THE #1 RESOURCE FOR NEW DENTISTS
How to Keep
PATIENTS
LOYAL
Handbook Myths Be a Better Leader Attorney Tips WINTER 2018
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FROM THE PUBLISHER’S DESK Dear Readers, Welcome to the Winter issue of The New Dentist™ magazine.
U
nresolved staff conflict can do a lot of damage to your young practice. The negative environment conflict creates often leads to low team morale and staff turnover. Patients also notice the tension, prompting them to seek out a new practice with a better vibe—hurting your production numbers and your bottom line. While staff conflict is unavoidable, there are ways you can reduce it and all the problems it brings. Not sure how? I’ve put together a few tips: Keep emotions in check. The ultimate goal is to resolve problems in a way that benefits the practice, not determine who is to blame. Talk with all employees involved and work together to find a solution that makes everyone happy. Remember to stay positive as you address the situation. Create policies. These policies should outline standards for professional behavior, leaving no doubt about how employees are expected to act. Be sure to include the policies in the employee handbook and have your team members read and sign off on them. Eliminate gossip. Petty gossip, eye rolling and snide remarks have no place in a dental practice. Make it clear you won’t tolerate this type of behavior. Tell team members they should only talk about co-workers who are in the same room, and if other team members don’t follow this rule, they should walk away or change the subject. Focus on communication. Better communication will result in less conflict. I suggest you hold daily morning huddle meetings and encourage employees to bring up concerns. Use monthly meetings as an opportunity for team members to give updates on their systems. Both meetings will help get team members on the same page, while also giving them the opportunity to identify issues and work together to find solutions. Create detailed job descriptions. Job descriptions make it clear who’s responsible for what, reducing confusion and the chance of conflict. Just like with any business, you’ll eventually have conflict in your practice. Instead of ignoring it and hoping it will go away on its own, embrace it. Look at conflict as an opportunity for positive change and practice growth. Work with employees to find solutions, and you’ll have a happier, more productive team and a healthier bottom line. In this issue… This issue is filled with advice to help you grow your practice. Turn to page 6 to read about how to keep patients loyal, and page 12 for pointers on choosing a delivery system. Top dental attorneys share their best tips on page 18, and you can learn about Arrowhead Dental Lab’s new dentist program on page 24. Find out what it takes to be a better leader on page 21, then turn to page 28 for an overview of what you should know about IT security. Finally, Dr. Sheri Doniger tells you how to get the most out of your career on page 30.
Here to help,
Sally McKenzie, Publisher
2 THENEWDENTIST.NET W I N T E R 2 0 1 8
Advisory Board
Christopher Banks, DDS Inwood, WV WVU, 2011
Rebecca Berry, DMD Oakland, ME Tufts, 2011
Julie Boerger, DMD Patchogue, NY University of Montreal, 2010
David Carter, DMD Zachary, LA University of Mississippi Medical Center, 2014
Hal Cohen, DMD Haverford, PA Temple University, 2010
Larry Dougherty, DMD San Antonio, TX Nova Southeastern, 2008
Dennis Frazee, DDS Mooresville, IN Indiana University, 2012
Lindsay M. Goss, DMD, MPH Chandler, AZ ASDOH, 2010
Erica Haskett, DDS New York, NY NYU, 2008
Crystal Johnson, DDS Powder Springs, GA University of Tennessee College of Dentistry, 2009
Aaron Layton, DDS Fort Collins, CO Indiana University, 2010
Leah Massoud, DMD San Jose, CA Tufts, 2009
Michael Potter, DDS Quincy, WA University of Minnesota, 2014
Tyler Scott, DDS Loudonville, OH Ohio State, 2009
Matthew Silverstein, DMD, MPH West Hartford, CT University of Pittsburgh, 2012
Nicole Smith, DDS Newport Beach, CA NYU, 2009
Gregory Snevel, DDS Cleveland, OH Ohio State, 2011
Bryan Stimmler, DDS Brooklyn, NY University of Southern California School of Dentistry, 2009
FOR SOME ELITE SOLDIERS, THIS IS A TACTICAL ADVANTAGE. As a dentist and officer on the U.S. Army Reserve health care team, you’ll advance your career by working alongside an outstanding team of professionals from diverse disciplines and backgrounds. You’ll have access to state-of-the-art equipment, accessories and restorative materials. Additionally, you may qualify to receive up to $250,000 for repayment of qualified education loans. To see the benefits of being an Army dentist call 800-431-6712 or visit healthcare.goarmy.com/mc34
©2018. ©20 1 Pa aid for f r by the e Unit United ed States Ar Army. my. Al A l righ ightss res reserv e ed.
TABLE OF CONTENTS
WINTER 2018
24
W I N T E R 2 018 PUBLISHER
Sally McKenzie Sally@thenewdentist.net DESIGN AND PRODUCTION
Picante Creative www.picantecreative.com EDITOR
Renee Knight renee@thenewdentist.net SALES AND MARKETING
Contact 877-777-6151. Visit our digital media book at www.thenewdentist.net/ mediabook.htm The New Dentist™ magazine is published quarterly by The McKenzie Management Company, LLC (302 N. Chestnut St., Barnesville, OH 43713) 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).
FE AT U R ES How to Keep Patients Loyal
21
6
Selecting a Dental 12 Delivery Unit for Modern Day Office Design
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 Management Company, LLC.
3 Myths About Creating 14 Your Employee Handbook 6 Tips for Managing Student Debt
16
Top Tips from 18 Dental Attorneys Be a Better Leader
21
How the Right 24 CE Courses Can Help Launch Your Career What Dentists 28 Need to Know about IT Security Dr. Sheri Doniger 30 on Getting the Most Out of Your Career
4 THENEWDENTIST.NET W I N T E R 2 0 1 8
Copyright ©2018 The McKenzie Management Company, LLC. 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 Management Company, LLC for libraries and other users registered with the Copyright Clearance Center.
32
DEPARTMENTS 2 Publisher’s Message 32 Skinny on the Street 32 Index of Advertisers
Contact Us — Questions, comments, and letters to the editor should be sent to renee@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.
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
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PHOTO COURTESY OF PATIENT NEWS
How to Keep
PATIENTS LOYAL These products and services will make patients want to call your practice their dental home.
G
rowing a dental practice isn’t easy. Not only do you need to attract patients to your office, you also have to find ways to turn those new patients into loyal patients who accept treatment and refer. Without those kinds of patients, you’ll find your practice will struggle and never actually meet its full potential. These days, patients have high expectations and a lot of options. If they have a negative experience at your practice or just don’t feel a connection, there’s a good chance they won’t be back—leaving you wondering what you did wrong. Incorporating the right products and services into your practice will help you develop those connections, fostering loyalty and growing your patient base. And while patient loyalty is important to any practice’s success, it’s especially critical for young dentists just starting out. You don’t have the experience or history with patients that other practices do, so you have to work even harder to develop a rapport with patients and show them why your practice should be their dental home. “When you’re a new dentist you’re unproven. You’re untested,” The New Dentist™ magazine advisory board member Dr. Gregory Snevel said. “That’s going to be a big challenge. You really have to control and think about every aspect of the new patient experience and decide how you want that to flow.” Adding the conveniences patients want, enhancing communication and providing an exceptional experience are all ways to boost loyalty and grow patient retention numbers in your practice. Investing in the right products and offering the right services can help you flourish in all three areas,
By Renee Knight, Editor
which will not only lead to more patients, but also increased practice production and revenues.
Give patients convenience Patient loyalty has changed quite a bit over the years, said Sameer Bhasin, CareCredit’s Vice President, Alliances. It used to be fairly common for adult patients to stay loyal to the same dentist they saw as a child, and to take their children to that office as well. That’s not the case today. With the change in demographics, more patients want to find an office that provides convenience. They want a practice that fits around their lives and schedules, and offering various payment options, such as third party financing, is part of that. “Do you offer payment choices or are you going to limit patients to what’s best for your office? It’s a huge mind shift,” Bhasin said. “In my opinion, many dentists focus on what’s best for the office. I disagree with that. If you’re trying to build loyalty and develop a patient base that refers good patients to your office, you have to do what’s best for the patient.” Putting the focus on your patients and their needs will go a long way in making them want to come back to your practice, Bhasin said. Offering flexible payment options is a great example of this, and might even help reduce cancellations and no-shows in your practice. Patients commit to treatment and don’t have to worry about how they’re going to pay, which helps improve compliance. Patients also want an easy way to see their information from the comfort of their own home. XLDent offers a Patient Portal that makes that possible, giving patients the ability to review proposed and past treatment, see their balance, view upcoming appointment dates and pay their bills. The portal integrates with the practice website and is easy to use. CONTINUED ON PAGE 8 >>
6 THENEWDENTIST.NET W I N T E R 2 0 1 8
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Patient Loyalty continued from page 6 “Everyone is busy,” said Jennifer Gibbs, XLDent’s Client Experience Manager. “The fact I as a patient don’t have to pick up the phone to call in my payment or mail in a check is a big convenience factor. Patients will remember that. Practices that offer that kind of convenience have the upper hand.” Providing more services in-house also makes the experience more convenient for your patients, Dr. Snevel said. “Any time you refer a patient to a specialist you’re literally sending them out of your office,” he said. “If you don’t want to do implant cases or extract third molars that’s fine, but you shouldn’t let a single canal endo case out of your office. Patients don’t want to go to a specialist. They want you to do the work, so it’s important to find a way to make that happen, whether it means investing in more equipment or education or finding what that niche is for you and your practice.” Flexible hours and keeping to a schedule so patients aren’t spending their afternoon in your waiting area are other ways to make the experience as convenient as possible, helping you build that loyal patient base.
Improve engagement and communication The more you can engage with your patients, the more likely they are to feel connected to your practice—and remain loyal, Gibbs said. The XLDent Patient Portal not only adds convenience for patients, it also improves engagement. As soon as patients call a practice to set up an appointment, a new account is created. That means you’re not introducing them to the portal when they come in for their first visit. They have the ability to fill out registration forms before that appointment, saving time during check-in. Once they leave, patients can continue to interact with the portal, keeping them engaged with the practice. “Patients really want to interact like a consumer more than ever before,” Gibbs said. “It’s really less of a clinical health care type interaction. They want to have shared responsibility in their health care, and giving them a window into that through a patient portal is a really easy way to do that. We see this with medical practices so it makes sense to carry this over to dental practices.” If you want patients to stay loyal, you have to earn their trust, said Karen Galley, President of Patient News, a dental marketing agency. How do you build trust? Through engagement and communication, and it all starts with the dentist. It’s important to really listen to patients’ needs and concerns, and to show them you care. Galley suggests calling new patients after their first visit, and to reach out to patients to see how they’re doing after extensive treatment. A clean office, accurate billing, financing options and a responsive, friendly team also go a long way toward establishing trust and fostering loyalty.
PHOTO COURTESY OF XLDENT
“Perceived indifference” is one of the main reasons patients opt not to come back to a practice, Galley said. The best way to let patients know you care is to communicate with them between scheduled appointments and to add value. Send an email thanking patients for choosing your practice for their dental care, for example, as well as newsletters with relevant articles and promotions. And don’t be afraid to add snail mail to the mix. “Print is an extremely effective vehicle for delivering highvalue contact. It arrives in a patient’s home in an envelope and it doesn’t get lost in an email stream,” Galley said. “It’s what happens in between appointments that makes your practice stand out, staving off that perceived indifference.” Dr. Michael Hasty, who uses Lighthouse 360 in his pediatric dental practice, said the ability to send customized newsletters helps him build loyalty. Not only can he provide content that’s relevant to his patients, he can narrow the audience that receives the communication. If the practice is having a princess day, for example, the announcement about the event only goes to girls 10 or younger, leaving out the college-aged football players from the list. Sending reminders via text, email, postcard or even telephone call helps improve loyalty, as well as reduces broken appointments, he said. Lighthouse 360 also sends out communications to past due patients, helping them to reconnect with the practice and get the care they need. “Such thorough and complete communications customized to my practice and each family builds brand loyalty,” Dr. Hasty said. “Besides the human touch, Lighthouse 360 is one of my best employees. It never calls in sick or comes in late and it makes very few mistakes. It’s an advantage for the office. We’re happier and more efficient, and that makes parents and patients happier.” CONTINUED ON PAGE 10 >>
8 THENEWDENTIST.NET W I N T E R 2 0 1 8
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Patient Loyalty continued from page 8 Social media is another great tool you can use to improve patient communication—but you have to know how to do it right. Facebook is one of the best platforms for patient engagement, said Grant Gooley, Director of Digital Marketing for Patient News. Once patients like your page, your posts will surface in their newsfeed. If patients see positive reviews, comments and a large number of likes and shares, they’ll likely put more trust in your practice. It’s also important to engage in other social media platforms, such as Instagram and Twitter, Gooley said. You should post three times a week on most social media platforms. Any more than that and algorithms will keep followers from seeing all your posts, except for on Twitter. “Engagement lowers if you post more than once per day,” Gooley said. “The sweet spot is about three times per week, and two of those three posts should be very specific to the practice and community. A photo of a doctor and a patient will go a lot further than a general post about dentistry. If you’re posting about race cars it will make
Building your Facebook presence Remember, you don’t automatically generate likes on Facebook unless you use Facebook ads, said Grant Gooley, Director of Digital Marketing for Patient News. If you want to grow your page organically, it starts with you and your team. Ask all of your team members to like the page and to share posts with family and friends. Your audience will start to grow, helping you attract new patients to your practice, keep current patients loyal and build brand awareness. Another tip? To generate more likes, Gooley suggests sending private messages to patients via Facebook messenger to wish them a happy birthday and to ask them to like your page. Include a link to your Facebook page in the message so it’s easy for them to visit the page and like it. “This won’t cost you a dime other than having someone dive in every morning to send messages to five to 10 patients a day,” he said. “A dentist I know who did this had 10,000 likes on his Facebook page. Other practices I’ve told about it also have had huge success.”
10 THENEWDENTIST.NET W I N T E R 2 0 1 8
patients feel like they’re not in the right place. You need to make sure you stay relevant.”
Create an experience they won’t forget When it comes down to it, patients want a practice that offers an exceptional experience. They want certain conveniences and they want to feel like top priority. Investing in the right products and services, along with focusing on offering outstanding customer service, will help you deliver that. The way payment is handled certainly has an impact on how patients view a practice, and if they’ll come back, Bhasin said. “Payment is a huge part of the experience,” he said. “They could have had the best experience, but when the discussion about money is something they don’t like or they feel like you’re making a decision on if they can afford $500 or not without giving them the choice, that could ruin everything up to that point and time. You could have the nicest team but when you sit down to talk about payment and the conversation is not very palatable, the experience they had before that conversation goes out the window. Everything has to be in sync, and that’s true even more so for a new dentist.” Offering products that make patients more comfortable or saves them time also enhances the overall experience, Dr. Snevel said. Single tooth anesthesia (STA), for example, offers patients a painless injection that doesn’t numb their face. Only the tooth that’s being worked on is numbed, making for a more comfortable experience during the procedure and post-op. Patients love it, and are happy to tell their friends about the great experience they had at Dr. Snevel’s practice. Using this type of product also helps open up the conversation about other technologies in the practice and their benefits, Dr. Snevel said. One of those technologies is CEREC CAD/CAM, which gives him the ability to provide crowns for patients in one day. Patients don’t have to come in for as many appointments or deal with impression material in their mouth, once again improving their experience. “We make investments that are for the patients,” Dr. Snevel said. “We’re not buying a brand new fish tank or a new Corvette or something like that.” Offering the right procedures also helps to build patient loyalty, Dr. Hasty said. Of course, this includes popular procedures patients want, as well as some of those less common procedures that will help differentiate your practice from others in your area. He performs frenectomies on infants who are having trouble latching to breastfeed, for example, greatly improving both the mother’s and the baby’s quality of life. “It’s a branding opportunity,” Dr. Hasty said. “When you get people out of pain that lends itself to loyalty.
TIP Procedures and connections solidify your relationship with patients more than just products and promotions.”
Grow your practice As a new dentist, having reliable cash flow is critical. You likely have a lot of student loans to pay and, if you’ve started your own practice, more debt from equipment and building investments as well as your typical overhead expenses. Having a steady flow of patients is key, and that comes from creating a base of loyal patients who are happy to refer and accept treatment. Through it all, it’s important to remember why you became a dentist and to treat patients with respect and kindness. Put yourself in their place and make sure you’re treating them the way you’d like to be treated. Say thank you. Be patient. Make it easy for them to make appointments
Consider doing away with no-show fees Many dental practices charge patients if they miss an appointment, which Dr. Michael Hasty said doesn’t do much to grow loyalty. It builds resentment instead, especially if an emergency kept them from your office. He suggests taking other steps to deal with patients who habitually cancel at the last minute, such as appointing them during non-peak hours. Reminders and other communications from companies like Lighthouse 360 also help keep patients educated and their appointments top of mind, so they’ll only cancel when they absolutely have to.
with your practice, focus on communication and create the best experience possible. That’s how you grow your practice. “It’s easy for new dentists to get caught up in fees and reimbursements and loans and equipment and profitability and ROI and all those other great buzz words salesmen love to throw at us,” Dr. Snevel said. “It boils down to remembering your job is a people job. If you just focus on that, you’re going to find loyalty isn’t going to be an issue.”
HOW CARECREDIT CAN HELP If you want to learn more about how to improve the patient experience and loyalty in your practice, contact CareCredit Provider Services at 800-859-9975.
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WINTER 201 8
THENEWDENTIST.NET
11
Selecting a Dental Delivery Unit for Modern Day Office Design
PHOTO COURTESY OF ASI DENTAL
By John W. McPeek, President, ASI Dental
I
t’s been a long time since the 1960s when pedestal dental units equipped with belt driven handpieces, suction and syringe, were the mainstay of dental office design. Even though the fundamental principles of a dental delivery system have remained the same, the needs of the practice and the available options have changed dramatically. In this day and age, choosing the right dental delivery system has significant importance. Terms like positive patient experience, efficiency, time per procedure, flexible design with minimized footprint, multi-specialty practice, ambidextrous and even standard of care come to mind when considering available types of delivery systems. To select a delivery system that will work best for you and your practice, it is helpful to create a list of requirements that incorporates modern day office design criteria. Don’t just settle for the least expensive option or what the sales rep says will work. Remember, you have to keep your needs in mind. You are in charge and must select what works best for your practice’s success. Customizing a dental delivery system to your needs is well worth the time you spend to get it right. This is an investment in yourself, your practice and your patients. Use the following criteria to guide you as you create your delivery system requirements list: Capability to configure desired instrument integration. To start, you need a delivery system that truly works for you, meaning it provides the instrumentation you require to treat your patients and even hand delivers them in the order you like. A modern-day delivery system shouldn’t make you contort your body to reach an accessory cart or cabinet every time you need to grab an “extra” instrument. These should be integrated alongside traditional handpieces and even allow for instrument upgrades as new technology is released. Positive patient impressions. This is an important area to consider, and one you should spend more time on. Why?
Getting this business decision right is vital. Take your head out of dentistry for a moment and think like an owner setting up a new restaurant. The quality of the food is essential, but so is the right ambience for the patrons. Do you design the dining area for the customers to enjoy a meal or for the convenience of the restaurant’s equipment supplier? Creating a positive dental patient experience can lead to repeat visits, referrals, and higher case acceptance. Remember, patients consider more than just the cost of a procedure when determining if they should go forward with advanced treatment. How much time and effort the procedure will take as well as their level of comfort all play into the decision-making process. Patients rarely care about frivolous features such as a massage chair with heated elements. Rather, they’re focused on the feeling they get from their surroundings in the dental treatment room. If your patients could talk freely, they would say get this stuff off me now! Draping a handpiece unit across the patient in a way that creates a confined, claustrophobic environment is an example of a design mistake you want to avoid. There is absolutely no “patient benefit derived” reason to purchase a chair mounted over the patient delivery system. It’s time to set your patient chair free, eliminating clutter and patient anxiety. Flexibility of design with a patient centered focus. Accommodating changes to easily perform different procedures is a must, but keep in mind staff changes and your patients’ physical size can affect how you treat them as well. Traditional fixed cabinet based designs require treatment and staff to adjust to how and where the cabinets were placed. In a patient centered design, both the operator’s and assistant’s delivery systems can easily change position for treatment, patient or staff. Flexible design will accommodate multi-specialty practices where different operators share the equipment, including ambidextrous requirements. Ergonomics and efficiency. The combination of these not only contribute to higher productivity and profitability, but also to the practice’s future earning value. Working ergonomically makes you more efficient and can translate into higher revenue each day. The daily physical toll of incorrect ergonomics can wear your body down and thus your ability to practice effectively. The CONTINUED ON PAGE 27 >>
12 THENEWDENTIST.NET W I N T E R 2 0 1 8
3 Myths About Creating
By Paul Edwards, CEO and Co-Founder of CEDR HR Solutions
Your Employee Handbook
Understand why your handbook is a critical employer protection.
A
common misperception is that employee handbooks only contain rules for how your employees need to conduct themselves—but a well-written handbook also contains many protections for the practice owner and can guide you to comply with employment rules. That is, if it’s written correctly and kept up-to-date. If it’s not written or updated correctly, the handbook that should be a protection and a tool for managing instead becomes a time bomb. Over the years, as problematic policies go unnoticed, laws change, or your practice grows, the handbook stays out of legal compliance and increases your liability. To make sure you know whether your own handbook is a protection or a problem, I’ve compiled the three most frequent handbook myths I hear from dentists:
MYTH NO. 1 – AN EMPLOYEE HANDBOOK IS A SET OF RULES FOR YOUR TEAM. This is the biggest misunderstanding about employee handbooks. The fact is, providing rules for your team is just one simple role your handbook fills. Your handbook’s most important function is to protect your practice from unnecessary risks. The first way it does this is by clearly establishing your compliance with mandatory employment laws. A great handbook also must include attorney-written policies that protect you and creates rules for your team. These policies must all be expertly vetted.
MYTH NO. 2 – YOU CAN BENEFIT AND SAVE MONEY BY USING A TEMPLATE OR BORROWING A WELL-ESTABLISHED PRACTICE’S HANDBOOK AND MAKING IT YOUR OWN. I understand why this sounds like a good idea, but it will only cost you more—in increased risk, money and time— in the long term. The reason you shouldn’t use somebody else’s handbook is the same reason you don’t use somebody else’s toothbrush—who knows what you might catch from that thing! Nasty germs are contagious, and so are illegal or unenforceable policies. And your handbook needs to fit your practice—your industry, your specialty, how many employees you have (this affects which laws apply), and even your unique culture. You need to know your policies are legally compliant, enforceable and protective. You also need to know that, as federal, state, and even local laws change or are passed each year, your handbook is being kept up to date. (The San Francisco handbook does not work in Sacramento, for example.) MYTH NO. 3 – IT’S BETTER TO FOREGO HAVING AN EMPLOYEE HANDBOOK BECAUSE IT MAKES YOU LESS OF A TARGET FOR LEGAL CLAIMS. Not true. If you don’t have policies in place when an employee dispute escalates to a legal claim, the actions you have taken as a manager will be scrutinized as if they were your policies. That may not sound too bad until you realize hundreds of well-intentioned, common-sense decisions can get you in trouble with employment laws. Maybe you told an employee not to discuss the raise you gave them—oops, that’s illegal. Perhaps you banned mentioning work on social media—a violation of protected employee rights. Maybe you accidentally implied in an email that continued employment was conditional upon your receptionist coming to work on time, instead of at-will. Bad idea! Dental practice owners are automatic targets for employment lawsuits. Not having a handbook just makes you an easier target, and so does having an improperly written one. CONTINUED ON PAGE 27 >>
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6 Tips for Managing Student Debt Seeking good financial advice was not my top priority when graduating from dental school. Naively, I thought I would begin practicing dentistry and my financial goals would organically align. Please consider a more intentional approach as you begin your dental career. I graduated in 2011 with Adam Burr, DDS $362,243 in student debt on the heels of the Great Recession. The student loan landscape changed drastically. Gone were the sweetheart consolidation deals offered by private lenders and any gains from investing in real estate. I graduated in the reality which only dentists who did so after 2010 can understand. Few dentists have lived this new reality of astronomical student debt and come out on the other side to offer help. I paid off my student debt in August 2017, six years after starting repayment. Here are six tips to help you get there too: 1. Get real about your debt, the principal amount, and especially the interest. Don’t pay more than is absolutely necessary for your degree. Unlike a house, a car, or a dental practice, your degree has zero resale value and does not appreciate in value over time. Interest on your loans erodes your income and your future net worth. If you haven’t already done so, figure out exactly how much you owe1. 2. Avoid income-driven repayment plans. The math simply doesn’t add up under most circumstances. You will pay more toward interest over time2. Although the lower initial payments are incredibly tempting, your future self will work harder and longer to pay off this debt. The amortization of those plans will almost always be negative, resulting in compounded interest, higher loan principals and higher payments. 3. Get real about what you need. Earning your degree doesn’t mean you have earned that presumed lifestyle just yet. I didn’t buy a house until four years after I graduated. I bought my first new car in 2018 after my debt was completely paid off. That isn’t to say I didn’t live well, but I intentionally minimized new obligations. 4. Become a case acceptance expert. Instead of rushing to master implants or sleep apnea, learn how to help
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patients arrive at “yes” and accept the treatment you already do well. The need for crowns and fillings are present in all patient populations. With great treatment acceptance, you can treat enough patients and produce enough dentistry to comfortably pay down your debt. Only when your debt is contracting should your clinical skillset be expanding. 5. Understand you aren’t in competition with other dentists. You are in competition with Apple and Amazon. Seek learning outside dentistry to understand basic sales psychology3. Companies spend billions of dollars annually to get people to spend money with them instead of you. Solely relying on the fact you are a health care provider will devastate your case acceptance and require you to treat more patients less efficiently and effectively. 6. Learn about the business of dentistry. Position yourself to maximize earnings. If you are inclined and apt, quickly put yourself on a path toward practice ownership. I became an equity partner in my first practice 18 months after I graduated. You can do this too. In 2016, solo practice owners earned an average net income of $180,260 and non-solo owners earned $239,9804. Compare this with the income of an employed or associated dentist at $150,580. The sooner you achieve ownership, the sooner you can grow your income without increasing work hours. The new student debt reality is daunting for young dentists. These six tips can help you manage debt intentionally and achieve your financial and career goals. References 1. National Student Loan Data System. U.S. Department of Education website. Retrieved from https://www.nslds.ed.gov/nslds/nslds_SA/. Accessed on September 17, 2018. 2. Income-driven Plans Questions and Answers. U.S. Department of Education website. Retrieved from https://studentaid.ed.gov/sa/repay-loans/understand/plans/income-driven/ questions#miscellaneous. Accessed on September 17, 2018. 3. Cialdini, R. Principles of Persuasion. Influence at Work website. Retrieved from https:// www.influenceatwork.com/. Accessed on September 15, 2018. 4. 2016 Income, Gross Billings, and Expenses. American Dental Association website. Retrieved from https://www.ada.org/en/science-research/health-policy-institute/dentalstatistics/income-billing-and-other-dentistry-statistics. Accessed on September 17, 2018.
Adam Burr, DDS, is a graduate of Loma Linda University School of Dentistry. He is an owner dentist supported by Pacific Dental Services® in West Jordan, UT, and a faculty member of the PDS University™ – Institute of Dentistry.
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TOP TIPS from
DENTAL ATTORNEYS
W
hether you’re buying an existing practice, opening a startup or joining an established office as an associate, you need to start building a team of trusted advisors to help guide you along the way—and that includes an attorney. There are many instances when you might need to consult an attorney, making it vital to choose someone with experience in the dental industry. The New Dentist™ magazine recently spoke with three respected dental attorneys—Jason Wood of Wood and Delgado, Frank Recker, DDS, of Frank R. Recker & Associates, and Bill Barrett of Mandelbaum Salsburg P.C.—to get their top tips for young clinicians like you, from when to hire an attorney to what questions dentists should ask. Here’s what they had to say:
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Q: WHAT ARE COMMON REASONS NEW DENTISTS MIGHT NEED TO HIRE AN ATTORNEY? Wood: New dentists may want to have an attorney review their associate contract prior to signing up for an associate position. Some of the contracts we see are extremely nasty, with compensation being forfeited even when the dentist follows all of the provisions of the contract. In addition, any dentist looking to acquire a practice, open a startup, Jason Wood, Esq. - Attorney enter into a partnership or acquire real estate always should have a knowledgeable attorney
involved as these steps can have a significant impact on a dentist’s career trajectory.
dentist who enters into an associate agreement with a restrictive covenant and they don’t have an attorney review the document to fully understand they may be unable to practice in certain markets in the future, which could be detrimental to their career.
Recker: New dentists often think of an attorney ‘last’ on their ‘to do’ list. They should consult with legal counsel when purchasing equipment (contracts), leasing an office and before signing an employment contract. Barrett: There’s a number of reasons a new dentist might need an attorney. For starters, when they are entering into their first employment or Independent Contractor agreement they should have an attorney review the documents. If they are going to start a practice from scratch, they would also need an attorney to form a new business entity and review a lease. If they are considering an opportunity to enter into an associate situation with a potential associate buy-in, there are critical agreements to be created and negotiated. Another example would be if they are looking to acquire a practice right out of school, an attorney would be the primary professional representing their interests.
Q: WHAT SHOULD NEW DENTISTS Frank Recker, DDS, J.D.
CONSIDER WHEN HIRING AN ATTORNEY? Wood: Unfortunately, far too many dentists view “cost” as No. 1 when looking for advisors. Your attorney should know everything there is to know about this industry, not just understand contracts. They should know about the changes in Delta, how DSOs are impacting the landscape of associate income and ownership, and overhead issues. The subtle differences in this type of knowledge can have profound impacts on the individual dentist because of the circumstances involved with their particular transaction, whether it be as an associate, practice owner or partner.
Bill Barrett, Esq.
Q: HOW CAN NOT HAVING AN ATTORNEY HARM NEW DENTISTS EARLY IN THEIR CAREERS? Wood: I wish I did not have to deal with all of the sob stories I get on a weekly basis about dentists who did something on their own, or used a non-dental attorney to help them, only to see their career sidetracked. A few of the major harms that can happen include: buying the wrong practice, not being protected in the practice they acquired, having a lease that can’t be transferred to another dentist unless they pay the landlord hundreds of thousands of dollars, going into the wrong type of loan for a startup or acquisition that costs them tens of thousands of dollars in costs/interest they shouldn’t have paid, and improper tax planning. The list goes on and on. Setting yourself up with the proper advisors (the hard part being knowing who the real experts are) can place you into a completely different stratosphere for your career and retirement. Recker: By not consulting with counsel early in their careers, new dentists can be hampered by a burdensome employment contract, onerous lease terms, or other legally binding provisions they did not consider. I had a personal experience many years ago by signing a long term lease for a computer system that far exceeded my dental practice’s needs, and came without any ‘software’ for billing purposes! I had failed to consult with legal counsel. Barrett: Not having an attorney early on in a dentist’s career could have huge implications in the future. Imagine the young
Barrett: When hiring an attorney, a dentist should consider their expertise in the dental industry. One of the first questions they should ask an attorney they are considering is “how many dentists have you represented prior to me?” At our firm, the answer is several hundred, which is what you want. They should also ask specifically about the matter they need counsel on and the attorney’s experience with that particular type of transaction.
Q: WHY IS IT IMPORTANT TO HIRE AN ATTORNEY WITH A BACKGROUND IN THE DENTAL INDUSTRY? Recker: Although some matters are routine for lawyers, such as promissory notes, leases and purchase contracts, I would say anything related specifically to the practice of dentistry such as a buy/sell agreement or employment contract should be reviewed by an attorney with experience in the dental profession. Wood: Dentistry is unique and has minutiae issues that one needs to have an intimate understanding of. In addition, there are changes impacting the industry that an attorney should understand to best protect their client. I can’t tell you the number of times I structure deals against non-dental attorneys (or even ones who claim to be dental attorneys) where this lack of knowledge has tremendous negative consequences for the other side and provides substantial benefits for my client. Barrett: You want an attorney who has a background in the dental industry for a number of reasons. First, they are familiar
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with and networked into all of the various professionals who service the dental industry. Second, they are familiar with the profession and business of dentistry and have a deep understanding of what is reasonable and considered fair market value when it comes to various business decisions and effectiveness in negotiating on behalf of the doctor.
Q: WHAT ARE COMMON QUESTIONS NEW DENTISTS HAVE WHEN THEY FIRST MEET WITH YOU? WHAT ARE COMMON MISCONCEPTIONS? Wood: They often don’t understand the difference between an attorney who is a litigator and one who is a transaction attorney. You do not want a litigator to represent you when dealing with transactional matters. They see the world differently and are taught to attack. Transaction attorneys (like myself and my partners) are taught to problem solve to get the deal to the finish line. That has a tremendous impact on the likelihood of a deal going forward. Not every hill is one I need to die on. Are there important issues? Absolutely, but I don’t need to win every battle for a deal to move forward. As an example, we were involved in a deal in Florida with an attorney who primarily does dental litigation but who “dabbles” in transactions. Every single issue was a fight he had to win, even when every advisor on both sides were saying “this isn’t how things are done.” Unfortunately for his client, a deal was not completed because the practice became “unmarketable.” The conditions the attorney placed on the deal made it impossible to secure financing. The practice is still sitting there, and even with reductions in price no one has acquired it. Our client offered full price (more than $1 million) and even desired the seller to stay on (if the seller wanted to) to help
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transition the goodwill. The point is, picking the correct advisors can have a huge impact on your career. Recker: When new dentists reach out to an attorney, they usually don’t know WHAT questions to ask. They need to be versed in patient informed consents, providing treatment plan options with an informed consent for each option, pre-treatment estimates in writing, and other documentation essential for meeting the standard of care. Barrett: All too often they ask how much something is going to cost before they even explain what it is they need. They should start by explaining their goals and what they perceive their needs to be as well as what they are trying to accomplish. Then an attorney can render the appropriate advice because they have a chance to ask questions. As far as common misconceptions, I’d say the biggest one is “dealing with an attorney is going to be cost prohibitive.” This is simply not true and also underscores why a dentist should go to an attorney who is an expert in the
industry. An attorney who has that background and experience has a much higher level of efficiency and is therefore going to be more cost effective. Another misconception is you’re going to have to pay hourly rates. Most highly experienced dental attorneys offer fixed fee or capped fee for services because they know what it takes to get the job done.
Q: DO YOU HAVE ANY OTHER ADVICE FOR NEW DENTISTS THAT YOU’D LIKE TO SHARE? Barrett: It’s important to mention that early in your professional life is the best time to assemble a team of professionals who are going to be there to guide you. If you surround yourself with the right team, you can go about doing what you are best at: practicing dentistry. It’s not just about having a great dental specific attorney, but also an accountant, financial advisor, insurance professional, bank, and bank officer who all have expertise and a focus on handling dentists’ needs. That’s the team you need by your side from the start and throughout your career.
Be a
Better
Leader R
unning a successful dental practice takes more than just offering patients topnotch clinical care. Yes, that’s important, but you also have to focus on tackling the business side of practice ownership, from dealing with human resource issues to understanding practice numbers to offering your team members the direction they need to excel.
By Sally McKenzie, CEO of McKenzie Management
Like it or not, you are the leader of your practice. As the practice CEO, your team members look to you for guidance. Without it, they’ll feel lost and your young practice will suffer. While leadership skills don’t come naturally to most dentists, they really are vital to your success. If you focus on becoming a better leader early in your career, your practice will flourish. You’ll have happier team members, higher production numbers and a more robust bottom line. Following these tips will help you get there.
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How can you provide this guidance? Through detailed job descriptions, proper training and continual feedback. Job descriptions serve as a road map to success, letting team members know what they’re responsible for and exactly what’s expected of them. Training makes them more efficient and confident in their roles, while feedback helps them see where they excel and where they could improve. All three combine to create a stronger, more effective team. Communicate. If you don’t talk with your team members about practice goals, how can they help you meet them? It’s important to communicate with your team members regularly about what’s going on in the practice, and to encourage them to come to you with any ideas or concerns they have. Let them know you value their opinion, and take action when they offer recommendations that can help move the practice forward. Hold team members accountable. This can be challenging, but it’s important for team members to know which systems they’re accountable for and exactly what’s expected of them. Duties and expectations should be clearly defined in each job description. It’s also a good idea to have team members give regular updates on their systems during staff meetings. Accountability will help build trust and confidence among the entire staff, helping to avoid conflict and all the problems it brings. Ask questions. A good leader isn’t afraid to ask the tough questions. Take a step back and really look at your practice. Here are examples of questions you should be asking: Have a clear vision. What exactly is a practice vision? It’s the ability to see where you want your practice to be in the future. The practice’s mission, values and overall strategy are all part of the vision. It’s important for you to own the vision and to share it with team members. Tie your vision with practice goals. Make sure employees know how they can contribute to making your vision a reality, and how achieving the vision benefits them. They’ll be much more engaged in practice success, leading to improved performance and higher job satisfaction.
•
What can be improved in the practice?
•
What system is not delivering the results it should? Why?
•
What needs to be changed, adjusted and improved?
Offer guidance. As nice as it would be, your team members aren’t mind readers. No matter how experienced they are or how long they’ve been with the practice, you, the practice CEO, must provide them with proper guidance. Expecting them to figure everything out on their own will only lead to frustration and inefficiencies, which of course damages the practice.
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I also suggest you ask yourself questions regarding your leadership skills, such as: •
Am I communicating a vision for my practice to my staff?
•
Am I doing what I need to achieve my priorities?
•
Do I give my team the tools and training they need to achieve their priorities and help me achieve mine?
•
Do I give employees timely and direct feedback?
•
Can I handle the pressure that comes with leading a team and running a practice? In your answers, go below the surface and determine where you need help. Be honest. From there, take action and start making improvements to your practice and your leadership style.
Supporting your team members and showing them you care will help them excel in their roles while also creating a deeper connection to your practice Recognize employee strengths and weaknesses. All your team members are different, and some are better suited for certain roles than others. For example, if collections are down, it might be because the person you have handling this system isn’t comfortable asking people for money, or prefers to avoid conflict at all costs. It’s important to recognize where employees excel and where they struggle, and to restructure responsibilities to make the most of team strengths. Remember your employees are people. Supporting your team members and showing them you care will help them excel in their roles while also creating a deeper connection to your practice (which helps reduce turnover). Never treat employees like resources or a means to an end. Understand their need for flexibility and a work/life balance. Build trust between you and your team members and always reward them when you see them going above and beyond. Celebrations for a job well done are powerful and will make team members want to continue to excel. Know Practice Indicators. This is an important part of your role as CEO. You should be well versed in all 20 business practice systems. These systems will profoundly impact your success today and throughout your entire career. If you need help, consider reaching out to an experienced dental consultant for guidance. Stay passionate about dentistry. Even when times are tough, it’s important to remember why you decided to become a dentist in the first place. Invest in continuing education that allows you to offer new services to your patients. Attend tradeshows to connect with colleagues and learn about new products that can help you provide better patient care or improve practice performance. Stay excited about dentistry and your team members will too.
Take time for yourself. Owning a dental practice can be stressful at times, and you’ll likely find yourself working long hours. To be an effective leader, you need to maintain a healthy work/life balance. If you don’t, you’re bound to burn out. Make it a priority to take time for yourself, which might mean going on vacation, enjoying a hobby or spending time relaxing with family and friends. Cultivate a leadership mindset. Train your team members to think like CEOs. Ask them to consider what they would do or change if they were in charge, and then encourage them to make recommendations they think will benefit the practice. Create an environment where they’re comfortable expressing their opinions. Even if you disagree with someone’s suggestion, try to build on it rather than knock it down. You’ll constantly hear ideas that can help move the practice forward, and your staff will feel like the valuable practice contributors they are.
The 20 Dental Business Practice Systems • • • • • • • • • • • • • • • • • • • •
Revenue & Production Business Overhead/Profits Scheduling Accounts Receivable Financial Arrangements Billing/Account Collections Fee Schedule Team Management Insurance Handling Job Descriptions Patient Arrival/Dismissal Business Office Work Flow Patient Base Treatment Acceptance Hygiene Department New Patients Patient Retention Communications Intra Office Marketing Communication Tools
Take action. When you notice problems or conflict starting to brew, you can’t sit back and hope these issues go away on their own. They won’t. You need to address them head on before any damage is done. If you’ve noticed tension and gossip among team members, talk to the parties involved to determine the problem and find a solution. Tackle all issues that come up, even if they don’t make you popular. Employees will have a deeper respect for you and each other. As you start your career, the thought of leading a team can be pretty intimidating. It doesn’t have to be. Focus on developing your leadership skills now, and your practice will reap the many benefits of an effective, well managed team.
Sally McKenzie is CEO of McKenzie Management, mckenziemgmt.com, a full-service, nation-wide dental practice management company. Contact her directly at 877-777-6151 or at sallymck@mckenziemgmt.com.
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How the Right CE Courses Can Help Launch Your Career
By Renee Knight, Editor
Arrowhead Dental Lab and the Dr. Dick Barnes Group have been offering courses designed for new dentists for about 10 years. Here’s how the program can help new dentists improve their confidence and grow their practices.
A
fter working as an associate for eight years, Dr. Valerie Holleman decided it was time to open her own practice. That was five years ago, and not long after opening her doors she began looking for continuing education courses that would help get her practice on the right track—and she found that through the Arrowhead Dental Lab and the Dr. Dick Barnes Group new dentist program. She’d heard good things about the courses and certainly wasn’t disappointed when she completed her first class.
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Today, the program consists of five core courses and is targeted at dentists who have been out of school for 10 years or less. Dr. Holleman took six courses and an extra implant course in the span of about two years. Not only was she able to implement what she learned as soon as she came back from the courses, she knew she’d have support from her instructors if she ever had any questions. “All of the reps and the doctors who are part of the program are readily available to you, especially if you show
you really want to make yourself a better dentist and you’re not just in it for the money,” Dr. Holleman said. “I was really surprised by how great the support was. I even called Dr. Barnes to help me through a case, and he called me back to follow up on it. That was really great.”
PHOTO COURTESY OF ARROWHEAD DENTAL LAB
THE PROGRAM Arrowhead started the program about 10 years ago as a way to help new dentists launch their careers, Arrowhead Director of Business Development Peggy Nelson said. A lot of experienced doctors were telling instructors how they wish they had taken their courses 10 years ago, which is what gave Arrowhead the idea to develop a program specifically for new dentists. Young doctors have a lot to learn when they’re just coming out of school and starting or taking over practices, and Arrowhead’s classes are designed to help them be more productive right away. The courses, taught by practicing dentists, are limited to 20 people and take place on Fridays and Saturdays, Nelson said. Dentists can go through the different classes at their own pace, making it easier for them to find time to be part of the program. “We give a systematic approach in each discipline area we teach, so on Monday morning dentists can start practicing differently. That’s our goal,” Nelson said. “They can start speaking to patients differently and treatment planning differently so they can gain success starting Monday morning.” The courses include Full Arch Reconstruction, Total Team Training, Implant EZ I, Everyday Occlusion and AirwayConscious Dentistry. Doctors are also able to substitute courses to fit their needs, Nelson said. If a doctor is already experienced in implants, for example, that doctor would be able to take the more advanced implant course. Investing in CE courses can be difficult for new dentists, Nelson said, which is why Arrowhead offers a cost savings for this program. New dentists no more than 10 years out of school can take the courses for half the price of the normal tuition, making it a lot more feasible financially. “There’s travel involved and dentists have to be away from their practice to take these courses,” Nelson said. “We know there’s a lot in play there, so we give a great cost savings to help offset that.”
THE BENEFITS FOR DR. HOLLEMAN’S PRACTICE While Dr. Holleman has gotten a lot out of the restorative classes she took through the program, she’s seen the biggest benefits from the Total Team Training course, she said. She has taken that course four times, and always brings team members with her. She learns something new during every class, and plans to take it again with new team members in February. “Every time I meet a new dentist or someone just starting out in practice, I push them toward taking this course,” Dr. Holleman said. “It puts the whole team on the same page. I know doctors who go to courses and come back gung ho because they learned so much, but no one else on the team feels the same because they weren’t there. They just feel like, gosh, the doctor is changing things again. With this course, you don’t have to sell them on it because they’ve already been sold. They already believe in it.” One of the first things Dr. Holleman implemented in her practice from the Total Team Training course is what she calls the dental interview. Instead of having patients fill out their own dental history, her Office Manager, who also collects money from patients at the end of appointments, sits down one-on-one with patients to go over the questions. Rather than asking the questions line by line, she has a conversation with patients, helping to build trust and a connection to the practice. This process makes patients feel like everyone in the practice cares, creating that wow experience that helps ensure patients come back and accept recommended treatment. Dr. Holleman and her team members also have learned the right words to use when talking with patients. For example, instead of saying “Can I get you on the schedule” when discussing treatment with patients, it’s better to say something like “When can I get you on the schedule.” You want to ask questions that don’t give patients the option to just say no; you want them to elaborate.
WHY NEW DENTISTS SHOULD CONSIDER THIS PROGRAM Nelson receives feedback from new dentists all the time, letting her know how the courses have helped them grow their practice. Dentists appreciate the intimate, interactive classes that
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often include patients. They have the chance to ask questions and really gain experience, and to develop a rapport with the instructors. And they have access to all this at half the price, making it a great investment. These courses really do help new dentists launch their careers, Nelson said, giving them the tools and techniques they need to provide highquality dentistry to their patients from the beginning. “You learn a lot. I can’t say enough about how it’s helped my practice,” Dr. Holleman said. “These courses help guide you in the right direction.”
INTERESTED IN LEARNING MORE? Visit arrowheaddental.com for more information or to sign up for the program. PHOTO COURTESY OF ARROWHEAD DENTAL LAB
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ASI continued from page 12
Handbook continued from page 14
incremental cost of a properly designed delivery system is insignificant in comparison to the future earning potential of the practice and practitioner.
FINALLY, A FACT: A GREAT EMPLOYEE HANDBOOK IS A FIRM FOUNDATION Your properly written handbook fulfills many functions in addition to protecting you as an employer—but it has to protect you first. Once it’s up to that task, it becomes a sound foundation for running your business. As a new dentist, my best guidance to you is handle this now. To put a good handbook in place, you’ll need to find HR experts you trust. I also want to mention that experts just giving dentists an employee handbook without any guidance on how to use it is a common and terrible practice. There is no way to navigate employment laws without experts you can talk to whenever you need to. Finally, I’d like to extend my own offer to help you find out where you stand now in HR compliance. All readers are invited to claim a free, confidential New Dentist HR Checkup. You can sign up today at cedrsolutions.com/newdentist.
Minimize foot print yet create an open, spacious room. Although the all-in-one chair mounted units have a small footprint, the cabinets around them fill the room and create a closed in space. By using modular designs and turning the chair to a slight diagonal in the room, you can minimize the amount of valuable floor space needed for each treatment room, incorporate modern instrument technology and still create that open feeling your patients desire—and that will also please you and your team members. As we near entering the third decade of this century, it is time to rethink dental instrument delivery and to allow your new practice to benefit from a modern design. John W. McPeek is a former CPA turned entrepreneur. He has started a number of successful ventures and began ASI Dental, a division of ASI Medical, Inc., 25 years ago. ASI Dental has helped numerous dentists by providing equipment solutions that enable them to begin their practice in a cost-effective manner.
Paul Edwards is the CEO and Co-Founder of CEDR HR Solutions (cedrsolutions.com), which provides individually customized employee handbooks and HR solutions to dental offices of all sizes across the United States. He has more than 20 years of experience as a manager and owner, and specializes in helping dental offices solve employee issues. He can be reached at paul.e@cedrsolutions.com.
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What Dentists Need to Know about
IT Security
M
ost dentists don’t put a lot of thought into IT security. Rather than giving it the priority it deserves, they convince themselves they can just call Steve the IT guy when something goes wrong. These days, that isn’t good enough, and is a mentality that will only serve to damage your practice in the long run. As a new dentist, it’s important for you to be aware of the various threats to IT security and how you can mitigate those threats. You also have to recognize the fact that this does apply to you—no matter how small your practice might be. Understanding the risk, partnering with a reliable IT management company and properly training your team in security matters are all ways you can protect your practice and your patients’ information from common threats.
The threats and how to mitigate them There are three main security threats you and your team members should be aware of—data loss, downtime (caused by malware, ransomware, and viruses), and hacking. Let’s take a closer look at each threat and how they can be mitigated: Data loss. When a server that isn’t properly backed up crashes, practices lose data. Often, dentists and their team members believe the server is backed up, but realize that isn’t the case when they try to restore data after it goes down. Investing in a stand by server (also known as a BDR) is 28 THENEWDENTIST.NET W I N T E R 2 0 1 8
By Bryan Currier, CEO of Advantage Technologies
an easy, inexpensive way to avoid this situation. The small server can be brought on line in the event of a primary server crash, ensuring you have access to your data if something happens. It also backs up all of your data to the cloud. When managed by a qualified IT management company, stand by servers are extremely reliable and are a must-have in every practice. The days of losing data to server crashes are long behind us. Using business class servers and workstations from trusted names like Dell and HP will help prevent these crashes in the first place, as will working with an IT company that continually monitors and manages all of your systems. Down time caused by malware, ransomware and viruses. This threat has grown exponentially in recent years. If you or another team member checks personal email on a work computer, it could lead to problems. Let’s say a team member clicks on a link they think is taking them to pay their cell phone bill, but it’s actually a phishing attack that downloads ransomware on the computer. Now your data is being held hostage, which unfortunately is becoming a more common problem in dental practices. Dentists are much more dependent on their computer systems today than, say, 20 years ago. If the computer system went down back then they’d lose their schedule and that was about it. Today, the life blood of patient care runs on technology. The system simply can’t go down because if it does, you can’t make clinical notes, take x-rays or process claims,
to name just a few problems. The financial, relational and clinical elements of a practice all rely on this technology. The question is no longer how quickly can we fix the system if it goes down, it’s how can we prevent it from happening in the first place. The best way is to realize security is a team effort and to provide staff members with proper training. If your system becomes infected with a virus, for example, it’s probably because one of your team members clicked on a link they shouldn’t have clicked on. Train them not to check personal email on work computers and to never click on links they’re unsure of. Technical safeguards, such as anti-malware systems and adding content filtering as part of your firewall strategy, are also musts for every dental practice. Hacking. Everyone is talking about hacking because instances have skyrocketed over the last few years—and it’s not just a problem for big companies like Sony and Home Depot. The number of data breaches against small businesses that hold critical information have gone off the charts. Why? There’s a market for it. The black market is willing to pay for names, addresses, phone numbers, social security numbers, dates of birth and credit card numbers. And what better place to get that valuable information than a dental office’s practice management system? It’s all right there for the taking. The fact the Internet is so much faster now makes it quicker and easier for hackers to access patient information. You can prevent this by making sure you only use secure remote access tools. Don’t store patient information in free sync and storage tools like Dropbox Free or Dropbox Personal. They’re a treasure trove for hackers and have no business in your practice. It’s also vital to have a solid firewall that is continually updated, monitored and managed.
How an IT management company can help Having an IT person on call simply isn’t enough anymore. You really need to partner with an IT management company to avoid breaches and to keep your patient and practice data safe. A good management company will provide you with the following: •
A business class firewall that protects you at multiple levels. It prevents outside attacks, monitors incoming and outgoing traffic for malware, and provides for safe
remote access to authorized employees. A firewall, properly managed and documented by a qualified IT company, is a cornerstone of practical IT security. •
Secure WiFi with segmented guest access for patients that isolates them from any practice information.
•
Antivirus and anti-malware protection for all workstations and servers and documentation that they’re in place.
•
Infrastructure monitoring so they can prevent a failure if they discover a server or workstation isn’t healthy. •
World class customer support that’s easy to access.
It’s best to partner with an IT management company that’s local to your area and that has experience in dentistry. They should not only know what’s required from a technical perspective, but clinical and regulatory perspectives as well. That means having knowledge of HIPAA, HITECH, PCI, and any other regulations you may be subject to. Finally, they should have the ability to develop a welldocumented plan that addresses all the issues I’ve discussed here, and that you can clearly understand.
Yes, it can happen to you Many dentists think their practices are too small to fall victim to these threats. That simply isn’t true. It’s your responsibility to protect patient information, and the best way to do that is to understand the threats and to work with an IT management company that can provide the necessary safeguards. These threats are real. Now, more than ever, dentists need to take the proper steps to keep patient and practice information out of the wrong hands. Eighteen years ago, while still in college, Bryan Currier started Advantage Technologies from his parents’ basement. Since, the team has grown to more than 60 people serving more than 800 clients. The firm has been recognized in multiple trade journals and publications as one of the leading IT firms in the country. Bryan has a bachelor’s degree in business leadership and his IT Security Certification from The Harvard Kennedy School of Business. Bryan and his team work alongside practices to help them safely and effectively use technology to the fullest potential. Bryan and his team can be reached at adv-tech.com or 877-723-8832. Follow Bryan on Instagram @BryanCurrier
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BEEN THERE, Done That
Key Opinion Leader Dr. Sheri Doniger on Getting the Most out of Your Career
W
hen Dr. Sheri Doniger first started college, she wanted to be a teacher. That all changed when she took two jobs to help pay for her education—one in a record store and one in a dental practice. She soon found she loved interacting with patients and being involved with medical treatment. Because of that, she eventually quit her job at the record store so she could spend more time working as a dental assistant, and took her boss’s advice when he suggested she pursue a career in dental hygiene. After completing hygiene school and working as a hygienist for a few years, Dr. Doniger decided she wanted more: she wanted to be a dentist.
Dr. Doniger began practicing in 1983 and over the years has taught in dental schools, worked for dental benefit companies, evaluated products for manufacturers and written for a variety of publications. She recently released a book designed to guide dentists as they open a new practice. While Dr. Doniger doesn’t have many regrets, she does wish she would have opened her own practice sooner and maybe found a partner early in her career, though she loves practicing as a solo dentist. As someone who has been in the industry for almost 50 years, Dr. Doniger has plenty of advice for new dentists on how to build long, satisfying careers, from focusing on developing relationships to maintaining a proper work/life balance.
CREATE A LOYAL PATIENT BASE It’s critical for new dentists to develop a loyal base of patients who accept treatment and refer. That starts by building relationships, Dr. Doniger said. Don’t try to sell patients on expensive dentistry right off the bat. Not only is this overwhelming, it makes it difficult for patients to trust you. “If you’re saying you need, you need, you need, you’ll never keep the patient,” Dr. Doniger said. “That was one of the things I did wrong as an associate. I knew I was only getting paid for the work I did, so I just sort of said you need everything. People don’t want to do everything, and that approach can really turn patients off. Focus on getting them to accept the treatment they need right away and on building relationships. Remember you want to keep patients for life.” FOCUS ON YOURSELF Maintaining the right work/life balance is an important part of a long, happy career. You have to make sure you’re not overworking yourself and your body, Dr. Doniger said. Pay attention to ergonomics, and remember dentistry shouldn’t hurt. If you find your neck or your hands are in pain after a long day, you should do something about it, whether that means investing in more ergonomic products or adding specific exercises to your routine. It’s also important to leave your work at the office, Dr. Doniger said. Use your off hours to spend time with friends and family, or to relax enjoying
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“If you’re saying you need, you need, you need, you’ll never keep the patient.” one of your favorite hobbies. And don’t forget to take care of yourself. Get your own teeth cleaned, keep your doctor appointments and always remember it’s OK to say no if you’re asked to work during your time off, especially if you know you need the break. “Saying no is difficult to do but it’s an important piece to maintaining a work/life balance,” Dr. Doniger said. “The dentistry will be there, but if you’re working when you’re sick, injured or stressed, it’s not going to be good.” Volunteering is another way to do something good for yourself and your community, Dr. Doniger said. While you can offer your services for free from time to time as a way to give back, it’s also a good idea to take on roles that have nothing to do with dentistry. Dr. Doniger has spent time volunteering on her community’s library board as well as the high school board, for example.
FIND MENTORS Without the periodontist who supported and encouraged Dr. Doniger to go to hygiene school, she never would be where she is today, she said, which shows just how valuable mentors can be early in a career. Remember mentors don’t have to be dentists. Other professionals also can help guide you, as well as friends and acquaintances in your personal life. Surround yourself with people who push you and encourage you in all aspects of your life—and be sure to play that same role for others. Taking CE courses also can help you find a support system, Dr. Doniger said, and is important for both you and your team. If money is tight, there are a variety of free classes you can take, helping you to expand your knowledge and become more comfortable performing various procedures. PRODUCTS TO INVEST IN One of the first products Dr. Doniger suggests investing in is an intraoral camera. You can find entry level versions on Amazon or purchase a more robust model like the CamX Elara from Air Techniques, which is what Dr. Doniger uses in her practice.
“Nothing will improve your bottom line more than the interpersonal relationships you have with your patients and your intraoral camera,” she said. “When you show people what they have going on in their mouths they think ‘oh my, I need to get that fixed. That’s really gross.’ It’s great for patient education as well as documentation.” Dr. Doniger also recommends investing in the Isolite system, especially if you practice alone, a reliable practice management software system and comfortable seating, like the Saddle Stool from Crown Seating.
A SATISFYING CAREER Dr. Doniger loves practicing dentistry, and even still does her own hygiene because she enjoys it so much. If you follow her tips, you’ll stay passionate about dentistry and be well on your way to a long, rewarding career as well.
Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. Her book, “Practical Practice Solutions in Dentistry,” focuses on building practice success. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, speaks internationally on a myriad of topics, and writes for several dental publications. She is a past president of the American Association of Women Dentists. You can reach her at donigerdental@aol.com.
Interested In Reading Dr. Doniger’s Book? “Practical Practice Solutions in Dentistry” covers a variety of topics including negotiating leases, hiring and team training, and billing and dental coding. It is available by emailing orders@pmphusa.com or calling 855-890-3365.
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SKINNY
on the Street
The latest news on products and services for new dentists and their practices Meron Plus QM Resin-Modified Glass Ionomer Cement in VOCO’s QuickMix Syringe
How To Hire The Best Dental Employee: A Dentist’s Guide to Effective Interviewing
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A complete guide to help dentists in hiring new How To Hire employees. Includes: The Best developing a job Dental Employee description, advertising, reviewing the resumes, initial telephone Recruiting • Interviewing screening, the interview process, the application form, asking the right questions, testing applicants, and checking references. The manual includes ads that generate responses, a ready-to-use application form, more than 100 questions designed specifically for business, hygiene, and clinical assistants positions, as well as competency tests. By Sally McKenzie , CEO
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PHOTO COURTESY OF CONVERGENT DENTAL
PHOTO COURTESY OF MCKENZIE MANAGEMENT
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