North Texas
Dentistry
premier issue VOLUME 1
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ISSUE 1
a business and lifestyle magazine for north texas dentists
BCD Dean Retiring
College to Establish Professorship in His Honor
The Abundant Leader
The Dental Dream Team Berland Dental Arts Center
Four Issues That Get Texas Dentists in Trouble
North Texas
Dentistry ON THE COVER
The Dental Dream Team
Berland Dental Arts Center FEATURES 5
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COVER STORY: The Dental Dream Team Dr. Lorin Berland believes patients deserve knowledgeable specialists with the best skills and expertise and has assembled the dental dream team to provide care at the Berland Dental Arts Center.
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ON THE COVER
From left: Drs. Mark Margolin, Sarah Kong, Lorin Berland, and Murat Ayik. Photo: Ray Bryant, Bryant Studios
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BAYLOR COLLEGE OF DENTISTRY Dr. James S. Cole, dean of Baylor College of Dentistry, will retire and a professorship is being established in his honor.
PRACTICE MANAGEMENT The Abundant Leader People who lead an abundant lifestyle see their universe as infinite and demand win-win scenarios in their personal and professional lives.
MONEY MATTERS Retirement or Entrepreneurialship Is retirement from the practice of dentistry a time to go fishing or an opportunity to use your dental experience in a new career?
FOUR ISSUES THAT GET TEXAS DENTISTS IN TROUBLE How to Avoid The Most Common Violations Non-compliance can be expensive and can put your reputation at risk
COMMUNITY NEWS 2011 6th Annual SMILE Walk & Run Mark your calendars now for Community Dental Care’s 6th Annual SMILE Walk & Run.
THE WINE CELLAR For Great Wine, Habla Español Today’s Spanish wines offer more bang for the buck than wines from any other parts of the world.
That Was Fast! How do you get 240 hours into a 40-hour work week? Ask Dr. Sandra Armstrong of Southlake, Texas who completed a stunning transformation of her office in January 2011. www.northtexasdentistry.com
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from the publisher
North Texas
Dentistry Publisher | LuLu Stavinoha Photographer | Ray Bryant, Bryant Studios Contributing Writers | Tina Cauller, Dr. Richard V. Lyschik, Dr. Joel T. Small, Duane Tinker, Beth Thiel, Kim Clarke
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t is often said that when one door closes another one opens. After ten years the door has closed on Doctor of Dentistry, and I am thrilled to open a new door as I welcome you to the Premier Issue of North Texas Dentistry! You will find familiarity to North Texas Dentistry because many key players of my previous association are still on my team. We will continue to be the leader in bringing news and information to the North Texas dental community. We have lots of fresh ideas to share in upcoming issues. I could not have found a better cover story for my Premier Issue. Dr. Lorin Berland is not only a highly acclaimed dentist but a fabulous guy to work with. He was a great supporter of the magazine changes and even helped me decide on the new name, North Texas Dentistry! Dr. Berland has assembled a ‘dream team’ of dentists at the Berland Dental Arts Center so we are not only highlighting him, but also his team. The team includes: Drs. Mark Margolin, Sarah Kong, Murat Ayik, and David Canfield. Patients can have the majority of their dental needs met in one location while relaxing and enjoying the scenic views of downtown Dallas.
In this issue, BCD announces the retirement of dean of the college, Dr. James Cole and the establishment of a Professorship in his honor. Dr. Joel Small offers an interesting perspective on managing people in another article, The Abundant Leader. Mark your calendars now to participate in Community Dental Care’s 6th Annual SMILE Walk & Run on September 10th. You will find details inside on this worth while event. I hope you enjoy these articles and much more! North Texas Dentistry appreciates its supporters and contributors and looks to increase the number of businesses and individuals who make up this outstanding group! Contact NTD for ad rates and for information on contributing editorial content. Watch your mailboxes for the arrival of North Texas Dentistry’s first Special Issue, The Future of Dentistry! Thanks to all for joining me on my new adventure. Until next time, keep smiling and have a great day!
LuLu Stavinoha, RDH Publisher lulu@northtexasdentistry.com (214) 629-7110
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Although every effort is made to ensure the accuracy of editorial materials published in North Texas Dentistry, the publisher cannot be held responsible for opinions expressed or facts supplied by its contributing authors. Copyright 2011. All rights reserved. Reproduction in part or in whole without written permission is prohibited. Advertise in North Texas Dentistry For more information on advertising in North Texas Dentistry, call LuLu Stavinoha at (214) 629-7110 or email lulu@northtexasdentistry.com.
Baylor College of Dentistry Dean Retiring
College to establish professorship in his honor to establish the James S. Cole, D.D.S., Endowed Professorship in Dentistry, which will help fund technology improvements and instructional innovations at the college. Dr. James S. Cole, dean of Baylor College of Dentistry, will retire on August 31 after eleven years at the helm of the dental school. Cole became dean in 2000, 25 years after graduating from the college and beginning his BCD career as a faculty member in dental materials. Prior to choosing dentistry as a profession, he graduated from Stephen F. Austin State University in Nacogdoches, Texas, with an accounting degree. He then honed technology skills while serving four years on a U.S. Navy ship in Vietnam, writing software programs that ran on the ship’s computers and helped keep track of the crew.
The professorship, the college’s first, will be funded at a minimum level of $500,000 and will be endowed to exist in perpetuity. Proceeds from the endowment will be available to the dean, who will be the holder of the professorship, to help address the technology needs that are critical to the future of dental education and the delivery of contemporary oral health care. “It has been awesome to witness the warmth and enthusiasm associated with gifts made to establish this professorship in Dr. Cole’s honor,” said Susan Mitchell Jackson, executive director of communications and institutional advancement
at the college. “We’re nearly two-thirds of the way toward our goal. I am confident that the generous giving will continue, not just to celebrate Dr. Cole’s past achievements but to help secure his vision for the college’s future.” The Cole Professorship Fund resides at the Baylor Oral Health Foundation. To honor Jim Cole with a gift to the fund, please contact Susan Mitchell Jackson at 214.828.8214 or by email at sjackson@bcd.tamhsc.edu. Pledges to the fund are payable over four years. Founded in 1905, Baylor College of Dentistry in Dallas is a college of the Texas A&M Health Science Center. TAMHSC-BCD is a nationally recognized center for oral health sciences education, research, specialized patient care and continuing dental education. The TAMHSC serves the state as a distributed, statewide health science center that is present in communities throughout Texas.
Cole’s fortuitous blend of skills and education in dentistry, accounting and computer technology have prompted tremendous success in his various roles at the college. These have included director of computer services, chief financial officer, legislative relations, interim dean and dean in addition to four years as president and treasurer of the Baylor Oral Health Foundation. Throughout his career at BCD, Cole has embraced innovation and has made technology enhancements a top priority. As dean, his vision has propelled the college to the upper echelon of dental schools, leading in the use of dental simulation, state-of-the-art clinics, hightech classrooms and instructional tools, virtual microscopy for histology, electronic patient records, digital radiography, dental implant clinical experiences and more. In honor of his dedicated leadership, friends and colleagues are raising funds www.northtexasdentistry.com
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Photographer: Ray Bryant, Bryant Studios
cover feature
The Dental Dream Team Berland Dental Arts Center by Tina Cauller Dr. Lorin Berland has assembled the dental dream team to provide the full range of dental services all in one place, the Berland Dental Arts Center. From left: Drs. Sarah Kong, Lorin Berland, Mark Margolin and Murat Ayik.
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hen it comes to quality dental care, people want dentists they can trust. Patients deserve knowledgeable specialists with the best skills and expertise, a committed team that is caring and competent, the most advanced technology, and most important, consistently excellent results. This is exactly what the patients of the Berland Dental Arts Center in the Dallas Arts District have learned to expect. Dr. Lorin Berland has assembled the dental dream team to provide the full range of dental services all in just one place. The Berland Dental Arts Center is located on the 9th floor of 2100 Ross, affording guests a spectacular cityscape view of the Dallas Arts District. The Center is conveniently situated on the corner of Ross Avenue and Pearl Street with secure, complimentary underground parking. Thanks to its appreciative and loyal patients, the Berland Dental Arts Center 6 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
has expanded three times since first opening its doors and is celebrating 25 years in the same location. This special anniversary was recently featured in the International Dental Tribune.
A Stellar Team of Specialists The most valuable asset of this unique multi-specialty group is its experienced and dedicated team. Dr. Lorin Berland was the first Fellow of the American Academy of Cosmetic Dentistry (AACD). He is the co-creator of the Lorin Library Smile Style Guide, the developer of the website, www.denturewearers.com, and the creator of various instructional videos for dentists, including Biomimetic Same Day Inlay/Onlays and The Latest and Greatest in Cosmetic Dentistry – A Full Mouth Rehab in 2 Visits. His unique approach to dentistry has been featured on television and in
publications such as 20/20, Time, Town & Country, Reader’s Digest, GQ, US News & World Report, Woman’s World, Details, D Magazine, The Dallas Morning News, and Good Morning Texas. Besides being voted Texas Super Dentist and Texas Best Cosmetic Dentist, Dr. Berland was voted “one of the best dentists in the United States” by the International Dental Tribune. He was also recently honored by the American Academy of Cosmetic Dentistry for his Contributions to the Art & Science of Cosmetic Dentistry. In fact, when it comes to Smile Design, Dr. Berland literally wrote the book. His Smile Style Guide has helped tens of thousands of patients achieve the smiles of their dreams.
Dr. Mark Margolin confers with Dr. Berlin using three-dimensional imaging from the i-CAT scanner which clearly visualizes the anatomy of the jaws, teeth and other critical structures in precise detail.
In order to offer his patients the best possible care, Dr. Berland has put together a dynamic team of specialists to complement his practice. Dr. Sarah Kong, a Dallas native, was voted as a Texas Super Dentist and Texas Best General Dentist for general dentistry by her peers. She focuses on preventive, cosmetic, restorative and pediatric care as well as oral appliance therapy for TMJ, snoring and sleep apnea. Dr. Kong worked with a master ceramist in one of the world’s finest dental laboratories prior to entering dental school. She received her Doctorate of Dental Surgery from Baylor College of Dentistry, where she has served on faculty in the Department of Restorative Dentistry. She is an active member in numerous professional organizations such as the American Academy of Cosmetic Dentistry, American Dental Association, Academy of General Dentistry, Texas Dental Association, and Dallas County Dental Society, where she has served on the membership committee and the peer review board. In addition, she has a passion for serving her community through her church, her children’s school and various outreach opportunities in dentistry. She has published numerous dental articles in various peer-reviewed dental journals. Dr. Mark Margolin, a board-certified periodontist, provides services for all aspects of periodontal therapy, tooth removal, and dental implantology, and has a particular interest in cosmetic gum surgery. He developed a minimallyinvasive cosmetic procedure to correct the gummy smile. He was also voted a
Texas Super Dentist for periodontics and Texas Best Periodontist / Implantologist by his peers. Dr. Margolin received his undergraduate degree from the George Washington University and his Doctorate of Dental Surgery from the State University of New York at Stony Brook. He completed a threeyear residency specializing in periodontics and dental implants at the Oregon Health Sciences University where he served as chief resident during his final two years. Dr. Margolin is a Diplomate of the American Board of Periodontology, a verification of expert status in the field. Dr. Margolin is an active member of the Dallas County Dental Society, serving on the membership development committee. He has been elected to the Dallas County peer review committee as well. Dr. Margolin provides services for all aspects of periodontal therapy and dental implantology, but he has a particular
Dr. Berland is co-creator of the Lorin Library Smile Style Guide which has helped tens of thousands of patients achieve the smiles of their dreams. www.northtexasdentistry.com
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Dr. Sarah Kong focuses on preventive, cosmetic and pediatric care as well as oral appliance theraphy for TMJ, snoring and sleep apnea.
interest in the field of aesthetic periodontal plastic surgery. He has given numerous seminars on those topics, teaching aesthetic dental surgery as well as implants to other dentists. Dr. Murat Ayik provides endodontic therapy within the practice. Dr. Ayik graduated from Tennessee Technological University and earned his DDS degree from the University of Tennessee College of Dentistry. After graduation, he was commissioned as a Naval Officer in the United States Navy and served for four years. He earned an Advanced Education in General Dentistry (AEGD) certificate at the Naval Medical/Dental Center San Diego, California. After his tenure in the U.S. Navy, he completed a 27-month advanced specialty training in root canals and microsurgical endodontics at The Texas A&M Health Science Center Baylor College of Dentistry, where he served as chief resident in his final year of training. Dr. Ayik currently holds board-eligibility status from the American Board of Endodontics. Dr. David Canfield, a dental anesthesiologist, is the Coordinator of Pain and Anxiety Control at Baylor College of Dentistry. Both anesthesiologists, Dr. Canfield and John McConnell, M.D., administer a full range of dental anesthesia services to provide deep sedation for anxious patients. The Berland Dental Laboratory has its own German master ceramist, Cornelia Ferenschuetz. Cornelia has more than 25 years of experience creating beautiful, life-like teeth. 8 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Her field of expertise is porcelain, focusing on full ceramic crowns and Dr. Berland’s own Microveneers – thinner, stonger, and more aesthetic than Lumineers. She also specializes in zirconium crowns, the most biocompatible material in dentistry. Because zirconium is so strong, it allows for metalfree restorations that are translucent and are able to reflect light much like a natural tooth, making it virtually impossible to distinguish them from natural teeth. She is joined by David Wiley, whose family has been creating excellent cosmetic dentures for two generations. After operating a full service dental lab for over 25 years, David decided to follow his passion for creating the finest dentures. Thanks to the on-site laboratory, the Berland Dental Arts Center delivers faster, more personal care. They even offer sameday inlays/onlays that can help avoid crowns and root canals for patients with chipped, broken, or damaged teeth. The inlay/onlay solution saves more tooth structure, resulting in a stronger, healthier, more durable and more natural-looking tooth. Altogether, the experienced team at the Berland Dental Arts Center brings a full complement of expertise, ensuring cohesive, comprehensive care for every patient – all coordinated in one convenient place.
A Foundation of Proven Principles Dr. Berland and his team use state-of-the-art restorative procedures based on the principles of tooth-conserving
biomimetic dentistry. He has not placed a silver filling since 1988. As Dr. Berland explains, “Biomimetic dentistry treats weak, fractured, and decayed teeth in a way that keeps them strong and seals them from bacterial invasion. It decreases the need to reduce teeth down for crowns and root canal treatments. In essence, it is utilizing the best in dental materials and technology to preserve what we’ve got, for as long as we’ve got – just as nature intended.”
Supporting the Best Care With the Best Tools Incorporating the best technology and experience gives the Berland Dental Arts team the ability to create spectacular smiles and happy patients. In addition to general and advanced cosmetic dentistry, Berland Dental Arts offers treatments for TMJ and migraines, FDA-approved oral appliances for snoring and sleep apnea, neuromuscular facelift dentures, root canal therapy, laser gum treatment, cosmetic gum lifts and dental implants. For patients with missing or failing teeth, the Berland Dental Arts Center offers dental implants, utilizing immediate tooth replacement and the All-on-4 Procedure, an advanced alternative to traditional dentures. The All-on-4 procedure can replace a full arch of teeth in just one day using only four implants. Technology can also elevate dental care to a new level of precision and accuracy. Digital radiography provides patient comfort, convenience and protection. Digital x-rays use up to 90% less radiation than conventional x-rays.
The Berland Dental Laboratory located on site has its own master ceramist and allows the doctors to deliver faster and more personal care.
In order to provide the utmost care, an i-CAT scanner was added to aid in implant cases. Three dimensional imaging with the i-CAT scanner clearly visualizes the anatomy of the jaws, teeth and other critical structures in precise detail. This eliminates the guesswork in planning dental implant treatment, orthodontics, TMJ analysis and airway assessment. In just seconds, with less radiation than a conventional CAT scan or dental x-rays, the Berland Dental Arts team can study and learn crucial information about the patient’s unique oral anatomy in order to plan treatment with confidence. The i-CAT can help determine the precise tooth position, visualize impaction within
Photos courtesy of Dr. Lorin Berland
Dr. Lorin Berland created a beautiful smile by using his own Microveneers which he has found to be thinner, stronger and more aesthetic than Lumineers.
Using zirconium crowns, which are the most biocompatible material in dentistry, Dr. Berland restores this patient’s smile. www.northtexasdentistry.com
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High-tech devices can also boost diagnostic power and support preventive care. The DIAGNOdent laser cavity finder detects very small lesions at the earliest stage. It allows the dentists to differentiate between stains and cavities and monitor questionable teeth over time. Berland Dental Arts has readily embraced technology when it is proven to yield beautiful, functional and predictable longterm results. They are dedicated to keeping up with the latest in materials and procedural techniques to ensure the most advanced dentistry for their patients. It’s also why they are on social media sites such as Facebook and YouTube and regularly contribute to a blog – to further connect to their patients and to keep them informed of the latest technology. “For us, the real allure of technology is improving patient care,” notes Dr. Berland.
What Sets the Berland Dental Arts Center Apart As Dr. Berland points out, “The combination of expertise, technology and compassion helps us deliver the best dentistry to our patients – all in one familiar setting. Having different specialists in the same place allows for better coordination of treatment and direct communication between our doctors to deliver personalized treatment in a pragmatic and efficient manner. And in our busy world, our specialized approach saves the patient time. This customized total dental care is what sets the Berland Dental Arts Center apart from the conventional dental office.” n Technology can elevate dental care to a new level of precision and accuracy. Dr. Murat Ayik uses a high powered microscope during endodontic procedures.
the alveolar bone, and pinpoint the relationship and proximity to vital structures, such as the nerve canal, sinus walls, and cortical borders. Berland Dental Arts always strives to improve patient comfort. Nitrous oxide (“happy gas”) is always available to help patients relax. Oral and IV sedation are also available for patients who prefer to sleep throughout treatment. When it comes to the dreaded shots, the practice was one of the first to use “the Wand”, a high-tech digital anesthesia delivery system that allows for painless injections, puts the patients at ease and sets the stage for a pain-free dental procedure. While dissipating patients’ concerns about the pain, fear and anxiety associated with standard syringe injections, the Wand helps the doctors to provide the highest level of dental care and anesthesia. Other technology employed at the Berland Dental Arts Center helps support their conservative, tooth-saving approach. Air abrasion is a delicate method to remove tooth decay using a precise air stream of tiny, fine aluminum oxide particles. Because air abrasion cuts tooth surfaces with great precision, it removes less tooth than a drill, shortens the treatment time, and improves bonding. This means no-shot, no-drill fills. 10 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
The team at the Berland Dental Arts Center has combined expertise, technology and compassion to deliver the best dentistry to their patients.
The Berland Dental Arts Center 2100 Ross Avenue, Suite 960, Dallas, TX 75201 214-999-0110 www.berlanddentalarts.com Lorin F. Berland, DDS Sarah K. Kong, DDS Mark D. Margolin, DDS Murat Ayik, DDS David W. Canfield, DDS, FADSA
practice management
Abundant Leader
The
“People with a scarcity mentality tend to see everything in terms of win-lose. There is only so much; and if someone else has it, that means there will be less for me. The more principle-centered we become, the more we develop an abundance mentality, the more we are genuinely happy for the successes, well-being, achievements, recognition, and good fortune of other people. We believe their success adds to... rather than detracts from... our lives.”
– Stephen R. Covey
by Dr. Joel T. Small
love the idea of abundance. I don’t see abundance as a philosophy. I see it as a lifestyle. People who lead an abundant lifestyle see their universe as infinite. They demand win-win scenarios in their personal and professional lives. In their world, it is not just acceptable for everyone to succeed – it is an imperative. Compare this to a lifestyle of scarcity, or what some call a zero sum philosophy, in which the universe is viewed as finite. This particular outlook requires that for every winner there must be a loser. A scarcity or zero sum philosophy is not compatible with effective leadership, because effective leaders are those that are committed to assuring that everyone they lead is given the opportunity and resources to succeed. To an effective leader, realizing one’s dreams is a universal goal. Taken a step further, leaders who embrace a scarcity philosophy believe that their role as leaders is to identify weaknesses in others and judge others by their weaknesses rather than their strengths. This is a lose/lose scenario, because dueling on weaknesses seldom creates a positive result for either party. Abundance-based leaders are the antithesis of scarcity-based leaders. They understand that each of us has weaknesses, but 12 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
they choose to judge others by their strengths. Their dental practices are always more successful because they know how to identify strengths and position their people so that they are able to successfully develop and utilize their strengths. The result is a culture that benefits the practice while providing the employees a sense of accomplishment and empowerment. Also, it has been my observation that in the abundant culture which stresses development of strengths, the weaknesses are likely to spontaneously disappear. It is my belief that this is the direct result of a culture that is accepting of failure and views deemphasizing weakness as a means of developing strength. An abundance leader who identifies and utilizes others’ strengths creates a very different kind of culture than does a scarcity leader who continually tries to correct weaknesses in others. The scarcity-based culture is an overall negative environment. The staff is always afraid to make their own decisions or try new ideas, because failure in itself will be viewed as a weakness. In an abundant culture, the staff is comfortable making creative suggestions and trying out new concepts because they know that failure will be viewed as a necessary part of the growth and development of their strengths. The contrast between the two lifestyles becomes most obvious when applied to a business model or, in our case, a dental
practice. Imagine a practice culture in which the doctor/leader attributes achievements to their staff and is the first to accept the blame for failures. What would it be like to work in an organization in which the leader was fully committed and engaged in assuring that everyone reached their full potential and realized their individual dreams? This is an organization that will prosper.
Building Stronger Smiles Specializing in the design, building, and remodeling of dental offices.
Now compare this to a practice culture based on scarcity, in which recognition is coveted by the doctor and seldom shared with the staff. Compare it to a culture in which the leader has an emotional need for control. This scenario — quite different from the abundant culture — will lack spontaneity, creativity, and member development. This is an organization that is in trouble. It will likely crumble because the burdens created by the leader’s scarcity mentality cannot be supported by the weakened cultural infrastructure. Abundant cultures are participative as well as being creative and adaptive. They are able to tap into their vital stream of human potential which is a prerequisite for a highly productive and culturally mature organization. They promote self-development and self-direction. Such organizations are the icons of their industries. Herb Kelleher, the untraditional CEO of Southwest Airlines, said this about his organization’s culture: “A financial analyst once asked me if I was afraid of losing control of our organization. I told him I’ve never had control and I never wanted it. If you create an environment where the people truly participate, you don’t need control. They know what needs to be done, and they do it. And the more that people will devote themselves to your cause on a voluntary basis, a willing basis, the fewer hierarchs and control mechanisms you need.� Is it any wonder that numerous studies have proven that organizations that create cultures based in abundance are significantly more profitable than those organizations whose culture is scarcity-based? n
WWW STRUCTURES INTERIORS COM s
Dr. Joel T. Small is an endodontist, speaker, author, and entrepreneur. He is a cofounder of North Texas Endodontic Associates in Plano, Texas. His thirty-plus years as an endodontist have been spent in private clinical practice. Dr. Small speaks nationally on the topics of leadership, practice management, and specialty practice transitions. He co-founded Phase Two Associates, LLC, a dental practice brokerage firm in Dallas, Texas that deals exclusively with practice transitions for the dental specialist. Dr. Small is the author of the newly released book, Face to Face: A Leadership Guide for Health Care Professionals and Entrepreneurs. For more information, visit www.readfacetoface.com.
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money matters
RETIREMENT OR ENTREPRENEURIALSHIP? by Richard V. Lyschik, DDS, FAGD
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f you make it to retirement in one piece without suffering too much physical damage, then it’s a dream come true. You are now ready to spend endless hours on the golf course, fishing, hunting, visiting grandchildren, and taking trips to all sorts of exotic places. Welcome to the “golden years”, the so-called autumn of your life, seemingly limitless hours in pursuit of personal happiness. Is it your lifetime dream, or the dream of a lifetime? After 20 or 30 years of practicing dentistry it’s finally time to put down the handpiece, get off that stool and walk out of the office… a free man (or woman, as the case may be). It was a race to the finish line… retiring before clinical dentistry took out your back, neck, shoulders, etc. It’s a dream all right, and for most dentists who have spent their lives doing dentistry, they discover that sooner or later the dream ends and it’s time for them to wake up to reality. There are noted exceptions, of course, but many dentists begin to tire of the “ings” of retirement such as golfing, fishing, hunting, skiing, traveling, reading, watching and playing. Dentists accustomed to “running their own show” (actually the show was running them) for decades would soon discover that they lacked a reason to get up in the morning. There was no longer any schedule to follow, patients to treat, staff to direct and business to do, and some of them find that they are now lacking direction in their life. The average working dentist devotes 33.33% of his/her working life commuting and practicing dentistry, sleep takes up another 33.33%, and 33.33% is used for personal needs, family time, socializing and recreational pursuits. When you retire, you are doubling the time available for recreation, and what you soon discover is that all play and no work makes Jack a dull boy (or Jill a dull girl). So, does this mean you should never retire? Should you forget about the “dream” and just work until you die or become disabled? Absolutely not! Retirement itself may or may not be the right goal for you. Instead of retirement being the primary objective, dentists should focus their attention on reaching financial independence. Financial independence means you can do what you want (within reason), with who you want, if you 14 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
want, and when you want to do it. That’s called “Quality of Life” and that is what your lifetime goal should be. You weren’t born a dentist and you don’t have to die a dentist. So what can you do with the rest of your life when dentistry is all you know? Well, the first thing is to stop thinking like a clinician and start thinking like a dental businessperson. You’ve got all of those years of dental experience behind you, and years to live ahead of you. As a dental entrepreneur, you take this experience and put it to good use. If you invest your money in a business you know already (dentistry) and work to grow this business so that your career status changes from clinician to entrepreneur, then this changes everything. Dental entrepreneurialship is a great alternative to just “hanging it up” and calling it quits. It opens a new chapter in your career that can be far more rewarding than those years spent just being a clinician. You can make a lot more money and would no longer be tied to a chair, your “golden years” can take on a whole new meaning. You can afford to take the time off you want, and afford to go where you want and when you want. Your life can really take a change for the better, and you no longer have to concern yourself with a clinical related disability. If you don’t see yourself “retiring” and driving off into the sunset someday, if you think that you’d rather use your experience to enter into another, perhaps more rewarding phase in your career, if you would like a new challenge and freedom from the chair, then consider practice ownership… again! No mask or gloves required! n Richard V. Lyschik, D.D.S., FAGD, is one of AFTCO’s leading innovative Senior Analysts who has helped over 2,900 dentists in associating, buying, expanding, or merging and guided older, disabled and/or “burned out” dentists to sell their practices. Dr. Lyschik’s clients have seen the considerable benefits of incentive programs, pension funding plans and increased productivity through his guidance. There is no substitute for experience in this business. Who better could you choose to talk to about your future transition plans than a seasoned fellow dentist, a recognized premier transition expert, and an AFTCO Analyst of the Year Award winner? Check out the impressive AFTCO website at www.AFTCO.net, then call for a free appraisal and a no-obligation consultation with Dr. Lyschik at your office or the AFTCO office in Dallas, TX at (214) 893-0410 or 1-800-232-3826.
FOUR ISSUES that get Texas dentists in
– and how to avoid them! by Duane Tinker
Quality of care issues, poor record keeping, dishonorable conduct and advertising violations are four issues that get
staff. Interact directly with your patients and listen to their concerns. Train your staff to bring serious issues to your attention immediately. Patients notice unsanitary conditions in your office. Or, they see that the staff is not using proper sanitation techniques. Patients are much savvier and more educated nowadays and they will often catch sanitation issues. These complaints also often come from disgruntled employees. Here’s the kicker, many quality of care complaints are ‘unfounded’ and would likely be dismissed except for the fact that the dentist’s records contain record keeping violations. Any record keeping violations that surface while the SBDE is investigating complaints against you will likely result in fines and possibly other disciplinary action.
Texas dentists in trouble. In this article we will look at each
poor record keeping
of these issues a little closer.
Record keeping violations are, by and large, one of the most prevalent problem areas for dental professionals. Even in the most squared away practice, we often find record keeping issues. Many of these issues are simply caused from practitioners’ lack of knowledge and training. While these bad habits may go unnoticed for years, rest assured they can quickly become your worst nightmare once discovered.
quality of care Quality of care issues range from “my dentist pulled the wrong tooth” to “my dentist’s office is unsanitary”. These allegations are very common and are routinely investigated by the State Board of Dental Examiners (SBDE). The majority of these complaints are preventable. The three most common reasons for quality of care complaints are: The patient perceived a lack of empathy from you and/or your staff. (Note: your patient’s perception trumps reality.) Take your time with your patients. Develop a good chairside manner. The extra two minutes you spend actually listening to your patient’s concerns might well save you $2,000 (or more) in fines, not to mention a huge headache. Your patient could not communicate with you because of interference by your office staff (quite common). Don’t hide behind your
Here are three phrases to keep in mind while preparing patient documentation: If you fail to write it down – it did not happen. You did not discuss it with the patient – it did not happen! No exaggeration! Take your time when documenting patient care and patient interactions. The time you spend on documentation may really pay off one day. When in doubt, write it out! If you wonder whether you should document something then you most certainly should. Detailed records may be the key to your (CONTINUED ON PAGE 22)
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community news
6th Annual
SMILE Walk & Run September 10, 2011
HELP PROVIDE DENTAL CARE TO THOSE IN NEED – JOIN US FOR A DAY OF DENTAL FUN!
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ather with friends, family, co-workers, sponsors, vendors, and other community dental supporters for fun, snacks, music, entertainment, games, bounce house for the children, clowns, balloons, free parking, event t-shirt, prize drawings and more!
Come together to support dental care needs in your community and help yourself accomplish a one-mile, 5K or 10K course around the centrally located Bachman Lake scenic course in Dallas, Texas. Registration time: 7:00 a.m. Start time: 8:00 a.m. If you are not able to participate, you can visit our website for easy on-line donation. Trophies for the largest team and best t-shirt design will be given away. See our website for registration, team building and fundraising tips and details.
www.smilewalkandrun.org
WHY
WE NEED YOU: All proceeds benefit Community Dental Care (CDC). The 6th Annual SMILE Walk & Run proceeds will benefit low-income, uninsured children, seniors, HIV patients, and the homeless who have no other dental resources. CDC has received funding from the City of Dallas from its general fund since 1982. This was reduced last year from $675,000 to $96,000 and this year we are in jeopardy of losing this all together. Our CDBG grant from the City of Dallas has also been reduced 50% from $200,000 to $100,000. As a result, CDC will see 400 fewer children. 16 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Very recently, our second mobile dental unit caught fire and is a total loss. In collaboration with Dallas County Dental Society, this unit provided dental care for those in need in the Seagoville area since November of 2010. Currently, there are no plans to replace.
WHO WE ARE:
Since Community Dental Care was established as a nonprofit organization in 1982, the population it serves has grown by more than 1 million people. CDC has become the largest nonprofit provider of routine and preventive dental care and dental health education in Texas. The organization operates twelve Community Dental Care centers in Dallas, Carrollton/Farmers Branch, Garland, Irving, McKinney and Plano, and is the largest nonprofit provider of quality, routine and preventive dental care and dental health education to lowincome individuals in Texas. Through the generous support of Parkland Health & Hospital Systems and Crystal Charity Ball, CDC opened its 12th location in Pleasant Grove on June 2, 2011. Also in collaboration with Parkland Health & Hospital Systems, CDC started our first
mobile dental unit that visits the Nexus Recovery Center, The Family Place, Promise House, Genesis Women’s Shelter and Volgel Alcove. The Nexus Recovery Center is a homeless shelter for substance abuse individuals, Volgel Alcove is a daycare for homeless children and the other locations are shelters for women and children who are victims of domestic violence. Last year, CDC provided more than 46,000 visits to 15,500 patients, including children, adults, seniors, patients with HIV/AIDS and the homeless. The CDC dental center at The Stewpot, an agency serving the homeless in Dallas, provided 2,700 visits last year to homeless children and adults at no charge. The majority of patients (70%) who receive treatment at the dental centers are children. Patients from families with incomes at or below 200-300% of the national poverty level (which is defined as approximately $30,000 for a family of four) receive services for an affordable, reduced fee. CDC has a full-time staff of 77, parttime staff of 20, and 65 volunteers. Dental students, residents, and hygienists from Baylor College of Dentistry and the Collin County Hygiene Program receive hands on experience by performing their clinical rotations throughout the CDC Dental Centers. CDC has been a United Way agency since 1992 and is currently supported by approximately 30 different funding sources. Specialty care procedures in the areas of endodontics, orthodontics, periodontics and oral surgery are referred to Baylor College of Dentistry and Parkland Oral Surgery. For more information on the SMILE Walk & Run and to inquire on how you can sponsor and/or sign up to be a vendor, visit www.smilewalkandrun.org or contact Rachel Sandoval, SMILE Walk & Run Coordinator at 214-879-7100. n
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For Great Wine, Habla Español ! by Kim Clarke
Having spent a fair amount of time in wine stores searching for the next great QPR (Quality-Price-Ratio) to try, I’ve found myself buying a bottle from the Spanish aisle more than ever before. Across the board, today’s Spanish wines offer more bang for the buck than wines from any other parts of the world.
large areas of Northeastern Spain where it is combined with Tempranillo, another common grape, to make wines from Navarre, Rioja and Priorat. Grenache ripens at relatively high sugar levels and usually yields higher alcohol in the wines it produces. No longer just a blending varietal, wines made from 100% Grenache are easily found in most wine shops and prove to be exemplary at all price levels. They’re dark purple in color with ripe black cherry, raspberry, spice and smoke on the nose and palate. The wines are smooth and easy to drink, juicy but not “grapey” and have enough backbone to stand up to most foods. Here are a few that I really like:
Spain has more land under vine than any other country in the world and many of the vineyards are more than 50 years old. With more than 140 grape varietals, Spain is one of the world’s most varied wine cultures. Adding to the complexity, there is a hierarchical classification system, Denominacion de Origen, similar to the AOC system used in France and Italy – 72 regions have a status of QWPSR (Quality Wines Produced in Specific Regions). Labels on these wines carry the region’s name but typically don’t disclose the grapes in the bottle, leaving most buyers guessing about what kind of wine they’re actually getting.
Las Rocas ($10) – an Eric Solomon project that first introduced a 2002 vintage of old vine Grenache to the United States in 2003. There’s an “Old Vines” version that’s a little bigger with a slightly higher price tag. Both arrived with rave reviews from Robert Parker (Wine Advocate).
Prior to the 1990’s, Spanish wines were seldom on anyone’s list of favorites. While there were wines that received measured amounts of praise from the pundits, hundreds of small wineries were stuck with archaic winemaking techniques that turned high-grade grapes into rustic, low quality wine. But as the world’s palates began to appreciate better wine and prices started to rise, wine entrepreneurs began looking for underdeveloped raw materials with which to make good wine. Spain quickly came up on their radar screen and two persistent oenophiles, Jorge Ordonez and Eric Solomon, scoured the country and worked with wineries that now produce some of the country’s best wines. Ordonez imports 130 wines from 40 different Spanish wineries while Solomon’s European Cellars’ operation brings in wines from more than 65 Spanish producers. Reds and whites in all price ranges are part of the mix. While individual tastes vary, it is probably safe to say that you’ll be happy with a bottle of wine bearing Jorge Ordonez’ or Eric Solomon’s name on the label. We’ll focus on the Grenache grape (Garnacha), the most common red grape grown in Spain, one of the most planted varietals in the world and probably best known as an important component of the wines from Chateauneuf du Pape and Gigondas in the Southern Rhone areas of France. It is grown in 18 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Evodia ($10) – Solomon sold the Las Rocas operation to Gallo in 2009. Known as “Las Rocas II”, Evodia is wine from the same Calatayud region using the same winemaker but Grenache grapes from a higher elevation. Tres Picos ($16) – A bit more elegant than the Las Rocas/ Evodia, but plenty of red and dark fruit, flowers, spice and a long finish. This wine is from Bodegas Borsao, a Jorge Ordonez winery, and has a little brother, Borsao ($7), made of 85% Grenache and 15% Tempranillo that’s also a good buy. The 2009 Tres Picos received a 92 rating from Robert Parker. Artazuri ($10) – A Wine Advocate 91, this winery takes full advantage of the excellent 2009 vintage to make a dense, rich wine full of spices and black cherry fruit. It’s user-friendly today but can last several years in the bottle. One of the better values around. Alto Moncayo ($45), et al. – If you’re a fan of bigger wines, the Alto Moncayo winery will definitely deliver. Its namesake wine is deep purple in the glass with a bouquet of lilacs, dark chocolate, cola and spices. Blackberries, dark cherries, licorice and coffee flavors mix with lush tannins on the palate to produce a long, spicy finish. This wine’s big brother, Aquilon ($100+), can hold its own with any of the big Napa wines that cost twice as much. Its little brother, Veraton ($28), is a mouthful of velvety, rich black and red fruits accented with cinnamon and smoke. All are Jorge Ordonez offerings made in partnership with Dan Phillips and winemaker Chris Ringland, the duo that also makes big, concentrated Australian wines. Great wines at great prices… what more needs to be said?
window treatments, cabinetry and furnishings all received a complete facelift. The success of the entire project hinged on the ability to maximize the urgency of every single square foot of the office without making any structural changes to the current finish out. In reality, the design and construction team transformed the office both aesthetically and functionally without moving a single wall.
BEFORE
Following the plans and project budget, Dr. Armstrong was forced to make a critical decision that would set the tone for the entire project experience: the construction schedule and how it would affect her patient care. As we know, few things are more stressful than the disruption of a business or home that results due to a construction project. Those who have lived through that nightmare are likely to dismiss the prospect of ever remodeling again. The constant interruptions and perpetual mess inherent in a construction project is overwhelming. Office downtime should be minimized to reduce patient inconvenience and loss of revenue which can be significant with projects of this sort.
“
In December, Dr. Armstrong was presented with two options for consideration regarding the schedule; to remain in business during construction and break the project into smaller phases – requiring the contractor to work nights and weekends to accomplish the work, or schedule the work using concentrated efforts and roundthe-clock labor to condense the time of construction and thus minimize the period of disruption for the business. Contractor Judy Doan suggested the compressed schedule due to the fact that it is less stressful for the doctors and staff as well as more cost effective due to labor efficiencies. Either approach can provide great success, and depends on individual circumstances for each practice.
”
Well, that was fast. by Beth Thiel
How do you get 240 hours of complete office redesign in a 40-hour work week?
Ask Dr. Sandra Armstrong, Dr. Amy Watts and their staff of Southlake Texas. Dr. Armstrong started a Pediatric Dental Practice in Grapevine/Southlake 20 years ago, which has grown leaps and bounds extending beyond what her lease space could manage. With the continual advancement of dental technology, professional offices must also advance and be able to accommodate these changes. In a pediatric practice, patients age and their needs may become more complex over time as well. Due to those facts, Dr. Armstrong’s original design, with outdated structures and everyday wear and tear, needed drastic and immediate attention. The doctors and patients alike were ready for a breath of fresh air that only a professional office design firm could remedy. “The project team was chosen for this daunting task based on their commitment to approach the project with budget sensitivity while executing the work with tremendous speed and professionalism,” states Dr. Armstrong. Every surface of the dental office, with the exclusion of the technical dental equipment, was modified. Ceilings, walls, floors, 20 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
After careful consideration Dr. Armstrong determined that the best time for construction would be a week in January 2011. The timeline was carefully planed with the scheduling demands of the practice as well as the promised date for furniture and product delivery. Once the dates were determined, the commitment was made to reopen the office one short week later – fully completed with a new design. The design was presented, an economical budget and schedule were approved and orders were placed. The design team worked behind the scenes managing a flurry of deadlines with their constant attention to detail ensuring all products arrived on time and in excellent condition. Inventive and creative solutions are required from the team when unexpected delays or damages occur, thus constant communication with all manufacturers and freight carriers remain critical.
The contractor is, of course, on a separate but similar journey with meticulous scheduling to ensure that once the construction begins, not an hour is wasted. Contingency plans are put in place to ensure that there are no surprises that cannot be overcome. The best plan to avoid complications is to “expect the unexpected”. Once the team had the overall scope and a fully dedicated work force, the renovation of Dr. Armstrong’s office began. As with any renovation project, it is important that the design team and contractor work carefully together while the project is in a moldable state, tweaking the design and adapting to unknown conditions that often surface during renovation. Case in point, when developing the time frame for the remodel, a winter ice storm that hit North Texas, paralyzing the city for the better part of the week was not on anyone’s radar. True to form however, our resourceful contractor had a contingency plan in place and arranged lodging for the crew near the jobsite. The project team held true to their commitment to meet the deadline – regardless of the disastrous weather! So, how do you get 240 hours of work performed in a 40-hour work week? Sandwich the “work week” between two weekends and work two crews in 12-hour shifts. This simple math expands a typical 40-hour work week into 240 hours of effective definitive labor. Dr. Armstrong confidently handed her keys to the contractor on Thursday, the 19th of January. With one work week closed, the doors re-opened gleefully at 6:59 a.m. on Monday the 31st as a new office, with a rich new life. It can be done. The transition,
as perceived by the doctors and the team, was painless, professional, and economical. The paradigm shift of redefining a contractor’s work week can provide new meaning to any construction project by removing the limitations of “normal working hours”, and combining that with meticulous planning and a dedicated workforce. These complex yet advantageous models for effective transformation can now provide pleasure of renovation. How do we measure the success of a project? Happy faces on the doctors, their team, the mothers, the patients and many current and future referrals. Most importantly, Dr. Armstrong breathed a sigh of relief. As she says, “That was easy!” n
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The office of Sandra Armstrong received a 2011 ASID Design Ovation Award for Excellence in Healthcare Design.
]
Thiel and Thiel is an award-winning architecture and interior design firm based in the Dallas/Fort Worth area that offers a comprehensive range of services including architecture, interior design, graphic design, procurement and installation services. Owners Beth and Kurt Thiel have handpicked professionals from across the design world to make up their team, who create complete brand strategies that are exclusive to each client and to each property. Go to www.thielandthiel.com to learn more about the firm’s extensive array of integrated services and review their substantial portfolio.
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survival during an investigation or other legal action. There is no such thing as “too much documentation”. It doesn’t matter if you write a book about a patient encounter. If that’s what it takes to help you remember a particular incident or encounter 1, 2, or 5 years down the road it is better to have written down “too much” than not enough. Never trust your memory!
poor conduct Dishonorable conduct is a broad category with violations that range from “allowing auxiliary personnel to perform impermissible duties” to “overdiagnosing to obtain a higher fee.” This catch-all includes: • patient abandonment; • expired licensures; • criminal misconduct; • fraud; • drug diversion (includes prescribing to family, staff or friends for non-dental
purposes); • permitting, allowing or employing unauthorized persons to practice dentistry or dental hygiene (expired or cancelled licenses); • failure to comply with the terms of a Board order; • inability to practice safely (either due to drug/alcohol or physical impairment); • failure to comply with Medicaid, insurance or other regulatory laws; • participation in conduct likely to disgrace, degrade or discredit the dental professional or the dental profession. There are a few key steps you can take to mitigate dishonorable conduct issues. Supervise your staff properly. Make sure you do not allow them to cut corners, practice beyond their scope or participate in unethical behavior. Keep all of your licenses, including DPS and DEA registrations, up to date. Writing a script on an expired registration is not worth the 6-digit fines we have seen practitioners settle for with federal and state agencies.
Above all, always behave in a manner that exemplifies you as a professional.
advertising violations Advertising violations – we know, the rules aren’t fair, they’re too restrictive, the rules of advertising are archaic, etcetera, etcetera. We feel your pain. The good news is, we have learned the SBDE may be about to review Business Promotion rules. For now, the rules stand and they are vigorously enforced! It does not matter that your marketing people are unaware of the rules; the dentist is held responsible for violations. You can be fined up to $3,000 per violation, per day. In our experience most advertising issues reported to the SBDE contain more than one violation. Learn the rules. Play the game. It is a fact that advertising is important to your bottom line. Don’t give up. These are the four top reasons we see dental professions in trouble with the Texas SBDE. Non-compliance can be very expensive and quite harmful to your reputation. At this point you have two choices:
1
You can continue working in your practice, oblivious to the dangers you are either not aware of or are avoiding.
2
You can work on your practice to identify and help you correct any dangers that are likely lurking in your office.
bloom a flower studio l
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FRESH FLORAL ARRANGEMENTS TO BRIGHTEN YOUR RECEPTION AREA FLOWERS FOR ALL OCCASIONS
214.697.8063
bloomdallas@gmail.com 22 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
Duane Tinker, a former Texas State Board of Dental Examiner investigator, is a partner of Dental Compliance Specialists, LLC. For more information or to schedule an audit of your practice, go to www.dentalcompliance.com or call 682-325-8465. ADVERTISER’S INDEX AFTCO ............................................inside back cover Bloom......................................................................22 Dental Keynote Concepts .........................................5 Destiny Dental Laboratory ......................................22 Med Dent Advisors..................................................17 Med+Tech Construction .............................back cover Ray Bryant Photography.........................................19 Structures & Interiors ..............................................13 Thiel & Thiel.....................................inside front cover Tina Cauller.............................................................17
WWW.AFTCO.NET
Helping dentists buy & sell practices for over 40 years. AFTCO is the oldest and largest dental practice transition consulting firm in the United States. AFTCO assists dentists with associateships, purchasing and selling of practices, and retirement plans. We are much more than a practice broker, we are there to serve you through all stages of your career.
Ahmed El-Halaby, D.D.S. has acquired the practice of Thomas M. Smith, D.D.S. - Longview, Texas
Randell S. Terry, D.M.D. has acquired the practice of Robert W. Gilbreth, D.D.S. - Wills Point, Texas
AFTCO is pleased to have represented all parties in these transactions.
Call 1-800-232-3826 today for a free practice appraisal, a $2,500 value!