SPRING 2010, VOLUME 36, ISSUE 2
Team TAGD, Serving You Inside this issue:
TAGD Advocacy Fund
2010 Lone Star Dental Conference Preview
Summer 2009
How Close Are You? TAGD wants to help you on the road to Fellowship & Mastership If you received your Fellowship before 2003 hours might be lost from your transcript. Contact the TAGD office and we will help you recover those hours. You may be closer to Mastership than you think!
TA w Mas orked GD has ben terTra to m ak e c sess fit for T k semin e the part ion is $ AGD m ars a t e r icip atio 895 for mbers. ue $18 n cred 48 hou Each for e it - T r ach hat’s s of hou only r!
September 9 - 12, 2010 Austin, TX AT&T Executive Education & Conference Center
Operative Dentistry • Presented by Dr. Gordon Christensen Implants • Presented by Dr. Frank Higginbottom For more information visit www.tagd.org or call the TAGD office at 512-244-0577
Let us be your dental health partner . . . And help grow your practice to include patients from the largest dental customer in the world—the TRICARE Dental Plan—which has over 167,000 enrollees in Texas.* Plus, you’ll join over 66,500 dentists nationwide and over 4,000 dentists in Texas* who enjoy network benefits, including: • Competitive and timely compensation and reimbursement • Claims submissions through our free online processing system • Online access to patients’ benefits and claims information through My Patients’ Benefits • Program updates and corporate and industry 1-866-300-9426 • www.unitedconcordia.com news in the quarterly Connection newsletter TXAGD-0608 • Texas dental products are offered by the following operating subsidaries of United Concordia Companies, Inc.—United Concordia Insurance Company for Fee-for-Service products and United Concordia Dental Plans of Texas, Inc. for DHMO products. *Based on United Concordia internal research & reports, 04/08.
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JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
2009/2010 OFFICERS President Dan McCauley, DDS, FAGD Mount Pleasant President-Elect Joey Cazares, DDS, FAGD McAllen Immediate Past-President Ron Theiss, DDS, MAGD Nacogdoches
J O U R N A L
T A B L E
O F
O F
T H E
AGD Regional Director Douglas Bogan, DDS, FAGD Houston AGD National Trustee Ralph Cooley, DDS, FAGD Conroe Executive Director Connie Sonnier, CAE Round Rock
TAGD Staff Sandy Frizzell • Programs Director Margaret Hulse • JTC Foundation Director Amy Knitt • Membership & Communications Director Administrative Assistants: Kimberly Blair Lauren Oakley Nick Prelosky Spring 2010
D E N T I S T R Y
SPRING 2010
2010 Lone Star Dental Conference Preview
8&9
Director (2011) Jamie Bone, DDS, FAGD Kerrville
Director (2012) Andrew Lazaris, DDS, FAGD Plano
G E N E R A L
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Director (2010) Dean Armstrong, DDS, MAGD Amarillo
Director (2012) Carlos Garcia, DMD Weslaco
O F
Emergency Preparedness
Editor Jeff Roy, DDS, FAGD Irving
Director (2011) Gary Jennings, DDS, MAGD Houston
A C A D E M Y
C O N T E N T S
Secretary/Treasurer Mark Peppard, DDS, MAGD Austin
Director (2010) Craig Armstrong, DDS, MAGD Houston
T E X A S
AGD Foundation Outreach Program in New Orleans
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Dental Fillin’s ......................................................................................4 President’s Message ...........................................................................5 Pearls of Wisdom . ..............................................................................6 Drill Bits .............................................................................................9 TAGD Advocacy for the GP ................................................................10 Motivational Minute ........................................................................11 TAGD Event & CE Schedule . ..............................................................15 Welcome New Members ..................................................................15
NEXT ISSUE:
Texas Dentist of the Year™ Nominees Information change request: Send your new address, phone, fax and e-mail to Amy@TAGD.org Disclaimer: The TAGD does not necessarily endorse opinions or statements contained in articles or editorials published in the TexasGP. The publication of advertisements in the TexasGP does not indicate endorsement for products and services. Texas GP is published quarterly by the Texas Academy of General Dentistry, 409 West Main Street, Round Rock, TX 78664. Address changes should be sent to the TAGD. TexasGP is provided as a member service to members of the TAGD. Nonmember subscription rates are $25.00 individual and $40.00 institutional. Canadian orders add $5.00; outside the U.S. or Canada, add $10.00. Single copy rates are $3.00 to individuals and $4.50 to institutions (orders outside the U.S. add $1.00 postage). All orders must be prepaid in U.S. dollars. Printed in U.S.A. Copyright 2010, Texas Academy of General Dentistry, Round Rock, TX. No portion of TexasGP may be reproduced in any form without prior written permission from the TAGD. The opinions expressed by TexasGP are not necessarily endorsed by the TAGD. The publication of an advertisement in TexasGP does not indicate endorsement for products and services. TAGD/AGD approval for continuing education courses or course sponsors will be clearly stated.
Important Contacts
TAGD
512-244-0577 Toll-free 877-464-8243 Fax 512-244-0476 www.tagd.org
AGD
888-243-3368 www.agd.org
ADA
800-621-8099 www.ada.org
TDA
800-832-1145 www.tda.org
TSBDE 512-463-6400 www.tsbde.state.tx.us 3
DENTAL FILLINS • Can I Get Real For a Moment?
G
rab a seat, witness the transparency of a personal train wreck, and vow to respect me still in the morning. I'm writing this following two prior work days of near hell in my practice. My business partner was out chasing CE for a couple of days and the world came down hard upon me. We have a practice with 14 operatories and five hygienists. When two Docs are there, life is copacetic. On Thursdays, I am always the only doc in house. It's a little frantic, but hey, I only have to push it for one day. The team is motivated by knowing it's the last treatment day of the week, and Sonic Happy Hour gives us something to look forward to. Not this week.
As things can, "stuff" happened. Bogging down in NP exams with unusually complex medical histories and tons of questions, the hall line waiting for Dr. Bottleneck was growing. With a restorative patient down the hall wondering how long the anesthesia "needs to soak," my shoulders began to slump, palms sweating. I was on the outside looking in and didn't like what I saw. Quite frankly, I was appalled by the product. Everything I believe in relation to my philosophy of practice, vision, and high demands for almost obsessive quality and customer service was under attack. For the first time in 14 years, I felt the walls coming in on me and worse, couldn't see a quick way out. Calgon take me away! This went on for an afternoon it seemed. At 5:00 p.m. I debriefed and brainstormed with my office manager and an assistant, formulating ways to NEVER let this happen again. I felt disappointed, embarrassed, and worst of all, responsible. I was already fearing the results of the daily electronic survey responses that would be deserved. I fell way below the bar set for my team, self, and most importantly my patients. Patients deserve better and on this afternoon, it was not delivered. Their time was not respected, their dollar was not valued. Even with a 20-30 minute commute home, which is usually perfect for being 100 percent fresh by the time the 4
door swings open into a drastically different world, the cloud was still above me. I felt guilty. The team, surely a few patients, and the boss weren't happy. Epic failure... horrible afternoon! I spent the evening reading motivational blogs, consulting my creator for guidance and encouragement, and replaying the patient apologies I'd given that afternoon. The gauntlet was thrown! I declared war, vowing to have a scheduling plan by Monday morning to prevent this from ever happening again. Our patients are smart; they are aware of the practice environment good or bad, and they have choices about where they spend their money. Unlike many medical offices, where in my opinion the bar is often rather low for customer service, the practice of dentistry is consumer-focused and driven; patients know it. The gauntlet has been thrown here at TAGD, also. We are becoming educated as board members in ways like never before. The commitment to be the presiding officer, a board or committee member, trustee, or regional director is more challenging than ever, yet exponentially rewarding. The stakes are higher and we are moving in new ways to be The Voice of the General Dentist. We know that the membership is smart and aware of the organizational environment good or bad. You, the customer, have choices about where you spend your dues dollars. Some members are excited about this new direction, some unaware; some want us to stick to CE. I wage that we must "soldier on" in the arena of advocacy for the Texas general dentist. There is no other voice that can speak solely for the GP's needs, in honor of our core beliefs. This profession is a treasured, respected occupation. It's under attack in ways that most could not imagine: midlevel providers, challenges against anesthesia portability, and lack of Botox privileges to name a few. Outside forces are working to define what we can do with our training, or even be trained in. We are learning how to better communicate with lawmakers
and the importance of open, synergistic lines of communications with the TSBDE, TDA, the three Texas dental schools, and a multitude of other peer Jeff Roy, DDS, FAGD organizations. We had our inaugural Advocacy Training in January led by our TAGD Lobbyist, in conjunction with the Dallas SWDC. It was a landmark event that will shape our future. I want to thank dentists serving on various committees and leaders in all branches and tiers of organizational dentistry. I'm amazed at what goes on behind the scenes and how hard some work to protect all, at the sacrifice of their families and pocket books. Please support the new TAGD Advocacy Fund without missing a step with DENPAC, ADPAC and the AGD Advocacy Fund. Yes, it's like insurance. Let the workers work for you! Send the letters and e-mails to legislators when ADA or AGD asks. I'd be lying if I said it didn't cost money to protect us, but it's cheaper than losing your freedoms to practice as a general practitioner. Don't wait for others to do it. I'm sitting in the rooms, watching it work; trust me when I say it's effective, responsible, and protecting you. If you question it, contact the TAGD office for a list of upcoming events and go watch your dues and advocacy dollars hard at work. The value of your dues dollars is increasing in unimaginable ways. For years, despite being the largest collective group of dentists as general practitioners, we've been unorganized, politically. Let us be perfectly clear, the goal is not division from ADA forces fighting for all dentists, it's simply added protection for our unique practices when GP advocacy is needed. This board, under Dr. McCauley's leadership, is both preparing for the rainy day and proactively trying to prevent it. Continued on page 6 JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
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MESSAGE FROM THE PRESIDENT
am honored to serve you as the President of the TAGD. The challenges that we face today as a profession are enormous and very serious. You have a board of directors that are very proactive, informed, and involved in every aspect of dentistry and the future of our profession.
offer quality continuing education courses that allow you, the practitioner, to competently treat your patients with evidencebased care. I recommend that each of you consider the MasterTrack program; consume continuing education and be the best professional you can be.
Health care is in a complete paradigm shift. The profession of dentistry, as we know it today, will vastly change in only a few years. New practice models, insurance fee control, insurance limitations and even government employment of dentists are a real probability. Quite easily, our government may mandate how you practice, your fee structure, and who you will have to treat.
In Texas, we have not allowed international accreditation as an answer to access to care, which exists in four states, including Arkansas. We do have border issues and illegal dentistry in Texas. We are seeing mall bleaching and dentists from Mexico coming into Texas to avoid the border drug wars. Presently, the TSBDE has neither authority to police nor fine people who do not have a license to practice in Texas.
Foundations are funding studies to address the access to dental care issues in the United States. Models of mid-level providers that include advanced dental hygiene practitioners, independent dental hygiene practitioners, dental provider models, dental health aid providers, denturists and advanced assistant programs all are being developed or are allowed in other states. As an Academy, we still promote the dentist’s control of the patient care in a dental home. Most of these other models do not value the education or experience necessary to provide what we consider the best dental care in the world. Many of the models being created see dentistry and access to care as a manpower issue, which can be remedied by supply and demand. This attempt to solve access to care may actually increase costs to the patients. It certainly compromises the quality of care offered to patients who need quality care or options for quality care.
To specifically address and support the practice needs of general dentistry this year, your TAGD board created an advocacy fund program and council, as well as a committee. We also hired a full-time lobbyist. All are positioned to monitor and financially support legislative and legal issues that affect general dentists. In our initial week, the fund accumulated over $40,000. I ask that you financially support your profession and the TAGD efforts to protect our practices. This is a very important and tangible way that you can be involved in supporting our profession.
We also have created a state board committee that monitors all state board activities and is present at all meetings. Current issues that are serious to general dentistry include the ability of the state board to deal with illegal dentistry in Texas, issues of Botox usage which under state law is only allowed by oral surgeons regardless of training, and Presently, in my opinion, the ADA anesthesia portability issues which can be appears to be allowing these mid-level pro- restrictive if you use sedation in your office vider models to be developed. I can assure as a general dentist. you that many other states do not think like we do in Texas. They also do not enjoy a To address state crisis management, we practice act that allows us to practice inde- have created a state emergency preparedpendently, as the owner of the practice and ness committee. They are working with head of our dental team, and with minimal state and national organizations to be ready governmental intervention or regulation. to provide dental care following an emergency situation in Texas. You will all have On a state level, our Academy continues to an opportunity to be part of this necessary Spring 2010
organization. We have also formed a finance and investment committee to monitor our investments, our budget, and to decide both long and Dan McCauley, DDS, FAGD short range investment needs. Presently, we are financially stable with proper reserves and have both investments and advocacy funds to protect the future of the TAGD. Nationally, we are monitoring the McCarran-Ferguson bill regarding insurance companies’ abilities (for 41 years) to be exempt from anti-trust lawsuits, thus stifling the ability to have free market competition in insurance benefits. International accreditation issues, and certainly the mid-level provider models, are also being monitored. Hopefully, through legislation, we can limit the dental health aid therapists to Alaska. Our board now has a long range planning committee that considers vision positioning for our state Academy. We also have a new missions committee that is creating state and international opportunities for service. In 2011, the state legislature will meet to consider new bills for Texas. This session will be largely focused on education, transportation, and health care. With a projected $15 billion deficit, we must be prepared to defend our position against taxing both dental and medical health care. Also, we must collectively push for legislation that will help and protect dentistry in Texas. Our legislative committee and lobbyist are working daily on your behalf, to see that we are at the table when dental issues are presented. I ask that you stay informed, and stay involved in organized dentistry. This is your profession and your future. Your board is giving you 100 percent daily. We have a lot at risk and much to protect. Rest assured that we are collectively speaking as one unified voice for dentistry in Texas, advocating for health care that works. 5
PEARLS OF WISDOM Oral Cancer Screenings with a Gentle Touch By Michael Hodapp, DDS, MAGD
T
he oral cancer screening exam is one area of our profession where we can effectively help save a patient’s life, so why is it often disregarded? One of the techniques taught is the protracting, or pulling of the tongue with a gauze, a method that feels both intimidating and unnatural. For every action, there is an equal and opposite reaction and when the tongue is pulled, it is just natural for it to pull back. This is uncomfortable for both the clinician and the patient. Over time, I developed a technique which allows me to do a thorough oral cancer screening with a gentle touch. This method is quick, thorough, and comfortable to the patient and clinician.
patient an initial feel of comfort then retract each cheek, one at a time. View gingival tissues of the mandible and the bilateral buccal mucosa with direct vision and a mirror. Follow through with the index fingers and thumb only, to palpate the lips and cheeks; this leaves the rest of the fingers dry. Next, place the mirror above the tongue and view the entire hard palate using your mirror as a scanning tool. Check both the tuberosity areas and the distal aspect of the lower second molars. Take your mirror and slide it between the lateral border of the tongue and gently tease the tongue medially, just enough to view the lingual side of the mandible. This allows vision behind the third molar region, the area most likely to reveal metastasis from other areas of the body. Then, take your mirror and hold it above the base of the tongue, where the hard and soft palates meet. Say to the patient, “take a deep breath through your mouth,” and at the same time place gentle pressure at the base of the tongue. Watch as the entire soft palate and oro-pharynx open up to you.
First, warm your mirror under running warm water to prevent fogging. Give the Dental Fillins continued Tell your friends and recruit new members. We are so much more than Fellowship and Mastership CE these days, two of our shining stars. As I said in an article a few years ago, "this is not your father's AGD" because this is a new and politically challenged practice environment. We must adapt. We may survey you in the coming year. If we survey, please take the time to tell us what information you want to read 6
I have found that very few patients will gag with this technique and you couldn’t ask for a better view. Ask the patient to place their tongue all the way over on their left cheek; you will see all the way back to the base of the tongue including the viliform papilla. Take the time to view it for a second or two and then gently glide your index finger down the lateral border to feel for any unusual bumps or irregularities. Do the same for the right side of the tongue, then have them place their tongue to their palate and finally say to them, “stick your tongue all the way out and open wide.” Hold your mirror above the tongue, at the center of the palate, to view the base of the tongue.
Then take your index finger only and gently palpate the floor of the mouth. This completes the intra-oral portion of the exam. Use your middle and ring finger to palpate the external structures of the neck and face to complete the screening. Try this, and you will be amazed how much easier your exam will go for both you and the patient, and more importantly, you might save your patient’s life.
and how you want us to advocate on your behalf. We need to know where you, the customer, stand. We want to educate you on the risks to general practice and insure that everything you believe in is protected, when under attack.
provider concerns and other emerging issues. It's all that we ask. Well, we always want you to recruit new members in the spirit of assembling sweeping, large quantities of advocating voices. Thank you for your commitment to TAGD!
This publication's contents are important and we acknowledge our responsibility to both inform and educate. Follow the Gatekeeper e-mails for more current feeds of advocacy information. Please commit to educating yourselves on mid-level
Please enjoy the reprinted article Customer Introduction; it relates to each of us and is now framed in my office break room. United we stand, Jeff JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
EMERGENCY PREPAREDNESS
May 6 - 9, 2010 San Antonio • Texas TAGD Sponsored Speaker Dr. Jeff Brucia Friday, May 7 • 8:30 a.m. - 11:30 a.m. 3 Lecture CE Hours • Fee: $65 Adhesive And Restorative Materials Update
T
Andrew Lazaris, DDS, FAGD
raining and experience has taught us how to manage emergencies in our dental practices. On a micro-scale, we are all emergency coordinators. We have medical training, treat patients and manage staff. By our nature, we also care about our communities and giving back. The networks of dentists that volunteer and do mission work, or serve in mobile dental clinics in under-served areas, attest to this. Our expertise has also had crossover into other fields. Dentists already work with the FBI and coroner’s offices for body identification.
This course provides detailed insight into the total spectrum of adhesive dental treatment. The numerous choices in restorative materials has confused the clinician as to what is best indicated in a given situation. Dr. Brucia will On the macro-scale, this will not always guide you through the step-by-step clinical be enough. As evidenced by recent events in Haiti and Chile, large-scale emergencies technique. Friday, May 7 • 1:30 p.m. - 4:30 p.m. 3 Hands-on CE Hours • Fee: $225 Direct Aesthetic Posterior Restorations; An Adventure In Excellence Direct aesthetic restorations are the most requested and performed procedures in any dental practice today. This in-depth workshop provides details to perfect the posterior Class II composite restoration. You should leave with a high level of predicable success when applying these techniques clinically. Saturday, May 8 • 9:00 a.m. - 12:00 p.m. 3 Lecture CE Hours • Fee: $45 Diagnosis And Treatment For Predictable Advanced Restorative Dentistry
do happen. Whether it is an earthquake, hurricane, or terrorist act, our profession can play an important role in crisis management. Dental representation is lacking in current emergency services provided by non-military, government agencies.
To explore areas that dentistry can be more involved in emergency preparedness, the TAGD has created an Emergency Preparedness committee. The goal of the committee is to open communication channels between dentists, and other health care providers or government agencies, to coordinate resources in the event of natural or man-made emergencies. Currently, there are no lines of communication between dental organizations and government agencies. Over the next year, organizational and communication efforts will increase and there will be opportunities to train and participate in emergency preparedness. A census will be taken to identify dentists and support staff available to assist in future emergencies. A list will also be compiled of available physical assets (i.e. dental equipment, office space, mobile dental clinics, etc.). Interested parties are invited to participate. Please contact TAGD for more info.
Save the Date Jack T. Clark Foundation Golf Classic
Forest Creek Golf Club June 18, 2010 • Austin, TX
Advanced diagnosis and treatment planning for comprehensive restorative dentistry is absolutely necessary to ensure the best possible chance for successful treatment. Learn when occlusal factors may play a role in restorative failure and TMD and how to restore patients using the latest materials coupled with the timetested approach of occlusion. To register for these courses visit www.tda.org Spring 2010
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2010 Lone Star Dental Conference September 9 - 11 • Austin, Texas
AT & T E x e c u t i v e E d u c a t i o n & C o n f e r e n c e C e n t e r
Your Future Friday Course • Open to the entire dental team • 8:00am - 4:00pm Dr. Gordon Christensen will present his brand new lecture:
New Aspects of Dentistry 2010 7 hours lecture credit
This full day program includes many of the new concepts in restorative dentistry compared to the long proven products and techniques. The morning session is a comparison of porcelain-fused-to metal restorations and the several competing types Gordon J. Christensen of all-ceramic crowns and fixed prostheses. The afternoon session is a fast paced, multi-topic discussion and comparison of the many techniques and materials used in DDS, MSD, PhD fixed prosthodontics.
Topics include: • • • • • •
Criteria for crowns vs. direct restorations in view of new superior direct restorative materials Ridge preservation for optimum pontic anatomy Building-up teeth rapidly and well The best posts and cores compared Are pins still necessary New tooth preparations
• • • • • • •
Air vs. electric hand pieces for fixed prosthodontics A brief clinical comparison of PFM and all-ceramic crowns Conventional and digital impressions. Which is best? Interocclusal records The best cements for specific situations Repair of ceramic restorations Many everyday dilemmas and solutions
Dr. Gordon J. Christensen is Founder and Director of Practical Clinical Courses (PCC) in Utah, and Senior Academic Advisor of the Scottsdale Center for Dentistry (SCD) in Arizona. Both groups are international continuing education organizations providing courses and videos for all dental professionals. Dr. Christensen has presented over 45,000 hours of CE throughout the world and has published many articles and books. Gordon’s degrees include: DDS, University of Southern California; MSD, University of Washington; PhD, University of Denver; an Honorary Doctor of Science from Utah State University, and an honorary Doctor of Dental Education and Research from Utah Valley University.
Saturday Seminars Photo Workshop
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Stain & Glaze Made Easy
8:00 am - 12:00 pm • 4 hrs hands-on Presented by Dr. Mike Malone
8:00 am- 12:00 pm • 4 hrs hands-on Presented by Dr. Todd Ehrlich
Sponsored Kodak Dental Systems
Sponsored Ivoclar Vivadent
The Abused Mouth
8:00 am - 12:00 pm • 4 hrs hands-on Presented by Dr. Jerry Bouquot Sponsored by the Jack T. Clark Foundation
JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
2010 LSDC Events
Thursday, September 9 • TAGD Leadership Reception
All LSDC attendees are invited to the Leadership Reception on Thursday night where we celebrate the achievements of our local components as well as leaders who have demonstrated their commitment to dental excellence through education. TAGD will also announce our New Dentist of the Year award recipient at this event.
Friday, September 10 • 2010 Texas Dentist of the Year Gala™
The 2010 Texas Dentist of the Year Gala™ celebrates dentists throughout the state who exhibit a commitment to continuing dental education, service to the community and activism in the dental profession. Nominees are selected by their colleagues from dental societies and local components around the state.
AT&T Executive Education and Conference Center
This year’s conference will once again be held at the AT&T Executive Education and Conference Center, located on the UT campus in Austin. The conference center also houses a four-star hotel where attendees can stay for the special rate of $170 per night. If you would like to reserve a room call 512-404-1900 and ask for the Lone Star Dental Conference room block. If you book your room online just enter our promotional code: LONEST0910. This rate is offered until August 17. *Be sure to book your room early, the UT Longhorns have a game vs. Wyoming on Saturday, September 11; the room block is limited.
For more information visit www.tagd.org • Online registration is now available 2.
DRILL BITS • ASSOCIATESHIPS
What is the first step I should take to look for an employer upon graduation?
The first step is not to wait until graduation. Students should be looking for jobs and making contacts beginning in their third year of dental school.
how much CE he/she attends. Getting a good read of their personality will also be very important. Understandably, this will be hard to do in the short time of an interview so talk to the office staff to get a little more insight.
What are some helpful tips to find an associateship?
What are important things to know or Direct mail/“cold calls” helped one new questions to ask when entering an graduate land interviews with several den- associateship? tists. He sent letters to prospective offices located in the area he wanted to work in and was able to land interviews with those he contacted. Job postings through dental schools and organized dentistry web sites (such as the AGD career center) are also helpful. Another useful method is to attend your local dental CE meetings and social events. By establishing and growing your network of colleagues you’ll be able to find out about new job openings and get information about a potential employer.
What are important qualities to look for in an employer? One of the most important elements is to see if you and your potential employer share the same belief system and professional values when it comes to practicing dentistry. For example, if new technology and learning new techniques are important to you, then ask the practice owner Spring 2010
• What the owner is expecting by hiring an associate • How new patients will be assigned • How many days and what hours the associate will work • How will the associate be compensated (percentage, hourly, etc.) • What types of procedures does the owner perform • Will there be special compensation for procedures the associate can do that the owner doesn’t do • Is there a restrictive covenant • Get an idea of the offices’ books, mainly in regards to the collection ratio of the practice • Know the employee turnover rate
What are important elements to have in the contract with your new employer? A Proximity Clause – there should be something in there about soliciting patients to your new office after you have left the practice.
Benefits – what type of health insurance you’ll have (or if that’s even included) and if there’s a retirement plan. Younger dentists don’t always think about retirement but it should be in the back of your mind. Long term plans – this is important to discuss but don’t have to be outlined in the contract. An example is if the owner would extend to you the option to buy in to the practice.
Can two dentists work together if their treatment planning differs?
4.
The key is to be able to discuss things openly. One dentist said she makes time to sit down with her associate once or twice a month. Even though you practice together work can get really busy and there’s not always time to just talk and have real conversations. Go somewhere away from the office where things are more relaxed when talking about work issues.
Best advice about working in this setting?
Communication is key! Plan those off-site lunches. You have to remember that this practice is the owner’s baby. They’ve worked hard for many years to build this practice to his/ her liking Don’t expect to come in as an associate and get rich. It takes time to build your patient load and establish yourself within the office. 9
TEXAS ACADEMY OF GENERAL DENTISTRY ADVOCACY Being a General Dentist requires a unique skill set unlike that of any other specialty. By virtue of this, legislative and regulatory issues more often directly affect the practice of General Dentistry than other specialty groups. As the “Voice of General Dentistry,” Texas AGD wants to help. Protecting the mission of Texas AGD, “Advancing Excellence in Dentistry” becomes more difficult every year as other states struggle with increasing regulations and the addition of mid-level providers such as the advanced dental hygiene practitioner and DHATs. Texas dentists have maintained a strong commitment to patient care, and Texas AGD intends to supply the support necessary to continue. In order to accomplish our goals of advocacy for our members we have created an advocacy fund. The Texas Advocacy Fund provides Texas AGD with resources needed to protect the rights and privileges of the General Dentist before the legislature and regulatory bodies. With the fund, Texas AGD will continue to: • Monitor regulatory and legislative issues that affect the GP • Provide grass roots training and communications so TAGD can make an impact on policies that can affect how you practice dentistry • Maintain advocacy staff, a lobbyist, and volunteer support
Texas Advocacy Fund Texas Academy of General Dentistry Advocacy Fund Committee Craig Armstrong, DDS, MAGD • Chairman Roberto Diaz, DDS, MAGD Dave Roberts, DDS Mike Stuart, DDS, FAGD Jacquelyn Vo, DDS
The Texas Advocacy Fund is not a political action committee and cannot be used to support candidates or ballot initiatives. Texas AGD recommends you continue to support the TDA’s DenPAC and to individually support candidates running for office as we must continue to have legislative sponsorship of bills that provide quality dental care for the patients of Texas. To create and sustain this fund, TAGD is calling on members to make a meaningful contribution at one of the following suggested giving levels: Founder Advocate Master Advocate Fellow Advocate General Advocate
$5000 $1500 $500 $250
The TAGD has long heard that its members want us to advocate for them legislatively, now is the chance to have your voice heard by making a contribution to the Texas Advocacy Fund. To make a contribution or if you have questions about the fund, contact Fund Chairman Dr. Craig Armstrong at carmst@aol.com or Sandy Frizzell at 512-244-0577.
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JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
MOTIVATIONAL MINUTE
Customer Introduction
because of me. Politicians and postal workers, sanitation workers and soldiers all owe their jobs to me. Without me, no taxes would be paid and any and all societal advances would come to a halt. The wise come to know, respect, and love me. The foolish disregard my importance and suffer accordingly.
Allow me to introduce myself. I am a customer. I am the person that makes the economic engine turn. I am the reason you take home a paycheck. I am the reason you are able to feed your family, pay your mortgage, go on vacation, buy a car, and contribute to your church or synagogue. Because of me, gigantic corporations and small businesses alike have risen and flourished. Because of my absence, they have faded from existence. The roads you drive on, the police and fireman that protect your community, the teachers that teach your children all exist
COMMON MEDICAID REPORTING ERRORS
Marko Alanis, DDS
One of the most common errors involves claims that are lacking documentation regarding medical necessity. For example, a provider submitting a claim for a new stainless steel crown that had been previously chewed through by the patient must include those essential, descriptive remarks. Too often, providers are not providing the specific documentation. Thus, the claim is reviewed and initially declined, requiring an appeal by the provider due to missing information. The provider will then need to resubmit the claim in its entirety, not just the missing information. The second most common error involves tooth and surface ID issues. Providers Spring 2010
By the way, you’ll notice that I didn’t introduce myself as your customer. That’s because I don’t belong to you. Even if I make a purchase from you, that doesn’t mean that I will do it again in the future. You are always on trial and I am always evaluating, measuring, and testing your product and service. So pay attention to me. Get to know me. Learn my habits. My likes. My dislikes. My desires. My dreams. My values. Learn my language. Learn to recognize my moods. Above all, treat me with respect. I will not be ill-treated, and why should I be? There are too many businesses vying for my attention. Every time you turn on the television, open a newspaper, or listen to the radio, you see and hear multitudes of companies competing for my attention. There are too many people who are willing to treat me right in exchange for my business. must identify all teeth and surfaces on their claims and without this, even sealants will be declined. A reminder was given that red or yellow ink on appeals does not show up on resubmitted claims, because they are scanned in black and white in the computer system. At a recent meeting, Dr. Linda Altenhoff, Medicaid State Dental Director, discussed the above and other common issues associated with providers using clearinghouses for claim submission. She reminded us that when there are internal issues within the clearinghouse, such as not submitting claims to TMHP within the 90 day deadline, the claim will be denied. The actual date that the provider submitted to the clearinghouse is irrelevant. Sometimes, clearinghouses will drop information needed by TMHP, leading to a claim denial. She reminded all that such contracts are between providers and clear-
And know this, I am not easily fooled. Businesses treat me right or suffer the consequences. Sooner or later I always discover dishonesty, disrespect, or disinterest. Most of the time, I don’t announce my displeasure. I simply take my business elsewhere. Occasionally, we will have disagreements. I don’t like mistakes but I understand that you sometimes make them. The manner in which you handle my complaint determines any future interaction I have with you. And, in my mind, it also determines the character of your business. I rarely ever give you a second chance to make the same mistake twice. So, watch for me in your business community. If you’re fortunate enough to see me, do everything in your power to woo me and make me your own, because I hold the key to your financial success. It is no exaggeration to say that when you interact with me, your future hangs in the balance. Learn me. Know me. I am a customer. © 2010 Charles Marshall. Charles Marshall is a nationally known humorous motivational speaker and author. Visit his Web site at www.charlesmarshall.net or contact him via e-mail at charles@charlesmarshall.net. inghouses; TMHP is just a third party. When a clearinghouse is being utilized, she recommended finding one that is an enrolled provider with TMHP. This way, TMHP can recoup monies from the clearinghouse (not the provider) if they change codes or make a mistake on claims. Dr. Altenhoff stated that it is critical for providers to keep track of all claims in relation to their respective submission deadlines, and encouraged all providers to take an active part in their practice which includes the front office, billing, and submission of dental claims. All claims are submitted under the provider’s license and they are ultimately liable for what is being submitted. She encouraged providers to stay abreast of code changes; they are posted in the quarterly Medicaid bulletin. 11
The Head Start Dental Home Initiative (DHI)
Partnering to Provide Dental Homes for Head Start Children in Texas As many readers already know, TDA has been working with the American Academy of Pediatric Dentistry (AAPD) along with the Texas Academy of Pediatric Dentistry, the Texas Academy of General Dentistry, the Texas Department of State Health Services – Oral Health Branch (OHB), and the Texas Dental Hygienists’ Association to establish dental homes for Texas children enrolled in Head Start – the DHI. Dr. Paul Kennedy, Jr., heads the DHI Steering Committee with Dr. Tommy Harrison serving as TDA’s liaison to the Steering Committee. Work is well underway to place every Head Start child into a dental home before the 2011 legislative session and to create an ex-
tensive network of dentists willing to provide needed dental care to Head Start enrollees. In December 2009, representatives from organized dentistry, Head Start, and the OHB met to finalize the first stage of dentist recruitment. By February 2010, invitations will be mailed asking dentists to participate in the DHI. This is an excellent opportunity for participating dentists to build their practice while helping Head Start children and their families engage in good oral health habits that will follow them for a lifetime. Please consider becoming involved in this very worthwhile project! For more information, contact Dr. Paul Kennedy at (361) 992-9500 or Diane Rhodes at TDA, (512) 4433675. or diane@tda.org
Membership Dues Renewal The AGD has now sent out an e-invoice, their dues renewal notices for 2010. Renewal is simple, either visit www.agd.org and renew online or contact Amy at the TAGD office at 512-244-0577 to renew over the phone. If you need to make a change to your contact information please e-mail Amy@tagd.org to update your address, e-mail, or phone number. 12
JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
It’s That Time
Please donate to the Jack T. Clark Foundation’s 2010 Silent Auction
T
he Jack T. Clark Foundation needs donations for its Silent Auction Fundraiser, which will be held during the TAGD’s Lone Star Dental Conference on September 9- 11 in Austin, Texas. Proceeds from the auction will fund programs that make public education of oral cancer available throughout Texas. Individuals, constituents, regions and exhibitors are welcome and encouraged to donate and bid on items. Auction items, such as continuing education courses, dental equipment and instruments, vacation and spa getaways, jewelry, artwork, tickets to sporting events, autographed items, luxury gift
baskets and gift certificates are especially needed. To make a donation, complete the form below and mail or fax it to: Jack T. Clark Foundation 409 W. Main Street Round Rock, TX
Fax: 512-244-0476
For questions please contact Meg Hulse at Meg@tagd.org or call 512-244-0577l Donations will be acknowledged on the Jack T. Clark Foundation web page, at the Lone Star Dental Conference on-site auction and in post-meeting materials
Donations are needed by August 13, 2010. Please mail the items to the Jack T. Clark office (at the address above) or let us know if you will be bringing the items with you to the Lone Star Dental Conference For best exposure and to raise as much money as possible, please include a product brochure or more information. Also, while all donations are appreciated, items that are easily shipped will bring more return for your donation.
Jack T. Clark Foundation
Thank you.
Phone:______-______-__________ E-mail:_______________________________________
The JTCF is a 501(c)(3) charity; gifts to the JTCF are fully deductible for United States federal income tax purposes, subject to the limitations placed on charitable gifts by the Internal Revenue Service. Be sure to check with your tax professional or attorney for specific, allowable deductions in your state.
Spring 2010
Silent Auction Donations Austin • September 9 & 10, 2010
Individual/Company Name: __________________ Contact Name:___________________________ Street Address:_______________________________________________________________ City:___________________________________ State:____________ Zip:_______________
Web site address, if applicable:____________________________________________________ (Web site address will be included with your item description) Dollar value of item(s) that you are donating (please list each item separately): $________________________________ $________________________________ $________________________________ $________________________________ Description and value of item(s) (please be as detailed as possible and include applicable expiration dates or restrictions):_______________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ 13
SAVOR THE
Terry T. Tanaka, DDS, MAGD David S. Hornbrook, DDS, FAACD Choose from choice continuing education* • A Dedicated Implant Track • Live-Patient Training • Education Hosted at the Louisiana State University School of Dentistry • Government Relations Training *Courses and speakers subject to change.
AGD 2010 Annual Meeting & Exhibits July 6 to 8, 2010: AGD House of Delegates July 8 to 11, 2010: AGD Annual Meeting & Exhibits
Visit the AGD Web site for more information at www.agd.org/neworleans.
D
iscover the industry’s best opportunity for learning—the AGD’s Annual Meeting & Exhibits. It is the premiere dental event of the year, offering general dentists and their team access to top-notch quality CE, new products, exciting social events, and an unforgettable convocation ceremony. Jeffrey Taylor, founder of Monster.com, will address the AGD’s Annual Meeting registrants this summer. Participants will hear from the globally recognized career giant, innovator, entrepreneur, and author about social networking, the power of the consumer, and many other exciting topics through his presentation, You Are the CEO of Your Own Life. After indulging in the AGD’s daily educational offerings, treat yourself to exciting attractions at night, beginning with the people, culture, and cuisine of New Orleans. Best known for its spicy Cajun and Creole dishes, New Orleans’ fanciful fares also blends French, Italian, Spanish, African, and Indian influences into its recipes.
AGD/ AGD Foundation Outreach Program
AGD Foundation’s ability to address the oral health needs of un-served and underserved populations.
Orleans, La. The State of Louisiana will provide a free temporary license for U.S. licensed dentists to practice in that state.
Since 1972, the Academy of General Dentistry (AGD) Foundation has been actively funding educational, scientific, and charitable initiatives that provide oral health resources for the public and continuing education (CE) opportunities for dentists.
The first-annual AGD/AGD Foundation Outreach Program will be held Thursday, July 8, at the Louisiana State University Dental Clinic, during the AGD Annual Meeting & Exhibits, July 8 to 11, 2010, and will continually strive to serve residents of each AGD Annual Meeting & Exhibits host city.
Volunteers are needed by May 1, 2010. To learn more about the AGD/AGD Foundation Outreach Program or to volunteer your services, please contact Marilyn Mays, manager, AGD Foundation, at 888.243.3368, ext. 4329 or marilyn. mays@agd.org.
Restoring more than smiles
This year, the AGD Foundation, in collaboration with the AGD, introduces its firstever AGD/AGD Foundation Outreach Program. This ambitious new program was conceived to increase the AGD and 14
The AGD/AGD Foundation Outreach Program is in need of volunteer dentists and dental teams to provide free oral health and dental care to residents of New
The AGD Foundation is a 501(c)(3) charity; gifts to the AGD Foundation are fully deductible for United States federal income tax purposes, subject to the limitations placed on charitable gifts by the IRS. JOURNAL OF THE TEXAS ACADEMY OF GENERAL DENTISTRY
TAGD CONTINUING EDUCATION & EVENT SCHEDULE April
April 21 Fort Worth AGD Using the Internet to Promote Your Practice & Cut Your Overhead w/ Dr. David M. Mikulencak Fort Worth, TX
May
May 7 TAGD Sponsored Speaker TDA TEXAS Meeting Adhesive & Restorative Materials Update & Direct Aesthetic Posterior Restorations w/ Dr. Jeff Brucia May 8 TAGD Sponsored Speaker Diagnosis & Treatment For Predicable Advanced Restorative Dentistry w/ Dr. Jeff Brucia
June
May 14 Jack T. Clark Foundation Differential Diagnosis of Common Oral Lesions w/ Dr. Jacqueline Plemons Richardson, TX
June 18 Fort Worth AGD Perfecting and Understanding Occlusion w/ Robert B. Kerstein Fort Worth, TX
May 14 Houston AGD Done In A Day! OSHA Annual Update & CPR Certification Houston, TX
August 6 CenTex AGD Practice Makes Perfect! Part 2 w/ Dr. Roger Levin AUSTIN, TEXAS
May 14 Dallas AGD E4D Preview Richardson, TX May 28 Fort Worth AGD Porcelain Veneers w/Dr. Jose Luis Ruiz Fort Worth, TX
August
September
September 9-11 Lone Star Dental Conference w/ Dr. Gordon Christensen Austin, TX
October
October 1 Houston AGD Reality Lecture: A Guide to Selecting Products w/ Dr. Michael B. Miller Houston, TX
November
November 12 East Texas AGD Periodontal Inflammation and the Impact on Systemic Health w/ Dr. David Paquette Tyler, TX
FAGD/MAGD credit #219328 • 1/1/06-12/31/10
For more information on these courses contact the TAGD office at 512-244-0577 or toll-free 877-464-8243
WELCOME NEW TAGD MEMBERS! Dr. Walid Abdel Fatah, Houston Dr. Elias Abou Khalil, Baytown Dr. Dwight Bailey, El Paso Mr. Justin Baker, Houston Ms. Allyson Bauch, Houston Dr. Matthew Bayne, Garden Ridge Dr. Ioan Bec, El Paso Dr. Matthew Bentley, Mabank Ms. Elizabeth Botello, Houston Dr. Jerry Bouquot, Houston Dr. Jason Burkett, McAllen Ms. Levely Castelo, Houston Dr. Edariz Castilla, Austin Dr. Karen Chandler, El Paso Dr. Eileen Chen, San Antonio Dr. Crystiane Couto, Euless Dr. Marlin Cox, Dallas Dr. Jonathan Dehart, Houston Dr. Eunjung Edwards, Cordova Dr. Daniel Edwards, Frisco Mr. Daniel Esobedo, Dallas Dr. Scott Essig, Spicewood Dr. Philip Estes, Frisco Dr. Theodore Fortier, McKinney Dr. David Gary, Houston Mr. Senaido Garza, Houston Spring 2010
Dr. Taylor Gehring, Dallas Dr. Matthew Gillham, Fort Worth Dr. Paul Graf, Houston Dr. Chet Gray, Midland Dr. Wesley Gray, Midland Dr. Joshua Haden, Waco Mr. RJ Harris, Houston Dr. Asra Hashmi, Cleveland Dr. Mohammad Hashmi, Cleveland Dr. Theresa Heaton, Allen Dr. Vincent Ip, Austin Dr. Trever Keele, Spring Mr. Kevin Keys, Houston Dr. Sayaka Kondo, Houston Dr. Dallas Krommenhoek, Round Rock Dr. Agee Kunjumon, Pearland Ms. Jini Kuruvilla, Sugar Land Ms. Christina Ky, Rowlett Dr. Brian Le, Spring Ms. Katelynn Le, Houston Dr. Mark Littlestar, San Antonio Dr. Pau Long, Houston Mr. Sergio Lopez, Houston Dr. Sasha Mahabir, League City
Dr. Kay Malone, Spring Brance Dr. Yahya Mansour, Dallas Dr. Brian Martin, Grapevine Mr. Juan Carlos Martinez, Houston Dr. Michael Melanson, Lubbock Dr. Angela Moore, Bedford Mr. Tyler Myser, Houston Mr. Kevin Nail, Houston Ms. Anh Quynh Nguyen, Dallas Dr. Hannah Nguyen, Houston Dr. Jennifer Nguyen, Katy Ms. Quyen Nguyen, Houston Dr. James Nielsen, Prosper Dr. Ricardo Ochinang, San Angelo Mr Brian Oribello, Houston Dr. W. Osborne, Frisco Dr. Samera Owhadian, Austin Dr. AnnaLynn Pappas, Richardson Dr. Minesh Patel, San Antonio Dr. Mary Peters, Austin Dr. Shelli Peters, Houston Ms. Hoa Phan, Houston Dr. Kevin Phan, Houston Dr. John Potter, Irving
Dr. Royanna Puen, San Antonio Dr. Nicholas Quach, McAllen Dr. Gayatri Raina, Irving Ms. Victoria Ramirez, Houston Dr. Anissa Reagor, Bryan Dr. Cecelia Reid, Richmond Dr. Donald Reynolds, San Antonio Mr. Justin Rich, San Antonio Mr. Jared Roberts, San Antonio Dr. Tim Robinson, Dallas Dr. Ivan Rodriguez, Harlingen Dr. Victor Rodriguez, Houston Dr. Rachana Sangani, Grapevine Ms. Naomi Sever, San Antonio Ms. Katya Sherchenko, Houston Dr. Chad Silvertooth, Kilgore Mr. Rory Smith, Dallas Dr. Lauren Standefer, Dallas Mr. Brian Stanworth, Houston Dr. Natalie Stimpson, Cedar Hill Dr. Ashley Strickland, Buda Dr. Kevin Sturdy, Burleson Mr. Austin Teitelbaum, Houston Ms. Dania Turcios, Houston Dr. Christa Walker, Roanoke Dr. Michael Witkowwski, Houston 15
Texas Academy of General Dentistry 409 West Main Street Round Rock, TX 78664 ADDRESS SERVICE REQUESTED
Texas AGD Membership Application 1. Choose your interests
3. Send in your application and dues
Check any areas of interest that you would like to know more
2010 Academy Dues - State & National Student Dues
about or participate in: Educational Programs Fellowship/Mastership Award Jack T. Clark Foundation/Volunteering Advocacy Other:________________________________
2. Tell us about you Name______________________________________ Address_____________________________________ City, State, Zip_______________________________ Phone_____-_____-______ Fax_____-_____-_____ E-mail______________________________________ Date of Birth ______/_____/______ M
F
License #____________ Year of Graduation*______ Dental School___________________ New Dentist?*
$504 $16
Or New Dentist Special Dues Rates - State & National 2006 Graduate $435 2007 Graduate $332 2008 Graduate $227 2009/2010 Graduate or Resident $131 Local Component Dues $_________ Dues vary by component area, see chart Brazos Valley $25 Panhandle Central Texas $35 Rio Grande Valley Dallas $45 River District East Texas $20 San Antonio El Paso $10 Southeast Texas Fort Worth $40 Houston Heart of Texas $15 2009 Grad Lubbock $35 2008 Grad 2007 Grad
$0 $40 $15 $50 $10 $50 $25 $35 $45
*If you graduated less than five years ago your dues are less (see special rates on the right)
Total Amount Due
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Mail or fax your completed form to: Texas Academy of General Dentistry • 409 West Main Street • Round Rock, TX 78664 • Fax 512-244-0476