Wsda News Issue 5 April 2014 by Washington State Dental Association

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WSDA 014 ril 2 · ap e5

The voice of the Washington State Dental Association

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race and dentistry: a conversation th e wsda ne w s · issue 5, april · 2014 · www.wsda.org · 1

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WSDA news Cover story by Rob Bahnsen

editorial

guest editorial

6-13

cover story

14-17

pndc news

18-19

herzog wins golden apple

legislative news

ce news

peer review

28-29

issue 5 · april 2014

letters to the editor

in memoriam

41, 43, 45 42

classifieds membership marketplace

44 newsflash 46

parrish or perish

wdia news

coy nominations

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

WSDA Staff: Executive Director Stephen Hardymon Senior Vice President/ Assistant Executive Director Amanda Tran Vice President/Chief Financial Officer Peter Aaron General Counsel Alan Wicks Vice President of Operations Brenda Berlin Vice President of Communications Kainoa Trotter

Vice President of Government Affairs Bracken Killpack Art Director/Managing Editor Robert Bahnsen Manager of Continuing Education and Speaker Ser vices Craig Mathews Government Affairs Coordinator Michael Walsh 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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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 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. 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 5, april 2014

a day in the life

editorial dr. mar y jennings

Celebrating diversity

This month’s magazine celebrates diversity. Washington State has enjoyed such a diverse population that many of us forget that there are beautiful stories to tell and serious problems to solve. Judging from my looks, one would never think I am a registered member of the Chickasaw Nation. Levi Colbert, the civil chief of the Chickasaws at our time of removal on the Trail of Tears, was my four times great grandfather. The Chickasaws are known as “Unconquered and Unconquerable” and that is how I was raised. Like many of you, I was also raised to give back. My first job out of dental school was on the Gila River Indian Reservation in Arizona. I loved them and they loved me right back. I learned how to pull teeth on people that I swear had the hardest and thickest bones in the world. I found that the “universal” shades of composite are really not quite so universal. Most of my patients were quiet and so kind to the brand new dentist who was trying her hardest to serve them well. It was kind of my assistant, Irma, to invite me to her all day Navajo (Dineh) house blessing potluck. Each room was blessed and sage smoked by specialist elders. The prayers were lengthy and solemn. The party was great! I felt honored to be included. The hospital where we worked was also blessed with a full day of drumming, praying and singing each year. There was the day we shared the thin bluish black piki bread brought back from the Hopi Maidenhood Ceremony. Then, the day they sang me the song of the Black Mountain. There were not so good days. Learning that our nine-year-old patient had died and that alcohol related car accidents are still one of the leading causes of Native American children’s deaths. Seeing clinically, that the Pima Indian’s bodies have not adapted well to our modern diets. They have the world’s highest incidence of type 2 diabetes. The Pima’s diabetes has been studied by the National Institute of Health since 1963. I got teary when I pulled 28 mobile teeth from a diabetic 23 year-old woman. Her cheeks collapsed like an old person’s. I clutched the chair and swore like Scarlett O’ Hara that, “as God as my witness, I will make you the best denture ever,” and I did. But my life and stories literally pale in comparison to dentists who have actually grown up in diverse communities. I am fortunate to know George Blue Spruce, the founder of the Society of American Indian Dentists, the first Native American dentist and a former Assistant Surgeon General. He crossed strong cultural lines when he left the Laguna/San Juan Pueblos on a bus to go to college in 1949. He recalls his first Thanksgiving alone in his book Searching for My Destiny. “If there was such a thing as dying from homesickness and loneliness, I would have died.” He spent that holiday at the movies trying to cope. He was physically and culturally isolated. No one thought to notice. Thinking to notice. That may be the bottom line in diversity. Noticing that everyone grows up in different styles of households and, if it’s not pathological, it’s all right! Noticing that perfectly capable people may need a hand up, especially if their families did not pave the way for them. I suppose that after noticing comes realization. Realizing that no one who earned the right to join a college should ever live there in isolation. They should belong. The same applies to their belonging to a Dental Association. Realizing that both dental school and solo practice are inherently self centered experiences so it is easy to miss someone’s struggles or to not have the insight to realize that the playing field may not be completely level. We must also realize that cultural sensitivity is at an all time high in our nation. That brings a deeper dimension to dental issues. The Pew Charitable Trusts is studying how native people on reservations feel about native versus non-native providers. Not surprisingly, their data supports Pew’s inclusive concept of Native American midlevel providers serving their own tribal members. Last year, the National Congress of American Indian’s passed a bill supporting midlevel providers. All while we were not particularly noticing. Everyone has a story to tell. I am delighted that WSDA has noticed, and we have a conduit to get these stories out through our News and blogs. We hope to delight in our dentist’s successes and gain insight to each community’s specific problems. We want to actively work with all dentists who are engaged in their communities to help solve problems with oral health, advocacy and access to care. Once united, informed and focused, we are a formidable force to bring better oral health to every community.

Dr. Mary Jennings Editor, WSDA News

“Levi Colbert, the civil chief of the Chickasaws at our time of removal on the Trail of Tears, was my four times great grandfather. The Chickasaws are known as “Unconquered and Unconquerable” and that is how I was raised. Like many of you, I was also raised to give back.”

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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Let’s get one thing straight. I have NOTHING against dental hygienists. As a student, I happily shared classroom space, clinic floors, and celebrations of academic and personal milestones with hygiene students. Now that I’m in private practice, hygienists are an essential part of my success in the dental office. They are my friends, colleagues, and teammates in our shared goal of helping our patients achieve the best dental health possible. I need them. I love them. I respect them. That said, if one more new patient shakes my hand and asks when the doctor is coming in, I’m going to stab myself in the eye with a discoid-cleoid. Since I first started seeing patients as a third-year dental student, getting mistaken for an assistant or hygienist has been almost a weekly occurrence. Why is the concept of a female dentist still so hard for some people to grasp in this day and age? Our profession has changed in so many ways since Lucy Hobbs became the first American woman to graduate from dental school in 1866. What used to be a stodgy old boys’ club is now an equalopportunity playing field where smart, talented, and business-savvy women are successful practice owners, powerful policymakers, and active leaders in their communities. Yet, that hasn’t stopped many a patient (both male AND female) from sharing obtuse comments with me as. “Really? I didn’t know girls could be dentists!” Or, “Oh, when they said ‘Dr. Nguyen’ would be doing the surgery, I just expected you to be a man.” And then there’s my personal favorite: “I don’t understand why a woman would waste her time and money with all that school and training.” Over the years, I’ve devoted considerable effort to defending my choice to pursue dentistry as a career. Unfortunately, I think most of my audience tunes out 95% of what I say, choosing instead to come to their own wildly-inaccurate conclusions. Despite all my attempts to enlighten them by citing current statistics on women in dentistry and my own personal experiences as a student and clinician, I’ve found that there are many who cling to one or all of the following impressions about female dentists: 1. Women choose dentistry because it is an easier alternative to a career in medicine. 2. Women who go to dental school ultimately just want to practice part-time or become stay-at-home moms, live off their husbands’ income, and never have to work hard. 3. DENTISTS MAKE MONEY. GIVE ME MONEY. MONEY MONEY! I’m not going to sit here and pretend like there has never been ONE female dentist who entered this profession after failing to gain entrance to medical school and deciding to change gears. I can’t say that no woman has ever been attracted to dentistry because it has demonstrated high earning potential. And I certainly can’t say that there aren’t any girls out there who make it a goal to pick up an MRS while they’re working towards their DDS. But I firmly believe that, for the vast majority of women dentists, the decision to pursue a career in dentistry is a highly-personal one motivated by a multitude of complex factors that are unique to our own individual upbringings, personalities, and life ambitions. There’s a lot more to it—and us—than we’re given credit for. Growing up, I got to witness firsthand what life is really like for a medical doctor. My father is a senior attending in anesthesiology at a large hospital in New York. Though his job literally gives him the opportunity to save lives on a daily basis and afforded our family a relatively comfortable lifestyle, it has not come without major personal sacrifices. Because of the demands of his occupation, he routinely missed holidays, recitals, soccer games, and many other events that make raising children and having a family of your own so wonderful. When he WAS home, he was typically exhausted and/or unable to do anything that he couldn’t leave at a moment’s notice in case his pager went off. My mother went to so many parent-teacher conferences alone that it was years before my school realized that my folks had been together and living in the same house all along. As much as I respected my father for his incredible work, I knew that I didn’t want that kind of professional life for myself. I wanted a job that was equal parts science, creativity, and service to others. I wanted more flexibility, more work-life balance, and more face time continued on page 30

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Dr. Diana Nguyen

“Our profession has changed in so many ways since Lucy Hobbs became the first American woman to graduate from dental school in 1866. What used to be a stodgy old boys’ club is now an equal-opportunity playing field where smart, talented, and business-savvy women are successful practice owners, powerful policymakers, and active leaders in their communities.”

guest editorial dr. diana nguyen

For the last time, I am not the hygienist

cover stor y a conversation about race and dentistr y

race and dentistry: a conversation

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Dr. Jessica Bremerman

Dr. Yoshitaka Ogata

Dr. Woody Crow

Dr. Princy Rekhi

Dr. Richard Ferguson

Dr. Tyrone Rodriguez

Dr. Greg Ogata

Dr. Eugene Sakai

Dr. Marshall Titus

Editor’s note: This is not a compendium on race relations within the WSDA today, nor was it intended to be. Rather, we set out to ask questions that would stimulate discussion between colleagues of all races about how people of color practicing dentistry in Washington would describe the conditions they practice in today, versus what colleagues entering dentistry in the past faced. As evidenced by the number of people who declined to participate, race can still be a provocative issue — the elephant in the room, if you will — even in Washington state, where we pride ourselves as being open and affirming to all.

It’s not so much that views have changed, but that laws have changed. I don’t think that people’s viewpoints have necessarily changed, except to say that a lot of the prejudiced people are dying off. There’s a shift towards a group of people who have grown up in a world where race is not an issue and who believe it is wrong to deny someone because of race. They’re reinforcing this with laws on the books that make it illegal, which helps, too. And that’s really basically it. If you’re in a major urban area, there has been a cultural shift, but when you look at a map of blue and red states, the middle of America is pretty homogenous. You have to wonder if that is by design – do they not want to be around people who don’t look like them?

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— Dr. Marshall Titus

cover stor y a conversation about race and dentistr y

Our Participants:

cover stor y a conversation about race and dentistr y

“In this country, American means white. Everybody else has to hyphenate.” — Toni Morrison As a society we like to think that views on race and gender are changing — and that may be, but as Dr. Titus and others we talked to for this article pointed out, it may just be that the people holding on to antiquated views are dying off, relics of a time when making judgments based on the color of someone’s skin or their sex were more the norm than not. With so many successful, intelligent people in dentistry, we wondered, was race even an issue anymore? It turns out it is, in ways both overt and subtle. Some of the dentists we talked to still feel isolated or marginalized by a dwindling white majority, others don’t, but all have felt the sting of racism in their lives, and each has been left to wonder what role race has played in the way they were treated in myriad situations — for some, it continues on today. For Dr. Yoshitaka Ogata, the racism was overt: imprisoned in an internment camp during WWII, Ogata and his family spent three years incarcerated simply because they were Japanese. 120,000 Japanese Americans living on the west coast were interned in ten camps established in California, Idaho, Utah, Arizona, Wyoming, Colorado, and Arkansas. During the war, Ogata and his family called Minidoka in Southern Idaho “home” as best they could, where education was often an afterthought, and families lived in tarpaper shacks with no running water or cooking facilities.

news. “I think anytime they show an image of one of the attackers on television there’s another emotional swell that occurs in the common population.” Still, Rekhi has been encouraged by shift in the public’s understanding of his religion and culture, saying, “Almost 11 years after 9/11, a horrific event occurred that jarred the Sikh community. A Sikh temple in Oak Creek, Wisconsin was the site of a mass shooting that left six dead and four wounded at a place of worship. This time the community response was different. While sitting at a doctor's office waiting for my appointment, I had a random older gentleman come and touch me on the shoulder and say, ‘You’re Sikh, right?’ I responded and said ‘yes’, he then looked at me and put his hand on my shoulder and said ‘I'm really sorry for the loss your community suffered last week, and wanted to offer my sincere condolences.’ This was a response that actually made me realize that there is a change that is occurring. It was really gratifying to see a few changes from 9/11/01. Namely, a random stranger recognized me for who I am, a Sikh; also, that a random stranger offered condolences to a random stranger who was far different then he.” And, while Rekhi says that it’s fairly routine for potential patients to ask if there is a dentist in the practice who doesn’t wear a turban, or ask his front desk staff if he speaks English, others engage him and ask questions about what it means to be Sikh, “I give them a breakdown of my religion, tell them where I am from, what I believe in. Some ask if I am Arab, and I explain that my family is from India. It’s different. A lot of

“Race had no bearing on my dental school experience. That’s one of the things about Seattle – I’ve never felt that any of my classmates, patients, or teachers cared" Dr. Greg Ogata

Today, the Japanese Americans we spoke with seem to shrug off the notion of racism, at least of anything overt. As Yoshitaka’s son WSDA's President-elect Dr. Greg Ogata said, “Race had no bearing on my dental school experience. That’s one of the things about Seattle – I’ve never felt that any of my classmates, patients, or teachers cared. Now, maybe some patients went to somebody else because they didn’t want to come to me, but I can’t say. But the ones who walked through the door didn’t care. I don’t think it was an issue.” However, six decades after the elder Ogata was interned, Dr. Princy Rekhi, past president of the Seattle-King County Dental Society, bore the brunt of a similar wave of racism immediately following the 9/11 attacks. Frightened Americans lashed out against anyone who looked remotely like the terrorists they saw on television. The fear enveloped the country, as people looked for someone to blame and worried about another attack. How many of us can say we didn’t look up to the sky for months after, when we heard the sound of a passing plane? Rekhi was a junior dental student at UMKC, and with his traditional Sikh turban and beard, he made an easy target on the ground. “Overnight people treated me differently. I had been accustomed to eating out almost every meal, but even walking down the street people would call me Osama Bin Laden or a terrorist — it was insulting, and it made me sad,” he says. Rekhi sometimes feels the lingering effects of the 9/11 tragedy, especially when the event is featured in the

patients will come in and assume that I’m Muslim and say, ‘Oh there’s a Muslim family that lives near to us’, and I will laugh and say, ‘We have Muslim families who live near to us too, but I’m Indian.’ I appreciate the fact that there’s some cultural awareness and that they ask questions.” In the 1950s Dr. Richard P. Ferguson could point to race as the reason he was repeatedly denied graduate schooling in any dental program provided by the Air Force Institute of Technology (AFIT). Finally in 1968, he applied directly to the University of Washington for the graduate orthodontic program. He was accepted; but then began the struggle to get AFIT to pay for his schooling. It took a trip to Washington, DC and an appointment with the then Surgeon General to get approval to attend the UW and to retain his commission as a Lieutenant Colonel in the Air Force. Finally AFIT agreed to pay for Dr. Ferguson’s schooling. He had been refused earlier, as no African American dentist in the United States Air Force had been given graduate schooling. Dr. Ferguson was the first African American on active duty in the Air Force to be promoted to the rank of Colonel, retiring in 1973. He was also the first African American to graduate from the UW’s program in orthodontics. He taught part time and was a member on the University’s Dental School Admissions Committee as well as a volunteer instructor for the ethics course for nearly 20 years. Dr. Ferguson was also WSDA’s only African American president.

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For Dr. Jessica Bremerman, race was less a factor than circumstance was. She says she always knew she was going to go into medicine, which is astonishing when you consider her childhood. Bremerman, a Yakama Indian, grew up on the Yakama reservation, shuttled from relative to relative as her parents went through a divorce. While she contends it’s common in Native American families to be raised by someone other than your biological parents, her story is a testament to her resilience. “I changed grade schools 11 times,” she says, “I lived with my aunt, my grandmother, my mother, and friends throughout that time. We were homeless for part of the time I was with my mother, so that taught me a lot.” While her parents were neither supportive nor dismissive of her studies, neither can say where her drive comes from — all Bremerman knows is that schoolwork became her sanctuary. By the time she was in high school her father was in jail and her brothers were dealing with addiction and gang issues, but Bremerman continued her path to success, saying, “I knew I wasn’t just going to graduate high school or college, I was always looking further ahead, I wondered how far I could go. I’ve always had that personality – I’m very goal-oriented, and has served me well. I’m always asking how it happened, given my upbringing. Some of it is just luck, and some of it comes from my drive.” Rekhi often encountered racism when he was growing up in Kenmore, Wash. He explains, “I got picked on quite often in

recalls incidents of racism as early as junior high, and says, ”Little things happened over and over, and the only boundary I could see was race. But it taught me to step back and observe the person or the situation to make a determination if it was isolated only to African Americans, or just the way that person treated everyone.” One incident fundamentally changed the way Ferguson reacted when he suspected racial inequity was at play. It was his first year at Ohio State, and he wrote a piece for his English Composition class about prejudice, specifically about sending servicemen from the south to the north, and vice versa. No mention was made of race, because Ferguson realized the problem was one affecting both blacks and whites equally. He received a D on the paper, even though no corrections were made. “It bothered me for two years,” he says, “So I went to my counselor to complain – I felt that the lowest I should have gotten was a B. My counselor told me that he was a new teacher, and if that had come to light he would have been in trouble, so I let it go. I have always said that if I had known then what I know now, I wouldn’t have stopped until I saw the president of the University, because that was incorrect. I learned from it, though — from then on, I documented everything.” Role Models Everyone we talked to had role models – from parents, to educators and dentists — lots of dentists. We wondered, were they of the same race? For Yoshitaka Ogata it was — his childhood dentist, Dr. Fukuda. The elder Ogata was able to pay that forward

“Overnight people treated me differently. I had been accustomed to eating out almost every meal, but even walking down the street people would call me Osama Bin Laden or a terrorist — it was insulting, and it made me sad" school, so I always had to have a little thicker skin to deal with it. I was fortunate because everyone in my family was well educated and intelligent — I can only imagine what it must be like to be impoverished and have the same issues I did. I may have looked different, but my parents treated me differently, too. I got a sports car when I turned 16, so while I stood out because I had a turban and beard, I also stood out because I had things. We lived in Northshore Summit, and that helped us fit into the socioeconomic model — so I wasn’t an outcast. Being smart helped, too — but being on top of your class put a bulls eye on your back for other reasons.” Ferguson grew up in Ohio in a town of 80,000, in largely mixed race neighborhoods where he recounts, “We had some of the same racial problems that all towns had at that time. My teachers were all white, both women and men, and while I was in high school I was probably the only African American in the class.” The youngest of nine, Ferguson planned on going to college from an early age, and grew up in a family that valued education, “In grade school my brother was three years ahead of me,” he recalls, “And when we got home at night he would teach me what he had learned that day - math and algebra.” His parents instilled confidence in their children, taught them to earn their own money, and emphasized that they were as good as anyone else, encouragement that proved valuable. It was a time when racism — especially that directed at African Americans — was part of everyday life, and Ferguson

Dr. Princy Rekhi

when he became the role model for Greg later in life, who says, “My dad was a huge role model in my life, I’ve always wanted to emulate him. My other role models were dad’s friends from his peer group in the ortho study club. They were great guys doing interesting work, but they were also happy and had fun. Dad enjoyed his work tremendously, but still had time to coach little league. I knew that when I was raising my kids I wanted to do the same things.” Bremerman, it seems, found mentors in every aspect of her life — her coaches, employers, and her high school counselor. And while none of them were Native American, later in life she found role models within the Native American community — Dr. Rex Quaempts, and the dental assistants she worked with at IHS, who remembered her as a child. All, she says helped support her and get her to where she is today. We profiled Dr. Tyrone Rodriguez in the WSDA News recently — the current president of the Hispanic Dental Association is active in all levels of organized dentistry – component, state and national — and he shows no signs of tiring. When asked about his mentors, he ticked off a litany of people who helped him along the way — his most influential chairside role model was African American; his greatest diagnostician, pathology and radiographic influence was Jewish; the doctors who illuminated the value of evidenced based practices and risk assessment were American; his biggest influence in dental philanthropy and missions was British;

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cover stor y a conversation about race and dentistr y

Growing up

cover stor y a conversation about race and dentistr y

and the best instructor in dealing with children was a six year old Hispanic boy who had taken a cattle truck, a bus, and had walked all night to have Rodriguez pull his tooth in the Nicaraguan jungle. As he says, “A mosaic of people and families have helped shaped my perspective as a practitioner, and I am truly grateful and blessed to have met and worked with them all.”

University life

University life can be difficult for anyone, and we wanted to know if the respondents felt any additional pressures or issues because they were minorities. Dr. Woody Crow attended UCLA, where he got along well with faculty, patients and fellow students. Crow, who recently retired after 30 years of service with the IHS (including serving as the group's regional director), is an enrolled member Seneca-Cayuga Tribe of Oklahoma. At UCLA he was the only Native American there, except for a Philippine woman who claimed to be American Indian because she thought it would help her get into dental school. “But it was always like that for me anyway,” Crow relates, “Between me, my brother and perhaps one or two other guys, I was always the only American Indian in school anyways. I grew up in suburban Los Angeles, not a reservation, so I was used to it.” Likewise, growing up in Spokane there weren’t many other Asians, or other minorities for that matter, recounts Dr. Eugene Sakai. As he tells it, it wasn’t a problem. “I was always one of the

Dr. Richard Ferguson

squarely within those expectations. Dentistry is his third career, following stints in molecular physiology /biophysics and teaching. Rodriguez also encountered racial quotas in university, but they worked to his advantage, not against it. Still, he felt that he had to overcompensate to justify his seat in the program, saying, “I took every chance to exceed my requirements and clinical experiences to prove others wrong about diversity quotas. The power of involvement and performance helped me to transcend stereotypes.” In his freshman year, Rodriguez became president of Hispanic Student Dental Association and began a newspaper called La Sonrisa. He found community outreach opportunities for dental and dental hygiene students, and served as both photographer and reporter, documenting the work of the students in the community. Rodriguez was so committed to the fledgling paper that he paid for the first three issues using his personal credit card, and made sure that every student had a copy in their mailbox. The cost to produce the paper was eventually underwritten by a dental product manufacturer in exchange for ad space, student participation began to expand, and Rodriguez was able to secure 501(c)(3) status for the chapter. The following year, his school enrolled 11 Hispanic students, which demonstrated how action could impact academic culture. Still, Rodriguez fielded criticism from those who didn’t understand why he wasn’t more involved with ASDA, who thought he was only looking for opportunities

”Little things happened over and over, and the only boundary I could see was race. But it taught me to step back and observe the person or the situation to make a determination if it was isolated only to African Americans, or just the way that person treated everyone.”

few minorities,” he explains, “So basically I always had the mindset that anything was possible.” When he went to dental school it was the same. He explains, “Maybe there were issues because of my race, but I wasn’t sensitive to them because of where I grew up. I didn’t have time to worry about it. If I wanted something I had to go after it and get it.” Sakai was one of three Asians in his class at OHSU — the last year, he says, that the school observed de facto quotas on minorities. “Of course, they didn’t call it a quota, but there were no women or non-whites other than the three in each class. After my year they had two women, and now that number as grown to almost 50 percent.” Calling the former dearth of women in dentistry shocking, Sakai is pleased with the explosion of women in the dental workforce, saying, “Women needed to get in the field because otherwise that might have wasted all that intellectual talent – they have changed the dynamic of how we practice by job sharing and working less hours in order to raise a family. There’s nothing wrong with that at all, it’s just different than many of us are used to. The real issue is that you cannot waste intellectual talent – you want the smartest, most capable people in every field.” Rodriguez was the first child on either family’s side to attend college, his family expected him to work hard, be honest, and make a difference in the world — and his achievements to date fit

to help Hispanics, and who felt he should focus more on dental school and not the community. Rodriguez says, “Truth be told, I wanted to get the most out of my dental education and felt I needed to work with familiar territory. These were my people, my culture and my heritage. If not me then who? It wasn’t easy, and leadership can be lonely with doubters and roadblocks all along the way.” Drs. Titus and Ferguson attended predominantly Black dental schools for different reasons. Ferguson was initially intent on attending Ohio State, but ran afoul of racial quotas — they had a system that allowed for only one African American dental student every other year, with one African American student accepted into their medical program on opposite years. Ferguson applied to dental school in a year when they were only reviewing for the single opening in the medical program. Because of that, he made his way to Meharry Medical College School of Dentistry, a then Black school in Nashville. When asked how the experience was going to an all-Black dental school, Ferguson replied “I didn’t think one way or the other, I thought that I got as good or better of an education than had I gone anywhere else, and having seen some of the other schools, our facility was much better than some of the others.” Finances and the opportunity to learn alongside other Black students were the primary reasons Titus chose

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said, “I actually felt that the other two American Indians were an asset to me because they knew what it was like to grow up on a reservation. I often joke with my husband when I commute to my job at Indian Health Services that I’m going into a different world because it is.” The three were able to confide in one another in a way that no one else could understand. Still, at times Bremerman felt isolated, saying she felt different than other students because she lacked some of the commonality many shared — a parent who had a practice, a well off family. Being different made her want to do more. Additionally, she says “ I think that my background got in the way at times – I had to miss some of my finals because I had to go back to Yakima to attend my brother’s court date. I had another source of stress while I was at dental school that nobody quite understood.” Rodriguez had this to say, “Fortunately, I felt that many of the leaders that I met in dentistry that were Hispanic were pediatric dentists. Do I see them as competition…not in my wildest dreams — they are my mentors, colleagues and friends.” By the time Dr. Greg Ogata was in dental school, the issue his father had faced was essentially reversed: there were too many Asians in competition for spots. “When I was in school they found many classes were becoming predominantly Asian, as they did at UC Berkeley. Those with the best scores and grades should have been enrolled, instead, they had to dial back the numbers to create equity for non-Asians, which left only the “super Asians” in classrooms and no space for other, high-achieving Asians.” Ogata

“I took every chance to exceed my requirements and clinical experiences to prove others wrong about diversity quotas. The power of involvement and performance helped me to transcend stereotypes.”

I became a citizen I was considered for the following year’s class.” Ogata initially planned to attend Washington University in St. Louis; but as they were driving cross-country, he and his wife, Mabel, stopped to visit friends attending University of Missouri Kansas City. While there, Ogata met with the Dean, who asked him if he would consider UMKC instead. Ogata explains, “Dean Reinhart liked Asian students because they did so well in school, and that’s why he accepted so many of them.” With Mabel’s blessing, UMKC became their new home. They lived in a housing project because it was all he could afford, and Ogata was in a small study group with other dentists, all Caucasian. There were only four Asian dentists in his class of 100, and all were from Hawaii. “Everything about the experience was positive for me,” says Ogata, “We worked together as a group, and I never felt that my race was a factor at all.” Mabel concurs, saying “Yosh graduated at the top of his class, and quite a few of his classmates credit him with helping them get through dental school.”

Competition

Reports have shown that minority students of the same race can feel in competition with each other, and we wondered if any of the respondents felt that way. Most didn’t, instead seeing fellow students of the same race as allies. Bremerman, for instance,

Dr. Tyrone Rodriguez

continues, “You hoped to excel in other ways – in the interview, your letters. We didn’t talk about it as a group, but we knew that we were in competition with other smart Asians. Once we were in the program, the playing field was leveled. We would often joke that even the last person in class became a doctor.”

Continuing issues

We wondered what the doctors thought the most pressing issues facing minorities are today, and we got an earful. Dr. Greg Ogata thought it was financing, regardless of a dental student’s race. Dr. Sakai is concerned about insurance companies dominating the industry, just as they do in medicine and pharmacy, gradually driving us more to the corporate form of practice. And, he’s concerned about the credibility of the training foreign doctors receive, saying, “We’re unfamiliar with their schools, the methods of teaching and the quality of the education they have received. It is like all prejudices – anytime someone does things differently than you or has different references, there is the tendency to wonder about their abilities. I have concerns about their morals and ethics with all young dentists – there is a heightened emphasis on making money as opposed to doing the right thing.” Dr. Ferguson, retired since 2001, still keeps his fingers on the pulse of what’s happening in Washington and the country. He says

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cover stor y a conversation about race and dentistr y

Howard University. He says, “The interesting thing about Howard that a lot of people don’t know is that we had people of color from all over the place. In my class of 90 people, 45 were women, and out of the other 45, only 20 were from the US – all the rest were from places like West Indies, Africa and all the other places of color around the world.” Howard is a community-service oriented school, where they instilled an understanding of the underserved and their needs, and made sure students were trained to provide whatever needs were required, rather than focusing on training specialists. Going to a predominantly Black school had many benefits for students like Titus, who says, “I am aware that I didn’t have to worry about race factors playing into things. I know that for other African American students at schools other than Howard and Meharry, it was definitely a factor in their education – they had to make sure they weren’t being singled out because of the color of their skin.” Because he had been born in Japan, Yoshitaka Ogata was denied entrance to the UWSoD (and others) but that changed with the passage of the McCarran-Walter Act which abolished racial restrictions in United States immigration and naturalization statutes going back to the Naturalization Act of 1790. The Act was life changing for Ogata, who says, “I was on one side one day, and on the other side the next, and it sure made a lot of difference in my life. It felt like a ton of bricks was taken off my back. One day I was getting letters that said we will only take our own, as soon as

cover stor y a conversation about race and dentistr y

that young African Americans have a harder time getting jobs, and may not get the grades they deserve because of prejudice. “I don’t know that I would say it is routine, but I think that it happens.” He continues, “It’s unfair, but I have tried to get this across to faculty at the UW that there may be a pattern, and it is worth looking into. I think that some African Americans won’t apply to the UWSoD because they feel they can’t get in, and I think the UW has an obligation to try to balance out the admissions. We’re a top school, and while I understand that grades are important, I think we should do more to make sure there is a better racial balance in the dental school.” Bremerman disagrees, saying, “In my graduating class at least 30 percent were women and there were quite a few minorities. My class was diverse in every way – age, sex, ethnicity and educational background. I think the UW does a great job of inclusion” Titus, however, agrees with Ferguson’s assessment of the UW, and finds it troubling. “UW doesn’t do enough to reach out to African American students. If not for Dr. Speed McIntyre, I fear there wouldn’t be any African American students at the UW — and that’s a red flag, as far as I am concerned. I was on the admissions committee for a short time, and there was always talk about whether or not African Americans weren’t far above and beyond the basic requirements to enter dental school. I think the biggest issue facing minorities today is getting more of them on admissions committees so that more of them are getting into dental schools –

Dr. Jessica Bremerman

a replacement dentist after one left. And, while tribes with a casino can have better healthcare, it isn’t always the case — according to Bremerman, Neah Bay has done an amazing job. She says, “They still have oral health issues, but they have great, passionate leaders who really care. Others haven’t done such a good job of it. At my clinic, the physicians and pharmacists are excellent and have benefitted from a culture that appreciates medicine and has made it a priority, but they haven’t done the same with dentistry.” Rekhi, a successful dentist with three practices, says professionally his toughest challenge is attracting and keeping patients, and adds, “From a collegiate standpoint, I believe that one of our biggest challenges is gaining acceptance from our older, established colleagues, who perhaps have never grown up around or have practiced in environments with minorities. Among other things, I really think the organization needs to focus on what it publishes in the WSDA News. I think some of those articles really turn people off and make people not want to be part of the organization. The older generation is retiring, and those who remain may still have difficulties in relating, but there is still a pack mentality at times. It’s a slow process – you invite people to sit at the table, but then you do something as an organization that makes people not want to be engaged.” At the component level, Rekhi says he and his non-white colleagues can still feel left out — “I think changing that has to start with a grassroots effort by the older membership to welcome and invite new people into the

“I changed grade schools 11 times,” she says, “I lived with my aunt, my grandmother, my mother, and friends throughout that time. We were homeless for part of the time I was with my mother, so that taught me a lot.”

because you can go through periods of time where they have no advocates in the university system. I realize that dental school is pretty expensive, so there are a lot of qualified kids out there who may not want to put themselves into the position of having that kind of debt for dentistry, but that is a universal problem.” For Bremerman, the issues she's most concerned about are those in her back yard. “Oral health continues to be a huge issue in the Native American community,” says Bremerman. “It is not taken seriously enough. I see massive decay all day long. Kids coming in with abscesses and complex medical issues, from broken homes, where oral health simply isn’t a priority, unfortunately. I don’t know how to change that – and I grew up in that environment. When my patients come in, I always tell them that I’m going to get as much done as I can in an hour, because chances are I’ll never see them again. I don’t know how to make oral health a priority in the reservation. We have five dentists and one hygienist covering a population of 14,000 people. There isn’t enough money to provide oral health care to the population – and every year that I have been here, we’ve experienced budget cuts. Some of the internal guilt that I have about leaving is that my position will be open for six months to a year because they can’t pay their dentists enough, and the government isn’t a well-oiled machine.” Bremerman says the application process is so grueling that many applicants drop out before they complete the process, noting that it took a year to find

organization. We see a lot of diversity at the new dentists meetings, then when you go to the society meetings those people will go once or twice and never go back because no one talks to them. There’s no welcome, or acceptance. People will say hi and then turn around and continue talking among their clique of five or six people. In all fairness, I know that for many people the meetings are the only chance they have to see their friends, but if you look at it from a professional setting, maybe the organization would benefit from holding socials where the older docs could have that time to share personally, but they could be counted on to be more inclusive in the professional setting. That's how we handle the new dentist meetings we have at SKCDS — executive council members focus on meeting as many new dentists as possible.”

In conclusion

We hope this piece will further stimulate discussion among colleagues, help to create change where possible, and alert dentists in the community to the travails and thoughts of minority dentists. If you would like to be a part of a broader, ongoing conversation about race, or would like to be interviewed for an upcoming article about gender in the community, please email Rob Bahnsen, Art Director./Managing Editor at rob@wsda.org.

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Race: Changing numbers in the state

If it seems like the numbers of minority dentists and women are exploding in the dental field…well, they are. The racial and ethnic diversity of Washington’s dental workforce has been increasing over time. Tracking race is getting more difficult, because more people now identify as being biracial. As Dr. Ferguson said, “I’m Scottish, African and Native American – should I go for one or the other? There's a saying in the African community, ‘If you have one drop of African blood, then you are African,’ Of course that’s not true. If you ask me what my culture is, I would say American, because my experience has not been all that different than that of the average American.” Yearly cohorts of newly-licensed dentists are making Washington’s overall workforce more diverse. While the current overall workforce is 75.3% White, 19.8% Asian, 2.0% Hispanic, 1.7% Black, 0.4% American Indian, 0.1% Pacific Islander, and 0.8% other unidentified groups, the 2011 cohort of newlylicensed dentists was 56.7% White, 31.7% Asian, 5.0% Hispanic, 3.3% Black, and 3.4% other groups — showing a decrease in the number of newly-licensed White dentists, and an increase in all other ethnicities. An increasing number of women are becoming licensed dentists in Washington. While the overall percentage of females in the workforce is 25%, the percentage of newly-licensed female dentists has been higher in recent years, up to a high point of 41% for the 2011 cohort of newly-licensed dentists. The UWSod shared some recent data on race with us: Class of 2013 African American........... 2 Asian.......................... 15 Caucasian................... 45 Hispanic...................... 3 More than one race....... 2 TOTAL......................... 67 Class of 2014 Asian.......................... 22 Caucasian................... 39 Hispanic...................... 3 More than one race....... 3 TOTAL......................... 67 Class of 2015 African American........... 1 Asian.......................... 13 Caucasian................... 47 Hispanic...................... 1 More than one race....... 6 TOTAL......................... 68

Class of 2016 Asian.......................... 18 Caucasian................... 42 Hispanic...................... 1 More than one race....... 6 TOTAL......................... 67 Class of 2017 Asian.......................... 20 Caucasian................... 38 Hispanic...................... 1 More than one race....... 5 TOTAL......................... 64

Enhance Your Leadership Potential, apply for the Institute for Diversity in Leadership

Established in 2003 by the ADA, the goal of the Institute is to provide a diverse group of dentists with education and experience so that they can set new leadership paths within the profession and their communities. Promising leaders of racial, ethnic and/or gender groups that have been traditionally underrepresented in leadership are encouraged to apply for this extraordinary educational experience. The class of 2014-15 will convene for three sessions held at ADA Headquarters in Chicago on the following dates: September 4-5, 2014; December 8-9, 2014 and September 10-11, 2015

Apply today

To apply, submit the completed Candidate Application Form (http://www.ada.org/sections/newsAndEvents/pdfs/ADA_2014_ IDL_Candidate_Application_Form.pdf) and arrange for two references to complete and submit the Candidate Reference Form (http://www.ada.org/sections/newsAndEvents/pdfs/ADA_2014_ IDL_Candidate_Reference_Form.pdf) on your behalf by April 30, 2014. We regret that the ADA cannot be responsible for or accept incomplete or late applications. Participation is open to active, licensed dentists, residing in the U.S. ADA members are encouraged to apply, but ADA membership is not required for participation in the Institute. Ideal candidates will have demonstrated leadership potential within dental associations or their communities. For more information, visit http://www.ada.org/5402.aspx If you have questions, please contact the ADA at 312.440.2598 or gingrichk@ada.org.

institute for diversity

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cover stor y apply for the ada institute for diversity in leadership

by the numbers

pndc news russell wilson at the pndc

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RUSSELL WILSON

THE SEAHAWKS QB AT PNDC! Calling all 12s! PNDC is proud to announce Seattle Seahawks Quarterback and Super Bowl XLVIII Champion, Russell Wilson will speak at PNDC 2014! Join us for a Q&A session with Wilson moderated by television personality Meeghan Black, featuring questions submitted by you, the attendees, as we get to know our quarterback and his life outside the gridiron.

When: Friday, June 13, 2014, 7:00 a.m., doors open at 6:30 a.m. Where: Grand Ballroom, 2nd Floor, Olympic Tower, Hyatt Hotel Tickets are available to all attendees above age 16 who purchase a full conference badge*

General Seating — $12: Limit one ticket per person, seating is on first-come, first-served basis

Premier Seating — $48: Reserved seating in front section VIP Access — $500: Only 25 tickets available - Includes one

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premier ticket, meet and greet with Russell Wilson, autograph signing and a picture taken by a professional photographer. Proceeds from VIP Access benefit the Washington Oral Health Foundation initiatives *Conference attendees must be 16 years of age or older

Visit https://pndc2014.expotracker.net/index.aspx to register for the conference, purchase your ticket, and submit questions for Wilson. Not all questions will be selected for the event. If you're already registered and want tickets to this event, call Katie Olson at (206) 448-1914.

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pndc news russell wilson at the pndc

Moderator Meeghan Black

pndc news highlights

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credits for just $200, and dental staff can earn 14 CE credits for only $130! Where else can you get a deal like that?

View the full schedule here: http://www.wsda. org/pndc-schedule/ More than 50 speakers will be presenting more than 80 lectures and workshops. Remember, all lectures are included with Before April 30, dentists can receive the best your full conference badge, workshops are tick1 6 · CE th e wsda w s require · issue 5, · 2014 fee. · www.wsda.org value we have ever offered: Earn up to 18.5 eted ne and anapril additional SAVE $100 • Conference badges will be $300 after April 30!

Fulfill your minimal sedation anesthesia CDE requirements at the PNDC — Take these lectures by Dr. Crossley

Pharmacology/drugs Street Drugs Exposed - What Your Patients and Your Kids Are NOT Telling You Thursday June 12 from 8:00 a.m. - 5:30 p.m. · 7 credits

The dental team is in a unique position of providing dental care to a patient population that may be experimenting with or regular users of mood altering drugs. This graphic lecture will take you from the streets into the office to help you identify and manage the substance abusing patient.

Avoid Liability: Know Your Patients’ Medications and Their Impact on Dental Treatment Friday, June 13 from 8:00 a.m. - 4:30 a.m. · 7 credits

Many medications used by your patients have dental implications and side effects including violent behavior, “burning mouth syndrome”, and sexual dysfunction. This lecture will cover the many indications, contraindications, and side effects of the most commonly prescribed medications.

Find a practice to buy

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your practice at the WSDA’s third Job Fair

Job Fair Job Fair Friday, June 13 1:00 p..m. – 4:00 p.m. Room: Hyatt, Olympic Tower, Grand ABCD The PNDC is proud to present the WSDA’s third Job Fair, an event connecting dentists looking to transition out of their practices or hire associates with dentists interested in buying practices or looking for associateships. This personal, welcoming event is designed to give participants ample time to talk and get a sense of needs and compatibility. For more information and to register for the Job Fair, visit:

For those seeking employment:

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For those selling or looking for an associate:

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In order to administer minimal sedation in Washington, a dentist must complete two training requirements: a one-time course (14 or 21 hours depending on method of minimal sedation) and continuing education (seven hours every five years). Dentists likely completed the one time course requirement while in dental school. Each dentist is responsible to determine if they have completed both training requirements. Initial Minimal Sedation Course: To administer minimal sedation a dentist must complete a course in either dental school or postgraduate instruction. The length of course required depends upon the method of minimal sedation (WAC 246-817-740, WAC 246-817-745): • To administer nitrous oxide or minimal sedation with a single oral agent, a dentist must have completed a course (in either dental school or postgraduate instruction) containing a minimum of 14 hours. • In order to administer any oral agent in combination with a different agent or multiple agents other than nitrous oxide a dentist must have completed a course (in either dental school or postgraduate instruction) containing a minimum of 21 hours. Continuing Education: In addition to the 14 or 21 hour training requirement stated above, a dentist must participate in seven hours of continuing education every five years. The continuing education must include instruction in one or more of the following areas: sedation physiology, pharmacology, inhalation analgesia, patient evaluation, patient monitoring, or medical emergencies. (WAC 246-817-740, WAC 246-817-745) To read a copy of the rule, please visit http://www.wsdasource. org/legal-regulatory/articles/dental-statutes-and-rules

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pndc news highlights

HIGHLIGHTS AT THE PNDC

member news herzog wins ada golden apple

GOLDEN APPLE:

Dr. Chris Herzog wins coveted award 1188 ·· th thee wsda wsda ne new wss ·· issue issue 5, 5, april april ·· 2014 2014 ·· www.wsda.org www.wsda.org

directions for the future. With an eye toward increasing access to care through internships and expanded satellite dental programs across the state, the task force is open to any number of options, and Dr. Herzog has shown he has the mettle to harness and focus the group. For a young dentist, Dr. Herzog has amassed an enviable list of accomplishments — including induction in the Pierre Fauchard Academy in 2011, serving as President of the Washington State Association of Pediatric Dentists in 2012, and continued service the boards (or executive councils) of the Washington State Dental Association, the Spokane District Dental Society, and the Washington Dentists’ Insurance Agency. As noted earlier, Dr. Herzog has been active since dental school and remains so, with an unwavering conviction not often seen in young dentists, who often put aside organized dentistry early in their to focus on raising a family. Dr. Herzog has a vitality and energy that allows him to manage family commitments and organized dentistry, with time left over to participate in charitable care throughout the Spokane region. At the component level, Herzog not only serves on the Executive Council, but also volunteers time for Society charitable events, and continues to see patients with no dental home in his thriving group practice. At the state level, Herzog continues his board, task force, and grassroots advocacy efforts, unabated. Bracken Killpack, Vice President of Government Affairs says, “When we need help with a fundraiser, getting the word out, or really anything that’s going to advance organized dentistry, Dr. Herzog always has his hand up. He really is a one-man juggernaut in the legislative arena.”

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member news herzog wins ada golden apple

The ADA recently announced that it has awarded WSDA member Dr. Christopher Herzog the 2014 Golden Apple for New Dentist Legislative Leadership. Herzog, a pediatric dentist from Spokane, has been a passionate grassroots advocate for organized dentistry since he was a student at the University of Washington School of Dentistry. The award recognizes an ADA member dentist who graduated on or after January 1, 2004, and who has demonstrated outstanding political or legislative leadership initiative. While at UWSoD, Herzog was an ASDA representative and student delegate, the face of the student body at local, state and national meetings — voicing the ideas, hopes and concerns of his fellow classmates. During that time, he first attended WSDA’s Dental Action Day, where he met with legislators making connections and relationships in the political arena that he continues to nurture. Dr. Herzog has been a stalwart supporter of WSDA’s efforts to defeat midlevel providers — each time bringing his expertise and gravitas to the fore. For three consecutive legislative sessions (2011-13), Dr. Herzog was a member of WSDA’s testimony team that advocated against any new provider who could perform irreversible procedures without the supervision of a dentist. Additionally, Dr. Herzog has remained active politically by continuing to attend Dental Action Day events and by working closely with his hometown legislators to further cement his relationship with them — through personal meetings, fundraisers and other events. As the Chair of the newly-formed Task Force on Public Policy Development, Dr. Herzog is working with dentists from around the state to formulate, shape, and examine current public policy on dentistry, while at the same time suggesting changes and new

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Congratulations on the following successful transitions: Dr. Gale Campbell to Dr. Brian Jacobsen Ephrata, WA Drs. Gerald and Valaree Becker to Drs. Yen-Wei Chen and Kanako Nagamoto Shoreline, WA Dr. Steven Harvey to Dr. Scott Bibbens Wenatchee, WA Dr. Jim Parrish to Dr. Herb Edwards Walla Walla, WA Dr. Jan Norvold to Dr. Jiyon Kim Seattle, WA Lakewood

Grays Harbor — Associateship

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Mercer Island—PENDING

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The 2014 Regular Session of the Washington State Legislature ended just before midnight on March 13. The session concluded with the passage of a small bipartisan supplemental operating budget and little else. The two major fiscal issues, education and transportation, have been left for resolution for some time after November’s midterm elections. Only one bill tracked by WSDA was signed into law: HB 2351. This bill will allow out-of-state health practitioners to apply for temporary licensure to perform uncompensated care in Washington state; a mechanism already in place in most states. The following is a brief overview of the other issues that were active in the last half of the 2014 legislative session. A report on all of the legislative issues WSDA faced during the 2014 legislative session can be found online at www.wsda.org/blog.

Embedded Dental Benefits Inside of Washington’s Exchange:

HB 2467, legislation that would allow both embedded and standalone pediatric dental products to be sold inside of Washington’s exchange, died in the Senate. Starting in 2015, both stand-alone and embedded pediatric dental benefits can be offered in the insurance market outside of the exchange (currently all medical insurance outside of the exchange must have an embedded pediatric dental benefit). WSDA believes the same flexibility should be extended to purchasers using Washington Healthplanfinder.

EFDA Continuing Education:

SB 6138, legislation that would authorize the Dental Quality Assurance Commission to develop continuing education rules for EFDAs, died in the House. This bill is supported by the Department of Health, DQAC, and WSDA. SB 6138 was voted out of the Senate and the House Health Committee without opposition. However, the bill was not called for a vote before the entire House before the session ended.

Affordable Care Act (ACA) Update

March 31 marked the end of the first open enrollment for medical plans offered on the state’s exchange (known as Washington Healthplanfinder). Preliminary numbers indicate that nearly 150,000 individuals enrolled in private medical plans

through the exchange marketplace during the first six month open enrollment period. An additional 400,000 individuals who were made eligible for Medicaid through Medicaid-expansion also enrolled at Washington Healthplanfinder during its first six months of operation. National reports indicate that over 7 million individuals enrolled in private medical plans through the federallyrun exchange, though this number does not include enrollments in state-run exchanges like Washington Healthplanfinder. WSDA will provide additional updates at www.wsda.org/blog. In Washington, approximately 5,000 children were enrolled in stand-alone dental plans on Washington Healthplanfinder in the last six months. Only children in families with incomes above 300 percent of the federal poverty level (FPL) were able to enroll in stand-alone pediatric dental plans. The children of families whose incomes are below the 300 percent FPL threshold were enrolled in Medicaid. In Washington state, adults are unable to purchase dental insurance on the exchange. Plans to begin offering adult and family dental coverage on Washington Healthplanfinder are being considered, though the soonest these offerings would be available is 2016. As health care implementation unfolds, the Association has been monitoring negative effects that impact the profession and patients. One area of concern is the coverage of preventive and diagnostic care on many pediatric dental plans. In many cases, patients are required to pay the entire out-of-pocket deductible before the carrier will pay for any pediatric dental procedures including diagnostic and preventive codes. Deductibles on many of these plans are thousands of dollars. WSDA is concerned that families may forgo routine, preventive care if this care must be entirely paid out-of-pocket. Under the ACA, a list of preventive and diagnostic medical procedures must be covered by insurance carriers without copayment or deductible payment by the patient. Unfortunately, federal regulators did not include any procedures provided by the dental team on this list. The Association is examining potential legislative or regulatory action on this issue in 2015. Questions and concerns about this topic can be referred to Bracken Killpack, WSDA’s Vice President of Government Affairs, at bracken@wsda.org.

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legislative news review

2014 Legislative session ends on time

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The Power of Facebook and Videos in Dentistry

Social Media Pictures Say a Thousand Words

89 million people in the US watch 1.2 billion videos a day. Videos are an important part of a successful Facebook presence. With the launch of Facebook Autoplay, now videos automatically start when viewed within someone’s Facebook wall.

Pictures make it possible to absorb large amounts of information quickly. Incorporating images into Facebook will drive significantly-higher engagement within your Facebook community. This webinar will cover what Facebook users look at when they visit your page and what graphics evoke the best response. Participants will receive a year’s worth of bi-weekly dental specific graphics to post on your own social media sites.

Learning Objectives • Learn why posting video on Facebook is so powerful for dental practices • Know the types of videos that will make the most impact on patients and prospective patients • Be able to take video and upload it to Facebook • Get patients to take and upload video on behalf of the practice

Learning Objectives • Learn why images are an important part of Facebook • Be able to setup Facebook cover image and profile picture • Incorporate images into your Facebook posts to drive engagement

Webinar recordings available Miss the live webinar? All WSDA webinars are available on The Source (http://www.wsdasource.org/webinars). From Affordable Care Act primers, to 365 Days of Facebook Posts, our recorded webinars give you the opportunity to catch up on all you might have missed. Webinars are posted to the site within a week of the live date, and while you won't have the chace to interact live, we've recorded the Q&A sessions that follow the webinars, too.

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cde news webinars

Free Webinars: learn on your lunch hour

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In an increasingly litigious society, Peer Review may be one of the best member benefits that you don't know about. It can save you the headache of having to engage an attorney to defend yourself against patient claims that may or may not be valid, take years to resolve, and could easily spiral into tens of thousands of dollars in attorney fees and lost revenue, according to Dr. Kal Kass, Peer Review Chair for Seattle-King County Dental Society. “Nearly all dentists have had a patient dispute a fee or service unless they haven't been practicing long,” says Klass, “And for non-members, engaging an attorney will quickly cost more than your WSDA yearly dues.” Member dentists aren’t always aware of the process, according to Jennifer Freimund, Executive Director for the Seattle-King County Dental Society, who says, “I always take a moment to explain what would have happened if they were not a member, to further solidify how valuable belonging to the Society and the Association can be. They’re grateful about the process — being on the receiving end of a complaint can be very humbling — and they’re most interested in resolving the conflict in a way that is beneficial to all parties. Peer review creates an environment for just that.” Peer Review starts with a phone call to your component society from a patient or another dentist. The person handling the call evaluates the complaint to see if it’s appropriate to move forward in the process. They will tell the caller what the peer review options are – what the program can and cannot do, and allow callers to choose whether or not to proceed. According to Dr. Rod Wentworth, past president of the WSDA, “The reality is most cases don’t go beyond intake — the vast majority of people who call in just want an opportunity to be heard and choose not to continue with a claim. The peer review process isn’t punitive – complainants aren’t going to get a trip to Hawaii out of it, and in our litigious society, the resolutions offered by peer review may not be satisfactory to someone thinking they’re going to reap a cash windfall. Just as importantly, the dentists involved in the dispute won’t be subject to censure. The process will determine whether the procedure was done appropriately, and whether or not the quality of care was adequate. If the dispute is resolved in favor of the patient, they can get a refund or have the procedure redone by the same dentist.” If the complainant decides to move forward, a mediator is assigned to the case. The mediator contacts both parties and attempts to find a mutually acceptable solution. If they can’t, then both parties have the option to have a formal review with a peer review panel comprised of dentists. In order for the case to proceed, both parties have to agree to binding arbitration, and there is typically a clinical exam to review the case. Each party is allowed to present their case separately to the panel, which then makes a decision on the case. The benefit to the patient is that they don’t have to engage an attorney – actually neither party is allowed to — and patients have access to a process where their concerns are reviewed by a panel of the dentists’ peers. Every effort is made to ensure that the panels are comprised of dentists who don’t work with, or know well, the dentist involved in the case, and panel participants take their work very seriously. Not every case is eligible for peer review, notes Freimund, “If someone complains about a community health, DSHS, or corporate practice issue, they’re not handled by our peer review process because they have their own. Complaints against non-members are immediately sent to DQAC.” And, notes Wendy Johnson, Executive Director for the Spokane District Dental Society, “We ascertain if the caller has already sought legal advice. If so, we don’t get involved at all. Ethically, our members have a responsibility to the patient, but there can be nuances to patient care

that aren’t always black and white. We’d prefer that our members call the other dentist first to discuss the case, but that can be a very tough call, especially if the case involves a junior dentist critical of a procedure performed by a senior dentist. Sometimes, peer review is the only way to proceed, but in a perfect world dentists would talk with each other first.” According to Cheryl Jenkins, Executive Director for the Pierce County Dental Society, “Peer Review is a really valuable resource for both the dentists and the patients. Most often what happens is that we call the dentist involved, describe the complaint, explain the peer review process, but nine times out of ten the front office has been running interference for the dentist, who is either unaware of the complaint or unaware of the severity of the problem. Most of the time the dentist wants to call the patient to resolve the issue. The best part is that the process is completely free for all parties. If it goes to panel review, the patient and the dentist both have to agree to binding arbitration, so no further legal action can be taken. Many members are completely unaware of that – they think they could go through the whole process and still be sued by the patient. While it is true that a patient could go through the mediation process and then refuse to go to panel, opting instead to take the issue to DQAC, most do not.” Within the staffed component societies, peer review requests are handled at the local level. Peer review requests for unstaffed component societies are received at the state level and referred to the local component's committee. For additional information, contact Mike Walsh at michael@wsda.org, or at 800-448-3368.

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PEER REVIEW:

The best benefit of membership you may not be aware of

member benefits peer review

Peer review: a unique member benefit

wdia news disability coverage

PLANNING AHEAD: HAVING THE RIGHT DISABILITY COVERAGE

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Personal Disability

Personal Disability is the most common type of disability coverage. Benefits from a Personal Disability policy are meant as personal income replacement to cover your loss of earned income if you become disabled. This coverage would be used to pay your home mortgage, water and electric bills, car payment, groceries, gas, children’s tuition: anything that your paycheck covers for your family. Without Personal Disability, all your monthly expenses would have to be paid from your savings.

Overhead Expense

Business Overhead Expense is specific to covering your business expenses if you become disabled. This coverage allows your business to continue to run while you are recovering from a disability or in the process of selling your practice. Expenses that are covered by this policy include: rent, staff salaries, electricity, dental supplies, janitorial and maintenance work, etc. Without Overhead Expense coverage, you may not be able to keep your business running while you are recovering from a disability.

Business Loan Protection

Business Loan Protection (also called Business Reducing Term coverage), specifically covers your mortgage or equipment loan payments to the bank if you become disabled. A practice loan is thousands of dollars per month and without Business Loan Protection, you would be paying for your loan out of your pocket. Although savings may cover the costs in one aspect of your life, it is unlikely that you would have enough funds to cover your personal and business expenses indefinitely. Washington Dentists’ Insurance Agency encourages dentists to acquire different types of disability insurance to ensure that all personal and professional expenses will be covered for the well being of themselves and their families. If you would like to review your current Disability Insurance or get quotes for additional coverage, please contact WDIA at 1-800-282-9342 or info@wdiains. com.

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wdia news disability coverage

Although Disability Insurance does not seem like a necessary expense compared to the mortgage on your home or your electric bill, it is still crucial to have disability insurance in force and in step with your needs. Disability protects your family and you if the worst should happen, but if you do not have policies that cover both personal and professional expenses and are at the needed coverage amounts, the gaps in coverage may cost you. The best way to protect yourself, your family and your practice is to make sure your insurance policies have the full protection you need. Ask yourself: how much money do I need on a monthly basis to pay all my personal expenses and for my practice to run effectively? If the amount you need is less than what you currently have in monthly benefit on your disability coverage or if you are not covered at all, then you will want to consider increasing your existing coverage and/or obtaining other types of disability coverage. Below are some important types of disability policies and how they protect you. Although each type provides coverage for a different aspect of your life, the benefits on each policy are triggered by you no longer being able to perform the duties of your profession. Having multiple policies at the correct coverage amounts ensure that every part of your life will be protected.

Matthew French Director of Insurance Services WDIA

“Ask yourself: how much money do I need on a monthly basis to pay all my personal expenses and for my practice to run effectively?”

guest editorial continued

with my family, friends, and community. I felt that, as a dentist, I would be more likely to have better control over my schedule and a greater ability to construct the career and life I wanted. That didn’t mean that attaining my goal was going to be any less challenging. Dental school is by no means an “easy” alternative to medical school. The admissions process for both medicine and dentistry is similarly rigorous, cutthroat, and expensive. The same anxiety levels, constant fear of failure, and lack of sleep that haunt physicians during their years of school and residency as they struggle to memorize a seemingly endless deluge of information, train their hands to expertly wield surgical instruments, and pass their board exams also plague dentists in an equally daunting and unforgiving fashion. Both paths require a thick skin for criticism, the ability to persevere in the face of adversity, and the mental clarity to make decisions quickly and adapt to change under duress. In practice, both physicians and dentists deal with stress, fatigue, and the multitude of pressures that come with being responsible for another person’s well-being. Whether you are male or female, no doctor has it easy. You would think that by the time I graduated from dental school and began a residency program at a level 1 trauma center, people would have no problem recognizing that I had achieved full-fledged tooth doctor status, and thus would be privy to all the rights, privileges, and respect that my male counterparts enjoy, right? WRONG! A few months into my GPR, an attending at the hospital commented, “It’s a shame that women like you who’ll eventually want to work part-time or give up their jobs so they can have kids take up spots in dental school classes that could go to men who’d work full-time and be more productive members of this profession.” Yeah. That happened. Without downplaying the truly archaic and sexist attributes of his flippant remarks, let’s address the part of that statement that really burns me. I deeply resent the notion that a woman who chooses to make adjustments to her professional life that may allow her to commit more time and energy to a family or other personal interests could ever be considered unproductive and/or not working to her full potential. I also have a huge problem with our culture’s perception that a stay-at-home mother does not work hard or have the ability to make valuable contributions to society. Feel free to disagree with me, but my personal belief is that if a woman makes the very personal decision to have children, the greatest contribution she can make to the future is to raise her children to be kind souls

who understand the importance of education, tolerance, and fairness for all people. If this is her goal as a parent, then she deserves the respect and support of others, no matter how she sets out to accomplish it and what she does or does not choose to give up in the process. Lastly, anyone who thinks that being a dentist means that I spend my days off swimming in piles of money, à la Scrooge McDuck, should speak to my accountant, who had an exceptionally good laugh doing my taxes last week. Reality television has a tendency to portray the lives of doctors and their families as a frothy whirlwind of walk-in closets, designer accessories, and sprawling real estate. While this may be a true reflection of life for some very successful healthcare professionals, for many others, it’s a mere droplet in a vast pool of existence that has far greater depth than those wading only in the shallow end can appreciate. For every doctor who frequents glitzy charity functions in the name of self-promotion and elevating social status, there are a hundred more who are making tremendous contributions to our world by participating in research, shaping healthcare reform, advocating for patient rights, teaching at the predoctoral or postdoctoral level, and performing pro bono treatment without expecting any compensation or recognition in return. But back to the plight of women in dentistry. It seems that the overarching problem that arises with having to constantly correct those who automatically assume that I must be playing a supporting role in the practice is that it reflects a culture that is still not accustomed to seeing women take the lead. There are still a lot of people who are uncomfortable with the idea of a female in charge, and I suspect that this is because there still aren’t enough people out there telling young girls that they can and deserve to be. A woman who chooses to enter the dental profession is declaring to the world that she has the drive, intellect, and confidence to handle the formidable task of charting the course of her professional destiny. She can suffer the slings and arrows of outrageous criticism and ignorance while setting her sights on success and achieving her personal definition of what it means to have it all. She can aim unapologetically high. Honestly, what woman WOULDN’T want that? Published with permission by the Academy of General Dentistry. © Copyright 2014 by the Academy of General Dentistry. All rights reserved.

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History of present illness:

This is a 25-year-old male who presented with a mass of five -years’ duration. The mass was described to be slowly enlarging in size and was 1.5 x 1.5 x 1 cm at its greatest dimensions at the time of presentation. The mass was smooth-surfaced and pink to red in color with prominent surface vasculature. It was located below teeth #s 20-22. It was not painful and was firm on palpation. This patient’s past medical history is not significant. This “Clinical Corner” case was contributed by Dr. Brian Hart, Oral & Maxillofacial Surgery, Seattle, Wash.

Test your knowledge!

An answer to this case study can be found on the University of Washington’s Web site at http://www.dental.washington.edu/departments/oral-surgery/case-of-the-month.html. Click on “Case of the Month” and look for the April 2104 entry.

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clinical corner issue 5, april 2014

Large swelling of the left floor of the mouth

Norm Culver WSDA News half page ad • 7.25 w x 4.75 t • grayscale • 12/9/2013 Learn a simplified method of performing equilibrations using models in this hands-on seminar. In just one half-day seminar you’ll learn how to:

Finally Learn EQUILIBRATION – HANDS-ON

q Simplify the entire procedure q Do a complete equilibration in about

30 minutes q Profit from doing it

Learn how to sell it, obtain insurance coverage and improve your bottom line. Dr. Culver has been doing these simplified equilibrations for nearly 40 years and he can show you how to do the same thing.

Seminars in your area – Portland, OR Apr 11, 2014 – Seattle, WA May 9, 2014 – Vancouver, BC May 23, 2014

Norm Culver, DDS

Receive $75 off tuition by registering 20 days prior to the seminar date. For more information and to register go to

www.equilibrationseminars.com

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citizen of the year call for nominations

RECOGNIZING GOOD 2014 CITIZEN OF THE YEAR AWARD Each year the WSDA requests nominations for the Citizen of the Year Award from its members, looking for exemplary service to the community. The work should be based on civic activities not affiliated with organized dentistry, and can include any number of activities and organizations such as service organizations, schools, non-salaried government positions or church sponsored community activities. Volunteer work does not have to be dental related. The award is not intended for an individual who provides limited uncompensated services or provides such services to an underserved population in the course of business for

which they are compensated. The award is presented at the Citizen of the Year banquet held during the annual House of Delegates meeting in September. Last year’s winner was Dr. Raymond Damazo, recognized for his years of work serving the Masaai people of Africa. Shortly after receiving the 2013 Citizen of the Year, it was announced that Damazo had been chosen by the ADA to receive their highest humanitarian award also. We grow them good in Washington state! Dentists and their staff are now invited to nominate a WSDA member dentist for the 2014 award. The deadline for nominations is May 30. Forms and award guidelines are

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available from component society secretaries and executive directors, or the WSDA office. All nominations will be reviewed by a task force of the WSDA. Nominations may be made by an individual member of the WSDA or a component dental society, or a staff member of a WSDA member dentist. Previous nominations are kept on file for three years and may be updated and resubmitted. Nominations should be submitted online at http://www.wsda.org/coy. For more information, call Amanda Tran at (206) 973-5217.

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CHALLENGE?

THE SUITE CONTEST IS BACK, AND IT’S MORE

SUPER THAN BEFORE!

Winners celebrate at last year’s event

The Goal: To draft as many non-member dentists to join organized dentistry with a grassroots approach that centers around you — the active WSDA member.

The Game:

Have all 17 component societies compete for the largest increase in membership based on the recruitment efforts of the component’s members.

The Prizes:

WSDA recruiters from the top three components will win pairs of tickets to a suite at a Superbowl Champions Seahawks game for the upcoming season, and everyone who recruits a new member can win cash and free badges to the PNDC.

Want to learn more? Visit www.wsda.org/suitechallenge Proudly sponsored by:

www.nordicins.com

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www.wdiains.com

membership suite contest returns

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Dr. Jennings — I just wanted to say great job on this editorial on Delta Dental. My biggest question for many months (in addition to just being irritated with how WDS decided to cut our fees) is them spending millions on advertising against non-PPO providers. Is that really beneficial to the patients? Good way to spend money? I keep thinking maybe dentists need to pool their money and do an ad campaign to open up the eyes of consumers about WDS practices. Have you sent this letter to DDoW?

Thank you! — Kate Weaver (McKinney) DDS

Dr. Jennings — Great observations on peds aca “coverage.” Keep up the fine work. — Marv Nelson

From the web: Dr. Jennings — Your recent commentary regarding “Delta Dental; Doing the Right Thing?” although provocative, is missing one key element - that the empowerment of WDS or

DDofWA or whatever the latest corporate brand has been affixed to this for-profit “non-profit” (1.003 BILLION in 2011 remember?) - is our own fault. That is right my colleagues. I have yet to see a dental benefits company do a filling. Your participation as a member of this company that has/is totally manipulating your care shows that you and your practice are an addicts. So does your denial. You are addicted to the foursome. The foursome used to be the pillar of the dental care delivery arrangement - Payer (usually employer)/Dental Insurance/Dentist/Patient. My colleagues, create a more contemporary solution for delivering patientcentered care in your practice that does not involve a third party - whether it is a patient-direct in-house membership program or otherwise. Highlighting the continued absurdity of the insurance provisions mandated by WDS upon its members achieves NOTHING except to proclaim the depth of your addiction. John K. McGuill CPA,MBA,JD publisher of the respected dental management newsletter The McGuill Advisory puts it best. “Once they dominate dental market, man-

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aged care plans often seek to manage the care itself”...The McGill Advisory 6.12 Let’s face it though, you’re not going to leave doctor, you’re too much of an addict....So remember, antibiotics first because that’s what’s best...isn’t it? Gregory C. Yen DDS Dental Wellness Club of Seattle Dr. Jennings — Great piece Mary! I love our editor! Dr. Theresa Cheng Dr. Jennings — My dentist husband, Steve and I were very impressed and pleased with your Delta Dental article. You have the ability to expose truth, reveal important concepts and inspire in a few paragraphs. We will keep watching for your leadership. Do you have a blog or website? Appreciatively, Steven and Janice Brazeau

letters to the editor issue 5, april 2014

Protect your practice and your beneficiaries

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Dr. Robert L. Anderson

Our loving father, Dr. Robert L. Anderson peacefully passed away on Monday, March 10, 2014, with family members at his side. Dr. Anderson was born on April 7, 1919, in York, Nebraska. In 1931 his family moved to Seattle where he graduated from Roosevelt HS ‘37, became an Eagle Scout and later spent many years as a Scoutmaster. Dr. Anderson earned a BS in Anatomy in 1942 from the UW. He served with distinction as a Lieutenant, and later a Captain, with the 2nd Armored Division in Europe during WWII and was highly decorated for valor. He graduated from the UW SoD in ‘51 and served two years as a dental officer in the army during the Korean War. Dr. Anderson practiced in Seattle until his retirement in 1999 and served as President of the Washington State Dental Association in 1974. Dr. Anderson was preceded in death by his son James N. Anderson in 1952. He is survived by his wife of 71 years Doris (Lynnwood, Wash), children William, David, Donald Gregory, Debra, and Emilie, and many grandchildren and great grandchildren. A loving and generous father, grandfather, and a great man, Dad will be missed by all as his memory lives on forever. No services will be held at his request.

Dr. Curtis Eugene Carlson

On Wednesday, March 19, 2014, Dr. Curtis E. Carlson of Seattle went home to be with his Lord and Savior. At 71 years old he joined parents, Kenneth and Dorothy (Johnson) Carlson, and sister, Patricia Joanne (Carlson) Grams, in eternity. He was born March 30, 1942, in Rockford, Ill. Carlson was first and foremost a beloved father, grandfather, husband, uncle and friend. He is survived by wife, Dr. Dona M. Seely; daughter, Jennifer (Micah) Theckston and grandson, Jonah; daughter, Gina (James) Rowles; and son, Erik Carlson. Carlson was a skillful and talented lifelong student of the dental sciences and committed to making a difference in his patients’ lives. He was both a periodontist and orthodontist, and in his last days was visited by numerous patients whose lives he touched with his expertise, jovial chairside manner and caring nature. In 1969, Carlson received a DDS from the University of Illinois Chicago Medical Center. From there he served in the U.S. Navy as an intern at Oaknoll Naval Hospital and as a dental officer on the U.S.S. Samuel Gompers. He attended the University of Washington for a combined four years of periodontal and orthodontic graduate school, while also serving on the periodontal faculty teaching at both the graduate and undergraduate levels. Dr. Carlson maintained a full-time private practice in Bellevue for forty years.

As an NRA member and avid fresh and saltwater fisherman, he loved most of all to use light tackle to catch salmon and steelhead not only in Washington but often traveling to Alaska and British Columbia in pursuit of the next big fish. His gourmet-tasting home-smoked salmon was eagerly shared with family and friends.

Dr. Frank Y. Kitamoto

Frank Kitamoto died after heart and kidney complications on March 15, 2014. A nationally respected Japanese American community leader, Kitamoto was born on May 28, 1939 on Bainbridge Island, Washington. He graduated as salutatorian from Bainbridge High School in 1957, went on to earn his Doctor of Dental Surgery degree from the University of Washington in 1965, and Kitamoto returned to Bainbridge Island to begin his successful 48-year dental practice. Kitamoto was just two-and-half years old when he and 226 other Bainbridge Islanders became the first to be forcibly removed to concentration camps in 1942. His family was first incarcerated at Manzanar in California and later transferred to Minidoka in Idaho. Because of this unconstitutional incarceration, Frank shared his inspirational message of tolerance, liberty and human rights by speaking to hundreds of groups ranging from school age children to senior citizens. For his work, Kitamoto received numerous awards for his decades of service. Including among the many groups in which Kitamoto was most active during recent years were the Bainbridge Island Japanese Community, the Bainbridge Island Japanese American Exclusion Memorial Association, Friends of Minidoka and the Bainbridge Island School District Multicultural Advisory Council. Kitamoto is survived by his wife Sharon and son Derek, Bainbridge Island; sisters Lilly (Mitsuhiro) Kodama, Bainbridge Island and Frances Ikegami, Bremerton; and many nieces and nephews. He was preceded in death by his parents Frank Yoshito Kitamoto and Shigeko Kitamoto and sister Jane Akita.

Dr. James MacFarlane

Jim MacFarlane, died on Feb. 14, 2014, he was 72. He died of natural causes on vacation in Palm Desert with his wife of 50 years, Sue, and his son, Stuart, by his side. He was raised with his older sister, Marion, and younger brother, Don, embracing the beauty of the Pacific Northwest and achieving the honor of Eagle Scout. He at-

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tended Seattle’s Lincoln High School and the University of Washington, graduating from dental school in 1967. In 1968 he served as a dental officer in the U.S. Army in New Jersey and at the 12th Evacuation Hospital in Vietnam, returning to the island in 1969 to fulfill his dream of practicing dentistry and raising his family. MacFarlane’s life was defined by his love of family and friends, travel, sports and nature. One of his favorite early memories was winning the city championship as a varsity member of the Lincoln High School basketball team. He also rowed for the Green Lake and University of Washington crews and was an avid Husky and Seahawk football fan. MacFarlane met Sue Gearhart through the fraternity and sorority system where he was elected president of Alpha Delta Phi house. They were married July 31, 1964. His fraternity brothers remain family even to this day, returning to the island every Fourth of July to celebrate his birthday. His 50th birthday was particularly memorable as the island honored him in the annual parade as their “Hometown Hero.” Many knew and loved MacFarlane through the exceptional care and dedication he gave to his profession as a dentist. He belonged to the American Dental Association and Washington State Dental Association, and was president of the Kitsap County Dental Society. He was also a founding member of the Northwest Academy of Dental Science. He contributed extensively to the community through dental services and mentorship, as well as participating in various other organizations. Their retirement was spent fulfilling lifelong dreams that included international travel, missionary trips to Africa, summers at Priest Lake, Idaho, winters in Kauai and Palm Desert. He shared life with their grandchildren skiing, hiking, fishing, golfing, camping and teaching them about God through the natural world he so loved. He enjoyed playing golf at Wing Point Golf & Country Club with the “Golf Buddies”. However, there was no place more sacred to him than the family home he built with Sue on Puget Sound, where they created a lifetime of memories with family and friends. MacFarlane is survived by his wife Sue; son Stuart MacFarlane (Kathleen); daughter Katie Pearson (Kevin); daughter Darcy Wagner (Arnie); and six grandchildren – Key, 14, Anna, 13, Layton, 12, Taylor, 12, Tess, 11, and Camden, 10 – whom he adored and gave so much of his creative and energetic spirit and deep love. He is also survived by brother Don (Mary, son Kevin) MacFarlane; nieces Sharon Carlson, Joanne Huffman and family; and nephew Steve Carlson and family, all of Fairbanks, Alaska.

in memoriam anderson, carlson, kitamoto, macfarlane

In memoriam

A Dental Association for Humanitarians in Washington . . . and Beyond

The Academy of LDS Dentists— an organization of practicing dentists, specialists, hygienists, retired professionals and dental students— was founded over 35 years ago. Experience the benefits of membership in the Academy: • Professional Development and mentoring • Continuing Education • Service • Fellowship For just $100/year for dentists ($30/year for dental hygienists), you can bless the lives of others around the world. Dues cover each complete calendar year and are used to fund humanitarian efforts, provide scholarships and help the needy. Join now! Note: The Academy is pleased to offer free membership during dental school and for two years AFTER graduation.

AcademyofLDSDentists.com WSDA NEWS Dr. Gordon J. Christensen, Founder

The Academy of LDS Dentists: for LDS dentists, dental hygienists and their friends.

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Aaron Pershall - Randy Harrison BELLEVUE, WA – Progressive, Biological dental practice collecting $600K. Great new patient flow. This amalgam free/safe office features 7 ops (5 equipped) and digital x-rays. BELLEVUE, WA – Exceptional G/P coming soon! LEWIS COUNTY, WA - Well established G/P collecting around $1.2M. Park-like setting with ample parking, great access, 7 ops, and pano. Real Estate also available. KETCHIKAN, AK – Longestablished G/P collecting $600K. 100% fee-for-service. 4 ops, updated about 5 years ago.

FAIRBANKS, AK – Exceptional G/P collecting $1 Million. Highly profitable practice has 3 ops, newer equipment and a digital pano. Great staff ready to transition. Motivated Seller! Price reduced! RURAL ALASKA – High profit practice collecting $350K+ working only 10 weeks per year! Includes small apartment and SUV. Perfect satellite practice! JUNEAU, AK – G/P collecting around $1 Million. Beautiful office boasts 5 ops, digital x-rays, pano, and plenty of space. Work back available as needed!

SW ALASKA – Great G/P situated in a sportsman’s paradise! Collecting $700K+ working only 37 weeks per year! Associateship also available! KENAI PENINSULA, AK Wonderful rural G/P collecting around $500K in 2012. Long established practice includes a great staff, digital x-rays, laser, and pano. OREGON OMS - Wonderful oral surgery opportunity in western Oregon with tremendous growth potential. Very nice, easy access building with good off-street parking.

www.PracticeSales.com Aaron@PracticeSales.com RandyH@PracticeSales.com 4 0 · th e wsda ne w s · issue 5, april · 2014 · www.wsda.org

OPPORTUNITIES AVAILABLE

WENATCHEE, WASH, PEDIATRIC DENTIST — We are currently seeking an associate pediatric dentist to join our three-doctor practice with an outstanding support staff.We provide the most comprehensive pediatric care for children and adolescents in NCW. We are looking for an ambitious pediatric specialist to join our highly energetic practice.We offer an Associateship Position leading to a possible partnership.An excellent compensation and benefit package will also be offered to the qualified candidate. This recreational paradise provides boating, hiking, fishing, snow skiing, and biking opportunities – all within 30 minutes of Wenatchee.This beautiful valley is a wonderful place to raise a family with over 300 days of sunshine.For more information contact Anne Knappert at (509) 886-2500.*Wenatchee Valley Dental Village*, 210 Valley Mall Parkway, East Wenatchee, Wash. 98802.

ASSOCIATE OR BUY-OUT — Endodontic associate or buy out for our SWWA second office. Desire to market this office. Excellent patient care a must. Please contact us for more information: vancouverendo@comcast.net

SEEKING PEDIATRIC DENTIST — Seeking talented and dedicated pediatric dentist to join our growing pediatric dental office, Snohomish county. Our position is flexible / part time. Send resume to doc.kahlon@gmail.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.

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.

PEDIATRIC DENTIST — (South King) Pediatric dentist opportunity. Part time with potential to buy in or buy out. Please email CV to shahramghaf@yahoo.com. OLYMPIA, WASH — Seeking Associate/ Partner Dentist. We are a well established practice with a large, growing patient base seeking a practitioner with exceptional interpersonal skills that is willing to commit to the potential of a long term partnership. Candidates must be comfortable and competent with all facets of general dentistry and share our passion for excellent patient care and superior dentistry. Our modern and attractive 8 operatory facility is home to a dedicated, skilled, long term team. We take great pride in providing an amazing patient experience and would require the same of any candidate. Experience is a must due to the pace we maintain and level of care we deliver. Please e-mail resume and CV to john@ smileolympia.com. WASHINGTON – Seattle Area. Orthodontic Associate wanted for busy, modern, growing orthodontic practice, three days a week. Excellent opportunity for partnership buy-in. We are seeking a caring, quality-focused Associate with outstanding people skills to join our team. Respond to Info.associateortho@gmail. com.

ASSOCIATE DENTIST — Associate dentist needed for mobile dental practice in the greater Seattle area. Must be passionate about improving the quality of care in the nursing home population. Email CV to: mcaldier@live.com. ASSOCIATE WANTED — Silverdale associate wanted part or full time. 20,000 bonus after four months. (certain criteria apply). Pay offered at 25% net production, no lab fees. Contact joeostheller@ gmail.com (360) 471-6608. ASSOCIATE DENTIST — Part time/ Full time - Vancouver, Wash. Interested in making Vancouver,WA your home? Join our team in a modern, Amalgam free office.  Days available are Fridays and Saturdays with a desire to grow this position to full time. The success of our office has been built on customer service and making a connection with the patient. Leadership skills are needed that can guide and motivate patients through treatment. Our office culture is patient centered that embraces quality, comfort, and fun! Support staff and Hygiene team are outstanding and all work towards a common goal. Candidate must be able to develop treatment plans and be comfortable with extractions and molar endo. Be familiar or willing to learn Cerec and Invisalign techniques. Positive attitude is paramount to the position. Technical skills can be taught and learned but the foundation of one’s self needs to be a positive attitude.  If you feel that you would like be a motivating leader as part of the team, please email your resume to “drspitty@gmail.com”.

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DENTIST NEEDED — Our pediatric office in South King county has an opening for a pediatric or general dentist for Thursdays. Please email your CV to skcpedodds@gmail.com. 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 37! 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.

classifieds issue 5, april 2014

OPPORTUNITIES AVAILABLE

membership membership marketplace

membership

MARKETPLACE

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.

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 and 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 patientfocused. 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. VERY MOTIVATED — and 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. 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

Welcome New Members Please join WSDA in welcoming the following new members into the community of organized dentistry

Benton-Franklin Counties Dental Society Dr. John Burleigh Dr. Craig Hisey Dr. Glenn Ostler Jr. Dr. Michael Pratt Dr. Anthony Russo Dr. Aaron Stevens

Clark County Dental Society Dr. David Morrison Dr. Jill Renton Dr. William Saiget Dr. Michael Sparrow

North Central District Dental Society Dr. Carl Fricke

Mount Baker District Dental Society Dr. Parker Haley Dr. Emily Piper Dr. Derek Wirth

Pierce County Dental Society Dr. Michael Brown

Dr. Beverly Goodman Dr. Navia Nguyen Dr. Ritu Salwan Dr. Jeffrey Bennett Dr. Sylvia Kim-Sioda

Seattle-King County Dental Society Dr. Timothy Bachman Dr. Michael Cho Dr. Christy Chu Dr. David Ford Dr. Roozbeh Khosravi Dr. Chandana Jain Dr. Hiu Tong Maria Lei Dr. Nandita Lilly Dr. Ekaterina Malinovska Dr. Molly McIntosh Dr. Bradley Mott Dr. Thanh Dung Nguyen Dr. Linda Paik Dr. Susan Park Dr. Nikole Shvartsur Dr. Belinda Song Dr. Robert Trujillo Dr. Greg Wu Dr. Bill Wong

Dr. Steve Yang Dr. Sang Yum Dr. Arbia Zainvi

Snohomish County Dental Society Dr. Tyler Lee

Spokane District Dental Society Dr. Patrick Bradley Dr. Marnie Collins Dr. Craig Ellsworth Dr. Sonia Idrogo Dr. John Kidd Dr. Anthony Weber

Thurston-Mason Counties Dental Society Dr. Ronal Mikkelson Dr. Amanda Rentschler

Walla Walla Valley Dental Society Dr. Joseph Peck

Yakima Valley Dental Society Dr. Jordan Bolles Dr. Jacob Butler Dr. Brian Hanchett

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OFFICES FOR SALE OR LEASE

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.

FACTORIA/BELLEVUE specialist office for lease. Want to work with other 3 dental offices in the same building? Easy I-90/I-405 frwy access. Across the street from Factoria Mall. Street sign by Factoria Blvd. available. T.I. Conversion required. Can be divided 1,100 sf to 2,000 sf. (206) 915-2263 Mark.

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 $4500,000/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, Class of 1990 U of W at (509) 633-3167 or (509) 631-1400.

GENERAL DENTIST WANTED — Olympia, Wash. Ownership position in $3M+ practice available for young dentist who would like to have integrate implant dentistry. If you do not have any implant experience we will train at our Seattle based Institute. Please email inquires to: kellichancey@gmail.com. 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. 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. GENERAL DENTISTS — Seeking FT and PT experienced general dentists for our offices in Lynnwood and North Seattle. Guaranteed salary plus additional benefits. Please email your CV to dentalcareers2014@gmail.com or call 206-4076804 for more information. OFFICES FOR SALE OR LEASE SEATTLE — Seattle Plumbed Dental Space - Four operatories, lots of parking, e-mail info@omni-pg.com.

COVINGTON — Covington Dental Space Available - 3,000 sq. ft., great location, former ortho space, great for specialist or generalist. e-mail info@omni-pg.com. FOR SALE OR LEASE — Attractive dental office, 5701 Bedford St., Pasco, Wash. New construction in 2003. 3,450 sq. ft. main level with 1,350 sq. ft. basement. Complete details can be obtained from Derrick Stricker, NAI Tri-Cities. (509) 430-8533 or derrick@dirkstricker.com. 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. FOR SALE — Four operatory office, established 35+ years ago with a strong patient base located in the Green Lake area. Collection for the previous 12 months is $760,000+. Improvements in the last year include $30,000 in office renovations, seven new computers, Dexis digital x-rays, intra-oral camera, digital charting, new mid-mark autoclave. With well over $100,000 improvements in the office, this is a once in a life time opportunity. Current owner is looking to relocate out of state as soon as possible. Contact Jonathan at jonathanmcgiverin@gmail.com. SPACE SHARING OPPORTUNITY — Presently working three days/ week and have ample room to share space in our five chair downtown Seattle general practice office with in-house lab and technician. Bring your patients and staff and share the rent, utilities and supplies. Contact Rick Nicolini, DDS at (206) 3105709 or drnicolini@hotmail.com. PLUMBED SPACES LIST — Free list of plumbed space available in King County. e-mail info@omni-pg.com to get your free report.

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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. PRICE REDUCED — Four OP dental practice located in the heart of Lakewood, Wash. right across from the mall. Newly remodeled and updated with two new Belmont chairs, Adec cabinets, compressor, Digital radiographs, Intra-oral camera, Kavo. Very low overhead at this office. Everything is ready for you to start right away. Price lowered to $158,000 for a quick transition. Seller financing available with $100,000 down. Please email questions to practiceop@gmail.com. NEXT/ANNIE MILLER & ASSOCIATES — Providing consulting services to the dental community for the past 35 years. New practice start-ups, practice transitions, sales and valuations. Dental space planning and architecture; real estate leasing and acquisitions, employment benefits; staffing resources and training; financing. Call today for your free consultation…we can’t mint money for you, but we can sure save what you have now! Annie Miller (206) 715-1444. Email: annie@ nextnw.com.

classifieds issue 5, april 2014

OPPORTUNITIES AVAILABLE

parrish or perish continued

parrish or perish, cont. continued from page 46

for one year; the trend is definitely upward. I can quibble with the use of debt vs. actual cost of dental school (a better measure in my opinion), but the point is the same: the trend is probably unsustainable. And we can all imagine the pressure on the new graduate who is not yet making a median income but has to begin paying back that debt. And none of this takes into account the interest on top of the overall debt. Are we going to be able to attract anyone but those with lots of family money, military scholarships or some category of student who holds “special interest” to a dental school which is willing to underwrite their educations? Let’s ask Dean Joel Berg how much scholarship money he has to dole out every year. I’ll bet it is not all that much. And speaking of Dean Berg and the UW School of Dentistry, a major overhaul of the curriculum and approach to educat-

ing a 21st Century dental student is well underway. I hope there are those who are part of that process who recognize that the model cannot continue as many of us knew it. Somehow the cost of a dental school education cannot continue to expand and might need to contract. Even the bargain that the UW SOD represents for students is not immune to economic laws and events. Brian Palmer writes in Slate on 3/13/14 with regard to the high cost of a medical school education, doctors should “turn the microscopes on themselves and their own training, and accept that the system that produced them may be imperfect.” I don’t know if that in dental education means attracting more higher paying patients, raising fees, having students produce more billable income, less undergrad time—both pre-dent and dental school, cutting expenses somewhere or exploring

some other totally radical approach that we cannot even imagine at the moment. But if the authors of this article are correct, no dental school can ignore the future and the potential of the dental education bubble bursting. We would all be worse off if that would happen. And you students have some responsibility in all this. You cannot assume that student loans are an endless source of money to allow you to continue the lifestyle Mom and Dad provided while growing up. Delayed gratification has to be the rule of the day. Government has made the money too easy to get, and they are making a handsome “profit” off the interest you have to pay them over the next 10-15 years while you are trying to start a successful practice. Wise up: borrow the minimum, live frugally. The perks will come in due time.

of time at the Club or League level. The WHL will honor Dr. Mary Smith in Spokane on Friday, March 14, in a special ceremony prior to the Spokane Chiefs game against the Tri City Americans.

front of 4,000 of your peers through a series of ads in the WSDA News. The best part? It’s free! The Marketplace is open only to those who were members of the last two graduating classes (2012 & 2013) and are WSDA members — this includes those who have completed specialty programs and residencies. Those who qualify can place an ad about themselves in the WSDA News that will run for six issues. Get started here

newsflash

newsflash issue 5, april 2014

Dr. Mary Smith honored

WSDA Member Dr. Mary Smith has been named the recipient of the 2013-2014 Distinguished Service Award by the Western Hockey League, league commissioner Ron Robison announced recently. Smith has been the team dentist of the Spokane Chiefs since 1985. She routinely works on WHL players, referees and WHL Personnel. Smith has been instrumental in keeping the Chief players safe, by equipping them in the most current protective mouth guards, preventing dental injury. All Chief players are fitted for mouth guards every training camp, at the expense of Smith and her clinic. With almost 30 years as part of the organization, Smith is the longest serving member of the Spokane Chiefs. “Given her long standing dedication and contribution to the Spokane Chiefs and the WHL, Dr. Mary Smith is a very worthy recipient of the WHL Distinguished Service Award,” said WHL Commissioner Ron Robison, “It is individuals such as Dr. Smith who not only provide essential dental care, but go above and beyond by serving countless games and post-game hours for the Chiefs organization and visiting teams. These contributions make Dr. Mary Smith most deserving of this recognition.” The WHL Distinguished Service Award, which was introduced by the WHL in 2004, is presented annually to an individual associated who has made an extraordinary contribution over an extended period

WOHF needs volunteers!

The Washington Oral Health Foundation needs your help to provide Oral Health presentations in the following cities through May. Presentation materials, hygiene kits, slide presentations, and instructions on how to present the materials will be provided by Foundation staff. If you would like to volunteer, please contact Launa Lea at (206) 973-5234 or email Launa at launa@wsda.org. Dates and locations: April 23 · Puyallup — One or two volunteers are needed (est. attendance 90 kids) April 24 · Puyallup — One or two volunteers are needed (est. attendance 60 kids) April 29 · Kent — One or two volunteers are needed (est. attendance 210 kids) May 2 · Sequim — Four or more volunteers are needed (est. attendance 440 kids)

Membership Marketplace

The Membership Marketplace (page 42) is one of the WSDA’s newest benefits targeted at younger dentists — it’s a way for you to get your name and qualifications in

The ad parameters are as follows: • To maximize the number of ads we can run we ask that copy be limited to no more than 30 words • Ad must include an email or phone number however, names can be left out upon request • We suggest uploading a CV to Google docs and including a link/web address to it in the ad (use tiny url to shrink the link). The Membership Marketplace debuted in the January issue of the WSDA News. To submit your ad, please visit http://www. wsda.org/membership-marketplace/. Questions? Contact Laura Rohlman at laura@wsda.org or by phone at (800) 4483368

4 4 · th e wsda ne w s · issue 5, april · 2014 · www.wsda.org

EQUIPMENT FOR SALE

SERVICES

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.

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.

NAKANISHI DENTAL LAB — Nakanishi Dental Laboratory is a technology based full service lab that’s CDL and DAMAS quality certified with twicedaily pick up and delivery service to most areas around Seattle. We have same-day service for repairs, relines, contact adds and shade adjustments along with high level CDT’s for technical consultations. www.nakanishidentallab.com 800-735-7231.

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. NEXT/ANNIE MILLER & ASSOCIATES — New dental practice listings and sites for sale in Bellevue, Kirkland, Federal Way, Renton and Tukwila. Call today for tours and info. Annie Miller, Re Max Eastside Broker’s Inc. (206) 715-1444 or email at annie@nextnw.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 206250-3282 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.

EQUIPMENT FOR SALE — Hydrim ($3000), Acclaim IO camera ($300), curing lights ($65-100), Velscope VX w/ camera ($1000), x-ray view boxes( 6 for $150), HP Laser Jet printer($65), Logitech Duet music system($100), Wireless stereo headsets ($85-100). All items in good condition. Inquiries: smilessouthcenter@comcast.net or (206) 575-9150. . EQUIPMENT WANTED EQUIPMENT WANTED — Looking for wide range 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 DESIGN SERVICES — Slater Interior Design uses a unique interactive and collaborative process to create a design that expresses your story, personality, and brand. By exploring your likes, desires, and use of space, we will bridge the gap between functionality and design in your home or office space. Call today for complimentary consultation! 206795-3245, or email us at slaterdesign@ frontier.com. AFFORDABLE DENTAL DESIGN & SPACE PLANNING — I provide full permit and architectural drawing sets in auto cad. I also prov ide project management throughout the project to ensure your new facility is built as planned. Over 20 years of experience in designing and building dental facilities. Contact Kelly 206-999-3457. MOBILE I.V. 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.

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EQUILIBRATION SEMINARS — Learn a simplified method of performing equilibrations using models in this hands-on seminar. In just one half-day seminar you’ll learn how to: simplify the entire process, do a complete equilibration in about 30 minutes, and profit from doing it. Learn how to sell it, obtain insurance coverage and improve your bottom line. Dr. Norm Culver has been doing these simplified equilibrations for nearly 40 years and he can show you how to do the same thing. Seminars in your area: Portland, Ore., Apr 11, 2014, Seattle, Wash., May 9, 2014, Vancouver, BC, May 23, 2014. Receive $75 off tuition by registering 20 days prior to the seminar date. For more information and to register go to www. equilibrationseminars.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.

classifieds issue 5, april 2014

OFFICES FOR SALE OR LEASE

I hate to burst your bubble

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

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

Most of you clearly remember the US housing bubble that popped in 2008. Some of you may remember the dot-com bubble in 2000; hopefully you were not in that market segment when it burst. There may be a few of us from the early 1980’s who recall the “busyness” blues that hit US dentistry—too many dentists and not enough patients. Several of my classmates declared bankruptcy, some dental schools completely closed, most dramatically cut their class sizes (UW went from 100+ to 50) and the number of dental school applicants plummeted. All of these were the result of a classic “bubble market” where the price of something shot well beyond any intrinsic value based on speculation that the price of the commodity would continue to rise unabated: the price exceeded perceived value. The New England Journal of Medicine published an article last October 13, 2013, entitled “Are We in a Medical Education Bubble Market?” by Asch, Nicholson and Vujicic. Much of my discussion today is based on that interesting perspective on the cost of various professional school educations and the expected return on those costs. I would urge you to read the entire paper; it’s only three pages. https://www.aavmc.org/data/files/ members%20only/board%20of%20directors/2014-01/medical%20education%20bubble%20nejm.pdf In a nutshell, they compare the ratio of student debt to future median income as it has changed over 20 years and conclude that, in most medical specialties at least, there is not a bubble yet, but it is trending that way. There is currently tremendous downward pressure on future ability for physicians to maintain their income stream. They state, “…[H]igh costs of medical education are sustainable only if we keep paying doctors a lot of money, and there are strong signs that we can’t or won’t.” The challenge then, recognizing that trend, is for medical schools to figure out how to educate physicians at less cost than today; the risk of not doing so is a burst bubble because young people will recognize the cost is not worth the return in the long run. Schools may close, applications will fall, fewer MD’s will enter the system and it will be more difficult to attract the “brightest and the best”. (See dentistry in the 1980’s although that was more of an excess output problem than a debt problem, but the net effect was the same.) While the authors do not think medicine is in a classic bubble scenario yet, they do believe veterinary medicine, optometry, pharmacy and dentistry are. These various fields have had an explosion in student debt over the last 20 years while “…dentists’ earnings have been sluggish since the early 2000s.” And I know their statistics were compiled well before the WDS onslaught and other third parties that may follow suit. Dental school debt is approaching 100% of the average dentist’s earnings continued on page 44

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SKYDIVING Didn’t work out so well for Mumbles

WASHINGTON DENTISTS’ INSURANCE AGENCY CAN HELP Call us today and ask about the 10% discount we give to all WSDA members on disability insurance - just one more benefit of membership.

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

Matt French · Kerri Seims 206.441.6824 · 800.282.9342 www.wdiains.com

Medicare Supplements and MedAdvantage Employment Practice Liability Cyber Theft Protection ERISA Surety Bonds

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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

Why settle? We don’t. We’re fighters At NORDIC, we don’t like to settle. Our attorneys will fight claims made against you. We’ve garnered a great reputation by having committed, experienced litigators working for us. Simply put, what NORDIC offers is exceptional, hands on service that our competitors cannot match — our value goes much deeper than price. Just ask any dentist who has ever been sued by a patient what mattered most when they got their day in court. The answer will be experience. Don’t settle for less, call us today. We take pride in our exceptional customer service. When you call, you’ll speak with a real person, with real knowledge of professional liability and business owners protection. We’re waiting for your call.

At NORDIC, we take things personally sole broker for NORDIC

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