THE #1 JOURNAL FOR NEW DENTISTS
TERMINATING AN EMPLOYEE
At Your Dental Practice
PLUS Hiring a Dental Assistant? What to Look For Top Minimally Invasive Implant Procedures
FALL 2014
75% ] of U.S. doctors use an Apple device of some kind.
JUST WHAT THE DOCTOR ORDERED With 30,000 users worldwide, more and more dentists are running their practice on Apple computers and iPads and trusting MacPractice for their software.
df ni
]4
a io n als u se
5
%
e.
60%
fess
on
pro
Pa
ar hc ] o f h e alt e
or w ork.
] 94% of healthcare organizations adopt Apple devices when provider preference is the deciding factor.
us e a n iPh
ST. STEVEN’S MEMORIAL HOSPITAL
] Traditional PC shipments have declined 11%.
2012 2013
] Smart tablet shipments have increased 68%.
2012 2013
Call (855) 679-0033 - WATCH WEBINAR & DEMOS MacPractice.com/company/events Sources: A Manhattan Research study claims 75% of U.S. physicians own Apple products. Vitera Healthcare reported that 60% of healthcare professionals use an iPhone for work, and 45% use an iPad. A KLAS study found that 94% of healthcare organizations adopt Apple devices when user preference is a factor. Samsung was the second most frequently adopted technology in this study with just 26% of organizations having at least one device. Gartner detailed market forecast data - "Forecast: Devices by Operating System and User Type, Worldwide, 2010-2017, 2Q13 Update."
282,749
UP TO 100% FINANCING • COMPETITIVE INTEREST RATES • GROUND UP CONSTRUCTION
SQUARE FEET, AND COUNTING...
In 2013, we financed over two hundred eighty-two thousand square feet of construction projects. Let’s measure success together.
Lending More than Capital ©2014 Live Oak Banking Company. All rights reserved. Member FDIC
Mike Stanton 404.995.2003
JP Blevins 910.796.1674
liveoakbank.com/dental • 877.890.5867
FROM THE PUBLISHER’S DESK
FA L L 2 0 1 4 PUBLISHER
Sally McKenzie Sally@thenewdentist.net DESIGN AND PRODUCTION
Dear Readers,
Picante Creative www.picantecreative.com
Welcome to the fall issue of The New Dentist™ magazine.
Tess Fyalka Tess@thenewdentist.net
MANAGING EDITOR
S
ome of the most challenging situations new dentists face involve knowing when to hire and when to fire staff. While the hiring of new employees often brings with it a sense of excitement and possibilities, it can be challenging to determine who is the best candidate. It can also be difficult to determine how to recruit qualified applicants or what to include in a job description. Conversely, letting an employee go is a decision that can be fraught with anxiety and trepidation. And, most importantly, it’s critical to ensure that you follow the letter of the law when you do. In this issue, we share advice from two noted experts. Lori Paschall, president, American Dental Assistants Association, offers key tips when hiring a dental assistant on p. 6. And Ali Oromchian, JD, LL.M., offers sound advice on what to do when it comes to terminating an employee in your practice on p. 16. Also in this issue, social media can be a fabulous place to connect with current and prospective patients; it can also be where your good reputation is maligned. Find out what Andy Beal, online reputation consultant, author and CEO of Trackur.com, recommends if you find yourself or your practice on the wrong side of a bad review. I’d like to take this opportunity to thank departing Advisory Board member Dr. Josh Austin for his contributions to the magazine and blog over the past five years. We wish him the very best, and we look forward to reading his column “Pearls for Your Practice” in Dental Economics. Dr. Austin is sure to be a significant contributor to the dental profession for many years to come. Finally, be sure to visit The New Dentist™ website at www.thenewdentist.net; take a moment to explore. In addition to The New Dentist™ blog, you’ll discover a wealth of FREE information and materials to guide you at every step throughout your dental career, as well as hundreds of FREE continuing education opportunities using interactive web-based training provided by Viva Learning™, an ADA CERP provider.
Fondly,
Sally McKenzie, Publisher
Join the New Dentist™ Advisory Board, see p. 28
Dr. Josh Austin San Antonio, TX UT San Antonio Dental School 2006
Dr. Charley Cheney III Dr. Katie Montgomery Newnan, GA Marysville, OH Tufts University School The Ohio State of Dental Medicine College of Dentistry 2004 2006
2 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
Dr. Kevin Rhodes Round Rock, TX UT San Antonio Dental School 2005
SALES AND MARKETING
For display advertising information, contact ads@thenewdentist.net or 877.777.6151. Visit our digital media book at www.thenewdentist.net/ mediabook.htm The New Dentist™ magazine is published quarterly by The McKenzie Company (3252 Holiday Court, Suite 110, La Jolla, CA 92037) on a controlled/complimentary basis to dentists in the first 10 years of practice in the United States. Single copies may be purchased for $8 U.S., $12 international (prepaid U.S. dollars only). Copyright ©2014 The McKenzie Company. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without permission in writing from the publisher. Authorization to photocopy items for internal or personal use is granted by The McKenzie Company for libraries and other users registered with the Copyright Clearance Center. Disclaimer — The New Dentist™ does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses or other damages incurred by readers’ reliance on such content. The New Dentist™ cannot be held responsible for the safekeeping or return of solicited or unsolicited articles, manuscripts, photographs, illustrations, or other materials. The opinions, beliefs, and viewpoints expressed by the various authors and contributors in this magazine or on the companion website, www. thenewdentist.net, do not necessarily reflect the opinions, beliefs, and viewpoints of The New Dentist™ magazine or The McKenzie Company. Contact Us — Questions, comments, and letters to the editor should be sent to Tess@thenewdentist.net. For advertising information, contact ads@thenewdentist. net or 877.777.6151. Visit our website at www.thenewdentist.net to download a media kit.
Dr. Mary Shields Louisville, KY University of Louisville Dental School 2011
Dr. Jared Simpson Bakersfield, CA UT San Antonio Dental School 2005
WHY SETTLE FOR
PROTECTING ONLY
20%?
Ordinary anti-cavity toothpastes only protect the 20% of the mouth that is hard tissue.1 80% of the mouth is soft tissue where bacteria can lurk even after brushing. These bacteria may act as a reservoir to recolonize teeth and gums, putting your patients at risk for gingivitis.
THE UNIQUE FORMULA OF COLGATE TOTAL®
ADHERES TO BOTH HARD AND SOFT TISSUE FOR
WHOLE MOUTH PROTECTION
*†2,3
Slow-Release Technology protects for 12 hours, even after eating and drinking
*2-4
Clinically proven to reverse gingivitis
*5
* †
vs non-antibacterial fluoride toothpaste. Defined as fluoride for cavity protection plus 12-hour antibacterial protection against gingivitis. References: 1. Collins LMC, Dawes C. J Dent Res. 1987;66:1300-1302. 2. Xu T, Deshmukh M, Barnes VM, et al. Compend Contin Educ Dent. 2004;25(Suppl 1):46-53. 3. Fine DH, Sreenivasan PK, McKiernan M, et al. J Clin Periodontol. 2012;39:1056-1064. 4. Amornchat C, Kraivaphan P, Triratana T. Mahidol Dent J. 2004;24:103-111. 5. Davies RM, Ellwood RP, Davies GM. J Clin Periodontol. 2004;31:1029-1033.
TABLE OF CONTENTS
FALL 2014
FEAT U R ES
6 Hiring a Dental Assistant? Here’s What to Look for
10 The Titanium Age of Dentistry: Top Minimally Invasive Implant Procedures
6
By Brady Frank, DDS
14 Reputation Management: How to Keep Your Online Reputation Strong
16 Terminating an Employee at Your Dental Practice By Ali Oromchian, JD, LL.M.
20 What is Straumann Doing for Today’s New Dentists?
22 Researchers Develop
Framework for Monitoring Oral Cancer Development, Progression, and Recurrence
24 Clinicians’ Role in Early Detection of Oral Cancer Critical By Alison Stahl, RDH, BS
26 Guru Dr. Robert Margeas Urges New Dentists: Do the Right Thing
28 The New Dentist™ Magazine Seeks Advisory Board Members
10 D EPARTMENTS 2 Publisher’s Message 32 Skinny on the Street
32 4 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
32 Index of Advertisers
16
SAVE 15% ON NEW CDT 2015 PRODUCTS!
New CDT 2015!
The only official source for the most up-to-date and accurate Dental Procedure Codes
CDT 2015: Dental Procedure Codes
Save 15% on new CDT 2015 Products!
NEW Coding for what you do has never been simpler. CDT 2015: Dental Procedure Codes gives dental staff a resource to code and document services accurately for claim submissions and dental records. CDT 2015 is only HIPAA-recognized code set for dentistry. Designed for daily use in every dental practice, this sturdy spiral-bound book opens flat for easy reference and includes claim form with detailed instructions for completion, and a searchable CD-ROM for quick code look up. Key features include: • Revised implant section with 8 new codes, 4 deleted codes and 10+ revised codes • New codes for post-operative visits, sealant repair, evaluation for deep sedation or general anesthesia, and missed appointments • Simplified table format for single and multisurface restorations • Reorganized maxillofacial section for quicker reference Code changes include: • 16 new procedure codes • 52 revised procedure codes • 5 deleted procedure codes J015 Book, 180 pages Member: $39.95 / Retail: $59.95 J015D e-Book Member: $29.95 / Retail: $44.95 J015B Print and e-Book Bundle Member: $49.95 / Retail: $69.95 K215 CDT/Companion Kit, 2 products Member: $75.00 / Retail: $112.50
CDT 2015 Companion: Help Guide and Training Manual NEW Your dental team is the first line of defense against claims rejection. Give them the tools they need for successful and efficient claims reimbursement with the CDT 2015 Companion: Help Guide and Training Manual. The Companion contains more than 150 coding questions and answers, 26 detailed coding exercises with solutions for every day dental procedures, and 15 quick quizzes. Other features include: · NEW! CDT Code to ICD Diagnosis Code Cross-Walk, information linking the codes of one system with codes of another · Full-color, illustrated chapter on implant services and how to code for them · Comprehensive explanation of CDT code components · HIPAA compliant 2012 dental claim form and completion instructions · Continuing education test worth 5 CE credits
Used in tandem with the 2015 CDT codes, the Companion is ideal to update current staff on code changes, or as a reference guide to help your team code with skill and confidence. J445 Book, 242 pages Member: $49.95 / Retail: $74.95 J445D e-Book Member: $39.95 / Retail: $59.95 K215D CDT/Companion e-Book Kit, 2 products Member: $65.00 / Retail: $97.50
SAVE 15% ON NEW CDT 2015 PRODUCTS!
USE PROMO CODE 14148. NO MINIMUM. EXPIRES 1/15/2015. SHOP ONLINE AT
adacatalog.org
CALL
800.947.4746
Hiring a Dental Assistant? What to Look For R
ecently, we had the opportunity to talk with Lori Paschall, CDA, CPFDA, CRFDA, FADAA, president, American Dental Assistants Association (ADAA), about what she recommends new dentists look for in hiring their first assistant. Here’s what she told us:
TND: At what point should a new dentist hire an assistant?
Ms. Paschall: Quickly! Typically, a new dentist will hire a dental assistant before hiring a hygienist. Many doctors will choose to do their own prophys when they first open their practice but will need a dental assistant immediately. The assistant may be pulling “double-duty” in the beginning, handling not only clinical duties but office duties as well.
TND: What should be included in the job description for a dental assistant?
Ms. Paschall: That would be determined by the practice type (general vs. specialty). Examples can be but are not limited to level of experience required; credentials if required or desired, i.e., if the state requires an expanded functions certificate for certain procedures, licensing or permits; and administrative functions.
TND: To ensure the dentist reaches the right audience when recruiting a dental assistant, where should dentists post their job ads – social media, specific websites, newsletters, other?
Ms. Paschall: There is no one place that is better than another for posting jobs in my opinion. Websites such as DentalWorkers.com that cater to dental jobs are a good place; local newspapers are another option. Many dental organizations will post on their websites or e-newsletters, but most 6 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
dental assistants looking for employment will not check these as they are not aware of them. Another avenue is through accredited dental assisting programs. Recent graduates will often come back to see what may be available.
TND: What should dentists look for in dental assisting applicants?
Ms. Paschall: An individual who is committed to their career and their profession as well as someone who is a multitasker and a great communicator – I tell dental assisting students that it takes more than just their clinical skills these days. They need to possess strong interpersonal communication skills, be self-motivated, be able to resolve conflicts, and have the ability to give presentations. They will be presenting every time they speak to a patient.
TND: Is previous experience a must?
Ms. Paschall: Previous experience is not necessarily a must as new dental assistants fresh out of school may not have a lot of experience, but they should be educated. The American Dental Assistants Association has long held the opinion that clinical dental assisting is most appropriately performed with the background and knowledge provided by a formal education. Doctors, particularly newer doctors, do not have the time to adequately and properly train a dental assistant while seeing CONTINUED ON PAGE 8 >>
“With Arrowhead I was doing full arch dentistry my first year.” Dr. Cody Bauer, Mansfield, TX
And you can too!
Arrowhead Dental Lab and the Dr. Dick Barnes Group have developed a CE plan specifically designed to make new dentists more successful. Dr. Cody Bauer used this plan to more than double his income in his first three years of practice, and triple overall production in his office. Bauer says, “Arrowhead’s plan really works! It’s so easy, dentists don’t believe it!” Get the skills and support you need for success and keep your patients coming back by providing the latest in dentistry. Sign up today for Arrowhead’s New Dentist CE Plan by visiting our website at www.ArrowheadDental.com or by calling 1-877-358-0285.
Arrowhead’s New Dentist Continuing Education (CE) Plan:
Full Arch Reconstruction: Be one of the 30% of all dentists who can. • Everyday Occlusion: Common sense concepts and techniques that take •
dentistry to a whole new level.
Implant EZ: Keep valuable revenue in your practice. • Sleep Dentistry: One in five Americans have sleep disorders–expand your •
practice with the latest treatments for these patients.
•
Total Team: Give your entire team the tools they need to help you build a more profitable practice.
•
Know Your Numbers: Master business principles that will give you the competitive edge in dentistry.
All For Only: $3,995*
*
Details available at www.ArrowheadDental.com
Hiring a Dental Assistant continued from page 6 patients. An experienced, educated dental assistant enables the doctor to produce better and more efficiently than an assistant who is not. It is important that the doctor also verify the credentials of an assistant that presents such. Only dental assistants that have successfully taken and passed the Dental Assisting National Board (DANB) can use the credential CDA, Certified Dental Assistant. This can be verified easily by going to the DANB website. There are many weekend, storefront, proprietary schools popping up all over these days that give certificates of completion upon finishing an 11-week weekend course, but this is not the same as the CDA credential.
TND: What should dentists do to ensure that the new hires are successful as dental assistants?
Ms. Paschall: Encourage them to ask questions. I recommend to new dental assistants that they carry a little notebook with them to jot down questions as it is not always appropriate to ask at the time a question comes up. Doctors should try to carve out a few minutes daily to check in with the assistant to see what questions s/he may have and schedule time to review procedures that may not have been taught in class. They should also encourage their assistants to participate in continuing education.
TND: What should the compensation package for an assistant include?
Ms. Paschall: Hourly rates would be based on the location of the practice, but doctors should also consider their level of experience and if the assistant holds any current credentials.
8 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
Only dental assistants that have successfully taken and passed the Dental Assisting National Board can use the credential CDA, Certified Dental Assistant. It might also include a uniform allowance, dental treatment for employees, medical insurance, vacation/sick time, 401(k), and/or bonuses. They might offer to pay the assistant’s membership in the ADAA, the professional organization for dental assisting professionals. The advantage of this membership for the doctor is that it comes with $50,000 of personal liability insurance in the dental assistant’s name. The doctor’s liability insurance does not cover the dental assistant specifically unless the doctor has a separate rider for that.
TND: What else should dentists know when hiring dental assistants?
Ms. Paschall: It is often said that dental assistants don’t produce, but the fact of the matter is dentists cannot produce without them. Whereas they may not be directly responsible for procedures that produce revenue, dental assistants contribute to the bottom line of any dental practice by bringing efficiency to chairside procedures, in sterilization and the lab areas or the front desk, which can ensure a successful, productive, and profitably-run office.
How will you really get ahead of your competition? Minimally-Invasive Implant Training. The demand for implant dentistry is high, and having the capability to provide minimally-invasive and highly efficient treatment to your patients will give your career the early boost it needs. The OsteoReady™ 2-Day Mini-Residency is designed to provide thorough and practical curriculum: Course graduates develop the skills to treat 80% of the implant cases in their practice. Become a leader—seize success with OsteoReady.™
✔ The No-Drill Implant Procedure
✔ The One-Drill Implant Procedure
✔ The OsteoHybrid™ Implant Procedure
✔ The OsteoLift™ Implant Procedure
$1,000 off Your first 2-day minimally-invasive implant course. Redeem your voucher here:
Visit OsteoReady.com/NewDentist Text OsteoReady to 206.971.6804 *Voucher valid for New Dentist subscribers only.
Call 855.300.1490 or visit OsteoReady.com for more information.
The Titanium Age of Dentistry: Top Minimally Invasive Implant Procedures
BY BRADY FRANK, DDS
PHOTOS COURTESY OF DR. BRADY FRANK AND OSTEO-READY™
In 1999, when I was a junior in dental school, I didn’t have a clear vision of my future in dentistry. I tried to clarify things by beginning with the end in mind. I interviewed 72 dentists about their retirement or transition strategy. It was interesting that just 5% had a clear plan for how to bring in a junior dentist and phase out of practice. To my surprise, 32 of the 72 dentists I interviewed offered to sell me their practice, either immediately or over a period of years. I committed to purchasing two of the practices after graduation. Within seven years, I acquired 12 practices and employed 28 junior partners and associates. I trained and mentored almost all of them to be proficient in efficient implant techniques, and something radical happened: Dentistry’s greatest “secret” began to reveal itself to me.
Fully Utilizing Available Bone (Reduction in Grafting)
Minimally Invasive Implant Procedure Integration
Many GPs call the 3-in-1™ Implant Procedure (Figures 1 & 2) the “5-minute implant, abutment, and crown” procedure. This procedure increases efficiency while reducing the patient’s discomfort. The reduction in pain is largely due to the usage of one of the top five minimally invasive, no-suture, soft-tissue accesses. The 3-in-1 Implant™ Procedure is applicable for almost any edentulous area in the mouth. Many believe this is because the periosteal membrane is left intact, allowing for more blood flow to
The term “minimally invasive,” as I use it, relates to implant dentistry in the general dentist’s practice. Many general practitioners (GPs) are not using up-todate implant techniques – but by using a few principles, GPs should be able to complete many cases without a large, invasive flap procedure. The key for efficient implant placement is to triage the implant cases that can be done in a general dentistry practice and refer the rest out. As Lasik surgery has revolutionized ophthalmology, and laparoscopic surgery transformed orthopedic surgery, so the following procedures reinvented implant dentistry for the GP.
10 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
The Availability Principle focuses on the available bone present to accommodate an implant to fit those specific dimensions. This may mean a narrow, long implant or a short, wide implant, depending on the width and height of the available bone. The international implant community has now proven long-term success rates with short implants (6-8mm long) as well as longer, narrower implants. A recent study by multiple oral surgeons concluded that short implants (8mm or less) had the same statistical long- and short-term success rates as their longer, more traditional implant counterparts.1
FIGURES 1 & 2: THE 3-IN-1™ IMPLANT PROCEDURE
the bone during the implant integration phase. A flap disturbs periosteal blood flow and allows a greater opportunity for microorganisms to enter the site. A recent study notes the same high success rate with flapless compared to flap PRE- AND POSTOPERATIVE X-RAYS OF THE 3-IN-1™ PROCEDURE:
3-in-1™ Implant Procedure
CONTINUED ON PAGE 12 >>
Brady Frank, DDS, received his doctorate of dental surgery at Marquette University Dental School. Now, as the clinical director and founder of OsteoReady™, he has developed a continuing education system that allows the general dentist to become comfortable in confidently providing simplified, efficient, lifetime implant solutions to patients. Dr. Frank has contributed several pivotal inventions to implant dentistry, including the OsteoConverter™, which allows the dentist to provide more affordable, efficient, and comfortable implant treatment. He is a national speaker and educator, and has addressed thousands of dentists at major dental meetings and events throughout the country.
Wells Fargo Practice Finance
Is now the time to buy or start a dental practice?
When you’re ready to purchase or start a practice, count on Wells Fargo Practice Finance to help you achieve your goals: · Up to 100% financing to help you acquire an existing practice or start one from scratch · Competitive fixed-rate loans with preferred pricing for ADA® members · Complimentary business planning tools, educational resources, and practice management consulting to help you successfully manage your transition to ownership
To get started, call 1-888-937-2321 or visit wellsfargo.com/thenewdentist to request your free Practice Starter Kit. Wells Fargo Practice Finance is the only practice lender selected especially for ADA® members and endorsed by ADA Business ResourcesSM.
All financing is subject to credit approval. ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association. ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. © 2014 Wells Fargo Bank, N.A. All rights reserved. Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A.
2149-0414-The-New-Dentist-Summer
Get the facts with a free Practice Starter Kit, including our latest issue of Strategies for Success, a New Dentist Planner, and an easy-to-use business plan template.
FIGURES 3-6: THE NO-DRILL™ IMPLANT PROCEDURE
FIGURES 7 & 8: THE ONE-DRILL™ IMPLANT PROCEDURE
Implant Procedures continued from page 10 procedures with a more favorable crestal bone response with flapless.1 The most popular of the five minimally invasive soft-tissue accesses is the high-speed handpiece approach. The initial soft-tissue access and the first 2-5mm of the pilot hole in bone are created using a circular motion with the high-speed handpiece and a special bur. The final osteotomy is created with the normal implant handpiece and MultiDrill™, and then the implant is placed. Immediately after, an OsteoReady™ customizable abutment is torqued to 32Ncms. This abutment has 20% more titanium than many abutments on the market and can be prepared directly in the mouth just like a standard crown preparation. This technique saves two appointments and reduces the costs and complexity for both the clinician and patient. The risk of peri-implantitis from cement retention is virtually eliminated due to the perioseal or attachment that develops around the abutment prior to seating the final crown. To more fully understand the 3-in-1™ Implant Procedure, please go to https://osteoready.com/blog/the-3-1implant-procedure-webinar to view a video on this technique.
The No-Drill™ Implant Procedure The OsteoReady™ No-Drill™ Implant Procedure, using an OsteoConverter™, has had a notable impact on the GP’s productivity and patient satisfaction (Figures 3-6). Immediately after extracting a tooth, an OsteoConverter™ is inserted with a spiraling motion into the socket. This achieves two important tasks: First, the periodontal ligament is scored in roughly 2mm increments, allowing blood flow and bone forming cells to enter the site to aid in osseointegration. Second, the unique curvature of the root is “converted” to more of a cylindrical shape that allows for an implant-worthy 12 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
PRE- AND POSTOPERATIVE X-RAYS OF THE ONE-DRILL™ IMPLANT PROCEDURE:
PRE- AND POSTOPERATIVE X-RAYS OF THE NO-DRILL™ IMPLANT PROCEDURE:
Closing Comments
osteotomy. The OsteoConverter™ is a hybrid between a bone condenser and osteotome but also serves as the permanent implant once inserted. In a study titled, “Flapless singletooth immediate implant placement,” researchers found a favorable implant success rate related to the flapless immediate implant placement protocol.
The One-Drill™ Implant Procedure The third and final procedure that can help GPs with placing implants more efficiently is the OsteoReady™ OneDrill™ Implant Procedure (Figures 7 & 8). Rather than going through a series of four or five drills to complete one osteotomy, The Multi-Drill™, which has the widths of four to five drills, is used to complete the final osteotomy.
These techniques have allowed me to provide lifetime implant services at very reasonable fees to my patients. Whether you do not currently place implants, only place mini (smalldiameter) implants, or place more than 40 conventional implants per month, I would encourage you to dig deeper into the procedures discussed in this article. When performed properly, these techniques will help you provide more streamlined, simplified,· and comfortable implant services for your patients. I’d like to invite you to attend a two-day OsteoReady™ mini-residency held in locations throughout the country and join the Titanium Age of Dentistry! References 1. Bashutski JD, Wang HL, Rudek I, Moreno I, Koticha T, Oh TJ. “Effect of flapless surgery on single-tooth implants in the esthetic zone: a randomized clinical trial.” J Periodontol. 2013 Dec;84(12):1747-54. doi: 10.1902/ jop.2013.120575. Epub 2013 Jan 24. CONTINUED ON PAGE 30 >>
BRIDGING THE GAP THERE IS A GAP BETWEEN YOUR PRACTICE AND YOUR PATIENTS. AS TECHNOLOGY CHANGES THE WAY HUMANS INTERACT WITH EACH OTHER, WE’RE BRIDGING THAT GAP. WE WILL REVOLUTIONIZE YOUR PATIENT RELATIONSHIPS BY CHANGING THE WAY YOU ENGAGE WITH YOUR PATIENTS. WE ENSURE THAT THE RIGHT MESSAGE IS DELIVERED TO THE RIGHT PATIENT AT THE RIGHT TIME, SO EVERY PATIENT FEELS LIKE THE ONLY PATIENT.
$
SR
TECHNOLOGY
COMMUNICATION
PATIENT RELATIONS
$10 GIFTCARD
PRACTICE OPTIMIZATION
TAKE A LIVE DEMO, GET A STARBUCKS GIFT CARD
SALES@SOLUTIONREACH.COM
888.979.7161 Current customers not eligible. This offer is only valid for new customers completing a demo. Only one gift card per person
REPUTATION MANAGEMENT:
How to Keep Your Online Reputation Strong
A
s a new dentist, you’re likely wondering how to protect your reputation in an era when any patient can take to online review sites to sing your praises or rain on your parade. With sites like Yelp, Citysearch, Angie’s List, Google Reviews, and HealthGrades, you may feel you’re at the mercy of any patient with an axe to grind.
Fear not. There are ways to manage your online presence and avoid having the inevitable negative views taint your reputation. All it takes is some planning and know-how on your part. Social media and online review sites can be a blessing as well as a curse, says Andy Beal, online reputation consultant, author, and CEO of Trackur.com. “Don’t be afraid that it’s easy to write a review,” he says. “You should be thrilled because it gives you an opportunity to quickly establish yourself as a skilled doctor. Online reviews can help convince potential patients that you can be trusted to make the right decision.” At the root of most patient complaints is lack of communication. Patients complain when they feel misled, Beal says. “They didn’t get the treatment they were expecting and don’t feel the dentist cares about their concerns, so they take to social media to vent.” Other common causes for gripes include being diagnosed with unnecessary treatment, long wait times, and billing issues, according to a survey of dental offices listed on Yelp by Dental Anywhere Mobile Apps. To minimize complaints, make sure patients understand their treatment plans, are comfortable with the costs involved, and know how a claim will be handled, says Beal. And if you have any inkling that a patient is unhappy, make every effort to address the issue before s/he leaves your office, Beal says. “Dealing with it early will be a whole lot better than cleaning up an online review and reputation mess.”
Why Search Engines Matter When consumers need a product or service, one of the first things they do is Google a name and see what shows 14 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
up. “Most people never look beyond the first page,” says Don Sorensen, president of Big Blue Robot and an expert in online reputation management. “Positive reviews will strengthen a buying decision, but if there’s negative feedback, that’s all it takes to move on. ” Find ways to get your name listed and ranked highly in the search engines. You can accomplish this by creating a practice website with an individual page for each dentist in your practice. Make sure the dentist’s name appears on the title page because search engines index based on what words are in the title. You’ll also show up in the search engines by having strong profiles on social networking sites. Consider a Facebook business page, LinkedIn, Google Plus, Twitter, and even YouTube for getting your name out there. Social media profiles help you stay connected with your patients and provide a forum for sharing positive patient reviews.
How to Encourage Positive Reviews to Offset the Negative Ones Even when dental work is done well, patients may experience pain and high cost, two things that don’t lend themselves to positive reviews. Another challenge is that most people who have a good dental experience don’t say anything about it. “That’s why you need to find ways to encourage positive reviews,” says Sorensen. “If there are no positive reviews, then a negative one is the only thing people will see.” Some offices set up iPads so patients can write a review while still in the reception area, says Sorensen. Others display a card on the counter that says “If you’ve had a good experience with us, we’d appreciate a positive review on one of the business review sites.” Try to find out why other dental offices get favorable reviews. Conduct an online search of established dental practices in your area and see what people like about them. Build your practice around those attributes, says Beal. You’ll also get positive press by getting involved in professional associations. This involvement shows you’re committed to continuing education and advances in technology. Get involved in community activities, too. Coach a youth sports team or raise money for a charitable cause.
Key Steps to Managing Your Reputation 1. If you do receive a complaint, verify it. Is the source an actual patient? Does their side of the story match up with the actual event? Know the details before you respond, Beal says. 2. If you’ve made a mistake, apologize quickly. Acknowledge that you didn’t deliver on what the patient expected and say you’re sorry. “That will resolve the overwhelming majority of issues,” says Beal. Patients want to feel that you care. Consider the lifetime cost of them remaining unhappy. 3. Monitor your online reputation. Google Alerts sends you an email update every time you or your practice is mentioned online. You can also periodically Google your name or business name to see what’s being said about you. 4. If you have a negative review, don’t use one of the review sites to write a rebuttal, says Sorensen. That attracts more attention to the negative review. If you know the person, contact them directly, or if a complaint appears on your Facebook page, follow up through a private message. Don’t argue in public. 5. If you do choose to acknowledge publicly that you’ve seen the complaint, state that this situation is not normal and that you hold your staff to the highest standards. Reiterate that you pride yourself on great service and if a patient ever has a problem, you’ll fix it. “Then take it off line,” Beal says. 6. Don’t feel obligated to respond to every complaint. When you and your dental staff are doing good work, generally your feedback will be good. Use your judgment. 7. Don’t panic if something is negative. Remember that most patients who are satisfied don’t say anything. The best potential patients are generally found through word of mouth. Make sure patients have a good experience and make it easy for them to refer their friends.
free
free Online Dental CE Earn live interactive and self-study credits from the comfort of your home or office
www.vivalearning.com • Instant Certification • ADA CERP Provider • World-respected Speakers
FA L L 2 0 1 4
WWW.THENEWDENTIST.NET
15
TERMINATING an Employee at Your Dental Practice BY ALI OROMCHIAN, JD, LL.M.
E
very dental practice has to terminate employees. Whether you have a problem with one employee, or you have to eliminate multiple employees for financial reasons, your practice is likely to go through the termination process on more than one occasion. While emotionally difficult for you and the remaining team, terminating an employee also takes time, preparation, and paperwork. By following proper protocols, you seriously reduce the chances that the terminated employee will re-emerge as a litigant in a lawsuit against you.
Prevention is key in keeping the cost of terminations low. Try to do everything you can to avoid firing your team members. You can’t always predict the future when hiring new employees, but you can implement some management practices that will reduce the likelihood of terminations. Although you went to school for dentistry, if you are running a practice, you will spend a significant amount of your time
16 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
addressing management issues. Learn how to be a good communicator. This can be as easy as calling the hygienists and front desk team by their first names, making eye contact, and asking them how things are operating in the office. And then listen. This kind of open communication will help you identify bottlenecks and inefficiencies in your practice and likely clue you into small issues
that can become large financial problems (the appointment follow-up process is a good example). In addition, when you are communicating with your team, they become aware of your presence as a leader and a boss. Problem employees prefer not to operate in the bright light of an engaged and interested manager. Manipulative or deceptive employees will be uncomfortable with your regular presence and typically will leave of their own accord. Spend some time outside of your personal office and outside of the clinical rooms. When you aren’t visible, you create a leadership gap in operations management. One employee with a strong personality can spoil the workplace for everyone else. If you have decided to eliminate an employee, there are some critical steps to take prior to informing that employee that s/he no longer has a job at your dental practice. The lead time for a specific termination can be many weeks or months, depending on how prepared you are. The most timeconsuming process will be documenting the problems. The reasons for terminating an employee have to be specific to the behaviors of that person alone. For example, if everyone dips into the petty cash on Monday mornings to buy a coffee, you can’t document just one employee for doing it. The same rule applies to being late and missing a morning huddle – if you are going to document one person for being five minutes late, you have to document everyone who is five minutes late. When you single out one person for a commonly accepted act, then you are creating a workplace that a court could deem as hostile or emotionally damaging. When you decide to document the employee for a problem, you are creating “cause” for the termination. While California is a state with at-will employment, documenting cause will protect you legally and may help prevent you from paying unemployment benefits. Cause consists of three steps: 1. Inform the employee of the rule and indicate how the employee has broken that rule. 2. Give the employee a chance to improve. Offer the employee time and training (when appropriate) to correct behaviors. 3. Inform the employee that if the behaviors do not change, s/he will be terminated.
At this point, you need to ensure that there will be no security problems once the employee leaves. Does the employee have a key? Can you change access codes quickly? Termination is a great excuse to review your clinic’s security protocols to ensure passwords are unique, data is secure, and cash handling is transparent. Don’t tell anyone about the impending termination but your human resources professional, such as your HR for Health representative. Frequently, employers will jump ahead and notify the health care carrier or change the employee’s security access, thereby giving the employee a signal that s/he is about to be fired. It’s best to have the final paycheck ready. In a small office, this may have to be a bank check or handwritten business check to keep the termination confidential until it occurs. Although California allows employers up to 72 hours to deliver the final check, there are steep fines for missing that deadline. Make the actual termination as quick as possible. The meeting for the termination should not be an excuse to go over the details of more behavioral problems. You should also not conduct the meeting alone. Having an office manager, human resources official, or even your lawyer present will ensure the meeting remains professional. Any potential allegations by the employee will be curbed by the presence of a witness. You will need to provide a packet of information as dictated by federal and state laws. Consult HR for Health or other human resources professionals or your lawyer, as each requirement has additional details worthy of attention:
While these three steps help protect the employee legally, as the boss these steps will also force you to examine the situation more closely. Why is the employee showing up late? Why are the day sheet reports not matching the production reports? Who is responsible for maintaining the equipment and supplies? While you might think you know everything that is happening in your dental office, you don’t. Use the requirements for cause as an excuse to delve deeper into problems at the practice. Once you have documented the individual’s problems and established cause, you can set a date for the termination.
Once you have delivered the final check and necessary paperwork, collect company property (key, scrubs, etc.) that
Federal Requirements • • •
•
You may have to provide a COBRA notice and election form (for employers with more than 20 employees). You may have to offer a HIPAA certificate of group health plan coverage. The IRS will require that you provide your employees with a statement advising them about their rights to retirement benefits. Generally, as a dental office, you do not need to concern yourself with the WARN act, a law written for plant closings and mass layoffs.
CONTINUED ON PAGE 18 >>
Ali Oromchian, JD, LL.M., is the founding attorney of the Dental & Medical Counsel, P.C. law firm and is renowned for his expertise in legal matters pertaining to dentists, veterinarians, optometrists, and physicians, including but not limited to practice transitions, employment law, estate planning, partnership agreements, and lease negotiations. He can be reached at ao@dmcounsel.com or by visiting www.dmcounsel.com.
FA L L 2 0 1 4
WWW.THENEWDENTIST.NET
17
CONTINUE YOUR
FREE SUBSCRIPTION TODAY!
Terminating continued from page 17
THE #1 JOUR NAL FOR NEW DENTISTS
FINANCIAL STATEMENT FUNDAMENTALS ‘Show Me The Money!’
RNA THE #1 JOU
S DENTIST L FOR NEW
PLUS
When to Start for a Practice to Looking Purchase 6 Steps to Get Patients in the Chair SPRING 2014
URE PRElySBaSlan ce UNFinDdinEgR Work/Fami
PLUS
Floss Patients to Finally Get Research The Latest porary on Contem ents t Cem Permanen
The New Dentist – New Dentist Resources, New ...
http://www.thenewdentist.net/subscribe.php
WINTER 2013
SIGN UP NOW AT
thenewdentist.net/subscribe.php 877.777.6151
http://kaywa.me/8pTxQ
are in the employee’s possession. For long-term security measures, it’s best to install a fob-based system for securing the office. These fobs allow you to easily turn off access to the building without the headache of changing locks and keys. Escort the employee to his or her desk. As a courtesy, have a box readily available so the employee can quickly pack up personal items. As an alternative, you could collect the employee’s belongings during the termination and avoid an awkward departure. Lastly, as another courtesy, try to schedule the termination early in the day and early in the week. Although you may not be concerned if you spoil the employee’s weekend, your other employees will see this as an act of decency and you as a considerate boss. Terminations are complicated, and state laws vary. As a general rule, you should carry an employment practices insurance policy in case you make any errors in the course of the termination process. In addition, you should utilize a trained human resources professional for each termination. Lastly, have a good lawyer on your side, as terminated employees will frequently turn to an employment lawyer to sue you for any given reason.
Download the Kaywa QR Code Reader (App Store &Android Market) and scan your code!
COMPLIANCE SHIELD More Young Dentists Trust Dental & Medical Counsel than any other dental law firm! Our comprehensive and unique approach enables the most entrepreneurial dentists, veterinarians, optometrists and physicians to achieve their personal and business goals as they create massive wealth through smart strategies with the peace of mind of knowing that their practices are compliant with all federal and state laws.
OPTIMUM PRACTICE L AUNCH
Assists new gra and young d ds octo looking to bu rs ild a new practice .
EMPOWERED BUYER’S PROGRAM Geared toward s doctors lookin g to buy practices.
18 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
STRATEGIC SUCCESSION PLAN Specifically designed to ensure that sellers successfully transition out of their practice.
WEALTH OPTIMIZER SOLUTION
Ensures complete compliance with all employment laws and creates trademark protection.
Tailored to enable doctors to have financial independence while minimizing taxes.
DO IT CORRECTLY THE FIRST TIME. Discover the Dental & Medical Counsel Advantage.
(925) 999-8200 Ali Oromchian, Esq. • ao@dmcounsel.com
More than a New Dentist.
A Straumann® Young Professional.
Feature article – A clinical or business topic to keep you up to speed on different topics important as you are moving from school to practice Portal highlight – Let us guide you to a new place in the portal
Touch point – The dental industry is changing so quickly. Touch point will help you stay on top of trending or hot topics Monthly book club – You know the clinical books. We know the business. Read reviews of business and leadership books as you start to run your own business Education alert – Learn more about Straumann courses and education opportunities!
Straumann Young Professional Life after dental school presents you with many questions, challenges, and key decisions. Join the Straumann Young Professional Program, and enter a community of likeminded students and professionals for support during this pivotal transition from school to practice. Straumann lends 60 years of experience at the forefront of the dental field, to provide you unique perspective and support now, and as your career and the industry advance. Register today for exclusive access at http://straumann.cvent.com/ YPRegister
What is Straumann Doing for Today’s New Dentists? The New Dentist™ magazine recently sat down with two members of Straumann’s Young Professional Program’s core team to better understand how this dental regeneration and implant company is supporting new dentists. Anna Stensvaag, senior marketing manager, regenerative and projects, and Jillian Foley, senior customer experience program manager, are two members of the team working to design and implement resource solutions for students and new graduates.
Tell us more about who Straumann® is. Anna Stensvaag: Straumann is a worldwide leader in dental implant and regenerative dentistry. The company has been around for 60 years globally and 25 years in the U.S. and is based on innovation, science, and practice support. Our goal is to provide dentists with solutions that will allow them to best treat patients who have compromised dentition. Jillian Foley: We are proud to have some of the most well-researched products on the market, from the Straumann Dental Implant System to Emdogain™, a unique* regenerative technology. However, it’s not just our products that make us who we are. By offering the technology that we do, we are able to help dentists differentiate the treatment they provide to patients. In addition, with the world-class sales organization and practice support tools that we offer, we strive to create a commercial partnership with our customers.
Why is this important to dentists in the first 10 years of practice and dental students? Anna: We know that student debt continues to increase and that overhead costs continue to rise for practices. New grads will look at all of this and consider just cutting costs – especially product costs. What they don’t consider is the value that comes with a product that has a solid reputation and backing. New grads will be in practice for many years to come, and in these early years they need to build their reputation. What would you rather stake your reputation on – a less-expensive product with limited data or limited longevity, or a product that is backed by years of science and long-term data? Jillian: New graduates shouldn’t just consider product reputation as they are setting up their practices. They should also consider the level of support that a company is willing to provide. With Straumann, dentists not only get a premium product that’s been shown to last for many years after placement, they also have a commercial partner who is dedicated to their success for years to come. From 20 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
our patient communication tools to our practice marketing support, we are able to help new grads set themselves up for long-term success. Anna: It comes down to one simple question for these graduates: Are you planning for the long term or for the short term?
Can you provide our readers with an example of how Straumann is helping new dentists set themselves up for long-term success? Anna: Straumann has created a program called the Straumann Young Professional Program with the goal of creating a series of resources for new dentists from the time they are in school through when they are first in practice. We know that dental students and residents learn a lot about the clinical side of their chosen profession in school. They leave knowing diagnosis and treatment options. But they don’t have as much exposure to the business side of running a practice. That’s where we come in. We know business and we know dentistry. We have many contacts throughout the industry that can help with both of these aspects – from clinicians running successful practices to other service providers. Jillian: We’ve created a portal for information called the Straumann Young Professional Portal. This portal gives new dentists access to the business side of the practice. Our goal is to provide ongoing information, like the practice management resources and patient education materials I referenced earlier. CONTINUED ON PAGE 30 >>
All Smiles. Every Step of the Way. From a first dental visit to hygiene, orthodontics and implants, the CareCredit credit card can make it easier for families — mom, dad and the kids — to get care when they want and need it. And CareCredit gives them a financing resource they can use again and again* as credit becomes available.
*Subject to credit approval.
Help more families achieve healthy, happy smiles. For more ways to optimize CareCredit in your practice, contact your Practice Development Team by calling 800-859-9975, option 1, then 6. Not yet enrolled? Call 866-246-6401
carecredit.com NWDNT0914DA
Researchers Develop Framework for Monitoring Oral Cancer Development, Progression, and Recurrence
E
ach year, approximately 22,000 Americans are diagnosed with oral cancer. The five-year survival rate of 40% in the U.S. is one of the lowest of the major cancers, and it has not improved in the past 40 years. More people die each year in the U.S. from oral cancer than from melanoma, cervical, or ovarian cancer. Worldwide, the incidence of oral cancer is increasing, particularly among young people and women, with an estimated 350,000– 400,000 new cases diagnosed each year. “The major risk factors, tobacco and alcohol use, alone cannot explain the changes in incidence, because oral cancer also commonly occurs in patients without a history of tobacco or alcohol exposure,” said Dr. Brian Schmidt, professor of oral and maxillofacial surgery and director of the Bluestone Center for Clinical Research at the NYU College of Dentistry. Changes in the microbial community are commonly associated with dental diseases such as periodontal disease, which is most likely a polymicrobial disease characterized by outgrowth of certain pathologic organisms, and chronic periodontitis has been reported to be a risk factor for oral premalignant lesions and cancers. “We know that other cancers, including gallbladder, colon, lung, and prostate, have been associated with particular bacterial infections, so we hypothesized that shifts in the composition of the normal oral cavity microbiome could be promoters or causes of oral cancer,” said Dr. Albertson. Drs. Schmidt and Albertson and their team profiled cancers and anatomically matched contralateral normal tissue from the same patient by sequencing 16S rDNA hyper-
22 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
variable region amplicons. The team’s findings, “Changes in abundance of oral microbiota associated with oral cancer,” published online in the journal PLOS ONE (June 2, 2014), begin to develop a framework for exploiting the oral microbiome for monitoring oral cancer development, progression, and recurrence. In cancer samples from both a discovery (n=5) and a subsequent confirmation cohort (n=10), abundance of Firmicutes (especially Streptococcus) and Actinobacteria (especially Rothia) was significantly decreased relative to contralateral normal samples from the same patient. Significant decreases in abundance of these phyla were observed for precancers, but not when comparing samples from contralateral sites (tongue and floor of mouth) from healthy individuals. Using differences in abundance of the genera Actinomyces, Rothia, Streptococcus, and Fusobacterium, the team was able to separate most cancer samples from precancer and normal samples. “The oral cavity offers a relatively unique opportunity to screen at-risk individuals for (oral) cancer, because the lesions can be seen, and as we found, the shift in the microbiome of the cancer and precancer lesions, compared to anatomically matched clinically normal tissue from the same individual, can be detected in noninvasively collected swab samples,” said Dr. Schmidt. Noninvasively sampling the microbiome of oral lesions and corresponding normal tissue opens the possibility to not only detect cancer‑associated changes at one time point, but the relative stability of the adult oral microbiome also offers the opportunity to monitor shifts in bacterial communities over time. “Here we observed changes in the microbiome, which, in future larger studies, may be confirmed as a potential biomarker of oral cancers or precancers, and may even have CONTINUED ON PAGE 24 >>
Oral Cancer Research
continued from page 22
utility to discriminate patients with lymph node metastases,” noted Dr. Albertson. “In addition, there are other challenges in clinical management of oral cancers that would benefit from better diagnostic tools.” Oral cancer patients are also at risk of second primary cancers and recurrences. The microbiome may provide signatures that can be used as a biomarker for monitoring field changes associated with the high rate of second primary oral cancers and recurrences. The team also notes the possibility of medically modulating
the oral microbiome for treatment of oral precancers and damaged fields (field cancerization). This work was supported in part by an award of a GS Junior 454 Sequencing run from Roche; the National Center for Research Resources; the National Center for Advancing Translational Sciences; and the Office of the Director, National Institutes of Health (NIH), through University of San Francisco CTSI grant number UL1 RR024129, and individual investigator awards from the National Cancer
Institute grant (R01 CA131286, R21 CA 941186215), and the National Institute of Dental and Craniofacial Research (R01 DE019796). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Information provided by the University of California, San Francisco, and New York University College of Dentistry.
By Alison Stahl, RDH, BS
Clinicians’ Role in Early Detection of Oral Cancer Critical Although Oral Cancer Awareness Month has passed, our responsibility to perform a comprehensive screening exam on every patient goes on. With the HPV virus now being one of the leading risk factors for oral and head and neck cancers, we must engage in dialogue related to current trends and risk factors, and expand on the education we provide. HPV-positive cancers are most often located in the tonsils or base of the tongue, where we may not be able to visually see variations in these structures. Therefore, be sure to ask patients if they have noticed a change or persistent hoarseness in their voice, if they are having difficulty swallowing, or are experiencing persistent ear pain, as these can all be potential warning signs that should be explored further. Be sure to check extraorally for swollen lymph nodes and glands. Non-tender, swollen nodes are of greater concern and more often associated with tumor growth. A referral to a six-year ENT (ear, nose, and throat) doctor or a board-certified oral pathologist may be warranted if any of these conditions is present for more than two weeks. Tragically, on average one person dies every hour of every day in the U.S. from oral cancer. According to The Oral Cancer Foundation, “The majority are found as late-stage cancers, and this accounts for the very high death rate of about 43% at five years from diagnosis … and high treatment-related morbidity in survivors. Late-stage diagnosis is not occurring because most of these cancers are hard to discover, it is because of a lack of public awareness coupled with the lack of a national program for opportunistic
24 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
screenings, which would yield early discovery by medical and dental professionals. “ So what can we do to change these statistics? Spreading awareALISON STAHL, RDH, BS ness does save lives! Make sure your patients know you are screening for variations in their oral tissues, lymph nodes, and glands, and for suspicious lesions that may be precancers or cancer. Educate them about current trends and risk factors. Encourage vaccination against the HPV virus in adolescent and young-adult patients. If you need a refresher on screening techniques, please view this video: “A Comprehensive Review of a Visual and Tactile Oral Cancer Screening Exam” https://www.youtube.com/watch?v=zPRDeFxDO5M . And finally, get involved with community outreach efforts. Throughout the U.S. there are many walk/run events sponsored by The Oral Cancer Foundation. Show your support and participate at an event near you, or start one up in your area. Visit our website to learn more: http://donate. oralcancer.org/index.cfm?fuseaction=donorDrive.home. In Illinois, we are seeking volunteers to assist with oral cancer screenings at various public events. If you are a dentist or hygienist who would like to join our screening team, please contact Alison Stahl, RDH, BS, at alison.il.ocf@ gmail.com for further information. Together we can give oral cancer a voice!
Guru Dr. Robert Margeas Urges New Dentists: Do the Right Thing
D
r. Robert Margeas has watched the traditional career path change for emerging new dentists. “Going to work as a general practice associate is not as prevalent, as more new dentists are joining the dental groups (corporate dentistry). The main reason is debt. It’s become so high, and some of these companies are offering dentists $150,000 coming out of school.” What is troubling, finds Dr. Margeas, is that because student debt is enormous for so many, he is seeing its influence on treatment planning. “They may be a little bit skewed in what their treatment plans are and overtreating because they have student debt and mortgages to pay.” He believes that in some cases those financial obligations are driving some new dentists to do more treatment than is necessary. Dr. Margeas emphasizes that the cornerstone of a successful practice is an honest dentist. “You have to tell the patient the truth about their treatment. Tell the patient what they need and try to make it financially feasible for the patient, and always do the right thing for the patient.” Although dentists emerge from dental school with enormous financial obligations from the start, Dr. Margeas tells new practitioners that they need to keep investing in their skills. He emphasizes that there is not enough time in dental school to teach new dentists how to perform essential procedures such as implants, veneers, and extensive crown and bridge. “I feel that the best money spent is on continuing education (CE). For me, if someone was going to choose between a threeyear residency and investing in continuing education through an organization such as the Kois Center, you can go to the Kois Center and take 10 courses and spend $50,000 and get the knowledge that you would gain from a two or three-year residency, but you are that much further ahead. With that experience, you are able to do the cases that you want to do.” He urges dentists to plan to take courses over a period of a few years. Dr. Margeas should know. After he completed his resi-
Dr. Margeas’ Go-To Products DuraBraze Diamond Bur from Brasseler
“It’s one of the best diamond burs on the market. You get a number of cuts on them that are good cuts. It’s not a throw-away diamond. You might get six to eight cuts.”
Bien-Air Electric Handpiece “It’s a great handpiece.”
Wolf Electric Handpiece
“It’s a very nice, cost-effective handpiece.”
26 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
dency, he invested heavily in continuing education. “My first five years out of dental school I had no money. All the money I made went to continuing education. I had 500 hours of CE. But when that implant case or veneer case came in, I had the ability to do it. I didn’t learn that in dental school. I learned it after dental school. A good course can cost you $5,000-$6,000, but that is money well spent. With programs such as the Seattle Study Club, it’s incredible the amount of CE you can get today.” Yet, Dr. Margeas readily acknowledges that pouring more money into their education is something that some new dentists don’t want to do. “When you get out of dental school, you want to buy the BMW. You want to buy a new house. You want to join the country club. When in fact you should be more concerned with learning more.” Becoming superior clinicians should be priority number one for new dentists, beginning with becoming both highly proficient and highly efficient at restorative dentistry. “Being able to do a class two posterior composite that is not only clinically excellent but also performed efficiently is essential. You have to be able to do a crown prep – impression and temporary – in an hour or less, because time is money. If you are taking two hours to perform a crown prep and another 30 minutes to seat it, you’re not going to be as profitable. There are only so many hours in the day and you only have that much time to sell.” In addition to fine-tuning their clinical skills, Dr. Margeas urges general dentists to learn about business. “Most dentists coming out of school don’t know anything about business at all. They wind up overstaffed. They don’t understand how to schedule. So they need to make business courses part of their continuing education as well.” From there, he recommends new dentists invest in the right tools, specifically a diamond bur and a “great handpiece.” “I believe that electric handpieces and a good diamond bur are critical. I want to be able to cut the tooth efficiently. If you don’t have the right equipment, you can’t be efficient.” Ultimately, Dr. Margeas advises new dentists to enjoy dentistry and be happy. “Happiness is the key to success, not the other way around. If you are happy, you will be successful.” Dr. Robert Margeas is an adjunct professor in the department of Operative Dentistry at the University of Iowa. He is board certified by the American Board of Operative Dentistry. He is a diplomate of the American Board of Aesthetic Dentistry and a fellow of the Academy of General Dentistry and International Team of Oral Implantologists. He has written numerous articles on esthetic and implant dentistry. He lectures and presents hands-on courses nationally and internationally on those subjects. Dr. Margeas maintains a full-time private practice focusing on comprehensive restorative and implant dentistry in Des Moines, IA.
Want to focus more on patients? You have our full support.
The New Dentist™ Magazine Seeks Advisory Board Members
At Aspen Dental, nothing stands between you and what you love doing most: helping patients. • Enjoy full operational and business support • Expect a reliable flow of new patients • Grow with our mentoring and development programs Ready for a better future? Call 866.748.4299.
Sally McKenzie, publisher of The New Dentist™, announced that the magazine is currently seeking applicants to join the publication’s advisory board. Dentists who have graduated dental school within the past 10 years are invited to apply. Board members serve for a two-year term in a volunteer advisory capacity, helping to identify appropriate content and connecting with individuals in the dental community to provide expertise. “It’s an honor to work with these new dentists who have great insights into the successes and challenges they face daily in the profession. They are in the trenches and know what’s important to their fellow new dentists and are willing to share their experience with their colleagues,” said Ms. McKenzie. The new advisory board members will join six current New Dentist™ Advisory Board members : • Dr. Josh Austin, University of Texas San Antonio Dental School, 2006 • Dr. Charley Cheney III, Tufts University School of Dental Medicine, 2004 • Dr. Katie Montgomery, The Ohio State College of Dentistry, 2006 • Dr. Kevin Rhodes, University of Texas San Antonio Dental School, 2005 • Dr. Mary Shields, University of Louisville Dental School, 2011 • Dr. Jared Simpson, University of Texas San Antonio Dental School, 2005
This open enrollment will continue until November 30, 2014. Interested new dentists can apply by going to The New Dentist™ website,
www.thenewdentist.net/advisoryboard.php
Dr. Chandan Chadha
AspenDentalJobs.com
28 WWW.THENEWDENTIST.NET 1 FA L L 2 0 1 4 KHJ20174_ASP-154_DentistPrint_3.7125x9.925.indd
8/5/14 12:01 PM
Build Revenue With High-Quality
NEW PATIENTS!
Complete System of Effective Marketing
PRECISION MARKETING DEMOGRAPHICS
PROFESSIONAL PRACTICE BRANDING
DETAILED CALL TRACKING SHOWS RESULTS
CUSTOM WEBSITE TO ENHANCE YOUR IMAGE
PHONE TRAINING FOR MAXIMUM APPOINTMENTS
HIGH-QUALITY CUSTOM DESIGNED POSTCARD
Would you like to … Attract new customers?
Spend less time marketing?
Boost customer retention?
Generate sustainable growth?
Enhance your public image?
....we can help you succeed!
Call today to start growing your revenue!
Nationwide 866.961.4412 www.affordableimage.com
Straumann continued from page 20 We also want the portal to be a resource for what’s hot in the industry. Past articles have included the issue of the online reputation of dental and medical professionals and how to keep a team motivated and engaged. We also have ongoing book reviews on anything from leadership styles to business applications. We don’t want to be just another clinical site. Our goal with the portal is to fill a much-needed gap for these new dentists.
How does a new dentist access the portal and this program? Jillian: To sign up for the site, simply visit http://straumann. cvent.com/ypregister and register. They will then have immediate access to the site and all the information available now and the e-newsletter for updates when new content is added. The site also has more information about the program itself and everything that’s available for students and new graduates. Anna: Our territory managers are another key resource. These are individuals who are out in the field and have the benefit of knowing more about the local markets. Email us at young.dentist@straumann.com to find your local territory manager. About the Straumann Young Professional Program The Straumann Young Professional Program is a collaborative community between Straumann and like-minded dental students and professionals for support during and immediately after dental school. Sign up at http://straumann.cvent. com/ypregister to gain exclusive access to the Straumann Young Professional community and a variety of tools, educational opportunities, and other resources. *Emdogain is unique as of 7/9/2014.
Implants continued from page 12 2. de Carvalho BC, de Carvalho EM, Consani RL. “Flapless single-tooth immediate implant placement.” Int J Oral Maxillofac Implants. 2013 MayJun;28(3):783-9. doi: 10.11607/jomi.2140. 3. Grant BT, Pancko FX, Kraut RA. “Outcomes of placing short dental implants in the posterior mandible: a retrospective study of 124 cases.” J Oral Maxillofac Surg. 2009;67:713-717.
Disclosure: Dr. Frank developed OsteoReady™ implants to better meet the needs of his patients. He is founder and clinical director of OsteoReady™ Practical Implant Solutions, based in Seattle, WA, with training locations throughout the U.S., www.OsteoReady.com. 30 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
SKINNY
on the Street
The latest news on products and services for new dentists and their practices Hu-Friedy EMS AIR-FLOW Master Piezon®
Colgate® Sensitive Toothpaste
The AIR-FLOW Master Piezon® delivers all AIR-FLOW® supragingival and PERIO-FLOW® subgingival air polishing therapies from one side of the device, while the other side offers Piezon® technology with a standalone irrigant bottle and LED handpiece. The easy-to-operate user interface and convenience of three technologies in one unit make it the ultimate prophylaxis and periodontal disease management device. Hu-Friedy and EMS formed an alliance to deliver the most clinically advanced prophylaxis protocol to the U.S. and Canadian markets. HuFriedy is the exclusive North American distributor of Piezon® power scaling and AIRFLOW® air polishing technologies. For more information, visit www.hu-friedy.com/hfems. PHOTO COURTESY OF HU-FRIEDY
Recommend Colgate® Sensitive Toothpaste for a clean, refreshing feeling patients want, so they can actually enjoy complying.
Aspen Dental At Aspen Dental, we have immediate opportunities for dental professionals of all kinds, in locations all around the country. This year we’re opening 55 new practices, expanding to new states like Minnesota, South Dakota, Arkansas, and Missouri. And we need people like you! As part of our mission to give America a healthy mouth, we go where patients need us most. This is your chance to live in a community that offers affordability, thankful patients, and a great quality of life. To learn more about specific opportunities, visit aspendentaljobs.com. IMAGE COURTESY OF ASPEN DENTAL
Product Characteristics • A clean, refreshing feeling patients want, so they can actually enjoy complying • Maximum strength* for clinically proven sensitivity relief Product Benefits • Colgate® Sensitive Prevent and Repair™ is clinically proven to provide superior relief vs. Sensodyne® Extra Whitening at 8 weeks • Long-lasting relief from hypersensitivity with continued use *Maximum-strength FDA-allowed antisensitivity active ingredient
IMAGE COURTESY OF COLGATE
INDEX O F A D V E R T I S E R S Advertisers in this issue of The New Dentist™ have made it possible for you to receive this publication free of charge. Please support these companies. Contact information can be found below, or visit The New Dentist™ Resources at www.thenewdentist.net to receive information from more than one company.
American Dental Association..... 5 www.adacatalog.org 800-947-4746
Colgate....................................... 3 www.colgateprofessional.com 800-372-4346
MacPractice............................ IFC www.macpractice.com 855-679-0033
Affordable Image.................... 30 www.AffordableImage.com 866.961.4412
Dental Dreams......................... 30 Danielle Tharp, 312-274-4524 Juliette Boyce, 312-274-4520
McKenzie Management..........BC www.mckenziemgmt.com 877-777-6151
Arrowhead Dental Laboratory................................. 7 www.ArrowheadDental.com 877-358-0285
Dental & Medical Counsel...... 18 www.dentalcounsel.com 925-999-8200
Midwest Business Capital....... 27 www.midwestbusinesscapital.com 877-751-4622
Henry Schein Professional Practice Transitions................IBC www.henryschein.com/ppt 800-730-8883
OsteoReady, LLC........................ 9 www.osteoready.com/NewDentist 206-971-6804
Aspen Dental........................... 28 www.AspenDentalJobs.com 866-748-4299 Bank of America...................... 31 www.bankofamerica.com/ practicesolutions Michael Pakula, 619-879-0423 CareCredit................................ 21 www.carecredit.com 866-246-6401
Kois Center............................... 25 www.koiscenter.com 206-621-5310 Live Oak Bank............................ 1 www.liveoakbank.com/dental Mike Stanton, 404-995-2003 JP Blevins, 910-796-1674
PNC Financial Services Group....................................... 23 www.pnc.com/hcprofessionals 888-PNC-BANK Solution Reach........................ 13 www.solutionreach.com 866-605-6867
Straumann............................... 19 www.straumann.cvent.com/ ypregister 800-448-8168 Viva Learning........................... 15 www.vivalearning.com Wells Fargo Practice Finance.... 11 www.wellsfargo.com/ thenewdentist 888-937-2321 Wood & Delgado Attorneys at Law....................................... 29 www.DentalAttorneys.com 800-499-1474
The New Dentist – New Dentist Resources, New ... http://www.thenewdentist.net/resources.htm
Scan the code with your mobile device to receive more information from these advertisers. Or visit www.thenewdentist.net/resources.htm http://kaywa.me/b4u2c
32 WWW.THENEWDENTIST.NET FA L L 2 0 1 4
Download the Kaywa QR Code Reader (App Store &Android Market) and scan your code!
14YS9525
This represents only a sample of our practice listings. For a complete listing, visit www.henryschein.com/ppt ALABAMA
Birmingham-Established Practice, Desirable Area, Seller Highly Motivated, GR $596K #AL108
ARIZONA
Tucson-4 Ops, 1400 SF, Dentrix & Dexis #12111
CALIFORNIA
When it’s time to buy, sell, or merge your practice, you need a partner on your side! • Practice Sales • Appraisals • Transition Planning • Mergers • Partnerships
1.800.730.8883 www.henryschein.com/ppt
Bay Area-Periodontal, 6 Ops, 2120 SF, Digital X-Ray, Pulse Oximeter, Endoscope #CA167 Eastern Sierras-4 Ops, 1650 SF, Low Overhead, 4 Days Hygiene, GR $521K #CA528 Granite Bay-3 Ops, 2 Add’l Available, Dentrix, Digital, GR $236K #CA128 Indian Wells-6 Ops, 4000 SF, Built 2 Yrs Ago, New Equip/Fixtures, GR $350K #CAM530
COLORADO
Denver-5 Ops, Great Start-Up, Location; Growth Opportunity #CA100
CONNECTICUT
Waterbury-General Practice, Up-To-Date Technology/Practice Mgmt Systems, GR $1.1M #CT104
FLORIDA
Pembroke Pines-6 Ops Equipped w/Latest Technology, 8 Days of Hygiene, GR $1.3M #FL501
GEORGIA
Atlanta-4 Op Perio Practice, Excellent Opportunity, GR $834K #GA500
IDAHO
Blaine County-General Practice, Fee for Service, Great Location, GR $742K #ID103
ILLINOIS
Far West Suburbs of Chicago-4 Ops, Desired Downtown Location, GR $563K #IL502
INDIANA
Mishawaka/South Bend-Established 4 Op Practice Near Revitalized & Growing Downtown Area, GR $381K #IN506
KENTUCKY
Beattyville-General Practice, 5 Ops, 1000 Active Patients, Equipped for Ortho, GR $415K #KY102 Paducah-6 Ops, General Practice, High Volume, Low Overhead, In-House Lab, GR $620K #KY100 Western-Established Practice & Office Building, 1800 Active Patients, GR $487K #KY500
MAINE
York County-2 Ops w/Room for One More, 1800 SF, Bldg must Sell w/Practice, GR $600K+ #ME100
MARYLAND
Montgomery County/Silver Spring-Well-Established, Oportunity for Start-Up/Second Location, Highly Visible #MD109
MASSACHUSETTS
Cape Cod-4 Ops, 2 Hygiene, R/E Also Available, GR $374K, Asking $188K #MA114 South Coast Boston-4 Ops, Beautiful Practice, RE Available, GR $742K #MA102
MICHIGAN
Lower Michigan County-Well-Equipped, Fully Digital, Fee for Service, GR $700K+ #MI118 Southeastern-Mobile Dentist, Established Route, Great Opportunity, GR $800K #MI3504
MINNESOTA
West Central Minnesota Lake Country-General Practice in Beautiful Setting, GR $688K #MN100
MISSISSIPPI
Mississippi Delta-8 Ops, Main Community Practice, Successful Family Practice #MS100
MISSOURI
Southwest Missouri-General Practice, 2 Ops, Located in County Seat of 8000+ Residents #MO100
NEW HAMPSHIRE
Gilford-General Practice Condo, Small Emphasis on Perio/Implant Surgery, GR $512K #NH100
NEW JERSEY
Ocean County-6 Ops, Spacious, Prime Location #NJ121
NEW YORK
Manhattan-4 Ops, 1400 SF, Digital, Prime Location, GR $400K #NY136 Orange County-Oral Surgery, 4 Ops, 2000 SF, Digital, Successful, Established #NY138
NORTH CAROLINA
Coastal Area-Well-Established, Highly Successful, Stand Alone Bldg, Remodeled, Beautiful! #NC504 Outer Banks-4 Ops, FFS, Cerec, Digital, Great Opportunity, GR $355K #NC106
NORTH DAKOTA
S Central-Wonderful Productive Rural Practice, GR $696K #43102
OKLAHOMA
Tulsa-Very Profitable GP, Modern Facility, Nicely Designed, GR $750K #OK501
PENNSYLVANIA
Philadelphia-3 Ops, FFS Practice in Center City, 33 Years at Location, GR $402 #PA122 West of Philadelphia-4 Ops, High Net Profit Ortho Practice, Dentrix, GR $809K #PA125 York County-5 Ops, 1875 SF, Implant/Cosmetic, Dentrix, Digital, Intraoral Camera, Pano #PA129
RHODE ISLAND
Warwick-Thriving General Dentistry Practice, 4 Ops, 1700 SF, Great Visibility, Asking $325K #RI102
SOUTH CAROLINA
Upstate-Oral & Maxillofacial Surgery, 8 Ops, 3400 SF, iCAT, R/E Available, #SC101
TENNESSEE
Coffee County-4 Ops, Well-Established, Desirable Location, Building Available, GR $400K #TN502 Pigeon Forge (Near Dollywood)-GR $400K #TN100
TEXAS
Bell County-Oral & Maxillofacial Surgery, 4 Ops, Leased Space, Successful, GR $1.3M #TX107
VERMONT
Windsor County-Immediate Sale! Wel- Established General Cosmetic Practice, Digital #VT100
VIRGINIA
Suffolk-3 Ops, 1200 SF, Tremendous Growth Area, 15-20 New Patients/Month #VA118
WASHINGTON
South Snohomish County-6 Ops, 1700 Active Patients, Strong Hygiene, GR $1.2M #WA500
WISCONSIN
Washington County-3 Ops, Great Satellite Office, Fully Transferrable Lease, GR $193K #WI100
© 2014 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.
Starting a Practice or Buying a Practice? Your first time being a business owner will take more knowledge than getting the margins right on that 3-unit bridge. Prepare yourself for the role of CEO, Operating Officer, HR Manager, Financial Wizard, Marketing Director, IT Specialist, Etc, etc, etc‌
Helping Dentists For Over 30 Years McKenzie Management - Dental Consulting, Dental...
McKenzie Management - Dental Consulting, Dental...
http://www.mckenziemgmt.com/cons-startup.php
1.877.777.6151
http://www.mckenziemgmt.com/cons-practiceacquis...
For More Information Visit
info@mckenziemgmt.com
http://kaywa.me/FyE5r
www.mckenziemgmt.com/cons-startup.php www.mckenziemgmt.com/practiceacquisition.php
http://kaywa.me/zJNM1