ARTICULATOR MDDS
Connections for Metro Denver’s Dental Profession
Winter 2013 Volume 18, Issue 2
WINTER'S AND THE 2014 RMDC IS JUST UP THE ROAD!
HERE COMPLETE CARE HYGIENISTS: THEIR ROLE IN TREATING OCCLUSAL DISEASE 8 THE WOLVES WITHIN 11 DIGITAL INTRAORAL IMPRESSION SYSTEMS SHIFTING INTO THE REALM OF DIGITAL DENTISTRY 12
PREVENTING INSURANCE CLAIMS ISSUES FROM TAKING OVER YOUR PRACTICE 14 COLORADO SUNSET REVIEW: CHANGING OUR STATE DENTAL LAWS 20
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ARTICULATOR MDDS
Connections for Metro Denver’s Dental Profession
Volume 18, Issue 2
MDDS Articulator
mddsdentist.com
Winter 2013
Inside This Issue:
Editor Carrie Seabury, DDS Director of Marketing and Communications Jason Mauterer Creative Manager & Managing Editor Chris Nelson Communications Committee Anil Idiculla, DMD, Chair Maria Juliana DiPasquale, DMD Karen Franz, DDS Kelly Freeman, DDS Brandon Hall, DDS Jeremy Kott, DDS Nicholas Poulos, DDS Maureen Roach, DMD Jennifer Thompson, DDS MDDS Executive Committee President Mitchell Friedman, DDS President-Elect Larry Weddle, DMD Treasurer Ian Paisley, DDS Secretary Sheldon Newman, DDS Executive Director Elizabeth Price, MBA, CDE, CAE Printing Dilley Printing The Articulator is published bi-monthly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership. Editorial Policy All statements of opinion and of supposed fact are published under the authority of the authors, including editorials, letters and book reviews. They are not to be accepted as the views and/or opinions of the MDDS.
A Letter From the President...............4
Spread So Thin ..............................18
Member Matters...............................5
Colorado Sunset Review: Changing Our State Dental Laws............................20
Laissez Les Bons Temps Roulet...et Roulet..............................6
Online Reputation Marketing - Is It Building Your Practice or Costing You A Fortune?....21
Complete Care Hygienists: Their Role In Treating Occlusal Disease.......................8
Creating Powerful Practices By Enhancing Emotional Intelligence..........................22
The Wolves Within........................... 11 Event Calendar..............................24 Digital Intraoral Impression Systems: Shifting Into the Realm of Digital
It’s Never Too Early To Plan
Dentistry........................................ 12
For Retirement.....................................27
Preventing Insurance Claims Issues From
D.I.S.C. 10-Year Anniversary..............29
Taking Over Your Practice ...................14 Classifieds......................................31 Colorado Orthodontic Foundation Increases Provider Involvement.............................. 17
The Articulator encourages letters to the editor, but reserves the right to edit and publish under the discretion of the editor. Advertising Policy MDDS reserves the right, in its sole discretion, to accept or reject advertising in its publications for any reasons including, but not limited to, materials which are offensive, defamatory or contrary to the best interests of MDDS. Advertiser represents and warrants the advertising is original; it does not infringe the copyright, trademark, service mark or proprietary rights of any other person; it does not invade the privacy rights of any person; and it is free from any libel, libelous or defamatory material. Advertiser agrees to indemnify and hold MDDS harmless from and against any breach of this warranty as well as any damages, expenses or costs (including attorney’s fees) arising from any claims of third parties. Inquiries may be addressed to: Metropolitan Denver Dental Society 925 Lincoln Street, Unit B Denver, CO 80203 Phone: (303) 488-9700 Fax: (303) 488-0177 mddsdentist.com ©2011 Metropolitan Denver Dental Society
Member Publication
Update Your ADA® Find-a-Dentist™ Profile at the 2014 RMDC with a Free Professional Photo So many patients are turning to the web to find their dental resources, it's critical to take advantage of this tangible tool. Visit the photo booth in front of the Expo Hall at the 2014 RMDC for a free professional photo which will be used to update your ADA member profile. You will also get to take your photo with you on a USB drive for personal use.
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A LETTER FROM OUR PRESIDENT Marketing Pitfalls By Mitch Friedman, DDS
T
imes have certainly changed when it comes to marketing a dental practice. When I graduated back in 1978, dental practices did very little marketing, and there was no Internet, no smart phones and no yellow page ads. Now, it’s more important than ever to create successful marketing strategies to attract new patients. Our members should beware of utilizing any marketing strategies that could be construed as misleading to patients. For example, if offering very low cost x-rays, including an exam and cleaning, be careful not to add on fees when the patient comes in for his/her
"Now, it’s more important than ever to create successful marketing strategies to attract new patients. " appointment. Also, be aware that the patient may expect this same fee structure each time they visit and could be disappointed if it is not honored each visit. Be wary of offering “new teeth in only one day,” as we all know that many times the patient may have multiple areas that need to be addressed over more than one visit. Many of these marketing strategies do get patients into the door, but if the patients do not receive what they believe they were promised they will not return. This could do more harm to a practices reputation by word of mouth and on social media than the advertisement was worth. There are other marketing strategies that actually do work and get people in the door such as “free whitening for new patients or for a referral.” However, your practice model has to be able to accommodate a good deal of free whitening. You need to be able
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to track the amount of new patients who are utilizing this and are also returning for their routine dental care and making your practice their new dental home. One of the most effective ways to market a dental practice is to have existing patients refer their family and friends to your office based on their personal, positive experience. With access to ever improving technology, dentists can develop informative websites which visually communicate their unique ideals and expertise. Direct mail, including the mailing of a special, custom brochure, can be used to market a dental office. Professional websites and direct mail cost money and an adequate marketing budget needs to be maintained to support any dental practice. Marketing must have a personal touch that appeals to the type of patients you wish to attract. It’s crucial
to work on constantly improving the “new patient experience,” to develop a continual referral system. It’s important to strive for a high reappointment rate, and keep track of the percentage of patients who schedule their next appointment. Times have changed and the economic climate has made it more difficult for many dentists, but as long as we market ethically and wisely, with excellent patient care as a priority, we will succeed. On another note, our MWDI grand opening was a huge success. If you have not yet seen it, please call and stop by for a tour. It is truly a state-of-the-art learning facility that will serve our members with world class economical CE for years to come. Mitch Friedman, D.D.S President, MDDS
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Winter 2013
MEMBER MATTERS
Grand Opening of the Mountain West Dental Institute – Sept. 19, 2013
New Members, Welcome!
The crowd gathered in the MWDI auditorium for the Grand Opening.
Drs. Charles Danna, Mitch Friedman and Larry Weddle cutting the ceremonial ribbon.
The MDDS Board of Directors sharing a toast to the new facility.
Dr. Fernando Astorga Dr. Steven D. Barney Dr. Dennis W. Black Dr. Courtney A. Bourret Dr. Peter D. Brink Dr. Evan T. Cettie Dr. Tristan O. Collins Dr. Angelica M. Damian Dr. Aaron W. DeGarmo Dr. Jason T. Difani Dr. Jack E. Emmons Dr. Jean M. Felton Dr. Tamara L. Fernandes Dr. Tiffany L. Fritz Dr. Hua Gao Dr. Daryl J. Gasca Dr. Sarah Glatt Dr. Todd M. Juhlin Dr. Max J. Klingenstein
Dr. Lawrence M. Kuljis Dr. Amy E. Lahm Dr. Bruce W. Lee Dr. Courtney S. Lundin Dr. Hani M. Marogil Dr. Michael S. McCormack Dr. Michael Millward Dr. Afsaneh S. Noori Dr. Anil P. Nutakki Dr. William S. Rasband Dr. David M. Rebber Dr. Dennis M. Thompson Dr. Michael K. Townsend Dr. Kami K. Wallner Dr. Thomas N. Wanat III Dr. Zachary T. Wells Dr. Paul S. Weyman Dr. Michelle H. Yang Dr. Sujin Yi
MDDS & CDA Editors at 2013 AADE Annual Conference
American College of Dentists New Fellows - Oct. 31, 2013
Dr. Carrie Seabury, MDDS Articulator Editor, and Dr. Michael Diorio, CDA Journal Editor, attending the 2013 American Association of Dental Editors Annual Conference in New Orleans, LA.
Drs. Larry Weddle, Michael Scheidt, Shauna Gilmore and Brad Guyton (Not Pictured: Nate Reynolds)
Congratulations,
Dr. Robert Berry A native of West Virginia, Dr. Berry graduated dental school from West Virginia University. He excelled in the clinic and participated in the Honors program helping underclassmen. After dental school he worked in a small Texas town, treating all types of people. As a member of the Army National Guard, Dr. Berry has undertaken humanitarian dental trips to Nicaragua and the Navajo Nation as
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well as several other areas of need. Dr. Berry embarked in building MountainAire Dental this summer, a 2,100 square foot office in Broomfield, including a four chair open bay, pano room, private operatory, sterlization, lab, private office, reception and waiting room. He is currently growing his patient base and exploring new ways to perfect customer experiences.
(303) 637-0981 info@bvgci.com
Articulator
Winter 2013
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REFLECTIONS REFLECTIONS Laissez Les Bons Temps Roulet...et Roulet By Carrie Seabury, DDS
T
he ADA is no John Cusack. Allow me to further my point. The ADA never starred in any 1980’s quirky but classic blockbuster movies nor did it ever serenade me outside my window with a boombox blasting Peter Gabriel. Unlike John Cusack, the ADA cannot be linked back to Kevin Bacon in seven actors or less. John Cusack was born in the same hometown as I was - the ADA was not. To my knowledge, the ADA has never been willing to soak it up in a hot tub time machine. Final thoughts? Cusack. For the Win. It makes me wonder what in the world the ADA has done for me lately? What has the ADA done for YOU lately? My job, right here and right now, is to tell you what the ADA is doing for us. I’m here to preach. Give me a busy street corner, a milk crate to stand on, some old cardboard to make my sandwich sign and a really fuzzy sound system. Scratch that. Give me a hoppin club and two tables and a mircophone, and I will DJ the pickles out of the ADA remix. So check it…. Today I am fresh off the plane from New Orleans where I attended the ADA Annual Session. Okay, fresh is not quite the right adjective. My trip to Louisiana involved hard work, hard play and a humidity level of 397% (approximately). It was a fantastic trip and I am going back to my office tomorrow ready to talk anyone’s ear off about the current state of the dental field. I learned so much through the American Association of Dental Editors (Yes! We have one of those!) and through my experience with the ADA House of Delegates. I’m ready to take every MDDS member AND non-member out to lunch and tell them just exactly what is happening outside the walls of our practices. There’s a whole dental world out there and I feel like I just opened my eyes to our national dental gossip hotline. OOOOeeee girlfriend! Saddle up to that barstool I ganked for you and go ahead and order yourself an appletini because it’s gonna be a long night! TO THE NEW DENTIST: This is how much Papabear ADA loves you. There is significant rising concern about the amount of debt our new dentists are graduating with. Tuition for dental school is on the rise nationally and the ADA House of Delegates members created and passed a two new resolutions pertaining directly
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to our incoming students. They read: “Resolved, that the ADA encourage dental schools, as part of their application and interview process, to disclose the actual costs incurred by their students to complete their degrees based on exit data collected for the two most recent classes.” and in a separate resolution: “Resolved, that the appropriate agencies of the ADA develop presentations for pre-dental students explaining the long-term financial implications of debt incurred during dental school.” Bottom Line? Oh yeah. Papabear makin sure no sweet-eyed innocent lamb is gonna have the wool pulled over her eyes. TO THE DENTIST WORKING IN A CORPORATE ENVIRONMENT: Papabear ADA loves himself his corporate colleagues and always has your back! The members of the ADA House of Delegates raised their voice in order to protect our colleagues working in a corporate setting. Their voice does not speak out against corporate dentistry – the members of the ADA want to make sure that the dentists working in the corporate environment are able to maintain a compassionate patientdoctor relationship in every work environment. I pulled out an excerpt to save your brain cells: Resolved: ….”An employee dentist should not be disciplined or retaliated against for exercising independent professional judgment in patient assessment, diagnosis, treatment and comprehensive management.” .. Bottom Line? Oh yeah. Papabear makin sure you can always make the safest, most beneficial recommendations for your patients. TO THE DENTIST ACCEPTING MEDICAID: You work every day to do the right thing and to help those in need. Papabear wants to protect you from any unfair auditing proceedings. Currently in the state of Colorado (and many other states in our nation). Medicaid providers can be subjected to a contingency based audit. While audits are imperative to eliminate fraud and abuse of our system, the contingency-based audit has several
elements that are unfair to the honest dentist. The auditor is highly motivated to find errors because he is paid a percentage of what he finds. The auditor is also allowed to extrapolate data across an entire practice after auditing a selected number of dental charts. The resolution proposed at the ADA House (by our very own State of Colorado) reads: “Resolved, that the appropriate agencies of the ADA study and evaluate how Medicaid audits are conducted, as well as explore options for improving the current audit system by revising contingency based audits, and be it further Resolved, that the appropriate agencies of the ADA coordinate with other healthcare organizations/ associations to develop a politically prudent, fiscally responsible federal legislative effort to revise contingency based audits as determined by the ADA Council of Governmental Affairs and/or the ADA Board of Trustees, and be it further Resolved, that the ADA advocate for auditing procedures that include appropriate professional participation.” .. Bottom Line? Oh yeah. Papabear watchin you auditors now. I came to New Orleans as a first-time alternate delegate with a skeptical mind. I didn’t know where my dues were going; I didn’t know if the ADA actually cared about me. Just like the kid chasing John Cusack in "Better Off Dead", I was shouting “I want my two dollars!” Every dollar I spend right now at this stage of my career is critical. I want to know where my money is going and if my concerns are valued. I was impressed by the amount of times I heard the phrase “member value.” It is at the top of every delegate’s mind. Everyone in the House is doing their part to ensure that our dues money is spent sparingly and only on issues that are at the heart of our members’ concerns. The victories that the ADA has won and the battles they are fighting affect the direction my practice is going. I don’t have time to fight the battles necessary to keep my practice in my hands and out of the hands of people that don’t truly understand our field. I need to devote my time to my patient care. But you are darn tootin that I’m going to check up on the ADA and make sure they are fighting for me. I’m going to stay active and involved and passionate about our field because it is my lifeline. And it’s yours too.
Articulator
Winter 2013
PROFESSIONAL MARKETING AND APPRAISAL
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COMPLETE CARE HYGIENISTS: THEIR ROLE IN TREATING OCCLUSAL DISEASE By Kimberley D. Daxon, DDS
T
he responsibility of today’s dental hygienist has evolved into a critical health care advocate for our patients. These are the duties of the dental hygienist as defined by the American Dental Association:
patient screening procedures; such as assessment of oral health conditions, review of the health history, oral cancer screening, head and neck inspection, dental charting and taking blood pressure and pulse taking and developing dental radiographs (x-rays) removing calculus and plaque (hard and soft deposits) from all surfaces of the teeth applying preventive materials to the teeth (e.g., sealants and fluorides) teaching patients appropriate oral hygiene strategies to maintain oral health; (e.g., tooth brushing, flossing and nutritional counseling) counseling patients about good nutrition and
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its impact on oral health making impressions of patients' teeth for study casts (models of teeth used by dentists to evaluate patient treatment needs) performing documentation and office management activities In a Complete Care practice, where Pete Dawson’s timeless principles are studied and implemented, the dental hygienist assumes a much bigger role. In addition to the above duties, a Complete Care hygienist must also assess the relative stability of our patients - periodontal stability AND occlusal stability. How do we know if our patients’ oral health is deteriorating? Do we wait for them to develop symptoms? As Pete teaches us, if we wait to treat based on symptoms, then the disease process is far too advanced. Recognizing the signs is key. Educating patients about the disease process caused by bacteria (decay and periodontal disease) is second nature for hygienists. They understand the implications if no treatment is done because they know and understand the cause and effect
relationship and they are confident in explaining this to our patients. Untreated decay will lead to root canal therapy; untreated periodontal disease will lead to loss of teeth. Treatment acceptance for these disease processes is typically very high. But what about the disease process that causes wear of the teeth, tooth migration, abfraction lesions and fremitus? Our hygienists are faced with these signs every day, but do they see them? Do they understand why they are occurring? If they don’t understand why they are occurring, then certainly we cannot expect our patients to understand! A Complete Care hygienist is equipped with the necessary knowledge to help patients understand the occlusal disease process and what will happen if no treatment is done. It is having a thorough understanding of the Masticatory System that enables them to assess and educate patients in this way. Pete refers to the dentist as the “Physician of the Masticatory System.” I refer to the hygienist as the “Physician’s Assistant of the Masticatory System!" Occlusion is but one part of the Masticatory System. Understanding occlusion is essential in a Complete Care practice. Understanding
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Winter 2013
RMDC CONNECT occlusion helps us to understand why teeth get loose, drift and wear down. When the teeth are not in harmony with the other parts of the system, the temporomandibular joints and muscles of mastication, then sore teeth, headaches and orofacial pain can develop. Occlusal disease is damage to the biting surfaces of the teeth and occurs when there is disharmony with other parts of the system. Due to the frequency of visits patients should have with their hygienist (every 3, 4 to 6 months), the Complete Care hygienist is the key team player
full awareness and understanding. This is a process and can take time. The stronger the hygienist-patient relationship, where faith and trust are at the highest level, the faster this process occurs, assuming the hygienist has the knowledge and has learned the necessary verbal skills to be effective. Options for treating occlusal disease may include night guard therapy, equilibration and/or restorative dentistry. Treatment acceptance is influenced by many things – fear, finances, and time to name a few – but most importantly - the patient’s ability
"The Complete Care hygienist is the key team player in recognizing, discussing and helping patients move to action in treating occlusal disease. " in recognizing, discussing and helping patients move to action in treating occlusal disease. At each hygiene visit, the hygienist is looking for signs of occlusal instability, checking for mobility, fremitus, and wear. Recession and full mouth probings are measured and changes are recorded every time. Increases in these values cannot be attributed solely to an increase in bacteria levels. The Complete Care hygienist understands that periodontal therapies will be much more effective if the role of occlusion in periodontal disease is understood. Starting with simple conversations and analogies, the Complete Care hygienist can help to transition a patient from complete unawareness of his or her occlusal disease to
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to understand the implications of not doing treatment. What happens if treatment is delayed? Will more extensive and costly treatment be necessary then? The Complete Care hygienists play a key role in helping our patients understand the implications of not treating occlusal disease and encouraging them to see the dentist for complete evaluation, diagnosis and treatment. Their ability to detect changes in the system and identify the signs of occlusal disease, early on before symptoms begin, is the key to long-term dental health and stability for our patients!
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Articulator
Winter 2013
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PERSONAL WELLBEING
THE WOLVES WITHIN
By Deanna M. Goodrich, RDH, Executive Coach for Fortune Management
L
eadership is a big word with a broad, deep, and pervasive meaning. You know it when you see it. You know when it is missing.
To help understand the powers of leadership, let’s look at a tale of a Native American grandfather, a Cherokee man who was teaching his grandson about life. He said, “A fight of Leadership is going on inside of me. It is a terrible fight between two wolves. One wolf represents pessimism: fear, anger, envy, sorrow, regret, and superiority. The other wolf stands for optimism: joy, peace, love, hope, generosity, truth, and compassion.” As the little boy listened to his grandfather speak of this terrible conflict he asked, “Which wolf will win?” The grandfather simply replied, “The one that I feed.” Feeding the optimistic wolf begins with you! Choose to enlarge your vision. Where are you now and where would you like to be? We can all relate to leaders such as Mahatma Gandhi, Nelson Mandela, Mother Teresa and Martin Luther King, Jr. The common thread here is they had strong principles and solid beliefs. They had an ability to influence others through hope and optimism by creating a cause that other’s could relate to. Attract the good around you. Hire a world-class team. Your team is your best asset. Leadership is less about doing and more about being for others. As John Quincy Adams, the 6th US President of the United States explains: “If your actions inspire others to dream more, learn more, do more and become more, you are a leader.” Step forward everyday. Create goals daily for the mind/body/ spirit. The power in setting goals shows in happiness and in achieving financial rewards. Did you know that by writing and sharing goals with a trusted person multiplies your chances of success by three times?
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Prepare for success. Attend continuing education opportunities, get involved with a mastermind group, and surround your self with ideas and innovative minds. We know what we know, but opportunities lie in what we don’t know. Believe in yourself. What if you had no limiting beliefs or there was no meaning attached to the word fear? How would this change your life, your practice, and your relationships? Man is what he believes – believe in yourself. Plan before you do. There are five steps to be taken to create massive results. 1. Define the gaps 2. Determine what the end project looks like 3. Create a plan and act 4. Measure the results 5. Refine the plan. (Sometimes a tweak is all that is required to fulfill the goal) Ask questions and question everything. The most basic of all human needs is the need to understand and be understood. Move outside your comfort zone. Get comfortable with being uncomfortable. “If we keep doing what we’ve always done, we will keep getting what we already have.” Begin with the end in mind: Imagine if you and your team were stranded on an island and the only way to safety was to build a ship. Would it be wise to assign tasks of how to collect the wood, plan the design, and build the ship? Or would it be wise to inspire your team to long for freedom, safety, and courage? This is leadership and the end begins with you. Deanna Goodrich, R.D.H., is an executive coach with Fortune Management. She can be contacted at deannagoodrich@ fortunemgmt.com or 720-810-3760.
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TECHNOLOGY
DIGITAL INTRAORAL IMPRESSION SYSTEMS
Figure 2: 3Shape’s TRIOS® has a unique autoclavable scanner tip on the powderfree device that allows the user to rotate the scan source from the mandible to the maxilla, capturing up to a quadrant in 25 seconds.
Shifting into the realm of digital dentistry. By Todd R. Schoenbaum, DDS, FACD
W
ith the advent of digital intraoral impression systems, the clinical side of restorative dentistry has only just begun its foray into the world of digital dentistry. Though the technology has been available in some form for over 25 years, it has only just begun to gain momentum and widespread acceptance. Much like other revolutionary technologies—eg, osseointegrated implants and dentin bonding systems—these developments have not been without their unique difficulties and detractors. Clinical dentistry has deep roots in a tradition of excellence and as such, often has difficulty adapting to evolving demands and techniques that do not immediately live up to previous standards of excellence and efficiency. However, it would be disappointing if the highest levels of clinical success were reached decades ago and any future developments were constantly labeled as inferior methodologies due to difficulties in the evolutionary process of a newer technology. Where would the profession be today were it not for the pioneers of implant dentistry who struggled through the challenges with early iterations of the field? Where would dentin bonding and adhesive science be if not for those clinicians, researchers and manufacturers who led the way through the earliest versions of the procedures?
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Admittedly, some of the initial results from digitally manufactured restorations were vastly inferior to other, more traditional, methods of
Figure 1: Glidewell’s IOS FastScan® scans 40 mm per second and includes built-in motion control software that maintains accuracy and eliminates hand-movement distortion.
production. Unfortunately, some of these early results have led clinicians and technicians alike to write off any and all similar technologies after over 20 years of refinement. The digital intraoral impression devices of today (and tomorrow) like Glidewell’s IOS FastScan® and 3Shape’s TRIOS® (Figure 1 and Figure 2) are vastly superior to what they were decades ago. Levels of marginal accuracy that surpass anything the
profession has been previously able to create with lost wax techniques on stone models have been demonstrated. But marginal accuracy and internal fit are only part of the path to clinical excellence. With intraoral digital impression devices, collaboration between clinicians and technicians can reach previously unimagined levels. Offsite laboratories can collaborate with their doctors on cases while both viewing and modifying the same three-dimensional (3D) representation of the definitive restoration. Casts—which are now more properly described as “models” because most are milled or printed, not “cast”—will likely evolve into an optional resource for the fabrication of basic restorations. More complicated prosthetic treatments will continue to require a model upon which to finalize the function and esthetics. Innovative new restorative materials that inherently require the use of a digitized model to be fabricated have been developed—for example, zirconia frameworks and prostheses that can only be milled. Ease of use in the demanding clinical environment previously served as a significant roadblock to the adoption of digital intraoral impressions, but many of the initial problems have been overcome. No longer is an opaquing powder required with most systems, and scanning protocols have been significantly streamlined. Current systems record
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Winter 2013
the intraoral environment with a series of automatically captured images or brief videos. This has greatly reduced the time required to take the scans. The scanning wands continue to decrease in size, with each iteration allowing improved access, particularly at the second molar. Additionally, some states have amended their dental regulations and permitted some classes of auxiliaries to take the digital impression for the fabrication of the definitive restoration. As computer hardware and software continue to improve both inside and outside the dental community, vast increases in capture speed and accuracy will continually develop. Much of the recent success and popularity of digital intraoral impression systems has come about due to the development of the stand-alone scanning device. For over 20 years, digital impression systems, which included inoffice milling devices, required the dental office to handle the design, milling, finishing and fitting of the restoration. This was, and continues to be, a fairly small segment of dental practices. Introduction of the stand-alone scanning units (without a mill) allowed many clinicians to implement digital impressions into their practice without making significant changes to their standard operating procedures and doing this at only a fraction of the cost when combined with milling units. Such systems offer high returns in patient comfort, satisfaction and perception, but they do not offer the strong potential return on investment (ROI) possible with in-office CAD/CAM systems. Many professionals in the dental laboratory industry have feared that if dentists were able to create the definitive restoration in their practice, their business would be significantly harmed. And though this may be true for some, there does not appear to be much demand for dentists to integrate a highly functioning ceramics laboratory within their own practice. Integration of in-office CAD/ CAM systems has worked wonderfully for some, but there are many inoffice CAD/CAM units collecting dust or available for sale in nearly unused condition to testify to the difficulties of CAD/CAM integration. Stand-alone digital intraoral impression devices, on the other hand, strengthen the dentistlaboratory relationship and allow seamless integration into a dental practice with little changes to existing, well-developed protocols and responsibilities. Clinicians who once looked at the question of digital impressions and inoffice CAD/CAM with a skeptical eye now seem to be coming around to the idea of the technology. Significant improvements in ease of use, accuracy and efficiency have all led to a change in the perception of the dental profession regarding digital restorative technology. Many dentists previously looked at such technologies and wondered if this were something they would purchase for their practices. That question has seemingly evolved in recent years into when. It is difficult to speculate what the future will hold for clinical dentistry, but undoubtedly we are in the midst of a significant shift into the realm of digital dentistry. As we enter this new era, we must remain steadfast in our dedication to excellence and develop techniques and materials at the highest levels available. It would indeed be sad if, as a profession, we had reached the pinnacle of care decades ago, and we were incapable of improving upon it. We should encourage and support the development and maturation of new technologies that will one day become the new “gold standards.� Todd R. Schoenbaum, DDS, FACD, is an assistant clinical professor at the UCLA School of Dentistry, Division of Restorative Dentistry.
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Winter 2013
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RMDC CONNECT
PREVENTING INSURANCE CLAIMS ISSUES FROM TAKING OVER YOUR PRACTICE By Lois Banta
T
he phone rings…there is a new patient on the phone. The most frustrating and challenging question they usually ask is…”Do you take my insurance?” It can make the heart beat faster and cause anxiety. This happens more often than not because the patient has placed expectations on the dental practice to resolve all of their insurance issues. And what is worse, dental practices have done it to themselves. Practices promise things they cannot possibly deliver. It is time to take the power back. The dental patient is your secret weapon. It is completely acceptable to educate and train patients how they can assist and partner with the dental practice to help themselves resolve challenging claims issues. There are many ways to assist the patient in partnering with the dental practice:
notifying you of any changes in the benefits or the submission of claims. 4. Have in place written guidelines that explain how long the dental practice will track a claim. Make sure the patient is aware of this both verbally and in writing. Make sure the patient is aware that if the claim ages beyond 60 or 90 days, a statement will be sent for the full balance which will be due and payable at that time. As a courtesy, the dental practice can offer to continue assisting the patient with claims questions and tracking. This avoids surprises with the patient.
Another obstacle to overcome is the length of time claims take to be processed and paid. It’s important to have guidelines for submitting claims and system for tracking them. First, make sure all information is correct. Second, make sure all necessary supporting documents are supplied: including, but not limited 1. Know that the patient will not usually have a clear understanding on how their to, detailed narratives, diagnostic films, photos and study models. Third, dental benefits plan works. Therefore, be sure to respond with enthusiasm when electronically file all claims. Statistically, most electronic claims get processed they notify the dental practice that they have insurance. Also, have a positive within 24 hours and payment is received within 3-5 days. discussion with the patient on what the dental practice has the ability to do to help the patient maximize their benefit. Tell the patient the potential bad news Many patients seem unaware that their dental benefit plan is an agreement before they get it in a statement i.e.; there may be a balance owed after insurance between them, their employer and the insurance company. Dental practices have little or no credibility with the insurance company. Most dental plans have rules payment is received. and regulations that prevent them from giving complete and sometimes accurate 2. Ask for complete dental benefit information during the first phone call. Get the information to the dental practice. This makes partnering with the patient a name, address and phone number of the patient’s dental benefit plan…from the crucial step in resolving claims quickly. patient directly. This is the first step in involving them. Always inform the patient that a statement will be sent for balances that remain if 3. Be professional, helpful, courteous and consistent. Most patients, when they their dental benefit plan pays less than is estimated. Informed patients don’t make discover they have a dental benefit plan that only helps them with the cost of angry phone calls. some of their dentistry, are both confused and upset. They mistakenly believe their dental benefit is all inclusive, pays 100% and that the dental practice is the Remember, your patient is your best weapon in reducing the frustration of insurance company’s best friend. Make yourself available to partner with your insurance claims issues taking over your practice. patient by going over their dental benefits book in person... When they see it in writing, they own it. Consistency will help to avoid any misunderstandings for Lois Banta is CEO, President and Founder of Banta Consulting, Inc., a company both the patient and the practice. Help them to understand their benefits and that specializes in all aspects of dental practice management. Lois has over 37 years its limitations and then promise to deliver the highest quality care taking into of dental experience and consults and speaks internationally. Lois also owns The consideration what is in their best interest. Also, make the patient responsible for Speaking Consulting Network.
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Winter 2013
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Articulator
Fall 2013
NON PROFIT NEWS
COLORADO ORTHODONTIC FOUNDATION INCREASES PROVIDER INVOLVEMENT By Alexandra Gage
A
s 2013 wraps up, the Colorado Orthodontic Foundation (COF) is proud to announce that they have reached a milestone in recruiting orthodontists to the organization. The non-profit, which aims to provide orthodontic health care to low-income families across the state, was able to bring on its 50th volunteer orthodontic provider this year. These 50 doctors have all generously accepted patients through the COF program and in some cases, actually brought additional patients of their own under the COF umbrella. With the generosity of the COF providers throughout the state, the organization has been able to start treatment on close to 250 patients since their inception. The COF has also made great strides this year in opening a clinic facility in Colorado Springs—Dr. Chad Watts and Dr. Jenee Kaplan from Rangewood Orthodontics have been running clinic days out of the Kids in Need of Dentistry clinic in Colorado Springs since February 2013. These doctors have been extremely generous with their time, even saying that "it has been a wonderful experience working with COF to transform the smiles of kids in Colorado Springs. The most rewarding part of our job is being able to see how their confidence grows as their beautiful smiles are revealed. We look forward to continuing to build not only smiles, but relationships with these kids, their families, and the community."
With the help of Dr. Kaplan and Dr. Watts, the organization hopes to expand access to orthodontic care throughout the Colorado Springs area, while maintaining a strong presence in communities in the Denver Metro Area. Without the generosity of all of our orthodontic providers, the Colorado Orthodontic Foundation would not be able to exist, much less flourish in the way it has in the past three years. The COF is also excited to once again be involved in Give Kids a Smile Day, which takes place on February 7, 2014. A national American Dental Association initiative, Give Kids a Smile Day is part of a program that aims to encourage dentists to provide their community’s underserved children with dental services. The COF is proud to be hosting their 4th Annual Give Kids a Smile orthodontic screening day in February. On these screening days, local orthodontists generously donate their time and skill to determining whether these deserving patients are in need of orthodontic treatment. The idea in providing these free screenings is to educate families about the benefits of orthodontics as well as potentially enroll these patients into the COF orthodontic treatment program. Dr. Cassy Wiggins from Summit Orthodontics, a board member and clinical provider for the Colorado Orthodontic Foundation, will be the lead orthodontist in charge of screenings on February 7th, and the organization hopes to screen close to 50 new patients. The COF is constantly looking for new orthodontists willing to become COF Providers. Interested in hearing more about the Colorado Orthodontic Foundation or volunteering your time and skill? Please visit our website at thecof.org or call Managing Director Alexandra Gage at (303) 501-3691.
MDDF volunteers will be happy to keep your things company in Room 701 while you attend the RMDC. Your donation supports MDDF – Thanks! MDDS, MDDF and the Colorado Convention Center are not responsible for items left in or taken from the coat room.
Congratulations to the 2013 Colorado Mission of Mercy and it’s volunteers and supporters for providing free oral healthcare services to over 1,200 adults and children who otherwise would have gone without. The 7th annual COMOM was held at the Island Grove Regional Park in Greeley on October 4 and 5. During these two days, more than $1,000,000 in dental care was donated to patients. The 2014 COMOM will be in Henderson.
MARK YOUR CALENDAR! A special one-night only Feed the Foundation event benefittingthe Metro Denver Dental Foundation.
MARCH 6, 2014
PARALLEL SEVENTEEN 1600 East 17th Avenue
Visit MDDF.org for more info and to register. mddsdentist.com
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Winter 2013
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RMDC CONNECT
SPREAD SO THIN By David Weber
I
t is 4:55 am. I should be fast asleep. I am not. I am staring at the clock. Why am I awake? (pause) Man, is my spouses’ snoring always this irritating? Gosh, there is a lot I have to do today. Hey, that’s why I am awake… I’m thinking about my to-do list: quiet time, exercise, work, work, work, lunch with Chris, Nathan to baseball, call the x-ray machine repairman, pick up the dry cleaning, church later tonight…whew, I am exhausted--and I haven’t even gotten out of bed yet. Sound familiar? Many are finding themselves trying to do more, with less, faster, cheaper, safer, and better. The result is people who, often, have trouble falling asleep or staying asleep because the volume of activities they are trying to manage is overwhelming. Answer these questions: Are you busier now than you’ve ever been? Does your mental to-do list wake you up at night? Are you drowning in a sea of information? Ever feel like there’s not enough of you to go around? The whirlwind pace we live in today is so
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sucking the life out of us that many times the first thought on our minds when we wake up is, “I’ve just got to survive.” We jump out of bed landing in a sea of details and deadlines and we tread water just as fast as we can to keep from going under. At the end of the day we tumble into bed thinking, “I made it…thank God I made it!” Moments later we hear the alarm clock go off again and the rat race starts all over as we dive back in to another day.
straightforward tools. I even know what they do and how to use them. The problem isn’t owning or using the tools…it is getting what I want out of them—a new house! I own all the right tools, but I don’t know the process for building the house. When it comes to personal productivity, here is what most people will tell you is “their new house”:
We now live in a society that is truly 24‐7‐365 and most people will quickly tell you that there is more on their plate than ever.
How to never have something fall through the cracks, and
To help us stay on top of all those details, many have acquired the latest devices, software, programs or apps to assist them. Smart phones, iPads, Google, Microsoft Outlook and IBM Notes are some of the hottest tools that busy people have obtained…and these are all great tools. The problem is that most people continue to do what they have always done…they just do with a new device. You see, when it comes to personal technology, most people are self‐taught… and self-taught equals gaps. The real challenge isn’t how to use this technology (most folks can do that) but rather, “how do I get out of these new tools what I want.” For example, I own a hammer, a saw and a tape measure. These are simple
How to manage every detail of my life,
How to be able to find information that“I know I put somewhere” in this tool. I have identified the critical success skills and key functionality needed to maximize the impact of all these different tools. As participants learn our process, their devices are transformed into a command control center of events, information, contacts, activities, notes and to do’s. My TimeLink™ solution is a simple and ‘streamlined’ process that can be learned in a few hours and implemented immediately. Additionally, due to the fact that most people today use multiple tools simultaneously, my process transcends one type of device and can actually be implemented in several at the same time. So how do I keep track of everything?
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Winter 2013
How do I get rid of this gnawing feeling that something is about to fall through the cracks? Believe it or not learning how to manage every detail of your life and never have anything “fall off your plate” is as easy as 1-2-3. The first secret to learning how to manage all of your responsibilities is to realize what tools are needed. As you would probably guess, a calendar is crucial to managing your schedule. Please note that I did not say calendars…just one. I call it a Master Calendar. You may have noticed that all calendars look the same whether they are electronic or paper-based…they are all boxes with numbers and lines in them. Now the key to effectively using a calendar is to discover what goes on it and, just as important, what does not go on it. While most people use a calendar to dump virtually everything in their life on, the primary use of a calendar is for what I call “Be There’s.” A “Be There” is anything that requires your physical presence at a specific place and time… meetings, doctor appointments, kid’s events, etc. If you have to physically be somewhere at a specific place and time, then you have to Be There…those are the items that go on a calendar in the box. All of those other things like remember to call, remember to write, remember to send the email, remember to set the appointment…there is a better way to manage all of those details than by putting them on your calendar. The second tool you must possess in order to keep track of all the details of your life is a ToDo list. Actually, that is not totally accurate. You need 31 to-do lists--one for each of the next 31 days. Years ago most of us learned that you should have one to-do list…and years ago that might have worked fine. But in today’s frenzied life, one to-do list simply won’t cut it…there is too much to do. The key to to-do listing is learning to jot down to-dos on the day you actually anticipate doing them and research has shown that 9496% of all the things we need to do, need to happen in the next 31 days. So rather than write down something on today’s list (that I
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don’t anticipate doing until next Monday), I sign up for the dental conference, remember should jot that down on “next Monday’s” to- to pay for basketball uniform at practice do list. Thursday, etc). If you take every incomplete in your life and answer the three W questions, The third tool needed to control all the you will literally earn the right to forget about details of life is a Contacts/A-Z filing system it and it will not fall through the cracks on for alphabetically filing all of the critical you. The three critical questions are: information that needs to be managed. Surprising to most, is that built right into What to do? our smart phones, iPads, Outlook and When to do it? Google/Gmail tools, there is a hidden A-Z Where is the information? filing system cleverly hidden in the Contacts section. For example: Let’s say that today is Monday, the 18th, and you need to take your daughter The key to mastering information control to see Dr. Maria Sanchez Friday, the 22nd at is what I call the three R’s of information 3:00pm, for her sports physical for soccer. management: Record it, Retain it, and Since this is a Be There (it requires your physical presence at a specific place and time) you would TimeLink© this event on the calendar (in the box) by answering the three W questions: 3:00 Appt. Dr. Sanchez(Contacts-S)
"We now live in a society that is truly 24‐7‐365 and most people will quickly tell you that there is more on their plate than ever. "
What to do? Appt. Dr. Sanchez When to do it? 3:00pm on the 22nd. Where is the info? Note that in parenthesis I have put “Contact – S” indicating that all of the information I need for Dr. Sanchez (directions to her office, questions that I want to be sure to ask, etc) have actually been captured in the contacts section of my phone and recorded in the Notes section.
Retrieve it. While most people are already recording (documenting) information, many struggle with retaining it (filing) and most importantly retrieving it (finding) when it is needed. By filing documents alphabetically, it is much easier to retrieve them down the road. By simply answering these three questions on either your Master Calendar (for Be Now, you might be thinking, “OK. I have all Theres) or your Reminders/Tasks/To-Do of these tools, but I still don’t feel like I am lists, and filing any appropriate information in control.” Since you understand the simple in your Contact/A-Z files, you will always 1-2-3s of getting organized, the ultimate be reminded to act at the appropriate time secret is how to link all of these tools together and be reminded of where any pertinent to ensure nothing falls through the cracks. I information related to that task is filed. believe the key is a process called TimeLink©. David Weber is the CEO/President of Weber Whenever you have something that requires Associates based in Atlanta and is a nationally your attention in the future, I call that an recognized speaker presenting over 150 times incomplete. Incompletes can vary from a year across the country. He is the creator of administer the test on Friday, to schedule a the LifeTime Organizer, the world’s newest physical, to purchase some new equipment. personal organization tool, the author of The bottom-line is that our brains are chock Sticks and Stones Exposed: The Power of Our full of incompletes (call the lab, bathe the dog, Words, and Leadership Redefined: The 12 X’s pick up doughnuts for church early Sunday, of Success for TODAY’S Leader.
Articulator
Winter 2013
19
LEGISLATIVE
COLORADO SUNSET REVIEW: CHANGING OUR STATE DENTAL LAWS
Photo Courtesy of Visit Denver
By Karen Foster, DDS
I
n preparation for the 2014 Sunset Review of the Dental Practice Law, the Colorado Dental Association created a taskforce in 2011 chaired by Dr. Ken Peters. I was honored to be selected as a member. The taskforce has a great mix of professionals including former State Board members, specialists including a periodontist, pediatric dentists, and an oral surgeon. There is also representation from the dental school and the Liability Trust. During several monthly meetings the CDA committee reviewed the existing Dental Practice Law line by line to identify areas that needed to be clarified, revised, removed or added. The committee also compared Colorado’s law to other states’ practice acts to see if there are any additional items that should be included in the 2014 version of Colorado’s dental practice act. The taskforce then made recommendations to the 2012 Colorado Dental Association House of Delegates for direction in what to present to the state Department of Regulatory Agencies
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(DORA). The areas approved by the House of Delegates were discussed with roughly 45 stakeholder groups such as the Colorado Dental Hygienist’s Association, Colorado Community Health Network, the Lab Association, Delta Dental, Pacific Dental, etc. The CDA was asked to meet with the DORA analyst and input was given to her. DORA released its recommendations report on October 15th, 2013; DORA opted not to forward many of the ideas presented by the CDA Sunset Review Taskforce. The taskforce reviewed DORA's report, then, based on the recommendations of the CDA House, decided to pursue the items not included in the DORA report through legislation. These priority items include defining a pediatric sedation permit and requiring continuing education. A pediatric sedation permit would add an additional category for sedating child patients with specific training and continuing education requirements. The addition of continuing education requirements would mirror what is needed to maintain membership in CDA in good standing.
DORA recommended continued competency be explored for the future and the CDA will work to address that. Continued competency is more a demonstration of skills in comparison to CE being learning/refreshing skills. DORA made some recommendations, including fining authority for the State Dental Board, opposed by the House of Delegates; the CDA taskforce in concert with CODPAC and GR Council will monitor those items in the legislative bill that will become the revised Dental Practice Act. The process has been a long one and there will be more effort required. Please support the CDA’s efforts by planning to attend Dentists at the Capitol Day scheduled for February 21st. Don’t forget to contribute to CODPAC and the new Small Donor Committee. Your contributions are essential in continuing to support legislators that are sympathetic to dentistry. If you have any questions or concerns please feel free to contact Karen Foster kdfdoc@gmail.com.
Articulator
Winter 2013
RMDC CONNECT ONLINE REPUTATION MARKETING – IS IT BUILDING YOUR PRACTICE OR COSTING YOU A FORTUNE? By Brian Devine, Owner, Top Line Management, Inc.
O
nline Reputation Marketing has become extremely important to the dental profession in the last few months. It used to be that there was an inherent trust in doctors, dentists and orthodontists. It was about as close to 100% as you could get and the internet has completely changed that.
There are many ways now for patients to find reviews of your practice as well as to give feedback on their experience. So, reputation, while it has always been important, is becoming increasingly more vital, and I believe over the next few years we’re going to see it revolutionize medical services in many ways. This is a very important topic and I hope that by the end of this article series, you are going to have some solid, valuable information and tips to help you as you move forward with defining your online reputation strategy. So what is Online Reputation Marketing? Online Reputation Marketing, or ORM, is the process of proactively using tools, processes and systems to be aware of and influence the conversation that is taking place about you and your practice online. That’s a bit of a mouthful, I know, and there are a handful of keywords here that I think are really important to stress. First, let’s make sure we note that we are talking about “reputation marketing”, not “reputation management” Simply managing your reputation and reacting to what’s happening is not a very good long term strategy and is really just an expense of both time and money. Marketing your reputation as a part of your online presence is a great way to not only control your reputation online but to help build your practice by capitalizing on it as well. The second word is “process.” Process indicates that this is something that should be mapped out with a series of steps that you are consistently following. This is not something that happens by chance or every once in a while. This is the best way to protect your online reputation. The third keyword to notice is “proactively.” It’s important that you are proactive in your approach so that you don’t wait for something to happen or be said about you and then react to it. You want to proactively manage the conversation that is taking place online about you and about your practice by creating the conversation instead of waiting for it to be created for you. The last word to focus on is “influence.” While you can’t force your patients to say positive things about you online, you can influence the conversation that is taking place and hopefully make sure that conversation is as positive as possible. What are the stakes when it comes to your online reputation? The short answer is that everyone is online, everyone has an opinion and everyone loves to share that opinion. All you have to do is get online and start searching around and you will see that people are already talking about you or a competitor in your local area. The idea I want to make clear is that there are a lot of people out there that are
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publishing their opinions online. And, over the past few years, online reviews have started to affect the medical community greatly. Please keep in mind that given the pace with which online reviews are proliferating, it will only be a matter of time before this impacts you and your practice, if it hasn’t already. The key take-away here comes from the old marketing adage that “a satisfied customer will tell 5-7 of their friends about their experience, whereas the dissatisfied customer will tell 15-20.” Today, an unhappy customer can tell a million of their closest strangers how they feel via the internet. Keeping control of your online reputation is only going to be more important as time goes by. It’s important to get your systems for managing it in place now. It needs to be very well understood at your practice that everybody that works there has a real impact on your online reputation, and all of your business functions play a role in making the patient experience top quality, so that they have only the best things to say about you when they’re talking to their friends, whether it’s online or off. There are five core principles of online reputation marketing that I want you to remember: 1. Listen to what your patients are saying both online and offline. 2. Contribute to the conversation by being proactive and responding quickly to comments. 3. Delight patients by exceeding expectations. Remember, everyone in your office plays a key role in delighting your patients. 4. Collect feedback, referrals, & testimonials. 5. Plan how you will respond before you need to And, while this all sounds like a lot, remember there are many tools that can help you with monitoring and managing your online reputation. One of my favorite tools is Google Alerts. This is a free service from Google that allows you to type in a search query into the Google Alert tool and tell it to notify you any time that combination of words is mentioned online. This gives you real-time access to monitor the online conversations that are happening about you and your practice. A few other tools that allow you to monitor the online conversation are TweetDeck, HootSuite and Social Mention. These all allow you to track what is being said about your practice, or about certain keyword terms on social media sites, where people are actively discussing their opinions of medical professionals. In our next article we’ll cover steps 2 and 3 with plenty of tips and tricks you can put into your systems right away. For now, get started by setting up your Google Alerts account, a free HootSuite account, and start looking at what you currently have in place in your office to keep in control of your online reputation.
Articulator
Winter 2013
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RMDC CONNECT
CREATING POWERFUL PRACTICES BY ENHANCING EMOTIONAL INTELLIGENCE Bob Frazer, JR, DDS, FICD, FACD & Bill Woodburn, MEd, LMFT, LPC particularly among the star performers is emotional intelligence.
E Bob Frazer
very major discretionary (dental) purchase is first and foremost an emotional decision. Effective leadership of a practice demands emotional competency. Therefore, E.I. is central to our success.
The leading businesses in the US and across the world have taken to heart research out of Harvard and Rutgers showing that 75% of high achiever's success comes from Emotional Intelligence Bill Woodburn (E.I.), while 25% comes from necessary technical competency. In doing so, they have insisted their leaders and key customer interface people have EI training. If EI training is one of the foundational cornerstones that BB&T CEO Kelly King claimed is one of the key reasons for their phenomenal growth and highest ranking among all banks for customer service – shouldn’t it be even more important for those of us in private practice. As a practitioner, speaker and performance coach to dentists for over 25 years, I have seen a pattern among the dentists and teams with whom we've worked. Often the most intellectually gifted (high I.Q.) and technically excellent dentists seem to be on a never-ending journey to elevate their technical competency. But, many end up frustrated, sometimes even depressed, as they encounter countless recurring leadership and staff problems, plus no mater how much they learn, they can’t get most patients to elect their finest service. At the same time, I encounter good dentists, generally well trained, with half the technical training, who have happy, prosperous practices with patients wanting the dentistry they offer. So what is the difference? I am convinced one must have technical competency, but the difference…
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"Emotional Intelligence is defined as our capacity for recognizing our own feelings and those of others, for motivating ourselves, for managing emotions well in ourselves and our relationships."1 It involves four key domains with a subset of eighteen emotional competencies. The four domains are: self-awareness, self -management, social awareness and relationship
"I am convinced one must have technical competency, but the difference… particularly among the star performers is emotional intelligence." management. 2 Research has shown that unlike I.Q., E.Q. your emotional quotient can be raised through emotional competency training and coaching. Let me illustrate my point with a recent experience. During a visit to one of my new performance coaching clients, I sat in on a case presentation. My client had prepared models, photographs and a computer generated treatment plan. The patient, “Kathy,” and her husband, “Ed,” were welcomed and escorted to the consult room, where the doctor greeted them warmly and introduced me, the visiting doctor (who they knew would observe). They were a healthy looking, casually well dressed couple in their mid 60's. This was a second consultation for Kathy in order for Ed to understand his wife's problems and recommended treatment. My doctor/client had recommended full reconstruction beginning with the maxillary teeth. Kathy's primary need when she presented, was the correction of her appearance from upper second bicuspid to second bicuspid. She had congenitally missing laterals that some years earlier had been replaced with a Maryland Bridge. There was moderate wear on the upper and lower anterior teeth, plus a number of discolored large old composites. Kathy was physically attractive, but
her smile clearly detracted from her appearance, causing her to look 10 years older. She was soft spoken and was most concerned about the implants that had been recommended. Ed was quite warm and extroverted. He projected the charisma of one who was a leader. After too short an initial dialogue, my client jumped right into Kathy's problems and how they could best be solved with a combination of implants and crowns. When the word implant was mentioned both Kathy and Ed's brows wrinkled slightly and they looked either confused or concerned. My client was on a roll with her models, photos, plus pictures of implants and it was about five minutes before she stopped to ask if they understood or had questions. They were concerned about the surgery and the appearance of implants. My client fielded that technically quite nicely, then noted that bridges could be used and surgery avoided. They liked that idea. But, then Ed wanted to know what just the upper dentistry would cost, since he was a little shocked by the total fee for upper and lower ($30,000.) My client answered about $12,000. But, she did not help him understand the fact that the upper needed to couple well with the lower, and without restoring the lower there would be an over contour of the lingual of the uppers. In turn this would accelerate the wear on the lowers and within five years, Kathy would have to have the lower restored and then the upper would have to be reshaped or remade. Very quickly a complete reconstruction was degenerating into segmented treatment for only the most visible. My client was unwittingly un-selling the case. Not because of technical competence (she has extensive post-graduate training), but because of lack of emotional intelligence. She was not resonating with this couple. It was obvious to me when Ed and Kathy arrived that they were people of means, who valued health and wanted to do what was best. They simply were concerned about surgery and I sensed they did not want to compromise treatment. How did I know that? Through EQ. Although, I was not there to enter into the dialogue, I couldn't resist! I simply asked to see the models and then asked my doctor/client the implications
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Winter 2013
of not doing the lower teeth at the same time. As she described the negative implication, I watched Kathy and Ed's facial expressions. This was not what they wanted. Then, I simply said, "As (doctor’s name) answered my question, I noticed that you seemed disturbed by her answer. Did I sense that accurately?” Ed confirmed that I did. Then, I simply said, “You two strike me as people who want things done once and done well." They nodded agreement and I said, "Then it's crucial to do these together." I added that doing both together would add a youthfulness to Kathy's smile and face. They both smiled and nodded. My client later thanked me for saving the case. Much of our coaching work will center on elevating her EQ, so that she can raise her awareness of her own and other's feelings quickly, responding gracefully in a resonant and motivating way. No discussion of emotional intelligence would be complete without visiting its origins. It really began in about 1970 with the work of Harvard's David McClelland. He was hired by the State Department to assess the capabilities of the most outstanding diplomats. Selection for a diplomatic post was based largely on tested abilities in things like history, cultural understanding, language fluency or special knowledge in fields like economics. However, the tests did not correlate with success in the field. In fact many of the best foreign-service people had barely qualified!
McClelland created radically different tests like having people watch snippets of videotapes of people talking about emotional situations or having an argument. He used an electronic filter to alter sounds. What came through were tones and nuances of body language that revealed how a person was feeling. He found that the stars scored much higher than the average diplomat. Daniel Goleman, was a graduate student of McClelland, and it is his books Emotional Intelligence, Working with Emotional Intelligence and Primal Leadership, that have popularized E.I. into the business literature of today. McClelland's consulting firm of Hey/McBer pioneered the research of high performers noted in the first paragraph of this article. Goleman states, "Paradoxically, IQ has the least power in predicting success among that pool of people smart enough to handle the most cognitively demanding fields, and the value of emotional intelligence grows more powerful the higher the intelligence barriers for entry into a field. In careers like engineering, law or medicine, where professional selection focuses on intellectual abilities, emotional intelligence carries much more weight than IQ in determining who emerges as a leader." 1 So what are the basics of emotional intelligence? Validated research says they are: Knowing your feelings and employing them to make life decisions you can live with.
The ability to mange your emotional life without being hijacked by it. Persistence in the face of setbacks while channeling your impulses in order to pursue your goals. Empathy - reading another's emotions without their having to tell you what they are feeling. Managing feelings in a relationship with skill and harmony... for example being able to express the unspoken pulse of another or a group. During our morning session Thursday, January 23, at the 2014 Rocky Mountain Dental Convention - we'll explore the powerful concepts of E.I. in our patient and team interactions, plus how to grow you E.Q. so that you and your team can join the stars of our profession. Bob Frazer, Jr., DDS, FACD, FICD, founder of R.L. Frazer & Assoc. and Senior Associate and Counselor Bill Woodburn, MEd., LPC are featured presenters at the 2014 Rocky Mountain Dental Convention. For information please visit frazeronline.com or call (512) 346-0455. References: 1
Daniel Goleman, Working With Emotional Intelligence. Bantam 1998
2
Daniel Goleman, Primal Leadership, Harvard Business Press, 2002
W E C A R E A B O U T Y O U R S U C C E S S Dental practice transitions are about relationships. The relationship of the doctors and between the doctors and patients. We work to build those relationships so there is trust and integrity which results in a successful, smooth transition.
CTC Associates Chatterley Transition Consulting info@ctc-associates.com
303-795-8800
www.ctc-associates.com
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EVENT CALENDAR January 2014 January 23, 24, 25 Metro Denver Dental Society: 2014 Rocky Mountain Dental Convention Colorado Convention Center Mountain West Dental Institute (303) 488-9700 For more info go to: rmdconline.com
February 2014 February 11 Metro Denver Dental Society: CPR & AED Training, A Two-Year Certification Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm – 9:00pm (303) 488-9700 For more info go to: mddsdentist.com February 20 Metro Denver Dental Society: New Member Networking Event - All Members Welcome Lala's Wine Bar & Pizzaria 410 E. 17th Avenue Denver, CO 80203 6:00pm – 9:00pm (303) 488-9700 For more info go to: mddsdentist.com
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mddsdentist.com
February 21 Metro Denver Dental Society: Basic Radiation Education for Unlicensed Dental Personnel Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 12:00pm (303) 488-9700 For more info go to: mddsdentist.com
MArch 2014 March 12 Metro Denver Dental Society: CPR & AED Training, A Two-Year Certification Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm – 9:00pm (303) 488-9700 For more info go to: mddsdentist.com
APRIL 2014 April 11 Metro Denver Dental Society: Hands-On Laser Perio for Hygienists Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:30am – 4:30pm (303) 488-9700 For more info go to: mddsdentist.com
April 17 Metro Denver Dental Society: CPR & AED Training, A Two-Year Certification Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm – 9:00pm (303) 488-9700 For more info go to: mddsdentist.com April 25 Metro Denver Dental Society: Practice Enhancement Day Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am – 5:00pm (303) 488-9700 For more info go to: mddsdentist.com
July 2014 July 17 ADA New Dentist Conference Sheraton Kansas City Hotel at Crown Center 2345 McGee Street, Kansas City, MO (303) 488-9700 For more information, contact the ADA New Dentist Committee at 312.440.2779 or by e-mail at newdentist@ada.org.
Articulator
Winter 2013
THANK YOU!
Stability · Strength · Service
For helping us celebrate ten successful years at the Denver Implant Study Club.
Look for the new DISC 2014 schedule coming soon. If you haven’t done so, go to www.knowledgefactoryco.com/subscribe and sign-up to receive our periodic news and event notifications.
About the Knowledge Factory: The Knowledge Factory is dedicated to the belief that the best doctors continually share the latest information with their peers and patients. The Knowledge Factory is a resource platform that provides doctors with the tools and expertise needed to clarify, expand and diversify the latest in Dental/Medical resources and information.
A great place to share information with your colleagues, receive information on dental events and seminars, connect and learn.
Did you realize we offer: • Malpractice Coverage - Administrator of the Dentists Professional Liability Trust • Workers Compensation - Low Rates • Business owners Package - tailored to your needs • Medical Insurance - Personal and Group • Disability - True own occupation • Business Disability • Business Insurance • Life Insurance • ERISA Bonds • Employment Practices Liability Coverage • Group Disability • Long Term Care • Home and Auto
F or more info r m a t i o n c o n t a c t :
Aldo Leopardi, BDS, DDS, MS Prosthodontist /// P. 720.488.7677 /// F. 720.488.7717 Or visit www.knowledgefactoryco.com
mddsdentist.com
_MDDS_artad_Winter2013v1.indd 1
2000 S Colorado Blvd, Annex Building, Suite 410 Denver, CO 80222
Phone: (303) 357-2600 Fax: (866) 699-1559 Toll Free: (877) 502-0100
www.dentalliability.com
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Articulator
Winter 2013
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FINANCE MANAGEMENT
IT’S NEVER TOO EARLY TO PLAN FOR RETIREMENT
By Edward Leone Jr., DMD, MBA, RFC
I
t is common knowledge that a savings habit started early in an individual’s working career dedicated to building assets on which to retire gives an extended time horizon in which to accomplish the task. It allows sufficient time to overcome the variations in market and business cycles which are likely to occur as they have in 1928, 1965, 1987, 2001 and 2008. Key elements in finding the financial assets to dedicate to this task revolve around compensation levels, tax burdens, life style expenses and debt service. Charles Dickens had it right when he stated in his classic work, “David Copperfield , that“Annual income twenty pounds, annual expenditure nineteen six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.” As stated, there are many unknowns regarding market and business cycles, but the unknowns which may occur in life affecting life style expenses can be a factor in successful retirement planning also. It is important to assemble a team composed of a financial planner, attorney, tax accountant and insurance expert to help address these elements. It is critical to address tax exposure and risk factors. The retirement plan must consider a target goal which represents considerations such as longevity, life style expenses, legacy issues, investment return expectations and an inflation factor since retirement distributions will be taken in future dollar values. Mathematical exercises when considering a 30 year time horizon and a 3% inflation factor
mddsdentist.com
tell us that if a $100,000 outcome is desired in today’s dollars, $242,000 is required in future dollars. Similarly, for $500,000, $1.21M is require and for $1M, $2.42M . The distribution of retirement funds at the appropriate time must meet retirement life style expenses. There are several rules of thumb which may help calculate this need. One which is very common is the 80% rule (80% of income while working is sufficient for support in retirement). It is much better to have a financial planner work through these calculations with the individual considering net worth and financial obligations upon retirement such as mortgage payments, health care costs, travel expenses, anticipated family obligations and anticipated recreational activities. It is common sense that during the accumulation phase and the distribution phase of any retirement savings plan that there are three modifiers which can be employed to help meet projected goals: Save more. Spend less. Work longer. As dentists, we must be aware of all elements of the above discussion since retirement success is in our hands and not controlled by other entities. Our dedication to an understanding of the discipline and the process needed to achieve a desired outcome along with utility of appropriate advisers is vital. Take the time to learn about and understand the choices in retirement savings such as IRA, 401K, SEP, Simple IRA, Profit Sharing Plans, Defined Benefit Plans, Money Purchase Plans and non-qualified retirement savings with a certified adviser to find a strategy that meets your needs.
Articulator
Winter 2013
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a law office for dental and medical business needs .
Office Leases Practice Transitions Formation of Practice Entities Property Purchases Estate Planning General Business Needs
Emphasis is placed on understanding client needs and using technology, resources, and relationships with your brokers, consultants, bankers and CPAs to meet those needs in an efficient, effective and professional manner.
Law Office of Kimberley G. Taylor, LLC | www.lawofficekgt.com | 303-526-8456 or 970-926-6389 | kim@lawofficekgt.com
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STUDY CLUB Powered by
By Aldo Leopardi, BDS, DDS, MS
I
t’s difficult to believe that 2013 marks The Denver Implant Study Club (DISC) 10-year anniversary. When launched in February of 2003, I had no idea it would have resonated throughout the dental community as well as it has. The main reason for its inception was necessity. Prior 2003, most continuing education in the area of implant dentistry was driven primarily by dental implant companies. I found these to be terribly biased, commercialized and non-informative. I wanted to develop an independent study club, with exposure to different implant systems and philosophies, while still embracing the corporate world. However, with the focus of the evening seminars on Dental Implant treatment modalities, and less but respectful discussion of product‌hence, DISC! DISC has now grown to have a rotating list of hundreds of General Dentists and Specialists within the greater metropolitan area, Colorado Springs, Bolder, Fort Collins and the Western Slopes. These participants have been exposed to many world-class presenters, their ideas, techniques, insight and utilization of the products that they enjoy delivering to their patients. Although the study
club is prosthodontically driven, recent incorporation of the surgical aspects of implant therapy into discussion has been well received. By engaging the broad corporate dental community, these high quality continuing educational experiences and credits have been provided at no fee to the participants. Their support is greatly appreciated. Special mention to our continued 10 year sponsor Perry and Young dental laboratory...this, along with a great learning environment provided by our MDDS partners, and great food by our chef and caterer Kevin Mooney, this formula shows no signs of abating. Ten years is a milestone for this community based continuing education club. So what will the future look like for DISC? 2014 is lining up to be another year of great speakers and topics, familiar and new corporate involvement. The direction of the study club is continually re-evaluated with the help of the DISC committee members: Dr. Michael Huber (Periodontist), Dr. Barry Keogh (Oral and Maxillofacial Surgeon), Dr. Roy Theriot (General Dentist) and myself. As long as there is an interest and support for the club, great continuing educational experiences will be made available to Colorado.
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Winter 2013
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CLASSIFIEDS Meeting Space; Hands-on; Clinic for your Event The Mountain West Dental Institute is open and available for your meeting, course, study club, etc. 2 auditoriums seating up to 140, banquet hall, executive conference room and a full clinic with 4 operatories! High-tech A/V always included with recording/streaming abilities. Discounted rates for MDDS Members & Assoc. Members. Contact Lori Steele at admin@mddsdentist.com or 303.488.9700 or visit mwdi.org.
Items For Sale or Wanted Sleep Apnea Diagnostic Equipment for Sale Pharyngometer, Rhinometer, 2 Embletta home sleep study units, $500 and other sleep apnea aids. SGS retail cost $26,000 but will sell for $14,000 OBO. Reply to danceattack73@hotmail. com
Job Board GENERAL DENTAL PRACTICE ASSOCIATE TRANSITION: South Corridor of Denver, Colorado All the bells and whistles! Not just a job! Seeking Buyer! Must have two or more years experience. Associate to Buy-out. Susan 303-973-2147 or susan@sastransitions.com SAS Dental Practice Brokers www.sastransitions.com
Real Estate DENTAL OFFICE SPACE: Arvada/Westminster, 1 story professional building complex. 1,100 sq. ft. professional office. Fronted by busy Old Chicago restaurant and adjacent professional massage therapy practice. Modern, welldesigned and attractive unit with 4 Tx rooms dental equipment installationready with cabinetry, gas lines, plumbing, electrical in place. Plenty of storage & Dr. private office with private entrance. Great drive-by & walk-by exposure with ample dedicated parking. New carpet tenant finish allowance. Contact: Jim True at 303-425-9200 Dental Office Space Highlands Ranch/Littleton Share space with specialty practice in high profile dental/medical building 2 days a week. Highlands Ranch/ Littleton. Reply to danceattack73@hotmail.com DENTAL PRACTICE SALES: Listing 2013! Northern Colorado with real estate, West Metro-Denver, South Denver, and Specialty Practices! Go to www.sastransitions.com for new listings! Susan 303-973-2147 or SAS Dental Practice Brokers susan@sastransitions.com ENDODONTIC DENTAL PRACTICE: Southern Colorado Top Endodontist is retiring! 5 treatment ops! Excellent Location! Referrals, referrals, referrals! Great Staff! Susan 303-973-2147 or susan@sastransitions. com SAS Dental Practice Brokers www.sastransitions.com GENERAL DENTAL PRACTICE: Denver, Colorado High growth area! Seller is retiring. Great staff! Collecting $300+ with low overhead! Susan 303-973-2147, susan@sastransitions.com SAS Dental Practice Brokers! www. sastransitions.com
GENERAL DENTAL PRACTICE: South Western, Colorado Mountain Town High tech digital practice! Collecting $800+ Five operatories, consultation room and more! Susan 303-973-2147, susan@sastransitions.com SAS Dental Practice Brokers! www.sastransitions.com General Practices for Sale: Practice listings along the Front Range in Denver, Arvada, Lakewood, Aurora, Littleton, Castle Rock, Colorado Springs, north Adams County, Fort Collins, and other areas of the state. We also have opportunities in New Mexico, Utah, Idaho, Alaska and Hawaii. For more information on current practice opportunities, please visit our website www. ctc-associates.com or call Larry Chatterley and Susannah Hazelrigg with CTC Associates at (303)795-8800. Ortho Practice for Sale: New, beautiful, high tech, spacious Orthodontic practice for sale in Colorado Springs. This practice offers private consolation room, large imaging room, 5 operatories, digital imaging and paperless charts, with plenty of room to expand. Contact Marie Chatterley with CTC Associates at (303)249-0611 or marie@ctc-associates.com. Practices for Sale: Listings in Colorado: Denver, Centennial, Boulder, Arvada, Parker, Colorado Springs, South I-25 corridor, Central & Western Colorado, Grand Junction and WY & KS. For more information and listing description(s), please visit our website: www.adsprecise.com; new listings added frequently; Peter Mirabito, D.D.S., Jed Esposito, M.B.A., ADS Precise Consultants 855-461-0101. Practice Sales, Practice Appraisals, Partnerships & Buy-In’s.
Announcements & Services HIRE A BROKER YOU CAN TRUST! IT IS A SELLER’S MARKET! This will never happen again in your dental lifetime! Great Motivated Buyers! Excellent Interest Rates! Pick from the Best Pool of Applicants! www. sastransitions.com Call me today to schedule a complimentary personalized review of your practice situation! Susan Spear, Practice Transition Specialist / Licensed Broker SAS Transitions, Inc. SAS Dental Practice Brokers 303.973.2147 susan@sastransitions.com Transition Services: For more information on how to sell your practice or bring in an associate, or for information on buying a practice or associating before a buy-in or buy-out please contact Larry Chatterley and Susannah Hazelrigg with CTC Associates at (303)795-8800 or visit our website for practice transition information and current practice opportunities www.ctcassociates.com.
Visit mddsdentist.com/classifieds to place an ad.
Teeing Up for a Fantastic 2014! THOUSANDS of DENTISTS are
SAVING 26%
GENERAL DENTAL PRACTICE: Mountain Town, Colorado Practice and Real Estate! Digital, Pano, and lots of extras! Don’t miss this opportunity to capture the market! Susan 303-973-2147 or susan@sastransitions.com SAS Dental Practice Brokers www.sastransitions.com GENERAL DENTAL PRACTICE: NE, Colorado Buy or Associate to Own! Own Right Out of Dental School! Income from day one! Great family lifestyle! Owner is retiring. Susan 303-973-2147, susan@sastransitions.com SAS Dental Practice Brokers! www.sastransitions.com
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“C
hoosing Carr Healthcare Realty to help me navigate through the relocation process turned out to be one of the best business decisions I have ever made. Colin and Christian were able to get me into a newer building while cutting my rent by over $3,000 per month! They also negotiated months of free rent and even were able to get the landlord to pay for half of the build out expenses. I would never have been able to achieve what Colin and Christian have done for me on my own.” David Micklin, DDS
Colin Carr President
303.817.6654 colin@carrhr.com
Christian Gile Principal Denver Metro
303.960.4072 christian@carrhr.com
At Carr Healthcare Realty… We provide experienced representation and skilled negotiating for dentists’ office space needs. Whether you are purchasing, relocating, opening a new office, or renewing your existing lease, we can help you receive some of the most favorable terms and concessions available. Every lease or purchase is unique and provides substantial opportunities on which to capitalize. The slightest difference in the terms negotiated can impact your practice by hundreds of thousands of dollars. With this much at stake, expert representation and skilled negotiating are essential to level the playing field and help you receive the most favorable terms.
Roger Hernandez Colorado Springs Southern Colorado
719.339.9007 roger@carrhr.com
Kevin Schutz
Boulder • Northern Colorado Western Slope • Wyoming 970.690.5869 kevin@carrhr.com
If your lease is expiring in the next 12 – 18 months, allow us to show you how we can help you capitalize on your next lease or purchase.
Lease Negotiations • Office Relocations • Lease Renewals • Purchases