2014 August WSDA News Issue 8

Issu

WSDA 014 t 2 gus · au e8

The voice of the Washington State Dental Association

news

2014 CITIZENS OF THE YEAR Drs. Amy Winston & Bart Johnson th e wsda ne w s · issue 8, august · 2014 · www.wsda.org · 1

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Dirty work: Photographer Scott Eklund lays down in the foliage to get the cover shot of Drs. Amy Winston and Bart Johnson

WSDA news Cover story by Rob Bahnsen Cover story photos: Scott Eklund/Red Box Pictures

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editorial

5 newsflash 6-7 8-14

legislative news hod candidates/resolutions

16-25

cover story

26-31

corporate practices

32-35

member news

38-39

wohf news

issue 8 · august 2014

41

in memoriam

42-45

new ideas: recycling waste

49, 51, 53

classifieds

50

membership marketplace

54

parrish or perish

Like us on Facebook: www.facebook.com/WashingtonStateDentalAssociation WSDA News Editor Dr. Mar y Jennings Editorial Advisor y Board Dr. Victor Barry Dr. Richard Mielke Dr. Jeffrey Parrish Dr. Rhonda Savage Dr. Robert Shaw Dr. Mary Krempasky Smith Dr. Timothy Wandell Washington State Dental Association Dr. David M. Minahan President Dr. Gregory Y. Ogata, President-elect Dr. Bryan C. Edgar, Vice President Dr. D. Michael Buehler, Secretary-Treasurer Dr. Danny G. Warner, Immediate Past President Board of Directors Dr. Theodore M. Baer Dr. Dennis L. Bradshaw Dr. Ronald D. Dahl Dr. Christopher Delecki Dr. Christopher W. Herzog Dr. Gary E. Heyamoto

Dr. Dr. Dr. Dr. Dr. Dr.

Eric J. Kvinsland Bernard J. Larson Christopher Pickel Lorin D. Peterson James W. Reid Ashley L. Ulmer

Senior Vice President of Government Affairs Bracken Killpack

Association Of fice: (206) 448 -1914 Fax: (206) 443 -9266 Toll Free Number: (800) 448 - 3368 E- mail: info@ wsda.org/w w w.wsda.org

Art Director/Managing Editor Robert Bahnsen

In the event of a natural disaster that takes down the WSDA web site and email accounts, the WSDA has established a separate email address.

Should an emergency occur, members can contact washstatedental@gmail.com.

WSDA Staff: Executive Director Stephen Hardymon

Manager of Continuing Education and Speaker Ser vices Craig Mathews

Senior Vice President/ Assistant Executive Director Amanda Tran

Government Affairs Coordinator Michael Walsh

Vice President/Chief Financial Officer Peter Aaron General Counsel Alan Wicks Vice President of Operations Brenda Berlin Vice President of Communications Kainoa Trotter

Public Policy Coordinator Emily Lovell Membership Manager Laura Rohlman Exhibits and Sponsorship Ser vices Coordinator Katie Olson Bookkeeper Joline Hartman Office Coordinator Gilda Snow

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The WSDA News is published 8 times yearly by the Washington State Dental Association. Copyright © 2014 by the Washington State Dental Association, all rights reserved. No part of this publication may be reproduced without permission of the editor.

Statements of fact or opinion are the responsibilit y of the authors alone and do not express the opinions of the WSDA, unless the Association has adopted such statements or opinions.

Subscription price is $65 plus sales tax per year for 8 issues of the News. Foreign rate is $97.92 per year.

Advertising is published as a service to readers; the editor reserves the right to accept, reject, discontinue or edit any advertising offered for publication. Publication of advertising materials is not an endorsement, qualification, approval or guarantee of either the advertiser or product. Communications intended for publication, business matters and advertising should be sent to the WSDA Office, 126 NW Canal Street, Seattle, Wash.

98107. ISSN 1064-0835

Member Publication American Association of Dental Editors. Winner: 2013: Journalism Award, Platinum Pencil, 2012: Journalism Award, Best Newsletter, Division 1, 2012: Platinum Pencil Award Honorable Mention (2), 2008: Best Newsletter, Division 1, 2007 Platinum Pen Award, 2006 Honorable Mention, 2005 Platinum Pencil Award, 2005 Publication Award; International College of Dentists

table of contents issue 8, august 2014

a day in the life

editorial dr. mar y jennings

Examining corporate practices Once upon a time in my quixotic dental career, my shiny new clinic director (who had never worked in a health care clinic) decided that he and I would have a meeting each Wednesday to go over any treatment plans that struck the new receptionist (who had never worked in a dental clinic) as peculiar.

At our first meeting, he told me he was banning me from referring patients to specialists. Referring to specialists, he opined, reduced the revenue stream and was the sign of a weak and incompetent dentist.

I explained my legal and ethical need for referral. I explained that it was illegal for him to make decisions reserved for licensed dentists. He lost his temper and called me insubordinate. I agonized, kept a cool head, and tried hard to communicate. There was much at stake. Then I thoughtfully quit.

To me, that situation exemplifies the dark side of corporate dentistry. The side where well intentioned, but bull headed and ignorant administrators interfere with a dentist’s ethical treatment of patients and, subsequently, the dentist’s life and livelihood.

It shouldn’t take a dentist going through an acute, degrading experience for dental leaders or our legislators to realize that non-dentists managing dental clinics is a poor proposition. That is why Washington State law mandates that only Washington licensed dentists can own a dental clinic.

There are dental clinics in Washington that may not be in complete compliance with the law. I find that alarming. So does the WSDA Board of Directors. At our June 20th board meeting, the directors voted to file a complaint with the Dental Quality Assurance Commission and the Washington State Health Department against both the corporation and the owner/dentist of two Pacific Dental Service offices. The concern is, in brief, whether the dentist/owner truly meets the definition of ownership of those practices.

Is the WSDA opposed to all corporate practices? If the practice is not owned 100 percent by a dentist, the answer is yes. The WSDA is clear about the difference between dentist-owned and illegal corporate practices in the state. Rest assured that our board knows that people like me enjoy working in a Community Health Center (which is similar in structure to a corporate practice) and that legal corporate practices can be a very good career choice for dentists.

If you are in a corporate practice, you should understand that the WSDA may have concerns about the legality and ethics of your practice. There are many stories like mine regarding clinic administrators forcing unreasonable production quotas, pushing more expensive restorations on our patients, and not being careful stewards of patients or dental providers — in practices that are completely legal. I am sure you have heard those stories.

There are clinics that burn dentists up. Clinics that, I suspect, both realize and perhaps capitalize on the fact that the dentist alone bears the legal brunt of any harm that comes to a patient, regardless of whether it was caused by a policy or procedure the corporation mandated. There is particular concern for our young dentists who carry such heavy debt.

The leaders I know in organized dentistry do not want our young peers to feel compelled to stay in a clinic that pushes them to make questionable choices to stay afloat financially.

I am glad that clinics such as the one I worked in are being scrutinized. That clinic director was not the only administrator who gave me hell for something completely irrational to a dentist’s mind. I am acutely aware that I work at the grace and favor of my employer and that I am replaceable. My career has been a long, and sometimes rough, study in patience and humility in order to serve the population I love.

I am glad the WSDA is filing this complaint. To me, it is the beginning of a conversation to make sure corporate practices tow the line in putting patients and people before profit.

That truly is the cutting line that makes dentistry a profession not just another job. While many corporate practices have a defined code of conduct, those good intentions often get sidelined in the daily grind of making production and profit. That holds especially true when the dentist owner is not physically present in the office to set the professional tone and adjudicate daily clinic issues.

I want organized dentistry to help all dentists and patients with their problems. Not just the ones in private practice. I think it is past time to shed light on corporate practice issues and develop clinics that we can all be proud of.

So please join in the conversation. We are listening and working for you. The debridement of poor practice policies helps everyone. If you are seeking employment in a corporate practice, ask questions about ethics, autonomy and production. Get everything you can in writing. Use your amazing ADA and WSDA member benefit of contract analysis.

And finally, always keep a little extra cash at the ready to allow you the flexibility to part company, just in case someone demands you do something you simply cannot abide.

Dr. Mary Jennings Editor, WSDA News

“There are dental clinics in Washington that may not be in complete compliance with the law.

I find that alarming. So does the WSDA Board of Directors. At our June 20th board meeting, the directors voted to file a complaint with the Dental Quality Assurance Commission and the Washington State Health Department against both the corporation and the owner/dentist of two Pacific Dental Service offices.”

Dr. Mary Jennings, WSDA News editor, welcomes comments and letters from readers. Contact her at her email address:mjenningsdds@gmail.com.

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Mark your calendars now and be sure you are in Olympia for this year’s Dental Action Day on February 20, 2015. The 2015 Legislative Session will feature many important issues that could impact the future of the dental profession. Be part of the discussion about dentistry in Washington state and have your voice heard by attending Dental Action Day 2015.

More information regarding event logistics and registration will be sent out in the coming months. Please direct any questions about DAD 2015 to WSDA Government Affairs Coordinator, Mike Walsh at (206) 448-1914 or by email at mike@wsda. org. We hope to see you in Olympia on February 20, 2015!

PNDC Emerald City Lecture Series now Accepting Applications

Do you have an exciting topic that you would like to share with the Washington dental community? The Emerald City Lecture Series is a great platform which has evolved into an extremely popular and competitive program highly anticipated by PNDC attendees. Many of our past Emerald City Lecturers are now regular speakers at the PNDC and dental meetings across the country.

To apply, visit: http://www.wsda.org/ emerald-city-lecture-series.

Oral Cancer Walk

The 3rd Annual Oral Cancer Foundation Walk/Run for Awareness of Seattle, Washington will take place on Saturday, October 11, 2014 at Seattle’s Magnuson Park!

Registration and event information can be found at online at http://donate.oralcancer. org /index.cfm?fuseaction=donorDrive. event&eventID=604.

Online registration closes at 12 p.m. on Friday, October 10. After October 10, please register in person the morning of the walk with cash/check/money order made payable to The Oral Cancer Foundation. There will be free oral cancer screenings, speakers and music, and goodie bags for the first 300 participants to arrive on event day!

New Resources On Emailing Patient Information

Member dentists with questions about transmitting patient information via email can turn to a new ADA resource (ADA log in required), developed in cooperation with the New Jersey Dental Association, entitled Emailing Patient Information: A

Resource for Dental Practices. Because the use of electronic means for the communication of such information is the subject of specific HIPAA regulations, this resource is a helpful means of advising dentists about the issues that they may face.

The resource, which contains sample forms, addresses such topics as: • Emailing patients • Emailing radiographs to a specialist • Encryption • Breach notification When it comes to utilizing email, every dental practice must decide for itself how best to meet patient needs in compliance with applicable regulations. These resources provide information that can help dentists better understand the legal issues and options. Access the emailing patient information resource.

CDE FAQs

According to state regulations, Washington dentists are required to complete 21 clock hours of continuing education every year as part of the dental license renewal process. In Washington state, dentists are required to renew their dental license before their birthday. The following are frequently asked questions about continuing education and licensure renewals. Please refer any additional continuing education questions to Mike Walsh at michael@ wsda.org.

How do I demonstrate that I have completed my continuing education requirement?

If you renew your license through the mail, you must sign and date a box on the renewal form where you attest that you have completed all of your continuing education requirements. In the past, this attestation box was located on the back page of the renewal notice. WSDA worked with the Department of Health and was able to get this attestation box moved to the front of the renewal form below where the payment information is listed. WSDA advocated for this change to help ensure all dentists successfully renew their licenses on time.

For online renewals, the attestation is a required field that must be completed before the renewal can be successfully submitted. Visit: http://www.doh.wa.gov/ LicensesPermitsandCertificates/ProfessionsNewReneworUpdate/LicenseRenewals for more information on online renewals.

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How does the Department of Health enforce continuing education requirements?

Every month, the Department of Health randomly selects between 10 and 30 dentists who have renewed their license in that month and asks them for their continuing education documentation from the previous year. DOH then reviews the course documentation to ensure it is in compliance with the regulations. According to DOH data, just under 20 percent of audited documentation is not in compliance. Dentists who are found not to be in compliance are required to submit their CE documentation to DOH the following year.

How can WSDA help keep me in compliance with the continuing education requirements?

Dentists can complete up to 16.5 of their required 21 continuing education hours by attending WSDA’s annual Pacific Northwest Dental Conference.

If any of your CE was completed at the PNDC, a component society event, or any other event where you scanned your WSDA membership card through a WSDA scanner, then the only documentation you need for these CE credits is a printout of your CE credits from The Source. To access your CE records, login using your last name and your WSDA or ADA ID number and select “Continuing Education Credit Tracking.” On this page, all of your credits tracked through a WSDA CE scanner will be recorded in one section and all of your manually entered CE will be recorded in a separate section. CE that was not tracked through a WSDA scanner will require additional documentation such as a paper certificate of completion.

Do you have an exciting topic that you would like to share with the Washington dental community? The Emerald City Lecture Series is a great platform which has evolved into an extremely popular and competitive program highly anticipated by PNDC attendees. Many of our past Emerald City Lecturers are now regular speakers at the PNDC and dental meetings across the country. Apply here: http://www.wsda. org /storage/2015-pndc/2015%20Emerald%20City%20application.pdf

newsflash dental action day, oral cancer run, and more!

Save The Date: 2015 Dental Action Day

legislative news van de wege fundraiser

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A friend of dentistry gets a boost from the WSDA

Dentists from around the state came out to show their support with their thanks and their wallets at a recent fundraiser for Rep. Kevin Van De Wege (D) held at the Hood Canal home of Steve and Sandy Hardymon. More than $5,000 was raised to support Van De Wege’s bid for re-election. Special thanks go out to organizers of the event: Drs. Todd Irwin, Douglas Walsh, and Tim Wandell Representative Van De Wege was first elected to the legislature in 2006 and is in his fourth term in the House of Representatives.

As Majority Whip, he is one of the highest ranking Democrats in the House and is also a member of the House Health Care & Wellness Committee. In his time on the Health Committee, Representative Van De Wege has been strong advocate for the dental profession and defended WSDA’s positions on several significant legislative issues.

This fund raising event for Representative Van De Wege is one of several events that will be held by WSDA grassroots dentists before the November election. If you would like to be involved in fund raising for legislative candidates or host an event for your local representatives, please contact Michael Walsh at (206) 9735216 or email Mike at mike@wsda.org.

Upcoming events

On Tuesday, September 9, Dr. John Lo will host a fundraiser for Senator Steve O’Ban (R). Senator O’Ban was elected to the House of Representatives in 2012 and appointed to the Senate after only six months in the legislature. Since taking office, Senator O’Ban has been a strong proponent of education and the small business community having been endorsed by the National Association of Independent Business. To attend, please contact Michael Walsh at (206) 973-5216 or email Mike at mike@wsda.org.

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legislative news van de wege fundraiser

VAN DE WEGE FUNDRAISER

2014 hod how the house works

WSDA House of Delegates — Your governing body The WSDA House of Delegates will be held this September 18-20 in Vancouver, Wash. The House is the legislative body of the WSDA, with full authority to direct and regulate the Association activities within the provisions of the Articles of Incorporation and Bylaws.

The WSDA House of Delegates is similar to the US House of Representatives, with delegates from each component society representing their constituency at the annual event. Delegates vote on resolutions, elect officers, board, committee members, and delegates to the American Dental Association House of Delegates. The House adheres to parliamentary procedure, with a Parliamentarian on hand to ensure compliance, and a Speaker of the House to maintain order.

House duties include election of officers, Board of Directors and elective committee members; determination of the time and place of the House of Delegates; receipt and passing reports from officers, standing committees and task forces; the approval of a budget as submitted by the Budget and Finance Committee; and other such duties as provided in the WSDA Bylaws. Once the business of the House of Delegates has been completed, the Board of Directors has general supervision of the business of the Association and is charged with implementing the decisions of the House. The Executive Director is charged with the day-to-day management of the Association, and with ensuring that the wishes of the House of Delegates and the Board are carried out.

Additionally, the House votes on any number of resolutions, which can come from a variety of sources. As outlined in the Bylaws, resolutions may only be submitted by the following: the individual officers of the WSDA, a standing committee or task force of the WSDA, a component society of the WSDA, a petition signed by ten members of the WSDA, or the Board of Directors of the WSDA. Resolutions have to be submitted 30 days prior to the House, although provisions exist which allow for resolutions to be added from the floor.

House activities, by day Thursday

On Thursday, the House opens with a critical issues forum, where selected issues or resolutions facing the Association are discussed. This forum includes a presentation of the budget by the chair of the Committee on Budget and Finance and the Secretary-Treasurer. Immediately following the critical issues discussion, a candidate forum is held for board, Committee and ADA delegate positions. The candidates running for office are given an opportunity to speak to the House. This ends the first day.

Friday

Delegates must register in the morning, followed by the First Business Session, which includes introductions and welcome speeches, the establishment of rules for the House, presentations and reports given by officers, the Washington Oral Health Foundation (WOHF), the Washington Dentists’ Insurance Agency (WDIA), the Northwest Dentists Insurance Company (NORDIC), University of Washington School of Dentistry, the Pacific Northwest Dental Conference, and others. It is during the Friday session that candidates for officer positions debate.

Later, the Reference Committees hold hearings where delegates are encouraged to discuss all resolutions before the House, and to make recommendations for amendments or changes when warranted. The primary duty of a Reference Committee is to recommend to the House of Delegates an appropriate course of action on the matters that have been placed before it.

Following the hearings, Reference Committee members meet privately for further discussion, fulfilling their obligation only when they take into consideration all of these factors and advise the House to adopt, amend, postpone, or reject a recommendation which has been placed before them. Each Reference Committee then creates a report that is made available to delegates later that evening.

Saturday

Delegates register in the morning before the Second Business Session begins. The election process begins with a review of the candidates nominated at the first business session. At this time, the House can entertain nominations for additional candidates from the floor, followed by the elections. Then, Reference Committees present their reports to the House, and discussion/debate regarding resolutions is allowed on the floor. Following the discussion, resolutions are voted on, officers are sworn in and the business of the House ends.

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2014 hod how the house works

2014 HOUSE OF DELEGATES How the WSDA’s governance system works

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2014 hod candidates

Candidate for President-elect

International Congress of Oral Implantologists Fellow Academy of Microscope Enhanced Dentistry member Education DDS, UWSoD, ‘76 General Practice Residency Certificate, Irwin Army Hospital, ‘77 Other Misch Institute, Fellow Kois Center Mentor AGD Lifelong Learning & Service Award

Dr. Bryan Edgar As I travel around the country, it becomes obvious that WSDA is a special association to be part of the governance. We have a great Board that seems to get better every year. Our accomplishments in laying the groundwork for future members and leaders to follow is well recognized by some of our recent successes. Not only have we made bold moves in securing the financial underpinnings of our association with the purchase of our own building and creating a partnership in owning the Nordic insurance company, but we have lead the country in technology development, member services, a best-of-class news magazine, web-based services and a stellar dental meeting. I wish to continue on this journey to progress to the position of WSDA President-elect.

My vision for WSDA, is to build our future as an association by developing new ways to serve the members, beginning with the first year of dental school. This year’s successes in Olympia were partly due to the success of the Dean of the School of Dentistry supporting getting involved. Issues for new dentists include student debt, corporative dental practices, problems with licensure, insurance company reimbursement practices and dental therapists to name a few. We must develop new strategies to address these challenges. With your help, I believe WSDA has a bright future. I ask for your support to help me serve you in developing this vision. Thank you.

Candidates for Board of Directors

Professional Affiliations ADA AGD Pierce County Dental Society Pierre Fauchard Society International College of Dentists Education BS Zoology, WSU, ‘79 DDS, Loyola University – Chicago, ‘86.

Other Boy Scouts of America, Asst. Scoutmaster, ‘03 - ‘13 Seattle Classical Guitar Society

Dr. Ted Baer

Former Positions WSDA, Secretary-Treasurer, six years ADA, Council on Ethics, Bylaws & Judicial Affairs, four years ADA CODA, member & Chair, four years SKCDS, President UW School of Dentistry Dean’s Search Committee

I believe in the vital importance of organized dentistry. Over the past three years, it has been a privilege to serve on the WSDA Board of Directors. Having started several large projects, I would deeply appreciate the opportunity to focus on them.

Organized dentistry, like most other associations both professional and nonprofessional, is at a crossroads. Diminishing membership, increased competition for attention, demand for more value, generational differences, and technical advances have created challenges for all associations.

We are struggling for relevancy at a time that demands it the most. External forces shaping our profession have never been as crushing. Our unified voice has never been as important as now.

In Washington State, thanks to the hard work of many, especially the WSDA staff, we have held our own, but it has not been easy with several body blows from external factions. During my recent tenure on the board, it was my honor to chair the task force on recruitment and retention.

This entailed “going to school” on what factors are curtailing organized dentistry’s growth, what groups are missing, and why.

In short, we need to be more inclusive. We need to be the one umbrella that covers all dentists, regardless of their other worthy affiliations.

My passion is identifying and developing young leaders. I have more work to do.

It would be an honor to continue serving you. I respectfully ask for your vote.

Professional Affiliations American & International Colleges of Dentists Fellowships Pierre Fauchard Academy Fellow Academy of Dentistry International Fellow

Current Positions WSDA – Board of Directors, ‘12 to present ADA – Alternate Delegate, ‘13 to present PCDS – Publications Committee member; ‘99 to present

Current Positions WSDA, Vice-President, one year ADA, Delegate AGD, Investment Committee, seven years AADB, Parliamentarian, ten years

Former Positions WSDA – Chair, Recruitment & Retention Task Force, ‘13 WSDA – Well-being Committee Member, ‘99 -‘02 PCDS President, ‘10

Dr. Marissa Bender Since I joined organized dentistry 13 years ago, I have been an active participant, starting locally and working my way to the WSDA. Joining the first class of WSDA’s Leadership Institute reinforced my belief that this organization was well-run and very efficient. I saw this when I became a member of the Budget and Finance Committee. We have been excellent stewards of our organization’s finances and will continue to work for the good of all our members. I believe our WSDA, through its leadership and staff, are dedicated, motivated and thorough. All these years, they have steered us away from potential economic and legislative disasters. However, we are anticipating a change at the helm of our leadership structure. In order for us to continue being proactive and useful, we need to know that the hard work and progress we have made thus far are not in vain.

This is why I am running for the Board of Directors. I want to be a part of the team that guides the new Executive Director and helps ensure a seamless transition so that our goals and objectives are met. I have faith that our Board will do a fine job throughout this process. I also believe that the unique skills and attributes I bring to the table will definitely benefit the team.

Knowing that there is always room for improvement, I will help look for ways to increase our efficiency and constantly strive for the best. Please vote for me. Thank you.

Current Positions Treasurer – Snohomish County Dental Society

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Walla Walla Valley Dental Association Pierre Fauchard Society

Former Positions Participant , WSDA’s Leadership Institute Snohomish County Dental Society, President Snohomish County Dental Foundation, Member, Executive Committee WSDA - Delegate

Education DMD, University of Oregon Health Science Center, ‘76

Education DDS, University of Oklahoma, ‘95 BS, University of Oklahoma ‘90 Other Toast Masters International, ‘06 - present

Other Past Academy of General Dentistry member

Professional Affiliations Snohomish County Dental Society Fellow, Pierre Fauchard Academy American Dental Society Academy of General Dentistry Washington Academy of General Dentistry Education DMD, University of Pennsylvania, ‘01 MBA, City University of Seattle, ‘96 Other Cagayan Valley Association of Washington State, President, two years

Dr. Douglas Coe So you always ask yourself “What can

I bring to the table” that will benefit the WSDA Board of Directors?

Maybe it is the perspective of 38 years of dentistry practiced in the rural setting of SE Washington, or maybe it is the experience of working with the National Indian Health Service, or maybe it is my volunteerism in doing dentistry. All of these things are important to my views on the issues at hand. I would like to pursue and help implement alternative reimbursement for dental services. I would like to provide direction to the possibility of midlevel providers with insight from working within the Indian Health Service. I would like to provide direction to the issue of corporate dental practices. And with over 30 years in private practice in rural Washington state, I can provide this perspective.

Dr. James Reid Dr. Mostafa Norooz My name is Mostafa Norooz, DDS, FAGD, FICOI, I am running for director position of WSDA board of directors. I have been involved with organized dentistry since dental school over twenty years ago. I have been in many leadership positions in the past with successful track record. My last post was presidency of Pierce County Dental Society. During my term, we were able to keep a healthy budget, increase the membership, and maintain energy and cohesiveness in our society.

I realized we have entered a new era of dentistry with growth of corporate dentistry, economic challenges, and social media. Each one of these elements could pose paramount challenges to our profession. I have been in private practice all of my career and know the challenges that are facing us every day.

At the same time that I am a team player, I am an independent thinker and a diplomat. I am not a “rubber stamp” of others’ ideas, however.

I would like to ask for your support and vote. I would be delighted to talk to you any time should you have any comment or question.

Current Positions WSDA, member, Committee on Budget and Finance PCDS Immediate Past President PCDS delegate

Current Positions House of Delegates Representative, eight years Walla Walla Valley Dental Society Peer Review, 10+ years Volunteer dentistry with Medical Teams International, 12 years

Former Positions PCDS President PCDS Vice President PCDS Treasurer PCDS Secretary PCDS Trustee

Former Positions Past President, Walla Walla Valley Dental Society Private practice, 28 years

Professional Affiliations Tripartite member with WSDA Fellow of Academy of General Dentistry Fellow of International Congress of Oral Implantology Fellow Doctors Organization of Conscious Sedation Member of Academy of Oral Implantology

Professional Affiliations ADA WSDA

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I believe in WSDA and am very proud of the good works that this organization accomplishes on behalf of member dentists.

I also have a strong belief in serving organized dentistry and throughout my career have consistently served in a number of capacities on Foundation Boards, Boards of Directors, and committees for component and state dental associations. Currently, I represent WSDA as a member of the Board of Directors, SKCDS as a member of the Executive Council, and have most recently completed service as past President of WDIA Board of Directors and as a SKCDS Delegate to the WSDA. In the ensuing years, WSDA and organized dentistry will face a number of challenges.

On an organizational level, the WSDA Board of Directors will be instrumental in implementing and ensuring a smooth succession of our executive director and current lobbyists. Also a vital component of a strong organization, WSDA will continue to emphasize membership; creating a strong grassroots community of all member dentists and supporting advocacy on behalf of that community. Important issues effecting dentistry in our State include reimbursement for non-covered services and related insurance reforms, corporate dentistry, and legislative pressure to establish mid-level providers. As a member of the Advisory Board to LifeMap, I look forward to overseeing the implementation, policy making and ongoing operations of the Dollar-Based Insurance Plan, LifeMap. I pledge to do my very best to represent the dentist of Washington State. Thank you for your support of my candidacy for the WSDA Board of Directors.

Current positions WSDA Board of Directors, ‘13-present Seattle King County Dental Society, ‘81 - present Executive Council, ‘12 - present

2014 hod candidates

Member, Budget and Finance Committee - WSDA Head Lector – St Pius X Church

2014 hod candidates

Candidates for Board of Directors Dr. James Reid, cont.

Former positions Board of Trustees, President Washington Dental Service Foundation Board of Directors, Chairman Northwest Community Bank Board of Directors Physicians and Dentist’s Credit Bureau, Inc. Board of Directors, President - WSDA Services, Inc./ Washington Dentists Insurance Agency Board of Directors, Dean’s Club University of Washington School of Dentistry Professional Affiliations WSDA, ‘81 - present ADA, ‘76 - present Washington State Association of Endodontists, ‘81 - present American Association of Endodontists, ‘80 - present Pierre Fauchard Academy, ‘09 - present Education BS, Zoology- Washington State University, ‘68 - ‘72 DDS, UW School of Dentistry ,‘72 - ‘76 U.S. Public Health Service Hospital Residency USPHS Hospital, New Orleans, LA, ‘76 - ‘77 USPHS Hospital Clinic, Lewisburg, PA, ‘77 - ‘78 CAGD,Certificate of Advanced Graduate Study in Endodontics,Boston University, ‘78 - ‘80 DScD, Doctorate of Science, Dentistry/Histology, Boston University, ‘78 - ‘80

Candidate for Committee on Budget and Finance

school. I am loyal to the WSDA and to all those who have mentored me along the way.

I am committed to its success.

The WSDA’s Committee on Budget and Finance plays a critical role in maintaining the association’s relevance and importance and advancing our profession. Our profession will face many challenges ahead. My desire is to serve our professional association and help ensure its financial stability for the years to come.

Education DDS, UWSoD, ‘77

Current Positions WSDA Leadership Institute Participant, present Kitsap County Dental Society – Executive Committee, ‘07-’14 WSDA Delegate, ‘13 – ‘16 USAF Reserves, 446th AMDS – Staff Dentist Former Positions KCDS – President, ‘10-’11 WSDA Midlevel Provider Taskforce - ‘08 ADA ADPAC Board of Trustee, ‘01-’03 WSDA Student Delegate, ‘01 and ‘02 ADA Student Delegate, ‘02 Professional Affiliations ADA, member WSDA, member Kitsap County Dental Society, member AGD, member USAF-Reserves Medical Corps Education Executive MBA, UW, Foster School of Business, ‘13 DDS, UWSoD, ‘03 BS Biology and Finnish, UW, ‘99

Candidates for Committee on Government Affairss

Dr. Nathan Russell Thank you for your consideration as a nominee for the WSDA Budget and Finance Committee.

I have been in private practice for nine years with three years prior active duty military service in the Air Force. I maintain my military status as an active traditional reservist.

I recently received my Executive MBA from the University of Washington Foster School of Business. My interests and favorite courses were in Finance and Financial Accounting. As dentistry and the role of professional associations continue to change, the WSDA has a charge to maintain its relevance and be the voice of dentistry in Washington State.

Maintaining the WSDA’s financial strength is crucial to the success of our association. I have been involved with the WSDA in some way or another since my first year of dental

Former Positions President-elect, SDDS Secretary, SDDS WSDA Delegate (HOD) WSDA Member Benefits Committee

Dr. Thomas Natale

As a 37 year member of the WSDA I welcome the opportunity to serve and help out in any and all ways that I am able. I have enjoyed learning about the legislative process and participating in the HOD as well as our component society. (Snohomish County) There is an ongoing need for all of us to maintain and improve not only the general state of health in Washington State but also to further the ongoing improvement of the WSDA. Toward that end I place myself at your direction should you want my services.

Thank you for considering my election.

Dr. Miki Suetsugu I am running for a position on the Committee of Government Affairs. My interest in the position first began when I met with legislators in Olympia during the last two Dental Action Days. I spoke to several of them about our role as dentists in improving the oral health of our patients in our communities. I feel, as both a mother and a dentist, we need to protect our profession to pave the way for our future generations.

I am currently fortunate enough to be one of three chosen in the ‘14 Leadership Institute through WSDA. Thus far, l have attended DentPAC meetings and the board of directors meetings at the WSDA headquarters and have been learning much about how our organization is run.

As an active member for the past 10 years for the SKCDS, WSDA and ADA, I am dedicated to our organization. Through the Committee on Government Affairs, I intend to contribute my ideas, communicate with legislators, and do my part in continuing to improve our practice as dentists.

Current Positions Ambassador Committee, three years Peer Review Comittee, two years Budget & Finance Committee, one year Co-Chair, Women in Dentistry Committee, one year Professional Affiliations SKCDS ADA Eastside Women Dentist Study Group.

Tufts University Alumni Club of Puget Sound Duke Universify Alumni Club of Puget Sound Education DMD, Tufts University School of Dental Medicine, ‘04 BS, Duke University, ‘97 Renton High School graduation certification, ‘93 Seattle Japanese Language School, graduation diploma, ‘90

Current Positions President, SDDS

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Dr. Sammy Pak

Organized dentistry is important to me for a variety of reasons. The landscape of dentistry is changing and will continue to change and organize dentistry needs to help shape it. There will be more pressure from local/ federal governments and third party payers that will make all of us evaluate how we function with new health reforms. Preservation and status quo will not be the answer for dentistry. I would like the opportunity to help maximize the health of current and future dentists as your delegate to the ADA House.

Current Positions ADA- Council on dental benefits, year two of four ADA, Subcommittee on dental codes, second year PCDS, Past President Former Positions PCDS, President PCDS, New Dentist Chair WSDA, Dentpac Professional Affiliations ADA Washington State Dental Association Pierce County Dental Society Pierre Fauchard I.C.O.I Education DDS, Loma Linda University Dental School, ‘99

years, I have been actively involved in organized dentistry.

Now is a time of shifting paradigms in which we must focus on building alliances, not burning bridges. It is a time at which the horizon is ablaze with the promise of our aspirations and a time at which I am deeply humbled to have served the local Society. From being a member to serving as President, I remained steadfast in my commitment to leading with passion and contagious energy. I hope that my actions have shown that I am very inclusive and will work tirelessly to make sure your voice is heard, your concerns vocalized, and our ideals protected. Differences of opinion are inherent to any situation of organized dentistry, and it is these opposing views that help us more deeply decipher our joint goals. Discussion and debate are paramount to ensuring great outcomes and, with our membership as our guiding light, we will be able to provide clear, concise solutions for issues that affect our profession locally and nationally. I hope to earn your support and confidence to serve as your ADA delegate.

Current Positions ADA, Success Speaker, ‘07 - present WDIA, Secretary-Treasurer, ‘13 - present Seattle King County Dental Foundation, Board Member, ‘11- present SKCDS, Ambassador, ‘04- present SKCDS, member, Program Committee, ‘10-’14 Former Positions SKCDS President, ‘12 WSDA Delegate, ‘10-’13 WSDA, Alternate Delegate, ‘07, ‘08 WDIA, Board Member, ‘11- present SKCDS, Member, Budget and Finance Committee ‘09 – ‘12 Professional Affiliations Pierre Fauchard Academy American Dental Association Washington State Dental Association Seattle King County Dental Society Academy of General Dentistry Education DDS, University of Missouri Kansas City School of Dentistry ‘03 Biology, UMKC, ‘03

Dr. Oleg Shvarstur I am running for the Delegate to the ADA position because I believe it is important to get involved early in my career and address the issues that will directly effect our profession for decades to come. I can relate to the struggles that younger doctors are facing: ever increasing student loans, corporate dentistry, and daily challenges with dental insurance companies. We must assist the legislators and public in understanding and accessing the already established dental safety net, while keeping the midlevel providers at bay. As a Delegate to the ADA, I will have the privilege of advancing my knowledge of how organized dentistry and the ADA operate and what it takes to protect our profession and the public that trusts us with their care.

I was elected Class President by my peers at the UWSoD and have worked with SKCDS and WSDA since the beginning of my dental career. I helped start a non-profit dental clinic in North Seattle and, during my training at UWSoD, I rotated through numerous community dental clinics around the state. These experiences have illuminated the struggles and obstacles people face in accessing basic dental care.

Being an affiliate faculty at the UWSoD, I believe it is vital for the ADA to have a strong connection with the dental students and continually stress the importance of involvement in organized dentistry. As a new business owner, I understand the challenges we face in striving to provide quality dental care with increasing costs and decreasing insurance reimbursements.

Current Positions UW Dental Alumni Member, 3 years UWSoD, Oral Medicine Department, Affiliate Faculty, 3 years WSDA, New Dentist Think Tank, 1 year SKCDS, Communication Committee, 1 year

Dr. Princy Rekhi

Former Positions UWSoD, Class President, four years

Dentistry is a wonderful profession and has been for years. This is due in large part to the visionary leaders, dedicated volunteers and hard working staff of organized dentistry. The unified efforts of our tripartite have shaped legislation, influenced policy and have kept dentistry an enviable career. I would like to contribute and serve as your ADA delegate. Over the past 11

Professional Affiliations ADA SKCDS WSDA AACD AGD

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Education Biology, UW, ‘07 DDS, UWSoD, ‘11

2014 hod candidates

Candidates for ADA Delegate

2014 hod resolutions

2014 RESOLUTIONS HD-01-2014 Rules for the House of Delegates – September 2014

Establishes the rules for the 2014 House of Delegates. Submitted by the President.

HD-02-2014 Committees and Parliamentarian for Annual Meeting of House of Delegates - September 2014 Names members of Credentials Committee, Rules and Order Committee, Reference Committees, and appoints a parliamentarian for the House of Delegates. Submitted by the President.

HD-11-2014 Recent Graduate Dues

Proposes zero dues for the first complete year after graduation from dental school/graduate program with reductions the next three years; and encourages and assists component societies in eliminating dues for the First Year Out category and updating their bylaws accordingly.

Submitted by the Board of Directors.

HD-12-2014 Ethics/Jurisprudence Continuing Education for License Renewal

Proposes the operating budget for 2014/2015 fiscal year.

Submitted by the Committee on Budget and Finance.

Encourages DQAC to make new rules requiring all dentists to take periodic Jurisprudence/Ethics education of no more than three hours every three years as a condition of licensure such that it will count towards the 21 hour annual requirement for CE in WAC 246-817-440. Additionally, encourages the appropriate rule making bodies to require the same education of all other licensed oral health care providers..

Submitted by WSDA Members.

HD-05-2014 WSDA Dues for 2015 (Bylaw Amendment)

HD-13-2014 Dental License Renewal Regulations Change

HD-03-2014 Acceptance of WSDA Audit For the Year Ending September 30, 2013 Submitted by the Committee on Budget and Finance.

HD-04-2014 WSDA 2014/2015 Budget

Proposes a schedule of dues. Submitted by the Committee on Budget and Finance.

HD-06-2014 Nominations for Elective Office

Submits names for nomination for offices indicated in the resolution, with the understanding that further nominations can be made from the floor. Submitted by the Task Force on Nominations.

HD-07-2014 Location of the 2017 House of Delegates Submitted by the Committee on Budget and Finance.

HD-08-2014 WSDA Legislative Agenda for 2015

Reaffirms the policy in determining the Association’s annual legislative agenda and adopts legislative positions in preparation for the 2015 session of the Washington State Legislature. Submitted by the Committee on Government Affairs.

HD-09-2014 Dental Benefits Legislation

Calls for the WSDA to support legislation which allows the pediatric dental essential health benefit to be purchased as a standalone benefit or as an embedded benefit within a medical plan, both inside and outside of the exchange. The resolutions also calls for the Association to support legislation or regulatory action to ensure that procedures covered under the pediatric dental essential health benefit are reimbursed before a plan’s insurance deductible is reached and to support legislation that requires all dental plans to meet a minimum medical loss ratio standard.

Submitted by the Committee on Government Affairs.

HD-10-2014 Dental Hygiene Board

Proposes that WSDA support legislation to add dental hygienists to DQAC and opposes legislation that would create an independent dental hygiene board.

Submitted by the Board of Directors.

Proposes that the WSDA seek regulatory and/or legislative relief for dentists that would result in preventing the Department of Health from suspending a license to practice without a process in place to remedy missing licensure renewal.

Submitted by the Seattle-King County Dental Society.

HD-14-2014 Reduced Faculty Dues

Proposes that WSDA Bylaw Article II Dues, in its last paragraph of subsection C. Schedule of Dues, be amended to allow for a 50 percent reduction in dues for all individual dentist faculty members who work for dental education programs accredited by CODA at least 80 percent of full time for the fiscal years beginning October 1, 2010 and extending through the fiscal year beginning October 1, 2017.

Submitted by the Seattle-King County Dental Society.

HD-15-2014 New Core Principles

Establishes new Core Principles that can only be amended by a majority vote of the House of Delegates.

Submitted by the Seattle-King County Dental Society.

HD-16-2014 Continuing Dental Education in Washington State Encourages the DOH to further enhance their existing guidelines to include additional points not currently addressed.

Submitted by the Seattle-King County Dental Society.

HD-17-2014 Definition of Dentistry

Proposes that WSDA develop and support legislation to revise the definition of dentistry in RCW 18.32.020 subparts (1) and (2) to be consistent with language developed by the ADA. Submitted by the Board of Directors.

Note on HD-17-2014: The operational language of this resolution is the same as both the original resolution language in HD-132013 Definition of Dentistry and a 2014 resolution prepared by the Seattle King County Dental Society. The House of Delegates will consider the subject as one resolution.

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“

I’ve been attending PNDC for the past twelve years, and each year I come away with valuable information and knowledge I can put to use on Monday.

The Bellevue location is ideal, I appreciate the variety of nice restaurants and shopping the city offers, and it was so nice to simply take an elevator down to the lecture halls! The shuttle is so efficient that I never had to wait,but I walked a couple times because the weather was ideal!

”

The exhibit hall has all the vendors that I buy from, and all of my reps were there so I could talk to them one on one. The cocktail reception is a nice touch.

— Sarah Tedrick, RDH

WHAT YOU LOVE ABOUT THE

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PNDC

JUNE 11 & 12, 2015

2014 citizens citizens of of the the year year drs. drs bart johnson and amy winston 2014

2014 CITIZENS OF THE YEAR Drs. Amy Winston & Bart Johnson 1 6 路 th e wsda ne w s 路 issue 8, august 路 2014 路 www.wsda.org

played exemplary service to the community through civic/charitable activities, whether dental-related or not.

This year, rather than choosing just one recipient, the Committee on Recognition chose two: Drs. Bart Johnson and Amy Winston, the workhorse partnership behind four charitable programs in Seattle (five, if you count the staggering amount of uncompensated care they provide at their private practice) designed to create access for some of the state’s most vulnerable populations — medically-complex and challenging patients, the poor and the uninsured, and patients with cancer and renal failure.

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2014 bart johnson johnson and and amy amy winston winston 2014 citizens citizens of of the the year year drs. drs bart

Each year, WSDA members from across the state nominate one of their own to receive the Association’s highest honor, the Citizen of the Year Award. Steeped in tradition, the award honors the dentist who has dis-

2014 2014citizens citizensofofthe theyear year drs. drs bart johnson and amy winston

“I think it’s that constant excitement and challenge that makes this work fun. It’s tiring, too, and it’s frustrating at times. There are times that we have patients who are so psychiatrically impaired that they come off as incredibly offensive and problematic, and I want to give up. But then the discussion we have is ‘Okay, if we don’t treat this person, who will? Where will this person go?’ And then we have to take The [Swedish Community Specialty] clinic has had a profound impact on the local a step back. We’re the community. It is open 4.5 days a week, currently receives around 300 referrals per end of the road for so month, and donated over $1.6M of care in 2013. This includes 4,744 extractions many of these people.” and 1,587 patient visits. In the first six months of 2014, the clinic has already donated $914,242 of care, 2,676 extractions and 888 patient visits. Additionally, the program provides emergency on-call services for the Swedish Emergency Department, allowing dental patients who present at the ED to be seen 24/7.

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Getting started in private practice

They met in 2002 when Winston was a resident at the UW General Practice Residency. Johnson was the program’s director, and one of a core group of early influencers for Winston, who says, “During those early, formative years in my career, Bart was the one who showed me a lot of things. He’s the one you want around when you have a really challenging situation and you’re not sure exactly what to do – he can usually figure it out. That works really well in a residency program because novice dentists are unsure of themselves, and having someone like Bart around makes everything so much more comfortable. That is the gift he brings to the profession” At the UWSoD, the pair was working with the same medically-complex populations they both find so fascinating, but in 2007, when changes in the political climate at the UW materialized, they began to look at options outside of academia. Winston suggested they privatize. For Johnson, it was an “aha” moment — something he’d never considered — and perhaps a harbinger of things to come. Winston was honing her knack for putting together ideas, programs and people, something she truly excels at today.

Their strength lies in their differences — as Letwin says, “They complement each other beautifully. They’re not afraid to get their hands dirty when they’re working through a problem or question.

Ultimately, the give and take results in a better solution than had one of them just rolled over without challenging an aspect of a program. The process can seem loud and argumentative at times, but these are people with thick skins and sharp teeth. They’re willing to go at it, circle around a problem until they come up with a solution they both like. That’s what makes them such a remarkable team – at the end of the day, they both want to be satisfied that the product they’re putting out is going to be the best product it can be. They are both very deserving of the award and would be even individually — but because they have done so much together it makes perfect sense to award them together.”

Johnson, he says, “Is hands down the finest educator I have ever met. He can sit down with a group of people and explain the technical skills necessary to make a project successful — whether it’s lecturing to volunteers so that they can safely treat renal patients, or giving our residents the didactic lectures they need to go and treat medically-complex patients in our extraction clinic or elsewhere. Bart’s not only very detailed when he lectures, but the breadth of what he is able to teach effectively is staggering” Winston concurs, “Bart is highly sought after on the lecture circuit, and spends a lot of weekends flying to major dental conferences all over the country delivering lectures. His impact on the profession is profound — the number of people who learn from him, the number of residents who learn from him – it’s one of the biggest gifts that he has to offer. He certainly taught me…although he doesn’t teach me much anymore,” she says with a genuine laugh, clearly enjoying ribbing her partner.

By all accounts, Winston’s biggest strength is that she is a team builder – she’s able to identify the components of the project and determine the right players to bring together for the team. She’s a tenacious organizer, and her follow through is the stuff of legends.

Says Letwin, “She puts a tremendous amount of time and energy into making a project happen, organizing multiple stakeholders like SKCDS, WDS Foundation, Swedish, and Burkhart, getting them talking, and moving the project forward.” Johnson says, “She is fearless – not afraid to come up with a new idea that no one’s ever thought of. She is a wonderful team builder. I enjoy sitting back and watching her at meetings because she can really make people understand the vision of a project and get them excited and on board. Once she formulates her team, she’s really good at figuring out how to make it so a project can’t fail – she finds the right people, the right resources, she brings everything in, and at the end of the day you can bet money that the project will work. And if it starts to falter, she’s on top of it – she’ll change things up and make it right. She does stuff that I simply am not good at and vice versa, and we’re both very stubborn. We disagree now and then, but our disagreements are almost always beneficial to the project because we figure out a common ground.”

From academia to private practice

When they moved to private practice, their business vision included starting a new GPR residency. They knew they would need sponsorship from a hospital, so they drafted a business proposal and took their idea to Swedish — “We had no business experience,” recounts Winston, “And they could have just as easily told us they weren’t interested, but instead they were open to our ideas.” The two say that Swedish Administrators Sandy Norris and Dan Dixon were incredibly open to the possibilities inherent in the marriage of medicine and dentistry. They believed a dental team could work, and quickly committed to moving forward with

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2014 citizens of the year drs. bart johnson and amy winston

To say that they have had an impact on access in the community does not adequately characterize the scope of their practice or charitable work. Last year, their private practice — Seattle Special Care Dentistry — provided $231,000 of charitable care, not including hundreds of thousands of dollars written off to Medicaid for treating other low-income patients. All of the colleagues we spoke to about Johnson and Winston lauded the pair as visionary, collaborative, and endlessly energetic in their passion to help the underserved. As Dr. Sarah Vander Beek, dental director at Neighborcare says, “They have a style that is both flexible and innovative. Their passion seems bottomless – they don’t lose their focus or energy. They’re busy, but they make the time for CHCs and mentorships, which is awesome.”

Winston and Johnson were nominated to be Citizens of the Year because of their work in four projects, each of which had its starting point in their private practice: Northwest Kidney Center Screenings, the Swedish Community Specialty Clinic, the Golden Ticket Emergency Department Diversion program, and the Head and Neck Reconstructive Team, their newest collaboration.

Dr. Noah Letwin, a former resident in their GPR and now Dental Director for the Swedish Community Specialty Clinic, says, “One of the things that I enjoy about the types of projects Bart and Amy work on is that they are big picture projects — they’re not helping one or two people, and it’s not a mission trip to a faraway place. Those are also lovely projects, but they don’t have the legs of the work Amy and Bart are doing here. Both of them are concerned with putting systems in place and creating local projects that are long-lasting and will help people for years to come.” The work is tough, but never boring. Johnson says, “You learn a lot about medicine working with this population — I love it because it’s professionally satisfying from an academic and personal point of view.

Many of these patients can be challenging — medically, personally, even physically.” But one has to wonder — are these patients ever too much for the pair? Winston says, “There are times that we have patients who are so psychiatrically impaired that they come off as incredibly offensive and problematic, and sometimes we want to run the other way. But then the discussion we usually have is, ‘Okay, if we don’t treat this person, who will? Where will this person go?’ We know we are the end of the road for so many of these people. And that’s how we see ourselves – we try to be the dental backstop for the most difficult patients.”

2014 citizens of the year drs. bart johnson and amy winston

“They complement each other beautifully. They’re not afraid to get their hands dirty when they’re working through a problem or question. Ultimately, the give and take results in a better solution than had one of them just rolled over without challenging an aspect of a program. The process can seem loud and argumentative at times, but these are people with thick skins and sharp teeth. They’re willing to go at it, circle around a problem until they come up with a solution they both like. That’s what makes them such a remarkable team – at the end of the day they both want to be satisfied that the product they’re putting out is going to be the best product it can be.”

— Dr. Noah Letwin, Dental Director Swedish Community Specialty Clinic

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2014 citizens of the year drs. bart johnson and amy winston

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Left to right, current residents Scott Howell, Elizabeth Kaminsky, Jay Owen, and Salma Helal with Amy Winston and Bart Johnson

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Photo: Rob Bahnsen

2014 citizens of the year drs. bart johnson and amy winston

“We love our residents and the program we have here, they’re incredibly important to us, and so rewarding. It’s exciting and satisfying.”

From dialogue to inception — Swedish Community Specialty Clinic (SCSC)

It was during a conversation with Johnson and Winston at the opening of their practice with Tom Gibbon, manager of community programs at Swedish, that the idea of SCSC was born. As Gibbon explains, Swedish had already broken ground on a medical specialty clinic, developed because of a federally-required community health needs assessment that determined that access to care for the uninsured and charitable care were two of the top four needs in King county. Swedish worked with several CHCs and determined that primary doctors had no place to refer their uninsured patients seeking specialty care. Gibbon says, “That night, Bart and Amy suggested that we also add a dental component to the specialty clinic — because the CHC dentists also had no place to refer their specialty care patients.” The idea was so intriguing, and the community need so great, that Swedish stopped work on the project to allow time to modify plans and put in the infrastructure at the clinic for three dental chairs and support space.

Even so, there was no funding to properly outfit the operatories – but the stakeholders joined forces to overcome the hurdle.

Winston explains, “It became a wonderful collaborative effort between our practice, Swedish, SKCDS, the local CHCs, Project Access Northwest, WDSF, and several other granting organiza-

tions. Jennifer Freimund, the Executive Director of SKCDS, wrote several successful grants under the direction of the Access Committee. About $500,000 was raised for the start up and the first operational year. Vander Beek says, “The biggest impact they’ve had with us would be the SCSC, which has really changed our patients’ access to advanced oral surgery – it’s just life-changing for people. If we can’t meet their needs at our health center we have a direct and reliable pipeline that has predictable outcomes and is easy to work with. So as far as having a collaboration and partnership with them, it has been amazing. If you look at 2010 compared to now, it’s like night and day.” Winston says, “We’re so proud of the success of this clinic, but much of the credit goes to Noah Letwin.” “He is a huge part of why the clinic has been so successful – he is the one on the ground, making sure that things are running well, that the schedule works, that communication between the staff and volunteers is great. We put in the time and effort to get it started and still serve in an advisory role, but a great deal of the credit for the clinic’s success should go to Noah.”

The clinic has had a profound impact on the local community.

It is open 4.5 days a week, currently receives around 300 referrals per month, and donated over $1.6M of care in 2013. This includes 4,744 extractions and 1,587 patient visits. In the first six months of 2014, the clinic has already donated $914,242 of care, 2,676 extractions and 888 patient visits. Additionally, the program provides emergency on-call services for the Swedish Emergency Department, allowing dental patients who present at the ED to be seen 24/7. Gibbon elaborates, “That’s what is so beautiful about this clinic – it’s all about collaboration between community partners. The program works well because it provides an alternative that wasn’t there before. People were being left untreated and wound up in the ED. It gave a referral source for the CHCs. It gives the right care at the right time. Instead of having a patient go through the ED five or six times for the same problem, they’re being referred to the SCSC and have the tooth or teeth removed, which eliminates infection. Any ED diversion saves money — it’s what Obamacare is all about. It also provides an alternative for the doctors who want to provide this care, but in a structured setting.

Our dental program is a hybrid of volunteers, residents and preceptors who teach. It’s much more cost-effective care — because services are being provided by either a volunteer, a precept, or a resident.”

Vander Beek is working with Johnson and Winston on expanding their collaboration by adding an SCSC rotation for dentists in Neighborcare’s residency program “That will be a new bridge to our partnership. We realize the value of the experience there and want to have our residents get some of that advanced oral surgery training. We’ll put people into the pipeline with advanced skills, and we’ll help increase the capacity of the SCSC and allow them to be open five days a week, because the patient demand is so high.

We’re evaluating our readiness and hope to collaborate in other ways as well.”

As Letwin noted, this program has legs — it’s a model that should be easy to replicate elsewhere. In fact, Providence and Swedish presented the model to their strategic planners at a recent forum for potential programs in our state. The collaborative vision could help even more people in Washington and across the country.

Northwest Kidney Centers (NWKC)

Their work with NWKC started four years ago. Prior to it, Seattle-area patients often could not get listed for transplants because they lacked dental clearance, and so they simply stayed on

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2014 citizens of the year drs. bart johnson and amy winston

the idea. The transition period was a tough one for the pair — they shared call 24/7/365 for a year and felt a bit isolated from colleagues, at least until Dr. Chris Delecki approached them to join the Access Committee at SKCDS. “We joined, and felt incredibly welcomed and included,” says Winston. “Suddenly the dental society welcomed us into their community. We became really engaged — I got appointed to the Executive Council when one of the members couldn’t complete his term. I initially felt unsure of myself, but that changed when my ideas were supported and encouraged.

It was a nurturing environment — there were leaders within the dental organization who really changed the game for us, and for that we will always be grateful to organized dentistry — and most importantly to Seattle-King. That’s why we continue to serve on committees even though our time is more limited. We’re committed to making sure our dental society knows we care.” Their vision of a clinic serving the most difficult patients in the county was becoming a reality, and would only serve as the fulcrum of many projects to come.

Today, their practice is balanced, with 60 percent of their base comprised of medically-complex patients of all kinds, the other 40 percent comprised of regular dental patients. The highly successful GPR they run in collaboration with Swedish pays it forward by bringing some of the best and brightest new graduates to the program every year, helping to train a new cadre of residents to treat the most difficult patients — 20 total residents since the program’s inception in 2009. “They’re bright-eyed, bushy-tailed, motivated to learn,” says Johnson. Winston agrees, saying, “We love our residents and the program we have here, they’re incredibly important to us, and so rewarding. It’s exciting and satisfying.” And while they know their grads will apply some skills and lose others depending on the type of practice they’re in, the intensity and range of exposure they get during the year allows them to incorporate what excites and interests them into their future practices. Johnson continues, “If our residents go out and have a regular dental practice but integrate a lot of what they learned in our residency, we consider that a success. At least we know they have the ability to do advanced work, so they have the option of not turning away patients with more difficult issues.”

2014 citizens of the year drs. bart johnson and amy winston

dialysis. One patient had been waiting for a transplant for nine years because he had difficulty accessing appropriate dental care.

“We started to do a lot of the clearances in our office, but it got overwhelming.” It was an unsustainable situation, so they worked with the SKCDS Access Committee and created a plan to partner with community volunteer stakeholders. The Northwest Kidney Center’s potential recipients are first screened by social workers and medical doctors to assess their eligibility for transplant, Project Access Northwest then handles all of the logistics of getting the patients to Seattle Special Care Dentistry for dental screening.

“Project Access Northwest is really critical to the process because they take care of transportation, arranging for interpreters, and handle the management of patient logistics, which means there are not a bunch of no shows. It’s a great system,” says Johnson.

The doctors at SSCD do a comprehensive exam and determine the patient’s treatment plan and put together a package that details what the patient needs in order to be transplanted. It’s very standardized, and it allows Johnson and Winston to determine which difficult patients they need to keep in house, versus those who are medically stable enough to be managed by the volunteer dentists. Freimund again plays a pivotal role by recruiting dentists to volunteer for the program — a task made a little easier by only giving volunteers work they’re fluent in. Winston says, “What’s nice is that our volunteers get to do work that they’re comfortable doing — so if you’re not somebody who extracts teeth or does root canals, we’ll send you a patient who needs fillings.

People aren’t put in situations they aren’t familiar with. Also, the treatment that we recommend is what is required to make the patient transplant-ready, nothing else. It’s not fancy, it’s not crowns or implants, but sometimes the volunteers will choose to do additional work. We only ask them to perform the basic work so that they don’t feel pressured to do more.” Since 2010, the system has cleared more than 100 patients, and 32 have received transplants that they likely wouldn’t have without this dental clearance — the program truly changes lives.

Working with cancer patients

Long ago, the two made a commitment to provide care to any cancer or transplant patient who needed it. These patients’ lives were at risk, and the dental component was key to their long-term health. Both felt that to deny someone care during that time in their lives seemed wrong, so they made the same commitment to all of the cancer and transplant teams that they work with in the area, not just Swedish. They agreed to take all newly-diagnosed patients, regardless of their ability to pay. In doing so, they became a part of the pretreatment oncology workup – along with seeing a speech pathologist, a dietician, a social worker, and a cardiologist. Johnson explains, “We wanted to make sure that we were part of that process so that we could get in on the front end of their cancer treatment.

We saw the results of people who hadn’t had dentistry in the beginning, and the results were often disastrous.” A critical element of this process is educating patients about what they can expect — for example, how radiation can affect their salivary glands and

the rate at which their teeth decay, even how important stretching can be as a preventative measure. Johnson explains, “The worstcase cancer scenario is when someone has had IV bisphosphonates for breast cancer yet has a mouthful of severe decay — once they have had those treatments we can’t take out teeth because the bone won’t heal. And so we sometimes we end up having to do root canals on little remnants of teeth — it’s a disastrous situation.

That’s why we think the work with them is so critical.” Dr. Upendra Parvathaneni of the Seattle Cancer Care Alliance says, “Over the years, they have consistently provided quality and timely services, which is very important with these patients. We use them as the primary referral source for dental clearance because they have worked with so many cancer patients that they understand radiation issues. It’s a different dimension than a typical dental practice. They see at least 100 of my patients a year, and about 250 in total through our head and neck service.” In fact, Johnson, Winston and Parvathaneni worked together to develop a stent for use in radiation therapy with cancer patients, allowing them to displace the oral structures that don’t have to be in the radiation field during treatment. They published a paper on how to manufacture the devices and hope that other oncologists around the country will use the devices in their treatment of head and neck cancers. It gives practitioners day-to-day stability of the target that they’re treating and allows them to spare oral tissues. “It’s a neat little idea, a cheap device to reduce toxicity,” Parvathaneni says, “Fewer salivary glands are affected by the radiation and more taste buds are spared. It’s in keeping of our mission to treat the needs of patients first.” Winston and Johnson are proud of the work they do on behalf of cancer patients — it’s life-changing work and allows them to “help people on the front end so their lives are better in the long run,” as Johnson says.

Golden Ticket Program

As all dentists know, Emergency Departments are constantly flooded with dental patients — many of whom do not need to be there.

Frustrated ED docs usually provide painkillers, antibiotics, and a list of dentists who take underfunded patients. Often though, the list includes resources who only accept a particular patient population, and it makes finding an appointment difficult in reality. ED docs never know if their patients will get care, or be back again with the same issue — and that is not a quality solution. Winston and Johnson knew that the key was getting patients definitive care, not just the promise of care, so they partnered with Dr. Marty Leiberman, who was Dental Director of Neighborcare at the time, to create the Golden Ticket program. They developed a care plan that begins once the ED doc assesses the situation and ascertains that the patient is not in danger. (The emergent/endangered patients are seen ‘round the clock by an attending and a Swedish GPR resident who are on call.) Non-emergent patients are given a “Golden Ticket” that allows them to be seen at a nearby Neighborcare clinic the next morning. Vander Beek says, “It’s an emergency room diversion program, but it’s a cost-saving program for all of us. It’s very patient-focused, which is a key to any collaboration we’re involved with – we need to determine the benefit to the patient. It creates a clear pathway for the patient and the providers. Our philosophy is

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Reconstructive team - their newest venture

Because they do so much work with cancer patients, Johnson and Winston have seen them evolve from cancer victims to cancer survivors, but unfortunately often with debilitating results like severe trismus, and cancer-eradication surgeries that can include removing half the patient’s tongue and jaw resections — intense, and sometimes disfiguring surgeries. Their lives are spared at the cost of their countenance. Their quality of life can be extremely poor, and dental reconstruction is not a covered benefit under the current healthcare system, in part because the cost can easily top $50,000.

Winston says, “It’s a complicated problem, and it’s interesting to me that medical insurance will think nothing of paying for breast reconstruction after a mastectomy, but when it’s someone’s mouth or face they’re less inclined to pay for anything. Medical insurances typically consider it a dental issue and won’t cover it, dental insurance covers $2,000 at best, and patients are caught in this incredibly difficult situation where they have no options. Even if you’re someone with a solid income, coming up with that kind of money is impossible.”

As general dentists, a good portion the treatment is beyond their scope of care, but because of the work they do, they were able to assemble a crack team of experts including three oral maxillofacial surgeons, a plastic surgeon, an ENT surgeon, and a maxillofacial prosthodontist. Just as they do with transplant patients, the team puts together a presentation that includes the patient’s picture, radiographs, CT scans and pertinent information about the patient, including medical history. Johnson elaborates, “We have a room full of incredibly bright, talented experts, and we collectively determine a plan to put the person back together and make them functional again. It is just amazing to watch the team interact, hear the kinds of things they can do from the different perspectives.” From this discussion they develop a treatment plan and figure out who will do what, what the sequence is, and what the cost will be, and then Winston sets out writing grants for the patient. It’s a time-consuming process, and while they have found organizations that are willing to cover people who are cancer survivors with medical/dental financial hardships, it doesn’t always get approved. Says Winston, “We present a very thoughtful sequence of care. We tell these organi-

zations what we expect, and then when we’re done, we send the organization pictures of the patient showing the outcomes. As of right now, we have gotten four people through the system. The impact it has made on those individual’s lives is huge – they’ve gone from not being able to eat anything but yogurt to being able to chew real food, they’re no longer embarrassed of their appearance.” While the program’s scale is small, the individual impact is immeasurable. Time, not desire, is the enemy with this program — writing grants is incredibly laborious. Ultimately, they’d like to see the program put through 10-20 patients a year – it’s a winwin for both patients and providers, Winston says, “We have an amazing team that wants to do this, all of whom were trained to do these higher-level surgeries. Not many patients can afford it, so the providers haven’t been able to do all the things they enjoy. The doctors get to do some really cool surgeries, and the patients get their mouths reconstructed.”

On the horizon

The pair has a few new GPR and AEGD residencies on the horizon, and they’ll continue to nurse the reconstructive project. Their biggest goal — one that they don’t yet know how to attack because of the enormity of the problem, is to get special needs developmentally-disabled patients better access to care in our state. The issue is primarily fiscal – the patients are so profoundly disabled that they cannot possibly support themselves financially and are completely dependent on state resources — and there is not enough money budgeted to cover them. Plus, they usually require advanced care such as IV sedation or general anesthesia to do a good job, and that’s what Winston and Johnson want. Says Winston, “It’s such a huge problem that we don’t know how to tackle it — there isn’t an obvious solution or someone probably would have already found it.”

If all of this is not enough, as the director of Hospital Dentistry at Swedish, Winston is involved with creating a regional center for orthognathic surgery and is working closely with the WSDA and its Task Force on Public Policy Development to research expanding existing residency programs in our state. Oh, and Winston has decided to squeeze in an MBA at OHSU in September. She explains, “I feel like having some formal education about the health care system would be extremely beneficial. Our profession is under a lot of stress from insurance companies and student debt, and there are going to be changes forced upon dentists. It’s very hard for me to not engage – I love the process of solving problems. I don’t see us as necessarily charitable, altruistic dogooders, we’re problem solvers. Because of our involvement with Hospital Dentistry, we’re in a position to identify problems in ways that others may not, and we’re in a position to solve problems because we have the resources. It’s our responsibility.” And while Johnson mostly agrees with her statement, he can’t sit back without giving Winston a gentle ribbing, saying “We’re willing to give away the free care and our life energy because it does feel good to take care of these patients and teach residents to do the same. Yes, we’re absolutely problem solvers, but I think we’re a little on the compassionate side, too.”

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2014 citizens of the year drs. bart johnson and amy winston

meeting the patients where they are, and Bart and Amy have been really easy to work with because they have the same philosophy and goals.” Winston and Johnson have trained attending ED docs to give local anesthetic, allowing them to numb the patient and get them out of pain, saving the hospital the cost and trouble of prescribing narcotic painkillers. The program is simple and effective, and could easily be duplicated in any city where there is a CHC near a hospital ED, although it would be beneficial to have a GPR close by to handle the truly emergent cases. Winston and Johnson are eyeing other counties as possible sites for a similar program.

Data mined over an 18-month period show only one repeat patient in that entire time, so while they can’t prevent that initial visit, they can keep the patients from coming back by addressing the problems quickly and definitively.

member news wsda fights back: corporate practices

For decades, many of Washington’s dentists have expressed concern, angst, and frustration over the corporate dental practice model. These emotions have arisen over concerns about quality of care and the often clandestine nature of these entities. Many dentists, including several who have worked for corporate dental organizations as associate dentists, do not completely understand their ownership structure, business relationship with the management group, and ultimately where the buck stops. Without transparency and clarity, there are very legitimate questions about whether corporate practices operate legally in Washington state.

Corporate practices: how they differ

Not all corporate practice models are the same. Many dentists see grouping together as a way to potentially cut overhead, increase flexibility in their schedule, and offer patients unique services that they could not otherwise afford to offer in a solo practice setting. WSDA does not see any issue with licensed dentists organizing themselves into a group practice or a single licensed dentist owning several dental offices. The Association does have concerns with non-dentists acquiring ownership stakes in dental practices whether overtly or more subtly. More specifically, the Association has concerns when contracts between dentists and non-dentists extend beyond normal consulting and clerical services and are structured to give corporate entities indirect ownership that allows them to control the flow of funds, business expenses, and office operations. All dentists should be aware of these issues and carefully review any contract they sign.

DQAC’s interest in corporate practices

Over the past several years the Dental Quality Assurance Commission (DQAC) has also taken great interest in the corporate practice model and has conducted frequent discussions regarding the regulation of corporate dental practices and the new complexities that have arisen with the model. In addition, DQAC established a Corporate Practice Committee to further analyze the relationship between corporate entities and dentists.

DQAC has invited corporate stakeholders to their Corporate Practice Committee meetings on several occasions. During these meetings, representatives from numerous corporate practices made presentations to commission members explaining their business model, internal quality control measures, and record keeping protocols, among other pertinent practice details.

A recurring topic that has been discussed at Corporate Practice Committee meetings is the issue of dental records and who was responsible for maintaining those records. Commission members are concerned that associate dentists in corporate practices could

be at risk for disciplinary action if they were unable to access patient records being controlled by the corporate entity. Additionally, DQAC has concern over their ability to access patient records in disciplinary settings if the records were in the possession of a non-licensed individual such as a corporation. The Corporate Practice Committee has already dedicated a significant portion of their meetings over the last several months looking for a practical solution regarding record maintenance. DQAC is still in the process of updating the records rules to be workable in practice settings with multiple dentists while preserving the current language that allows dentists and regulators to obtain patient records when necessary.

In spring of 2014, DOH staff drafted a series of scenarios representing ownership and fact patterns relating to corporate and group practices encountered by DOH over the last several years. The matrix they assembled provided DOH and DQAC various approaches that could be considered for disciplinary cases involving corporate dental practices. The matrix demonstrates the range of options available to address corporate and group practice issues under existing Washington law and cites relevant statutes and case law. WSDA is hopeful that the full commission will support the adoption of this matrix and that the creation of this matrix is an indication of the DOH’s willingness to ensure that existing corporate practice entities are in compliance with existing state laws relating to dentistry.

The DOH matrix does not provide a scenario that would excuse the treating dentist from their responsibility for providing quality care and complying with law. The concern surrounding the large number of young dentists entering corporate practices is that they are signing contracts without a full understanding of state laws pertaining to dentistry and practice ownership. According to DOH, actions and policies of the employing corporation can be a mitigating factor for a dentist facing disciplinary action, but those policies will not fully absolve the dentist of wrongdoing. Dentists looking to enter into corporate practice settings should review their employment agreement and corporate policies before they begin working for a company and engage legal counsel if there is any portion of their contract that they do not understand.

In a presentation to DQAC last September, Pacific Dental Services, one of the more recent corporate groups to set up practices in Washington, expressed their support for modifying several sections of Washington’s Dental Practice Act (RCW 18.32) and dental rules (WAC 246-817). One suggestion they support is the deletion of subpart 3 of the Definition of Dentistry (RCW 18.32.020) which states that anyone who “owns, maintains, or operates an office for the practice of dentistry” is according to the statute practicing dentistry.

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against Half Dental WA, Inc. This corporate entity is a subsidiary of a Nevada corporation which owns dental practices in several states including one office in Washington. The Cease and Desist Order explains that Half Dental, an entity controlled by non-dentists, has the following controls on the dental practice in Washington state:

Keeping a watchful eye

• Half Dental is not compensated with a fixed fee for service by a dentist. Instead Half Dental is compensated using a formula that reimburses it for its costs plus “an amount equal to the lesser of net Pre-tax Income or 30 percent of Net Revenues.”

The WSDA Board of Directors has been extensively discussing the issue of corporate practice of dentistry for nearly two years.

During its extensive discussion, the Board concluded that the state’s laws and existing case law was clear in prohibiting the ownership of dental practices by non-dentists (see page 28). In the spring of 2013, the Board decided the Association should work with state agencies to ensure that the existing state law was enforced. To this end, the Association sought to work with the Office of the Attorney General and the Department of Health.

In an August 2013 letter addressed to Attorney General Robert Ferguson, WSDA expressed its concern that some corporate practices may be operating in Washington state illegally. Furthermore, the letter cited extensive case law on corporate practice and echoed the concern that “ownership of dental practices by nondentists could be an unwarranted intrusion on the dentist’s diagnosis and professional judgment.” The letter prompted a meeting with WSDA and the Attorney General’s office to discuss the Association’s concerns in more detail. The Attorney General’s Office, while understanding of WSDA’s concerns, deferred to the Department of Health and its department with oversight over the unlicensed practice of regulated health professions.

In November 2013, WSDA sent a letter to Secretary of Health John Wiesman which expressed the same concerns as the letter sent to the Attorney General. WSDA met with DOH staff in January 2014 and identified several corporate practices believed to be in direct violation of Washington law by having non-dentist owners. The Association recommended that the Department of Health’s unlicensed practice division investigate these practices in order to determine if they were in compliance with the law. WSDA left with the impression that at least one complaint had been filed against a corporate dental practice and that this complaint was in some stage of investigation.

In June 2014, the Department of Health’s Unlicensed Practice Program issued a notice of intent to issue a cease and desist order

• Half Dental maintains and supervises custody of all business records.

• Half Dental performs all billing and collection and retains “sole discretion” over attempts at collection, the methods of collection and settlement of disputed charges.

• Half Dental selects all “non-Dental Personnel” and controls the terms of their employment, including “rates of compensation, supervision, direction, training, and assignment of duties.”

• The dental office is leased by Half Dental from a third party along with the clinically-related equipment.

The Unlicensed Practice Program concludes that these actions establish an ownership interest in a dental office and therefore constitutes the unlicensed practice of dentistry.

WSDA’s leadership believes the state’s current law on dental practice ownership should be maintained and enforced. To ensure the enforcement of state law, the Board of Directors decided to file a complaint against a corporate practice entity.

Making a move

After extensive deliberation, the Board of Directors decided to file a complaint against Pacific Dental Service with the nonlicensed practice division of the Department of Health for practicing dentistry without a dental license. In this complaint, the Association states that an “investigation will reveal that PDS, through its web of contractual relationships with dentists and resulting power to influence the operation of the affiliated dental practices, effectively owns, maintains, or operates offices for the practice of dentistry, or otherwise is practicing dentistry in violation of Washington law.” Additionally, the Board decided to file a complaint with DQAC against a dentist with an ownership stake in PDS controlled practices in Washington state for aiding and abetting the unlicensed practice of dentistry in Washington state.

WSDA is awaiting action on the filed complaints and will inform the membership of developments as appropriate.

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member news wsda fights back: corporate practices

Pacific Dental Services, like many corporate dental groups operating in Washington has testified before DQAC that their affiliated offices are owned by Washington licensed dentists. WSDA has on several occasions asked to review business contracts between the corporate entity and licensed dentists and has each time been denied the opportunity to review those contracts. Pacific Dental Services employs dentists at various levels within their affiliated offices. Dentists designated as owners have a different contractual agreement than those employed as associates. Based on information revealed in lawsuits against corporate practices in states around the country, contracts with corporate dental groups often limit the dentist’s decisions on day-to-day office operations, ownership rights, and freedom to sell or transfer their interest or share in the practice. Without a complete understanding of the business relationship between the corporation and the dentist, WSDA is unable to fully advise members in areas of compliance and their legal responsibilities as licensed dentists.

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By Alan Wicks, WSDA General Counsel

Background

Any discussion concerning corporate practice of dentistry in Washington should begin with a common understanding of the essential terms and provisions under current Washington law.

In 1935, the legislature revised Washington’s statutes defining and regulating the practice of dentistry.1 Among the changes made at that time, the legislature added language to the statutory definition of the practice of dentistry stating that a person who “owns, maintains, or operates an office for the practice of dentistry…” is practicing dentistry.2 In the same 1935 bill, the legislature adopted a general prohibition on the corporate practice of dentistry. The section begins “No corporation shall practice dentistry…” and it goes on to state limited exceptions for charitable care and clinics for a company’s employees. The current text of the statute codifying this provision is the same as in 1935.3 Years later when Washington adopted a statute allowing for professional corporations (and, more recently, professional limited liability companies) the statutes permitting these structures require that all shareholders must have the requisite professional license.4 The prohibition on ownership of a dental office by an unlicensed person has been tested in the courts.

In the earliest case, Washington’s supreme court decided such a prohibition was unconstitutional as interfering with the unlicensed person’s natural right to own property.5 But in 1950, Washington’s Supreme Court overruled the Brown decision and upheld the prohibition.6 Writing for the 7-2 majority, Justice Schwellenbach included these statements: The state, under its police power, has the right, and it is its duty, to protect its people in their health and general welfare.7 “When a person engages the services of a doctor, a dentist, or an optometrist, he is entering a realm of which he knows practically nothing. Of necessity, he must rely upon the skill and training of the expert to whom he goes. So the state, for the protection of its citizens, through the exercise of its power, has attempted to regulate the conduct of such learned professions by requiring that each person practicing such a profession must first obtain a license to practice. As a further precaution, the state has designated certain subjects, peculiar to the particular profession, in which the applicant must prepare himself before he can be examined as to his fitness to practice his profession.” 8 And Justice Schwellenbach quoted with approval from a case determining commercial corporations could not practice law by employing competent lawyers as this would be “unlawfully practicing law as a principal through its agents…” 9 In concluding the court’s reasoning, Justice Schwellenbach wrote: “The care and treatment of the teeth is not a business. It is not a commercial transaction. It is a profession. A person may own and sell dental equipment and supplies. But the state, in the exercise of its police power, has said that he cannot, without a license, practice dentistry. The state has said, in its wisdom, that a person practices dentistry “who owns, maintains or operates an office for the practice of dentistry.” There can be no question but that the activities of Boren and Shepherd come within this definition. The state has decided that such a practice does not adequately protect the health of its people.

Clearly, such a regulation is a reasonable exercise of its police power.”10

More recent cases have agreed with the reasoning of Justice Schwellenbach’s opinion.

A 2004 Washington Court of Appeals opinion concluded that indirect ownership through a high percentage rent clause in a lease violated the practice of dentistry statute. 11 Also in 2004, Judge John Coughenour, a federal judge in the Western Washington District, granted summary judgment in a case against Orthalliance, Inc., writing that defendant’s agreements with certain orthodontists placed it in the position of a “virtual employer” finding the defendant “was, through its interconnected contractual relationships…practicing dentistry in violation of Washington’s law against the corporate practice of dentistry…”

Inasmuch as the corporate practice was also a misdemeanor under RCW 18.32.675, Judge Coughenour also concluded the contracts were not enforceable.12 Judge Coughenour wrote: “Direct employment of a licensed professional is not the only way non-licensed entities have been found to fall afoul of Washinton’s law against the corporate practice of medicine…the courts have not hesitated to find a de facto relationship which puts the non-licensed entity in contravention of the doctrine…the court closely scrutinizes the effect and purpose of the contractual agreements between the parties…”13 Based on these authorities, it seems that if a set of agreements with non-dentist persons, or with an entity whose members are shareholders are not Washington licensed dentists, has any of these characteristics, there is likely to be a violation of Washington law: 1. Ownership or control of the dental office space, or substantial percentage rents; 2. Ownership or control of the dental equipment or furnishings; 3. Control of practice revenues or the authority to determine how the revenues are to be expended; 4. A share of gross receipts or net profits, or a vote or voice in deciding about any potential sale of the practice or its discontinuance; 5. A dental support or consulting agreement which is for a longer period of time than typical consulting arrangements, or which cannot be canceled at will or upon short notice, or without incurring a penalty or paying damages; 6. Bonuses which are not at the dentist’s discretion, or consulting or promotional fee arrangements based on valuation of the practice or its development.

Conclusion

Dentistry in this decade is, if anything, more complex than it was when Justice Schwellenbach wrote his opinion in 1950. Patients seeking dental care now, as then, need the professional relationship with their dentist unencumbered by the indirect equity ownership of commercial corporations and unlicensed persons.

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member news corporate dentistr y: legal precedence

Corporate dentistry: legal precedence

Congratulations on the following successful transitions:

Dr. George Stephens to Dr. Chad Merkel, Dr. Justin Hanson & Dr. Brandon Ford Renton, WA Dr. William Busacca to Dr. Steve Bowers Shelton, WA Dr. Lee Sorensen to Dr. Cesar Cruz Seattle, WA Dr. Kirk Kallander to Dr. Randle Carr Oak Harbor, WA Dr. Randle Carr to Dr. Mathew Dorsch Bellingham, WA Spokane

Sandpoint, ID– NEW

Beautiful general practice with 6 ops, close to $1.4 million in collections on approximately 180 days annually. Offered at $910,000.

Yakima–NEW

General practice located in high traffic area, 5 ops, with room to grow hygiene. Practice needs hands-on management. Annual collections $675K. Offered at $479,000.

Skagit County — NEW

Full time associateship leading to partnership.

GPR or 3+ years experience preferred.

Spokane

Close to $800K collections the past 3 years with $230K net on less than 150 eight-hour days. Free standing building also available. Offered at $485,000.

North Seattle Perio

Prosthodontic practice collecting $1.5 million on 155 doctor days annually. Very strong net, and only prosthodontic practice in North Spokane. 6 ops, active hygiene department.

Offered at $815,000.

Great location, strong referral base, seller willing to assist in transition.

Southeast King County Collecting $470,000 on 125 days/year.

Property also available.

Bremerton

Team in place who knows how to manage the business. Needs a motivated owner to ramp up the practice. Average collections in the mid-$500K range. Priced for quick transition at $357,000.

San Juan Island

Lakewood—REDUCED PRICE

Collecting an average of $300K per year on limited days, referring all specialty procedures.

Beautiful area, great opportunity for the doctor desiring a slower-paced practice.

Gray’s Harbor — COMING SOON

Renton — NEW

Upscale professional building, newly remodeled, digital, 6 ops, totally turn-key.

Burien — NEW

4 ops, recently upgraded, currently part-time.

A real GEM. Great location with excellent visibility and great signage, 3 ops. with plenty of room in this 2,000 plus sq. ft. office to add 2 more. Very good hygiene dept. and steady dependable income. $439,000.

Yakima—Associateship

Large Yakima Valley practice looking for full or part time associate.

Chelan

Well-established practice in a beautiful setting on Lake Chelan. 3 operatories, extremely profitable.

Renton

2 ops, part-time practice, digital, recently remodeled

Eastside—PENDING

Extraordinary practice opportunity in desirable Eastside location. 5 operatories with a 6th op ready to outfit. Long-term doctor, largely fee-forservice, new computers, beautifully appointed.

Space Only Edmonds Everett

3 0 · th e wsda ne w s · issue 8, august · 2014 · www.wsda.org

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1. 1935 Washington Session Laws, chapter 112.

2. 1935 Washington Session Laws, chapter 12, section 6, now codified as RCW 18.32.020 (3). The current text of RCW 18.32.020 is as follows: A person practices dentistry, within the meaning of this chapter, who (1) represents himself or herself as being able to diagnose, treat, remove stains and concretions from teeth, operate or prescribe for any disease, pain, injury, deficiency, deformity, or physical condition of the human teeth, alveolar process, gums, or jaw, or (2) offers or undertakes by any means or methods to diagnose, treat, remove stains or concretions from teeth, operate or prescribe for any disease, pain, injury, deficiency, deformity, or physical condition of the same, or take impressions of the teeth or jaw, or (3) owns, maintains, or operates an office for the practice of dentistry, or (4) engages in any of the practices included in the curricula of recognized and approved dental schools or colleges, or (5) professes to the public by any method to furnish, supply, construct, reproduce, or repair any prosthetic denture, bridge, appliance, or other structure to be worn in the human mouth.

The fact that a person uses any dental degree, or designation, or any card, device, directory, poster, sign, or other media whereby he or she represents himself or herself to be a dentist, shall be prima facie evidence that such person is engaged in the practice of dentistry.

X-ray diagnosis as to the method of dental practice in which the diagnosis and examination is made of the normal and abnormal structures, parts, or functions of the human teeth, the alveolar process, maxilla, mandible or soft tissues adjacent thereto, is hereby declared to be the practice

of dentistry. Any person other than a regularly licensed physician or surgeon who makes any diagnosis or interpretation or explanation, or attempts to diagnose or to make any interpretation or explanation ofthe registered shadow or shadows of any part of the human teeth, alveolar process, maxilla, mandible or soft tissues adjacent thereto by the use of X-ray is declared to be engaged in the practice of dentistry, medicine, or surgery.

The practice of dentistry includes the performance of any dental or oral and maxillofacial surgery. “Oral and maxillofacial surgery” means the specialty of dentistry that includes the diagnosis and surgical and adjunctive treatment of diseases, injuries, and defects of the hard and soft tissues of the oral and maxillofacial region.

3. 1935 Washington Session Laws, chapter 112, section 19, now codified as RCW 18.32.675. The current text of RCW 18.32.675 is as follows:

gaged in the practice of dentistry, when such dentist assumes full responsibility for such information and services.

(2) Any corporation violating this section is guilty of a gross misdemeanor, and each day that this chapter is violated shall be considered a separate offense.

4. RCW 18.100.050 (as to professional corporations) and RCW 25.15.045 (as to professional limited liability companies).

5. State v. Brown, 37 Wash. 97, 79 Pac. 635 (1905).

6. State v. Boren, 36 Wn. 2d 522, 219 p. 2d 566 (1950).

7. 36 Wn. 2d at 525.

8. 36 Wn. 2d at 525.

(1) No corporation shall practice dentistry or shall solicit through itself, or its agent, officers, employees, directors or trustees, dental patronage for any dentists or dental surgeon employed by any corporation: PROVIDED, That nothing contained in this chapter shall prohibit a corporation from employing a dentist or dentists to render dental services to its employees: PROVIDED, FURTHER, That such dental services shall be rendered at no cost or charge to the employees; nor shall it apply to corporations or associations in which the dental services were originated and are being conducted upon a purely charitable basis for the worthy poor, nor shall it apply to corporations or associations furnishing information or clerical services which can be furnished by persons not licensed to practice dentistry, to any person lawfully en-

th e wsda ne w s · issue 8, august · 2014 · www.wsda.org · 31

9. 36 Wn. 2d at 528-529.

10. 36 Wn. 2d at 532.

11. Fallahzadeh v. Ghorbanian, 119 Wn. App. 596, 82 p. 3d 684 (Div. One 2004).

12. Engst et al v. Orthalliance, Inc. USDC W.D. Wash. Case No Col-1469 C, Order of March 1, 2004, p. 14-15.

13. Engst et al v. Orthalliance, Inc., above at footnote 12, at p. 7-8.

member news legal precedence, references

References

membership news mentor program

Mentor a dental student — Save the Date for the Mentor Reception!

The annual Mentor Reception will be here before you know it! Save the date for Thursday, November 20th and join the WSDA and the UW Dental Alumni Association at the Burke Museum for an evening of fun, food and great conversation. Whether you are a new mentor or have been with the program for years, this event is the perfect opportunity to connect with your mentee.

Come mix it up, mingle, meet other mentors and the students involved in the program, all while taking in this amazing museum.

Program information: 1. Being a mentor doesn’t take a lot of time. You get to choose the level of engagement. Most students and their mentors communicate via email and phone. It’s up to you.

2. You don’t have to be a UW Grad to participate, you only have to be a WSDA member.

3. You don’t have to live in the greater Seattle area — mentors from all over the state have had successful, productive mentor relationships with UWSoD students. Phoning and emailing are perfectly acceptable.

5. Mentors say giving back is filled with rewards, from a renewed sense of vigor to finding the perfect Associate. Be forward-thinking, participate, give back.

6. Women mentors are especially needed. The playing field is changing — there are more women than men in dental school 4. No special skills are required. You’d be surprised at how ef- today. They need your guidance and your perspective.

WSDA NEWS AUGUST 2014 fective you can be as a mentor — remember, you were once a student too. Don’t sell yourself short.

Sign up today at wsda.org/mentor-program. Have questions? Contact Laura Rohlman at laura@wsda.org, or at 800-448-3368.

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OR COAST – Several opportunities.

BELLEVUE, WA – Biological dental practice collecting $600K. Amalgam free/safe office features 7 ops (5 equipped) and digital x-rays.

SW ALASKA – Great G/P situated in a sportsman’s paradise! Collecting $700K+ working only 37 weeks per year! Associateship also available.

NEW! SPOKANE VALLEY – G/P collecting around $1M in 2013. Office boasts pano, digital x-rays and 6 ops (7th possible). Cerec also available.

NEW! WA PERIODONTIC – Wonderful perio practice with an emphasis on implants. 4 ops, Pano and more. Collected $550K+ in 2013.

W. OREGON OMS - Tremendous growth potential. Easy access building with good off-street parking.

ALASKA PROSTHO - Exceptional practice collecting $1.5M+ in 2013.

Seller willing to stay for transition.

FAIRBANKS, AK – Profitable G/P collecting $700K in 2013. 3 ops and great staff ready to transition.

FAIRBANKS, AK – Associate wanted for busy endodontic practice!

KETCHIKAN, AK –G/P collecting $600K. 100% fee-for-service. Longestablished office has 4 ops, updated about 5 years ago.

HOMER, AK - G/P collecting around $550K in 2013. Wonderful, long established practice includes a great staff, digital x-rays, laser, and pano.

RURAL ALASKA – Collecting $350K+ working just 10 weeks per year! Includes SUV and small apartment. Perfect satellite practice!

MAT-SU VALLEY, AK – Excellent G/P collecting almost $400K in 2013.

Newer equipment, 3 ops, pano and digital x-rays. Seller relocating.

www.PracticeSales.com Aaron@PracticeSales.com RandyH@PracticeSales.com 3 2 · th e wsda ne w s · issue 8, august · 2014 · www.wsda.org

Questions? Email Laura Rohlman at laura@ wsda.org or call (206) 973-5218

Puget Sound

In association with Pierce County Dental Society, Seattle King County Dental Society, Snohomish County Dental Society 10/15 Dental Materials 101: Understanding What to Use and

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Spokane

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Spokane District Dental Society, Yakima Valley Dental Society 9/25

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10/10 Practice Management and Marketing for Practice Owners

Dr. Rhonda Savage and Sesame Communications 11/19 Dental Materials 101: Understanding What to Use and

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In association with: Clark County Dental Society, Lewis

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Society, Thurston-Mason Counties Dental Society 9/17

Dental Materials 101: Understanding What to Use and When for Direct and Indirect Restorations · Dr. Scott Dyer

10/17 Practice Management and Marketing for Practice Owners

Dr. Rhonda Savage and Sesame Communications 11/20 An Interdisciplinary Approach: Utilizing Orthodontics to

Enhance Restorative Outcomes · Dr. Duane Grummons 12/11 Models of Dental Practice - How Dental Benefits Effect Your

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th e wsda ne w s · issue 8, august · 2014 · www.wsda.org · 33

membership news wsda academy schedule

The WSDA Academy: A statewide CE program directed to the needs of dentists out of dental school or their graduate/specialty program for a decade or less. The Academy offers 16 courses presented at no cost to 20 participants (per course) at three locations in the state — the greater Seattle area, as well as Clark and Spokane Counties.

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Apply today to secure your spot

Are you ready to participate at a higher level? We’re soliciting applications for the fifth WSDA Leadership Institute. The Institute exists to develop future leaders of organized dentistry from the rank and file members of today.

Former participants have been elected to Board and task force positions within the WSDA and continue to make their mark at higher levels of organized dentistry. Your voices, ideas, and passion for dentistry are needed.

WSDA’s Leadership Institute can help shape you into a leader of the future by pairing you with a WSDA Board member who will shepherd you through six key activities tailored to developing emerging leaders.

It is always vital to encourage leaders of the future, and this program lends structure to the process. Given the uncertainty of national health care and how it may affect dentistry, it has never been more important.

VIEW SCHEDULE & APPLY TODAY! Apply for the 2015 Leadership Institute at wsda.org/leadership-institute

Applications must be received by November 21, 2014 to be

considered eligible. Questions? Contact Kainoa Trotter at 800448-3368 or by email at kainoa@wsda.org.

thee wsda wsda ne new wss ·· issue issue 8, 8, august august ·· 2014 2014 ·· www.wsda.org www.wsda.org ·· 35 35 th

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wohf news wohf staff goes to queets, wash.

By Launa Lea, Special to the WSDA News

A Small Town Dentist does more than her share

Dr. Kirsti Turella, a Sequim resident and mother of two hit the schools in and around her community with a fierce tenacity. We met up with her at a Boys and Girls Club presentation in her hometown of Sequim in May. She has managed to connect with school nurses throughout the peninsula, delivering oral health education programs to more than 975 kids since March of this year. Turella says, “I have little kids, and I’ve always enjoyed going and talking to their classes – there is a lot of need here. I find that I’m delivering the same message to kids and adults out here, and while it’s possible to make a difference in an adult’s life, I know that it’s more likely to have an impact with a young child who is just getting their permanent teeth. I think if we can influence them to make better choices, and it can make a huge difference in the long run.”

Most of her presentations are with the younger kids. She brings in puppets, fluoride experiments and disclosing tablets. Kids specifically request seeing her when it’s time to go to the dentist, but she’s not after patients. She wants to make a difference. She wants to develop relationships with the schools, the nurses and the kids, so if she does go into the high schools to talk about serious issues like meth and heroin, they remember her — although meth is less of an issue in her community for the time being. Turella says “I just had a patient who is a local high school student tell me that meth is no longer a big deal in their school in Port Angeles, but kids are still using marijuana, Percocet and cocaine, to a lessor degree. I was planning to talk with the alternative high school in Sequim, focusing on caries and dental economics. Kids don’t realize the cost of dentistry, and if you’ve never had to worry about something or pay for it, it doesn’t have any meaning. By reviewing the economics of prevention versus the cost of repairing teeth, I may have an impact witht he older kids.”

We are so grateful to have volunteer dentists we can support throughout Washington state. As a WSDA member, it’s free to borrow materials, DVDs, PowerPoints, and if you’re going to an underserved population, we’ll send you hygiene kits for free.

If there’s a Science Night, community event or school you’d like to visit, please contact WOHF to request support. We have presentations for smoking, drug use and general oral hygiene.

Not sure what you’d like to do, but want to know more? Please contact Launa@wsda.org.

WOHF Visits Queets-Clearwater School

“Drive up to the mile marker, and it’s there by the trees.”

The Foundation has been to some little schools in some ‘blink and you’ll miss it’ towns, but we’ve never received directions quite like this before. A colorful totem pole guards the entrance to Queets-Clearwater School. The kids all know each other, and the school is one of the few places on that stretch of ancient shrubs and forever sky. The closest Native Community Health Center is over an hour away, so we set to work when Principal Ferguson invited us out to do an oral health presentation. He explained that the Smile Mobile was coming out, and he wanted to make sure families knew how important it was to receive dental services.

Dr. Marc Tomlinson agreed to join the Foundation for the trip. Tomlinson says he loves his experience with the population out there but noted that without the Smilemobile, many locals wouldn’t get rudimentary oral health education and care. “We need more consistent fluoride applications and better oral health education — there is a tremendous dental need in the area. A third of the adult population in that area has at least one full denture in their mouth, and that’s sad.” He provided all the students and visitors with a free screening and referral chart, so the parents of kids with carries could make appointments with the SmileMobile. Principal Ferguson even arranged drivers to get the kids from the school to treatment.

Dr. Tomlinson says, “The children in the Queets-Clearwater schools have issues with diet and exercise, and even though the water is fluoridated many of the kids aren’t drinking it. The parents are poorly educated, so they’re not getting the oral health message to their children — at a recent event only one child had healthy teeth — the other kid’s teeth had either been restored or had lots of problems. Diet is a problem, there’s no local access to healthy foods, the Queets store has mostly junk food, and you have to drive a long way to Aberdeen or Forks to get to grocery stores with healthy choices.”

Between WOHF staff and volunteers, more than 2,000 kids in our state benefitted from oral health education programs last February.

Children may not be able to decide what they eat or whether they see a dentist, but we can teach them how to take charge of their oral health and give them the tools to keep doing it. It’s one of the most important ways in which we can empower our state’s youth.

Interested in volunteering? Please contact Launa@wsda.org.

Adopt-A-School Program at Work

In early May, the Foundation got a frantic call from a school nurse in Spokane. She’d spent the morning consoling a teary-eyed mother and her eleven-year-old son. He’d broken his teeth off skateboarding, and they’d exhausted themselves trying to find a dentist who would see them. It was a Friday, and they couldn’t find a dentist who took Medicaid.

Dr. Toillion responded immediately. He didn’t care what kind of coverage they had or whether they had any at all. Michele, a front office staffer at Toillion’s practice explains, “Our doctor’s priority is to take care of the child and get him out of pain — the ability to pay is secondary. In this case, the child was covered by Medicaid, but had he not been, we would have taken care of him anyway.”

WOHF staffer Launa Lea got a call from the boy’s mother later that day. She was breathless and almost hysterical from relief.

“He’s smiling again,” she stuttered, “he’s smiling with all his teeth back in!” I heard the little guy for the first time, faintly, in the background, “Thank you.”

There are still families who aren’t covered. We are so grateful for our dedicated dentists who will accept emergency referrals, volunteering to take kids out of pain. Thank you. Thank you. Thank you.

For more information about how you can adopt a school near you, please contact Jiwon@wsda.org.

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wohf news wohf staff goes to queets, wash.

QUEETS, WASH

WOHF staff visit the bucolic town

ththee wsda wsdane newws s · · issue issue8, 8,august august· ·2014 2014· ·www.wsda.org www.wsda.org· ·39 39

U N I V E R S I T Y

O F

W A S H I N G T O N

SCHOOL OF DENTISTRY

CONTINUING DENTAL EDUCATION FALL 2014

SEPTEMBER

NOVEMBER

6

1

Hollender Symposium – Oral Radiology, The Evolution Goes On. Where Are We Now? Robert Langlais, DDS; John Ludlow, DDS, MS, FDS RCSED; Alan Lurie, DDS, PhD; Axel Ruprecht, DDS, MScD, FRCD(C); and Gerard Sanderink, DDS, PhD

12 Restorative Update 2014 Richard G. Stevenson III, DDS 22 Oral Pathology Evening Course: HPV-Induced Benign & Malignant Oral Lesions Dolphine Oda, BDS, MS

OCTOBER 3

An Update on Implant Options for the Partially Dentated and Edentulous Patient Including Fixed Removable Prosthetics Keith Phillips, DMD, MSD This course is offered in partnership with the Seattle King County and Pierce County Dental Societies, and will be presented in Auburn.

7

Olympia

15 Provisionalization of Single Implants in the Esthetic Zone – a hands on course Yen-Wei Chen, DDS, MSD and Sul Ki Hong, DDS

Kitsap Peninsula Office

21 Perio Topics for Today’s Dental Practice Morning: Perio Patient Information Management Afternoon: Nutrition, Lifestyle and Perio: An approach that can change lives Timothy Donley, DDS, MSD This course will be presented in Tacoma, Washington.

Plan Ahead for Sunshine and Oral Pathology in 2015!

February 14-15, 2015 To Biopsy or Not to Biopsy: Soft tissue and Bone Pathology for all Dental Practitioners Dolphine Oda, BDS, MS This course will be presented in Lahaina, Hawaii

Online Courses at www.uwcde.com including Bloodborne Pathogens!

Registration Information: REGISTER Telephone: (206) 543-5448 Toll Free: (866) 791-1278 NOW! For more detailed course information and to register online visit www.uwcde.com

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Oral Health to Total Wellness: Discover the Links and Learn Practical Application Susan Maples, DDS

31 Clues to Your Patients’ Health: The Most Common Physician-Prescribed Medications Hal Crossley, DDS, PhD

Save the Day with Emergency Preparedness!

Bart Johnson, DDS, MS

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14 Oral Cancer Eric Statler, RDH and Dolphine Oda, BDS, MS This course is presented in partnership with the Washington State Dental Hygienists’ Association.

17 Sixth Annual Washington Dental Service Practice Management CDE

27 Oral Pathology Evening Course: Oral Ulcers and Sloughing Epithelium: An InDepth Evaluation of the Causes Dolphine Oda, BDS, MS

Morning lecture: Management and Prevention of Gingival Recession: The Interactive Seminar George K. Merijohn, DDS Afternoon workshop: Autogenous Gingival Grafting: The KIWImethod™ Minimally Invasive Non-palatal Approach – a hands-on course George K. Merijohn, DDS

Professional Management Associates, Inc

SCHOOL OF DENTISTRY UNIVERSITY of WASHINGTON

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4 0 · th e wsda ne w s · issue 8, august · 2014 · www.wsda.org

Dr. Harry J. Kraft

Dr. Harry Kraft, beloved father, grandfather, great grandfather, brother, uncle, friend and dentist, passed away August 5 after recently celebrating his 90th birthday.

He leaves behind not only a large and loving family but generations of patients who to him were also family.

Kraft was born July 1, 1924 in Seattle to Eli and Esther Kraft, and he attended Horace Mann School and graduated from Garfield High School in 1941. He attended the University of Washington before enrolling at the University of Oregon School of Dentistry where he earned his DMD. He spent two years in the United States Army as a Captain in the Medical-Dental Corps. He taught at the University of Washington in 1955-56 and practiced dentistry from 1948 to 2004 — 49 of those years in the Cobb Medical Center in downtown Seattle. He married Leatrice Hanan in 1948, and they celebrated 64 happy and laugh filled years of marriage before her death in 2012. They raised their family on Mercer Island and lived there until they moved to the Bellettini in Bellevue in 2011.

While many decades past college age, Kraft felt there was never a time he couldn’t learn more. He was an avid reader and bridge player. Regretting he never earned a Bachelor’s Degree, he returned to the UW and in 1996 earned that Bachelor’s Degree in History.

He was active in many dental organiza-

tions, including the Alpha Omega Dental Fraternity, which he served as president, a frequent handball player at the Jewish Community Center on Mercer Island and a tremendous supporter of his children and grandchildrens’ sports and activities. Everyone knew and loved “Bop.” Kraft is survived by his three children, Elaine (Jeff Bean), Rob (Lori) and Richard (Debra); grandchildren; Paul Somerstein (Karly), Leslie Somerstein, Rachel Barrasso (Danny), Aaron Kraft and Bri Kraft; two “bonus” grandchildren, Shoshana Bean and Ahmad Corner, and great grandchildren Adam and Alex Somerstein, plus numerous nieces and nephews with whom he was very close. His sister, Sylvia Menard, also lived at the Bellettini over the last year, giving both of them great comfort.

Dr. John Andrew Herseth

Dr. John Andrew Herseth was called to his eternal home July 18, 2014, at the age of 89. He passed peacefully, surrounded by children, grandchildren and great-grandchildren at his home in Bellingham. Herseth was born in Hitterdal, Minn., August 26, 1924, to Cora (Sylvester) and Adolph Herseth, and was raised in Bertha, Minn.

He graduated from the University of Minnesota Dental School in 1947 and married Betty Jane Anderson at First Lutheran in Ballard on December 31 that same year.

After serving as a dentist in the military, Herseth began his dental practice in Both-

ell in 1954. They raised their four children in Woodinville and Bothell. They were active members at First Lutheran in Bothell and Peace Lutheran in Monroe. Their last parish was Zion Lutheran in Snohomish.

He was always active in his church in many capacities.

He was a true renaissance man with a beautiful tenor voice that he shared at church and in a barber shop quartet. He also enjoyed golfing, hiking, skiing, growing berries, his Norwegian heritage (especially lefse making), animals (raising horses, goats, sheep, chickens, peacocks, geese and many dogs and cats), traveling, and craftsmanship (including designing and building a log home from trees on the family property), all the while maintaining his keen sense of humor.

He also helped to start the Northshore First National Bank in Bothell, serving as president of the board. He was preceded in death by his loving wife, Betty, his parents and siblings. He is survived by children, Elizabeth Herseth (Phil Kuyper), John Herseth, Freda Herseth (Braxton Blake), and Marie Herseth Kenote; grandchildren, Anneliese Floyd (Jared), Saul Seyler (Giovanna McLaughlin), AnneKristine Valentine (Benjamin), Rebekah AuYeung (Matthew), and Ruth Kenote; great-grandchildren, Cora Floyd, Mieka Floyd, Allegra Seyler, and Reina Seyler; and all those to follow.

the future. We look with a suspicious eye with the goings on in the “corporate clinics” sometimes forgetting there are actual dentists practicing there. They may have little or no control over their staff so issues relating to hiring and firing of a front office person is not something that affects them; a PNDC class on the topic is irrelevant. It is doubtful that many public health clinics and military offices are going to be installing a CEREC soon so that training may not be of interest to them. More and more of our colleagues will not identify with private practice, and we don’t identify with their practice environments.

But we are all dentists, most of whom are subject to the whims of Olympia and DC. We all need to know how to place a good implant, invest our money, utilize the skills of our hygienists, whether that bond-

ing agent works and what is the latest instrument out there to make my life easier. I fear we are becoming isolated even more in our own little worlds without contact with other dentists and even knowing about the issues facing our profession. Will we fragment like medicine has?

We are always going to be stronger when united. Are we going to just deal with the immediate pressures of the day and go home without any thought for what’s happening to our profession—leaving that to outside forces who may not have our patients’ best interests in mind? And those forces certainly don’t have our interests in mind.

Organized dentistry has figured out the “woman thing” fairly well and welcomed lots of talented ladies into the profession and leadership throughout the entire

th e wsda ne w s · issue 8, august · 2014 · www.wsda.org · 41

tripartite structure (Hoo-rah!). We still struggle at times with some minorities, but outreach efforts are continually made. But the generational gap may be the downfall of organized dentistry if we don’t find ways to be relevant and attract younger dentists into membership. The profession is imperiled if we don’t. See Medicine!

parrish or perish continued

parrish or perish, continued from page 50

in memoriam drs. herseth, kraft

In memoriam

new ideass annie spalding, recycling queen

Annie Spalding never really set out to have a mission — she was a dental hygienist with a fulfilling career when her life took a terrible, tragic turn. “I lost my brother and grandparents to cancer in a five year period,” she says. Spalding and her mother were cancer survivors, too — and that, coupled with the losses put her in a slump. “I had to figure it out, “ she explains, “I needed to know why I was still here. Instead, I asked myself a different question —‘What is it that I love?’ You have to follow what you love to do, otherwise our life is pointless.”

A love of the ocean

Spalding always had a fascination with the ocean and what she calls the mysticism of it, so she began volunteering at the Seattle Aquarium (http://www.seattleaquarium.org) where she learned about the gyres of trash in the Pacific Ocean (see sidebar on page 41). Gyres are massive, slow rotating whirlpools, which accumulate plastic trash that has made it way into the ocean. According to the website 5gyres.com, “The North Pacific Gyre, the most heavily researched for plastic pollution, spans an area roughly twice the size of the United States – though it is a fluid system, shifting seasonally in size and shape.” When Spalding learned about the gyres, she set out to make a difference, starting in the dental practice where she works. First, she got in touch with Cleanscapes/Recology and had them conduct a waste audit of her office. “They had us save up all of our trash for a week prior to the audit and did a full report of the contents of our trash,” she relates, “They found that 65 percent was recyclable plastic. None of the dental companies have any infrastructure in place to recycle any of the plastics — and now I see why. We’re habitual as an industry, and in the 80s when cross contamination issues first came to the fore, we set standards in place to protect our patients – gloves, masks, plastic barriers for everything. It’s a necessary evil. But the plastics part got me wondering if we really need all those barriers. That’s uncertain at this point, but at least we can recycle it.”

Spalding started putting out feelers and found that the morass of recycling criteria and laws is a lot to wade through. Within King county, each of the cities contracts a different recycling contractor with slightly different criteria – it’s a mess, and was a battle Spalding knew she couldn’t effectively fight. Instead, she decided to make it her mission to create awareness and serve as a conduit for information, so that people are aware that recycling dental plastics is possible — albeit to varying degrees, depending on where you live. She explains, “My goal was to get each office participating in recycling just one type of plastic — the sheaths we use to cover chairs and lights — and create one stream for that kind of plastic to be reused. The trouble is, that represents so much plastic, that in order to recycle it an office would have to have a lot of storage space, or be able to transport their recyclables to a facility often enough to not require storage.”

A mountain of waste

Even a regular sized office can generate an enormous cache of recyclable plastic in a month’s time (see inset photo — that’s the amount of recyclable plastic Spalding collected from her own office in one month). Spalding had her work cut out for her, noting that plastic consumption is all over the map — “I’ve been in offices that use twice as much plastic as ours, and those that use less.” To illustrate the amount of plastic used in King county, Spalding describes it this way. “In King County there are about 2,000 dentists, and if every office used just one bag per patient per visit (in her office Spalding says they use three bags per patient, per visit), in one year the bags used would fill 3.25 Olympic-sized swimming pools full of plastic waste — and that’s just in King County.” continued on page 45

4422 ·· th thee wsda wsda ne new wss ·· issue issue 8, 8, august august ·· 2014 2014 ·· www.wsda.org www.wsda.org

new ideass annie spalding, recycling queen

RECYCLING QUEEN:

Annie Spalding is on a mission, and she needs your help

th thee wsda wsda ne new wss ·· issue issue 8, 8, august august ·· 2014 2014 ·· www.wsda.org www.wsda.org ·· 43 43

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4 4 · th e wsda ne w s · issue 8, august · 2014 · www.wsda.org

Finding resources

For the time being only Cleanscapes/Recology has a program in place that will take the clear bags, and even then only in parts of Burien, Carnation, Des Moines, Issaquah, Seattle and Shoreline. Everyone else can visit www.bagyourbags.com to learn how they can recycle bags and film in the following areas: Auburn, Bellevue, Bothell, Burien, Covington, Des Moines, Duvall, Enumclaw, Federal Way, Issaquah, Kent, Kirkland, Maple Valley, Mercer Island, Newcastle, North Bend, Redmond, Renton, Seattle, Shoreline, and Woodinville.

For those not fortunate enough to live in an area serviced by Cleanscapes/Recology, the quandary is storage and transportation of the material, combined with finding interested people with a passion to make a difference — people willing to schlep bags from their practice to approved facilities. Spalding gets it — there are a lot of hoops to jump through, but she’s looking for budding conservationists to take the baby steps with her to get this movement off the ground. And, she realizes that not many practices have the room to save up the materials before transporting them to an approved site, although some simple solutions might work, she says, explaining, “It’s all air, we need to condense it down so it doesn’t take up so much space and is easier to transport offsite. We have to make it easy for them.” She’s come up with ideas like vacuumsealing the film into bricks, or finding other ways to minimize storage issues. And while Spalding says that King County is on board with her efforts, she’s a one-woman operation, and hasn’t had the time to revisit with them to see how all of this could be coordinated. To make matters worse, the bags can only be recycled together — not with any other plastics, and you have another impediment to the problem.

So what’s next? Spalding looked into creating biodegradable bags and, but there’s a catch: the film needs organic material inside and around it to properly degrade — a bag filled only with film would take too long. The bags can also be broken down and made into pellets to make lids and hundreds of other recycled products. There are companies who use the products – Trex is one, International Paper is another. But it’s still a matter of getting it to one location and baling it. The shocking truth is that nearly all of our recycling waste right now goes to China. Recently, however, China has started to refuse recycling and garbage shipped from the US, because the number of colors and types of plastic made it too hard to work with. And, she says, the biggest problem is access: even though coverage in western Washington is spotty, she knows there’s even less on the east side of the state. There is much work to be done, and Spalding’s goal is that this piece will generate interest in helping her attack the problem.

How you can help

gyre info Want to learn more?

Here are links to papers explaining gyres Plastic pollution accumulates in oceanic gyres http://5gyres.org/media/Tracking_ Ocean_Debris_2008.pdf

The Quantitative Distribution And Characteristics of Neuston Plastic in the North Pacific Ocean http://5gyres.org/media/Day_1989_plastic_in_North_Pacific_Gyre.pdf

A Comparison of Plastic and Plankton in the North Pacific Central Gyre http://5gyres.org/media/Moore_2001_ plastic_in_North_Pacific_Gyre.pdf

Plastic Particles in Surface Waters of the Northwestern Atlantic http://5gyres.org/media/Plastic_particles_in_surface_water_of_the_northwestern_Atlantic.pdf

Like the gyres she hopes to eradicate, Spalding is awash in a problem too big for one woman (no matter how determined she is) to handle. She needs allies and foot soldiers to help her take her campaign to the next level. If you would like to join her cause, you can reach her through her website at cleanseaconsulting.com, on her facebook page at facebook.com/pages/Clean-Sea-Consulting/1405908532961453 , or at her email at annie@cleanseaconsulting.com. Additionally, Spalding says you can purchase recycling bins for your office and purchase clear plastic liners for your bins (low density polyethylene) to recycle all of your clear plastic film. It is imperative that the liners that you use are clear, you cannot use black. Remember to separate out all of your clear plastic bags during the course of your day at the practice. And please, visit 5gyres.com to read about this tragedy on the seas. It’s a problem that won’t go away on its own.

Plastics on the Sargasso Sea Surface

Additional resources:

http://www.sciencedirect.com/science/ article/pii/S0025326X09001787

King County Bag drop locations*: http://your.kingcounty.gov/solidwaste/garbage-recycling/bag-your-bags.asp

Plastic Debris in the Surface Waters of the South Atlantic

http://5gyres.org/media/Carpenter_1972_plastic_in_North_Atlantic_Gyre.pdf

Floating marine debris surface drift: Convergence and accumulation toward the South Pacific subtropical gyre

CleanScapes/Recology (current customers): http://www.cleanscapes.com/burien/recycling_guidelines/recycling/recyclable_materials_list/

http://5gyres.org/media/Plastic_Debris_ the_South_Atlantic_Gyre.pdf

*The clear dental plastic bags MUST be bundled in a clear plastic bag.

Natural and Plastic Flotsam Stranding In The Indian Ocean http://5gyres.org/media/Flotsam_in_ the_Indian_Ocean.pdf

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new ideas annie spalding, recycling queen

recycling queen, continued from previous page

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Ryan R. Busk, D.M.D. has acquired the practice from the estate of Richard T. Grubb, D.D.S. - Wenatchee, Washington

Priti Bhat, D.D.S. has acquired the practice of Harleston E. Runion, III, D.M.D. - Kirkland, Washington AFTCO is pleased to have represented all parties in these transitions.

Helping dentists buy & sell practices for over 40 years. th e wsda ne w s 路 issue 8, august 路 2014 路 www.wsda.org 路 47

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4 8 · th e wsda ne w s · issue 8, august · 2014 · www.wsda.org

OPPORTUNITIES AVAILABLE

OPPORTUNITIES AVAILABLE

DENTIST ASSOCIATE OPPORTUNITY — S.W. Washington State. An opportunity for an experienced associate dentist is open in Vancouver, Wash. This is a busy, locally owned, well established, multi-dentist office. This modern, well-equipped, quality practice is very Patientoriented, great Staff, excellent Dentists, very stable business. We offer very competitive earnings, benefits, opportunity. Email your CV to mbowercons@aol.com or Fax to (360) 604-7927.

SEEKING ASSOCIATE/PARTNER DENTIST — Port Angeles, Wash. We are a small group of private practices in Western Washington dedicated to providing dentistry at the highest level.

We are seeking a long term associateship/partnership with someone who is passionate about providing excellent care and has the ability to relate to each and every patient. The facility is modern, digital, and most importantly has an experienced caring staff to support you. Please email resume and CV to adam@cramerdentistry.com.

PORTLAND, ORE. — Dentist opportunity.

Do the clinical dentistry you want to do. We offer paths in which you can manage or open your own practice with profit sharing. Pdxdentist@yahoo.com.

ASSOCIATE DENTIST, SHELTON, WASH — We are a well-known private practice in Shelton, Wash. seeking an associate that believes in delivering the highest quality of dentistry in a friendly, family oriented environment. We offer great benefits and long term possibilities. You will be free to work in the areas of patient care you are most comfortable with, but will always have the encouragement to gain further skills. If this opportunity is of interest please email resume to help4dds@gmail.com.

ASSOCIATE DENTIST — A busy private practice in Marysville seeking a highly skilled longterm associate dentist to join our family practice.

Must have 1-2 years of private practice experience and be proficient in operative dentistry.

Three days available with the opportunity for growth and benefits. We are looking for someone who is productive, communicates well with the patients and the staff and has high energy.

Please submit your CV for consideration. Email to dupontfamilydentist@gmail.com.

EXPERIENCED DENTIST WANTED — For a non-profit clinic in Vancouver, Wash. The clinic provides dental care to adults, children, and seniors. Send resumes to Melody at melody@ newdaydental.org.

ORTHODONTIST WANTED — Looking for an Orthodontist for our office in Lynnwood, Wash. Apply Online: http://interdent.force.com/ careers/apex/ts2__JobDetails?jobId=a0xi00000 01ZNRtAAO. PEDODONTIST WANTED — Part time position open in North Seattle. Apply Online at : http://interdent.force.com/careers/apex/ts2__Jo bDetails?jobId=a0xi0000001ZLQ9AAO. GENERAL DENTIST — Full time, North Seattle. Would you like to apply to this job? http:// interdent.force.com/careers/apex/ts2__JobDetai ls?jobId=a0xi0000001ZLJFAA4 ASSOCIATE WANTED-Seeking FT or PT experienced general dentist to join established family and cosmetic practice in Tacoma. This can also lead to a Buy In/Partnership opportunity if desired. Dentist must be skilled and personable and willing to be an integral part of the practice in our state of the art facility. Please e-mail resume to: docvan99@aol.com or fax to: 253891-1442.

DENTIST – TWISP, WASH. — Wonderful opportunity to practice in the beautiful Methow Valley, located in the heart of the North Cascade Mountains. Well established and busy practice offers an associate position or purchase option.

Owner dentist available to ease transition and work for you if desired. State of the art facility, remodeled in 2009 with 5 operatories and 1400 active patients. Interested parties can email: johno@methownet.com.

DENTIST NEEDED — Growing general dental offices are seeking caring, competent dentist with great people skills to join our team at greater seattle area. Excellent opportunity for potential partnership. Please email resume to dentalresumeneeded@gmail.com.

EXPERIENCED DENTIST WANTED-- For associate position in busy Camano Island, WA practice in scenic rural setting. Emphasis on family dentistry. Prefer training and experience in oral surgery and removable prosthetics. Very stable long-term staff. Please send resumes to Camano Island Dental, 810 N. Rekdal Rd. Camano Island, Wash 98282.

GENERAL DENTIST — Seeking an experienced general dentist to join established group practice approximately 32 hours per week in Vancouver Washington. Please send CV to jennifers@wendeldental.com.

ASSOCIATE DENTIST — Downtown Seattle.

Experienced associate dentist needed for a busy, well established, fee-for-service practice in downtown Seattle. Long term, highly capable staff. 3-5 days a week. Great income opportunity. Please email CV campheathern@ gmail.com.

PART TIME OPPORTUNITY FOR RESTORATIVE DENTIST – High quality solo practice with top staff, facility and equipment seeks an experienced dentist to work at least one day a week routinely and willing to fill in for occasional vacation time coverage. Perfect for retired dentist or one with young children who may not desire a full time commitment. Easy to reach location, just north of Seattle. Please fax resumes to (425) 775-9615.

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GENERAL OR PEDIATRIC DENTIST — Great opportunity on the east side of the cascades.

Established and very busy group practice looking for an energetic and motivated general or pediatric dentist. We’ve got the patients, the chairs, and the best support staff possible ready to make your transition easy from the start. Great earnings potential if you are experienced and efficient. We are also a great place to learn if you are a recent grad or just need a little brushing up on children’s dentistry. Our experienced dentists and orthodontists can help get you up to speed. Contact us today if you’re ready for a new adventure! Please contact Jolene Babka at jbabka@applesmiles.com for further information.

WASHINGTON GENERAL DENTISTS — Our goal is to partner with our patients and practice proactive dentistry. We have excellent opportunities for skilled dentists and specialists throughout Washington. For current practice openings please contact Nathalie La Chance: (503) 952-2172 or nlachance@willamettedental.com and visit www.willamettedental.com/careers. See our ad on page 47!

DENTISTS NEEDED — Dental Professionals is recruiting dentists for temporary and permanent positions throughout western Washington – Vancouver to Bellingham and the Olympic Peninsula. No fee to you and you pick the days and geographic locations that you are available to work. This is a great opportunity to earn supplemental income or find a permanent position. If interested please call Bob at (206) 767-4851.

ASSOCIATE DENTIST — Prosthodontic/IV Sedation. Practice seeks experienced dentist to practice in the Woodinville area, state of the art equipment and facility. Please fax resumes to (425) 485-0764.

PART-TIME GP IN BELLEVUE — We are looking for an associate in Bellevue to work 2.5 days Wed-Fri. More days possible. We are a top office in our area. Beautiful modern office with state of the art technology. Fantastic patients and team. Fully digital. Must be highly skilled and experienced. Please email resume to bellevuedentists@gmail.com.

classifieds issue 8, august 2014

OPPORTUNITIES AVAILABLE

membership membership marketplace

membership

MARKETPLACE GENERAL DENTIST — Seeking associate position in private practice. Focused on providing conservative dental care with the patient’s best interest at heart. Confidence with providing dental care to children. Fluent in Mandarin. Email maoj@uw.edu.

CONFIDENT AND PERSONABLE — Student (graduation 6/2014) seeking associateship with path to ownership. Interested in practices north of downtown Seattle. Six months experience as provider in CHC. Email matt1485@uw.edu for resume.

GENERAL DENTIST — Seeking associate position in private practice. Responsible, patient, compassionate, enthusiastic. Interested in Seattle&Eastside area position. USA and EU license. View my CV at http://chalakov.net/yankach.pdf Email: yanka@chalakov.net GENERAL DENTIST — Seeking associate position in private practice. Confident, friendly and patient-focused. Interested in Puget Sound area but all opportunities welcomed. View CV at http:// tinyurl.com/ny28pts. Email me at deaster5@uw.edu.

GENERAL DENTIST — Seeking long-term associate position in private practice. Interested in greater Seattle area. Compassionate, dynamic, patient-focused. CV available at http://tinyurl.com/ mxg25ng. Email me at estherradds@gmail.com. 206-972-3374.

Each issue, the WSDA News will run up to 30 free classifieds for dental students and new graduates of dental schools who are seeking employment. To qualify, you must be a member of ASDA or the WSDA. Restrictions apply. Please contact Laura Rohlman at laura@wsda.org for more information.

VERY MOTIVATED —Personable graduate seeking associate-position on the East Side. Comfortable doing OS, endo, pedo, perio surgery, and pros. Willing to work extra days and great addition to any staff. Email: alexwardian@gmail.com ENDODONTIST — seeking long term associateship or buy-in/out in Washington State. I am also interested in providing care for an organization or multi-specialty center. E-mail me at: waendo@ yahoo.com DENTIST ANESTHESIOLOGIST — 10,000+ hours experience in sedation and anesthesia. Nationally recognized author. Safe and effective techniques. Comprehensive services in your office. Responsible for malpractice and DEA. www.northwestdentalanesthesia.com info@northwestdentalanesthesia.com UW GRADUATE ‘14 — Seeking associateship in private general practice. Keen to develop business skill. Oral medicine interest. Considering positions w/i 50 mi. of Seattle. CV available at http:// tinyurl.com/kdn5e98. t.duffman@gmail.com 425.890.7205 SEEKING LONG-TERM ASSOCIATE POSITION — In private practice in King/Pierce County. Personable, people oriented, skilled, and motivated to learn more about advanced dentistry. Graduation June 2014. For resume please email szolfa@gmail.com SEEKING LONG TERM ASSOCIATE POSITION — In greater Seattle area. Compassionate, patient-focused and enjoy doing dentistry. 2 years experience in private practice. Please email shan0313@u.washington.edu for resume and CV.

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OFFICES FOR SALE OR LEASE

OFFICES FOR SALE OR LEASE

DENTIST OPPORTUNITY IN WESTERN WASH. — Seeking experienced dentist for busy, well established, successful, fee for service, group dental practice. Full-time position available. Excellent immediate income opportunity ($180,000 to $375,000 + per year) depending on productive ability and hours worked. Secure, long-term position. You can concentrate on optimum patient treatment without practice management duties. Modern well-equipped office with excellent staff, and lab services provided. If you are bright, energetic with a desire to be productive, very personable, and people oriented, and have great general and specialty clinical skills, Fax resume to Dr. Hanssen at (425) 484-2110.

BELLEVUE, WASH — Great downtown location; easy access to I-405 and 520; freestanding building with ample private parking; & ready to move-in turnkey opportunity for a satellite office or any dentist looking to start immediately. Reasonable monthly rent. Four modern state-of-the-art fully-equipped operatories with networked dual-monitor Dell computers for ease of patient communication. Each operatory has small instruments and an x-ray machine plus a central pano/ceph/developer.

The office is fully furnished with modern reception area, sterilization, doctor’s office, lab, staff room, 2 bathrooms and a private shower.

Asking $325K; owner ready to sell now. Call (425) 770-2288.

FOR TRANSITION — King County- Snohomish County border- Practice available for transition. This established fully equipped office is near residential areas, schools, multiple retail centers and a major park and ride. This experienced 15 and ½ year practitioner is a proven income producer. The practice generates a great net income and priced to sell. For additional information please call or email linda@pnwpps. net (206-399-5677) or email conradelledge@ earthlink.net.

OFFICES FOR SALE OR LEASE

PRACTICE FOR SALE — Multiple doctor practice, Snohomish County. Excellent opportunity to purchase a mature well-established family general practice! Established 1978, this strong family practice has a thriving loyal patient base built primarily on referral. This one of a kind opportunity is Ideal for a younger dentist who wants a turnkey, well maintained business and facility without the hassles of starting from scratch. We offer our patients the best in materials, technology, procedures and customer service. Our team is well educated and trained in providing the highest standards of patient care.

We believe in building long-term, meaningful relationships with our patients for a lifetime of health. We are looking for a partner with a similar philosophy who is interested in massive success and continuing the legacy. Owner will stay to ensure smooth transition and will sign a non-competitive agreement. Contact us for more details: dentistrypracticeforsale.@gmail.com.

DENTAL OFFICE FOR SALE OR LEASE — Available for immediate occupancy. Ideal for auxiliary office or specialist. Four operatories.

(425) 495-2635.

FOR SALE — Great Start up or satellite office for GP or specialist. Located on busy street in Lakewood, WA. Four ops. 2 new chairs.

KAVO, digital, new compressor. All the supplies to start working right away. Low overhead. Asking 75,000. Some owner financing available with 50,00 down. Email practiceop@ gmail.com.

FOR SALE — Selling my dental practice of 23 years. Located in beautiful Grand Coulee Dam, the eastern side of Washington State.

500+ miles of lake shoreline, no traffic and some of the best fishing and hunting in the state. Live where other people play. Averaging $4-500,000/year on a three day work week.

Four operatories with new digital x-ray, double monitor computers in each room and an intraoral camera. Office paperless. Seeing 15-20 patients per day for general dentistry. Practice draws form approximately 10,000 including Coulee Dam, Grand Coulee, Electric City, Elmer City, Coulee City and surrounding wheat fields. Great place to own a boat and raise a family. Come take a look. Contact Dr. Jay Worden DDS, Class of 1990 U of W at (509) 6333167 or (509) 631-1400.

FOR SALE — 6,085 sq. ft. dental complex for sale $850,000, Great location with excellent visibility & signage Income in place $3,900.00 per month. Perfect owner user opportunity.

Joel Shabel (253) 653-3878.

FOR LEASE — Issaquah: Great opportunity for start up, relocation, or expanding office. Desirable Issaquah location providing 2588 sq ft with multiple rooms, high visibility and high traffic count, abundant parking and convenient freeway access to I-90. Serene view of tranquil Issaquah creek from your rooms. Neighboring general dentists and schools. Ideal for specialist. Opportunities are endless. Must see to appreciate. Available now. Call 425-786-1411 or email issaquahoffice@gmail.com.

SOUTHWEST WASHINGTON — Rare opportunity. This is the one you’ve been waiting for! Beautiful building and practice in Southwest Washington. There are seven operatories, five of which are equipped with top-of-the-line A-dec equipment. The practice uses Eaglesoft and is digital throughout utilizing the Scan-X phosphor plate system. Collections have averaged $846,000 for the past three years. This is a completely turn-key practice. The practice is equipped with A-dec Chairs, Units, Lights, and Cabinetry as well as Digital by Scan-X and Eaglesoft. The building is a free-standing dental building and also for sale with the practice.

Seller will consider carrying the note under certain circumstances. Call Rob 503-781-7311 or John (503) 320-8991.

DENTAL OFFICE SPACE, EVERETT — Great corner lot location, a few blocks South of downtown. 1,400 square feet -- with another 150 square feet shared storage and panolispe area. Four operatories, each with nitrous oxide, and custom cabinetry. Available August 2014. (206) 913-3376.

FOR LEASE —Vancouver, Wash. Next to Vancouver Mall. Brand new remodel 2,000 sq. ft., just move in equipment. Built-in cabinets, Pano room, private office. Very nice! neilgray@comcast.net.

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FOR SALE —— Downtown Seattle dental practice for sale. Long-established, small boutique practice with 3 operatories, Dentrix, Dexis, and Kavo handpieces. The office is nicely appointed with Stelty cabinets, and monitors and computers in the operatories. Asking $225,000, send all inquiries to: downtownseattledds@ gmail.com.

FOR LEASE — Ideal pediatric dental office space in Burien. Close to elementary schools in a neighborhood setting, corner office, great street exposure. Two established DDS GPs in professional building. Concept design for 5 chair pediatric office available. Request a showing at wckv@hotmail.com.

FOR LEASE — Turn key and fully equipped dental office in greater Olympia area. Located with close proximity to I-5; great visibility and easy access. Suite is 2000+ sq.ft., 5 operatories, great natural light, ample parking, staff lounge, and private office. Ready for immediate use, space available February 2014. Email: Hannajack@comcast.net or call 360.789.4841.

FOR SALE — Prosthodontic practice in the greater Seattle area. An outstanding practice with lo overhead and hi net collecting over $2 million annually. Building is in a great location with plenty of parking and visibility.

Building would eventually be for sale to prospective buyer. Experienced staff will stay on with the practice. Owner also would stay on 1-2 days per week for up to a year to ensure a smooth and complete transition. Practice also has two full-time removable lab personnel on staff. Ideal practice for someone with implant surgery experience who could take this practice to a whole new level. Contact: Buck Reasor, DMD, Reasor Professional Dental Services, Cell: (503) 680-4366, Fax: (888) 317-7231. Email: reasorprofessionaldental@ gmail.com.

PRACTICE SALE OPPORTUNITIES — South Seattle general practice,Four ops/ collecting $560k, new to market. Two general dental practice opportunities in Everett, Wash. For more details and information please contact: Jennifer Paine at (425) 216.1612 or email Jennifer@cpa4dds.com.

classifieds issue 8, august 2014

OPPORTUNITIES AVAILABLE

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OFFICES FOR SALE OR LEASE

EQUIPMENT FOR SALE

CHELAN LIFESTYLE — This is a well-established solo practice located in the beautiful community of Manson, Wash., literally on Lake Chelan. The office is centrally located in an established garden across the street from Manson Bay Park and marina.

Three fully equipped operatories well appointed with views of Lake Chelan. An ideal opportunity for a younger dentist who wants a growing practice without the hassle of a build-out Rural practice affords opportunities in all aspects of dentistry.

Routine procedures include oral surgery, placement of implants, periodontal treatment, endodontic treatment, and fixed and removable prosthetics. Local Highland Dental Lab within minutes from the office.

Lake Chelan lifestyle is a recreational paradise — boating, hiking, fishing, and skiing are all within minutes of the practice.

Annual production 800,000 on three day work week with six weeks vacation. Contact Delaney Transitions: 425-890-8271 / piega@delaneytransitions.com / www.delaneytransitions.com

NEXT/ANNIE MILLER & ASSOCIATES — I now have practices for sale in Bellevue, Tacoma, Lynnwood and Marysville. New dental locations for sale and lease at Cedar River, Olympia, Everett and 25 retail shopping centers. Annie Miller, ReMax Eastside Broker’s Inc 206-715-1444

USED/REFURBISHED EQUIPMENT — Adec, Gendex, Pelton Crane, Dentalez, Porter, Air Tech, Midwest, Midmark and etc. Lab equipment. Parts are also available for almost all equipment. Call Dental Warehouse at 800-488-2446 or http://cascade-dental.net.

FOR SALE — G/P practice for sale in downtown Seattle. Well established, mature practice for sale collecting over $350,000 annually.

Excellent modified start-up practice. Seven fully equipped operatories. Current staff will stay with the practice. Excellent collection policy in place. Practice has been located in downtown Seattle for over 50 years. Contact: Buck Reasor, DMD Reasor Professional Dental Services at info@reasorprofessionaldental services.com, (503) 680-4366.

G/P PRACTICE — For sale in West Seattle.

Practice collecting over $890,000 annually.

Facility located in a hi-demand area of Seattle. Excellent hygiene program in place.

Three Ops and digital X-rays. Great collection policy in place. Well trained staff will assist with the transition and stay w/ the practice. Please contact Buck Reasor, DMD, Cell: 503-680-4366 email : reasorprofessionaldental@gmail.com, www.reasorprofessionaldental.com.

SPACE SHARING OPPORTUNITY DOWNTOWN SEATTLE – Looking for a dentist with an existing practice to share our office space. This is not an Associate position.

Restorative practice with In-House C&B, and denture processing lab, and technician.

Modern downtown Seattle five chair office.

Lease ending soon? Decrease your overhead now! Opportunity to buy into the facility for the right person. drnicolini@hotmail.com.

FOR LEASE — Burien, Wash. Brand new, 2,700 ft, six op dental office with pano room, lab, break room, two restrooms and private offices. Completely wired and plumbed for state of the art digital dental office. $10/ft NNN or $2,200/mo. Must see to believe and appreciate. Great opportunity for start up or relocation. Contact (206) 909-3863.

FOR LEASE — Great location, over 2000 square feet, five operating suites in beautiful Olympia, conveniently located on Martin Way close to St. Peter Hospital. Over 30 years of quality dental care provided here. Contact Don at uncledgh@aol.com.

OFFICE SPACE TO SHARE — Excellent opportunity for specialist who wants to work one or two days a week or a start-up practice for any practitioner. Front office support. Contact Breezy at (425) 481-1038 or email office@ gentletouchdental.com.

FOR RENT OR SALE — Dental building available for rent or for sale in Marysville, Wash. to restart dental practice. This great opportunity is situated in an ideal midsize and growing cosmopolitan town in beautiful Pacific Northwest. Last time patients were seen at this location: end of June 2014. Right candidate needed to re-start and take ownership of dental practice established since 1984. Start-up inventory, the domain name listed below and community good will is available to support the right doctor for this location. For more information call (208)699-5311 or go to: www.marysvilledentalclinic.com. Email: olaruproperties@gmail.com.

FOR LEASE — Available for immediate occupancy. A fully plumbed dental office. 1,350 sq ft , three operatories, air, water, vacuum, nitrous oxide and oxygen, private office, lab, staff lounge, separate staff entrance. This office has exceptional exposure to the Southcenter Mall traffic. Call Diana at Medical Centers Management (253) 508-1293.

OPPORTUNITY — Dental office for sale in Burien. 15+ years in the same location.

Grosses over $350,000 a year, six operators and laboratory. Owner is retiring but will stay for transition. Some financial available.

Call JD at (206) 992-8771.

FOR LEASE — New construction. Professional Building in Lynnwood by Alderwood Mall. 2,000-6,000 sq ft available. Ample parking. Private entry. High visibility and high traffic count. Each unit has up to 40 sq ft of signage on main-street. Ideal for specialist and/or group practice. Call Dr. Nguyen at 206-250-3282 or email datman1@mac.com.

FOR LEASE — 300 Pelly Ave N. Dental suite available in Renton, walking distance to the prestigious Landing, as well as Boeing. 1,361 sq. ft. on 2nd floor, with only two other dentists in building. Three operatories, open configuration, plumbed with electrical, air, vacuum, and plumbing. Corner lot with heavy traffic flow. Rate is $23.26/SF/Y NNN, Triple Net is $5.60 (incl utilities). Contact Dennis Schmuland (425) 417-1206.

th e wsda ne w s · issue 8, august · 2014 · www.wsda.org · 53

EQUIPMENT WANTED EQUIPMENT WANTED — Looking for w ide ra nge of used equipment. Adec, Kavo, Midmark, Pelton Crane, Midwest, Gendex, Air Techniques, Apollo, Porter, Cerec, Sirona. If you want to sell equipment, call (206) 260-3563.

SERVICES MOBILE IV SEDATION — Have your patients treated in your office with safe and proven techniques. Set your practice apart from others. Attract new patients. Increase quality referrals. Neil E. Bergstrom, DDS (360) 825-6596.

TEMPORARY DENTIST/LOCUM TENENS: Hunting? Fishing? Photography safar i?

Maternity leave? Experienced, skilled, and compassionate female dentist, great with all patients, even young children, available to care for your patients while you’re away.

E-mail USDentalOutreach@gmail.com.

H AV E SE DAT ION, W I L L T R AV E L — Make fearful patients comfortable with IV Conscious Sedation. I am set up to come to your office and sedate your patients so that you can perform needed treatments the patients avoid due to fear. I have over 19 years exper ience prov iding safe I V Conscious Sedation. Serving Washington & Oregon. Richard Garay, DDS. (360) 2810204, garaydds@gmail.com.

GUEST DENTIST — Will fill in at your practice for maternity leave, injury, illness, family emergency, etc. 35 years of general dental practice experience. Personable and patient oriented. Dr. Ed Kardong (206) 842-6300.

OFFICE CONSTRUCTION CONSTANTINE BUILDERS INC. (CBI) — WSDA endorses CBI as their preferred builder of Dental facilities with over 25 years of experience from ground up buildings, renovations, remodels, and interior tenant improvement projects. All projects are completed on time and within budget. CBI provides the highest level of quality service with integrity that exceeds our client’s expectation. Please see our display ad on page two and website at www.constantinebuilders.com for additional information and how you can become another satisfied client. Telephone (206) 957-4400, O. George Constantine.

ALLIED CLINIC BUILDERS — Premier healthcare contractors in the PNW for over 35 years. On time, on budget and providing quality that you can afford. Call today for consultation George McBee - Allied clinicbuilders@comcast.net (425) 941-3088.

classifieds issue 8, august 2014

OFFICES FOR SALE OR LEASE

Who would have ever thought?

Dr. Jeffrey Parrish “If everyone is thinking alike, then somebody isn’t thinking.”

— George Patton

Back in the good old days of the 70’s (when men were men! Hoo-rah!), there was basically one way to get a dental license in Washington: take and pass the “nation’s most difficult clinical exam.” Yeah, you could practice at Fort Lewis (when it was Ft. Lewis and not JBLM—see good old days) without a coveted Washington license, but that was very much the exception. After many years of lobbying, griping, and moaning, we now have many different ways to get a license here. Frankly, that is probably for the good as one can debate the reliability of a board to weed out bad actors. And certainly, in order to move to another state, no one wants to have to take another board exam especially when they used to be given only in June and September (again, see good old days above).

Today, if you have passed a board somewhere and have a clean license, you can get in.

Or if you are a military spouse, out-of-state licensed dentist wanting to work a non-profit event, or here for some hands-on CDE course, you can get a temporary license to practice.

Faculty member at UW? No sweat; we’ll get you a license to practice and teach. (I remember a particularly touchy situation of a very talented specialist at UWSOD who could not get by the “nation’s most difficult clinical exam”. It took several tries as the guy had not done a foil or amalgam in decades. What a waste of his time, talent and resources to have to jump through that hoop to teach…and very well I might add. I still hear his admonition, “Elevate, elevate, elevate” whenever I am doing surgery.)

And now consider the increased avenues to practice compared to yesteryear; a minority of graduates now actually start in private practice. Most of us ‘70’s grads were going into private practice immediately or eventually; the few enlisting in the military were coming back to private practice either in a few years or after retirement. So we all basically had a common goal and point of reference: our own show somewhere.

But today there are many more options. Public health in all its iterations has expanded tremendously. There are many clinics out there looking to hire and not always just new grads. I recently spoke to a director of a large system of community clinics who indicated he takes new grads only from a few select schools because he can hire experienced folks who are “public health minded” and come to him. One can find employment in rural, urban and suburban clinics throughout the entire state so geography is not an impediment. And it appears that these opportunities will do nothing but expand as government funds more programs. Certainly there will be more dentists practicing their entire careers in these settings.

So-called “corporate dentistry” is expanding greatly and likely will continue to do so.

It seems like Willamette and Gentle Dental were the only games in town for many years, but lots more possibilities have popped up in recent years. Will they ultimately survive unlike the “doc in a box” clinics that appeared in some shopping malls 20 years ago? Time will tell, but lots of entrepreneurs are betting a bunch of money they will.

So why am I bringing up the obvious that is the real world of many dentists today? Because this all presents a unique challenge for organized dentistry. Over half of the dentists practicing in Washington are not graduates of UWSOD so we don’t have that commonality. More and more will never be in a private practice so the pressures and challenges of that venue will be foreign to many. Organized dentistry always has had a hard time relating to dentists’ needs in the military and public health, and there will be more of them in continued on page 41

The views expressed are those of the writer and do not necessarily reflect the opinion or official policy of the WSDA.

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50 IS THE NEW 40: It’s also the ideal time to purchase Long Term Care insurance.

Are you covered?

Washington Dentists’ Insurance Agency will make sure you are.

You’re in your 40s, and healthier than you’ve ever been.

So it may seem counter-intuitive to shop around for the Long Term Care coverage, but it’s actually the best time.

At WDIA, we can guide you and help you make decisions for your future.

Call Matt or Kerri today for a complimentary Long Term Care insurance assessment. They’ll help you navigate through the myriad choices, and connect you with the best products available. Call us today!

Life Disability Long Term Care Professional Liability Practice Loan Protection Health Savings Accounts Business Owner Coverage Group and Individual Medical Risk Management Consultation Medicare Supplements and MedAdvantage Employment Practice Liability

Matt French · Kerri Seims 206.441.6824 · 800.282.9342

CyberSecurity Protection ERISA Surety Bonds

www.wdiains.com

Washington Dentists’ Insurance Agency: LONG TERM CARE INSURANCE

th e wsda ne w s · issue 8, august · 2014 · www.wsda.org · 55

Sole broker for:

Washington State Dental Association 126 NW Canal Street Seattle, WA 98107

PRESORTED STANDARD U.S. POSTAGE PA ID SEATTLE, WA PERMIT NO. 8115

CHANGE SERVICE REQUESTED

How much is good customer service worth?

You may never really know how good your insurance company is until a claim is filed against you.

At NORDIC, we’re invested in you and the business ofinsuring you and your practice. When you call with a question, you’ll speak directly with the person handling that aspect of your policy, not a random operator. In fact, you’ll always speak with a live person unless you call after hours. We think that’s important.

Those big companies? Not so much.

NORDIC prides itself in excellent customer service before, during, and after a claim is filed against our customers.

800-662-4075 · www.nordicins.com 206-343-7800 · 206-441-6824

sole broker for NORDIC

5 6 · th e wsda ne w s · issue 8, august · 2014 · www.wsda.org