DENTAL SLEEP MEDICINE
Insider
MAGAZINE
Jan 2020 Issue 34
ZMACHINE SYNERGY THE LATEST ADVANCEMENT IN HOME SLEEP TESTING AIRWAY CONNECTS EVERYTHING
ZMACHINE SYNERGY;
DON’T IGNORE THAT CLICKING!
Steve Carstensen, DDS shares steps for navigating protocols & guidelines for the DSM workflow.
Nate Craft, VP of Sales & Marketing at General Sleep explains the benefits & unique attributes of the Zmachine Synergy HST.
Jamison Spencer, DMD, MS outlines what those TMJ clicks mean for your patients.
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GY YATROS, DMD
GASP! WHAT’S CHOKING YOUR PRACTICE? Today I’d like to talk about the common challenges dentists face when implementing dental sleep medicine into their practice. We have been travelling to several practices involved in our DS360 Premier Tier program and we identified some common hurdles that these offices must overcome. Most are focused around communication and verbal skills. You have to really believe in this process, and understand that
your job is to provide this lifesaving treatment. Another common hurdle is setting up effective processes and systems for screening, testing, treating and billing for sleep apnea. In the video below I outline how to overcome some of these challenges. I invite you to join me at the 2020 NADSM Symposium where I will be diving into this topic in detail. I hope to see you there!
Gy Yatros DMD, DABDSM CO-FOUNDER OF DSS & DS3
NATE CRAFT
THE LATEST ADVANCEMENT IN HOME SLEEP TESTING W
my back all night. Between e all have our own “Why� all the wires, and having to for getting into the field sleep on my back, I thought of Dental Sleep Medicine. “there has to be a better way Whether we ourselves than this�, but at the time suffer from obstructive there wasn’t. sleep apnea, or know others affected by it, the result is More than a decade later, that more and more of us I met the team at General are bringing attention to this Sleep who introduced me life-threatening disease and to their Zmachine Synergy doing our part to save lives. product which had just been launched a few months My “Why� earlier. I was amazed by the advances in technology since Around 2002, I went through my own time in the sleep lab. an experience that is becoming more and more common these days. My wife had a regular habit of leaving our bedroom in the middle of the night because I was snoring so loudly that the walls would shake (her words not mine). I visited my doctor in hopes As I learned more about of solving this problem. He General Sleep and promptly referred me to our their Synergy product, I knew they local sleep lab to get tested had developed something and, evenwww.GeneralSleep.com back then, the wait info@GeneralSleep.com (888) 330-4424 www.generalsleep.com info@generalsleep.com 216-289-2331 truly special that had the time for an appointment was potential to change the considerable. world and aid in treating this life-threatening disease. I arrived at the lab and Needless to say, I joined the was surprised by the sheer company shortly thereafter number of wires and sensors and, along with the team, that were attached to me. began to map out a strategy Then, I was told to go to for bringing the Zmachine sleep, but try to keep on
Synergy into the hands of more dental and medical professionals in order to increase the number of patients getting tested, diagnosed, and treated. One of the first things I did was to test myself and my mother. My own diagnosis was re-confirmed, and my mother was newly diagnosed. Both of us started our respective treatment. It was very gratifying to help a loved one likely add years to her life, and to dedicate my own career to bringing this same opportunity to others.
Who is General Sleep? General Sleep was founded, and still run today, by engineers with the singular focus of developing worldclass medical technologies to improve human health. The company possesses deep expertise in biomedical signal processing, medical electronic design, and software development.
NATE CRAFT Over our 25-year history, we have invented ground-breaking medical technologies in the fields of intraoperative anesthesia monitoring, insomnia treatment, and more. In the early years, we sold or licensed our technologies to well-known companies, but today we sell products directly under our own name with all systems manufactured right here in the United States.
How the Zmachine Synergy came into being General Sleep wasn’t always focused on sleep apnea. In fact, our original products were focused on the nondrug treatment of chronic insomnia by helping patients perform the steps of Cognitive Behavioral Therapy at home using our system to monitor their sleep and provide feedback at just the right time. Technologies available at the time, like actigraphy, just didn’t have the accuracy necessary to be sure the system wasn’t going to alert a patient at the wrong time and wake them up. The EEG signal, which is the gold standard signal used by sleep
labs to monitor sleep, was the only option. A multi-year development program was started to create the core EEG technology and the first Zmachine products.
HSAT at that time had limited channels, difficult user experience, no information about sleep and sleep quality, and a high price tag for what they offered.
Of course, the market will always provide surprises. There was consistently more interest in the EEG-based sleep staging capability of the Zmachine products than in the insomnia treatment they were designed to facilitate! Over time, the Zmachine products began to be used extensively in academic and industrial research, drug trials, and corporate product development.
The entire company began a detailed exploration of all things sleep apnea, including the state-of-the-art in lab testing, home testing, and the various treatment modalities, with the goal of engineering a totally new HSAT device that would be more capable, and less expensive, than anything else on the market.
Another surprise came from the large number of sleep physicians who suggested that we should add respiratory signals to our product, which some said would revolutionize home sleep apnea diagnosis. Based on this unexpected market response, we began exploring the Home Sleep Apnea Testing (HSAT) market more seriously and our founder, Dr. Richard Kaplan, decided to try a popular HSAT device on himself only to realize just how much these devices needed to be improved. Like many of the devices still in use today, the
Please extend our gratitude to Dr. Kaplan. Of all the HST’s we have used, by far this is the best and easiest to use for our patients and on our end as well. The amount of information it gives us is so helpful and easy to read. I love being able to advise our patients about their sleep positions and where their AHI is the lowest. - Dr. David S. Owner of 3 Zmachine Synergy Systems
NATE CRAFT We didn’t invent the Home Sleep Test, we just made it better® The culmination of this development effort was the Zmachine Synergy which combines the sleep staging capability of the original Zmachine products with traditional respiratory and body position sensors (that combination is the “Synergy” in the product name). The Zmachine Synergy is a patient-applied, 8 channel, Type II HSAT with integrated EEG-based sleep staging, and includes airflow, snore, 3D body position, respiratory effort, pulse, SpO2, and photoplethysmography. With a simplified patient experience, more channels of information, and a lower cost, the Zmachine Synergy represents the latest advancement in home sleep apnea testing. There are three main features that separate the Zmachine Synergy from other HSAT’s on the market. 1. The Zmachine Synergy actually monitors sleep using our FDA-cleared EEG-based sleep staging technology. This ability to monitor sleep makes the Synergy well suited for the hard-to-diagnose mild and moderate patients where time spent awake would otherwise dilute the critical AHI number. 2. The Zmachine Synergy is backed by a cloud-based portal using world-class
infrastructure to provide a seamless experience from start to finish. Safety and security are inherent in our HIPAA-compliant cloud portal which provides high availability, high security, continuous backup, virtually unlimited storage space, and high speed network access. Our customers can seamlessly share studies with our nationwide network of Registered PSG Technologists and Sleep Physicians, or share directly with their own partner network. 3. Consistent with our overarching vision of improving human health, this technology is offered at a much more affordable price than other systems on the market, thereby making home sleep apnea testing more readily available to people through physicians and dentists.
Dental Advantages Dentists are now able to monitor sleep and breathing in one easy-to-use device. Dentists can access patient studies on a cloud-based portal that is safe and secure. They can autoscore data to see the patient’s baseline AHI and send the sleep study directly to a licensed sleep physician for diagnosis. All of this is now available at a more affordable price. Innovative technology coupled with progressive dental practices, along with making it easier and more convenient for
patients to be compliant, brings us closer to a brighter horizon. We are on the tipping point of decreasing the staggering percentage of undiagnosed patients who suffer from Obstructive Sleep Apnea, thereby increasing access to care. Let’s join together in 2020 as we approach the New Year of Dental Sleep Medicine, where lives are changed for the better one patient at a time.
JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
NATE CRAFT VP SALES, GENERAL SLEEP Nate Craft is V.P. of Sales and Marketing for General Sleep Corporation. For over twenty years, Nate has represented various innovative devices that would qualify as disruptive technology and eventually change the landscape of the market. He now brings that experience to General Sleep in hopes of spreading the message about obstructive sleep apnea and encouraging doctors and dentists to screen their patient populations so that fewer people have to live with this silent killer.
www.GeneralSleep.cominfo@generalsleep.com info@GeneralSleep.com (888) 330-4424 www.generalsleep.com 216-289-2331
STEVE CARSTENSEN, DDS
AIRWAY CONNECTS D
o you find yourself confused, and maybe even a little scared, by what you are hearing about the dental sleep medicine (DSM) practice? You think you are safe in what you do, but someone tells you about another dentist who got in trouble for “practicing medicine without a license.” You read guidelines by one organization, but another group says something completely different. What do you need to know? There is only one regulatory body that controls what is legal for you to do – your state dental board. Another legal restriction on our practices is in the criminal code, where fraudulent behavior is defined. Stepping over those lines endangers your license, but that will be the smaller of the problems you will face. There are nine steps to making this work out well for you. The first few you’ve heard plenty about: Understand why you are wanting to treat airway patients in the first place, bring your team onboard with excellent training, and begin screening every patient. The next three get a little trickier: use objective evaluation, know your limitations, and expand your scope. Let’s look at these a bit closer.
Use Objective Evaluation. The ADA says we should use some measuring device to assess whether our therapy is effective. We do this every day managing periodontal disease with pocket probing. Other groups say measurement is for physicians only. This issue is not yet settled at the state board level.
Know Your Limitations. Dentists get pretty great education in professional school, but our physician colleagues keep more of the physiology in mind during medical decision making. On the other hand, they disavow the TMJoint.
EVERYTHING Join me next month in Clearwater Florida for the 2020 NADSM Symposium where I’ll be presenting on “Protocols, Policies, and Position Statements – What Should I Pay Attention To?” You’ll see plenty to help you make sense of these steps that must be taken! I look forward to seeing you there. JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
Expand Your Scope. You can perform services within your license as long as you are trained to do so. Since you didn’t get any DSM lectures in school, you have choices about where you learn what is needed to practice safely. The final three steps are these: Form a team, commit to follow-up, and keep in mind the first therapy choice may not last a lifetime. You can’t do DSM with only your resources. You need diagnosing physicians, surgeons, a medical biller, software people and myofunctional therapists. Since DSM is disease management, your patients need help for a lifetime. Someday, they’ll tell you they ‘went back to CPAP’ and you’ll be OK with it.
STEVE CARSTENSEN, DDS Steve Carstensen DDS started treating sleep problems in 1998 and practices at Premier Sleep in Bellevue, WA. He’s completed UCLA’s Mini-Residency in Sleep and is a Diplomate of the American Board of Dental Sleep Medicine. He lectures internationally, directs sleep education at the Pankey Institute and is a guest lecturer at Spear Education, University of the Pacific, and Louisiana State University Dental Schools. From 2014 – 2019 he was Editor-in-Chief of Dental Sleep Practice Magazine. In 2019, Quintessence published A Clinician’s Handbook of Dental Sleep Medicine, written with a co-author.
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1. Comparison of AHI using recording time versus sleep time. Schutte - Rodin et al., J Sleep Abs supl 2014, p. A373
DANIA TAMIMI, DDS, DMSC
LET’S LOOK INSIDE THE NOSE – A RADIOGRAPHIC JOURNEY B
reath is life. Our lives on Earth are bordered by two distinctive breaths: the furious cry of a newborn and the faint gasp that leaves our lips on our deathbeds. In modern man, the breaths in between are often an involuntary flow of shallow breaths unreflective of intent or efficiency. Yogic traditions encourage nasal breathing as it helps bring back the full spectrum of focus and healing that the breath has to offer. It allows for the important nasal functions of filtration, humidification and temperature control to occur.
This increases vitality as there is a reduction of pathogens and thermal fluctuations that may affect the body adversely if nasal breathing is bypassed. Some of the conditions leading to the substitution of nasal breathing for mouth breathing are obstructions and deviations of anatomy of the nasal cavity and sinuses. As the anatomy of the nasal cavity, paranasal sinuses and nasopharynx is housed in the bony casing of the skull, the best way to visualize
these structures and to rule out abnormality is through radiographic evaluation. The ability to create cross sections in multiple planes enables us to evaluate the nuances of the anatomy and correlate it to the patient’s clinical presentation. In my presentation at the North American Dental Sleep Medicine Symposium on February 15th, 2020, I will be exploring the anatomy of these structures through the eyes of a radiologist. It is a process that allows the dissection of the patient’s anatomy and the unveiling of the risk factors for upper airway resistance syndromes as well as the exploration of the etiology and development of these risk factors. Although I will not have time to cover the entire upper respiratory tract, I will give a comprehensive overview of the natural entryway of the breath and how a compromised nasal tract can lead to the breath’s inefficient back up plan mouth breathing - to kick in. If you would like to learn more about the anatomy of the craniofacial structures that increase the risk for sleepdisordered breathing, please join me in my hands-on course “How to Read a Cone Beam CT” in Seattle, WA on March 27-28, 2020 where I teach you how to perform a detailed analysis of all the structures on the volume that may affect your
patient’s ability to breathe, including the upper respiratory tract, the cervical spine, the skull base, the jawbones and the TMJ. Information can be found at www.beamreaders. com/education. I look forward to seeing you in Clearwater! JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
DANIA TAMIMI, DDS, DMSC Dr. Dania Tamimi graduated with a dental degree from King Saud University, Riyadh, Saudi Arabia in 1999. She trained at Harvard University, School of Dental Medicine and earned a doctorate of medical science (DMSc) and certificate of fellowship in Oral and Maxillofacial Radiology in 2005. She is board certified by the American Board of Oral and Maxillofacial Radiology (ABOMR) She is the lead author on two textbooks: “Specialty Imaging: Dental Implants” and “Specialty Imaging: Temporomandibular Joint” and a co-lead author on “Diagnostic Imaging, Oral and Maxillofacial”. She lectures nationally and internationally. She currently runs her oral and maxillofacial radiology private practice in Orlando, Florida.
JAMISON SPENCER, DMD, MS
WHY YOU SHOULDN’T IGNORE THAT
D
uring your examination of a new sleep apnea patient you palpate a clicking in the right TMJ. You ask the patient about it and she reports that it has clicked for “as long as she can remember,” and never really bothers her.
Most patients believe that when their jaw clicks upon opening that something is getting OUT of place, when more than likely the disc is actually already out of place, and it’s only when it clicks that it’s coming INTO place.
It’s a pretty loud click. Your assistant can hear it and physically jumps when it happens, clearly indicating to the patient that this isn’t a normal occurrence in your office. The click happens when the patient just barely opens her mouth. You think to yourself that this is one of the worst clicks you have ever seen. Loud AND quick! Bad and more bad! The next patient also reports that her jaw clicks, but you can barely feel it, and it seems to only happen when the patient opens really wide. You think to yourself that this one isn’t that bad at all. Really soft, and only clicks when they open really wide. Good and more good! But you’re most likely wrong… it’s actually the opposite. TMJ problems are funny that way. First of all, let’s make sure we’re on the same page here and recognize that typically clicking in the jaw is due to the articular disc moving from being OUT of place when the teeth are together to being IN place when the patient opens. This is referred to as a “reducing disc displacement” and the clicking is sometimes called “reciprocal clicking” if there is an opening and closing click.
CLICKING
When treating a patient with a reducing disc displacement with an oral appliance for their sleep apnea the appliance will almost for sure help keep them ON the disc throughout the night. That’s great! However, since this is a BETTER position for the joint, it may be more difficult for the patient to get back to their habitual occlusion SINCE THIS REQUIRES THEIR DISC TO BE DISPLACED! So don’t ignore that clicking.
I tell my patients all the time, “when it comes to TMJ problems, take whatever you would think would be obvious, flip that 180 degrees, and then you’ll likely be right.” A loud click is “good,” compared to a soft click, because it tends to mean that the disc still has an hourglass type shape. Fat, skinny, fat. This “fat part” of the displaced disc coming back onto the condyle makes for a nice loud click or pop. Usually a softer click means that this shape has been flattened out over time. An early click is also “good,” compared to a late click, because it means that the retrodiscal tissues aren’t as stretched out so the disc moves back into place easier.
I hope you will join me in Clearwater, Florida in February for the 2020 NADSM Symposium. I will be presenting on “WHY your why matters, WHAT MDs care about, and HOW oral appliance therapy can be better than you think.”
JAMISON SPENCER, DMD, MS Dr. Jamison Spencer is the director for the Centers for Sleep Apnea and TMJ in Boise, Idaho and Salt Lake City, Utah. Dr. Spencer is a Diplomate of the Board of Dental Sleep Medicine and the Board of Craniofacial Pain, and is adjunct faculty at the University of the Pacific and University of North Carolina at Chapel Hill Dental Schools.
LISA FISCHER -HERDT
PREPARATION IS KEY MEDICARE & 2020 I blinked and 2019 was
over. With that being said - Happy New Year! Now is the prime time to start making our resolutions and preparing for the year ahead! As a DSM provider, you also need to prepare for medical insurance changes in 2020. So, what’s new you ask? As you know, Medicare began issuing ID cards with the new ID format through 2019.
Effective January 1, 2020: ALL claims must contain the MBI (Medicare Beneficiary Identification) Claims without the MBI will be denied
on an inside scoop from an insurance agent friend of mine, she is seeing an approximate 10% increase in both IN and OUT of network deductibles. The changes don’t stop there. We have encountered new requirements when requesting GAP/in-network waivers as well. In a new trend, insurance companies are advising that the patient or the “best physician” must initiate GAP. The real question is how do you, as a provider combat all these new potential hurdles? How do you prepare for unexpected or expected changes? You can start by: • Utilizing the “What’s New” icon in DS3 - this will provide you a number of resources • Registering with the Medicare Provider Portal in your region
Guess what’s new with deductibles? As you may have guessed, they are on the rise, yet again. Based
• Enrolling for the Medicare Learning Network • Contacting your billing service
Change is inevitable I’m afraid. Preparation is key to ensure that we clear the hurdles that are put before us and continue to provide treatment to our patients. You are making a difference in the lives of many and single handedly changing the Dental Sleep Medicine landscape.
Make 2020 an amazing year! JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
LISA FISCHER-HERDT
Lisa is the Director of Member Communications at Dental Sleep Solutions and 4 Pillar Billing. She has over 15 years of Medical Billing experience and serves on the Manatee Tech College Advisory Board. Lisa@4pillarbilling.
Boost Reimbursement. Increase Efficiency. HOW WE HELP YOU: Four Pillar Billing. Medical Billing for Dental Practices
Our Service Includes:
- Application completion - Step by step instructions for the credentialing process - Bi-Weekly follow up for tracking and notification
DME Application This application is required by Medicare to be recognized to deliver the appliance and receive payment -Completion of DME application -List of documents required to be sent with application -Bi- Weekly follow up with a status update -Step by step assistance during the process
EFT Application
Electronic Funds Transfer application is required by Medicare to receive payment -Completion of EFT application -List of documents required to be sent with application
- Status updates - Personal support from a credentialing specialist
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+ =
*Must be done with DME application, required by Medicare
Prescribing Application This application allows a provider to write prescriptions to Medicare patients -We complete this application as a courtesy with the DME and EFT application
Part B Application
This application is required by Medicare if a provider would like to bill for other services -Completion of Part B application -List of documents required to be sent with application -Bi- Weekly follow up with a status update -Step by step assistance during the process
CONTACT US TODAY! “We collected less than $5,000 during the first half of the year for sleep cases, but since we started using Four Pillar Billing over the past couple months, we’ve collected approximately $30,000.”
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MARK T. MURPHY, DDS, D.ABDSM, FAGD
OSA IS A HEALTH CARE CRISIS;
TREATING MORE OSA PATIENTS
look at this health Ycareou can crisis and the obvious
solutions, from many perspectives. I have chosen a very pragmatic, threepronged approach; Public Awareness, More Providers and Greater Efficiency. These three initiatives can increase the throughput of patients. For this audience, I will focus on what dentistry can do to leverage these opportunities. Medicine has the same dilemma and concerns. The executable order for these is reversed for financial and practical reasons. Let me explain. Pulling patients through a treatment supply chain of trained dentists is a worthy design. Today, there are not enough providers to serve the need. Patient education of the importance of sleep is improving dramatically as witnessed by the explosion of mattress, pillow, sleep aid and OTC solutions. Yet we are not keeping up with the need or demand.
A robust Public Awareness campaign is not in the cards currently for the AADSM, ASBA, AASM, ATS or any of the other sleep focused organizations for one obvious reason, cost. A multi-media campaign would require substantial resources and cooperation of the invested parties. Dentistry, medicine and the other related healthcare stakeholders would have to work together, pool resources and then deploy them efficiently to improve public awareness. Even if a generous financial partner emerged, it would be difficult to agree on a unified message.
The AADSM has been diligent on driving DSM Education within dentistry. The addition of a few hundred Diplomates and Qualified dentists is a great first step, but not until we are adding thousands will more providers have a significant impact. There are estimated to be 4,0006,000 dentists treating DSM in their practice, and maybe 500-700 doing it actively. That represents a small fraction (3.3%) of dentistry. In contrast, Invisalign has trained over 50,000 U.S. dentists and spends tens of millions on Direct-toConsumer Marketing. These two growth drivers will reach DSM when investors realize the opportunity and can visualize an appropriate ROI for shareholders.
Efficiency is our best tool.
Designing medical devices that have better efficacy, save chair time, require less
MARK T. MURPHY, DDS, D.ABDSM, FAGD
maintenance and prevent side effects will help us treat more patients with greater effectiveness and efficiency. The ProSomnus next-gen appliances are doing just that. The DSM caregivers who are utilizing these advantages have seen large increases in their capacity to provide care. Less chair time is the key.
An excellent impression/ scan and bite registration coupled with a precision engineered/manufactured platform provides efficiencies that were not as available previously. The correlative and causative relationships listed below are allowing dentists to help more patients in fewer appointments. Less time is better for the patient experience and drops to the bottom line of the practice.
• • • • • • • • • • • • • •
Smaller devices Better comfort More tongue space Less advancement Retainer fit No tooth movement Maintains Tx position Fewer follow up adjustments No moving parts Less repair Stronger material Less breakage Denser material Easier hygiene
The ProSomnus [PH] Precision Herbst-style Device
150,000 dentists doing one device per week could treat 7.5 million patients who were motivated to seek treatment annually. That would have a huge impact! Alternatively, the 5,000 dentists treating sleep today, could accomplish the same by treating 30 patients weekly. Neither is a likely short-term scenario. Leveraging efficiency through device designs and
practice efficiencies is a worthy short-term goal that will help more patients have better health. Join me at the 4th annual North American Dental Sleep Medicine Symposium where I’ll be presenting on “3 Keys to Closing (LOTS!) More Patients”. JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
MARK T. MURPHY, DDS, D.ABDSM, FAGD Mark T. Murphy, DDS, D.ABDSM, FAGD, is Lead Faculty for Clinical Education at ProSomnus, serves on the Guest Faculty at the University of Detroit Mercy, is a Regular Presenter on Business Development, Practice Management and Leadership at the Pankey Institute and is the Principal of Funktional Consulting. He has served on the Board of Directors of the Pankey Institute, National Association of Dental Laboratories, the Identalloy Council, the Foundation for Dental Laboratory Technology, St. Vincent DePaul’s Dental Center and the Dental Advisor.
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ERIN ELLIOTT, DDS
I
GENERAL DENTISTRY AND SLEEP?
am a general dentist in North Idaho. It’s Monday at 6:45 AM and it’s time to suit up for the day. I adorn myself in my white lab coat (as a female, how else will the patient know I’m a dentist??), my radio to communicate with my team, my loupes and most importantly, my rollerskates.
I am ready to run two columns of dentistry. I am ready to do fillings, crowns, extractions, dentures and what feels like, endless re-care exams. But my favorite part of the day is looking at my sleep column. Why? Because we get to help people SLEEP which really means I get to help people LIVE. But how in the heck can I do both? I will be the first to admit that when I started implementing sleep in 2009 it wasn’t always smooth, and I didn’t always know what to do. Heck, I don’t always know what to do now! But what I can tell you is that having an existing pool of dental patients helped get my sleep program started. Back then I said, “If I could only get my team to help with the screening and the conversations.” Or I would talk to patients, get them excited, only to find that they did nothing about it when they came back in 6 months. I had other dentists and multiple consultants tell me “it’s too hard to add sleep.” That is why I changed things up. I didn’t throw in the towel. I didn’t tell everyone “this sleep thing just
doesn’t work.” I figured out a way to make it happen. I teach a course that boils it down to a 4-step process:
1. Create Awareness 2. Get a Diagnosis 3. Financials (which includes medical insurance) and finally 4. Treatment NOTE: The treatment part is the easiest part sometimes because that’s dentistry. I always say, “It doesn’t matter what appliance you choose if you don’t have a patient to put it in.” At the 2020 North American Dental Sleep Medicine Symposium in Clearwater, FL I will be sharing the 3 practice pivots that made sleep a permanent, profitable, & paramount part of my practice. My presentation will expound on the following 3 pivots.
test results. Suddenly they WANT treatment. THIS is my favorite part. I love to see the light bulb go off and the patient get a real sense of urgency.
PIVOT NUMBER 3: The
third key to my success was establishing myself as the ‘go to” sleep apnea and snoring office in the area, and it didn’t just magically happen. I hit the pavement and I spread our message. In my lecture I will be sharing some of the ideas I had that were more than showing up at the sleep physician’s office with treats. If you want to know more, then register for the 2020 NADSM Symposium. See you on the beach! JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
PIVOT NUMBER 1: The first
major turning point was promoting an assistant to be our “Sleep Champion.” She “owns” the program and “owns” her column. She is in charge and oversees all of DSM, but she utilizes other team members to help. That frees me so I don’t have to sweat minor device adjustments, and it allows me to focus time on consults.
PIVOT NUMBER 2: The second shift was when I made it easier for my patients to get a sleep test. There are a variety of ways to remove hurdles. It’s one thing to create awareness, but something magical happens when patients see their sleep
ERIN ELLIOTT, DDS Erin Elliott, DDS’s general dentistry practice in Post Falls, ID is busy helping patients SMILE and SLEEP better. Dr. Elliott is an international speaker and educator with 3D-Dentists on the topic of sleep disordered breathing and has been featured in innumerable dental journals and podcasts.
DENTAL SLEEP MEDICINE GPS STEP BY STEP DIRECTIONS TO DRIVE YOUR SUCCESS
REGISTER TODAY! WHETHER YOU’RE BRAND NEW TO SLEEP OR ALREADY PRACTICING, THIS COURSE WILL HELP YOU LEARN TO EFFECTIVELY:
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TEST
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THIS COMPREHENSIVE HANDSON COURSE IS FOR DENTISTS & TEAMS THAT WANT TO GO FROM AZ IN DENTAL SLEEP MEDICINE & AVOID ALL THE TRAFFIC JAMS & WRONG TURNS THAT PREVENT PRACTICES FROM SUCCESSFULLY REACHING THEIR DESTINATION.
PRESENTERS UPCOMING COURSES 2/28 - 2/29 RALEIGH, NC
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4/24 - 4/25 CHICAGO, IL 5/1 - 5/2 DENVER, CO 5/15 - 5/16 TAMPA, FL 5/22 - 5/23 SEATTLE, WA 6/5 - 6/6 WASHINGTON, DC 9/18 - 9/19 MINNEAPOLIS, MN
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MARC FOWLER
4 REASONS YOU NEED PATIENT REVIEWS FOR YOUR SLEEP PRACTICE
O
nline reviews are the modern word-of-mouth and they are ubiquitous. As is true with your dental practice, patient reviews play a critical role in making your sleep practice a success. Positive reviews can push potential patients to set an appointment. On the other hand, negative reviews can bury your practice. Here are some of the ways reviews can impact your sleep practice.
1. Reviews Build Trust Trust is a key factor in patients’ decision making. Choosing a healthcare provider involves an element of uncertainty and risk, more so than most other service providers. I don’t know anyone who gets nervous booking a plumber or scheduling an appointment with a CPA, but when it comes to healthcare it’s a different story. In some cases, choosing the right healthcare provider really is a “life or death” decision. For the patient who doesn’t already know you and wasn’t referred to you, the only point of reference they have is what they read online. Consumers have been conditioned by websites like Amazon.com to seek out and read reviews. Studies show that the average consumer will read about 10 reviews before they feel
they can trust a business. If the reviews for your sleep practice are lacking or less than stellar, potential patients will move on to the next provider.
2. They Improve Online Visibility It’s not just consumers who place heavy importance on reviews; Google does too. The benchmark Moz Local Search Ranking Factors study, as well as recent research from Whitespark, cite review signals as the third most important local SEO ranking factor. Google considers several review elements including the quantity, frequency, diversity and average star rating.
Additionally, reviews left about your sleep practice will contain keyword terms that you want Google to associate your practice with. For example, a sleep patient leaving a review is likely to mention sleep apnea, snoring or
CPAP alternative. Having these keywords associated with your website, Google My Business listing, Facebook page, or Yelp listing will dramatically increase your chances of being found by prospective sleep patients searching for solutions online.
3. They Generate More Clicks, More Calls & More Delivered Appliances Like it or not, the widespread usage of review sites like Google, Yelp & Facebook have changed the landscape of how healthcare providers attract patients. A widely referenced survey of 1,000 consumers last year by BrightLocal found that 86% of consumers read reviews for local businesses (up from 67% in their 2010 survey). Digging deeper into the data reveals a more relevant statistic for dental sleep practices - nearly half of all respondents said they read reviews prior to selecting a healthcare provider. Reading positive reviews from other sleep patients will result in more new patients choosing to schedule an initial appointment with your office.
MARC FOWLER There is a psychological principal called social proof that comes into play when potential patients see numerous positive reviews for your practice. Social proof is a bias whereby we mirror the actions of others in an attempt to reflect what we perceive to be correct behavior. For example, you probably feel better about your dining decision when walking into a busy restaurant than one that’s empty during peak time. With this in mind, which of the three sleep providers in this Google Map Pack do you believe receives the most clicks (and subsequently phone calls)? Sleep Better Austin with 42 reviews and an average star rating of 4.8 is going to receive significantly more activity from their listing than either of the other two listings.
easier, while also increasing the likelihood that your new patient will follow through with the treatment recommendations.
4. They Provide Valuable Feedback Patient reviews are inherently valuable because they allow you to see your practice through your patient’s eyes. The reviews provide insight into how you and your team can improve the way you communicate with and serve patients. For instance, if you notice several patients mentioning how much easier it is to travel with an oral appliance than their CPAP, you can incorporate that verbiage into your marketing. Or, if you notice that billing is a recurring complaint, you can proactively address that part of your office process.
To learn more about this topic click here to watch a short video webinar excerpt.
If you would like to discuss ways to effectively target your ideal sleep patients, click here to schedule time on my calendar for a complimentary 30 minute marketing strategy call. JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
So how do you get more reviews? The first step is to claim your sleep practice profiles on the most utilized websites and platforms. While there are dozens, the three most critical to start with are Google My Business, Facebook, and Yelp.
While establishing a certain level of trust is critical to getting prospective patients in the door, it becomes even more important once they’re in your office. You have a limited amount of time that you can spend with each patient. If they arrive predisposed to trusting you through social proof, it makes your job significantly
The second step is to actively encourage patients to leave reviews. This can be done by emailing or texting patients after appointments, handing them a review request card at checkout, and by posting in-office signage. According to the BrightLocal survey, 70% of consumers will leave a review when asked, and this can lead to a steady increase in positive reviews and a higher overall rating.
MARC FOWLER
Founder, Bullseye Media Marc Fowler is the founder of Bullseye Media. Since 2006, the team at Bullseye Media has helped hundreds of dental practices across the U.S. and Canada leverage the internet to achieve their practice growth goals. Learn about their turnkey 3 step direct-to-patient sleep marketing program at DentalSleepMarketing. com. Email: Marc@ BullseyeDental.com
THE 3 STEP MODEL FOR GROWING A DENTAL SLEEP PRACTICE Discover the direct-to-patient system that is working for successful dental sleep practices nationwide.
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NEED A PARTNER FOR YOUR JOURNEY TO DENTAL SLEEP MEDICINE SUCCESS?
CONSIDER US YOUR DSM SHERPA Pracccing Dental Sleep Medicine can be extremely rewarding, but it brings challenges and hurdles that are difficult to overcome without some help. We’ve trained thousands of providers and developed systems and best praccces so you can avoid the medical billing nightmares, missed opportuniies, legal hassles, and wasted me that many dennsts before you had to endure. so ma Consider us your DSM Sherpa – we will guide you every step of the way. You aren’t just signing up for a sooware or training connnuum, you are gaining a partner who will guide you on your journey to dental sleep medicine success!
START YOUR JOURNEY TODAY With over 120 years of combined Dental Sleep Medicine experience, we have lived through the pain, learned from wide-ranging experiences, pioneered, and innovated to provide you with educaaon, tools, and resources to achieve success! We’ve created the DS3 Experience to help dennsts like you with the 4 Steps of Educaaon, Coaching, Sooware, and Support needed to efficiently implement the 4 Pillars of Dental Sleep Medicine Success; Screening, Tessng, Treaang, and Billing. Contact us today to learn how we can help you achieve your dental sleep medicine goals - the path to success awaits!
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RICHARD DRAKE, DDS
UNMET EXPECTATIONS I
was vacationing with the family out in sunny Southern California in July of 2019 (as I get older, I value the time I get to spend with my family more and more). Anyway, I had the pleasure of meeting up with Randy Clare at Glidewell Lab in Newport Beach. He’s been on me for some time about coming out and taking a tour of their state-of-theart facility. To quote him: “You just won’t believe all the things we’re doing here.” Wow, was he right! They get about 8,000 crown and bridge cases. Not every month, not every week, but EVERY DAY. The simple logistics of how to handle that many cases and the systems they have in place is truly a modern work of art. Average time to get the case back out to the dentist is 48 hours. Yikes! So, I get paid nothing to say this, but if you’re ever out in cloudy Southern California in the Newport Beach area, give Randy a call and see if they will give you a tour of Glidewell Lab. It’s a real treat. A guy… one guy, started that business in 1978… in his kitchen. They’re doing a few things right, wouldn’t you agree? Randy said something that stuck in my mind that I’d like to pass on to you. I think it
will help YOU increase not only your sleep business but also your job satisfaction: “We’ve done a lot of research, and through it all, we have determined the number one reason that we lose a customer is due to unmet expectations.” Ruminate on that for just a moment, and tell me I’m wrong, or tell me I’m right – but isn’t that something you can take and run with? At my dental sleep consultation, I have always asked for “top 3” chief complaints. I number them and write them down, on a piece of paper, right in front of the patient.
TALK to your patient about how what you do might effect a change in each of their chief complaints. Snoring… studies say a 96% improvement… you get my point. Let’s make it a New Years’ resolution to communicate better with our patients about what they can expect from us.
JOIN ME AT THE NADSM SYMPOSIUM! REGISTER NOW
1. Snoring 2. Tired all the time 3. Wake up with headaches almost every day
RICHARD DRAKE, DDS
Sure, sometimes it’s hard to get three, and for other patients, you have to stop at a baker’s dozen, but get in the habit of doing this, and then:
Dr. Richard Drake has been exclusively treating snoring and apnea for 20 years. He Co-Founded Dental Sleep Solutions and DS3 and has a state of the art sleep practice in San Antonio, TX.
THE RELIABLE HOME SLEEP TESTING SERVICE YOU’VE BEEN DREAMING ABOUT
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FEB 14-15, CLEARWATER, FL
INSPIRING PRESENTATIONS
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PRACTICAL KNOWLEDGE
Join us for the 4th annual NADSM Symposium! The event focuses on the practical aspects of Dental Sleep Medicine, emphasizing practice growth, increased efficiency and providing optimal care. Hear from KOLâ&#x20AC;&#x2122;s, network with innovative sponsors and earn 12 hours of CE at this 2 day event! See you on the beach!
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877-95-SNORE
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PRISTINE BEACHES Hilton Clearwater Resort, Clearwater FL