ARTICULATOR MDDS
Connections for Metro Denver’s Dental Profession
Winter 2016 Volume 21, Issue 2
WINTER EDITION
10 16 28
The 5 A's of Confident Dentistry So You Think You Need New Dental Equipment? Four Questions to Ask Before You Sign on the Dotted Line
Case Study: Lease Renewals, Relocations, Purchases
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whats inside?
features 10 The 5 A's of Confident Dentistry 12 Welcome to the Family 14 Freedom Day 2016 16 So You Think You Need
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New Dental Equipment? Four
p.
Questions to Ask Before You Sign the Dotted Line
18 Creative Metal Occlusals
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A New Approach to an Old Technique
Advertisers Directory ADS Precise Consultants adsprecise.com ................................ 31
Design Resource Group design-resource.com......................... 27
Records: The Importance of
Berkley Risk Services of Colorado berkleyrisk.com ................................ 21
Healthcare Medical Waste Services, LLC hcmws.com...................................... 21
Organization
Best Card bestcardteam.com ............................ 31
Life Rescue CPR, LLC liferescuecpr.com .............................. 29
Carr Healthcare Realty carrhr.com .......................... Back Cover
Northwest Mutual shawncopeland.nm.com ................... 19
Catalyst Retirement Advisors, LLC catalystretirement.com ........................ 7
Pacific Continental Bank therightbank.com ............................... 5
20 Maintaining Your Financial
26 Excercise-When Less is More . with HIIT
28 Case Study: Lease Renewals, Relocations, Purchases
CDA cdaonline.org................................... 13 Commerce Bank commercebank.com ........................... 9 Copic Financial Services Group copicfsg.com .................................... 12
departments
Professional Financial Specialists, Inc. pfsi.net ............................................ 23 SAS Transitions sastransitions.com ............................ 19 SEO.com seo.com....................Inside Front Cover
Dentists Professional Liability Trust of Colorado tdplt.com ......................................... 24
4 President's Letter 6 Member Matters 8 Reflections 17 Peer Review Puzzler 25 Nonprofit News 30 Event Calander 31 Classifieds
Guest Editor Emmanuel Paguio, DDS Creative Manager & Managing Editor CT Nelson Director of Marketing & Communications Cara Stan MDDS Executive Committee President Sheldon Newman, DDS President-Elect Nicholas Chiovitti, DDS Treasurer Brian Gurinsky, DDS Secretary Nelle Barr, DMD
Editorial Policy All statements of opinion and of supposed factare published under the authority of the authors,including editorials, letters and book reviews.They are not to be accepted as the views and/oropinions of the MDDS. The Articulator encourages letters to the editor, but reserves the right to edit and publish underthe discretion of the editor. Advertising Policy MDDS reserves the right, in its sole discretion,to accept or reject advertising in its publicationsfor any reasons including, but not limitedto, materials which are offensive, defamatoryor contrary to the best interests of MDDS. Advertiser represents and warrants the advertisingis original; it does not infringe the copyright,trademark, service mark or proprietary rights ofany other person; it does not invade the privacy rights of any person; and it is free from anylibel,libelous or defamatory material.Advertiser agrees to indemnify and hold MDDS harmlessfrom and against any breach of this warranty aswell 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 Printing Denver, CO 80203 Dilley Printing Phone: (303) 488-9700 Fax: (303) 488-0177 The Articulator is published bi-monthly by the Metropolitan Denver Dental Society and distributed to MDDS members as a direct benefit of membership. mddsdentist.com Š2016 Metropolitan Denver Dental Society Executive Director Elizabeth Price, MBA, CDE, CAE
Member Publication
3
PRESIDENT'S LETTER By Sheldon Newman, DDS
Will You Join Us?
M
DDS is one of the most successful component
Dr. Nelle Barr is your Secretary. She comes from a Kentucky family of dentists
societies in the ADA. Our accomplishments
and graduated from the University of Kentucky with a certificate in Pediatric
are due, in large part, to excellent direction
Dentistry. She currently practices in Westminster. She has the passion and
from member volunteers in leadership roles
organizational skills she applies to any job she takes on to achieve success. She is
and the staff who supports them. These
someone I can rely on to resolve especially challenging problems.
dentists devote their time to making the tough decisions in
the best interests of our organization’s members. Some may feel intimidated
Your Directors are:
about becoming a leader but there are many benefits. While serving, volunteers
Dr. Eric Beckman is your newest Director. He is from Minnesota where he also
develop leadership and business management skills, gain a greater understanding
received his dental degree. Since getting to know him, he has earned my respect
of the organization and form lifelong bonds with colleagues. They expand their
for being a quality leader in this organization.
world through working together for the betterment of their profession. MDDS volunteers gain a sense of fulfillment from having given back to the profession
Dr. Karen Franz is a Colorado native who received her dental degree and
that has made it possible to have such a wonderful life.
Orthodontic certificate from UCLA School of Dentistry. She has a thriving orthodontic practice in Stapleton. Her thoughtfulness and
I currently serve as President of MDDS after having been on many committees and the Board of Directors for approximately 10 years. I am from Tennessee and have practiced and taught dentistry in Memphis, Edmonton and now Denver. With continued studies through my career, I have gained some expertise in dental materials. During my time with MDDS, we have faced some interesting challenges and I have made new friends who I would not have otherwise known. MDDS has allowed me to expand my experience beyond the office and academic environment of my teaching position at the University of Colorado of Dental Medicine. One of the greatest thrills is serving with a group of highly qualified, dedicated professionals. Let me introduce you to them: Dr. Nicholas Chiovitti is your President-Elect. Though a
"While serving, volunteers develop leadership and business management skills, gain a greater understanding of the organization and form lifelong bonds with colleagues. They expand their world through working together for the betterment of their profession."
Colorado native, he went to dental school at the University of Southern California. He is a man of service to the profession having directed
service has been an asset to the Board of Directors and the committees to which she has devoted her time. Dr. Brett Levin, a Colorado native who received his DDS from the University of Pennsylvania, continues to provide valued input. This is his second term on the Board of Directors. He should also be recognized for his leadership in a number of charitable organizations. Dr. Kevin Patterson is an oral and maxillofacial surgeon in Denver. We are proud of his accomplishments having provided services to patients in need. He provides a different and interesting prospective into the functioning of MDDS. Dr. Eric Rossow, an Iowa native, practices in Cherry Creek after serving in the Navy and being awarded the Navy Achievement Medal. He was the 2016 RMDC Chair and has made valuable
contributions to the discussion of the direction forward for MDDS.
a very successful COMOM in 2014. He recently retired from decades of general practice and is now pursuing his passion for guitars by going back to school for
Our Trustee and Alternate Trustee representing MDDS at CDA are Dr. David
performance and music theory. For the last few years, we have been able to openly
Klekamp and Dr. Michael Scheidt. Both served as president bringing extensive
discuss the answers to many questions that have arisen in our organization. He
knowledge and experience to MDDS and represent us well at the state level.
will be your next president. I write this article to invite you to become an MDDS leader. There are many Dr. Brian Gurinsky is your Treasurer. A Texas native, he was educated in his
committees that could use your expertise. This is a good place to start gaining
home state culminating in a certificate in Periodontics from the University of
the experience to become a leader. We need both experienced dentists as well as
Texas Health Science Center San Antonio. He is one of MDDS’s most popular
young professional minds to help guide the organization into the future. You can
presenters and maintains practice locations in downtown Denver and Centennial.
call our offices anytime to volunteer. Will you join us?
After several years of serving MDDS, it became obvious to leadership that he has the acumen and attention to detail that makes a great treasurer. He has a sense of responsibility that you can rely upon.
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MEMBER MATTERS
In Memory of a Denver Dental Legend: Dr. Jacob Eisenson (1919-2016) The Denver Dental Community and the Pediatric Dental Community worldwide has lost one of our greats this year. Dr. Jacob Eisenson was a dentist adored by his patients and respected by his colleagues. He devoted his career to advancing the dental profession and advocating the best treatment for patients. A pediatric dentist for over 50 years, he treated countless children, providing them with a solid foundation in the importance of good oral health. His warm smile and friendly demeanor made him a favorite among his pediatric clientele for generations. Dr. Eisenson received his DDS from Northwestern University Dental School in 1950. He returned to the Denver area in 1951 to begin his private practice. Later that year, at St. Anthony Hospital, he established hospitalization for children’s full-mouth-rehabilitation under general anesthesia. He recalled having to use a foot-pump drill during these procedures due to the high risk of fire caused by ether, which was used as anesthesia at the time. In addition to running his successful solo practice, he worked on staff at Denver General Hospital (now Denver Health), Children’s Hospital and Colorado General Hospital (now University Hospital). He had a true concern for proper dental treatment in pediatric patients and served as president of the Colorado Society of Pedodontics and the Colorado Section of the American Society of Dentistry for Children (ASDC). Not only did Dr. Eisenson dedicate himself to the dental health of children, he
also was committed to the success of his fellow dentists. As a respected leader in organized dentistry, he served as President of the Metro Denver Dental Society (MDDS) and the Colorado Dental Association (CDA). He skillfully guided both organizations in their pursuit of advancing the dental profession. He cared deeply about dentistry and took a special interest in those new to the profession. To many young dentists he was a treasured mentor and professional role model who stressed the value of membership in organized dentistry and encouraged them to become involved at all levels. He urged these dentists to educate themselves and join in the community of informed and active dentists from all specialties. Scores of dentists have expressed sincere appreciation for the guidance Dr. Eisenson provided as they were beginning and continuing to establish their dental careers. During his esteemed career, Dr. Eisenson was recognized by his colleagues with numerous accolades and awards, including the Distinguished Award from the Colorado Unit ASDC, as well as the President’s Award and Honus Maximus Award from MDDS. At the former location of the CDA and MDDS headquarters building in Denver, a conference room was named in his honor. Dr. Eisenson will be remembered for his remarkable dedication and service to the dental profession. He shined as a guiding light on what was best for the patient and dentist. We are sure he will continue to shine on in heaven - our deepest condolences to his family, what a wonderful legacy he leaves behind.
Member
Highlights
This summer the ADA premiered a valuable new member benefit – the ADA Credentialing Service. This service allows you to enter, store an update your professional credentials all in one place. The most valuable aspect of this new feature is that, the credentialing service will allow you to streamline the submittal of application data to third-party payers, hospitals and employers. Here are some additional benefits according to the ADA,
Easy upload and storage of supporting documents Automated reminders when license or certification are due to expire Time saver, takes only 15 minutes Secure design specific to the dental market
For more information about this benefit, visit ada.org/credentialing. 6
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Resume Workshop – 8-23-16
New Members, Welcome!
Tamara Cook, of Talent Advantage Partners, provided resume tips and consultations during a workshop with the University of Colorado’s international dental students.
New Member Welcom Event, Rhein Haus – 8-25-16
Nearly 100 people attended the New Member Welcome Event at Rhein Haus – making it our largest attendance yet!
Dr. Matthew Alleman Dr. Zachary Arquilla Dr. Vincenzo Artino Dr. Andy Barseghyan Dr. Benjamin B. Bassett Dr. Gretchen Bauer Dr. Gary Boling Dr. Jennifer Brownie Dr. Paul Casey Dr. Thomas Chubb Dr. Brett Cole Dr. Elizabeth Dunkleberger Dr. Christopher Gipple Dr. Michael Harkins Dr. Sara Hauschild Dr. Kayee Herzberg Dr. Karen Hoffman Dr. Eric Johnson Dr. Hamid Khanjari Dr. Sahel Khorshidian Dr. Albert Kim Dr. Hana Kim Dr. Stephen Knox Dr. Susan Kutis Dr. Issac B. Lee Dr. James Liu Dr. Lindsay Moore Dr. Chetan Patodia Dr. Lauren Peterson Dr. Sage Pollack Dr. Preston Polson Dr. Michelle Rowe Dr. Melissa Strange Dr. Jon Vandewalker Dr. Catherine Vieregger Dr. Deepa Vyas Dr. Symone Webley Dr. Kelly White Dr. Paula Young
Retirement Planning for Dental Professionals
BEYOND INVESTMENTS:
A retirement roadmap built for dentists. We are dedicated to consulting with dental professionals. We design personalized retirement strategies that serve people not products.
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Members enjoy appetizers and drinks while networking with their colleagues.
www.catalystretirement.com (303) 617-7270 Securities offered through Kestra Investment Services, LLC (Kestra IS), member FINRA/SIPIC. Investment advisory services offered through Kestra Advisory Services, LLC (Kestra AS) an affiliate of Kestra IS. Catalyst Retirement Advisors, LLC is not affiliated with Kestra IS or Kestra AS.
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REFLECTIONS By Emmanuel Paguio, DDS
Begin With the End in Mind
Y
ou may not know me as I am not only new as a guest research and education. These new advancements have caused us to have to navigate a writer here for the Articulator, but I am somewhat new labyrinth of treatment options for our patients. to Colorado as well. My wife and I moved here four years I’m sure you’ve heard the old saying, “you don’t know what you don’t know.” With all the ago and we now consider this home. We moved from challenges in dentistry, I think the best way to conquer our fears is to dive in the deep end Chicago for all the same reasons everyone else moves and educate ourselves. After all, if you don’t invest in yourself, who will? To tackle my fears here - Colorado is awesome! We have two kids and our son was born in dentistry, to motivate myself and my employees, I attend as many continuing education here, so I’m happy to be able to say that he is a “native” of Colorado. courses as possible. To learn what I “don’t know,” my team and I I am an endodontist and I opened a practice attend the ADA Annual Meeting. It is a great way for us to educate in Arvada called Art of Endodontics. When faced with new ourselves and an amazing opportunity to re-boost our enthusiasm "To find out what I don’t challenges like a growing family, moving, owning a practice or for dentistry. It reminds all of us where we started, where we are just being a dentist, I have found that FEAR often seems to be know; my team and I and where we want to go! If you want to expand your knowledge the road block to success. How do you overcome your fears in going the ADA national on endodontics, periodontics, oral surgery or cosmetic dentistry dentistry? OR if you want to learn about practice management, marketing meeting because it is a My path in dentistry began over 15 years ago. When I started this or team building, they have it all there. Dentists from all over the great way for all of us journey, Bill Clinton was president, OJ Simpson was the top story, world will be in our back yard to take advantage of these classes and the San Francisco 49ers won the Super Bowl, Forrest Gump won better our profession. It is a great opportunity to reconnect with to educate ourselves best picture and we were learning how to hand file in endodontics old friends, meet new ones and rejuvenate why we do what we do. but it’s also an amazing while using film x-rays. I actually started practicing in Chicago as It also reminds us that within some of those long days, there is a opportunity to reboost our a young, new, eager general dentist. When I went to my first ADA reason and purpose to that daily grind. I’ve learned, through years Annual Meeting, I was like a kid in a candy store. I was so excited of continually keeping up with the changes in dentistry, that the enthusiasm for dentistry." catch up with dental school friends, take CE classes, network with more I learn the less fear I have! people in the industry and check out all the new fascinating “toys” Now, the Denver Broncos are Super Bowl champions (go team!), in dentistry that we didn’t have access to in dental school. When I the nation will have a new leader in November, Star Wars is back on the big screen and got to that meeting, I had no idea how many people were involved in our profession. My dentistry is constantly on the verge of another breakthrough in treatment. Don’t miss mind was officially blown away at the world-wide scope of dentistry and I left motivated opportunities to reinvigorate and invest in yourself. Begin with the End in Mind! to learn more and continue to grow in my new career. That marked the beginning and I was excited to see what was to come next! As the years went by, I often found myself contemplating the long days or weeks of private practice and pondered what keeps me motivated. The ADA meeting only came once a year and as life seemed to keep changing, I couldn’t make it to every convention. I was thirsty to stay motivated and learn more and gravitated towards endodontics. During residency, we dove into the research and new technology and I was fulfilled again! Fast forward to now, and I am back to the daily grind of private practice. There are some good days and some bad days. How do we energize and stay motivated 300 days out of the year? I read a book years ago, Seven Habits of Highly Effective People by Steven Covey. BTW if you’ve never read it, I highly suggest you buy, borrow or steal one from a friend to implement his suggestions within your practice and life ASAP! One habit suggests to Begin with the End in Mind! When I look at my career as a dentist, I constantly strive to be great at what I do within this journey. I try to continue my education to benefit this purpose. I want my patients to appreciate what I do because I care. I hope to motivate and inspire my employees to want to work hard for the common goal and vision I have created for my practice. How do I do this? Where do I begin? I think back to that first meeting over 15 years ago. That inspiration I felt I now obtain from every meeting I attend, large or small. Motivation created by learning, networking with new people like me that care, trying new instruments or equipment to stay on the forefront of endodontics are on my agenda every time. We all need to take the time to learn what is new in our industry as it will continue to evolve and improve. Several improvements have been made in the last 15-20 years in dentistry thanks to the advancements in materials, instruments, equipment, techniques and, most importantly,
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SAVE THE DATE!
Dine in style for a great cause at MDDS’s 1st Annual Serving Up Smiles charity dinner BENEFITTING DENTAL LIFELINE NETWORK
Coohills
Thursday, April 13, 2017 6:00pm – 9:00pm Dress: Cocktail Stay tuned for registration information! Email Cara Stan at marcom@mddsdentist.com for more information.
Grow your dental practice and your world. We know in the world of dentistry, every decision counts. That’s why at Commerce Bank we ask you the right questions, listen to your answers and help you streamline and increase efficiencies in your revenue cycle. Get more time to focus on patient care while we work together to provide customized financing solutions and the latest in payments products and technology to help foster smart, sustainable growth for your world. · Practice acquisition financing · Equipment loans and leases · Real estate financing · Payments processing Let’s talk business.
303.214.5430 | commercebank.com/dentistry
©2016 Commerce Bancshares, Inc.
THE
A’S
OF CONFIDENT DENTISTRY By David Maloley, DDS
H
ow confident are you in your craft as both a dentist and business leader?
because we don’t feel like we’re any good at it. We’d rather be doing the things we do well, like working on teeth.
I have always found it interesting that 99% of what we talk about in dentistry is strategy. Nearly every CE course out there is either founded in clinical strategy or business strategy. Yet, when we reflect on your practice’s successes and struggles, they are largely based on the psychology of you, the dentist.
Confident business leadership is primarily a learned behavior. It requires the owner to stop blaming the economy, the team, the patients, the lab, etc. Take 100% accountability for your practice success.
Three years ago, I started a podcast called The Relentless Dentist. My goal was to find out how the most successful dentists act and (more importantly) how they think! Here’s a simple truth: If you don’t know how to lead your practice from a place of confidence, then it’s difficult to succeed. I’ve distilled the following five important areas of practice focus from years of experience in building my own practice and interviewing highly successful dentists who are doing the same. If you focus on developing yourself in each of these aspects, then you’ll certainly become a more confident practice leader. Accountability Growing a practice is hard work. It often requires us to get out of our comfort zones and do things we don’t enjoy. Sometimes we shy away from business development precisely
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Instead of pointing the finger at a team member, reflect first at your hiring and training protocols. Perhaps you haven’t made your expectations and your practice vision crystal clear. When we take this approach of extreme accountability, we then can own and better control the outcomes in our practice. Authenticity Sometimes it’s hard to be yourself even in your own dental practice. Much responsibility comes with having the title of “Doctor” and having your name on the door of your practice comes with a lot of responsibility. Our patients and team members often expect us to have all the answers. I believe for a doctor to feel confident in their own practice, it requires a concerted effort to “be yourself.” We have to let down our guard and be comfortable in our own skin. Do you take time to get to know your team and your patients? Do you let them get to know you? The real you?
If you can share your sense of humor, your hopes, your passions; even your regrets and frustrations, you will find yourself connecting with the people around you at a deeper level. They want you to know you as a human, not just a dental expert.
to be about protecting your share of the market. This kind of mindset can sink your practice.
Action Do you have an idea for a marketing campaign, but you’re too afraid to put yourself out there? That’s fine, but don’t expect your business to magically grow on its own. Only action can beget results.
You’re not engaged in a zero-sum game with your colleagues. Only 62% of adults in America actually went to the dentist last year, which means there’s plenty of business to go around. Instead of feeling like you need to steal yourself a piece of that proverbial pie from the dentist down the street, concentrate on making the pie bigger. Add value to your patients’ experience!
That new procedure you just learned at the weekend course isn’t going to implement itself. Take action. One of the most important action items that dentists tend to avoid is conversations with the team. If a team member isn’t pulling their weight, you need to let them know your expectations. Conversely, your star performer needs to feel your gratitude because an under-appreciated employee will soon start looking for a practice that truly recognizes their talents and efforts. Adaptability If you get serious about taking action, then you’ll quickly learn that nothing goes 100% according to plan. You can meticulously lay everything out and control for all the variables. Still, something will inevitably come up that forces you to adapt. Developing confidence as a health care provider means adopting the mindset of a Marine: improvise, adapt and overcome. Adaptability requires equal parts reflex and fortitude. Dentistry is a rapidly changing profession. We must stay open minded and be innovators in our practice. If we haven’t made decisions about how we want the new economy, technology and consumer behavior to impact our livelihoods, some of those decisions will be made for us. Abundance Mindset The opposite of abundance is scarcity. When we adopt a scarcity mindset, we begin to lead from a place of fear. Every decision ceases to be about providing value and starts
"Nearly every CE course out there is either founded in clinical strategy or business strategy. Yet, when we reflect on your practice’s successes and struggles, they are largely based on the psychology of you, the dentist."
The best way to develop an appreciation for what you have is to give it away. Volunteer some time and serve in your community. Better yet, find someone from an underprivileged area and bless them with a few hours of free treatment. If you work diligently to improve yourself in each of these areas, you’ll begin to see amazing results in your business. All it takes is a plan and a commitment to yourself, your practice and your patients. Strengthening your confidence is like strengthening a muscle. It takes exercise. As your confidence grows, you will see more practice success.
About the Author: David Maloley, DDS lives in Vail, CO with his wife, Karah, six-year-old son, Bennett, and a boxer named Brux. He is a graduate of the University of Nebraska College of Dentistry and the U.S. Army AEGD-1 residency program. He served in the Army Dental Corps for four years in Europe before founding Vail Valley Dental Care in 2009 and The Relentless Dentist Podcast in 2013. He can be reached by email at david@vailvalleydentist.com.
Save the Date & Network Among the Fishes
MDDS Awards Gala & President’s Dinner Join us in honoring MDDS President Dr. Sheldon Newman at this entertaining social event. Attendees will be treated to live music, a vendor fair reception, dinner and Society awards ceremony. Thursday, January 26, 2017 6:30pm – 10:00pm Fee: $80/person Dress: Cocktail
Register online at rmdconline.com
WELCOME
TO THE FAMILY
M
DDS is excited to announce the addition of a new membership category for our supporting vendors. This category is long overdue! With it, we hope to welcome companies who consistently support organized dentistry, the efforts of MDDS and provide services to the Society’s members. Some of the benefits these new members will enjoy are:
Name Recognition As a loyal supporter of the profession, MDDS vendor members will stand out to potential customers as a supporter of their Society by gaining use of the MDDS logo and recognition on the MDDS website.
Education
Vendor members will receive one additional seniority point each year of membership while increasing their visibility through recognition in the RMDC Onsite Guide, special booth signage and name badge ribbons.
MDDS prides itself on being a top-rated provider of dental education, especially through the Rocky Mountain Dental Convention (RMDC). MDDS vendor members will be able to attend courses at RMDC through their membership. To stay informed on the latest in the dental industry, vendor members will receive a subscription the quarterly, award-winning Articulator magazine and weekly e-newsletter, the Byte Register.
Mountain West Dental Institute
Industry Discounts
MDDS members are encouraged to share their expertise and knowledge by offering continuing education courses at the renowned Mountain West Dental Institute (MWDI). All members receive 15% off MWDI rentals and member companies may also apply to use MDDS CERP CE certification for free – a $1,000 value!
Vendor members will have the opportunity to save 5% on their current marketing efforts through discounts on advertising and sponsorship rates.
Rocky Mountain Dental Convention
Networking and Lead Generation As part of membership in the Society, vendor members will be able to join select MDDS committees and connect with other members and customers through MDDS social sites. Additionally, all members enjoy access to one free member mailing list per year.
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MDDS is excited to welcome our vendors into the organized dentistry family. Please join us in this welcome by supporting our new fellow members! For more information on vendor membership or to sign up today, contact Korinna Milam, Membership & Events Manager, at (303) 488-9700 or membership@ mddsdentist.com.
CDA Endorsed Companies Are you taking advantage The CDA endorsed companies provide members with products and services at discounted prices AND provide the CDA with revenues to better serve your in the 2015/2016 fiscal year, the received by the CDA from these companies helped to fund: Statewide lobbying efforts
and government relations for the dental profession
Community Water Flouridation
Advocacy to protect your patients and the public
New Dentist Committee
networking and study club events for dentists 10 years or less out of dental school
Ladies in the Loupe
networking events for female dentists to connect with their peers.
CDA endorsed companies most frequently used by your colleagues:
www.bestcardteam.com
www.copic.com
www.officite.com
www.shwj.com
www.solmetex.com/dental.html
www.imedicor.com
www.tdplt.com
www.associationgloves.com
www.easyreďŹ ne.com
Other CDA Endorsed Companies: CareCredit, InTouch Practice Communications, Lands’ End, Medical Systems of Denver, SoFi, UPS, US Bank, Wells Fargo Bank, and Whirlpool Corporation
To learn more, visit www.cdaonline.org/endorsedoffers or contact the Colorado Dental Association at 303-740-6900 or info@cdaonline.org. 13
FREEDOM DAY 2016
E
ach September dental offices and other businesses across the country participate in the nation’s largest military thank you event – Freedom Day USA. Since 2013, Denver area dentists have opened their doors to veterans, active military and their immediate families to provide free dental care for those who
have sacrificed so much. Eleven offices in the metro area participated in the 2016 event on September 8th. Dr. Carrie Mauterer, general dentist in Thornton and MDDS Community Outreach & Public Relations Chair, has volunteered as a Freedom Day dentist the past two years. “The patients we see on Freedom Day have given so much to our country and despite this, they are so humble and thankful for the work we are doing. The smiles on their faces and the hugs our staff get is the best kind of payment," she said. If you are interested in learning more about the event or would like volunteer, please call the MDDS office at (303) 488-9700 or visit freedomdayusa.org.
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Dr. Brockman and patient discuss his time in the military on Freedom Day USA.
Drs. Adler and Bousaba of Northstar Dental make care for our military a priority each year.
Dr. Brockman's office welcomed veterans on September 8th.
Dr. Adler consults with a hygienist during Freedom Day USA.
Dr. Mauterer at Appletree Dental provides free dental care to a 98-year-old military veteran.
Patients show gratitude to the staff at Appletree Dental during the 2016 Freedom Day event.
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SO YOU THINK YOU NEED NEW DENTAL EQUIPMENT?
FOUR QUESTIONS TO ASK BEFORE YOU SIGN ON THE DOTTED LINE By Paul Jerez
W
ho wouldn’t prefer an office brimming with new technologies and equipment over one with outdated models?
The answer may seem obvious – unless you are a dentist who has seen the price tag on a state-of-the-art dental office. A Periapical X-ray unit, for example, retails for as much as $5,000. A top-of-the-line patient chair could set you back $9,000. Factor in the cost of the latest hand pieces, sterilization systems, operating lights, computers and all the other furniture, supplies and equipment a dentist needs, and you could be looking at a total investment of $150,000 or more for an office upgrade or expansion. While your heart might be telling you to focus on the amazing advances this equipment offers to today’s dentists, your brain might be slamming on the financial brakes. Before you make a decision, there are four key questions to consider: 1. Is the investment worth it? Some purchases are “no brainers.” If the cost to repair existing equipment approaches that of total replacement, for example, buying new is common
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sense. So does purchasing essential equipment that will pay for itself in a reasonable length of time. The decision is less clear-cut when buying equipment that is not central to your practice and may not deliver the return-on-investment (ROI) needed to justify its purchase. For example, consider the special equipment needed for cosmetic dentistry. It could take longer than its expected life to deliver a return, especially if the demographic you serve cannot afford the expense associated with dental asthetics. A wise practitioner will sit down, often with a financial adviser, and literally do the math when considering options. 2. How long will it take for the equipment to begin paying for itself? When you are figuring the ROI on a potential purchase, keep in mind that most equipment does not begin generating revenue on day one. In fact, it can take months to build the business and collect the patient payments needed to begin payback. Understanding this lag time is important when working with a lender to create a payment schedule for a loan. A lender that is accustomed to working with dentists is more likely to work with you and design a payment plan that factors in lower first-year revenues and keeps your cash flow strong.
3. Is it better to lease or purchase? It depends. There are advantages to each approach. An equipment company’s leasing business, for example, may allow a dentist to trade in a piece of equipment for a newer model before the lease ends. Be sure to ask about interest rates. Some equipment companies tend to bury this information.
"The decision to expand or upgrade dental office is an expensive proposition, and it might be just the thing you need to grow your practice."
If you are interested in owning equipment outright, a dentist-friendly bank, on the other hand, may offer a better interest rate, potentially saving money and making it easier to reach your goal of ownership. A bank may also offer payment options not available in equipment leases, such as interest-only payments at the onset. Also, if you have visions of long loan applications, you may be pleasantly surprised. 4. What if I must act quickly? Dentists often plan expansions or exam room upgrades years in advance. But sometimes, a need or an opportunity presents itself when it is least expected.
specifically for dental practices. Commerce Bank, for example, offers a Fast Track Dental Loan Program that makes it easy for a dentist to move quickly when necessary. The process results in a pre-approved, guidance line of credit that converts into a term loan when you make a purchase.
The bottom line? The decision to expand or upgrade dental office is an expensive proposition, and it might be just the thing you need to grow your practice. A key component to building a successful practice is selection and timing of expenditures combined with the financing solution that will enable you to meet your business goals.
About the Author: Paul Jerez joined Commerce Bank in 2014 as a Small Business Banking Specialist. With over 12 years of business lending experience in the Colorado Market.Paul’s alma mater is the University of Arizona and he is working toward his Master’s in Business Administration.
That is why virtually EVERY dentist will benefit by getting pre-approved for financing before they start an equipment search. If you haven’t already been pre-approved, you might look for financing options designed
CLINICAL
PEER REVIEW PUZZLER Peer Review is a member benefit of the Metro Denver Dental Society. The following is a sample of an actual event, with real patients and real MDDS dentists that was reviewed and mediated by the MDDS Peer Review Committee. Case The patient’s chief complaint was negligence in the form of an undiagnosed
experiencing facial swelling, neck and ear pain and visible pus pockets.
infection during the placement of two crowns. The treatment plan for the patient was crown replacement on teeth 18 and 19. According to the patient, during the
Upon visiting the endodontist, the patient was diagnosed with a significant
removal of the old crowns and placement of the temporary crowns there was a
infection and was informed 18 would need to be extracted and 19 would need a
“distinct, foul smell.” Despite having no pain prior to the procedure, the patient
root canal. The patient was prescribed antibiotics and referred to an oral surgeon
documented complaints of pain following the placement of the temporaries.
for an extraction and bone graft. After the infection healed, the crown on 19 was replaced.
Approximately three weeks after the initial procedure, during the placement of the permanent crowns, the patient commented that they noticed the “foul smell” again
During interviews with the Peer Review Committee, the patient stated they were
and began to experience heat and cold sensitivity which progressed as time went
requesting a full refund for the amount of the crowns billed to insurance – a total of
on.
$1,517.30 though no money came out of pocket. Dr. X was notified of the case by a Committee member. Dr. X was given follow-up and resolution information and
Two months following the placement of the temporary crowns, the patient’s pain
had time to review patient records. On a follow-up call to the patient, the refund
had escalated and they followed up with Dr. X. According to the patient, Dr. X
request was revised to $775 for 18 and $225 for 19.
informed the patient they needed to follow up with an endodontist and was prescribed a pain reliever. Before seeing the endodontist, the patient reported
Peer Review answer on page 22
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CLINICAL
CREATIVE METAL OCCLUSALS A new approach to an old technique By “Diamond� Dave Andrus, CDT
M
etal occlusals are one of those things in dentistry that are occasionally necessary. While we in dentistry understand the benefits, patients may tend to reject the appearance of large portions of the occlusal surface of a crown covered in metal. Creatively designing the metal occlusal surface in the shape of an amalgam filling can increase patient acceptance while compensating for reduced occlusal clearance and/or provide the benefits of metal surfaces in areas where porcelain often fails.
Lingual view of the 6 unit case with metal occlusal stops on teeth numbers 2 and 31.
Creatively designed metal occlusal surfaces provide a strong surface for opposing gold crowns and allows for a PFM when the occlusal reduction is limited allowing occlusal contact on the distal marginal ridge without the risk of fracture.
Occlusal view of the mandibular right posterior quadrant with the lingual cusp tips of tooth number 2 in metal.
Metal occlusal stops can be used even with high aesthetic demand patients when the metal occlusal surfaces are designed to mimic amalgams. Buccal view of metal occlusal stops on teeth numbers 2 and 31 of a high aesthetic demand patient. Future plans include an implant crown in the number 30 position.
About the Author: Dave Andrus has owned and operated Diamond Dental Studio in Byers, CO for 29 years. He has been a technician for 37 years and can be reached at andruscompanies@netecin.net or (303) 822-6666.
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Occlusal view of tooth number 31 with the occlusal contact in metal while maintaining as much aesthetic quality as possible.
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DO YOU HAVE A COMPREHENSIVE FINANCIAL PLAN FOR YOUR FAMILY AND YOUR DENTAL PRACTICE? Leverage our 15 years experience advising dentists. With a broad and clearly documented financial picture, you’ll be empowered to implement solutions around insurance, investments, and tax planning. Reach out today and schedule a Planning Analysis with my team.
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2016 Northwestern Mutal is the marketing name for The Northwestern Mutual Life Insurance Company (NM). Milwaukee WI (life and disability insurance, annuities, and life insurance with long-term care benefits) and its subsidiaries, Northwestern Mutual Investment Services, LLC (NMIS) (securities), a subsidiary of NM, broker-dealer, registered investment adviser, and member of FINRA and SIPC. Shawn Copeland, Insurance Agent of NM, Shanw Copeland, Registered Representative of NMIS, Shawn Copeland Representative of Northwestern Mutal Wealth Management Company (NMWMC) Milwaukee, WI (fiduciary and fee-nbased planning) subsidiary of NM and a federal savings bank. Financial Representatives do not give legal or tax advice. Taxpayers should seek advice based on their particular circumstances from an independent tax advisor.
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Maintaining Your Financial Records:
THE IMPORTANCE OF ORGANIZATION By David Easton, CFP® & Ron Lottridge, CFP®
A
n important part of managing your personal finances is keeping your financial records organized. Whether it's a utility bill to show proof of residency or a Social Security card
for wage reporting purposes, there may be times when you need to locate a financial record or document – and you'll need to locate it relatively quickly. By taking the time to clear out and organize your financial records, you'll be able to find what you need exactly when you need it.
What should you keep?
How long should you keep your records? Generally, a good rule of thumb is to keep financial records and documents only as long as necessary. For example, you may want to keep ATM and credit-card receipts only temporarily, until you've reconciled them with your bank and/or credit-card statement. On the other hand, if a document is legal in nature and/or difficult to replace, you'll want to keep it for a longer period or even indefinitely. Some financial records may have more specific timetables. For example, the IRS generally recommends that taxpayers keep federal tax returns and supporting documents for a minimum of three years up to seven years after the date of filing. Certain circumstances may even warrant keeping your tax records indefinitely.
If you tend to keep stuff because you "might need it someday," your desk or home office is probably overflowing with nonessential documents. One of
Listed below are some recommendations on how long to keep specific
the first steps in determining what records to keep is to ask yourself, "Why do
documents:
I need to keep this?"
Records to keep one year or less:
Documents you should keep are likely to be those that are difficult to obtain,
• Bank or credit union statements
such as:
• Credit card statements
• Tax returns
• Utility bills
• Legal contracts
• Auto and homeowners insurance policies
• Insurance claims • Proof of identity
Records to keep more than a year: • Tax returns and supporting documentation
On the other hand, if you have documents and records that are easily
• Mortgage contracts
duplicated elsewhere, such as online banking and credit card statements, you
• Property appraisals
probably do not need to keep paper copies of the same information.
• Annual retirement and investment statements • Receipts for major purchases and home improvements
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Continued on page 22
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Continued from page 20 Records to keep indefinitely: • Birth, death, and marriage certificates • Adoption records • Citizenship and military discharge papers • Social Security card Keep in mind that these recommendations are general guidelines, and your personal circumstances may warrant keeping these documents for shorter or longer periods of time. Out with the old, in with the new An easy way to prevent paperwork from piling up is to remember the phrase "out with the old, in with
You could also use a cloud storage service that encrypts
"If you tend to keep stuff because you "might need it someday," your desk or home office is probably overflowing with nonessential documents. One of the first steps in determining what records to keep is to ask yourself, "Why do I need to keep this?"
your uploaded information and stores it remotely. If you use cloud storage, make sure to use a reliable company that has a good reputation and offers automatic backup and technical support. Once you've found a place to keep your records, it may be helpful to organize and store them according to specific categories (e.g., banking, insurance, proof of identity), which will make it even easier to access what you might need. Consider a personal document locator Another option for organizing your financial records is to create a personal document locator, which is simply a
the new." For example, when you receive this year's
detailed list of where you have stored your financial records.
auto insurance policy, discard the one from last year.
This list can be helpful whenever you are trying to locate a specific document and can also assist your loved ones in locating your financial records in the
When you receive your annual investment statement, discard the monthly
event of an emergency. Typically, a personal document locator will include
or quarterly statements you've been keeping. In addition, review your files at
the following information:
least once a year to keep your filing system on the right track. Finally, when you are ready to get rid of certain records and documents, don't just throw them in the garbage. To protect sensitive information, you should invest in a good quality shredder to destroy your documents, especially if they contain Social Security numbers, account numbers or other personal information.
• Personal information • Personal contacts (e.g., attorney, tax preparer, financial advisor) • Online accounts with username and passwords • List of specific locations of important documents (e.g., home, office, safe) About the Authors David Easton, CFP® and Ron Lottridge, CFP® are founding partners of Catalyst
Where should you keep your records? You could go the traditional route and use a simple set of labeled folders in a file drawer. More important documents should be kept in a fire-resistant file cabinet, safe or safe-deposit box. If space is tight and you need to reduce clutter, you might consider electronic storage for some of your financial records. You can save copies of online
Retirement Advisors. Catalyst Retirement Advisors specializes in serving the retirement planning needs of dentists, orthodontists, oral surgeons and other dental professionals. Securities offered through Kestra Investment Services, LLC (Kestra IS) member FINRA/SIPC. Investment advisory services offered through Kestra Advisory Services, LLC (Kestra AS) an affiliate of Kestra IS. Catalyst Retirement Advisors, LLC is not affiliated with Kestra IS or Kestra AS
documents or scan documents and convert them to electronic form. You'll want to keep backup copies on a portable storage device or hard drive and make sure that your computer files are secure.
Answer to the Peer Review Puzzler (continued from page 17) Dr. X granted the $1,000 refund and the patient signed a hold harmless waiver to protect Dr. X against any potential future litigation regarding this case. Litigation and claims on a dentist’s malpractice insurance can be an expensive and lengthy process – one that is best avoided. If you have questions about the peer review process or are interested in joining the committee, please contact Marlene Pakish, MDDS Finance & Operations Manager, at finance@mddsdentist.com or (303) 488-9700 ext. 3268.
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mddsdentist.com
Articulator Winter 2015
24
NONPROFIT NEWS
I
THE POWER OF A SMILE t’s hard for many of us to imagine what life would be like being terrified to smile;
Chad M. Boustany, DDS, MS, prosthodontist and a founder of Renewing Smiles, just
acking the confidence to speak your mind because of the way your teeth look; being
couldn't turn her away. He knew that he could fix her problem and give her a new lease
unable to enjoy the simple pleasures of eating an apple or laughing while taking
on life. Dr. Boustany pulled together his team and community to find a way to make
selfies with friends. Dreading what someone might think of you when they catch a
sure Blake would get the care she needed. He reached out to everyone he knew that
glimpse of your teeth and how they might judge you based on it.
could potentially help was able to provide the surgery and care pro bono.
Dental work is expensive. The cost can be a tremendous burden and prevent many
"I was sobbing on the phone," Blake tells us of when Dr. Boustany called her to tell her
from getting the treatment they need. That's where Renewing Smiles Inc. comes in.
that he might be able to help her. "I thanked him profusely." For the first time in a long
Born out of the University of Denver’s Executive MBA program with it’s dedication to
time, Blake had hope that someday she'd have a smile that fit her personality. Blake was
social impact projects, Renewing Smiles is a nonprofit helping those with congenitally
able to look to the future with excitement.
missing teeth handle the financial cost and supporting them through their journey to a beautiful smile.
"When I see Blake smile, I don’t know if I’m looking at her smile or if it’s in her eyes. She’s a different person," Dr. Boustany says of the transformation he sees in Blake now that
The first case that Renewing Smiles took on was Blake, a vibrant young woman with
she is confident in her smile and herself.
congenitally missing teeth without the ability to pay for the surgery. At just 12-years-old
figure 2
she was told she had no adult teeth growing in. From that moment on her life changed.
Once a young woman who hid in a cubical, never opening her mouth when she smiled,
The once bubbly, smiling kid stopped smiling with her mouth open and became self-
she is now a young woman with confidence and aspirations to becoming a real estate
conscious.
broker. She is ready to tackle the world with the power of a bright figurenew 2 smile.
In school, Blake was teased endlessly, grades suffering, confidence suffering, and
The Renewing Smiles team can't wait to assist more cases like Blake's. Giving the gift of
believing she'd never get married because there would be photographers. The pain
a smile is giving the gift of confidence. Renewing Smiles is looking for more volunteers,
she felt purely based on the way people saw her weighed on her. When she turned 18,
donations and involvement. We host fundraising events like our annual Crawfish Boil
her family couldn't afford the surgery she'd need and all she could do was hope that
and more! To get involved, visit our website renewingsmiles.org and be the power
someday she'd save enough (potentially up to $50,000 or $60,000) to pay for the surgery.
behind someone else's smile.
Luckily, she didn't have to wait that long.
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By Uche Odiatu BA, DMD, NSCA
EXERCISE – WHEN LESS IS MORE WITH HIIT
W
ant to begin a regular exercise habit and don’t have the time? By the time you get half way through this article it will dawn on you that HIIT. is going to be your way out of sedentary living. I know it’s hard to believe that anything in the exercise industry is new, but HIIT. is all the rage in high end personal training circles. And it’s time for me to blow the doors open on this insider strategy with my dental colleagues. HIIT stands for High Intensity Interval Training and can be performed anytime anywhere with little or absolutely no equipment. From beginners to seasoned exercisers, it can improve your muscular strength, increase cardiovascular fitness, boost a sluggish metabolism and burn incredible amounts of fat. It is the intensity in this new style of exercise that makes it different than “run of the mill” steady state styles of exercise (i.e. jogging). What are the major physiological adaptations that occur with HIIT? Skeletal muscles form new mitochondria – the powerhouse factories in every cell that burn fuel for performance and energy1. Want a second wind at the end of a long clinic day? Say good bye to the afternoon blahs and hello to renewed energy for you and your family when you get home. Have I got your attention? A HIIT exercise session is made up of a warm up period followed by three to ten repetitions of high intensity exercise periods, alternating with medium intensity exercise as a recovery and consummating with an easy cool down. The high intensity portion should be done at near heart rate maximum (HRM). The medium exercise section is recommended to be about 50% intensity or 50% HRM. The exact number of reps and length of time each depends on your current fitness level and overall goals. There may be as few as four repetitions with as little as 30 seconds of high intense exercise bursts alternated with moderate periods for recovery. Benefits of HIIT: Time Efficient: 5-10 minutes as good as 50-60 minutes to boost lung health Excellent Fat burner: metabolism is heightened for 24 hours after Unique: a new challenge for your heart, lungs and muscles
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Engaging: multiple adjustments of intensity demand your attention Simple: easy to implement for almost any type of exercise Cost Effective: needs little or no equipment Boost V02 max: the gold standard of measuring your fitness level Strengthens your immune system: purges stale immune cells Fun to do: a very different but pleasurable way to exercise Why is HIIT getting so popular? Because of its lack of complexity and huge payoffs in physiological benefits! Eighty-five percent of the population does not participate in regular exercise – each for many different reasons. The number one reason is time! But many don’t exercise because they aren’t sure what to do or have made the entire process too complicated themselves. Is it just cardio or aerobic exercise that is done with HIIT? Not at all! HIIT workouts may include a variety of exercises and drills that include bodyweight exercises, jumping ropes, dumbbells, kettle bells, rebounders and tractor tires/sledge-hammers. Yes, I said sledge hammers. One of the advantages of being a certified trainer is that I get to attend loads of continuing education at personal training conferences around North America and I see the wildest, most invigorating workouts you can imagine. HIIT workouts that include multiple exercises and pieces of equipment might be a little confusing or overwhelming for people in the beginning. They would include a general warm up (i.e. walking or using an elliptical) but would move on to a series of alternating exercises (i.e. walking lunges from one side of the room to the other with sun salutations from yoga and jumping on the rebounder (mini trampoline). Here’s an example of an HIIT workout: 3 minutes on the treadmill (warm up – no incline and walking) Walking lunges (from one side of the room to the other) Standing toe touches: 1 set of 10 Walking lunges Dumbbell chest presses on an incline bench: 1 set, 12 reps 30 seconds on rebounder Dumbbell chest presses: 1 set, 12 reps
This pattern of back and forth high intensity / recovery can go until you have been working for approximately 5-12 minutes, depending on your fitness level. This type of training, even though it might seem very basic, is capable of providing incredible fat reduction results. But the results aren’t just for shrinking the adipose tissue (one of your body’s biggest culprits for fueling chronic inflammation in your body).
1 minute on elliptical with intensity Lat machine pull-downs: 1 set, 12 reps 1 min on elliptical with intensity Dumbbell curls: 1 set, 12 reps Push-ups (until failure) Dumbbell curls: 1 set 12 reps Push-ups (until failure) Is there an easier strategy to follow for the beginner (there’s way more beginners than elite athletes in this world)? I am going to focus on the beginner or novice exerciser as it’s these people who need to be sold on the value of exercise and understand the payoffs. For my favorite group to inspire, I will spend some time on an area they will appreciate. I am going to choose the stationary bike as it is one of the simplest pieces of exercise equipment to use to learn HIIT and experience the benefits. It’s hard to fall off and no previous experience is required to ride it. Warm up (2minutes) Set the resistance at a low level – one that you can still breathe easily without any labor. RPM (Revolutions Per Minute) are 60-80. Moderate Intensity
"HIIT stands for High Intensity Interval Training and can be performed anytime anywhere with little or absolutely no equipment."
Set your resistance at a higher level – now you can say a few sentences but that is it. Keep the RPM the same (60-80) so you are working at a higher level. Maintain this for one minute. It will feel more challenging than the warm up and so it ought to be — “you are exercising!” You will feel your heart pumping and you may even break a sweat. Once you reach the one minute mark, set the resistance lower and enjoy some recovery
HIIT is capable of boosting cardiovascular strength and endurance. The heart is a muscle and needs to be worked hard beyond what it is routinely capable of to get a training adaptation. Your chest has the bench press to strengthen it, but you cardiac tissue doesn’t have hands to grab a dumbbell. In one sixteenweek study, it was found that maximum aerobic capacity was greater with interval training than regular steady state or continuous training2. An important key to remember is to be gentle with your body with any new exercise program. HIIT, like any other exercise, technique adds new stress to your body and can be very demanding and can lead to overtraining if you push too hard. Add some HIIT at most two to three times a week. And make sure you incorporate other types of exercise into a complete exercise routine. Good quality sleep and excellent nutrition must be a part of the recipe if you want the body to respond by growing stronger. References: 1 Journal of Applied Physiology 111:1554, 2011 2 Journal of Cardio. Rehab. Prev. 31: 378, 2011 About the Author Uche Phillip Odiatu, BA, DMD, is the author of "The Miracle of Health & Fit for the LOVE of IT!" This practicing dentist is a NSCA Certified Personal Trainer & professional member of the American College of Sports Medicine. He lectures at major dental conferences. Send questions to facebook.com/Odiatu.
Recovery In this phase you are allowing your body to recover and replenish. Breathing ought to return to normal and you will get a sense that you could push it again. High Intensity Yes, the moment people have been waiting for. Set the resistance higher than in your moderate intensity phase and stay at 60-80 RPM for 30 seconds. fifteen seconds into it, it will feel like your thighs muscles are on fire. You may even need to stand up on the pedals as you go and pull on the handle bars like the cyclists do climbing Mont Ventoux in the Tour De France. You are working very hard and you cannot even utter a few words as all your energy is going toward getting you away from an imaginary grizzly bear chasing you through the forest. At the 30 second mark you will be ready for the next recovery phase. Recovery This phase you will again be providing your 600 muscles a much needed rest. It can last as long as one minute (but can be as long as three minutes for deconditioned people). After one minute (if that is what you have chosen), you can go back to high intensity.
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CASE STUDY:
LEASE RENEWALS, RELOCATIONS, PURCHASES By Stephen Strecker NOTE: Although the names have been changed for privacy purposes, this case study is based on a real story.
L
ike most doctors at lease renewal time, Dr. Thompson felt stuck.
You see, like most dental practices in the market today, Dr. Thompson knew that his current lease rate was significantly higher than the rest of the businesses in his area, but he had no idea how to change this. Sure, he could engage with the upcoming negotiation on his own like he had in the past, but all he had accomplished to this point was having a lease with unfair terms and which was way too expensive. At the same time, he knew how difficult and costly it would be to move his practice to a new location—something he had no desire to tackle at this point in his career. Dr. Thompson was fortunate enough to receive a phone call from his landlord
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letting him know that his lease was up for renewal in nine months. Fortunate because these calls often come only weeks before a renewal, when landlords know that tenants will be stuck on the weak side of the negotiation table because there is not enough time to relocate their office before expiration. Thankfully, Dr. Thompson now had time on his side. What did he do with this time? In this case it all started with Mark, a merchandise representative for a dental distribution company who decided that caring about Dr. Thompson’s overall practice success was more important than just selling products. During one of his regular visits to the doctor’s office, Mark found out that Dr. Thompson was anxious about his upcoming lease renewal. Mark thought of a contact he had in the real estate world who specialized in healthcare real estate and only represented doctors, not landlords, in property negotiations. After a brief conversation about the situation, Mark gave Dr.
Thompson this agent’s information and the rest, as they say, is history. After one phone call, Dr. Thompson was out on a tour looking at other properties in the area, finding out what was really available in the market. He was hoping to avoid a move and stay where he was at, but he knew there would always be that nagging thought in the back of his mind: “Did I really get the best deal available?” Well, after looking at actual opportunities in his area, he was surprised to find some options that piqued his interest. At the end of his search he was able to consider three different options: 1. Stay where he was and re-negotiate his current space. While this was originally a thought that created anxiety and feelings of being taken advantage of, he now had an advocate on his side that would help him ensure he was getting the best possible terms and the highest concessions. On top of that, he had now seen what was really out there in the market and, whatever the outcome, he knew he was in a place to choose the best available option. 2. Build out a new leased space and relocate his office. At first this sounded like a chore, but much to his surprise, he discovered an office for lease that would save him thousands of dollars per month and provide a nice suite in a nearby building with all new finishes that he could be proud of. A brand new office in a great location for less money? Up until now he didn’t even know this was possible. Now he did. 3. Purchase his own office building. Just down the street was a property for sale that he didn’t even know was available. This one intrigued him the most because it was already built out as a really nice dental practice. To boot, it had some great dental equipment that came with the property. He drove by that building on a regular basis, but he never knew there was a dental office inside or that it was for sale—there wasn’t even a sign in front. But thanks to his agent, now he knew.
3. 4. 5. 6.
Enabled him to upgrade his dental equipment Removed the stress of negotiating with his landlord Allowed him to concentrate on his patients instead of his building Dramatically improved his bottom line
Now, instead of being faced with yet another stressful lease renewal negotiation where he knew he was going to lose, Dr. Thompson was looking at three legitimate scenarios that could put an additional $500,000 to $800,000 in his pocket over the next 10 years. Instead of calling other landlords in the area and hoping he could find a better deal, he knew that he had the best deal in town. Instead of taking time away from his patients and his family to research properties and negotiate his own terms, he got to focus on doing what he does best while his agent focused on doing what he does best. Instead of putting money in the landlord’s pocket, he got to put it in his own.
What is perhaps the most surprising part of this whole story is that Dr. Thompson was able to accomplish all of this for free. Just like in a residential real estate transaction, his agent got paid by the seller when the deal was done. In this case, Dr. Thompson ended up choosing the purchase opportunity just down the street. Compared to the lease rate "Now, instead of being he was scheduled to renew at in the beginning, he saved over $500,000 in actual cash flow and had an additional $300,000 faced with yet another asset to show for it at the end of his 10-year loan.
stressful lease renewal negotiation where he knew he was going to lose, Dr. Thompson was looking at three legitimate scenarios that could put an additional $500,000 to $800,000 in his pocket over the next 10 years. "
With one phone call, Dr. Thompson improved his bottom line by a total of $800,000. It only took a few emails and phone calls, an hour and a half of driving around with his agent, and a couple thousand dollars to move his office to a new location. He now has more space, newer equipment, and less stress. Never again does he have to worry about lease negotiations. Never again does he need to wonder, “Am I really getting the best deal?” His second highest expense—real estate—is now settled for good.
About the Author Stephen Strecker is a broker Carr Healthcare Realty, a commercial real estate firm that provides representation
Dr. Thompson had some choices to make.
for lease and purchase negotiations for healthcare professionals. He lives in
After a few weeks of negotiations, his agent helped make the options even more appealing. The agent was able to negotiate lease terms on his current space that were 50% lower than his current rate, leveraged by a competing lease property with more aggressive terms, while at the same time presenting a legitimate purchase opportunity that put him in the driver’s seat for the rest of his career.
He loves spending time in the mountains with his wife and two kids
At this point the numbers for the purchase became too attractive to pass up. The only problem was that Dr. Thompson wasn’t sure he would be able to qualify for financing to pull it off—until his agent connected him with a lender that specialized in dental financing. In spite of a couple hiccups in Dr. Thompson’s credit history, this lender fully understood the dental industry and was able to focus on the practice financials instead of Dr. Thompson’s personal credit, and within a matter of days he was approved. One phone call to a healthcare real estate broker: 1. Saved him over $800,000 2. Put him in a larger, newer office
Colorado almost 20 years and enjoy skiing, golfing and mountain biking. whenever he get the chance.
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Be sure to check out the RMDC HANDS-ON COURSES being held at the:
MOUNTAIN WEST DENTAL INSTITUTE!
Visit MDDSdentist.com for a full schedule of other upcoming courses at the MWDI! • 140-seat Auditorium (can be divided in two) • Banquet Hall • 20-seat Executive Board Room • Hands-on Learning Lab Benches for 40 participants • Large Wet Lab • Four (4) Educational Operatories including one (1) equipped for surgery • 2D/3D Digital Imaging Suite • Planmeca PlanScan™ (mill & scanner) • Equipped to capture and stream live video • MDDS members receive a 15% discount • Multi-day & multi-room discounts • A/V always included • No catering restrictions • Free Wi-Fi • Two (2) free parking structures Metro Denver Dental Society | 925 Lincoln Street, Unit B, Denver, CO 80203 | (303) 488-9700
MWDI.ORG
EVENT CALENDAR DECEMBER 2016 December 3 Nitrous Oxide/Oxygen Administration Training -Dr. Jeffrey Young Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-4:00pm (303) 488-9700 December 9-10 Advanced Grafting and Implantology Utilizing a Cadaver Specimen - Dr. Charles Schlesinger Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700
JANUARY 2017 January 26 MDDS Awards Gala & President's Dinner Downtown Aquarium 700 Water Street Denver, CO 80211 6:30pm-10:00pm (303) 488-9700
FEBRUARY 2017 February 10 Bye, Bye Biofilm: The Power of Supra and Subgingival Air Polishing - Ms. Kim Miller Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-4:00pm (303) 488-9700 February 15 CPR/AED Training - Life Rescue CPR Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm-9:00pm (303) 488-9700
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February 24 Basic Radiation Education for Unlicensed Dental Personnel - Dr. Brad Potter Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-12:00pm (303) 488-9700
MARCH 2017
March 25 The Secret to Power, Precision and Prevention: Advanced Reinforced Periodontal Scaling Techniques -Ms. Diane Millar, RDH, MA Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-4:30pm (303) 488-9700
March 3-4 Recognition and Management of Medical Emergencies: Participate in an Advanced and Realistic Clinical Simulation - Dr. Jeffrey Young Children's Hospital 13123 E. 16th Avenue Aurora, CO 80045 9:00am-4:00pm (303) 488-9700
APRIL 2017
March 4 The Walletectomy: Embezzlement in the Dental Office (open to dentists and spouses only) - Dr. Pat Little Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 9:00am-12:00pm (303) 488-9700
April 7 Botulinum Toxin (Xeomin, Dysport, Botox) and Dermal Filler Training Level I, II & III -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:00am-5:00pm (303) 488-9700
March 4 Dental Financial Stewardship: A Total-Team Approach - Dr. Pat Little Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 1:00pm-4:00pm (303) 488-9700
April 8 Frontline TMJ and Facial Pain Therapy -American Academy of Facial Esthetics Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 8:30am-12:00pm (303) 488-9700
March 11 Access to Care Float-Denver St. Patrick's Day Parade Downtown Denver All Day (303) 488-9700
April 18 CPR/AED Training - Life Rescue CPR Mountain West Dental Institute 925 Lincoln Street, Unit B Denver, CO 80203 6:00pm-9:00pm (303) 488-9700
April 13 Serving Up Smiles Benefiting Dental Lifeline Network Coolills 1400 Wewatta St. Denver, CO 80202 6:00pm-9:30pm (303) 488-9700
CLASSIFIEDS Real Estate: Registered Hygienist: Specific functions pertaining to the dental program are established by the dental hygienist and are approved by the Medical Director and RMYC Board of Directors. The Dental Hygienist will be the lead representative of the dental care program and participate in pertinent collaborative committee meetings as assigned. Real Estate: GP: SE Metro Denver: General Practice: SE Metro Denver, CO (CO 1621) Annual Revenues $800K, 4 Ops + room for 1 more, 1,500 square feet, Dr. Retiring. ADS Precise Consultants, adsprecise.com, email: frontdesk@adsprecise.com, 888-909-2545. GP: Metro Denver: General Practice: Metro Denver, CO (CO 1137) Annual Revenues $1.3M, 4 Ops. Heavy Ortho component. Great neighborhood! ADS Precise Consultants, www.adsprecise.com, email: frontdesk@adsprecise.com, 888-909-2545. GP: Aurora: General Practice for Sale: Aurora, CO (CO 1624) Gross Revenues $875K, 6 Ops, Dr. Retiring. ADS Precise Consultants, www.adsprecise.com, 888-909-2545, email: frontdesk@adsprecise.com. GP SW Metro Denver: General Practice for Sale: SW Metro Denver (CO 1618) Annual Revenues $704K, 6 Ops +3 Ops plumbed but not equipped, 4,300 square feet. Building also for sale, Dr. Retiring. ADS Precise Consultants, www.adsprecise.com, email: frontdesk@adsprecise.com, 888-909-2545.
OMS-Cleveland Area, OH: Oral Surgery Practice for Sale: Cleveland Area, OH - Annual Revenues $900K, 3 Ops, 2,500 square feet, Dr. Retiring. ADS Precise Consultants, email: frontdesk@adsprecise.com, www.adsprecise.com, 888-909-2545. GP: Mountains Central, CO: Annual Revenues $711K, 4 Ops + 1 plumbed, 2,260 square feet, condo also for sale, Dr. Retiring. ADS Precise Consultants, email: frontdesk@ adsprecise.com, 888-909-2545, www.adsprecise.com. GP: Boulder, CO (CO 1609) Annual Revenues: $542K, 5 Ops, Dr. Relocating. ADS Precise Consultants, email: frontdesk@adsprecise.com, 888-909-2545, www.adsprecise. com.
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