm that they call the “secret key dimensions of compatibility.” Using assessments and defined metrics can help create better matches, which can lead to marriages, or in the dental hiring world, the team member best fit for the job.

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Let’s Define “FIT” If you were asked how cohesive your team is today on a scale from failing to thriving, where would you land? Even if you can self-assess as having a good team, it’s worth considering what it would take for your team to move to being great. The key is bringing on board individuals with the right mix of skills, personality, culture and values. Or in short, the right fit.

Fit can be defined across three key platforms: communications style, values and culture. Each of these brings along with it a cross section of attributes your future employees bring to the table. Whether it’s the value they place on flexibility and fun, to their preferred pace of work and office décor style, there are a host of critical factors you will not find listed on a resume.

Chances are your candidates don’t know how to accurately express, or have the self-awareness needed to understand, what will make a great fit in their next position. The odds are doubly stacked if you haven’t considered including these seemingly intangible concepts in the job description itself. For instance, when you write, “looking for hygienist for busy office with five-plus years of experience,” how will this description help you attract the right fit candidate? When sifting through a stack of resumes, chances are you won’t see a list of the candidate’s core values or a preferred communication style. Data is the key to unlock the attributes you know will make a great fit for

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2015 Graduates and Residents: New AGD Member Insurance Benefit

}

“Have you heard? The AGD

New Graduate Professional Liability Insurance Coverage will provide up to 12 months of professional liability insurance coverage at no cost to you!”*

“Yes, and the cost of the coverage is assumed by the AGD and is available through Dentist’s Advantage.”

{

Find out why people are talking about the latest member benefit…

Along with easy and affordable practice protection, the AGD New Graduate Professional Liability Insurance Coverage will offer you all of the benefits Dentist’s Advantage program is recognized for — unparalleled financial security, $1 million/$3 million coverage limits, and comprehensive risk management support — plus Dentist’s Advantage is an AGD Member Savings & Offers program participant, and Lead Corporate Sponsor.

}

Give us a call or visit us on the web to hear more about this exciting, new insurance benefit for new grads!

Enroll Today!

Professional Liability Insurance

888-778-3981 www.agd.org/NewGrad

*The cost of coverage is assumed by the AGD. Policy coverage is effective May 1, 2015, through April 30, 2016, for qualified applicants who enroll by April 30, 2015; for those who sign up after this date, coverage applies from the enrollment date through April 30, 2016. Qualified applicants must graduate from an accredited U.S. or Canadian dental school or complete an accredited U.S. or Canadian general dentistry residency program between Jan. 1 and Dec. 31, 2015; be entering their first year of licensed dental practice in the U.S.; be an active AGD member at the time of enrollment; and maintain active AGD membership through Dec. 31, 2015.

Dentist’s Advantage is a division of Affinity Insurance Services, Inc.; (TX 13695); (AR 100106022); in CA & MN, AIS Affinity Insurance Agency, Inc. (CA 0795465); in OK, AIS Affinity Insurance Services Inc.; in CA, Aon Affinity Insurance Services, Inc., (CA 0G94493), Aon Direct Insurance Administrators and Berkely Insurance Agency and in NY, AIS Affinity Insurance Agency. © 2015 Affinity Insurance Services, Inc.

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your practice both for you and the job seeker.

Data is at Our Fingertips Tools that can help you begin to identify so called “right fit” candidates are everywhere and can offer access to data like we’ve never seen before. A recent study found that 67 percent of employers who use (big) data to inform their recruitment efforts said it lowered their cost per hire, and 71 percent said it lowered their time to hire.

While a variety of self-assessment tools exist, the best ones are integrated directly in to the job search function. Each assessment provides a different set of data points that when put together can provide a holistic view of what could potentially make a great match in the workplace. By knowing ourselves we can understand our own tendencies about how communicate and our needs, while also recognizing and adapting to other people’s styles in the workplace.

One of the more popular tools is called a DISC test. Have you ever considered how your personality type could influence the way you work or how you communicate with your co-workers? How about the way you navigate challenges or celebrate victories? As dental professionals, we interact with hundreds of people on a daily basis, but the key to effective communication lies in understanding ourselves first, especially during the job search and hiring process.

The DISC assessment ultimately reveals a deeper understanding of yourself and how your behavior affects others. A completed profile can provide an increased ability to respect, appreciate and value individual differences, offer a better ways to work with others to increase pro-

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ductivity and efficiency, and improve the way you relate to others both in and out of the workplace. n short, knowing the results of this type of assessment can increase your overall Emotional Intelligence. Emotional intelligence is often a bigger indicator of success in careers and lives than IQ since our success depends on the ability to read other people’s signals and react appropriately to them.

A recent survey of 180,000 dental professionals took a high-level look at how different personality types are distributed throughout the industry. Not surprisingly, the personality type that made the strongest showing is Steadiness, which is marked by traits including sincerity and sympathy.

Although each of us will align most strongly with one of the four quadrants–Dominance, Influence, Compliance and Steadiness–there are a variety of factors that influence how that individual is motivated to act and respond in a given situation as well as how they make decisions.

Create a Cohesive Team with Shared Values If you ask individuals to list the factors that motivate them the most, what you’ll end up with is a list of key values including compassion, integrity, leadership, purpose and fun. The most critical motivator is purpose. Although 90 percent of individuals will initially reach for “pleasure,” it does not provide long lasting happiness. Ultimately finding purpose unlocks the key to long lasting happiness, both in the personal and professional world.

While we’ve focused on what a job-seeker should know about themselves before applying for a position, what about the role of the employer? To make a true match, an employer should be able to clarify during the interview process what they believe are the key values within their practice. This is critical. If you hire someone who does not share your vales the end result is an individual who will not align with the company’s culture which generally leads to decreased job satisfaction and high turnover rates.

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The values you hold ultimately set the culture and the tone for the entire practice. Finding a right fit between your employee’s values and your values can make all the difference.

Don’t Leave your Culture to Chance The key to bottom-line success for your practice is ensuring that your culture is well aligned between your practice and your staff.

This is where all the data you’ve collected to date comes in to play: combining values and behaviors and using these to make great-fit hires. Being able to identify your practice’s culture, pace, supervision style, flexibility, etc., and aligning these with your candidates’ preferences will all come together in the hiring process. What this does NOT mean is finding a group of people who are all exactly alike.

Ultimately, finding the right fit or match is about hiring a variety of staff whose values are aligned with yours and will ultimately fit in to

industry’s premier online and mobile job board with more than 550,000 registered job seekers nationwide . Tonya’s involvement in the dental industry goes far beyond the dental practice.

In addition to being a member of the Academy of Dental Hygiene (ADHA), Entrepreneurial Organization (EO) and Academy of Dental Management Consultants (ADMC), she is on the planning committee for the Northern District Dental Society (NDDS) Gala for Smiles, public relations liaison for the Georgia Dental Hygiene Association (GDHA), and volunteers for the Georgia Mission of Mercy and the Ben Mansell Clinic. Tonya also works with the Georgia Department of Education’s Business Advisory Committee. She is a talented and engaging public speaker, using her boundless energy and enthusiasm to deliver her message about helping practices find and hire the right team member; while assisting job seekers with career coaching.

your culture. They each bring their own set of skills and tools to the table in order to get the job done.

Just as with online dating, you can’t judge a character solely by a profile picture, or in this case, a resume. If you can identify your core values and the things that provide you with your purpose in life, you’ll stand a much better chance of finding and hiring that diverse group of people that can make your team thrive.

Known as a onewoman LinkedIn for her industry, Tonya is changing the way professionals in the dental industry search for jobs. Ten years ago she created DentalPost which has grown to become the dental

WITH OUR SUPPORT, YOUR DENTAL CAREER CAN BE A WALK IN THE PARK. Henry Schein Professional Practice Transitions is with you every step of the way. From the day you graduate and begin your first Associateship, to the day you retire...and every day in between.

www.henryscheinppt.com

1-800-988-5674

n

PRACTICE SALES n VALUATIONS n TRANSITION CONSULTING/ PLANNING n ASSOCIATESHIPS

© 2016 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors. 16PT3680

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12/18/15 Dental Entrepreneur Winter 2016 9:40 13 AM

Getting Started

Culture Eats Strategy for Breakfast Michelle Amiel

I

went to school for more than 12 years to become a “professional” and was told to just “build it and they will come.” I chose the most populated location where the influence of money is obvious, and spared no expense when it came to hiring designers, marketers and staff members, while also implementing the latest technology.

When I thought I was ready, the ceiling came tumbling down.

All I wanted to do is practice dentistry!

The money was coming in as my patient base started to grow, yet the ocean was not calm. I hired the top consultants and the finances, protocols, systems and advertising have all been put into place. My team was not happy and I was not happy. But why?

It all boiled down to culture. Culture is the language of large corporations and businesses like Zappos, WalMart and Starbucks, and it is the glue that creates loyalty, happiness and the motivation to come to work everyday. It is the reason team members don’t quit their jobs.

What Is Culture?

Webster’s Dictionary defines culture as the set of shared attitudes, values, goals and practices that characterizes an institution or organization.

The culture is what we do and say, the way we behave, the way we treat each other, our products, our customers, our community and ourselves. In essence, it’s the “personality of our practice.”

While speeches, grand plans and fancy training manuals have some influence on the culture, they are just as likely to have a negative as a positive influence. Ultimately, it’s much more about what leaders do than what they say that makes the culture what it is.

Still confused as to how this relates to dentistry?

Your patients will never know how great a clinician you are if they do not have a great experience with the person that answers the phones or greets them upon arrival with a smile on their face.

This is the strategy part of your company. It’s what you pay your employees for.

Culture is an inside job and is how your team makes your patients feel. There is no denying that we live in a feel-good world, so it’s important to make your patients feel good about receiving services from your company. The dentists who make it

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their priority to have their patients and team feel great will have a happier and more successful team in the long run.

When was the last time your patient wrote a review like, “Dr. Smith, you’re filling on my tooth No. 19 is the best I ever had!”

Reviews usually read, “The team made me feel welcome. The doctor was gentle, and I felt no pain. He took the time to listen to me.” This is a big difference.

To effectively transform your office from a money-driven practice to that of a culture-driven practice is simple if you know the steps. Embrace culture and reap the benefits of a happier team and more satisfied patients, which will lead to greater profits and satisfaction.

1. Teach It The more effectively we teach people what we are looking for in our culture, the more likely it will become reality. Whatever orientation and training work you’re doing, you should talk about the kind of culture you’re going after. Describe the informal ways in which you envision the group working together and how you want the customer experience to feel.

It’s also important to put this vision in writing. Documenting it is far more likely to help you get where you want to go and ensure everyone is on the same page.

2. Live it Leaders have a great impact on culture and should be a meaningful example of the culture they would like to have in the office.

Team members will look to the leader when they need to handle a tough situation, have to reward someone, or when they’re at a professional crossroads.

How we manage difficult situations is one of the biggest contributors to the creation of organizational culture. It’s easier to build a culture when everything is going well, but strong cultures are partially built by what we do during hard times. When money is tight, how do we act? When a team member is ill, how do we respond? When a good customer can’t pay their bills, what do we say?

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3. Measure It Once we’ve identified the key elements of our desired culture and written them down, we must measure our success in making them a (cultural) reality. Many will argue that you cannot measure things like fun or supportiveness or camaraderie, but you can. If you want to have a resultsoriented organization, you are more likely to succeed if you measure your success at putting the culture into place.

4. Reward It Money is one way to reward people, but money alone will never do the trick.

We need to use multiple methods in various settings. Positive cultures are built over time and take a wide range of rewards and recognition. Find out what speaks to your team members and reward them individually.

5. Keep It Alive A rule of thumb for meaningful cultural change is that it takes two to three years to get something woven in to what we do. Do not become impatient by how long it takes. By accepting that reality rather than fighting it, you can do a much better job of managing yourself and leading the changing process. In three or four months, the glamour of the idea of the change will have long since worn off. At that point, leaders need to refocus people on the long-term vision, to give encouragement and energy to get through the seemingly inevitable zone of doubt and blame.

It all starts with you, the leader. Be the change you wish to see in your organization and motivate your team to join you by creating a culture that speaks to them, your patients and your long-term goals.

You will be happier and more successful, and will be able to achieve much more than you ever thought.

Michelle Amiel holds a degree in Expanded Dental Hygiene and brings nearly 40 years of knowledge to the dental profession, helping many businesses reach their maximum potential and growth. She is a visionary coach and trainer and helps dentists create their dream practice and life vision by strengthening their office culture, engaging team members, and fostering a thinking-outside-of-the-box mentality, which help to ultimately attain the practice vision.

DENTAL PRACTICES FOR SALE ADS DENTAL TRANSITIONS HAS EXCELLENT PRACTICE OPPORTUNITIES AVAILABLE. TAKE THE FIRST STEP IN BECOMING A PRACTICE OWNER AND VISIT:

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ADS companies are each independently owned and operated.

16 Winter 2016 Dental Entrepreneur

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If you are not using the right software, you’re not protecting your patients’ personal information.

You may be fined $1.5 Million.

Most dentists’ software does not encrypt their patient’s personal information on their network and their drives or integrate secure email. Most dentists are therefore at risk for HIPAA fines up to $1,500,000 in 2016.

MacPractice DDS is the most advanced and robust practice management and clinical software, with best in class features including; ONC/ACB Certified AES data encryption, HIPAA compliant secure messaging and so much more. Welcome to the future of dental software. Welcome to MacPractice.

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MacPractice Simplicity in practice

Resource Guide ADS Dental Transitions

Dentist’s Advantage

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 14.

888-778-3981 www.dentists-advantage.com Since 1949, Dentist’s Advantage has provided dental practitioners with access to a comprehensive professional liability insurance program that offers a vigorous legal defense against allegations of dental malpractice. More than 17,000 dentists across the nation depend on Dentist’s Advantage to protect their practice, their license and their financial security.

ADS Dental Transitions 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 35.

Aspen Dental 877-330-1349 www.AspenDentalJobs.com 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 27.

Bank of America Practice Solutions 800-428-2847 www.bankofamerica.com/practicesolutions Dental practice financing designed to help you succeed.

Bank of America Practice Solutions offers a full range of dental practice financing options from purchasing an existing practice or starting your own practice. We provide critical knowledge you need to establish and develop your business. See our ad on page 21.

Comfort Dental

Henry Schein Nationwide Dental Opportunities 866-409-3001 www.dentalopportunities.com Henry Schein Nationwide Dental Opportunities (HS NDO) offers Dental Associate recruitment and placement services that pair job opportunities listed by dental practitioners with qualified, prescreened dental associate candidates. HS NDO matches dentists based on skillset, practice philosophy, and style to ensure a high success rate. We are specialists who work confidentially to help doctors fill critical roles within their office by defining the job, attracting qualified candidates, and managing the interview/placement process. Dentists can make a decision with confidence, knowing that we have helped them through the process. And candidates can rest easier knowing that there is never a fee charged to them.

We work to make the match a win-win situation for both the hiring doctor and the Associate with our personalized placement service and years of success. See our ad on page on the inside back cover.

Henry Schein Professional Practice Transitions (PPT) 800-988-5674 www.henryscheinppt.com/ Henry Schein Professional Practice Transitions is the leader in dental practice brokerage (sales and buying), transition services, and practice valuation. We have a broad range of dental practice listings nationwide and have closed sales in all 50 states, yet have the expertise and knowledge of your local area. Our responsive support gives you a clear advantage and we can help you to refine your plans and create new options as your practice goals change.

We offer valuable webinars, seminars, and other resources to support dentists throughout their career, as well as many value-added services such as practice valuations. See our ad on page 9.

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 25.

18 Winter 2016 Dental Entrepreneur

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Business Beyond the Classroom IgniteDDS

Sirona Dental Systems, LLC

716-912-7970 david.rice@ignitedds.com Building the bridge between dental school and tomorrow’s most successful, quality-conscious private practices Mission: Fueling Passions Beyond The Classroom for dental students, new dentists and new dental team members Description: igniteDDS empowers the next generation of dental professionals with the knowledge and resources you’ll need for tomorrow’s treatment and practice decisions!

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 1-800659-5977 or visit www.cereconline.com. Please see our ad on page 15.

MacPractice, Inc

Ultradent

402-420-2430 MacPractice.com MacPractice DDS is the leading practice management and clinical application for dentists who prefer to use a Mac, featuring electronic insurance submission, Mac native digital radiography and photos, charting, Electronic Dental Records, Kiosk, Web Interface, iPhone Interface, speech dictation, and Mac stability and ease of use.

Please see our ad on page 11.

800-552-5512 www.ultradent.com info@ultradent.com Ultradent Products, Inc. is a leading developer and manufacturer of high-tech dental materials, devices, and instruments, world-wide.

Founded in 1978 as a family-owned company, Ultradent’s vision remains to continue to improve oral health globally by creating better dental products that set new industry standards. Ultradent also aims to improve quality of live and the health of individuals through financial and charitable programs. Please see our ad on page 23.

PARAGON Dental Practice Transitions 866-898-1867 www.paragon.us.com 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 29.

Patterson Dental

Wells Fargo Practice Finance 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 the back cover.

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 front cover and page 7.

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Dental Entrepreneur Winter 2016 19

Business Fundamentals

Maximizing Your (Huge) Investment Earl Douglas, DDS

I

n my career of helping dentists acquire their practices, obtaining financing is one of the bigger tasks. In previous years, I was dealing with the commercial brick and mortar banks that you pass on the way to wherever you go. These banks are required by federal law to make sure that any loans that they do are collateralized, or backed by something of value that the borrower pledges to them.

Naturally, newly graduated dentists, and actually many associate dentists of long standing, did not have hundreds of thousands of dollars saved up in cash, or expensive homes that were paid off, or a very sizable investment portfolio. That made the bankers unhappy because doing a loan for someone with no collateral could get the banker in serious trouble.

I was always quick to point out, but to no avail, that the young dentist did have an incredibly valuable asset–a dental degree and a dental license. It is not unusual for me to see dental school debts of $400,000 and even more. I would tell the banker of this sizable investment, all the time knowing that it would not impress them because they could not put a dental license in their vault.

When a person makes that huge commitment to apply to dental school, they are also making a huge investment in themselves and in their future. Considering an outlay of $400,000 or more requires that there be a significant return on that investment. By that, I mean a significant profit that is over and above the cost of that investment. Just paying back the investment is not a success, but paying it back and

20 Winter 2016 Dental Entrepreneur

making multiples of profit from the investment is the only justification for the considerable risk of getting that dental degree.

How then does a dentist find and measure that return on investment? Many times, new dentists are intimidated by the debt they have accrued and change from being risk takers–the person who applied to dental school in the hopes that they would graduate and pass a dental board–to becoming very risk-adverse–avoiding the risk of purchasing and owning their own practice.

In an effort to avoid the risk of further debt and management responsibilities, dentists will frequently choose to work for corporations or other dentists as associates. This feels like the safest choice and the lost opportunity that they suffer is not even apparent to them.

But if we are to maximize the investment of getting that dental degree, we have to find the source of that return on investment. Quite simply, the only source of that profit is ownership.

Ownership has many rewards–control, security, choices, but mainly profit. Consider the dentist who chooses to work for a corporation.

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* All programs subject to credit approval and loan amounts are subject to creditworthiness. Some restrictions may apply. The term, amount, interest rate and repayment schedule for your loan, and any product features, including interest rate locks, may vary depending on your creditworthiness and on the type, amount and collateral for your loan. Bank of America may prohibit use of an account to pay off or pay down another Bank of America account. ♥ Bank of America Practice Solutions makes no express or implied warranties with respect to any aspect of the Practice Heartbeat® program, nor does it guaranty any success or promise any results, and hereby disclaims the same to the extent allowed by law. The opinions of Bank of America Practice Solutions are based upon prior experience, and it makes no promise or guaranty that you will achieve any particular measure of success or results by participating in the program. You are not bound by any recommendations provided under this program and retain full responsibility for the results achieved by your professional practice. † Bank of America Practice Solutions engages Scott McDonald & Associates, a national marketing firm specializing in demographic research, site analysis and profile reports for health care professionals to produce a demographic report to assist health care professionals in evaluating where to locate their professional practices. Scott McDonald & Associates charges a fee for this service, which is passed on to the customer.

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They receive a commission for the work they do. Period. Consider the dentist who owns their own practice. They receive a commission also for the work they do, but in addition to their commission, there is also a profit component.

as 25 percent that associates may be paid) amounts to $165,000. But in addition to this commensurate salary for the work the owner did, they will also receive in addition, a profit, or return on their investment, of $252,000, a 59-percent rate of return on their

owner of this practice will make a 59-percent profit each and every year.

Many dentists would agree that the idea of owning this practice is wonderful, but that it’s not practical and not possible, and certainly not affordable. However the den-

How does that work? In examining one actual practice that is currently on the market in North Carolina that has a gross of $700,000, the net income of the practice after all expenses is $393,000. Let’s break down that net income because it is neither all profit nor all salary. The salary component, based on 30 percent of the owners personal production (compared to as little

investment (practice price) of $430,000, which was borrowed at that.

You’re thinking that is too good to be true, but in this practice, those are the facts. The alternative is to go to work for someone else, make a lower-percent commission and then try to invest some savings in the stock market and hope for an average of 7 percent, as seen in the period 2008-14. Meanwhile, the

tists who will look very closely at practice acquisitions usually discover that they cannot afford not to purchase their own practice.

The first concern is that they cannot “afford” to buy a practice. My answer is how can you not afford to make a 30-percent commission for the work you do and receive an additional $252,000 in pure profit?

22 Winter 2016 Dental Entrepreneur

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Another concern is that they cannot afford the payments to buy a practice. The payments for this $430,000 practice price plus an additional $35,000 in working capital plus the $164,000 for purchasing the building amount to annual payments of $93,000!

That is a huge amount, and how could anyone ever pay that? The answer is to simply use part of the $252,000 profit to pay that $93,000 debt service, still leaving $159,000 of profit to invest and live on.

Then some buyers will say, “I can’t afford to pay $164,000 for a building while I’m paying $430,000 for the practice, too.” But if the dentist does not buy the building with a $1,300-per-month mortgage payment, they will have to pay $2,000 in monthly rent, which will increase annually. So the choice is pay $1,300 per month for 180 months and own something, or pay $2,000 per month forever, which will increase every year, and own nothing.

Then some dentists will feel that they will have to work too hard to make those monthly payments for the practice, working capital and building, which will total $7,800 per month in the case of this practice. I can understand that, so I prefer to let the hygienist pay for the practice and building for me.

The profit from the hygiene department in this practice, after paying the hygienists’ salaries, is $9,200 per month, so the hygienist is paying off the practice and building for the buyer.

Still need more incentive to consider the “risk” of ownership and extremely high salary and additional return on investment?

Consider that Uncle Sam has agreed to pay one-third of the practice price for you. In virtually every practice purchase sold, the entire price of the practice is tax deductible.

For the dentist playing it “safe” and working as an associate rather than purchasing this practice, they will pay $155,000 more in taxes to the IRS. For the dentist buying this practice, they will pay $155,000 less in taxes, and that can be applied to the price of the practice, or more wisely, invested in a retirement plan for future growth.

Many dentists are under the false assumption that they cannot get financing to pur-

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chase a practice. In today’s world, there are a plethora of companies that finance dental practice acquisitions. Why do you suppose that is? It is because these lenders have discovered that dental loans are over 99.5-percent successful. If a dentist can avoid the three D’s–drugs, divorce, and depression–they have a 99.5-percent probability of success. Sometimes with newer graduates, the Small Business Administration may even be involved, but for a dentist who will not take no for an answer, I can almost always find the money for the purchase.

Purchasers feel that they are taking on a huge risk when it comes to borrowing money for a practice purchase, but consider that all the risk is really on the lender’s part.

Lenders are putting up every penny for the acquisition and working capital, while purchasers rarely if ever put up any money.

A huge advantage of using lenders is that they are very experienced and very skilled at assessing risk, so if a lender agrees to finance a practice for a borrower who they have not even met, that means the lender is expecting a very high probability of success for that purchaser.

But what about the dentists who don’t know how to run a practice? Again, if you buy a practice, you are in luck. First of all, most sellers are happy to coach and advise buyers on how to handle staff, patients and the other management elements. For the buyer who doesn’t want to learn the seller’s mistakes–they are marbled in his wisdom like fat in a steak–there are management consultants who can advise owners in how to produce more income with less stress. If you’re concerned about the cost of these consultants, they invariably pay for themselves and much more. And for the owner who wants nothing at all to do with management, there are organizations that will take over all management of the practice for the owner, leaving them with just the task of dentistry.

Still need more convincing to be super successful? Practice owners, while they will complain about how tough they have it, are the happiest, most successful and highestpaid dentists in the profession. Owners

have security. They choose who works in their practice and the tone and personality of their practice. They choose the labs and supplies that they want to use. They choose the vendors and contractors that they want.

Owners can choose what benefits they want the practice to provide for them and their staff. They can choose retirement plans, health insurance, long term care insurance and if incorporated, can enjoy tax benefits for these and many other benefits. They can choose their continuing education and what direction they want to enhance their skills and knowledge and practice direction.

Owners can also hire other dentists to help increase their practice revenues and add that precious business profit to their own bottom line.

In my previous article, we learned how a practice owner can retire with 14 million dollars more in savings than a dentist who practiced as an associate for an equivalent 30-year career. But there’s an even more noble reason to own your practice, and that is so that you can own your profession. We have seen in other professions that when the professionals and new entrants will defer to the large corporations that the profession ceases to exist and is replaced by a business, whose only obligation to satisfy is to the shareholders, the recipients of the profit that the workers provide. So I urge anyone considering becoming an associate or working for big business to be your own shareholder, recapture that investment you have made in becoming a dental professional and not forfeit it to anyone else.

Earl M. Douglas is the author of many articles on dental transitions. He has also authored software for the financial analysis of dental practices. His company, ADS South, LLC, is engaged in the valuation and sale of dental practices in the Southeast. He can be reached at 770-664-1982 or earl@adssouth.com

Dental Entrepreneur Winter 2016 23

Business Fundamentals

It’s a Scary World Out There: What You Need to Know Roy Shelburne, DDS

I

’m generally not an alarmist and choose to look on the bright side of almost every situation. However, there are times when this view of the world, through rosecolored glasses, could lead to disaster. As I speak to groups of dentists and to dental students at many of the dental schools across the country I have noted a disconnect.

There are many speakers, writers and consultants who say, “I don’t want to scare you.”Just so you know, I’m not that guy. Not only should you be scared, you should be terrified. But only if you choose to ignore the dangers and fail to implement the systems necessary to address the concerns. Ultimately, there must be an overarching focus on compliance in every practice to insure the right thing happens consistently and that there are programs in placed that identify errors and thereby lead to improvements that elevate treatment results and overall outcomes. It’s very important for any new graduate to both understand the pitfalls that exist but also be equipped to recognize and avoid them.

So, what must you know?

Doctor, you are ultimately responsible for everything that happens in the office, even if you are not directly involved in the process or even aware of the action(s) taken by staff on your behalf. That means that OSHA compliance, HIPAA Compliance, Human Relations (HR: hiring and firing), claims submission, coding, documentation,

24 Winter 2016 Dental Entrepreneur

accounting as well as treatment outcomes, conforming to contractual agreements … and this list is not exhaustive I know that’s daunting for a new dentist and new business owner, but it’s the reality and you should have a healthy appreciation for what can happen if these requirements are ignored.

Doctor, you are being monitored on multiple levels and by multiple entities. This is a given in the world we now reside. There are regulators that keep an eye on every single aspect of the dental practice to insure compliance. In my world and area of focus, insurance carriers use sophisticated software that can compare the submission histories

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for every doctor in the U.S., whether you are in or out of network. Boards are concerned with documentation to the extent that it must meet a specific standard and include some basic information to meet the standards established. Malpractice actions are at an all-time high.

Doctor, there are consequences should you choose to ignore the dangers and conduct your practice in a way that does not meet the requirements established and are non-compliant. The consequences could begin with a “slap on the wrist” and move all the way up to the loss of your license or even incarceration. I know what I’m talking about here!

Doctor, ignorance is excuse. The doctor, in today’s practice, no matter how long they have practiced and regardless of the training received during dental school or in the years since graduation must understand the risks, know how to run the business and how to maintain compliance if they expect to steer clear of the dangers that exist and to be able to practice without fear.

So, what must you do?

Learn: Knowledge is power and can also be the first step in implementing systems that protect and defend the practice against any complaint or regulatory action against dental_entrepreneur.pdf

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the practice. Before one can prepare for battle, one must first know the enemy.

As the doctor, this information can be gained by paying attention to the chatter.

Most state and national associations have newsletters and/or journals that can help to alert the memberships and the professions of potential pitfalls and alert you to

Many aspects of a sound compliance program are designed to protect the privacy and safety of the patient as well as protect the staff. the changes before they become a concern.

There are chat rooms and message boards that openly discuss what’s going on in the “Real World.” It will be important to ignore the little voice inside that says, “That’s never going to happen to me.” I understand, as a student, you have many other concerns that 10:47 AM

take precedence over these issues. However, once you graduate, this issue must become a primary concern, so it would be to your benefit to begin the learning process before reality hits. Actually, today would not be too early to begin this leaning process and by reading this article, you have.

Lead: Be proactive, not reactive. Doctors, you must take the lead in the compliance process whether owner, associate, or some other professional arrangement. The leadership process begins by sharing the concerns with the team and by stressing “what’s in it for them” before the regulators come knocking at the door. It would be very important to share with the staff the benefits to the patient, to the practice and for them when systems are implemented to address any potential issue. Most quality assessment/ quality improvement programs tie directly to patient care and to improving outcomes for the patients. Many aspects of a sound compliance program are designed to protect the privacy and safety of the patient as well as protect the staff. It is important to share with the team that many of the regulations and laws that govern the practice of dentistry also pertain to the staff. In many instances, the staff member can be held equally accountable if there is an action against the doctor.

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Dental Entrepreneur Winter 2016 25

Establish the expectations: Before any plan can be implemented, the first step is to establish the expectations (requited results).

OSHA and HIPAA regulations very specifically establish the expectations and requirements to maintain compliance. Those standard have already been established. Adhere to them. Although many standards have been established by a government/regulatory entity, many other areas of the practice, the expectations can vary. For example, the clinical documentation required to meet the standard of care in a particular area may vary and the regulations established by the dental practice act by the state may vary from another state’s. It’s important that the doctor understand and set the standards in a way that meet or exceed any regulatory requirement associated with the area of the practice and/or standard of care. If the standard has not been set by the regulating entity, the doctor must then establish the expectations of the result(s).

Education and Training: Once the standards and expectations have been established, there must be an investment made to educate and train the entire team to meet or exceed the standard established.

Any chain, as you probably already know, is only as strong as the weakest link in the chain. Every member of the team must be aware of the expectations of them and they must fully understand the system and the part they play in insuring the expectations are met. It would be unreasonable to expect an acceptable result from an individual who is inadequately trained and who does not understand the expectations, or what they must do in the process to achieve the expected result. Doctor, if you are willing and able to learn enough to provide this education, go for it. If not, outside help may be necessary to provide education and training to the doctor and staff to become and maintain established standards.

Monitor: Once the system has been implemented, the outcomes must be continually monitored to insure that expectations are being met. What is monitored improves, period. If you expect a system to 26 Winter 2016 Dental Entrepreneur

lead to improvement and/or to compliance to the practice’s established expectations, the outcomes must be monitored, reviewed

This entire process is often referred to as quality improvement/ quality assessment (QA/QI) and has been a successful system used in medicine for a number of years to address concerns and to lead to more positive outcomes. and compared to previous results and to the ultimate expectation.

Improve: By monitoring the systems, results can then be compared system by system. Celebrate when improvement is noted.

Doctor, it’s always important to catch the team member doing something right and acknowledge it. When positive feedback is given for a particular behavior, studies show, then that behavior is repeated. Is the expectations are not being met and/or the needed improvement is not recognized, review the system and identify where the wheels came off and rework/revamp the system.

Repeat: Once an improvement program of this type is implemented to address one particular area of concern the same principals can be used to address other areas of concerns in the practice. The improvement process is truly never ending.

This entire process is often referred to as quality improvement/quality assessment (QA/QI) and has been a successful system used in medicine for a number of years to

address concerns and to lead to more positive outcomes. The bad news is that dangers do exist. The good news is that you can be prepared for any of the potential pitfalls and rest easily at night by being proactive and implementing the appropriate compliance programs into the practice. You do not have to live in fear if you choose to address the concerns proactively. I am not being alarmist, but I am a realist. You are soon to be living in the professional world of dentistry and can choose to begin your practice life on the right foot. The right choice will help you have a long and uneventful career in dentistry. Should you choose to ignore the dangers and be unwilling to implement systems in your practice to identify correct potential problems, there could be significant repercussions.

Dr. Shelburne graduated from the University of Virginia with a double major in Biology and Religious Studies in 1977. He went on to graduate with honors from Virginia Commonwealth University’s Dental School and opened a private general practice in Pennington Gap, Virginia, in 1981. He and his family have served as short-term volunteer missionaries with the Baptist Medical Dental Missions International and on various Mission of Mercy projects in Virginia. In March 2008, he surrendered his dental license after being convicted of healthcare fraud and spent 19 months in Federal Prison and 2 months in a halfway house. Dr. Shelburne is a nationally known speaker/writer/consultant and an American Dental Association Subject Matter Expert who openly shares his mistakes, what he learned as a result, and how to avoid those career ending errors. “It is a wise man who learns from his mistakes, but a wiser man still that learns from another’s.

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

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 at dentalentrepreneur.com Send your questions or comments to anneduffyde@gmail.com dentalentrepreneur.com

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Dental Entrepreneur Winter 2016 27

Practice Builders

Dental Education Following Graduation: What to Consider James Roos, DDS

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or the graduating dental student, dental education doesn’t end when you complete your senior year. It continues throughout your dental career–not only because we are required to complete a certain number of continuing education credits per year, but because dental education is necessary to stay abreast of the latest developments in the profession and provide our patients with the best possible care.

There are many choices available to obtain continuing education in dentistry, but none are as valuable as attending a national dental conference like the Hinman Dental Meeting. Conferences like this offer the emerging dentist many reasons to attend. The top five reasons you should consider attending a dental conference following graduation are: •

•

•

Special Student/New Dentist Programs: Most conferences offer day-long programs or special courses geared to the graduating student or new dentist. These programs and courses will help you start and maintain a practice or find an associateship, learn best practices from seasoned dentists and establish formulas for success. These programs also typically offer opportunities to network with your peers and experienced dentists who can offer key insight into owning a thriving practice.

Technical Exhibits: Dental conferences also feature comprehensive technical exhibits that have the latest technology, equipment, products and services available in dentistry. This is the perfect opportunity to interact with vendors and learn about the latest advancements in the industry. This is a chance to get some hands-on experience with new products and equipment, as well as ask questions of company representatives.

Educational Tracks & Workshops: National dental conferences will offer literally hundreds of courses. Select the ones of most interest to you and your specialty and practice. Many conferences will provide lengthier courses or educational tracks that cover everything from business and financial management to pediatric dentistry and cone beam technology and anatomy. Many of the world’s foremost authorities in

28 Winter 2016 Dental Entrepreneur

dentistry lead these courses and workshops at conferences and share their experience and best practices with attendees.

•

Networking/Social Events: As important as it is to attend workshops and lectures from some of the world’s dental authorities, it’s also valuable to network and socialize with other dental professionals. Where else will so many dentists gather in one place? Take advantage of this opportunity to learn from others in the profession and determine what has worked for them. Conferences offer many social events that lend themselves to meeting and networking with others in the industry.

•

Employment Opportunities: Dental conferences can also be great resources for searching for a practice to join or professional to hire. Many have programs like Hinman’s Career Connections that help bring employers and employees together. It can be challenging to search for talent or to find the right practice, but dental conferences can help make this an easier proposition.

Continuing education doesn’t have to be a lifelong “task,” but instead can be an opportunity to build your practice, expand your knowledge, learn the latest advancements, network with colleagues and find the right employees. It also can be a nice break from your routine in a fun-filled city like Atlanta. Consider the possibilities!

Go For the Gold at Hinman!

DE: The Hinman Dental Meeting introduced its G.O.L.D. Program last year. Will this be offered again this year?

Dr. Roos: Yes, we are excited to offer G.O.L.D. 2.0–the new dentist’s guide to successful practice ownership–at Hinman 2016 in March. We invite graduates of the last decade (2005-15) to join us for a full-day program that focuses on preparing new dentists for the challenges and pressures of operating a successful, independent dental practice.

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DE: What did your attendees of last year’s G.O.L.D. Program think of the program?

DE: Who are the speakers at this year’s program?

Dr. Roos: We have a great lineup this year of experts in their fields. We are fortunate to have Dr. Gordon Christensen provide a course titled “Dentistry 101,” in which he will share his vast experience. G.O.L.D. 2.0 also will feature Dr. Wayne Kerr, Mr. Steve Anderson, Mr. Wes Moss, Mr. Joseph Jordan and Dr. Parag Kachalia. They will cover topics ranging from starting a practice off right and dental technology to formulas for a successful practice.

Dr. Roos: We surveyed attendees and the feedback was overwhelmingly positive. We knew we had to bring back the program and promote it broadly to recent graduates. We have some new speakers on the roster this year and we think it will attract a large audience. There’s no fee for dental students and only a modest fee of $40 for recent graduates. Attendees receive seven hours of continuing education credit, a great value. To register for Hinman and the G.O.L.D. program (Course FR500), visit Error! Hyperlink reference not valid.

Dr. James Roos is General Chairman of the 2016 Thomas P. Hinman Dental Meeting and a longtime member of the Hinman Dental Society. He has a thriving practice in Smyrna, Ga., a suburb of Atlanta.

104th Thomas P. Hinman Dental Meeting

DE: Why is Hinman providing a program that targets recent dental school graduates?

Dr. Roos: Today, graduating dentists face extraordinary challenges with economic pressures, considerable student debt, increased competition and the lure of corporate dentistry. The G.O.L.D. Program offers seven courses that will help new dentists navigate these challenges and prepare them to run a successful dental practice. There are things you don’t learn in school about establishing a dental practice and we want to ensure these young dentists are prepared to be entrepreneurs and ready to run their own practice. The day-long program also ends with a networking reception that enables recent graduates to speak with another, as well as the G.O.L.D. speakers and Hinman Dental Society members.

Earn up to 21 hours of CE • Join us for Hinman’s Night Out: Dancing in the Georgia Dome, an all-new Friday night experience featuring live music, food, drinks and prizes.

• To book a hotel or register online, please visit www.hinman.org

March 17 – 19, 2016 Georgia World Congress Center & Omni Hotel at CNN Center Dr. James A. Roos, General Chairman & Dr. Jonathan S. Dubin, President

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Dental Entrepreneur Winter 20164:10 29PM 2/8/16

Practice Builders

Making the Most of the DoctorHygiene Exam Rachel Wall, RDH, BS

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s you begin your dental career, chances are you’ll work with a hygienist; if not immediately after graduation, then likely sometime in your future. The hygiene department has been called the ‘Backbone’ of the general dental practice, and the hygienists you work with can have a huge impact on the success of a practice.

Effectively communicating your expectations for how you’d like your hygienists to share information with you during the exam is key to empowering them to help you enroll restorative care.

Here are some specific things you can communicate to your hygienist that will help them make the Doctor/Hygiene exam most effective.

30 Winter 2016 Dental Entrepreneur

1: You’ve spent anywhere from 20-50 minutes with this patient. I’m walking in cold. Please, bring me up to speed.

Imagine you’re at a cocktail party, and you see someone that you’ve wanted to meet for a long time. Perhaps it’s a potential new client or someone you really admire. Your friend just had a 20-minute conversation with that person, and so you hope this is your chance. You walk up and they’re both quiet. Your friend introduces you, but beyond that you just stand there in awkward silence. You’ve got to leave the party in about 10 minutes, and you want to find out everything you can about this person, but your friend is offering no help. So you ask a million questions and talk really fast and then take off.

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As a new dentist, hygiene checks can feel like you’re walking into an already established conversation and you’re the third wheel? You fumble through an awkward conversation, and then you leave.

Or you try to tell them everything about you and find out everything about them while talking quickly, and it’s all very overwhelming.

Now think of the opposite scenario.

You walk up to the pair at the cocktail party, and your friend introduces you and brings you right into the conversation telling you all about this person you’ve been wanting to meet. The new friend feels special, and you all feel connected right away.

Developing an empowered hygiene team prevents those awkward exams where you feel like you’re walking in cold to try and figure out the patients

needs in 10 minutes or less. Giving your hygienists permission to openly discuss their patient’s treatment needs and share them with you during the exam is a critical step in building trust and treatment acceptance.

To work as a team, we must all have the same beliefs in what is best for our patients.

To build your hygienist’s confidence in co-diagnosis, tell him/her that you are confident in their dental knowledge and skills. Then set out your specific

expectations regarding co-diagnosis. It may sound something like this …

“I respect you as a highly skilled dental professional. To effectively support our patients in staying healthy, I need your help. Patients trust you and your opinions.

To work as a team, we must all have the same beliefs in what is best for our patients.

I would like to spend time reviewing my personal treatment philosophy and why I make certain treatment recommendations.

This will allow us to discuss areas in which we may have different opinions on treatment and resolve them.’

Although it is your job, as the dentist, to make a final diagnosis and treatment plan for your patients, it is perfectly acceptable to expect your team to contribute to that diagnosis process with thorough observation and education of our patients.

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Give your hygienist permission to observe restorative needs and to begin educating patients of those conditions.

Permission to participate in diagnosis, not only for perio disease, but also for restorative needs, is critical. Give your hygienists permission to think beyond calculus and gingival health and begin to think about what might have caused that abfraction on #11. To think about what you might recommend to strengthen that second molar that is broken. To look at X-rays and analyze the root tips as well as the bone level.

Clearly communicate your treatment philosophy. Often, dentists assume that since their team works with them each day, they are familiar with their treatment philosophy. This may be true but there may be some specific aspects of treatment that the staff is unfamiliar with.

Reviewing cases together will build confidence in your treatment recommendations and get everyone on the same page.

2: I’m OK with you taking charge of the exam.

So many times hygienists are timid about directing the doctor in the hygiene exam. At the same time, 95 percent of the hundreds of dentists we’ve worked with WANT the hygienist to guide them through the exam. This presents a great opportunity for learning and open communication. Again, be very clear with your expectations on what how you’d like the information delivered.

Map out the flow of the dialogue and practice. Here’s an example: Greet patient and connect Patient’s concerns Medical/Dental history-risk factors and changes Perio/Restorative status Treatment discussed Patient’s readiness to move forward

32 Winter 2016 Dental Entrepreneur

Not only is this helpful in hygiene, but the same format can be used by your assistants for emergency or new patient exams.

Many of our clients have a checklist in the op next to the computer to remind them of this sequence. This helps calibrate the entire team so the doctor is getting information in the same way from each team member. Can you imagine how receiving this information in a very similar way from every clinical team member can free you up to be more effective at treatment planning and enrollment?

3: If I talk too much about personal stuff, it’s OK to redirect me.

Ok, no one wants to be rudely interrupted, but I’ve found that some hygienists are reluctant to jump in to move you along in the exam. The first step is to give them permission to do so. The next step is to share with your hygienists exactly HOW you’d like them to redirect you. It could be something like, “So Dr. Smith, I’m really concerned about Sue’s old metal fillings.”

Even better, there are two non-verbal cues that your hygienist can give you that will help you immediately know you should connect quickly with the patient and then get down to business: •

•

Intra-oral photo of a treatment need up on the monitor or printed out Perio chart printed in color and handed to the doc upon entering the room

4: Please give me a hint as to how much information the patient needs from me.

Dentists and hygienists can get frustrated with each other when it comes to the balance of patient education. If the hygienist has already talked with the patient about the benefits of a crown and then the doc comes in and does the same

thing, someone is going to be annoyed.

Especially if it means the appointment runs long.

Have you ever felt that you talked a patient out of treatment that is in their best interest? Perhaps with too much information or too many options? What if your hygiene team let you know what was discussed and the patient’s readiness to move forward? That would give you a cue as to how much you need to educate.

It can be something as simple as, “Dr. Brown, Jane has a few more questions for you about the bite guard we discussed.”

Or, “Dr. Brown, Jane is ready to schedule a time to take impressions for the bite guard.” That’s your cue to confirm the plan and move on.

5: I appreciate you.

It’s that simple. Bonuses and benefits are wonderful AND just as important are these simple words. When interviewing our client team members, many of them are yearning for a “good job today” or any words of sincere appreciation. It costs nothing, goes a long way and reinforces the actions you’re looking for.

Would you like more information on how to unlock the untapped potential in your future hygiene department? We are pleased to give you our popular CD, 10 Essentials to Increasing Hygiene Service, Systems and Profits. Please visit www.inspiredhygiene. com to order your free CD and to register for our free weekly e-zine, where we share weekly tips on building a thriving hygiene department. Rachel can be reached at: rachel@inspiredhygiene.com

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Power to Succeed

How Rookie Dentists CRUSH it David Rice, DDS

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emember how you felt when you opened your first dental school acceptance letter?

Your excitement?

Your pride?

Your determination?

That’s the CRUSH it rookie feeling.

When you embrace that feeling as a new dentist … when you live by it … everyday … YOU become unstoppable!

Experience has taught me two things in dentistry: First, passion and excitement are contagious. Not the runnynose kind. The amazing kind. Think about your favorite sport.

Who do you believe is bringing more mojo to the team? The guy or gal trying to make the team for the first time or the 15-year veteran already who knows they have a spot on the team?

Passion and excitement. We all thrive on it. We hunger to be around it. And that, my friends, is your edge. That is the opportunity you have that most dentists who’ve been in the game for a while forget about. You WANT success. You WANT to make the team. You WANT to CRUSH it!

Second, natural smarts may win a battle or two, but hard work wins the war every time. Think about what rookie athletes do in training camp. Are they the last to show up, or the first? Do they sneak out at the end of the day or sneak in that extra workout?

I had the opportunity to hang with Hall-of-Fame wide receiver Jerry Rice a few years back. I asked him what he thought made the biggest difference in his career. How did he succeed for so long in the NFL? Twenty years,13 Pro Bowls, 3 Super Bowl Championships and to this day still holds 100 records!

His answer was compelling.

Every year he went to training camp, he went with a rookie mindset. With every practice, with every game and with every opportunity, he played as if he was trying to make the team. He played with the emotion you had the moment you opened your first acceptance letter.

34 Winter 2016 Dental Entrepreneur

Did you know every time Jerry Rice caught a pass in practice, he didn’t stop his route?

Did you know that every pass he caught, he’d run into the end zone?

It didn’t matter if it was 5 yards or 90 yards. Every single practice pass, Jerry Rice ran it into the end zone. When his coach asked him why, he said, “That’s the goal in a game, isn’t it?”

Think about that. Think about your goals in dental school. Think about every clinical board, every practical, every patient opportunity you have. Are you playing with the same intensity? The same emotion you had the first time you opened an acceptance letter?

If you want to CRUSH it as a dentist, if you want to CRUSH it in life, embrace your strengths. Own your rookie status. And start today!

Dr. David Rice graduated cum laude in 1994 from The State University of New York at Buffalo’s School of Dental Medicine. In 1995, he completed his general practice residency from the Allegheny General Hospital in Pittsburgh Pennsylvania. With a strong belief in continuing education and mentorship, Dr. Rice went on to complete continuums at the Pankey Institute, The Dawson Center and The Spear Center all while building the Restorative Practice of his dreams and maintaining an associate clinical professorship at the SUNYab School of Dental Medicine.

Dr. Rice combined his passions for teaching, mentoring and making a difference and igniteDDS was born. Today he continues to maintain his private practice and travels the country inspiring dentistry’s future to live their dream, have great success and to make that same difference that has brought him so much joy.

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Dr. David R. Rice, a nationally renowned expert on dental practice success, and the online dental community igniteDDS, recently published C.R.U.S.H. It!, the first volume in a series of guides highlighting strategies to take your dental career to the next level.

With a steady shift in dental school graduates opting for corporate dentistry over private practice, many students with the passion and ambition of owning their own practice lack the necessary guidance and resources to realize their dreams.

That is, until now.

C.R.U.S.H. It! Brings together industry experts like Patterson Dental and The Progressive Dentist magazine to share advice and insights to truly help dentists ignite their own careers.

Split into five sections that cover topics like continuing education, team-building and personal development, the C.R.U.S.H. It! guide is free for students and available for current dentists at no cost for a limited time.

A free, web-based community, igniteDDS offers students and new dentists networking and opportunities on the job board, one-on-one and group chats, connection to top thought leaders in dentistry, and training in practice management, debt management, technology, and more. Explore the new success guide and more at igniteDDS.com.

igniteDDS.com

Dental Trade Shows 2016 Mid-Winter Meeting of the Chicago Dental Society February 25-27, 2016 McCormick Place Chicago, Illinois Thomas P. Hinman Dental Meeting March 17-19, 2016 Georgia World Congress Center Atlanta, Georgia CDA Presents The Art and Science of Dentistry May 12-14, 2016 California Dental Association Anaheim, California National Dental Student Lobby Day April 11 -12, 2016 Washington, DC

National Dental Student Lobby Day

April 11 -12, 2016 Washington, DC ASDA Annual Session March 2 – 5, 2016 Dallas, Texas

ASDA Annual Session inspires members to Dream Bigger The American Student Dental Association (ASDA) is a unified voice representing 22,000 members and 90 percent of dental students. Our Annual Session will take place March 2–5 in Dallas, Texas. Annual Session is the official meeting of the House of Delegates, where members discuss and vote on policies that will shape the future of the association. In between House meetings, students will attend networking events, district caucuses, the Gold Crown awards ceremony and career development workshops led by prominent dental experts.

In line with the theme of his year’s meeting — “Dream Bigger” — actor, activist and PBS TV host Chris Bashinelli will present his inspirational keynote address: “Life Lessons for Ignoring the ‘Noise’ and Discovering your Passion.” More information can be found at ASDAnet.org/Annual Session.

Index of Advertisers ADS Dental Transitions South……………………………………………………………............................. 5 ADS Dental Transitions…………………………………………………………….................................... 16 Bank of America……………………………………………………………............................................. 21 Comfort Dental............................................................................................................................ 27 Dentist Advantage........................................................................................................................ 11 Heartland Dental........................................................................................................................... 9 Henry Schein PPT ....................................................................................................................... 13 Henry Schein Nationwide ............................................................................................................. 37 Hinman...................................................................................................................................... 29 igniteDDS................................................................................................................................... 35 MacPractice................................................................................................................................ 17 National Children’s Oral Health Foundation..................................................................................... 13 Paragon...................................................................................................................................... 25 Patterson Dental.......................................................................Inside front cover/page 1, and page 15 Wells Fargo................................................................................................................................. 38

36 Winter 2016 Dental Entrepreneur

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All financing is subject to credit approval.

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. © 2016 Wells Fargo Bank, N.A. All rights reserved. Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A. 2846-0116 WFPF-Ad-Dental-Entrepreneur-Winter-16