Dental Practice
CANADA’S CANADA’S LEADING LEADING BUSINESS BUSINESS & & LIFESTYLE LIFESTYLE MAGAZINE MAGAZINE FOR FOR DENTISTS DENTISTS
MANAGEMENT
FALL 2010
REAL ESTATE Dental Tenants... Beware
Dental Patient Management Software Requires Medical Device Licence
A Professional Corporation Is It the Answer for Me?
Office Equipment
Electric Handpieces: Profiting From Increased Efficiency w w w.oralhealthjournal.com Canada Post Product Agreement No. 40069240 ISSN 0827-1305 (PRINT)
ISSN 1923-3450 (ONLINE)
Crest® Oral-B® believes every woman, every day, deserves to look and feel her best. That’s why we’ve made a commitment to the Canadian Breast Cancer Foundation. We invite your dental office to join us in support of breast cancer research by choosing the toothbrush for your patients. Please call us at 1-800-543-2577 or contact your Dental Dealer to order your brushes today. With your help, we’ll rise to the challenge of creating a future without breast cancer.
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Dental Practice
MANAGEMENT
Fall 2010
Features REAL ESTATE
8 Dental Tenants...
Beware of Landlords with 13-Inch Rulers!
8
Dale Willerton OFFICE EQUIPMENT
14 Electric Handpieces:
Profiting From Increased Efficiency George Freedman DDS, FAACD, FACD OFFICE DESIGN
20 A Move For The Better
PRACTICE MANAGEMENT
22 Dental Patient Management Software Requires Medical Device Licence Jeff Coward FINANCE
24 A Professional Corporation – Is It the Answer for Me? Lorne Dubros, CFP
20
BOOK REVIEW
26 Profitable Practice
Review by Jordan Soll, BSc, DDS PRACTICE MANAGEMENT
27 Motivational Interviewing:
An Alternative to the Marshall Art of Tongue Fu Suzan Bekolay
Dep a r t m e n t s 5 Editorial
Web + log = Blog!
6 News Briefs
No dental cash for working poor Are you hypersensitive?w
29 Dental Marketplace
27 www.oralhealthjournal.com
Dental Practice Management Fall 2010
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Editorial
Web + log = Blog!
The newest arm of the Fourth Estate
A Catherine Wilson, Editor
Blogging is no fad, no phenomenon. It is revolutionary. It is changing the way we do business, interact with others, follow politics, participate in pastimes.
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ccording to Wikipedia, a blog is a type of website or part of a website. Blogs are usually maintained by an individual with regular entries of commentary, descriptions of events, or other material such as graphics or video. Blog can also be used as a verb, meaning to maintain or add content to a blog. Most blogs are interactive, allowing visitors to leave comments and even message each other via widgets on the blogs and it is this interactivity that distinguishes them from other static websites. Many blogs provide commentary or news on a particular subject...a typical blog combines text, images, and links to other blogs, web pages, and other media related to its topic. The ability of readers to leave comments in an interactive format is an important part of many blogs. To blog or not to blog, that is the question. Considering there are 133 million blogs on the Internet, give or take a few, to blog seems to be the answer! What makes a blog great? Chris from Performancing.com listed these traits: • Credibility • Authority • Passion • Personality • Reliability • Empathy • Reality • Unique • Timeliness • Membership From The State of the Blogosphere by Technorati via the Search Engine Journal, some fascinating figures: • More than 133,000,000 blogs have been indexed by Technorati since 2002 • 7 7% of Internet users read blogs according to Universal McCann • 75% have college degrees and 40% have graduate degrees • Around half of Bloggers are working
on at least their second blog. • 68% have been blogging for two years or more. • 86% have been blogging for at least a year. • 70% of all respondents say that personal satisfaction is a way they measure the success of their blog. • 72% say they blog in order to share their expertise. • 5 3% of professional Bloggers are interested in attracting new clients from blogging. • 15% of Bloggers spend 10 or more hours each week blogging. • One in five Bloggers report updating on a daily basis. • The most common rate of updating is 2-3 times per week. • The majority of blogs use tags (85%). • 82% of respondents say that they post photos to their blog, making images the most popular form of multimedia. • Bloggers participate in an average of 5 activities to drive traffic to their blogs. • 56% say that their blog has helped their company establish a positioning as a thought leader within the industry. • 58% say that they are better-known in their industry because of their blog. • Blogging is equally popular among both men and women with 50.9% of bloggers being female and 49.1% being male. Some of the medium’s more extreme evangelists claim blogging will replace traditional media by putting the power of the press in the hands of the ordinary citizen...not likely. There’s a reason we’re called ‘ordinary’. Blogging is no fad, no phenomenon. It is revolutionary. It is changing the way we do business, interact with others, follow politics, participate in pastimes. Business blogs are as credible and professional, as useful and influential as you make them. Oralhealthjournal.com The rest is just noise... DPM
Dental Practice Management Fall 2010
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News Briefs
A BUSINESS INFORMATION GROUP PUBLICATION
Sybron Unveils State-of-the-Art Continuing Ed Centre ORANGE, CA – Sybron Dental Specialties (SDS), Inc. announced the official opening of the Sybron Learning Center (SLC), a state-of-the-art continuing education center designed to provide dental professionals the opportunity to demonstrate and learn cutting-edge best practices.The 15,000+sq-ft facility is located directly adjacent to the Disneyland(r) Resort Theme Parks in Anaheim, CA. The learning centre is equipped with the latest laboratory and multimedia technologies, including: full film and broadcast capability, a primary surgery suite, a 200-seat auditorium and a 50-person bench laboratory with adjoining observation room, four fully-functional operatories and an x-ray room equipped with 3-D panoramic, Pan/ Ceph, and intraoral x-ray imaging.
Working Poor Shut Out of Dental Cash TORONTO – Ontario’s Health Minister says there is no money to improve the oral health of Ontario’s 500,000 working poor. Deb Matthews said the province doesn’t have the resources to keep a promise of providing a dental plan for Ontario’s impoverished adults. Instead, the $135 million earmarked three years ago for affordable, routine care for adults struggling to pay the pricey fees of licensed Canadian dentists, will go to their children. Toronto Star reporters Michele Henry and Rob Ferguson report that 32 percent of Canadians do not have dental insurance and 17 percent of residents across the country avoided seeing a licensed dentist last year because of cost, according to a recent Health Canada report. The Liberals promised in the 2007 election campaign to bring in dental care for low-income Ontarians, following that up with a budget commitment in 2008 to provide $45 million annually for three years to help about half a million of the working poor unable to afford private insurance coverage. Another barrier from keeping the dental care plan from expanding beyond children is that public health units across the province were asked to submit proposals. Those have only recently been completed and submitted to the ministry, Matthews said.
Hypersensitivity Breakthrough from Colgate TORONTO – Colgate introduced its new Colgate Sensitive Pro-Relief desensitizing toothpaste with Pro-Argin Technology at a special launch party in downtown Toronto recently. The paste is clinically proven to provide instant and lasting sensitivity relief after one application. Dr. Bill Dorfman (of Extreme Makeover fame) was on hand to introduce the product, which contains arginine, an amino acid naturally found in saliva and an insoluble calcium compound in the form of calcium carbonate. The Pro-Argin Technology helps attract calcium to the dentin surface to form a calcium-rich mineral layer; this forms a protective seal that occludes open tubules and helps address the cause of pain sensations. The product is not yet available in the US.
Dr. William Dorfman explains the benifts of Colgate’s Pro-Argin Technology.
Colgate’s Dr. Brian Feldman (right) and Colgate crew at the product launch.
Editorial Director: Catherine Wilson 416-510-6785 cwilson@oralhealthjournal.com Art Direction: Valerie Perrott Production Manager: Phyllis Wright Circulation: Cindi Holder Advertising Services: Karen Samuels 416-510-5190 karens@bizinfogroup.ca Consumer Ad Sales: Barb Lebo 905-709-2272 barblebo@rogers.com Classified Advertising: Karen Shaw 416-510-6770 kshaw@oralhealthjournal.com Dental Group Assistant: Kahaliah Richards 416-510-6777 krichards@oralhealthjournal.com Associate Publisher: Hasina Ahmed 416-510-6765 hahmed@oralhealthjournal.com Senior Publisher: Melissa Summerfield 416-510-6781 msummerfield@oralhealthjournal.com Vice President/ Canadian Publishing: Alex Papanou President/ Business Information Group: Bruce Creighton OFFICES Head Office: 12 Concorde Place, Suite 800, Toronto, ON M3C 4J2. Telephone 416-442-5600, Fax 416-510-5140. Montreal: 1 rue Holiday Street, East Tower – Suite 705, Pointe-Claire, Quebec H9R 5N3, telephone 1-800-363-1327, 514-630-5955, Fax 514-630-5980. Dental Practice Management is a quarterly publication designed to provide the entire dental team with business management information to make practices more successful. Articles dealing with investment planning, personal finances, scheduling and collection procedures, in addition to lifestyle issues, are geared to all practicing Canadian dentists, hygienists, dental assistants and office managers. Please address all submissions to: The Editor, Dental Practice Management, 12 Concorde Place, Suite 800, Toronto, ON M3C 4J2. Dental Practice Management (ISSN 0827-1305) is published quarterly, 12 Concorde Place, Suite 800, Toronto, ON M3C 4J2. Subscription rates: $10.00 single copy Canada. One year: ON & rest of Canada $26.70; QC $28.70; NB, NF, NS $28.69; U.S.A. US$27.95; Foreign US$45.95. Dental Guide $18.40 in ON, QC, NS, NB, NF; rest of Canada $17.12; US & Foreign US$16.00. Printed in Canada. All rights reserved. The contents of this publication may not be reproduced either in part or in full without the written consent of the copyright owner. From time to time we make our subscription list available to select companies and organizations whose product or service may interest you. If you do not wish your contact information to be made available, please contact us via one of the following methods: Phone: 1-800-668-2374; Fax: 416442-2191; E-mail: privacyofficer@businessinformationgroup. ca; Mail to: Privacy Officer, Business Information Group, 12 Concorde Place, Suite 800, Toronto, ON M3C 4J2. Canada Post: Return undeliverables to Circulation Dept. – DPM, 12 Concorde Place, Suite 800, Toronto, ON M3C 4J2. Canada Post product agreement No. 40069240. Dental Practice Management, USPS 019-616 is published quarterly by Business Information Group, a leading Canadian information campany with interests in daily and community newspapers and business-to-business information services. US office of publication: 2424 Niagara Falls Blvd., Niagara Falls, NY 14304-0357. Periodicals postage paid at Niagara Falls, NY. US postmaster: Send address changes to DPM, P.O. Box 1118, Niagara Falls, NY 14304. ISSN 0827-1305 (PRINT) ISSN 1923-3450 (ONLINE)
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Fall 2010 Dental Practice Management
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Canada's dental software leader, ABELDent Inc.'s mission is to maximize your benefit from dental software for as long as you practice dentistry. ABELDent is feature-rich, user-friendly software for your entire practice and it is backed by an experienced team with a 30-year track record of delivering innovative, high quality software and services to Canadian dentists. Comprehensive software that adapts to your needs. ABELDent's comprehensive clinical and management features include secure recordkeeping and other tools for the paperless dental office. Developed in collaboration with over 2300 practices that use it daily, ABELDent offers a perfect balance of ease of use and flexibility to support a variety of practice styles/needs. High quality, low cost support. Professional, responsive support 24/7/365 at a very reasonable price. Support plan options to meet your needs - flat rate packages available, or pay only for the support you actually use. High client satisfaction. In an independent survey sponsored by Microsoft, 97.4% of the respondents reported satisfaction with ABEL products, support and customer service.
Freedom of choice. As an independent company, we will work with dental equipment and hardware suppliers of your choice to provide the most seamless experience possible. ABELDent integrates with many imaging and digital radiography solutions. Services with impact. Innovative services including online/on- site training options, web-based patient services, websites, remote system monitoring, remote data backup and integrated payment processing, help ABELDent users to maximize the benefits of their technology investment. Committed to Canadian dentists. ABELDent Inc. is guided by and responsive to the needs of Canadian dentists. ABELDent is taught in dozens of dental programs and there are thousands of experienced ABELDent users across Canada.
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Real Estate
DENTAL TENANTS... Beware of Landlords with 13-Inch Rulers! Dale Willerton
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Fall 2010 Dental Practice Management
www.oralhealthjournal.com
Real Estate
A
re you paying for Phantom Space? Some landlords are over-charging dentists for more square footage than the tenant actually has. This is a common discrepancy in the commercial leasing industry. Dental tenants frequently trust the reported square footage of their leased premises. However, whether this figure was accidently reported by the landlord or reported by a distant property manager who has never even seen the site, the amount of reported square footage can easily be wrong. The end result is that dental tenants needlessly pay an increased rent, based on their incorrect square footage ... isn’t it better to keep this money in your own pocket than pay it to your landlord? To explain further ... I was having dinner one evening with a client. She shared that she had recently moved into a new 4,400 square foot office. She went on to explain how spacious, beautiful and comfortable the office was. When I asked her if she had ever verified the square footage, she said “no”. Why was this necessary? After all, this was the total area stated on her Lease Agreement. It took me several weeks to convince her to let me measure the space to determine if she was actually getting the 4,400 square feet that the landlord was charging her for. Finally, she agreed. When we completed measuring the premises, the measured space was 800 square feet short. In the real estate industry, we refer to this as “phantom space” where the tenant is paying more than is required for space that doesn’t exist. And, in this case, my client was paying over $50,000 more (for her entire lease term) than she needed to for space she
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didn’t have. We approached the landlord and corrected the problem - both for the past and the future. The tenant was reimbursed for her previous overpayments and continued to pay an adjusted rate. Even the smallest amount of phantom space can grow to be quite large as rental rates and Common Area Maintenance (CAM) charges increase over time. As an example, we found that one previous client had a discrepancy of only 27 square feet. While this doesn’t sound like much, this specific unit was located in a prime downtown shopping mall with high rent. When this came to our attention, it was seven years into the tenant’s lease term and the landlord had collected $20,000 more than was rightfully due. Again, this came to a satisfactory conclusion with the tenant being reimbursed. Yet one more example was our accountant for The Lease Coach who consented to have his space measured as well. We confirmed the space actually measured less than reported and negotiated for the landlord to reimburse our accountant $3500.00 as well as ensured the problem was corrected for future rental payments. For our accountant, this was a pleasant surprise. Yet another issue for dental tenants to consider is how phantom space can repeatedly affect them. Understand that every tenant pays two rents - the base rent (which is negotiable) as well as the Common Area Maintenance (CAM) charges. CAM costs cover charges on property upkeep which benefits all tenants (eg: trash removal, property taxes and building maintenance) and are charged proportionately. Therefore, if a tenant occupies 1800 square feet, then he/
Dental Practice Management Fall 2010
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Real Estate
It’s never too soon or too late to have your space professionally measured
she is responsible for the CAM charges on that area as well. If that tenant has been wrongfully paying for phantom space, he/she will also wrongfully pay too much for CAM charges. Such square footage discrepancies are very common for business-owners (specifically, those leasing retail and office space). In my experience, many discrepancies are negligent, not necessarily fraudulent. This is a small consolation as the tenant remains overcharged. When the landlord is receiving rent on 107% of a building, it stands to reason that the landlord should have questioned how he/she could get more than 100% of rent from that building. It’s never too soon or too late to have your space professionally measured. Nearly all lease agreements will state what measurement standard that the landlord has used to determine the area of your premises. Just as there are various similar – yet slightly different – recipes for a German Chocolate cake, there are several different industry standards for measuring commercial space. If you have been taking the landlord’s word for the measurement of your busi-
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ness premises, you may be overpaying substantially on one, or more, of your locations. You may be presented with a “measurement certification”. Don’t take this certification at face value. Many of the locations where we have found discrepancies were “verified” as accurate, but, in fact, were measured incorrectly. Sometimes, the discrepancies are only 30 - 40 square feet; however, these can also be hundreds of square feet off – especially if the leased space is significant in size. On a related note, I was just speaking to a dentist before writing this article. He had made an Offer to Lease for a 2,000 square foot area of a building which was still under construction. When the dust settled, this had ballooned to almost 2,400 square feet, thereby blowing his rental budget out of the water. My advice is that, when you are negotiating a lease for space that is not fully demised and measureable in advance, you should restrict the maximum increase or decrease that will be allowable on the area of the location. This restriction or condition should appear in both the Offer to Lease and
Fall 2010 Dental Practice Management
the Formal Lease Agreement. As you can see, phantom space is a simple concept and can be simply avoided. No one can ascertain the exact size of an area by naked eye alone. Nor should a tenant always trust what is stated on his/her Lease Agreement. Space measurement can provide peaceof-mind and can save you thousands of dollars ... as a dental tenant, isn’t this worth looking into? DPM
Dale Willerton is The Lease Coach and exclusively works for tenants. He has authored “Negotiate Your Dental Office Lease or Renewal”Contact information: 1-800-738-9202, e-mail DaleWillerton@TheLeaseCoach.com or visit www.TheLeaseCoach.com www.HelpULeaseDental.com.
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The all new Patient Questionnaire helps you save time by processing patient paperwork electronically and automating data entry. Your patient can complete the transformation with DENTRIX G3, offering technology that information in your lobby or even at home, and with a Comes Together to make your practice more efficient and more profitable. DENTRIX G3 enables offices to take the next couple of clicks, the information is entered into DENTRIX. step toward a paperless practice and offers a new level in Faster patient communication and treatment planning. G3 is faster, too. Much faster. A heavy hitter without being a heavyweight, benchmark testing has shown that G3 loads Better the chart more than 30% faster than previous versions, The enhanced Perio Chart allows you to easily enter exam allowing you to spend more time where it matters most— data using an input device, such as a mouse. with your patients. G3 also has enhanced functionality within the Document Stronger Center that will help your practice achieve your goal of G3 makes in-depth treatment planning and effective patient practicing paperless. You can import and store any patient education more effective than ever with the seamlessly document—Excel, PowerPoint, Word, or PDF—directly integrated Guru patient education system. G3 and Guru to the Document Center for easy access. You can also allow you to attach consent forms, procedure animations electronically sign and display signatures in documents. and case details to a treatment plan and improve case acceptance and patient retention.
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Office Equipment
ELECTRIC HANDPIECES:
PROFITING FROM INCREASED EFFICIENCY
T
he dental electric handpiece is steadily winning converts in North America. These handpieces have been the more popular choices for practitioners in Europe and Asia for several decades. The reasons were initially practical: the older and less penetrable construction of buildings in these regions made it very difficult to run air lines from a central compressor to remote dental units. In addition, the
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single operatory set up and small space typical of these practices makes a compressor both unnecessary and loudly obtrusive. In most practices, handpieces have a role in just about every task from occlusal adjustments to tooth preparation to surgery and everything in between. In response to the profession’s demands, manufacturers produce a wide range of dental handpieces; some are workhorses designed
Fall 2010 Dental Practice Management
for handling most dental office tasks while others are focused on specific procedures. The large number of handpiece manufacturers creates competition in ongoing development and price structures, both welcome features for the dentist consumer. Developments that herald clinical benefits are seen rather often in the handpiece industry, typically several times each year. Given that the dental handpiece is the most
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Office Equipment
George Freedman DDS, FAACD, FACD
www.oralhealthjournal.com
Dental Practice Management Fall 2010
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Office Equipment
The handpiece often represents a very significant part of the practice activity, and thus, of the practice overhead
16
commonly utilized technology tool of the dental practice, it is essential that the practitioner be up-to-date with as many of these innovations as possible. Electric handpiece motors generate up to 200,000 rpm of rotation. While this is significantly less than the 400,000 rpm often seen for air driven units, the multiplier handpieces (usually identified by a red ring) can increase the rotation considerably. The important feature, however, is that electric handpieces can produce up to 60 watts of cutting power vs. less than 20 watts for most air driven units. Thus, the electric handpiece will not slow down or stop as the bur is applied to various tooth and restorative materials; it simply continues cutting with a constant torque through the entire speed range, regardless of the load. Electric turbines offer a greater concentricity of the rotating bur during cutting. Thus, the bur tends to “wobble” less than it would with an air driven handpiece. This results in a decreased “chatter” of the bur blades against the tooth structure, and a more defined, cleaner cut. Precise, continuous margins are easier to prepare. The faster preparation with the electric handpiece creates less heat buildup at the tooth surface. In fact, this smoother cutting function of the electric handpiece provides a “milling” of the tooth structure rather than the “chopping” that is seen commonly seen with air turbines. Electric handpieces are generally quieter, saving important wear and tear on the dental team’s ears, an important bonus. The smoother operation milling also decreases the high-pitched whine often heard with air driven units. Electric motors and handpieces are often heavier than comparable air driven units; their ergonomic design and scientifically developed balancing often make this additional weight virtually unnoticeable. Overall, electric motor cutting is faster and more effective, resulting in less operator fatigue at the
Fall 2010 Dental Practice Management
end of the day and greater comfort for both the patient and the dentist. Fiber optic illumination has become an indispensable part of the dental armamentarium over the last two decades. Fortunately, many electric handpieces are equipped with fiber optic illumination. This feature increases the visibility within the operating field, a highly desirable outcome. As dentists age, and their visual acuity in low light situations diminishes, illumination is not an option; it is a basic requirement for effective continued practice. The handpiece often represents a very significant part of the practice activity, and thus, of the practice overhead. Thus, it is important to select handpieces that are specifically suited to the dentist’s particular needs. They must be easy and comfortable to use. Handpieces should facilitate (not hamper) the procedures for which they are specifically designed, and they must have adequate torque in order to rotate the operative burs quickly enough such that they can be useful in removing enamel, dentin, filling materials, crowns, bridges, polishing, etc. While certain handpieces command a higher price (and electric motors typically do), their cost must be weighed against their greater efficiency, speed, and endurance. It is often found that a slightly higher up-front expense pays many dividends in both short and longterm calculations. DPM Dr. Freedman is a founder and past president of the American Academy of Cosmetic Dentistry, a co-founder of the Canadian Academy for Esthetic Dentistry and a Diplomate of the American Board of Aesthetic Dentistry. Dr. Freedman sits on the Oral Health Editorial Board (Dental Materials and Technology) is a Team Member of REALITY and lectures internationally on dental esthetics and dental technology. Dr. Freedman maintains a private practice limited to Esthetic Dentistry in Markham, ON.
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With Lasers: It’s the Wavelength, Power, Control, and Ergonomics; That Matters! By Scott D. Benjamin, D.D.S. The promotion, popularity, and success of laser treatment outcomes in other healthcare areas, like ophthalmology, have made patients more inquisitive about dental laser use. This desire facilitates the investigation and use of lasers in all aspects of dentistry by patients and clinicians alike. The benefit of laser use for soft tissue treatment and management is that treatments are often less invasive, more precise, and very conservative, preserving healthy tissue while treating the diseased site. When evaluating which laser is best important considerations are; who will use it, what procedures will be performed, why will it be beneficial, where will it be placed, and how will training be done. This simple, who, what, why, where, when and how philosophy, seems elementary, yet often over looked with new technology acquisition. This also translates into investigating; the science of laser physics, the ergonomics and device portability, the type of training, cost and dependability of the manufacturer. How the laser interacts with tissue is strictly dependent on laser physics. The science does not change from device to device, but the individual properties do. I am often asked, “When will we have one laser that will be the best to do everything?” With the introduction of the portable SIROLaser Advance we are as close as the laws of physics will ever permit for soft tissue procedures. This 980nm class laser’s wavelength takes advantage of soft tissue’s 70% water content which highly absorbs its light energy and enhances the laser’s ablating (vaporizing / cutting) efficiency. The absorption coefficient of the 980nm wavelength is by water 10 times greater than the 810nm wavelengths used by most other lasers. Additionally, because the 980nm wavelength interacts with tissue using light energy, as well as thermal conduction, it allows for water irrigation to cool surrounding tissues, controlling collateral thermal damage. This is not possible with most lasers in the 800-940nm range; their interaction mechanism is strictly thermal conduction which may be negated by the cooling process.
The SIROLaser Advance’s high 14 watt peak power with microsecond pulse feature allows microscopic tissue to be precisely removed with each pulse and allows thermal recovery (relaxation) between pulses, minimizing collateral tissue damage and post-operative discomfort. Other benefits of the portable battery operated SIROLaser Advance are its phenomenal ergonomics, with its integrated finger switch eliminating the need for another foot control, and its intuitive, easy navigation touch screen, simplifying its use and improving treatment outcomes. With increasingly significant differences being introduced into dental lasers, it is important to understand their enhancement values. It is the responsibility of clinicians to become knowledgeable about laser physics and select the best devices for their practices. It is imperative that practitioners become properly trained specifically on the lasers they use enabling the best patient care possible.
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A Move For The Better
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n 2008, after practicing for almost 20 years in the historic Medical Arts Building as the St. George Dental Group in Toronto, Drs. Michael Weinberg and Jay Niman faced a difficult and career changing decision. The University of Toronto had purchased the building and all existing tenants were asked to leave as soon as their existing leases expired. Not wanting to move with a gun to their heads, the two partners decided to exercise their renewal option and include a 30 day out clause. The decision when to move would be theirs alone and not the Landlord. Realizing that they needed professional advice in finding and securing a lease on a new location, the doctors enlisted the services of Anita Goodman of Devencore Realty. It was hoped that suitable space would be found along Bloor Street, maintaining the current proximity to the subway line. It became evident however that Landlords in the area were either unwilling to lease to dentists or provide the security of a longterm lease. Goodman discovered storefront space at 65 St. Clair Avenue East. It was within 100 metres of the subway and the 14-foot high ceilings created an instant attraction. It was not long before a long-term lease was negotiated and signed. The doctors then turned to designer Gloria Fine to create the design and décor that would take their practice to the next level. Fine had to create an environment that was not just for general dentistry but also for implant surgery as the identity of the practice was changed to St. Clair Dental Associates and the Midtown Centre for Dental Implants. Working with Henry Schein’s planning department, Fine used every inch of available space to allow for six operatories, custom sterilization unit, consult room, a staff room, laboratory and private office.
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Fall 2010 Dental Practice Management
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Office Design
Her choice of stone for the front desk and flooring in the common areas creates an aura of quiet elegance in a modern workspace. In the operatories, the professional vinyl flooring with the cove baseboards allows for the durability and sterility necessary in a surgical setting. The most stunning features of the office are the ceiling pods in the six operatories and the high cove ceiling with up lighting along the entire length of the hallway. Many aspects of modern technology are present in the office, the most important being digital radiography and the special lighting in the surgical ops. Patients are particularly pleased by the available Wi-Fi.
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Six months after opening the new location Drs. Weinberg and Niman welcomed Dr. Ted Margel and his team to the office. The new storefront location has exposed the doctors to a level of new patients never seen before. The doctors thank those responsible for seeing the project to completion: Shane Emer of Rease Construction for building the office; Graham Caisse and Ken Croney from Henry Schein; Gus Regas of Regency Custom cabinetry for all millwork; Jason Marshall of J-TEK Solutions Inc., for setting up the IT Network and the digital radiography. DPM
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Practice Management
Dental Patient Management Software
Requires Medical Device Licence Jeff Coward
O
n August 31, 2009, Health Canada issued a notice clarifying the classification of patient management software as a Class I or Class II medical device.1 Under the Food and Drug Act, Health Canada reviews medical devices to assess their safety, effectiveness and quality before authorizing them for sale in Canada. Since 2003, Health Canada has required manufacturers and distributors of dental products to obtain medical device licenses for their products. Until the August 2009 notice, dental
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patient management software operated in a “grey area” outside of the Health Canada’s medical device licence process. In the absence of specific language regarding patient management software, vendors were not compelled to seek this licensing. The notice issued on August 31, 2009 addressed this issue by clearly classifying patient management software as a medical device subject to medical device licensing requirements. Under the Act, software that is limited to archiving and viewing patient information, and does not involve the primary acquisition, manipulation and
Fall 2010 Dental Practice Management
transfer of data, is considered a Class I medical device and subject to Class I licensing. In contrast, Health Canada considers patient management software involved in image acquisition, data manipulation, data analysis, recording of measurements, graphing and flagging of results, or performing calculations to be a Class II device requiring a Class II licence. An ISO 13485:2003 Quality Systems audit is part of the medical device licensing requirements. ISO 13485:2003 certification addresses quality assurance of products, management of customer requirements, and
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Practice Management other elements of quality system management. Most dental software available for sale in Canada today includes some clinical functionality that falls under the Class II definition. For example, functionalities for the capture, import or export of digital images, the rendering and display of numerical data in a graphical format on an Odontogram, perio chart or report, and the compilation and presentation of data demonstrating treatment progress over time, are all covered in the definition of a Class II medical device licence. End users’ use of specific software features that fall under Class II guidelines is not a factor in determining the requirement for licensing. The onus is on the manufacturer to obtain the necessary licence if their product includes Class II functionality. In a notice issued on May 21, 2010, Health Canada provided guidance to manufacturers of non-compliant patient management software.2 The notice recommended that manufacturers determine the classification of their software
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by June 15, 2010 in order to have sufficient time to meet the licensing requirements. As of February 1, 2011, Health Canada will focus their compliance efforts on non-compliant Class I patient management software medical devices and, as of September 1, 2011, on noncompliant Class II patient management software medical devices. By those dates, all patient management software will be expected to have obtained the necessary licence in order to be eligible for sale in Canada. The Canadian Dental Association spoke to their membership in a news release dated March 5, 2010. 3 The release noted that “patient management software is considered a medical device and is therefore subject to compulsory licensing”. The news release further stated “the costs that vendors may incur as a result of these licensing requirements will likely affect the price or availability of some patient management software in the future. Dentists purchasing patient management software that includes any type of patient data manipulation capacity should
ensure that the software product is licensed for sale in Canada and has the appropriate Class I or II classification.” There is a strong need for quality standards to be upheld by the dental software vendor community, given the increasing use by dentists of software functionality that affects treatment decisions and the move towards a “paperless” or software-based practice. Health Canada’s requirements will ensure that dentists can select products and vendors that are subject to regular testing against a recognizable standard. DPM REFERENCES 1. www.hc-sc.gc.ca/dhp-mps/md-im/activit/announceannonce/md_notice_software_im_avis_logicels-eng.php 2. www.hc-sc.gc.ca/dhp-mps/md-im/applic-demande/ guide-ld/md_gd_suppliers_ im_ld_fournisseurs-ghtf-eng. php 3. www.cda-adc.ca/en/cda/ news_events/media/dentistry_news/2010/03_05_10.asp
Jeff Coward is the President of ABELDent Inc., and may be contacted at JeffC@ABELDent.com.
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Finance
A Professional Corporation –
Is It the Answer for Me? Lorne Dubros, CFP
I
n recent years, a number of professions across the country have passed regulations allowing their members to incorporate. This has prompted many professionals to ask whether or not incorporation is for them. What are the benefits? The drawbacks? Here is a review of some of the issues to consider when making a decision as to whether or not incorporation is right for you.
How Does A Corporation Work? When you choose to incorporate, all of your earnings are paid to the corporation, not to you individually. You would be the shareholder of the corporation (perhaps along with other family members or a trust, in those jurisdictions where trusts are allowed to be shareholders), as well as a director and officer of the corporation. Since you would be the person providing the services for which the corporation is bill-
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ing, the corporation would pay you a salary. Any amounts not paid as a salary would accrue within the corporation, gradually increasing the value of your shares. These amounts could be paid out to you (or the other shareholders) as dividends at such time as they are required. From a tax perspective, this can be advantageous, but only if you choose to leave some of the corporation’s earnings in the corporation itself. Here is how the taxation of your earnings works if you have a corporation: • If the business income of the corporation is paid to you as salary in the same year it is earned by the corporation, then the income will be 100% taxable at your regular personal rates, resulting in no tax savings. • If you choose to leave some (or all) of the earnings in the corporation, then the first $500,000 will be taxed at a low small business corporate
Fall 2010 Dental Practice Management
rate federally (and the first $400,000 - $500,000 will be taxed at a lower rate provincially, depending upon where you reside). • Any business income originally taxed in the corporation, but which is later paid out to you (or the other shareholders) as a dividend, will then be subject to tax in the hands of the shareholder who has received the dividend. The Canadian tax system has been structured so that generally speaking, the amount of tax paid by the corporation at the small business rate, plus the amount of tax paid by the shareholder on dividends will approximately equal the amount of tax that would have been paid had the shareholder earned the income personally. Therefore, a professional corporation is advantageous only to the extent that you are able to leave a portion of the earnings within the corporation and defer the personal
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Finance
level of taxation. If you require all of the earnings on an annual basis for living expenses, a professional corporation may not provide any tax savings. It is also important to understand that it is only active business income which will be taxed at lower rates. Therefore, you must be an independent contractor earning active business income, not an employee earning employment income in order to achieve any tax savings. If you are currently an employee, you may be able to reorganize your practice so that you are considered an independent contractor, but in some cases this may not be feasible.
Are There Any Other Advantages?
There may be some other advantages to incorporating: • Income Splitting Through “Dividend Sprinkling” – Even if you require all of your earnings on an annual basis to fund your lifestyle, a corporation may provide some tax advantages if you are able to divert some of the dividends to family members who are in a lower tax bracket. With an unincorporated business, the ability to income split is often limited to the payment of a “reasonable” salary for the services provided to your practice by your spouse or child. In contrast, there is no reasonableness test restricting the payment of dividends to a shareholder. So, in some cases it may be easier to “income split” with a spouse or an adult child or grandchild by paying dividends. (Anti-avoidance rules generally make it unattractive to pay dividends from private corporations to a person under the age of 18). In the context of professional corporations, however, you will need to determine whether the legislation for your profession in your province or territory permits non-professional shareholders. Some
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bylaws of the governing bodies for some professions, and the legislation for professional corporations in some provinces and territories, have placed restrictions on the persons eligible to hold shares in a professional corporation. • There may be increased protection from liability if your corporation is the entity which enters into various business contracts such as your office lease, supplier contracts, etc. However, there is generally no protection from personal liability with respect to professional negligence claims. • You may be able to pay off debt with partially-taxed corporate dollars, as opposed to fully taxed personal dollars (e.g. if your corporation buys a practice or invests in real estate). • Y ou may choose to pay insurance premiums with partially-taxed corporate dollars, as opposed to fully taxed personal dollars (however, if the corporation is the owner of the policy and pays the premiums, the corporation should also be the beneficiary of the policy to avoid negative tax consequences). • You may choose to create an individual pension plan (an “IPP”) instead of making RRSP contributions. Depending on your age, an IPP may allow you to make larger comprehensive contributions than would be allowed in an RRSP with the added benefit of the creditor protection provided under provincial or territorial pension legislation. There are costs to establishing and maintaining an IPP, including the cost of a periodic actuarial report to determine the amount your corporation will be allowed to contribute to the IPP. Contributions are 100% tax deductible, and the investments in the IPP are tax sheltered. Unlike an RRSP, investment losses can be replaced with additional contributions (IPPs are defined benefit pension plans), and interest paid on money borrowed to fund an IPP is
tax deductible. • Assets which are left in the corporation will continue to grow on a taxdeferred basis until such time as you choose to withdraw them. Unlike an RRSP, there is no requirement to wind-up the corporation at any particular time, or pay any specific amount of dividends in any one year Disadvantages of Incorporation It is important to understand that incorporating will come with a cost. In addition to the initial set-up and legal costs, there will be ongoing requirements to file annual tax returns and prepare corporate resolutions. Also, if you choose to incorporate, you will need to follow a number of formalities including: • Obtaining the consent of any third party to any current contract (such as a lease, loan, etc.) to transfer or assign it into the name of the professional corporation; • C hanging all stationery, telephone listings, etc. to reflect that it is now the corporation which is providing the services; and • Registering for a new Canada Revenue Agency (Revenu Québec) registration number for Goods and Services Tax and source deduction purposes. If you think that professional incorporation is right for you, speak to a consultant for more information, and always speak to a legal and tax advisor before incorporating to ensure you understand the implications of what you are doing. DPM
Lorne Dubros CFP, Senior Financial Consultant, Iorne. dubros@investorsgroup.com, (416) 4917400
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Book Review
PROFITABLE
PRACTICE REVIEW
Jordan Soll BSc, DDS
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n June of 1986, I contacted ROI Corporation to assist me in the purchase of my dental practice. The invaluable advice and guidance was instrumental in the successful purchase of one of my most profitable assets. At the age of 29, and borrowing what I thought was all the money in the world, it was important to have a knowledgeable representative to navigate the process.
emerging pitfalls to avoid. Little did I realize that obtaining the “inside edge” was easier than I knew and available to anybody with an interest. The pearls of information that are available to all are neatly contained in Tim’s book, Profitable Practice - Why a Dental Practice is an Exceptional Investment. Profitable Practice is an extremely easy, 193-page, must read; whether you are a new graduate or a dentist look-
“Leaving the Business Profitably”, helps the maturing dentist transition into a position of strength when planning for the eventual sale of the practice Through my representative at the time, Lani Brown, who is no longer active in the 36-year-old family run business, I became good friends with Lani’s brother Tim. I consider Tim to be one of the most knowledgeable sources of information in the area of dental practices past, present and future. In my quest to always keep up with the realities of our industry, I will often chat casually with Tim whenever our paths cross, hoping to get the “inside scoop” on potential opportunities to explore or
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ing at transitioning your practice. For the beginner, Tim thoroughly examines the pros and cons of the different scenarios from associating, purchasing an established practice, or starting out fresh. The information presented is the product of two generations of expertise in dealing exclusively with the purchase and sale of dental practices. Additional sections, such as “Strategies for Managing Staff”, are useful reference points to compare with your own practice or serve as a foundation for
Fall 2010 Dental Practice Management
a young practice’s office policies. The book also addresses “Optimizing Success” which incorporates tips and tricks that Tim has gathered over the years from the thousands of dental offices he has stepped into. The last section, “Leaving the Business Profitably”, helps the maturing dentist transition into a position of strength when planning for the eventual sale of the practice. Right up to the end, Profitable Practice gives you steak and not just sizzle by providing informative appendices. Some of the documents include sample associate agreements, practice transition manual, locum agreement and offer to purchase. Profitable Practice, beyond being an interesting read for dentists, no matter what stage of their career they are at, also serves as a resource as you pass through the various phases of your career. As our profession becomes more challenging from regulations, patient expectations, to the differences between generational attitudes of established and newly minted graduates, Timothy Brown levels the playing field in a no nonsense fashion. PM Dr. Jordan Soll is the Co-Cosmetic Consultant to Oral Health Journal and is principle of Aesthetics in Dentistry.
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Practice Management
Suzan Bekolay
MOTIVATIONAL INTERVIEWING: An alternative to the Marshall Art of Tongue Fu
W
hat happens between a dentist (or any auxiliary) and a patient is shaped by many curious and confounding forces. Confusion between beliefs, actions or words and intent can sometimes be far from what we mean to convey. The slightest adjustment can change the way we are perceived and ultimately impact how we are valued, trusted and most important of all; impact the health of patients. Many people think “I should” but they don’t. It’s a considerable challenge for dental practices where the “no pain – no problem” syndrome seems pandemic. In a way it is captured in the words, “you would think...” • You would think a person at risk to lose teeth to periodontal disease would be diligent with home care as recommended by the hygienist or doctor; • you would think when a person has experienced pain they would be interested in being proactive and follow recommendations before signs turn to symptoms;
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• y ou would think with education, rather than risking more involved treatment or losing teeth prematurely, people would choose to invest in other than patch-o-metrics. Motivational interviewing (MI) facilitates a natural process of change. Developed in part by clinical psychologists Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D., this client centric method, which deals with the phenomenon of change, came from their work with addictive behaviours including alcoholism and smoking. Emerging in 1983, 10 to 15 years later, this variant of client-centred counselling became one of the most popular approaches to the treatment of alcohol problems. The method was subsequently revised and enlarged (Miller & Rollnick, 1991), a research base emerged, and attempts were made to adapt the method to other client groups and settings. MI is now supported by more than 80 randomized clinical control trials across a range of target populations and behaviours, including substance abuse, health-promotion behaviours,
medical adherence, mental health issues and dentistry. To effect change, the model is to teach people, put something in to them, motivate them, convince or confront them. Although well intended, the Marshall Art of Tongue Fu often prevails; over-teaching, evangelizing, or overquestioning which can easily become manipulative or border on strong-arming. In contrast, Motivational Interviewing (MI) draws out a person’s own thinking and valuing. It coincides with the ideas that “people don’t care how much you know until they know how much you care.”
The Trouble with Questions Some promote the use of questions in dentistry; much of it coming from selling models. To continually formulate questions is not only difficult, it risks putting people on guard as the probing occurs. The created “reactance” can take on many forms including false agreement just to stop the uncomfortable feelings associated with interrogation.
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Practice Management The requirement to formulate questions puts a lot of pressure on professionals; to continually come up with the next “smart” question. Fearing or sensing reactance, anticipating misunderstanding or being unsure as to how to respond, the fall back for professionals is often to withdraw in silence and “wait”.
Where Education Fails Education often embodies negative future forecasts which risks the patient perceiving threat; thus feeling strongarmed. By teaching; using “perfect” logic a person can feel painted into a corner or exposed for poor choice or pressured to action; thus leaving them feeling somewhat manipulated and sometimes defensiveness becomes the coping mechanism.
sun made effort, nothing would happen.
Fruitless Insurance Paperwork & Reluctant Teams
Most auxiliaries do want to be helpful. What they seek is safety; a way that respects the patient’s autonomy and avoids feeling like they are being pushy. (The spirit of MI) Giving their best effort some may, for example, show a disturbing image hoping it will trigger change. This rather confrontational style often doesn’t. If “it doesn’t bother me” isn’t the defensive response, if the image is disturbing enough a patient will ask what needs to be done, quickly followed by “how much does it cost?” or “will my insurance cover it?”. Both are essentially objections and are no fun to handle.
Give them choices and wait Many professionals are clearly uncomfortable with “Tongue Fu” and believe the only right thing to do is provide all the options, consequence of options and leave the patient to choose. Unfortunately, leaving the patient at sea with a boat-load of choices also helps people get stuck.
Beyond EQ EQ (The measuring of EI; Emotional Intelligence) has value and gained popularity. More than enhance the ability to follow emotions, which is appropriate with intense emotional experiences, MI goes further having concrete objectives; triggering change and facilitating movement of people to action.
Learning from Aesop Aesop’s fable of the wind and the sun illustrates the distinction of MI. The wind and sun observing a traveller challenged each other as to which of them could be most effective in having the traveller remove his coat. (Change behaviour) The wind blew (an outside-in approach). The traveller clung tightly to his coat. Try as he might, the more the wind gusted, the more steadfastly the traveller held to his coat. The sun asked for his turn. Beaming brightly the traveller was quickly warmed (an inside-out approach) and removed his coat. (changed the behaviour). Obviously, if neither the wind nor
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What’s happened is that guiding has been replaced by telling or confronting via the image, thus triggering objections and defensiveness. By being forced to jump to remedies too soon by only showing a confrontational image without an appropriate conversational framework, effectiveness for change is difficult if not impossible to recover. By telling or confronting with reality, neither does anything to uncover the meaning of the problem as could be expressed or felt by the patient were guiding conversational skills employed. Worse, it can trigger a debate, give way to cognitive dissonance, or seem to demand the need to ask the patient a lot of questions, or teach more; all of which strengthen resolve for the status quo. “Lets see what insurance will do” often ends the interaction (said by the patient or team member) and not surprisingly leads to the next phase; “dial-
Fall 2010 Dental Practice Management
ling for dollars”. The conversational framework which can incorporate feedback like an image unfortunately requires much more explanation in order to be effective because the answer is part of a strategic process and not a “magic bullet” (tactic). This from Dr. Rollnick; “Despite the positive outcome of controlled trials and the apparent popularity of motivational interviewing, the commitment of counsellors to developing and extending their empathic listening skills will be critical to its survival. Without this commitment, motivational interviewing could be mistakenly viewed or practised as a set of simple techniques applied on or to clients. This approach is unlikely to be of enduring benefit...., since it involves discarding the use of the one element of motivational interviewing, empathic listening, which has stood the test of numerous research efforts.” (Dr. Stephen Rollnick; The Essential Handbook of Treatment and Prevention of Alcohol Problems) On the other hand, if a team member doesn’t believe your best and finest appropriate, it’s a whole other kettle of fish. It’s often more a matter of not understanding the service itself (as with joint based occlusion) than it is a values conflict with the practice. In a recent survey of top rung dentists, less than one percent of all CE is devoted to behavioural competence. Most CE is devoted to putting “more products on the shelf” or perfecting what too many patients don’t seem to want. It’s understandable because it’s the most comfortable thing to do for many committed clinicians. Interesting that while change is fundamental to prevention, so little CE is devoted to it. In the end, using Tongue Fu or doing nothing but wait, the status quo prevails. So much for prevention! For more information visit www. clickcoaching.ca. Contact: suzan@clickcoaching.ca or (613) 292-1978 DPM REFERENCES 1. Motivational Interviewing in Health Care: Helping Patients Change Behavior: Stephen Rollnick, William Miller and Christopher C. Butler (c) 2008 The Guilford Press. 2. Dr. William Miller, Distinguished Professor of Psychology and Psychiatry, University of New Mexico. 3. Dr. Stephen Rollnick, Department of General Practice, University of Wales College of Medicine.
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Dental Marketplace Contact: Karen Shaw • tel: 416-510-6770 • fax: 416-510-5140 • e-mail: kshaw@oralhealthjournal.com Toll free: CDA 1-800-268-7742 ext 6770 • Toll free: USA 1-800-387-0273 ext. 6770
Professional Services
ONTER CONSTRUCTION • Specialized in dental office design & construction. • In-house architect and interior designer. • We are qualified code consultants to review all drawings and make your building permit application easy. • Own millwork facilities for best quality of custom built cabinets and time control of your project.
Tel: (905) 793-2344
www.onterconstruction.com
Alglobe • • • • • •
Construction Company
20 years construction experience Dental office construction and design + cabinet making. Provide turn key operation to dental office. Reliable construction timing, Good following up service after construction. Call: Stanley New dental location and lease negotiation. Tel: (416) 321-3313 Save time, save money. www.alglobe.com
J.E.S. DESIGN INC.
PH. 905 726 4309 www.jesdesignservices.com DESIGN SERVICES Workplace strategies u Facility planning u New technology integration u
Interior design Construction drawings u Project co-ordination u u
JOHN McMILLAN — Barrister & Solicitor Serving Dental Professionals Professional Corporations • Practice Purchases and Sales Professional Agreements • Commercial Contracts Commercial Leasing • Regulatory Matters 8 King Street East 416 364 4771 Suite 1807, Toronto johnmcmillan@bellnet.ca McMILLAN LAW PROFESSIONAL CORPORATION
Dental Practice Advisory Services • Practice Purchase Consulting • Professional Corporation Tax and Investment Strategies • Financial Planning Contact us to receive a copy of Tomorrow’s Successful Dentist Victor Staniewski CA Fedder, Gurau & Staniewski victor@fgsaccountants.com chartered accountants 416-222-3221
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Dental Practice Management Fall 2010
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Professional Services
Careers
KEEP IMPLANTS IN-HOUSE GP awaiting periodontal certification is available to place implants for your patients. Experienced in surgical implant placement , implant related surgery and all aspects of periodontal surgery. Will travel to your office. Call at 416-277-1365 or e-mail at pragtipals@gmail.com
DENTAL IMAGING WITH CT IMAGING Dental CT image data is processed in-house at St. Michael’s Hospital with SimPlant ® software Features of Reformatted CT scans: • No Distortion • Accurate Measurements • Visualization of Internal Structures • Determine Bone Quality CT Scanning and SimPlant ® : • Can Increase Case Acceptance • Provide Case Predictability • Increase Referrals • Improve Cost Effectiveness • Reduce Overhead Reasonable fees – Mandible or Maxilla $300 – Both $500 FOR APPOINTMENTS OR MORE INFORMATION PLEASE CALL BETTY ANN LEBLANC 416-864-6060 x6112 www.stmichaelshospital.com/content/programs/medical_imaging/index.asp
LESS OFFICE RESPONSIBILITY EXCEPTIONAL OPPORTUNITY We are a progressive office in mid-town Toronto that is able to accommodate your existing practice 2-4 days per week. All aspects of practice management looked after. This is an ideal opportunity for someone facing lease termination due to sale and demolition, or simply wants to practice without additional stress. Our practice offers comprehensive care with a strong preventive model and on-site periodontist. Dreaming of an easier 9-5? Consider joining our high profile practice that is quality centered. Serious Inquiries Only: info@aestheticsindentistry.com
P
SPACE AVAILABLE
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OTTAWA, ONTARIO PRACTICE FOR SALE 20 year well established general Practice for sale. Three operatories. Central with easy access from Highway. Call 613-232-2610 E- mail: P_T_Y_B@hotmail.com
Fall 2010 Dental Practice Management
GTA PRACTICE WANTED I am looking for a large dental practice in the GTA, ideally with production in excess of $1M. I am flexible as far as transition terms go, whether you want to get your equity out while continuing to practice or if you just want out. Either way, save yourself anywhere up to 10% commission by selling your practice privately! If you’re interested, please contact me at: pract.wanted@gmail.com
PRACTICE FOR SALE OKANAGAN, BC
Practices & Offices
Great location in Aurora/Newmarket Area. Modern, caring family practice. Looking for associate dentist with existing clientele. Move your practice or retire with us Tel: 416-464-8051 Email: michael_aharon@yahoo.com
Practices & Offices
Ready for another long cold winter. It’s never really winter in the Okanagan. Live, work and play in Osoyoos. Enjoy desert climate and wine country. For sale info, contact a.singletondds@gmail.com
OFFICE SPACE STRIP SHOPPING MALL SOUTH SURREY, BC
Highly visible, well established location with documented, high new patient flow in the fastest growing area in the lower mainland. Modern 4 operatory, contemporary leasehold improvements, reasonable lease. Computer wired for paperless management. We’ve outgrown the office in less than 10 years are relocating. Connect your equipment and you are ready to go. Please email kcreek@telus.net, or call 604-576-8822 for more information.
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Practices & Offices GEORGETOWN DENTAL OFFICE FOR LEASE
Fully equipped dental office which can also be shared with other professionals. Map and photos available. E-mail: piotrk@sympatico.ca or tel: 905-873-4413.
OAKVILLE, ON
dentalclassifieds.com
Business opportunity. Excellent location for lease. Premium office space currently used as specialist office. Fully set up. Ideal for a new dentist, specialist or any other professional. Contact arielle@endoweb.com
Associateships ASSOCIATE REQUIRED IQALUIT, NUNAVUT
Experience the North in Canada’s youngest and fastest growing capital city. Well established clinic seeks associate with all-round skills. Generous fee guide in effect. Retention bonus payable to committed indiviual. Just three hours from Ottawa, Iqaluit offers a range of recreational activities. Call administration at (867) 873-6940, fax: (867) 873-6941 or write to Box 1118, Yellowknife, NWT X1A 2N8
BARRIE, ONTARIO
Needed : F/T Associate DDS position available ASAP. Evenings & Saturdays are a must. E-mail: dental_manager@hotmail.com
WILLIAMS LAKE, BRITISH COLUMBIA FULL-TIME ASSOCIATE
Full-time associate dentist position available in our modern, large, family dental practice with a 35 year proven track record. This is a great opportunity for a new graduate to gain excellent clinical experience and earn a SIX figure income while enjoying this outdoor recreation hotspot. Mountain biking, hiking, fishing, skiing, golf and kayaking all at our doorstep. Start day is July 2011. Call Perry collect 250-398-7161 (daytime); 250-398-9085 (evening); 250-398-8633 (fax) or vitoratos@shaw.ca (email) or visit www.cariboodentalclinic.com PART-TIME ASSOCIATE TORONTO, ONTARIO
KITCHENER, ONTARIO
A part-time associate required to join a progressive practice. Should work unsupervised. Self motivated, with highest quality of all aspects of dentistry in mind. Please e-mail resume to dr.gogniev@gmail.com
BRAMPTON, ON
Part time associate opportunity in Brampton for a quality minded, highly motivated, caring individual. Outline weekdays available. Saturday required. E-mail: dentalspots@gmail.com ASSOCIATE-PARTNER REQUIRED GREAT OPPORTUNITY! Busy, store-front plaza located in Scarborough area. Looking for highly motivated associate with a partnership potential. Great opportunity to grow into the 6 operatory practice. If you think you are the right candidate please fax your resume to 416-755-7025 or e-mail: innov.dentistry@gmail.com
TORONTO, ON
Associate for busy, modern practice, full-time Toronto. Complete range of services provided including orthodontics, periodontics, implants, oral surgery and sedation. An excellent opportunity for professional developments and higher than average remuneration. Call: 416-748-3353 or toll free 1-866-866-8437
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BRAMPTON, ONTARIO
DR. ELIZABETH DIMOVSKI’S DENTAL OFFICE Dentist required to join our well-established, busy practice. Self-motivated, caring individual, who can work unsupervised with the highest quality of all aspects of family dentistry in mind.
Fax resume to 905-458-7085.
SOUTH CALGARY / SUBURB PRACTICE
Part-time Associateship available for a Dentist interested in realizing an exceptional opportunity. Two consecutive days per week (Thursday and Friday) presently available with an opportunity to expand. Modern, busy practice with a well established patient base. Excellent team support. The ideal candidate will have 3 to 5 years of general dentistry experience and aspire to continually provide patients with high standards of general and cosmetic dental care. All inquires held in strictest confidence. Email resume to sbodentistry@gmail.com Successful candidates will be contacted.
Associate wanted, part-time or full-time for busy Kitchener family practice. Great location in a busy plaza. Position is replacing an existing associate who is relocating out of the province. Please fax resumes to 519-744-7354 or e-mail to mbensky@rogers.com
BUSY DENTAL PRACTICE IN NORTH SCARBOROUGH
Needed for weekdays & Satur days in an upscale dental office. Experienced dentist or new grad. With Canadian professional train ing experience preferred. Chi nese speaking an asset. Fully booked schedule. Apply with confidence. Fax resume 4164925567.
TORONTO CENTRAL ASSOCIATE OPPORTUNITY
Part time Associate with 2 years minimum experience required for well established modern dental practice. Please forward your resume and availability to dds.resumes11@gmail.com
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Associateships
REVELSTOKE, BC
SW CALGARY, AB
Full-time associate required for very busy, well established general practice in beautiful Revelstoke. Future partership opportunity for the right candidate. We are Canada’s most talked about Mountain Resort Town boasting a booming economy and world class skiing. Check out this mountain paradise at seerevelstoke.com. Please call 250-837-9431 evenings or e-mail: schwenck@telus.net
COLD LAKE, ALBERTA
Full Time associate dentist required immediately for very busy dental practice located in Cold Lake, Alberta. Please forward resume by email to ehan@telusplanet.net.
ASSOCIATE REQUIRED WOODSTOCK, ON
Our established busy Woodstock office is seeking a personable dentist to join our friendly team. We provide a full range of services including ortho, invisalign, implants, oral surgery, sedation, and laser treatment in our modern family practice facility. We offer excellent remuneration for the suitable candidate. Come and enjoy the benefits of a busy little town only 30 minutes from Kitchener or London. Please send resume with cover letter to Oral Health Box 998.
CALGARY/ EDMONTON
Full and part-time associates required for growing and established practices in successful areas of Calgary and Edmonton. Great patient flow, wonderful staff. For more information on our group, please visit dentalchoice.ca. All applications kept strictly confidential. Contact Candice at fax 780-444-9411 or info@dentalchoice.ca. Please identify which city you are applying for.
RED DEER ASSOCIATESHIP This is it……the opportunity I wish I had available when I graduated. Please help by taking over an established full time family practice for me. Just think; no worries about busyness; no management worries; no weekends. Incentives negotiable. Experience an asset. Reply in confidence to RDdentist@yahoo.ca for further information.
FULL TIME ASSOCIATE REQUIRED
Excellent opportunity for full time associate. Our newly renovated dental centre located in the High Prairie hospital is well established, busy, highly productive, and offers a stress free positive environment. All aspects of general dentistry with emphasis on oral surgery and implants. Be fully booked from day one. Principal dentist willing to mentor in oral surgery and implants. Enjoy boating, camping, fishing and hunting with the Lesser Slave Lake a mere 20 minutes away. New grads welcome! Apply in confidence to: High Prairie & Area Dental Centre Chyann Henderson Phone: (780) 523-4448 Fax: (780) 523-4434 Email: hpdental@telus.net
OTTAWA, ONTARIO
Do you want to be an Associate with the opportunity of becoming a partner? If so, we are a busy, progressive practice looking for a people oriented dentist seeking to associate with the opportunity of becoming a partner. Please fax resume to 613-523-5318. 32
This is an exceptional opportunity for an Associate to join our established, busy, high tech family and cosmetic practice in SW Calgary. Our practice includes the latest in technology with all the gadgets you’d expect from a state of the art clinic. Expedite your learning curve by years with Comprehensive Mentorship encompassing all aspects of dentistry including clinical techniques (injections, prep’s etc.) and proven effective patient communication. Candidates with a Proficiency in endodontics are preferred although all aspects of general dentistry will be performed. Email resume in confidence to newdentist@shaw.ca
KENT PLACE DENTAL
Seeking full-time or part-time associate for busy general family practice in Lindsay and Minden, Ontario. Excellent team in place and enjoyable work atmosphere. High remuneration. New grads welcome. Contact Dr. Rene Boljkovac at bobcaygeonfamilydentistry@hotmail.com
Fall 2010 Dental Practice Management
GEORGETOWN, ON
Family Oriented dental practice in Georgetown, looking for part-time associate. With possible full-time potential. Please send email to gtdentalclinic@bellnet.ca
PRACTICE IN IL, TX, MA, CT or PA Earn 250K-350K while working in a great environment with paid malpractice, health insurance and visa sponsorship. Must have started US boards. Fax: 312-944-9499 E-mail: hr@dentaldreams.org
DOVE DENTAL CENTRES Full-time associate required for one of their dental centres in London ON. Any inquiries, please e-mail to: dovedental@ody.ca
ASSOCIATE REQUIRED BURLINGTON/OAKVILLE AREA Part-time associate required for well established busy family practice. Applicant should be a positive easy going individual able to practice all aspects of dentistry. Potential for future full-time will be available. Please e-mail to drmgc@rogers.com
PERIODONTAL PRACTICE AB NORTH OF EDMONTON,
FOR SALE F/P Time Dentist required for First SASKATOON, SK 3 hours Nations Community approx. Established practice for sale providNorth of Edmonton, Alberta. Busy, ing comprehensive periodontal therapy modern, well equipped office has including implants. Tremendous growth excellent staff. potential in the implant of the pracAccommodations are aspect available. tice. Excellent location and staff.atGross Please contact Samantha income of 1.2M 4 days 780 on 891 2000 per or week. Contact: periopractice4sale@hotmail.com samantha.bownoskiye@bigstonehealth.ca
www.oralhealthjournal.com
Associateships SCARBOROUGH, ON
Well established, family practice requires part-time associate. Full range of dentistry offered. Friendly and supportive staff. Female, 2+ years experience preferred. E-mail resume/inquiries to dassoc@bellnet.ca
KITCHENER-WATERLOO ON
TORONTO, ONTARIO
Dentist Required- Part-Time leading to Full-Time. Experience preferred however, new graduates are welcome. Sheppard/ Allen Rd. area. Please e-mail resume to dinicolol@yahoo.ca Attention: Ms. DiNicolo
LONDON, ON
Progressive, energetic associate required immediately for full time position. We offer no evenings or weekends, great new patient flow, a full schedule, experienced staff and a relaxed office enviroment. Please forward resume to jawman_24@yahoo.com
Associate with experience required 2 to 3 days per week for very busy office. Contact office manager at tel: 519-619-1113, fax: 519-649-7714 or e-mail: m_atiya@hotmail.com
FULL-TIME ASSOCIATE NORTH BATTLEFORD, SK
MISSISSAUGA, ONTARIO ORTHODONTIC ASSOCIATE
Our practice offers an exceptional opportunity for a highly motivated and enthusiastic individual as a FULL-TIME ASSOCIATE. Established dental practice located in North Battleford providing comprehensive and progressive treatment to our large client base with excellent new client growth. A wonderful opportunity to join our professional team with future partnership. E-mail: willd@sasktel.net
Looking for an orthodontic associate for a stand alone office next to a busy dental center in Mississauga. Please fax resume to 905-286-4562 or contact 416-999-5712.
P/T / F/T ASSOCIATE REQUIRED NIAGARA AREA, ON
Associate required immediately for a busy, progressive dental office in Niagara Region. No evenings or weekends. Experience an asset. Fax resume to 905-871-5474.
DENTAL ASSOCIATE NEEDED
Associate required for Toronto Clinic. Overall excellence in performing the dentistry expected. Call 416-322-5155 or reply to: or dralaindds@yahoo.com
GENERAL DENTIST CALGARY, AB
Progressive, upscale office requires a strong clinical dentist with proven ability to produce $80,000 to $100,000 per month or higher. Will take over an existing client base due to family illness. Entire team is growth focused. Only applicants with a desire to continue education & personal growth will be considered. Successful candidate will enjoy creating personal relationships and believe in extraordinary care for guests. A clinically strong, high energy, self starter with defined professional and personal goals will fit our culture. Potential for future partnership will be considered. To apply for this exceptional opportunity please apply directly with resume and cover letter to Box8282@gmail.com
www.oralhealthjournal.com
FULL TIME ASSOCIATE REQUIRED ORILLIA,ON Large, newly renovated office located in beautiful cottage country. Thirty minutes north of Barrie, Ontario. Opportunity available to buy into the practice in the future. Call or email for more information. heatherflemming@reach.net or drhill@reach.net. Phone: 705-326-7874 Orillia, Ontario.
PART TIME ASSOCIATE REQUIRED NORTH VANCOUVER, BC Established modern family practice requires part time associate to replace current associate. We are looking for someone with at least 2 years experience, ability to use Cerec an asset. Future Buyin option for right candidate. Please e-mail resume to: rodchow@shaw.ca
CALGARY,AB
Busy general practice in Calgary requires full time associate dentist. Digital office. Some extended hours expected. New grads welcome. Confidentiality assured. Inquire at dentaljobsforu@live.com and fax at 403-398-0518.
IMMEDIATE OPENINGS FULL/PART TIME
HALIFAX, N.S. - Near water or nature with a long term career in General Dentistry. We have great opportunities for those experienced wanting to dive/ walk right in. Call Today – Positions must be filled 902-835-4222, ext. 223
dentalclassifieds.com BRAMPTON, ON
Dental Associate needed in a busy family practice in Brampton. New grads are welcome. Please fax resume at (905)915-2123. GP + ORAL SURGEON ASSOCIATES – MISSISSAUGA Vibrant+ busy group practice near Square One seeks bright, personable and experienced candidates p/t. email: ddsstaffsearch@gmail.com
KITCHENER/WATERLOO, ON
Seeking Full Time Associate in Kitchener/ Waterloo area. Great opportunity for an independent dentist to work with complete autonomy at higher than average income. Email: kwdentalgroup@gmail.com
ENHANCE DENTAL CENTRE REGINA, SK Looking for full time associate asap...8-5 Monday to Friday....new modern practice just 3 years old and expanding....best staff and equipment...great location and patient flow. Call for interview.... Dr. Tony Romaniuk... 306-757-7645
SPECIALIST REQUIRED GUELPH, ON A new Oral Surgery Clinic in Guelph is looking for a Specialist to share in a new, spacious Clinic. Great location with lots of free parking. Please email: drcooperband@gmail.com for more information.
Dental Practice Management Fall 2010
33
Associateships
ASSOCIATESHIP WANTED TORONTO, ON
www.broadwaydental.ca
BROADWAY DENTAL ASSOCIATES • Experience the Medicine Hat advantage. • Protect your career from gridlock. • You are interested in predictable community living. • How do you value family time? • Lowest tax and utility rates in the province. • Children walk to nearby schools. • Highest grossing private practice in Southeastern Alberta. • Enjoy all the technological advances in today’s dentistry. • Achieving excellence with our experienced team is assured. • You are interested in above average compensation. • Check out our website, contact Dr. Greg Bradley. • Home of the Medicine Hat Tigers, the team has won two Memorial Cups, five WHL Championships and seven Division Titles. 101 - 7 Strachan Bay S.E. • Medicine Hat, Alberta • T1B 4Y2 Ph: (403) 548-7000 Fax (403) 548-7111 Toll Free 1-888-607-6453
OAKVILLE,ON
With 5yrs + exp. in Calgary SW (Mission) area to serve our long term patient base. All phases of dentistry. Weekdays, no evening or weekends. Good location. Mature or semi –retired dentist welcome. Email: gillesdental@yahoo.ca
Periodontist required for a busy, well established Specialist office in Oakville. Full or part time. New state of the art facility. Contact arielle@endoweb.com
WOODSTOCK,ON
LONDON, ONTARIO
Established Woodstock Dental Practice requires an Associate for 1-2 days per week. No evenings or weekends. Above average remuneration. Recent graduates welcome. Fax resume to 519-537-8911 or email to gnidec@rogers.com Attention: Trish Gnidec.
ASSOCIATE required for family and cosmetic based practice. Please email CV to TDsuite@hotmail.com
ORAL SURGEON NEEDED MISSISSAUGA, ON
MISSISSAUGA, ON
Busy Dental Office looking for an Oral Surgeon 2 days/month to start in Mississauga. Fax resume to 416-622-3838 or E-mail: doctorkannan@hotmail.com
TORONTO,ON
Associate wanted for a busy practice. Part-time, flexible schedule. Please call 416-568-1153. 34
Looking for dental associates in a Mississauga area for two to three days a week. E-mail your resume to kannanpethaperumal@yahoo.com GREAT EDMONTON, ALBERTA ASSOCIATE POSITION
Associate leaving to serve the ADA. Very busy and productive office with a great team. Please forward your resume to AponiaDental@gmail.com or call Krista at 780-944-1999
Fall 2010 Dental Practice Management
Oral Health Classified Ads
Equipment
DIGITAL PAN FOR SALE
Reduced for quick sale to $29,900.00 or best offer. Orthophos 3 Digital Panoramic machine with a brand new tubehead, multimeter, ribbon cable, DXI board, etc… This unit has been totally renewed and comes with warranty from Patterson. The pan was appraised at $50,000.00. Where else can you find a Sirona pan for that price?!! Contact Sylvia at smilemaker1@incentre.net or call us at 1-780-352-5113.
FIRE SALE
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ASSOCIATE REQUIRED CALGARY, AB
I am an experienced dentist moving back to Toronto and I am looking for a part-time associate position in the GTA. My experience includes placing and restoring implants, performing molar endos as well as endo retreats and cosmetic procedures. If this sounds like it might be a good fit, please feel free to contact me for an interview at: assoc.wanted@gmail.com
TWO complete dental delivery ops, with chair, light, stool, cuspidor. Kavo Systematica 1032. Good condition. $2500 each or best offer. Please call Chin at 416 977 8877.
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